aids to forensic medicine and toxicology by w.g. aitchison robertson m.d., d.sc., f.r.c.p.e. lecturer on forensic medicine, school of medicine, edinburgh; late examiner in the universities of edinburgh and st. andrews; for the triple board; diploma in public health, etc. ninth edition twentieth thousand london bailliÈre, tindall and cox , henrietta street, covent garden preface to ninth edition i trust that, having thoroughly revised the "aids to forensic medicine," it may prove as useful to students preparing for examination in the future as it has been in the past. w.g. aitchison robertson. surgeons' hall, edinburgh, _november_, . preface to eighth edition this work of the late dr. william murrell having met with such a large measure of success, the publishers thought it would be well to bring out a new edition, and invited me to revise the last impression. this i have done, and while retaining dr. murrell's text closely, i have made large additions, in order to bring the "aids" up to present requirements. i have also rearranged the matter with the object of making the various sections more consecutive than they were previously. w.g. aitchison robertson. surgeons' hall, edinburgh, _june_, . contents part i forensic medicine page i. crimes ii. medical evidence iii. personal identity iv. examination of persons found dead v. modes of sudden death vi. signs of death vii. death from anæsthetics, etc. viii. presumption of death; survivorship ix. assaults, murder, manslaughter, etc. x. wounds and mechanical injuries xi. contused wounds, etc. xii. incised wounds xiii. gunshot wounds xiv. wounds of various parts of the body xv. detection of blood-stains, etc. xvi. death by suffocation xvii. death by hanging xviii. death by strangulation xix. death by drowning xx. death from starvation xxi. death from lightning and electricity xxii. death from cold or heat xxiii. pregnancy xxiv. delivery xxv. foeticide or criminal abortion xxvi. infanticide xxvii. evidences of live-birth xxviii. cause of death in the foetus xxix. duration of pregnancy xxx. viability of children xxxi. legitimacy xxxii. superfoetation xxxiii. inheritance xxxiv. impotence and sterility xxxv. rape xxxvi. unnatural offences xxxvii. blackmailing xxxviii. marriage and divorce xxxix. feigned diseases xl. mental unsoundness xli. idiocy, imbecility, cretinism xlii. dementia xliii. mania, lucid intervals, undue influence, responsibility, etc. xliv. examination of persons of unsound mind xlv. inebriates acts part ii toxicology i. definition of a poison ii. scheduled poisons iii. classification of poisons iv. evidence of poisoning v. symptoms and post-mortem appearances of different classes of poisons vi. duty of practitioner in supposed case of poisoning vii. treatment of poisoning viii. detection of poison ix. the mineral acids x. sulphuric acid xi. nitric acid xii. hydrochloric acid xiii. oxalic acid xiv. carbolic acid xv. potash, soda, and ammonia xvi. potassium salts, etc. xvii. nitrate of potassium, etc. xviii. barium salts xix. iodine--iodide of potassium xx. phosphorus xxi. arsenic and its preparations xxii. antimony and its preparations xxiii. mercury and its preparations xxiv. lead and its preparations xxv. copper and its preparations xxvi. zinc, silver, bismuth, and chromium xxvii. gaseous poisons xxviii. vegetable irritants xxix. opium and morphine xxx. belladonna, hyoscyamus, and stramonium xxxi. cocaine xxxii. camphor xxxiii. tetrachlorethane xxxiv. alcohol, ether, and chloroform xxxv. chloral hydrate xxxvi. petroleum and paraffin oil xxxvii. antipyrine, antefebrin, phenacetin, and aniline xxxviii. sulphonal, trional, tetronal, veronal, paraldehyde xxxix. conium and calabar bean xl. tobacco and lobelia xli. hydrocyanic acid xlii. aconite xliii. digitalis xliv. nux vomica, strychnine, and brucine xlv. cantharides xlvi. abortifacients xlvii. poisonous fungi and toxic foods xlviii. ptomaines or cadaveric alkaloids index aids to forensic medicine and toxicology part i forensic medicine i.--crimes forensic medicine is also called medical jurisprudence or legal medicine, and includes all questions which bring medical matters into relation with the law. it deals, therefore, with ( ) crimes and ( ) civil injuries. . a _crime_ is the voluntary act of a person of sound mind harmful to others and also unjust. no act is a crime unless it is plainly forbidden by law. to constitute a crime, two circumstances are necessary to be proved--(a) that the act has been committed, (b) that a guilty mind or malice was present. the act may be one of omission or of commission. every person who commits a crime may be punished, unless he is under the age of seven years, is insane, or has been made to commit it under compulsion. crimes are divided into _misdemeanours_ and _felonies_. the distinction is not very definite, but, as a rule, the former are less serious forms of crime, and are punishable with a term of imprisonment, generally under two years; while felonies comprise the more serious charges, as murder, manslaughter, rape, which involve the capital sentence or long terms of imprisonment. an _offence_ is a trivial breach of the criminal law, and is punishable on summary conviction before a magistrate or justices only, while the more serious crimes (_indictable offences_) must be tried before a jury. . _civil injuries_ differ from crimes in that the former are compensated by damages awarded, while the latter are punished; any person, whether injured or not, may prosecute for a crime, while only the sufferer can sue for a civil injury. the crown may remit punishment for a crime, but not for a civil injury. ii.--medical evidence on being called, the medical witness enters the witness-box and takes the oath. this is very generally done by uplifting the right hand and repeating the oath (scottish form), or by kissing the bible, or by making a solemn affirmation. . he may be called to give _ordinary evidence_ as a _common witness_. thus he may be asked to detail the facts of an accident which he has observed, and of the inferences he has deduced. this evidence is what any lay observer might be asked. . _expert witness._--on the other hand, he may be examined on matters of a technical or professional character. the medical man then gives evidence of a skilled or expert nature. he may be asked his opinion on certain facts narrated--_e.g._, if a certain wound would be immediately fatal. again, he may be asked whether he concurs with opinions held by other medical authorities. in important cases specialists are often called to give evidence of a skilled nature. thus the hospital surgeon, the nerve specialist, or the mental consultant may be served with a subpoena to appear at court on a certain date to give evidence. the evidence of such skilled observers will, it is supposed, carry greater weight with the jury than would the evidence of an ordinary practitioner. skilled witnesses may hear the evidence of ordinary witnesses in regard to the case in which they are to give evidence, and it is, indeed, better that they should understand the case thoroughly, but they are not usually allowed to hear the evidence of other expert witnesses. in civil cases the medical witness should, previous to the trial, make an agreement with the solicitor who has called him with reference to the fee he is to receive. before consenting to appear as a witness the practitioner should insist on having all the facts of the case put before him in writing. in this way only can he decide as to whether in his opinion the plaintiff or defendant is right as regards the medical evidence. if summoned by the side on which he thinks the medical testimony is correct, then it is his duty to consent to appear. if, however, he is of opinion that the medical evidence is clearly and correctly on the opposite side, then he ought to refuse to appear and give evidence; and, indeed, the lawyer would not desire his presence in the witness-box unless he could uphold the case. whether an expert witness who has no personal knowledge of the facts is bound to attend on a subpoena is a moot point. it would be safer for him to do so, and to explain to the judge before taking the oath that his memory has not been sufficiently 'refreshed.' the solicitor, if he desires his evidence, will probably see that the fee is forthcoming. a witness may be subjected to _three_ examinations: first, by the party on whose side he is engaged, which is called the 'examination in chief,' and in which he affords the basis for the next examination or 'cross-examination' by the opposite side. the third is the 're-examination' by his own side. in the first he merely gives a clear statement of facts or of his opinions. in the next his testimony is subjected to rigid examination in order to weaken his previous statements. in the third he is allowed to clear up any discrepancies in the cross-examination, but he must not introduce any new matter which would render him liable to another cross-examination. the medical witness should answer questions put to him as clearly and as concisely as possible. he should make his statements in plain and simple language, avoiding as much as possible technical terms and figurative expressions, and should not quote authorities in support of his opinions. an expert witness when giving evidence may refer to notes for the purpose of refreshing his memory, but only if the notes were taken by him at the time when the observations were made, or as soon after as practicable. there are various _courts_ in which a medical witness may be called on to give evidence: . =the coroner's court.=--when a coroner is informed that the dead body of a person is lying within his jurisdiction, and that there is reasonable cause to suspect that such person died either a violent or unnatural death, or died a sudden death of which the cause is unknown, he must summon a jury of not less than twelve men to investigate the matter--in other words, hold an inquest--and if the deceased had received medical treatment, the coroner may summon the medical attendant to give evidence. by the coroners (emergency provisions) act of , the number of the jury has been cut down to a minimum of seven and a maximum of eleven men. by the juries act of , the coroner has the power of holding a court without a jury if, in his discretion, it appears to be unnecessary. in charges of murder, manslaughter, deaths of prisoners in prison, inmates of asylums or inebriates' homes, or of infants in nursing homes, he must summon a jury. the coroner may be satisfied with the evidence as to the cause of a person's death, and may dispense with an inquest and grant a burial certificate. cases are notified to the coroner by the police, parish officer, any medical practitioner, registrar of deaths, or by any private individual. witnesses, having been cited to appear, are examined on oath by the coroner, who must, in criminal cases at least, take down the evidence in writing. this is then read over to each witness, who signs it, and this forms his _deposition_. at the end of each case the coroner sums up, and the jury return their verdict or _inquisition_, either unanimously or by a majority. if this charges any person with murder or manslaughter, he is committed by the coroner to prison to await trial, or, if not present, the coroner may issue a warrant for his arrest. a chemical analysis of the contents of the stomach, etc., in suspected cases of poisoning is usually done by a special analyst named by the coroner. if any witness disobeys the summons to attend the inquest, he renders himself liable to a fine not exceeding £ s., but in addition the coroner may commit him to prison for contempt of court. in criminal cases the witnesses are bound over to appear at the assizes to give evidence there. the coroner may give an order for the exhumation of a body if he thinks the evidence warrants a post-mortem examination. coroners' inquests are held in all cases of sudden or violent death, where the cause of death is not clear; in cases of assault, where death has taken place immediately or some time afterwards; in cases of homicide or suicide; where the medical attendant refuses to give a certificate of death; where the attendants on the deceased have been culpably negligent; or in certain cases of uncertified deaths. the medical witness should be very careful in giving evidence before a coroner. even though the inquest be held in a coach-house or barn, yet it has to be remembered it is a court of law. if the case goes on for trial before a superior court, your deposition made to the coroner forms the basis of your examination. any misstatements or discrepancies in your evidence will be carefully inquired into, and you will make a bad impression on judge and jury if you modify, retract, or explain away your evidence as given to the coroner. you had your opportunity of making any amendments on your evidence when the coroner read over to you your deposition before you signed it as true. by the licensing act of , an inquest may not be held in any premises licensed for the sale of intoxicating liquor if other suitable premises have been provided. the duties of the coroner are based partly on common law, and are also defined by statute, principally by the coroners act of ( and vict. c. ). they have been modified, however, by subsequent acts--_e.g._, the act of , the coroners (emergency provisions) act, , and the juries act of . the fee payable to a medical witness for giving evidence at an inquest is one guinea, with an extra guinea for making a post-mortem examination and report (in the metropolitan area these fees are doubled). the coroner must sign the order authorizing the payment, and should an inquest be adjourned to a later day, no further fee is payable. if the deceased died in a hospital, infirmary, or lunatic asylum, the medical witness is not paid any fee. should a medical witness neglect to make the post-mortem examination after receiving the order to do so, he is liable to a fine of £ . in scotland the procurator fiscal fulfils many of the duties of the coroner, but he cannot hold a public inquiry. he interrogates the witnesses privately, and these questions with the answers form the _precognition_. more serious cases are dealt with by the sheriff of each county, and capital charges must be dealt with by the high court of justiciary. in scotland the verdicts of the jury may be 'guilty,' 'not guilty,' or 'not proven.' . =the magistrate's court or petty sessions= is also a court of preliminary inquiry. the prisoner may be dealt with summarily, as, for example, in minor assault cases, or, if the case is of sufficient gravity, and the evidence justifies such a course, may be committed for trial. the fee for a medical witness who resides within three miles of the court is ten shillings and sixpence; if at a greater distance, one guinea. in the metropolis the prisoner in the first instance is brought before a magistrate, technically known as the 'beak,' who, in addition to being a person of great acumen, is a stipendiary, and thus occupies a superior position to the ordinary 'j.p.,' who is one of the great unpaid. in the city of london is the mansion house justice-room, presided over by the lord mayor or one of the aldermen. the prisoner may ultimately be sent for trial to the central criminal court, known as the old bailey, or elsewhere. . =quarter sessions.=--these are held every quarter by justices of the peace. all cases can be tried before the sessions except felonies or cases which involve difficult legal questions. in london this court is known as the central criminal court, and it also acts as the assize court. in borough sessions a barrister known as the _recorder_ is appointed as sole judge. . =the assizes= deal with both criminal and civil cases. there is the _crown court_, where criminal cases are tried, and there is the _civil court_, where civil cases are heard. before a case sent up by a lower court can be tried by the judge and petty jury, it is investigated by the _grand jury_, which is composed of superior individuals. if they find a 'true bill,' the case goes on; but if they 'throw it out,' the accused is at liberty to take his departure. at the court of assize the prisoner is tried by a jury of twelve. in bringing in the verdict the jury must be unanimous. if they cannot agree, the case must be retried before a new jury. at the assize court the medical witness gets a guinea a day, with two shillings extra to pay for his bed and board for every night he is away from home, with his second-class railway fare, if there is a second class on the railway by which he travels. if there is no railway, and he has to walk, he is entitled to threepence a mile for refreshments both ways. . =court of criminal appeal.=--this was established in , and consists of three judges. a right of appeal may be based ( ) solely on a question of law; ( ) on certificate from the judge who tried the prisoner; ( ) on mitigation of sentence. speaking generally, in the superior courts the fees which may be claimed by medical men called on to give evidence are a guinea a day if resident in the town in which the case is tried, and from two to three guineas a day if resident at a distance from the place of trial, this to include everything except travelling expenses. the medical witness also receives a reasonable allowance for hotel and travelling expenses. if a witness is summoned to appear before two courts at the same time, he must obey the summons of the higher court. criminal cases take precedence of civil. a medical man has no right to claim privilege as an excuse for not divulging professional secrets in a court of law, and the less he talks about professional etiquette the better. still, in a civil case, if he were to make an emphatic protest, the matter in all probability would not be pressed. in a criminal case he would promptly be reminded of the nature of his oath. a medical man may be required to furnish a _formal written report_. it may be the history of a fatal illness or the result of a post-mortem examination. these reports must be drawn up very carefully, and no technical terms should be employed. no witness on being sworn can be compelled to 'kiss the book.' the oaths act ( and vict., c. , § ) declares, without any qualification, that 'if any person to whom an oath is administered desires to swear with uplifted hand, in the form and manner in which an oath is usually administered in scotland, he shall be permitted to do so, and the oath shall be administered to him in such form and manner without further question.' the witness takes the oath standing, with the bare right hand uplifted above the head, the formula being: 'i swear by almighty god that i will speak the truth, the whole truth, and nothing but the truth.' the presiding judge should say the words, and the witness should repeat them after him. there is no kissing of the book, and the words 'so help me, god,' which occur in the english form, are not employed. it will be noted that the scotch form constitutes an oath, and is not an affirmation. the judge has no right to ask if you object on religious grounds, or to put any question. he is bound by the provisions of the act, and the enactment applies not only to all forms of the witness oath, whether in civil or criminal courts, or before coroners, but to every oath which may be lawfully administered either in great britain or ireland. a witness engaged to give expert evidence should demand his fee before going into court, or, at all events, before being sworn. with regard to notes, these should be made at the time, on the spot, and may be used by the witness in court as a refresher to the memory, though not altogether to supply its place. all evidence is made up of testimony, but all testimony is not evidence. the witness must not introduce hearsay testimony. in one case only is hearsay evidence admissible, and that is in the case of a _dying declaration_. this is a statement made by a dying person as to how his injuries were inflicted. these declarations are accepted because the law presumes that a dying man is anxious to speak the truth. but the person must believe that he is _actually_ on the point of death, with _absolutely_ no hope of recovery. a statement was rejected because the dying person, in using the expression 'i have no hope of recovery,' requested that the words 'at present' should be added. if after making the statement the patient were to say, 'i hope now i shall get better,' it would invalidate the declaration. to make the declaration admissible as evidence, death must ensue. if possible, a magistrate should take the dying declaration; but if he is not available, the medical man, without any suggestions or comments of his own, should write down the statements made by the dying person, and see them signed and witnessed. it must be made clear to the court that at the time of making his statement the witness was under the full conviction of approaching or impending death. iii.--personal identity it is but seldom that medical evidence is required with regard to the identification of the living, though it may sometimes be so, as in the celebrated tichborne case. the medical man may in such cases be consulted as to family resemblance, marks on the body, nævi materni, scars and tattoo marks, or with regard to the organs of generation in cases of doubtful sex. tattoo marks may disappear during life; the brighter colours, as vermilion, as a rule, more readily than those made with carbon, as indian ink; after death the colouring-matter may be found in the proximal glands. if the tattooing is superficial (merely underneath the cuticle) the marks may possibly be removed by acetic acid or cantharides, or even by picking out the colouring-matter with a fine needle. with regard to scars and their permanence, it will be remembered that scars occasioned by actual loss of substance, or by wounds healed by granulation, never disappear. the scars of leech-bites, lancet-wounds, or cupping instruments, may disappear after a lapse of time. it is difficult, if not impossible, to give any certain or positive opinion as to the age of a scar; recent scars are pink in colour; old scars are white and glistening. the cicatrix resulting from a wound depends upon its situation. of incised wounds an elliptical cicatrix is typical, linear being chiefly found between the fingers and toes. by way of disguise the hair may be dyed black with lead acetate or nitrate of silver; detected by allowing the hair to grow, or by steeping some of it in dilute nitric acid, and testing with iodide of potassium for lead, and hydrochloric acid for silver. the hair may be bleached with chlorine or peroxide of hydrogen, detected by letting the hair grow and by its unnatural feeling and the irregularity of the bleaching. finger-print impressions are the most trustworthy of all means of identification. such a print is obtained by rubbing the pulp of the finger in lampblack, and then impressing it on a glazed card. the impression reveals the fine lines which exist at the tips of the fingers. the arrangement of these lines is special to each person, and cannot be changed. hence this method is employed by the police in the identification of prisoners. in the determination of cases of doubtful sex in the living, the following points should be noticed: the size of the penis or clitoris, and whether perforate or not, the form of the prepuce, the presence or absence of nymphæ and of testicles or ovaries. openings must be carefully sounded as to their communication with bladder or uterus. after puberty, inquiry should be made as to menstrual or vicarious discharges, the general development of the body, the growth of hair, the tone of voice, and the behaviour of the individual towards either sex. with regard to the identification of the dead in cases of death by accident or violence, the medical man's assistance may be called. the sex of the skeleton, if that only be found, may be judged from the bones of the female generally being smaller and more slender than those of the male, by the female thorax being deeper, the costal cartilages longer, the ilia more expanded, the sacrum flatter and broader, the coccyx movable and turned back, the tuberosities of the ischia wider apart, the pubes shallow, and the whole pelvis shallower and with larger outlets. but of all these signs the only one of any real value is the roundness of the pubic arch in the female, as compared with the pointed arch in the male. before puberty the sex cannot be determined from an examination of the bones. age may be calculated from the presence, nature and number of the erupted teeth; from the cartilages of the ribs, which gradually ossify as age advances; from the angle formed by the ramus of the lower jaw with its body (obtuse in infancy, a right angle in the adult, and again obtuse in the aged from loss of the teeth); and in the young from the condition of the epiphyses with regard to their attachment to their respective shafts. to determine stature, the whole skeleton should be laid out and measured, - / to inches being allowed for the soft parts. iv.--examination of persons found dead when a medical man is called to a case of sudden death, he should carefully note anything likely to throw any light on the cause of death. he should notice the place where the body was found, the position and attitude of the body, the soil or surface on which the body lies, the position of surrounding objects, and the condition of the clothes. he should also notice if there are any signs of a struggle having taken place, if the hands are clenched, if the face is distorted, if there has been foaming at the mouth, and if urine or fæces have been passed involuntarily. urine may be drawn off with a catheter and tested for albumin and sugar. if required to make a post-mortem examination, every cavity and important organ of the body must be carefully and minutely examined, the seat of injury being inspected first. v.--modes of sudden death there are three modes in which death may occur: ( ) syncope; ( ) asphyxia; ( ) coma. . =syncope= is death beginning at the heart--in other words, failure of circulation. it may arise from--( ) _anæmia_, or deficiency of blood due to hæmorrhage, such as occurs in injuries, or from bleeding from the lungs, stomach, uterus, or other internal organs. ( ) _asthenia_, or failure of the heart's action, met with in starvation, in exhausting diseases, such as phthisis, cancer, pernicious anæmia, and bright's disease, and in some cases of poisoning--for example, aconite. the symptoms of syncope are faintness, giddiness, pallor, slow, weak, and irregular pulse, sighing respiration, insensibility, dilated pupils, and convulsions. post mortem the heart is found empty and contracted. when, however, there is sudden stoppage of the heart, the right and left cavities contain blood in the normal quantities, and blood is found in the venæ cavæ and in the arterial trunks. there is no engorgement of either lungs or brain. . =asphyxia=, or death beginning at the lungs, may be due to obstruction of the air-passages from foreign bodies in the larynx, drowning, suffocation, strangling, and hanging; from injury to the cervical cord; effusion into the pleuræ, with consequent pressure on the lungs; embolism of the pulmonary artery; and from spasmodic contraction of the thoracic and abdominal muscles in strychnine-poisoning. the symptoms of this condition are fighting for breath, giddiness, relaxation of the sphincters, and convulsions. post mortem, cadaveric lividity is well marked, especially in nose, lips, ears, etc.; the right cavities of the heart and the venæ cavæ are found gorged with dark fluid blood. the pulmonary veins, the left cavities of the heart, and the aorta, are either empty or contain but little blood. the lungs are dark and engorged with blood, and the lining of the air-tubes is bright red in colour. much bloody froth escapes on cutting into the lungs. numerous small hæmorrhages (tardieu's spots) are found on the surface and in the substance of the internal organs, as well as in the skin of the neck and face. . =coma=, or death beginning at the brain, may arise from concussion; compression; cerebral pressure from hæmorrhage and other forms of apoplexy; blocking of a cerebral artery from embolism; dietetic and uræmic conditions; and from opium and other narcotic poisons. the symptoms of this condition are stupor, loss of consciousness, and stertorous breathing. the post-mortem signs are congestion of the substance of the brain and its membranes, with accumulation of the blood in the cavities of the heart, more on the right side than on the left. it must be remembered that, owing to the interdependence of all the vital functions, there is no line of demarcation between the various modes of death. in all cases of sudden death think of angina pectoris and the rupture of an aneurism. the following is a list of some of the commoner causes of sudden death: (a) =instantaneously sudden death=-- . syncope (by far the commonest cause). . aortic incompetence. . rupture of heart. . rupture of a valve. . rupture of aortic aneurism. . embolism of coronary artery. . angina pectoris. (b) =less sudden but unexpected death=-- . cerebral hæmorrhage or embolism. . mitral and tricuspid valvular lesions if the patient exerts himself. . rupture of a gastric or duodenal ulcer; rupture of liver, spleen, or extra-uterine gestation, or abdominal aneurism. . suffocation during an epileptic fit; vomited matter or other material drawn into the trachea or air-passages; croup. . arterio-sclerosis may lead to thrombosis, embolism, or aneurism. . poisoning, as by hydrocyanic acid, cyanide of potassium, inhalation of carbonic acid or coal gas, oedema of glottis following inhalation of ammonia. . rapid onset of some acute specific disease, such as pneumonia or diphtheria; collapse from cholera. . heat-stroke, lightning, shocks of electricity of high tension. . mental or physical shock. . exertion while the stomach is overloaded. . diabetic coma; uræmia. . _status lymphaticus._ this is a general hyperplastic condition of the lymphatic structures in the body, and is seen in enlargement of tonsils, thymus, spleen, as well as of peyer's patches and mesenteric glands. it is a frequent cause of death during chloroform anæsthesia for slight operations in young people. in addition, it may be as well to remember that death sometimes occurs suddenly in exophthalmic goitre, hypertrophy of the thymus, and in addison's disease. in some cases of sudden death nothing has been found post mortem, even when the autopsy has been made by skilled observers, and the brain and cord have been submitted to microscopical examination. vi.--signs of death ( ) cadaveric appearance; ashy white colour. ( ) cessation of the circulation and respiration, no sound being heard by the stethoscope. cessation of the circulation may be determined by (a) placing a ligature round the base of a finger (magnus' test); (b) injecting a solution of fluorescin (icard's test); (c) looking through the web of the fingers at a bright light (diaphanous test); (d) the dulling of a steel needle when thrust into the living body; (e) the clear outline of the dead heart when viewed in the fluorescent screen. ( ) the state of the eye; the tension is at once lost; iris insensible to light, fundus yellow in colour; cornea dull and sunken. ( ) the state of the skin; pale, livid, with loss of elasticity. ( ) extinction of muscular irritability. the above signs afford no means of determining how long life has been extinct. the following, however, do: =cooling of the body.=--the average internal temperature of the body is from ° to ° f. the time taken in cooling is from fifteen to twenty hours, but it may be modified by the kind of death, the age of the person, the presence or absence of clothing on the body, the surrounding temperature, and the stillness or otherwise of the air about the body. still, the body, other things being equal, may be said to be _quite cold_ in about _twelve hours_. =hypostasis= or =post-mortem staining= is due to the settling down of the blood in the most dependent parts of the body while the body is cooling. it is a sure sign of death, and occurs in all forms of death, even in that due to hæmorrhage, although not so marked in degree. post-mortem staining (_cadaveric lividity_) begins to appear in from eight to twelve hours after death, and its position on the body will help to determine the length of time the body has lain in the position in which it was found. the staining is of a dull red or slaty blue colour. it must be distinguished from ecchymosis the result of a bruise, by making an incision into the part; in the case of hypostasis a few small bloody points of divided arteries will be seen, in the case of ecchymosis the subcutaneous tissues are infiltrated with blood-clot. internally, hypostasis must not be mistaken for congestion of the brain or lungs, or the results of inflammation of the intestines. if the intestine is pulled straight, inflammatory redness is continuous, hypostasis is disconnected. about the neck hypostasis must not be mistaken for the mark of a cord or other ligature. when the blood is of a bright red colour after death (as happens in poisoning by co or hcn, or in death from cold), the hypostasis is bright red also. =cadaveric rigidity--rigor mortis.=--for some time after death the muscles continue to contract under stimuli. when this irritability ceases--and it seldom exceeds two hours--rigidity and hardening sets in, and in _all_ cases precedes putrefaction. it is caused by the coagulation of the muscle plasma. it commences in the muscles of the back of the neck and lower jaw, and then passes into the muscles of the face, front of the neck, chest, upper extremities, and lastly to the lower extremities. it has been noticed in the new-born infant, as well as in the foetus. it lasts from sixteen to twenty hours or more. in lingering diseases, after violent exertion, and in warm climates, it sets in quickly, and disappears in two or three hours; in those who are in perfect health and die from accident or asphyxia, it may not come on until from ten to twenty-four hours, and may last three or four days. after death from convulsions or strychnine-poisoning, the body may pass at once into rigor mortis. rigor mortis must be distinguished from _cadaveric spasm_ or the _death clutch_; in the former, articles in the hands are readily removable, in the latter this is not the case. in tetanic spasm the limbs when bent return to their former position; not so in rigor mortis. =putrefaction= appears in from one to three days after death, as a greenish-blue discoloration of the abdomen; in the drowned, over the head and face. this increases, becomes darker and more general, a strong putrefactive odour is developed, the thorax and abdomen become distended with gas, and the epidermis peels off. the muscles then become pulpy, and assume a dark greenish colour, the whole body at length becoming changed into a soft, semi-fluid mass. the organ first showing the putrefactive change is the trachea; that which resists putrefaction longest is the uterus. these putrefactive changes are modified by the fat or lean condition of the body, the temperature (putrefaction taking place more rapidly in summer than in winter), access of air, the period, place, mode of interment, age, etc. bodies which remain in water putrefy more slowly than those in air. =saponification.=--in bodies which are very fat and have lain in water or moist soil for from one to three years this process takes place, the fat uniting with the ammonia given off by the decomposition to form _adipocere_. this consists of a margarate or stearate of ammonium with lime, oxide of iron, potash, certain fatty acids, and a yellowish odorous matter. it has a fatty, unctuous feel, is either pure white or pale yellow, with an odour of decayed cheese. small portions of the body may show signs of this change in six weeks. =post-mortem examination.=--never make an autopsy in criminal cases without a written order from the coroner or procurator fiscal. if authorized, however, first have the body identified, then photographed if it has not been identified. a medical man representing the accused may be present, but only by consent of the crown authorities or of the sheriff. clothing should be examined for blood-stains, cuts, etc. examine external surface of body and take accurate measurements of wounds, marks, deformities, tattooings; note degree and distribution of post-mortem staining, rigidity, etc. examine brain by making incision from ear to ear across vertex, reflect scalp forwards and backwards, and saw off calvarium. examine brain carefully externally and on section. examine organs of chest and abdomen through an incision made from symphysis menti to pubis, reflecting tissues from chest wall and cutting through costal cartilages. in cases of suspected poisoning have several clean jars into which you place the stomach with contents, intestines with contents, piece of liver, kidney, spleen, etc., and seal each up carefully, attaching label with name of deceased, date, and contained organs, and transmit these personally to the analyst. =exhumation.=--a body which has been buried cannot be exhumed without an order from a coroner, fiscal, or from the home secretary. there is no legal limit in england as to when a body may be exhumed; in scotland, however, if an interval of twenty years has elapsed, an accused person cannot be prosecuted (_prescription of crime_). vii.--death from anÆsthetics, etc. the coroner in england and wales and ireland must inquire into every case of death during the administration of an anæsthetic. the anæsthetist has to appear at the inquest, and must answer a long series of questions relative to the administration of the drug. before, therefore, giving an anæsthetic, and so as to furnish yourself with a proper defence in the event of death occurring, you ought to examine the heart, lungs, and kidneys of the patient to see if they are healthy. should a fatal result follow, the anæsthetist will require to prove that it was necessary to give the anæsthetic, that the one employed was the most suitable, that the patient was in a fit state of health to have it administered, that it was given skilfully and in moderate amount, that he had the usual remedies at hand in case of failure of the heart or lungs, and that he employed every means in his power to resuscitate the patient. the condition of the lungs is of more importance than the state of the heart. the chloroformist ought always to use the best chloroform. an anæsthetic should never be administered except in the presence of a _third person_. this applies especially to dentists who give gas to females. =malpractice.=--in every case where a medical man attends a patient, he must give him that amount of care, skill, knowledge, or judgment, that the law expects of him. if he does not, then the charge of malpractice may be brought against him. it is most frequently alleged in connection with surgical affections--_e.g._, overlooking a fracture or dislocation. before a major operation is performed, it is well to get a written agreement. viii.--presumption of death; survivorship =presumption of death.=--if a person be unheard of for seven years, the court may, on application by the nearest relative, presume death to have taken place. if, however, it can be shown that in all probability death had occurred in a certain accident or shipwreck, the decree may be made much earlier. =presumption of survivorship.=--when two or more related persons perish in a common accident, it may be necessary, in order to decide questions of succession, to determine which of them died first. it is generally accepted that the stronger and more vigorous will survive longest. ix.--assault, murder, manslaughter, etc. =assault.=--this is an attempt or offer to do violence to another person; it is not necessary that actual injury has been done, but evil intention must be proved. when a corporal hurt has been sustained, then _assault and battery_ has been committed. the assault may be aggravated by the use of weapons, etc. =homicide= may be _justifiable_, as in the case of judicial execution, or _excusable_, as in defence of one's family or property. _felonious homicide_ is murder. this means that a human being has been killed by another maliciously and deliberately or with reckless disregard of consequences. =manslaughter= or =culpable homicide= (scotland) is the unlawful killing of a human being without malice--as homicide after great provocation; signalman who allows a train to pass, and so collide with another in front. x.--wounds and mechanical injuries a wound may be defined as a 'breach of continuity in the structures of the body, whether external or internal, suddenly occasioned by mechanical violence.' the law does not define 'a wound,' but the _true skin must be broken_. wounds are dangerous from shock, hæmorrhage, from the supervention of crysipelas or pyæmia, and from _malum regimen_ on the part of the patient or surgeon. _is the wound dangerous to life?_ this question can only be answered by a full consideration of all the circumstances of the case; a guarded prognosis is wise in all cases. =burns= are caused by flames, highly heated solids, or very cold solids, as solid carbonic acid; scalds, by steam or hot fluids. burns may cause death from shock, suffocation, oedema glottidis, inflammation of serous surfaces, bronchitis, pneumonia, duodenal ulcer, coma, or exhaustion. a burn of the skin inflicted during life is followed by a bleb containing serum; the edges of this blister are bright red, and the base, seen after removing the cuticle, is red and inflamed; if sustained after death, a bleb, if present, contains but little fluid, and there are no signs of vital reaction. there are six degrees of burns: ( ) superficial inflammation; ( ) formation of vesicles; ( ) destruction of superficial layer of skin; ( ) destruction of cellular tissue; ( ) deep parts charred; ( ) carbonization of bones. the larger the area of skin burnt, the more grave is the prognosis. burns of the abdomen and genital organs are especially dangerous. young children are specially liable to die after burns. xi.--contused wounds and injuries unaccompanied by solution of continuity if a blow be inflicted with a blunt instrument, there is produced a bruise, or _ecchymosis_, of which it is unnecessary here to describe the appearance and progress. a bruise may be distinguished from a post-mortem stain by the cuticle in the former often being abraded and raised. when an incision is made into the bruise, the whole of the subcutaneous tissues are found to be infiltrated with blood-clot, and there is no clear margin. in the case of a post-mortem stain the edges are sharply defined, not raised, and, on section, mere bloody points are seen which are the cut ends of the divided blood vessels. xii.--incised wounds and those accompanied by solution of continuity these comprise incised, punctured, and lacerated wounds. in a recent incised wound inflicted during life there is copious hæmorrhage, the cellular tissue is filled with blood, the edges of the wound gape and are everted, and the cavity of the wound is filled with coagula. lacerated wounds combine the characters of incised and contused wounds. they are caused by falls, being ridden over, machinery crushes, bites, blows from blunt weapons, etc. the wounds heal by suppuration. _punctured wounds_ come intermediate between incised and lacerated. they are greater in depth than in length, being caused by sword or rapier thrusts. they cause little hæmorrhage externally, but death may be due to internal hæmorrhage. they may be complicated by ( ) the introduction of septic material adhering to the instrument; ( ) the entrance of foreign bodies which lodge in the wound, not only carrying in septic matter, but acting as mechanical irritants; ( ) injury to deeper parts, which may at the time be difficult to detect. an apparently _incised wound_ may be produced by a hard, blunt weapon over a bone--_e.g._, shin or cranium. it is often difficult to distinguish between a wound of the scalp inflicted with a knife and one made by a blow with a stick. a puncture with a sharp-edged, pointed knife leaves a fusiform or spindle-shaped wound. a wound from a blow with a stick might be of this character, or it might present a jagged, swollen appearance at the margin, with much contusion of the surrounding tissues. if the wound is seen soon after it is inflicted, examination with a lens may disclose irregularities of the margins, or little bridges of connective tissue or vessels running across the wound, and so be inconsistent with its production by a cutting instrument. _lacerated wounds_ as a rule bleed less freely than those which are incised. symptoms of concussion would favour the theory of the injury having been inflicted by a heavy instrument. again, it is often difficult to decide whether the injury which caused death was the result of a blow or a fall. a heavy blow with a stick may at once cause fatal effusion of blood, but this might equally result from fracture of the skull resulting from a fall. the wound should be carefully examined for foreign bodies, such as grit, dirt, or sand. the distinction between incised wounds inflicted during life and after death is found in the fact that a wound inflicted during life presents the appearances already described, whereas in a post-mortem incised wound only a small quantity of liquid venous blood is effused; the edges are close, yielding, inelastic; the blood is not effused into the cellular tissue, and there are no signs of vital reaction. the presence of inflammatory reaction or pus shows that the wound must have been inflicted some time before death, probably two or three days. _self-inflicted wounds_ are made by the person himself in order to divert suspicion, or in order to bring accusation against another. such wounds are always in front, not over vital organs, and superficial in character. note the condition of the clothes in such cases. xiii.--gunshot wounds these may be punctured, contused, or lacerated. round balls make a larger opening than those which are conical. small shot fired at a short distance make one large ragged opening; while at distances greater than feet the shot scatter and there is no central opening. the lee-metford bullet is more destructive than the mauser. the former is the larger, but the difference in size is not great. the martini-henry bullet weighs grains, the lee-metford , and the mauser . speaking generally, a gunshot wound, unlike a punctured wound, becomes larger as it increases in depth; the aperture of entrance is round, clean, with inverted edges, and that of exit larger, less regular than that of entrance, and with everted edges. in the case of high-velocity bullets from smooth-bore rifles, including the mauser and lee-metford, the aperture of entry is small; the aperture of exit is slightly larger, and tends to be more slit-like. there is but little tendency to carry in portions of clothing or septic material, and the wound heals by first intention, if reasonable precautions be taken. the external cicatrices finally look very similar to those produced by bad acne pustules. the contents of all gunshot wounds should be preserved, as they may be useful in evidence. a pocket revolver, as a rule, leaves the bullet in the body. wounds inflicted by firearms may be due to accident, homicide, or suicide. blackening of the wound, singeing of the hair, scorching of the skin and clothing, show that the weapon was fired at close quarters, whilst blackening of the hand points to suicide. even when the weapon is fired quite close there may be no blackening of the skin, and the hand is not always blackened in cases of suicide. smokeless powder does not blacken the skin. wounds on the back of the body are not usually self-inflicted, but a suicide may elect to blow off the back of his head. a wound in the back may be met with in a sportsman who indulges in the careless habit of dragging a loaded gun after him. if a revolver is found tightly grasped in the hand it is probably a case of suicide, whilst if it lies lightly in the hand it may be suicide or homicide. if no weapon is found near the body, it is not conclusive proof that it is not suicide, for it may have been thrown into a river or pond, or to some distance and picked up by a passer-by. a bullet penetrating the skull even from a distance of , yards may act as an explosive, scattering the contents in all directions; but the bullet from a revolver will usually be found in the cranium. the prognosis depends partly on the extent of the injury and the parts involved, but there is also risk from secondary hæmorrhage, and from such complications as pleurisy, pericarditis, and peritonitis. death may result from shock, hæmorrhage, injury to brain or important nervous structures. xiv.--wounds of various parts of the body . =of the head.=--wounds of the scalp are likely to be followed by ( ) erysipelatous inflammation; ( ) inflammation of the tendinous structures, with or without suppuration. a severe blow on the vertex may cause fracture of the base of the skull. injuries of the brain include concussion, compression, wounds, contusion, and inflammation. concussion is a common effect of blows or violent shocks, and the symptoms follow immediately on the accident, death sometimes taking place without reaction. compression may be caused by depressed bone or effused blood (rupture of middle meningeal artery) and serum. the symptoms may come on suddenly or gradually. wounds of the brain present very great difficulties, and vary greatly in their effect, very slight wounds producing severe symptoms, and _vice versâ_. a person may receive an injury to the head, recover from the first effects, and then die with all the symptoms of compression from internal hæmorrhage. this is due to the fact that the primary syncope arrests the hæmorrhage, which returns during the subsequent reaction, or on the occurrence of any excitement. inflammation of the meninges or brain may follow injuries, not only to the brain itself, but to the scalp and adjacent parts, as the orbit and ear. inflammation does not usually come on at once, but after variable periods. . =injuries to the spinal cord= may be due to concussion, compression (fracture-dislocation), or wounds. that the wound has penetrated the meninges is shown by the escape of cerebro-spinal fluid. the cord and nerves may be injured ( ) by the puncture; ( ) by extravasation of blood and the formation of a clot; and ( ) by subsequent septic inflammation. division or complete compression of the cord at or above the level of the fourth cervical vertebra is immediately fatal (as happens in judicial hanging). when the injury is below the fourth, the diaphragm continues forcibly in action, but the lungs are imperfectly expanded, and life will not be maintained for more than a day or two. when the injury is in the dorsal region, there is paralysis of the legs and of the sphincters of the bladder and rectum, but power is retained in the arms and the upper intercostal muscles act, the extent of paralysis depending on the level of the lesion. in injuries to the lumbar region the legs may be partly paralysed, and the rectal and bladder sphincters may be involved. _railway spine_, or traumatic neurasthenia, may be set up by concussion of the cord as a result of blows or falls. passengers after railway accidents, or miners, often suffer from this affection. . =of the face.=--these produce great disfigurement and inconvenience, and there is a risk of injury to the brain. the seventh nerve may be involved, giving rise to facial paralysis. punctured wounds of the orbit are especially dangerous. wounds apparently confined to the external parts often conceal deep-seated mischief. . =of the eye.=--the iris may be injured by sharp blows, as from the cork of a soda-water bottle. it is usually followed by hæmorrhage into the anterior chamber, and there may be separation of the iris from its ciliary border. wounds at the edge of the cornea are often followed by prolapse of the iris. acute traumatic iritis or irido-cyclitis may supervene four or five days after the injury. the lens is frequently wounded in addition to the cornea and iris. in dislocation of the lens into the anterior chamber as the result of a blow, the lens appears like a large drop of oil lying at the back of the cornea, the margin exhibiting a brilliant yellow reflex. partial dislocations of the lens as the result of severe blows generally terminate in cataract. . =of the throat.=--very frequently inflicted by suicides. division of the carotid artery is fatal, and of the internal jugular vein very dangerous on account of entrance of air. wounds of the larynx and trachea are not necessarily or immediately dangerous, but septic pneumonia is very apt to follow. wounds of the throat inflicted by suicides are commonly situated at the upper part, involving the hyoid bone and the thyroid and cricoid cartilages. the larynx is opened, but the large vessels often escape. in most suicidal wounds of the throat the direction is from left to right, the incision being slightly inclined from above downwards. at the termination of a suicidal cut-throat the skin is the last structure divided, the wound being shallower as it reaches its termination; the wounds often show parallelism. the weapon is often firmly grasped in the hand. inquiry should be made as to whether the patient is right or left handed, or ambidextrous. homicidal cut throat is usually very severe and situated low down in the neck or far to the side. . =of the chest.=--incised wounds of the walls are not of necessity dangerous; but severe blows, by causing fracture of the bones and internal injuries, are often fatal. the symptoms of penetrating wounds of the chest are--( ) the passage of blood and air through the wound; ( ) hæmoptysis; ( ) pneumothorax; and ( ) protrusion of the lung forming a tumour covered with pleura. fracture of the ribs may be due to direct violence, as from a blow, when the ends are driven inwards, or to indirect violence, as from a squeeze in a crowd, when the ends are driven outwards. . =of the lungs.=--these usually cause hæmorrhage, and are frequently followed by pleurisy, either dry or with effusion, and by pneumonia. . =of the heart.=--penetrating wounds are fatal from hæmorrhage, of the base more speedily than of the apex; but life may be prolonged for some time even after a severe wound to the heart. injury to the right ventricle is the most fatal injury and the most frequent. rupture from disease usually occurs in the left ventricle; rupture from a crush is usually towards the base and on the right side. . =of the aorta and pulmonary artery.=--fatal. . =of the diaphragm.=--generally fatal, owing to the severe injury of the other abdominal organs. if the diaphragm be ruptured, hernia of the organs may result. . =of the abdomen.=--of the walls, may be dangerous from division of the epigastric artery; ventral hernia may follow, internal hæmorrhage, etc. blows on the abdomen are prone to cause death from cardiac inhibition. . =of the liver.=--may divide the large vessels. venous blood flows profusely from a punctured wound of the liver. wounds of the gall-bladder cause effusion of bile and peritoneal inflammation. laceration of the liver may result from external violence without leaving any outward sign of the injury; it is commonly fatal. there is rapid and acute anæmia from the pouring out of blood into the abdominal cavity. this may also occur with injuries of other organs in the abdomen. . =of the spleen.=--fatal hæmorrhage may result from penetrating wounds or from rupture due to kicks, blows, crushes, especially if the spleen be enlarged. . =of the stomach.=--may be fatal from shock, from hæmorrhage, from extravasation of contents, or from inflammation. the danger is materially lessened by prompt surgical intervention. . =of the intestines.=--may be fatal in the same way as those of the stomach. more dangerous in the small than in the large intestines. . =of the kidneys.=--may prove fatal from hæmorrhage, extravasation of urine, or inflammation. . =of the bladder.=--dangerous from extravasation of urine. in fracture of the pelvis the bladder is often injured, and extraperitoneal infiltration of urine occurs, with frequently a fatal issue. . =of genital organs.=--incised wounds of penis may produce fatal hæmorrhage. removal of testicles may prove fatal from shock to nervous system. wounds of the spermatic cord may be dangerous from hæmorrhage. wounds to the vulva are dangerous, owing to hæmorrhage from the large plexus of veins without valves. xv.--detection of blood-stains, etc. stains may require detection on clothing, on cutting instruments, on floors and furniture, etc. the following are the distinctive characters of blood-stains: (a) =ocular inspection.=--blood-stains on dark-coloured materials, which in daylight might be easily overlooked, may be readily detected by the use of artificial light, as that of a candle, brought near the cloth. blood-spots when recent are of a bright red colour if arterial, of a purple hue if venous, the latter becoming brighter on exposure to the air. after a few hours blood-stains assume a reddish-brown or chocolate tint, which they maintain for years. this change is due to the conversion of hæmoglobin into methæmoglobin, and finally into hæmatin. the change of colour in warm weather usually occurs in less than twenty-four hours. the colour is determined, not entirely by the age of the stain, but is influenced by the presence or absence of impurities in the air, such as the vapours of sulphurous, sulphuric, and hydrochloric acids. if recent, a jelly-like material may be seen by the aid of a magnifying-glass lying between the fibres. if old, a cinnabar-red streak is seen on drawing a needle across the stain. (b) =microscopic demonstration.=--with the aid of the microscope, blood may be detected by the presence of the characteristic blood-corpuscles. the human blood-corpuscle is a non-nucleated, biconcave disc, having a diameter of about / of an inch. all mammalian red corpuscles have the same shape, except those of the camel, which are oval. the corpuscles of birds, fishes, reptiles, and amphibians, are oval and nucleated. the corpuscles of most mammals are smaller than those of man, but the size of a corpuscle is affected by various circumstances, such as drying or moisture, so that the medical witness is rarely justified in going farther than stating whether the stain is that of the blood of a mammal or not. unfortunately, the corpuscles are usually so dried that little information regarding their size can be given. (c) =action of water.=--water has a solvent action on blood, fresh stains rapidly dissolving when the material on which they occur is placed in cold distilled water, forming a bright red solution. the hæmatin of old stains dissolves very slowly, so employ a weak solution of ammonia, and this will give a solution of alkaline hæmatin. rust is not soluble in water. (d) =action of heat.=--blood-stains on knives may be removed by heating the metal, when the blood will peel off, at once distinguishing it from rust. should the blood-stain on the metal be long exposed to the air, rust may be mixed with the blood, when the test will fail. the solution obtained in water is coagulated by heat, the colour entirely destroyed, and a flocculent muddy-brown precipitate formed. (e) =action of caustic potash.=--the solution of blood obtained in water is boiled, when a coagulum is formed soluble in hot caustic potash, the solution formed being greenish by transmitted and red by reflected light. (f) =action of nitric acid.=--nitric acid added to a watery solution produces a whitish-grey precipitate. (g) =action of guaiacum.=--tincture of guaiacum produces in the watery solution a reddish-white precipitate of the resin, but on addition of an aqueous solution of peroxide of hydrogen, or of an ethereal solution of the same substance (known as _ozonic ether_), a blue or bluish-green colour is developed. this test is delicate, and succeeds best in dilute solutions. it is not absolutely indicative of the presence of blood, for tincture of guaiacum is coloured blue by milk, saliva, and pus. (h) =hæmin crystals (teichman's crystals).=--these are produced by heating a drop of blood, or a watery solution of it, with a minute crystal of sodium chloride on a glass slide and evaporating to dryness. a cover-glass is placed over this, and a drop of glacial acetic acid allowed to run in. it is again heated until bubbles appear. crystals of hæmin may now be detected by the microscope. they are dark brown or yellow rhombic prisms. an improvement on this test is the use of formic acid alone; on slowly evaporating it, numerous very small dark crystals are visible if hæmoglobin has been present (whitney's test). (i) =spectroscopic appearances.=--if a solution of a recent stain be examined by the spectroscope, we get two absorption bands situated between the lines d and e, the one nearer e being doubly as broad as the other. these bands indicate _oxyhæmoglobin_. if we now add a little ammonium sulphide to this solution, we get the spectrum of _reduced hæmoglobin_, which is a single broad absorption band situated in the interval between the preceding oxyhæmoglobin bands. by shaking the solution, oxyhæmoglobin is again reproduced, and gives its special absorption bands. if ammonia be added to the original solution, _alkaline hæmatin_ is produced, or if acetic acid be chosen, _acid hæmatin_ is produced, and each gives its appropriate absorption bands. _methæmoglobin_ is formed in stains which have been exposed to the air for a few days, and _hæmatin_ is found in old stains. _hæmochromogen_ gives a very characteristic spectrum, and is obtained by reducing alkaline hæmatin by ammonium sulphide. _carbon monoxide hæmoglobin_ gives a spectrum which resembles that of oxyhæmoglobin, but it is not reduced by ammonium sulphide. (j) =precipitin test.=--this allows us to tell whether the blood is from a human being or not. a specific serum must be obtained from a rabbit which is sensitized as follows: c.c. of human blood is injected into its peritoneal cavity at intervals, until from three to five injections have been given. the serum of this animal's blood will then give a white precipitate only when brought into contact with dilute solutions of human blood, but with the blood of no other animal. this is known also as the 'biologic,' or uhlenhuth's test. =rust stains.=--these are yellowish-red in colour, and do not stiffen the cloth. the iron may be dissolved by placing the stain in a dilute solution of hydrochloric acid, when, on adding ferrocyanide of potassium, prussian blue is produced. =fruit stains= are seldom so dark as blood-stains. solutions of these do not change colour or coagulate on boiling; ammonia changes the colour to blue or green; acid brightens the original colour, while chlorine bleaches it. =hairs.=--human hairs must be identified and distinguished from those of the lower mammals. if the hair has been pulled out from the root, the microscope will show that the bulbous root has a concave surface which fitted over the hair papilla, or that the root is encased in a fatty sheath. =fibres of clothing.=--microscopically, wool fibres are coarse, curly, and striated transversely; cotton fibres appear as flattened bands twisted into spirals; linen fibres are round, jointed at frequent intervals, with small root-like filaments; silk fibres are solid, continuous, and highly glistening. xvi.--death by suffocation _signs and symptoms._--there are usually three stages: . exaggerated respiratory activity; air hunger; anxiety; congested appearance of face; ringing in ears. . loss of consciousness; convulsions; relaxation of sphincters. . respirations feeble and gasping, and soon cease; convulsions of stretching character; heart continues to beat for three to four minutes after breathing ceases. _post-mortem appearances--external._--cadaveric lividity well marked; nose, lips, ears, finger-tips almost black in colour; appearance may be placid or, if asphyxia has been sudden, the tongue may be protruded and eyeballs prominent, with much bloody mucus escaping from mouth and nose. _internal._--the blood is dark and remains fluid; great engorgement of venous system, right side of heart, great veins of thorax and abdomen, liver, spleen, etc. lungs dark purple in colour; much bloody froth escapes on squeezing them; mucous lining of trachea and bronchi congested and bright red in colour; air-cells distended or ruptured; many small hæmorrhages on surface of lungs and other organs, as well as in their substance (_tardieu's spots_), due to rupture of venous capillaries from increased vascular pressure. xvii.--death by hanging in hanging, death occurs by asphyxia, as in drowning. sensibility is soon lost, and death takes place in four or five minutes. the eyes in some cases are brilliant and staring, tongue swollen and livid, blood or bloody froth is found about the mouth and nostrils, and the hands are clenched. in other cases the countenance is placid, with an almost entire absence of the signs just given. the mark on the neck, which may be more or less interrupted by the beard, shows the course of the cord, which in hanging is obliquely round the neck following the line of the jaw, but straight round in strangulation. in judicial hanging, death is not due to asphyxiation, but, owing to the long drop, the cervical vertebræ are dislocated, and the spinal cord injured so high up that almost instant death takes place. on dissection the muscles and ligaments of the windpipe may be found stretched, bruised, or torn, and the inner coats of the carotid arteries are sometimes found divided. in ordinary suicidal hanging there may be entire absence of injury to the soft parts about the neck, the length of the drop modifying these appearances. the mark of the cord is not a sign of hanging, is a purely cadaveric phenomenon, and may be produced some hours after death. xviii.--death by strangulation this differs from hanging in that the body is not suspended. it may be effected by a ligature round the neck, or by direct pressure on the windpipe with the hand, in which case death is said to be caused by _throttling_. strangulation is frequently suicidal, but may be accidental. when homicidal, much injury is done to the neck, owing to the force with which the ligature is drawn. in throttling, the marks of the finger-nails are found on the neck. xix.--death by drowning death by drowning occurs when breathing is arrested by watery or semi-fluid substances--blood, urine, etc. the fluid acts mechanically by entering the air-cells of the lung and preventing the due oxidation of the blood. the post-mortem appearances include those usually present in death by asphyxia, together with the following, peculiar to death by drowning: excoriations of the fingers, with sand or mud under the nails; fragments of plants grasped in the hand; water in the stomach (this is a vital act, and shows that the person fell into the water alive); fine froth at the mouth and nostrils; cutis anserina; retraction of penis and scrotum. on post-mortem examination, the lungs are found to be increased in size ('ballooned'); on section, froth, water mud, sand, in air-tubes. the presence of this fine (often blood-stained) froth is the most characteristic sign of drowning. froth like that of soap-suds in the trachea is an indication of a vital act, and must not be mistaken for the tenacious mucus of bronchitis. the presence of vomited matters in the trachea and bronchi is a valuable sign of drowning. the blood collects in the venous system, and is dark and fluid. tardieu's spots are not so frequently met with in cases of drowning as in other forms of asphyxia. the other signs of death by asphyxia are present. wounds may be present on the body, due to falling on stakes, injuries from passing vessels, etc. the methods of performing artificial respiration in the case of the apparently drowned are the following (the best and most easily performed is schäfer's prone pressure method): . _schäfer's._--place the patient on his face, with a folded coat under the lower part of the chest. unfasten the collar and neckband. go to work at once. kneel over him athwart or on one side facing his head. place your hands flat over the lower part of his back, and make pressure on his ribs on both sides, and throw the weight of your body on to them so as to squeeze out the air from his chest. get back into position at once, but leave your hands as they were. do this every five seconds, and get someone to time you with a watch. keep this going for half an hour, and when you are tired get someone to relieve you. other people may apply hot flannels to the limbs and hot water to the feet. hypodermic injections of / grain of atropine, suprarenal or pituitary extracts, may be found useful. . _silvester's._--in this method the capacity of the chest is increased by raising the arms above the head, holding them by the elbows, and thus dragging upon and elevating the ribs, the chest being emptied by lowering the arms against the sides of the chest and exerting lateral pressure on the thorax. the patient is in the supine position--but first the water must have been drained from the mouth and nose by keeping the body in the prone position. the tongue must be kept forward by transfixing with a pin. . _marshall hall's._--this consists in placing the patient in the prone position, with a folded coat under the chest, and rolling the body alternately into the lateral and prone positions. . _howard's._--this consists in emptying the thorax by forcibly compressing the lower part of the chest; on relaxing the pressure the chest again fills with air. here the patient is placed in the supine position. the objections to the supine position are that the tongue falls back, and not only blocks the entrance of air, but prevents the escape of water, mucus, and froth from the air-passages. . _laborde's method._--this consists in holding the tongue by means of a handkerchief, and rhythmically drawing it out fully at the rate of fifteen times per minute. this excites the respiratory centre, and this method may be employed along with any of the other methods. xx.--death from starvation the post-mortem appearances in death from starvation are as follows: there is marked general emaciation; the skin is dry, shrivelled, and covered with a brown, bad-smelling excretion; the muscles soft, atrophied, and free from fat; the liver is small, but the gall-bladder is distended with bile. the heart, lungs, and internal organs are shrivelled and bloodless. the stomach is sometimes quite healthy; in other cases it may be collapsed, empty, and ulcerated. the intestines are also contracted, empty, and translucent. in the absence of any disease productive of extreme emaciation (_e.g._, tuberculosis, stricture of oesophagus, diabetes, addison's disease), such a state of body will furnish a strong presumption of death by starvation. in the case of children there is not always absolute deprivation of food, but what is supplied is insufficient in quantity or of improper quality. the defence commonly set up is that the child died either of marasmus or of tuberculosis. in cases where it is alleged that a child has been starved and ill-used, one must examine the body for signs of neglect--_e.g._, dirtiness of skin and hair, presence of vermin, bruises or skin eruptions. compare its weight with a normal child of the same age and sex. if the disproportion be great and signs of neglect present, then the probability is great (provided there be no actual disease present) that the child has been starved. xxi.--death from lightning and electricity the signs of death from lightning vary greatly. in some cases there are no signs; in others the body may be most curiously marked. wounds of various characters--contused, lacerated, and punctured--may be produced. there may be burns, vesications, and ecchymoses; arborescent markings are not uncommon. the hair may be singed or burnt and the clothing damaged. rigor mortis is very rapid in its onset and transient. post mortem there are no characteristic signs, but the blood may be dark in colour and fluid. the presence or absence of a storm may assist the diagnosis. injuries by electrical currents of high pressure are not uncommon; speaking generally, , to , volts will kill. in america, where electricity is adopted as the official means of destroying criminals, , volts is regarded as the lethal dose, but there are many instances of persons having been exposed to higher voltages without bad effects. the alternating current is supposed to be more fatal than the continuous. much depends on whether the contact is good (perspiring hands or damp clothes). death has been attributed in these cases to respiratory arrest or sudden cessation of the heart's action. the best treatment is artificial respiration, but the inhalation of nitrite of amyl may prove useful. rescuers must be careful that they, also, do not receive a shock. the patient should be handled with india-rubber gloves or through a blanket thrown over him. xxii.--death from cold or heat =cold.=--the weak, aged, or infants, readily succumb to low temperatures. the symptoms are increasing lassitude, drowsiness, coma, with sometimes illusions of sight. post mortem, bright red patches are found on the skin surface, and the blood remains fluid for long. =heat.=--death may result from syncope, the result of exposure to great heat. =sunstroke.=--the person loses consciousness and falls down insensible; the body temperature may be ° f., the pulse is full, and a peculiar pungent odour is given off from the skin. coma, convulsions with (rarely) delirium, may precede death. _treatment_ consists in lowering the body temperature by application of cold cloths, stimulants, strychnine or digitalin hypodermically. xxiii.--pregnancy the signs of the existence of pregnancy are of two kinds, uncertain and certain, or maternal and foetal. amongst the former class are included--cessation of menstruation (which may occur without pregnancy); morning vomiting; salivation; enlargement of the breasts and of the abdomen; quickening. it must be borne in mind that every woman with a big abdomen is not necessarily pregnant. the tests which afford conclusive evidence of the existence of a foetus in the uterus are--ballottement, the uterine souffle, intermittent uterine contractions, foetal movements, and, above all, the pulsation of the foetal heart. the uterine souffle is synchronous with the maternal pulse; the foetal heart is not, being about beats per minute. evidence of pregnancy may also be afforded by the discharge from the uterus of an early ovum, of moles, hydatids, etc. disease of the uterus and ovarian dropsy may be mistaken for pregnancy. careful examination is necessary to determine the nature of the condition present. pregnancy may be pleaded in bar of immediate capital punishment, in which case the woman must be shown to be 'quick with child.' a woman may also plead pregnancy to delay her trial in scotland, and both in england and scotland, in civil cases, to produce a successor to estates, to increase damages for seduction, in compensation cases where a husband has been killed, to obtain increased damages, etc. a woman may become pregnant within a month of her last delivery. in cases of rape and suspected pregnancy, it must be borne in mind that a medical man who examines a woman under any circumstances against her will renders himself liable to heavy damages, and that the law will not support him in so doing. if, on being requested to permit an examination, the woman refuse, such refusal may go against her, but of this she is the best judge. the duty of the medical man ends on making the suggestion. xxiv.--delivery the signs of recent delivery are as follows: the face is pale, with dark circles round the eyes; the pulse quickened; the skin soft, warm, and covered with a peculiar sweat; the breasts full, tense, and knotty; the abdomen distended, its integuments relaxed, with irregular light pink streaks on the lower part. the labia and vagina show signs of distension and injury. for the first three or four days there is a discharge from the uterus more or less sanguineous in character, consisting of blood, mucus, epithelium, and shreds of membrane. during the next four or five days it becomes of a dirty green colour, and in a few days more of a yellowish, milky, mucous character, continuing for two to three weeks. the change in character of the lochial discharge is due to the quantity of blood decreasing and its place being taken by fatty granules and leucocytes. the os uteri is soft, patulous, and its edges are torn. the uterus may be felt for two or three hours above the pubis as a hard round ball, regaining its normal size in about eight weeks after delivery. most of these signs disappear about the tenth day, after which it becomes impossible to fix the date of delivery. in the dead the external parts have the same appearance as given above. the uterus will vary in appearance according to the time elapsed since delivery. if death occurred immediately after delivery, the uterus will be wide open, about or inches long, with clots of blood inside, and the inner surface lined by decidua. the signs of a previous delivery consist in silvery streaks in the skin of the abdomen, which, however, may be due to distension from other causes; similar marks on the breast; circular and jagged condition of the os uteri (the virgin os being oval and smooth); marks of rupture of the perineum or fourchette; absence of the vaginal rugæ; dark-coloured areola round the nipples, etc. the difference between the virgin _corpus luteum_ and that of recent pregnancy is not so marked as to justify a confident use of it for medico-legal purposes. xxv.--foeticide, or criminal abortion this consists in giving to any woman, or causing to be taken by her, with intent to procure her miscarriage, any poison or other noxious thing, or using for the same purpose any instruments or other means whatsoever. it is a felony to procure or attempt to procure the miscarriage of a woman, whether she be pregnant or not, and it is a felony for the woman, if pregnant, to attempt to procure her own miscarriage. it is a misdemeanour for any person or persons to procure drugs or instruments for a like purpose. it is not necessary that the woman be _quick_ with child. the offence is the intent to procure the miscarriage of any woman, _whether she be or be not with child_. when from any causes it is necessary to procure abortion, a medical man should do so only after consultation with a brother practitioner. even in these cases there is no exemption legally. any medical man who gives even the most harmless medicine where he suspects the possibility of pregnancy may render himself liable to grave suspicion should the woman abort. in medicine, an _abortion_ is said to occur when the foetus is expelled before the sixth month; after that it is _premature birth_. in law, however, any expulsion of the contents of the uterus before the full time is an _abortion_ or _miscarriage_. in deciding whether any substance expelled from the uterus is really a foetus or a mole, and therefore the result of conception, or the coat of the uterus, and unconnected with pregnancy, the examination of the substances expelled must be carefully made. moles are blighted foetuses. an examination of the woman will be necessary, though it is not easy during the early months of pregnancy, and especially in those who have borne children, to say whether abortion has taken place or not. the history must be inquired into; the regular or exceptional use of drugs to promote menstruation is important, for in the former case no criminal intent may exist, although pregnancy be present. the state of the breasts, the hymen, and the os uteri, should all be carefully examined. putting a few apparently unimportant questions as to the frequent use of purgatives, the presence or absence of constipation, will often assist the diagnosis as showing that the woman has acted in an unusual manner. abortion may be procured by the introduction of instruments, by falls, violent exercise, blows on the abdomen, etc. in the hands of ignorant persons the use of instruments (sounds, bougies, skewers, etc.) is attended with great danger. perforation of the vaginal walls, bladder, cervix, or uterus, may follow their use. septic pelvic peritonitis may ensue, and the woman may lose her life. the person who has employed such means for inducing abortion is liable to be charged with the crime of murder. there is no evidence to show that ergot, savin, bitter-apple, pennyroyal, or any other drug administered internally, will cause a woman to abort, except when taken in such large doses that actual poisoning results, with inflammation of the contents of the true pelvis. in such cases reflex uterine contractions may be set up, and abortion may follow. diachylon pills are largely employed to induce abortion, and very often the woman taking them suffers severely from lead-poisoning. xxvi.--infanticide infanticide, or the murder of a new-born child, is not treated as a specific crime, but is tried by the same rules as in cases of felonious homicide. the term is applied technically to those cases in which the mother kills her child at, or soon after, its birth. she is often in such a condition of mental anxiety as not to be responsible for her actions. it is usually committed with the object of concealing delivery, and to hide the fact that the girl has, in popular language, 'strayed from the paths of virtue.' the child must have had a separate existence. to constitute 'live birth,' the child must have been alive after its body was entirely born--that is, entirely outside the maternal passages--and it must have had an independent circulation, though this does not imply the severance of the umbilical cord. every child is held in law to be born dead until it has been shown to have been born alive. killing a child in the act of birth and before it is fully born is not infanticide, but if before birth injuries are inflicted which result in death after birth, it is murder. medical evidence will be called to show that the child was born alive. the methods of death usually employed are--( ) suffocation by the hand or a cloth. ( ) strangulation with the hands, by a tape or ribbon, or by the umbilical cord itself. ( ) blows on the head, or dashing the child against the wall. ( ) drowning by putting it in the privy or in a bucket of water. ( ) omission: by neglecting to do what is absolutely necessary for the newly-born child--_e.g._, not separating the cord; allowing it to lie under the bed-clothes and be suffocated. with regard to the question of the maturity of a child, the differences between a child of six or seven months and one at full term may be stated as follows: between the sixth and seventh month, length of child to inches--that is, the length of the child after the fifth month is about double the lunar months--weight to pounds; skin, dusky red, covered with downy hair (lanugo) and sebaceous matter; membrana pupillaris disappearing; nails not reaching to ends of fingers; meconium at upper part of large intestine; testes near kidneys; no appearance of convolutions in brain; points of ossification in four divisions of sternum. at nine months, length of child to inches; weight, to pounds; skin rosy; lanugo only about shoulders; sebaceous matter on the body; hair on head about an inch long; testes past inguinal ring; clitoris covered by the labia; membrana pupillaris disappeared; nails reach to ends of fingers; meconium at termination of large intestine; points of ossification in centre of cartilage at lower end of femur, about - / to - / lines in diameter; umbilicus midway between the ensiform cartilage and pubis. owing to the difficulty of proving that the crime of infanticide has been committed, the woman may in england be tried for _concealment of birth_, and in scotland for _concealment of pregnancy_, if she conceal her pregnancy during the whole time and fail to call for assistance in the birth. either of these charges would only be brought against a woman who had obviously been pregnant, and now the child is missing or its dead body has been found. it is expected that every pregnant woman should make provision for the child about to be born, and so should have talked about it or have made clothes, etc., for it. the punishment for concealment is imprisonment for any term not exceeding two years. the charge of concealment is very often alternative to infanticide. to substantiate the charge, however, it must be proved that there had been a _secret disposition of the dead body_ of the infant, as well as an endeavour to conceal its birth. a woman may be delivered of a child unconsciously, for the contractile power of the womb is independent of volition. under an anæsthetic the uterus acts as energetically as if the patient were in the full possession of her senses. nowadays a woman is rarely hanged for infanticide, and it is a mere travesty of justice to pass on her the death sentence, well knowing that it will never be executed. xxvii.--evidences of live birth the signs of live birth prior to respiration are negative and positive. a negative opinion may be formed when evidence is found of the child having undergone intra-uterine maceration. in this case the body will be flaccid and flattened; the ilia prominent; the head soft and yielding; the cuticle more or less detached, and raised into large bullæ; the skin of a red or brownish-red colour; the cavities filled with abundant bloody serum; the umbilical cord straight and flaccid. a positive opinion is justified when such injuries are found on the body as could not have been inflicted during birth, and are attended with such hæmorrhage as could only have occurred while the blood was circulating. fractures of the cranium from accidental falls (precipitate labour) are as a rule stellate, and are situated on the vertex or in the parietal protuberance. the fractures from violence are more extensive, usually depressed, and accompanied by laceration of the scalp. the evidences of live birth after respiration has taken place are usually deduced from the condition of the lungs, though indications are also found in other organs. the diaphragm is more arched before than after respiration, and rises higher in the thorax in the former case than in the latter. the lungs before respiration are situated in the back of the thorax, and do not fill that cavity; they are of a dark, red-brown colour and of the consistence of liver, without mottling. after respiration they expand and occupy the whole thorax, and closely surround the heart and thymus gland. the portions containing air are of a light brick-red colour, and crepitate under the finger. the lungs are mottled from the presence of islands of aerated tissue, surrounded by arteries and veins. the weight of the lungs before respiration is about grains, after an hour's respiration grains; but this test is of little value. the ratio of the weight of the lungs to that of the body (ploucquet's test), which is also unreliable, is, before respiration, about to ; after, to . lungs in which respiration has taken place float in water; those in which it has not, sink. there are exceptions to this rule, on which, however, is founded the _hydrostatic test_. as originally performed, this test consisted merely in placing the lungs, with or without the heart, in water, and noticing whether they sank or floated. the test is now modified by squeezing, and by cutting the lungs up into pieces. the objections to the test as originally performed are--( ) that the lungs may sink as the result of disease--_e.g._, double pneumonia. ( ) that respiration may have been so limited in extent that the lungs may sink, owing to large portions of lung tissue remaining unexpanded (_atelectasis_). ( ) putrefaction may cause the lungs to float when respiration has not taken place. ( ) the lungs may have been inflated artificially. few of these objections apply, however, when the hydrostatic test, modified by pressure, is employed. to take these objections in detail, it may be stated: ( ) if the lungs sink from disease, the question of live birth is answered. ( ) this objection is too refined for practical use. the lungs sink, there is an absence of any of the signs of suffocation, and the matter ends. the examiner has only to describe the conditions which he finds, and is not required to indulge in conjectures as to the amount of respiration which may or may not have taken place. ( ) gas due to putrefaction collects under the pleural membrane, and can be expelled by pressure, and is not found in the air cells. the lungs decompose late, hence in a fresh body putrefaction of the lungs is absent; in a putrefied child, if the lungs sink, it must have been stillborn. the so-called _emphysema pulmonum neonatorum_ is simply incipient putrefaction. the lung test simply shows that the child has breathed, but affords no proof that the child has been born alive. the child may have breathed as soon as its head protruded, the rest of the body being in the maternal passages. the child is not born alive until it has been completely expelled, although it is not necessary that the umbilical cord should have been cut. in addition to these tests, live birth may be suspected from the following conditions: the _stomach_ may contain milk or food, recognized by the microscope and by trommer's test for sugar; the _large intestines_ in stillborn children are filled with meconium, in those born alive they are usually empty; the _bladder_ is generally emptied soon after birth; the _skin_ is in a condition of exfoliation soon after birth. the _organs of circulation_ undergo the following changes after birth, and the extent to which these changes have advanced will give an idea of how long the child has lived: the _ductus arteriosus_ begins to contract within a few seconds of birth; at the end of a week it is about the size of a crow quill, and about the tenth day is obliterated. the _umbilical arteries and vein_: the arteries are remarkably diminished in calibre at the end of twenty-four hours, and obliterated almost up to the iliacs in three days; the umbilical vein and the ductus venosus are generally completely contracted by the fifth day. the _foramen ovale_ becomes obliterated at extremely variable periods, and may continue open even in the adult. importance of late has been attached to the _stomach-bowel test_. if the stomach and duodenum contain air, and consequently float in water, the chances are that the child did not die immediately after birth; this is known as breslau's second life test, and the lower the air in the intestinal canal, the greater is the probability that the child survived birth. the umbilical cord in a new-born child is fresh, firm, round, and bluish in colour; blood is contained in its vessels. the cord may be ruptured by the child falling from the maternal parts in a precipitate labour, and the ruptured parts present ragged ends. it is seldom that a child bleeds to death from an untied or cut umbilical cord, and the chances in a torn cord are still more remote. the changes in the cord are as follows: first it shrinks from the ligature towards the navel; this change may begin early, and is rarely delayed beyond thirty hours; the cord becomes flabby, and there is a distinct inflammatory circle round its insertion. the next change is that of desiccation or mummification; the cord becomes reddish-brown, then flattened and shrivelled, then translucent and of the colour of parchment, and falls off about the fifth day. the third stage, that of cicatrization, then ensues about the tenth to the twelfth day. the bright red rim round the insertion of the cord, with inflammatory thickening and slight purulent secretion, may be considered as evidence of live birth, and the stage at which the separation of the cord by ulcerative process has arrived will point to the probable duration of time the child has existed after birth. there are many fallacies in the application of any of these tests, and the whole subject bristles with difficulties. the medical witness would do well to exhibit a cautious reserve, for if the child dies immediately after birth it is almost impossible to prove that it was born alive. xxviii.--cause of death in the foetus the death of the foetus may be due to--( ) immaturity or intra-uterine malnutrition, or simply from deficient vitality; ( ) complications occurring during or immediately after birth, which may either be unavoidable or inherent in the process of parturition, or may be induced with criminal intent. in the latter category come such accidents as the pressure of tumours in the pelvic passages, or disease of the bones in the mother, or pressure on the cord from malposition of the child during labour, asphyxiation from the funis being twisted tightly round the neck or limbs, or from injuries due to falls on the floor in sudden labours. where the death of the foetus has been induced with criminal intent, it may be due to punctured wounds of the fontanelles, orbits, heart, or spinal marrow; dislocation of the neck; separation of the head from the body; fracture of the bones of the head and face; strangulation; suffocation; drowning in the closet pan or privy, or from being thrown into water. under the head of infanticide by _commission_, we have injuries of all kinds; under infanticide by _omission_, neglecting to tie the cord, allowing it to be suffocated by discharges in the bed, neglect to provide food, clothes, and warmth, for the new-born child. xxix.--duration of pregnancy the natural period of gestation is considered as forty weeks, ten lunar months, or days. a medical witness would have to admit the possibility of gestation being prolonged to days, and if this time were not very materially exceeded it would be well to give the woman the benefit of the doubt. it may be mentioned that days is the extreme limit fixed by the french and scottish law. no fixed period is assigned in english or american law to the duration of pregnancy, though it is allowed that utero-gestation may be greatly prolonged. in a recent case decided, the lord chancellor accepted a case where it was alleged pregnancy had extended to days. a child only five months old may live, for a short time at all events. there is considerable difficulty in many cases in fixing the date of conception. the data from which it is calculated are the following: ( ) _peculiar sensations attending conception_, which are not sufficiently defined to be recognized by those conceiving for the first time. ( ) _cessation of the catamenia._ other causes may, however, cause this; and, on the other hand, a woman may menstruate during the whole period of her pregnancy. this datum also gives a variable period, and may involve an error of several days or a month, for the menses may be arrested by cold, etc., at one monthly period, and the woman become pregnant before the next. ( ) _the period of quickening._ this, when perceived (which is not always the case), also occurs at variable periods from the tenth to the twenty-sixth week. ( ) _a single coitus._ this does not, however, correspond to the time of fertilization. several days may elapse before the spermatozoa meet with an ovum and fertilize it. in scotland a child born six months after marriage is legitimate, which is allowing an ample margin. xxx.--viability of children a child may be born alive, but may not be viable, by which is meant that it is not endowed with a capacity of maintaining its life. speaking generally, days represents the lowest limit at which a child is viable, but prolonged survival under these circumstances is the exception. many cases, however, have been recorded in which children born at six months have been reared. the signs of immaturity and maturity may be thus tabulated: immaturity. maturity. centre of body high; head strong movements and cries as soon disproportionate in size; membrana as born; body clear, red colour, pupillaris present; testicles coated with sebaceous matter; mouth, undescended; deep red colour of nostrils, eyelids, and ears, open; parts of generation; intense red skull somewhat firm, and fontanelles colour, mottled appearance, and not far apart; hair, eyebrows, and downy covering, of skin; nails not nails, perfectly developed; formed; feeble movements; testicles descended; free discharge inability to suck; necessity for of urine and meconium; power of artificial heat; almost unbroken suction, indicated by seizure on the sleep; rare and imperfect nipple or a finger placed in the discharges of urine and meconium; mouth. closed state of mouth, eyelids, and nostrils. xxxi.--legitimacy a child born in wedlock is presumed to have the mother's husband for its father. this may, however, be open to question upon the following grounds: absence or death of the reputed father; impotence or disease in the husband preventing matrimonial intercourse; premature delivery in a newly-married woman; want of access; and the marriage of the woman again immediately on the death of her husband. in the last case, where either husband might have been the father, the child at the age of twenty-one is at liberty to select its father from the possible pair. a child born of parents before marriage is in scotland rendered legitimate by their subsequent marriage, but in england the offspring remains illegitimate whether the parents marry or not after its birth. the offspring of voidable or invalid marriages may be made legitimate by application to the courts. there is a difference between being legitimate and lawfully begotten. a child born in wedlock is legitimate, but if the parents were married only a week previously it could not have been lawfully begotten. the acts and rulings relating to marriage and legitimacy are extremely complicated. it is not putting it too strongly to say that a very large number of people in this country who believe themselves to be legally married are not married at all, and that thousands of children who have not the slightest doubt as to their legitimacy are in the eyes of the law bastards. xxxii.--superfoetation by superfoetation is meant the conception, by a woman already pregnant, of a second embryo, resulting in the birth of two children at the same time, differing much in their degree of maturity, or in two separate births, with a considerable interval between. the possibility of the occurrence of superfoetation has been doubted, but there are well-authenticated cases which countenance the theory of a double conception. it has been shown that the os uteri is not closed, as was once supposed, immediately _on conception_. should an ovum escape into the uterus, it may become impregnated a month or so after a previous conception. the most probable explanation is that the case has been one of twins, one being born prematurely; or, on the other hand, the uterus may have been double, and conception may have taken place in one cornu at a later period than in the other cornu. xxxiii.--inheritance in order to inherit, the child must be born alive, must be born during the lifetime of the mother, and must be born capable of inheriting--that is to say, monsters are incapable of inheriting. there is a mode of inheritance called 'tenancy by courtesy.' when a man marries a woman possessed of an estate or inheritance, and has, by her, issue born alive in her lifetime capable of inheriting her estate, in this case he shall, on the death of his wife, hold the lands for his life as tenant by the courtesy of england. the meaning of the words 'born alive' in this instance is not the same as in cases of infanticide. in civil law any motion of the child's body, however slight, or the fact of it having been heard to cry by witnesses, is held to be sufficient proof of the child having been born alive. it may die immediately afterwards, and it is not necessary that the child be viable. xxxiv.--impotence and sterility in the male, impotence may arise from physical or mental causes. the physical causes may be--too great or too tender an age; malformation of the genital organs; _crypsorchides_, defect or disease in the testicles; constitutional disease (diabetes, neurasthenia, etc.); or debility from acute disease, as mumps. masturbation, and early and excessive sexual indulgence, are also causes. the mental causes include--passion, timidity, apprehension, aversion, and disgust. the case will be remembered of the man who was impotent unless the lady were attired in a black silk dress and high-heeled french kid boots. if a man is impotent when he marries, the marriage may be set aside on the ground that it had never been consummated. the law requires that the impotency should have existed _ab initio_--that is, before marriage--and should be of a permanent or incurable nature; marriage, as far as the law goes, being regarded as a contract in which it is presupposed that both the contracting parties are capable of fulfilling all the objects of marriage. in the case of the earl of essex the defendant admitted the charge as regards the countess, but pleaded that he was not impotent with others, as many of her waiting-maids could testify. when a man becomes impotent _after_ marriage, his wife must accept the situation, and has no redress. a man may be _sterile_ without being impotent, but the law will not take cognizance of that. the wife may be practically impotent, but the law will not assist the husband. he must continue to do his best under difficult circumstances. in former times in case of doubt a husband was permitted to demonstrate his competency in open court, but this custom is no longer regarded with favour by the judges. the removal of the testicles does not of necessity render a man impotent, although it deprives him of his procreative power. eunuchs are capable of affording illicit pleasure, whilst the male sopranos, or _castrati_, are often utilized for that purpose. in the female, impotence may be caused by the narrowness of the vagina, adhesion of the vulva, absence of vagina, imperforate hymen, and tumours of the vagina. sterility in women may occur from the above-named causes of impotence, together with absence of the uterus and ovaries, or from great debility, syphilis, constant amenorrhoea, dysmenorrhoea, or menorrhagia. xxxv.--rape rape is the carnal knowledge of a woman by force and against her will. the resistance of the woman _must be_ to the utmost of her power, but if she yield through fear or duress it is still rape. the woman is a competent witness, but her statements may be impugned on the ground of her previous bad character, and evidence may be called to substantiate the charge. the perpetrator must be above the age of fourteen years. the definition of rape which we have given is not altogether satisfactory. take, for example, the case of a woman who goes to bed expecting her husband to return at a certain hour. the lodger, let us say, takes advantage of this fact, and, getting into bed, has connection with her, she not resisting, assuming all the while that it is her husband. this is rape, but it is not 'by force,' and it is not 'against her will,' but it is 'without her consent,' as she has not been fully informed as to all the circumstances of the case. in all cases of rape in which there is no actual resistance or objection, consent may be assumed. it is not essential that the woman should state in so many words that she does not object. the force used may be moral and not physical--_e.g._, threats, fear, horror, syncope. by and vict., c. , the carnal knowledge of a girl under thirteen is technically rape. the consent of the girl makes no difference, since she is not of an age to become a consenting party. an attempt at carnal knowledge of a girl under thirteen is a misdemeanour. her consent makes no difference, and even the solicitation of the act on the part of the child will not exonerate the accused. intercourse with a girl between thirteen and sixteen, even with her consent, is a misdemeanour. this act is a favourite with the blackmailer. the child is sent out to solicit, dressed like a woman, but appears in the witness-box in a much more juvenile costume. to constitute rape there must be _penetration_, but this may be of the slightest. there may be a sufficient degree of penetration to constitute rape without rupturing the hymen. proof of actual emission is now unnecessary. the subject of carnal knowledge (c.k.) or its attempt may be summed up as follows: under thirteen c.k. felony. under thirteen attempt misdemeanour. consent no defence. from thirteen to sixteen c.k. misdemeanour. from thirteen to sixteen attempt misdemeanour. consent and even solicitation no defence. reasonable cause to believe the girl over sixteen is a good defence. charge must be brought within three months. over sixteen c.k. with consent nil. subject to civil action for loss of girl's services by father. idiot or imbecile c.k. with violence rape. idiot or imbecile c.k. without violence misdemeanour. personation of husband rape. tacit consent no defence, for obtained by fraud. married woman c.k. with consent adultery. mother, sister, daughter, c.k. consent immaterial; incest. grand-daughter born in wedlock or not females indecent assaults misdemeanour. it is a misdemeanour to give to a woman any drug so as to stupefy her, and so enable any person to have unlawful connection with her. false charges of rape are very often made. the motive may be to extort blackmail, revenge, or mere delusion. on examining such cases bruises are seldom found, but scratches which the woman has made on the front of her body may be discovered, and the local injuries to the generative organs are slight, if present at all. _physical signs._--in the adult the hymen may be ruptured, the fourchette lacerated, and blood found on the parts, together with scratches and other marks and signs of a struggle. in the child there may be no hæmorrhage, but there will be indications of bruising on the external organs, with probably considerable laceration of the hymen, the laceration in some cases extending into the rectum. severe hæmorrhage, and even death, may follow the rape of a young child. the patient will have difficulty in walking, and in passing water and fæces. after some hours the parts are very tender and swollen, and a sticky greenish-yellow discharge is present. these signs last longer in children than in adults; but as a rule--in the adult, at least--all signs of rape disappear in three or four days. young and delicate children may suffer from a vaginal discharge, with swelling of the external genitals, simulating an attempt at rape. infantile leucorrhoea is common, and many innocent people have been exposed to danger from false charges of rape on children, instituted as a means of levying blackmail. a knowledge of these facts suggests the necessity of giving a guarded opinion when children are brought for examination in suspected cases. pregnancy may follow rape. _seminal stains_ render the clothing stiff and greyish-yellow in colour, with translucent edges. on being moistened they give the characteristic seminal odour. semen may be found on the linen of the woman and man, and will be recognized under the microscope by the presence in it of spermatozoa, minute filamentary bodies with a pear-shaped head; but it must not be forgotten that the non-detection of spermatozoa is no proof of absence of sexual intercourse, for these bodies are not always present in the semen of even healthy adult young men. spermatozoa must not be mistaken for the _trichomonas vaginæ_ found in the vaginæ of some women. the latter have cilia surrounding the head, which is globular. _florence's micro-chemical test for spermatic fluid._--if a drop of the fluid obtained by wetting a supposed spermatic stain be mixed with a drop of the following solution (ki, parts . ; pure iodine, . ; distilled water, ) in a watch-glass, brownish-red pointed crystals resembling hæmin crystals are obtained. _barberio's test._--mix a drop of the spermatic stain with a drop of a saturated solution of picric acid, when needle-shaped yellow rhombic crystals are formed. _gonorrhoeal stains._--a cover-glass preparation stained with methylene blue reveals the gonococci lying in pairs within the leucocytes. xxxvi.--unnatural offences trials for =sodomy= and =bestiality= are common at the assizes, but, as they are rarely reported, they fail to attract attention. sodomy is a crime both in the active and passive agent, unless the latter is a non-consenting party. the evidence of either associated may be received as against his colleague. if the crime is committed on a boy under fourteen, it is a felony in the active agent only. as in cases of rape, emission is not essential, and penetration, however slight, answers all practical purposes. there can be no doubt that in the majority of these cases there exists a congenitally abnormal condition of the sexual instinct, these individuals from their childhood manifesting a perverted sexual instinct. the man is physically a man, but psychically a woman, and _vice versâ_. the tendency nowadays is not to charge these people with the more serious offence, but to deal with them under section of the criminal law amendment act, ( and vict., c. ). this section, which is sufficiently comprehensive, runs as follows: 'any male person who in public or private commits or is a party to the commission, or attempts to procure the commission by any male person, of any act of gross indecency with another male person, shall be guilty of a misdemeanour.' the penalty is imprisonment for two years, with or without hard labour. it is provided by section of the same act that a boy under sixteen may be whipped. =incest.=--this crime is dealt with under the punishment of incest act, ( edward vii., c. ). carnal knowledge with mother, sister, daughter, or grand-daughter, is a misdemeanour, provided the relationship is known. it also applies to the half-brother and half-sister. it is equally an offence whether the relationship can or cannot be traced through lawful wedlock. consent is no defence. a woman may be charged under the act if she, being above the age of sixteen, with consent permits her grandfather, father, brother, or son, to have carnal knowledge of her. xxxvii.--blackmailing there are in london and every large city scores of men and women who live by blackmailing or chantage. there are many different forms of this industry. there is the man who knows something about your past life, which he threatens to reveal to your friends or colleagues unless you buy him off. there is the breach-of-promise blackmailer, and there is the female patient, who threatens to charge you with improper conduct or indecent assault. medical men from their position are often selected as victims. the introduction of corridor carriages on many of our railways has done much to stamp out one particular form of blackmailing, but public urinals are still a source of danger. it is the worst possible policy to temporize with a blackmailer. if you give him a single penny, you are his for life. it is as well to remember that it is just as criminal to attempt to extract money from a guilty as from an innocent person. it is of no use attempting to deal with these cases single-handed. you must not only deny the allegation, but 'spurn the allegator.' put the matter into the hands of a good sharp criminal solicitor, and instruct him to rid you of the nuisance by taking criminal proceedings. xxxviii.--marriage and divorce marriage may be accomplished in many ways: ( ) by the publication of banns; ( ) by an ordinary licence; ( ) by a special licence; ( ) by the superintendent-registrar's licence; ( ) by a special licence granted by the archbishop of canterbury in consideration of the payment of the sum of £ . then, for persons having a domicile in scotland, there is the marriage by repute. the consent of the parties, which is the essence of the contract, may be expressed before witnesses, and it is not requisite that a clergyman should assist, but it is essential that the expressions of consent must be for a matrimonial intent. 'habit and repute' constitute good evidence, but the repute must be the general, constant, and unvarying belief of friends and neighbours. the cohabitation must be in scotland. any irregularity in the marriage ceremony or the non-observance of any formality will not invalidate the marriage, unless it were known to both the contracting parties. if a man were married in a wrong name the contract would still be valid if the wife were unacquainted with the deception at the time. if the person who officiated were a bogus clergyman, the marriage would hold good if the contracting parties supposed him to be a properly ordained priest. in a case in which a marriage was solemnized in a building near the church at a time when the church was undergoing repairs, and where during such alterations divine service had been performed, it was held that the ceremony was good. to all intents and purposes marriage comes under the 'law of contract' (see anson, w.r., bart.), and the law looks to the _intention_ rather than to the actual details. all marriages between persons within the prohibited degrees of consanguinity or affinity are null and void. this prohibition extends both to the illegitimate as well as the legitimate children of the late wife's or husband's parents. a marriage with a deceased wife's sister is now legal in great britain and the colonies, and is recognized in most foreign countries. a common device with people within the prohibited degrees is to get married abroad, but such marriage is strictly speaking inoperative, and the children of such union are illegitimate. practically, however, it is a matter of no importance, for when people live together and say they are married, they are accepted at their own estimate. a man can obtain a divorce from his wife if he can prove that she has been guilty of adultery since her marriage. this may be established by inference. obviously, it is difficult in the majority of cases to establish by ocular demonstration that adultery has been committed. but given evidence of familiarity and affection with opportunity and suspicious conduct, a jury will commonly infer it. a woman cannot obtain a divorce from her husband for adultery alone. she must prove adultery plus cruelty, or adultery plus desertion without reasonable cause. failing this, she may be able to prove either bigamy or incestuous adultery. legal cruelty is a very comprehensive term, and does not of necessity mean physical violence. if the husband as the result of his infidelity were to give his wife a contagious disease, that would constitute cruelty. taking a more extreme case, if a husband were to have connection in her house with his wife's maid, that would probably be held to constitute cruelty, as it would tend to lower her in the eyes of her servants. a wife can obtain a judicial separation if she can prove ( ) adultery, ( ) cruelty, or ( ) desertion without reasonable cause for two years. if a husband is away on his business, as, for example, the case of an officer ordered abroad, that is not desertion. for a woman to get a judicial separation, it is sufficient if she can prove one variety of matrimonial offence, but for a divorce she requires more than one. the jury may find that mrs. a. has committed adultery with mr. b., but that mr. b. has not committed adultery with mrs. a. the explanation is, that a wife's confession is evidence against herself, but not against another person. you can confess your own sins, but not another's. the divorce law of scotland differs materially from that of england. in scotland there is no decree nisi, no decree absolute, and no intervention by the king's proctor. instead there is a single and final judgment, and when a decree of divorce is pronounced the successful litigant at once succeeds to all rights, legal and conventional, that would have come to him or her on the death of the losing party. if the husband is the offender, the wife in such circumstances may claim her right to one-third of his real estate; and if there are children, to one-third of his personal property, and to one-half if there are none. =voidable marriages.=--if a man and woman go through the marriage ceremony, such a contract is null and void under the following circumstances: ( ) where bigamy has been committed; ( ) if one of the parties were insane at the time of marriage; ( ) where the plaintiff is under sixteen years of age; ( ) when the marriage has not been consummated or followed by cohabitation; ( ) when one of the parties was incapable of performing the marital act (impotent, and such not known by the other at the time); ( ) when drunkenness had been induced so as to obtain consent; ( ) concealment of pregnancy at the time of marriage. xxxix.--feigned diseases malingering in its various forms is by no means uncommon, and by many is regarded as a disease in itself. it is necessary, however, to distinguish between those cases in which it is feigned for some definite purpose--for example, to escape punishment or avoid public service--and those in which there is adequate motive, and the patient shams simply with the view of exciting sympathy, or from the mere delight of giving trouble. it is not uncommon for individuals summoned on a jury, or to give evidence in the law courts, to apply to their doctor for a certificate, assigning as a cause of exemption neuralgia, or some similar complaint unattended with objective symptoms. in such cases it is well to remind the patient that in most courts such certificates are received with suspicion, and are often rejected, and that the personal attendance of the medical man is required to endorse his certificate on oath. malingering has become much more common since the national health insurance act has been passed. the possibility of obtaining a fair sum each week without the necessity of working for it induces many persons either to feign disease or to make recovery from actual disease or accident much more tedious than it ought really to be. the feasibility of successfully malingering is greatly enhanced by the possession of some chronic organic disease. an old mitral regurgitant murmur is useful for this purpose. it is not flattering to one's vanity to overlook a case of malingering, but should this occur little harm is done. it is a much more serious matter to accuse a person of malingering when in reality he may be suffering from an organic disease. here are some of the diseases which are most frequently feigned: =nervous diseases=, as headache, vertigo, paralysis of limbs, vomiting, sciatica, or incontinence or suppression of urine, spitting of blood; others, again, simulate hysteria, epilepsy, or insanity. on the other hand, the malingerer may actually produce injuries on his person either to excite commiseration or to escape from work. thus, the beggar produces ulcers on his legs by binding a penny-piece tightly on for some days; the hospital patient, in order to escape discharge, produces factitious skin diseases by the application of irritants or caustics. it is much more difficult to decide whether certain symptoms are due to a real disease which is present, or whether they are merely exaggerations of slight symptoms or simulations of past ones. the miner, after an injury to his back, recovers very slowly, if at all. he is suffering from 'traumatic neurasthenia'--a condition only too often simulated, and a disease very difficult to diagnose accurately. the miner takes advantage of our ignorance, and continues to draw his compensation. a workman during his work receives a fracture; instead of being able to resume work in six weeks, he asserts that the pain and stiffness prevent him, and this disability may persist for months. such cases as these frequently come before the courts when the employer has discontinued to pay the weekly compensation for the injury. medical men are called to give evidence for or against the injured workman. =epilepsy= is often simulated. the foaming at the mouth is produced by a piece of soap between the gums and the cheek. the true epileptic, especially if he suspects that a fit is imminent, takes his walks abroad in some secluded spot, whilst the impostor selects a crowded locality for his exertions. the epileptic often injures himself in falling, his imitator never; one bites his tongue, but the other carefully refrains from doing so. the skin of an epileptic during an attack is cold and pallid, but that of the exhibitor is covered with sweat as the result of his exertions. in epilepsy the urine and fæces are passed involuntarily, but his colleague rarely considers it necessary to carry his deception to this extent. in true epilepsy the eyes are partly open, with the eyeballs rolling and distorted, whilst the pupils are dilated and do not contract to light; the impostor keeps his eyes closed, and he cannot prevent the iris from contracting when a bicycle-lamp is flashed across his face. a useful test is to give the impostor a pinch of snuff, which promptly brings the entertainment to an end. =lumbago= is often feigned, and the imposture should be suspected when there is a motive, and when physical signs, such as nodes and tender spots, are absent. a simple test is to inadvertently drop a shilling in front of him, when he will promptly stoop and pick it up. the same principles apply to spurious sciatica. =hæmorrhages= purporting to come from the lungs, stomach, or bowels, rarely present much difficulty. the microscope is of use in all cases of bleeding. possibly the gums or the inside of the cheeks may have been scratched or abraded with a pin. =skin diseases= are excited artificially, especially those which may be produced by mechanical and chemical irritants. the most commonly employed are vinegar, acetic acid, carbolic acid, nitric acid, and carbonate of sodium; but tramps frequently use sorrel and various species of ranunculus. the lesions simulated are usually inflammatory in character, such as erythema, vesicular and bullous eruptions, and ulceration of the skin. they may be complicated by the presence of pediculi and other animal and vegetable parasites. chromidrosis of the lower eyelids in young women often owes its origin to a box of paints. factitious skin diseases are seen most commonly on the face and extremities, especially on the left side--in other words, on the most accessible parts of the body. feigned menstruation, pregnancy, abortion, and recent delivery are common, and should give rise to no difficulty. the same may be said of feigned insanity, aphonia, deaf-mutism, and loss of memory. the following hints may be useful to a medical man when called to a supposed case of malingering: do not be satisfied with one visit, but go again and unexpectedly; see that the patient is watched between the visits; make an objective examination, compare the indications with the statements of the patient, noting especially any discrepancies between his account of his symptoms and the real symptoms of disease; ask questions the reverse of the patient's statements, or take them for granted, and he will often be found to contradict himself; have all dressings and bandages removed; suggest, in the hearing of the patient, some heroic methods of treatment--the actual cautery, or severe surgical operation, for example; finally, chloroform will be found of great use in the detection of many sham diseases. xl.--mental unsoundness the presumption in law is in favour of a person's sanity, even though he may be deaf, dumb, or blind. the terms 'insanity,' 'lunacy,' 'unsoundness of mind,' 'mental derangement,' 'madness,' and 'mental alienation or aberration,' are indifferently applied to those states of disordered mind in which the person loses the power of regulating his actions and conduct according to the ordinary rules of society. the reasoning power is lost or perverted, and he is no longer fitted to discharge those duties which his social position demands. in some cases of insanity, as in confirmed idiocy, there is no evidence of the exercise of the intellectual faculties. it is probable that no standard of sanity as fixed by nature can be said to exist. the medical witness should decline to commit himself to any definition of insanity. there is no practical advantage in attempting to classify the different forms of insanity. according to english law, madness absolves from all guilt, but in order to excuse from punishment on this ground it must be proved that the individual was not capable of distinguishing right from wrong in relation to the particular act of which he is accused, and that he did not know at the time of committing the crime that the offence was against the laws of _god_ and _nature_. lunatics are competent witnesses in relation to testimony, as in relation to crime, if they understand the nature of an oath and the character of the proceedings in which they are engaged. the judge, as in the case of children, examines the lunatic tendered as a witness as to his knowledge of the nature and obligation of an oath, and, if satisfied, he allows him to be sworn. a person, if suffering from such a state of mental unsoundness as to be unable to take care of his property, may be placed under the care of the court of chancery. the court then administers his property, and otherwise allows him entire freedom of action. with regard to the care of lunatics, no person is allowed to receive more than one lunatic into his house unless such house is licensed and the proper certificates have been signed. one patient may be taken without the house being licensed, but the usual certificates must in all cases be signed, and the lunacy commissioners communicated with. if a person receives another not of unsound mind into his house, and such person becomes subsequently insane, the person so keeping him renders himself liable to heavy penalties, unless the legal certificates are at once procured and the commissioners of lunacy communicated with. at common law it appears that a lunatic cannot be placed in an asylum unless dangerous to himself or to others, but under the lunacy acts the placing of a madman in an asylum is considered as a part of the treatment with a view to the cure of the patient. xli.--idiocy, imbecility, cretinism =idiocy= is not a disease, but a congenital condition in which the intellectual faculties are either never manifested or have not been sufficiently developed to enable the idiot to acquire an amount of knowledge equal to that acquired by other persons of his own age and in similar circumstances with himself. idiots, as a rule, are deformed in body as well as deficient in mind. their heads are generally small and badly-shaped, and their features ill-formed and distorted. the teeth are few in number and very irregular. the hard palate has a very deep arch, or may even be cleft. the complexion is sallow and unhealthy, the limbs imperfectly developed, and the gait is awkward, shambling, and unsteady. in his legal relations an absolute idiot is civilly disabled and irresponsible, but in regard to crime, or as a witness, see remarks made above. =imbecility= is a form of mental defect not usually congenital, but commencing in infancy or in early life. the line of demarcation between the imbecile and the idiot may be found in the possession by the former of the faculty of speech, in distinction from the mere parrot-like utterance of a few words which can be taught the idiot. imbecility may be intellectual, moral, or general. questions frequently arise as to their responsibility for actions done by them, or as to their ability to manage their own affairs. =cretinism= is a form of amentia, which is endemic in certain districts, especially in some of the valleys of switzerland, savoy, and france. the malady is not congenital, but its symptoms usually appear within a few months of birth. the characteristics of this form of idiocy are an enlarged thyroid gland constituting a goitre or bronchocele, a high-arched palate, dwarfed stature, squinting eyes, sallow complexion, small legs, conical head, large mouth, and indistinct speech. =feeble-minded.=--these are persons who are capable of earning a living under favourable circumstances, but are incapable, from mental defect which has existed from birth or from an early age, of (a) competing on equal terms with their normal fellows, or (b) of managing themselves and their affairs with ordinary prudence. feeble-mindedness may affect the moral nature only, rendering the person selfish, untruthful, obscene, or unemployable. the act of controls feeble-minded children; many such become paupers, criminals, prostitutes, etc. =mental deficiency and lunacy act, .=--those included under this act are idiots, imbeciles, feeble-minded persons, and moral imbeciles. the parents or guardians of such children between the ages of five and sixteen years must provide for them education and proper care. if they are unable to do so, the school boards or parish councils must do so. xlii.--dementia: acute, chronic, senile, and paralytic in dementia the mental aberration does not occur until the mind has become fully developed, thus differing from amentia, which is congenital or comes on very early in life. =acute dementia.=--this is a condition of profound melancholy or stupor, which arises from sudden mental shock, the mind being, as it were, arrested and fixed in abstraction on the event. =chronic dementia= is generally caused by the gradual action on the mind of grief or anxiety, by severe pain, mania, apoplexy, paralysis, or repeated attacks of epilepsy. =senile dementia= is a form which is incidental to aged persons, and commences gradually with such symptoms as loss of memory for recent events, dulness of perception, and inability to fix the attention. later on the reasoning powers begin to fail, and finally, memory, reason, and power of attention, are quite lost, the muscular power and force remaining intact. in the last stage there is simply bare physical existence. =general paralysis of the insane, paralytic dementia.=--this is a most interesting form of dementia. it is closely allied to, if not identical with, locomotor ataxy. its most prominent and characteristic symptom consists in delusions of great power, exalted position, and unlimited wealth--megalomania. the exaltation is universal, and the patient may maintain at one and the same time that he is running a theatrical company, that he is the prince of wales, and that he is the almighty. moral perversion is a common symptom, and the patient is often guilty of criminal assaults, indecent exposures, bigamous marriages, and the like. it is accompanied with progressive bodily and mental decay. women are comparatively rarely affected by it, and it generally commences in men about middle age, and its duration is from a few months to three years. it is commonly parasyphilitic in origin. paralytic symptoms first appear in the tongue, lips, and face; the speech becomes thick and hesitating. the paralytic symptoms gradually go on increasing, the sphincters refuse to act, and death may occur from suffocation and choking. sometimes, during the earlier stages especially, there may be maniacal paroxysms or epileptic fits. the delusions remain the same throughout, the patient always expresses himself as being happy, and his last words will probably have reference to money and other absurd delusions. when a person of hitherto blameless life is charged with an act of indecency, he should be examined for g.p.i. the condition of his prostate should also be investigated. he may be suffering from either mental or physical disease, or both (see p. ). xliii.--mania under the term 'mania' are included all those forms of mental unsoundness in which there is undue excitement. it is divided into general, intellectual, and moral, and each of the two latter classes again into general and partial. =general mania= affects the intellect as well as the passions and emotions. mania is usually preceded by an incubative period in which the patient's general health is affected. the duration of this period may vary from a few days to fifteen or twenty years. when the disease is established, the patient has paroxysms of violence directed against himself as well as others. he tears his clothes to pieces, either abstains from food and drink or eats voraciously, and sustains immense muscular exertion without apparent fatigue. the face becomes flushed, the eye wild and sparkling; there is pain, weight, and giddiness in the head, with restlessness. =general intellectual mania=, attacking the intellect alone, is rare; but some one emotion or passion, as pride, vanity, or love of gain, may obtain ascendancy, and fill the mind with intellectual delusions. a _delusion_ may be defined as a perversion of the judgment, a chimerical thought; an _illusion_, an incorrect impression of the senses, counterfeit appearances; hence we speak of a delusion of the mind, an illusion of the senses. lawyers lay great stress on the presence of delusions as indicative of insanity. an _hallucination_ is a sensation which is supposed by the patient to be produced by external impressions, although no material object acts upon his senses at the time. =partial intellectual mania=, or =monomania=, also called =melancholia=, is a form of the disease in which the patient becomes possessed of some single notion, contradictory alike to common-sense and his own experience. =general moral mania.=--this is a morbid perversion of the natural feelings, affections, inclinations, temper, habits, moral dispositions, and natural impulses, without any remarkable disorder or defect of the intellect, or knowing and reasoning faculties, and particularly without any insane illusion or hallucination. it is often difficult to distinguish this form of mania from the moral depravity which we associate with the criminal classes. =partial moral mania--paranoia--delusional insanity.=--in this form one or two only of the moral powers are perverted. delusions are always present, and very frequently are those of persecution. the patient's conduct is dominated by his delusion; thus murder and suicide may be committed. there are several forms: _kleptomania_, a propensity to theft; common in women in easy circumstances. _dipsomania_, or _oinomania_, an insatiable desire for drink. _morphinomania_, a craving for morphine or its preparations. _erotomania_, or amorous madness. when occurring in women this is also called _nymphomania_, and in men _satyriasis_. it consists in an uncontrollable desire for sexual intercourse. _pyromania_, an insane impulse to set fire to everything. _homicidal mania_, a propensity to murder. _suicidal mania_, a propensity to self-destruction. some consider suicide as always a manifestation of insanity. =insanity of pregnancy.=--this may show itself after the third month of pregnancy in the form of melancholia. it is not recovered from until after delivery. =puerperal mania.=--this form of mania attacks women soon after childbirth. there is in many cases a strong homicidal tendency against the child. =insanity of lactation= comes on four to eight months after parturition, either as mania or melancholia. the mother may repeatedly attempt suicide. =mania with lucid intervals.=--in many cases mania is intermittent or recurrent in its nature, the patient in the interval being in his right mind. the question of the presence or absence of a lucid interval frequently occurs where attempts are made to set aside wills made by persons having property. in these cases the law, from the reasonableness of the provisions of the will, may assume the existence of the lucid interval. a will made during a lucid interval is valid. when an attempt is made to set aside the provisions of a will on the ground of insanity in a person not previously judged insane, the plaintiff must show that the testator was mad; when the provisions of the will of a lunatic are attempted to be upheld, the plaintiff must show that the will was made during a lucid interval. a testator is capable of making a valid will when he has ( ) a knowledge of his property and of his kindred; ( ) memory sufficient to recognize his proper relations to those about him; ( ) freedom from delusions affecting his property and his friends; and ( ) sufficient physical and mental power to resist undue influence. the fact of a man being subject to delusions may not affect his testamentary capacity. he may believe himself to be a tea-kettle, and yet be sufficiently sound mentally to make a valid will. =undue influence.=--persons of weak mind or those suffering from senile dementia are often said to have been unduly influenced in making their wills, and subsequently their dispositions are disputed in court. before witnessing the will made by such a person, the medical man should satisfy himself that the testator is of a 'sound disposing mind.' this he will do by questioning, and his knowledge of the home-life of the patient will either confirm or set aside the idea of influence. a person who is aphasic may be competent to make a will. he may not be able to speak, but may understand what is said to him, and may be able to indicate his wishes by nods and shakes of the head. ask him if he wishes to make a will, then inquire if he has £ , to leave, then if he has £ , and in this way arrive approximately at the sum. then ask him if he wishes to leave it all to one person. if he nods assent, ask if it be to his wife or some other likely person. if he wishes to divide it, ascertain his intention by definite questions, and, having ascertained his views, commit them to writing, read the document over to him, and ask if it expresses his intentions. that being settled, a mark which he acknowledges in the presence of two witnesses, preferably men of standing, will constitute a valid document. in certain forms of neurasthenia, the 'phobias' are common, but must not be regarded as evidence of insanity. 'agoraphobia' is the fear of crossing an open space, 'batophobia' is the fear that high things will fall, 'siderophobia' is the fear of thunder and lightning, 'pathophobia' is the fear of disease, whilst 'pantophobia' is the fear of everything and everybody. =epilepsy in relation to insanity.=--the subjects of this disease are often subject to sudden fits of uncontrollable passion; their conduct is sometimes brutal, ferocious, and often very immoral. as the fits increase in number, the intellect deteriorates and chronic dementia or delusional insanity may supervene. ( ) before a fit the patient may develop paroxysms of rage with brutal impulses (_preparoxysmal insanity_), and may commit crimes such as rape or murder. ( ) instead of the usual epileptic fit, the patient may have a violent maniacal attack (_masked epilepsy_, _epileptic equivalent_, _psychic form of epilepsy_). ( ) after the fit the patient may perform various automatic actions (_post-epileptic automatism_) of which he has no subsequent recollection. thus the patient may urinate or undress in a public place, and may be arrested for indecent exposure. epileptics who suffer from both petit and grand mal attacks are specially liable to maniacal attacks. such insanity differs from ordinary insanity in its sudden onset, intensity of symptoms, short duration and abrupt ending. to establish a plea of epilepsy in cases of crime, one must show that the individual really did suffer from true epilepsy, and that the crime was committed at a period having a definite relation to the epileptic seizure. =alcoholic insanity.=--this may occur in three forms: . _acute alcoholic delirium_ (_mania a potu_), due to excessive amount of alcohol consumed. . _delirium tremens_, due to long-continued over-drinking. the patient suffers from horrible dreams, illusions, and suspicions, which may lead him to attack people or commit suicide. . _chronic alcoholic insanity._ loss of memory is the chief symptom, with paralysis of motion, hallucinations and delusions of persecution. =responsibility for criminal acts.=--to establish a defence on the ground of insanity, it must be proved that the prisoner at the time when the crime was committed did not know the nature and quality of the act he was committing, and did not know that it was wrong. at the present time, however, the _power of controlling his actions_ is usually made the test. the plea of insanity is brought forward, as a rule, only in capital charges, so that the prisoner, if found guilty, will escape hanging. if proved 'guilty, but insane,' the person is sentenced to be kept in a criminal lunatic asylum 'during his majesty's pleasure.' xliv.--examination of persons of unsound mind the following hints with regard to the examination of patients supposed to be insane will be useful: the general appearance and shape of head, complexion, and expression of countenance, gait, movements, and speech, should be noted; the state of the general health, appetite, bowels, tongue, skin, and pulse, should be inquired into; and in women the state of the menstrual function should be ascertained. the family history must be traced out, and the personal history taken with care, especially as to whether the unsoundness came on late in life or followed any physical cause. ascertain whether it is a first attack, whether the patient has suffered from epilepsy, has squandered his money, grown restless, has absurd delusions, etc. in order to ascertain the capacity of the mind, questions should be asked with regard to age, birthplace, profession, number of family, and common events, such as the day of week, month, and year. the power of performing simple arithmetical operations may be tested. it may be necessary to pay more than one visit. the examiner should be careful to ask questions adapted to the station of life of the supposed lunatic; a man is not necessarily mad because he cannot perform simple arithmetical operations, or does not know about things with which his questioner is well acquainted. the opinion of a supposed lunatic that his examiner's feet _were large_ was not considered by the commissioners among the facts indicating insanity, yet statements quite as absurd are made by medical men as 'facts of insanity' observed by themselves. 'reads his bible and is anxious about the salvation of his soul' is another example of a bad certificate. some well-marked delusion should be recorded. for a lunacy certificate (_reception order on petition_ or _judicial reception order_), except in the case of a pauper patient, there are required the signatures of two independent medical men and of a relation or friend. the medical men must not be in partnership or in any way interested in the patient; they must make separate visits at different times, and write on the proper forms the facts observed by themselves and those observed by others, giving the name of the informer. a certificate is valid only for seven days. in very urgent non-pauper cases the signature of one medical man is sufficient, but such certificate (_emergency certificate_ or _urgency order_) is only valid for two days, and, as the patient can only be detained in the asylum under this order for seven days in england or three in scotland, it must be supplemented by another signed as above directed. the medical certificate must contain a statement that it is expedient for the alleged lunatic to be placed forthwith under care, with reasons for making such statement. the certifying medical practitioner must have personally examined the patient not more than two clear days before his reception. in london and other large towns, where an expert opinion is readily obtainable, it is not expedient to resort to such urgency orders. medical men should be careful how they sign certificates of insanity. no medical man is bound to certify, but if he does so he must be prepared to take the responsibility of his acts. there must be no reasonable ground for alleging want of 'good faith' or 'reasonable care.' the practitioner must exercise that amount of care and skill which he may reasonably be expected to possess. xlv.--the inebriates acts it is somewhat difficult to define an inebriate, but for the moment the following will suffice, and will ultimately, in all probability, be officially adopted: an inebriate is a person who habitually takes or uses any intoxicating thing or things, and while under the influence of such thing or things, or in consequence of the effects thereof, is--(a) dangerous to himself or others; or (b) a cause of harm or serious annoyance to his family or others; or (c) incapable of managing himself or his affairs, or of ordinary proper conduct. under the provisions of the habitual drunkards acts ( and vict., c. , and and vict., c. ), any habitual drunkard may voluntarily place himself under restraint. he must make an application to the owner of a licensed retreat, stating the time during which he undertakes to remain. his application must be accompanied by a statutory declaration of two persons stating that they knew the applicant to be a confirmed drunkard. without this testimony as to moral character his application cannot be entertained. his signature must also be attested by two justices, who must state that he understands the effect of his application, and that it has been explained to him. the limit to the term of restraint is twelve months, after which he must resume his former habits if he wishes to qualify for another period. the act works automatically, and, when it has been set for a certain time, the patient cannot release himself until the period has expired. the inebriates' retreat must be duly licensed, and the licensee incurs distinct obligation in return for the powers entrusted to him. it is an offence against the act to assist any habitual drunkard to escape from his retreat, and should he succeed in effecting his escape he may be arrested on a warrant. a drunkard who does not obey orders and conform to the rules of the establishment may be sent to prison for seven days. it may be as well to mention that it is an offence to supply any drunkard under the act with any intoxicating drink or sedative or stimulant drug without authority, and that the penalty is a fine of £ or three months' imprisonment. the act is a good one, but might be carried farther with advantage. it has been ruled that a crime committed during drunkenness is as much a crime as if committed during sobriety. a person is supposed to know the effect of drink, and if he takes away his senses by drink it is no excuse. he is held answerable both for being under the influence of alcohol or of any other drug, and for the acts such influence induces. =inebriates act= ( - ).--if an habitual drunkard be sentenced to imprisonment or penal servitude for an offence committed during drunkenness, or if he has been convicted four times in one year, the court may order him to be detained for a term not exceeding three years in an inebriate reformatory. part ii toxicology i.--definition of a poison though the law does not define in definite terms what a poison really is, it lays stress on the _malicious intention_ in giving a drug or other substance to an individual. it is a _felony_ to administer, or cause to be administered, any poison or other destructive thing with intent to murder, or with the intention of stupefying or overpowering an individual so that any indictable offence may be committed. it is a _misdemeanour_ to administer any poison, or destructive or noxious thing, merely to aggrieve, injure, or annoy an individual. for a working _definition_ we may state that a poison is a substance which, when introduced into or applied to the body, is capable of injuring health or destroying life. a poison may therefore be swallowed, applied to the skin, injected into the tissues, or introduced into any orifice of the body. ii.--sale of poisons; scheduled poisons the sale of poisons is regulated by various acts, but chiefly by the pharmacy act, , and by the poisons and pharmacy act, . only registered medical practitioners and legally qualified druggists are permitted to dispense and sell scheduled poisons. they are responsible for any errors which may be committed in the sale of poisons. if a druggist knows that a drug in a prescription is to be used for an improper purpose, he may refuse to dispense it. the practitioner who carelessly prescribes a drug in a poisonous dose is not held responsible, but the dispenser would be if he dispensed it and harmful or fatal consequences followed on its being swallowed. when a dispenser finds an error in a prescription, it is his duty to communicate with the prescriber privately pointing out the mistake. a great responsibility rests on the medical man who does his own dispensing, as there is no one to check his work. if a doctor prescribes a drug with the intention of curing or preventing a disease, but that, contrary to expectation and general experience, it causes illness or even death, no responsibility can rest with the prescriber. it has to be proved that actual injury has been sustained by the complainant before an action for damages can be commenced, and that the plaintiff was free from all contributory negligence. =scheduled poisons.=--by the pharmacy act of two groups of poisons are scheduled. part i. contains a list of those which are considered very active poisons--_e.g._, arsenic, alkaloids, belladonna, cantharides, coca (if containing more than per cent. alkaloids), corrosive sublimate, diachylon, cyanides, tartar emetic, ergot, nux vomica, laudanum, opium, savin, picrotoxin, veronal and all poisonous urethanes, prussic acid, vermin killers, etc. such poisons must not be sold to strangers, but only to persons known to or introduced by someone known to the druggist. if sold, the latter must enter into the 'poison register' the name of the poison, the name of the person to whom it is sold, the quantity and purpose for which it is to be used, and date of sale. the entry must be signed by the purchaser and by the introducer. the word 'poison' must be affixed to the bottle or package, and also the name and address of the seller. part ii. contains a list of poisons supposed to be less active. these may only be sold if on the bottle, box, or package there is affixed a label with the name of the article, the word 'poison,' and the name and address of the seller. it is not necessary to enter the transaction in a register. chemists are required to keep poisons in specially distinguishable bottles, and these in a special room or locked cupboard. =dangerous drugs act, .=--the regulations restrict the manufacture and sale of opium, morphine, cocaine, and heroin so as to prevent their abuse. preparations containing less than / per cent. of the first two or less than / per cent. of the last two are excluded. prescriptions containing the above drugs must be dated and signed with the full name and address of the prescriber, and must have also those of the patient. the total amount of the drug to be supplied must be stated, and it must not be dispensed more than once; the dispenser retains the prescription. special books must be kept recording the purchase and sale of these drugs. =proprietary medicines bill= (introduced in , and likely soon to become law).--the sale of any unregistered proprietary medicine purporting to cure certain diseases or produce abortion is made an offence. a register of proprietary medicines, etc., is established. the object is to protect the public against quack remedies. =notification of poisoning.=--every case of poisoning which occurs in any industry (lead, arsenic, anthrax, etc.) must be notified by the medical attendant to the chief inspector of factories (factory and workshops act, ). iii.--action of poisons; classification of poisons =action of poisons.=--they may act either locally or only after absorption into the system. . _local action_, as seen in (a) corrosive poisons; (b) irritant poisons, causing congestion and inflammation of the mucous membranes--_e.g._, metallic and vegetable irritants; (c) stimulants or sedatives to the nerve endings, as aconite, conium, cocaine. . _remote action._--this may be of reflex character, as seen in the shock produced by the pain caused by corrosive poisons, or the poison may exert a special action on certain structures, as belladonna on the cells of the brain, strychnine on the motor nerve cells of the spinal cord. . _in both ways._--certain poisons, as carbolic or oxalic acids, act in this way. age, idiosyncrasy, tolerance, and disease, all exert modifying influences on the action of a poison. the form in which the poison is swallowed and the quantity also determine its action. in the gaseous form, poisons act most rapidly and fatally. when in solution and injected hypodermically, they also act very rapidly. in the solid form they act as a rule slowly, and may even set up vomiting, and so may be entirely ejected by vomiting. poisons act most energetically when the stomach is empty. if taken when the stomach already contains food, solution and absorption may be greatly delayed. some poisons are cumulative in their action, and thus, even if infinitesimal doses be swallowed each day, there is a certain amount of storage in the tissues (though a certain percentage of the poison is being constantly eliminated), and at last symptoms of poisoning show themselves. =classification of poisons.=--as an aid to memory, the following classification is perhaps the best: i. _inorganic._ . corrosive acids and alkalies, and caustic salts (carbolic and oxalic acids also). . irritant--practically all the metals and the metalloids (i. cl. br. p.). ii. _organic._ { animal--venomous bites, food poisoning, cantharides. . irritant { vegetable--all strong purgatives, hellebores, savin, { yew, ergot, hemlock, laburnum, bryony, etc. . neuronic. (a) somniferous--opium and its alkaloids. (b) deliriant--belladonna, hyoscyamus, stramonium, cannabis, cocaine, cocculus, camphor, fungi. (c) inebriants--alcohol, ether, chloral, carbolic acid (weak), benzol, aniline, nitro-glycerine. . sedative or depressant. (a) neural--conium, lobelia, tobacco, physostigma. (b) cerebral--hydrocyanic acid. (c) cardiac--aconite, digitalis, colchicum, veratrum. . excito-motory or convulsives--nux vomica, strychnine. . vulnerants--powdered glass. iii. _asphyxiants._ poisonous and irrespirable gases. iv.--evidence of poisoning it may be inferred that poison has been taken from consideration of the following factors: symptoms and post-mortem appearances, experiments on animals, chemical analysis, and the conduct of suspected persons. . _symptoms_ in poisoning usually come on suddenly, when the patient is in good health, and soon after taking a meal, drink, or medicine. many diseases, however, come on suddenly, and in cases of slow poisoning the invasion of the symptoms may be gradual. . _post-mortem appearances._--these in many poisons and classes of poisons are characteristic and unmistakable. the post-mortem appearances peculiar to the various poisons will be described in due course. . _experiments on animals._--these may be of value, but are not always conclusive. . _chemical analysis._--this is one of the most important forms of evidence, as a demonstration of the actual presence of a poison in the body carries immense weight. the poison may be discovered in the living person by testing the urine, the blood abstracted by bleeding, or the serum of a blister. in the dead body it may be found in the blood, muscles, viscera--especially the liver--and secretions. its discovery in these cases must be taken as conclusive evidence of administration. if, however, it be found only in substances rejected or voided from the body, the evidence is not so conclusive, as it may be contended that the poison was introduced into or formed in the material examined after its rejection from the body, or if the quantity be very minute it will be argued that it is not sufficient to cause death. a poison may not be detected in the body, owing to defective methods, smallness of the dose required to cause death, or to its ejection by vomiting or its elimination by the excretions. . _conduct of suspected persons._--a prisoner may be proved to have purchased poison, to have made a study of the properties and effects of poison, to have concocted medicines or prepared food for the deceased, to have made himself the sole attendant of the deceased, to have placed obstacles in the way of obtaining proper medical assistance, or to have removed substances which might have been examined. v.--symptoms and post-mortem appearances of different classes of poisons whilst recognizing the fact that toxic agents cannot be accurately classified, the following grouping may for descriptive purposes be admitted with the view of saving needless repetition: . =corrosives.=--characterized by their destructive action on tissues with which they come in contact. the principal inorganic corrosives are the mineral acids, the caustic alkalies, and their carbonates; the organic are carbolic acid, strong solutions of oxalic acid, and acetic acid. _symptoms._--burning pain in mouth, throat, and gullet, strong acid, metallic or alkaline taste; retching and vomiting, the discharged matters containing shreds of mucus, blood, and the lining membrane of the passages. inside of mouth corroded. there are also dysphagia, thirst, dyspnoea, small and frequent pulse, anxious expression, shock. death may result from shock, destruction of the parts--_e.g._, perforation of stomach or duodenum, suffocation; or some weeks subsequently death may be due to cicatricial contraction of the gullet, stomach, or pylorus. _post-mortem appearances._--those of corrosion, with corrugation from strong contraction of muscular fibres, and followed by inflammation and its consequences. the mouth, gullet, and stomach, and in some cases the intestines, may be white, yellow, or brown, shrivelled and corroded. the corrosions may be small, or may extend over a very large surface. sometimes considerable portions of the lining membrane of the gullet or stomach may be discharged by vomiting or by stool. beyond the corroded parts the textures are acutely inflamed. the stomach is filled with a yellow, brown, or black gelatinous liquid or black blood, and may in rare cases be perforated. . =irritants.=--these are substances which inflame parts to which they are applied. the class includes mineral, animal, and vegetable substances, and contains a larger number of poisons than all the other classes together. irritants may be divided into two groups: ( ) those which destroy life by the irritation they set up in the parts to which they are applied; ( ) those which add to local irritation peculiar or specific remote effects. the first group includes the principal vegetable irritants, some alkaline salts, some metallic poisons, etc.; and the second comprises the metallic irritants, the metalloids (phosphorus and iodine), and one animal substance, cantharides. _symptoms._--burning pain and constriction in throat and gullet, pain and tenderness of stomach and bowels, intense thirst, nausea, vomiting, purging and tenesmus, with bloody stools, dysuria, cold skin, and feeble and irregular pulse. the vomit consists at first of the food, then it becomes bile-stained, and later dark coffee-grounds in appearance, due to extravasation of blood from the over-distended vessels in the gastric mucous membrane. death may occur from shock, convulsions, collapse, exhaustion, or from starvation on account of chronic inflammation of the gastro-intestinal mucous membrane. _post-mortem appearances._--those of inflammation and its consequences. coats of stomach, fauces, gullet, and duodenum, may be thickened, black, ulcerated, gangrenous, or sloughing. vessels filled with dark blood ramify over the surface. acute inflammation is often found in the small intestines, with ulceration and softening of mucous membrane. the rectum is frequently the seat of marked ulceration. . =poisons acting on the brain.=--three classes: the opium group, producing sleep; the belladonna group, producing delirium and illusions; and the alcohol group, causing exhilaration, followed by delirium or sleep. _symptoms._--of the opium group, giddiness, headache, dimness of sight, contraction of the pupils, noises in the ears, drowsiness and confusion, passing into insensibility. of the belladonna group, delirium, illusions of sight, dilated pupils, dry mouth, thirst, redness of skin, coma. of the alcohol group, excitement of circulation and of cerebral functions, want of power of co-ordination and of muscular movement, double vision, mania, followed by profound sleep and coma. in the chronic form, delirium tremens. _post-mortem appearances._--in the opium group, fulness of the sinuses and veins of the brain, with effusion of serum into the ventricles and beneath the membranes. in the belladonna group, nil. in the alcohol group, signs of inflammation, congestion of brain and membranes, fluidity of blood, long-continued rigor mortis. . =poisons acting on the spinal cord.=--strychnine, brucine, thebaïne. the leading symptom is tetanic spasm. . =poisons affecting the heart.=--these kill by sudden shock, syncope, or collapse. they comprise prussic acid, dilute solution of oxalic acid and oxalates, aconite, digitalis, strophanthus, convallaria, and tobacco. . =poisons acting on the lungs.=--these have for their type carbonic acid gas and coal gas. the fumes of ammonia are intensely irritating, and may give rise to laryngitis, bronchitis, and even pneumonia. nitric acid fumes sometimes produce no serious symptoms for an hour or more, but there may then be coughing, difficulty of breathing, and tightness in the lower part of the throat, followed by capillary bronchitis (see p. ). vi.--duty of practitioner in supposed case of poisoning if called to a case supposed or suspected to be one of poisoning, the medical man has two duties to perform: to save the patient's life, and to place himself in a position to give evidence if called on to do so. if life is extinct, his duty is a simple one. he should make inquiries as to symptoms, and time at which food or medicine was last taken. he should take possession of any food, medicine, vomited matter, urine, or fæces, in the room, and should seal them up in clean vessels for examination. he should notice the position and temperature of the body, the condition of rigor mortis, marks of violence, appearance of lips and mouth. he should not make a post-mortem examination without an order in writing from the coroner. in making a post-mortem examination, the alimentary canal should be removed and preserved for further investigation. a double ligature should be passed round the oesophagus, and also round the duodenum a few inches below the pylorus. the gut and the gullet being cut across between these ligatures, the stomach may be removed entire without spilling its contents. the intestines may be removed in a similar way, and the whole or a portion of the liver should be preserved. these should all be put in separate jars without any preservative fluid, tied up, sealed, labelled, and initialled. all observations should be at once committed to writing, or they will not be admitted by the court for the purpose of refreshing the memory whilst giving evidence. if the medical practitioner is in doubt on any point, he should obtain technical assistance from someone who has paid attention to the subject. in a case of attempted suicide by poisoning, is it the duty of the doctor to inform the police? he would be unwise to do so. he had much better stick to his own business, and not act as an amateur detective. vii.--treatment of poisoning the modes of treatment may be ranged under three heads: ( ) to eliminate the poison; ( ) to antagonize its action; ( ) to avert the tendency to death. . the first indication is met by the administration of emetics, to produce vomiting, or by the application of the stomach-tube. the best emetic is that which is at hand. if there is a choice, give apomorphine hypodermically. the dose for an adult is minims. it may be given in the form of the injection of the pharmacopoeia, or preferably as a tablet dissolved in water. apomorphine is not allied in physiological action to morphine, and may be given in cases of narcotic poisoning. sulphate of zinc, salt-and-water, ipecacuanha, and mustard, are all useful as emetics. tickling the fauces with a feather may excite vomiting. in using the elastic stomach-tube, some fluid should be introduced into the stomach before attempting to empty it, or a portion of the mucous membrane may be sucked into the aperture. the tube should be examined to see that it is not broken or cracked, as accidents have happened from neglecting this precaution. the bowels and kidneys must also be stimulated to activity, to help in the elimination of the poison. . the second indication is met by the administration of the appropriate antidote. antidotes are usually given hypodermically, or, if by mouth, in the form of tablets. in the absence of a hypodermic syringe, the remedy may be given by the rectum. in the selection of the appropriate antidote, a knowledge of pharmacology is required, especially of the physiological antagonism of drugs. antidotes may act ( ) chemically, by forming harmless compounds, as lime in oxalic acid poisoning; ( ) physiologically, the drug which is administered neutralizing more or less completely the poison which has been absorbed; ( ) physically, as charcoal. every doctor should provide himself with an antidote case. the various antidotes will be mentioned under their respective poisons. . to avert the tendency to death, we must endeavour to palliate the symptoms and neutralize the effects of the poison. pain must be relieved by the use of morphine; inflamed mucous membrane soothed by such _demulcents_ as oils, milk, starch; stimulants to overcome collapse; saline infusions in shock, etc. in the case of narcotics and depressing agents, stimulants, electricity, and cold affusions, may be found useful. we should endeavour to promote the elimination of the poison from the body by stimulating the secretions. viii.--detection of poisons notice the smell, colour, and general appearance, of the matter submitted for examination. the odour may show the presence of prussic acid, alcohol, opium, or phosphorus. the colour may indicate salts of copper, cantharides, etc. seeds of plants may be found. this examination having been made, the contents of the alimentary canal, and any other substances to be examined, must be submitted to chemical processes. simple filtration will sometimes suffice to separate the required substance; in other cases dialysis will be necessary, in order that crystalloid substances may be separated from colloid bodies. in the case of volatile substances distillation will be required. the poisons thus sought for are alcohol, phosphorus, iodine, chloral, ether, hydrocyanic acid, carbolic acid, nitro-benzol, chloroform, and anilin. the organic matters are placed in a flask, diluted with distilled water if necessary, and acidulated with tartaric acid. the flask is heated in a water-bath, and the vapours condensed by a liebig's condenser. in the case of phosphorus the condenser should be of glass, and the process of distillation conducted in the dark, so that the luminosity of the phosphorus may be noted. for the separation of an alkaloid, the following is the process of stas-otto. this process is based upon the principle that the salts of the alkaloids are _soluble in alcohol and water_, and _insoluble in ether_. the pure alkaloids, with the exception of morphine in its crystalline form, are _soluble_ in ether. make a solution of the contents of the stomach or solid organs minced very fine by digesting them with acidulated alcohol or water and filtering. the filtrate is shaken with ether to remove fat, etc., the ether separated, the watery solution neutralized with soda, and then shaken with ether, which removes the alkaloid in a more or less impure condition. the knowledge of these facts will help to explain the following details, which may be modified to suit individual cases: ( ) treat the organic matter, after distillation for the volatile substances just mentioned, with twice its weight of absolute alcohol, free from fusel oil, to which from to grains of tartaric or oxalic acid have been added, and subject to a gentle heat. ( ) cool the mixture and filter; wash the residue with strong alcohol, and mix the filtrates. _the residue may be set aside for the detection of the metallic poisons, if suspected._ expel the alcohol by careful evaporation. on the evaporation of the alcohol the resinous and fatty matters separate. filter through a filter moistened with water. evaporate the filtrate to a syrup, and extract with successive portions of absolute alcohol. filter through a filter moistened with alcohol. evaporate filtrate to dryness, and dissolve residue in water, the solution being made distinctly acid. now shake watery solution with ether. ( ) ether from the acid solution dissolves out _colchicin_, _digitalin_, _cantharidin_, and _picrotoxin_, and traces of _veratrine_ and _atropine_. separate the ethereal solution and evaporate. hot water will now dissolve out _picrotoxin_, _colchicin_, and _digitalin_, but not cantharidin. ( ) the remaining acid watery liquid, holding the other alkaloids in solution or suspension, is made strongly alkaline with soda, mixed with four or five times its bulk of ether, chloroform, or benzole, briskly shaken, and left to rest. the ether floats on the surface, holding the alkaloids, except morphine, in solution. ( ) a part of this ethereal solution is poured into a watch-glass and allowed to evaporate. if the alkaloid is volatile, oily streaks appear on the glass; if not volatile, crystalline traces will be visible. if a volatile alkaloid, add a few pieces of calcium chloride to ethereal solution to absorb the water; draw off the ethereal solution with a pipette, allow it to evaporate, and test the residue for the alkaloids, conine and nicotine. if a fixed alkaloid, treat the acid solution with soda or potash and ether, evaporate ethereal solution after separation, when the solid alkaloid will be left in an impure state. to purify it, add a small quantity of dilute sulphuric acid, and, after evaporating to three-quarters of its bulk, add a saturated solution of carbonate of potash or soda. absolute alcohol will then dissolve out the alkaloid, and leave it on evaporation in a crystalline form. _general reactions for alkaloids._--( ) wagner's reagent (iodine dissolved in a solution of potassium iodide) yields a reddish-brown precipitate; ( ) mayer's reagent (potassio-mercuric iodide) gives a yellowish-white precipitate; ( ) phospho-molybdic acid gives a yellow precipitate; ( ) platinic chloride, a brown precipitate; ( ) tannic acid, etc. in order to isolate an inorganic substance from organic matter, fresenius's method is adopted. boil the finely divided substance with about one-eighth its bulk of pure hydrochloric acid; add from time to time potassic chlorate until the solids are reduced to a straw-yellow fluid. treat this with excess of bisulphate of sodium, then saturate with sulphuretted hydrogen until metals are thrown down as sulphides. these may be collected and tested. from the acid solution, hydrogen sulphide precipitates copper, lead, and mercury, _dark_; arsenic, antimony, and tin, _yellowish_. if no precipitate, add ammonia and ammonium sulphide, iron, _black_, zinc, _white_, chromium, _green_, manganese, _pink_. the residue of the material after digestion with hydrochloric acid and potassium chlorate may have to be examined for silver, lead, and barium. for the detection of minute quantities, the microscope must be used, and guy's and helwig's method of sublimation will be found advantageous. crystalline poisons may be recognized by their characteristic forms. ix.--the mineral acids these are sulphuric, nitric, and hydrochloric acids. _symptoms of poisoning by the mineral acids._--acid taste in the mouth, with violent burning pain extending into the oesophagus and stomach, and commencing immediately on the poison being swallowed; eructations, constant retching, and vomiting of brown, black, or yellow matter containing blood, coagulated mucus, epithelium, or portions of the lining membrane of the gullet and stomach. the vomited matters are strongly acid in reaction, and stain articles of clothing on which they may fall. there is intense thirst and constipation, with scanty or suppressed urine, tenesmus, and small and frequent pulse; the lips, tongue, and inside of the mouth, are shrivelled and corroded. exhaustion succeeds, and the patient dies either collapsed, convulsed, or suffocated, the intellect remaining clear to the last. after recovering from the acute form of poisoning, the patient may ultimately die from starvation, due to stricture of the oesophagus, stomach, etc. _post-mortem appearances common to the mineral acids._--stains and corrosions about the mouth, chin, and fingers, or wherever the acid has come in contact. the inside of the mouth, fauces, and oesophagus, is white and corroded, yellow or dark brown, and shrivelled. epiglottis contracted or swollen. stomach filled with brown, yellow, or black glutinous liquid; its lining membrane is charred or inflamed, and the vessels are injected. pylorus contracted. perforation, when it takes place, is on the posterior aspect; the apertures are circular, and surrounded by inflammation and black extravasation. the blood in the large vessels may be coagulated. avoid mistaking gastric or duodenal ulcer, with or without perforation, for the effects of a corrosive poison. _treatment._--calcined magnesia or the carbonate or bicarbonate of sodium, mixed with milk or some mucilaginous liquid, are the best antidotes. in the absence of these, chalk, whiting, milk, oil, soap-suds, etc., will be found of service. the stomach-pump should not be used. if the breathing is impeded, tracheotomy may be necessary. injuries of external parts by the acid must be treated as burns. x.--sulphuric acid =sulphuric acid=, or oil of vitriol, may be concentrated or diluted. it is frequently thrown over the person to disfigure the features or destroy the clothes. parts of the body touched by it are stained, first white, and then dark brown or black. the presence of corrosion of the mouth is as important as the chemical tests. black woollen cloths are turned to a dirty brown, the edges of the spots becoming red in a few days, due to the dilution of the acid from the absorption of moisture; the stains remain damp for long, owing to the hygroscopic property of the acid. _method of extraction from the stomach._--the contents of the stomach or vomited matter should, if necessary, be diluted with pure distilled water and filtered. the stomach should be cut up into small pieces and boiled for some time in water. the solution, filtered and concentrated, is now ready for testing. blood, milk, etc., may be separated by dialysis, and the fluid so obtained tested. a sulphate may be present. take a portion of the liquid, evaporate to dryness, and incinerate; a sulphate, if present, will be obtained, and may be tested. _caution._--sulphuric acid may not be found even after large doses, due to treatment, vomiting, or survival for several days. in all cases every organ should be examined. vomited matters and contents of stomach should not be mixed, but each _separately_ examined. this rule holds good for all poisons. on _cloth_ the stain may be cut out, boiled in water, the solution filtered, and tested with blue litmus and other tests. _post-mortem appearances._--where the acid has come in contact with the mucous membranes there are dark brown or black patches. the stomach is greatly contracted, the summits of the mucous membrane ridges being charred and the furrows greatly inflamed; the contents are black or brown. _tests._--concentrated acid chars organic matter; evolves heat when added to water, and sulphurous fumes when boiled with chips of wood, copper cuttings, or mercury. dilute acid chars paper when the paper is heated; gives a white precipitate with nitrate or chloride of barium, and is entirely volatilized by heat. dilute solutions give a white precipitate with barium nitrate, insoluble in hydrochloric acid even on boiling. _fatal dose._--in an adult, drachm. _fatal period._--shortest, three-quarters of an hour; average period from onset of primary effects, eighteen to twenty-four hours. xi.--nitric acid =nitric acid=, or aqua fortis, is less frequently used as a poison than sulphuric acid. the fumes from nitric acid have caused death from pneumonia in ten or twelve hours. _method of extraction from the stomach._--the same as for sulphuric acid. in beer, etc., the mixture may be neutralized with carbonate of potassium, dialyzed, the fluid concentrated and allowed to crystallize, when crystals of nitrate of potassium may be recognized. _post-mortem appearance._--the mucous membranes are rendered yellow or greenish if bile be present; they are also thickened and hardened. _tests._--concentrated acid gives off irritating orange-coloured fumes of nitric acid gas. when poured on copper, it gives off red fumes and leaves a green solution of nitrate of copper. it gives a red colour with brucine, turns the green sulphate of iron black, and with hydrochloric acid dissolves gold. a delicate test for the acid, free or in combination, is to dissolve in the suspected fluid some crystals of ferrous sulphate, and then to gently pour down the test-tube some strong sulphuric acid. where the two liquids meet, if nitric acid be present, a reddish-brown ring will be formed. it turns the skin bright yellow, and does the same with woollen clothes, from the formation of _picric_ acid. _fatal dose._--two drachms. _fatal period._--shortest, one hour and three-quarters in an adult; in infants in a few minutes, from suffocation. xii.--hydrochloric acid =hydrochloric acid=, muriatic acid, or spirit of salt, is not uncommonly used for suicidal purposes, being fifth in the list. _method of extraction from the stomach._--the same as for sulphuric acid. as hydrochloric acid is a constituent of the gastric juice, the signs of the acid must be looked for. _post-mortem appearances._--the mucous membranes are dry, white, and shrivelled, and often eroded. _tests._--the concentrated acid yields dense white fumes with ammonia. when warmed with black oxide of manganese and strong sulphuric acid it gives off chlorine, recognized by its smell and bleaching properties. diluted it gives with nitrate of silver, a white precipitate, which is insoluble in nitric acid and in caustic potash, but is soluble in ammonia, and when dried and heated melts, and forms a horny mass. stains on clothing are reddish-brown in colour. _fatal dose._--half an ounce. _fatal period._--shortest, two hours; average, twenty-four hours. death may occur after an interval of some weeks from destruction of the gastric glands and inability to digest food. xiii.--oxalic acid =oxalic acid= is used by suicides, though not often by murderers. the crystals closely resemble those of epsom salts or sulphate of zinc; oxalic acid has been taken in mistake for the former. it is in common use for cleansing brass, in laundry work, for dyeing purposes, and especially for bleaching straw hats. _symptoms._--if a concentrated solution be taken, it acts as a corrosive, causing a burning acid, intensely sour taste, which comes on immediately, great pain and tenderness and burning at pit of stomach, pain and tightness in throat. vomiting of mucus, bloody or dark coffee-ground matters, purging and tenesmus, followed by collapse, feeble pulse, cyanosis and pallor of the skin; also swelling of tongue, with dysphagia. in some cases cramps and numbness in limbs, pain in head and back, delirium and convulsions. may be tetanus or coma. if taken freely diluted, the nervous symptoms predominate, and may resemble narcotic poisoning. sometimes almost instant death. _post-mortem appearances._--mucous membrane of mouth, throat, and gullet, white and softened, as if they had been boiled; there are often black or brown streaks in it. stomach contains dark, grumous matter, and is soft, pale, and brittle. intestines slightly inflamed, stomach sometimes quite healthy. _treatment._--warm water, then chalk, carbonate of magnesium, or lime-water, freely. not alkalies, as the oxalates of the alkalies are soluble and poisonous. castor-oil. emetics, but not stomach-pump. _fatal dose._--one drachm is the smallest, but half an ounce is usually fatal. _method of extraction from the stomach._--mince up the coats of the stomach and boil them in water, or boil the contents of the stomach and subject them to dialysis. concentrate the distilled water outside the tube containing the vomited matters, etc., and apply tests. _tests._--white precipitate with nitrate of silver, soluble in nitric acid and ammonia. when the precipitate is dried and heated on platinum-foil, it disperses as white vapour with slight detonation. sulphate of lime in excess gives a white precipitate, soluble in nitric or hydrochloric acid, but insoluble in oxalic, tartaric, acetic, or any vegetable acid. =oxalate or binoxalate of potash= (salts of sorrel or salts of lemon) is almost as poisonous as the acid itself. xiv.--carbolic acid =carbolic acid, phenic acid, or phenol=, is largely employed as a disinfectant, and is often supplied in ordinary beer-bottles without labels. _symptoms._--an intense burning pain extending from the mouth to the stomach and intestines. indications of collapse soon supervene. the skin is cold and clammy, and the lips, eyelids, and ears, are livid. this is followed by insensibility, coma, stertorous breathing, abolition of reflex movements, hurried and shallowed respiration, and death. the pupils are usually contracted, and the urine, if not suppressed, is dark in colour, or even black. patients often improve for a time, and then die suddenly from collapse. when the poison has been absorbed through the skin or mucous membranes, a mild form of delirium, with great weakness and lividity, are the first signs. _post-mortem._--if strong acid has been swallowed, the lips and mucous membranes are hardened, whitened, and corrugated. in the stomach the tops of the folds are whitened and eroded, while the furrows are intensely inflamed. _treatment._--soluble sulphates which form harmless sulpho-carbolates in the blood should be administered at once. an ounce of epsom salts or of glauber's salts dissolved in a pint of water will answer the purpose admirably. after this an emetic of sulphate of zinc may be given. white of egg and water or olive-oil may prove useful. warmth should be applied to the body. _fatal dose._--one drachm, but recovery has taken place after much larger quantities, if well diluted or taken after a meal. _tests_ are not necessary, as the smell of carbolic acid is characteristic. _local action_ of carbolic acid produces anæsthesia and necrosis. accidents sometimes happen from too strong lotions applied as surgical dressings. =lysol= is a compound of cresol and linseed-oil soap, and is much less toxic than carbolic acid. xv.--potash, soda, and ammonia =caustic potash= occurs in cylindrical sticks, is soapy to the touch, has an acrid taste, is deliquescent, fusible by heat, soluble in water. =liquor potassæ= is a strong solution of caustic potash, and has a similar reaction. =carbonate of potassium=, also known as potash, pearlash, salt of tartar, is a white crystalline powder, alkaline and caustic in taste, and very deliquescent. the bicarbonate is in colourless prisms, which have a saline, feebly alkaline taste, and are not deliquescent. _symptoms._--acrid soapy taste in mouth, burning in throat and gullet, acute pain at pit of stomach, vomiting of bloody or brown mucus, colicky pains, bloody stools, surface cold, pulse weak. these preparations are not volatile, so that there is not much fear of lung trouble. in chronic cases death occurs from stricture of the oesophagus causing starvation. _post-mortem appearances._--soapy feeling, softening, inflammation, and corrosion of mucous membrane of mouth, pharynx, oesophagus, stomach, and intestines. inflammation may have extended to larynx. _method of extraction from the stomach._--if the contents of the stomach have a strong alkaline action, dilute with water, filter, and apply tests. _tests._--the carbonates effervesce with an acid. the salts give a yellow precipitate with platinum chloride, and a white precipitate with tartaric acid. they are not dissipated by heat, and give a violet colour to the deoxidizing flame of the blowpipe. stains on dark clothing are red or brown. _treatment._--vinegar and water, lemon-juice and water, acidulated stimulant drinks, oil, linseed-tea, opium to relieve pain, stimulants in collapse. do not use the stomach-tube. the glottis may be inflamed, and if there is danger of asphyxia, tracheotomy may have to be performed. =carbonate of sodium= occurs as _soda_ and _best soda_, the former in dirty crystalline masses, the latter of a purer white colour. it is also found as 'washing soda.' _symptoms, post-mortem appearances, treatment, and extraction from the stomach._--as for potash. _tests._--alkaline reaction, effervesces and evolves carbonic acid when treated with an acid; crystallizes, gives yellow tinge to blowpipe flame. no precipitate with tartaric acid, nor with bichloride of platinum. =ammonia= may be taken as _liquor ammoniæ_ (harts-horn), as carbonate of ammonium, as 'cleansel,' or as 'scrubb's cloudy ammonia.' _symptoms._--being volatile, it attacks the air-passages, nose, eyes and lungs, being immediately affected; profuse salivation; lips and tongue swollen, red, and glazed. the urgent symptoms are those of suffocation. inhalation of the fumes of strong ammonia may lead to death from capillary bronchitis or broncho-pneumonia. death may result from inflammation of the larynx and lungs. when swallowed in solution, the symptoms are similar to those of soda and potash. _post-mortem appearances._--similar to other corrosives. _method of extraction from the stomach._--the contents of the stomach, etc., must be first distilled, the gas being conveyed into water free from ammonia. _tests._--nessler's reagent is the most delicate, a reddish-brown colour or precipitate being produced, but ammonia may be recognized by its pungent odour, dense fumes given off with hydrochloric acid, and strong alkaline reaction. _treatment._--vinegar and water. other treatment according to symptoms. _fatal dose._--one drachm of strong solution. _fatal period (shortest)._--four minutes. xvi.--inorganic irritants =nitrate of potassium (nitre, saltpetre)--bitartrate of potassium (cream of tartar)--alum (double sulphate of alumina and potassium)--chlorides of lime, sodium, and potassium.=--all these are irritant drugs, and give the usual symptoms. xvii.--chlorate of potassium, etc. =chlorate of potassium= produces irritation of stomach and bowels; hæmaturia; melæna; cyanosis, weakness, delirium, and coma. _post-mortem._--blood is chocolate-brown in colour, and so are all the internal organs; gastro-enteritis; nephritis. _tests._--spectroscope shows blood contains methæmoglobin; the drug discharges the colour of indigo in acid solution with so_{ }. _treatment._--transfusion of blood or saline fluid; stimulants. =sulphuret of potassium= (liver of sulphur) occurs in mass or powder of a dirty green colour; has a strong smell of sulphuretted hydrogen. _symptoms._--of acute irritant poisoning, with stupor or convulsions. excreta smell of sulphuretted hydrogen. _post-mortem appearances._--stomach and duodenum reddened, with deposits of sulphur. lungs congested. _treatment._--chloride of sodium or lime in dilute solution, and ordinary treatment for irritant poisoning. _fatal period (shortest)._--fifteen minutes. xviii.--barium salts =chloride of barium= occurs crystallized in irregular plates, like magnesium sulphate, soluble in water and bitter in taste. =carbonate of barium= is found in shops as a fine powder, tasteless and colourless, insoluble in water, but effervescing with dilute acids, and readily decomposed by the free acids of the stomach. =nitrate of barium= occurs in octahedral crystals, soluble in water. _method of extraction from the stomach._--dialysis as for other soluble poisons. _tests._--precipitated from its solutions by potassium carbonate or sulphuric acid. burnt on platinum-foil, it gives a green colour to the flame. _symptoms._--besides those of irritants generally, violent cramps and convulsions, headache, debility, dimness of sight, double vision, noises in the ears, and beating at the heart. the salts of barium are also cardiac poisons. _post-mortem appearances._--as of irritants generally. stomach may be perforated. _treatment._--wash out stomach with a solution of sodium or magnesium sulphate, or of alum, and give stimulants by the mouth and hypodermically. xix.--iodine--iodide of potassium =iodine= occurs in scales of a dark bluish-black colour. it strikes blue with solution of starch, and stains the skin and intestines yellowish-brown. liquid preparations, as the liniment or tincture, may be taken accidentally or suicidally. _symptoms._--acrid taste, tightness of throat, epigastric pain, and then symptoms of irritant poisons generally. chronic poisoning (iodism) is characterized by coryza, salivation, and lachrymation, frontal headache, loss of appetite, marked mental depression, acne of the face and chest, and a petechial eruption on the limbs. _post-mortem appearances._--those of irritant poisoning with corrosion, and staining of a dark brown or yellow colour. _treatment._--stomach-pump and emetics, carbonate of sodium, amylaceous fluids, gruel, arrowroot, starch, etc. _analysis of organic mixture containing iodine._--add bisulphide of carbon, and shake. the iodine may be obtained on evaporation as a sublimate. it will be recognized by the blue colour which it gives with starch. =iodide of potassium.=--colourless, generally opaque, cubic crystals, soluble in less than their weight of cold water. _symptoms._--not an active poison, but even small doses sometimes produce the effects of a common cold, including those symptoms already mentioned as occurring with iodine. _analysis._--iodide of potassium in solution gives a bright yellow precipitate with lead salts; a bright scarlet with corrosive sublimate; and a blue colour with sulphuric or nitric acid and starch. xx.--phosphorus =phosphorus= is usually found in small, waxy-looking cylinders, which are kept in water to prevent oxidation. it may also occur as the amorphous non-poisonous variety, a red opaque infusible substance, insoluble in carbon disulphide. ordinary phosphorus is soluble in oil, alcohol, ether, chloroform, and carbon disulphide; insoluble in water. it is much used in rat poisons, made into a paste with flour, sugar, fat, and prussian blue. yellow phosphorus is not allowed to be used in the manufacture of lucifer matches, and the importation of such is prohibited. in 'safety' matches the amorphous phosphorus is on the box. _symptoms._--at first those of an irritant poison, but days may elapse before any characteristic symptoms appear, and these may be mistaken for those of acute yellow atrophy of the liver. the earliest signs are a garlicky taste in the mouth and pain in the throat and stomach. vomited matter luminous in the dark, bile-stained or bloody, with garlic-like odour. great prostration, diarrhoea, with bloody stools. harsh, dry, yellow skin, purpuric spots with ecchymoses under the skin and mucous membranes, retention or suppression of urine, delirium, convulsions, coma, and death. usually there are remissions for two to three days, then jaundice comes on, with enlargement of the liver; hæmorrhages from the mucous surfaces and under the skin; later, coma and convulsions. in chronic cases there is fatty degeneration of most of the organs and tissues of the body. the inhalation of the fumes of phosphorus, as in making vermin-killers, etc., gives rise to 'phossy-jaw.' _post-mortem appearances._--softening of the stomach, hæmorrhagic spots on all organs and under the skin, fatty degeneration of liver, kidneys, and heart, blood-stained urine, phosphorescent contents of alimentary canal. _treatment._--early use of stomach-pump and emetics, followed by the administration of permanganate of potassium or peroxide of hydrogen to oxidize the phosphorus. oil should not be given. sulphate and carbonate of magnesium, mucilaginous drinks. sulphate of copper is a valuable antidote, both as an emetic and as forming an insoluble compound with phosphorus. _fatal dose._--one grain and a half. _fatal period._--four hours; more commonly two to four days. _detection of phosphorus in organic mixtures._--mitscherlich's method is the best. introduce the suspected material into a retort. acidulate with sulphuric acid to fix any ammonia present. distil in the dark, through a glass tube kept cool by a stream of water. as the vapour passes over and condenses, a flash of light is perceived, which is the test. xxi.--arsenic and its preparations =arsenic= is the most important of all the metallic poisons. it is much used in medicine and the arts. it occurs as metallic arsenic, which is of a steel-grey colour, brittle, and gives off a garlic-like odour when heated; as arsenious acid; in the form of two sulphides--the red sulphide, or realgar, and the yellow sulphide, or orpiment; and as arsenite of copper, or scheele's green. it also exists as an impurity in the ores of several metals--iron, copper, silver, tin, zinc, nickel, and cobalt. sulphuric acid is frequently impregnated with arsenic from the iron pyrites used in preparing the acid. it is a constituent of many rat pastes, vermin or weed killers, complexion powders, sheep dips, etc. =arsenious acid= (white arsenic, trioxide of arsenic).--colourless, odourless, and almost tasteless. it occurs in commerce as a white powder or in a solid cake, which is at first translucent, but afterwards becomes opaque. slightly soluble in cold water; ounce of water dissolves about / grain of arsenic. fowler's solution is the best-known medicinal preparation of arsenic, and contains grain of arsenious anhydride in minims. _symptoms._--commence in from half to one hour. faintness, nausea, incessant vomiting, epigastric pain, headache, diarrhoea, tightness and heat of throat and fauces, thirst, catching in the breath, restlessness, debility, cramp in the legs, and convulsive twitchings. the skin becomes cold and clammy. in some cases the symptoms are those of collapse, with but little pain, vomiting, or diarrhoea. in others the patient falls into a deep sleep, while in the fourth class the symptoms resemble closely those of english cholera. the vomited matters are often blue from indigo, or black from soot, or greenish from bile, mixed with the poison. should the patient survive some days, no trace of arsenic may be found in the body, as the poison is rapidly eliminated by the kidneys. in all suspected cases the urine should be examined. the symptoms of _chronic_ poisoning by arsenic are loss of appetite, silvery tongue, thirst, nausea, colicky pains, diarrhoea, headache, languor, sleeplessness, cutaneous eruptions, soreness of the edges of the eyelids, emaciation, falling out of the hair, cough, hæmoptysis, anæmia, great tenderness on pressure over muscles of legs and arms, due to peripheral neuritis, and convulsions. pigmentation is common; the face becomes dusky red, the rest of the body a dark brown shade. this darkening is most marked in situations normally pigmented and in parts exposed to pressure of the clothes, such as the neck, axilla, and inner aspect of the arms, the extensor aspects being less marked than the flexor. the pigmentation resembles the bronzing of addison's disease, but there are no patches on the mucous membranes, and the normal rosy tint of the lips is not altered. the skin over the feet may show marked hyperkeratosis. the nervous system is notably affected. the sensory symptoms appear first: numbness and tingling of the hands and feet, pain in the soles of the feet on walking, pain on moving the joints, and erythromelalgia. then come the motor symptoms, with drop-wrist and drop-foot. the patient suffers severely from neuritis, and there may be early loss of patellar reflex. the nervous symptoms come on later than the cutaneous manifestations. _post-mortem appearances._--signs of acute inflammation of stomach, duodenum, small intestines, colon, and rectum. stomach may contain dark grumous fluid, and its mucous coat presents the appearance of crimson velvet. ulceration is rare, and cases of perforation still less common, the patient dying before it occurs. if life has been preserved for some days, there is extensive fatty degeneration of the organs. there may be entire absence of _post-mortem_ signs. putrefaction of the body is retarded by arsenic. _treatment._--the stomach-pump, emetics, then milk, milk and eggs, oil and lime-water. inflammatory symptoms, collapse, coma, etc., must be treated on ordinary principles. as an antidote, the best when the poison is in solution is the hydrated sesquioxide of iron, formed by precipitating tinctura ferri perchloridi with excess of ammonia, or carbonate of soda. this is filtered off through muslin and given in tablespoonful doses. it forms ferric arsenate, which is sparingly soluble. colloidal iron hydroxide may be used instead. dialyzed iron in large quantities is efficacious. _fatal dose (smallest)._--two grains. exceptionally, recovery from very large doses if rejected by vomiting. _fatal period (shortest)._--twenty minutes. exceptionally, death as late as the sixteenth day. the effects of arsenic are modified by tolerance, some persons being able to take considerable quantities. the peasants of styria are in the habit of eating it. _method of extraction from the stomach._--the coats of the stomach should be examined with a lens for any white particles. these, if present, may be collected, mixed with a little charcoal in a test-tube, and heated. if arsenic is present, a metallic ring will be formed in the cooler parts of the tube. if this ring be also heated, octahedral crystals of arsenic will be deposited farther up the tube, and are easily recognized by the microscope. the contents of the stomach, or the solid organs minced up, should be boiled with pure hydrochloric acid and water, then filtered. the filtrate can then be subjected to marsh's or reinsch's process. _tests._--in _solution_, arsenic may be detected by the liquid tests. ( ) ammonio-nitrate of silver gives a yellow precipitate (arsenite of silver). ( ) ammonio-sulphate of copper gives a green precipitate (scheele's green). ( ) sulphuretted hydrogen water gives a yellow precipitate. _marsh's process._--put pure distilled water into a marsh's apparatus with metallic zinc and sulphuric acid. hydrogen is set free, and should be tested by lighting the issuing gas and depressing over it a piece of white porcelain. if no mark appears, the reagents are pure, and the suspected liquid may now be added. the hydrogen decomposes arsenious acid, and forms arseniuretted hydrogen. the gas carried off by a fine tube is again ignited. a piece of glass or porcelain held to the flame will have, if arsenic be present, a deposit on it having the following characters: in the centre a deposit of metallic arsenic, round this a mixture of metallic arsenic and arsenious acid, and outside this another ring of arsenious acid in octahedral crystals. the deposit is dissolved by a solution of chloride of lime, turned yellow by sulphide of ammonium after evaporation; on the addition of strong nitric acid, evaporated and neutralized with ammonia and nitrate of silver added, a brick-red colour is produced--arseniate of silver. _reinsch's process._--boil distilled water with one-sixth or one-eighth of hydrochloric acid, and introduce a slip of bright copper. if, after a quarter of an hour's boiling, there is no stain on the copper, add the suspected liquid. if arsenic be present, it will form an iron-grey deposit. if this foil be dried, cut up, put in a reduction-tube, and heated, crystals of arsenious trioxide will be deposited on the cold part of the tube. these tests are difficult to apply, but as arsenic is a ubiquitous poison, and as there are many sources of fallacy, it would be well, when possible, to obtain the services of an expert. _biological test._--put the substance to be tested into a flask with some small pieces of bread, sterilize for half an hour at ° c. when cold, inoculate with a culture of _penicillium brevicaule_, and keep at a temperature of ° c. if arsenic is present, a garlic-like odour is noticed in twenty four hours, due to arseniuretted hydrogen or an organic combination of arsenic. this test is delicate, and will detect / of a milligramme, but it is not quantitative. =other preparations of arsenic.=--these are arsenite of potash (fowler's solution), cacodylate of sodium, and arsenite of copper (scheele's green), the last frequently used for colouring dresses and wall-papers. persons using these preparations may suffer from catarrhal symptoms, rashes on the neck, ears, and face, thirst, nausea, pain in stomach, vomiting, headache, perhaps peripheral neuritis and loss of patellar reflex. the cacodylates, although formerly employed in the treatment of phthisis, should be used with the utmost caution. the arsenites give the reactions of arsenious acid. arsenic is eliminated not only by the kidneys and bowels, but by the skin, and in women by the menses. it may be detected in the sweat, the saliva, the bronchial secretion, and, during lactation, in the milk. the sale of arsenic and its preparations to the public is properly hedged round with restrictions of all kinds. it is included in part i. of the poisons and pharmacy act ( edward vii., c. ). no arsenic may be sold to a person under age, nor may it be sold unless mixed with soot or indigo in the proportion of ounce of soot or / ounce of indigo at the least to every pound of arsenic. =arseniuretted hydrogen= (arsine, ash_{ }) is an extremely poisonous gas, and is evolved in various chemical and manufacturing processes. when damp, _ferro-silicon_ evolves ash_{ } and ph_{ }, both very lethal gases. _ferrochrome_ is used in making steel, and it also evolves ph_{ }, and in such extreme dilution as . per cent. may cause death. xxii.--antimony and its preparations =tartar emetic= (tartarized antimony, potassio-tartrate of antimony) occurs as a white powder, or in yellowish-white efflorescent crystals. vinum antimoniale contains grains to a fluid ounce of the wine. _symptoms._--metallic taste, rapidly followed by nausea, incessant vomiting, burning heat and pain in stomach, purging. dysphagia, sense of constriction in throat, intense thirst, cramps, faintness, profound depression; in fatal cases, giddiness and tetanic spasms. in _chronic poisoning_, nausea, vomiting and purging, weak pulse, loss of appetite, debility, cold sweats, great prostration, progressive emaciation. the symptoms in chronic poisoning may simulate gastritis or enteritis. externally applied, it produces an eruption not unlike that of smallpox. _post-mortem appearances._--inflammation, softening, and an aphthous condition of the throat, gullet, and stomach, the last reddened in patches. in chronic poisoning, inflammation also of cæcum and colon. brain and lungs may be congested. decomposition is hindered for long. _treatment._--promote vomiting by warm greasy water, or the stomach-tube may be used. cinchona bark or any preparation containing tannin, as tea, decoction of oak bark, etc. morphine to allay pain. _fatal dose._--in an adult grains (same as arsenic). _fatal period._--death follows in eight to twelve hours, from exhaustion. _method of extraction from the stomach._--the contents of the stomach or its coats should be finely cut up and boiled in water, acidulated with tartaric acid and subjected to dialysis, or strained and filtered. pass hydrogen sulphide through the filtered or dialyzed fluid until a precipitate ceases to fall; collect the sulphide thus formed, wash and dry it. boil the orange-coloured sulphide in a little hydrochloric acid. if the solution be now added to a large bulk of water, the white oxychloride is precipitated, which is soluble in tartaric acid and precipitated orange yellow with hydrogen sulphide. the chloride of bismuth is also precipitated white, but the precipitate is not soluble in tartaric acid, and the precipitate with hydrogen sulphide is black. _tests._--soluble in water, but not in alcohol. heated in substance, it crepitates and chars; and if heat be increased, the metal is deposited. treated with sulphuretted hydrogen, a characteristic orange-red sulphide is formed. a drop of the solution evaporated leaves crystals, either tetrahedric, or cubes with edges bevelled off. sulphuretted hydrogen passed through gives the orange-red precipitate above named. dilute nitric acid gives a white precipitate, soluble in excess, and also in tartaric acid. marsh's and reinsch's processes are applicable for the detection of antimony, but reinsch's is the better. reinsch's process gives a violet deposit instead of the black, lustrous one of arsenic. =chloride of antimony= (butter of antimony).--a light yellow or dark red corrosive liquid. _symptoms._--violet corrosion and irritation of the alimentary canal, with the addition of narcotic symptoms. after death the mucous membrane of the entire canal is charred, softened, and abraded. _treatment._--as for tartar emetic; magnesia in milk. xxiii.--mercury and its preparations the most important salt of mercury, toxicologically, is corrosive sublimate. other poisonous preparations are red precipitate, white precipitate, mercuric nitrate, the cyanide and potassio-mercuric iodide. calomel has very little toxic action. metallic mercury is not poisonous, but its vapour is. =corrosive sublimate= (perchloride of mercury) is in heavy colourless masses of prismatic crystals, possessing an acrid, metallic taste. it is soluble in sixteen parts of cold and two of boiling water. soluble in alcohol and ether, the latter also separating it from its solution in water. _symptoms_ come on rapidly. acrid, metallic taste, constriction and burning in throat and stomach, nausea, vomiting of stringy mucus tinged with blood, tenesmus, purging. feeble, quick, and irregular pulse, dysuria with scanty, albuminous or bloody urine or total suppression. cramp, twitches and convulsions of limbs, occasionally paralysis. in poisoning from the medicinal use of mercury, there may be salivation, a coppery taste in the mouth, peculiar foetor of breath, tenderness and swelling of mouth, inflammation, swelling and ulceration of gums (cancrum oris), a blue line on the gums, and the loosening of teeth. mercury is less quickly eliminated from the body than arsenic. in chronic cases 'mercurialism,' 'hydrargyrism,' 'ptyalism,' or 'salivation,' including most of the symptoms enumerated above. may get _eczema mercuriale_ and periostitis. profound anæmia often a prominent symptom; neuritis not uncommon. if fumes of mercury inhaled, mercurial tremors develop. _post-mortem appearances._--corrosion, softening, and sloughing ulceration of stomach and intestines. the mucous membrane of the oesophagus and stomach is often of a bluish-grey colour. the large intestine and rectum are often ulcerated and gangrenous. inflamed condition of urinary organs, with contraction of the bladder. _treatment._--encourage or produce vomiting. albumin, as white of egg, gluten, or wheat flour, is the best antidote. demulcent drinks, milk, and ice. stomach-tube to be used with care, owing to softened state of gullet and stomach. _fatal dose._--three grains in a child. _fatal period._--half an hour the shortest. _method of extraction from the stomach._--a trial test may be made of the contents of the stomach with copper-foil. if mercury is found, the contents of the stomach may be dialyzed, the resulting clear fluid concentrated and shaken with ether, which has the power of taking corrosive sublimate up, and thus separating it from arsenic and other metallic poisons. the ether allowed to evaporate will leave the corrosive sublimate in white silky-looking prisms. suppose no mercury is found in the dialyzed fluid, owing to the fact that corrosive sublimate enters into insoluble compounds with albumin, fibrin, mucous membrane, gluten, tannic acid, etc., we must dry the insoluble matter, and heat it with nitro-hydrochloric acid until all organic matter is destroyed and excess of nitric acid expelled. the residue dissolved in water, filtered, and tested with copper-foil, etc. _tests._--the following table gives the action of corrosive sublimate with reagents: . with iodide of potassium bright scarlet colour. . with potash solution bright yellow colour. . with hydrochloric acid and first a yellowish and then a black sulphuretted hydrogen colour. . heated in a reduction-tube melts, boils, is volatilized, and forms a white crystalline sublimate. . with ether freely soluble; the ethereal solution, when allowed to evaporate spontaneously, deposits the salt in white prismatic crystals. . heated with carbonate of globules of metallic mercury are sodium in a reduction-tube produced. a very simple process for detecting corrosive sublimate is to put a drop of the suspected solution on a sovereign and touch the gold through the solution with a key, when metallic mercury will be deposited on the gold. xxiv.--lead and its preparations =acetate of lead= (sugar of lead).--a glistening white powder or crystalline mass. soluble in water, with a sweetish taste. it is practically the only lead salt which gives rise to acute symptoms, and only when taken in large doses. _symptoms._--metallic taste, dryness in throat, intense thirst, vomiting, colicky pains, cramps, cold sweat, _constipation_ and scanty urine, severe headache, convulsions. _chronic lead-poisoning_ is liable to occur in those who handle lead in any form--white-lead workers, paint manufacturers, plumbers, pottery workers, etc. in chronic lead-poisoning the most prominent symptoms are a blue line on the gums, anæmia, emaciation, pallor, quick pulse, persistent constipation, colic, cramps in limbs, and paralysis of the extensor muscles, causing 'dropped hand.' may get _saturnine encephalopathies_, of which intense headache, optic neuritis, and epileptiform convulsions, are the most common. albumin in urine, tendency to gout, and in women to abortion. _post-mortem appearances._--inflamed mucous membrane of stomach and intestines, with layers of white or whitish-yellow mucus, impregnated with the salt of lead. _treatment._--sulphate of sodium or magnesium, or a mixture of dilute sulphuric acid, spirits of chloroform, and peppermint-water. milk, or milk and eggs. as a prophylactic among workers in lead, a drink containing sulphuric acid flavoured with treacle should be given. lavatory accommodation should be provided, and scrupulous cleanliness should also be enjoined in the workshops. the dry grinding of lead salts should be prohibited. the ionization method of sir thomas oliver is most useful both as regards cure and also prevention of chronic poisoning by lead. _fatal dose and fatal period._--uncertain. _method of extraction from the stomach._--dry the contents of the stomach or portions of the liver, etc., and incinerate in a porcelain crucible. treat the ash with nitric acid, dry, and dissolve in water. the solution of nitrate of lead may now have the proper tests applied. _tests._--sulphuretted hydrogen gives a black precipitate; liquor potassæ, white precipitate; sulphuric acid, white precipitate, insoluble in nitric acid; iodide of potassium, a bright yellow precipitate. a delicate test for lead in water is to stir the water, concentrated or not, with a glass rod dipped in ammonium sulphide: a brown coloration is produced. one-tenth of a grain of lead in a gallon of water may be detected. chronic lead-poisoning is an 'industrial disease,' and, being an occupation risk, its victims are entitled to compensation at the hands of their employers. in case of death, compensation has been awarded even when at the autopsy the patient has been found to have suffered from acute tuberculosis of the lungs. the responsibility of apportioning the monetary value of disablement resulting from the action of the lead rests with a judge or jury, who are guided by the expert medical evidence available. diachylon, or lead-plaster, is largely used as an abortifacient. xxv.--copper and its preparations poisoning with copper salts is rare. the most important are the sulphate, subacetate, and arsenite. =sulphate of copper= (bluestone, blue vitriol) in half-ounce doses is a powerful irritant. has been given to procure abortion. =subacetate of copper= (verdegris) occurs in masses, or as a greenish powder. powerful, astringent, metallic taste. half-ounce doses have proved fatal. _symptoms._--epigastric pain, vomiting of bluish or greenish matter, diarrhoea. dyspnoea, depression, cold extremities, headache, purple line round the gums. jaundice is common. a _chronic_ form of poisoning may occur, with symptoms closely resembling those of lead. _post-mortem appearances._--inflammation of stomach and intestines, which are bluish or green in colour. _treatment._--encourage vomiting. give albumin or very dilute solution of ferrocyanide of potassium. _method of extraction from the stomach._--boil the contents of the stomach in water, filter, pass hydrogen sulphide, filter, collect precipitate and boil in nitric acid, filter, dilute filtrate with water and apply tests. in the case of the solid organs, dry, incinerate, digest ash in hydrochloric acid, evaporate nearly to dryness, dilute with water, and test. _tests._--polished steel put into a solution containing a copper salt receives a coating of metallic copper. ammonia gives a whitish-blue precipitate, soluble in excess. ferrocyanide of potassium gives a rich red-brown precipitate. sulphuretted hydrogen gives a deep brown precipitate. xxvi.--zinc, silver, bismuth, and chromium the salts of zinc requiring notice are the sulphate and chloride. =sulphate of zinc= has been taken in mistake for epsom salts. in large doses it causes dryness of throat, thirst, vomiting, purging, and abdominal pain. _post-mortem appearances._--those of inflammation of digestive tract. _treatment._--tea, decoction of oak-bark, carbonate of potassium or sodium as antidote. =chloride of zinc.=--a solution containing this substance ( grains to the ounce) constitutes 'burnett's disinfecting fluid.' it is a corrosive poison. the symptoms are burning sensation in the mouth, throat, stomach, and abdomen, followed by vomiting, diarrhoea, with tenesmus and distension of the abdomen. the vomited matter contains shreds of mucous membrane with blood. there is profound collapse, cold surface, clammy sweats, weak pulse, with great prostration. the _treatment_ is to wash out the stomach with large and weak solutions of carbonate of sodium. mucilaginous drinks may be given, and hypodermic injections of morphine are useful to allay the pain. _method of extraction from the stomach._--dry and incinerate the tissues in a porcelain crucible, digest ash in water, apply tests. _tests._--ammonia, a white precipitate soluble in excess, reprecipitated by sulphuretted hydrogen; ferrocyanide of potassium, a white precipitate; sulphuretted hydrogen, a white precipitate in pure and neutral solutions. nitrate of baryta will show the presence of sulphuric acid, and nitrate of silver of hydrochloric acid. =silver.=--nitrate of silver is a powerful irritant. _tests._--black precipitate with sulphuretted hydrogen; white with hydrochloric acid. _treatment._--common salt. chronic nitrate of silver poisoning is characterized by _argyria_. the gums show a blue line, which is darker than that produced by lead, and the skin presents a greyish hue, which is permanent. =bismuth.=--the bismuth salts are not poisonous, but may contain arsenic as an impurity, although this is far less common than it was some years ago. =chromic acid, chromate, bichromate of potassium.=--these act as corrosives when solid or in concentrated liquid forms. in dilute solutions they act as irritants. used as dyes; have proved fatal more than once. those engaged in their manufacture suffer from unhealthy ulcers on the nasal septum and hands. the former may to some extent be prevented by taking snuff. lead chromate (chrome yellow) is a powerful irritant poison. two drachms of the bichromate caused death in four hours. _tests._--yellow precipitate with salts of lead, deep red with those of silver. _treatment._--emetics, magnesia, and diluents. washing out of the stomach with weak solution of nitrate of silver. xxvii.--gaseous poisons =carbon dioxide.=--carbon dioxide is a product of combustion and respiration, and is generated in many ways during fermentation. it is a constituent of _choke damp_ due to explosions in coal-mines, and is given off from lime-kilns, brick-kilns, and cement-works. it is often met with in dangerous quantities in wells and in brewers' vats. from to per cent. in the atmosphere would prove fatal, but even per cent. inhaled for long would produce serious symptoms. the proportion usually present in air is . per cent. _symptoms._--inhalation of the _pure_ gas causes spasm of the glottis, insensibility, and death from asphyxia, at once; _diluted_, causes sense of weight in forehead and back of head, giddiness, vomiting, somnolence, loss of muscular power. insensibility, stertorous breathing, lividity of face and body, and death from asphyxia. convulsions occasionally. _post-mortem appearances._--face swollen and livid, or calm and pale; lividity is most marked in eyelids, lips, ears, etc.; limbs usually flaccid, abdomen distended; right side of heart, lungs, and large veins, gorged with dark-coloured blood. brain and membranes congested. _treatment._--pure air, cold affusion, stimulants, artificial respiration, galvanism, inhalation of oxygen, venesection, transfusion. =carbonic oxide.=--this is one of the most poisonous of gases. it is evolved in the process of burning charcoal and coke in stoves or furnaces. water-gas, obtained by passing steam over heated coke, contains per cent. of the substance, the remainder being chiefly hydrogen. it forms the chief part of the deadly 'choke damp' after an explosion in a mine. two per cent. in the atmosphere is immediately fatal. _symptoms._--when in _large amount_, insensibility comes on at once; when in _very small amounts_, headache, giddiness, noises in the ears, nausea, and vomiting, with prostration, insensibility, and coma. there may be convulsions. even in cases which recover, permanent impairment of the brain may result. _post-mortem appearances._--the blood is bright red in colour, due to the interaction of carbonic oxide with hæmoglobin. a rosy hue of the skin-surface and viscera is often noticed. bright red patches of colour are found over the surface of the body. the spectrum of the blood is characteristic. _treatment._--ammonia to the nostrils, inhalation of oxygen, cold douche in moderation, artificial respiration, transfusion of blood. =coal gas.=--coal gas contains light carburetted hydrogen or marsh gas, olefiant gas, ammonia, sulphuretted hydrogen, carbonic acid, carbonic oxide, free hydrogen, and nitrogen. coal gas has an offensive odour, burns with a yellowish-white flame, yielding water and carbonic acid. cases of poisoning often due to escape of gas into the room. _symptoms._--headache and giddiness, foaming at mouth, vomiting, convulsions, tetanic spasms, stertorous breathing, dilated pupil. the breath smells of gas; there is profound stupor; the patient, if alive, exhales gas from the lungs when removed into a fresh room or into the air. smell of gas in the room and in patient's breath. _post-mortem appearances._--pallor of skin and internal tissues; florid colour of neck, back, and muscles, if much co present in the coal gas; fluid florid blood; infiltration of lungs. _treatment._--fresh air, artificial respiration, cold affusion, diffusible stimulants; inhalation of oxygen freely. =sulphuretted hydrogen= is characterized by its odour, like that of rotten eggs. it is extremely poisonous. _symptoms._--giddiness, pain and oppression in stomach, nausea, loss of power; delirium, tetanus, and convulsions. _post-mortem appearances._--fluid and black blood (sulph-hæmoglobin), smell of h_{ }s on opening the body; loss of contractility of muscles, rapid putrefaction. _treatment._--fresh air, stimulants, inhalation of chlorine. _tests._--acetate of lead throws down a brown or black precipitate according to the quantity of the gas. =sewer gas.=--cesspool emanations usually consist of a mixture of sulphuretted hydrogen, sulphide of ammonium, and nitrogen; but sometimes it is only deoxidized air with an excess of carbonic acid gas. _symptoms._--if poison concentrated, death may ensue at once; if gas diluted, or exposure only short, insensibility, lividity, hurried respiration, weak pulse, dilated pupils, elevation of temperature to °, tonic convulsions not unlike those of tetanus. _treatment._--fresh air, oxygen, with artificial respiration. stimulants, hypodermic of strychnine, and alternate hot and cold douche. =irritant gases= are--( ) nitrous acid gas; ( ) sulphurous acid gas; ( ) hydrochloric acid gas; ( ) chlorine; ( ) bromine; ( ) ammonia. they have the common property of causing irritation and inflammation of the eyes, throat, and air-passages, and may cause spasm of the glottis, bronchitis, and pneumonia. =sulphurous acid gas.=--one of the products of combustion of common coal. =hydrochloric acid gas.=--irrespirable when concentrated, and very irritating when diluted. very destructive to vegetable life. =chlorine.=--used in bleaching, and as a disinfectant. greenish-yellow colour, suffocating odour. in poisoning, inhalation of sulphuretted hydrogen gives relief. xxviii.--vegetable irritants the chief vegetable purgatives are aloes, colocynth, gamboge, jalap, scammony, seeds of castor-oil plant, croton-oil, elaterium, the hellebores, and colchicum. all these have, either alone or combined, proved fatal. the active principle in aloes is aloin; of jalap, jalapin; of white hellebore, veratria; and of colchicum, colchicin. morrison's pills contain aloes and colocynth; aloes is also the chief ingredient in holloway's pills. _symptoms._--vomiting, purging, tenesmus, etc., followed by cold sweats, collapse, or convulsions. _post-mortem appearances._--inflammation of alimentary canal; ulceration, softening, and submucous effusion of dark blood. _treatment._--diluents, opium, stimulants, abdominal fomentations, etc. certain of these irritant poisons exert a marked influence on the central nervous system, as the following: =laburnum= (_cytisis laburnum_).--all parts of the plant are poisonous; the seeds, which are contained in pods, are often eaten by children. contains the alkaloid _cytisine_, which is also contained in arnica. it has a bitter taste, and is powerfully toxic. symptoms are purging, vomiting, restlessness, followed by drowsiness, insensibility, and convulsive twitchings. death due to respiratory paralysis. most of the cases are in children. treatment consists of stomach-pump or emetics, stimulants freely, artificial respiration, warmth and friction to the surface of the body. =yew= (_taxus baccata_) contains the alkaloid _taxine_. the symptoms are convulsions, insensibility, coma, dilated pupils, pallor, laboured breathing, collapse. death may occur suddenly. treatment as above. post-mortem appearances not characteristic, but fragments of leaves or berries may be found in the stomach and intestines. =arum= (_arum maculatum_).--this plant, commonly known as 'lords and ladies,' is common in the woods, and the berries may be eaten by children. it gives rise to symptoms of irritant poisoning, vomiting, purging, dilated pupils, convulsions, followed by insensibility, coma, and death. many plants have an intensely irritating action on the skin, and when absorbed act as active poisons. =rhus toxicodendron= is the poison oak or poison ivy. poisoning by this plant is rare in england, though not uncommon in the united states. mere contact with the leaves or branches will in many people set up an acute dermatitis, with much oedema and hyperæmia of the skin. the inflammation spreads rapidly, and there is formation of blebs with much itching. there is often great constitutional disturbance, nausea, vomiting, diarrhoea, and pains in the abdomen. the effects may last a week, and the skin may desquamate. =primula obconica= is another plant which, when handled, gives rise to an acute dermatitis of an erysipelatous character. the face swells, and large blisters form on the cheeks and chin. xxix.--opium and morphine =opium.=--the inspissated juice of the unripe capsules of the _papaver somniferum_. as a poison it is generally taken in the form of the tincture (laudanum), which contains grain opium in minims. opium is found in almost all so-called 'soothing syrups' for children, and in godfrey's cordial, dalby's carminative, and collis browne's chlorodyne. laudanum contains per cent. morphine, and it, along with all other preparations (_e.g._, paregoric) which contain or more per cent. morphine, are included in part i. of the schedule of poisons, and come under the dangerous drugs regulations. the most important active principles of opium are the alkaloids morphine and codeine. _symptoms_ usually commence in from twenty to thirty minutes: giddiness, drowsiness and stupor, followed by insensibility. patient seems asleep; may be roused by loud noise, but quickly relapses. breathing slow and stertorous, pulse weak, countenance livid. as coma increases, pulse becomes slower and fuller. the pupils are contracted, even to a pin's point; they are insensible to the action of light. in deep, natural sleep the eyes are turned upwards and the pupils contracted. bowels confined, skin cold and livid or bathed in sweat. temperature subnormal. nausea and vomiting are sometimes present. remissions are not infrequent, the patient appearing about to recover and then relapsing. hæmorrhage into the pons may give rise to contracted pupils. young children and infants are specially susceptible to the poison. _diagnosis_ is not always easy, and one has to differentiate poisoning from _cerebral apoplexy_. in the latter one can seldom rouse the patient, the pupils are often unequal, and hemiplegia is present. in _compression of the brain_, fracture of the skull may be present, subconjunctival hæmorrhages may be seen, the pupils are unequal and dilated, and the paralysis increases. in _uræmic or diabetic coma_ the urine must be examined. the habitual use of opium is not uncommon, and opium-eaters are able to take enormous quantities of the drug. the opium-eater may be known by his attenuated body, withered yellow countenance, stooping posture, and glassy, sunken eyes. _post-mortem appearances._--not characteristic. turgescence of cerebral vessels. there may be effusion under arachnoid, into ventricles, at base of the brain, and around the cord. rarely extravasation of blood. stomach and intestines usually healthy. lungs gorged, skin livid. _fatal period._--usually nine to twelve hours; but in many cases, if life is prolonged for eight hours, recovery takes place. _fatal dose._--four grains of opium is the smallest fatal dose in an adult, or one drachm of laudanum; children are proportionately much more susceptible to the action of opium than adults. _treatment._--stomach-tube, emetics, strong coffee or tea, ammonia to nostrils. give grains of permanganate of potassium in a pint of water acidulated with sulphuric acid, and repeat the dose every half hour. belladonna by mouth, or atropine hypodermically. patient must be kept roused by dashing cold water over him, flagellating with a wet towel, walking about, etc. in conditions of collapse, however, this treatment must not be continued, but everything should be done to preserve the strength. treatment must be continued as long as life remains. _method of extraction from the stomach._--opium itself cannot be directly detected, but we test for morphine and meconic acid. these may be separated from organic mixtures thus: boil the organic matter with distilled water, spirit, and acetic acid; filter, and to the fluid passed through add acetate of lead till precipitate ceases. filter. acetate of morphine passes through, and meconate of lead remains. the solution of acetate of morphine may be freed from excess of lead by hydrogen sulphide and filtered, excess of hydrogen sulphide driven off by heat, and tests applied. put the meconate of lead with water into a beaker and pass hydrogen sulphide; sulphide of lead is formed, and meconic acid set free. filter. concentrate the solution of meconic acid, allow a portion to crystallize, and apply tests. _tests._--morphine and its acetate give an orange-red colour with nitric acid, becoming brighter on standing; decompose iodic acid, setting free iodine; with perchloride of iron, gives a rich indigo-blue; with bichromate of potassium, a green turning to brown. when the alkaloid is heated in a watchglass with a drop of strong sulphuric acid until the acid begins to fume, and is then allowed to get quite cold, a drop of nitric acid produces a brilliant red colour. the iodic acid test is very delicate, but requires great care, and may be used in the presence of organic matter. meconic acid gives a blood-red colour with perchloride of iron, not discharged by corrosive sublimate or chloride of gold. the similar colour produced by sulpho-cyanide of potassium and perchloride of iron is discharged by chloride of gold and corrosive sublimate. =morphine habit.=--individuals who have acquired this habit take the drug usually by hypodermic injection. the victim suffers from nausea and vomiting, and becomes so mentally debilitated that asylum treatment is required. xxx.--belladonna, hyoscyamus, and stramonium =belladonna.=--the root, leaves, and berries, of the _atropa belladonna_ are poisonous from the presence of alkaloid atropine. _symptoms._--dryness of mouth and throat, intense thirst, dysphagia and dysphonia, quick pulse, noisy delirium and stupor. strangury and hæmaturia, and redness of the skin, especially of the face, like that of scarlatina, have been noticed. dilatation of the pupil occurs, whether the poison be taken internally or applied locally to the eye. _post-mortem appearances._--congestion of cerebral vessels, dilated pupils, red patches in alimentary canal. _treatment._--wash out the stomach freely; a hypodermic injection of apomorphine as an emetic, followed by hypodermic injections of pilocarpine or morphine. tea, coffee, or tannin, to precipitate the alkaloid. _tests._--atropine may be recognized by its action on the pupil. the chloro-iodide of potassium and mercury precipitates it from very dilute solutions. =hyoscyamus= (henbane).--_hyoscyamus niger._ =stramonium= (thorn-apple).--_datura stramonium._ _symptoms._--identical with those of belladonna and hyoscyamus, the _post-mortem appearances_ and _treatment_ being also the same. =cannabis indica= (indian hemp).--when smoked, produces intoxication and mania. _hashish_, used in the east as a narcotic, may cause persons to run 'amok' and commit murder. xxxi.--cocaine =cocaine.=--any dose above / grain applied to a mucous membrane or injected hypodermically may give rise to alarming symptoms. these are intense pallor, faintness, giddiness, dilatation of pupils, paroxysmal dyspnoea, rapid, intermittent, and weak pulse, nausea and vomiting, intense prostration verging on collapse, and convulsions. the patient may recover if allowed to remain in a recumbent position, but stimulants by mouth--_e.g._, ammonia--and the hypodermic injection of brandy or ether may be necessary, with the inhalation of nitrite of amyl. for care in the prescribing of cocaine see under the 'dangerous drugs act, ' (p. ). the =cocaine habit= consists in the self-administration of the drug hypodermically. it induces excitement, which is followed by prostration. in time melancholia or mania develops, with great irritation of the skin ('cocaine bugs'). xxxii.--camphor the liniment, oil, and spirit have been poisonous in large dose. _symptoms._--odour of breath, languor, giddiness, faintness, dimness of vision, difficulty of breathing, delirium, convulsions, with hot skin, flushed face, and dilated pupils. _fatal dose._--thirty grains. =cocculus indicus.=--the fruit of _anamirta cocculus_. contains a poisonous active principle, picrotoxin; used to adulterate beer, and by poachers to stupefy fish. _symptoms._--convulsions, followed by stupor and complete loss of voluntary power. xxxiii.--tetrachlorethane, etc. =tetrachlorethane= ('cellon').--acetylene tetrachloride; vapour has caused poisoning in aeroplane ('dope') and cinema film works. _symptoms._--gastric symptoms and marked jaundice. this may be followed in days or weeks by stupor, coma, death. _post-mortem._--fatty degeneration of internal organs, chiefly liver. =trinitrotoluene (t.n.t.).=--an explosive solid which stains the skin an orange colour; may be absorbed through skin or be inhaled. _symptoms._--shortness of breath, headache, drowsiness. later, skin irritation, gastritis, jaundice, blood degeneration. _treatment._--remove from work, rest in bed, diuretics, purgatives, alkalies. xxxiv.--alcohol, ether, and chloroform alcohol, ether, and chloroform, induce general anæsthesia, often preceded by delirious excitement, and followed by nausea and vomiting. when they cause death, it is by inducing a state like apoplexy or by paralyzing the heart. =alcohol.=--absolute alcohol is ethyl hydroxide (c_{ }h_{ }oh) with not more than per cent. by weight of water. rectified spirit (spiritus rectificatus) contains per cent. of alcohol. methylated spirit consists of rectified spirit with per cent. of wood spirit. proof spirit contains a little over per cent. of absolute alcohol; brandy or whisky, per cent.; port wine, to per cent.; ales and stout, to per cent. _symptoms._--acute poisoning; confusion, giddiness, staggering gait, headache, passing into stupor, with subnormal temperature, and coma. vomiting may occur and recovery ensue, otherwise collapse sets in. pupils usually dilated. dipsomaniacs suffer from indigestion, vomiting and purging, jaundice, albuminuria, diabetes, cirrhosis of liver, degeneration of kidneys, congestion of brain, peripheral neuritis, alcoholic insanity, and various forms of paralysis. in the acute form delirium tremens is the most common manifestation. _post-mortem appearances._--deep red colour of lining membranes of stomach. sometimes congestion of cerebral vessels and meninges. lungs congested, blood fluid. rigor mortis persistent. _fatal dose._--death from / pint of gin and from two bottles of port, but recovery from larger quantities. _fatal period._--average about twenty-four hours. _treatment._--stomach-tube, cold affusion, electricity, injection of a pint of hot coffee into the rectum. give chloride of ammonium in grain doses to prevent delirium; strychnine or digitalin hypodermically. _method of extraction from the stomach._--neutralize the contents of the stomach, if acid, with sodium carbonate; place them in a retort and carefully distil. collect the distillate, mix with chloride of calcium or anhydrous sulphate of copper, and again distil. agitate distillate with dry potassium carbonate, and draw off some of the supernatant fluid for testing. _tests._--odour. dissolves camphor. with dilute sulphuric acid and bichromate of potassium turns green, and evolves aldehyde. product of combustion makes lime-water white and turbid. =methyl alcohol: wood naphtha.=--used to produce intoxication by painters, furniture-polishers, etc. _symptoms_ are those of alcoholic poisoning, but vomiting and delirium are more persistent. total or partial blindness may follow as a sequel of optic atrophy. a fatal result not infrequently follows. the following table gives the points of distinction between concussion of brain, alcoholic poisoning, and opium poisoning: concussion of brain. alcohol. opium. . marks of violence . no marks of violence, . as alcohol. on head. unless person has fallen. history will be of use. . stupor, sudden. . excitement precedes . symptoms slow. sudden stupor. drowsiness, stupor, lethargy. . face pale, cold; . face flushed; pupils . face pale; pupils pupils sluggish, generally dilated. contracted. sometimes dilated. . remission rare. . partial recovery may . remission rare. patient recovers occur, followed by slowly. death. . no odour of alcohol . odour of alcohol . odour of opium in in breath. in breath. breath. =ether= is a volatile liquid prepared from ethylic alcohol by interaction with sulphuric acid. it contains per cent. of ethyl oxide (c_{ }h_{ })o. it was formerly called 'sulphuric ether.' it is a colourless, inflammable liquid, having a strong and characteristic odour, specific gravity . . =purified ether= from which the ethylic alcohol has been removed by washing with distilled water, and most of the water by subsequent distillation in the presence of calcium chloride and lime. it is this preparation which is used for the production of general anæsthesia. it has a specific gravity of . to . , and its vapour is very inflammable. _symptoms._--when taken as a liquid, same as alcohol. when inhaled as vapour, causes slow, prolonged, and stertorous breathing; face becomes pale, lips bluish, surface of body cold. pulse first quickens, then slows. pupils dilated, eyes glassy and fixed, muscles become flabby and relaxed, profound anæsthesia. then pulse sinks and coma ensues, sensation being entirely suspended. nausea and vomiting not uncommon. _post-mortem appearances._--brain and lungs congested. cavities of heart full of dark, liquid blood. vessels at upper part of spinal cord congested. _treatment._--exposure to pure air, cold affusion, artificial respiration, galvanism. _method of extraction from the contents of the stomach._--same as for alcohol. during distillation pass some of the vapour into concentrated solution of bichromate of potash, nitric and sulphuric acids, and note reaction as for alcohol. _tests._--vapour burns with smoky flame, depositing carbon. sparingly soluble in water. with bichromate of potash and sulphuric acid same as alcohol. =chloroform.=--a colourless liquid, specific gravity . to . , very volatile, giving off dense vapour. sweet taste and pleasant odour. _symptoms._--when swallowed, characteristic smell in breath, anxious countenance, burning pain in the throat, stomach, and region of the abdomen, staggering gait, coldness of the extremities, vomiting, insensibility, deepening into coma, with stertorous breathing, dilated pupils, and imperceptible pulse. when inhaled, much the same as ether, but produces insensibility and muscular relaxation more rapidly. it would be impossible to instantly render a person insensible by holding a pocket-handkerchief saturated with chloroform over the face. statements such as this, which are often made in cases of robbery from the person and in cases of rape, are incredible. _delayed chloroform-poisoning._--death may take place in from four to seven days after chloroform has been administered, especially in the case of children. the internal organs are found to be fattily degenerated, and death is thought to be due to acetonuria. _post-mortem appearances._--cerebral and pulmonary congestion. heart empty, or right side distended with dark blood. _treatment._--stomach-tube and free lavage; cold affusion; drawing forward tongue; artificial respiration; galvanism and suspension with head downward. inhalation of nitrite of amyl; strychnine hypodermically. _fatal dose._--when swallowed, from to ounces. _method of extraction from the stomach._--by distillation at ° f. the vapour, as it passes along a glass tube, may be decomposed by heat into chlorine, hydrochloric acid, and carbon--the first shown by setting free iodine in iodide of starch, the second by reddening blue litmus-paper, and the last by its deposit. _tests._--taste, colour, weight; burns with a green flame; dissolves camphor, guttapercha, and caoutchouc. =iodoform.=--poisoning may result from its use in surgery. it produces delirium, sleepiness, and coma. it may lead to mental weakness or optic neuritis. xxxv.--chloral hydrate it was formerly largely used as a hypnotic, and many fatal consequences ensued. it is prepared from alcohol and chlorine. _symptoms._--deep sleep, loss of muscular power, diminished or abolished reflex action and sensibility, followed by loss of consciousness and marked fall of temperature. pulse may become quick, and face flushed or livid and bloated. prolonged use of this drug may produce a peculiar eruption on the skin. supposed to act in the blood by being decomposed into chloroform and sodium formate. its effects are due chiefly to depression of the central nervous system, the medulla being the last part of the nervous system to be attacked. _method of extraction from the stomach._--by distillation in strongly alkaline solutions, when it may be obtained as chloroform and tested as such. _treatment._--stomach-tube or emetic. hypodermic injections of strychnine. keep patient warm, and inject a pint of hot strong coffee into the rectum. nitrite of amyl and artificial respiration. _tests._--heated with caustic potash, it yields chloroform and potassium formate. the chloroform is readily recognized by its odour, and, if the solution be concentrated, by separating as a heavy layer at the bottom of the test-tube. xxxvi.--petroleum and paraffin-oil cases of poisoning by petroleum and paraffin are common, and occur chiefly in children. =petroleum= is a natural product, and is a mixture of the higher saturated hydrocarbons. the crude petroleum is purified by distillation, and is then free from colour, but retains its peculiar penetrating odour. different varieties are sold under the names of cymogene, gasolene, naphtha, petrol, and benzoline. benzoline is highly inflammable, and is often called mineral naphtha, petroleum naphtha, and petroleum spirit. benzoline is not the same as benzene or benzol, which is one of the products of the dry distillation of coal. from its very general use as a fuel in motor-cars many accidents have happened from inhaling the vapour of petrol. it gives rise to coldness, shallow respiration, syncope, and insensibility, but seldom death. =paraffin=, also known as kerosene and mineral oil, is a mixture of saturated hydrocarbons obtained by the distillation of shale. by the retailer the terms 'petroleum' and 'paraffin' oil are used indifferently, and each is sold for the other without prejudice. _symptoms._--these substances are not very active poisons, and, as a rule, even children recover. the breath has the odour of paraffin, the face is pale and cyanotic, hot and dry, and there may be vomiting. death may result from gastro-enteritis or from coma. _fatal dose._--in the case of an adult, / pint should not prove lethal, and patients have recovered after drinking a pint. _treatment._--emetics, purgatives, and stimulants. xxxvii.--antipyrine, antifebrin, phenacetin, and aniline many of the synthetical coal-tar products now so largely employed as analgesics are powerful toxic agents. =phenazone, antipyrine, or analgesin=, is a complex benzene derivative prepared from aniline, aceto-acetic ether, and methyl iodide. it is in colourless, inodorous, scaly crystals, which have a bitter taste. it is soluble in its own weight of water. _tests._--can be extracted from an alkaline solution of chloroform. the residue left on the evaporation of chloroform should be employed for testing. if heated with strong nitric acid and allowed to cool, a purple colour is produced. ferric chloride gives a blood-red coloration, destroyed by the addition of mineral acids. _treatment._--stimulants freely, inhalation of oxygen, patient to be kept in the recumbent position. =acetanilide, antifebrin, phenylacetamide= (a constituent of 'daisy' or 'headache' powders), is obtained by the interaction of acetic acid and aniline. it is in colourless, inodorous, lamellar crystals, which have a slight pungent taste. it is insoluble in water. _tests._--may be extracted from acid solutions by ether or chloroform. if heated with solution of potassium hydroxide, odour of aniline is given off; if liquid, when it is warmed with a few drops of chloroform, a penetrating and unpleasant odour of isocyanide. _treatment._--emetics, stimulants, inhalation of ether, recumbent position. =phenacetin, phenacetinum=, is produced by the interaction of glacial acetic acid and para-phenetidin. it is in white, tasteless, inodorous, glistening, scaly crystals, insoluble in water. of all the members of the group, it most rarely produces toxic symptoms. _treatment._--as for the other members of this group. =exalgin, aspirin, etc.=, as well as the above, may all act as poisons to certain persons, and even small medicinal doses may cause serious and even fatal consequences. _symptoms_ (more or less common to all).--nausea, vomiting, hurried respiration, marked cyanosis, syncope. persistent sneezing and widespread urticaria may be present; collapse. =aniline= is an oily liquid, heavier than, and not soluble in, water. it is colourless or reddish-brown; it has a peculiar tar-like odour; it is soluble in alcohol, and forms a soluble sulphate with sulphuric acid. a solution of bleaching-powder gives with solution of the sulphate a purple colour changing to red-brown. _symptoms._--nausea, vomiting, giddiness, intoxication, drowsiness, gasping for breath, feeble pulse, and marked cyanosis. in its _industrial use_ it may act as a poison either by inhalation of the fumes or by absorption through the skin. the symptoms then are mainly those of peripheral neuritis with blindness. _fatal dose._--about drachms. _treatment._--wash out stomach; stimulants, artificial respiration, inhalation of oxygen, transfusion. =nitro-benzol= (artificial oil of bitter almonds).--it is used in perfumery, but is very poisonous when swallowed, or inhaled, or absorbed through skin. it is used in the manufacture of aniline dyes, and may act as an industrial poison. the symptoms closely resemble those of aniline poisoning, but there is perhaps greater mental confusion. _fatal dose._--eight to ten drops have caused death. _treatment._--emetics, stimulants, transfusion of saline or blood, pituitrin, strychnine, or digitalin hypodermically. =nitroglycerine= gives rise to intense and persistent headache ('powder headache'). throbbing and pulsation of all the arteries in the body; flushing of the face and collapse may follow. =dinitrobenzene= causes symptoms resembling nitro-benzol poisoning, and when acting as a chronic poison gives rise to weakness, jaundice, peripheral neuritis. xxxviii.--sulphonal, trional, tetronal, veronal, paraldehyde these are dangerous drugs. the ordinary _symptoms_ of the group are noises in the ears, headache, vertigo, inability to stand or to walk properly, insensibility, and cyanosis. the most interesting point is the condition of the urine. in cases of poisoning it is dark or reddish-brown in colour, due to the presence of _hæmatoporphyrin_. it contains albumin and casts, but no red corpuscles. in cases of hæmatoporphyrinuria the prognosis is bad, and it is said that these cases invariably end fatally. _treatment._--in an ordinary case emetics, strong coffee, hypodermic injections of strychnine, saline injections, and transfusion. cases of chronic poisoning from the 'als' are not uncommon, and are increasing in frequency. hypnogen is apparently identical with veronal. all the above-named aniline derivatives are included in part i. of the scheduled poisons. xxxix.--conium and calabar bean =conium maculatum= (spotted hemlock).--all parts of the plant are poisonous, often mistaken for parsley. contains the poisonous principle _coniine_, a volatile liquid alkaloid with a mousy smell; insoluble in water; soluble in alcohol, ether, and chloroform. it also contains methyl coniine. _symptoms._--dryness of throat, headache, dilated pupil, dysphagia, loss of muscular power, passing into complete paralysis. delirium, coma, and convulsions, occasionally. _post-mortem appearances._--congested brain and lungs; redness of the mucous membrane of the stomach. the stomach and intestines should be examined for fragments of the leaves and fruit, recognized by their microscopical appearances. _treatment._--emetics, tannic acid or gallic acid. diffusible stimulants. _method of extraction from the stomach._--use stas-otto process. _tests._--the mousy odour. deepened colour and dense white fumes with nitric acid. pale red, deepening, with hydrochloric acid. there are several other umbelliferous plants which are poisonous. the water hemlock (_cicuta virosa_) produces symptoms not unlike those of hemlock; it has been mistaken for parsnip and celery. it contains an active principle, _cicutoxin_, which in some respects is allied to strychnine and picrotoxin. the fool's parsley, or lesser hemlock (_Æthusa cynapium_), is another member of this group, although doubt has been expressed as to whether it is really poisonous. the water dropwort (_oenanthe crocata_) is undoubtedly poisonous, especially to cattle. in man it produces abdominal pain with diarrhoea and vomiting; dilated pupils, slow pulse, and cyanosis; delirium, insensibility, and convulsions. the post-mortem appearances are not characteristic, but the stomach and intestines should be examined for portions of the plant. =calabar bean or physostigma.=--the bean of _physostigma venenosum_ contains the alkaloid physostigmine or eserine, with the antagonistic alkaloid calabarine. _symptoms._--vomiting, giddiness, irregular cardiac action, contraction of the pupils, paralysis of lower extremities, and death from asphyxia. _treatment._--emetics; hypodermic injection of / grain sulphate of atropine, repeated if necessary. _method of extraction from the stomach._--use stas-otto process. _test._--the contraction of the pupil which it causes. xl.--tobacco and lobelia =tobacco.=--_nicotiana tabacum_ owes its poisonous properties to its alkaloid nicotine, a volatile, oily, amber-coloured liquid, with an acrid taste and ethereal odour; soluble in water, alcohol, ether, and chloroform. the drug has an intense depressant action on the heart and respiratory centre. _symptoms._--giddiness, fainting, nausea, and vomiting, with syncope, muscular tremors, stupor, stertorous breathing, and insensible pupil. death has occurred after seventeen or eighteen pipes at a sitting. _post-mortem appearances._--not uniform or characteristic. general relaxed condition of muscles; engorgement of cerebral and pulmonary vessels. congestion of gastric mucous membrane. _treatment._--emetics, stimulants, hypodermic injection of / grain of strychnine. warmth to the surface by hot bottles, hot blankets. _method of extraction from the stomach._--digest the contents of the stomach in cold distilled water and _very dilute_ sulphuric acid; strain, filter, and press residue. evaporate the filtrate to half its bulk, digest with alcohol, and evaporate alcohol off in a water-bath. dissolve residue (sulphate of nicotine) in water, and make solution alkaline with potash; then shake with ether in a test-tube. remove ether and allow it slowly to evaporate. test resulting alkaloid. _tests._--no change of colour with the mineral acids. white deposit with corrosive sublimate. sulphuric acid and bichromate of potassium give a green colour, oxide of chromium. precipitate with bichloride of platinum and with carbazotic acid. =lobelia inflata= (indian tobacco).--much used in america by the coffenite practitioners, and a valuable remedy for asthma. _symptoms._--nausea, vomiting, giddiness, cold sweats, prostration. headache, giddiness, tremors, insensibility, and convulsions. xli.--hydrocyanic acid =prussic acid= is the most active of poisons. the diluted hydrocyanic acid of the pharmacopoeia contains per cent. of hydrocyanic acid, scheele's per cent. it is a colourless liquid, feebly acid, with odour of bitter almonds. =cyanide of potassium= is largely used in photography and in electro-plating, and is also poisonous. it often contains undecomposed carbonate of potassium, which may act as a corrosive poison and cause erosion of the mucous membranes of the lips, mouth, and stomach. =oil of bitter almonds=, used as a flavouring agent, may contain (when improperly prepared) from to per cent. of the anhydrous acid. _symptoms._--the symptoms usually come on in a few seconds, and are of the shortest possible duration. there is a sudden gasp for breath, possibly a loud cry, and the patient drops down dead. if the fatal termination is prolonged for a few minutes, the symptoms are intense giddiness, pallor of the skin, dilatation of the pupils, laboured and irregular breathing, small and frequent pulse, followed by insensibility. there may be convulsions or tetanic spasms, with evacuation of urine and fæces. death results from paralysis of the central nervous system, but artificial respiration is useless, as the drug promptly arrests the heart's action. it also kills the protoplasm of the red blood-corpuscles, rendering them useless as oxygen-carriers. _post-mortem appearances._--skin livid, pale, or violet, with bright red patches on the dependent parts. the gastro-intestinal mucous membrane is bright red in colour, owing to the presence of cyanmethæmoglobin. hands clenched, nails blue, jaws fixed, froth about mouth. eyes prominent and glistening, odour of acid from body, venous system gorged. _treatment._--empty the stomach by the tube at once, and wash it out with a solution of sodium thiosulphate. strong ammonia to the nostrils. stimulants freely--brandy, chloric ether, ammonia, sal volatile _ad libitum_. if patient cannot swallow, inject hypodermically either brandy or ether. hypodermic injection of / grain atropine. douche to the face, alternately hot and cold. death commonly occurs so rapidly that there is no time for treatment. _fatal dose (smallest)._--half a drachm of the b.p. acid, equal to . grain of the anhydrous. _recovery_ from / ounce of the b.p. acid. these records are fallacious, for in specimens the percentage of anhydrous acid varies enormously. practically, grain of the anhydrous acid is fatal. _fatal period._--from two to five minutes after a large dose, but may be less. _method of extraction from the stomach._--having previously carefully fitted a watchglass to a wide-mouthed bottle, nearly fill the bottle with the contents of the stomach, blood, secretions, etc. place a few drops of a solution of nitrate of silver on the concave surface of the watchglass, and cover the mouth of the bottle with it. the vapour of hydrocyanic acid, if present, will form a white precipitate which may be tested. other watchglasses, treated with sulphide of ammonium or sulphate of iron and liquor potassæ, will give the reactions of the acid with appropriate tests. this method removes all objections as to foreign admixture. if the acid is not at first detected, gentle warming of the bottle in a water-bath will assist the evolution of the vapour. the vapour may be obtained by distillation, but this process is open to objections to which the other is not. in some cases it becomes changed in the body into formic acid, which should therefore be sought for. _tests._--with nitrate of silver a white precipitate, insoluble in cold, but soluble in boiling, nitric acid. the precipitate heated, evolves cyanogen, having an odour of peach-blossoms, and burning, when lighted, with a pink flame. liquor potassæ and sulphate of iron give a brownish-green precipitate, which turns to prussian blue with hydrochloric acid. liquor potassæ and sulphate of copper give a greenish-white precipitate, becoming white with hydrochloric acid. sulphide of ammonium gives sulpho-cyanide of ammonium. this develops a blood-red colour with perchloride of iron, bleached by corrosive sublimate. xlii.--aconite =aconite= (_aconitum napellus_, monkshood).--root and leaves. poisonous property depends upon an alkaloid, aconitine. aconite is one of the constituents of st. jacob's oil. _symptoms._--numbness and tingling in mouth, throat, and stomach, giddiness, loss of sensation, deafness, dimness of sight, paralysis, first of the lower and then of the upper extremities, vomiting, and shallow respiration. pupils dilated. pulse small, irregular, finally imperceptible. the mind remains unaffected. death often sudden. _post-mortem appearances._--venous congestion, engorgement of brain and membranes. _treatment._--emetics, stimulants freely. best antidote is sulphate of atropine, / grain hypodermically, and also strychnine. digitalis also useful. warmth to whole body. patient to make no exertion. _fatal dose._--of root or tincture, drachm. _fatal period._--average, less than four hours. _method of extraction from the stomach, etc._--extraction from contents of stomach by stas-otto process. it may be found in the urine; gives usual alkaloidal reactions, but no distinctive chemical test known. _tests._--chiefly physiological; tingling and numbness when applied to tongue or inner surface of cheek. effects on mice, etc. a cadaveric alkaloid or ptomaine has been found in the body, possessing many of the actions of aconitine. the presence of this substance was suggested in the lamson trial. the indian aconite, _aconitum ferox_, the bish poison, is much more active than the european variety. it contains a large proportion of pseudaconitine, and is frequently employed in india, not only for the destruction of wild beasts, but for criminal purposes. =aconitine= varies much in activity according to its mode of preparation and the source from which it is derived. the most active kind is probably made from _a. ferox_. xliii.--digitalis all parts of the plant _digitalis purpurea_ (purple foxglove) are poisonous. contains the glucoside digitalin and other active principles. _symptoms._--nausea, vomiting, purging, and abdominal pains. vomited matter grass-green in colour. headache, giddiness, and loss of sight; pupils dilated, insensitive; pulse weak, remarkably slow and irregular; cold sweat. salivation occasionally, or syncope and stupor. death sometimes quite suddenly. _post-mortem appearances._--congested condition of brain and membranes; inflammation of gastric mucous membrane. _treatment._--emetics freely; infusions containing tannin, as coffee, tea, oak-bark, galls, etc. stimulants. hypodermic injection of / grain of aconitine. _method of extraction from the stomach, etc._--use stas-otto process. _tests for digitalin._--a white substance, sparingly soluble in water, not changed by nitric acid; turns yellow, changing to green, with hydrochloric acid. the minutest trace of digitalin moistened with sulphuric and treated with bromine vapour gives a rose colour, turning to mauve. this is very delicate, but in experienced hands the physiological test is more reliable. the chemist who has had no practical experience in pharmacological methods would be wiser to keep to his chemical tests. xliv.--nux vomica, strychnine, and brucine =nux vomica= consists of the seeds of the _strychnos nux vomica_. from these strychnine and brucine are obtained. the symptoms, post-mortem appearances, and treatment, of poisoning by nux vomica are the same as for strychnine. =strychnine= is a powerful poison, and forms the active ingredient of many 'vermin-killers.' it occurs as a white powder or as colourless crystals, with a persistent bitter taste; very slightly soluble in water; more or less soluble in benzol, ether, and alcohol. _symptoms._--sense of suffocation, twitchings of muscles, followed by tetanic convulsions and opisthotonos, each lasting half to two minutes. mental faculties unaffected, face congested and anxious; eyes staring, lips livid; much thirst. the period of accession of the symptoms varies with the mode of administration of the poison. symptoms, as a rule, come on soon after food has been taken. patient may die within a few hours from asphyxia or from exhaustion. in _tetanus_ there is usually history of a wound; the symptoms come on slowly; lockjaw is an early symptom, and only later complete convulsions; the intervals between the fits are never entirely free from rigidity. death is delayed for some days. _post-mortem appearances._--heart empty, blood fluid, rigor mortis persistent. hands usually clenched; feet arched and inverted. congestion of brain, spinal cord, and lungs. _treatment._--emetics or stomach-pump if the patient is deeply anæsthetized. tannic acid and permanganate of potassium. bromide of potassium / ounce with chloral grains, repeated if necessary. _fatal dose (smallest)._--quarter of a grain. _fatal period (shortest)._--ten minutes; usually two to four hours. _method of extraction from the stomach._--the alkaloid may be separated by the process of stas-otto. _tests._--strychnine has a characteristic, very bitter taste; it imparts this taste to even very dilute solutions; it is unaffected by sulphuric acid, but gives a purple-blue colour, changing to crimson and light red, when the edge of this solution is touched with dioxide of manganese, potassium bichromate, ferricyanide of potassium, or permanganate of potassium. this test is so delicate as to show the / of a grain of the alkaloid. a very minute quantity ( / grain) in solution placed on the skin of a frog after drying causes tetanic convulsions. =brucine.=--this alkaloid, found associated with strychnine, possesses the same properties, though in a less powerful degree. nitric acid gives a blood-red colour, changed to purple with protochloride of tin. xlv.--cantharides =cantharides.=--spanish fly, or blistering beetle, is the basis of most of the blistering preparations. it is sometimes taken as an abortifacient or given as an aphrodisiac, but whether it has any such action is open to question. it acts as an irritant to the kidneys and bladder, and sometimes produces haæmaturia and a good deal of temporary discomfort. _symptoms._--burning sensation in the throat and stomach, with salivation, pain and difficulty in swallowing. vomiting of mucus mixed with blood. tenesmus, diarrhoea, the motions containing blood and mucus. dysuria, with passage of small amounts of albuminous and bloody urine. peritonitis, high temperature, quick pulse, headache, loss of sensibility, and convulsions. _post-mortem._--gastro-intestinal mucous membrane inflamed, with gangrenous patches. genito-urinary tract inflamed. acute nephritis. _treatment._--an emetic of apomorphine; demulcent drinks, such as barley-water, white of egg and water, linseed-tea and gruel (but not oils), with a hypodermic injection of morphine to allay pain. _tests._--the vomited matter often contains shining particles of the powder. the urine will probably be albuminous. xlvi.--abortifacients emmenagogues are remedies which have the property of exciting the catamenial flow; ecbolics, or abortives, are drugs which excite contraction of the uterus, and are supposed to have the power of expelling its contents. the vegetable substances commonly reputed to be abortives are ergot, savin, aloes (hierapicra), digitalis, colocynth, pennyroyal, and nutmeg; but _there is no evidence to show that any drug possesses this property_. lead in some parts of the country is a popular abortifacient. a medicine may be an emmenagogue without being an ecbolic. permanganate of potassium and binoxide of manganese are valuable remedies for amenorrhoea, but will not produce abortion. the vegetable substances frequently used as abortives are savin and ergot. =savin= (_juniperus sabina_).--leaves and tops of the plant yield an acrid oil having poisonous properties, and which has even produced death. _symptoms._--those of irritant poisons. purging not always present, but tenesmus and strangury. _post-mortem appearances._--acute inflammation of alimentary canal. green powder found. this, washed and dried and then rubbed, gives odour of savin. _test._--a watery solution of savin strikes deep green with perchloride of iron, and if an infusion of the twigs has been taken the twigs may be detected with the microscope. the twigs obtained from the stomach, dried and rubbed between the finger and thumb, will give the odour of savin. =ergot= (_secale cornutum_).--a parasitic fungus attacking wheat, barley, oats, and rye, which is reputed to have the power of causing contraction of unstriped muscular fibre, especially that of the uterus. _symptoms._--lassitude, headache, nausea, diarrhoea, anuria, convulsions, coma. small quantities frequently repeated have in the past produced gangrene of the extremities, or anæsthesia of fingers and toes. _tests._--lake-red colour with liquor potassæ; this liquid filtered gives a precipitate of same colour with nitric acid. xlvii.--poisonous fungi and toxic foods =fungi.=--of the poisonous mushrooms, the _amanita phalloides_ and the fly agaric, or _agaricus muscarius_, are the most potent. the active principle of the former is _phallin_, and of the latter _muscarine_. the _amanita phalloides_ is distinguished from the common mushroom (_agaricus campestris_) by having permanent white gills and a hollow stem. the _agaricus muscarius_ is bright red with yellow spots. phallin is a toxalbumin which destroys the red blood-corpuscles, causing the serum to become red in colour and the urine blood-stained. fibrin is liberated, and thromboses occur, especially in the liver. the symptoms may be mistaken for phosphorus-poisoning or acute yellow atrophy of the liver. muscarine affects the nervous system chiefly. _edible fungi_ have an agreeable taste and smell, and are firm in substance. _poisonous fungi_ have an offensive smell and bitter taste, are often of a bright colour, and soon become pulpy. _symptoms._--these may be of the narcotic or irritant types. usually, however, there is violent colic, with thirst, vomiting, and diarrhoea, mental excitement, followed by delirium, convulsions, coma, slow pulse, stertorous breathing, cyanosis, cold extremities, and dilated pupils. _post-mortem._--in phallin-poisoning the blood remains fluid; numerous hæmorrhages are present, with fatty degeneration of the internal organs. _treatment._--use the stomach-tube to give a solution of permanganate of potash, emetics, followed by a hypodermic injection of / grain of atropine. transfusion of saline fluid. a dose of castor-oil would be useful. =foods.=--the kinds of food which most frequently produce symptoms of poisoning are pork, veal, beef, meat-pies, potted and tinned meats, sausages, and brawn. sausage-poisoning is common in germany. it is not necessary that the food should be 'high' to give rise to poisoning. it may arise from the use of the flesh of an animal suffering from some disease, from inoculation with micro-organisms, or from the presence of toxalbumoses or ptomaines. many diseases, such as diarrhoea, enteric fever, and cholera, and perhaps tuberculosis, may be caused by eating infected food. trichiniasis may also be mentioned. tinned fish often gives rise to symptoms of poisoning, and shell-fish are not uncommonly contaminated with pathogenic micro-organisms. mussel-poisoning was formerly supposed to be due to the copper in them derived from ships' bottoms, but it is more probably the result of the formation of a toxine during life, and not after decomposition has set in. milk, too, may give rise to gastro-intestinal irritation from the occurrence in it of chemical changes. there have been epidemics of poisoning from eating cheese containing _tyrotoxicon_. ergotism from eating bread made with ergotized wheat is now rare, but _pellagra_ from the consumption of mouldy maize, and _lathyrism_, due to the admixture with flour of the seeds of certain kinds of vetch, are still common in southern europe. _symptoms._--the symptoms which result from the ingestion of poisonous meat are often very severe. in some cases their appearance is delayed from twenty-four to forty-eight hours. they may resemble those of an infectious disease or those of acute enteritis. usually there are headache, anorexia, rigors, intestinal disturbance, pains in the back and limbs, and delirium. sometimes the symptoms resemble atropine-poisoning, a condition due to ptomatropine. _treatment._--emetics, purgatives, stimulants, with hypodermic injections of strychnine and atropine along with stimulants. xlviii.--ptomaines or cadaveric alkaloids every medical man, before presenting himself to give evidence in a case of suspected poisoning, should make himself thoroughly acquainted with recent researches on the subject. ptomaines are, for the most part, alkaloids generated during the process of putrefaction, and they closely resemble many of the vegetable alkaloids--veratrine, morphine, and codeine, for example--not only in chemical characters, but in physiological properties. they are probably allied to neurine, an alkaloid obtained from the brain and also from the bile. some of them are analogous in action to muscarine, the active principle of the fly fungus. some are proteids, albumins, and globulins. ptomaines may be produced abundantly in animal substances which, after exposure under insanitary conditions, have been excluded from the air. ptomaines or toxalbumins are sometimes found in potted meats and sausages, and are due to organisms--the _bacillus botulinus_, the _b. enteritidis_ of gärtner, the _b. proteus vulgaris_, or the _b. ærtrycke_ (which is perhaps the most common of all). the symptoms produced by the latter are usually vomiting, abdominal pain, pains in the limbs and cramps, diarrhoea, vertigo, coldness, faintness, and collapse. the symptoms of _botulism_ are dryness of skin and mucous membranes, dilatation of pupils, paralysis of muscles, diplopia, etc. articles of food most often associated with poisoning are pork, ham, bacon, veal, baked meat-pie, milk, cheese, mussels, tinned meats. in a case of suspected poisoning, counsel for the defence, if he knows his work, will probably cross-examine the medical expert on this subject, and endeavour to elicit an admission that the reactions which have been attributed to a poison may possibly be accounted for on the theory of the formation of a ptomaine. there is practically no counter-move to this form of attack. index abdomen, injuries of, abortifacients, abortion, criminal, acetanilide, acetate of lead, aconite, adipocere, adultery, age, determination of, alcohol, alcoholic insanity, alkaloids, alum, ammonia, anæsthetics, death from, aniline, antifebrin, antimony, antipyrine, aqua fortis, arsenic, arsenious acid, artificial oil of bitter almonds, arum, asphyxia, assaults, assizes, atropine, barberio's test, barium salts, belladonna, bestiality, bichromate of potassium, bismuth, blackmailing, bladder, injuries of, blood-stains, born in wedlock, botulism, brain, injuries to, breslau's life test, brucine, bruises, bullet wounds, burnett's fluid, burns, cadaveric alkaloids, rigidity, calabar bean, camphor, cantharides, carbolic acid, carbonic acid gas, oxide, carnal knowledge, cellon, chemical analysis, chest injuries, chloral, chlorate of potassium, chloride of zinc, chlorine, chloroform, , choke-damp, chromium, chronic lead-poisoning, clothing, fibres of, coal-gas, cocaine, cocculus indicus, cold, death from, coma, common witness, concealment of birth, of pregnancy, conium, contused wounds, cooling, rate of, copper, coroners, coroner's court, corrosive sublimate, corrosives, cretinism, crimes, criminal abortion, criminal appeal court, courts, cross-examination, crown court of assize, culpable homicide, cut throat, dangerous drugs bill, death in the foetus, signs of, delivery, dementia, depositions, determination of sex, diachylon pills, diaphragm, wounds of, digitalis, dinitrobenzene, divorce, "dope," drowning, duration of pregnancy, dyeing of hair, dying declarations, ecchymosis, electricity, 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wounds, lead, lee-metford bullet, legitimacy, lightning, live-birth, - liver, injuries of, lobelia, lucid intervals, lumbago, lunacy, certification, lungs, injuries of, evidences of live-birth from, magistrate's court, malingering, malpractice, malum regimen, mania, manslaughter, marriage, marsh's process, martini-henry bullet, maturity of infant, mauser bullet, medical evidence, mentally deficients, mercury salts, methyl alcohol, mineral acids, misdemeanour, monkshood, monomania, morphine, murder, muriatic acid, naphtha, nitrate of silver, nitric acid, nitro-benzol, notes, nux vomica, oaths act, oil of bitter almonds, opium, oxalate of potash, oxalic acid, paraffin oil, paranoia, personal identity, petroleum, petty sessions, phenacetin, phenol, phosphorus, phossy-jaw, physostigma, picrotoxin, poison, definition of, poisonous foods, poisons acting on the brain, classification of, detection of, evidence, scheduled, symptoms and post-mortem appearances, treatment of, potash, precipitin 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natural law is as sacred as a moral principle"] civics and health by william h. allen secretary, bureau of municipal research former secretary of the new york committee on physical welfare of school children, author of "efficient democracy" and "rural sanitary administration in pennsylvania," joint author of "school reports and school efficiency" with an introduction by william t. sedgwick professor of biology in the massachusetts institute of technology ginn and company boston · new york · chicago · london entered at stationers' hall copyright, by william h. allen all rights reserved . the athenæum press ginn and company · proprietors · boston · u.s.a. introduction it is a common weakness of mankind to be caught by an idea and captivated by a phrase. to rest therewith content and to neglect the carrying of the idea into practice is a weakness still more common. it is this frequent failure of reformers to reduce their theories to practice, their tendency to dwell in the cloudland of the ideal rather than to test it in action, that has often made them distrusted and unpopular. with our forefathers the phrase _mens sana in corpore sano_ was a high favorite. it was constantly quoted with approval by writers on hygiene and sanitation, and used as the text or the finale of hundreds of popular lectures. and yet we shall seek in vain for any evidence of its practical usefulness. its words are good and true, but passive and actionless, not of that dynamic type where words are "words indeed, but words that draw armed men behind them." our age is of another temper. it yearns for reality. it no longer rests satisfied with mere ideas, or words, or phrases. the modern ulysses would drink life to the dregs. the present age is dissatisfied with the vague assurance that the lord will provide, and, rightly or wrongly, is beginning to expect the state to provide. and while this desire for reality has its drawbacks, it has also its advantages. our age doubts absolutely the virtues of blind submission and resignation, and cries out instead for prevention and amelioration. disease is no longer regarded, as cruden regarded it, as the penalty and the consequence of sin. nature herself is now perceived to be capable of imperfect work. time was when the human eye was referred to as a perfect apparatus, but the number of young children wearing spectacles renders that idea untenable to-day. meanwhile the multiplication of state asylums and municipal hospitals, and special schools for deaf or blind children and for cripples, speaks eloquently and irresistibly of an intimate connection between civics and health. there is a physical basis of citizenship, as there is a physical basis of life and of health; and any one who will take the trouble to read even the table of contents of this book will see that for dr. allen prevention is a text and the making of sound citizens a sermon. given the sound body, we have nowadays small fear for the sound mind. the rigid physiological dualism implied in the phrase _mens sana in corpore sano_ is no longer allowed. to-day the sound body generally includes the sound mind, and vice versa. if mental dullness be due to imperfect ears, the remedy lies in medical treatment of those organs,--not in education of the brain. if lack of initiative or energy proceeds from defective aëration of the blood due to adenoids blocking the air tides in the windpipe, then the remedy lies not in better teaching but in a simple surgical operation. shakespeare, in his wildwood play, saw sermons in stones and books in the running brooks. we moderns find a drama in the fateful lives of ordinary mortals, sermons in their physical salvation from some of the ills that flesh is heir to, and books--like this of dr. allen's--in striving to teach mankind how to become happier, and healthier, and more useful members of society. dr. allen is undoubtedly a reformer, but of the modern, not the ancient, type. he is a prophet crying in our present wilderness; but he is more than a prophet, for he is always intensely practical, insisting, as he does, on getting things done, and done soon, and done right. no one can read this volume, or even its chapter-headings, without surprise and rejoicing: surprise, that the physical basis of effective citizenship has hitherto been so utterly neglected in america; rejoicing, that so much in the way of the prevention of incapacity and unhappiness can be so easily done, and is actually beginning to be done. the gratitude of every lover of his country and his kind is due to the author for his interesting and vivid presentation of the outlines of a subject fundamental to the health, the happiness, and the well-being of the people, and hence of the first importance to every american community, every american citizen. william t. sedgwick massachusetts institute of technology contents part i. health rights chapter page i. health a civic obligation ii. seven health motives and seven catchwords iii. what health rights are not enforced in your community? iv. the best index to community health is the physical welfare of school children part ii. reading the index to health rights v. mouth breathing vi. catching diseases, colds, diseased glands vii. eye strain viii. ear trouble, malnutrition, deformities ix. dental sanitation x. abnormally bright children xi. nervousness of teacher and pupil xii. health value of "unbossed" play and physical training xiii. vitality tests and vital statistics xiv. is your school manufacturing physical defects? xv. the teacher's health part iii. coÖperation in meeting health obligations xvi. european remedies: doing things at school xvii. american remedies: getting things done xviii. coÖperation with dispensaries and child-saving agencies xix. school surgery and relief objectionable, if avoidable xx. physical examination for working papers xxi. periodical physical examination after school age xxii. habits of health promote industrial efficiency xxiii. industrial hygiene xxiv. the last days of tuberculosis xxv. the fight for clean milk xxvi. preventive "humanized" medicine: physician and teacher part iv. official machinery for enforcing health rights xxvii. departments of school hygiene xxviii. present organization of school hygiene in new york city xxix. official machinery for enforcing health rights xxx. school and health reports xxxi. the press part v. alliance of hygiene, patriotism, and religion xxxii. do-nothing ailments xxxiii. heredity bugaboos and heredity truths xxxiv. ineffective and effective ways of combating alcoholism xxxv. is it practicable in presenting to children the evils of alcoholism to tell the truth, the whole truth, and nothing but the truth? xxxvi. fighting tobacco evils xxxvii. the patent-medicine evil xxxviii. health advertisements that promote health xxxix. is class instruction in sex hygiene practicable? xl. the element of truth in quackery; hygiene of the mind xli. "a natural law is as sacred as a moral principle" index civics and health part i. health rights chapter i health a civic obligation in forty-five states and territories the teaching of hygiene with special reference to alcohol and tobacco is made compulsory. to hygiene alone, of the score of subjects found in our modern grammar-school curriculum, is given statutory right of way for so many minutes per week, so many pages per text-book, or so many pages per chapter. for the neglect of no other study may teachers be removed from office and fined. yet school garrets and closets are full of hygiene text-books unopened or little used, while of all subjects taught by five hundred thousand american teachers and studied by twenty million american pupils the least interesting to both teacher and pupil is that forced upon both by state legislation. to complete the paradox, this least interesting subject happens also to be the most vital to the child, to the home, to industry, to social welfare, and to education itself. whether the subject of hygiene is necessarily dull, whether the statutes requiring regular instruction in the laws of health are violated with impunity, whether health principles are flaunted by health practice at school,--these are questions of immediate concern to parents as a class, to employers as a class, to every pastor, every civic leader, every health officer, every taxpayer. interviews with teachers and principals regarding the present apathy to formal hygiene instruction have brought out the following points that merit the serious consideration of those who are struggling for higher health standards. . _there is many a slip 'twixt the making of a law and its enforcement._ if laws regarding hygiene instruction are not enforced, we should not be surprised. it has been nobody's business to see whether and how hygiene is being taught. the moral crusade spent itself in forcing compulsory laws upon the statute books of every state and territory. making a fetish of _legislation_, the advocates of anti-alcohol and anti-tobacco instruction failed to see the truth that experienced political reformers are but slowly coming to see--_legislation which does not provide machinery for its own enforcement is apt to do little good and frequently will do much harm._ machinery, however admirably adapted to the work to be done, will get out of order and become useless, or even harmful, unless constantly watched and efficiently directed. of what possible use is it to say that state money may be withheld from any school board which fails to enforce the law regarding instruction in hygiene, if state officials never enforce the penalty? so long as the penalty is not enforced for flagrant violation, what difference does it make whether the reason is indifference, ignorance, or desire to thwart the law? fortunately, it is easy for each one of us to learn how often and in what way the children in our community are being taught hygiene, and how the schools of our state teach and practice the laws of health. if either the spirit or the letter of the law regarding instruction in hygiene is being violated, we can measure the penalty paid in health and morals by our children and our community. we can learn whether law, text-book, curriculum, or teacher should be changed. we can insist upon discussion of the facts and upon remedies suggested by the facts. . _teachers give as one reason for neglecting hygiene, that they are often compelled to struggle with a curriculum which requires more than they are able to teach and more than pupils are able to learn in the time allowed._ while an overcharged curriculum may explain, it surely does not justify, the violation of law and the dropping of hygiene from our school curriculum. if there is any class of citizen who should teach and practice respect for law as law, it is the teacher. parents, school directors, county and state superintendents, university presidents, social workers, owe it not only to themselves, but to the american school-teacher, either to repeal the laws that enjoin instruction in hygiene or else so to adjust the curriculum that teachers can comply with those laws. the present situation that discredits both law and hygiene is most demoralizing to teacher, pupil, and community. many of us might admire the man teacher who frankly says he never explains the evils of cigarettes because he himself is an inveterate smoker of cigarettes. but what must we think of the school system that shifts to such a man the right and the responsibility of deciding whether or not to explain to underfed and overstimulated children of the slums the truth regarding cigarettes? if practice and precept must be consistent, shall the man be removed, shall he change his habits, shall the law regarding instruction in hygiene be changed, or shall other provision be made for bringing child and essential facts together in a way that will not dull the child's receptivity? . _teachers are made to feel that while arithmetic and reading are essential, hygiene is not essential._ whatever may be the facts regarding the relative value of arithmetic and hygiene, whether or not our state legislators have made a mistake in declaring hygiene to be essential, are questions altogether too important for child and state to be left to the discretion of the individual teacher or superintendent. it is fair to the teachers who say they cannot afford to turn aside from the three r's to teach hygiene, to admit that they have not hitherto identified the teaching of hygiene with the promotion of the physical welfare of children. teachers awake to the opportunity will sacrifice not only hygiene but any other subject for the sake of promoting children's health. they do not really believe that arithmetic is more important than health. what they mean to say is that hygiene, as taught by them, has not heretofore had an appreciable effect upon their pupils' health; that other agencies exist, outside of the school, to teach the child how to avoid certain diseases and how to observe the fundamental laws of health, whereas no other agencies exist to give the child the essentials of arithmetic, reading, and geography. "we teach (or try to teach) what our classes are examined in. if you want a subject taught, you must test a class in it and hold a teacher responsible for results, and examinations are mercilessly unhygienic, you know." . _teachers believe that they get better results for their children from teaching hygiene informally and indirectly than from stated formal lessons._ whether instruction should be informal or formal is merely a question of method to be determined by results. what the results are, can be determined by principals, superintendents, and students of education. it is easy to understand how at the time of a fever epidemic children could be taught as much in one week about infection, disease germs, antiseptics, value of cleanliness, etc., as in five or ten months when vivid illustration is lacking. physicians themselves learn more from one epidemic of smallpox than from four years of book study. to make possible and to require a daily shower bath will undoubtedly do more to inculcate habits of health than repeated lessons about the skin, pores, evaporation, and discharge of impurities. if one illustration is better than ten lessons, if an open window is worth more than all that text-books have to say about ventilation, if a seat adjusted to the child is better than an anatomical chart, this does not mean that instruction in hygiene should cease. on the contrary, it means that provision should be made for every teacher to open windows, to adjust desks, to use the experience of individual children for the education of the class. if the rank and file of teachers have not hitherto been sufficiently observant of physiological and hygienic facts, if they are unprepared from their own lives to detect or to furnish illustrations for the child, this again does not mean that the child should be denied the illustrations, but that the teacher should either have instruction and experience to incite interest and to stimulate powers of observation, or else be asked to give place to another teacher who is able to furnish such qualifications. . _children, like adults, can be interested in other people, in rules of conduct, in social conditions, in living and working relations more easily than in their own bodies._ the normal, healthy child thinks very little of himself apart from the other boys and girls, the games, the studies, the animals, the nature wonders, the hardships that come to him from the outside. so true is this that one of the best means of mitigating or curing many ailments is to divert the child's attention from himself to things outside of himself that he can look at, hear, enjoy. the power to concentrate attention upon oneself is a sign either of a diseased body, a diseased mind, or a highly trained mind. to study others and to recognize the similarity between others and oneself is as natural as the body itself. teachers are consulting this line of easiest access to children's attention when they honor children according to cleanliness of hands, of teeth, of shoes. human interest attaches to what parks or excursions are doing for sickly children, how welfare work is improving factory employees, how smallpox is conquered by vaccination, how insurance companies refuse to take risks upon the lives of men or women addicted to the excessive use of alcohol or tobacco. other people's interests--tenement conditions, factory rules--can be described in figures and actions that appeal to the imagination and impress upon the mind pictures that are repeatedly reawakened by experience and observation on the playground, at home, on the way to school or to work. "once upon a time--" will always arrest attention more quickly than "the human frame consists--." what others think of me helps me to obey law--statutory, moral, or hygienic--more than what i know of law itself. how social instincts dominate may be illustrated by an experience in advertising a public bath near a thoroughfare traveled daily by thousands of working girls. i prepared a card to be distributed among these girls that began: "a cool, refreshing bath, etc." this card was criticised by one who knows the ways of girls and women, as follows: "of course you get no success when you have a man stand on the street corner and pass out cards telling girls to get clean. every girl that is worth while is affronted by the insinuation." acting upon this expert advice, we then got out a neatly printed card reading as follows: "for a clear complexion, sprightly step, and bounding vitality, visit the center market baths, open from a.m. to p.m. daily." the board of managers shook their sage masculine heads and reluctantly gave permission to issue these appeals. woman's judgment was vindicated, however, and the advantage was proved of urging health for "society's" sake rather than for health's sake, when the patronage of the bath jumped at once to considerable proportions. . _other people's habits of health influence our well-being quite as much, if not more, than our own._ because we are social beings, ability to get along with our families, our friends, our employers, is--at least so it seems to most of us--quite as important as individual health. for too many of us, living hygienically is absolutely impossible without inconveniencing and bothering the majority of persons with whom we live. i remember a girl in college,--a fresh-air fiend,--who every morning, no matter how cold, threw the windows wide open. then, with forty others, i thought this girl a nuisance as well as a menace to health, but now, twenty years afterwards, i find myself wanting to do the same thing. professor patten, the economist, whom i shall quote many times because he is particularly interested in the purpose of this book, was recently dining at my house and illustrated from his own health the importance of teaching hygiene so as to affect social as well as personal standards. "to be true to my own health needs, i ought to have declined nearly everything that has been offered me for dinner, but in the long run, if i am going to visit, my eating what is placed before me is better for society than making those who entertain me feel uncomfortable." most of us know what uphill work it is to live hygienically in an unhygienic environment. i remember how hard it was to eat happily when sitting beside a college professor who took brown pills before each meal, yellow pills between each course, and a dose of black medicine after the meal was over. mariano, an italian lad cured of bone tuberculosis by out-of-door salt air at sea breeze, returned to his tenement home an ardent apostle of fresh air day and night, winter and summer. his family allowed him to open the window before going to bed, but closed it as soon as he was asleep. lawrence veiller, our greatest expert on tenement conditions, says: "to bathe in a tenement where a family of six occupy three rooms often involves the sacrifice of privacy and decency, which are quite as important to social betterment as cleanliness." to live unhygienically where others live hygienically is quite as difficult. witness the speedy improvement of dissipated men when boarding with country friends who eat rationally and retire early. it must have been knowledge of this fact that prompted the tramways of belfast to post conspicuous notices: "spitting is a vile and filthy habit, and those who practice it subject themselves to the disgust and loathing of their fellow-passengers." it is almost impossible to have indigestion, blues, and headache when one is camping, particularly where action and enjoyment fill the day. our practical question is, therefore, not "what shall i eat, how many hours shall i sleep, what shall i wear," but "how can i manage to get into an environment among living and working conditions where the people i live with and want to please, those who influence me and are influenced by me, make healthy living easy and natural?" . _because the problems of health have to do principally with environment,--home, street, school, business,--it is worth while trying to relate hygiene instruction to industry and government, to preach health from the standpoint of industrial and national efficiency rather than of individual well-being._ since healthful living requires the coöperation of all persons in a household, in a group, or in a community, we must find some working programme that will make it easy for all the members of the group to observe health standards. a city government that spends taxes inefficiently can produce more sickness, wretchedness, incapacity in one year than pamphlets on health can offset in a generation. failure to enforce health laws is a more serious menace to health and morals than drunkenness or tobacco cancer. unclean streets, unclean dairies, unclean, overcrowded tenements can do more harm than alcohol and tobacco because they can breed an appetite that craves stimulants and drugs. others have taught how the body acts, what we ought to eat, how we should live. we are concerned here not with repeating the laws of health, but with a consideration of the mechanism that will make it possible for us so to work together that we can observe those laws. chapter ii seven health motives and seven catchwords in making a health programme as in making a boat, a garden, or a baseball team, the first step is to look about and see what material there is to work with. a baseball team will fail miserably unless the captain places each man where he can play best. gardening is profitless when the gardener does not know the habits of plants and the possibilities of different kinds of soil. so in planning a health programme we must study our materials and use each where it will fit best. the materials of first importance to a health programme in civilized countries are men; for men working together can control water sources, drainage, and ventilation, or else move away to surroundings better suited to healthful living. therefore the first concern of the leader in a health crusade is the human kind he has to work for and work with. seven kinds of man are to be found in every community, seven different points of view with regard to health administration. each individual, likewise, may have seven attitudes toward health laws, seven reasons for demanding health protection. these seven points of view, seven stages of development, are clearly marked in the evolution of sanitary administration throughout the civilized world. with few exceptions, it is possible, by examining ourselves, our friends, and our communities, to see where one motive begins and leaves off, giving way to or mixing with one or more other motives. a friend once asked me if i could keep this number seven from growing to eight or nine. perhaps not. perhaps there are more kinds of people, more health motives, more stages in health progress; but i am sure of these seven, and certain that they have been of great help to me in planning health crusades for the state of new jersey and for new york city. the number seven was not reached hit-or-miss fashion, nor was it chosen for its biblical prestige. on the contrary, it came as the result of studying health administration in twoscore british and american cities, and of reading scores of books on sanitary evolution. seven catchwords make it easy to remember the characteristics and the source of every motive, every kind of person, and every stage in the evolution of sanitary standards. these seven catchwords are: _instinct_, _display_, _commerce_, _anti-nuisance_, _anti-slum_, _pro-slum_, _rights_. by the use of these catchwords any teacher, parent, public official, educator, or social worker should be able to size up the situation, the needs, and the opportunity of the individuals or the communities for whom a health crusade is planned. _instinct_ was the first health officer and made the first health laws. instinct warns us against unusual and offensive odors, sights, and noises, just as it causes us to seek that which is agreeable. primitive man in common with other animals learned by sad experience to avoid certain herbs as poisons; to bury or to move away from the dead; to shun discolored drinking water. during the roaming period sun and air and water acted as scavengers. when tribes settled down in one spot for long periods, habits that had hitherto been inoffensive and safe became noticeably injurious and unpleasant. heads of tribes gave orders prohibiting such habits and restricting disagreeable acts and objects to certain portions of the camp. instinct places outhouses on our farms and then gradually removes them farther and farther from dwellings. in many school yards, more particularly in country districts and small towns, outhouses are a crying offense against animal instinct. in visiting slum districts in irish and scotch cities, and in london, paris, berlin, and new york, i never found conditions so offensive to crude animal instinct as those i knew when a boy in minnesota school yards, or those i have since seen in a boy republic. but the evil is not corrected because it is not made anybody's business to execute instinct's mandates. in the boy republic the leaders were waiting for the children themselves to revolt, as does primitive man. table i typhoid a rural disease[ ] ==========================================+============+============== | average | average | per cent | typhoid fever | of rural | death rate | population | per , ------------------------------------------+------------+-------------- five states in which the urban | | population was more than % of the total | | | | six states in which the urban population | | was between % and % | | | | seven states in which the urban | | population was between % and % | | | | eight states in which the urban | | population was between % and % | | | | twelve states in which the urban | | population was between % and % | | | | twelve states in which the urban | | population was between and % | | ==========================================+============+============== among large numbers of persons, in city as well as country, washing the body is still a matter of instinct, a bath not being taken until the body is offensive, the hands not being washed until their condition interferes with the enjoyment of food or with one's treatment by others. there is a point of neglect beyond which instinct will not permit even a tramp to go. if cleanliness is next to godliness, the average child is most ungodly by nature, for it loathes the means of cleanliness and otherwise observes instinct's health warnings only after experience has punished or after other motives from the outside have prompted action. the chief form of legislation of the instinct age is provision of penalties for those who poison food, water, or fellow-man. there are districts in america where hygiene is supposed to be taught to children that are conscious of no other sanitary legislation but that which punishes the poisoner. _display_ has always been an active health crusader. professor patten says the best thing that could happen to the slums of every city would be for every girl and woman to be given white slippers, white stockings, a white dress, and white hat. why? because they would at once notice and resent the dirt on the street, in their hallways, and in their own homes. people that have nothing to "spoil" really do not see dirt, for it interferes in no way with their comfort so far as they can see. their windows are crusted with dust, their babies' milk bottles are yellow with germs. who cares? similar conditions exist among well-to-do women who live on isolated farms with no one to notice their personal appearance except others of the family who prefer rest to cleanliness. but let the tenement mother or the isolated farmer's wife entertain the minister or the school-teacher, the candidate for sheriff or the ward boss, let her go to coney island or to the county fair, and at once an outside standard is set up that requires greater regard for personal appearance and leads to "cleaning up." elbow sleeves and light summer waists have led many a girl to daily bathing of at least those parts of the body that other people see. entertainments and sociables, saturday choir practice and church have led many a young man to bathe for others' sake when quite satisfied to forego the ordeal so far as his own comfort and health were concerned. streets on which the well-to-do live are kept clean. why? not because madam well-to-do cares so much for health, but because she associates cleanliness with social prestige. it is necessary for the display of her carriages and dresses, just as paved streets and a plentiful supply of water for public baths and private homes were essential to the display of rome's luxury. generally speaking, residence streets are cleaned in small towns just as waterworks are introduced, to gratify the display motive of those who have lawns to water and clothes to show. instinct strengthens the display motive. as every one can be interested in instinct hygiene, so every one is capable of this display motive to the extent that his position is affected by other people's opinion. it was love of display quite as much as love of beauty that gave greece the goddess hygeia, the worship of whom expressed secondarily a desire for universal health, and primarily a love of the beautiful among those who had leisure to enjoy it. _commerce_ brooks no preventable interference with profits, whether by disease, death, impassable streets, or disabled men. the age of chivalry was also the age of indescribable filth, plague, black death, and spotted fever that cost the lives of millions. it would be impossible in the civilized world to duplicate the combination of luxury and filthy, disease-breeding conditions in the midst of which queen bess and her courtiers held their revels. the first protest was made, not by the church, not by sanitarians, but by the great merchants who were unable to insure against loss and ruin from the plagues that thrived on filth and overcrowding. by an interesting coincidence the first systematic street cleaning and the first systematic ship cleaning--maritime quarantine--date from the same year, a.d.; the former in the foremost german trading town, cologne, and the latter in venice, the foremost trading town of italy. the merchants of philadelphia and new york started the first boards of health in the united states. for what purpose? to prevent business losses from yellow fever. desire for passable streets, drains, waterworks, and strong boards of health has generally started with merchants. for commercial reasons many of our states vote more money for the protection of cattle than for the protection of human life, and the united states votes millions for the study of hog cholera, chicken pip, and animal tuberculosis, while neglecting communicable diseases of men. no class in a community will respond more quickly to an appeal for the rigid enforcement of health laws than the merchant class; none will oppose so bitterly as that which makes profits out of the violation of health laws. table ii cost in life capital of preventable diseases[ ] =============+============+=========================================== | | multiply by the number of deaths for each | estimated | age group to learn the cost in life | value of | capital to your community in loss of life age | human life | from one or all preventable diseases. -------------+------------+------------------------------------------- - years | $ , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | - " | , | =============+============+=========================================== _anti-nuisance_ motives do not affect health laws until people with different incomes and different tastes try to live together. in a small town where everybody keeps a cow and a pig, piggeries and stables offend no one; but when the doctor, the preacher, the dressmaker, the lawyer, and the leading merchant stop keeping pigs and cows, they begin to find other people's stables and piggeries offensive. the early laws against throwing garbage, fish heads, household refuse, offal, etc., on the main street were made by kings and princes offended by such practices. the word "nuisance" was coined in days when neighbors lived the same kind of life and were not sensitive to things like house slops, ash piles, etc. the first nuisances were things that neighbors stumbled over or ran into while using the public highway. next, goats and other animals interfering with safety were described as nuisances, and legal protection against them was worked out. it has never been necessary to change the maxim which originally defined a nuisance: "so use your own property that you will not injure another in the use of his property." the thing that has changed and grown has been society's knowledge of acts and objects that prevent a man from enjoying his own property. to-day the number of things that the law calls nuisances is so great that it takes hundreds of pages to describe them. stables and outhouses must be set back from the street. every man must dispose of garbage and drainage on his own property. stables and privies must be at least a hundred feet from water reservoirs. factories may not pollute streams that furnish drinking water. merchants may be punished if they put banana skins in milk cans, or if they fail to scald and cleanse all milk receptacles before returning them to wholesalers. automobile drivers may be punished for disturbing sleep. anything that injures my health will be declared a nuisance and abolished, if i can prove that my health is being injured and that i am doing all i can to avoid that injury. no educational work will accomplish more for any community than to make rich and poor alike conscious of nuisances that are being committed against themselves and their neighbors. the rich are able to run away from nuisances that they cannot have abated. if proper publicity is given to living conditions among those who do not resist nuisances, the presence of such conditions will itself become offensive to the well-to-do, who will take steps to remove the nuisance. jacob riis in this way made the slums a nuisance to rich residents in new york city and stimulated tenement reform, building of parks, etc. _anti-slum_ motives originated in cities where there is a clear dividing line between the clean and the unclean, the infected and the uninfected, the orderly and the disorderly, high and low vitality. as soon as one district becomes definitely known as a source of nuisance, infection, and disease, better situated districts begin to make laws to protect themselves. a great part of our existing health codes and a very large part of the funds spent on health administration are designed to protect those of high income against disease incident to those of low income, high vitality against low vitality, houses with rooms to spare against houses that are overcrowded. to the small town and the country the slum means generally the near-by city whose papers talk of epidemic scarlet fever, diphtheria, or smallpox. cities have only recently begun to experience anti-slum aversion to country dairies whose uncleanliness brings infected milk to city babies, or to filthy factories and farms that pollute water reservoirs and cause typhoid. the last serious smallpox epidemic in the east came from the south by way of rural districts that failed to notify the pennsylvania state board of health of the outbreak until the disease was scattered broadcast. every individual knows of some family or some district that is immediately pictured when terms like "disease," "epidemic," "slum," are pronounced. the steps worked out by the anti-slum motive to protect "those who have" from disease arising from "those who have not" are given on page . [illustration: a country menace to city health] _pro-slum_ motives are not exactly born of anti-slum motives, but, thanks to the instinctive kindness of the human heart, follow promptly after the dangers of the slum have been described. you and i work together to protect ourselves against neglect, nuisance, and disease. in a district by which we must pass and with which we must deal, one of us or a neighbor or friend will turn our attention from our danger to the suffering of those against whom we wish to protect ourselves. charles dickens so described oliver twist and david copperfield that great britain organized societies and secured legislation to improve the almshouse, school, and working and living conditions. when health reports, newspapers, and charitable societies make us see that the slum menaces our health and our happiness, we become interested in the slum for its own sake. we then start children's aid societies, consumer's leagues, sanitary and prison associations, child-labor committees, and "efficient government" clubs. _rights_ motives are the last to be evolved in individuals or communities. the well-to-do protect their instinct, their comfort, their commerce, but run away from the slums and build in the secluded spots or on the well-policed and well-cleaned avenues and boulevards. uptown is often satisfied with putting health officials to work to protect it against downtown. pro-slum motives are shared by too few and are expressed too irregularly to help all of those who suffer from crowded tenements, impure milk, unclean streets, inadequate schooling. so long as those who suffer have no other protection than the self-interest or the benevolence of those better situated, disease and hardship inevitably persist. health administration is incomplete until its blessings are given to men, women, and children as rights that can be enforced through courts, as can the right to free speech, the freedom of the press, and trial by jury. there is all the difference in the world between having one's street clean because it is a danger to some distant neighbor, or because that neighbor takes some philanthropic interest in its residents, and because one has a right to clean streets, regardless of the distant neighbor's welfare or interest. when the right to health is granted health laws are made, and all men within the jurisdiction of the lawmaking power own health machinery that provides for the administration of those laws. a system of public baths takes the place of a bathhouse supported by charity; a law restricting the construction and management of all tenements takes the place of a block of model tenements, financed by some wealthy man; medical examination of all school children takes the place of a private dispensary; a probation law takes the place of the friendly visitor to the county jail. most of the rights we call inalienable are political rights no longer questioned by anybody and no longer thought of in connection with our everyday acts, pleasures, and necessities. when our political rights were formulated in maxims, living was relatively simple. there was no factory problem, no transportation problem, no exploitation of women and children in industry. our ancestors firmly believed that if the strong could be prevented from interfering with the political rights of the weak, all would have an equal chance. the reason that our political maxims mean less to-day than two hundred years ago is that nobody is challenging our right to move from place to place if we can afford it, to trial by jury if charged with crime, to speak or print the truth about men or governments. if, however, anybody should interfere with our freedom in this respect, it would be of tremendous help that everybody we know would resent such interference and would point to maxims handed down by our ancestors and incorporated in our national and state constitutions as formal expressions of unanimous public opinion. the time is past when any one seriously believes that political freedom or personal liberty will be universal, just because everybody has a right to talk, to move from place to place, to print stories in the newspapers. the relation of man to man to-day requires that we formulate rules of action that prevent one man's taking from another those rights, economic and industrial, that are as essential to twentieth-century happiness as were political rights to eighteenth-century happiness. political maxims showed how, through common desire and common action, steps could be taken by the individual and by the whole of society for the protection of all. health rights, likewise, are to be obtained through common action. a modern city must know who is accountable when an automobile runs over a pedestrian, when a train load of passengers lose their lives because of an engineer's carelessness, when an employee is incapacitated for work by an accident for which he is not responsible, or when fever epidemics threaten life and liberty without check. how can a child who is prevented by removable physical defects from breathing through his nose be enthusiastic over free speech? of what use is freedom of the press to those who find reading harder than factory toil? how futile the right to trial by jury if removable physical defects make children unable to do what the law expects! who would not exchange rights of petition for ability to earn a living? children permanently incapacitated to share the law's benefits cannot appreciate the privilege of pursuing happiness. succeeding chapters will enumerate a number of health rights and will show through what means we can work together to guarantee that we shall not injure the health of our neighbor and that our neighbor shall not injure our health. the truest index to economic status and to standards of living is health environment. the best criterion of opportunity for industrial and political efficiency is the conditions affecting health. the seven catchwords that describe seven motives to health legislation and health administration, seven ways of approaching health needs, and seven reasons for meeting them, should be found helpful in analyzing the problem confronting the individual leader. generally speaking, we cannot watch political rights grow, but health rights are evolved before our eyes all the time. if we wish, we can see in our own city or township the steps taken, one by one, that have slowly led to granting a large number of health rights to every american. footnotes: [ ] prepared by dr. john s. fulton, secretary of the state board of health, maryland, and quoted by dr. george c. whipple in _typhoid fever_. [ ] marshall o. leighton, quoted in whipple's _typhoid fever_. chapter iii what health rights are not enforced in your community? laws define rights. men enforce them. for definitions we go to books. for record of enforcement we go to acts and to conditions.[ ] what health rights a community pretends to enforce will, as a rule, be found in its health code. what health rights are actually enforced can be learned only by studying both the people who are to be protected and the conditions in which these people live. a street, a cellar, a milk shop, a sick baby, or an adult consumptive tells more honestly the story of health rights enforced and health rights unenforced than either sanitary code or sanitary squad. not until we turn our attention from definition and official to things done and dangers remaining can we learn the health progress and health needs of any city or state. the health code of one city looks very much like the health code of every other city. this is natural because those who write health codes generally copy other codes. even small cities are given complicated sanitary legislative powers by state legislatures. therefore those who judge a community's health rights by its health laws will get as erroneous an impression as those who judge hygiene instruction in our public schools from printed statements about the frequency and character of such instruction. advocates of health codes have thought the battle won when boards of health were given almost unlimited power to abate nuisances and told how to exercise those powers. [illustration: a dairy inspector's outfit] the slip 'twixt law making and law enforcement is everywhere found. in new york state prohibited the sale of adulterated milk. law after law has been made since that time, giving health officials power to revoke licenses of milk dealers and to send men to jail who violated milk laws. we now know that no law will ever stop the present frightful waste of infant lives, counted in thousands annually, unless dairies are frequently inspected and forced to be clean; unless milk is kept at a temperature of about fifty degrees on the train, in the creamery, at the receiving station, and in the milk shop; unless dealers scald and thoroughly cleanse cans in which milk is shipped; unless licenses are taken from farmers, creameries, and retailers who violate the law; unless magistrates use their power to fine or imprison those who poison helpless babies by violating milk laws; and unless mothers are taught to scald and thoroughly cleanse bottles, nipples, cups, and dishes from which milk is fed to the baby. we know that these things are not being done except where men or women make it their business to see that they are done. experience tells us that inspectors will not consistently do their duty unless those who direct them have regular records of their inspections, study those records, find out work not done properly or promptly, and insist upon thorough inspection. whether work is done right, whether inspectors do their full duty, whether babies are protected, can be learned only from statements in black and white that show accurately the conditions of dairies and milk shops, the character of milk found and tested by inspectors, and the number of babies known to have been sick or known to have died from intestinal diseases chiefly due to unsafe milk. any teacher or parent can learn for himself, or can teach children to learn, what steps are taken to guarantee the right to pure milk by using a table such as table iii. whether conditions at the dairy make pure milk impossible can be told by any one who can read the score card used by new york city (table iv). table iii milk inspection within new york city, ======================================+===============+=============== | new york | each borough +-------+-------+-------+------- | stores| wagons| stores| wagons +-------+-------+-------+------- field | | | | permits issued during | | | | permits revoked during | | | | for discontinuance of selling | | | | for violation of law | | | | average permits in force in | | | | | | | | inspection | | | | regular inspections | | | | inspections at receiving stations | | | | total | | | | average inspections per permit per | | | | year | | | | specimens examined | | | | samples taken | | | | | | | | conditions found | | | | inspections finding milk above ° | | | | % of such discoveries to total | | | | inspections | | | | inspections finding adulteration | | | | warning given | | | | prosecuted | | | | % of adulterations found to | | | | inspections | | | | | | | | rooms connected contrary to | | | | sanitary code | | | | ice box badly drained | | | | ice box unclean | | | | store unclean | | | | utensils unclean | | | | milk not properly cooled | | | | infectious disease | | | | | | | | persons found selling without permit | | | | | | | | action taken | | | | destruction of milk | | | | lots of milk destroyed for being | | | | over ° | | | | quarts so destroyed | | | | lots of milk destroyed for being | | | | sour | | | | quarts so destroyed | | | | lots of milk destroyed for being | | | | otherwise adulterated | | | | quarts so destroyed | | | | total quarts destroyed | | | | | | | | notices issued | | | | to drain and clean ice box | | | | to clean store | | | | | | | | criminal actions begun | | | | for selling adulterated milk | | | | for selling without permit | | | | for interference with inspector | | | | total | | | | ======================================+===============+=============== table iv perfect score % score allowed ...% file no............ department of health (thirteen items are here omitted) =dairy inspection= =division of inspections= inspection no. ...... time ...... a. p. m. date ...... all persons in the households of those engaged in producing or handling milk are ...... free from all infectious disease ...... date and nature of last case on farm ...... a sample of the water supply on this farm taken for analysis ...... ... and found to be ...... ====================================================+=========+======= stable | perfect | allow ----------------------------------------------------+---------+------- cow stable is ... located on elevated ground | | with no stagnant water, hog pen, or privy | | within feet | | ... floors are ... constructed of concrete or | | some nonabsorbent material | | ... floors are ... properly graded and water-tight | | ... drops are ... constructed of concrete, stone, | | or some nonabsorbent material | | ... drops are ... water-tight | | ... feeding troughs, platforms, or cribs are ... | | well lighted and clean | | ... ceiling is constructed of ... and is ... tight | | and dust proof | | ... ceiling is ... free from hanging straw, dirt, | | or cobwebs | | ... number of windows ... total square feet ... | | which is ... sufficient | | ... window panes are ... washed and kept clean | | ... ventilation consists of ... which is | | sufficient , fair , insufficient | | ... air space is ... cubic feet per cow which is | | ... sufficient ( and over-- ) ( to | | -- ) ( to -- ) (under -- ) | | ... interior of stable painted or whitewashed on | | ... which is satisfactory , fair , never | | ... walls and ledges are ... free from dirt, dust, | | manure, or cobwebs | | ... floors and premises are ... free from dirt, | | rubbish, or decayed animal or vegetable matter | | ... cow beds are ... clean | | ... live stock, other than cows, are ... excluded | | from rooms in which milch cows are kept | | ... there is ... direct opening from barn into | | silo or grain pit | | ... bedding used is ... clean, dry, and absorbent | | ... separate building is ... provided for cows | | when sick | | ... separate quarters are ... provided for cows | | when calving | | ... manure is ... removed daily to at least | | feet from the barn ( ... ft.) | | ... manure pile is ... so located that the cows | | cannot get at it | | ... liquid matter is ... absorbed and removed | | daily and ... allowed to overflow and saturate | | ground under or around cow barn | | ... running water supply for washing stables is | | ... located within building | | ... dairy rules of the department of health are | | ... posted | | ... | | cow yard | | cow yard is ... properly graded and drained | | ... cow yard is ... clean, dry, and free from | | manure | | ... | | cows | perfect | allow cows have ... been examined by veterinarian ... | | date ... report was | | ... cows have ... been tested by tuberculin, and | | all tuberculous cows removed | | ... cows are ... all in good flesh and condition | | at time of inspection | | ... cows are ... all free from clinging manure and | | dirt. (no. dirty ... ) | | ... long hairs are ... kept short on belly, flanks, | | udder, and tail | | ... udder and teats of cows are ... thoroughly | | cleaned before milking | | ... all feed is ... of good quality and all grain | | and coarse fodders are ... free from dirt and | | mold | | ... distillery waste or any substance in a state | | of fermentation or putrefaction is ... fed | | ... water supply for cows is ... unpolluted and | | plentiful | | ... | | milkers and milking | | attendants are ... in good physical condition | | ... special milking suits are ... used | | ... clothing of milkers is ... clean | | ... hands of milkers are ... washed clean before | | milking | | ... milking is ... done with dry hands | | ... fore milk or first few streams from each teat | | is ... discarded | | ... milk is strained at ... and ... in clean | | atmosphere | | ... milk strainer is ... clean | | ... milk is ... cooled to below ° f. within two | | hours after milking and kept below ° f. | | until delivered to the creamery ... ° | | ... milk from cows within days before or days | | after parturition is ... discarded | | ... | | utensils | | milk pails have ... all seams soldered flush | | ... milk pails are ... of the small-mouthed design, | | top opening not exceeding inches in diameter. | | diameter ... | | ... milk pails are ... rinsed with cold water | | immediately after using and washed clean with | | hot water and washing solution | | ... drying racks are ... provided to expose milk | | pails to the sun | | ... | | milk house | | milk house is ... located on elevated ground | | with no hog pen, manure pile, or privy within | | feet | | ... milk house has ... direct communication with | | ... building | | ... milk house has ... sufficient light and | | ventilation | | ... floor is ... properly graded and water-tight | | ... milk house is ... free from dirt, rubbish, and | | all material not used in the handling and | | storage of milk | | ... milk house has ... running or still supply of | | pure clean water | | ... ice is ... used for cooling milk and is cut | | from ... | | ... | | water | | water supply for utensils is from a ... located | | ... feet deep and apparently is ... pure, | | wholesome, and uncontaminated | | ... is ... protected against flood or surface | | drainage | | ... there is ... privy or cesspool within feet | | ( ... feet) of source of water supply | | ... there is ... stable, barnyard, or pile of | | manure or other source of contamination within | | feet ( ... feet) of source of water supply | | ... |---------| | | ----------------------------------------------------+---------+------- it is a great pity that we americans have taken so long to learn that laws do not enforce themselves, that even good motives and good intentions in the best of officials do not insure good deeds. thousands of lives are being lost every year, millions of days taken from industry and wasted by unnecessary sickness, millions of dollars spent on curing disease, the working life of the nation shortened, the hours of enjoyment curtailed, because we have not seen the great gap between health laws and health-law enforcement. in our municipal, state, and national politics we have made the same mistake of concentrating our attention upon the morals and pretensions of candidates and officials instead of judging government by what government does. gains of men and progress of law are useful to mankind only when converted into deeds that make men freer in the enjoyment of health and earning power. in protecting health, as in reforming government, an ounce of efficient achievement is worth infinitely more than a moral explosion. one month of routine--unpicturesque, unexciting efficiency--will accomplish more than a scandal or catastrophe. such routine is possible only when special machinery is constantly at work, comparing work done with work expected, health practice with health ideals. where such machinery does not yet exist, volunteers, civic leagues, boys' brigades, etc., can easily prove the need for it by filling out an improvised score card for the school building, railroad station, business streets, "well-to-do" and poor resident streets, such as follows: table v score card for citizen use =======================================================+=======+====== |perfect|allow -------------------------------------------------------+-------+------ _schoolhouse_ | | well ventilated, ; badly, - | | ... cleaned regularly, ; irregularly, - | | ... feather duster prohibited, | | ... no dry sweeping, | | ... has adequate play space, ; inadequate, - | | ... has clean drinking water, | | ... has clean outbuildings and toilet, : unclean, - | | ... | ------| | | | | _church and sunday school_ | | well ventilated, ; badly, - | | ... heat evenly distributed, ; unevenly, - | | ... cleaned regularly, ; irregularly, - | | ... without carpets, | | ... without plush seats, | | ... | ------| | | | | _streets_ | | sewerage underground, ; surface, - | | ... no pools neglected, | | ... no garbage piled up, | | ... swept regularly, ; irregularly, - | | ... sprinkled and flushed, | | ... has baskets for refuse, | | ... all districts equally cleaned, ; unequally, - | | ... | ------| | | -------------------------------------------------------+-------+------ until recently the most reliable test of health rights not enforced was the number of cases of preventable, communicable, contagious, infectious, transmissible diseases, such as smallpox, typhoid fever, yellow fever, scarlet fever, diphtheria, measles, whooping cough. by noticing streets and houses where these diseases occurred, students learned a century ago that the darker and more congested the street the greater the prevalence of fevers and the greater the chance that one attacked would die. the well-to-do remove from their houses and their streets the dirt, the decomposed garbage, and stagnant pools from which fevers seem to spring. it was because fevers and congestion go together that laws were made to protect the well-to-do, the comfortable, and the clean against the slum. it is true to-day that if you study your city and stick a pin in the map, street for street, where infection is known to exist, you will find the number steadily increase as you go from uncongested to congested streets and houses, from districts of high rent to districts of low rent. because it is easier to learn the number of persons who have measles and diphtheria and smallpox than it is to learn the incomes and living conditions prejudicial to health, and because our laws grant protection against communicable diseases to a child in whatever district he may be born, the record of cases of communicable diseases has heretofore been the best test of health rights unenforced. even in country schools it would make a good lesson in hygiene and civics to have the children keep a record of absences on account of transmissible disease, and then follow up the record with a search for conditions that gave the disease a good chance. but to wait for contagion before taking action has been found an expensive way of learning where health protection is needed. even when infected persons and physicians are prompt in reporting the presence of disease it is often found that conditions that produced the disease have been overlooked and neglected. for example, smallpox comes very rarely to our cities to-day. wherever boards of health are not worried by "children's diseases," as is often the case, and wait for some more fearful disease such as smallpox, there you will find that garbage in the streets, accumulated filth, surface sewers, congested houses, badly ventilated, unsanitary school buildings and churches are furnishing a soil to breed an epidemic in a surprisingly short time. where, on the other hand, boards of health regard every communicable disease as a menace to health rights, you will find that health officials take certain steps in a certain order to remove the soil in which preventable diseases grow. these steps, worked out by the sanitarians of europe and america after a century of experiment, are seen to be very simple and are applicable by the average layman and average physician to the simplest village or rural community. how many of these steps are taken by your city? by your county? by your state? . notification of danger when it is first recognized. . registration at a central office of facts as to each dangerous thing or person. . examination of the seat of danger to discover its extent, its cost, and new seats of danger created by it. . isolation of the dangerous thing or person. . constant attention to prevent extension to other persons or things. . destruction or removal of disease germs or other causes of danger. . analysis and record, for future use, of lessons learned by experience. . education of the public to understand its relation to danger checked or removed, its responsibility for preventing a recurrence of the same danger, and the importance of promptly recognizing and checking similar danger elsewhere. with a chart showing what districts have the greatest number of children and adults suffering from measles, typhoid fever, scarlet fever, consumption, one can go within his own city or to a strange city and in a surprisingly short time locate the nuisances, the dangerous buildings, the open sewers, the cesspools, the houses without bathing facilities, the dark rooms, the narrow streets, the houses without play space and breathing space, the districts without parks, the polluted water sources, the unsanitary groceries and milk shops. in country districts a comparison of town with town as to the prevalence of infection will enable one easily to learn where slop water is thrown from the back stoop, whether the well, the barn, and the privy are near together. [illustration: the baby, not the law, is the test of infant protection in country and in city] testing health rights requires not only that there be a board of health keeping track of and publishing every case of infection, but it requires further that one community be compared with other communities of similar size, and that each community be compared with itself year for year. these comparisons have not been made and records do not exist in many states. footnotes: [ ] a striking demonstration of law enforcement that followed lawmaking is given in _the real triumph of japan_, l.l. seaman, m.d. chapter iv the best index to community health is the physical welfare of school children compulsory education laws, the gregarious instinct of children, the ambition of parents, their self-interest, and the activities of child-labor committees combine to-day to insure that one or more representatives of practically every family in the united states will be in public, parochial, or private schools for some part of the year. the purpose of having these families represented in school is not only to give the children themselves the education which is regarded as a fundamental right of the american child, but to protect the community against the social and industrial evils and the dangers that result from ignorance. great sacrifices are made by state, individual taxpayer, and individual parent in order that children and state may be benefited by education. almost no resistance is found to any demand made upon parent or taxpayer, if it can be shown that compliance will remove obstructions to school progress. if, therefore, by any chance, we can find at school a test of home conditions affecting both the child's health and his progress at school, it will be easy, in the name of the school, to correct those conditions, just as it will be easy to read the index, because the child is under state control for six hours a day for the greater part of the years from six to fourteen.[ ] [illustration: (facsimile) physical record.] what, then, is this test of home conditions prejudicial to health that will register the fact as a thermometer tells us the temperature, or as a barometer shows moisture and air pressure? the house address alone is not enough, for many children surrounded by wealth are denied health rights, such as the right to play, to breathe pure air, to eat wholesome food, to live sanely. scholarship will not help, because the frailest child is often the most proficient. manners mislead, for, like dress, they are but externals, the product of emulation, of other people's influence upon us rather than of our living conditions. nationality is an index to nothing significant in america, where all race and nationality differences melt into americanisms, all responding in about the same way to american opportunity. no, our test must be something that cannot be put on and off, cannot be left at home, cannot be concealed or pretended, something inseparable from the child and beyond his control. this test it has been conclusively proved in chicago, boston, brookline, philadelphia, and particularly in new york city, is the physical condition of the school child. to learn this condition the child must be examined and reëxamined for the physical signs called for by the card on page . weight, height, and measurements are needed to tell the whole story. when this card is filled out for every child in a class or school or city, the story told points directly to physical, mental, or health rights neglected. if for every child there is begun a special card, that will tell his story over and over again during his school life, noting every time he is sick and every time he is examined, the progress of the community as well as of the child will be clearly shown. such a history card (p. ) is now in use in certain new york schools, as well as in several private schools and colleges. have you ever watched such an examination? by copying this card your family physician can give you a demonstration in a very short time as to the method and advantage of examination at school. the school physician goes at nine o'clock to the doctor's room in the public school, or, if there is no doctor's room, to that portion of the hall or principal's office where the doctor does his work. the teacher or the nurse stands near to write the physician's decision. the doctor looks the child over, glances at his eyes, his color, the fullness of his cheeks, the soundness of his flesh, etc. if the physician says "b," the principal or nurse marks out the other letter opposite to number , so that the card shows that there is bad nutrition. in looking at the teeth and throat a little wooden stick is used to push down the tongue. there should be a stick for every child, so that infection cannot possibly be carried from one to the other. if this is impossible, the stick should be dipped in an antiseptic such as boric acid or listerine. if, because of swollen tonsils, there is but a little slit open in the throat, or if teeth are decayed, the mark is y or b. the whole examination takes only a couple of minutes, but the physician often finds out in this short time facts that will save a boy and his parents a great deal of trouble. very often this examination tells a story that overworked mothers have studiously concealed by bright ribbons and clean clothes. i remember one little girl of fourteen who looked very prosperous, but the physician found her so thin that he was sure that for some time she had eaten too little, and called her anæmic. he later found that the mother had seven children whom she was trying to clothe and shelter and feed with only ten dollars a week. a way was found to increase her earnings and to give all the children better living conditions,--all because of the short story told by the examination card. in another instance the card's story led to the discovery of recent immigrant parents earning enough, but, because unacquainted with american ways and with their new home, unable to give their children proper care. [illustration: looking for enlarged tonsils and bad teeth note the mouth breather waiting] the most extensive inquiry yet made in the united states as to the physical condition of school children is that conducted by the board of health in new york city since . from march, , to january , , , children have been examined, and , or . per cent have been found to have defects, as shown in table vi. table vi physical examination of school children--performed by the department of health in the borough of manhattan, - =============================================+==========+=========== | total | percentage ---------------------------------------------+----------+----------- number of children examined | , | number of children needing treatment | , | . _defects found:_ | | malnutrition | , | . diseased anterior or posterior cervical | | glands | , | . chorea | , | . cardiac disease | , | . pulmonary disease | , | . skin disease | , | . deformity of spine, chest, or extremities | , | . defective vision | , | . defective hearing | , | . obstructed nasal breathing | , | . defective teeth | , | . deformed palate | , | . hypertrophied tonsils | , | . posterior nasal growths | , | . defective mentality | , | . =============================================+==========+========= it is generally believed that new york children must have more defects than children elsewhere. if this assumption is wrong, if children in other parts of the united states are as apt to have eye defects, enlarged tonsils, and bad teeth as the children of the great metropolis, then the army of children needing attention would be seven out of ten, or over , , . whether these figures overstate or understate the truth, the school authorities of the country should find out. the chances are that the school in which you are particularly interested is no exception. to learn what the probable number needing attention is, divide your total by ten and multiply the result by seven. the seriousness of every trouble and its particular relation to school progress and to the general public health will be explained in succeeding chapters. the point to be made here is that the examination of the school child discloses in advance of epidemics and breakdowns the children whose physical condition makes them most likely to "come down" with "catching diseases," least able to withstand an attack, less fitted to profit fully from educational and industrial opportunity. the only index to community conditions prejudicial to health that will make known the child of the well-to-do who needs attention is the record of physical examination. no other means to-day exists by which the state can, in a recognized and acceptable way, discover the failure of these well-to-do parents to protect their children's health and take steps to teach and, if necessary, to compel the parents to substitute living conditions that benefit for conditions that injure the child. among the important health rights that deserve more emphasis is the right to be healthy though not "poor." a child's lungs may be weak, breathing capacity one third below normal, weight and nutrition deficient, and yet that child cannot contract tuberculosis unless directly exposed to the germs of that disease. but such a child can contract chronic hunger, can in a hundred ways pay the penalty for being pampered or otherwise neglected. physical examination is needed to find every child that has too little vitality, no zest for play, little resistance, even though sent to a private school and kept away from dirt and contagion. the new york committee on the physical welfare of school children visited fourteen hundred homes of children found to have one or more of the physical defects shown on the above card. while they found that low incomes have more than their proper share of defects and of unsanitary living conditions, yet they saw emphatically also that low incomes do not monopolize physical defects and unsanitary living conditions. many families having $ , $ , $ a week gave their children neither medical nor dental care. the share each income had in unfavorable conditions is shown by the summary in the following table. table vii showing per cent share of physical defects of children, unfavorable housing conditions, and child mortality found among each family-income group ========================+============================================= | weekly family income +-----+------+------+------+------+------+---- | | | | | | $ | |$ - |$ - |$ - |$ - |$ - | and |$ | | | | | | over | +-----+------+------+------+------+------+---- | % | % | % | % | % | % | % ------------------------+-----+------+------+------+------+------+---- proportion to total | | | | | | | families | . | . | . | . | . | . | | | | | | | | _physical defects_: | | | | | | | malnutrition | . | . | . | . | . | . | " enlarged glands | . | . | . | . | . | . | " defective breathing | . | . | . | . | . | . | " bad teeth | . | . | . | . | . | . | " defective vision | . | . | . | . | . | . | " | | | | | | | _unfavorable housing | | | | | | | conditions_: | | | | | | | dark rooms | . | . | . | . | . | . | " closed air shaft | . | . | . | . | . | . | " no baths | . | . | . | . | . | . | " paying over % rent | . | . | . | . | ... | . | " | | | | | | | _child mortality_: | | | | | | | families losing | | | | | | | children | . | . | . | . | . | . | " families losing no | | | | | | | children | . | . | . | . | . | . | " children dead | . | . | . | . | . | . | " infants dying from | | | | | | | intestinal diseases | . | . | . | . | . | . | " children working | . | . | . | . | . | . | " ========================+============================================= the index should be read in all grades from kindergarten to high school and college. last winter the chairman of the committee on the physical welfare of school children was invited to speak of physical examination before an association of high-school principals. he began by saying, "this question does not concern you as directly as it does the grammar-school principals, but you can help secure funds to help their pupils." one after another the high-school principals present told--one of his own daughter, another of his honor girls, a third of his honor boys--the same story of neglected headaches due to eye strain, breakdowns due to undiscovered underfeeding, underexercise, or overwork. are we coming to the time when the state will step in to prevent any boy or girl in high school, college, or professional school from earning academic honors at the expense of health? harmful conditions within schoolrooms and on school grounds will not be neglected where pupils, teachers, school and family physicians, and parents set about to find and to remove the causes of physical defects. disease centers outside of school buildings quickly register themselves in the schoolroom and in the person of a child who is paying the penalty for living in contact with a disease center. if a child sleeps in a dark, ill-ventilated, crowded room, the result will show in his eyes and complexion; if he has too little to eat or the wrong thing to eat, he will be underweight and undersized; if his nutrition is inadequate and his food improper, he is apt to have eye trouble, adenoids, and enlarged tonsils. he may have defective lung capacity, due to improper breathing, too little exercise in the fresh air, too little food. existence of physical defects throws little light on income at home, but conclusively shows lack of attention or of understanding. several days' absence of a child from school leads, in every well-regulated school, to a visit to the child's home or to a letter or card asking that the absence be explained. even newly arrived immigrants have learned the necessity and the advantage of writing the teacher an "excuse" when their children are absent. furthermore, neighbors' children are apt to learn by friendly inquiry what the teacher may not have learned by official inquiry, why their playmate is no longer on the street or at the school desk. while physicians are sometimes willing to violate the law that compels notification of infection, rarely would a physician fail to caution an infected family against an indiscriminate mingling with neighbors. whether the family physician is careless or not, the explanation of the absence which is demanded by the school would give also announcement of any danger that might exist in the home where the child is ill. if it be said that in hundreds of thousands of cases the child labor law is violated and that therefore school examination is not an index to the poverty or neglect occasioning such child labor, it should be remembered that the best physical test is the child's presence at school. the first step in thorough physical examination is a thorough school census,--the counting of every child of school age. moreover, a relatively small number of children who violate the child labor law are the only members of the family who ought to be in school. younger children furnish the index and occasion the visit that should discover the violation of law. appreciation of health, as well as its neglect, is indexed by the physical condition of school children. habits of health are the other side of the shield of health rights unprotected. physical examination will discover what parents are trying to do as well as what they fail to do because of their ignorance, indifference, or poverty. in so far as parents are alive to the importance of health, the school examination furnishes the occasion of enlisting them in crusades to protect the public health and to enforce health rights. the committee on the physical welfare of school children found many parents unwilling to answer questions as to their own living conditions until told that the answers would make it easier to get better health environment not only for their own children but for their neighbors' children. generally speaking, fathers and mothers can easily be interested in any kind of campaign in the name of health and in behalf of children. the advantage of starting this health crusade from the most popular american institution, the public school,--the advantage of instituting corrective work through democratic machinery such as the public school,--is incalculable. to any teacher, pastor, civic leader, health official, or taxpayer wanting to take the necessary steps for the removal of conditions prejudicial to health and for the enforcement of health rights of child and adult, the best possible advice is to learn the facts disclosed by the physical examination of your school children. see that those facts are used first for the benefit of the children themselves, secondly for the benefit of the community as a whole. if your school has not yet introduced the thorough physical examination of school children, take steps at once to secure such examination. if necessary, volunteer to test the eyes and the breathing of one class, persuade one or two physicians to coöperate until you have proved to parent, taxpayer, health official, and teacher that such an examination is both a money-saving, energy-saving step and an act of justice. we shall have occasion to emphasize over and over again the fact that it is the use of information and not the gathering of information that improves the health. the united states weather bureau saves millions of dollars annually, not because flags are raised and bulletins issued foretelling the weather, but because shipowners, sailors, farmers, and fruit growers obey the warnings. mere examination of school children does little good. the child does not breathe better or see better because the school physician fills out a card stating that there is something wrong with his eyes, nose, and tonsils. the examination tells where the need is, what children should have special attention, what parents need to be warned as to the condition of the child, what home conditions need to be corrected. if the facts are not used, that is an argument not against obtaining facts but against disregarding them. in understanding medical examination we should keep clearly in mind the distinction between medical school inspection, medical school examination, and medical treatment at school. medical inspection is the search for communicable disease. the results of medical inspection, therefore, furnish an index to the presence of communicable diseases in the community. medical examination is the search for physical defects, some of which furnish the soil for contagion. its results are an index not only to contagion but to conditions that favor contagion by producing or aggravating physical defects and by reducing vitality. medical treatment at school refers to steps taken under the school roof, or by school funds, to remove the defects or check the infection brought to light by medical inspection and medical examination. treatment is not an index. in separate chapters are given the reasons for and against trying to treat at school symptoms of causes that exist outside of school. when, how often, and by whom inspection and examination should be made is also discussed later. the one point of this chapter is this: if we really want to know where in our community health rights are endangered, the shortest cut to the largest number of dangers is the physical examination of children at school,--private, parochial, reformatory, public, high, college. apart from the advantage to the community of locating its health problems, physical examination is due every child. no matter where his schooling or at whose expense, every child has the right to advance as fast as his own powers will permit without hindrance from his own or his playmates' removable defects. he has the right to learn that simplified breathing is more necessary than simplified spelling, that nose plus adenoids makes backwardness, that a decayed tooth multiplied by ten gives malnutrition, and that hypertrophied tonsils are even more menacing than hypertrophied playfulness. he has the right to learn that his own mother in his own home, with the aid of his own family physician, can remove his physical defects so that it will be unnecessary for outsiders to give him a palliative free lunch at school, thus neglecting the cause of his defects and those of fellow-pupils. footnotes: [ ] sir john e. gorst in _the children of the nation_ reads the index of the health of school children in the united kingdom; john spargo, in _the bitter cry of the children_, and simon n. patten in _the new basis of civilization_, suggest the necessity for reading the index in the united states and for heeding it. part ii. reading the index to health rights chapter v mouth breathing if the physical condition of school children is our best index to community health, who is to read the index? unless the story is told in a language that does not require a secret code or cipher, unless some one besides the physician can read it, we shall be a very long time learning the health needs of even our largest cities, and until doomsday learning the health needs of small towns and rural districts. fortunately the more important signs can be easily read by the average parent or teacher. fortunately, too, it is easy to persuade mothers and teachers that they can lighten their own labors, add to their efficiency, and help their children by being on the watch for mouth breathing, for strained, crossed, or inflamed eyes, for decaying teeth, for nervousness and sluggishness. years ago, when i taught school in a minnesota village, i had never heard of adenoids, hypertrophied tonsils, myopia, hypermetropia, or the relation of these defects and of neglected teeth to malnutrition, truancy, sickness, and dullness. i now see how i could have saved myself several failures, the taxpayers a great deal of money, the parents a great deal of disappointment, and many children a life of inefficiency, had i known what it is easy for all teachers and parents to learn to-day. [illustration: mouth breathers before "adenoid party"] the features in the following cut are familiar to teachers the world over. parents may reconcile themselves to such lips, eyes, and mouths, but seldom do even neglectful parents fail to notice "mouth breathing." children afflicted by such features suffer torment from playfellows whose scornful epithets are echoed by the looking-glass. no fashion plate ever portrays such faces. no athlete, thinker, or hero looks out from printed page with such clouded, listless eyes. the more wonder, therefore, that the meaning of these outward signs has not been appreciated and their causes removed; conclusive reason, also, for not being misled by recent talk of mouth breathing, adenoids, and enlarged tonsils, into the belief that the race is physically deteriorating. three generations ago charles dickens in his _uncommercial traveller_ pointed out a relation between open mouths and backwardness and delinquency that would have saved millions of dollars and millions of life failures had the civilized world listened. he was speaking of delinquent girls from seventeen to twenty years old in wapping workhouse: "i have never yet ascertained why a refractory habit should affect the tonsils and the uvula; but i have always observed that refractories of both sexes and every grade, between a ragged school and the old bailey, have one voice, in which the tonsils and uvula gain a diseased ascendency." to-day we are just beginning to see over again the connection between inability to breathe through the nose and inability to see clearly right from wrong and inability to want to do what teachers and parents wish. physical examinations show now, and might just as well have shown fifty years ago, that the great majority of truants and juvenile offenders have adenoids and enlarged tonsils. a recent examination made by the new york board of health on children in one school made up from the truant school, the juvenile court, and randall's island, showed that only three were without some physical defect and that had adenoids and large tonsils. dickens wrote his observations in ; in the new york juvenile asylum was started, and up to cared for , children; in william meyer pointed out, so that no one need misunderstand, the harmful effects of adenoids. what would have been the story of juvenile waywardness, of sickness, of educational advancement, had examinations for defective breathing been started in or instead of ; if one per cent of the attention that has been given to teaching mouth breathers the ten commandments had been spent on removing the nasal obstructions to intelligence? [illustration: a "degenerate" made normal by removal of adenoids] william hegel, who is pictured on page , before his tonsils and adenoids were removed was described by his father in this way: "when playing with other boys on the street he seems dazed, and sluggish to grasp the various situations occurring in the course of the game. when he decides to do something he runs in a heedless, senseless way, as if running away,--will bump against something, pedestrian or building, before he comes to himself; seems dazed all the time. when told something by his mother he giggles in the most exasperating way, for which he receives a whipping quite often." the father said the whipping was of no avail. the child was restless, talkative, and snored during sleep. he had an insatiable appetite. he was removed or transferred from five different schools in new york city. to get redress the father took him to the board of education, whence he was referred to the assistant chief medical inspector of the department of health, whose examination revealed immensely large fungous-looking tonsils and excessive pharyngeal granulations (adenoids). he was operated on at a clinic. the tonsils and adenoids removed are pictured on the opposite page, reduced one third. after the operation the child was visited by the assistant medical inspector. there was a marked improvement in his facial expression,--he looked intelligent, was alert and interested. when asked how he felt, he answered, "i feel fine now." it required about fifteen minutes to get his history, during all of which time he was responsive and interested, constantly correcting statements of his father and volunteering other information. eleven days after the operation he was reported to have had no more epileptic seizures. "doesn't talk in sleep. doesn't snore. doesn't toss about the bed. has more self-control. tries to read the paper. his immoderate appetite is not present." [illustration: reason enough for mouth breathing adenoid and tonsils reduced one third] while the open mouth is a sure sign of defects of breathing, it is not true that the closed mouth, when awake and with other people, is proof that there are no such defects. children breathe through the mouth not because they like to, not because they have drifted into bad habits, not because their parents did, not because the human race is deteriorating, but because their noses are stopped up,--because they must. a mouth breather is not only always taking unfiltered dirt germs into his system but is always in the condition of a person who has slept in a stuffy room. what extra effort adenoids mean can be ascertained by closing the nostrils for a forenoon. for many reasons it is perhaps unfortunate that we can breathe at all when the nose is stopped up. if we could see with our ears as well as with our eyes, we should probably not take as good care of our eyes. in this respect the whole race has experienced the misfortune of the man of whom the coroner reported, "killed by falling too short a distance." because we can breathe through the mouth we have neglected for centuries the nasal passages. when a cold stops the nose we necessarily breathe through the mouth. unfortunately children make the necessary effort required to breathe through the nose long before other people notice the lines along the nose and the slow mind. mouth breathing will show with the child asleep, before the child awake loses power to accommodate his effort to the task. therefore the importance of a physical test at school to detect the beginnings of adenoids and large tonsils before these symptoms become obvious to others. no child should be exempted from this examination because of apocryphal theories that only the poor, the slum child, the refractory, or the unclean have defects in breathing. this very afternoon a friend has told me of her year abroad with a girl of nine, whose parents are very wealthy. the girl is anæmic. her backwardness humiliates her parents, especially because she gave great promise until two years ago. high-priced physicians have prescribed for her. it happens that they are too eminent to give attention to such simple troubles as adenoids that can be felt and seen. they are looking for complications of the liver or inflammation of muscles at the base of the brain. one celebrated french savant found the adenoids, assured the mother that the child would outgrow them, and advised merely that she be compelled to breathe through the nose. the mother and nursemaids nag the child all day. the poor unwise mother sits up nights to hold the child's jaws tight in the hope that air coming through the nose will absorb the adenoids. the mother is made nervous. of course this makes the child more nervous and adds to the evil effects of adenoids. if the mother had the good fortune to be very poor, she could not sit up nights, and would long ago have decided either to let the child alone or else to have the trouble removed. adenoids are not a city specialty. country earache is largely due to adenoids or to inflammation that quickly leads to adenoids. in villages of new york state twelve per cent were found to be mouth breathers. for two summers i have known a lad named fred. he lives at the seashore. throughout his twelve years he has lived in a veritable el dorado of health and nature beauty. groves and dunes and flora vie with the blues of ocean and sky in resting the eye and in filling the soul with that harmony which is said to make for sound living. yet to a child, fred's schoolmates are experts on patent medicines and on the heredity that is alleged to be responsible for bad temper, running sores, tuberculosis, anæmia, and weak eyes. freddie is particularly favored. his well-to-do parents have supplied him with ponies, games, and bicycles. nothing prevents his breathing salt air fresh from the north pole but hermetically sealed windows. the father thinks it absurd to make a fuss over adenoids. didn't he have them when a boy, and doesn't he weigh two hundred pounds and "make good money"? the mother never knew of operations for such trifles when she taught school; she supposes her boy needs an operation, but "just can't bear to see the dear child hurt." as for fred, he breathes through his mouth, talks through his nose, grows indifferent to boy's fun, fails to earn promotion at school, and fears that "i won't be strong in spite of all the patent medicine i've taken." father, mother, and fred feel profound pity for the city child living so far from nature. adenoids are not monopolized by children whose parents are ignorant of the importance of them and of physical examination. last summer i was asked by a small boy to buy some chocolate. a glance at his cigar box with its two or three uninviting things for sale showed that the boy was really begging. he had thick lips, open mouth, "misty" eyes, and a nasal twang. i asked him if his teacher had not told him he had lumps back of his nose and could not breathe right. he said, "no." i explained then that he could make a great deal more money if he talked like other boys, stepped livelier, and breathed as other people breathe. he said he had "been by a doctor onct but didn't want to be op'rated." i turned to my companion and asked, "have you never noted those same lines on your boy's face?" although he had been lecturing on mouth breathers, he had never noticed his own boy's trouble. he hastened home and found the infallible signs. the mother declared it could not be true of her boy. about five months before, their family physician had said of the child's earache, "the same inflammation of the nasal passages that causes earache causes adenoids; you must be on the lookout." although in the country, the boy's appetite was not good and his zest for play had flagged. they had looked for the trouble to back generations and in psychology books,--everywhere but at the boy's face, in his mouth, and in his nose. after the operation, which took less than two minutes, the appetite was ravenous, the eyes cleared, and the spirit rebounded to its old buoyancy that craved worlds to conquer. the new personal experience made a deep impression upon my friend's mind. he wanted everybody to know how easy it was to overlook a child's distress. one person after another had a story to tell him; even the janitor said: "you'd ought to have seen our john at sixteen. he spent a week by the hospital." the only people who do not seem to know more than the new convert are the mouth breathers whom he religiously stops on the street. the indexes to adenoids and large tonsils for the teacher to read at school are: . inability to breathe through the nose. . a chronically running nose, accompanied by frequent nose-bleeds and a cough to clear the throat. . stuffy speech and delayed learning to talk. "common" is pronounced "cobbéd"; "nose," "dose"; and "song," "sogg." . a narrow upper jaw and irregular crowding of the teeth. . deafness. . chorea or nervousness. . inflamed eyes and conjunctivitis. the adenoids and large tonsils discovered at school are an index: . to children needlessly handicapped in school work. . to teachers needlessly burdened. . to whole classes held back by afflicted children. . to breeding grounds for disease. . to homes where children's diseases and tuberculosis are most likely to break out and flourish. . to parents who need instruction in their duty to their children, to themselves, and to their neighbors, and who are ignorant of the way in which "catching" diseases originate and spread. the riot that occurred when the adenoids of children in a school on the "east side" in new york city were removed without the preliminary of convincing the parents as to the advantages of the operation was merely a demand for the "right to knowledge," which is never overlooked with impunity. reluctance to permit operation on a young child, and the natural shrinking of a parent at seeing a child under the surgeon's knife, require the teacher or school physician or nurse to answer fully the usual questions of the hesitant mother and father. . is the operation necessary? will the child not outgrow its adenoids? usually the adenoid growths atrophy or dry up after the age of puberty. adenoids are not uncommon in adults, however. the surgeon general of the army reports that during the year , out of operations on officers and enlisted men in service, there were operations on the nose, mouth, and pharynx, of which were operations for adenoids and enlarged or hypertrophied tonsils. allowing the child to "outgrow" adenoids may mean not only that he is being subjected to infection chronically but that his body is allowed to be permanently deformed and his health endangered. beginning at the age of the second dentition, the bones of jaw, nose, throat, and chest are undergoing important changes--nasal occlusion. adenoids left to atrophy--if large enough to cause mouth breathing--may mean atrophy of this developing process, permanent disfiguration of face, and permanent deformity of chest and lungs. . will the growth recur? in a few cases it does recur; frequently either because it was not desirable to make a complete removal of the adenoid tissue or because the surgeon was careless. if the growths do recur, then they must be removed again. . is the operation a dangerous one? . is an anæsthetic necessary? . will the operation cure the child of all its troubles? these questions are best answered by the process and results of an "adenoid party," which was given especially for the benefit of this book, every step and symptom of which were carefully studied. the seven children pictured here were discovered by their school physician to have moderately large adenoid growths,--one boy having enlarged tonsils also. [illustration: mouth breathers immediately after "adenoid party"] the picture on page was taken by flash light at . p.m., january , . at p.m. the principal escorted these children into the operating room at vanderbilt clinic. the doctor examined the throat and nose of each child, entered the name and age of each, together with his diagnosis, on a clinic card, sending each child into the next room after examination. he then called the first boy and explained that it would hurt, but that it would be over in a minute. the principal stood by and told him to be brave and remember the five cents he could have for ice cream afterwards. the clinic nurse tied a large towel about him and put him in her lap; with one hand she held his clasped hands, while the other held his head back. the doctor then took the little instrument--the curette--and pushed it up back of the soft palate, and with one twist brought out the offending spongy lump. the boy's head was immediately held over a basin of running water. he was so occupied with spitting out the blood that rushed down to choke him that he hadn't time to cry before the acute pain had ceased. the rush of cool air through his nostrils was such a pleasurable sensation that he smiled as the school nurse escorted him out into the hall to wait for his companions. at . p.m. all seven children were out in the hall, all seven mouths were closed, and all seven faces were clothed with the sleepy, peaceful expression that comes with rest from the prolonged labor of trying to get enough air. at . p.m. they had been all reëxamined by the doctor, and a few tag ends were picked out of the nasopharynx of one child. at p.m. the "party" had returned to the children's aid society's school and to the ice cream that follows each adenoid party. it is worth while to tell mothers stories of the "marvelous improvement in school progress of those children whose brains have been poisoned and starved by the accursed adenoid growths, and how their bodies fairly bloom when the mysterious and awful incubus is removed," to use the words of one school principal. it is worth while to show them "before" and "after" pictures, and "before" and "after" children, and "before" and "after" school marks. chapter vi catching diseases, colds, diseased glands deadly fevers, the plague, black death, cholera, malaria, smallpox, taught mankind invaluable lessons. millions of human beings died before the mind of man devoted itself to preventing the diseases for which no sure cure had been found. efforts to conquer these diseases were tardy because men were taught that some unseen power was punishing men and governments for their sins. the difference between the old and the new way is shown powerfully by a painting in the liverpool gallery entitled "the plague." a mediæval village is strewn with the dead and dying. bloated, spotted faces look into the eyes of ghouls as laces and jewelry are torn from bodies not yet cold. in the foreground a muscular giant, paragon of conscious virtue, clad like john the baptist and bible in hand, finds his way among his plague-stricken fellow-townsmen, urging them to turn from their sins. modern efficiency learns of the first outbreak of the plague, isolates the patient, kills rats and their fleas which spread the disease, thoroughly cleanses or destroys, if necessary, all infected clothing, bedding, floors, and walls, and makes it possible for us to go on living for each other with a better chance of "bringing forth fruits worthy for repentance." where boards of health make it compulsory to report cases of sickness due to contagion, health records are a reliable index to "catching" diseases. but now that the chief infection is the kind that afflicts children, we can read the index before the outbreak that calls in a physician to diagnose the case. school examination shows which children have defects that welcome and encourage disease germs. it points to homes that cultivate germs, and consequently menace other homes. to locate children who have enlarged tonsils may prevent a diphtheria epidemic. to detect in september those who are undernourished, who have bad teeth, and who breathe through the mouth will help forecast winter's outbreaks of scarlet fever and measles. one dollar spent at this season in examination for soil hospitable to disease germs may save fifty dollars otherwise necessary for inspection and cure of contagious diseases. it is harder at first to interest a community in medical examination than in medical inspection, because we are all afraid of "catching" diseases, while few of us know how they originate and how they can be prevented by correcting the unfavorable conditions which physical examination of school children will bring to light. courses in germ sociology are therefore of prime necessity. how do germs act? on what do they live? why do they move from place to place? what causes them to become extinct? with few exceptions, germs migrate for the same reason as man,--search for food, love of conquest, and love of adventure. when there is plenty of food they multiply rapidly. full of life, overflowing with vitality, they move out for new worlds to conquer. like human beings, they will do their best to get away from a country that provides a scanty food supply. like men and women, they starve if they cannot eat. like boys and girls, they avoid enemies; the weak give way to the strong, the slow to the swift, the devitalized to the vitalized. human sociology imprisons, puts to death, deprives of opportunity to do evil, or reforms those who murder, steal, or slander. germ sociology teaches us to do the same with injurious germs. we imprison them, we take away their food supply, we kill them outright, or we starve them slowly. they have a peculiar diet, being especially partial to decomposing vegetable and animal matter and to what human beings call dirt. by putting this diet out of their reach we make it impossible for them to propagate their kind. by placing poison within their reach or by forcing it upon them we can successfully eliminate them as enemies. as the president of mexico restored order "by setting a thief to catch a thief," so modern science is setting germs to kill germs that harm crops and human stock. of utmost consequence is it that the body's germ consumer--its pretorian guard--be always armed with vitality ready to vanquish every intruding hostile germ. if we are false to our guard, it will turn traitor and join invaders in attacking us. but here, as in dealing with evils that originate with human beings, an ounce of prevention is worth a ton of cure. the most effectual way to eliminate germ diseases is to remove the cause--the food supply of disease germs. the fact that many germs are plants, not animals, does not weaken the analogy, for weeds do not get a chance in well-tilled soil. perhaps the most notable recent example of government germ extermination is the triumph over the yellow-fever and malaria mosquito in panama. when the french started to build a canal in panama, the first thing they did was to build a hospital. the hospital was always full and the canal was given up. at the time the united states proposed to re-attempt the work, it was thought that it could not be done without great loss of life and without great labor difficulties. instead of taking the sickness for granted and enlarging the french hospital, the chief medical inspector, gorgas, took for granted that there need be no unusual sickness if proper preventive measures were taken. he knew what the french had not known, that the yellow-fever scourge depends for its terrors upon mosquitoes. accordingly, with the aid of six thousand men and five million dollars he set about to starve out the few infected and infectious kinds of mosquito,--the yellow-fever or house mosquito and the malaria or meadow mosquito. he introduced waterworks and hydrants, paved the streets, drained the swamps and pools in which they breed, and instituted a weekly house-to-house inspection to prevent even so much as a pail of stagnant water offering harbor to these enemies. the grass of the meadows where the malaria mosquito breeds was cut short and kept short within three hundred feet of dwellers,--as far as the mosquito can fly. all ditches were disinfected with paraffin, and the natives were forced to observe sanitary laws. president roosevelt, in his special message to congress on the panama canal in , stated that in the weekly house-to-house visit of the inspectors at the time he was in panama but two mosquitoes were found. these were not of the dangerous type. as a consequence of this sanitary engineering there is very little sickness in panama, the hospital is seldom one third full, and the canal is progressing very much faster than was expected. panama, like havana, is now safer than many american cities, because cleaner and less hospitable to disease germs. any place where numbers of people are accustomed to assemble favors the propagation of germs,--whether it be the meetinghouse, the townhall, the theater, or the school. every teacher can be the sanitary engineer of her own schoolroom, school, or community by coöperating with the school doctor, the town board of health, family physicians, and mothers. every teacher can exterminate disease by applying the very same principles to her schoolroom as chief medical inspector gorgas applied to panama. knowledge, disinfection, absolute cleanliness, education, and inspection are the essential steps. first she must know that "children's diseases" are not necessary. she should discountenance the old superstition that every child must run the gamut of children's diseases, that every child must sooner or later have whooping cough, measles, chicken pox, mumps, scarlet fever, just as they used to think yellow fever and cholera inevitable. the price of this terrible ignorance has been not only expense, loss of time, acquisition of permanent physical defects, and loss of vitality, but, for the majority of children, death before reaching five years of age. all these "catching" diseases are germ diseases, which disinfection can eliminate. the free use of strong yellow soap and disinfectants on the school floor, windows, benches, desks, blackboards, pencils, in the coat closets and toilets, plus the natural disinfectants, hot sun and oxygen, will prevent the schoolroom from being a source of danger. one or more of these germ-killing remedies must be constantly applied; cleansing deserves a larger part in every school budget. often country towns are as ignorant of the existence of germs and of the means of preventing the spread of disease as the woman in a small country town who used daily to astound the neighbors by the "shower of snow" she produced by shaking the bedding of her sick child out of the window. their astonishment was soon changed to panic when that shower of snow resulted in a deadly epidemic of scarlet fever. medical inspection of new york city's schools was begun after an epidemic of scarlet fever was traced to a popular boy who passed around among his schoolmates long rolls of skin from his fingers. much of the care exercised at school to prevent children's diseases is counteracted because children are exposed at home and in public places to contagion, where ignorance more often than carelessness is the cause of uncleanliness. by hygiene lessons, illustrating practically the proper methods of cleaning a room, much may be done to enlist school children in the battle against germs. through the enthusiasm of the children as well as through visits to the homes parents may be instructed as to the danger of letting well children sleep with sick children; the wisdom of vaccination to prevent smallpox, of antitoxin to prevent serious diphtheria, of tuberculin tests to settle the question whether tuberculosis is present; why anything that gathers dust is dangerous unless cleansed and aired properly; and why bedding, furniture, floor coverings, and curtains that can be cleansed and aired are more beautiful and more safe than carpets, feather beds, upholstery, and curtains that are spoiled by water and sunshine; how to care for the tuberculous member of the family, etc. anti-social acts may be prevented, such as carrying an infected child to the doctor in a public conveyance, thereby infecting numberless other people; sending infected linen to a common laundry; mailing a letter written by an infected person without first disinfecting it; sending a child with diphtheria to the store; returning to the dairy unscalded milk bottles from a sick room. the daily inspection of school children for contagious diseases by the school physician has, where tried, been found to reduce considerably the amount of sickness in a town. such inspection should be universally adopted. moreover, the teacher should be conversant with the early symptoms of these diseases so that on the slightest suspicion the child may be sent home without waiting for the physician's call. like the little girl who never stuttered except when she talked, school children and school-teachers are rarely frightened until too late to prevent trouble. the "easy" diseases such as measles, whooping cough, etc., cost our communities more than the more terrible diseases like typhoid and smallpox. during one typical week ending may , new cases of measles were reported to one department of health. obviously the nineteen deaths reported give no conception of the suffering, the cost, the anxiety caused by this preventable disease. the same may be said of diphtheria and croup, of which only thirty-two deaths are reported, but cases of sickness. yet no one to-day will send a child to sleep with a playmate so as to catch diphtheria and "be done with it." the most strategic point of attack is almost universally unrecognized. that is the child's mouth. here the germs find lodgment, here they find a culture medium--at the gateway of the human system. the mouth is never out of service and is almost never in a state of true cleanliness. solid particles from the breath, saliva, food between the teeth, and other débris form a deposit on the teeth and decompose in a constant temperature of ninety-eight degrees fahrenheit. in the normal mouth from eight to twenty years of age the teeth present from twenty to thirty square inches of dentate surface, constantly exposed to ever-changing, often inimical, conditions. this bacterially infected surface makes a fairly large garden plot. every cavity adds to the germ-nourishing soil. dental caries--tooth decay--is a disease hitherto almost universal from birth to death. thus the air taken in through the mouth becomes a purveyor of its poisonous emanations and affects the lung tissues and the blood. food and water carry hostile germs down into the stomach. thence they may be carried into any organ or tissue, just as nourishment or poison is carried. moreover, the child with an unclean mouth not only infects and reinfects himself but scatters germs in the air whenever he sneezes or coughs. in a cold apartment where there is no appreciable current of air a person can scatter germs for a distance of more than twenty-two feet. germs are also scattered through the air by means of salivary or mucous droplets. it is this fact that makes colds so dangerous. table viii =city of manchester education committee= =infectious or contagious diseases in schools information for teachers= four columns are omitted: ( ) interval between exposure to infection and the first signs of the disease; ( ) day from onset of illness on which rash appears; ( ) period of exclusion from school after exposure to infection; ( ) period of exclusion from school of person suffering from the disease -----------+------------------------------+------------+------------------ disease | principal signs and symptoms | method of | remarks | | infection | -----------+------------------------------+------------+------------------ measles |_begins like cold in the | |after effects |head_, with _feverishness, | |often severe. |running nose, inflamed and | |period of greatest |watery eyes, and sneezing_; | |risk of infection |small crescentic groups of | breath and |first three or |_mulberry-tinted spots_ appear| discharges |four days, before |about the third day; _rash | from nose |the rash appears. |first seen on forehead and | and mouth. |may have repeated |face_. the rash varies with | |attacks. great |heat; may almost disappear if | |variation in type |the air is cold, and come out | |of disease. |again with warmth. | | -----------+------------------------------+------------+------------------ german |illness usually slight. onset | | measles |sudden. _rash often first | | |thing noticed;_ no cold in | breath and | |head. usually have | discharges |after effects |_feverishness_ and _sore | from nose |slight. |throat_, and the _eyes may | and mouth | |be inflamed. rash_ something | | |between measles and scarlet | | |fever, variable. | | -----------+------------------------------+------------+------------------ chicken |sometimes begins with | |when children pox |feverishness, but is _usually | |return, examine |very mild_ and without sign | |head for |of fever. _rash_ appears on | |overlooked spots. |second day as _small pimples_,| |all spots should |which in about a day become | |have disappeared |filled with _clear fluid_. | breath and |before child |this fluid then becomes | crust of |returns. a mild |_matter_, and then the _spot | spots. |disease and |dries up_and _the crust falls | |seldom any after |off_. | |effects. | | | |may have _successive crops of | | |of rash_ until tenth day. | | -----------+------------------------------+------------+------------------ whooping |_begins like cold in the | |after effects cough |head_, with _bronchitis_ and | |often very severe |_sore throat_, and a _cough_ | |and the disease |which is _worse at night_. | breath and |causes great |symptoms may at first be very | discharges |debility. relapses |mild. characteristic | from nose |are apt to occur. |_"whooping" cough_ develops | and mouth. |second attack |in about a fortnight, and the | |rare. specially |spasm of coughing often ends | |infectious for |with _vomiting_. | |first week or two. | | |if a child is sick | | |after a bout of | | |coughing, it is | | |most probably | | |suffering from | | |whooping cough. | | | | | |great variation in | | |type of disease. -----------+------------------------------+------------+------------------ mumps |onset may be sudden, beginning| | |with sickness and fever, and | | |_pain about the angle of the | breath and |seldom leaves |jaw_. the _glands become | discharges |after effects. |swollen and tender_, and the | from nose |very infectious. |_jaws stiff_, and the _saliva | and mouth. | |sticky_. | | -----------+------------------------------+------------+------------------ scarlet |the _onset is usually sudden_,| breath, |dangerous both fever or |with _headache, languor, | discharges |during attack and scarlatina |feverishness, sore throat_, | from nose |from after effects. |and often the child is _sick_.| and mouth, |great variation |usually within twenty-four | particles |in type of disease. |hours the _rash_ appears, and | of skin, |slight attacks |is _finely spotted, evenly | and |as infectious as |diffused_, and _bright red_. | discharges |severe ones. many |the _rash_ is seen first on | from |mild cases not |the _neck and upper part of | suppuratory|diagnosed and many |chest_, and lasts three to | glands or |concealed. the |ten days, when it fades and | ears. milk |peeling may last |the _skin peels in scales, | specially |six to eight weeks. |flakes_, or even _large | apt to |a second attack is |pieces_. the _tongue_ becomes | convey |rare. when scarlet |whitish, with bright red | infection. |fever is occurring |spots. the eyes are not watery| |in a school, all |or congested. | |cases of sore | | |throat should be | | |sent home. -----------+------------------------------+------------+------------------- diphtheria |onset insidious, may be rapid | breath and |very dangerous |or gradual. typically _sore | discharges |both during attack |throat_, great weakness, and | from nose, |and from after |swelling of glands in the | mouth, and |effects. when |neck, about the angle of the | ears. |diphtheria is |jaw. the back of the throat, | |occurring in a |tonsils, or palate may show | |school all children |_patches_ like pieces of | |suffering from sore |yellowish-white kid. the most | |throat should be |pronounced symptom is great | |excluded. there is |debility and lassitude, and | |great variation of |there may be little else | |type, and mild |noticeable. there may be | |cases are often not |hardly any symptoms at all. | |recognized but are | | |as infectious as | | |severe cases. there | | |is no immunity from | | |further attacks. | | |fact of existence | | |of disease | | |sometimes | | |concealed. -----------+------------------------------+------------+------------------- influenza |_begins with feverishness, | breath and |excessively |pain in head, back_, and | discharges |infectious. after |_limbs_, and usually _cold in | from nose |effects often very |the head_. | and mouth. |serious and | | |accompanied with | | |great prostration | | |and nervous | | |debility. -----------+------------------------------+------------+-------------- smallpox |the illness is usually well | breath, |peculiarly |marked and the onset rather | all |infectious. when |sudden, with _feverishness, | discharges,|smallpox occurs in |severe backache, and | and |connection with a |sickness_. about third day | particles |school or with any |a _red rash_ of _shotlike | of skin |of the children's |pimples_, felt below the skin,| or scabs. |homes, an endeavor |and seen first about the | |should be made to |_face_ and _wrists. spots | |have all persons |develop_ in _two days_, then | |over seven years |form _little blisters_, and | |of age |in other two days become | |revaccinated. |_yellowish_ and filled with | | |matter. _scabs_ then form, | |cases of modified |and these fall off about | |smallpox--in |the fourteenth day. | |vaccinated | | |persons--may be, | | |and often are, so | | |slight as to | | |escape detection. | | |fact of existence | | |of disease may be | | |concealed. mild | | |or modified | | |smallpox as | | |infectious as | | |severe type. -----------+------------------------------+------------+----------------- =in the following diseases only the affected child is excluded= =erysipelas.= child should not | =ringworm on scalp.= child should return till all swelling and | be excluded till cured. very peeling of skin has disappeared. | difficult to cure and often takes | a very long time. =ophthalmia.= child should not | return till all traces have | =phthisis= (=consumption=). if in disappeared. | advanced stage and coughing much | _or spitting_, child should be =scabies or itch.= child should be | excluded. (infection from breath excluded until cured. | and dried spit floating in the air | as dust.) =ringworm on skin.= child should be | excluded till cured. this takes | =impetigo= (=contagious sore=). only a few days if properly | child should be excluded until treated. | cured. a week or ten days should | suffice. =a. brown ritchie=, _medical officer to education committee_. most people still think that colds are due to cold air or draughts rather than to a cold germ, which finds a body unequipped with resisting power, with its germ police off guard, exhausted from overwork, or disaffected and ready to turn traitor if the enemy seems stronger than our vitality. sometimes it seems as if we contracted it from a sneezing fellow-passenger, sometimes from a draught from an open car window. an uninformed opponent of the theory that colds are a germ disease wrote the following letter last winter to a new york newspaper: in addition to the society for the suppression of noises there should be in this town a society for the suppression of "fresh-air" fiends. the newspapers report an epidemic of pneumonia, grippe, and colds. it is almost entirely due to the fact that the average new yorker is compelled to live, move, and have his being from daylight to midnight in a succession of draughts of cold air caused by the insanity of overfed male and female hogs, who, with blood almost bursting through their skins, demand "fresh air" in order to keep from suffocating. everywhere a man goes, day or night, he is in a draught caused by the crazy ideas about fresh air. our wise ancestors, who as a rule lived much longer than we do, and had much better health, said: "if the wind should blow through a hole, god have mercy on your soul." after the correspondent has learned that our ancestors had more colds than we, had poorer health, and died twenty years younger, perhaps he will listen to proof that his unclean warm air weakens the body and makes it an easy prey to cold germs. many physicians preach and practice this fallacy as to fresh air and colds, but few physicians now deny that influenza is a germ disease or that a nose so irritated and so neglected as to secrete large quantities of mucus is a better place for breeding disease germs than a nose whose membranes are clean and not thus irritated. until medical specialists are agreed, and until they have definitely located the cold germ, we laymen must choose for ourselves a working theory. the weight of opinion at the present time declares that colds are due to germs. strong membranes with good circulation and drainage provide poor food for germs. congested membranes furnish proper conditions for propagation. the germ theory explains the spread of germs from the nose to the passages of the head, and from head to arteries and lungs. a cold can always be charged to some one else. how many can be laid to our account? there is one right that is universally not recognized, and that is the right of protection from the germs showered in the air we breathe, over the food we eat, by the sneezes of our unfortunate neighbor at school, in the street car, at the restaurant. the chief danger of a cold is to our neighbor, not to ourselves. a cold which a strong person may throw off in a day or two may mean death to his tuberculous neighbor. though for our own health "lying up for a mere cold" is an unnecessary bore, the failure to do so may deprive our neighbor of a right greater than the right to protection against scarlet fever or smallpox. though formerly this statement would not have been true, rights change with conditions, and the fact that to-day the three most deadly diseases are pneumonia, tuberculosis, and diphtheria,--all diseases of the respiratory organs,--justifies the assertion that we have a right to protection against colds. the prevalence of colds, sore throats, irritated vocal cords, bad voices, catarrh, bronchitis, laryngitis, and asthma in america to-day demands summary measures. one can learn to sneeze into a handkerchief, not into a companion's face or into a room. school children can be taught to avoid handkerchiefs on which mucus has dried. in the far distant future we may be willing to use cheesecloth, and boil it or throw it away, or, like the japanese, use soft paper handkerchiefs and burn them after using. table ix death rate per , population, pneumonia and bronchitis five-year period, - england and wales . scotland . stockholm . london . berlin . vienna . christiania . boston . chicago . philadelphia . new york city . one child with a cold can infect a whole class or family, thus depriving the class and family of the top of their vitality and efficiency without their consent. because a person is thought a weakling who lies up for a "mere cold," one is inclined to wish that colds were as prostrating as typhoid, in which case there would be some hope of their extermination. the exclusion of children with colds from school deserves trial as a check to children's diseases. many of these "catching" diseases start with a cold in the head, as, for instance, measles, influenza, and whooping cough. the first symptom of mumps, diphtheria, and scarlet fever is a sore throat or swollen glands, which, because they commonly accompany a cold, are not at first distinguished from it. the first step for the teacher or mother in reading the index for colds is to look into the coat closet for evidence of warm clothing and overshoes, then to note whether the children put them on when they go out for lunch or recess. whether "cold" settles in the nasal passages, ear, or stomach depends upon which is the weak spot. draughts, thin soles, wet soles, exposure when perspiring, may be the immediate cause of the nutritional or respiratory disturbances that give cold germs a foothold. adenoids, diseased teeth, inflamed ears, may furnish the food supply. "there is no use treating children and sending them on fresh-air trips as long as they have nutritional and digestive disturbances due to bad teeth, or colds due to adenoids," said a physician when examining a party of children for a summer outing. the great preventive measure to be taken for catching diseases, colds, diseased glands,--in fact all germ diseases,--is the repeated cleansing of those portions of the human body in which germs may find lodgment,--the mouth, the nose, the eyes, and the ears. in caring for young infants great pains is taken to cleanse all the orifices daily, but as soon as the child washes himself this practice is usually abandoned. washing these gateways is far more important than washing the surface of the body through which germs could not possibly gain entrance into the system except through wounds. oftentimes the douching of the nostrils with salt water will stop a cold at once. the mouth is the most important place of all, and the teacher should take care of her pupils' mouths first and foremost. as bad teeth, enlarged tonsils, and adenoids harbor germs and putrescent matter that vitiate every incoming and outgoing breath, these defects should be immediately corrected. are we coming to a time when a thorough house-cleaning in the mouth of every child will take place before he enters the schoolroom, preferably in the presence of the teacher? two other "catching" diseases cause city schools a great deal of trouble,--trachoma and pediculosis (head lice). there are probably no two diseases more quickly transmitted from one person to another. almost before their presence is known, all children of a school or all persons of a group have contracted them. when at college twenty men of my fraternity discovered almost at the same time that they had an infectious eye trouble; yet we thought we were using different towels and otherwise taking sanitary precautions. last summer a vassar graduate took a party of tenement children for a country picnic. she returned with head lice that required constant attention for weeks. what then may we expect of children who live in homes where there is neither water, time, nor privacy for bathing, where one towel must serve a family of six, where mothers work for wages away from home and see their children only before seven and after six? unfortunately for thousands of children, many parents still believe these troubles will be outgrown. last summer a fresh-air agency in new york city arranged for several hundred school girls to go to a certain camp for ten days each. the only condition was that the heads should be free from lice and nits (eggs). from the list furnished by school-teachers--girls supposed to have been cured by school nurses--not one in five was accepted. a baby two weeks old, brought to caroline rest, had already begun to suffer from this easily preventable scourge. of children examined in edinburgh, scotland, , or per cent, had some skin disease, and per cent had sores due to head lice. even when neglect has caused the loss of hair and ugly sores on the head, mothers deceive themselves into believing that some other cause is responsible. trachoma, if neglected, not only impairs the health of the eye, but may cause blindness. tears carry the germs from the eye to the face, where they are taken up on handkerchiefs, towels, and fingers and infect other eyes. of late, thanks to school nurses and physicians and hygiene instruction, american cities have found relatively little trachoma except among recent immigrants. so dangerous is the germ and so insidious its methods of propagation, that a physician should be summoned at once at the first sign of inflammation. conjunctivitis is due to a germ, and will spread unless checked. since the board of health of new york city has instituted the systematic examination of the eyes of the children in the public schools, it has found fully one third affected with some form of conjunctivitis. many of these cases are out-and-out trachoma, others acute conjunctivitis, and a larger proportion are "mild trachoma." this last form of the disease is found to a great extent among children who have adenoids. the adenoids should be regarded as a predisposing factor rather than a direct cause. therefore sore eyes are given as one of the indexes of adenoids. when we consider that adenoids are made up of lymphoid material, and that trachoma follicles are made up of the same sort of tissue, it is not surprising that the two conditions are found in the same child. the catarrhal inflammation produced by adenoids in the nasal mucous membrane travels up the lachrymal duct and thus infects the conjunctiva by contiguity. in preventing pediculosis and infection of the eye vigilance and cleanliness are indispensable. after the diseases are advanced, after the germ colonies have taken title, some antiseptic or germ killer more violent than water is needed,--kerosene for the hair or strong green oil soap; for the eye, only what a physician prescribes. chapter vii eye strain wherever school children's eyes have been examined, from six to nine out of thirty are found to be nearsighted, farsighted, or otherwise in need of attention. a child is dismissed from school for obstinately declaring that the letter between _c_ and _t_ in "cat" is an _o_; "a pupil in her fourth school year was recently brought to me by her teacher with the statement that she did unreasonably poor work in reading for an intelligent and willing child;" a boy is punished for being backward. these three cases are typical. examinations showed that the first child was astigmatic and not obstinate; the boy had run a pin into one eye ten years before and destroyed its sight; while the second girl was found to be afflicted with diplopia, and in a friendly chat told the following story: "i very often see two words where there is only one. when i was a very little girl i used to write every word twice. then i was scolded for being careless. _so i learned that i must not say two words even when i saw them._" as miss alida s. williams, principal of public school in new york city, has in many articles and addresses freely illustrated from school experience, the art of seeing is acquired, not congenital, and every human being who possesses it has learned it. the large proportion of children suffering more or less seriously from eye trouble has led many persons to suggest physical deterioration as the cause. eye specialists, however, assure us that eye troubles are probably as old as man. our tardiness in learning the facts regarding these troubles is due in part to the lack, until recently, of instruments for examining the eye and for manufacturing glasses to correct eye defects; in part, also, to the tendency of the medical profession, which i shall repeatedly mention, to explain disorders by causes remote and hard to find rather than by those near at hand. about dr. s. weir mitchell's attention was called "to the marked relief of headache, insomnia, and other reflex symptoms following the correction of optical defects by glasses." in and he wrote two articles that "impressed upon the general profession the grave significance of eye strain." since that time, "in philadelphia at least, no study of the rebellious cause of headache or of the obscure nervous diseases has ever been considered complete until a careful examination of the eyes has included them as a possible cause of the disturbance." the new fact, therefore, is not weak eyes or strained eyes, but rather ( ) an increase in the regular misuse of eyes by school children, seamstresses, stenographers, lawyers, etc.; and ( ) the incipient propaganda growing out of school tests that show the relation of eye strain to headache, nervous diseases, stomach disorder, truancy, backwardness. every school, private and parochial as well as public, should supply itself with the snellen card for testing eyes. employers would do well to have these cards in evidence also, for they may greatly increase profits by decreasing inefficiency and risks. if there is no expert optician near, apply for cards to your health board or school board; failing there, write to your state health and school boards. in many states rural teachers are already supplied with these cards by state boards. in october, , the new york state board of health sent out cards, with instructions for their use, to incorporated towns. the state commissioner of education also sent a letter giving school reasons for using the cards. results from schools having shown that nearly half the children had optical defects, it is proposed to secure state legislation that will make eye tests obligatory in all schools. such a test in massachusetts recently discovered twenty-two per cent of the school children with defective vision, and from forty to fifty thousand in need of immediate care by specialists. [illustration: positions often suggest eye strain] of course eye specialists,--oculists,--if skillful, know more about eyes and eye troubles than general medical practitioners or teachers. preliminary eye tests, however, may be made by any accurate person who can read. the massachusetts state board of health reports that tests made by teachers were "not less efficient" than tests made by specialists. in june, , a group of eminent oculists recommended to the school board of new york city that teachers make this first test after being instructed by oculists. persons interested in the schools nearest them can quickly interest teachers and pupils by starting tests with this card. in cities oculists can be found who will be glad to explain to teachers, individually or in groups, how the cards should be used and what dangers to avoid. nature intended the human eye to read the last line of this card at a distance of ten feet. this conclusion is not a guess, but is based upon the examination of thousands of eyes. in making the test, the number of feet the eye ought to see is written as the denominator of the fraction; the distance the eye can see clearly is the numerator. if the child's card reads, "right eye / , left eye / ," it means that the right eye sees without conscious strain the distance it is intended to see, while the left eye must be within ten feet to see what it ought to see twenty feet away. the practical steps for a teacher to take in making eye tests are: . scrutinize the faces for a strained or worried expression while reading or writing, for squint eyes, for unnatural positions, and for improper distances (more or less than nine inches) from eye to book. . select for first tests the children who obviously need attention and will be obviously benefited. use the eye test to help trace the cause of headaches, nervousness, inattention. . let the children mark off the distances with a foot rule and chalk, going as high as twenty. be sure to get the best light in the room. . start all children on the ten-foot line. if a child cannot read at ten feet the letter which should be seen at that distance, move the child forward, have it step forward and backward, and note the result carefully. it is better to have ten separate letters of exactly the right size and the same size than a row of letters on one card, as in the snellen test, otherwise memory will aid the eye, or, as happened recently, a whole class may agree to feign remarkable nearsightedness or farsightedness by confusing letters learned in advance from the card. if the snellen card is used, and if it is more convenient to have both child and card stationary, satisfactory results will be obtained by having the child read from large letters down as far as he can see. . have the child read from right to left, from left to right, or skip about so that memory cannot aid the eye. . test each eye separately. i was twenty-five years old before i learned that my left eye did practically all of the close sight work. a grown woman discovered just a few days ago that she was almost blind in the left eye; when she rubbed the right one while reading she was shocked to find that she could see nothing with the left eye. . if the card is stationary and the child moved, and if only one size of the letter is used, put in the denominator the number of feet at which the normal eye should see clearly, and in the numerator the distance at which each eye and both together can easily see. if the regular snellen card is used containing letters of different size, place in the denominator the number of the lowest line each eye and both eyes together can read easily, and in the numerator the number of feet from card to eye. . explain the result to the child, to his fellows, to his parents. if the left eye reads / and the right eye / , it means that neither eye is normal, and that reading small type is a constant strain, even though unnoticed. the right eye must be within ten feet to read what it should read at twenty feet. the left eye must be within ten feet to read what it should read at thirty feet. if the two eyes read at ten, it means that in working together they successfully strain for a result that is not worth what it is costing. when eyes thus unconsciously see what they are not intended to see, it is only a matter of time when stomach and nervous system will announce that the strain can no longer be borne. indigestion, dislike of study, restlessness follow. if, however, the eyes are so near the normal that their story reads / or / , the strain will be negligible _for the present_. if, on the other hand, the only difficulty is a confusion of _x_ and _z_ with _c_ and _g_, it means that there is a strain due to astigmatism, and that the child should be sent to an oculist. . teach children and parents (and practice what you preach) the urgent importance of periodic reëxamination, just as you would teach them to visit a dentist twice a year. this is needed by those who wear eyeglasses, and more particularly by those who have recently put them on. moreover, as shown below, it is needed by children able to pass satisfactorily the snellen test. . acquire the habit of reading the eye for evidence of temperate or intemperate living, sleeping, eating, dancing, drinking, and smoking. inflamed eyes are _results_,--signals of danger. "the organ may be faultless in construction and in its work poor, because of nerve exhaustion, or, in a less and more easily recoverable degree, nerve fatigue." if unusual eye conditions are not readily explained by mode of living or by eye tests, an oculist should be consulted. the limits of the card test must be constantly kept in mind: ( ) it does not register eye sickness due to dust, smoke, or disease germs; ( ) it does not show unconscious eye strain due to successful accommodation. but it will discover a great part of the children who most need care. sooner or later, too, inflammation of the eyelids, due to external causes, will affect the nerves of the eye and their power to conceal by accommodation the eye's defects. just as we unconsciously open the mouth when a cold stops up the nose, the eye adapts itself to our needs without our realizing it. we expect it to see. it sees. if our eyes are not made alike, they do their best to work together. like a good team of horses, the slow one hurries, the fast one holds back a little. but if one eye is / and the other / , they will both be unnatural and strained if both read the same type. the effects of this strain frequently upset the stomach before the eyes rebel. i learned that i needed eyeglasses after a case of protracted indigestion, first diagnosed as "nervous" and later traced to eyes. thousands of upper-grade children and college students are dieting for stomach trouble that will last until the eyes are relieved of the undue and unrecognized strain. to prove the influence of eye strain on indigestion, persuade some obstinate parent to wear improperly focused glasses for a day; she will then be willing to have her child's eyes attended to. it is unfortunate that the eyes will overwork without protesting. for years many persons suffer without learning that their eyes are unlike, or, as often happens, that one eye does all the close range work. even when being tested, eyes will seem to see easily what requires a great effort of "accommodation." to prevent this self-deception skilled oculists do not trust the eye card, but put a drug in the eye that benumbs the muscles of accommodation. they cannot contract or expand if they want to. the oculist then studies the length of the eye and the muscle of accommodation. with this absolute knowledge of how each eye is made he knows what is wrong, exactly at what angle light enters the eye, whether objects are focused too soon or too late, exactly what kind of eyeglasses or what operation upon the eye is needed to enable it to do its work without undue straining or accommodation. so unconsciously do the eyes accommodate themselves to the work expected of them that not infrequently a child with seemingly perfect sight may be more in need of glasses than the child with imperfect sight. practically, however, it is out of the question at the present time to have the majority of children given a more thorough test than that provided by the snellen card. where eye strains escape this test teachers will find evidence in complaints of headache, nervousness, sick stomach, chorea, or even epilepsy. the constant strain may also cause red or inflamed lids. parents and teachers must be on the constant lookout for these symptoms of good sight persisting in spite of imperfect eyes. an epidemic of eyeglasses is usually the consequence of eye tests. so naturally do we associate eyeglasses with eye defects that some people assert that the eye tests at school originate with opticians more intent upon selling spectacles than upon helping children. in fact, even among educators who proclaim the need for eye tests there has been far more talk of eyeglasses than of removable conditions that cause eye strain. the women principals of new york city have sounded an alarm, and urge more attention to light and to reading position, more rest, more play, more hand work, less home study and less eye work at school, rather than more eyeglasses to conceal temporarily the effect of abusing children's eyes. putting glasses on children without changing causal conditions is like giving alcohol to consumptives. the feeling of relief is deceptive. the trouble grows worse. for some time to come eye tests will find eye troubles by the wholesale in every industrial and social class, in country as well as city schools. in new york villages . per cent of school children had defects of vision,--this without testing children under seven,--while . per cent had sore eyes. there are three possible ways of remedying defects: ( ) changing the eye by operation; ( ) changing the light as it enters the eye by eyeglasses; ( ) decreasing the demands made upon the eye. to change eyes or light requires a technical skill which few physicians as yet possess. it will be remembered that it is but thirty years since the medical profession in america first began to understand the relation of eye defects to other defects. until a generation of physicians has been trained by medical colleges to learn the facts about the eye and to apply scientific remedies, it is especially necessary that teachers and parents reduce the demands made upon children's eyes; oral can be substituted for written work, manual for optical work, relaxed and natural movement for discipline, outdoor exercise for less home study. other requirements are suitable light and proper position, and abolition of shiny paper, shiny blackboard, and fine print. even after it is easy to obtain the correction of eye defects it will still be necessary to adapt the demands upon children's eyes to the strength and shape of those eyes. because we are born farsighted, nearsighted, and astigmatic, we must be watchful to eradicate conditions that aggravate these troubles. finally, there is no excuse whatever for permitting the parent of any school child in the united states to remain ignorant of the fact that it is just as absurd to go to the druggist or jeweler for eyeglasses as to the hardware store for false teeth. the education of physician, oculist, and optician can be expedited by eye tests in school and by the follow-up work of schools in removing the prejudice of parents against glasses when needed. because knowledge of chemistry preceded knowledge of the human body, the teaching of medicine still shows the effect of predilection for the remote, the problematical, the impossible. this predilection has influenced many specialists as well as many general practitioners, both overlooking too frequently obvious causes that even intelligent laymen can be taught to detect. very naturally the man who makes money out of attention to simple troubles has stepped into the field not as yet occupied by the general practitioner and the specialist. thus we have the optician, the painless tooth extractor, and quack cures for consumption. opticians are placing before hundreds of thousands simple truths about the eye not otherwise taught as yet. because they make their money by selling eyeglasses and because their special knowledge pertains to glasses rather than to eyes they frequently fail to recognize their limitations. physicians feel very strongly that it is as unethical for an optician to fit eyeglasses without a physician's prescription as for a pharmacist to give drugs without a physician's prescription. the justification for this feeling should be based not upon the commercial motive of the optician but upon his ignorance. a physician uninformed as to eye troubles is just as unsafe as an optician determined to sell glasses. it must be made unethical and unprofessional for physician and optician alike to prescribe in the dark. laymen and physicians must be taught that it is just as unethical and unprofessional for oculists and physicians to fail to bring their knowledge within the practical reach of the masses as for the optician to advertise his wares. school tests will not have been used to their utmost possibilities until optician and physician alike take the ethical position that the first consideration is the patient's welfare, not their own profits. it must soon be recognized as unethical and unprofessional for an optician who is also a skilled physician to refer patients to a medical practitioner ignorant as to optical science. whether opticians and physicians are unprofessional or unethical may be told by reëxamination if the _examiner_ is himself competent and ethical. there is no better judge of their efficiency than the patient himself, who can tell whether the results promised have been effected. whether the work of a country oculist is efficient and ethical can be learned: ( ) by teaching country school children to recognize eye strain; ( ) by comparing his results with those of other physicians. as soon as one or two states have tested eyes, we shall have an average by which to compare each class, school, and city with others of their size under similar conditions. if a particular physician finds half as many more or only half the average number, the presumption will be that his results are inaccurate and warrant an investigation. the interested teacher or parent can render an inestimable service to her local school and to the children of her state by taking steps to secure state laws compelling eye tests in all schools. finally, it must be remembered by teachers, employers, parents, and all eye users that eyes are constantly changing; that eyes may need glasses six months after they are examined and found sound; that glasses change or develop the eye, so that they may be unnecessary and harmful six months after they are prescribed, or the eye may require a stronger glass; that eyeglasses become bent and scratched, so that they worry and strain the eye; that a periodic examination is essential to the health of the eye. in caring for the health of the eye, we should also remember that our eyes are our chief interpreters of the world that gives us problems, profits, and pleasures. out of gratitude, if not out of enlightened self-interest, we owe our eyes protection, attention, and training, so that without straining we shall always be able to see truth and beauty. chapter viii ear trouble, malnutrition, deformities the presence of adenoids is a frequent cause of both slight and aggravated deafness. of deaf mutes examined per cent had adenoids, while only per cent of the general run of the children in the neighborhood had this trouble. in mouth breathing, the current of air entering the mouth draws out some of the air from the eustachian tube which ventilates the middle ear and unequalizes the atmospheric pressure on the eardrum, causing it to sink in and to blunt the hearing. an examination of the eardrums of school children in new york who are mouth breathers showed a high percentage of deafness, incipient or pronounced, accompanying adenoids. for example, of mouth breathers selected from one class (average age - years), were well-marked cases of deafness. of mouth breathers (average age - years), and of mouth breathers (average age - years), all had noticeable defects of hearing. many adults that suffer from deafness maintain that they never had any trouble in childhood. yet the evidences of nose and throat trouble in childhood persist and disprove such statements. _the foundations of deafness in later life are, in most instances, laid in childhood._ since the majority of cases of ear trouble occurring in school children accompany diseased conditions of the nose and throat, the proper care of nose and throat will, in large measure, balance the shortcomings of the aural examinations. since the examination of the drum itself is not practicable, especial care should be given to the examination of the nose and throat. the figures published by new york city's department of health show that of , children examined from march, , to january, , , or . per cent, gave evidence of defective hearing. ear specialists suggest that this small percentage results from employing the whisper test at twenty feet. the whisper test at sixty feet has been set by experts as a test of normal hearing. but preciseness with this test is well-nigh impossible when we consider that the acoustics, the quality of the examiner's voice, the weather, the vowel or consonant sounds, all are variable quantities. the watch test is frequently used, but since a young teacher in her enthusiasm used an alarm clock to make the test, specialists have decided that the volume of sound differs in watches to such a degree as to make the watch test unreliable. the examination of the eye has been reduced to mathematical precision, due altogether to the anatomy of that organ. as yet there is no instrument for the ear comparable to the ophthalmoscope. the acoumeter is largely used by aurists and can be obtained from the optician. this instrument has an advantage over the whisper or watch tests in that its tick is uniform. each ear should be tested separately. let the child place his finger against the flap of one ear while the other is being tested. then compare the farthest distance from the ear at which the tick can be heard with the normal, standard distance. during the test all sound should be eliminated as far as possible and the eyes should be closed. at a demonstration of ear testing at teachers college, one student stated that she could not hear the tick of the watch at a distance greater than twenty inches. then the tester walked noisily toward her, leaving the watch on the desk, five feet away from the patient. she heard it now. when the class burst out laughing she opened her eyes, and, seeing the watch so far away, exclaimed, "why, i thought i imagined it." be careful in testing a child to distinguish between what he "thinks he imagines" and what he really hears. because of the difficulties of this test a doubt should be sufficient to warn the teacher to send the child to be tested by an expert. detection of slight deafness may lead to the discovery of serious defects of nose or throat. inflammation from cold or catarrh may cause deafness, which if neglected may permanently injure the ear. often deafness is due to an accumulation of wax. a running ear should receive immediate attention, as it is an indication of inflammation which may imperil the integrity of the eardrum, and, if neglected, may eat its way through the thin partition between the ear and the brain and cause death. it should never be assumed that deafness is incurable. stupidity, inattention, and slowness to grasp a situation accompany difficulty of hearing and should cause the teacher to examine the ears. no ear trouble is negligible. children and parents should be taught that the normal ear is intended to hear for us, not to divert our attention to itself. when the ear aches or "runs" or rumbles there is something wrong, and it should be examined together with the throat and nose. nervousness in new york city one child in ninety-one already examined has had the form of nervous disease known as st. vitus's dance, or chorea. so prone are we to overlook moderate evils and moderate needs that the child with aggravated st. vitus's dance is apt to be cured sooner than the child who is just "nervous." teachers cannot know whether twitching eyes, emotional storms, constant motion of the fingers or feet are due to chorea, to malnutrition, to eye strain, or to habits acquired in babyhood or early childhood and continued for the advantage that accrues when discipline impends. many a child treasures as his chief asset in time of trouble the ability to lose his temper, to have a "fit," to exhibit nervousness that frightens parent, teacher, or playmate, incites their pity, and wards off punishment. the school examination will settle once for all whether the trouble can be cured. the family physician will explain what steps to take. tests of malnutrition we americans were first interested in the physical examination of school children by exaggerated estimates of the number of children who are underfed. as fast as figures were obtained for eye defects, breathing defects, bad teeth, some one was ready to declare that these were results of underfeeding. hence the conclusion: give children at least one meal a day at school. scientific men began to set us straight and to give undernourishment a technical meaning,--soft bones, flabby tissue, under size, anæmia. while too little food might cause this condition, it was also explained that too much food of the wrong sort, or even food of the right sort eaten irregularly or hurriedly or poisoned by bad teeth, might also cause undernourishment, including the extreme type known as malnutrition. in extreme instances the symptoms enable an observant teacher who has learned to distinguish between the pretty hair ribbon and clean collar and the sunken, pale, or hectic cheek and lusterless eyes to detect the cause. but as with eyes and nose, an unhealthy condition of nourishment may exist long before outward symptoms are noticeable. therefore the value of the periodic searching examination by the school physician. [illustration: same age, same school, different nutrition] bone tuberculosis; orthopedic tests only recently have we laymen learned that knee trouble, clubfoot, ankle sores, spine and hip troubles, scrofula, running sores at joints, etc., are not hereditary and inevitable, but are rather the direct result of carelessness on the part of adult consumptives. these conditions in school are indices of homes and houses where tuberculosis is or has been active, and of health boards that are or have been inactive in checking the white plague. early examination may disclose the small lump on the child's spine,--which one mother diagnosed as inherited "round shoulders,"--and save a child from being a humpback for life. moreover, the examination of the crippled child's brothers and sisters will often show the beginnings of pulmonary tuberculosis. [illustration: a grievous penalty for neglect by adult consumptives] enlarged glands--tuberculosis in almost every class are one or more children who are proud of small or big lumps under one or more jaws. only physicians can find very small lumps. many family doctors will say, "oh, he will outgrow those," or "those lumps will be absorbed." like most other evils that we "outgrow" or that pass away, these lumps shriek not to be neglected. they mean interference with nourishment and prevent proper action of the lymphatic system, as adenoids prevent free breathing. even when not actually infected with tubercle bacilli, they are fertile soil for the production of these germs. if detected early, they point to home conditions and personal habits that can be easily corrected. in new york one child in four has these enlarged glands. if the same proportion prevails in other parts of the united states, there are , , children whose strength is being needlessly drained, many of whom, if neglected, will need repeated operations. [illustration: model of america's first hospital for seashore fresh-air treatment of nonpulmonary tuberculosis in children to be erected at rockaway beach, new york city] chapter ix dental sanitation "have their teeth attended to first, and many of the eye defects will disappear." this was an unexpected contribution to the debate upon free eyeglasses for the school children of new york city. so little do most of us realize the importance of sound, clean teeth, and the interrelation of stomach and sense nerves, that even the school principals thought the eye specialist was exaggerating when he declared that bad teeth cause indigestion and indigestion causes eye strain. "bad" teeth mean to most people dirty teeth and offensive odors, loose, crooked, or isolated teeth, or black stumps. even among dentists a great many, probably the majority, do not appreciate that "bad" teeth mean indigestion, lowered vitality, plague spots for contaminating sound teeth and for breeding disease germs. until recently the only rule about the teeth of new recruits in the united states army was: "there must be two opposing molars on each side of the mouth. it doesn't matter how rotten these molars may be." the surgeon general was persuaded to change to "four opposing molars on each side"; still nothing as to the condition of the two additional molars! in the german army there is a regular morning inspection of teeth and toothbrushes. several german insurance companies give free dental treatment to policy holders, not to bestow charity but to increase profits. neglecting "baby teeth" and adenoids may mean crooked second teeth that will cause: ( ) hundreds of dollars for straightening; ( ) permanent business handicap because crooked teeth are disagreeable to others, because mastication is less perfect, and because a disfigured mouth means dis-arranged nerves; or perhaps ( ) large dental bills because it is difficult to clean between cramped, crooked teeth. unfortunately the great majority of parents rarely think of their children's teeth until too late to preserve them intact. even among families where the rule of brushing the teeth twice daily prevails, regular dental examination is often not required. doctors and dentists themselves have not been trained to realize that the teeth are a most dangerous source of infection when unclean. does your dentist insist upon removing tartar and food particles beyond your reach, upon polishing and cleansing, or does he regard these as vanity touches, to be omitted if you are in a hurry? [illustration: industrial handicaps discovered at school] physicians send tuberculosis patients to hospitals or camps without correcting the mouth conditions that make it impossible for the patient to eat or swallow without infecting himself. tonics are given to women whose teeth are breeding and harboring disease germs that tear down vitality. nurses watch their suffering patients and do the heavier tasks heroically, but are not trained to teach the simple truths about dental hygiene. the far-reaching results of neglect of teeth will not be understood until greater emphasis is placed on the bacteriology, the economics, the sociology, and the æsthetics of clean, sound teeth. whether or not there is at present a tendency to exaggerate the importance of sound teeth, there is no difference of opinion as to the fact that the teeth harbor virulent germs, that the high temperature of the mouth favors germ propagation, that the twenty to thirty square inches of surface constantly open to bacterial infection offer an extensive breeding ground, and that the formation of the teeth invites the lodgment of germs and of particles of food injurious both to teeth and to other organs. by scraping the teeth with the finger nail and noticing the odor you can convince yourself of the presence of decomposing organic matter not healthful to be carried into the stomach. by applying a little iodine and then washing it off with water, your teeth may show stains. these stains are called gelatinous plaques, which are transparent and invisible to the naked eye except when colored by iodine. these plaques protect the germs, which ferment and create the acid which destroys tooth structure. their formation can be prevented by vigorous brushing and by eating hard food. the individual with decayed teeth, even with unclean teeth, is open to infection of the lungs, tonsils, stomach, glands, ears, nose, and adenoid tissues. every time food is taken, and at every act of swallowing, germs flow over the tonsils into the stomach. mouth breathers with teeth in this condition cannot get one breath of uncontaminated air, for every breath becomes infected with poisonous emanations from the teeth. bad teeth are frequently the sole cause of bad breath and dyspepsia, and can convey to the system tuberculosis of the lungs, glands, stomach, or nose, and many other transmissible diseases. they may also cause enlarged tonsils and ear trouble. apart from decomposing food and stagnant septic matter from saliva injured by indigestion, and by sputum which collects in the healthy mouth, there are in many infected mouths pus, exudations from the irritated and inflamed gum margins, gaseous emanations from decaying teeth, putrescent pulp tissue, tartar, and chemical poisons. every spray from such a mouth in coughing, sneezing, or even talking or reading, is laden with microbes which vitiate the air to be breathed by others. indigestion from imperfect mastication and imperfect salivation (themselves often due solely to bad teeth) is far less serious than indigestion from germ infection. germs taken into the stomach can so change the composition of saliva (a natural disinfectant when healthy) as to render it no longer able to kill germs. indigestion may result in excess of uric acid and toxic material, so that the individual becomes subject to gout and rheumatism, which in turn frequently destroy the bony support of the teeth and bring about riggs's disease. the last named is a prevalent and disfiguring disease, whose symptom is receding gums. the irritating toxins deposited on the teeth cause inflammation of the tissues at the gum margins. the gums withdraw more and more from sections of the teeth; the poisons get underneath and work back toward the roots; the infection increases and hastens the loosening of the teeth. i know of a man who had all of his teeth extracted at twenty-one years of age, because he was told that this was the only treatment for this disease, which was formerly thought to be incurable. yet thorough cleansing and removal of this matter from under the edges of the gums, disinfection, a few visits to the dentist, will stop the recession but cannot regain lost ground. among those who regularly use the toothbrush, instinct, comfort, or display is the ruling motive, while a small percentage have evolved to the anti-nuisance stage, where the æsthetic standard of their group forbids any member to neglect his teeth. the anti-slum and pro-slum motives for mouth cleanliness and dental sanitation have been awakened in but one or two places. a significant pro-slum activity is the dental clinic organized by forty volunteer dentists, acting for an industrial school maintained by the new york children's aid society. [illustration: new york children's aid society's dental clinic for school children] here children have been examined, teeth extracted, teeth filled, teeth treated for diseased pulp (and only sets cleaned), dentists taking turns in giving time to this work. the equipment cost but $ ; cards and stationery, $ ; incidentals, $ . the principal attends the clinic, because in her presence no child is willing to confess fear or unwillingness. to supplement this work, the dentists have prepared for free distribution a leaflet which tells in short, clear sentences how to care for the teeth. [illustration: (leaflet)] +----------------------------------------------------------------------+ | a dental catechism =when should they be cleansed?= | | | | =what are the teeth for?= immediately after the morning and | | noonday meals and before going to | | to masticate food; that is, bed. | | grind it into fine particles, | | mix it with saliva, and so =by what means should they be | | begin its digestion; also to cleansed?= | | aid in speaking and singing. | | by a moderately stiff brush, | | =how long should they last?= water, and floss silk. | | | | to the very end of life. =how should these be used?= | | | | =how do we lose them?= the brush should be first used in | | a general way, high up on the | | by decay, by loosening, and by gums length-wise of the jaws, to | | accident. remove large particles and | | stimulate the gums, then the | | =what causes teeth to decay?= brush and the teeth should be | | carefully rinsed with water. the | | particles of food decaying in brush should next be used with a | | contact with them. rolling or circular motion, so | | that the bristles will follow the | | =where does food lodge?= lines of all the grooves and | | spaces in which the particles of | | all along the edges of the gums, food have lodged, and so brush | | in the spaces between the teeth, them out. then again the mouth | | and in the crevices of their should be rinsed with water. | | grinding surfaces. | | =should the gums be brushed?= | | =can we prevent this loss?= | | yes, moderate friction helps to | | yes, to a large extent. keep them healthy. | | | | =how can we do it?= =how can the spaces between the | | teeth be reached?= | | by using the teeth properly and | | by keeping them clean and the by dental floss silk passed | | gums healthy. between the teeth, drawn | | carefully back and forth till it | | =what does using them properly reaches the gum, pressed firmly | | mean?= against the side of each tooth in | | turn and drawn out towards the | | . using sufficient hard or grinding end of the tooth, and | | fibrous food to give the teeth this repeated several times in | | and gums full exercise. each space. | | | | . taking time enough to =should tooth powder or paste be | | masticate food thoroughly before used?= | | swallowing. | | usually once a day. | | =how often should teeth be | | cleansed?= | | | | as often as they are used. | +----------------------------------------------------------------------+ such a leaflet should be given out at dispensaries, hospitals, dental offices, schools, and from many sunday schools and missions.[ ] the time for the schools to begin is when the child is first registered. examination and reëxamination must be accompanied by explanation of the serious disadvantages of neglected teeth, and the physical, social, and economic advantages of clean, sound teeth. instruction at school must be followed by education of parents. the school or health authorities should examine the teeth of all children before issuing work certificates. finally, the dental, medical, and nursing professions and the press must be enlisted in the school's campaign for dental hygiene. the dental hygiene council of massachusetts should be copied in all states. a preliminary examination of teeth can be made by parent or teacher. crooked, loose, dirty, or black teeth or receding gums can be detected by a layman's naked eye. in fact, children can be interested in finding the most obvious defects in their own or their brothers' teeth. there could be no better first lesson than to ask each pupil to look in a hand mirror and to count each tooth obviously needing a cleaning or a filling. the most urgent need can thus be ascertained without expert aid. but because parent, teacher, or child cannot discover defects does not prove that dental care is not imperative; hence the importance of examination by a dentist or by a physician competent to discover dental needs. if a private, public, or parochial school has no paid visiting dentist, a zealous school officer can, at least in large towns, persuade one or more dentists or physicians to make a few first tests to confirm the teacher's findings, and to persuade the community that regular examination and reëxamination are necessary and a saving of pain, beauty, and money. reëxamination is necessary because decay _may_ start the day after a dentist has pronounced a tooth sound. for most of us twice a year is often enough. a reëxamination should be made upon the slightest suspicion of decay, breaking, or loosening. educational use should be made by the teacher of the results of school examination. children cannot be made self-conscious and cleanly by telling them that their teeth will ache three or five years from now. they can be made to brush or wash their teeth every morning and every night if they once realize that cavities can be caused only by _mouth garbage_. all decay of human teeth starts from the outside through the enamel that covers the soft bone of the tooth. this enamel can be destroyed by accidentally cracking or breaking it, or by acids eating into it. these acids come from ( ) particles of food allowed to remain in the teeth; ( ) tartar, etc., that adheres to the teeth and can be removed only by a dentist; ( ) saliva brought up from an ill-conditioned stomach. even where the enamel is destroyed, absolute cleanliness will prevent serious decay of the tooth. a perfectly clean tooth will not decay. generally speaking, unless particles of food or removable acids remain on or between the teeth long enough to decompose, teeth cannot decay. decay always means, therefore, uncleanliness. to unclean teeth is due in large part the offensive odor of many schoolrooms. uncleanliness becomes noticeable to our neighbors sooner or later. there is no offense we are so reluctant to commit as that of having uncleanliness of our bodies disagreeable to those about us. very young children will make every effort in their power to live up to the school's standard of cleanliness. the other side to this reason for having clean teeth is vanity. because all cleanliness is beautiful to us, clean teeth are one attribute of beauty that all of us can possess. habits of cleanliness are easily fixed. in the most crowded, most overworked section of large cities visitors from "uptown" are surprised by the children's bright hair ribbons, clean aprons, clean faces, and smoothly combed hair. it will be easy to add clean teeth to the list of things necessary to personal and family standing. armenian children are taught to clean their teeth after eating, even if only an apple between meals. they covet "beautiful teeth." american standards will soon prevent these armenians from cleaning their teeth in public, but desire for beautiful teeth will stay, and will remind them to care for their teeth in private. as coarse food gives way to sugars and soft foods, stiff toothbrushes must supplement tongue and toothpicks. [illustration: an armenian school girl] strong as are the instinct and display motives in cleaning teeth, both parents and children need to be reached through the commerce motive. instinct makes children afraid of the dentist, or content when the tooth stops aching. display may be satisfied with cleaning the front teeth, as many boys comb only the front hair or as girls hide dirty scalps under pompadours and pretty ribbons. desire to save money may give stronger reasons for not going to the dentist than instinct and comfort can urge for going. but parents can be made to see, as can children after they begin to picture themselves as wage earners, that a dentist in time saves nine, and that no regular family investment will earn more money than the price of prompt and regular dental care. a problem in arithmetic would be convincing, if, by questions such as those on page , we could compare the family cost of neglecting teeth with the cost of toothbrushes, bicarbonate of soda, pulverized chalk or tooth powder, early and repeated examination by a dentist, and treatment when needed. how many members in your family? what does a toothbrush cost? how many teeth have they? how many do you need in one year? how many teeth have they lost? how much does tooth powder how many false teeth have they? cost? how many teeth have been filled? how much is needed for one year? what is the total cost to date? how much would two examinations how many days have been lost a year by a dentist cost? from work because of toothache? how many teeth are now decayed? what will it cost to have them attended to? the result will show that the money spent for one good "house cleaning" of one child at fourteen or eighteen exceeds the cost of keeping clean and in repair the teeth of the entire family. how effective and economical is thorough cleaning is confessed by an eminent dentist, who taught an assistant to clean his patients' teeth. "do you know," he said, "i had to stop it, so perceptibly did my work decrease." the total time required to examine school children for teeth needing attention is much less than the time now lost by absence from school or wasted at school on account of toothache. to remind school children regularly of dental hygiene is not more important than for the school to remind parents repeatedly of the many reasons for attending to their children's teeth. it is not enough, however, to send one message to parents. illustrated lectures, mothers' meetings, demonstrations at hospitals and fresh-air homes are all very serviceable, but listening is a poor substitute for understanding. schools should see that parents understand the æsthetics, the economics, the humanity of dental hygiene. the best test of whether the parent has understood is the child's tooth. dental examination of children applying for work certificates gives the health and school authorities a means of enforcing their precepts. when no child is allowed to go to work whose teeth cause malnutrition or disgust, the news will spread, and both child and parent will see clearly the grave need for dental care. [illustration: won by the economic argument] finally, local papers can be interested. they will print almost anything the teacher sends about the need for dental care. they like particularly facts about the number of cavities found, the number of children needing care, efforts made to procure care, and new facts about diseases that can be caused by bad teeth or about diseases that can injure teeth. teachers can persuade dentists and physicians to write stories. no newspaper will refuse to print such statements as this: "a tuberculous patient in six weeks lost ground steadily. i persuaded him to go to a dentist to clean the vestibule to his digestive system, and to have a set of false teeth. he enjoys his meals, and has gained twelve pounds in six weeks." popular magazines and newspapers mention teeth seldom, because those who best know the interesting vital things are making money, not writing articles or otherwise concerning themselves with dental education. it is said that of forty thousand american dentists not over eleven thousand are readers of dental journals, and probably not three hundred contribute to professional literature. one dentist who is working for the children's clinic described above, when asked by the board of education to lecture to the people on the care of the teeth and to recommend simple, readable books, told me that he knew no good books to suggest. five obstacles exist to practicing what is here preached: . the expensiveness of proper dentistry. . the untrustworthiness of cheap dental service and "painless" dental parlors; the domination of the supply houses wishing to sell instruments and other supplies. . the ethical objection to any kind of advertising or to work by wholesale. . the lack of dispensaries. . the profit-making basis of dental education. additional reasons these for cleanliness that will make the dentist serviceable for his knowledge rather than for his time and gold. good dentists really "come too high" for both the poor and the comfortably situated. families in new york city that have four or five thousand dollars a year hesitate to go to a dentist whom they thoroughly trust, because his time is worth more than they feel they can afford to pay. the "free-extraction" dental parlors undoubtedly are doing a vast amount of harm. in every city are dental quacks that injure wage-earning adults as much as soothing-sirup quacks injure babies. instead of teaching people to preserve their teeth, they extract, and then, by dint of overpersuading by a pretty cashier hired for the purpose, make a contract for a gold crown or a false set at an exorbitant price. a reputable dentist has said that a dental parlor can do more damage to the welfare of the race in a few months than a well-intentioned man in the profession can repair in a lifetime. its question is not, what can i do for this patient? but what is there in this mouth for me? many "parlors" never expect to see the same person twice, because they do not make him comfortable or gain his confidence; they put a filling in on top of decayed matter or even diseased pulp; put in plates and bridges that do not fit; charge more than the examination at first leads one to expect; refuse to correct mistakes; deny having ever seen the patient before. yet true and severe as this arraignment is, many of these parlors, with their liveried "runners in," are doing an educational service not otherwise provided; it is conceivable that in many cities they are doing less harm by their malpractice than well-intentioned men in the profession by neglect of public needs or by failure to organize facilities for meeting those needs. i realize that advertising is "unethical" among dentists as among physicians. humbug and imposition are supposed to go inevitably with self-advertising by the methods used in selling shoes or automobiles. therefore such advertising is prohibited. but what seems to be forgotten in this definition of ethics is that the need and the opportunity for dental care must be advertised in some way, if we are ever to control diseases and evils due to bad teeth. the rich that one dentist can help are able to pay for his good taste, his neat attendants, his automobile, his club dues, his vacations at fashionable resorts, his hours without work, his standard of living. all of these things advertise him, just as hospital appointments and social position may and do advertise successful physicians. the patients of moderate means that one dentist can treat cannot afford to pay for rent, time disengaged, and indirect advertising. either they must have free treatment, must go without treatment, or must go to a dental parlor where dental needs are organized so that a very large number will contribute to rent and display. it is out of the question to have both dentists and patients so distributed and prices so adjusted that dentists can make a good living by charging what the patient can afford, and at the same time admit of every patient being properly treated when necessary. judging from every other branch of work, the solution of the problem lies partly in free care for those who can pay nothing or very little, and partly in coöperative treatment through the heretofore objectionable dental parlors. if instead of inveighing against advertisers, honorable and capable dentists worked through dental and medical societies to secure adequate public supervision of dental practice, more progress would be made against dental malpractice. dental clinics will quickly follow the publication of facts that schools should gather. in some places these should be separate; but at first the best thing is to make every hospital, every children's home, every settlement a clinic, and every school an examining center. a skilled dentist informs me: "the demand that will follow examination of school children's teeth will make it profitable for young dentists to adopt a coöperative scheme, where several young men hire a parlor in a cheap district, and, under the supervision of some experienced dentist, give good advice at reasonable rates. this is the best antidote to the dental parlor which exploits the public so shamelessly." bellevue hospital in new york is the first general hospital to establish regular dental examination; others will undoubtedly soon follow. dental education for profit rather than for instruction and for health has been the rule. even where universities have put in dental courses, they have demanded a net profit from tuition. instead of protecting society against men incapable of caring for teeth, the schools have marketed certificates to as large numbers as slowly enlightened self-interest would permit. much progress has been made toward uniform standards of admission and graduation, but dental colleges sadly need the light and the inspiration of school facts about teeth. of fourteen dental journals in america, only one has the advancement of dental science as its first reason for existence. thirteen are trade journals. not one of these would print articles proving that the supplies advertised by their backers were inimical to dental hygiene. many dental colleges still retain on their faculties agents or editors in the pay of supply houses, harvard's new dental school being a notable exception. this trade motive tolerates and encourages the disreputable practices of existing dental parlors. largely because of this prostitution of the dental profession, patients generally neglect the repairing and cleansing of the teeth and the sterilizing of the mouth from which germs are carried to all parts of the body. dental journalism for the sale of supplies cannot outlive the dentist's reading of the school's index. many dentists will say that they must learn dentistry before they learn the economics and sociology of clean teeth. being a young profession, it is natural that dentistry should first devote itself to learning its own mechanics,--the tricks of the trade--how to fill teeth. but the fact that it took the medical profession centuries to begin to feel responsibility for community health is no reason why the social sense of the dentist should be dormant for centuries or decades. we need training and exercise to determine what kind of filling will be most comfortable and most serviceable; whether the pulp of the teeth needs treating or removing before the filling is inserted; whether it is worth while to fill a deciduous or baby tooth. sociology will never take the place of dental technic. the few dentists who have studied the social significance and social responsibility of their profession declare, however, that careless workmanship and indifferent education of patients continue chiefly because dentists themselves do not see the community's interest in dental hygiene. the school can socialize or humanize the dental profession if teachers themselves possess the social sense and make known the facts about the need for dental care among school children. footnotes: [ ] _the teeth and their care_, by thaddeus p. hyatt, d.d.s., is a short, concise treatment of the principles of dental sanitation. chapter x abnormally bright children what is commonly considered abnormal brightness in a school child is often a tendency to live an abnormal physical life. being a child bookworm means that time is spent indoors that should be spent playing games with one's fellows. excellence in the activities of children, not ability to imitate the activities of adults, should be the test of child brightness. to be able to hit a bull's-eye, to throw a ball accurately, to calculate the swing of a curve or the bound of a "grounder," these are tests of brightness quite as indicative of mental power as the ability to win highest marks in school, while less injurious to physical power. the child who is abnormally bright requires special treatment just as much as the child who is abnormally dull. the former as well as the latter must have his abnormal condition corrected if he is to grow into a normally bright man. the college man who sacrifices health to "marks" is thus described by the director of physical training at harvard university: a drooping head, a pale face, dull, sunken eyes, flat chest and rounded shoulders, with emaciated limbs, soft flabby muscles, and general lack of good physical, mental, and moral tone. for the protection of these physical defective grinds it is suggested to put a physical qualification upon the candidates of phi beta kappa and their awards of scholarship. if scholarship men cannot be induced to take time to improve their physique for fear of lowering their college standing, then give them credit for standing in physical work. the abnormally bright, at whatever age, is as much a subject for examination and treatment as the child with adenoids and pulmonary tuberculosis. such attention will increase the percentage of abnormally bright schoolmates who figure in active business in later life. moreover, it will decrease the number of high school superintendents who declare that their honor pupils are physical wrecks. there are children who develop very rapidly, both physically and mentally, and whose mental superiority is not at the expense of their bodies. protection of such children requires that their minds be permitted to progress as rapidly as bodily health justifies. it is as cruel to keep back a physically and mentally superior child, as to push the physically or mentally defective beyond his powers. worry and fatigue can be produced by lack of interest as well as by overwork. "normal" should not be confused with "average." to keep a bright child back with the average child--marking time till the dull ones catch up--is to make him abnormal. the tests that we have employed for grading pupils are either the tests of age in years or of mental capacity. the first takes no account of slowness or rapidity of physiological development,--of physiological age. the second encourages mental activity at the expense of physique. the entrance of a child into school, the promotion from one class to another, the entrance into college, are thus determined either by the purely artificial test of age or by the individual teacher's discretion. there is nothing to prevent the ambitious teacher or the ambitious parent from pushing a child into kindergarten at four, high school at twelve, college at fifteen. if this cannot be done at the public school, a private school is resorted to. a community of college professors once started a school for faculty children. a tremendous pressure was put upon these scions of intellectual aristocracy to enter the high school at twelve. no thought was given to the ventilation of the school. the windows were so arranged that they could not be opened without the air blowing on some child's back. "you could cut the air with a knife" was a description given by one sensible professor who had taken his sturdy girl of seven away from the school, because he feared that in this environment she would become like the other little puny, pale, undersized children of that school. the university of pennsylvania has instituted a psychological clinic. parents and teachers are invited to bring any deviation from the usual or the expected to the attention of this clinic. every month a bulletin is published called the _psychological clinic_, which will be found of great service in dealing with the abnormally bright as well as with the abnormally dull. naturally the well-to-do and the rich are the first to take advantage of these special facilities for ascertaining just what work should be done by a precocious child or by the mentally and morally retarded. abnormal brightness means power to be happy and to be serviceable that is above the average. every school can be a miniature psychological clinic. while every teacher cannot be an expert, national and state superintendents can constantly remind teachers that the abnormally bright are also abnormally apt to neglect physical welfare and to endanger future mental power. chapter xi nervousness of teacher and pupil nervousness of teacher and pupil deserves special mention. so universal is this physical defect that we take it for granted, especially for teachers. teachers themselves feel that they need not even apologize for nervousness, in fact they too frequently use it as an excuse for impatience, ugly temper, discourtesy, and unfairness. children, slates, papers, parents, blackboards "get on their nerves." nervousness of teacher causes nervousness of pupils and adds to the evil results of mouth breathing, bad teeth, eye strain, and malnutrition. these conditions, added to bad ventilation, bad light, and an overcrowded schoolroom, render the atmosphere thoroughly charged with electricity--nerves--toward the end of the day. lack of oxygen to breathe as well as inability to breathe it; lack of well-printed books and good light, as well as lack of the power to use them; toothache, earache, headache, deplete the vitality of both teacher and pupil. most of the disturbances at school are but outward signs of unwholesome physical conditions. if the teacher attempts to treat these causes by crushing the child, she makes confession of her own nervousness and inadequacy and visits her own suffering upon her pupils. a transfixing glance prolonged into an overbearing stare, a loud, sharp voice, a rough manner, are successful only so far as they work on the nervousness of her pupil. she finds that it is temporarily effective, and so by her example and practice sets the child an example in losing control of himself. the position often assumed by school children when before authority, of hands held stiffly at the side, head drooped, and roving eye, does not mean control: it means a crushed spirit, hypocrisy, or brooding anarchy. the mother or teacher who obtains obedience by clapping her hands, pointing her finger, distorting her face, is copying in her own home the attitudes of caste in india, of serfdom in russia, the discipline of the prison the world over, a modern reminder of the power of life and death or of physical torture. a young college girl unfamiliar with the ways of the public school was substituting in the highest grammar grade. the time for civics arrived. here, she thought, is a subject in which i can interest them. the boys showed a vast amount of press information, as well as decided opinions on the politics of the day. the candidates which they elected for the position of ideal american patriot were rockefeller, lincoln, and sharkey the prize fighter. during the ensuing debate, which gave back to lincoln his proper rank, the boys in the back of the room had moved forward and were sharing seats with the boys in the front. every boy was engrossed in the discussion. the room was in perfect order,--not, however, according to the ideas of the principal, who entered at that moment to see how the new substitute was managing the class, famed for its bad boys. with the stern look of a simon legree she demanded, "how dare you leave your seats!" when one child started to explain she shouted: "how dare you speak without permission! don't you know your teacher never permits it? every boy take his own seat at his own desk." this principal was far more to be pitied than the boys, for they had before them the prospect of "work papers" and a grind less monotonous and more productive than the principal's discipline. she was a victim of a nerve-racking system, more sinned against than sinning. there is nothing in school life _per se_ to cause nervousness. given a well-aired, sunny room, where every child has enough fresh air to breathe, where he can see without strain, where he has a desk fitted to his body and work fitted to his maximum abilities, a teacher who is physically strong and mentally inspiring, and plenty of play space and play time, there will be no nervousness. one who visits vacation schools is struck with the difference in the atmosphere from that of the winter day schools. here are the same rooms, the same children, and in many cases the same teachers, but different work. each child is busy with a bright, interested, happy expression and easy attitude. some are at nature study, some are weaving baskets, making dresses, trimming hats, knitting bright worsted sacks and mittens for the winter. boys are at carpentering, raffia, or wrought-iron work. in none of the rooms is the absolute unity or the methodical order of the winter schoolroom, but rather the hum of the workroom and the order that comes from a roomful of children interested in the progress of their work. this condition only illustrates what a winter schoolroom might be were physical defects corrected or segregated, windows open, light good, and work adapted to the child. [illustration: vacation school interest: an antidote to nervousness] nervousness is not a monopoly of city teachers and city pupils. in country schools that i have happened to know, nervous children were the chief problem. nervousness led in scholarship, in disorder, in absences, in truancy, and in backwardness. after reading macdonald's _annals of a quiet neighborhood_, i became interested in one or two particularly nervous children, just to see if i could overcome my strong dislike for them. to one boy i gave permission to leave the room or to go to the library whenever he began to lose his self-control. my predecessors had not been able to control him by the rod. a few weeks after willie's emancipation from rules, the county superintendent was astonished to see that the county terror led my school in history, reading, and geography. had i known what every teacher should be taught in preparation,--the relation of eye strain, bad teeth, adenoids, "overattention," and malnutrition to nervousness and bad behavior,--i could have restored many "incorrigibles" to nerve control. had i been led at college to study child psychology and child physiology, i should not have expected a control that was possible only in a normal adult.[ ] in its primary aspect the question of nervousness in the schoolroom is purely physiological, and the majority of principals and teachers are not trained by professional schools how to deal with it. normal schools should teach the physical laws which govern the child's development; should show that the pupil's mental, moral, and physical nature are one and inseparable; that children cannot at one time be docile, sickly, and intelligent,--perfect mentally and imperfect physically. until teachers are so taught, the condition cannot be changed that makes of our schools manufactories of nervous teachers and pupils. country nervousness, like city nervousness, is of three kinds: ( ) that caused by defective nervous systems; ( ) that resulting from physical defects other than defects of the nervous system, but reacting upon it; ( ) that due to habit or to lack of self-control. children who suffer from a defective nervous system should, in city schools, be segregated where they can have special care under constant medical supervision. such children in schools too small for special classes should be given special treatment. their parents should know that they have chorea, which is the same trouble as st. vitus's dance, although often existing in a degree too mild to attract attention. special treatment does not mean that such children should be permitted to interfere with the school progress of other children. in many rural schools, where special privileges cannot be given children suffering with chorea without injury to other children, it would be a kindness to the unfortunates, to their parents, and to all other children, were the parents requested to keep such children at home. nervousness that results from removable physical defects--eye strain, adenoids, indigestion, earache--will be easily detected by physical examination, and easily corrected by removing the physical defect. preventable nervousness due to "habit" can be quite as serious in its effects upon the mind and health as the other two forms of nervousness. twitching the face, biting the nails, wetting the lips, blinking the eyelids, continually toying with something, being in perpetual motion and never relaxing, always changing from one thing to the next, being forever on the rush, never accomplishing anything, are common faults of both teacher and pupil. we call them mannerisms or tricks of personality. they are readily imitated by children. i once knew a young lawyer who had started life as an oyster dealer, whose power of imitation helped to make him responsive to both helpful and harmful influences. after being at the same table for two weeks with a talented man whom he admired, he acquired the latter's habit of constantly twitching his shoulder and making certain gestures. these habits in turn quickly produced a nervousness that interfered with his power to reason straight. nervousness is often confused with aggressiveness, initiative, confidence. "think twice before you jump, and perhaps you won't want to jump" is a very difficult rule to follow for any one whose bodily movements are not under perfect control. it is said that the confusion of city life causes habits of nervousness. unfortunately no one knows whether the city children or the country children have the highest percentage of nervousness. there is a general feeling that city life causes an unwholesome degree of activity, yet one finds that those people in the city who least notice the elevated railway are those whose windows it passes. city noises irritate those who come from the country, or the city man on returning to the city from the country, but a similar irritation is felt by the city-bred man on coming to the country. mr. dooley's description of a night in the country with the crickets and the mosquitoes and the early birds shows that it is the unusual noise rather than the volume or variety of noises that wreck nerves. at the time of the opening of the new york schools in a newspaper published an editorial on "where can the city child study?" showing that in new york the curriculum, the schoolhouse, and the tenements are so crowded and so noisy that study is practically impossible. lack of sleep, lack of a quiet place in which to study at school and at home, are causes for nervousness, whether these conditions are in the city or in the country. what evidence is there that the country curriculum is less crowded or country work better adjusted to the psychological and physiological age of the country pupil? the index is there; it should be read. in breaking habits of nervousness the first step is to explain how easily habits are formed, why their effects may be serious, and how a little attention will correct them. when a habit loses its mystery it becomes unattractive. children will take an interest in coöperating with each other and with the teacher in curing habits acquired either at home or at school. my pupils greatly enjoyed overcoming the habit of jumping or screaming after some sudden noise. i told them how, when a boy, my imagination had been very much impressed by one of thackeray's characters, the last remnant of aristocratic traditions, almost a pauper, but possessing one attribute of nobility,--absolute self-control. when his house burned he stood with his ankles crossed, leaning on his cane, the only onlooker who was not excited. for months i imitated that pose, using sticks and rakes and fork handles. the result was that when i taught school, a scream, a broken desk, or unusual noise outside reminded me of my old aristocrat in time to prevent my muscles from jumping. in a very short time several fidgety and nervous girls and boys had learned to think twice and to relax before jumping. one test of thorough relaxation in a dentist's chair proves the folly of tightening one's muscles. when in school or out the remedy for nervousness is relaxation. the discipline that prohibits a pupil from stretching or changing his posture or seat is as much to be condemned as that which flourishes the rod. it has been said of our schools that children are not worked to death but bored to death. wherever a room must be stripped of all beauty and interest to induce concentration, wherever the greater part of the teacher's time must be spent in keeping order, there is confession either of inappropriateness of the present curriculum or of the failure of teacher and text-book to present subjects attractive to the pupils. nervous habits will be inevitable until the pupil's attention is obtained through interest. sustained interest will be impossible until teacher and pupil alike practice relaxation, not once a morning or twice a day, not during recess or lunch hour, but whenever relaxation is needed. in overcoming nervousness of teacher and pupil, both must be interested in home causes as well as school causes of that nervousness. time must be found to ask questions about those causes and to discuss means for removing them. naturally it will be embarrassing for a very nervous teacher to discuss nervousness with children,--until after she has overcome her own lack of nerve stability. to help her or to compel her to learn the art of relaxation of bodily and of mental control is the duty and the privilege of the school physician, of her doctor, and of superintendent and trustees. the outside point of view is necessary, because of the peculiar fact that almost every nervous person believes that he has unusually good control over his nerves, just as a man in the midst of his anger will declare that he is cool and self-controlled. had robert burns been thinking of the habit of nervousness he could not have thought of a better cure than when he wrote: oh wad some power the giftie gie us to see oursel's as ithers see us; it wad frae mony a blunder free us, and foolish notion. footnotes: [ ] _the unconscious mind_ by schofield, _the study of children and their school training_ by dr. frances warner, and _the development of the child_ by nathan oppenheimer show clearly the physical and mental limitations and possibilities of children. chapter xii health value of "unbossed" play and physical training _a boy without play means a father without a job. a boy without physical training means a father who drinks. when people have wholesome, well-disciplined bodies there will be less demand for narcotics as well as for medicines._ on these three propositions enthusiasm has built arguments for city parks and playgrounds, for school gymnastics, and for temperance instruction. we have tried the remedies and now realize that too much was expected of them. neither movement appreciated the mental and physical education of spontaneous games and play. like hygiene instruction, physical training was made compulsory by law in many states, and, like hygiene instruction, physical training had to yield to the pressure of subjects in which children are examined. at the outset both were based upon distorted psychology and physiology. of late physical training has been revived "to correct defects of the school desk and to relieve the strain of too prolonged study periods." in new york grammar schools ten minutes a day for the lower grades, and thirty minutes a week for the higher grades, are set aside for physical training. with the exception of eighteen schools where apparatus is used, the exercise has been in the class rooms. it consists of what are known as "setting-up exercises,"--deep breathing and arm movements for two minutes between each study period, often forgotten until it is time to go home, when the children are tired and need it least. many teachers so conduct these exercises that children keenly enjoy them. [illustration: serviceable relief from school strain, but a poor substitute for outdoor play] like hygiene instruction, physical training preceded physical examination. generally speaking, it has not yet, either in schools or in colleges, been related to physical needs of the individual pupil. in fact, there is no guarantee that it is not in many schools working a positive injury on defective children or imposing a defective environment on healthy children. formal exercises in cramped space, in ill-ventilated rooms, with tight belts and heavy shoes, are conceded to be pernicious. formal exercises should never be given to any child without examination and prescription by a physician. children with heart weakness, enlarged tonsils, adenoid growths, spinal curvature, uneven shoulders, are frequently seen doing exercises for which they are physically unfit, and which but serve to deplete further their already low vitality. attention might be called to many a class engaged in breathing exercises when by actual count over half the boys were holding their mouths open. special exercises are needed by children who show some marked defect like flat foot, flat chest, weak abdominal muscles, habitual constipation, uneven shoulders, spinal trouble, etc. that no physical training should be provided for normal children is the belief of many leading trainers. this special training is useful to develop athletes or to correct defects. like massage, osteopathy, or medicine, it should follow careful diagnosis. the time is coming when formal indoor gymnasium exercises for normal pupils or normal students will be considered an anomaly. there is all the difference in the world between physical development and what is called physical training. the test of physical development is not the hours spent upon a prescribed course of training, but the physical condition determined by examination. to be refused permission to substitute an hour's walk for an hour's indoor apparatus work is often an outrage upon health laws. given a normal healthy body, plenty of space, and plenty of playtime, the spontaneous exercise which a child naturally chooses is what is really health sustaining and health giving. mere muscular development artificially obtained through the devices of a gymnasium is inferior to the mental and moral development produced by games and play in the open air. eustace miles, m.d., amateur tennis player of england, says: i do not consider a mere athlete to be a really healthy man. he has no more right to be called a really healthy man than the foundations or scaffolding of a house have a right to be called a house. they become a good house, and, indeed, they are indispensable to a good house, but at present the good house exists only in potentiality. the "healthy-mindedness" and "physical morality" which play and games foster rarely result from physical training as a business, at stated times, indoors, under class direction. it is too much like taking medicine. a certain breakfast food is said to have lost much of its popularity since advertised as a health food. when the national playground association was organized president roosevelt cautioned its officers against too frequent use of the word "supervision" on the ground that supervision and direction were apt to defeat the very purpose of games and to stultify the play spirit. is the little girl on the street who springs into a hornpipe or a jig to the tune of a hurdy-gurdy, or even the boy who runs before automobiles or trolley cars or under horses' noses, getting less physical education than those who play a round game in silence under the supervision of a teacher in the school basement, or who stretch their arms up and down to the tune of one, two, three, four, five, six? who can doubt that the much-pitied child of the tenement playing with the contents of the ash can in the clothes yard or with baby brother on the fire escape is developing more originality, more lung power, and better arteries than the child of fortune who is led by the hand of a governess up and down fifth avenue. children have not forgotten how to play, but adults have forgotten to leave space in cities, and time out of school, home work, and factory work in which children may play. again, the child--whether a city child or a country child--rarely needs to be taught how to play. teaching him games will not produce vitality. games are the spontaneous product of a healthy body, active mind, and a joy in living. give the children parks and piers, roof gardens and playgrounds in which they may play, and leave the rest to them. give them time away from school and housework, and leave the rest to them. instead of lamenting the necessity for playing in the streets, let us reserve more streets for children's play. there are too many students of child welfare whose reasoning about play and games is like that of a lady of cincinnati, who, upon reading the notice of a child-labor meeting, said: "well, i am glad to see there is going to be a meeting here for child labor. it is high time some measure was taken to keep the children off the streets." physical examinations would prove that streets are safer and better than indoor gymnasiums for growing children. intelligent physical training will train children to go out of doors during recess; will train pupils and teachers not to use recess for study, discipline, or eating lunch. [illustration: spontaneous play on one of new york city's school roof playgrounds] "after-school" conditions are quite as important as physical training and gymnastics at school. not long ago a nurse was visiting a sick tenement mother with a young baby. she found a little girl of twelve standing on a stool over a washtub. this child did all the housework, took care of the mother and two younger children, got all the meals except supper, which her father got on his return from work. as the nurse removed the infant's clothes to give it a bath, the little girl seized them and dashed them into the tub. "yes, i am pretty tired when night comes," she confessed. this child has prototypes in the country as well as the city, and she did not need physical training. she did not lack initiative or originality. she did need playmates, open air, a run in the park, and "fun." the educational value of games and outdoor play should be weighed against the advantages of lowering the compulsory school age, and of bridging over the period from four to seven with indoor kindergarten training. neither physical training nor education is synonymous with confinement in school. the whole tendency of nature's processes in children is nutritional; it is not until adolescence that she makes much effort to develop the brain. overuse of the young mind results, therefore, in diverting natural energy from nutritive processes to hurried growth of the overstimulated brain. the result is a type of child with a puny body and an excitable brain,--the neurotic. the young eye, for example, is too flat (hypermetropic)--made to focus only on objects at a distance. close application to print, or even to weaving mats or folding bits of paper accurately, causes an overstrain on the eye, which not only results in the chronic condition known as myopia,--short-sightedness,--so common to school children, but which acts unfavorably on the constitution and on the whole development of the child. at the recent international congress of school hygiene in london, dr. arthur newsholme, medical officer of health of brighton, made a plea for the exclusion of children under five years of age from schools. "during the time the child is in the infant department it has chiefly to grow. nutrition and sleep are its chief functions. paints, pencils, paper, pins, and needles should not be handled in school by children below six." luther burbank, in an article on "the training of the human plant," says: the curse of modern child life in america is overeducation, overconfinement, overrestraint. the injury wrought to the race by keeping too young children in school is beyond the power of any one to estimate. the work of breaking down the nervous systems of the children of the united states is now well under way. every child should have mud pies, grasshoppers, and tad-poles, wild strawberries, acorns, and pine cones, trees to climb and brooks to wade in, sand, snakes, huckleberries, and hornets, and any child who has been deprived of these has been deprived of the best part of his education. not every child can have these blessings of the country, but every child can be protected from the stifling of the nature instinct of play by formal indoor "bossed" exercises, whether called games, physical training, gymnastics, or delsarte. [illustration: new york city's school farm does not stifle nature instinct] the answer to the protest against too early and too constant confinement in school has always been: "where will the child be if out of school? will its environment at home not work a worse injury to its health? will not the street injure its morals?" because we have not yet worked out a method of supervising the health of those children who are not in school, it does not follow that such supervision is impossible. perhaps the time will come when there will be state supervision over the health of children from birth, parents being expected to present them once a year at school for examination by the school physician. in this way defects can be corrected and health measures devised to build up a physique that should not break down under the strain of school life. for children whose mothers work during the day, and for those whose home environment is worse than school, it might be cheaper in the long run to assign teachers to protect them from injury while they play in a park, roof garden, or out-of-door gymnasium. if parks and playgrounds come too slowly, why not adopt the plan advocated by alida s. williams, a new york principal, of reserving certain streets for children between the hours of three and five, and of diverting traffic to other streets less suitable for children's play? so great is the value--mentally, morally, and physically--of out-of-door play that it has even been suggested that the substitution of such play for school for all children up to the age of ten would insure better minds and sounder physiques at fifteen. it is generally admitted that the child who enters school at eight rather than at six will be the gainer at twelve. what a travesty upon education to insist upon schooling for children because they are apt to be run over on the street, or to be neglected at home, to shoot craps, or belong to a gang and develop bad morals. educators will some day be ashamed to have made the schools the catch-all or the court-plaster for the evils of modern industry. instead of pupils and mothers going to the school, enough hygiene teachers, and play teachers, and district physicians could be employed with the money now spent on indoor instruction to do the house-to-house visiting urged in many chapters of this book. such a course of action would have an incalculable effect on the reduction of tuberculosis, not only in making healthier physiques but by inculcating habits of outdoor life and love of fresh air. the danger of those contagious diseases which ravish childhood would be greatly reduced. an ambition for physical integrity would make unnatural living unpopular. competition in games with children _of the same physical class_ develops accuracy, concentration, dispatch, resourcefulness, as much as does instruction in arithmetic. smoking can easily be discredited among boys trying to hit the bull's-eye. a boy would sooner give up a glass of beer than the championship in rifle shooting or a "home run." the influence of the "spirit of the game" on practical life has been described thus by new york's director of physical training, dr. luther h. gulick: play is the spontaneous enlistment of the entire personality in the pursuit of some coveted end. we do not have to pursue the goal; we wish to--it is our main desire. this is the way in which greatest discoveries, fortunes, and poems are made. it is the way in which we take the responsibilities and problems of life that makes it either a deadly bore--a mere dull round of routine and drudgery--or the most interesting and absorbing game, capable of enlisting all the energy and enthusiasm we have to put into it. the people who accomplish things are the people who play the game. they let themselves go; they are not afraid. under the stimulus and enthusiasm of play muscles contract more powerfully and longer than under other conditions. blood pressure is higher in play. it is far more interesting to play the game than to work at it. when you work you are being driven, when you play you are doing the driving yourself. we play not by jumping the traces of life's responsibilities, but by going so far beyond life's compulsions as to lose sight of the compulsion element. play up, play up, and play the game. chapter xiii vitality tests and vital statistics two things will disclose the strength or weakness of a bank and the soundness or unsoundness of a nation's banking policy, namely, a financial crisis or an expert audit. a searching audit that analyzes each debit and each credit frequently shows that a bank is solvent only because it is not asked to pay its debts. it continues to do business so long as no obvious weaknesses appear, analogous to measles, adenoids, or paralysis. a frequent disorder of banking results from doing too big a business on too little capital, in making too many loans for the amount of cash held ready to pay depositors upon demand. this disorder always comes to light in a crisis--too late. it can be discovered if looked for in advance of a crisis. many individuals and communities are likewise physically solvent only because their physical resources are not put to the test. weaknesses that lie near the surface can be discovered before a crisis by physical examination for individuals and sanitary supervision for communities. whether individuals or communities are trying to do too much business for their health capital, whether the health reserves will pay debts that arise in a crisis, whether we are ill or well prepared to stand a run on our vitality, can be learned only by carefully analyzing our health reserves. health debits are compared with health credits for individuals by vitality tests, for communities by vital statistics. of the many vitality tests none is practicable for use in the ordinary class room. scientific training is just as necessary for such tests as for discovering the quality of the blood, the presence or absence of tubercle bacilli in the sputum, diphtheria germs in throat mucus, or typhoid germs in milk. but scientific truth, the results of scientific tests, can be made of everyday use in all class rooms. state and national headquarters for educators, and all large cities, can afford to engage scientists to apply vitality tests to school children for the sake of discovering, in advance of physical breakdown and before outward symptoms are obvious, what curriculum, what exercise, what study, recreation, and play periods are best suited to child development. it will cost infinitely less to proceed this way than to neglect children or to fit school methods to the loudest, most persistent theory. the ergograph is an interesting strength tester. it takes a picture ( ) of the energy exerted, and ( ) of the regularity or fitfulness of the manner in which energy is exerted. perhaps the time will come when science and commerce will supply every tintype photographer with an ergograph and the knowledge to use it. then we shall hear at summer resorts and fairs, "your ergograph on a postal card, three for a quarter." we can step inside, harness our middle finger to the ergograph, lift it up and down forty-five times in ninety seconds, and lo! a photograph of our vitality! if we have strong muscles or good control, the picture will be like this: [illustration: fig. . ergogram of t.r., a strong, healthy girl, before taking minutes' work in the gymnasium. weight used, . kg. distance lifted, cm. work done, . kg.-cm.] if weak and nervous, we shall look like this before taking exercise: [illustration: fig. . ergogram of c.e., a weak and somewhat nervous girl, before taking minutes' work in the gymnasium. weight used, . kg. distance lifted, cm. work done, . kg.-cm.] and like this after gymnasium exercise: [illustration: fig. . ergogram of c.e. after taking minutes' work in the gymnasium, showing that the exercise proved very exhausting. weight used, . kg. distance lifted, cm.] in chicago, two of whose girls are above photographed, the physician was surprised to have four pupils show more strength late in the day than in the morning. "upon investigation it was found that the teacher of the four pupils had been called from school, and that they had no regular work, but had been sent to another room and employed themselves, as they said, in having a good time." the chart on page shows the effect of the noon recess and of the good time after three o'clock. chicago's child-study experts concluded after examining a large number of children: . in general there is a distinct relationship in children between physical condition and intellectual capacity, the latter varying directly as the former. . the endurance (ergographic work) of boys is greater than that of girls at all ages, and the difference seems to increase after the age of nine. . there are certain anthropometric (body measurements) indications which warrant a careful and thorough investigation into the subject of coeducation in the upper grammar grades. . physical condition should be made a factor in the grading of children for school work, and especially for entrance into the first grade. . the great extremes in the physical condition of pupils in the upper grammar grades make it desirable to introduce great elasticity into the work of these grades. . the classes in physical culture should be graded on a physical instead of an intellectual basis. [illustration: fig. ] to these conclusions certain others should be added, not as settled beyond any possibility of modification, but as being fairly indicated by these tests. . the pubescent period is characterized by great and rapid changes in height, weight, strength of grip, vital capacity, and endurance. there seems to accompany this physical activity a corresponding intellectual and emotional activity. it therefore is a period when broad educational influences are most needed. from the pedagogic standpoint it is preëminently a time for character building. . the pubescent period is characterized by extensive range of all physical features of the individuals in it. hence, although a period fit for great activity of the mass of children, it is also one of numerous individual exceptions to this general law. during this period a greater per cent of individuals than usual pass beyond the range of normal limits set by the mass. it is a time, therefore, when the weak fail and the able forge to the front, and hence calls for a higher degree than usual of individualization of educational work and influence. . unidexterity is a normal condition. rapid and marked accentuation of unidexterity is a pubescent change. on the whole, there is a direct relationship between the degree of unidexterity and the intellectual progress of the pupil. at any given age of school life bright or advanced pupils tend toward accentuated unidexterity, and dull or backward pupils tend toward ambidexterity.... training in ambidexterity is training contrary to a law of child life. . boys of school age at the bridewell (reform school) are inferior in all physical measurements to boys in the ordinary schools, and this inferiority seems to increase with age. . defects of sight and hearing are more numerous among the dull and backward pupils. these defects should be taken into consideration in the seating of pupils. only by removing the defects can the best advancement be secured. . the number of eye and ear defects increases during the first years of school life. the causes of this increase should be investigated, and, as far as possible, removed. . there are certain parts of the school day when pupils, on the average, have a higher storage of energy than at other periods. these periods should be utilized for the highest forms of educational work. . the stature of boys is greater than that of girls up to the age of eleven, when the girls surpass the boys and remain greater in stature up to the age of fourteen. after fourteen, girls increase in stature very slowly and very slightly, while boys continue to increase rapidly until eighteen. . the weight of the girl surpasses that of the boy about a year later than her stature surpasses his, and she maintains her superiority in weight to a later period of time than she maintains her superiority in height. . in height, sitting, girls surpass boys at the same age as in stature, namely, eleven years, but they maintain their superiority in this measurement for one year longer than they do in stature, which indicates that the more rapid growth of the boy at this age is in the lower extremities rather than in the trunk. . commencing at the age of thirteen, strength of grip in boys shows a marked accentuation in its rate of increase, and this increase continues as far as our observations extend, namely, to the age of twenty. in girls no such great acceleration in muscular strength at puberty occurs, and after sixteen there is little increase in strength of grip. the well-known muscular differentiation of the sexes practically begins at thirteen. . as with strength of grip, so with endurance as measured by the ergograph; boys surpass girls at all ages, and this differentiation becomes very marked after the age of fourteen, after which age girls increase in strength and endurance but very slightly, while after fourteen boys acquire almost exactly half of the total power in these two features which they acquire in the first twenty years of life. . the development of vital capacity bears a striking resemblance to that of endurance, the curves representing the two being almost identical. physiological age, according to studies made in new york city, should be considered in grading, not only for physical culture classes but for all high school or continuation classes. dr. c. ward crampton, assistant physical director, while examining boys in the first grade of the high school of commerce, noticed a greater variation in physical advancement than in years. he kept careful watch of the educational progress and discovered three clear divisions: ( ) boys arrived at puberty,--postpubescent; ( ) boys approaching maturity,--pubescent; ( ) boys not yet approaching maturity,--prepubescent. the work in lower grades they had all passed satisfactorily, but in high school only the most advanced class did well. practically none of the not-yet-maturing boys survived and few of the almost mature. in other words, the high school course was fitted to only one of the three classes of boys turned out of the grammar schools. the others succumbed like hothouse azaleas at christmas time, forced beyond their season. physiological age, not calendar years or grammar school months, should determine the studies and the companions of children after the tenth year. physiological strength and vitality, not ability to spell or to remember dates, should be the basis of grading for play and study and companionship among younger children. vitality, power to endure physically, should be the test of work and recreation for adults. physicians may be so trained to follow directions issued by experts that physical examinations will disclose the chief enemies of vitality and the approximate limits of endurance. teachers may train themselves to recognize signs of fatigue in school children and to adapt each day's, each hour's work to the endurance of each pupil. one woman principal has written: school programmes, after they have been based upon the laws of a child's development, should provide for frequent change of subject, alternating studies requiring mental concentration with studies permitting motor activity, and arranging for very short periods of the former. anæmic children should be relieved of all anxiety as to the results of their efforts, and only short hours of daylight work required of them. the disastrous consequences of eye strain should be understood by all in charge of children who are naturally hypermetropic. the ventilation of a class room is far more important than its decoration or even than a high average percentage in mathematics, and the lack of pure air is one of the auxiliary causes of nervous exhaustion in both pupils and teachers. deficient motor control is a most trustworthy indication of fatigue in children, and teachers may safely use it as a rough index of the amount of effort to be reasonably expected of their pupils. facial pallor or feverish flushes are both evidences of overtasking, and either hints that fatigue has already begun. as to unfavorable atmospheric conditions, the teacher herself will undoubtedly realize them as soon as the children, but she should remember that effort carried to the point of exhaustion, injurious as it is in an adult, is yet less harmful than it is to the developing nerve centers of the child. because adults at work and at play reluctantly submit themselves to vitality tests, because few scientists are beseeching individuals to be tested, because almost no one yearns to be tested, the promotion of adult vitality and of community vitality can best be hastened by demanding complete vital statistics. industrial insurance companies and mutual benefit societies are doing much to educate laborers regarding the effect upon vitality of certain dangerous and unsanitary trades, and of certain unhygienic habits, such as alcoholism and nicotinism. progress is slower than it need be because state boards of health are not gathering sufficiently complete information about causes of sickness and death. american health and factory inspection is not even profiting, as it should, from british, german, and french statistics. statistics are in ill repute because the truth is not generally known that our boasted sanitary improvements are due chiefly to the efficient use of vital statistics by statesmen sanitarians.[ ] the vital statistics of greatest consequence are not the number of deaths or the number of births, not even the number of deaths from preventable diseases, but rather the number of cases of sickness from transmissible diseases. the cost and danger to society from preventable diseases, such as typhoid, diphtheria, scarlet fever, measles, are imperfectly represented by the number of deaths. medical skill could gradually reduce death rates in the face of increasing prevalence of infectious disease. with few exceptions, only those patients who refuse to follow instructions will die of measles, diphtheria, or smallpox. the scarlet-fever patient who recovers and goes to church or school while "peeling" can cause vastly more sickness from scarlet fever than a patient who dies. dr. w. leslie mackenzie, who has recently written _the health of the school child_, said ten years ago, while health officer of leith: death is the ultimate and most severe injury that any disease can inflict, but short of death there may be disablement, permanent or temporary, loss of wages, loss of employment, loss of education, increase of home labor, increase of sickness outlays, increase of worry, anxiety and annoyance, disorganization of the household, general impairment of social efficiency. the best guarantee against such loss, the best protection of health, and the most essential element of vital statistics is prompt, complete record of cases of sickness. statistics of sickness are confined to sickness from transmissible diseases, because we have not yet arrived at the point where we recognize the state's right to require information, except when the sick person is a menace to the health of other persons. the annual report of a board of health should give as clear a picture of a community's health during the past week or past quarter as the ergograph gives of the pupils mentioned on page . as ragged, rapidly shortening lines show nervousness and depleted vitality, so charts and diagrams can be made to show the needless waste of infant life during the summer months, the price paid for bad ventilation in winter time, when closed windows cause the sickness-and-death line from diphtheria and scarlet fever to shoot up from the summer level. in cities it is now customary for health boards to report weekly the number of deaths from transmissible diseases. health officers will gladly furnish facts as to cases of sickness, if citizens request them. newspapers will gladly publish such information if any one will take the pains to supply it. wherever newspapers have published this information, it quickly takes its place with the weather reports among the news necessities. marked changes are commented on editorially. children can easily be interested, as can adults, in filling out week by week a table that will show increases and decreases in preventable sickness due to transmissible diseases. table x cases of infectious and contagious diseases reported =================+================================================ | week ending +------+------+------+------+------+------+------ | oct. | nov. | nov. | nov. | nov. | nov. | dec. | | | | | | | -----------------+------+------+------+------+------+------+------ tuberculosis | | | | | | | pulmonalis | | | | | | | diphtheria and | | | | | | | croup | | | | | | | measles | | | | | | | scarlet fever | | | | | | | smallpox | -- | | -- | | -- | -- | varicella | | | | | | | typhoid fever | | | | | | | whooping cough | | | | | | | cerebro-spinal | | | | | | | meningitis | | | | | | | -----------------+------+------+------+------+------+------+------ total | | | | | | | =================+======+======+======+======+======+======+====== =================+========================================= | week ending +------+------+------+------+------+------ | dec. | dec. | dec. | jan. | jan. | jan. | | | | | | -----------------+------+------+------+------+------+------ tuberculosis | | | | | | pulmonalis | | | | | | diphtheria and | | | | | | croup | | | | | | measles | | | | | | scarlet fever | | | | | | smallpox | | | | -- | | -- varicella | | | | | | typhoid fever | | | | | | whooping cough | | | | | | cerebro-spinal | | | | | | meningitis | | | | | | -----------------+------+------+------+------+------+------ total | | | | | | =================+======+======+======+======+======+====== in cities where physicians are not compelled to notify the health board of danger centers,--that is, of patients sick from measles, smallpox, or diphtheria,--and in smaller communities where notices are sent only to state boards of health, parents will find it difficult to take a keen interest in vital statistics. but if teachers would start at the beginning of the year to record in such a table the days of absence from school because of transmissible disease, both they and their pupils would discover a new interest in efficient health administration. after a national board of health is organized we may reasonably expect that either state boards of education or state boards of health will regularly supply teachers with reports that will lead them to compare the vitality photographs of their own schools and communities with the vitality photographs of other schools and other communities working under similar conditions. then children old enough to study physiology and hygiene will be made to see the happiness-giving possibilities of vitality tests and vital statistics. [illustration: vital statistics can make disease centers as obvious and as offensive as the smoke nuisance] instead of discussing the theory of vital statistics, or the extent to which statistics are now satisfactory, it would be better for us at this point to make clear the significance of the movement for a national fact center for matters pertaining to personal, industrial, and community vitality. five economic reasons are assigned for establishing a national department of health: . to enable society to increase the percentage of exceptional men of each degree, many of whom are now lost through preventable accidents, and also to increase the total population. . to lessen the burden of unproductive years by increasing the average age at death. . to decrease the burden of death on the productive years by increasing the age at death. . to lessen the cost of sickness. it is estimated that if illness in the united states could be reduced one third, nearly $ , , would be saved annually. . to decrease the amounts spent on criminality that can be traced to overcrowded, unwholesome, and unhygienic environment. in addition to the economic gain, the establishment of a national department of health would gradually but surely diminish much of the misery and suffering that cannot be measured by statistics. sickness is a radiating center of anxiety; and often death in the prime of life closes the gates of happiness on more than one life. let us not forget that the "bitter cry of the children" still goes up to heaven, and that civilization must hear, until at last it heeds, the imprecations of forever wasted years of millions of lives. if progress is to be real and lasting, it must provide whatever bulwarks it can against death, sickness, misery, and ignorance; and in an organization such as a national department of health, adequately equipped,--a vast preventive machine working ceaselessly,--an attempt at least would be made to stanch those prodigal wastes of an old yet wastrel world. among the branches of the work proposed for the national bureau are the following: infant hygiene; health education in schools; sanitation; pure food; registration of physicians and surgeons; registration of drugs, druggists, and drug manufacturers; registration of institutions of public and private relief, correction, detention and residence; organic diseases; quarantine; immigration; labor conditions; disseminating health information; research libraries and equipment; statistical clearing house for information. given such a national center for health facts or vital statistics, there will be a continuing pressure upon state, county, and city health officers, upon physicians, hospitals, schools, and industries to report promptly facts of birth, sickness, and death to national and state centers able and eager to interpret the meaning of these facts in such simple language, and with such convincing illustrations, that the reading public will demand the prompt correction of preventable evils. our tardiness in establishing a national board of health that shall do this great educational work is due in part to the fact that american sanitarians have frequently chosen to _do things_ when they should have chosen to _get things done_. almost every state has its board of health, with authority to require registration of births, deaths, and sickness due to transmissible disease; with few exceptions the heads of these state boards have spent their energies in abating nuisances. in a short time they have degenerated into local scavengers, because they have shown the public neither the meaning of the vital statistics gathered nor its duty to support efficient health administration. the state reports of vital statistics have not been accurate; therefore in many states we have the anomalous situation of an aggressive veterinary board arousing the farmer and the consumer of milk to the necessity of protecting the health of cattle, and an inactive, uninformed state board of health failing to protect the health of the farmer and the consumer. vital statistics presume efficient health administration. an inefficient health officer will not take the initiative in gathering health statistics. if some one else compels him to collect vital statistics, or furnishes him with statistics, they are as a lantern to a blind man. unless some one also compels him to make use of them, unless we remove the causes of transmissible or infectious diseases and check an epidemic when we first hear of it, the collection of information is of little social value. "statistics" is of the same derivation as "states" and "statesmen." statistics have always been distinguished from mere facts, in that statistics are instruments in the hands of the statesman. wherever the term "statistics" is applied to social facts it suggests action, social control of future contingencies, mastery of the facts whose action they chronicle. the object of gathering social facts for analysis is not to furnish material for future historians. they are to be used in shaping future history. they are facts collected with a view to improving social vitality, to raising the standard of life, and to eliminating permanently those forces known to be destructive to health. unless they are to be used this way, they are of interest only to the historical grub. no city or state can afford to erect a statistical office to serve as a curiosity shop. unless something is to be done to prevent the recurrence of preventable diseases annually experienced by your community or your school, it is not reasonable to ask the public printer to make tables which indicate the great cost of this preventable sickness. a tax collector cannot discharge his duties unless he knows the address of every debtor. the police bureau cannot protect society unless it knows the character and haunts of offenders. a health officer cannot execute the law for the protection of society's health unless he knows the haunts and habits of diseases. for this he must look to vital statistics. but the greatest service of vital statistics is the educational influence. health administration cannot rise far above the hygienic standards of those who provide the means for administering sanitary law. the taxpaying public must believe in the economy, utility, and necessity of efficient health administration. power and funds come from town councils and state legislatures. to convince and move these keepers of the purse, trustworthy vital statistics are indispensable. information will be used for the benefit of all as soon as it is possessed by all. fortunately the gathering of vital statistics is not beyond the power of the kind of health officer that is found in small cities and in rural communities. if years of study of mathematics and of the statistical method were required, we should despair of obtaining light within a century. but the facts we want are, for the most part, common, everyday facts, easily recognizable even by laymen; for example, births, deaths, age at death, causes of death, cases of transmissible diseases, conditions found upon examination of children applying for work certificates, etc. where expert skill is required, as at state and national headquarters, it can be found. every layman can train himself to use skillfully the seven ingredients of the statistical method which it is his duty to employ, and to know when to pay for expert analysis and advice. we can all learn to base judgment of health needs upon the seven pillars,--desire to know, unit of inquiry, count, comparison, percentages, classification, and summary. footnotes: [ ] dr. arthur newsholme's _vital statistics_ should be in public libraries and on the shelves of health officers, public-spirited physicians, and school superintendents. chapter xiv is your school manufacturing physical defects? last year a conference on the physical welfare of school children was told by a woman principal: "of course we need physicians to examine our children and to teach the parents, but many of us principals believe that our school curriculum and our school environment manufacture more physical defects in a month than all your physicians and nurses will correct in a year." at the same meeting the physical director of schools of new york city appealed eloquently for "biological engineers" at school, who would test the child's strength as building engineers are employed to test the strength of beams and foundations.[ ] as explanation for the need of the then recently organized national school hygiene association, he elaborated the proposition that school requirements and school environment damage child health. "ocular defects are in direct ratio to the length of time the pupil has attended school.... a desk that is too high may easily be the indirect agent for causing scoliosis, producing myopia or astigmatism.... physically examine school children by all means, but do not fail to examine school desks." fifty schools in different parts of new york city were examined last year with especial reference to the factors likely to cause or to aggravate physical defects.[ ] the results, tabulated and analyzed, prove that the woman principal was right; many schools are so built or so conducted, many school courses are so devised or so executed, that children are inevitably injured by the environment in which the compulsory education law forces them to spend their formative years. [illustration: one of new york city's roof playgrounds] recently i noticed that our little office girl, so anæmic and nervous when she left school that we hesitated to employ her, was becoming rosy and spirited. the child herself explained the change: "i like it better. i have more money to spend. i get more outdoor exercise, and then, oh, the room is so much sunnier and there is more air and the people are all so nice!" and these were just the necessities which were lacking in the school from which she came. moreover, it is a fair commentary on the school work and the school hygiene in too many of our towns and cities to-day. "i like it better" means that school work is not adapted to the dominant interests of the child, that the curriculum includes subjects remote from the needs and ambitions of the modern school child, and fails to include certain other subjects which it recognizes as useful and necessary, and therefore finds interesting. "i have more money to spend" means that this little girl was able to have certain things, like a warm, pretty dress, rubbers, or an occasional trolley ride, which she longed for and needed. "i get more outdoor exercise" means that there was no open-air playground for her school, that "setting up" exercises were forgotten, that recess was taken up in rushing home, eating lunch, and rushing back again, and that "after school" was filled up with "helping mother with the housework." "the office is so much sunnier and i get more air" accounts for the increase in vitality; and "the people are all so nice," for the happy expression and initiative which the undiscriminating discipline at school had crushed out. [illustration: bone tuberculosis is one of the penalties for dry sweeping and feather dusters] for such unsanitary conditions crowded sections of great cities have no apologies to make to rural districts. a wealthy suburb recently learned that there was overcrowding in every class room, and that one school building was so unsanitary as to be a menace to the community. unadjustable desks, dry sweeping, feather dusters, shiny blackboards, harassing discipline that wrecks nerves, excessive home study and subjects that bore, are not peculiar to great cities. in a little western town a competition between two self-governing brigades for merit points was determined by the amount of home study; looking back fifteen years, i can see that i was encouraging anæmic and overambitious children to rob themselves of play, sleep, and vitality. many a rural school violates with impunity more laws of health than city factories are now permitted to transgress. after child labor is stopped, national and state child labor committees will learn that their real interest all the time has been child welfare, not child age, and will be able to use much of the old literature, simply substituting for "factory" the word "school" when condemning "hazardous occupations likely to sap [children's] nervous energy, stunt their physical growth, blight their minds, destroy their moral fiber, and fit them for the moral scrap heap." many of the evils of school environment the teacher can avert, others the school trustee should be expected to correct. so far as unsanitary conditions are permitted, the school accentuates home evils, whereas it should counteract them by instilling proper health habits that will be taken home and practiced. questions such as were asked in miss north's study will prove serviceable to any one desiring to know the probable effect of a particular school environment upon children subject to it. especially should principals, superintendents, directors, and volunteer committeemen apply such tests to the public, parochial, or private school, orphanage or reformatory for which they may be responsible. i. neighborhood health resources . is the district congested? . is congestion growing? . how far away is the nearest public park? a. is it large enough? b. has it a playground or beauty spot? c. has it swings and games? d. is play supervised? e. have children of different ages equal opportunities, or do the large children monopolize the ground? f. are children encouraged by teachers and parents to use this park? . are the streets suitable for play? a. does the sun reach them? b. are they broad? c. are they crowded with traffic? . how far away is the nearest public bath? a. has it a swimming pool? b. has it showers? c. is it used as an annex to the school? [illustration: vacation-school play clinic on a "vacant" city lot owned by the rockefeller institute for medical research] ii. effect of school equipment upon health . is there an indoor yard? a. is the area adequate or inadequate? b. is the floor wood, cement, or dirt? c. is the heat adequate or deficient? d. is the ventilation adequate or deficient? e. is the daylight adequate, deficient, or almost lacking? f. is there equipment for light gymnastics and games? g. is it used out of school hours; by special classes, athletic teams, etc., or by pupils generally? . is there an outdoor yard? a. is the area ample or inadequate? b. is the area mainly occupied by toilets? c. is the daylight sufficient or deficient? d. for how many hours does the sun reach it? e. is it equipped for games? f. how much larger ought it to be? g. is it used out of school hours; by special classes, athletic teams, etc., or by pupils generally? . is there a gymnasium? a. is it large enough? b. is it used for a gymnasium? c. is it cut up into class rooms? d. is it used out of school hours; by special classes, athletic teams, etc., or by pupils generally? . is there a roof playground? a. is there open ventilation? b. is it used in the daytime? c. is it used at night? d. is it used during the summer? e. is it monopolized by the larger children? f. is it used out of school hours; by special classes, athletic teams, etc., or by pupils generally? . are washing facilities adequate? a. how many pupils per washbasin? b. are there individual towels? c. have eye troubles been spread by roller towels? d. are only clean towels permitted? e. are there bathing facilities; are these adequate? f. are swimming pools used for games, contests, etc.? g. are bathing facilities used out of school hours? h. who is responsible for cleanliness of towels, washbasins, and swimming pools? i. how often is water changed in swimming pool, or is it constantly changing? . is adequate provision made for clean drinking water? a. are sanitary fountains used that prevent contamination of faucet or water? b. how often are cups or faucets cleaned? . is provision made for airing outer clothing? a. are children permitted to pile their clothing in the class room? b. are there hooks for each child? c. are lockers provided with wire netting to permit ventilation? d. are lockers or hooks in the halls or in the basement? e. have you ever thought of the disciplinary and social value of cheap coat hangers to prevent wrinkling and tearing? [illustration: an attempt to overcome the disadvantages of congestion--a boys' high school, new york city] iii. the class room as a place of confinement . how many sittings are provided? a. how many pupils are there? . what is the total floor area? a. what proportion is not occupied by desks? . are the seats adjustable? a. are the seats adjusted to pupils? b. where desks are adjustable, are short children seated in low desks, or are children seated according to class or according to discipline exigencies without regard to size of desk? c. are seats placed properly with reference to light? . is the light ample and proper? a. for how many hours must artificial light be used in the daytime? b. is artificial light adequate for night work? c. does the reflection of light from blackboard and walls injure the eye? d. are the blackboards black enough? e. are the walls too dark? f. is the woodwork too dark? g. are window panes kept clean? . is the air always fresh? a. is ventilation by open windows? b. is ventilation artificial? c. does the ventilating apparatus work satisfactorily? d. are the windows thrown open during recess, and after and before school? e. do unclean clothes vitiate the atmosphere? f. do unclean persons vitiate the atmosphere? g. does bad breath vitiate the atmosphere? h. are pupils and parents taught that unclean clothes, unclean persons, and bad breath may decrease the benefits of otherwise adequate ventilation and seriously aggravate the evils of inadequate ventilation? . is the temperature properly regulated? a. has every class room a thermometer? b. are teachers required to record the thermometer's story three or more times daily? c. is excess or deficiency at once reported to the janitor? . are the floors, walls, desks, and windows always clean? a. how often are they washed? b. is twice a year often enough? c. do the floors and walls contain the dust of years? d. is dry sweeping prohibited? e. has wet sawdust or even wet sand been tried? f. has oil ever been used to keep down surface dust on floors? g. are feather dusters prohibited? h. are dust rags moist or dry? i. is an odorless disinfectant used? . does overheating prevail? a. do you know teachers and principals who protest against insufficient ventilation, particularly against mechanical ventilation, while they themselves are "in heavy winter clothing in a small room closely sealed, the thermometer at degrees"? iv. exercise and recreation . how much time and at what periods is exercise provided for in the school schedule? a. indoors? b. outdoors? . how much exercise indoors and outdoors is actually given? . are the windows open during exercise? . is exercise suited to each child by the school physician after physical examination, or are all children compelled to take the same exercise? . whose business is it to see that rules regarding exercise are strictly enforced? . do clouds of dust rise from the floor during exercise and play? . are children deprived of exercise as a penalty? . should hygiene talks be considered as exercise? [illustration: home workshops need fresh air] v. the school janitor and cleaners . do they understand the relation of cleanliness to vitality? . is their aim to do the least possible amount of work, or to attain the highest possible standard of cleanliness? . will the teacher's complaint of uncleanliness be heeded by trustees? if so, is the teacher not responsible for uncleanliness? . have you ever tried to stimulate the pride of janitors and cleaners for social service? a. have you ever tried to show them how much work they save themselves by thorough cleansing? b. have you ever shown them the danger, to their own health, of dust and dirt that may harbor infection and reduce their own vitality? . what effort is made to instruct janitors and cleaners by your school trustees or by your community? . have you explained to pupils the important responsibility of janitors for the health of those in the tenements, office buildings, or schools? a. do you see in this an opportunity to emphasize indirectly the mother's responsibility for cleanliness of home? [illustration: school workshops also need fresh air] vi. requirements of curriculum . how much home study is there? a. how much is required? b. what steps are taken to prevent excessive home study? c. are light and ventilation conditions at home considered when deciding upon amount of home study? . is the child fitted to the curriculum, or is the curriculum fitted to the child? a. does failure or backwardness in studies lead to additional study hours or to regrading? b. are there too many subjects? c. are the recitation periods too long? d. are the exercise periods too short and too few? e. is there too much close-range work? f. is it possible to give individual attention to individual needs so as to awaken individual interest? . is follow-up work organized to enlist interest of parents, or, if necessary, of outside agencies in fitting a child to do that for which, if normal, he would be physically adapted? by reducing the harm done by old buildings and by the traditions of curriculum and discipline, teachers can do a great deal. perhaps they cannot move the windows or the desks, but they can move the children. if they cannot insure sanitary conditions for home study, they can cut down the home study. if the directors do not provide proper blackboards, they can do less blackboard work. they can make children as conscious, as afraid, and as resentful of dirty air as of dirty teeth. they can make janitors believe that "dry sweeping" or "feather dusting" may give them consumption, and leave most of the dirt in the room to make work for the next day; that adjustable desks are made to fit the child's legs and back, not the monkey wrench; that the thermometer in the schoolroom is a safer guide to heat needed than a boiler gauge in the basement; that fresh air heated by coal is cheaper for the school fund than stale air heated by bodies and by bad breath. finally, they can make known to pupils, to parents, to principals and superintendents, to health officials and to the public, the extent to which school environment violates the precepts of school hygiene. if the state requires the attendance of all children between the ages of five and fourteen at school for five hours a day, for five days in the week, for ten months in the year, then it should undertake to see that the machinery it provides for the education of those children for the greater part of the time for nine years of their lives--the formative years of their lives--is neither injuring their health nor retarding their full development. if the amount of "close-range" work is rapidly manufacturing myopic eyes; if bad ventilation, whether due to faulty construction or to faulty management, is preparing soil for the tubercle bacillus; if children with contagious diseases are not found and segregated; if desks are so ill adapted to children's sizes and physical needs that they are forming crooked spines; if too many children are crowded into one room; if lack of air and light is producing strained eyes and malnutrition; if neither open air, space, nor time is provided for exercise, games, and physical training; if school discipline is adapted neither to the psychology nor the physiology of child or teacher, then the state is depriving the child of a greater right than the compulsory education law forces it to endure. not only is the right to health sacrificed to the right to education, but education and health are both sacrificed. in undertaking to enforce the compulsory education law, to put all truants and child laborers in school, the state should be very sure for its own sake that it is not depriving the child of the health on which depends his future usefulness to the state as well as to himself. table xi effects of a child labor law increase in chicago attendance grades - ######## - ############# - ###################################################### - grades - ####################### - #################### - ###################################################### - footnotes: [ ] _the sanitation of public buildings_, by william paul gerhard, contains a valuable discussion of how the school may avoid manufacturing physical defects. [ ] by professor lila v. north, baltimore college for women, for the new york committee on the physical welfare of school children, east d street, new york city. chapter xv the teacher's health "teachers, gentlemen, no less than pupils, have a heaven-ordained right to work so adjusted that the highest possible physical condition shall be maintained automatically." this declaration thundered out by an indignant physician startled a well-meaning board of school directors. the teacher's right to health was, of course, obvious when once mentioned, and the directors concluded: . school conditions that injure child health also injure teacher health. . poor health of teacher causes poor health of pupil. . poor health of pupil often causes poor health of teacher. . adequate protection of children requires adequate protection of their teachers. . teachers have a right to health protection for their own sake as well as for their children's sake. too little concern has hitherto been shown for the vitality of teachers in private or public schools and colleges. without protest, and without notice until too late, teachers often neglect their own health at home and at school,--recklessly overwork, undersleep, and undernourish; ruin their eyes, their digestion, and their nerves. school-teachers are frequently "sweated" as mercilessly as factory operatives. the time has come to admit that a school environment which destroys the health of the teacher is as unnecessary and reprehensible as an army camp that spreads typhoid among a nation's defenders. a school curriculum or a college tradition that breaks down teachers is as inexcusable as a gun that kills the gunner when discharged. experience everywhere else proves that periodic physical examinations and health precautions, not essays about "happy teachers--happy pupils," are indispensable if teachers' health rights are to be protected. physical tests are imposed upon applicants for teachers' licenses by many boards of education. in new york city about three per cent of those examined are excluded for defects of vision, of hearing, of probable endurance. once a teacher, however, there is no further physical examination,--no way of discovering physical incapacity, nothing to prevent a teacher from exposing class after class to pulmonary tuberculosis contracted because of overwork and underventilation. the certainty of salary increase year by year and of a pension after the twentieth year will bribe many a teacher to overtax her own strength and to jeopardize her pupils' health. seldom do training schools apply physical tests to students who intend to become teachers. one young girl says that before starting her normal course she is going to the physician of the board of education for examination, so as to avoid the experience of one of her friends, who, after preparing to be a teacher, was rejected because of pulmonary tuberculosis. during her normal course no examination will be necessary. overwork during the first year may cause pulmonary tuberculosis, and in spite of her foresight she, too, may be rejected four years hence. the advantages of physical examination upon beginning and during the courses that prepare one for a teacher are so obvious that but little opposition will be given by prospective teachers. the disadvantages to teacher and pupil alike of suffering from physical defects are so obvious that every school which prepares men and women for teachers should make registration and certification dependent upon passing a satisfactory physical test. no school should engage a teacher who has not good proof that she can do the required work without injury to her own or her pupils' health. long before physicians can discover pulmonary tuberculosis they can find depleted vitality which invites this disease. headaches due to eye trouble, undernourishment due to mouth breathing, preventable indigestion, are insidious enemies that cannot escape the physical test. three objections to physical tests for teachers will be urged, but each loses its force when considered in the light of general experience. . _a sickly teacher is often the most efficient teacher in a school or a county._ it is true that some sickly teachers exert a powerful influence over their pupils, but in most instances their influence and their efficiency are due to powers that exist in spite of devitalizing elements. rarely does sickness itself bring power. it must be admitted that many a man is teaching who would be practicing law had his health permitted it. many a woman's soul is shorn of its self-consciousness by suffering. but even in these exceptional instances it is probable that children are paying too dearly for benefits directly or indirectly traceable to defects that physical tests would exclude. . _there are not enough healthy candidates to supply our schools._ this is begging the question. in fact, no one knows it is true. on the contrary, it is probable that the teacher's opportunity will make even a stronger appeal to competent men and women after physical soundness and vitality are made conditions of teaching,--after we all believe what leading educators now believe, that the highest fulfillment of human possibilities requires a normal, sound body, abounding in vitality. . _examination by a physician, especially if a social acquaintance, is an unnecessary embarrassment._ the false modesty that makes physical examination unwelcome to many adults, men as well as women, is easily overcome when the advantages of such examination are understood. it is likewise easy to prove to a teacher that the loss of time required in having the examination is infinitesimal compared with the loss of time due to ignoring physical needs. the programme for school hygiene outlined in chapter xxvii, part iv, assumes that state and county superintendents will provide for the examination of teachers as well as of pupils. [illustration: teachers will prefer physical examinations to forced vacations boston society for relief and study of tuberculosis] because the health of others furnishes a stronger motive for preventive hygiene than our own health, it is probable that the general examination of teachers will come first as the result of a general conviction that unhealthy teachers positively injure the health of pupils and retard their mental development. children at school age are so susceptible and imitative that their future habits of body and mind, their dispositions, their very voices and expressions, are influenced by those of their teachers. experts in child study say that a child's vocal chords respond to the voices and noise about him before he is able to speak, so that the tones of his voice are determined before he is able to express them. this influence is also marked when the child begins to talk. babies and young children instinctively do what adults learn not to do only by study,--follow the pitch of others' voices. can we then overestimate the effect upon pupils' character of teachers who radiate vitality? the character and fitness, aside from scholarship, of applicants for teachers' licenses are now subjected by the board of examiners of new york city to the following tests: . moral character as indicated in the record of the applicant as a student or teacher or in other occupation, or as a participant in an examination. . physical fitness for the position sought, reference being had here to all questions of physical fitness other than those covered in a physician's report as to "sound health." . satisfactory quality and use of voice. . personal bearing, cleanliness, appearance, manners. . self-command and power to win and hold the respect of teachers, school authorities, and the community. . capacity for school discipline, power to maintain order and to secure the willing obedience and the friendship of pupils. . business or executive ability,--power to comprehend and carry out and to accomplish prescribed work, school management as relating to adjustment of desks, lighting, heating, ventilation, cleanliness, and attractiveness of schoolroom. . capacity for supervision, for organization and administration of a school, and for the instructing, assisting, and inspiring of teachers. these tests probably exclude few applicants who should be admitted. experience proves that they include many who, for their own sake and for children's sake, should be rejected. the moral character, physical fitness, quality of voice, personal bearing, self-command, executive ability, capacity for supervision, are qualities that are modified by conditions. the voice that is satisfactory in conference with an examiner may be strident and irritating when the teacher is impatient or is trying to overcome street noises. on parade applicants are equally cleanly; this cannot be said of teachers in the service, coming from different home environments. self-command is much easier in one school than in another. physical fitness in a girl of twenty may, during one short year of teaching, give way to physical unfitness. therefore the need for _periodic tests_ by principal, superintendent, and school board, _to determine the continuing fitness_ of a teacher to do the special task assigned to her, based upon physical evidence of her own vitality and of her favorable influence upon her pupils' health and enjoyment of school life. shattered nerves due to overwork may explain a teacher's shouting: "you are a dirty boy. your mother is a dirty woman and keeps a dirty store where no decent people will go to buy." a physical examination of that unfortunate teacher would probably show that she ought to be on leave of absence, rather than, by her overwork and loss of control, to cause the boys of her class to feel what one of them expressed: "grandmother, if she spoke so of my mother i would strike her." just as there should be a central bureau to count and correct the open mouths and closed minds that clog the little old red schoolhouse of the country, so a central bureau should discover in the city teacher as well as in the country teacher the ailments more serious than tuberculosis that pass from teacher to pupil; slovenliness, ugly temper, frowning, crossness, lack of ambition, cynicism,--these should be blackballed as well as consumption, contagious morphine habit, and contagious skin disease. crooked thinking by teacher leads to crooked thinking by pupil. disregard of health laws by teacher encourages unhygienic living by pupils. a man whose fingers are yellow, nerves shaky, eyes unsteady, and mind alternately sleepy and hilarious from cigarettes, cannot convey pictures of normal, healthy physical living, nor can he successfully teach the moral and social evils of nicotinism. both teacher and pupil have a right to the periodic physical examination of teachers that will give timely warning of attention needed. until there is some system for giving this right to all teachers in private, parochial, charitable, and public schools, we shall produce many nervous, acrid, and physically threadbare teachers, where we should have only teachers who inspire their pupils with a passion for health by the example of a good complexion, sprightly step, bounding vitality, and forceful personality born of hygienic living. part iii. coÖperation in meeting health obligations chapter xvi european remedies: doing things at school recently i traveled five hundred miles to address an audience on methods of fitting health remedies to local health needs. i told of certain dangers to be avoided, of results that had always followed certain remedies, of motives to be sought and used, of community ends to seek. not knowing the local situation, i could not tell them exactly what to do next, or how or with whom to do it; not seeing the patient or his symptoms, i did not diagnose the disease or prescribe medicine. several members of the audience who were particularly anxious to start a new organization on a metropolitan model were disappointed because they were told, not just how to organize, but rather how to find out what sort of organization their town needed. they were right in believing that it was easier to copy on paper a plan tried somewhere else, than to think out a plan for themselves. they had forgotten for the time being their many previous disappointments due to copying without question some plan of social work, just as they copy paris or new york fashions. they had not expected to leave this meeting with the conviction that while the _ends_ of sanitary administration may be the same in ten communities, health _machinery_ should fit a particular community like a tailor-made suit. american-like, they had a mania for organization. i once heard an aged kindergartner--the savant of an isolated german village--describe my fellow-americans as follows: "every american belongs to some organization. the total abstainers are organized, the brewers are organized, the teachers are organized, the parents are organized, the young people and even the juniors are organized. finally, those who belong to no organization go off by themselves and organize a society of the unorganized." love of organization and love of copying have given us americans a feverish desire for what we see or read about in europe. when we talk about our european remedies we try to make ourselves believe that we are broad-minded and want to learn from others' experience. in a large number of cases our impatient demand for european remedies is similar to the schoolboy's desire to show off the manners, the slang, or the clothes picked up on his first visit away from home. with many travelers and readers european remedies or european ways are souvenirs of a pleasant visit, to be described like a collection of postal cards, a curious umbrella, a cane associated with alpine climbing, or a stolen hymnal from an historic cathedral. experience proves, however, that just as roman walls and norman castles look out of place in new york and kansas, so european laws and european remedies are too frequently misfits when tried by american schools, hospitals, or city governments. yesterday a canadian clergyman, after preaching an eloquent sermon, met a professional beggar on the street in new york city and emptied his purse--of canadian money! quite like this is the enthusiastic demand of the tourist who has seen or read about "the way it's done in germany." the trouble is that european remedies are valued like ruins, by their power to interest, by their antiquity or picturesqueness, or, like the beggar, by their power to stimulate temporary emotion. but we do not sleep in ruins, go to church regularly in thirteenth-century abbeys, or live under the remedies that fire our imagination. we do not therefore see their everyday, practical-result side. the souvenir value of european remedies is due to the assumption that no better way was open to the european, and that the remedy actually does what it is intended to do. because free meals are given at school to cure and prevent undernourishment, it is taken for granted that undernourishment stops when free meals are introduced; therefore america must have free meals. because it is made compulsory in a charming italian village for every child to eat the free school meal, it is taken for granted that the children of that village have no physical defects; therefore let kansas city, seattle, and boston introduce compulsory free meals. but when one goes to europe to see exactly how those much-advertised, eulogized remedies operate from day to day, it is often necessary to write, as did a great american sanitarian recently, of health administration in foreign cities continually held up as models to american cities: "in spite of the rules and theories over here, the patient has better care in new york city." we have been asked of late to copy several very attractive european remedies for the physiological ills of school children, and for the physical deficiencies of the next generation of adults: breakfasts or lunches, or both, at school for all children, rich as well as poor, whether they want school nourishment or not; school meals for the poor only; school meals to be given the poor, but to be bought by those who can afford the small sum required; free eyeglasses for the poor, for poor and well-to-do, for those who wish them, for those who need them whether they want to wear eyeglasses or not; free dental care; free surgical treatment; free rides and outings during summer and winter; country children to visit the metropolis, city children to visit country and village; free treatment in the country of all children whose parents are consumptives; free rides on street cars to and from school; city-owned street railways that will prevent congestion by making the country accessible; city-built tenements to prevent overcrowding, dark rooms, insufficient air and light; free coal, free clothes, free rent for those whose parents are unable to protect them properly against hunger and cold. every one of these remedies is attractive. every one is being tried somewhere, and can be justified on emotional, economic, and educational grounds, if we think only of its purpose. let us view them with the eyes of their advocates. would it not be nice for country children to know that toward the end of the school year they would be given an excursion to the largest city of their state, to its slums, its factories, parks, and art galleries? they would grow up more intelligent about geography. they would read history, politics, sociology, and civil government with greater interest. they would have less contracted sympathies. they might even decide that they would rather live their life in the spacious country than in the crowded, rushing city. city children, on the other hand, would reap worlds of physical benefit and untold inspiration from periods of recreation and study in the country, with its quiet, its greens and bronzes and yellows, its birds and animals, its sky that sits like a dome on the earth, its hopefulness. winter sleigh rides and coasting would give new vigor and ambition. why spend so much on teaching physiology, geography, and nature study, if in the end we fail to send the child where alone nature and hygiene tell their story? why tax ourselves to teach history and sociology and commercial geography out of books when excursions to the city and country will paint pictures on the mind that can never be erased? what more attractive or more reasonable than appetizing, warm meals, or cool salads and drinks for the boys and girls who carry their little dinner pails and baskets down the long road where everything runs together in summer and everything freezes in winter? one needs little imagination to see the "smile that won't come off," health, punctuality, and school interest resulting from the school meal. again, if children must have teeth filled and pulled, eyes tested and fitted for glasses, adenoids and enlarged tonsils removed, surely the school environment offers the least affrighting spot for the tragedy. thence goblins long ago fled. there courage, real or feigned, is brought to the surface by the anxious, critical, competitive interest of one's peers. [illustration: a south ireland argument for "doing things"] the economic defense of these remedies is many-sided. an english drummer once instructed me during a railroad journey from southern to northern ireland. as we entered the fertile fields of lord dunraven's estate near athlone, i expressed sympathy for other countries impoverished of soil, of wealth, and of thrift. my instructor replied: "it would pay the government to bring them all to this land free once a year, just to show them what they are missing." that his idea of an investment is sound has been proved by railroads and land companies and even by states, who give away excursions to entice settlers and buyers. ambition at almost any cost is cheaper than indifference to opportunity. it would be cheaper for our american taxpayer to send school children to city and country than to pay the penalty for having a large number of citizens with narrow interests, unconscious of the struggles and joys of their co-citizens. free meals, free books, free rides, free eyeglasses, are cheaper than free instruction for the second, third, and sixth terms in studies not passed because of physical defects,--infinitely cheaper than jails and almshouses, truant officers and courthouses. the demoralizing results of giving "something for nothing" did not follow free schooling or free text-books. perhaps they would not follow the free remedies that we are asked to copy from europe. in fact, the word "free" is the wrong word. these remedies rather require coöperation of parent with parent. it has demoralized nobody because the streets are cleaned by all of us, country roads made by the township, police paid for by taxes and not by volunteer subscription. the man whose children do not need glasses or nourishment or operation for adenoids would find it cheaper to pay for european remedies than for the useless schooling of boys unable to get along in school because of removable defects. an unruly, uninterested boy sitting beside your boy in public school, a pampered, overfed, undisciplined child sitting beside yours at private school, is taxing you without your consent and doing your child injury that may prove irreparable. it costs $ . to furnish a child with eyeglasses. it costs $ to $ to give that child a year's schooling. if the child cannot see right and fails in his studies, we have lost a good investment and, after one year so lost, we are out $ . . in two years we have lost $ . . but, what is more serious, we have discouraged that boy. used to failure in school, his mind turns to other things. he is made to think that it is useless for him to try for first place. perhaps he can play ball, and excels. he chooses a career of ball playing. valuable years are lost. initiative and competition are not interrupted any more by free eyeglasses and free operation for adenoids than by free schooling. there is only one place in the world where there is less competition or less struggle than among the ignorant, and that is among the ignorant and unwell. the boy who can't see the blackboard, who can't learn to spell, who can't breathe through his nose, and can't be interested, doesn't compete at all with the bright, healthy boy. remove the adenoids, give glasses, make interest possible, and fitness to survive takes a higher level because larger numbers become fit to survive. professor patten says that it is easier to support in the almshouse than in competitive industry a man who cannot earn more than $ . a day. the question, therefore, regarding european remedies is not, to what general theory do they belong? but, what will they accomplish? how do they compare with other remedies of which we know? chapter xvii american remedies: getting things done in new york city there is a committee called the committee on the physical welfare of school children. the word "welfare" was used rather than "condition" because the committee proposed to use whatever facts it could gather for the improvement of home and school conditions prejudicial to child welfare. the following programme was adopted: . _study of the physical welfare of school children._ a. examination of board of health records of children needing medical, dental, or ocular care, and better nourishment. b. home visitation of such children, in order to ascertain whether their need arises from deficient income or from other causes. c. effort to secure proper treatment, either from parents or from free clinics or other established agencies. d. effort to secure proper physical surroundings of children while at school--playgrounds, baths, etc. . _effort to secure establishment of such a system of school records and reports_ as will disclose automatically significant school facts,--e.g. regarding backward pupils, truancy, regularity of attendance, registered children not attending, sickness, physical defects, etc. . _effort to utilize available information regarding school needs_ so as to stimulate public interest and thus aid in securing adequate appropriations to meet school needs. the committee grew out of the discussion, in the year , of the following proposition: _to insure a race physically able to receive our vaunted free education, we must provide at school free meals, free eyeglasses, free medical and dental care._ thanks to the superintendent of schools of new york city, to robert hunter's _poverty_, to john spargo's _bitter cry of the children_, hundreds of thousands of american citizens were made to realize for the first time that a large proportion of our school children are in serious need of medical, dental, or ocular attention, or of better nourishment. because physicians, dentists, oculists, hospitals, dispensaries, relief agencies, had seemingly been unconscious of this serious state of affairs, they had no definite, constructive remedy to propose. their unpreparedness served to strengthen the arguments for the european method of _doing things_. france, germany, italy, england, had found it necessary to do things at school. arguing from their experience, it was only a matter of time when american cities must follow their example. why not, therefore, begin at once to deal radically with the situation and give school meals, school eyeglasses, etc.? those who organized the committee on the physical welfare of school children realized the danger of trying to settle so great a question with the little definite information then available. if _doing things at school_ were to be adopted as a principle and logically carried out, vast sums must be added to the present cost of the public school system. complications would arise with private and parochial schools, whose children might have quite as serious physical defects, even though not educated by public funds. it would be difficult to obtain proper rooms for medical and dental treatment and meals, and perhaps still more difficult to insure proper food, skilled oculists, dentists, surgeons, and physicians. no one was clear as to how the problem was to be solved by small cities and rural districts, whose needy children are no less entitled to public aid simply because their numbers are smaller. great as were the difficulties, however, the committee saw that difficulties are in themselves no reason for not doing the right thing. on the other hand, if doing things at school is wrong, if school meals fail to correct and remove physical defects, great social and educational wrong would result from new york's setting an example that would not only misdirect funds and attention in that city, but would undoubtedly lead other cities to move in the wrong direction. right could be hastened, wrong could be prevented more effectually by facts than by any amount of theory. school meals had been made a political issue in england. the arguments supporting them were stronger than any possible arguments against them, except proof that they would be less effective in helping children than other means that might be proposed. if the american people must choose between sickly, unteachable, dull children without school meals, on the one hand, and bright, teachable, healthy children plus school meals, on the other hand, they will not hesitate because of expense or eighteenth-century objections to "socialism." during one year of investigation and of _getting things done_ the committee has prepared three studies for publication: ( ) a report on the home conditions of fourteen hundred school children of different nationalities, found by school physicians to have defects of vision, breathing, hearing, teeth, and nourishment; ( ) an examination of fifty schools--curriculum, buildings, home-study requirements, play space and playtime, physical culture--in an attempt to answer the question, how far does school environment directly cause or aggravate physical defects of school children; ( ) a comparative study of methods now employed in a hundred cities to record, classify, and make public significant school facts. the results of the first year's work prove conclusively that physical defects are not caused solely by the inability of parents to pay for proper food. among the twenty significant facts reported by the committee are the following: . physical defects found in public schools are, for the most part, such as frequently occur in wealthy families and do not of themselves presume as the cause insufficient income. of reported for malnutrition, were from families having over $ weekly. . few of the defects can be corrected by nourishment alone; plenty of fresh air, outside nourishment at school, or extra nourishment at home will not entirely counteract the influences of bad ventilation and bad light in school buildings. country children have adenoids, bad teeth, and malnutrition. plenty of food will not prevent bad teeth and bad ventilation from causing adenoids, enlarged tonsils, and malnutrition. . children whose parents have long lived in the united states need attention quite as much as the recent immigrant. . a large part of the defects reported could be produced by conditions due directly to neglect of teeth. from twenty such statements of fact and from its experience in _getting things done_ for one year, the committee drew fifteen practical conclusions, among which the following deserve emphasis here: . the only new thing about the physical defects of school children is not their existence, but our recent awakening to their existence, their prevalence, their seriousness if neglected, and their cost to individual children, to school progress, to industry, and to social welfare. . _physical deterioration_, applied to america's school children, is a misnomer. no evidence whatever has been given that the percentage of children suffering from physical defects in is greater than the percentage of children suffering from such defects in . on the contrary, the small proportion of defects that are not easily removable, as well as a vast amount of evidence from medical experience and vital statistics, indicates that, if a comparison were possible, the children of would be found to have sounder bodies and fewer defects than their predecessors of fifty years ago. if there is an exception to this statement, it is probably defects of vision, with regard to which school authorities and oculists seem to agree that confinement in school for longer hours and more constant application under unfavorable lighting conditions have caused a marked increase. positive evidence as to tendencies will be easily obtained after thorough physical examination has been carried on for a generation. . the effect of massing facts as to physical defects of school children should not be to cause alarm, but to stimulate remedial and preventive measures, to invoke congratulations and aggressive optimism, not doleful pessimism and palliative measures born of despair. . the causes of physical defects are not confined to "marginal" incomes, but, while more apt to be present in families having small incomes, are found among all incomes wherever there exist bad ventilation, insufficient outdoor exercise, improper light, irregular eating, overeating, improper as well as insufficient food, lack of medical, dental, and ocular attention. . whatever may be said of free meals at school as a means of insuring punctual attendance or better attention, they are inadequate to correct physical conditions that home and street environment produce. . _to remove physical defects, causal conditions among all income classes should be treated, and not merely symptoms revealed at school by children of the so-called poor._ . parents can and will correct the greater part of the defects discovered by the physical examination of school children, if shown what steps to take. where parents refuse to do what can be proved to be within their power, and where existing laws are nonenforced or inadequate, the segregation of children having physical defects in special classes might prove an effective stimulus to obstinate parents. . where parents are unable to pay for medical, dental, and ocular care and proper nourishment, private philanthropy must either provide adequately or expect the state to step in and assume the duty. . private dispensaries and hospitals must either arrange themselves to treat cases and to educate communities as to the importance of detecting and correcting physical defects, or must expect the state to provide hospital and dispensary care. until private hospitals and dispensaries take steps to prevent people with adequate incomes from imposing upon them for free treatment, it is difficult to make out a case against free eyeglasses and free meals for school children. . either private philanthropy or the state must take steps to procure more dental clinics and an educational policy on the part of the dental profession that will prevent the exploitation of the poor when dental care is needed. . the united states bureau of education is the only agency with authority and equipment adequate to secure from all sections of the country proper attention to the subject. nothing in the world can prevent free meals, free eyeglasses, free medical care, free material relief at school, unless educational use is made by each community of the facts learned through physical examination to correct home, school, and street conditions that produce and aggravate physical defects. the national bureau can mass information in such a way as to convince budget makers in city, county, and state to vote gladly the funds necessary to promote the physical welfare of school children. [illustration: the dark-hall evil is here indexed by adenoids.] how the committee got things done is often referred to. there is something about a request for coöperation, whether by schools or by any other agency, that enlists the interest of those whose help is asked. the reason is not that people are flattered by requests to serve on committees, or that human nature finds it difficult to be unfriendly or unkind. on the contrary, men and women are by nature social; there is more joy in giving than in withholding, in working with others than in working alone. men and women, official and volunteer agencies, will coöperate with school-teachers when invited, for the same reason and with the same readiness that ninety-nine farmers out of a hundred, on the prairie or in the mountain, will welcome a request for food and lodging. [illustration: where "getting things done" is possible but "doing things" ineffective] mothers will naturally take a greater interest in the welfare of their children if held responsible for proper food and proper home surroundings than if not reminded of their responsibility. in new york city a woman district superintendent of schools, miss julia richman, has organized a unique "social settlement." she and several school-teachers occupy a house, known as "the teachers' house." this is their residence. here they are subject to neither intrusion nor importunity; no clubs or classes are held here; visitors are treated as guests, not as beneficiaries. the purpose these teachers have in living together is to work out the methods of interesting private and official leaders in community needs disclosed at school. where clubs and social gatherings are held in school buildings, it is not unusual for a thousand mothers, recent immigrants, to meet together in one hall to hear talks on the care of children. thus, instead of principals, teachers, and physicians taking the place of mothers (which they nowhere have succeeded in doing), they do succeed in harnessing mothers to the school programme. it may take two, three, or ten visits to get a particular mother to do the necessary thing for her child, but when once convinced and once inspired to do that thing, she will go on day in and day out doing the right thing for that child and for all others in her home. it may take a year to convert a police magistrate whose sympathy for delinquent parents and truant children is an active promoter of disorder; but a magistrate convinced, efficient, and interested is worth a hundred volunteer visitors. to get things done in this way for a hundred thousand children costs less in time and money than to do the necessary things for one thousand children. chapter xviii coÖperation with dispensaries and child-saving agencies scientists agree that the human brain is superior to the animal brain, not because it is heavier, but because it is finer and better supplied with nerves. as one writer has said, the human brain is better "wired," has better organized "centrals." a poor system of centrals will spoil a telephone service, no matter how many wires it provides. an independent wire is of little use, because it will not reach the person desired at the other end. the ideal system is that which almost instantly connects two persons, no matter how far away or how many other people are talking at the same time on other wires. the school that tries to do everything for its pupils without using other existing agencies for helping children[ ] will be like the man who refuses to connect his telephone with a central switch board, or like a bank that will not use the central clearing house. as one telephone center can enable scores of people to talk at once, and as one clearing house can make one check pay fifty debts, so hospital and relief agencies enable a teacher who employs "central" to help several times as many children as she alone can help. [illustration: adequate relief recognizes the family as the unit] it seems easier for a teacher to give twenty-five cents to a child in distress than to see that the cause of the misery is removed. in new york city there are over five hundred school principals, under them are over fifteen thousand teachers, and the average attendance of children is about six hundred thousand, representing one hundred and fifty thousand homes. if teachers give only to those children who ask for help, many will be neglected. in certain sections of the city principals have combined to establish a relief fund to be given out to children who need food, clothes, shoes, etc. one principal had to stop replacing stolen overcoats because, when it was known that he had a fund, an astonishingly large number of overcoats disappeared. at poughkeepsie school children get up parties, amateur vaudeville, minstrel shows, basket picnics, to obtain food and clothing for children in distress. they are, of course, unable to help parents or children not in school. of this method a district superintendent in new york said to his teachers and principals: "for thirty-two years i have been working in the schools of this district. i have given food and shoes to thousands of children. i know that however great our interest in a particular child when it comes to us with trouble at home, our duty as teachers prevents us from following our gift into the home and learning the cause of the child's trouble. this last winter we have made an experiment in using a central society, which makes it a business to find out what the family needs, to supply necessaries, country board, medicine, etc. we now know that we can put a slip of paper with the name and address of the child into a general hopper and it will come out eyeglasses, food, rent, vacation parties, as the need may be." relief at home through existing agencies was brought about by the distribution of cards like those on opposite page, which offer winter and summer coöperation. [illustration: fresh-air agencies like sea breeze prefer to aid children in order of need] [illustration: (facsimile of flyer for the new york association for improving the condition of the poor.)] +--------------------------------------------------------------------+ | =for school children= | | | | compulsory education implies the ability of all families, even the | | poorest, to take advantage of school benefits. this means that | | children should be fed properly, clad comfortably, and healthfully | | housed. | | | | the new york association for improving the condition of the poor | | aims to coöperate with school-teachers in every part of manhattan | | and the bronx to insure comfort and prevent suffering among school | | children, their parents, and younger brothers and sisters. on one | | day last winter we received appeals from school principals and | | teachers in behalf of twenty-nine families. within six hours every | | family was visited, emergent aid in food and coal provided for | | many, and orders given for shoes and dresses and coats required by | | the children of school age. during the winter we gave not only | | clothing, groceries, food, and rent, but found work for older boys | | and parents, taught mothers to prepare food properly, and sent a | | visiting cleaner to make sick mothers comfortable and to get the | | children ready for school. | | | | in a word, we followed that need, the surface evidence of which | | comes to the attention of the teacher, back into the home and its | | conditions, aiding throughout the period when the family was | | unable to do justice by the school child. | | | | in many instances the home income was sufficient, but the home | | management inefficient. probably such homes could be more | | effectively benefited through educational work emanating directly | | from the school. | | | | we can be reached by telephone ( , , and gramercy) from | | a.m. to m. letters or postal cards should be addressed to | | mrs. h. ingram, superintendent, east d street. reference | | slips will be gladly furnished upon application. | | | | the new york association for improving | | * the condition of the poor * | | | | =teachers of manhattan and the bronx= | | | | _do you know of such children as these:_ | | | | . convalescent children now out of school, who would be | | benefited by a stay at the seashore in may or june? | | | | . children in school whose anæmic condition would be | | greatly improved by a week at sea breeze during july or | | august? | | | | . small brothers and sisters (and tired mothers) who may | | need outings or special help? | | | | the new york association for improving the condition of the | | poor will act promptly. write or telephone ( gramercy). | +--------------------------------------------------------------------+ when these cards were first distributed several teachers went from room to room, asking children who needed help to raise the hand. in many cases parents were very angry that their children should have asked for help. but help given in instances like the following soon proved to teachers that they could afford the time necessary to notice children who appeared neglected, when so much good would ensue: the father is sick and unable to work. they cannot get clothes for the children, who are not attending school on that account. children were provided with shoes and clothes. november , , a school principal reported that six children in one family needed underwear. a visitor discovered that one of the boys who had the reputation of being unruly and light-fingered also had adenoids. he was taken to a hospital for operation, and was later interested in his school work. a little girl was unruly and truant. no attempt was made to keep her at school, but she was reported to the committee on the physical welfare of school children. the parents could not control her. the girl was taken for examination by a specialist and found to be feeble-minded. later she was sent to a custodial institute. another little girl was nine years old, but could not talk. a university extension society worker found that she was not kept at school because it was too much trouble. the child was taken to a physician who operated and corrected the tongue-tie. a girl of twelve said she must stay home to "help mother." the mother was found to be a janitress, temporarily incapacitated by rheumatism. a substitute was provided until the mother was well, and all the children were properly clad for school. after the adenoid operations in a new york school that occasioned the east side riots of , the physicians and principals who had persuaded parents to permit the operations were fearful lest the summer in unsanitary surroundings might make the demonstration less complete. over forty children in three parties were sent away for the summer, where they had wholesome food and all the milk they could drink and fresh air day and night. when they returned in the fall the principal wrote: "the improvement in each individual is simply marvelous. we shall try to continue this condition and shall constantly urge the parents to keep up the good work by means of proper food and fresh air." in none of these instances could the teachers have accomplished equal results for the individual children or for the families without neglecting school duties. by informing other agencies as to children's needs, teachers started movements that have since helped practically every school child in new york city. dispensaries are setting aside separate hours for school children; fresh-air agencies are giving preference to children found by teachers or school physicians to be in physical need; relief agencies are making "rush orders" of every note from teachers; the health board is more active because volunteer agencies have added their voice to that of teacher and health officer in demanding adequate funds for physical examination of school children. [illustration: "central" found the mother sick in a hospital, the father killed--the children were boarded in the country until the mother recovered] coöperation is at present easier in new york than in any other city. charitable societies, hospitals, dispensaries, are probably more keenly alive to their responsibilities and are at least more apt to have acquired the habit of coöperation when asked. yet even here i have been told repeatedly by teachers: "if we have to wait for that hospital or that charitable society, our children will go barefoot." in small communities where hospital and relief agencies are for emergencies only and generally inactive, it seems that the first thing to do is to ask some friends to establish a small relief fund, just as it is easier to give a child a five-cent meal than to teach its mother how to prepare its food. but the school-teacher will find that it takes very much less energy to arouse the relief society than to maintain her own relief work. in fact, in many cities nothing could do more to strengthen hospitals and charitable societies than to put them in touch with the needs of school children. for a principal to make known the fact that school children are neglected will help the charitable society and hospital to get the funds necessary to do their part better than they are now doing it and better than the school could ever do it. finally, one reason for a breakdown of charitable societies is not their own inadequacy, but rather the failure of the school and church to make use of an agency better equipped than themselves to give material relief. the teacher sees the child every day, while the relief society will never see it and has no reason to see it until some one calls attention to it. the very first step, and an indispensable one in relief policy, is for teachers to be on the lookout for children not adequately provided for, and then have the physical evidence discovered at school followed to the home for the cause of the child's distress. [illustration: home-to-home instruction in cooking anæmic condition of child due to bad cooking, not to lack of income] _coöperation_ removes the cause of distress; _doing_ may aggravate it. teachers would do well to draw up for themselves a chart which will show exactly what part of the community's work can be best done by their school. on the following page is charted the social work now being conducted at the massachusetts general hospital, boston. so far as agencies exist to deal with any individual or family problem coming into the social-work square, the hospital aims to utilize that agency. its own direct dealing with neurasthenics, with hygiene education, with sexual deviates, is primarily for the purpose of giving adequate treatment to the needy, and secondarily to demonstrate how adequate treatment should be organized for the community. please to note that governmental agencies are not mentioned in dr. cabot's chart. this does not mean that he would not emphasize the importance of those agencies, but that up to the present time, for the particular cases dealt with in his clinics, governmental agencies can be reached most effectively through the private charitable agencies in the reference square. so the teacher will frequently find that the relief bureau, children's society, public education association, or church can get better results for her pupils from public health and correctional agencies than can she by writing directly. [illustration: chart of social work, massachusetts general hospital] +-----------------------------------+ | _work for the tuberculous_ | | | | . tuberculosis classes | | . reference to other agencies | | . examination of children | | . stimulation of suburbs | +-----------------------------------+ | | | +--------------------------------+ | +--------------------------------+ | _psychiatric work_ | | | _work for hygienic conditions_ | | | | | | | . for neurasthenics and | | | . individual instruction | | hysterics | | | . convalescent homes | | . for defectives | | | . industrial hygiene | | . for stammerers | | | . home hygiene | | . for epileptics | | | | +--------------------------------+ | +--------------------------------+ \ | / \ | / \ | / \ | / \ | / \ | / \ | / +-----|-----+ | | /social work\ /| m.g.h. |\ / +---/|\-----+ \ / / | \ \ / / | \ \ / / | \ \ / / | \ \ +-------/-----|-----\-------\---+ | _references to other agencies_| | | /| . hospitals and sanatoriums | / | . associated charities |\ / | . societies for children | \ / | . district and visiting nurses| \ / | . settlements | \ / | . homes--temporary or not | \ / /| . employment agencies | \ / / +-------------|-----------------+ \ +------------/-----/----+ | +--\-------\----------+ | _ward work_ | | | | | | | | _work for | | . with cases soon to | | | cases of | | be discharged | | | varicose ulcer_ | | . cases needing | | | | | friendly offices | | | | +-------------/---------+ | +---------\-----------+ / | \ +-----------/-----------+ | +--------------\----------+ | _work for | | | _assistance to m.g.h._ | | sexual deviates_ | +---------|---------+ | financial investigation | | | | _assistance to | | | | . unmarried but | | other agencies_ | |(a) of cases asking free | | pregnant | | | | treatment | | . diseased | | . steering cases | |(b) of cases presumably | | . exposed | | . coöperation | | able to pay a physician | +-----------------------+ +-------------------+ +-------------------------+ in country districts no plan has yet been worked out for adequate relief. fortunately, however, the distress is generally of such a kind, and the teacher so well acquainted with all the parents of her district, that it will not be difficult to procure such attention as is necessary. country schools should be furnished by county and state superintendents with clear directions for getting the treatment afforded in the immediate vicinity. where teachers are alone in seeing the need for coöperation they can quickly interest young and old, physicians, dentists, pastors, health officers, in home visiting, street cleaning, nursing, helping truants, needed changes of curriculum, etc. _getting things done_ is easy because it is human to love the _doing_; getting things done is _doing_ of the highest order. footnotes: [ ] the importance of recognizing the family as the unit of social treatment is presented in edward t. devine's _principles of relief_, and in homer folks's _care of dependent, defective, and delinquent children_. chapter xix school surgery and relief objectionable, if avoidable the popular arguments for free meals, free relief, free medical treatment at school, are based upon the assumption that there are but two ways to travel, one leading to a physically sound, moral, teachable child, the other to an undernourished, subnormal, backward child. they tell us we must choose either school meals or malnutrition, school eyeglasses or defective vision, free coal or freezing poor, free rent or people sleeping on the streets, free dental clinics at school or indigestion and undernourishment, free operation at school for adenoids or backward, discouraged pupils. if there is no other alternative than neglect of the child, if we must either waste fifty dollars in giving a child education that he is physically unable to take, or pay two, three, four, or even fifty dollars to fit him for that education, the american people will not hesitate. whether there are other roads to healthy children, whether it is cheaper and better for the school to see that outside agencies prepare the child for education rather than itself to take the place of those outside agencies, is a question of fact, not of theory. facts prove, as we have seen, that there is more than one way to prevent malnutrition. parents can be taught to attend to their children; hospitals and dispensaries will furnish eyeglasses where parents are unable to pay for them; charitable societies will go back of the need for eyeglasses to the conditions that produce that need and will do vastly more for the child than can eyeglasses alone. if parents, hospitals, dispensaries, and charitable societies will attend to children's needs, then relief at school is unnecessary, even though it may seem desirable. the objection to school surgery should be clearly before us, so that we can judge of the two methods that are open to us,--_treatment at school_ vs. _treatment away from school_. society is so organized that the treatment of serious physical defects and social needs at school would upset the machinery a very great deal. for the school to do for its children whatever they may need during their school years will require the setting up of a miniature society in every school building or under every school board. unless schools are to equip themselves to take the place of all existing facilities for relief and surgery, children would not be so well taken care of as at present. it should not be forgotten that the physical welfare of the school child is the most accurate index to the physical needs of the community. after all, the child lives for six important years before coming to the school and leaves at the early age of fourteen or fifteen; even while attending school it sleeps at home and is influenced more by home and street standards of ventilation, cleanliness, and morality than by conditions at school. it would seem, therefore, the wider use of the school's influence to use the child's appeal to strengthen every agency having to do with community health, rather than to concentrate upon the child himself. if babies were properly cared for up to the sixth year, the protection of the school child's health would be infinitely easier. to take our eyes from the child not yet in school and from the child just out of school is to make the mistake that so many advocates of the child labor movement have made of going whither and only so far as our interest leads us and of not continuing until our work is accomplished. [illustration: "doing things" through model tenements] do we want to make of our schools miniature hospitals, dispensaries, relief bureaus, parks? or shall we use the momentum of society's interest in the school child to put within the reach of every school building adequate hospitals, dispensaries, relief centers, and parks for school child and adult? shall every little school have its library, or shall the child be taught at school how to use the same library that is available to his parents and older brothers and sisters? if the library is to be under the school roof, if dispensary and relief hospital are to be conducted on the same site as the school, shall they be known as dispensary, library, relief bureau, each under separate management, or shall they be known as school under the management of school principal and superintendent? so complicated and many-sided is the problem of working together with one's neighbor for mutual benefit that it is a safe rule for the schools to adopt: _we shall do nothing that is unnecessary or extravagant. we shall have done our part if we do well what no one else can do. whatever any agency can do better than we, we shall leave to that agency. work that another agency ought to have done and has left undone, we shall try to have done by that agency._ [illustration: immediately opposite the model tenements, but uninfluenced "getting things done" by the tenement house department their special need] i know a hospital where a welfare nurse was recently employed. within a few blocks were three different relief agencies and two visiting-nurse's associations, having among them over one hundred visitors and nurses going to all sections of manhattan. this nurse had the choice of telephoning to one of these agencies and asking it to call at the needy home of one of her hospital patients, or of going to the home herself. had she chosen to use another agency, she could have been the means of furnishing the kind of help needed in every needy home discovered in her hospital rounds, but she chose to do the running about herself and thus of helping ten families where she ought to have helped five hundred. much the same condition confronts the school that tries to do all extra work for its child instead of seeing that the work is done. illustration is afforded by the new york tenement department. whereas european cities have built a few model tenements, new york city secured a law declaring that everybody who built a tenement and everybody who owned a tenement should provide sanitary surroundings. at the present time a philanthropist, by spending two million dollars, could give sanitary surroundings to thirty-five families; by spending each year the interest on one tenth that sum he could insure the enforcement of the tenement laws affecting every tenement resident in new york city. if schools are to perform surgical operations, they are in danger of being sued for malpractice; discipline will be interfered with. finally, let us not forget that we are dealing with buildings, teachers, and school institutions as they exist. where education is made compulsory, the unpleasant and the controversial should be kept out of school. because a democratic institution, the american school should represent at all times a maximum of general agreement. to take _palliative measures to public schools_ not only _leaves undone remedial_ work necessary for the health of public school children but _neglects entirely the still large numbers who go to parochial, private pay, and private free schools_; no one has had the temerity to suggest that the public shall force upon nonpublic schools a system of free operations, free eyeglasses, free meals. civilization has painstakingly developed a large number of agencies for the education and protection of mankind. of these agencies the school is but one. its first and peculiar function is _to teach and to train_. this it can do better than any other agency or combination of agencies. in attempting to "bring all life under the school roof," we use but a small part of our resources. instead of persuading each of the agencies for the promotion of health to do its part for school children, we set up the school in competition with them. thus in trying to _do things_ for school children we are in danger of crippling agencies equipped to do things for both school children and their parents, for babies before they come to school, and for wage earners after they leave school. _getting things done_ will lead schools to study underlying causes; _doing things_ has heretofore caused schools to confine themselves to symptoms. _getting things done_ will leave the school free to concentrate its attention upon school problems; _doing things_ will lead it afield into the problem of medicine, surgery, restaurant keeping, and practical charity. chapter xx physical examination for working papers there is no sacred right to work when our work involves injury to ourselves and to our neighbor. work at the expense of health is an unjustifiable tax upon the state. it is the duty of society to protect itself against such depletion of national efficiency. three classes of workmen need special attention: ( ) those who are physically unfit to work; ( ) those who are physically unfitted for the work they are doing; ( ) those who are subjected to unhealthful surroundings while at work. viewing these three classes from the standpoint of their neighbors, we have three social rights that should be enforced by law: ( ) the right to freedom from unhealthy work; ( ) the right to work fitted to the body; ( ) the right to healthy surroundings at work. it is undoubtedly true that just as the sick child may be found at the head of his class, so unhealthy men and women are often good business managers, good salesmen, good typewriters, successful capitalists. they excel, however, not because of their ill health, but in spite of it, excepting of course those instances where men and women, because of ill health, have devoted to business an attention that would have been given to recreation if bad health had not deprived recreation of its pleasure. as statistics in school have proved that the majority of mentally superior children are also physically superior, so statistics will probably prove that the number of the "sick superior" among the working classes is very small, while the danger of inefficiency that comes from physical defect is very great. there is one time in the individual's working life when the state may properly step in and demand an inventory of physical resources, and that is when the child asks the state for permission to go to work. strategically, this is probably the most important of all contact as yet provided between society and the future wage earner. here at the threshold of his industrial career the boy may be told for what work he is physically fitted, what physical defects need to be remedied, what physical precautions he needs to take, in order to do justice to himself and his opportunity. every year from two to three million children leave the public schools of this country to join the army of workers. the percentage of those recruits who have physical defects needing attention is undoubtedly great; how great we shall never know until the benefits of physical examination are given to all of them. what steps is your state taking to ascertain the physical fitness of the children who present themselves each year for working papers? how does it insure itself against the risk of their defective eyesight, chorea, deafness, or general debility? does it inform children of their defects, or tell them how they may increase their earning power by correcting these defects? what effort does it make to induce children to avoid dangerous trades, or trades that are particularly dangerous for their physiques? at the close of school last spring i had my secretary look in upon the new york board of health and see what demands that city makes upon its boys and girls before allowing them to drive its machinery, to run its elevators, to match its colors, to sew on its buttons, to set its type, to carry its checks to the bank. the officer at the door of the room where the children were being examined, greeted her as follows: "you must bring your child with you; bring his birth certificate or swear that he is fourteen years old, and bring a signed statement from his teacher that he has been in school for one hundred and thirty consecutive days within twelve months." "is there no physical examination or test?" she asked. "no, no," he answered impatiently. yet the board of health certifies that "said child has in our opinion reached the normal development of a child of its age, and is in sound health and is physically able to perform the work which it intends to do." in addition the blank calls for place and date of birth, color of hair and of eyes, height, weight, and facial marks. volunteer societies in practically every state in the union have been working for years to have it made a criminal offense to employ a child who has not been in school a minimum of days after a stated age ( , , , ). even in new york, however, the center of this agitation, no strong demand was made upon the board of health to apply a physical-fitness test as well as an age test until when examination for working papers was added to the programme for child hygiene. yet who does not know girls and boys of sixteen less fit for factory or shop work than other boys and girls of twelve? it is the fetich of age which has made possible the "democracy" that permits a child of fourteen to work all day on condition that he go to school at night! [illustration: children enlisting in the industrial army] [illustration: waiting to be examined for working papers an excellent opportunity for physical-fitness tests] so great is the risk of defective, sickly, or intemperate employees, that in some trades employers take every precaution to exclude them. one man with defective eyesight or unsteady nerves may cost a railroad thousands of dollars. as insurance companies rank trades as first-, second-, or third-class risks, so many factories, from long experience, debar men with certain characteristics which have been found detrimental to business. the interborough rapid transit company of new york city examines all applicants for employment, as to age, weight, height, keenness of vision, hearing, color perception, lungs, hearts, arteries, alcoholism, and nicotinism. those who fall below the standard are rejected, but in each case the physical condition is explained to the applicant. where defects are removable or correctable, the applicant is told what to do and invited to take another test after treatment. moreover, accepted employees are periodically reëxamined. while designed to increase company profits and to reduce company losses, this examination obviously decreases the employees' losses also, and increases the certainty of work and prospect of promotion. our states, and many of our industries, still have the attitude of a certain manufacturer who employs several hundred boys and girls. i asked him what tests he employed. "i look over a long line of the applicants and say," pointing his finger, "i want you, and you, and you; the rest may go." i asked him if he made a point of picking out those who looked strong. "no. the work is easy, sitting down all day long and picking over things. i select those whose faces i like. yes, there is one question we now ask of all the girls. one day a girl in the workroom had an epileptic fit and it frightened everybody and upset the work so that the foreman always asks, 'do you have fits? because if you do, you can't work here.'" he makes no attempt to determine the physical fitness and endurance of the children employed, because when the strength of one is spent there is always another to step into her place. because the apprentice's future is of no value to the manufacturer, the state must restrict the manufacturer's freedom to spend like water society's capital,--the health of the coming generation. could there be a grosser mis-management of society's business than to permit trade to waste children on whose education society spends so many millions yearly? the most effective and most timely remedy is physical examination as a condition of the work certificate. a simple, easily applied, inexpensive measure that imposes only a legitimate restriction upon individual freedom, it is absolutely necessary in order to get to the bottom of the child labor problem. if thoroughly applied, children of the nation will no longer be exploited by unscrupulous or indifferent employers, nor will their health be hazarded by lack of discriminating examination that rejects the obviously sick and favors the apparently robust. furthermore, knowledge that this test will be applied when work certificates are required, will be an incentive to the school boy and girl to keep well. tell a boy that adenoids or weak lungs will keep him from getting a job, and you will make him a strong advocate of operation and of fresh air. show him that his employers will not wish his services when his week is out if he is physically below par, and he will gladly submit to a board of health examination and ask to be told what his defects are and how to correct them. [illustration: children at work below both age limit and vitality limit national child labor committee] some there are who will object to this appeal to the child's economic instinct. this objection does not remove the instinct. the normal child is greedy for a job. his greed, as well as that of the manufacturer and parent, is responsible for much of the child labor; his greed for activity, for association, for money, and so for work. a little boy came into my office and wanted to hire as an office boy. i looked at him and said: "my little fellow, you ought to be in school. what do you want to hire out here for?" he said, "i am tired of school; nothing doing." he doesn't care about work for its own sake; he doesn't care about wealth for its own sake; he wants to get into life; to be where there is "something doing." in this lies one potent argument for vocational training. to tell a boy of his physical needs just before he has taken his first business step is to put him everlastingly in our debt. then he is responsive, and, fortunately for the extreme cases, necessarily dependent, for he knows that his refusal would stand between himself and his ambition. when boys and girls go for work certificates to dr. goler, medical officer of health at rochester, he requires not merely evidence of age and of schooling, but examines their eyes for defective vision and for disease, their teeth for cavities and unhealthy gums, and their noses and throats for adenoids and enlarged tonsils. if a boy has sixteen decayed teeth, dr. goler explains to him that teeth are meant to be not only ornaments and conveniences, but money getters as well. the boy learns that decayed teeth breed disease, contaminate food, interfere with digestion, make him a disagreeable companion and a less efficient worker. if he will go and have them put into proper condition he will enjoy life better and earn good wages sooner. after the teeth are attended to the boy secures his work certificate. if the boy's mother protests in tears or in anger that her boy does not work with his teeth, she learns what she never learned at school, that sound teeth help pay the rent. if a girl applicant for working papers has adenoids, she is asked to look in the mirror and to notice how her lips fail to meet, how the lower jaw drops, how much better she looks with her jaws and lips together. she is told that other people breathe through the nose, and that perhaps the reason she dislikes school and does not feel as she used to about play is that she cannot breathe through her nose as she used to. she is shown that her nose is stopped up by a spongy substance, as big as the end of her little finger, which obstruction can be easily removed. she is shown adenoids and enlarged tonsils that have been removed from some other girl, and is so impressed with the before-operation and after-operation contrast and by the story of the other girl's rapid increase in wages, that she and her mother both decide not to wait for the adenoids to disappear by absorption. after the operation they come back with proof that the trouble is gone, and get the "papers." similar instruction is given when defects of vision seriously interfere with a child's prospects of getting ahead in his work, or when evidence of incipient tuberculosis makes it criminal to put a child in a store or factory. [illustration: the grenfell association finds mouth breathers at work in labrador] no law as yet authorizes the health officer of rochester to refuse work certificates to children physically unfit to become wage earners. a higher law than that which any legislature can pass or revoke, has given dr. goler power over children and parents, namely, interest in children and knowledge of the industrial handicap that results from physical defects. this higher law authorizes every health officer in the united states to examine the school child before issuing a work certificate, to tell the child and his parents what defects need to be removed, for what trades he is physically unfitted, what trades will not increase his physical weakness, and to what trade he is physically adapted. we should not forget that a large proportion of our children never apply for work certificates; some because they never intend to work; some because they expect to remain in school until sixteen or later; some because they live on farms, in small towns, or in cities and states where prohibition of child labor is not enforced. because there is no reason for this large proportion of children to visit a board of health, some substitute must be found. this substitute has been already suggested by principals and district superintendents in new york city, who claim that the natural place for the examination of children is the school and not health headquarters. developing the idea that the school should pronounce the child's fitness to leave school and to engage in work, we are led to the suggestion that the state, which compels evidence that every child, rich or poor, is being taught during the compulsory school age, shall also at the age of fourteen or sixteen require evidence that the child is physically fit to use his education, and that it shall not, because of preventable ill health, prove a losing investment. parochial and private schools, the ultra-religious and ultra-rich, may resent for a time public supervision of the physical condition of children who do not ask for work certificates. this position will be short-lived, because however much we may disagree about society's right to control a child's act after his physical defects are discovered, few of us will question the state's duty to tell that child and his parents the truth about his physical needs before it accepts his labor or permits him to go to college, to "come out," to "enter society," or to live on an income provided by others. thus an invaluable commencement present can be given by the state to children in country schools and to those compelled to drop out of fourth or fifth grades of city schools. [illustration: the health department's clinical care and home instruction come after wage losses, while work certificates precede breakdowns from tuberculosis] a brief test of this method of helping children, such as is now being made by several boards of health at the instance of the national bureau of labor, will prove conclusively that parents are grateful for the timely discovery of these defects which handicap because of their existence, not because of their discovery. of the cadets preparing for war at west point, it has recently been decided that those "who in the physical examinations are found to have deteriorated below the prescribed physical standard will be dropped from the rolls of the academy." shall not cadets preparing for an industrial life and citizenship be given at least a knowledge of an adequate physical standard? to allow the school child to deteriorate whether before or after going to work is only to waste potential citizenship. citizens who use themselves up in the mere getting of a living have no surplus strength or interest for overcoming incompetence in civic business, or for achieving the highest aim of citizenship,--the art of self-government for the benefit of all the governed. chapter xxi periodical physical examination after school age governor hughes, in his address to the students in gettysburg college, pleaded for such lives that strength would be left for the years of achievement. how many men and women can you count who are squandering their health bank account? how many do you know who are now physically bankrupt? the man who is prodigal of his health may work along all right for years, never realizing until the test comes that he is running behind in his vitality. the test may be hard times, promotion, exposure to cold, heat, fever, or a sudden call for all his control in avoiding accident. if his vitality fails to stand the test, his career may be ruined, "all for the want of a horseshoe nail": because of no health bank account to draw upon in time of need,--failure; because of vitality depleted by alcohol, tobacco, overeating, underexercise, or too little sleep,--no power to resist contagious diseases; because of ignorance of existing lung trouble,--a year or more of idleness, perhaps poverty for his family; or there is neglected ear or eye trouble,--and thousands of lives may be lost because the engineer failed to read the signals. adults are now examined when applying for insurance or accident policies, for work on railroads, for service in the army and on the police and fire forces of cities that provide pensions. it is somewhat surprising that the hundreds of thousands who carry life insurance policies have not realized that a test which is rigorously imposed for business reasons by insurance companies can be applied by individuals for business reasons. generations hence the state will probably require of every person periodic physical examination after school age. decades hence business enterprises will undoubtedly require evidence of health and vitality from employees before and during employment, just as schools will require such evidence from teachers. it is, after all, but a step from the police passport to the health passport. why should we not protect ourselves against enemies to health and efficiency as well as against enemies to order? but for the present we must rely upon the intelligence of individuals to recognize the advantage to themselves, their families, and their employers, of knowing that their bodies do not harbor hidden enemies of vitality and efficiency. from a semi-annual examination of teeth to a semi-annual physical examination is but a short step when once its effectiveness is seen by a few in each community. [illustration: the old southfield, now anchored at bellevue hospital's dock, new york city, gives daily lessons in the preventable tax levied by tuberculosis] ignorance of one's physical condition is a luxury no one can afford. no society is rich enough to afford members ignorant of physical weaknesses prejudicial to others' health and efficiency. every one of us, even though to all appearances physically normal, needs the biological engineer. new conditions come upon us with terrific rapidity. the rush of work, noise, dust, heat, and overcrowding of modern industry make it important to have positive evidence that we have successfully adapted ourselves to these new conditions. only by measuring the effects of these environmental forces upon our bodies can we prevent some trifling physical flaw from developing into a chronic or acute condition. as labor becomes more and more highly specialized, the body of the laborer is forced to readapt itself. the kind of work a man does determines which organs shall claim more than their share of blood and energy. the man who sets type develops keenness of vision and manual dexterity. the stoker develops the muscles of his arms and back, the engineer alertness of eye and ear. all sorts of devices have been invented to aid this specialization of particular organs, as well as to correct their imperfections: the magnifying glass, the telescope, the microscope, extend the powers of the eye; the spectacle or an operation on the eye muscles enables the defective eye to do normal work. a man with astigmatism might be a policeman all his life, win promotion, and die ignorant of his defect; whereas if the same man had become a chauffeur, he might have killed himself and his employer the first year, or, if an accountant, he might have been a chronic dyspeptic from long-continued eye strain. it is a soul tragedy for a man to attempt a career for which he is physically unadapted.[ ] it is a social tragedy when men and women squander their health. a great deal of the success attributed to luck and opportunity, or unusual mental endowment, is in reality due to a chance compatibility of work with physique. to secure such compatibility is the purpose of physical examination after school age. if the periodic visit to the doctor is the first law of adult health, still more imperative is the law that competent physicians should be seen at the first indication of ill health. even when competent physicians are at hand, parents and teachers should be taught what warning signs may mean and what steps should be taken. in germany insurance companies find that it saves money to provide free medical and dental care for the insured. department stores, many factories and railroads, have learned from experience that they save money by inducing their employees to consult skilled physicians at the first sign of physical disorder. many colleges, schools, and "homes" have a resident physician. wherever any large number of people are assembled together,--in a hotel, factory, store, ship, college, or school,--there should be an efficient consulting physician at hand. if people are needlessly alarmed, it is of the utmost importance to show them that there is nothing seriously wrong. therefore visits to the consulting physician should be encouraged. the reader's observation will suggest numerous illustrations of pain, prolonged sickness, loss of life, that could have been prevented had the physician been semi-annually visited. a strong man, well educated, with large income, personally acquainted with several of the foremost physicians of new york city, after suffering two weeks from pains "that would pass away," was hurriedly taken to a hospital at three o'clock in the morning, operated upon immediately, and died at nine. a business man of means put off going to a physician for fifteen years, for fear he would be told that his throat trouble was tobacco cancer, or incipient tuberculosis, or asthma; a physical examination showed that a difficulty of breathing and chronic throat trouble were due to a growth in the nose, corrected in a few minutes by operation. a celebrated economist was forced to give up academic work, and consecrated his life to painful and chronic dyspepsia because of eye trouble detected upon the first physical examination. a woman secretary suffered from alleged heart trouble; paralysis threatened, continuous headache and blurred vision forced her to give up work and income; a physical examination found the cause in nasal growths, whose removal restored normal conditions. a woman lecturer on children's health heard described last summer a friend's experience with receding gums: "'why, i never heard of that disease.' she said. 'don't you know you have it yourself'? i asked. she had never noticed that her gums were growing away in little points on her front teeth. i touched the uncovered portion and she winced. that ignorance has meant intense pain and ugly fillings. if it had gone longer, it might have meant the loss of her front teeth." a teacher lost a month from nervous prostration; physical examination would have discovered the eye trouble that deranged the stomach and produced the nerve-racking shingles which forced him to take a month's vacation. a journalist lost weeks each year because of strained ankles; since being told that he had flat foot, and that the arch of his foot could be strengthened by braces and specially made shoes, he has not lost a minute. a relief visitor, ardent advocate of the fresh-air, pure-milk treatment for tuberculosis, had a "little cough" and an occasional "cold sweat"; medical friends knew this, but humored her aversion to examination; when too late, she submitted to an examination and to the treatment which, if taken earlier, would most certainly have cured her. a mother's sickness cost a wage-earning daughter nearly $ ; softening of the brain was feared; after six years of suffering and unnecessary expense, physical examination disclosed an easily removable cause, and for two years she has contributed to the family income instead of exhausting it. untold suffering is saved many a mother by knowledge of her special physical need in advance of her baby's birth. untold suffering might be saved many a woman in business if she could be told in what respects she was transgressing nature's law. [illustration: new york city's tuberculosis sanatorium at otisville is sending home apostles of semi-annual examinations] [illustration: boston's picturesque day camp for tuberculosis patients is teaching the need for a periodic inventory of physical resources] to encourage periodic physical examination is not to encourage morbid thinking of disease. one reason for our tardiness in recognizing the need for thorough physical examination is the doctor's tradition of treating symptoms. after men and women are intelligent enough to demand an inventory of their physical resources,--a balance sheet of their physical assets and liabilities,--physicians will study the whole man and not the fraction of a man in which they happen to be specializing or about which the patient worries. by removing the mystery of bodily ailments and by familiarizing ourselves with the essentials to healthy living, we find protection against charlatans, quacks, faddists, and experimenters. by taking a periodic inventory of our physical resources we discharge a sacred obligation of citizenship. footnotes: [ ] see _dangerous trades_, compiled by thomas oliver; also list of reports by the united states bureau of labor. chapter xxii habits of health promote industrial efficiency education's highest aim is to train us to do the right thing at the right moment without having to think. the technic of musician, stenographer, artist, electrician, surgeon, orator, is gained only from patient training of the body's reflex muscles to do brain work.[ ] the lower nerve centers are storehouses for the brain energy, just as central power houses are used for storing electric energy to be spent upon demand. from habit, not from mental effort, we turn to the right, say "i beg pardon" when we step on another's foot, give our seats to ladies or to elderly persons, use acceptable table manners. no person seems "to the manner born" who has to think out each act necessary to "company manners." how numerous are the mental and physical processes essential to good manners no one ever recognizes but the very bashful or the uncouth person trying to cultivate habits of unconsciousness in polite society. the habit of living ethically enables us to go through life without being tempted to steal or lie or do physical violence. no person's morals can be relied upon who is tempted constantly to do immoral acts; ethical training seeks to incapacitate us for committing unethical deeds and to habituate us to ethical acts alone. eight different elements of industrial efficiency are concerned with the individual's health habits,--the industrial worker, his industrial product, his employer, his employer's profit, his trade or profession, its product, his nation, national product. obviously few men have so little to do that they have time to think out in detail how this act or that indulgence will affect each of these eight factors of industrial efficiency. once convinced, however, that all of these elements are either helped or injured by the individual's method of living, each one of us has a strong reason for imposing habits of health upon all industries, upon employees and operatives, upon all who are a part of industrial efficiency. when these eight relations are seen, parents and teachers have particularly strong reasons for inculcating habits of health in their children. that industrial inefficiency results from chronic habits of unhealthy living is generally recognized. the alcoholic furnishes the most vivid illustration. the penalties suffered by him and his family are grave enough, but because he has not full possession of his faculties he is unpunctual, wastes material, disobeys instructions, endangers others' lives, decreases the product of his trade and of his employer, lessens the profits of both, depresses wages, increases insurance and business risks. because no one can foresee when the "drop too much" will be taken, industry finds it important to know that the habit of drinking alcoholics moderately has not been acquired by train dispatcher, engineer, switchman, chauffeur. because the habit of drinking moderately is apt, among lower incomes, to go hand in hand with other habits injurious to business and fatal to integrity, positions of trust in industry seek men and women who have the habit of declining drink. in the aggregate, milder forms of unhealthy living interfere with industrial efficiency even more than alcoholism. many capable men and women, even those who have had thorough technical training, fail to win promotion because their persons are not clean, their breath offensive, their clothes suggestive of disorderly, uncleanly habits. persons of extraordinary capacity not infrequently achieve only mediocre results because they fail to cultivate habits of cleanliness and health. an employer can easily protect his business from loss due to alcoholism among his own employees; but loss through employees' constipation, headache, bad ventilation at home, irregular meals, improper diet, too many night parties, nicotinism, personal uncleanliness, is loss much harder to anticipate and avoid. because evil results are less vivid, it is also hard to convince a clerk that intemperance in eating, sleeping, and playing will interfere with his earning capacity and his enjoyment capacity quite as surely as intemperance in the use of alcohol and nicotine. where employees are paid by the piece, instead of by the hour, day, or week, the employer partially protects himself against uneven, sluggish, slipshod workmen; but, other things being equal, he awards promotion to those who are most regular and who are most often at their best, for he finds that the man who does not "slump" earns best profits and deserves highest pay. [illustration: these patients on the old southfield are taxing their unions and their trades as well as their families and the tuberculosis committee] there are exceptions, it is true, where both industrial promotion and industrial efficiency are won by people who violate laws of health,--but at what cost to their efficiency? your efficiency should be measured not by some other person's advancement, but by what you yourself ought to accomplish; while the effect of abusing your physical strength is shown not only in the shortening of your industrial life and in the diminishing returns from your labor, but by the decrease of national and trade efficiency. "sweating" injures those who buy and those in the same trade who are not "sweated" just as truly as it injures the "sweated." [illustration: habits of health among dairymen mean safe milk for babies] what are the health habits that should become instinctive and effortless for every worker? what acts can we make our lower nerve centers--our subconscious selves--do for us or remind us to do? the following constitutes a daily routine that should be as involuntary as the process of digestion: . throw the bedding over the foot of the bed. . close the window that has been open during the night. . drink a glass of water. . bathe the face, neck, crotch, chest, armpits (finishing if not beginning with cold water), and particularly the eyes, ears, and nose. if time and conveniences permit, bathe all over. . cleanse the finger nails. . cleanse the teeth, especially the places that are out of sight and hard to reach. . breakfast punctually at a regular hour. eat lightly and only what agrees with you. if you read a morning paper, be interested in news items that have to do with personal and community vitality. . visit the toilet; if impracticable at home, have a regular time at business. . have several minutes in the open air, preferably walking. . be punctual at work. . as your right by contract, insist upon a supply of fresh air for your workroom with the same emphasis you use in demanding sufficient heat in zero weather. . eat punctually at noon intermission; enjoy your meal and its after effects. . breathe air out of doors a few minutes, preferably walking. . resume business punctually. . stop work regularly. . take out-of-door exercise--indoor only when fresh air is possible--that you enjoy and that agrees with you. . be regular, temperate, and leisurely in eating the evening meal; eat nothing that disagrees with you. . spend the evening profitably and pleasantly and in ways compatible with the foregoing habits. . retire regularly at a fixed hour, making up for irregularity by an earlier hour next night. , , . repeat , , . . turn underclothes wrong side out for ventilation. . open windows. . relax mind and body and go to sleep. no man chronically neglects any one of the above rules without reducing his industrial efficiency. no man chronically neglects all of them without becoming, sooner or later, a health bankrupt. in addition to this daily routine, there are certain other acts that should become habitual: . bathing less frequently than once a week is almost as dangerous to health as it is to attractiveness. . distaste for unclean linen or undergarments and for acts or foods that interfere with vitality should become instinctive. . excesses in eating or playing should be automatically corrected the next day and the next. parties we shall continue to have. it will be some time before reasonable hours and reasonable refreshments will prevail. meanwhile it is probably better for an individual to sacrifice somewhat his own vitality for the sake of the union, the class, or the church. while trying to improve group habits, one can acquire the habit of not eating three meals in one, of eating less next day, of sleeping longer next night, of being particularly careful to have plenty of outdoor air. . visits to the dentist twice a year at least, and whenever a cavity appears, even if only a week after the dentist has failed to find one; whenever the gums begin to recede; and whenever anything seems to be wrong with the teeth. . periodic physical examination by a physician. . examination by a competent physician whenever any disorder cannot be satisfactorily explained by violation of the daily routine or by interruption of business or domestic routine. health habits do not become instinctive until a continued, conscious effort is made to accustom the body to them. when this is once done, however, the body not only attends to its primary health needs automatically, but it rebels at their omission, as surely as does the stomach at the omission of dinner. witness the discomfort of the consumptive, trained to fresh air at a sanatorium, when he returns to his overheated and underventilated home, or the actual pain experienced in readjusting our own healthy bodies to the stuffy workroom or schoolroom after a summer vacation out of doors. i heard a consumptive say that he left a sanatorium for a day class after trying for three nights to sleep in an unventilated ward. for many people the regular morning bath is at first a trial, then a pleasure, and finally a need; if omitted, the body feels thirsty and dissatisfied, the eyes sleepy, and the spirit flags early in the day. [illustration: improvised seaside hospital for nonpulmonary tuberculosis at sea breeze teaches passers-by the fresh-air gospel] cold baths are not essential or even good for everybody. the same diet or the same amount of food or time for eating is not of equal value for all. the temperature of bath water, the kind and quality of food, are influenced by one's work and one's cook. set rules about these things do more harm than good. such questions must be decided for each individual,--by his experience or by the advice of a physician,--but they must be decided and the decisions converted into health habits if he would attain the highest efficiency of which he is capable. here again our old contrast between "doing things" and "getting things done" applies. get your body to attend to the essential needs for you, and get it to remind you when you let the exigencies of life interfere. don't burden your mind every day with work that your body will do for you if properly trained. [illustration: crippled children leaving sea breeze hospital for bone tuberculosis find stale air offensive by night or by day] obstacles to habits of health are numerous; therefore the importance of correcting those habits of factory, family, trade, city, or nation that make health habits impracticable. we must change others' prejudices before we can breathe clean air on street cars without riding outside. when one's co-workers are afraid of fresh air, ventilation of shop, store, and office is impossible. so long as parents fear night air, children cannot follow advice to sleep with windows open. unless the family coöperates in making definite plans for the use of toilet and bath for each member, constipation and bad circulation are sure to result. indigestion is inevitable if employees are not given lunch periods and closing hours that permit of regular, unhurried meals. cleanliness of person costs more than it seems to be worth where cities fail either to compel bath tubs in rented apartments or to erect public baths. a temperate subsistence on adulterated, poisonous, or drugged foods might be better for one's health than gormandizing on pure foods. no recipe has ever been found for bringing up a healthy baby on unclean, infected milk; for avoiding tuberculosis among people who are compelled to work with careless consumptives in unclean air; or for making a five-story leap as safe as a fire escape. perfect habits of health on the part of an individual will not protect him against enervation or infection resulting from inefficient enforcement of sanitary codes by city, county, state, and national authorities. [illustration: at junior sea breeze, teaching mothers the health routine for babies] the "municipalization" or "public subsidy" of health habits is indispensable to protecting industrial efficiency. public lavatories, above or below ground, have done much to reduce inefficiency due to alcoholism, constipation of the bowels, and congestion of the kidneys. theaters, churches, and assembly rooms could be built so as to drill audiences in habits of health instead of fixing habits of uncleanly breathing. street flushing, drinking fountains, parks and breathing spaces, playgrounds and outdoor gymnasiums, milk, food, and drug inspection, tenement, factory, and shop supervision, enforcement of anti-spitting penalties, restriction of hours of labor, prohibition of child labor,--these inculcate community habits of health that promote community efficiency. it is the duty of health boards to compel all citizens under their jurisdiction to cultivate habits of health and to punish all who persistently refuse to acquire these habits, so far as the evils of neglect become apparent to health authorities. the unlimited educational opportunity of health boards consists in their privilege to point out repeatedly and cumulatively the industrial and community benefits that result from habits of health, and the industrial and community losses that result from habits of unhealthy living. footnotes: [ ] serviceable guides to personal habits of health are _aristocracy of health_ by mary foote henderson, and _efficient life_ by dr. luther h. gulick. chapter xxiii industrial hygiene to call the movement for better factory conditions the "humanizing of industry" implies that modern industry not influenced by that movement is brutalized. the brutalizing of industry was due chiefly to a general ignorance of health laws,--an ignorance that registers itself clearly and promptly in factory and mine. it is not that a man is expected to do too much, but that too little is expected of the human body. the present recognition of the body's right to vitality is not because the employer's heart is growing warmer, or because competition is less vicious, but because the precepts of hygiene are found to be practical. where better ventilation used to mean more windows and repair bills, it now means greater output. where formerly a comfortable place in which to eat lunch meant giving up a workroom and its profits, it now means per cent more work done in all workrooms during the afternoon. the general enlightenment as to industrial hygiene has been accelerated by the awakening that always follows industrial catastrophes, by the splendid crusade against tuberculosis, and by compulsory notification and treatment of communicable diseases. catastrophes, however, have dominated the vocabulary that describes factory "welfare work." because accidents such as gas in mines, fire in factories, fever in towns, and epidemics of diseases incident to certain trades were beyond the power of the workers themselves to control or prevent, wage earners have come to be looked upon as helpless victims of the cupidity and inhumanity of their employers. this attitude has weakened the usefulness of many bodies organized to promote industrial hygiene. although the term "industrial hygiene" is broad enough to include all sanitary and hygienic conditions that surround the worker while at work, it is restricted by some to the efforts made by altruistic or farsighted employers in the interest of employees; others think of prohibitions and mandates, in the name of the state, that either prevent certain evils or compel certain benefits; for too few it refers to what the wage earner does for himself. pity for the employee has caused the motive power of the employee to be wastefully allowed to atrophy. yet when a man becomes an employee, he does not forfeit any right of citizenship, nor does being an employee relieve him from the duties of citizenship. in too many cases it has been overlooked that a worker's carelessness about habits of health, as well as about his machinery, causes accidents and increases industrial diseases. too often the worker himself is responsible for uncleanliness and lack of ventilation and his own consequent lack of vitality. a study into the conditions of ventilation and cleanliness of workers' homes will prove this. knowing that a light, well-aired, clean, safe factory would not of itself insure healthy men, many employers have built and supplied houses for their workmen at low rents. just as these employers failed to see that they could reach more people and secure more permanent results if they demanded that tenement laws and the sanitary code be enforced as well as the laws for the instruction of children in hygiene, so the employee has failed to see that he is a part of the public that passes laws and determines the efficiency of factory inspection. the enforcement of state legislation for working hours, proper water and milk supply, proper teaching of children, proper tenement conditions, efficient health administration, is dependent upon the interest and activity of the public, of which the working class is no small or uninfluential part. [illustration: country club house for new york social workers given by the founder of caroline rest educational fund] the first and most important step in securing hygienic rights for workingmen is to make sure that they know the rights that the law already gives them. men still throw out their chests when talking of their rights. the posting of the game laws in a club last summer, and the instruction of all the natives of the countryside in regard to their rights as against those of outsiders, meant that for the first time in their history the game laws were enforced. all the natives, instead of poaching as has been their wont, joined together in protecting club property from intruding outside sportsmen. poachers were caught and served with the full penalties of the law. over winter fires these people's heroism will grow, but their respect for law will grow also, and it is doubtful if the game laws can be violated in that section so long as the tradition of this summer's work lives. and so it would be in a factory, if employees once realized that by uniting they could, as citizens, enforce health rights in the factory. the hygiene of the workshop is not the same problem as the hygiene of the home and schoolhouse, because there are by-products of factory work that contaminate the air, overheat the room, and complicate the ordinary problems of ventilation. certain trades are recognized as "dangerous trades." the problem of adequate government control of factories is one for a sanitary engineer. it has to do with disease-bearing raw material that comes to a factory, disease-producing processes of manufacture. there is need for revision of the dangerous-trade list. many of the industries not so classed should be; many of the so-called dangerous trades can be made comparatively harmless by devices for exhausting harmful by-products. industrial diseases should be made "notifiable," so that they can be controlled by the factory or health department. it is those trades that are dangerous because of remediable unsanitary and unhygienic conditions which demand the employer's attention. complaints should be made by individuals when carelessness or danger becomes commonplace. the manner in which many organizations have tried to better working conditions is similar to the manner in which europeans are trying to help defective school children. here, as there, is the difference between _doing things_ and _getting things done_. here more than there is the tendency to exaggerate legislation and to neglect enforcement of law. instead of harnessing the whole army of workingmen to the crusade and strengthening civic agencies such as factory, health, and tenement departments, houses are built and given to men, clubs are formed to amuse factory girls, amateur theatricals are organized. all this is called "welfare work." "what is welfare work?" reads the pamphlet of a large national association. "it is especial consideration on the part of the employer for the welfare of his employees." in the words of this pamphlet, the aim of this association "is to organize the best brains of the nation in an educational movement toward the solution of some of the great problems related to social and industrial progress." the membership is drawn from "practical men of affairs, whose acknowledged leadership in thought and business makes them typical representatives of business elements that voluntarily work together for the general good." as defined by this organization, welfare work is something given to the employee by the employer for the welfare of both. it is not something the employee himself does to improve his own working conditions. we are told that employees should assume the management of welfare work. should they install sanitary conveniences? of course not. would they know the need of a wash room in a factory if they never had had one? no. should they manage lunch rooms? a few employers have attempted unsuccessfully to turn over the management of the lunch rooms to the employees, the result being that one self-sacrificing subofficial in each concern would find the burden entirely on his shoulders before working hours, during working hours, and after working hours. employees cannot attend committee meetings during working hours, and they are unwilling to do so afterwards, for they generally have outside engagements. furthermore, the employees know nothing about the restaurant business. if they did, they would probably be engaged in it instead of in their different trades. all experiments along this line of which we have heard have failed. the so-called "democratic idea," purely a fad, never has been successfully operated. many employers would introduce welfare work into their establishments were it not for the time and trouble needed for its organization. the employment of a welfare director removes this obstacle. successful prosecution of welfare work requires concentration of responsibility. all of its branches must be under the supervision of one person, or efforts in different directions may conflict, or special and perhaps pressing needs may escape attention. pressure of daily business routine usually relegates welfare work to the last consideration, but the average employer is interested in his men and is willing to improve their condition if only their needs are brought to his attention. [illustration: first lessons in industrial hygiene] +--------------------------------------------------------------------+ | =consumption= | | | | is chiefly caused by the filthy habit of | | | | =spitting= | | | | take this card home | | | | and show it to your family, friends, and neighbors | | | | consumption is a disease of the lungs, which is taken from others, | | and is not simply caused by colds, although a cold may make it | | easier to take the disease. | | | | the matter coughed up and sneezed out by consumptives is full of | | living germs or "tubercle bacilli" too small to be seen. these | | germs are the cause of consumption, and when they are breathed | | into the lungs they set up the disease. | | | | don't get consumption yourself | | | | keep as well as possible, for the healthier your body, the harder | | for the germs of consumption to gain a foothold. every person | | should observe the following rules: | | | | | | =don't= live, study, or sleep in rooms where there is no | | fresh air. fresh air and sunlight kill the consumption | | germs and other germs causing other diseases; therefore | | have as much of both in your room as possible. | | | | =don't= live in dusty air; keep rooms clean; get rid of dust | | by cleaning with damp cloths and mops. =don't= sweep with | | a dry broom. | | | | =keep= one window partly open in your bedroom at night, and | | air the room two or three times a day. | | | | =don't= eat with soiled hands. wash them first. | | | | =don't= put hands or pencils in the mouth, or any candy or | | chewing gum other persons have used. | | | | =don't= keep soiled handkerchiefs in your pockets. | | | | =take= a warm bath at least once a week. | | | | =don't= neglect a cold or a cough, but go to a doctor or | | dispensary. | +--------------------------------------------------------------------+ [illustration: welfare work that counts] +-------------------------------------------------------------------+ | =how to get well if you have consumption= | | | | if you or any one in your family have consumption, you must obey | | the following rules if you wish to get well: | | | | =don't= waste your money on patent medicines or advertised | | cures for consumption, but go to a doctor or dispensary | | (see last page). if you go in time, you can be cured; if | | you wait, it may be too late. | | | | =don't= drink whisky or other forms of liquor. | | | | =don't= sleep in the same bed with any one else, and, if | | possible, not in the same room. | | | | =good food, fresh air, and rest are the best cures. keep out | | in the fresh air and in the sunlight as much as possible.= | | | | =keep= your windows open winter and summer, day and night. | | | | =if= properly wrapped up you will not catch cold. | | | | =go= to a sanatorium while you can and before it is too | | late. | | | | =the careful and clean consumptive is not dangerous to those | | with whom he lives and works.= | | | | =don't give consumption to others.= | | | | many grown people and children have consumption without knowing | | it, and can give it to others. therefore every person, even if | | healthy, should observe the following rules: | | | | =don't spit= on the sidewalks, playgrounds, or on the | | floors or hallways of your home or school. it spreads | | disease, and is dangerous, indecent, and unlawful. | | | | =when you must spit=, spit in the gutters or into a spittoon | | half filled with water. | | | | =don't cough or sneeze= without holding a handkerchief or | | your hand over your mouth or nose. | +-------------------------------------------------------------------+ $/ this method of promoting the welfare of the worker may have been a necessary step in the development of industrial hygiene. undoubtedly it has succeeded, in many cases, in bringing to an employer's consciousness the needs of his workmen, in accustoming employees to higher sanitary standards, and in teaching them to demand health rights from their employers. in many cases, however, "welfare work" has miseducated both employer and employee. the fact that "the so-called democratic idea, purely a fad, has never been successfully operated," is due to the interpretation given to "democratic idea." the two alternatives in the paragraph above quoted are lunch rooms, wash rooms, as gifts from employers to employees, or lunch rooms and wash rooms to be furnished by employees at their own expense. the true democratic idea, however, is that factory conditions detrimental to health shall be prohibited by factory legislation, and this legislation enforced by efficient factory inspectors, regardless of what may be given to employees above the requirement of hygiene. until employees are more active as citizens and more sensitive to hygienic rights, it is desirable that welfare directors be employed in factories to arbitrate between employer and employee, to raise the moral standard of a factory settlement, to organize amusements. welfare work at its best is a method of dividing business profits among all who participate in making these profits. too often welfare secretaries teach employees how to be happy in the director's way, rather than in their own way. this adventitious position increases suspicion on both sides, disturbs the discipline of the foreman, weakens rather than strengthens the worker's efficiency, because it depends upon other things than work well done and the relation of health to efficiency. in a small factory town the owner of a large cotton mill has recognized the financial benefit of physically strong workers, and is trying the experiment of a welfare director. the man himself works "with his sleeves up." the social worker has an office in the factory. a clubhouse is fitted up for the mill hands to make merry in. a room in the factory is reserved for a lunch room, with plants, tables, and chairs for the comfort of the women. parties are given by the employer to the employees, which he himself attends. he has thrown himself into whatever schemes his director has suggested. the director complained that the reason the new lunch room was not more popular was because a piano was needed. a second-hand one would not do, for that would cultivate bad taste in music. this showed the employer that soon everything would be expected from the "big house on the hill." an event which happened at the time when the pressure was greatest on him for the piano, convinced him that his employees could supply their real needs without any trouble or delay. the assistant manager was about to leave, and in less than a week five hundred dollars was raised among the workers for his farewell gift. walking home that night late from his office the owner was attracted by the sound of jollity, and saw a little room jammed full of mill people enjoying the improvised music of a mouth organ played to the accompaniment of heels. he resolved henceforth to train his employees to do his work well and to earn more pay,--and to let them amuse themselves. from that time on he refused to be looked upon as the _deus ex machina_ of the town. he decided that the best way to give english lessons to foreigners was to improve the school. his beneficence in supplying them with pure water at the mill did not prevent a ravaging typhoid epidemic because the town water was not watched. he saw that the best way to improve health was to strengthen the health board and to make his co-workers realize that they were citizens responsible for their own privileges and rights. emergency hospitals and y.m.c.a. buildings are sad substitutes for safety devices and automatic couplers. christmas shopping in november is less kind than prevention of overwork in december. night school and gymnastic classes are a poor penance for child labor and for work unsuited to the body. the left hand cannot dole favors enough to offset the evils of underpay, of unsanitary conditions, of inefficient enforcement of health laws tolerated by the right hand. just because a man is taking wages for work done, is no reason why he should forfeit his rights as a citizen, or allow his children, sisters, neighbors, to work in conditions which decrease their efficiency and earning power. what the employee can do for himself as a citizen, having equal health rights with employers, he has never been taught to see. factory legislation is state direction of industries so far as relates to the safety, health, and moral condition of the people,--and which embraces to-day, more than in any other epoch, the opinion of the workers themselves. no government, however strong, can hope successfully to introduce social legislation largely affecting personal interests until public opinion has been educated to the belief that the remedies proposed are really necessary. until schools insist upon a better ventilation than the worst factories, how can we expect to find children of working age sensitive to impure air? where work benches are more comfortable than school desks, where drinking water is cleaner and towels more sanitary, however unsanitary they may be, than those found in the schoolhouse, the worker does not realize that they menace his right to earn a living wage as much as does a temporary shut-down. employers are by no means solely to blame for unhealthy working conditions. a shortsighted employee is as anxious to work overtime for double pay as a shortsighted employer is to have him. among those who are agitating for an eight-hour day are many who, from self-interest or interest in the cause, work regularly from ten to sixteen hours. would it help to punish employees for working in unhealthy places? the highest service that can be rendered industrial hygiene is to educate the industrial classes to recognize hygienic evils and to coöperate with other citizens in securing the enforcement of health rights. chapter xxiv the last days of tuberculosis if the historian lecky was right in saying that the greatest triumphs of the nineteenth century were its sanitary achievements, the lecky of the twenty-first century will probably honor our generation not for its electricity, its trusts, and its scientific research, but for its crusade against the white plague and for its recognition of health rights. thanks to committees for the prevention of tuberculosis,--local, state, national, international,--we are fast approaching the time when every parent, teacher, employer, landlord, worker, will see in tuberculosis a personal enemy,--a menace to his fireside, his income, and his freedom. just as this nation could not exist half slave, half free, we of one mind now affirm that equal opportunity cannot exist where one death in ten is from a single preventable disease.[ ] of no obstacle to efficient living is it more true than of tuberculosis, that the remedy depends upon enforcing rather than upon making law, upon practice rather than upon precept, upon health habits rather than upon medical remedies, upon coöperation of lay citizens rather than upon medical science or isolated individual effort. without learning another fact about tuberculosis, we can stamp it out if we will but apply, and see that officers of health apply, lessons of cleanliness and natural living already known to us. [illustration: dr. trudeau's "little red cottage" at saranac--birthplace of out-of-door treatment in america] perhaps the most striking results yet obtained in combating tuberculosis are those of the massachusetts general hospital in boston. to visit its tuberculosis classes reminds one more of the sociable than the clinic. in fact, one wonders whether the milk diet and the rest cure or the effervescing optimism and good cheer of the physicians and nurses should be credited with the marvelous cures. the first part of the hour is given to writing on the blackboard the number of hours that the class members spent out of doors the preceding week. so great was the rivalry for first place that the nurse protested that a certain boy in the front row gave himself indigestion by trying to eat his meals in ten or fifteen minutes. it was then suggested that twenty hours a day would be enough for any one to stay out of doors, and that plenty of time should be taken for meals with the family and for cold baths, keeping clean, etc. interesting facts gathered by personal interviews of two physicians with individual patients are explained to the whole class. next to the number of hours out of doors, the most interesting fact is the number of hours of exercise permitted. a man of forty, the head of a family, beamed like a school child when told that, after nearly a year of absolute rest, he might during the next week exercise ten minutes a day. a graduate drops in, the very picture of health, weighing two hundred pounds. an apparently hopeless case would brighten up and have confidence when told that this strong, handsome man has gained fifty pounds by rest, good cheer, fresh air, all on his own porch. one young man, just back from a california sanatorium where he progressively lost strength in spite of change of climate, is now returning to work and is back at normal weight. [illustration: outdoor life chart.] [illustration: fighting tuberculosis in the mountains--saranac] every patient keeps a daily record, called for by the following instructions: make notes of temperature and pulse at , , , and o'clock, daily; movements of bowels; hours in open air; all food taken; total amount of milk; total amount of oil and butter; appetite; digestion; spirits; cough (amount, chief time); expectoration (amount in hours, color, nature); exercise (if allowed), with temperature and pulse minutes after exercise; sweats; visitors. the following simple instructions can be followed in any home, even where open windows must take the place of porches: rest out of doors is the medicine that cures consumption. absolute rest for mind and body brings speedy improvement. it stops the cough and promotes the appetite. the lungs heal more quickly when the body is at rest. lie with the chest low, so the blood flow in the lungs will aid to the uttermost the work of healing. the rest habit is soon acquired. each day of rest makes the next day of rest easier, and shortens the time necessary to regain health. the more time spent in bed out of doors the better. do not dress if the temperature is above degrees, or if there is blood in the sputum. it is life in the open air, not exercise, that brings health and strength. just a few minutes daily exercise during the active stage of the disease may delay recovery weeks or months. rest favors digestion, exercise frequently disturbs digestion. when possible have meals served in bed. never think the rest treatment can be taken in a rocking-chair. if tired of the cot, shift to the reclining chair, but sit with head low and feet elevated. do not write letters. dictate to a friend. do not read much and do not hold heavy books. while reading remain in the recumbent posture. [illustration: fighting tuberculosis in day camps--boston] once having learned the simple facts that must be noted and the simple laws that must be followed, once having placed oneself in a position to secure the rest, the fresh air, and the health diet, no better next steps can be taken than to observe the closing injunction in the rules for rest: there are few medicines better than clouds, and you have not to swallow them or wear them as plasters,--only to watch them. keeping your eyes aloft, your thoughts will shortly clamber after them, or, if they don't do that, the sun gets into them, and the bad ones go a-dozing like bats and owls. [illustration: the back of a street-car transfer, sundays, new york city] +--------------------------------------------------------------------+ | consumption in early stages can be cured | | | | take your case in time to a good physician or to a dispensary and | | you may be cured--do not wait. | | | | consumption is "caught" mainly through the spit of consumptives. | | | | friends of consumption--dampness, dirt, darkness, drink. | | | | enemies of consumption--sun, air, good food, cleanliness. | | | | if you have tuberculosis do not give it to others by spitting; | | even if you have not, set a good example by refraining from a | | habit always dirty and often dangerous. | | | | _the committee on the prevention of tuberculosis_ | | _of the charity organization society_ | | | | (by courtesy of siegel cooper co.) | +--------------------------------------------------------------------+ important as are sanatoriums in mountain and desert, day or night camps within and near cities, milk and egg clinics, home visiting, change of air and rest for those who are known to be tuberculous, their importance is infinitesimal compared with the protection that comes from clean, healthy environment and natural living for those not known to be tuberculous. this great fact has been recognized by the various bodies now engaged in popularizing the truth about tuberculosis by means of stationary and traveling exhibits, illustrated lectures, street-car transfers, advertisements, farmers' institutes, anti-spitting signs in public vehicles and public buildings, board of health instructions in many languages, magazine stories, and press reports of conferences. this brilliant campaign of education shows what can be done by national, state, and county superintendents of schools, if they will make the most of school hygiene and civics. [illustration: an example in coÖperation that anti-tuberculosis crusaders should follow] +-------------------------------------------------------------------+ | circular issued by | | | | the committee of sanitation of the central federated union of | | new york | | | | the committee on the prevention of tuberculosis of the charity | | organization society | | | | east d street, new york city | | | | * * * * * | | | | don't give consumption to others | | | | don't let others give it to you | | | | * * * * * | | | | =how to prevent consumption= | | | | =the spit and the small particles coughed up and sneezed out by | | consumptives, and by many who do not know that they have | | consumption, are full of living germs too small to be seen. these | | germs are the cause of consumption.= | | | | | | =don't spit on the sidewalks--it spreads disease, and it is | | against the law.= | | | | =don't spit on the floors of your rooms or hallways.= | | | | =don't spit on the floors of your shop.= | | | | =when you spit, spit in the gutters or into a spittoon.= | | | | =have your own spittoons half full of water, and clean them | | out at least once a day with hot water.= | | | | =don't cough without holding a handkerchief or your hand | | over your mouth.= | | | | =don't live in rooms where there is no fresh air.= | | | | =don't work in rooms where there is no fresh air.= | | | | =don't sleep in rooms where there is no fresh air.= | | | | =keep at least one window open in your bedroom day and | | night.= | | | | =fresh air helps to kill the consumption germ.= | | | | =fresh air helps to keep you strong and healthy.= | | | | =don't eat with soiled hands--wash them first.= | | | | =don't neglect a cold or a cough.= | | | | | | =how to cure consumption= | | | | =don't waste your money on patent medicines or advertised | | cures for consumption, but go to a doctor or a | | dispensary. if you go in time you can be cured; if you | | wait until you are so sick that you cannot work any | | longer, or until you are very weak, it may be too late; | | at any rate it will in the end mean more time out of work | | and more wages lost than if you had taken care of | | yourself at the start.= | | | | =don't drink whisky, beer, or other intoxicating drinks; | | they will do you no good, but will make it harder for you | | to get well.= | | | | =don't sleep in the same bed with any one else, and, if | | possible, not in the same room.= | | | | =good food, fresh air, and rest are the best cures. keep in | | the sunshine as much as possible, and keep your windows | | open, winter and summer, night and day. fresh air, night | | and day, is good for you.= | | | | =go to a hospital while you can and before it is too late. | | there you can get the best treatment, all the rest, all | | the fresh air, and all the food which you need.= | | | | =the careful and clean consumptive is not dangerous to those | | with whom he lives and works= | +-------------------------------------------------------------------+ is it not significant that america's national movement is due primarily to the organizing capacity of laymen in the new york charity organization society rather than to schools or hospitals? most of the local secretaries are men whose inspiration came from contact with the non-medical relief of the poor in city tenements. the secretary of the national association is a university professor of anthropology, who has also a medical degree. the child victim's plea--little jo's smile--was nationalized by an association of laymen, aided by the advertising managers of forty magazines. the smaller cities of new york state are being aroused by a state voluntary association that for years has visited almshouses, insane asylums, and hospitals. these facts i emphasize, for they illustrate the opportunity and the duty of the lay educator, whether parent, teacher, labor leader, or trustee of hospital, orphanage, or relief society. three fundamental rules of action should be established as firmly as religious principles: . the public health authorities should be told of every known and every suspected case of tuberculosis. . for each case proved by examination of sputum to be tuberculous, the public-health officers should know that the germs are destroyed before being allowed to contaminate air or food. . sick and not yet sick should practice habits of health that build up vitality to resist the tubercle bacilli and that abhor uncleanliness as nature abhors a vacuum. [illustration: fighting tuberculosis with a national organization] all laws, customs, and environmental conditions opposed to the enforcement of these three principles must be modified or abolished. if the teachers of america will list for educational use in their own communities the local obstacles to these rules of action, they will see exactly where their local problem lies. the illustrations that are given in this book show in how many ways these rules of action are now being universalized. three or four important steps deserve especial comment: . compulsory notification of all tuberculous cases. . compulsory removal to hospital of those not able at home to destroy the bacilli, or compulsory supervision of home care. . examination of all members of a family where one member is discovered to be tuberculous. . special provision for tuberculous teachers. . protection of children about to enter industry but predisposed to tuberculosis. . prohibition of dry cleaning of schools, offices, and streets. . tax provision for educational and preventive work. compulsory notification was introduced first in new york city by hermann m. biggs, m.d., chief medical officer: , partially voluntary, partially compulsory; , compulsory for all. physicians who now hail dr. biggs as a statesman called him persecutor, autocrat, and violator of personal freedom fifteen years ago. foreign sanitarians vied with american colleagues in upbraiding him for his exaggeration of the transmissibility of consumption and for his injustice to its victims. as late as one british expert particularly resented the rejection of tuberculous immigrants at ellis island, and said to me, "perhaps if you should open a man's mouth and pour in tubercle bacilli he might get phthisis, but compulsory notification is preposterous." in the international congress on tuberculosis met in paris and congratulated new york upon its leadership in securing at health headquarters a list of the known disease centers within its borders; in more than twenty thousand individual cases were reported, ten thousand of these being reported more than once. to know the nature and location of twenty thousand germ factories is a long step toward judging their strength and their probable product. to compulsory notification in new york city is largely due the educational movements of the last decade against the white plague, more particularly the growing ability among physicians to recognize and to treat conditions predisposing to the disease. as in new york city, the public should provide free of cost bacteriological analysis of sputum to learn positively whether tuberculosis is present. simpler still is the tuberculin test of the eyes, with which experiments are now being made on a large scale in new york city, and which bids fair to become cheap enough to be generally used wherever physical examinations are made. this test is known as calmette's eye test. inside the eyelid is placed a drop of a solution-- per cent alcohol and tuberculin. if conjunctivitis develops in twenty-four hours, the patient is proved to have tuberculosis. some physicians still fear to use this test. others question its proof. the "skin test" is also being thoroughly tried in several american cities and, if finally found trustworthy, will greatly simplify examination for tuberculosis. dr. john w. brannan, president of bellevue and allied hospitals, new york city, is to report on skin and eye tuberculin tests for children at the international congress on tuberculosis, mentioned later. [illustration: fighting tuberculosis by organized coÖperative dispensary work] [illustration: fighting bone tuberculosis at sea breeze, where eye and skin tuberculin tests are being made] compulsory removal of careless consumptives is yet rare. one obstacle is the lack of hospitals. in new york ten thousand die annually from tuberculosis and fifty thousand are known to have it, yet there are only about two thousand beds available. so long as the patients anxious for hospital care exceed the number of beds, it does not seem fair to give a bed to some one who does not want it. on the other hand, it should not be forgotten that patients are taken forcibly to smallpox and scarlet-fever hospitals, not for their own good, but for the protection of others. the last person who should be permitted to stay at home is the tuberculous person who is unable, unwilling, or too ignorant to take the necessary precautions for others' protection. a rigid educational test should be applied as a condition of remaining at home without supervision. the objections to compulsory removal are two: ( ) it is desired to make sanatorium care so attractive that patients will go at the earliest stage of the disease; ( ) an unwilling patient can defeat the sanitarian's effort to help him and others. the alternative for compulsory removal is gratuitous, and, if need be, compulsory, supervision of home care, such as is now given in new york city. in brighton, england, dr. newsholme treats his municipal sanatorium as a vacation school, giving each patient one month only. thus one bed helps twelve patients each year. almost any worker can spare one month and in that time can be made into a missionary of healthy living. family examining parties were begun in new york by dr. linsly r. williams, for the relief agency that started the seaside treatment of bone tuberculosis. many of the crippled children at sea breeze were found to have consumptive fathers or mothers. in one instance the father had died before charlie had "hip trouble." long after we had known charlie his mother began to fail. she too had consumption. family parties were planned for families. weights were taken and careful examination made, the physician explaining that predisposition means defective lung capacity or deficient vitality. of members, supposedly free from tuberculosis, sixteen were found to have well-marked cases. (of twenty boston children whose parents were in a tuberculosis class, four had tuberculosis.) in one instance the father was astonished to learn not only that he was tuberculous, but that he had probably given the disease to the mother, for whom he was tenderly concerned. of special benefit were the talks about teeth and nourishment, and about fresh air and water as germ killers. one examination of this kind will organize a family crusade against carelessness. [illustration: fighting tuberculosis in small cities new york state charities aid association] tuberculous teachers ought to be excluded from schoolrooms not merely because they may spread tuberculosis, but because they cannot do justice to school work without sacrifices that society ought not to accept. a tuberculous teacher ought to be generous enough to permit public hospitals to restore her strength or enterprising enough to join tuberculosis classes. it is selfish to demand independence at the price which is paid by schools that employ tuberculous teachers. [illustration: fighting bone tuberculosis with salt water and salt air] predisposition to tuberculosis should be understood by every child before he is accepted as an industrial soldier. many trades now dangerous would be made safe if workers knew the risk they run, and if society forbade such trades needlessly to exhaust their employees. a perfectly sound man is predisposed to tuberculosis if he elects to work in stale, dust-laden air. ill-ventilated rooms, cramped positions, lack of exercise in the open air, prepare lungs to give a cordial reception to tubercle bacilli. rooms as well as persons become infected. fortunately, opportunities to work are so varied in most localities that workers predisposed to tuberculosis may be sure of a livelihood in an occupation suited to their vitality. destruction of germs in the air, in carpets, on walls, on streets, is quite as important as destruction of germs in lungs. why should not tenants and workers require health certificates stating that neither house nor working place is infected with tubercle bacilli? some cities now compel the disinfection of premises occupied by tuberculous persons _after_ their removal. landlords, employers, tenants, and employees can easily be taught to see the advantage of disinfecting premises occupied by tuberculous cases _before_ detection. [illustration: fighting feather dusters is one object of sea-air hospitals for bone tuberculosis] dry cleaning, feather dusters, dust-laden air, will disappear from schoolrooms within twenty-four hours after school-teachers declare that they shall disappear. we have no right to expect street cleaners, tenement and shop janitors, or overworked mothers to be more careful than school-teachers. last year i said to a janitress, "don't you realize that you may get consumption if you use that feather duster?" her reply caused us to realize our carelessness: "i don't want any more than i've got now." shall we some day have compulsory examination and instruction of all cleaners, starting with school cleaners? [illustration: fighting tuberculosis in open tents] taxing is swift to follow teaching in matters of health. teachers can easily compute what their community loses from tuberculosis. the totals will for some time prove a convincing argument for cleanliness of air, of body, and of building wherever the community is responsible for air, building, and body. the annual cost of tuberculosis to new york city is estimated at $ , , and to the united states at $ , , . the cost of exterminating it will be but a drop in the bucket if school-teachers do their part this next generation with the twenty million children whose day environment they control for three fourths of the year, and whose habits they can determine. the first meeting in america of the international congress on tuberculosis was held at washington, d.c., september to october , . for many years the proceedings of this congress will undoubtedly be the chief reference book on the conquest of tuberculosis.[ ] how many aspects there are to this problem, and how many kinds of people may be enlisted, may be seen from the seven section names: i. pathology and bacteriology; ii. sanatoriums, hospitals, and dispensaries; iii. surgery and orthopedics; iv. tuberculosis in children--etiology, prevention, and treatment; v. hygienic, social, industrial, and economic aspects; vi. state and municipal control of tuberculosis; vii. tuberculosis in animals and its relation to man. [illustration: fighting tuberculosis in cheap shacks, $ per bed, otisville, new york] how many-sided is the responsibility of each of us for stamping out tuberculosis is shown by the preliminary programme of the eight sessions of section v. these topics suggest an interesting and instructive year's study for clubs of women, mothers, or teachers, or for advanced pupils. i. economic aspects of tuberculosis . the burdens entailed by tuberculosis: a. on individuals and families. b. on the medical profession. c. on industry. d. on relief agencies. e. on the community. f. on social progress. . the cost of securing effective control of tuberculosis: a. in large cities. b. in smaller towns. c. in rural communities. ii. adverse industrial conditions . incidence of tuberculosis according to occupation. . overwork and nervous strain as factors in tuberculosis. . effect of improvements in factory conditions on the health of employees. . legitimate exercise of police power in protecting the life and health of employees. iii. the social control of tuberculosis . outline of a comprehensive programme for: a. national, state, and municipal governments. b. departments of health and departments of public relief. c. private endowments. d. voluntary associations for educational propaganda. e. institutions, such as schools and relief agencies, which exist primarily for other purposes. . a symposium on the relative value of each of the features in an aggressive campaign against tuberculosis: a. compulsory registration. b. free sputum examination. c. compulsory removal of unteachable and dangerous cases. d. laboratory research. e. hospital. f. sanatorium. g. dispensary. h. the tuberculosis class. i. day camp. j. private physician. k. visiting nurse. l. after-care of arrested cases. m. relief fund. n. climate. o. hygienic instruction,--personal and in class. p. inspection of schools and factories. q. educational propaganda. iv. early recognition and prevention . importance of discovering the persons who have tuberculosis before the disease has passed the incipient stage. . examination of persons known to have been exposed or presumably predisposed. . systematic examination of school children during their course and on leaving school to go to work. . professional advice as to choice of occupation in cases where there is apparent predisposition to disease. v. after-care of arrested cases . instruction in healthful trades in the sanatorium. . training for professional nursing in institutions for the care of tuberculous patients. . farm colonies. . convalescent homes or cottages. . aid in securing suitable employment on leaving the sanatorium. . how to deal with the danger of a return to unfavorable home conditions. vi. educational methods and agencies . special literature for general distribution. . exhibits and lectures. . the press. . educational work of the nurse. . labor organizations. . instruction in schools of all grades. . presentation and discussion of leaflets awarded prizes by the congress. vii. promotion of immunity . development of the conception of physical well-being. . measures for increasing resistance to disease: a. parks and playgrounds. b. outdoor sports. c. physical education. d. raising the standards of living: housing, diet, cleanliness. . individual immunity and social conditions favorable to general immunity. viii. responsibility of society for tuberculosis . a symposium of representative a. citizens. b. social workers. c. employers. d. employees. e. physicians. f. nurses. g. educators. h. others. cash prizes of one thousand dollars each are offered: ( ) for the best evidence of effective work in the prevention or relief of tuberculosis by any voluntary association since ; ( ) for the best exhibit of a sanatorium for working classes; ( ) for the best exhibit of a furnished home for the poor, designed primarily to prevent, but also to permit the cure of tuberculosis. [illustration: boston fights tuberculosis with a comprehensive plan _a-d, f, h-j_, private hospitals and agencies reporting cases to the official center; _e_, home care; _k, l, m_, day camp and hospitals for incipient and advanced cases] a white-plague scrapbook containing news items, articles, and photographs will prove an interesting aid to self-education or to instruction of children, working girls' clubs, or mothers' meetings. everybody ought to enlist in this war, for the fight against tuberculosis is a fight for cleanliness and for vitality, for a fair chance against environmental conditions prejudicial to efficient citizenship. so sure is the result and so immediate the duty of every citizen that dr. biggs wrote in : _in no other direction can such large results be achieved so certainly and at such relatively small cost. the time is not far distant when those states and municipalities which have not adopted a comprehensive plan for dealing with tuberculosis will be regarded as almost criminally negligent in their administration of sanitary affairs and inexcusably blind to their own best economic interests._ footnotes: [ ] the best literature on tuberculosis is in current magazines and reports of anti-tuberculosis crusaders. for a scientific, comprehensive treatment, libraries and students should have _the prevention of tuberculosis_ ( ) by arthur newsholme, m.d. a popular book is _the crusade against tuberculosis_, by lawrence f. flick, of the henry phipps institute for the study, treatment, and prevention of tuberculosis. [ ] those desiring copies this year or hereafter will do well to write to the national association for the study and prevention of tuberculosis, east d st., new york city. the congress is under the control of the national association and is managed by a special committee appointed by it. even after a national board of health is established, the national association for the study and prevention of tuberculosis will continue to be a center for private interest in public protection against tuberculosis. one of its chief functions is the preparation and distribution of literature to those who desire it. chapter xxv the fight for clean milk "with the approval of the president and with the coöperation of the department of agriculture,[ ] the [national quarantine] service has undertaken to prepare a complete report upon the milk industry from farm to the consumer in its relation to the public health." this promise of the united states treasury insures national attention to the evils of unclean milk and to the sanitary standards of farmer and consumer. nothing less than a national campaign can make the vivid impression necessary to wean dairymen of uncleanly habits and mothers of the ignorant superstition that babies die in summer just because they are babies. when two national bureaus study, learn, and report, newspapers will print their stories on the first page, magazines will herald the conclusions, physicians will open their minds to new truths, state health secretaries will carry on the propaganda, demagogues and quacks will become less certain of their short-cut remedies, and _everybody will be made to think_. the evolution of this newly awakened national interest in clean milk follows the seven stages and illustrates the seven health motives presented in chapter ii. i give the story of robert m. hartley because he began and prosecuted his pure-milk crusade in a way that can be duplicated in any country town or small city. robert m. hartley was a strong-bodied, strong-minded, country-bred man, who started church work in new york city almost as soon as he arrived. he distributed religious tracts among the alleys and hovels that characterized lower new york in . meeting drunken men and women one after another, he first wondered whether they were helped by tracts, and then decided that the mind befogged with alcohol was unfit to receive the gospel message. then for fifteen years he threw himself into a total-abstinence crusade, distributing thousands of pamphlets, calling in one year at over four thousand homes to teach the industrial and moral reasons for total abstinence. finally, he began to wonder whether back of alcoholism there was not still a dark closet that must be explored before men could receive the message of religion and self-control. so in he organized the new york association for improving the condition of the poor, which ever since has remembered how hartley found alcoholism back of irreligion, and how back of alcoholism and poverty and ignorant indifference he found indecent housing, unsanitary streets, unwholesome working conditions, and impure food. [illustration: fighting infant mortality by a school for mothers in the heart of new york city,--junior sea breeze] [illustration: providing against germ growth and adapting milk to the individual baby's need,--rochester's model dairy] hartley's instinct started the first great pure-milk agitation in this country. while visiting a distillery for the purpose of trying to persuade the owner to invest his money in another business, he noticed that "slops smoking hot from the stills" were being carried to cow stables. he followed and was nauseated by the sights and odors. several hundred uncleaned cows in low, suffocating, filthy stables were being fed on "this disgusting, unnatural food." similar disgust has in many other american cities caused the first effort to better dairy conditions. hartley could never again enjoy milk from distillery cows. furthermore, his story of made it impossible for any readers of newspapers in new york to enjoy milk until assured that it was not produced by distillery slops. the instinctive loathing and the discomfort of buyers awakened the commerce motives of milk dealers, who covered their wagons with signs declaring that they "no longer" or "never" fed cows on distillery refuse. but hartley could not stop when the anti-nuisance stage was reached. he did not let up on his fight against impure or adulterated milk until the state legislature declared in that _every baby, city born or country born, no matter how humble its home, has the right to pure milk_. +-------------------------------------------------------------------+ | =clean milk for new york city= | | | | =conference= | | | | =room , n.y. academy of medicine= | | =no. west d street= | | | | =november th, , tuesday p.m. and p.m.= | | | | | | =essential facts as to new york city= | | | | =manhattan's infant mortality= | | (=under yrs.=) | | | | june to september, , | | june to september, , | | june to september, , | | | | =daily consumption of milk= | | | | , , qts. | | ¼ in quart bottles | | ¾ in -quart cans | | "certified," , quarts | | "inspected," , quarts | | to hours old on arrival | | | | =comes from= | | | | , dairies, to miles distant | | creameries-- proprietors | | city railroad depots | | | | =sold in= | | | | , places, mostly from cans | | sale of skim milk prohibited | | | | =milk law violations, = | | | | destroyed, , quarts | | arrests, | | fines, $ , | | | | =new york city inspectors= | | | | in country since july; might make rounds not oftener than | | once a year | | (for yrs. before, only ; previously none) | | in city, might make rounds in to days | | (before july, ) | | | | | | =points of agreement= | | | | =cleanliness is the supreme requisite, from cow to consumer= | | | | cows must be healthy, persons free from contagious diseases, | | premises clean, water pure, utensils clean, cans and bottles | | sterile, shops sanitary | | | | =temperature is second essential= | | | | ° f. or lower at dairy | | ° f. at creamery | | ° f. or less during transportation | | not above ° when sold to the consumer | | | | =as to pasteurization= | | | | not necessary for absolutely clean milk | | destroys benign as well as harmful germs | | disease germs develop more rapidly than in pure raw milk | | true, ° for minutes to ° for minutes | | cost per quart, estimated, ¼ to ½ ct. | | commercial, ° for seconds | | cost per quart, negligible | | | | =as to inspection= | | | | _some_ inspection needed within the city | | _some_ inspection needed of dairy and creamery | | | | | | =what next steps should new york take?= | | | | =skim milk= | | | | should its sale be permitted? | | under what conditions? | | how would this affect price of whole milk? | | | | =pasteurization= | | | | should pasteurization be made compulsory? | | for what portion of the supply? | | at whose expense? | | would it increase price of milk? | | does it render inspection unnecessary? | | does it reduce need for inspection? | | should sale of repasteurized milk or cream be permitted? | | should bottles show whether true or commercial pasteurization | | is used? | | | | =infants' milk depots= | | | | should they use pasteurized or clean milk? | | are municipal depots desirable? | | should private philanthropy support depots? | | how many depots would be required in new york city? | | is rochester experience applicable to new york city? | | what educational work is possible in connection with milk | | depots? | | | | | | =model milk shops= | | | | what may safely be sold in connection with milk? | | should law discourage other than model shops? | | are present sanitary laws rigid enough? | | should private capital be encouraged to establish shops? | | is it practicable to prohibit use of cans? | | what provision can be demanded for proper refrigeration? | | what for receiving milk before business hours when delivered | | from stations? | | what for sterilization of utensils and bottles? | | what for attendants' dress and care of person? | | would such restrictions increase price? | | | | =inspection= | | | | is it practicable by inspection alone to secure a clean milk | | supply? | | will it protect against more dangerous forms of infection? | | how many inspectors does new york city need? | | within the city? | | among country dairies and creameries? | | how many inspectors should the state employ? | | | | =legislation= | | | | what needed as to diseased cattle? | | what as to diseases of persons producing or handling milk? | | is present sanitary code sufficient? | | shall law require sterilization of all milk cans and bottles | | by milk company or creamery before returned to farms or | | refilled? | | shall sealing cans at creameries be required? | | shall transferring from one can to another or from can to | | bottle in open street be made a misdemeanor? | | shall pollution of milk cans and bottles be made a | | misdemeanor? | | shall bacterial standard be established? | | is state supervision now adequate? | | what further legislation is needed? | | does present law prescribe adequate penalties? | | | | =education= | | | | should state system of lectures before agricultural institutes | | be extended? | | should maryland plan of traveling school be adopted as means | | of reaching producer? | | what can be done to assist teachers college in its plan for | | milk exhibit? | | what can be done to teach mothers to detect unclean milk and | | to care properly for milk purchased? | | how can tenement mothers keep milk at proper temperature? | | can nothing be done to increase the supply and cheapen the | | price of ice? | | is it desirable that a local committee be formed to coöperate | | with the department of health and county medical society? | +-------------------------------------------------------------------+ unfortunately hartley and his contemporaries had never heard of disease germs that are carried by unclean milk into the human stomach. science had not yet proved that many forms of barnyard filth could do quite as much harm as distillery refuse. commerce had not invented milk bottles of glass or paper. the law of failed in two particulars: ( ) it did not demand cleanliness from cow to consumer; ( ) it did not provide means for its own enforcement, for learning whether everything and everybody that had to do with milk was clean. not knowing of germs and their love for a warm climate and warm food, they naturally did not prohibit a temperature above fifty degrees from the time of milking to the time of sale. how much has been left for our generation to do to secure pure milk is illustrated by the opening sentence of this chapter, and more specifically by the programme of a milk conference held in new york in november, , the board of health joining in the call. the four-page folder is reproduced in facsimile (excepting the names on the fourth page), because it states the universal problem, and also because it suggests an effective way to stimulate relevant discussion and to discourage the long speeches that spoil many conferences. this conference led to the formation of a milk committee under the auspices of the association founded by hartley. business men, children's specialists, journalists, clergymen, consented to serve because they realized the need for a continuing public interest and a persisting watchfulness. such committees are needed in other cities and in states, either as independent committees or as subcommittees of general organizations, such as women's clubs, sanitary leagues, county and state medical societies. teachers' associations might well be added, especially for rural and suburban districts where they are more apt than any other organized body to see the evils that result from unclean milk. the new york milk committee set a good example in paying a secretary to give his entire time to its educational programme,--a paid secretary can keep more volunteers and consultants busy than could a dozen volunteers giving "what time they can spare." thanks chiefly to the conference and the milk committee's work, several important results have been effected. the general public has realized as never before that two indispensable adjectives belong to safe milk,--_clean_ and _cool_. additional inspectors have been sent to country dairies; refrigeration, cans, and milk have been inspected upon arrival at night; score cards have been introduced, thanks to the convincing explanations of their effectiveness by the representatives of the bureau of animal industry of the national department of agriculture; milch cows were inspected by veterinary practitioners ( - ), to learn the prevalence of bovine tuberculosis (of these thirty-six per cent reacted to the tuberculin test); state societies and state departments have been aroused to demand an efficient live-stock sanitary board; magistrates have fined and imprisoned offenders against the milk laws, where formerly they "warned"; popular illustrated milk lectures were added to the public school courses; illustrated cards were distributed by the thousand, telling how to keep the baby well; finally, private educational and relief societies, dispensaries, settlements, have been increasingly active in teaching mothers at home how to prepare baby's milk. in a conference on summer care of babies was organized representing the departments of health and education, and fifty private agencies for the care of sick babies and the instruction of mothers. the superintendent of schools instructed teachers to begin the campaign by talks to children and by giving out illustrated cards. similar instructions were sent to parochial schools by the archbishop. [illustration: night inspection of country milk upon arrival in new york city] as elsewhere, there are two schools of pure-milk crusaders: ( ) those who want cities to _do things_, to pasteurize all milk, start milk farms, milk shops, or pure-milk dispensaries; and ( ) those who want cities and states to _get things done_. so far the new york milk committee has led the second school and has opposed efforts to municipalize the milk business. the leader of the other school is the noted philanthropist, nathan strauss, who has established pasteurization plants in several american and european cities. the discussion of the two schools, similar in aim but different in method, is made more difficult, because to question philanthropy's method always seems to philanthropy itself and to most bystanders an ungracious, ungrateful act. as the issue, however, is clean milk, not personal motive, it is important that educators and parents in all communities benefit from the effective propaganda of both schools, using what is agreed upon as the basis for local pure-milk crusades, reserving that which is controversial for final settlement by research over large fields that involve hundreds of thousands of tests. [illustration: a new york milk committee's infant depot and school for mothers] pasteurization, municipal dairies, municipal milk shops, municipal infant-milk depots, are the four chief remedies of the _doing things_ school. european experience is cited in support of each. we are told that cow's milk, intended by nature for an infant cow with four stomachs, is not suited, even when absolutely pure, to the human infant's single stomach. cow's milk should be modified, weakened, diluted, to fit the digestive powers of the individual infant; hence the municipal depot or milk dispensary that provides exactly the right milk for each baby, prescribed by municipal physicians and nurses who know. that the well-to-do and the just-past-infancy may have milk as safe as babies receive at the depot, municipalization of farm and milk shop is advocated. some want the city to run only enough farms and milk shops to set a standard for private farmers, as has been done in rochester. this is city ownership and operation for educational purposes only. finally, because raw milk even from clean dairies may contain germs of typhoid, scarlet fever, or tuberculosis, pasteurization is demanded to kill every germ. there are advocates of pasteurization that deprecate the practice and deny that raw milk is necessarily dangerous; they favor it for the time being until farms and shops have acquired habits of cleanliness. likewise many would prefer private pasteurization or laws compelling pasteurization of all milk offered for sale; but they despair of obtaining safe milk unless city officials are held responsible for safety. why wait to discuss political theories about the proper sphere for government, when, by acting, hundreds of thousands of lives can be saved annually? these methods of _doing things_ will not add to the price of milk; it is, in fact, probable that the reduction in the cost of caring for the sick and for inspecting farms and shops will offset the net cost of depots, farms, and dairies. [illustration: one of rochester's schools in cleanliness] [illustration: rochester's model dairy farm] as to pasteurization, its cost is negligible, while the cost of cleanliness is two, four, or ten cents a quart. whether ideally clean milk is safe or not, raw milk that is not clean is unfit for human consumption. all cities should compel evidence of pasteurization as a condition of sale. large cities should have their own pasteurizing plants, just as many cities now have their own vaccine farms and antitoxin laboratories. parents in small towns and in the country should be taught to pasteurize all milk. the _getting things done_ school admits the need for modified milk of strength suited to the infant's stomach; affirms the danger of milk that contains harmful germs; demands educational work by city, state, and nation; confesses that talk about cleanliness will not make milk safe. on the other hand, it denies that raw milk is necessarily dangerous; that properly modified, clean, raw milk is any safer when pasteurized; that talking about germ-proof milk insures germ extinction. it maintains that pasteurization kills benign germs essential to the life of milk, and that after benign germs are killed, pasteurized milk, if exposed to infection, is more dangerous than raw milk, for the rapid growth of harmful germs is no longer contested by benign germs fighting for supremacy. while it is admitted that raw milk produced under ideal conditions may become infected by some person ignorant of his condition, and before detection may cause typhoid, scarlet fever, or consumption, it has not been proved that such instances are frequent or that the aggregate of harm done equals that which pasteurized milk may do. pasteurization does not remove chemical impurities; boiling dirt does not render it harmless. the remedy for germ-infected milk is to keep germs out of milk. the remedy for unclean milk is cleanliness of cow, cow barn, cowyard, milker, milk can, creamery, milk shop, bottle, nipple. if the sale of unclean milk is prevented, farmers will, as a matter of course, supply clean milk. by teaching farmers and milk retailers the economic advantages of cleanliness they will cultivate habits that guarantee a clean milk supply. by punishing railroads and milk companies that transport milk at a temperature which encourages germ growth, and by dumping in the gutter milk that is offered for sale above degrees, the refrigerating of milk will be made the rule. purging magistrates' courts of their leniency toward dealers in impure, dangerous milk is better than purging milk of germs. boiling milk receptacles will save more babies than boiling milk. teaching mothers about the care of babies will bring better results than giving them a false sense of safety, because only one of many dangers has been removed by pasteurization. educating consumers to demand clean milk and to support aggressive work by health departments leaves fewer evils unchecked than covering up uncleanliness by pasteurization. [illustration: new york milk committee's graphic method of showing babies' progress] [illustration: producing winter conditions in midsummer by proper refrigeration for milk in freight cars] when doctors disagree what are we laymen to do? we can take an intelligent interest in the inquiries that are now being made by city, state, and national governments. because everybody believes that clean milk is safer than unclean milk, that milk at degrees will not breed harmful germs, we can demand milk inspection that will tell our health officers and ourselves which dealers sell only clean milk at degrees and never more than degrees, that never shows over , colonies to the cubic centimeter. we can get our health departments to publish the results of their scoring of dairies and milk shops in the papers, as has been done in montclair. we can tell our health officers that the best results in fighting infant mortality are at rochester, which city, winter and summer, by inspection, correspondence, and punishment, educates farmers and dealers in cleanliness, not only censuring when dirty or careless, but explaining how to make more money by being clean. finally, mothers can be taught at home how to cleanse the bottles, the nipples, all milk receptacles, and all things in rooms where milk is kept. absolutely clean milk of proper temperature _at the shop_ may not safely be given to a baby in a dirty bottle. infant milk depots, pasteurization, the best medical and hospital care, breast feeding itself, cannot prevent high baby mortality if mothers are not clean. the most effective volunteer effort for pure milk is that which first makes the health machinery do its part and then teaches, teaches, teaches mothers and all who have to do with babies. [illustration: neither pasteurization nor inspection can make it safe to sell "dip milk" under such unclean conditions] "clean air, clean babies, clean milk," has been the slogan of junior sea breeze,--a school for mothers right in the heart of new york's upper east side. in the summer of twenty nurses went from house to house telling , mothers how to keep the baby well. this was the only district that had fewer baby deaths than for . had other parts of the city shown the same gain, there would have been a saving of babies. the following winter a similar work was conducted by nurses from the recently founded caroline rest, which has an educational fund for instruction of mothers in the care of babies, especially babies not yet born and just born. heretofore the baby has been expected to cry and to have summer complaint before anybody worried about the treatment it received. if the baby lived through its second summer, it was considered great good fortune. junior sea breeze and caroline rest start their educational work before the baby is sick, in fact, before it is born. their results have been so notable that several well-to-do mothers declare that they wish they too might have a school. dispensaries and diet kitchens and more particularly maternity wards of hospitals, family physicians, nurses, and midwives, should be required to know how to teach mothers to feed babies regularly, the right quantities, under conditions that insure cleanliness whether the breast or the bottle is used. perhaps some day no girl will be given a graduating certificate, or a license for work, teaching, or marriage, until she has demonstrated her ability to give some mother's baby "clean air, clean body, clean milk." footnotes: [ ] libraries should obtain all reports on milk, bureau of animal industry, washington, d.c. chapter xxvi preventive "humanized" medicine: physician and teacher no profession, excepting possibly the ministry, is regarded with greater deference than the medical profession. our ancestors listened with awe and obedience to the warnings and behests of the medicine man, bloodletter, bonesetter, family doctor. in modern times doctors have disagreed with each other often enough to warrant laymen in questioning the infallibility of any individual healer or any sect, whether homeopath, allopath, eclectic, osteopath, or scientist. yet to this day most of us surround the medical profession or the healing art with an atmosphere of necromancy. even after we have given up faith in drugs or after belief is denied in the reality of disease and pain, we revere the calling that concerns itself, whether gratuitously or for pay, with conquering bodily ills. self-laudation continues this hold of the medical profession upon the lay imagination. one physician may challenge another's faults, ridicule his remedies, call his antitoxin dangerous poison, but their common profession he proudly styles "the most exalted form of altruism." young men and women beginning the study or the practice of medicine are exhorted to continue its traditions of self-denial, and in their very souls to place human welfare before personal or pecuniary advancement. newspapers repeat exhortation and laudation. we laymen pass on the story that we know is not universally true,--physicians know, physicians apply what they know without consciousness of error, physicians must be implicitly trusted. for a physician to give poison when he means to give food is worse, not better, than for a layman to make the same mistake. neither the moral code nor the law of self-preservation enjoins a tuberculous mother to take alcohol or to sleep in an unventilated room, even if an uninformed physician prescribes it. instruction in physiology and hygiene would be futile if those who are educated as to the elementary facts of hygiene and physiology must blindly follow blind physicians. a family doctor who gives cod-liver oil for anæmia due to adenoids may do a child as much harm as a nurse who drugs the baby to make it sleep. the physician who refuses to tell the board of health when smallpox or typhoid fever first breaks out takes human life just as truly as if he tore up the tracks in front of an express train. this is another way of saying that parents and teachers must fit themselves to know whether the family physician and their community's physicians are efficient practitioners and teachers. every one can learn enough about the preventable causes of sickness and depleted vitality to insist upon the ounce of education and prevention that is better than a pound of cure. for its sins of omission, as for its sins of commission, the medical profession shares responsibility with laymen. for years leading educators, business men, hospital directors, public officials, have known that communicable diseases could be stamped out. the methods have been demonstrated. there is absolutely no excuse to-day for epidemics of typhoid in trenton, pittsburg, or scranton, for epidemics of scarlet fever in the small towns of minnesota, for uninterrupted epidemics of tuberculosis everywhere. had either laymen, physicians, or school-teachers made proper use of the knowledge that has been in text-books for a generation, this country would be saving thousands of lives and millions of dollars every year. our _doing_ and _getting done_ have lagged behind our _knowing_. the failure of physicians to "socialize" or "humanize" their knowledge is due to two causes: ( ) no one has been applying _result tests_ to the profession as a whole and to the state in its capacity as doctor, testing carefully the sickness rate, the death rate, and the expense rate of preventable diseases; ( ) physicians themselves have not needed to know, either at college or in practice, the tax levied upon their communities by preventable sickness. public schools can do much to secure result tests for individual physicians, for the profession as a whole, and for boards of health. schooling in preventive medicine, or, better named, schooling in preventive hygiene, will fit physicians to do their part in eradicating preventable disease. preventive hygiene is not an essential part of the training of american physicians or nurses to-day. not only are there no colleges of preventive hygiene, but medical schools have not provided individual courses. it is possible for a man to graduate with honors from our leading medical colleges without knowing what "vital statistics" means. even boards of health, their duties and their educational opportunities, are not understood by graduates; it is an accident if the "social and economic aspects of medical practice," "statistical fallacies," "hospital administration," "infant mortality," are familiar terms. it is for this reason, rather than because physicians are selfish, that indispensable and beneficent legislation is so generally opposed by them when the prerogatives of their profession seem in danger. practically every important sanitary advance of the past century has been fought at the outset by those whose life work should have made them see the need. physicians bitterly attacked compulsory vaccination, medical inspection of schools, compulsory notification of communicable diseases. what is perhaps more significant of the physician's indifference to preventive hygiene is the fact that most of the sanitary movements that have revolutionized hygienic conditions in america owe their inception and their success to laymen, for example, tenement-house reform, anti-child labor and anti-tuberculosis crusades, welfare work in factories, campaigns for safety appliances, movement for a national board of health, prison, almshouse, and insane-asylum reform, schools for mothers, and milk committees. the first hospital for infectious diseases, the first board of health, the first out-of-door sea-air treatment of bone tuberculosis in the united states, were the result of lay initiative. dr. hermann m. biggs says that in america the greatest need of the medical profession and of health administration is training that will enable physicians and lay inspectors to use their knowledge of preventive hygiene for the removal of living and working conditions that cause preventable sickness. a physician without knowledge of preventive hygiene is simply doing a "general repair" business. for a few months in new york city had a highly efficient commissioner of street cleaning, who, in spite of the unanimous protests and appeals of the press, refused to give up the practice of medicine. hitherto the board of health of that city has been unable to obtain the full time of its physicians because professional standards give greater credit to the retail application of remedies than to the wholesale application of preventives. statesmanship as well as professional ability is expected of physicians in the leading european cities, more particularly of those connected with health departments. there it is not felt that a medical degree is of itself a qualification for sanitary or health work. after the professional course, physicians must take courses in preventive hygiene and in health administration. medical courses include such subjects as vital statistics, duties of medical officers of health, sanitary legislation, state medicine. the needless cost for one year of "catching" diseases in new york city would endow in perpetuity all the schools and lectureships and journals necessary to teach preventive hygiene in every section of this great country. that city alone sacrifices twenty-eight thousand lives annually to diseases that are officially called preventable. the yearly burial cost of these victims of professional and community neglect is more than a million dollars. when to the doctor bills, wages lost, burial cost of those who die are added the total doctor bills, wages lost, and other expenses of the sick who do not die, we find that one city loses in dollars and cents more every year from communicable diseases than is spent by the whole united states for hospitals and boards of health. many diseases and much sickness are preventable that are not communicable. indigestion due to bad teeth is not itself communicable, but it can be prevented. one's vitality may be sapped by irregular eating or too little sleep; others will not catch the trouble, although too often they imitate the harmful habits. adenoids and defective vision are preventable, but not contagious. spinal curvature and flat foot are unnecessary, but others cannot catch them. preventive hygiene, however, should teach the physician's duty to educate his patient and his community regarding all controllable conditions that injure or promote the health. in the absence of special attention to preventive medicine new truth is forced to fight its way, sometimes for generations, before it is accepted by the medical profession. so strong are the traditions of that profession and so difficult is it for the unconventional or heterodox individual to retain the confidence of conservative patients, that the forces of honorable medical practice tend to discourage research and invention. the man who discovers a surgical appliance is forced by the ethics of his profession either to commercialize it and lose his professional standing, or to abide the convenience of his colleagues and their learned organizations in testing it. rather than be branded a quack, charlatan, or crank, the physician keeps silent as to convictions which do not conform to the text-books. many a life-saving, health-promoting discovery which ought to be taken up and incorporated into general practice from one end of the country to the other, and which should be made a part of the minimum standard of medical practice and medical agreement, must wait twenty-five or fifty years for recognition. [illustration: the disciple of fresh air and home instruction is still an outcast in scores of hospitals] for want of a school of preventive medicine to emphasize universally every new truth, the medical colleges are permitted to remain twenty-five or fifty years behind absolutely demonstrated facts as to medical truth and medical practice. in a german physician, avenbruger, after discovering that different sounds revealed diseased tissue, used "chest tapping" in the diagnosis of lung trouble. in lëannec discovered that sound from the chest was more distinct through a paper horn. on that principle the modern stethoscope is built. he made an accurate diagnosis of tuberculosis, and while suffering from that disease treated himself as a living clinical study. in pasteur proved the presence of germs "without which no putrefaction, no fermentation, no decay of tissue takes place." in trudeau started the first out-of-door care of pulmonary tuberculosis in america. in biggs secured the compulsory notification of pulmonary tuberculosis. in began our first out-of-door sea-air treatment for bone tuberculosis. yet there are thousands of physicians to-day who sincerely believe that they are earning their fees, who, from houses shut up like ovens, give advice to patients for treatment of tuberculosis, who prescribe alcohol and drugs, who diagnose the disease as malaria for fear patients will be scared, who oppose compulsory registration, and who never look for the tuberculous origin of crippled children. just think of its being possible, in , for a tuberculous young man of thirty to pay five dollars a day to a sanatorium whose chief reliance is six doses of drugs a day! in america's first dentist came to the united states. by itinerant dentists had built up a lucrative practice. in a course of lectures on dentistry was delivered before the medical class at the university of maryland. as early as treatises were written "upon dentition and the breeding of teeth in children." in the possibility of correcting irregularities was pointed out, as was the pernicious effect of tartar on the teeth in . in attempts were made to abolish, "in all common cases, the pernicious habit of tooth drawing." in treatises were written on the importance of regulating the teeth of children before the fourteenth year and on the importance of preserving the first teeth. yet in it is necessary to write the chapter on dental sanitation. few physicians, whether in private practice or hospitals or just out of medical college, consider it necessary to know the conditions of the mouth before prescribing drugs for physical illness. osteopathy furnishes an up-to-date illustration. discredited by the medical profession, by medical journals and medical schools, it has in fifteen years built up a practice of eight thousand men, having from one to three years' training, including over one hundred physicians with full medical training plus a course in osteopathy. there were means of learning fifteen years ago what was truth and what was quackery about the practice of osteopathy. by refusing to look for its truth and by concentrating attention upon its quackery the medical profession has lost fifteen years. whereas the truth of osteopathy should have been adopted by the medical colleges and a knowledge of its possibilities and limitations required of every practicing physician, a position has been reached where alleged quackery seems in several important points to be discrediting the sincerity, the intelligence, and the efficiency of orthodox medicine. no appeal to the natural can be stronger, no justification of schools of preventive medicine more complete, than the following paragraph from an osteopathic physician who is among the small number who, having both the medical and osteopathic degrees, see both the possibilities and limitations of manual surgery and demand the inclusion of this new science in the medical curriculum. the physical method of treating disease presents a tremendous and significant departure from the empiricism of medicine and the experimentation of dietetics, the restricted fields of electricity, suggestion, water cures, and massage. the patient as an individual is not treated; the disease as a disease is not treated; the symptoms are not treated; but the entire physical organism, with its many parts and diverse functions, is exhaustively examined until each and every abnormal condition, whether of structure or of function, causing disease and maintaining symptoms, is found and administered to with the skill of a definite art, based upon the data of an exact science. likewise the truths underlying christian science have been disdained by medical schools and medical experts, just as its spiritual truth has been disdained by religious leaders, until it has grown to such strength that laymen are almost forced to question the sincerity and the efficacy of the conventional in religion as well as medicine. in may, , the emmanuel church in boston organized a clinic for the purpose of utilizing for neurasthenics particularly both the spiritual and the physical truths underlying religion and the various branches of medical science. daily papers and magazines are giving a great deal of space to this experiment in "psychotherapy," which is discussed in the chapter on mental hygiene. schools and chairs in preventive hygiene would soon give to the medical profession a point of view that would welcome every new truth, such as the alliance of religion and medicine, and estimate its full worth promptly. truth seeking would be not only encouraged but made a condition of professional standing. just what attitude any particular physician takes can be learned by the teacher or parents whose children he treats. if he pooh-poohs or resents board of health regulations as to isolation of scarlet-fever patients, he is a dangerous man, no matter how noble his personal character. if he says cross-eyes will straighten, weak eyes will strengthen, or nose-stopping adenoids "absorb," he is bound to do harm. if he says tuberculosis is incurable, noncommunicable, hereditary, or curable by drugs, or if he tries to cure cancer by osteopathy, he can do more injury than an insane criminal. if he fails to teach a mother how to bathe, feed, and clothe the baby, how to ventilate a room for the sick or the well, he is an expensive luxury for family or for school, and belongs to an age that knew neither school nor preventive hygiene. if he takes no interest in health administration; if he overlooks unclean milk or unclean streets, open sewers, and unsanitary school buildings, street cars, churches, and theaters; if he does not help the health board, the public hospitals, the schools, the factory, and tenement departments enforce sanitary laws, he is derelict as a citizen and as a member of an "exalted profession." if he sees only the patients he himself treats or one particular malady, he is derelict as a teacher, no matter how charming his personality or how skilled in his specialty. if a school physician is slovenly in his work, if he spends fifteen minutes when he is paid for an hour, should the efficient school-teacher conceal the fact from her superiors because he is a physician? if private hospitals misrepresent facts or compromise with political evils for the sake of a gift of public money, their offense is more heinous because of their exalted purpose. the test of a physician's worth to his patients and to his community is not what he is or what he has learned, and not what his profession might be, but what happens to patient and to community. human welfare demands that the medical profession be judged by what it does, not by what it might do if it made the best possible use of its knowledge or its opportunity. [illustration: too many physicians and even maternity hospitals fail to teach mothers, either before or after babies are born caroline rest educational fund was given to show the value of such teaching] a dispensary that treats more patients than it can care for properly is no better than a street-car company that chronically provides too few seats and too many straps. unless physicians test themselves and their profession by results, we shall be compelled to "municipalize the medical man." preventable sickness costs too much, causes too much wretchedness, and hampers too many modern educational and industrial activities to be neglected. if the medical profession does not fit itself to serve general interests, then cities, counties, and states will take to themselves the cure as well as the prevention of communicable and other preventable sickness. human life and public health are more precious than the medical profession, more important even than theories and traditions against public interference in private matters. the unreasoning opposition of medical men to government protection of health, their concentration on cure, and their tardy emphasis on prevention have forced many communities to stumble into the evil practices mentioned in chapter xvi. incidentally, the best physicians have learned that the prosperity of their profession increases with every increase in the general standard of living. it is the man in the ten-room house not the man in one room who supports physicians in luxury. it is the healthy man and the healthy community that value efficient medical service. many american cities maintain dispensaries and hospitals for the poor. whether they will go to the logical conclusion of engaging physicians to give free treatment to all regardless of income depends largely upon what the next generation of private physicians do. the state already says when a physician's training fits him to practice. it will soon expect him to pass rigid examinations in the social and economic aspects of his profession,--its educational opportunity, vital statistics, sick and death rates. will it need to municipalize him in order to protect itself? obviously the teacher or parent should not begin cooperation with physicians by lecturing them or by assuming that they are selfish and unwilling to teach. the best first step is to ask questions that they should be able to answer: what causes cholera morbus or summer complaint? when does milk harm the baby? how can unclean milk be made safe? whose fault is it that the milk is sold unclean and too warm? what agencies help sick babies? what is the health board doing to teach mothers? or, if a school physician, the teacher can ask: why not remove these adenoids? what causes them? when will they disappear by absorption? what harm can they do in the meantime? how long would an operation take? would it hurt very much? what would be the immediate effects? why not act at once? what provisions are there in town for such operations? why have the physicians paid so little attention to breathing troubles? what could your state do to interest physicians in school hygiene? will the school physician talk to a mothers' meeting? what agencies will give outings to sick children? what dispensaries are accessible? who is the proper person to organize a public health league? physicians love to teach. if teachers and parents will love to learn and will ask the right questions, all physicians can be converted into hygiene missionaries, heralds of a statesmanship that guarantees health rights to all. licensing the practitioner three parties are interested in setting a high standard for physicians, dentists, druggists, nurses, and veterinary surgeons--the profession itself, the schools that educate, and the general public on whom the arts are practiced. the schools and the practitioners are, for the most part, primarily interested in protecting a monopoly of skill. their interest in restrictive legislation is analogous to that of the labor union which limits the number of apprentices. this trade unionism among professional colleges and professional graduates of these colleges has gradually developed a higher and higher standard that results in greater protection to the public. the first step is generally to demand that all persons entering a profession after a given date shall prove to the state their ability to "practice" without injury to clients. it is almost impossible to get such laws through unless the original law exempts all persons by whatever name, who are practicing the art in question at the time the law is passed. whether we are speaking of medicine, law, dentistry, accountancy, osteopathy, or barbering, this has been the history of compulsory restriction and of state examinations. as with regard to most other legislation, the enforcement of the law lags behind its definition. moreover nothing is done after a man has passed a certain examination to see that he remains fit and safe to treat the public. because no supervision is provided except on the day of examination, it is possible for men and women to fill their brains for a week or two weeks with the information necessary to pass what coaches and tutors have learned will, in all probability, be asked. forever after, the public is left to protect itself. out of this condition have arisen the evil, unethical, and unprofessional practices represented particularly by painless dentists, by ignorant or dishonest physicians, and by osteopaths and careless nurses. the machinery for preventing these evils is discussed in chapter xxix. suffice it here to present to parents and teachers the need for examination in advance of certification that will show whether or not those who make a livelihood by caring for others' health are equipped to mitigate rather than aggravate evils, and for further tests by which the public can learn from time to time which, among those professional men who are protected by the public against competition, continue to be safe. finally, if, as will be clearly seen, it is desirable that what we call professional ethics persist and that self-advertisement be discouraged, society must, for its own protection, adopt some other means than epithets to correct the evils of self-advertisement and quackery. even though we admit the responsibility of each citizen when he goes to the house of a private practitioner who has made no other effort to lure him thither than to place a card in the window, it must be seen that we cannot hold responsible for their choice men and women who receive through newspapers, magazines, or circulars convincing notices that dr. so-and-so or the integrity company or the peerless dental parlor will place at their disposal, at prices within their reach, skill and devotion absolutely beyond their reach at the office of an efficient private practitioner. some way must be found by which departments of health will currently impose tests of methods and results upon physicians, opticians, pharmacists, manufacturers of medicine, and dentists. as laymen become more intelligent regarding their own bodies and healthy living, it grows harder and harder for quacks and incompetents to mislead and exploit them. better than any possible outside safeguard is hygienic living. fortunately, we can all learn the simple tests of environment and of living necessary to the selection of physicians, dentists, and opticians, or other "architects of health" whose efficiency and integrity are beyond question. part iv. official machinery for enforcing health rights chapter xxvii departments of school hygiene the term "school hygiene" generally suggests no other school than the public school. state laws say nothing about compulsory hygiene in military academies, ladies' seminaries, or other preparatory and finishing schools. yet when one thinks of it, one must conclude that the right to health and to healthful school environment cannot equitably be confined to the children whose tuition is given at public expense. there is a better way to check "swollen" fortunes than by ruining the health of "fortune's children." the waste and danger of slow-minded, noticeably inefficient children are no less when parents are rich than when parents are poor. there is no justification for neglecting the health of children in parochial schools, in private schools for the well-to-do or rich, or in commercial schools for the ambitious youth of lower income strata. nor has the commercial, parochial, private school, or college, any clearer right than the public school to injure or to fail to promote pupils' health. so far as school hygiene is advisable, so far as it is right to make hygiene compulsory, its personal and social benefits should be shared by children of school age without regard to income, and its laws should be enforced by all teachers, principals, and officers that have to do with school. in presenting a programme for school hygiene this chapter refers to the hygiene taught, the hygiene practiced, the hygiene not taught, and the hygiene not practiced in buildings and on grounds where children and youth are at school, whether these children are in kindergarten or high school, in reformatory or military academy, in charitable school, or in finishing and preparing center for society's juniors. the question of the local, state, and national machinery by which proper standards of school hygiene shall be made effective will be taken up after we have considered individual steps in a comprehensive programme for school hygiene. . _thorough physical examination of all candidates for teachers' positions and periodic reëxamination of accepted teachers._ teachers would be grateful to be told in time their own physical needs and the relations of their vitality to the vitality of their pupils. are your teachers examined? do they know the laws of health and the signs of child health? are they permitted to continue in schoolrooms after tuberculosis is discovered? are normal graduates given physical tests before being permitted to teach and before being permitted to give four years to preparation for teaching? . _thorough physical examination of every single child in every single school upon entering and periodically during school life._ we believe a vast number of things that "ain't so" about the health of country children as compared with city children, of private-school children as compared with public-school children. where do we find more degenerate men, physically and morally, than in so-called "american settlements," where, for generations, children have had all outdoors to play in, except when in homes and schoolhouses that are seldom cleansed and seldom ventilated? open mouths and closed minds clog the "little red schoolhouse"; there headaches do not suggest eye strain; there deafness and running ears are frankly attributed to scarlet fever which everybody must have with all the other "catching" diseases, the earlier the better; there colds begin in december and run until march, to the serious injury of attendance and promotion records; there bone tuberculosis is called "knee trouble" or "spine trouble in the family"; there boys like my little friend fred count the bottles of cod-liver oil they take to cure adenoids that could be removed in two minutes. the index to community life and community living conditions should be read in the country, not only for the country's sake, but also for the sake of the city whose milk and water, poisoned in the country, cause thousands of deaths annually, besides annual sick bills exceeding many times over the russell sage and carnegie foundations, which we rightly call munificent. reading the index of private schools and colleges is important for their children and youth, but still more important for the community upon which unbridled passion, inability to work or to spend properly, inconsequential thinking, mediæval ideals of caste, etc., can inflict greater injuries than can typhoid fever or cholera. the physical record of each child should be kept from date of entrance to date of leaving school, showing condition at successive examinations, absence because of illness, etc. . _thorough physical examination of children when leaving school, or when passing compulsory school age, as a condition to "working papers" and to "coming out."_ to give working papers to children seriously handicapped by physical defects is to buy future industrial trouble, hospital and poorhouse bills. a boy with adenoids, a girl with eye trouble, should not be permitted to begin the fight for self-support without at least being clearly shown that the correction of these defects will increase their earning power. at present a schoolgirl with incipient tuberculosis, or predisposed to that disease, can get working papers, go to a hammock or tobacco factory, work long hours, breathe bushels of dust, deplete her vitality, spread tuberculosis among her co-workers and home associates, infect a tenement,--and all this without any help or advice or any protection from society until she is too sick to work and her physician notifies the health department that she is a danger center. we may disagree about society's right to control a child's act after the defects are discovered, but who will question society's duty to tell that child and her parents the truth about her physical needs before it accepts her labor or permits her to "enter society"? . _supervision by physicians of hygiene practiced in schoolrooms and on playgrounds._ superintendent maxwell, of new york city, and other educational leaders urge teachers to do their utmost to learn the physical conditions and home environment of the individual child, and to fit school treatment to the individual possibilities and handicaps. but experience proves conclusively that try as they will, teachers and principals have neither the special knowledge nor the time to acquire the special knowledge requisite to use the facts disclosed by the physical examination of school children. physicians and nurses are needed, not so much for treating children, as for teaching children, parents, teachers, family and dispensary physicians. private schools have visiting physicians who may be consulted; they need physicians to supervise, with power to examine or to require certificates of examination. the committee on the physical welfare of school children found that when a visitor was detailed for that purpose it was easy to secure the coöperation of parents, teachers, family physicians, dispensaries, school boards, and charitable societies. the hawthorne club's school secretary has been similarly successful in boston, as have those of hartley house, greenwich house, and the public education association in new york. . _restriction of study hours at school and at home to limits compatible with health._ whether the hours of study at school and at home are excessive cannot be learned from treatises on pedagogics or physiology. because children differ in vitality as in ability to learn, the maximum limit for study hours should be determined by the individual child's physical condition. when the japanese went to war with russia the highest authority in the field was the army surgeon. to this fact was largely due the astonishingly small amount of sickness and the high fighting capacity and endurance of the japanese, working under unfavorable conditions. no board of school superintendents or board of directors, no state superintendent of schools or college professor, has the right to compel or to allow study hours beyond the maximum compatible with the individual student's physical condition and endurance. the physician responsible for school hygiene should have an absolute veto upon any educational policy, method, or environment demonstrably detrimental to children's vitality. . _establishment of a "follow-up" plan to insure action by parents to correct physical defects and to attend to physical needs._ the advantages of _getting things done_ over _doing things_ have been repeatedly emphasized. in smaller cities and in rural districts it is particularly important for schools to get things done better by existing local agencies, such as churches, health and street-cleaning departments, hospitals, clinics, medical and sanitary societies, trade unions, young people's societies, and women's clubs. where parents who have been followed up and taught, obstinately or ignorantly refuse to attend to their children's needs, the segregation of the physically defective or needy will encourage the coöperation of children themselves in persuading parents to act intelligently for the child's sake. no child wants to remain "queer" or "dopey" or behind his peers. the city superintendent of schools for new york city has asked for laws compelling parents to permit operations and punishing them for neglecting to take steps, within their power, to remove physical defects discovered at school. [illustration: teaching a mother to care for one child insures better care for all her children] . _physiological age should influence school classification and school curriculum._ on this subject the studies of dr. c. ward crampton, referred to in the chapter on vitality tests, are invaluable and as convincing as they are revolutionary. scientists accept his proof that our present high school curriculum is ill adapted to a large proportion of children; the "physiologically too young" drop out; only the physiologically mature succeed. the two physiological ages should be given different work. children whose bodies yearn for pictures, muscular and sense expression, should be given a chance in school for normal development. analysis should wait for action. organized play and physical training antedated physical examination in our schools. like the curriculum they often disregard physiological age, doing harm instead of good. facts as to physical condition and physiological development would enable us to utilize the momentum of these two to broaden school hygiene and to insure proper physical supervision. only good would result from adopting leipsic's plan of having school children examined without clothing, in the presence of parents if parents desire. expensive? not so expensive as high school "mortality" due to maladjusted curriculums that force the great majority of boys and girls to drop out before graduation and ruin the health of a large fraction of those who remain. . _construction of school building and of curriculum so that, when properly conducted, they shall neither produce nor aggravate physical defects._ when the state for its own protection compels a child to go to school, it pledges itself not to injure itself by injuring the child. thousands of children are now being subjected to conditions in school far more injurious than the factory and shop conditions against which the national and state child labor committees have aroused universal indignation. two illuminating studies of school buildings in new york city were made last year by the committee on the physical welfare of school children, and later by the board of education. similar studies should be made of every schoolroom. whereas our discussions of buildings and curriculum have hitherto proceeded largely from abstract principles of light, ventilation, heating, and pedagogics, these two reports deal with rooms, equipment, courses of study, and school habits as they are, with obvious detrimental effects on child victims. numerous questions that it is practicable to answer are given in chapter xiv. what and when to build can be better determined after we have learned the what and the where of present equipment. in passing it is worth while to note that in large cities teachers are frequently forced to choose between bad ventilation and street noises. from boston comes the suggestion that we avoid noises and evils of congestion by building schoolhouses for city children on the outskirts in the midst of fields, transporting, and, if necessary, feeding children at public expense. while it is true that the public funds now spent in attempting to cure physical and moral ills would purchase ample country reservations, the practical next step seems to be to provide ample play space and breathing space within the city for every school building already erected, and without fail for all buildings to be erected hereafter. . _hygiene should be so taught that children will cultivate habits of health and see clearly the relation of health and vitality to present happiness and future efficiency._ social rather than personal, public rather than private, health needs emphasis. children can be shown how their health affects their neighbor; why money spent for health boards is a better investment than money given to corrupt politicians; that the cost of accepting thanksgiving turkey or a park picnic from a political leader who encourages inefficient government is sickness, misery, deficient schooling, lifelong handicap; that children and adults have health rights in school and factory, on street and playground, which the law will protect if only they know when these rights are infringed. . _central supervision of school hygiene._ in private and public, boarding and day, country and city, reformatory and military, commercial and high schools, the index--physical welfare of school children--should be read and interpreted. headquarters should learn whether or not physical examinations are made and whether harmful conditions are corrected. so far as public schools are concerned, "headquarters" means for cities the fact center that informs city superintendent or school board; for rural schools, it means the county superintendent's office. whether city or county headquarters have the facts and act accordingly should be known by state superintendents. whether state superintendents are demanding the facts and educating the county and city headquarters of their states should be known to the national commissioner of education and by him published for all the world. some people think the state health board should be responsible, others the state educational authority. the important thing is to make some one officer responsible. methods can be easily worked out if the need is conceded. legislatures will gladly confer the powers necessary to reading the index of all public schools. as for parochial and private schools, they may resent for a time public supervision of their hygiene teaching and practice. however, the case could be so presented that they would ask for it, because it would help not only their pupils and society but the schools themselves. no religious belief or private investment can afford to admit that it disregards child health; state supervision would require nothing more than evidence of adequate school hygiene. . _information gained at school regarding conditions prejudicial to community health should be published and made the basis of an aggressive campaign for the enforcement of sanitary laws._ ten thousand uses can be made of the information gained at school, ten thousand forces can be made to do educational work, but only a few kinds of work can be done effectively at school. franklin ford has said: "you can relate school to all life, but you cannot bring all life under the school roof." as chapters xvi-xviii make clear, to socialize the point of view of dispensaries and hospitals is more effective than to put clinics in school buildings. to _do for_ or _give to_ people who can help themselves is to _give up_ and _do up_ power of self-help. machinery that must some day exist for the execution of this programme will be approximately the following: i. national machinery . clearing house for facts regarding school hygiene as taught and practiced in all schools under the stars and stripes; this to be a part of the national bureau of education. . scientific research to be conducted by the national bureau of education or by the future national board of health. ii. state machinery . clearing house for facts regarding school hygiene taught and practiced in all schools within state limits; this to be maintained by the state educational authorities. . agents to make special inquiries as to practice and teaching of school hygiene. . agents to inspect and to instruct county superintendents, county physicians, teachers, normal schools, etc. . a bureau of experts--architect, sanitarian, teacher--whose approval must be obtained before any school building can be erected. (a plan which brought excellent results when applied by state boards to charitable institutions, hospitals for the insane, etc.) . standard making by normal schools, state universities, hospitals, or other educational and correctional institutes under direct state management. iii. county machinery . clearing house for facts regarding school hygiene taught and practiced in all schools within county limits; this to be maintained by the county superintendent of schools. . physician and nurse to organize inspection and instruction for rural schools, to give lessons and make demonstrations at county institutes, to show teachers how to interest physicians, dentists, health officers, and parents in the physical welfare of school children. iv. town and township machinery . teachers intelligent as to physical needs, as to sanitation of buildings, etc. . an examining physician, to be salaried where the population justifies; elsewhere to work as a volunteer in coöperation with teacher and with county physician. . physical history of each child from date of entrance to date of leaving school, to be kept up to date by teacher. v. city machinery . a division to be known as the department of school hygiene, headed by an officer who gives his entire time to that department. . a subcommittee of the board of education. . clearing house for facts regarding school hygiene taught and practiced in all schools within city limits. . specialists to examine applicants for teaching positions, and to reëxamine teachers to determine fitness for continuance, for promotion, and for special assignments. . a bureau for inspection and control of all hygiene of school buildings, old and new, with power to compel repairs or to reject plans that do not make adequate sanitary provision. . similar supervision of curriculum and of study hours prescribed. . a bureau for the inspection and control of curriculum, required home study, exercise, physical training, etc., so far as relates to the health of pupils, and to the physical ability of children to be in certain grades or to be promoted. this will decide the duration of lessons, frequency of intermissions, sequence of subjects, time and method of recess throughout the various grades. . supervision of indoor and outdoor playgrounds, roof gardens, indoor and outdoor gymnasiums, swimming pools, etc. . supervision of instruction in school hygiene. . a staff of inspectors for communicable diseases of pupils and teachers, to be subject to the board of education or the board of health. . a staff of examiners adequate to examine all children and teachers at least once a year for defects of eye, ear, teeth, nose, throat, lungs, spine, bones, glands, etc., and for weight and height to be under the control of the board of education or the board of health. the expense would not be as great as the penalty paid for omitting such examination. . a staff of nurses to assist medical examiners to give children practical demonstrations in cleanliness, to teach mothers the care of children both at their homes and in mothers' meetings, to enlist the coöperation of family physician and neighborhood facilities, such as hospitals, dispensaries and relief agencies, magistrates' courts and probation officers,--all to be under the control of the board of education or the board of health. whether inspectors, examiners, and nurses shall be directed by the board of education or the board of health is a question that it is impossible to decide without knowledge of local conditions. so far as state and county organizations are concerned, it is clear that whatever the boards of health may do, it will be necessary for state and county superintendents of education to equip themselves with the machinery above recommended. in cities it is quite clear that a board of education should be responsible for all of the machinery suggested, excepting the three divisions that have to do with work hitherto considered as protection against transmissible diseases, namely, inspection, examination, district visiting. in cleveland these are school duties. in new york they are duties of the health department. boston has school nurses and health department physicians. the state law of massachusetts provides that where health boards do not examine school children, school boards may spend money for the purpose. as to inspection for transmissible diseases, it seems quite clear that health boards should not delegate their authority or responsibility to any other body, for they alone are accountable to their communities for protection against contagion. it is clear, too, that in the interest of community health, departments of health are justified in pointing out in advance of contagion those children most likely to become a menace. similar grounds of public interest justify the health boards in sending nurses and physicians to the home as a means of getting things done. dr. biggs feels that responsibility for the physical welfare of school children will strengthen health work in all cities, and, given proper interest on the part of school officials, should make possible universal coöperation in a constructive programme. on the other hand, he believes that division of responsibility between school and health boards will weaken both in their appeals for funds and for support of a constructive programme. i have heard principals and superintendents maintain also that the moral effect of a visit to the school by a representative of the health board vested with powers of that board was much greater than a visit by a representative of the school board. they further allege that a physician coming from the outside is more apt to see things that need correction and less apt to accept excuses than an inspector who feels that he belongs to the same working group as the school-teacher. because the follow-up work in the homes incident to successful use of knowledge gained at school involves so many sanitary remedies, it is theoretically better organization to hold the health authority responsible. chapter xxviii present organization of school hygiene in new york city many of the elements of the machinery outlined in the preceding chapter already exist in new york city. all of them brought together, either by amalgamation or by proper coördination, would present a very strong front. unfortunately, however, there is not only unsatisfactory team work, but the efficiency of individual parts is seriously questioned by the heads of the health and school departments. the inspection for contagious diseases, the examination for physical defects, the follow-up work by nurses and physicians, are in charge of the department of health. physical training and athletics for elementary and high schools, winter recreation centers, and vacation playgrounds are under directors and assistants employed by the board of education. heretofore inadequate powers and inadequate assistance for training or for research have been given to the physical director. the city superintendent of schools, in his report for the year , presented to the board of education in january, , declares that the "present arrangements have been inadequate.... in only schools--less than half the total number--were any examinations for possible diseases made. in these schools not more than one third of the pupils were examined. it is only a few months since any examinations for physical defects were made outside of the boroughs of manhattan and the bronx, and then only on account of the new york committee on the physical welfare of school children." as is so often the case, it is difficult to decide the merits of a method that has not been efficiently executed. the department of health has not hitherto done its best in its school relations. the commissioner of health, in a public interview, expresses resentment at the strictures by the school authorities. yet in he permitted to accumulate an unexpended balance of $ , specifically voted for school inspectors, and repeatedly tried to have this amount transferred to other purposes. the interest of the bureau of municipal research in municipal budgets that tell for what purposes money is voted and then prevent transfers without full publicity, preserved this particular fund. moreover, the discussion that prevented its diversion from physical examinations strengthened the health department's interest in this important responsibility. neither physicians nor nurses have been adequately supervised. instead of seeing that defects were removed, the department of health sent out postal cards like the following: [illustration: (notice example)] +-----------------------------------------------------------------------+ | "this notice does not exclude this child from school" | | | | department of health | | the city of new york | | | | _oct. , _ _ | | | | the parent or guardian of ___________________________________________ | | of____________________________________attending p.s.__ ___________ | | is hereby informed that a physical examination of this child seems to | | show an abnormal condition of the ___________________________________ | | ___eyes, nose, throat and teeth______________________________________ | | _____________________________________________________________________ | | remarks__is anaemic__________________________________________________ | | _____________________________________________________________________ | | | | take this child to your family physician for treatment and advice. | | take this card with you to the family physician. | | | | thomas darlington, m.d., | | commissioner of health. | | | | hermann m. biggs, m.d., | | general medical officer | +-----------------------------------------------------------------------+ from , such notices sent out only replies were received, of which only one in twenty stated that attention had actually been given the needy child. the department had been satisfied with evidence that family physicians had advised parents properly, as in the case of the child above reported: [illustration: (card example)] +----------------------------------------------------------------------+ | take this card to your physician | | | | the physician in charge is requested to fill out and | | forward this postal after he has examined this child. | | | | i have this day examined ___________________________________________ | | of p.s. __ ______________ and find the following condition: | | | | __as reported, also enlarged (unclear) glands_______________________ | | and advised as follows:__operation for adenoids and tonsils_________ | | _____dental treatment at cornell. fresh air ________________________ | | _____outing at sea breeze eyes wait.________________________________ | | | | respectfully yours, | | _______p.l. ob___________ | | date __oct. , ______ _________________________ | | | +----------------------------------------------------------------------+ for a candid, complete criticism of the medical examination work up to june, , consult the report of the bureau of municipal research, presented to the washington congress of public education associations in october, , by commissioner of health, dr. darlington. the bureau's study is entitled _a bureau of child hygiene_, and, in addition to the story of medical examination in new york city schools, gives the blank forms adopted for use in september, . important as are the facts given in this study, its greatest value, its authors declare, is in its account of "the method of intelligent self-criticism and experiment which alone enables a public department to keep its service abreast of public needs." the bureau of municipal research made its study for the purpose of learning whether the disappointing results emphasized by the school authorities were due to "dual responsibility in the school--that of the board of education and that of the department of health"--and to "lack of power or inclination to compel parents to remedy defects," or to _deficient administration_ of power and inclination by health officials. coöperating with school physicians and nurses in three schools, children were examined, of whom , or . per cent, had defects that needed treatment. the postal-card notice was followed by an interview with the parent either at school or at home. only . per cent of the total number of parents refused to act, per cent secured or permitted treatment for one or more defects, while per cent promised to take the proper steps at the earliest possible date. three fourths of the parents acted after one personal interview. "the net average result of a day's work by a nurse was the actual treatment of over five children, three of them completely, and two of them for one or more defects,"--sixty cents per child! [illustration: a photograph of mouth breathing may make compulsion unnecessary] having established the willingness--even eagerness--of parents to do all in their power to remove defects that handicapped their children, it was obviously the duty of the health department so to organize its work that it could insure the education of parents. the new bureau of child hygiene gives foremost place to instruction of parents in care of babies, in needs of school children, and in the importance of physical examination when enlisting in the industrial army. whether this work is well done is learned by result tests applied at headquarters, where work done and results are reported daily and summarized weekly. no longer will it be possible, without detection, for one physician to find only eye trouble and to neglect all other defects; for two inspectors examining different children in the same school to report results differing by per cent; for physicians in different schools to find one per cent, another per cent with defects; for two inspectors examining identical children to agree on out of cases of vision, on out of cases of adenoids, or out of cases of skin disease. so conclusive were the results of follow-up work efficiently supervised by the department of health, that school officials are, for the present, inclined to waive the demand for the transfer of physicians and nurses to the board of education, and to substitute education for compulsion with parents who obstinately refuse to take proper remedial measures for their children when reported defective. this present plan requires the entire working time of inspectors and nurses for school work. thus new york has for the present definitely abandoned the plan of having the district inspection for contagious diseases done by school physicians. the purpose of the change is not to reduce danger of infection, which was negligible, but to increase the probability of scientific attention to school children. before a final settlement is made for new york city there should be tests showing what the school authorities would do if physicians and nurses were subordinate to them. it is conceivable that one physician working from nine to five would accomplish more than six physicians working the alleged three hours a day. so imperative are the demands of school hygiene that it seems probable that in new york and in other large cities school physicians, whether paid by the board of health or the board of education, must be expected to be at the service of school children, subject to the call of school officers, during as many hours of the day as teachers themselves must give. it is even conceivable that effective use of the knowledge gained by physical examinations of school children, and by those responsible for school hygiene, will require evening office hours or evening visits to homes, and regular saturday office hours and saturday visits by school physicians and nurses. finally, it must be expected that the programme for school hygiene will need the special attention of physicians and nurses during the summer months, and other vacation periods when children and parents alike have time to receive and to carry out their instructions. one danger in new york city is that the board of education, like the board of health, when compelled to choose between so-called standard, necessary, traditional duty and school hygiene, will sacrifice the latter. the school authorities, without any more funds and without physicians and nurses, could already have made, had they desired, eye tests and breathing tests sufficiently accurate to detect the majority of children needing attention. the outcome of the discussion as to the jurisdiction of the two boards will undoubtedly be to interest both in their joint responsibility for children's welfare, and to increase the attention given by both to the physical condition of the child when he presents himself for registration as a wage earner. chapter xxix official machinery for enforcing health rights the argument for _getting things done_ presumes adequate active machinery, official and private, for _doing things_ that schools are being urged to do. the chapter on departments of school hygiene suggests local, county, state, and national machinery necessary ( ) to protect the child from injuries due to school environment, school methods, and school curriculum; ( ) to getting those things done for the child at home and on the street, need for which is disclosed by physical and vitality tests at school. it is unreasonable to confine the school to the activities above outlined unless health machinery, adequate to the demands placed upon it by school and other community needs, is devised and kept in order. generally speaking, adequate health machinery is already provided for by city charters and by the state laws under which villages, townships, and counties are organized. quite as generally, however, machinery and methods of adequate administration are undeveloped. how much machinery has already been set to work by new york city is shown by the accompanying chart. a useful exercise for individuals or school classes wishing to study health administration would be to chart in this way the machinery actually at work in their locality, county, and state. even for new york it should be remembered that this chart does not include national quarantine, the state protection of the port, the state dairy and health commissions, or the state and national food inspection. to get an idea of the vast amount of attention given to health in new york city there should be added to this chart the work of many departments other than the department of health. the building bureau, tenement-house department, board of water supply, sewage commission, street cleaning, public baths and comfort stations, the department of water, gas, and electricity, and finally the department of hygiene and physical training in the public schools. [illustration: chart showing how new york city's department of health exercises it's authority courtesy of bureau of municipal research] five elements of adequate machinery are generally lost sight of: . the voter. . the nonvoter, subject to health laws and often apt to violate them. . the mayor, governor, or president who appoints health officers. . the council, board of aldermen, legislature, or congress that enacts health laws. . the police courts and the judiciary--police, circuit and supreme--that decide whether society has suffered from violation of law and what penalties should be inflicted for such violation. legislative bodies have hitherto slighted their responsibilities toward public health. the chairman of a committee on public health of a state legislature was heard to remark, "i asked for that committee because there isn't a blooming thing to do." if voters, nonvoters, and health officials will follow the suggestion of this book to secure school and health reports that will disclose community and health needs, it will be increasingly difficult for legislators to refuse funds necessary to efficient health administration. to the courts tradition has required such deference that one hesitates to find out in how far they have been responsible in the past for the nonenforcement of health laws. yet nothing is more obstructive of sanitary progress than the failure of magistrates to enforce adequate penalties for truancy, adulteration of milk, maintaining a public nuisance, defiling the air with black smoke, offering putrid meats for sale, running an unclean lodging house, defying tenement-house or factory regulations, working children under age and overtime, spitting in public places, or failing to register transmissible diseases.[ ] the appointing officer cannot, of course, be held responsible unless voters and nonvoters know in how far his appointees are inefficient, and in how far he himself has failed to do his utmost to secure funds necessary to efficiency. too frequently appointments to health positions have been made on political grounds, and catastrophes have been met by blundering incapacity. the political appointee has been made the scapegoat, and the appointing officer, whether mayor, governor, or president, has regained public confidence by replacing an old with a new incompetent. in order to have health machinery work properly, the appointing officer should not be allowed to shift responsibility for failure to his subordinates. for example, it was recently found in new york city that while the tenement-house commissioner was being condemned for failing to enforce the law, he had turned over to the corporation counsel, also appointed by the mayor, for prosecution ten thousand "violations" to which no attention whatever had been paid! the voter, nonvoter, appointing officer, legislative officer, and judicial officer determine the character and purpose of machinery and are analogous to the surveyors, stock-holders, directors, and constructors who provide railroads with tracks and with running stock. the actual running force of health department or railroad is what is meant by its official machinery. what this machinery should be depends, of course, upon the amount of business to be done, and differs with the size of the district and the character of population to be served. [illustration: for push-cart food, inspection is particularly needful] local health machinery should guarantee protection against the evils mentioned in preceding chapters. in general, one man is better than three to execute, although three may be better than one to legislate. where small communities do not wish to have the entire state sanitary code rigidly administered, they can adopt new york's method of a legislative board of three members, headed by an executive, whose business it is to act, not talk; to watch subordinates, and to enforce rigidly and continuously ordinances passed by the board. the national bureau of census places under the general heading health and sanitation the following activities: health administration, street cleaning and refuse disposal, sewers and sewage disposal. sanitarians generally emphasize also the health significance of efficient water service. a community's health programme should be clearly outlined in the annual budget. where health work is given funds without specification of the kinds of work to be done, serious evils may be overlooked and lesser evils permitted to monopolize the energies of health officers. again, after money has been voted to prevent an evil, records should be made of work done when done, and of money spent when spent, so that any diversion will be promptly made known. the best present guides to budget making, to educational health reports, and to records that show efficiency or inefficiency of health administrators are the budget and report of the department of health for new york city, and the story of their evolution told in _making a municipal budget_, by the bureau of municipal research. to find out whether local machinery is adequate, the reader must enumerate the things that need to be done in his community, remembering that in all parts of the united states to-day there are sanitary laws offering protection against dangers to health, excepting some dangers not understood until recently, such as child labor, dangerous trades, lack of safety devices. adequate local protection, however, will not become permanent until adequate state machinery is secured. state health machinery should be of two kinds,--fact-gathering and executive supervision through inspection. the greatest service of state boards of health is to educate localities as to their own needs, using the experience of all communities to teach each community in how far its health administration menaces itself and its neighbors. in addition to registration of contagious diseases, facts as to deaths and births should be registered. state health boards should "score" communities as dairies and milk shops are now being scored by the national bureau of animal industries and several boards of health. when communities persist in maintaining a public nuisance and in failing to enforce health laws, state health machinery should be made to accomplish by force what it has failed to accomplish by education. [illustration: national machinery has stimulated local milk inspection and state dairy inspection] states alone can cope adequately with dangers to milk and water sources and to food. the economic motive of farmers has developed strong veterinary boards for the protection of cattle. similar executive precaution must soon be taken by cities for the protection of babies and adults of the human species. it is far more economical to insure clean dairies, clean water sources, and wholesome manufactured foods by state inspectors than by local inspectors. at present the task of obtaining clean milk and clean water falls upon the few cities enlightened enough and rich enough to finance the inspection of community foods. once tested, it would be very easy to prove that properly supported state health authorities will save many times the cost of their health work in addition to thousands of lives. county or district machinery is little known in america. for that reason rural sanitary administration is neglected and rural hospitals are lacking. in the british isles rural districts are given almost as careful inspection as are cities. houses may not be built below a certain standard of lighting, ventilation, and conveniences. outbuildings must be a safe distance from wells. dairies must be kept clean. patients suffering from transmissible diseases may be removed by force to hospitals. what is more to the point, rural hospitals have proved that patients cared for by them are far more apt to recover than patients cared for much more expensively and less satisfactorily at home, while less likely to pollute water and milk sources or otherwise to endanger health. with national machinery the chapter on vital statistics has already dealt. we shall undoubtedly soon have a national board of health. like the state boards, its first function should be educative. in addition, however, there are certain administrative functions where inefficiency may result in serious losses to nation, state, and locality. national quarantine, national inspection of meats, foods, and drugs are administrative functions of vital consequence to every citizen. authorities are acquainted at the present time with the fact that the sanitary administration of the army and navy is unnecessarily and without excuse wasteful of human energy and human life. in the spanish american war soldiers died of disease for killed in battle; in the civil war died of disease to killed in battle; during the wars of the last years have died of disease for killed in battle. yet japan in her war with russia, by using means known to the united states army in , gave health precedence over everything else and lost but man to disease for killed in battle. diseases are still permitted to make havoc with american commerce because the national government does not apply to its own limits the standards which it has successfully applied to cuba and panama. "the japanese invented nothing and had no peculiar knowledge or skill; they merely took occidental science and used it. the remarkable thing is not what they did, but that they were allowed to do it. it is a terrible thing that congress should choose to make one of its rare displays of economy in a matter where a few thousand dollars saved means, in case our army should have anything to do, not only the utterly needless and useless loss of thousands of lives, but an enormous decrease of military efficiency, and might, conceivably, make all the difference between victory and defeat." footnotes: [ ] the technic and principles of municipal engineering have been treated in detail in _principles of sanitary science and the public health_, by william t. sedgwick, and in _municipal sanitation in the united states_, by charles n. chapin, m.d. chapter xxx school and health reports for every school-teacher or school physician responsible for the welfare of children at school, there are fifty or more parents responsible for the physical welfare of children at home. therefore it is all important for parents to know how to read the index for their own children, for their children's associates, and for their community. school reports and health reports should tell clearly and completely the story of the school child's physical needs. [illustration: necessary to efficient democracy] it is impracticable at the present time to expect a large number of men and women to be interested in the reports published by school and health boards, for, with few exceptions, little effort is made to write these reports so that they will interest the parent. fortunately, a small number of persons wishing to be intelligent can compel public officials to ascertain the necessary facts and to give them to the public. so backward is the reporting of public business that at the present time there is probably no service that a citizen can render his community which would prove of greater importance than to secure proper publicity from health and school boards. generally speaking, these published reports fail to interest the citizen, not because officials wish to conceal, but because officials do not believe that the public is interested. a mayor of philadelphia once furnished a notable exception. he called at the department of health and complained against publishing the number of cases of typhoid and smallpox lest stories in the newspapers "frighten the city and injure business." a sanitary inspector who was in the room asked if philadelphia's business was more important than the health of philadelphia's citizens. as a result of her "impertinence" the inspector was removed. that same year an epidemic of smallpox spread through all the rural districts and cities of pennsylvania, because physicians thought it would be kinder to the patients not to make known to their neighbors the presence of so disagreeable a disease. almost all health and school authorities, however, can be made to see the advantage of taking the public into their confidence, because public confidence means both public recognition and greater success in obtaining funds. with more funds comes the power to do more work. other details with regard to health reports will be found in the chapter on vital statistics. as to school reports, little thought has been given in the past to their educational possibilities. a book was recently published--_school reports and school efficiency_--by the committee on the physical welfare of school children, which tells the origins of school reports; contains samples of reports from one hundred cities; gives lists of questions frequently answered, occasionally answered, and never answered; and shows how to study a particular report so as to learn whether or not important questions are answered. the united states commissioner of education has organized among state and city superintendents special committees on uniform and adequate reporting. his aggressive leadership is welcomed by school men generally, and promises vast benefits. just because the physical welfare of the school child is an index to health needs, the school report can put into one statement for a city or a state the story told by the index. the accompanying card tells facts that the individual teacher and individual parent want to know about a child, what a superintendent wants to know about all children, and what a community wants to know about all children. a modification of this card will soon be adopted in new york city. it is both a card index and a card biography of the individual boy or girl. it is expected to follow the child from class to class, each teacher telling the story of his physical welfare and his progress. when the boy goes to a new school or new grade, his new teacher can see at a glance not only what subjects have given him trouble, but what diseases or physical defects have kept him out of school or otherwise retarded his progress. with this card it is easy to take a hundred children of the same age and the same grade, to put down in one column those who have eye defects, and in another those who have no eye defects, for every school, every district, and for the schools as a whole. schools that use these record cards are enabled, by thus classifying the total, to learn where the defects of children are, how serious the problem is, how many days children lose from school because of preventable defects, and in what section of the city the defects are most prevalent. the mere reporting of facts will stimulate teachers, principals, and parents to give attention. for example, assume a table: field of inspection total number of public schools public schools under inspection public schools not under inspection the reader wonders why four schools are neglected and which particular schools they are. let the next table read: examination total registration in all schools number of children examined number of children not examined parents begin to wonder whether or not their children were examined, and why the taxes spent for school examination of all children go to one third of the children. the next table arrests attention: treatment number needing treatment number known to have been treated number not known to have been treated we ask, at once, if examination is worth while, and if treatment really corrects the defects, saves the pupil's time and teacher's time, discovers many defects; and we want to find out whether the one hundred and fifty reported not treated have since been attended to. [illustration: pupil's record] [illustration: department of health city of new york report] again, if three out of five of those examined need treatment, people will wonder whether among the thousand not examined there is the same proportion--three out of five, or six hundred--who have some trouble that needs attention. having begun to wonder, they will ask questions, and will expect the board of health or the school physicians to see that the questions are answered. as has been proved in new york, taxpayers and the press will go farther and will demand that the annual budget provide for making general next year the benefits found to result last year from a test of health policies. the story of the prevalence of contagious diseases in school children could be told by a table such as is now in use by new york's department of health: table xii prevalence of contagious diseases in school children (case rate schools) key: a: in school b: among absentee =========+========================================+====================== | | communicable | general communicable diseases[ ] | diseases of eye school | | and skin[ ] +----------------------------------------+----------+----------- | number | | | +----------+-----------+-----+ number per| |number |found by | reported | | |number |per |inspectors| by | | registered|found by |registered +-----+----+ attending + + in schools+inspectors|in schools | a | b | physician |total| inspected |and nurses|inspected ---------+-----+----+-----------+-----+-----------+----------+----------- a | | | | | | | b | | | | | | | c | | | | | | | =========+=====+====+===========+=====+===========+==========+=========== [ ] smallpox, diphtheria, scarlet fever, measles, chicken pox, mumps, and whooping cough; excluded when found. [ ] trachoma and other contagious eye diseases, ringworm, impetigo, scabies, favus, and pediculosis; excluded only for persistent nontreatment. another table shows the following facts for each disease: table xiii contagious diseases found in schools by inspectors and nurses (number and disposition of cases) key: a: diphtheria j: other b: scarlet fever k: ringworm c: measles l: impetigo d: smallpox m: scabies e: chicken pox n: favus f: whooping cough o: pediculosis g: mumps p: miscellaneous h: total q: total i: trachoma ===================+=======================+=========================== | general | communicable diseases | communicable | of eye and skin | diseases |-----+--------------------- | | eye | skin +--+--+--+--+--+--+--+--+--+--+--+--+--+--+--+--+--- | a| b| c| d| e| f| g| h| i| j| k| l| m| n| o| p| q -------------------+--+--+--+--+--+--+--+--+--+--+--+--+--+--+--+--+--- cases found in | | | | | | | | | | | | | | | | | school | | | | | | | | | | | | | | | | | cases excluded | | | | | | | | | | | | | | | | | from school | | | | | | | | | | | | | | | | | cases treated in | | | | | | | | | | | | | | | | | school | | | | | | | | | | | | | | | | | cases instructed | | | | | | | | | | | | | | | | | in school or | | | | | | | | | | | | | | | | | evidence of | | | | | | | | | | | | | | | | | treatment | | | | | | | | | | | | | | | | | furnished | | | | | | | | | | | | | | | | | number of | | | | | | | | | | | | | | | | | treatments | | | | | | | | | | | | | | | | | number of | | | | | | | | | | | | | | | | | instructions | | | | | | | | | | | | | | | | | ===================+==+==+==+==+==+==+==+==+==+==+==+==+==+==+==+==+=== the story of noncontagious physical defects found and treated is set forth in the following table: table xiv medical examination of school children: noncontagious physical defects found and treated, ==============+=============================+=============================+ | school a | school b | |--------------+--------------+--------------+--------------| | found | reported | found | reported | | | treated | | treated | |-----+--------+-----+--------+-----+--------+-----+--------| defects | no. | % of | no. | % of | no. | % of | no. | % of | | | total | |defects | | total | |defects | | |defects | | found | |defects | | found | | | found | | | | found | | | --------------+-----+--------+-----+--------+-----+--------+-----+--------+ adenoids | | | | | | | | | | | | | | | | | | nasal | | | | | | | | | breathing | | | | | | | | | hyper-trophied| | | | | | | | | tonsils | | | | | | | | | defective | | | | | | | | | palate | | | | | | | | | defective | | | | | | | | | hearing | | | | | | | | | defective | | | | | | | | | vision | | | | | | | | | defective | | | | | | | | | teeth | | | | | | | | | bad nutrition | | | | | | | | | diseased | | | | | | | | | anterior | | | | | | | | | cervical | | | | | | | | | glands | | | | | | | | | diseased | | | | | | | | | posterior | | | | | | | | | cervical | | | | | | | | | glands | | | | | | | | | heart disease | | | | | | | | | chorea | | | | | | | | | pulmonary | | | | | | | | | disease | | | | | | | | | skin disease | | | | | | | | | deformity | | | | | | | | | of spine | | | | | | | | | deformity | | | | | | | | | of chest | | | | | | | | | deformity of | | | | | | | | | extremities | | | | | | | | | defective | | | | | | | | | mentality | | | | | | | | | total | | | | | | | | | ==============+=====+========+=====+========+=====+========+=====+========+ ==============+=============================+ | school c | |--------------+--------------| | found | reported | | | treated | |-----+--------+-----+--------| defects | no. | % of | no. | % of | | | total | |defects | | |defects | | found | | | found | | | --------------+-----+--------+-----+--------+ adenoids | | | | | | | | | | nasal | | | | | breathing | | | | | hyper-trophied| | | | | tonsils | | | | | defective | | | | | palate | | | | | defective | | | | | hearing | | | | | defective | | | | | vision | | | | | defective | | | | | teeth | | | | | bad nutrition | | | | | diseased | | | | | anterior | | | | | cervical | | | | | glands | | | | | diseased | | | | | posterior | | | | | cervical | | | | | glands | | | | | heart disease | | | | | chorea | | | | | pulmonary | | | | | disease | | | | | skin disease | | | | | deformity | | | | | of spine | | | | | deformity | | | | | of chest | | | | | deformity of | | | | | extremities | | | | | defective | | | | | mentality | | | | | total | | | | | ==============+=====+========+=====+========+ the effect of a report telling what schools have enough seats, proper ventilation, adequate medical inspection, safe drinking water, ample play space, and what schools are without these necessities is to cause the reader to rank the particular school that he happens to know; i.e. he says, "school a is better equipped than school b; or, school c is neglected." county and state superintendents in many states have acquired the habit of ranking schools according to the number of children who pass in arithmetic, algebra, etc. it would greatly further the cause of public health and, at the same time, advance the interest of education if state superintendents would rank individual schools, and if county superintendents would rank individual schools, _according to the number of children found to have physical defects, the number afflicted with contagious diseases, and the number properly treated_. it is difficult to compare one school with another, because it is necessary to make subtractions and divisions and to reduce to percentages. it would not be so serious for a school of a thousand pupils as for a school of two hundred, to report for adenoids. to make it possible to compare school with school without judging either unfairly, the state superintendent of schools for connecticut has made tables in which cities are ranked according to the number of pupils, average attendance, per capita cost, etc. as to each of these headings, cities are grouped in a manner corresponding to the line up of a battalion, "according to height." a general table is then shown, which gives the ranking of each city with respect to each important item. applied to schools, this would work out as follows: table xv table of ranking-schools arranged alphabetically ============================================================= | school | rank in -------+----------+----------+----------+----------+--------- | register | defects | children | children | children | | found | needing | treated | not | | | treatment| | treated -------+----------+----------+----------+----------+--------- a | | | | | b | | | | | c | | | | | =======+==========+==========+==========+==========+========= such a table fails to convey its significance unless the reader is reminded that rank in children not treated is as good a record for a school that ranks in register as is rank for a school that ranks in register. the connecticut report makes a serious mistake in failing to arrange schools according to population. if this were done, schools of a size would be side by side and comparison would be fair. when, as in the above table, schools are arranged alphabetically, a school with four thousand pupils may follow or precede a school with four hundred pupils, and comparison will be unfair and futile. where, on the other hand, schools are arranged in order of register, a table will show whether schools confronted with practically the same problems, the same number of defects, the same number of children needing treatment, are equally successful, or perhaps equally inactive, in correcting these defects. the following table brings out clearly marked unequal achievement in the face of relatively equal need. table xvi table of ranking-schools arranged according to register, not alphabetically ============================================================= | | rank in school +----------+----------+----------+----------+--------- | register | defects | children | children | children | | found | needing | treated | not | | | treatment| | treated -------+----------+----------+----------+----------+--------- a | | | | | x | | | | | h | | | | | =======+==========+==========+==========+==========+========= if the number of schools in a state is so large that it is unlikely that people will read the table of ranking because of the difficulty of finding their own school, an alphabetical table might be given that would show where to look in the general ranking table for the school or schools in which the reader is interested. experience will demonstrate to public school superintendents the strategic advantage of putting together all the things they need and of telling the community over and over again just what needs there are, what penalties are paid for want of them, and what benefits would result from obtaining them. if health needs of school children were placed side by side with mental results, the relation would come out so clearly that parents, school boards, and taxpayers would realize how inextricably they are bound together and would see that health needs are satisfied. to this end superintendents should require teachers to keep daily reports of school conditions. table xvii weekly class-room schedule ===========+================+========================+============== | temperature | cleaning | exercise +-----+-----+-----+-----+-----+------------+------+------- | | | | | | | in |out of | . | . | . | dry | wet |disinfecting| room | room ----------+-----+-----+-----+-----+-----+------------+------+------- monday | | | | | | | | tuesday | | | | | | | | wednesday | | | | | | | | thursday | | | | | | | | friday | | | | | | | | ==========+=====+=====+=====+=====+=====+============+======+======= the teacher's daily report of the temperature of a schoolroom, taken three times a day, tells the parent exactly what is the efficiency of the ventilating and heating apparatus in the particular school in which he is interested; whereas the report of the department of buildings gives only the number of schools which have an approved system of ventilation and steam heat. school authorities may or may not know that this system of ventilation is out of order, that the thermometer in the indoor playground of school a stood at forty degrees for many days in winter. but they must know it when the principal of school a sends in a daily record; the school board, the parents, or the press will then see that the condition is remedied. if the condition is due to lack of funds, funds will never be forthcoming so long as the condition is concealed. similar results will follow publicity of overcrowding, too little play space, dry cleaning of school buildings, etc. the intent of such reporting is not to "keep tabs" on the school-teacher, the school child, the janitor, the principal, superintendent, or board, but to insure favorable conditions and to correct bad conditions. this is done best by giving everybody the facts. the objective test of the efficiency of a method throws emphasis on the method, not on the motive of those operating it. the blackboard method of publishing facts concentrates attention upon the importance of those facts and enlists aid in the attainment of the end sought. chapter xxxi the press the president of princeton university declares that for several decades we have given education that does not instruct and instruction that does not educate. others tell us that because we read daily papers and magazines our minds become superficial, that our power to concentrate or memorize is weakened,--that we read so much of everything that we learn little of anything. as the habit of reading magazines and newspapers is constantly increasing, i think we must assume that it has come to stay. if we cannot check it, we can at least turn it to good advantage, systematize it, and discipline ourselves. among the subjects continually described in newspapers and magazines, and even on billboards and in street-car advertising, is the subject of hygiene. no greater service can be rendered the community than for those who are conducting discussions of health to teach people how to read correctly this mass of information regarding health, to separate misinformation from information, and to apply the lessons learned to personal and public hygiene. there is no better way of doing this than to teach a class or a child to clip out of magazines and newspapers all important references to health, and then to classify these under the subject-matter treated. a teacher, parent, or club leader might practice by using the classification of subjects outlined in the contents of this book. it is surprising how rapidly one builds up a valuable collection serviceable for talks or papers, but more particularly for giving one a vital and intelligent interest in practical health topics. interested in comparing the emphasis placed on health topics in a three-cent paper having a small circulation with a penny paper having twenty times the circulation, i made during one week thirty-eight clippings from the three-cent paper and ninety-five from the penny paper. the high-priced paper had no editorial comment within the field of health, whereas the penny paper had three columns, in which were discussed among other things: _the economics of bad teeth_; _need for individual efficiency_; _"good fellows" lower standard of living by neglecting their families_. the penny paper advertised fifty-two foods, garments, whiskies, patent medicines, or beautifiers urged upon health grounds. in the three-cent paper twenty-six out of thirty-eight items advertised food, clothing, patent medicine, or whisky. one issue of a monthly magazine devoted to woman's interests contained twenty-eight articles and editorials and fifty-five advertisements that concern health,--thirty-seven per cent of total reading matter and thirty-seven per cent of total advertisement. excellent discipline is afforded by this clipping work. it is astonishing how few men and women, even from our better colleges, know how to organize notes, clippings, or other data, so that they can be used a few weeks later. there is a satisfaction in seeing one's material grow, as is remembered by all of us, in making picture scrapbooks or collections of picture postal cards and stamps. "collections" have generally failed for want of classification,--putting things of a kind together. chronological arrangement is uninteresting because unprofitable. one never knows where to find a picture, or a stamp, or a health clipping. clippings, like libraries, will be little used if not properly catalogued so that use is easy. if a health-clipping collection is attempted, there are four essentials: ( ) arrangement by topic; ( ) inclusion of advertisements; ( ) inclusion of items from magazines; ( ) cross references. for classification, envelopes can be used or manila cards × inches. the teacher, parent, or advanced student will probably think the envelope most useful because most easily carried and filed,--most likely to be used. but clippings should be bound together in orderly appearance, or else it will be disagreeable working with them. children, however, will like the pasting on sheets, which show clearly the growth of each topic. envelopes or cards should not have clippings that deal with only one health topic. unless a test is made to see how many health references there are in a given period, it should be made a rule not to clip any item that does not contain something new,--some addition to the knowledge already collected. advertisements will prove interesting and educative. when newspapers and magazines announce some new truth, the commercial motive of manufacturer or dealer sees profit in telling over and over again how certain goods will meet the new need. children will soon notice that the worst advertisements appear in the papers that talk most of "popular rights," "justice," and "morality." they will be shocked to see that the popular papers accept money to tell falsehoods about fake cures. they will be pleased that the best monthly magazines contain no such advertisements. they will challenge paper or magazine, and thus will be enlisted while young in the fight against health advertisements that injure health. to clip articles from magazines will seem almost irreverent at first. but the reverence for magazines and books is less valuable to education than the knowledge concealed in them. except where families preserve all magazines, clippings will add greatly to their serviceability. the art of cross-referencing is invaluable to the organized mind. the purpose of classifying one's information is not to show how much there is, but to answer questions quickly and to guide constructive thinking. a clipping that deals with _alcoholism_, _patent medicine_, and _tuberculosis_ must be posted in three places, or cross-referenced; otherwise it will be used to answer but one question when it might answer three. if magazines may not be cut, it will be easy to record the fact of a useful article by writing the title, page, and date on the appropriate index card, or inclosing a slip so marked in the proper envelope. while it is true that the most important bibliography one can have in his private library is a classification of the material of which he himself has become a part while reading it, there are a number of health journals that one can profitably subscribe for. in fact, it is often true that the significant discoveries in scientific fields, or the latest public improvements, such as parks, bridges, model tenements, will not be appreciated until one has read in health journals how these improvements affect the sickness rate and the enjoyment rate of those least able to control their living conditions. the physician and nurse in their educational work for hospitals are distributors of health propaganda. wherever there is a local journal devoted to health, parents, teachers, educators, and club leaders would do well to subscribe and to hold this journal up to a high standard by quoting, thanking, criticising it. in new jersey, for example, is a monthly called the _new jersey review of charities and corrections_ that deals with every manner of subject having to do with public health as well as with private and public morality and education. a similar journal, intended for national instruction, is _the survey_, whose topical index for last year enumerates two hundred and thirty-two articles dealing with subjects directly connected with public hygiene, e.g.: schools, ; school inspection, ; eyes,--school children, ; sex instruction in the schools, ; psychiatric clinic, special children, ; industrial education, ; child labor, ; playgrounds, ; alley, crap, playing in streets, ; labor conditions, ; industrial accidents, ; wage-earner's insurance, ; factory inspection, ; consumer's league, ; women's work, ; tuberculosis, ; hospitals, dispensaries (social), ; tenement reform, ; living conditions, ; baths, ; public comfort stations, ; lodging houses, ; clean streets, ; clean milk, ; smoke, ; noises, ; parks, ; patent medicines, ; sanitary code, ; mortality statistics, ; social settlements and public health, ; midwives, ; children's bureau, ; juvenile and adult delinquent, ; dependent, defective, and insane, ; blind, ; cripples, ; homes for aged, ; inebriates, ; traveler's aid committee, ; infant mortality, ; social diseases, . * * * * * _the national hospital record_, the _dietetic and hygienic gazette_, the _journal of nursing_, are three other magazines primarily intended for nurses and physicians, but full of suggestive material for unprofessional readers. national magazines concerned with health, but seeking popular circulation, are _good health_ and _physical culture_. in england there is a special magazine called _children's diseases_, which could be of great help to a school library for special reference. the same can be said of the _psychological clinic_, _pediatrics_, and other technical journals published in this country. for many persons, to make the best use of any one copy of these magazines, clipping is of course impossible, but noting on a card or envelope is practicable. of late many of the national popular magazines have several columns devoted to health. we have not appreciated the educational possibilities of these columns. in most large cities there are monthly book reviews which may be profitably consulted in learning the new thought in the health field. if teachers would either write their experience or ask questions, if children knew that in a certain magazine or newspaper questions as to ventilation, bathing, exercise, would be answered, they would take a keen interest in the progress of discussions. the large daily papers make a great feature of their health hints. it is not their fault if questioners care more about cosmetics and hair bleaches than about the fresh-air cure of headaches. they will coöperate with teachers and parents in securing more general discussion of other problems than beauty doctoring. finally, persons wanting not only to have intelligence as to matters promoting health, but actually to exert a helpful influence in their community, ought to want the published reports of the mayor, health department, the public schools, and other institutions, noting carefully all that is said about conditions relating to health and about efforts made to correct all unfavorable conditions. the best literature of our day, with regard to social needs, appears in the reports of our public and private institutions and societies. of increasing value are the publications of the national government printing office. because it is no one's business to find out what valuable material is contained in such reports, and because no educational museum is comparing report with report, those who live nearest to our health problems and who see most clearly the health remedies, are not stimulated to give to the public their special knowledge in an interesting, convincing way. teaching children how to find health lessons in public documents will advance the cause of public ethics as well as of public health. at the new york state conference of charities, of , one official complained that the physicians made no educational use of their valuable experience for public education. he stated that a study of medical journals and health articles in popular magazines revealed the fact that the number of papers prepared by physicians in state hospitals averaged one to a doctor for every five or six years of service. this state of affairs is even more exaggerated in strictly educational institutions. columbia university has recently instituted a series of lectures to be given by its professors to its professors, so that they may have a general knowledge of the work being done in other fields besides their own at their own university. this is equally important for teachers and heads of departments in elementary schools. it is now admitted by most educators that elementary schools and young children present more pedagogical difficulties and pressing biological problems than higher schools. if teachers and parents would realize that their method of solving the health problems that arise daily in the schoolroom and in the home would interest other mothers and teachers, their spirit of coöperation would soon be reflected in school journals, popular magazines, and daily newspapers. part v. alliance of hygiene, patriotism, and religion chapter xxxii do-nothing ailments "men have died, from time to time, and worms have eaten them, but not for love"--_nor for work_. work of itself never killed anybody nor made anybody sick. work has caused worry, mental strain, and physical breakdown, only when men while working have been deprived of air, sun, light, exercise, sleep, proper food at the proper time, opportunity to live and work hygienically. fortunately for human progress, doing nothing brings ailments of its own and has none of the compensations of work. as the stomach deprived of substantial food craves unnatural food,--sweets, stimulants,--so the mind deprived of substantial, regular diet of wholesome work turns to unwholesome, petty, fantastic, suspicious, unhappy thoughts. this state of mind, combined with the lack of bodily exercise that generally accompanies it, reacts unfavorably on physical health. an editor has aptly termed the do-nothing condition as a self-inflicted confinement: a great deal of the misery and wretchedness among young men that inherit great fortunes is caused by the fact that they are practically in jail. they have nothing to do but eat, drink, and enjoy themselves, and they cannot understand why their lives are dull. we have had the owner of a great railroad system pathetically telling the public that he is unhappy. that is undoubtedly true, because with all his race horses, and his yachts, and all the things that he imagines to be pleasures, he is not really doing anything. if he were running one little railroad station up the road, handling the freight, fussing about dispatches, living above the railroad station in two rooms, and buying shoes in a neighboring village for fifteen children he would be busy and happy. but he cannot be happy because he is in prison,--in a prison of money, a prison that is honorable because it gives him everything that he wants, and he wants nothing. a new york newspaper that circulates among the working classes where young men and women are inclined to associate health and happiness with doing nothing recently gave two columns to "dandy jim," the richest dog in the world. dandy jim's mistress left him a ten-thousand-dollar legacy. during his lifetime he wore diamonds. every day he ate candy that cost eighty cents a pound. the coachman took him driving in the park sunny afternoons. he had no cares and nothing to work for. his food came without effort. he had fatty degeneration of the vital organs. he was pampered, coddled, and killed thereby. thousands of men and women drag out lives of unhappiness for themselves and others because, like dandy jim, they have nothing to work for, are pampered, coddled victims of fatty degeneration. when president butler of columbia university finds it necessary to censure "the folly and indifference of the fathers, vanity and thoughtless pride of the mothers" who encourage do-nothing ailments; and when the editor of the _psychological clinic_ protests that the fashionable private schools and the private tutor share with rich fathers and mothers responsibility for life failures,--it is time that educators teach children themselves the physical and moral ailments and disillusions that come from doing nothing. ten years ago a stenographer inherited two hundred and fifty thousand dollars. her dream of nothing to do was realized. she gave up her strenuous business life. possessions formerly coveted soon clogged her powers of enjoyment. she imagined herself suffering from various diseases, shut herself up in her house, and refused to see any one. she grew morbid and was sure that every person who approached her had some sneaking, personal, hostile motive. though always busy, she accomplished little. desultory work, procrastination, and self-indulgence destroyed her power of concentration. she could not think long enough on one subject to think it out straight, therefore she was constantly deceived in her friends and interests. she first trusted everybody, then mistrusted everybody. infatuation with every new acquaintance was quickly followed by suspicion. for years she was a very sick woman, a victim of do-nothing ailments. doing nothing has of late been seriously recommended to american business men. they are advised to retire from active work as soon as their savings produce reasonable income. it is true, this suggestion has been made as an antidote to greed rather than for the happiness of the business man. what retiring from business is apt to mean, is indicated by a gentleman who at the age of sixty decided to sell his seat on the new york stock exchange and to enjoy life. he became restless and very miserable. he threw himself violently into one thing after another; in less than a year he became an ill, broken old man, after trying vainly to buy back his business. both mind and body were made to work. the function of the brain is to think to a purpose, just as the function of the heart is to pump blood. the habit of doing nothing is very easily formed. the "out-of-work" soon become "the work-shy." having too little to do is worse for the body and mind than having too little to eat. social reformers emphasize the bad effect on society of vagrancy. evils of indiscriminate relief to the poor are vividly described year after year. the philanthropist is condemned, who, by his gifts, encourages an employee's family to spend what they do not earn, and to shun work. yet the idleness of the tramp, street loafer, and professional mendicant is a negligible evil compared with the hindrance to human progress caused by the idleness of the well-to-do, the rich, the educated, the refined, the "best" people. it is as much a wrong to bring up children in an atmosphere of do-nothingism, as to refuse to have their teeth attended to or to have glasses fitted to weak eyes. from the point of view of community welfare it is far more serious for the rich child to be brought up in idleness or without a purpose than for the poor child to become a public charge. not only has society a right to expect more from rich children in return for the greater benefits they enjoy, but so long as rich children control the expenditure of money, they control also the health and happiness of other human beings. unless taught the value and joy of wholesome work they cannot themselves think straight, nor are they likely to want to understand how they can use their wealth for the benefit of mankind. to quote president butler again: the rich boy who receives a good education and is trained to be a self-respecting member of the body politic might in time share on equal terms the chance of the poor boy to become a man of genuine influence and importance on his own account, just as now by the neglect, or worse, of his parents the very rich boy is apt to be relegated to the limbo of curiosities, and too often of decadence. nervous invalids make life miserable for themselves and for others, when often their sole malady is lack of the right kind of work to do. suiting work to interest and interest to work is an economy that should not be overlooked. the energy spent in forcing oneself to do a distasteful task can be turned to productive channels when work is made pleasurable. the fact is frequently deplored that whereas formerly a man became a full-fledged craftsman, able to perform any branch of his trade, he is now confined to doing special acts because neither his interest nor his mind is called into play. work seems to react unfavorably on his health. he has not the pride of the artisan in the finished product, for he seldom sees it. he does a task. his employer is a taskmaster. he decides that work is not good for him as easily as when a school-boy he grasped the meaning of escape from his lessons. by failing to fit studies to a student's interest, or by failing to insure a student's interest in his studies, schools and colleges miseducate young men and young women to look upon all work as tasks, as discipline, necessary but irksome, and to be avoided if possible. just as there is a way of turning all the energy of the play instinct into school work, so there is a way of interesting the factory and office worker in his job. however mechanical work may be, there is always the interest in becoming the most efficient worker in a room or a trade. routine--accurate and detailed work--does not mean the stultification of the imagination. it takes more imagination to see the interesting things in statistical or record work than to write a novel. therefore employers should make it a point to help their employees to realize the significance of the perfection of each detail and the importance of each man's part. the other day a father said to me, "i want my boys to be as ashamed to do work in which they are not interested as to accept graft." when interest in work and efficiency in work are regarded as of more importance than the immediate returns for work, when it is as natural for boys and girls to demand enjoyment and complete living in work as it is to thrill at the sight of the stars and stripes, do-nothing ailments will be less frequent and less costly. work--that one enjoys--is an invaluable unpatented medicine. it can make the sick well and keep the well from getting sick. it is the chief reliance of mental hygiene. "i should have the grippe if i had time," said a business woman to me the other day; but she did not have time, hence she did not have the grippe. if you're sick with something chronic, and you think you need a tonic, do something. there is life and health in doing, there is pleasure in pursuing; doing, then, is health accruing-- do something. and if you're seeking pleasure, or enjoyment in full measure, do something. idleness, there's nothing in it; 'twill not pay you for a minute-- do something. chapter xxxiii heredity bugaboos and heredity truths one of the red-letter days of my life was that on which i learned that i could not have inherited tuberculosis from two uncles who died of consumption. for years i had known that i was a marked victim. silently i carried my tragedy, suspecting each cold and headache to be the telltale messenger that should let others into my secret. he was a veritable emancipator who informed me that heredity did not work from uncle to nephew; that not more than a predisposition to consumption could pass even from parent to child; that a predisposition to consumption would come to nothing without the germ of the disease and the environmental conditions which favor its development; and that if those so predisposed avoid gross infection, lead a healthy life, and breathe fresh air they are as safe as though no tuberculous lungs had ever existed in the world. some years later i learned to understand the other side of the case; i realized how i had been in real danger of contracting consumption in the darkened, ill-ventilated sick room of the uncle who taught me my letters and gave me my ideal of god's purpose in sending uncles to small boys. there are two distinct things which make each individual life: the living stuff, the physical basis of life, handed down from parent to child; and the environmental conditions which surround it and play upon it and rouse its reactions and its latent possibilities. it is like the seed and the cultivation. you cannot grow corn from wheat, but you can grow the best wheat, or you may let your crop fail through careless handling. it is well that we should think seriously about the part played by heredity, for the living stuff of the future depends upon our sense of responsibility in this regard. the intelligent citizen would do well to read such a book as j. arthur thompson's _heredity_ ( ), in which the latest conclusions of science are clearly and soundly set forth. the main problem of to-day, however, is to use well the talents that we have. here two things should always be kept in mind: first, the inherited elements which make up our minds and bodies are complex and diverse. health and strength are inherited as well as disease and weakness; they have indeed a better chance of survival. in the most unpromising ancestry there are latent potentialities which may be made fruitful by effort. no limit whatever can be set to the possibilities of improvement in any individual. in the second place, if science has shown anything more clearly than the importance of heredity, it is the importance of environment. this influence upon human lives is within our control, and it is a grave error to neglect what lies clearly within our power and to bemoan what does not. science has wrought no benefits greater than those which result from drawing a clear line between heredity bugaboos and heredity truths. an overemphasis on the hereditary factor in development at the expense of the environmental factor, i call a heredity bugaboo; and it is a tendency which cannot be too strongly condemned. to fight against the sins and penalties of one's grandfather is a forlorn task that quickly discourages. to overcome diseases of environment, of shop and street, of house and school, seems, on the contrary, an easy task. heredity bugaboos dishearten, enervate, encourage excesses and neglect. heredity truths stimulate remedial and preventive measures. we may well watch with interest the progress of eugenics, that new science which biologists and sociologists hope will some day remake the very living stuff of the human race. but meanwhile let us take up with hope and courage and enthusiasm the great hemisphere of human fate which lies within our grasp. good food and fresh air, well-built cities, enlightened schools and well-ordered industries, stable and free and expert government,--given these things, we can transform the world with the means now at our disposal. we can reap, if we will, splendid possibilities now going to waste, and by intelligent biological and sociological engineering we can hand on to the next generation an environmental inheritance which will make their task far easier than ours. "physical deterioration" is a bugaboo that is discovered by some in heredity and by others in modern industrial evils. the british director general called attention a few years ago to the fact that from forty to sixty per cent of the men who were being examined for military service were physically unfit. a commission on physical deterioration was appointed to investigate the cause, and to learn whether the low physical standard of the would-be tommy atkins was due to inherited defects. the results of this study were published in a large volume called _report on physical deterioration, _, in which is set forth a positive programme for obtaining periodically facts as to the physique of the nation. in the course of the commission's exhaustive investigation there was found no evidence that any progressive deterioration was going on in any function of the body except the teeth. "there are happily no grounds for associating dental degeneracy with progressive physical deterioration." the increase in optical defects is attributed not to the deterioration of the eye, but to greater knowledge, more treatment, and better understanding of the connection between optical defects and headache. [illustration: testing environment--house score] +--------------------------------------------------------------------+ | definitions of terms used in house score card | | | | light--light enough to read easily in every part. | | | | gloomy--not light enough to read easily in every part, but enough | | readily to see one's way about when doors are closed. | | | | dark--too dark to see one's way about easily when doors are | | closed. | | | | well ventilated--with window on street or fair-sized yard (not | | less than ft. deep for a five-story tenement house not on a | | corner), or on a "large," "well-ventilated" court open to the sky | | at the top: "large" being for a court entirely open on one side to | | the street or yard in a five-story tenement, not less than ft. | | wide from the wall of the building to the lot line; for a court | | inclosed on three sides and the other on the lot line in a | | five-story tenement, not less than × ft., "well ventilated" | | meaning either entirely open on one side to the street or yard, or | | else having a tunnel at the bottom connecting with the street or | | yard. | | | | fairly ventilated--with window opening on a shallow yard or on a | | narrow court, open to the sky at the top, or else with × inside | | window ( ft. square) opening on a well-ventilated room in same | | apartment. | | | | badly ventilated--with no window on the street, or on a yard, or | | on a court open to the sky, and with no window, or a very small | | window, opening on an adjoining room. | | | | in good repair--no torn wall paper, broken plaster, broken | | woodwork or flooring, nor badly shrunk or warped floor boards or | | wainscoting, leaving large cracks. | | | | in fair repair--slightly torn or loose wall paper, slightly broken | | plaster, warped floor boards and wainscoting. | | | | in bad repair--very badly torn wall paper or broken plaster over a | | considerable area, or badly broken woodwork or flooring. | | | | (rooms not exactly coinciding with any of the three classes are to | | be included in the one the description of which comes nearest to | | the condition.) | | | | sinks: good--iron, on iron supports with iron back above to | | prevent splashing of water on wall surface, in light location, | | used for one family. water direct from city water mains or from a | | clean roof tank. | | | | bad--surrounded by wood rims with or without metal flushings, | | space beneath inclosed with wood risers; dark location, used by | | more than one family; water from dirty roof tank. | | | | fair--midway between above two extremes. (sinks not exactly | | coinciding with any of the three classes are to be included in the | | one the description of which comes nearest to the condition.) | | | | water-closet: good--indoor closet. in well lighted and ventilated | | location, closet fixture entirely open underneath, abundant water | | flush. | | | | fair--indoor closet, poor condition--badly lighted and ventilated | | location, fixture inclosed with wood risers, or poor flush. | | | | poor--yard closet--separate water-closet in individual compartment | | in the yard. | | | | bad--school sink--sewer-connected privy, having one continuous | | vault beneath the row of individual toilet compartments. | +--------------------------------------------------------------------+ the commission hoped "that the facts and opinions they have collected will have some effect in allaying the apprehensions of those who, as it appears, on insufficient grounds, have made up their minds that progressive deterioration is to be found among people generally." in regard to the facts which started the fear, the report says: ( ) the evidence adduced in the director general's memorandum was inadequate to prove that physical deterioration had affected the classes referred to; ( ) no sufficient material (statistical or other) is at present available to warrant any definite conclusions on the question of the physique of the people by comparison with data obtained in past times. [illustration: the best inheritance is a mother who knows how to keep her baby well] the topics dealt with in the report refer to only a partial list of conditions that need to be carefully studied before we can know what environment heredity we are preparing for those who follow us: i. as to babies training of mothers, provident societies and maternity funds, feeding of infants, milk supply, milk depots, sterilization and refrigeration of milk, effect of mother's employment upon infant mortality, still births, cookery, hygiene and domestic economy, public nurseries, crèches. ii. as to children anthropometric measurements, sickness and open spaces, medical examination of school children, teeth, eyes, and ears, games and exercises for school children, open spaces and gymnastic apparatus, physical exercise for growing girls and growing boys, clubs and cadet corps, feeding of elementary school children, partial exemption from school, special schools for "retarded" children, special magistrate for juvenile cases, juvenile smoking, organization of existing agencies for the welfare of lads and girls, education, school attendance in rural districts, defective children. iii. as to living and working conditions register of sickness, medical certificates as to causes of death, overcrowding, building and open spaces, register of owners of buildings, unsanitary and overcrowded house property, rural housing, workshops, coal mines, etc., medical inspection of factories, employment of women in factories, labor colonies, overfatigue, food and cooking, cooking grates, adulteration, smoke pollution, alcohol, syphilis, insanity. iv. as to health machinery medical officers of health, local, district, and national boards, health associations. scientists of the next generation will continue to differ as to heredity truths and heredity bugaboos unless records are kept now, showing the physical condition of school children and of applicants for work certificates and for civil service and army positions. the british investigators declared that "anthropometric records are the only accredited tests available, and, if collected on a sufficient scale, they would constitute the supreme criterion of physical deterioration, or the reverse.... the school population and the classes coming under the administration of the factory acts offer ready material for the immediate application of such tests." in addition to the physical tests proposed in other chapters, there is great educational opportunity in the records of private and public hospitals. every nation, every state, and every city should enlist all its educational and scientific forces to ascertain in what respects social efficiency is endangered by physical deficiencies that can be avoided only by restricting parenthood, and the environmental deficiencies that can be avoided by efficient health machinery. the greatest of all heredity truths are these: ( ) the deficiencies of infants are infinitesimal compared with the deficiencies of the world with which we surround them; ( ) each of us can have a part in begetting for posterity an environment of health and of opportunity. chapter xxxiv ineffective and effective ways of combating alcoholism wherever the stars and stripes fly over school buildings it is made compulsory to teach the evils of alcoholism. for nearly a generation the great majority of school children of the united states have been taught that alcohol, in however small quantities, is a poison and a menace to personal and national health and prosperity. yet during this very period the per capita consumption of every kind of alcoholic beverage has increased. whereas . gallons of spirituous liquors were consumed per capita of population in , . gallons were used in . obviously the results of methods hitherto in vogue for combating alcoholism are disappointing. why this paradoxical relation of precept to practice? why is this, the most hygiene-instructed country in the world, the elysium of the patent-medicine and cocaine traffic? if we have only the expected divergence of achievement from ideal, then there is nothing for us to do but to congratulate ourselves and posterity upon the part played by compulsory legislation in committing all states and territories to hygiene instruction in all public schools. if, on the other hand, our disappointment is due to ineffective method, then the next step is to change our method. the chief purpose of school hygiene has hitherto been not to promote personal and community health, but to lessen the use of alcohol and tobacco. arguments were required against whisky, beer, cigars, and cigarettes. as the strongest arguments would probably make the most lasting impression upon the school child and the best profits for author and bookseller, writers vied with one another in the rhetoric and hyperbole of platform agitation. what effect would it have upon you if you were exhorted frequently during the next eight years to avoid tobacco because a mother once killed a child by washing its head in tobacco water? what is the effect on the mind of a boy or a girl who sees that the family doctor, the minister, the teacher, the judge, the governor, the president, and the philanthropist use tobacco and alcoholic beverages, when taught that "boys who use tobacco and alcoholic beverages will find closed in their faces the doors to strength, good health, skill in athletics, good scholarship, long life, best companions, many business positions, highest success"? it is probably true that "a boy once drank some whisky from a flask and died within a few hours." but that story is about as typical of boys and of whisky as that a boy once drank whisky from a flask and did not die for ninety years afterwards, or that george washington drank whisky and became the father of his country. how special pleading has dominated the teaching of school hygiene is illustrated by a recent book which, for the most part, successfully breaks away from the narrow point of view and the crude methods hitherto prevailing. it presents the following facts concerning new york city: saloons , arrests , expense of police department $ , , police courts, jails, workhouses, reformatories , , hospitals, asylums, and other charities , , it is fair to the author to state that she does not declare in so many words that the shutting up of the saloons would obviate all the arrests and all the hospital, jail, and charity bills. instead of _wipe out_ she says _shrivel_. no truth would have been lost by avoiding all misrepresentation. the author probably felt as i did when i took my total abstainer's protest to a celebrated scientist who had exposed certain misstatements regarding the effect of small quantities of alcohol: "is not the untruth of these exaggerated statements less dangerous than the untruth of dispassionate, scientific statement? so long as the child mind takes in only an impression, is it not better to write this impression indelibly?" he sadly but indulgently replied, "and in what other studies would you substitute exaggeration for truth?" the reaction has already begun against exaggeration in hygiene text-books, against drawing lessons from accidental or exceptional cases of excessive use of alcohol, against classing moderate drinking and smoking with drunkenness as sins of equal magnitude, and against overlooking grave social and industrial evils that threaten children far earlier and more frequently than do tobacco and alcohol. instead of adding an ell to the truth, text-book writers are now adding only an inch or two at a time. no longer do we favor highly colored charts that picture in purple, green, and black the effect of stimulants and narcotics upon the heart and brain, the stomach, the liver, the knee, and the eardrum, _assuming that all resultant evils are concentrated in one organ_. menacing habits, such as overeating and indulgence in self-pity, are beginning to receive attention. it is also true that physiology and anatomy are progressively made more interesting. publishers are looking for the utmost originality compatible with the purpose of the present laws and with the only effective public sentiment that has hitherto been interested in the interpretation of those laws. a score of improvements in the method of carrying out a small ideal will not take the place of enlarging that ideal. if existing laws stand in the way of broadening the purpose of school hygiene, let the laws be changed. if text-book publishers stand in the way, let us induce or compel them to get out of the way. if we fear rumsellers, their money, and the insidious political methods that they might employ to bring in undertruth if overtruth is once sacrificed, let us go to our communities and locate the rumseller's guns, draw their fire, tell the truth about their opposition, and educate the public to overcome it. if, on the other hand, misguided teetotalism stands in the way, then, as one teetotaler, i suggest that we prove, as we can, in our respective communities that there is a better way of inculcating habits of temperance and self-restraint than by telling untruths, overtruths, or half truths about alcohol and tobacco. let us prove, as we can, that a subject vital to every individual, to every industry, and to every government is now prevented from fulfilling its mission not by its enemies but by its friends. we can learn the character of hygiene instruction in our schools and the interest taken in it by teachers, principals, and superintendents. we can learn how teachers practice hygiene at school, and how the children of our communities are affected by the hygiene instruction now given. finally, we can compel a public discussion of the facts, and action in accordance with facts. without questioning anybody's avowed motive, we can learn how big that motive is and how adequate or inadequate is the method of executing it. alcohol and tobacco really occupy but a very small share of the interest and attention of even those men and women by whom they are habitually used. hygiene, on the other hand, is of constant, uninterrupted concern. why, therefore, should it be planned to have alcohol and tobacco displace the broader subject of personal and public hygiene in the attention and interest of children throughout the school life? beyond the text-book and schoolroom a thousand influences are at work to teach the social evils, the waste of energy, and the unhappiness that always accompany the excessive use--and frequently result from a moderate use--of stimulants and narcotics. of the many reasons for not drinking and smoking, physiology gives those that least interest and impress the child. the secondary effects, rather than the immediate effects, are those that determine a child's action. most of the direct physiological effects are, in the majority of instances, less serious in themselves than the effects of overeating, of combining milk with acids, of eating irregularly, of neglecting constipation. were it not for the social and industrial consequences of drunkenness and nicotinism, it is doubtful if the most lurid picture of fatty degeneration, alcoholic consumption, hardened liver, inactive stomach lining, would outweigh the pleasing--and deceiving--sensations of alcoholic beverages and cigarettes. the strong appeal to the child or man is the effect these habits have upon his mother, his employer, his wife, his children. the vast majority of us will avoid or stop using anything that makes us offensive to those with whom we are most intimately associated, and to those upon whom our professional and industrial promotion depends. children will profit from drill in and out of school in the science of avoiding offense and of giving happiness, but unless the categories--_acts that give offense_ and _acts that give happiness_--are wide enough to include the main acts committed in the normal relations of son, companion, employer, husband, father, and citizen, those who set out to avoid alcohol and tobacco find themselves ill equipped to carry the obligations of a temperate, law-abiding citizen. things do not happen as described in the early text-book. other things not mentioned hinder progress and happiness. the child at work resents the mis-education received at school and suspects that he has been following false gods. the enemies that cause him trouble come from unexpected sources. he finds it infinitely easier to eschew alcohol and tobacco than to avoid living conditions that insidiously undermine his aversion to stimulants and narcotics. the reasons for avoiding stimulants in the interest of others are more numerous and more cogent than the reasons for avoiding stimulants and narcotics for one's own sake. the altruistic reasons for shunning stimulants and narcotics cannot be implanted in the child unless he sees the evil of excess _per se_ in anything and everything, and unless he becomes thoroughly grounded in the life relations and health relations to which he must adapt himself. unclean streets, unclean milk, congested tenements, can do more harm than alcohol and tobacco, because they breed a physique that craves stimulants and drugs. adenoids and defective vision will injure a larger proportion of the afflicted than will alcohol and tobacco, because they earlier and more certainly substitute discouragement for hope, handicap for equal chance. failure to enforce health laws is a more serious menace to health and morals than drunkenness or tobacco cancer. if it is true that we must attack the problem of alcohol from the standpoint of its social and industrial effects, we are forced at once to consider the machinery by which cities and governments control the manufacture and sale of alcohol. it is not an exaggeration to say that courses in regulating the traffic in alcohol are more necessary than courses in the effects of alcohol upon digestion and respiration. if sunday closing of saloons, local option, high license, and prohibition have failed, there is no evidence that the failure is due to the principles underlying any one of these methods. until more earnest effort is made to study the effects of these methods, the results of their enforcement and the causes of their nonenforcement, no one is justified in declaring that either policy is successful or unsuccessful. it is very easy to select from the meager facts now available convincing proofs both that prohibition does not prohibit and that high license leads to increased drunkenness. the consequence is that the movements to control, restrict, or prohibit the use of alcohol are emotional, not rational. it is impossible to keep emotion, sensation, sentiment, at white heat. most extremists worship legislation and do not try to keep interest alive by telling every week or every month new facts about the week or the month before. no new fuel is added to the anti-saloon fire, which gradually cools and dies down. not so, however, with those who make money by the sale of intoxicants. the greater the opposition, the more brains, the more effort, the more money they put into overcoming or circumventing that opposition. fuel is piled on and the bonfire is fed freely. every day the anti-restriction bonfire becomes larger and larger, and the anti-saloon bonfire becomes smaller and smaller. by carefully selecting their facts, by counting the number of arrests for drunkenness and the number of saloons open on sunday, by reiteration of their story the pro-saloonists gradually win recruits from the opposition, and, when the next election comes, their friends outnumber their enemies and the "dry" policy of a city, county, or state is reversed. the failures attributed to prohibitive or restrictive measures are probably no more numerous than the failures of government in other respects. the present ambassador from england, james bryce, writing his _american commonwealth_, declared that municipal government was america's "most conspicuous failure." the mayor of toledo, writing in , says, "there has been a pessimism, almost enthusiastic, about the city." these failures are due not to any lack of desire for good government, not to any fundamental evils of cities, but to the fact that municipal reform, like the crusade against alcohol, has been based upon emotionalism, not upon definite proof. reformers have been unable to lead in the right direction, because they have looked at their lantern instead of their road. not having cumulative information as to government acts, they have been unable to keep their fires burning. to illustrate: in november, , the governor of new york state, the mayor of new york city, and reformers of national reputation eulogized the tenement-house department; yet this department, whose founding was regarded as a national benefaction, was the only department of the city government that did not receive an increase for . it is in the position of temperance legislation, the facts of whose enforcement or nonenforcement are not promptly and continuously made public. fear of the negro victim of alcoholism, social evils of intemperance, whether among white or black, industrial uncertainty and waste due to alcoholism, are the three chief motives that have swept alcohol traffic out of the greater part of the south. knowledge of physiological evils has had little influence, except as it may have rendered more acceptable the claim that alcoholism is a disease against which there is no insurance except abolition of alcohol as a beverage. religious revivals, street parades by day and by night, illustrated banners, personal intercession, lines of women and children at the polls, made it necessary for voters to make known their intention, and made it extremely difficult for respectable men, engaged in respectable business, to vote for saloons. some states have gone so far as to prohibit the manufacture of alcoholic stimulants, even though not offered for sale within state limits. in georgia wine cannot be used at the communion service, nor can druggists sell any form of liquor except pure alcohol. in louisiana it is illegal for representatives of "wet districts" to solicit orders for liquor in any of the "dry districts." in texas the sale of liquor in dining cars is forbidden, and the traveler may not even drink from his own flask. congress is being urged by senators and congressmen, as well as by anti-saloon advocates, to pass laws prohibiting common carriers from delivering alcoholics to any "dry" community. the more optimistic anti-saloon workers believe it is but a matter of a short time when congress will pass laws prohibiting the manufacture or sale of alcoholic beverages within any limits protected by the united states constitution. southern states have been warned that they could not afford the depreciation of real estate values, of rents, and of business that would surely follow the "confiscation of capital" and "interference with personal liberty." this warning has been met by plausible arguments that the buyers of legitimate and nonpoisonous commodities could pay better rents, better profits on business and on real estate, if freed from the uneven fight against temptation to drink. the argument that schools and streets and health must suffer if the license money was withdrawn, has been met by the plausible argument that the ultimate taxpayer--the family that wants clothing, food, and shelter--will save enough money to be able to spend still larger sums than heretofore upon education, health, and public safety. for the first time dealers in alcohol recognize the possibility of a great national movement and of national prohibition. both the defects in methods hitherto used to oppose saloon legislation and the reasons for meeting the present situation by new methods are presented in the may issue ( ) of the _transactions of the american brewing institute_. under the title, "social order and the saloon--the measure of the brewer's responsibility," mr. hugh f. fox, known throughout the union as a defender of child rights, advocate of probation and children's courts, promoter of health and education, outlined a plan for research that is indispensable to the proper settling of this great question. whether brewer or anti-saloon leaguist, total abstainer or moderate drinker, employer or trade unionist, it is necessary to the intelligent control of alcohol that each of us approach this momentous question of control or abolition of the saloon in the spirit expressed in this paper, whose thoroughness and whose social point of view would do credit to a church conference. the address is quoted and its questions copied because both show how much depends upon knowing whether laws are enforced and how much greater is the difficulty of coping with a conciliatory antagonist who professes willingness to submit to tests of evidence. the regulation of the liquor business involves fundamental questions of the function and scope of government, and there is hardly any department of organized human activity that has been the subject of so much experiment and futile tinkering.... the only people who are perfectly consistent are the prohibitionists, whose policy is abolition. let us, however, try to detach ourselves from any personal interest that we may have in the subject, and consider it impartially as a matter of public concern. what the brewer as an individual cannot do, the brewers as an organization have done successfully in many places in spite sometimes of official negligence, corruption, or incapacity. the texas brewers' association is reported as having successfully prosecuted two thousand cases against keepers of disreputable resorts during the past three years. the object of their campaign was to purify the retail liquor trade from unclean and law-defying elements. the greatest gain that has come to society, as distinguished from the individual, through the temperance movement is its effect in unconsciously informing the public that the regulation and administration of licensing is in itself a great and vital problem; and as a secondary result of such agitation, i should cite the growing sensitiveness of all persons in the business to the power of public opinion. the recognition by brewers of the force of public opinion is a recent affair. in former years they were totally indifferent to it, if indeed they did not openly flout it. even now their appeal to public sentiment is mainly a special plea for defensive purposes, and has little or no educational value. brewers have opposed practically every effort to effect a change in excise laws, often without any convincing reason, but simply because the proposed change involved temporary inconvenience and uncertainty, and perhaps a temporary loss. the brewing trade has utterly failed to develop a constructive programme in connection with the public regulation of its affairs. it does not seem to have any fixed principles or positive convictions as to excise methods and liquor laws. its policy has been that of an opportunist, at the best,--or an obstructionist, at the worst. as in all other industries which affect the welfare of the people, reforms have been forced from the outside, with no help from within. of course this is equally true of insurance and railroad corporations, of food purveyors, mine owners, cotton merchants, and a score of other interests. it is due not merely to human selfishness but to shortsightedness; in other words, to a lack of statesmanship. to call your opponents hypocrites, cranks, fakirs, and fanatics may relieve your feelings, but it doesn't convince anybody, and only hurts a just cause. it is foolish to question the motives of men who, without thought of personal gain, are trying to remedy the evils of inebriety. the church is perfectly right in urging total abstinence upon the individual. the only path of safety lies in abstinence for some individuals.... the recognition of the right of a community to establish its own licensing conditions carries with it the right of the community to determine whether there shall be any licenses at all! to make the discussion of this subject as fruitful as possible, i venture to submit the following questions for your consideration. none of them involve any direct moral issue, but there is an honest difference of opinion about each one of them, and they are certainly of vital importance in determining the course of wise and just administration. what has been the effect of high license? how much public revenue should the traffic yield? does high license stimulate unlawful trade? how much license tax should be imposed upon local bottlers and grocers? should they be allowed to peddle beer or to sell it in single bottles? should the place or the individual be licensed? should the licensing authorities be appointive or elective? by whom should they be appointed, and for what term of office? have the courts made good or bad licensing authorities? where the courts issue licenses, what has been the effect on the court? should the licensing authority alone have the power to revoke a license, and discretion to withhold a license? how can the licensing authority enforce the law? should it not be independent of the police? what should be the penalty for breach of the law? do not severe penalties miscarry? on what plea, and under what conditions, should licenses be transferred? what has been the effect of limiting the number of saloons? should limitation be according to area or to population? is there any relation between the number of saloons and the volume of consumption? what should be the limit to the hours of selling? should saloons be allowed to become places of entertainment? how can the sale of liquor by druggists be controlled? how can spurious drinking clubs be prevented or controlled? how can the operation of disreputable hotels be prevented? what should be the definition of a hotel? who should define it? by whom should it be licensed? what special privileges should be given to it? how can the "back-room" evil be stopped? is it legal (i.e. constitutional) to prohibit the sale or serving of liquor to women? has the removal of screens reduced the volume of consumption? has it improved the character of saloons? has it solved the problem of sunday prohibition for any length of time? what has been the general effect of it in the tenement districts? should the state undertake to regulate the liquor business or to enforce liquor laws? is it possible to devise any working plan which will apply with equal effectiveness and equity in communities of compact and of scattered population? should, or should not, the principle of self-government be carefully preserved in the whole scheme of legislation to regulate the liquor business? whether the present prohibition wave shall wash away the legalized saloon, as ocean waves have from time to time engulfed peninsulas, islands, and whole continents, depends upon the power of american educators and american officials to answer right such questions as the foregoing. the great danger is that we shall, as usual, over-emphasize lawmaking, underemphasize lawbreaking, and go to sleep during the next two or three years when we should be wide-awake and constantly active in seeing that the law is enforced. unless exactly the same principles of law enforcement are applied in "dry districts" as we have urged for eradication of smallpox, typhoid, scarlet fever, and adenoids, local and city prohibition are doomed to failure. there must be: . inspection to discover disease centers--"blind pigs," "blind tigers," etc. . compulsory notification by parents and landlords, and by police and other officials. . prompt investigation upon complaint from private citizens. . prompt removal of the disease and disinfection of the center. . segregation of individual units that disseminate disease, whether bartender, saloon keeper, owner of premises, or respectable wholesaler, none of whom should be permitted to shift to another the responsibility for violating liquor laws. . persistent publicity as to the facts regarding enforcement and violation, so that no one, whether saloon leaguist or anti-saloon leaguist, shall be uninformed as to the current results of "dry" laws. it is perfectly safe to assume that none of these things will be done consistently unless funds are provided to pay one or more persons in each populous locality to give their entire time to the enforcement of laws, just as the improvement of other ills of municipal government require the constant attention of trained investigators. cogent arguments for such funds have recently appeared in the _new york evening post's_ symposium on "how to give wisely," by mrs. emma garrett boyd, of atlanta, and miss salmon, of vassar college. if the saloon is here to stay, we must all agree that it is a frightful waste of human energy and of educational momentum to be appealing for its abolition when we might be hastening its proper control. on the other hand, if the saloon is destined to be abolished as a public nuisance and a private wrong, as a menace to industry and social order, is it not a frightful, unforgivable waste of energy to permit prohibition laws to fail, and thus to discredit the principle of prohibition? philanthropists have provided millions for scientific research, for medical research, for the study of tuberculosis, and for the study of living conditions. it is to be hoped that a large benefaction, or that an aggregation of small benefactions, will apply to governmental attempts to regulate the sale of alcohol those methods of scientific research which have released men from the thraldom of ignorance and diseases less easily preventable than alcoholism. chapter xxxv is it practicable in presenting to children the evils of alcoholism to tell the truth, the whole truth, and nothing but the truth? if children are taught that the most effective way of combating alcoholism is to insure the enforcement of existing laws and to profit from lessons taught by such enforcement; if children are taught that the strongest reasons for total abstinence are social, economic, and industrial rather than individual and physiological,--there is much to be gained and little to lose from telling them the truth, the whole truth, and nothing but the truth about alcohol. to stimulate a child's imagination by untruths about alcohol is as vicious as to stimulate his body with alcohol. whisky drinking does not always lead to drunkenness, to physical incapacity, to short life, or to obvious loss of vitality. beer drinking is not always objected to by employers. neither crime, poverty, immorality, lack of ambition, nor ignorance can always be traced to alcohol. on the contrary, it is unquestionably true that the majority of the nation's heroes have used alcoholics moderately or excessively for the greater part of their lives. it is probably true that among the hundred most eminent officials, pastors, merchants, professors, and scientists of to-day, the great majority of each class are moderate users of one or more forms of alcoholics. overeating of potatoes or cake or meat, sleeping or working in ill-ventilated rooms, neglect of constipation, may occasion physiological and industrial injuries that are not only as grave in themselves as the evils of moderate drinking, but, in addition, actually tempt to moderate drinking. all of this can be safely admitted, because whether parents and teachers admit it or deny it, children by observation and by reading will become convinced that up to the year the noblest and the most successful men of america, as well as the most depraved and least successful, have used alcoholics. to be candid enough to admit this enables us to gain a hold upon the confidence and the intelligence of children and youth that will strengthen our arguments, based upon social and industrial as well as physiological grounds, against running the risks that are inevitably incurred by even the moderate use of alcohol. other things being equal, the same man will do better work without alcohol than with alcohol; the same athlete will be stronger and more alert without alcohol than with alcohol; the clerk or lawyer or teacher will win promotion earlier without alcohol than with alcohol; man or woman will grow old quicker with than without alcohol. other things being equal, a man of fifty will have greater confidence in a total abstainer than in a man of identical capacity who uses alcohol moderately; a mother will give better vitality and better care to her children without than with alcohol; a policeman or fireman or stenographer is more apt to win promotion without than with alcohol. whatever the physical ailment, there is in every instance a better remedy for an acute trouble, and infinitely better remedies for deep-seated troubles, than alcoholics. the percentage of failure to use alcoholics moderately is so high, the uncertainty as to a particular individual's ability to drink moderately is so great, as to lead certain insurance companies, first, to give preference to men who never use alcoholics, and later, to refuse to insure moderate drinkers. life insurance companies have the general rule that habitual drinkers are bad risks, as the alcohol habit is prejudicial to health and longevity; but they have no means of studying the risk of moderate drinkers, because, except where alcohol has already left a permanent impression upon the system, the indications are by no means such as to enable the medical examiner to trace its existence with certainty. for this reason the life insurance companies have little effect in _preventing_ alcoholism. though they are agreed that habitual drinkers ought to be declined altogether, only a few companies have taken the decided stand of declining them. "habitual drinkers, if not too excessive, are admitted into the general class where the expected mortality, according to the experience of the pennsylvania mutual life insurance company, is per cent, as against per cent for the temperate class. though it is only necessary to look over the death losses presented each day to see that intemperance in the use of liquors, as shown by cirrhosis of the liver, bright's disease, diseases of the heart, brain, and nervous system, is the cause of a large proportion of the deaths, these companies prefer to grade the premiums accordingly rather than to decline habitual drinkers altogether. while this is partly due to the difficulty and expense of diagnosis, it is more probably due to an objection to take a definite stand on the temperance question." thus the insurance companies' rules touch only the confirmed drinker, whose physique is often irreparably injured. one company writes: "men who have been intemperate and taken the keeley or other cures are never accepted until five years have elapsed from the date of taking the cure, and only when it can be conclusively shown that during the whole period they have refrained entirely from the use of alcoholic liquor, and that their former excesses have not in any way impaired the physical risk." thus far american insurance companies are doing little preventive and educational work on the alcohol question, though they have the very best means at their command for so doing. according to the metropolitan life insurance company nine tenths of the school children in new york city are insured by them, and an even greater proportion of workingmen. even though this is done "at twice the normal cost," the most cursory medical examination is given and no attempt is made to instruct them in the relation of their physical condition to their working power, or in the evils of the alcohol and the smoking habits. naturally the moderate drinker is first rejected for positions where an occasional overindulgence would be most noticeable and most serious. the manager of a large factory tells his men: "you cannot work here unless you are sober. if you must drink at parties, stay at home if necessary until o'clock the next day and sleep it off, but don't come here till you are straight. we cannot afford it." occasionally his men stay at home and not a word is said, but the minute they are found at work in an unsteady condition they are summarily discharged. from this position it is but a step to that of an upholsterer in new york city, who prints on his order blanks, "no drinking man employed." his company recently discharged a man after twenty years of service because a customer for whom this man was working detected a whisky breath. men reported to trade unions for frequent intoxication are blacklisted. a certain financial corporation permits no liquor on its grounds or in its lunch rooms. the head of one of its large branches was heard to say recently that he would discharge on the spot a man who showed evidences of drinking, even though he had previously worked faithfully for years. rejection of moderate drinkers by business houses is not done on moral grounds alone, but because experience has proved the danger of employing men who have not their faculties fully under control _all_ the time they are at work. the rules are especially strict for men working for a railroad or street railway company. the pennsylvania railroad company replied to my inquiry as to their custom of discriminating against drinking men in these words: "we have no printed rules in regard to this except in a general way,--that no employee is allowed to go into a saloon during his hours of work or wearing the company's uniform. of course the men are promptly discharged or disciplined if they show the effects of liquor while on duty, and the whole tendency of the administration of the rules is to get rid of any men who are habitual drinkers, but the administration of the rules and discipline is left to the superintendent of each division." the interborough rapid transit company of new york has these printed rules for the physical standard required for applicants for employment: . _examination of heart and arteries._ rejection of candidates showing excessive or long-continued use of tobacco and alcohol, with explanation of condition, causes, and dangers of continued use. warning to chiefs of departments regarding those accepted who show tendency to drink at times, but whose physical examination does not disclose sufficient evidence to warrant their disqualifications. foremen and chiefs of departments to be notified and to carry out the policy of employing only men who are at all times sober and not under the influence of alcohol at all. . _on reëxamination of employees._ warning to or rejection of those showing, on physical examination, indulgence to excess of alcohol, tobacco, or drugs. warning to chief of department of evidence of such habits on part of any employee examined for any reason, but retained in service of the company with injunction to chief of department to speak with such employee and have him under proper supervision. the blacklisting of habitual drinkers by their union, and the growing tendency on the part of large corporations, factories, and business houses to take a decided stand against drinking, are having a marked effect in reducing drunkenness where it does most harm. this practice has been declared by john bach mcmasters, the noted american historian, to have exerted a stronger influence in promoting temperance and total abstinence than all the temperance crusades from hartley's time to the prohibition wave of . the school, by instructing children how the alcohol habit will affect their chances of business success, future usefulness as citizens, and enjoyment of life, will inevitably reduce the evils of alcohol. by teaching based on facts that intimately concern the life of the child, as well as by caring for his health and his environment, the schools can help supplant the desire for alcohol with other more healthy desires. no truth about alcohol is more important than that the craving for alcohol or something just as bad will exist side by side with imperfect sanitation, too long hours of work, food that fails to nourish, lack of exercise, rest, and fresh air. conditions that produce bounding vitality and offer freedom for its expression at work and at play will supplant the craving for stimulants. finally, the great truth contained in the last chapter must be taught, that success in coping with alcoholism is a community task requiring efficient government above all else. chapter xxxvi fighting tobacco evils "it is not necessarily vicious or harmful to soothe excited nerves." this editorial comment explains, even if it condemns while trying to justify, the tobacco habit. to soothe excited nerves by lying to them about their condition and by weakening where we promise to nourish, is vicious and harmful just as other lying and robbery are vicious and harmful. yet two essential facts in dealing with tobacco evils must be considered: tobacco does soothe excited nerves, and the harm done to the majority of smokers seems to them to be negligible. for these two reasons the tobacco user, unless frightened by effects already visible, refuses to listen to physiological arguments against his amiable self-indulgence. cheerfully he admits the theoretical possibility that by its method of soothing nerves tobacco kills nerve energy. but in all sincerity he points to men who have found the right stopping point up to which tobacco hurts less perhaps than coffee or tea, candy or lobster, overeating or undersleeping. therefore the physician, the bishop, the school superintendent, candidly run the necessary risk for the sake of nerve soothing and sociability. less harm would be done by tobacco if it were more harmful. like so many other food poisons, its use in small quantities does not produce the prompt, vivid, unequivocal results that remove all doubt as to the user's injuries and intemperance. as inability to see the physiological effect upon himself encourages the tobacco user to continue smoking or chewing, so failure to identify evil physiological effects upon the smoker encourages the nonuser to begin smoking or chewing. a very few smokers give up the habit because they fear its results, but too often the man who can see the evil results would rather give up almost anything else. the one motive that most frequently stops inveterate smoking--fear--is the least effective motive in dissuading those who have not yet acquired the habit; every young man, unless already suffering from known heart trouble, thinks he will smoke moderately and without harm. unfortunately, every boy who begins to smoke succeeds in picturing to himself the adult who shows no surface sign of injury from tobacco, rather than some other boy who has been stunted physically, mentally, and morally by cigarettes. for adult and child, therefore, it behooves us to find some other weapons against tobacco evils in addition to fear of physiological injuries. among these weapons are: . enforcement of existing laws that make it an offense against society for dealer, parent, or other person to furnish children under sixteen with tobacco in any form; and raising the age limit to twenty-one, or at least to eighteen. . enforcement of restrictions as to place and time when smoking is permitted. . agitation against tobacco as a private and public nuisance. . explanation of commercial advantages of abstinence. because the childish body quickly shows the injurious effects of what in adults would be called moderate smoking, the proper physical examination of school children will reveal injuries which in turn will show where and to what extent the cigarette evil exists among the children of a community. even the scientists who claim that "in some cases tobacco aids digestion," or that "tobacco may be used without bad effects when used moderately by people who are in condition to use it," declare emphatically that tobacco "must not be used in any form by growing children or youths." prohibitive laws can be rigidly enforced if a small amount of attention is given to organizing the strong public sentiment that exists against demoralizing children by tobacco. thus children and youths will not need to make a decision regarding their own use of tobacco until after other arguments than physiological fear have been used for many years by parent, teacher, and society. one effective weapon is the sign on a ferryboat or street car: "no smoking allowed on this side," or "smoking allowed on three rear seats only." public halls and vehicles in increasing numbers either prohibit smoking altogether or put smokers to some considerable inconvenience. the trouble involved in going to places where smoking is permitted tends gradually to irritate the nerves beyond the power of tobacco to soothe. again, many men would rather not soothe their excited nerves after five, than have their nerves excited all day waiting for freedom to smoke. restrictions as to time or place make possible and expedite still further restrictions. thus gradually the army of occasional smokers or nonsmokers is being recruited from the army of regular smokers. the anti-nuisance motive follows closely upon the drawing of sharp lines of time and place for the use of tobacco. like treason, smoking in the presence of nonsmokers can be considered respectable only when the numbers who profess and practice it are numerous. if the two first-mentioned weapons are effectively used, there will be an increasing proportion of nonsmokers and not-yet-smokers who will give attentive ear to proof that nicotinism is a nuisance. the physical evidences of the cigarette habit can easily be made distasteful to all nonsmokers if frankly pointed out,--the yellow fingers, the yellow teeth, the nasty breath, the offensive excretions from the pores that saturate the garments of all who cannot afford a daily change of underwear. the anti-nuisance argument is always insidious and abiding. in the presence of nonsmokers accustomed to regard tobacco using as a nuisance, smokers become self-conscious and sensitive. men and women alike would prefer a reputation for cleanliness to the pleasures of tobacco. the educational possibility of fighting tobacco with the name "nuisance" was recognized the other day by an editorial that protested against a law to prevent women from using cigarettes in restaurants. "the way for any man who has the desire to reform some woman addicted to the cigarette habit is insidiously and gently to point out the injurious effects on her appearance. cigarette smoking stains a woman's fingers and discolors her teeth. it also tends to make her complexion sallow and to detract from the rubiness of her lips. it bedims the sparkle of her eyes. it makes her less attractive mornings." chewing has practically disappeared, not because it ceased to soothe excited nerves but because it was seen to be a nasty nuisance. finally, the selfishness of the smoker is a nuisance that continues only because it has not been called by its right name. "do you mind if i smoke?" was a polite question two hundred years ago when tobacco was rare enough to make smoking a distinction, or fifty years ago when everybody smoked at home and in public. but it is effrontery to-day when people do mind, when smoking pollutes the air of drawing room and office, and while soothing the excited nerves of the smoker lowers the vitality of nonsmokers compelled to breathe smoke-laden air. it is selfish to intrude upon others a personal weakness or a personal appetite. it is selfish to divert from family purposes to "soothing excited nerves" even the small amounts necessary to maintain the cigar or cigarette habit. it is selfish to run the risk of shortening one's life, of reducing one's earning capacity. because the tobacco habit is selfish it is anti-social and a nuisance, and should be fought by social as well as personal weapons, as are other recognized nuisances, such as spitting in public or offensive manners. the economic motive for avoiding and for eliminating tobacco is gaining in strength. the soothing qualities of all drugs are found to be expensive to physical and business energy if enjoyed during business hours. strangely enough, employers who smoke are quite as apt as are nonsmokers, to forbid the use of tobacco by employees at work. some of this seeming inconsistency is due to a dislike for cheaper tobacco or for mixed brands in one atmosphere; some of it is due to the smoker's knowledge that "soothing nerves" and sustained attention do not go hand in hand, while "pipe dreams" and unproductive meditation are fast companions; finally no little of the opposition to tobacco in business is due to fear of fire. these various motives, combining with the anti-nuisance motive among nonsmokers, have led many business enterprises to prohibit the use of tobacco in any form on their premises or during business hours, even when on the premises of others. notable examples are railroads that permit no passenger trainman to use tobacco while on duty. (freight trainmen are restricted more tardily because the risk of damages is less and the anti-nuisance objection is wanting.) from penalizing excessive use and prohibiting moderate use in business hours, it is a short cut to choosing men who never use tobacco and thus never suffer any of its effects and never exhibit any of its offensive evidences. no young man expects to obtain a favorable hearing if he offers himself for employment while smoking or chewing tobacco. business men dislike to receive tobacco-scented messengers. cars and elevators contain signs prohibiting lighted cigars or cigarettes. insurance companies reject men who show signs of excessive use of tobacco. why? because they are apt to die before their time. the interborough rapid transit company of new york city rejects applicants for motormen and conductors "for excessive or long-continued use of tobacco." why? because, other things being equal, such men are more apt to lose their nerve in an emergency and to fail to read signals or instructions correctly. armed with these weapons against tobacco, parents and teachers can effectively introduce physiological arguments against excessive use, against use by those who suffer from nervous or heart trouble, and against any use whatever by those who have not reached physical maturity. by avoiding physiological arguments that children will not--cannot--believe contrary to their own eyes, parents and teachers are able to speak dogmatically of that which children will believe,--injuries to children, evils of excess, restrictions as to time and place, and offensiveness to nonsmokers. but even here it is wrong, as it is inexpedient, to leave the physical strength of the next generation to the persuasive power of parents and teachers or to the faith and knowledge of minors. society should protect all minors against their own ignorance, their own desires, the ignorance of parents and associates, and against the economic motive of tobacco sellers by machinery that enforces the law. chapter xxxvii the patent-medicine evil "dhrugs," says dock o'leary, "are a little iv a pizen that a little more iv wud kill ye. ye can't stop people fr'm takin' dhrugs, an' ye might as well give thim somethin' that will look important enough to be inthrojuced to their important and fatal cold in th' head. if ye don't, they'll leap f'r th' patent medicines. mind ye, i haven't got annything to say agin' patent medicines. if a man wud rather take them thin dhrink at a bar or go down to hop lung's f'r a long dhraw, he's within his rights. manny a man have i known who was a victim iv th' tortures iv a cigareet cough who is now livin' comfortable an' happy as an opeem fiend be takin' dr. wheezo's consumption cure." the dock says th' more he practices medicine th' more he becomes a janitor with a knowledge iv cookin'. he says if people wud on'y call him in befure they got sick he'd abolish ivry disease in th' ward except old age and pollyticks. thus mr. dooley with his usual wit and insight tells the american people why they spend over two hundred million dollars annually on patent medicines. americans consume more drugs and use more patent medicines than the people of any other country on the civilized globe. self-medication has grown to tremendous proportions. everywhere--in cars, on transfers, on billboards, in magazines, in newspapers, in the mails--are advertised medicines to cure disease and devices to promote health. when we consider that electric cars contain from thirty-two to fifty-two advertisements each, three fourths of which are directly or indirectly concerned with health; when we multiply these by the number of cars actually in use in american cities; when we consider the number of advertisements in magazines and daily papers, and the enormous circulation of these papers and magazines; when we consider that an increasingly large proportion of advertising space is devoted to health,--we begin to realize the cumulative power for good or for evil that health advertisements must have. to illustrate advertisements devoted to health to-day, i have kept clippings for one week of news items, editorials, and advertisements in a penny and a three-cent paper, and had them classified according to the subjects treated: ===================+=========================+======================== | penny paper | three-cent paper +------+---------+--------+-----+---------+-------- | news |editorial| adver- | news|editorial| adver- | item | |tisement| item| |tisement -------------------+------+---------+--------+-----+---------+-------- milk | | -- | | | -- | teeth | -- | | | -- | -- | shoes | -- | -- | | -- | -- | food | | -- | -- | | -- | alcohol | | -- | | | -- | tuberculosis | -- | -- | | | -- | -- patent medicine | -- | -- | | -- | -- | -- constipation cures | -- | -- | | -- | -- | eyes | | -- | | | -- | -- beauty | | | | -- | -- | general | | | | | -- | -- -------------------+------+---------+--------+-----+---------+-------- total | | | | | -- | ===================+======+=========+========+=====+=========+======== the following list of health topics was treated in the advertisements, editorials, and articles of a popular monthly periodical devoted to women: =========================+=========+===========+=============== | article | editorial | advertisement -------------------------+---------+-----------+--------------- babies | | -- | soaps and powders | -- | -- | beauty | | -- | quack cures | -- | | -- tooth powders | -- | -- | household | | -- | food and cooking | | -- | clothes | | -- | teaching sex laws | | | -- medicine | | | -- -------------------------+---------+-----------+--------------- total | | | =========================+=========+===========+=============== besides the classic patent medicines, such as lydia pinkham's vegetable compound, castoria, cod liver oil, etc., there are "colds cured in one day," "appendixine," health foods, massage vibrators, violet rays, porosknit underwear, sanitary tooth washes, soaps, vitopathic, naturopathic, and faith cures. new ones appear every day,--enough to make a really sick person dizzy, let alone a person suffering from imaginary ailments. all seem to outline my particular symptoms. after they have flamed at me in red letters in the surface cars, pursued me in the elevated and underground, accompanied me out into the country and back again to the city, greeted me each morning in the daily paper and in my daily mail, each week or each month in the periodical, the coincidence of a familiar package on a drug-store counter seems to be providential and therefore irresistible. i know that i ought to be examined by a physician, but i am busy and not unwilling to gamble for my health; it cannot kill me and there is a chance that it will cure me. if there is nothing the matter with us, we may be cured by our faith. if we are taking a cure for consumption, the morphine in it may lull us into thinking we feel better. if we are taking a tonic for spring fever, the cheap alcohol may excite us into thinking our vitality has been heightened. soothing sirup soothes the baby, often doping its spirit for life, or soothing it into a sleep from which it never wakes. in spite of the fact that the "great american fraud" has been exposed repeatedly in newspapers and magazines of wide circulation, the appeal of the quack still catches men and women of intelligence. the other night a friend went out to a dinner and conference with a lawyer in the employ of the national government. annoyed by a nagging headache, he made for the nearest drug store and ordered a "headache powder." he admitted that it was an awful dose, but he had been told that it always "did the business." he knew the principle was bad, confessed to a scorn for friends of his whom he knew to be bromo-seltzer fiends, but he had the headache and the work to do--a sure cure and a quick one seemed imperative. the headache was due to overwork, indigestion, constipation. plain food and quiet sleep was what he needed most. but the dinner conference plus the headache was the unanswerable argument for a dose with an immediate result. last winter an irish maid slowly lost her rosy cheeks and grew hollow-eyed and thin. she was taken to a specialist who discovered a rapidly advancing case of consumption. he said that owing to the girl's ignorance, stupidity, and homesickness, her only chance of recovery was to return to the "auld countrie" at once. the girl agreed to go, but insisted on a few days "to talk it over with her cousins in new york." after two weeks had elapsed she was found in a stuffy, overcrowded new york tenement. she had found a doctor who had given her a little bottle of medicine for two dollars, which would cure her in the city. it was futile to protest. days in the unventilated tenement and nights in a "dark room" meant that she would never live to finish the bottle. for a year miss h. took a patent preparation for chronic catarrh. it seemed to "set her up"; but it so undermined her strength, through its artificial nerve spur, that chronic catarrh was followed by consumption. it later transpired that the cure's chief ingredient was whisky, and cheap whisky. a good grandmother, herself a vigorous temperance agitator and teetotaler, offered to pay for it as long as my friend would take it faithfully. the irony of it makes one wonder how many earnest advocates of total abstinence are in reality addicted to the liquor habit. last summer a district nurse of the summer corps who visited city babies under two years of age encountered in the hallway of a tenement a bevy of frenzied women. a baby lay on the bed gasping and "rolling its eyes up into the top of its head." the nurse asked the frightened mother what she had been giving it. "nothing at all," said the woman. but a telltale bottle of soothing sirup showed that the child was dying from morphine poisoning. happily the nurse came in time to save it. is it not pitiful, this grasping for a poison in an extremity; this seizing of a defective rope to escape the fire? [illustration: learning how to keep baby well without patent medicines recreation pier, new york city, summer, ] the patent-medicine evil cannot be cured by occasional exposure or by overexposure. nor can it be cured by legislation, legislation, legislation, unless laws are rigidly enforced. occasional exposure is no better than occasional advertising of good things. the patent-medicine business thrives on constant, not occasional, advertising. leading advertisers expect so little from the first notice that they would not take the trouble to write out a single advertisement. that is the reason merchants charge advertising in the programmes of church, festival, and glee-club concert to charity, not to business. warning people once does no more lasting good than sending a child to school once a month. the exposure of patent-medicine evils must be as constant as efforts to sell the medicines. overexposure is ineffective. it is the evils of patent medicines that do harm, not their name and not their patents. the medical profession has in vain protested against proprietary medicines. ethical barriers cannot be erected by resolution. calling things unethical does not make them unethical. the mere patenting of medicines for profit does not make the medicine injurious any more than the mere mixing of unpatented drugs makes a physician safe. physicians who would not themselves patent a drug will use certain patented drugs whose ingredients are known to be safe and uniform. true exposure of patent-medicine evils will enable the average physician and the average layman to distinguish the dangerous from the safe, the fraud from the genuine, lies from truths. legislation is needed to crystallize modern knowledge and to establish in courts the right to protection against the evils of patent medicines. the national pure food law, passed january , , and now in force throughout the country, requires on the "labels of all proprietary medicines entering into interstate commerce, a statement of the quantity or proportion of any alcohol, morphine, opium, heroin, chloroform, cannabis indica, chloral hydrate, or acetanilid, or any derivative or preparation of any such substance contained therein; this information must be in type not smaller than eight-point capital letters; also _the label shall embody no statement which shall be false or misleading in any particular_." this law does not forbid patent medicines nor the use of alcohol and narcotics in patent medicines; it merely says, "let the label tell, that all who _buy_ may read." it does not require that all who _run_ may read, for _it does not say that advertisements of a patent medicine shall tell the truth about its ingredients or its action on the human body_; only that the label on the bottle shall tell. the object of this law is to explain to the consumer the exact nature of the medicine. but to the majority of people the word "acetphenitidin" on the label of a headache medicine does not explain. the new order that requires manufacturers to substitute acetanilid for acetphenitidin does no more than replace fog with mist. protection requires legislation that cannot be evaded by technical terms. the present law requires that packages must be properly labeled _on entering the state_. to carry out the national law, state laws should make it an offense for dealers to have in their possession proprietary medicines without explanatory labels that explain. where state laws to this effect do not exist, the packages once in the state may be deprived of their labels and sold as secret remedies, thus nullifying the whole effect of the national law. enforcement must be insured. impure drugs may do as much harm as patent medicines containing harmful drugs. in new york a vigorous campaign was recently inaugurated by the department of health to drive out impure drugs. drugs are dangerous enough at their best. when they are not what they pretend to be, whether patented or not, they may take life. one extreme case where a patient's heart was weakened when it ought to have been strengthened, led to the discovery that practically all of one particular drug offered for sale in new york city was unfit to use and calculated to kill in the emergency where alone it would be used. yesterday four lives and several million dollars were lost in a new york fire because the hose was rotten or weak. as inspection and testing were needed to insure hose equal to emergency pressure, so inspection and testing of patent medicines and drugs are needed to make legislation effectual. legislation and enforcement should reach the newspaper, magazine, billboard, street car, that advertises a falsehood or less than the essential truth regarding drugs, foods, and patent medicines. public sentiment condemns the advertising of many opportunities to commit crime or to be disorderly or indecent or to injure one's neighbor. the facts about hundreds of nostrums can be absolutely determined. the advertising agency, whether secular or religious, that carries misrepresentation of drugs and foods should be forbidden circulation through the mails. the existence of such advertisements should be made evidence of complicity in a public offense and punished accordingly. treat them as we treated the louisiana lottery. boards of health, instead of furnishing names to druggists and manufacturers who want to sell patent foods and medicines, should print circulars exposing frauds, and punish so far as the law permits. while trying to secure adequate legislation and efficient administration of the above-mentioned standards, there is much that can be done by individuals and clubs. we can give preference to those journals that refuse drug and food advertisements unless evidence is produced that the truth is told and that the goods are not harmful. we can refuse to have in the house a paper or journal which prints notices that lie or that conceal the truth. if this drastic measure would cut us off entirely from daily papers, we could choose the least offensive and petition it to exclude specific lying methods. when it preaches health, honesty, and philanthropy, we can cut out of one issue the noble editorial and the exploiting advertisements and send them to the editor with our protest. knowledge of the ingredients and dangers of patent medicines should be a prerequisite for the practice of medicine or pharmacy. we can help bring about such conditions, and we can patronize physicians who send patients to drug stores that cater to intelligence rather than to ignorance. fighting patent-medicine evils is a civic duty to be accomplished by civic coöperation, not private effort. it is impossible to organize unofficial educational agencies that can offset the cumulative, lying advertisement. personal opposition is but the beginning. official machinery must be set running and kept running so as to protect the public health against the commercial motive that preys upon ignorance and easily inspired faith. chapter xxxviii health advertisements that promote health it is usually considered futile to attempt to defeat the devil with his own methods, because he knows so much better how to use them. but abuse does not do away with use, and the success of quacks in reaching the people demands our respect. there is no reason why their methods, based on a knowledge of human nature and human psychology, should not be employed to appeal to needs rather than to weaknesses. a good thing may lie unused because of lack of advertisement. vitality is coming to be the passion of the american people. it is on this sincere passion that fakirs have so long traded. there can be no doubt that advertisements of health-promoting goods are quite as profitable as health advertisements that injure health, when equally effective methods are used to make them reach the public. the tradition has been repeatedly mentioned in this book that the better the doctor, the less he advertises himself, except in medical and scientific journals that notoriously fail to reach the people. the same is too often true of reputable remedies and goods. the theory that these things stand or fall on their merits is not borne out by practical experience,--conspicuously in the case of "fake" remedies. purely philanthropic undertakings for the advancement of health fail, if not placed before the people whom they aim to help in an attractive, convincing form. failure to advertise a worthy cause limits its usefulness, and is therefore unjustifiable, whether we speak of medicine, legal aid, or dental clinics. an intensive study of the methods used to advertise patent medicines will suggest means of extending the usefulness of health-promoting goods. aside from clever methods of suggestion that lead many people to take medicine for imaginary ailments, especially seasonal ailments, patent-remedy advertisers have employed (as an argument for the efficiency of their cures) scientific theory, bacterial origin of diseases, recent medical or physiological discoveries, and state and national movements for promoting health. in fact, they have turned to their own uses the very law that seeks to control them and the exposures that seek to exterminate them. whatever may be the merits of castoria, the "don't poison baby" advertisement on the following page, printed just after the accompanying "babies killed by patent medicines," which appeared in a home journal, was surely a clever bit of advertising. upon an editorial in a daily paper on the relation of eyeglasses to headache and indigestion, an optician based a promise of immediate relief for these ailments if he himself were patronized. the recent investigations of the department of agriculture, and of professors chittenden and fisher, in regard to foodstuffs, are proving helpful to food quacks and advertisers of pills for constipation and indigestion. since the passage of the pure food law one health food is advertised in a column headed "pure food." when the season for pneumonia comes around numerous medicines are "sure cures" for grippe and pneumonia. "rosy teachers look better in the schoolroom than the sallow sort," is surely a good introduction to a new food. woman's vanity sells many a remedy advertised to counteract the "vandal hand of disease, which robs her of her beauty, yellows and muddies her complexion, lines her face, pales cheek and lip, dulls the brilliancy of her eye, which it disfigures with dark circles, aging her before her time." who in your town is as good a friend to "owners of bad breath" as the advertiser who tells them that they "whiff out odor which makes those standing near them turn their heads away in disgust"? the climax of effective educational advertising as well as of consummate presumption and villainy is reached in the notice of an alcoholic concoction that uses the headline, "medical supervision needed to prevent the spread of consumption in the schools." thus grafting itself on the successful results of the medical examination in the massachusetts schools, it enlists the aid of teachers, trades on the fear of tuberculosis, even indorses the fresh-air treatment. so convincing was this appeal that it was reprinted in the news columns of a daily paper in new york as official advice to school children. [illustration: don't poison baby.] so clever are these methods of advertising and so successful are they in reaching great numbers of people, that if reputable physicians would take lessons of them, they might conduct a health crusade that would exterminate tuberculosis, diminish the use of alcohol and tobacco, and save thousands of babies that die unnecessarily. the theory of patent-medicine advertising is sound. it emphasizes the joys of health, the beauty of health, the earning power of health. it adapts its message to season, event, and need. it offers testimonials of real persons cured. it is all-appealing, promising, convincing,--a fearful menace to health when the remedies offered are dishonest, a universal opportunity for promoting health if the cure is genuine. a classic example of health advertising that promotes health is sapolio. the various hygiene lessons that have promoted sapolio have done much to raise the standard of living in the united states. few eminent physicians have done so much for public health as the "poor m.d. of spotless town who scoured the country for miles around, but the only case he could find was a case of sapolio." recent press discussions about furnishing free eyeglasses to the children in the public schools have so enlightened people as to the need for expert examination of their eyes that opticians will be forced to employ competent oculists to make the preliminary examination and to see that the glasses are properly adjusted. in spite of the long mis-education by makers of corsets, the persistent advertising of "good health" and "common-sense" waists has gained an increasing number of recruits from the ranks of the self-persecuting. it is only a matter of time when the term "stylish" will be transferred to the advocates of health, because advertisers who tell the truth will, if persistent, gain a larger patronage than advertisers of falsehoods; there is profit in retaining old customers. the advertisement of a window device for "fresh air while you sleep" will make prevention of tuberculosis more profitable than "sure cures" that lie and kill. a man deserves profit who sends this message to millions of readers: there are three kinds of cleanliness: first, the ordinary soap-and-water cleanliness. second, the so-called "beauty" cleanliness. third, prophylactic cleanliness, or the cleanliness that "guards against disease." but the man who sells soap ought to be the one to use this advertisement, not a man who sells toothwash that, when pure, is little better than water, that is seldom pure, and that always hurts the teeth. many children and adults are being cured of flat foot by men who make money by selling shoes designed to strengthen the arch of the foot. millions would never know how to discover the evil effects upon themselves of coffee and alcohol except for money-making advertisements. little jo's smile taught a nation that the majority of crippled children are victims of neglect on the part of adult consumptives. certain it is that advertising is an art promoted by the severest competition of the cleverest brains. it is a force which we cannot afford to ignore. if we can harness it to the promotion of aids to health, it will do more good than all the hygiene books ever written. to this end we must educate ourselves to distinguish between goods which do what they profess to do and those which do not. a good eye opener would be to keep for a week clippings from a high-priced daily paper, a penny daily paper, and one or two representative magazines, including a religious paper. teachers and parents can very easily interest children in such clippings. moreover, they can use the bulletin method, the stereopticon exhibit, the _cumulative illustration_ of a fact, which is the essence of successful advertising. boards of health can use all the typographical aids to clear understanding,--cuts, diagrams, interesting anecdotes. in new york both the health board and the school board have issued circulars and given illustrated lectures, some of them being in school and some on public squares. medical and sanitary societies and other educators can be induced to follow what a successful business man has called the three cardinal rules of advertising: first, put your advertisement where it will be seen. (tell your story where it will be heard.) second, write it so that people will read it. (tell it so that people will understand it.) third, tell the truth, so that people will believe it. chapter xxxix is class instruction in sex hygiene practicable? among remedies for preventable disease and preventable poverty, the following was urged at a national conference for the betterment of social conditions: "we have been too prudish. because we have been unwilling to teach school children the evils of violating sex hygiene, we have been unsuccessful in combating evils justly attributable to ignorance on the part of girls as to the duties and dangers of motherhood." this point of view is shared by so many men and women that a national body was organized in to promote the teaching of sex hygiene,--the society for sanitary and moral prophylaxis. this society has its headquarters in new york, and distributes at cost lectures and essays. the second of its educational pamphlets is addressed to teachers, and is entitled "instruction in the physiology and hygiene of sex." the introduction asks eleven questions of the teachers as follows: . do you wish a pamphlet on sex subjects to hand to your pupils? why? . do you wish separate pamphlets for boys and girls? . for what age limits and social conditions do you wish them? . what topics do you wish the pamphlets for boys to "handle"? . what topic do you wish the pamphlet for girls to "handle"? . if you think one pamphlet sufficient for both sexes, what should it consider? . how far do you go in teaching sexual hygiene or reproduction? by what method? . what special difficulties do you find in teaching it? . what special need of teaching it have you found? . what special benefits (or otherwise) have you noticed from teaching it? . what criticisms (favorable or otherwise) do you encounter? the difficulty of introducing formal instruction in sex hygiene, even in the upper grades of public and private schools, is hinted at in the pamphlet. the purpose of the publishing society as given in its constitution is "to eliminate the spread of diseases which have their origin in the social evil." although sex hygiene does not begin with sex immorality, almost every text-book on sex hygiene, and almost every pamphlet urging class instruction in sex hygiene, begins with sex immorality. yet only the exceptional school child is in danger of violating sex morals, while every school child needs instruction in sex hygiene. instruction in sex hygiene, whether at school or at home, should deal with sex normality, sex health, sex temperance. instruction in sex immorality is objectionable, not merely because it offends prudists, not because it is difficult, but because it can be shown by experience to be less efficacious than training in sex health. to expect fear to prompt sex hygiene is to make a mistake that has retarded the development of sound measures in the treatment of offenders against criminal law. for centuries man failed in attempts to fit the punishment to the crime. to deter men from committing crime by holding up a threat of prolonged and dreadful punishment has been found futile. individuals take the risk because they think they will escape detection. it is an axiom of criminal procedure that a would-be offender is deterred by the certainty, not by the severity, of punishment. the modern theory of probation is, that children and adults may be best led away from evil practices by crowding out old influences with newer and stronger interests. occupations that are wholesome are made to rival diversions or occupations that are harmful and criminal. [illustration: object lessons for instruction in sex health note the uncomfortable, unhealthy overdressing] abnormal conditions of mind and body in regard to sex can almost always be traced to general physical ill health or to an unhealthy moral environment. cure and prevention require two kinds of treatment within reach of parents and teachers: ( ) build up the child's physical condition; and ( ) give him other interests. proper physical care, and work adjusted to body and mind, may be relied upon to do infinitely more to promote sex hygiene than instruction, either at home or at school, in immoral sex diseases. that sex morality is weak and untrustworthy which is based upon fear of sex diseases. like alcoholism and nicotinism, the saddest results of sex diseases are social and economic. the strongest reasons against such diseases are economic and social, not physiological. [illustration: the study of infant health is conducive to pure-mindedness note the simple, comfortable, hygienic dress] once having made up our minds to concentrate the teaching of sex hygiene upon sex health rather than upon sex immorality, upon sex functions rather than upon sex diseases, the chief objection to school instruction and to instruction in class will disappear. our school text-books in history, literature, and biology abound in references to sex distinctions, sex functions, and sex health. in enumerating the daily routine of health habits i mentioned daily bathing of the armpits and crotch. there is nothing in this injunction to offend or injure a boy or girl. if studies and physical training are to be adapted to physiological age, and if children are to know why they are graded according to physiological age as well as mental brightness, we shall soon be talking of mature, maturing and not-yet-maturing girls and boys, so that everybody will be instructed in sex hygiene without offense. any teacher who can explain the family troubles of king henry viii without becoming self-conscious can easily learn to look a class of girls and boys in the face and explain how a mother's health will injure her baby before its birth, why breast-fed babies are more apt to live than bottle-fed babies, why it is as important for the mother to keep a nursing breast absolutely clean as to clean the nipple of a nursing bottle. words whispered by children, or marked in dictionaries, to be stealthily and repeatedly looked upon and talked over with other children, lose all their glamour when pronounced by a teacher. in these days of state subsidy of school libraries the child is hard to find who has not free access to books of fiction full of voluptuous allusions that make undesirable impressions which only blunt, candid discussion of sex facts can make harmless. children now learn, whether in fashionable private schools or crowded slums, practically all that is lascivious and unwholesome about sex. for teachers to explain that which is wholesome and pure will disinfect the minds of most children and protect them against miseducation. class instruction in hygiene is practicable for all matters pertaining to normal sex health. girls of thirteen should be taught in classes the fact and meaning of menstruation, and its grave importance to the health, in order that they may care for themselves not only before, during, and immediately after the menstrual period, but throughout the month, in order that menstruation itself shall not be unnecessarily painful, enervating, and harmful to efficiency. it is not yet advisable to discuss dangers peculiar to girls or dangers peculiar to boys in mixed classes. generally speaking, it is undesirable that men teachers discuss girls' troubles with girl pupils. but why should it not become possible for women teachers to explain health dangers peculiar to girls to classes of boys? individual instruction in sex matters should be reserved for the diseased mind, for the boy or girl who has already been morbidly instructed. discussion of immoral sex diseases should be confined to individual talk. this field teachers have already entered. repeated physical examination of children will detect symptoms of sex abnormality. when detected, the fact and the meaning should be explained to the individual by school physician, school nurse, or school-teacher. while much can be done through mothers' meetings and through individual instruction of parents, the most effective means of improving the general attitude towards sex health is to give the simple truth to the millions of children who have not yet left school. armed with the a b c's of sex hygiene at school, boys and girls will be prepared to select employment, associates, and newspapers that will permit normal, healthy sex development. men and women who are leading normal lives, who have plenty of work, sleep, fresh air, nourishing food, amusement, and exercise are unlikely to be sexually abnormal. after all, the question of instruction in sex hygiene will quickly settle itself when it is made a condition of a teacher's certificate that the applicant shall himself or herself know the personal and social reasons for sex health. the woman who does not know how to take care of her own sex health, the man who is ignorant of a woman's special needs, cannot do justice to the requirements of arithmetic, language, and discipline. whether men and women teachers are mentally, physically, and morally equipped to be sexually normal and to teach the law of sex health will be disclosed as soon as trustees and superintendent dare to ask the necessary questions. whether an instructor's personality will enable him to fill the minds of children with interests more wholesome, more absorbing than obscene stories or morbid sex curiosity can also be learned. when school-teachers are prepared to teach the social and economic aspects of general health they will quickly solve the problem of instruction in sex health. just one word about country morality. it is customary to deplore the influence of large cities on the young. of late, however, there has been a tendency to question whether, after all, sex morality is apt to be higher in the country than in the city. parents and teachers in small towns and in rural districts will do well to take an inventory of the influences surrounding their children. it will always be impossible to give country children city diversions. one great disadvantage of country children frequently counter-acts the beneficial influence of out-of-door living; namely, isolation. the city child is practically always in or about to be in the sight of, if not in the presence of, other people. numbers and close contact with people, though they be strangers, mean restraint and pervading social conscience. city children find it difficult to have good times in pairs. no amount of instruction of rural pupils in sex hygiene will take the place of amusements and entertainments for groups of children, forming thus a special antidote for "two's company, three's a crowd." liberating and standardizing normal intersex relations and discouraging cramped social intersex relations are more urgent needs than instruction in sex diseases. a working environment that permits pure-mindedness will do more to inculcate a reverence for sex cleanliness and for parenthood than lectures and essays on moral prophylaxis. chapter xl the element of truth in quackery; hygiene of the mind patent medicines and other forms of quackery could not pay such enormous dividends unless there was some truth in their claims; unless their victim found some beneficial return for his money. they win confidence because they raise hopes and combat fear. they do cure thousands of people of fear and of "ingrowing thoughts." in so doing they remove the sole cause of much disability.[ ] in so doing they are merely applying by wholesale principles of mental hygiene that are legitimately used by physicians, tradesmen, teachers, and parents who deal successfully with nervousness. quackery makes cures and makes money because of the undoubted influence of mind in causing and in removing those ailments that originate in fear, imagination, or morbid introspection. a few years ago a little out-of-the-way town in southern minnesota was visited by train loads of the sick and crippled from miles around. miraculous cures were heralded broadcast. life-long cripples left wagon loads of crutches and braces to decorate the little church with the enchanted transom. people who had not walked for years returned to their homes cured. the marvels of famous shrines were fast being duplicated when the church authorities at st. paul issued an explanation of the alleged miraculous appearance of biblical figures in the transom of the new church. the outlines of a mother carrying a baby had been vaguely impressed in the transom glass when molten. when the mystery was explained the excursions and the cures stopped. nearly every physician and practically every medical charlatan can count scores of cures of ailments that had previously defied the skill of eminent physicians. a child's bumps actually stop aching after the mother or nurse kisses the abused spot. invalids forget their limitations under stress of some great excitement or some intense desire for pleasures incompatible with invalidism. many a physician of reputation owes his success in great part to the discriminating use of the _placebo_,--a bread pill designed to supplant the patient's fear with confidence. hypnotism and "suggestion" have been successfully used to cure alcoholism and to fill patients' minds with conviction stronger than the fear that produced the sickness. a well-known writer and preacher cures insomnia by auto-suggestion, telling himself he is sleepy, is very sleepy, is going to sleep, is almost asleep, is fast asleep. treatment by osteopathy has been followed by disappearance of diseases that cannot possibly be cured by osteopathy. christian science has restored to health and happy usefulness hundreds of thousands of chronic invalids. verily is hygiene of the mind an important factor in the civics of health. fear can originate with mind. fear produces fear. fear disarranges circulation of the blood and the nourishment of muscle and nerve. fear can produce many bodily disorders which in turn feed fear. fear cannot last unless bodily symptoms exist or arise to justify and feed it. fear can be cured and removed in two ways: ( ) by driving away fear and releasing bodily disorders from its thraldom; ( ) by removing the disorders and making fear impossible to the logical mind. an enforced sea voyage begins with the disorder; a clever, buoyant physician begins with the fear. patent-medicine proprietors, quacks, and fakes of every kind begin by displacing the fear with hope or cheer; the physical disorders frequently vanish by the same window as fear. for _fear_ write _self-pity_, _morbid self-consciousness_, _hypertrophied submission_; to _hope_ and _cheer_ add _smile_, _relaxation_, and _zest_; and we have the chief elements of mental hygiene and the reason why intelligent as well as unintelligent men like to be swindled by medical or other quacks. the social aspects of mental hygiene are particularly important. once admitting the power of the mind to decrease vitality, we recognize the duty of seeming happy, buoyant, cheerful, vital, at least when with others, for the sake of others' minds and bodies. secondly, we find the duty to refrain from commenting on others' appearance in a way that will start "ingrowing thoughts." a "grouchy" foreman can give blues and indigestion to a roomful of factory girls. a self-pitying teacher can check the heart beats of her class, cause arteries and lungs to contract, and deprive the brain of fresh blood. an oversympathetic neighbor can put a strong man to bed by discovering signs of nervous disintegration. shall we gradually work out a code of mental hygiene rights and nuisances that will require compulsory notification of the "blues" and compulsory segregation of every person unable to "smile dull care away"? is the time coming when boards of health will accompany infection leaflets with messages such as this from james whitcomb riley: talk health. the dreary, never-changing tale of mortal maladies is worn and stale. you cannot charm or interest or please by harping on that minor chord, disease. "whatever the weather may be," says he, "whatever the weather may be, it's the songs ye sing, and the smiles ye wear, that's a-making the sun shine everywhere." mental hygiene has hitherto enjoyed an evil reputation and has been condemned to generally evil associations, because the rank and file have been ignorant of hygiene of every kind. medical science has so long enveloped itself in mystery that it is in danger now of becoming discredited and of falling heir to the mantle of quackery. quacks often get social and economic results more agreeable to the patient and more helpful to society than orthodox medicine. "when traitors become numerous enough treason becomes respectable." so when mental hygiene succeeds, it becomes science for the case in question, and for that case orthodox medicine loses its respectability. for the layman there is no safety except in having intelligence enough to know whether his trouble has defied the sincere application of mental treatment, auto-suggestion, and loyalty to the health ideal. mental hygiene admits the existence of dental cavities, scarlet fever germs, adenoids, cross-eyes, uncleanliness, broken legs, inflamed eyes, overeating. the organic, structural defects which are to be sought by physical examination are all admitted by mental hygienists. they work for an orderly, daily routine and affirm the penalties of its violation. they would even favor going periodically to a physician, provided that we never go to him except when organic or structural disorders may safely be assumed from the fact that cheer and relaxation treatment does not give relief. unhygienic living and mind cure cannot go together. the mind that tries to deceive itself cannot cure either mind or body. the man who violates the habits of health cannot patch his injuries or conceal the ravages of dissipation by mental hygiene. here is the great advantage of knowing how to live hygienically, of observing habits of health, and then concerning ourselves not with ourselves, but with conditions of living for all those whose health can be affected by our health, or can affect our health and efficiency. the most recent practical application of mental hygiene for moral and physical uplifting is the "moral clinic" or "psychotherapeutic" clinic established by emmanuel church in boston. this clinic represents the union of three forces,--religion, medical diagnosis, mental hygiene. as a result of this alliance it is anticipated that both religion and medicine will be humanized, socialized, vitalized, made to express more accurately and more consistently that community consciousness and that yearning for equal opportunity and equal happiness which constitute the profoundest religious impulse. no person is treated at this moral clinic whose trouble is organic or structural. in determining whether the case belongs to this clinic, expert medical diagnosis is relied upon rather than the credulity of the patient or the zeal of the clergyman. medical scientists of highest repute can consistently coöperate, because they recognize two scientific facts: first, that many troubles are due primarily to mental disorder; and, second, the greatest asset of the human mind is that something called religion, which is no less real and potent because peculiar to each individual. whatever may be that deepest current of thought and feeling, whatever that synthetic philosophy, that explanation of being, which guides my life, it can be of inestimable aid if enlisted in an effort to secure normal vitality of mind and body. the controlling motive of the moral clinic has proved infectious. there is reason to believe that the alliance of medicine and religion has come to stay, and that the present excitement over psychotherapeutics will settle down into a scientific utilization of religious motive and medical knowledge to prevent mental and moral disease. unwholesome, morbid, self-centered thought is driven out. a recognition of others' claims takes its place. hypnotism, suggestion, and group enthusiasm are used to their utmost possibilities. the success of the boston moral clinic is due to establishing in the mind of the neurasthenic, the alcoholic, the world-weary, and the purposeless a truer conception of the pleasures that result from vitality and from altruistic effort. it is too early to classify by kind of functional disorder the patients treated. results from one patient have been described in newspapers as follows: a school-teacher, as a result of nervous collapse, had lost control, began to fear the children under her care, and thought of relinquishing her profession. she was instructed in the art of self-control and the control of others; the notion of fear was dislodged and a sentiment of love for her little charges took its place. in the course of a few weeks this conscientious and experienced teacher regained her poise and found herself performing her duties better than ever before. many alcoholics have for months given evidences of complete cure. stories almost incredible are quickening pastor and physician alike throughout the country. after individual treatments are given, after religious motive is appealed to, and the soul stirred to heed the lessons of religion, medicine, and sociology, patients are given the work cure. thus a branch of social service is established, where after-treatment is given to the patient whose thoughts have been turned from himself to others. all of a sudden the church finds itself in need of definite knowledge as to opportunities for altruistic work, as to definite community needs not met, as to people in distress who can be relieved by volunteers, as to agencies which can be called upon to coöperate both in treating the individual and in utilizing his energies for others' benefits. because a relatively small percentage of men and women are neurasthenic, melancholy, morbid, alcoholic, the lesson of the moral clinic is most serviceable when extended for the benefit of the "not yet alcoholic" and the "not quite neurasthenic." in other words, individuals in thinking of themselves must learn the health value and soul value of purpose that centers in others' happiness. that thing which we have called tact in personality, and which in the past was discovered by induction, namely, the law of mental hygiene and the control it gives over others' health, must be taught in schools to children by wholesale, must be taught in medical and theological schools, to all physicians and all pastors. this alliance of medicine and religion, which is at present confined to one or two moral clinics, should be incorporated into education, into social work, into church work, becoming thus a part of civilization's normal point of view. mental hygiene cannot survive conscious violation of the fundamental laws of medicine and religion. the alliance of medicine and religion will prove utterly futile unless habits of living and of thinking are inculcated that conform to nature's law of self-preservation and to god's law of brotherly love. self-centered religion, like self-centered medicine, destroys both body and soul. footnotes: [ ] the alliance of mental hygiene, medicine, and religion is discussed in the emmanuel church book, _religion and medicine; the moral control of nervous disorders_; also in its bulletins, _religion and medicine_. chapter xli "a natural law is as sacred as a moral principle" when a grammar-school boy i learned from the game "quotations" that louis agassiz, scientist, had written the sentence with which i introduce a final appeal for living that will permit physical and civic efficiency. agassiz has been called "america's greatest educator," and again "the finest specimen yet discovered of the genus _homo_, of the species _intelligens_." the story of his long life as teacher of teachers reads like a romance. but among his gifts to education and citizenship none can be made to mean more than the simple proposition that natural law is as sacred as a moral principle. all who remember this "beatitude" will be helped to solve many perplexing problems of dress, diet, play, education, philanthropy, morals, and civics. reverence for the natural carries with it a distaste for the unnatural. those who obey natural law soon come to regard its violation as a nuisance when not immoral. on the other hand, compromise with the unnatural, like compromise with vice, quickly leads first to toleration and thence to interest and practice. therefore the importance of giving children agassiz's conception of the sacredness of the laws that govern the human body. a passion for the natural is a strong foundation for habits of health and a priceless possession for one who wishes to know morality in its highest sense. "natural" is less attractive to us than it would be had agassiz first interpreted it for us rather than rousseau or present-day exponents of "the simple life," "back to nature," and "back to the land." it is too often forgotten that no one sins against natural law more grievously than the primitive man or the isolated man in daily contact with non-human nature. communing with nature seems not only to require communing with man but to give joys in proportion as the nature lover is concerned for the human society of which he is a part. natural law does not become a moral principle until man is benefited or injured by man's use of nature's resources within and about him. natural living according to natural law must be something sounder, more beautiful, and more progressive than can be read into or out of mountains, trees, brooks, and sky, or primitive society. natural law points to a nature fore as well as a nature back, to a nature up and beyond as well as a nature down and behind. the nature that was yesterday will not do for to-morrow, any more than a man is willing to give up his nature aspirations for the careless, animal ways of romping childhood. civilization is constantly urged at each step to repeat the prayer of holmes's old man who dreams for the autocrat of the breakfast table: oh for one hour of youthful joy! give back my twentieth spring! i'd rather laugh a bright-haired boy than reign a gray-beard king! off with the wrinkled spoils of age! away with learning's crown! tear out life's wisdom-written page, and dash its trophies down! one moment let my life blood stream from boyhood's fount of flame! give me one giddy, reeling dream of life all love and fame! but every experiment in turning back exalts the present and the future. gifts as well as problems are seen to come with complexity, and civilization flatly refuses to relinquish these gifts. sound maturity is better than youth or age: the smiling angel dropped his pen,-- "why, this will never do; the man would be a boy again, and be a father too!" problems of health and of civics can never be solved by appealing to nature back, when only the few could be healthy, when one baby in three died in infancy, when old age was toothless and childish, when infection ravished nations, when the average life was twenty years shorter than now, and when unspeakable filth was tolerated in air, street, and house. they can all be solved by appeals to nature fore, which holds up an ideal of mankind physically able to enjoy all the benefits and to conquer all the dangers of civilization. it is not looking back, but looking in and forward that reveals what natural law promises to those who obey it. by using numerous tests which have been suggested in preceding chapters we can learn how far we and our communities obey natural law when working and playing. health for health's sake has nowhere been urged. on the contrary, healthful living has been frankly valued for its aid to efficient living by individual and by community; wherefore the emphasis upon others' health and upon the civic aspects of our own health. tests furnish us with the technic necessary to efficient living; civics, with the larger reason; natural law, with the "pillar of fire by night" to help us choose our path among habits and pleasures whose immediate results upon efficient living cannot easily be determined. fashions, tastes, mannerisms, personal indulgences, have been left for agassiz to deal with. generally speaking, we all know of numerous acts committed and numerous acts omitted in our daily routine that convict us of not living up to our knowledge of physiology and hygiene,--wearing tight shoes or tight corsets, drinking strong coffee, smoking, reading while reclining, failing to insure clean air and clean bodies. then there are other acts whose omission or commission violate no physical law so far as we can see, but whose unnaturalness we concede,--putting chalk on the eyebrows, wearing false hair or curious puffs, putting perfumery in the bath or on handkerchiefs, assuming artificial poses of body or mouth. these violations of natural law are forced upon us by "style" or "custom" or family convenience. when we come to choose between following fashions and disobeying them, we generally decide that it is better to do a foolish or slightly harmful thing than to occasion criticism, mirth, or even special notice by our dress or our abstemiousness. last night i went to a dinner party at eight. i ate and ate a great variety of palatable foods that nature back never knew. after two hours of eating i imbibed for two hours the tobacco smoke of the gentlemen who made up the party. i knew that eight o'clock was too late for me to begin eating, that two hours was too long to eat, that the tobacco of others was bad for my health and for to-day's efficiency. all this i knew when i accepted the invitation to dinner. i went with no intention of preventing others from smoking or of lecturing my host or his chef or his guests for the unhygienic practices of our day. yet the physical ills were more than offset by certain definite gains to the school children of new york that will result from last night's meeting. natural law was abated in part. but i declined certain dishes that would not agree with me, helped myself sparingly of many dishes, avoided tobacco and wines, and by a three-mile walk in the open air, a bath, and a good long night's sleep have almost recovered my right to talk of the sacredness of natural law. nature back says i should not have gone to this dinner. but i was compelled to go. i know i am going to others. i cannot do my work unless i overdraw my current health account. nature fore tells me that effective coöperation with others will frequently require me to eat at the dinner hour of others, to retire at others' sleeping time, to wear what others will approve, to violate natural law. but nature fore also tells me how to build up a health reserve so that i can meet these emergencies without endangering my health credit. nature back demands "dress reform." nature fore tells me that i can march in step with my contemporaries without either attracting attention or discrediting and affronting natural law. passion for the natural has effected numerous reforms in dress, diet, and social habits, until commerce provides a natural adaptation of practically every fashion. with regard to few things is it necessary to-day for any one who reads magazines to do violence to bodily health for fashion's sake. we may wear what we will, eat what we prefer, decline what is unnatural for us, without inviting censure. the debauches of those unfortunate people who live an unnatural, purposeless existence, affect such a small number that their laws need not be considered here. natural law makes obedience to itself attractive; hence commerce is rapidly learning to cater to distaste for the unnatural. with few exceptions, only temporary concessions to unnatural living are required in order to dress and act conventionally. nature back throws little light upon conditions necessary for modern labor. it can do nothing but demand the abolition of the factory, the big store, the tenement, the school. nature fore says we cannot abolish the means of working out the highest forms of coöperation. but we can make them compatible with natural living. we can modify conditions so that earning a livelihood will not compel workers to violate natural law at any or all times. the greatest need of factory and tenement reform is for parents and teachers to make a religion of nature fore and to instill its principles in the minds of children. parents and teachers must live the natural before they can make children love the natural. parents and teachers cannot possibly be natural in this day, cannot live or love natural law unless they know the machinery by which their communities are combating conditions prejudicial to health, morals, and civic efficiency. index adenoids. see _mouth breathing_ administration, health: steps in evolution, - ; knowledge of needs, ; machinery, - ; in combating alcoholism, ; departments of health: ( ) new york city, , , , , , , , - , ; ( ) general, , advertisements: motives for, ; for dental parlors, ; for consumptives, ; by physicians, ; educational, in newspapers and magazines, ; "no smoking" signs, ; of patent medicines, ; that promote health, - agassiz, louis, , air, night, . see _fresh air_ alcoholism, - ; compulsory instruction in, ; insurance companies against, ; disqualifies for railroad service, ; depletes vitality, ; results, ; hartley's fight against, ; injures the tuberculous, ; ineffective ways of combating, ; incited by bad living conditions, ; injury to negroes, ; so-called moderate use, ; labor unions blacklist drunkards, ; social dangers, ; mental hygiene, , animal sanitation, , , association for improving the condition of the poor, new york, , , babies. see _milk_ bathing: motives for, , ; a social requirement, ; cold-water, beauty, reason for health, bibliography: a bureau of child hygiene (bureau of municipal research), ; annals of a quiet neighborhood (macdonald), ; aristocracy of health (henderson), ; bitter cry of the children (spargo), , ; bulletins of emmanuel church, ; bureau of municipal research, publications, ; care of dependent, defective, and delinquent children (folks), ; charities and the commons, ; child growth (newsholme), ; children of the nation (gorst), ; children's diseases, ; clean milk for new york city, ; clippings, , ; white-plague scrapbook, ; committee on physical welfare of school children, programme, , three studies, ; crusade against tuberculosis (flick), ; dangerous trades (oliver), ; dental catechism, ; dentistry, lectures and treatises, ; deterioration, physical, report on, ; development of the child (oppenheimer), ; dietetic and hygienic gazette, ; efficient life (gulick), ; environment of child at school (north), ; pure food (u.s. department of agriculture), ; good health, ; health of the school child (mackenzie), ; heredity (thompson), ; how to give wisely, ; international congress, tuberculosis, programme, - ; journal of nursing, ; making a municipal budget (bureau of municipal research), ; milk industry, ; municipal sanitation in the united states (chapin), ; national hospital record, ; new basis of civilization (patten), ; new jersey review of charities and corrections, ; pediatrics, ; physical culture, ; poverty (hunter), ; press and magazines, - ; prevention of tuberculosis (newsholme), ; principles of relief (devine), ; principles of sanitary science and the public health (sedgwick), ; psychological clinic, , , ; real triumph of japan (seaman), ; religion and medicine (emmanuel church), ; reports of schools, ; reports of schools and health, - ; reports of institutions and societies, ; reports of state and national conferences of charities and corrections, ; reports of united states bureau of labor, ; sanitation of public buildings (gerhard), ; school reports and school efficiency (snedden and allen), ; social order and the saloon (fox), ; study of children and their school training (warner), ; study of school buildings in new york city, ; teeth and their care (hyatt), ; training of the human plant (burbank), ; typhoid fever (whipple), , ; uncommercial traveller (dickens), ; unconscious mind (schofield), ; vital statistics (newsholme), biggs, hermann m., m.d., , , , , boston, , , , , , , boston society for the relief and study of tuberculosis, boyd, emma garrett, brannan, john winters, m.d., breath, bad, , brightness, abnormal, - bronchitis, brookline, budget: should provide for cleansing, ; and tuberculosis, ; annual health programme, ; reforms in new york city, burbank, luther, bureau of municipal research, , butler, nicholas murray, ll.d., , cabot, richard c., m.d., calmette's eye test, carnegie foundation, caroline rest, , catching diseases: cost of, ; unenforced laws, ; steps in eradicating, ; germ sociology, , ; favorable soil at school, ; instruction concerning, ; mouth a breeding ground for, ; information for bathers, ; dangers of, ; reasons for national board of health, ; cost of, in new york city, ; remedies urged, charity organization society, new york, , chicago, chicken-pox, child hygiene, bureau of: working-paper tests, ; established, new york city, ; programme, child labor: compulsory school attendance, ; welfare or age test, ; movement's limitations, ; national and local committees, , ; physical-fitness tests, children's aid society, new york, , child-saving agencies: coöperation with schools, - ; do-nothingism in, chorea. see _nervousness_ christian science, , christmas shopping, cigarettes. see _tobacco_ cincinnati, cleanliness: acquired taste, ; beauty of, ; personal uncleanliness, ; cost of, ; dry cleaning dangerous, ; in fighting tuberculosis, cleveland, ohio, clippings: scrapbook, ; envelope method, ; advertisements, coffee, strong, colds, - college, physical tests, committee on physical welfare of school children, new york, - , , , , , , compulsory laws: school hygiene, ; purpose of, ; registration of catching diseases, ; removal of tuberculosis cases, ; notification of tuberculosis, , ; hygiene, for private schools, ; to remove physical defects, ; restricting alcoholism, conference on summer care of babies, new york, congestion: evils avoided, ; and alcoholism, conjunctivitis, . see _eyes_ connecticut's school reports, constipation, , , , consumption. see _tuberculosis_ corsets, , cost: of preventable diseases, ; of bad breath, ; of diseases to nation, ; of tuberculosis, crampton, c. ward, m.d., , dangerous trades, darlington, thomas, m.d., death rates: of bronchitis, ; of pneumonia, ; how to reduce, defects, physical: index of community needs, - ; removable, of children, ; schools manufacture, ; income distribution, delinquency, and mouth breathing, dental hygiene council, dental sanitation, - ; surface for breeding germs, ; dentists, ; state organizations, ; clinics needed, ; insurance companies treat teeth, ; family instruction, ; indigestion, ; early treatises, ; advertising parlors, devine, professor edward t., diet: cooking lessons at home, ; overeating, , ; improper, ; proper and regular, ; adapted to need, , ; kitchens, ; irregular eating, , diet kitchens, diphtheria, , dispensaries and hospitals: dental supervision, ; coöperate with schools, - , ; welfare nurse, ; emergency, ; to prevent duplication, ; lack of, ; teach baby feeding, ; inefficient, ; social interest of, doing things at school, - ; free meals, , , ; may hurt, ; cripple social agencies, , ; danger of malpractice, , ; analogous to model tenements, do-nothing ailments, - ear trouble, - ; periodic tests for, , edinburgh, ellis island, environment: health problem, ; tests, , ; injurious school, - ; effect on physique, ; and tuberculosis, - ; do-nothing ailments, ; within our control, ; in combating liquor, epidemics, , epilepsy, , ergograph, - erysipelas, ethics, professional, , , eugenics, and heredity, european remedies, - eye trouble, - ; in high school, ; catching diseases, - ; caused by bad teeth, ; eyeglasses, free, , , , ; in business, ; examination for adults, ; tuberculin test, ; inefficient inspection of, ; teachers' test, examination, physical: of school children, - ; best test of health needs, - ; individual record of, , ; snellen test, , ; of teachers, ; for work certificates, - , , ; by railroads, ; at west point, ; periodic after school, - , , ; semi-annual, ; tuberculin tests, ; stripped, at leipsic, ; follow-up work, - ; of teachers and sex hygiene, family: unit of social treatment, ; examining parties, , ; tuberculosis histories, fear and bodily disorders, flick, lawrence f., m.d., follow-up work, - fox, hugh f., fresh air: others' standards of, ; fiends, ; outings, , ; economic value of, ; ventilation at school, ; ventilation at home, ; ventilation at work, ; ventilation at sanatoriums, ; ventilation at churches and theaters, . see _air_ georgia, germany, , germs, disease: in milk bottles, ; isolation, ; germ sociology, - ; dental sanitation, - ; locating germ factories, ; tuberculosis, getting things done, - ; doing of highest kind, ; study underlying causes, ; by local agencies, glands, goler, george w., m.d., gorgas, william c., m.d., government. see _administration_ greenwich house, grenfell association, grippe, gulick, luther h., m.d., , habits of health, - ; combat tobacco, ; mental hygiene, ; and nature fore, hartley house, hartley, robert m., havana, hawthorne club, headache, heredity, - high schools need physical tests, hip trouble. see _tuberculosis_ home conditions: indexed by epidemics, ; indexed at school, ; among different incomes, ; cooking instructions, ; weighing parties, ; score card, ; promote alcoholism, hughes, governor charles e., hunter, robert, hyatt, thaddeus p., d.d.s., impetigo, income, , , india, indigestion: anti-social, ; due to teeth, individual record card, , - industrial hygiene: educates laborers, ; factory conditions, , ; factory reforms, ; employers, , , , , ; employees, , , , , influenza, - ingram, helene, insomnia, inspection: of milk, , ; score cards, , , ; of school children, , , ; of factories, ; of milch cows, ; of transmissible diseases, ; of foods, instinct, motive to health, , , international congress on tuberculosis, , itch, japan, , , junior sea breeze, kansas city, kidney trouble, labrador, lavatories, public, laws: nonenforcement demoralizing, ; define rights, ; when not enforced, ; should not injure health, ; enforcement better than character, ; regarding milk, ; licensing practitioners, ; need machinery, , ; to control liquor, , ; test of prohibition, ; on patent medicine, ; on pure foods, leipsic, louisiana, , lung trouble. see _tuberculosis_ machinery, health: unsatisfactory coordination, ; necessary, - ; five elements, mackenzie, w. leslie, m.d., magistrates: promote disorder, ; enforce health laws, malnutrition, ; income distribution, ; signs and tests, ; prevention of, ; education of family, massachusetts, maxwell, superintendent william h., , measles, mental hygiene, - ; blues, anti-social, ; hospital welfare work, ; moral clinics, , , ; and insomnia, meyer, william, m.d., milk: unclean dairies, ; scalding receptacles of, ; carries typhoid, ; inspector's outfit, ; tests of protection, ; score cards, , , ; public should know, ; fight for pure, - ; new york conferences, , ; breast feeding, milk committee, new york, , minnesota, , misgovernment causes sickness, mitchell, s. weir, m.d., montclair, mosquitoes, , motives, seven health, - , mouth breathing, - ; and delinquency, ; adenoid parties, ; causes deafness, ; injures baby teeth, ; industrial disadvantage of, ; in labrador, ; preventable defect, ; inefficient inspection of, national association for the study and prevention of tuberculosis, , national board of health, , , national bureau of labor, national bureau of census, national bureau of animal industry, national bureau of education, , national playground association, national school hygiene association, nature fore and nature back, - negroes and alcoholism, nervousness, ; and school life, ; physical defects, ; preventable, ; causes of, ; habit, , ; from tobacco, neurasthenia. see _mental hygiene_ new jersey, newsholme, arthur, m.d., , , , new york city, , , new york juvenile asylum, new york state, , new york state charities aid association, , nicotinism. see _tobacco_ normal schools, north, professor lila v., notification of diseases, , nuisances, , , , nurses at school, , , , . see _milk_ oliver, thomas, orthopedics. see _tuberculosis_ ophthalmia, oppenheimer, nathan, m.d., osteopathy, panama, parents: and school hygiene, ; interested by examinations, ; should coöperate with physician, ; interested in school examinations, ; need health reports, ; heredity, - ; nicotinism, parks and playgrounds, , , , , , , , parochial schools, , patent medicines: evils of, - ; advertisements, patten, professor simon n., , , , pediculosis, - pennsylvania, philadelphia, phthisis. see _tuberculosis_ physical training, - ; in new york city, ; and sex hygiene, physician: preventive medicine, - ; and eyes, ; semi-annual visit to, ; self-advertisement, ; school, , , , physiological age, , , pittsburgh, plague, , pneumonia, , preventable diseases: those not communicable, . see _catching diseases_ private schools, , , , , prohibition laws, , , pro-slum motive, - public education association, new york, , publicity, , , , , - , quarantine, first, ; national, records: of disease centers, ; defective, ; individual, , - reform's failure, registration: of diseases, relief, material: sound principles of, ; at school, , , ; indiscriminate, harmful, richman, julia, riggs disease, rights: political, ; not enforced, - ; of workmen at work, ; machinery for enforcing, - riis, jacob, ringworm, rochester, n.y., , rome, roosevelt, theodore, , rural districts: encourage disease, ; compared, ; physical defects, ; schools unsanitary, ; hygiene in great britain, russia, sage foundation, st. vitus's dance, salmon, professor lucy m., scabies, . see _itch_ scarlatina, scarlet fever: thrives in slums, ; signs and method of infection, ; "peeling," ; compulsory removal of cases, ; germ carried in milk, school hygiene: and employers, ; instruction compulsory, - ; practice of, , ; biological engineering, , , ; departments of, - ; in new york city, , - score cards, , , , scranton, sea breeze fresh-air home, sea breeze seaside hospital, , seaman, l.l., m.d., seattle, sedgwick, professor william t., sex hygiene, - sexual deviates, shoes, tight, sickness, preventable, cost of, sleep and vitality, , slum, a menace, , smallpox: epidemics great teachers, ; conquered by vaccination, ; neglected in rural pennsylvania, ; comes rarely to cities, ; compulsory removal of cases, snedden, professor david s., , , snellen eye test, , society for sanitary and moral prophylaxis, southern states, spargo, john, , spitting, , state activity, , , , , , statistics, object of, , , strauss, nathan, streets, , , , , study hours, too long, sweating, , taxes, taxpayers. see _budget_ teacher's health: tests of, - teachers: social work, ; health passport, ; for tuberculous pupils, ; excluded when tuberculous, ; and physicians, ; physical examination of, ; use of alcohol, ; cigarettes, ; use clippings, teeth. see _dental sanitation_ temperance. see _alcoholism_ tenement reforms, , , , , thompson, j. arthur, tobacco: instruction at school, ; economic injuries of, ; forbidden to employees, ; evils of nicotinism, - , tonsils, hypertrophied, trachoma, - trudeau, e.l., m.d., tuberculosis: pupils excluded from school because of, ; aggravated by colds, ; bone tuberculosis, , , ; and bad teeth, , ; in teachers, ; examination for working papers, ; periodical examination for, ; last days of, - ; eye and skin tests for, ; tests of cows, ; carried in milk, ; out-of-door treatment, ; only predisposition to, inherited, typhoid: a rural disease, ; carried in milk, university extension society, vacation schools, playgrounds, , veiller, lawrence, vitality tests and statistics, - water, drinking: reason for works, ; factories pollute, ; fountains, ; public responsibility for, ; protecting sources, welfare work, , - west point, wheeler, herbert l., d.d.s., whipple, george c., ph. d., , white plague. see _tuberculosis_ whooping cough, williams, alida s., , williams, linsly r., m.d., work: physical examination for working papers, - , ; healthful habits, - ; unpatented medicine, . see _industrial hygiene_ young men's christian association, * * * * * +-----------------------------------------------------------+ | typographical errors corrected in text: | | | | page : heath replaced with health | | | | text moved to avoid splitting paragraphs with tables: | | | | first half of last paragraph on page , moved to page | | , following table iii and table iv on pages to . | | first half of last paragraph on page , moved to page | | , following table viii on pages to . | | first half of last paragraph on page , moved to page | | , following illustration on page . | | continuation of paragraph begun on page , moved from | | page to the end of the paragraph on page , to | | precede text ads/illustrations on pages and . | | continuation of paragraph begun on page , moved from | | page to the end of the paragraph on page , to | | precede conference information on pages to . | | first half of last paragraph on page , moved to page | | , following score cards on pages and . | | | +-----------------------------------------------------------+ * * * * * --------------------------------------------------------------------- transcriber's note: in preparing this ebook i have corrected a small number of obvious typographical errors, including the two which are mentioned in the september issue. i have not interrupted the text by marking each, but they are marked in the html version of this text. --------------------------------------------------------------------- _the_ healthy life the independent health magazine volume v july-december london graham house, tudor st., e.c. index volume v.--july-december ballade of skyfaring, a, s. gertrude ford, book reviews, breathe, on learning to, dr j. stenson hooker, camping out, c.r. freeman, , care of cupboards, florence daniel, castles in the air, e.m. cobham, cloud-capped towers, e.m. cobham, correspondence, , , , cottage cheese, curtained doorways, the, edgar j. saxon, doctor on doctors, a, doctor's reason for opposing vaccination, a, dr j.w. hodge, doctors and health, fasting, a significant case, a. rabagliati, m.d., , fear and imagination, e.m. cobham, food and the source of bodily energy, fruit-oils and nuts, futurist gardening, g.g. desmond, health queries, dr h. valentine knaggs:-- about sugar, ; bad case of self-poisoning, ; boils, their cause and cure, ; canary _versus_ jamaica bananas, ; can malaria be prevented? ; cereal food in the treatment of neuritis, ; correct blending of foods, ; concerning cottage cheese, ; deafness, , ; diet for obstinate cough, ; diet for ulcerated throat, ; dilated heart, ; difficulties in changing to non-flesh diet, ; dry throat, ; eczema as a sign of returning health, ; excessive perspiration, ; farming and sciatica, ; faulty food combinations, ; giddiness and head trouble, ; going to extremes in the unfired diet, ; long standing gastric trouble, ; malt extract, ; neuritis, ; onion juice as hair restorer, ; phosphorus and the nerves, ; refined paraffin as a constipation remedy, ; saccharine, ; stammering, ; severe digestive catarrh, ; sciatica, ; temporary "bright's disease" and how to deal with it, ; ulceration of the stomach, ; unfired diet for a child, ; water grapes, ; why the red corpuscles are deficient in anaemia, health and joy in hand-weaving, minnie brown, health through reading, isabella fyvie mayo, healthy brains, e.m. cobham, , , , , healthy homemaking, florence daniel, , healthy life abroad, d.m. richardson, healthy life recipes, , , , hired help, florence daniel, , holiday aphorisms, peter piper, , how much should we eat? , , , , human magnetism, imagination in insurance, e.m. cobham, imagination in play, e.m. cobham, imagination in use, e.m. cobham, indication, an, editors, , , , , , learning to breathe, on, dr j. stenson hooker, letters of a layman, i., lime juice, pure, longevity, a remedy for, edgar j. saxon, mental healing, a scientific basis for, j. stenson hooker, m.d., midsummer madness, edgar j. saxon, modern germ mania: a case in point, dr h.v. knaggs, more about two meals a day, wilfred wellock, new race, the, s. gertrude ford, ode to the west wind, shelley, pickled peppercorns, peter piper, , , , plain words and coloured pictures, edgar j. saxon, play spirit, the, d.m. richardson, play spirit, the: a criticism, l.e. hawks, quest for beauty, the, edgar j. saxon, recipes, , , , remedy for longevity, a, edgar j. saxon, remedy for sleeplessness, salads and salad dressings, salt cooked vegetables, swan song of september, the, s. gertrude ford, sea-sickness, some remedies, hereward carrington, semper fidelis, "a.r.," sleeplessness, a remedy, scientific basis for mental healing, a, j. stenson hooker, m.d., scientific basis of vegetalism, the, prof. h. labbe, , significant case, a, a. rabagliati, m.d., , symposium on unfired food, a, d. godman, , taste or theory? arnold eiloart, b.sc., travels in two colours, edgar j. saxon, to-morrow's flowers, g.g. desmond, two meals a day, more about, wilfred wellock, vaccination, a doctor's reason for opposing, dr j.w. hodge, vegetalism, the scientific basis of, prof. h. labbe, , west wind, ode to, shelley, what makes a holiday? c., world's wanderers, the, shelley, the healthy life the independent health magazine. amen corner london e.c. vol. v july no. . _there will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--claude bernard. an indication. some laymen are very fond of deprecating the work of specialists, holding that specialisation tends to narrowness, to inability to see more than one side of a question. it is, of course, true that the specialist tends to "go off at a tangent" on his particular subject, and even to treat with contempt or opposition the views of other specialists who differ from him. but all work that is worth doing is attended by its own peculiar dangers. it is here that the work of the non-specialist comes in. it is for him to compare the opposing views of the specialists, to reveal one in the light thrown by the other, to help into existence the new truth waiting to be born of the meeting of opposites. specialisation spells division of labour, and apart from division of labour certain great work can never be done. to do away with such division, supposing an impossibility to be possible, would simply mean reversion to the state of the primitive savage. but we have no call to attempt the abolition of even the minutest division of labour. what is necessary is to understand and guard against its dangers. specialisation _may_ lead to madness, as electricity _may_ lead to death. but no specialist need go far astray who, once in a while, will make an honest attempt to come to an understanding with the man whose views are diametrically opposed to his own. for thus he will retain elasticity of brain, and gain renewed energy for, and perhaps fresh light on, his own problems.--[eds.] camping out. iv. the five-foot sausage. the question of blankets and mattresses may be taken as settled. we can now sleep quite comfortably, take our fresh air sleeping and waking, and find shelter when it rains. but that same fresh air brings appetite and we must see how that appetite is to be appeased. take a frying-pan. it should be of aluminium for lightness; though a good stout iron one will help you make good girdle-cakes, if you get it hot and drop the flour paste on it. you must find some other way of making girdle-cakes, and if you take an iron frying pan with you, don't say that i told you to. though it is obviously necessary that a frying-pan should have a handle, i was bound to tell gertrude that i do not find it convenient to take handled saucepans when i go camping. i take for all boiling purposes, including the making of tea, what is called a camp-kettle. most ironmongers of any standing seem to keep it, and those who have it not in stock can show you an illustration of it in their wholesale list. it is just like the pot in which painters carry their paint, except that it has an ordinary saucepan lid. you should have a "nest" of these--that is, three in diminishing sizes going one inside the other. the big lid then fits on the outer one and the two other lids have to be carried separately. [illustration: _the five-foot sausage_] you hang these camp-kettles over the fire by their bucket handles, from the tripod or other means of getting over the fire. sometimes the bough of a tree high out of the reach of the flames will do. sometimes a stick or oar thrust into the bank or in a crevice of the wall behind the fire is more convenient than a tripod. again, you can do without any hanging at all, making a little fireplace of bricks or stones and standing the saucepans "on the hob." it is a simple thing to tie the tops of three sticks together and make a tripod. then from the place where they join you dangle a piece of string, pass it through the handle of the kettle and tie it to itself, in a knot that can be adjusted up or down to raise or lower the kettle from the fire. this knot is our old friend the two half-hitches. pass the loose end round the down cord, letting it come back under the up cord, then round again with the same finish, and lo! the up cord makes two half-hitches round the down cord. you can slip, them up and put them where you like and they will hold, but you have to undo them to take the kettle clean away from the fire. so we add to our equipment a few pot-hooks or pieces of steel wire shaped like an s. their use will be obvious. if we have three of them it is quite easy to keep three kettles going over one fire. they swing cheek by jowl when they all want the same amount of fire, but each can be raised or lowered an inch or several inches to let them respectively boil, simmer or just keep warm. these are the cooking utensils. a biscuit tin would make an oven and gertrude says she must have an oven. for my part i would not attempt baking when camping out and i will say no more about ovens, except that all the biscuit tins in the world won't beat a hole in the ground first filled with blazing sticks and then with the things to be baked and covered with turves till they are done. i had great difficulty in persuading gertrude to feed out of tin dishes like those which we use sometimes for making shallow round cakes or setting the toffee in. they are ever so much better than plates, being deep enough for soup-plates and not easy to upset when you use them on your lap. any number of the same size will go into one another and a dozen scarcely take up more room than one. it was worse still when it came to a still more useful substitute, the camp equivalent of the teacup. in the first place we abolish the saucer, for the simple reason that we have no earthly use for it in camp. we take tin mugs with sloping sides and wire bucket handles. they fit into one another in the same accommodating way as the eating dishes. gertrude was nearly put off this device altogether by basil's remark that he had only seen them in use in poulterers' shops, where they are put under hares' noses.... "basil, you, you monster," cried gertrude, and i had to push those tin mugs as though i had been a traveller interested in the sale of them. the drinking of hot tea out of these mugs is quite a beautiful art. you hold the wire handle between finger and thumb and put the little finger at the edge of the bottom rim. it is thus able to tilt the mug to the exact angle which is most convenient for drinking. when gertrude had learnt the trick, she became perfectly enamoured of the mugs. she sometimes brings one out at ordinary afternoon tea and insists that the tea is ever so much better drunk thus than out of spode. smaller mugs of the same shape do for egg-cups, and the egg-spoons i take to camp are the bone ones, seldom asked for but easy to get in most oil-and-colour shops. dessert spoons and forks and table knives are of the usual pattern, but the former can be had in aluminium and therefore much lighter than britannia metal. the camping-out valise is by all means the rucksack. never the knapsack. i am almost ashamed to say this, because as far as my knowledge goes the knapsack is now obsolete. it may be, however, that it lingers here and there. if you see one, buy it for a museum if you like but not for use. the bundle should be allowed to fit itself to the back, as it does in a canvas bag. suppose now that you fix the v point of a pair of braces somewhere near the top of the sack and bringing the webs over your shoulders, fix them, nicely adjusted, to the lower corners of the sack, it will ride quite comfortably upon your back--that is, you have made it from a plain sack into a rucksack or back-sack. get or make as many good large strong ones as you have shoulders in the party to carry them. have them made of a waterproof canvas, green or brown, to reeve up tight with strong cord passed through a series of eyelet-holes and, if you would be quite certain of keeping out the rain, with a little hood to cover the reeved bag end. the great bulk of your luggage you will generally find it best to carry by wheeling it on a bicycle. spread your ground-sheet on the floor. on that lay your blankets, doubled so as to make a smaller square, tent, mattress cover and bed suits on that, then your camping utensils and all other paraphernalia and roll the whole up into a sausage about five feet long, when the loose ends of the ground-sheet have been tucked over as in a brown-paper parcel. tie it well with whipcord and fasten it to the top bar of your bicycle frame, leaving freedom of course for the handles and the front wheel to move and steer. push the tent-poles through the lashings and start for your camp at a comfortable four or five miles an hour. you will find it easy to move camp at the rate of twenty miles a day and will see a great deal of country in the course of a fortnight. the sausage on the bicycle shown in the illustration may be taken to contain all the gear and a little food. the rucksacks will take the rest and each man's most precious personal belongings. there is a small parcel tied to the handle-bar, scarcely to be seen because it is smaller than the end of the sausage. it is a complete tent tied up in its ground-sheet. c.r. freeman. how much should we eat: a warning. _this article, by one of the pioneers of modern dietetics, is in the nature of a challenge, and is certain to arouse discussion among all who have studied the food question closely._--[eds.] when men lived on their natural food, quantities settled themselves. when a healthy natural appetite had been sated the correct quantity of natural food had been taken. to-day all this is upside down, there is no natural food and only too often no natural healthy appetite either. thus the question of quantity is often asked and many go wrong over it. the all-sufficient answer to this question is: "go back to the foods natural to the human animal and this, as well as a countless number of other problems, will settle themselves." but supposing that this cannot be done, suppose, as is often the case, that the animal fed for years on unnatural food has become so pathological that it can no longer take or digest its natural food? those who take foods which are stimulants are very likely to overeat, and when they leave off their stimulants they are equally likely to underfeed themselves. flesh foods are such stimulants, for it is possible to intoxicate those quite unaccustomed to them with a large ration of meat just as well as with a large ration of alcohol. the one leads to the other, meat leads to alcohol, alcohol to meat. taking any stimulant eventually leads to a call for other stimulants. how are we to tell when a given person is getting enough food, either natural or partly natural? medically speaking, there is no difficulty; there are plenty of guides to the required knowledge, some of them of great delicacy and extreme accuracy. the trouble generally is that these guides are not made use of, as the cause of the disaster is not suspected. a physiologist is not consulted till too late, perhaps till the disorder in the machinery of life is beyond repair. diminishing energy and power, decreasing endurance, slowing circulation, lessening blood colour, falling temperature, altered blood pressure, enlarging heart and liver, are some of the most obvious signs with which the physician is brought into contact in such cases. but every one of these may, and very often does, pass unnoticed for quite a long time by those who have had no scientific training. the public are extremely ignorant on such matters because the natural sciences have been more neglected in this country in the last fifty years than anywhere else in europe, and that is saying a good deal. hence diet quacks and all those who trade on the ignorance and prejudices of the public are having a good time and often employ it in writing the most appalling rubbish in reference to the important subject of nutrition. being themselves ignorant and without having studied physiology, even in its rudiments, they do not appear to consider that they should at least abstain from teaching others till they have got something certain for themselves. if the public were less ignorant they would soon see through their pretensions; but, as it is, things go from bad to worse, and it is not too much to say that hundreds of lives have been lost down this sordid by-path of human avarice. on one single day a few weeks ago the writer heard of three men, two of whom had been so seriously ill that their lives were in danger, and one of whom had died. the certified cause of death in this case might not have led the uninitiated to suspect chronic starvation, but those who were behind the scenes knew that this was its real cause. a further extraordinary fact was that two out of these three men were members of the medical profession, whose training in physiology ought, one would have thought, to have saved them from such errors. the conclusion seems to be that they did not use their knowledge because at first they had no suspicion of the real cause of their illness. in other words, chronic starvation is insidious and, if no accurate scientific measurements are made, its results, being attributed to other causes, are often allowed to become serious before they are properly treated. these three men went wrong by following a layman quite destitute of physiological training, who appeared to have produced some wonderful results in himself and others on extraordinarily small quantities of food. if the above tests had been made at once by a trained hand the error involved in such results could not have escaped detection, and none of these men would have endangered their lives. i myself examined the layman in question and finding him not up to standard refused to follow him. the writer has no difficulty in recalling at least a dozen cases similar to those above mentioned which have been under his care in the last twelve months, and the three above mentioned were none of them under his care at the time of their danger. what, then, must be our conclusions in reference to these and similar facts of which it is only possible to give a mere outline here? i suggest that they are:-- . food quantities are of extreme importance. . these quantities were settled by physiologists many years ago, and no good reasons have since been adduced for altering them. . the required quantity is approximately nine or ten grains of proteid per day for each pound of bone and muscle in the body weight. . any considerable departure from this quantity continued over months and years leads to disaster. . the nature of this disaster may appear to be very various and its real cause is thus frequently overlooked. i will say a few words about each of these except the first, which is already obvious. the layman above mentioned asserted that he could live on but little more than half this quantity, but the food quantity really required is that which will keep up normal strength, normal circulation, normal colour, normal temperature and normal mental power. as we have got perfectly definite standards of all these normal conditions, serious danger can only be run into by neglecting to measure them. it is also possible to tell fairly accurately the quantity of food a man is taking in a day, and then, by collecting and estimating his excreta, the quantity also out of this food which he is utilising completely and burning up in his body. you would say that no danger should be possible with all these safeguards, and yet the above case history shows that of two trained physiologists, members of the medical profession, one died at least twenty years before his time, and the other was in great danger and only recovered slowly and with difficulty. another similar case came to the writer suffering from increasing debility and what appeared to be some form of dyspepsia. he was quite unable to pass any of the above-named tests as to physiological standards, and an investigation of his excreta showed that his food was at least one-fifth or one-sixth below its proper quantity and had probably been so for many months past. some of his doctors had been giving his "disease" a more or less long list of names and yet had not noted the one essential fact of chronic defective nutrition and its cause--underfeeding. naturally their treatment was of no avail, but when he had been sent to a nursing home and had put back the lbs. of weight he had lost he came slowly back to more normal standards and is now out of danger. in this case there was marked loss of weight, and few people, one would think, would overlook such a sign of under nutrition. but loss of weight is not always present in these cases, at least not at first. some people tend to grow stout on deficient proteid, and then the fact that some of the essential tissues of the body (the muscles, the heart and the blood) are being dangerously impoverished is very likely to be overlooked. in the case last mentioned the loss of weight was put down to the dyspepsia, whereas the real fact was that the "dyspepsia" and loss of weight were both results of a chronic deficiency in food. it is evident that some care about food quantities must be taken by all those who do not live on natural foods. for physiologists there is no difficulty in settling the question of quantity in accordance with the signs of the physiology of a normal body. that all, even physiologists, may run into danger if, while living on unnatural or partly unnatural foods, or while making any change of food, they do not consider the question of quantity with sufficient care. that the question of nutrition should be considered in relation to _every illness_ even though it may appear on the surface to have no direct connection with foods or quantities. as a matter of fact, the nature of the food and its quantity controls all the phenomena of life. some twenty years ago most people lived fairly close to the old physiological quantities, now they have been cut adrift from these and completely unsettled and are floundering out of their depth. a most unsatisfactory, even dangerous, condition of affairs. for the public it will now probably suffice if they insist on raising the question of quantity whenever they suffer in any way. if they are unable to answer the question themselves let them go to a trained physiologist who can do so, and not to a diet quack. but muscular strength, endurance, mental and bodily energy, skin circulation, temperature and blood colour are all things which the public can see for themselves and from which they should in all cases be able to get sufficient warning to save them from the worst forms of disaster. some people imagine that they eat very little, when as a matter of fact they have good healthy appetites. others again think they are eating a great deal, when as a matter of fact they take very little. in both cases a physiological test of the excreta will give accurate information. i once had a medical patient who imagined that he produced great amounts of force and performed feats of endurance on wonderfully small quantities of food. his excreta showed, however, that he was merely under-estimating the food he took. a fat man may seem to be living on very little, but fat does not require to be fed, and his real bone and muscle weight is not large. a thin man may seem to require a large quantity of food, but he is really very heavy in bone and muscle, the tissues that have to be nourished. in all these ways appearances are apt to be deceptive for those who are ignorant of science and who do not go down to the root of the matter. it is not necessary to follow the given quantity of grains per pound slavishly and without regard to consequences. it is necessary to see that the required physiological results are obtained. if a patient says he can live on less than i ordered for him and if he can pass the physiological tests satisfactorily i know that his bone and muscle weight has been over-estimated. on the other hand, if a patient falls below the physiological tests, though taking and digesting the quantities ordered for him, i conclude that his bone and muscle weight has been under-estimated. in all cases it is possible to obtain the best physiological results and to say when quantities are just right, neither too much nor too little. the evil effects of too much are not serious; they entail perhaps a little "gout" or some temporary loss of freedom from waste products. the evil effects of too little, if persevered in and continued, especially if some of these effects are attributed to causes which have no real existence, are deadly and dangerous, for they bring on an insidious deterioration both of function and structure which leads by several avenues, often miscalled "diseases," to death itself. m.d. healthy brains. _comparatively few health enthusiasts or food reformers realise the necessity for mental, as distinct from bodily, hygiene, yet all real health has its roots in the mind. moreover, it is only by studying the hygiene of mind that we are enabled to do work in greater quantity and of better quality than we should otherwise be capable of, and to do this without risk of strain on the nerves or injury to health. the articles under this heading put forward some of the elementary laws of mental hygiene._--[eds.] imagination in use. to some people any talk about the importance of training the imagination of children through their toys, games and studies seems fantastic and trivial. they compare it to feeding them on sweetmeats; they think it means substituting story books for real life and encouraging the easy exercise of fancy for the careful study of fact. but imagination is not a mere ornament to a life-work; it is rather one of its most valuable and necessary tools. if it did no more than sweeten and adorn the world, it would be well worth having, well worth making considerable sacrifices to attain. but it does more than this. it bears much fruit as well as flowers; fruit that, if it ripens in suitable weather, endures and can be used for the service of man. there is a wonderful palm-tree, called the tal or palmyra palm, which in india and ceylon supports six or seven millions of people, and "works" also in west africa, where it is probably native. it gives its young shoots and unripe seeds as food; its trunk makes a whole boat, or a drum or a walking-stick, according to size; hats, mats, thread and baskets--in fact, almost all kinds of clothing and utensils--are made from the split and plaited leaves; gum comes from it, and certain medicines, jaggery sugar too and an intoxicating drink for those who desire it. in one of the museums at kew--a wet day brings always _something_ besides disappointment--there is a book made up of the very leaves of the palm, containing a tamil poem enumerating more than eight hundred human uses to which this marvellous single plant can be put. now the imagination is like a palmyra palm. we stand a long way off and, looking up, say "what a graceful tree! but what a pity it produces that intoxicating 'toddy' and nothing else!" yet all the while food and clothing and shelter and travel and learning are all wrapped up in it, if only we were not too ignorant to guess, or too idle to seek. we talk as if the poet and painter had need of imagination, but not the student, the doctor, the philanthropist, the business man, whereas none of these can do work at a really human standard without imagination that is living, penetrating, active and yet trained and disciplined. a recent illuminating address to a body of students pointed out that germany's immense industrial strides have been made possible by an education which draws men's minds out of narrow old grooves, and helps them to see and grasp wider possibilities. but the same speaker went on to point out that the english worker has far more real initiative and imagination than the german, and that in our own country we have not even to make elaborate plans for developing these qualities, but rather to release them in our administrators so far as to prevent actually checking them in the children now growing up. imagination in business, for instance, means new possibilities, fresh sources of supply and fresh markets to demand, economy of working and better adjustment of work to worker, so as to have less waste of our greatest capital, human time and power. america has taught us something in these respects; what we must do is to take what new light she has developed, while keeping our long-grown, well-earned skill which she has not had the chance to make. in research work, again, we need perpetually the synthetic and constructive imagination if individual work is not to become narrowly specialised and shut off from other divergent or parallel lines which would illuminate it. the other day i was told of a great surgeon who not only has six or seven assistants to help him in his immediate tasks, but also, since he is too busy in the service of humanity to have time for reading, has eight trained assistants whose business it is to read in many languages what is being done all over the civilised world in his own line, and keep him informed as to the development of experience. a wonderful advance on the crystallisation of individual method, this, and yet it needed but the imaginative projection upon scientific work of what every business firm and every political unit has long done. to transfer to our own concerns a method developed elsewhere is one of the most valuable services imagination can render. almost all educational reform comes about thus, most mechanical inventions, a great part of economy and comfort in individual homes. also, besides these particular advantages, the incessant coming and going between the different fields of activity, the circulation of attention which this use of the imagination involves, tends to vitalise and enrich not only the individuals who carry it out, but the whole social organism of which they form part. upon the moral side not much need be said. "put yourself in his place" is a very old and respectable recipe for growing justice in one's conduct, consideration in one's speech, sympathy in one's heart. as employer or magistrate, as teacher or nurse, as customer or shopman, as parent or husband or child we must all deal somehow with our fellow-men: honestly and truthfully, we mean, kindly and helpfully, we hope. but is it not the more or the less of our imagination that makes such dealings possible? without it, we are cruel because of something we do not feel, unjust because there is something we do not know, unwittingly deceitful because there is something we do not understand. with it, our justice will support, our kindness uplift, our attempt at help will not be barren, but will awake response and raise the whole level of our human intercourse into a region of higher possibilities. e.m. cobham. futurist gardening. to-morrow's flowers. these three months of july, august and september are the second seed-time. i think they must be the most proper sowing-time, for is it not clear that nature sows seed, not in spring, but in autumn? at any rate, now we can do more towards making a perpetually beautiful flower garden than in any other season. the biennials, those that blossom in their second year of life and those jolly perennials that come up year after year and always stronger than before, without any trouble on our part, are best started in life not too long before the winter. spring-sown seed sometimes forgets that it is biennial and blossoms rather futilely the same summer, and at other times it grows so lush and large by winter that it cannot stand the frost. now we see the flowers in blossom in the vineyards of our friend naboth and we know which we should most like in our own garden. there is an exquisite joy in begging or stealing a few seeds and bringing them home to blossom for us as they did for naboth. i carry at this time a few small envelopes bought for a few pence a hundred at straker's, and whenever i see something nice in seed i bag it. in another week it would drop beneath the plant it grew on and, not being cared for by a gardener, would be smothered or hoed up. in a nice little seed-bed all to itself it can unfold all manner of pleasure for its abductor. plant your flower seeds on a nice ripe, rich bed--that is, one compounded of old and even half-used manure. keep the seedlings watered as they grow and by judicious pricking-out give them the room they need. about october you can plant the best of them in the place where you want a good bush next year, and, if it is a perennial, you have for many years to come a beautiful plant with a personal history. even if you have bought your penn'orth of seed there may be a pleasant anecdote connected with it. my garden is at present amazingly blue with dropmore alkanet (anchusa). three years ago i bought three seeds for a penny. two of them came up. i slashed up the plants and now i have half-a-dozen clumps as well as a similar number left in the old garden whence i have removed. if you asked me what kinds of seed in particular you ought to plant for perennial flowers just now, i might want many more pages to tell you in. let me give you a very short list of those that most appeal to me on the spur of the moment. it will be enough to go on with:-- trollius (globe flower). helianthemum (rock rose). epilobium (willow herb). hollyhock. echinops (globe thistle). anchusa italica, dropmore variety. lupine. tritoma (red-hot poker). heuchera (coral-root). yarrow. lychnis (garden campion). inula (elecampane). funkia (plaintain lily). eremurus. this list is representative because it includes some species, such as eremurus, trollius and tritoma, that are not usually grown from seed by the amateur. to raise these rather expensive monsters from pennyworths of seed is a floral adventure which brings its own abundant reward. i should be very proud of a garden that consisted entirely of plants that i had raised from seed. it might be one that had never had anything else in or the seedlings might gradually oust the bulbs and corms and grown plants with which the garden began. there would be many things there intrinsically as well as extrinsically valuable. carnation seed, for example, is constantly producing new varieties, and to grow rose seedlings is even to court fortune. it is a long time before you see your rose. the seed takes sometimes two years to germinate, and then you have to wait a year or two before you get a typical blossom. the growers hurry matters by cutting a very tiny bud from the first sprout and splicing that on to an older stock. one of the advantages of having your roses grown from seed and on their own stocks would be that they could not produce wild suckers. i have just seen a wonderful grove of aquilegias, the glorified columbine which has the centre of one colour and the outside petals of another--sulphur with mauve or yellow with pink, and many other varieties. the nucleus was grown from shop seed and the rest from the seed of the first-comers. the only thing to choose between them is that the new ones have produced a least one variety not represented in the first batch. you may be sure that i am going to get some seed from here and raise some aquilegias for myself. good reader, go thou and do likewise. g.g. desmond. midsummer madness. we had come, " . " and i, to the boundary, a white, unpaved road which winds across the full width of wimbledon common, from the old roman camp to the windmill. simultaneously we cried a halt, i because i never cross that road without some hesitation, he because he wanted to get out of the folding go-cart in which he had been riding and turn it, with the aid of a small piece of string and a big piece of imagination, into a -horse-power motor car. on the map the road is not called the boundary. if you want to know why i call it so i can only say that once you have crossed it things are different; i do not mean a difference merely of country or scenery, but a difference of atmosphere; better, and more literally, a change of spirit. to put it bluntly, i never knew the reality of fairyland until i blundered across that road one grey gusty evening ten years ago, and heard the tall grasses whistling in the wind. since then the road has always been a frontier, not to be crossed without preparation. as " . " tumbled out of his go-cart i looked at my watch and saw it lacked but a few minutes to noon. it was just such a cloudless june day as must have inspired shelley's _hymn of apollo_. no smallest cloud to break the dazzling blue; and, high above our heads, apollo, standing "at noon upon the peak of heaven." if it had been midsummer day i should have thought twice about crossing the boundary. as it was, we were quite near enough to the th of june to make it risky. so, as " . " bent a tangled head over the bonnet of his daimler, i flung myself down on the level turf beside him and stared across the road. behind us and on either side were clumps of gorse bushes, and beyond them the immense level expanse of the open heath. immediately in front was the road, sunk a foot beneath the turf, which comes right up to it, both on this side and that. "another piece of string, please," said " . ," rummaging in my pockets without waiting for an answer, "and a pencil, and----" and then i saw it. on the farther side of the road there is a stretch of short turf, some hundred yards wide; and beyond that an irregular line of silver birches; and beyond that the blue of distant hills, for the common slopes down where the trees begin. between the silvery wood and the road, through the midst of the wide belt of turf, and parallel with the boundary, ran a river. there was nothing to be much surprised at, for it was just the kind of river you would expect to see running through the fields of fairyland. it was a river of grass. it was the slender-stalked, tufted, not very tall, grey-headed grass that grows quite generally in open country and wild places. but the wind and the sun now turned it into a river which ran fast between its banks of green, its waves silvery grey, quick-flowing waves, gleaming and dappled, an endless succession. it flowed from somewhere out of sight in the west, and disappeared to the east over the edge of the great slope that brings you down to the woods, vanishing, to all intents and purposes, over the edge of the world. without taking my eyes off this astonishing spectacle i stretched out a hand and, catching " . " by the edge of his white smock, told him to run across the road to the grass and--paddle in it. i said it was better than motor cars. he made no comment on this but, after glancing warily up and down the road (for he has been brought up in wholesome awe of the entire tribe of automobiles), he crossed the boundary, ran across the turf and plunged up to his knees in the river. i cannot be certain, but it is my considered opinion that apollo stopped his golden chariot for the space of a whole minute to look down at the golden-haired boy wading in that noiseless, fast-flowing river. in another minute " . " was back at my side, both hands full of the tufted grass he had pulled. i regret to say he tickled my ear with it. * * * * * honest, solemn reader, ardent food reformer, keen educationist, clear-headed moralist, practical-minded housewife, i tell you frankly there is no moral to this little episode. it throws no light on what to eat, or on the purchasing power of an english shilling, or on the ethical training of young children, or on the nature of neurasthenia. fairyland, of course, is a childish fiction, apollo a solar myth, a road is a road, grass is grass and heaven is a state of mind. i quite agree with you. but let me whisper something in your ear. if you should ever blunder across your boundary, don't be surprised if things look queer on the other side; above all, whatever you do, don't let any strange river you may find flowing there carry you away, or it may bring you, spite of all your protests, through one of the gates of pearl into the city of god. edgar j. saxon. a scientific basis for mental healing. there is a vast amount of loose talk, and innumerable assertions from irresponsible individuals concerning the wonders that have been achieved by mental healing, but naturally the scientist and physician, when dealing with such a question as this, has to put aside, not all enthusiasm, but certainly all emotionalism, and then, most carefully sift the evidence laid before him. the scientist here wants hard, dry, irrefutable facts; the responsible physician requires to know--by his own careful diagnosis or by an array of tabulated facts--the condition of the patient before and after treatment--that is, of the one who claims to have been cured by mental means. innumerable claims are thus being made by patients and others, so that it is imperative for the unbiased physician at all events to consider the above question; this in order to give a reason for the faith that is in him, when he is known to be one of those who favour the metaphysical means of healing. even the sciolist in the matter knows that in the case, say, of blushing, or blanching of the face, the action of mind over matter--of the body--is palpable; all admit that the quality of joy, for instance, will prove a splendid tonic; that despair, on the other hand, will pull down the bodily condition. but all this, we shall be told, is unconscious action; true, but fortunately we are now aware that by a forceful action of the will we can _consciously_ direct or derivate, as the case may be, currents of nerve-force to any part of the body. occultists have known this for many centuries. joy, hope, faith: these are very potent factors in improving the health conditions--simply because they act upon the sympathetic nervous system, and this latter acts upon the circulation. happiness dilates the blood-vessels. fear contracts them. thus, unbounded faith; renewed hope; sudden joy; enforced will-power; all have a marked effect upon bringing about an equilibriated condition of the circulation--just the same as a hot bath does, though not so rapidly or so perceptibly. further, we must remember that all disease more or less is a stasis, a congestion, somewhere; we have only to dissipate this; to separate the cells; to expand the part, as it were, and "resolution," as we call it in congestion of the lungs, takes place. so that it seems to me that we can fairly claim a strictly scientific basis for mental healing. i have always, however, maintained that the attitude of the patient's own mind has much to do with the result: in his consciousness there must be faith and hope in order to get the best effect. judging, then, of the very remarkable and palpable changes which anyone can see occur on such superficial parts as the face and extremities, i can see no reason that, by an enforced mental action, the deeper parts--including any hidden diseased part--should not be altered for good. i am very confident that it is upon these lines, coupled, as they can always be, with advice as to clean feeding and right living generally, the physician of the future will largely depend for his cures. thus we are fully justified in not only trying the system on "functional," but also for "organic," cases. j. stenson hooker, m.d. a significant case. account of a fast, undertaken for the cure of a profound blood disease. the following account of a fast is worthy of attention. it is rigidly accurate _in principle_, as far as i could make it so, and i am responsible for its truthfulness. but the subject of it, feeling that he is engaged in a duty and "labour of love," as he expresses it, is yet naturally anxious to prevent his identity from being discovered; and so, while the facts of the narrative are true in principle they have been varied in a few details for the purpose of preventing the recognition of the subject of them. they occurred in the history of a man of about years of age, who fell ill of an infectious disease some years ago, while living abroad. the exact time of the infection is not known. the patient was treated by qualified doctors living in the same country as himself, and there is no reason to believe that he was not properly and skilfully treated. he had, however, for years buoyed himself up with the hope that he should be able to come to england for the best treatment, and recently he found himself in this country for that purpose. it goes without saying that the eminent men consulted treated him after the most modern and approved methods, which were also, so far as knowledge goes, the most likely to benefit him. not only as to treatment must it be assumed that the best was done, but the diagnosis also is supported by the authority of the doctors seen, and was confirmed by physiological and pathological investigation. this would be recognised if it were possible to publish names, places and dates which are withheld from the courteous reader for the reason already given. i can only say that i entirely concur in the diagnosis and in the suitability of the treatment. the man came under my care on a sunday, the fast, which is the subject matter of this communication, having been commenced on the friday six weeks before that day, the last food having been taken on the thursday at p.m. i saw him, therefore, on the forty-fifth day of the fast. his pulse was , soft, steady, regular. temp. . degrees, about a.m. he was able to be up, and walked actively, all his bodily movements being active and his mind quite clear and rational. his weight on the day after i first saw him was, in the same clothes as when weighed at the beginning of the fast, + / lbs. he said he weighed lbs. on the machine at the commencement, and therefore the loss of bodily weight up to that time was . lbs. the average loss of weight during the days of the fast was about nine-tenths of a pound daily if the . lbs. loss is divided by the days of the continuance of the fast up to that time-- . / =. lbs. almost exactly. when he came to my consulting room on the forty-sixth day, about . p.m., the pulse was , temp. . degrees (thermometer minutes under tongue). he was much troubled with a nasty expectoration of mucus. his breath was very offensive. no enlarged glands could be felt in either groin--perhaps a trifling enlargement in the right. in middle of front border of right tibia a little irregularity is felt, and a small hollow, which he thinks is filling up; but it might be that the exudation on the bone immediately above and below the hollow is somewhat reduced, as this would equally give the suggestion that the hollow is filling up. there is a similar but rather smaller irregularity on the left tibia also. he felt rather weak that day, which he attributed to not having had his usual walk the day before. the nasal cavity consists of a large grey septumless cavern showing dry crusts. the issuing breath is most offensive. patient had drunk freely of water, he said, to the extent of or quarts a day during the fast but when i said--do you mean that you have been taking over a gallon of water daily?--he rather hesitated, and did not think it was so much as that. he had not measured it and had taken it cold usually, though occasionally hot, and had taken it without stint as he wanted it. on the forty-eighth day of the fast he complained of being weak but worst of all, he said, his breath was very offensive to himself. it was so to me also--faint, fetid, putrid. his sense of smell was greatly impaired, so much so that he could not smell the offensiveness of the bowel-excreta which came away every day on using the gravitation-enema, and which were horrible to by-standers. it would seem from this as if his distress at the bad smell of his breath was probably due to a perversion of the sense of smell, which can be easily understood if we reflect that the disease-process was going on in the region where the smell-apparatus is specially located. the temperature was . degrees that morning the patient said. at p.m. when i saw him the pulse was , regular, even, steady. he says he was feverish last night. i suppose he felt hot. he sleeps well, but says he hears the clogs of the mill-hands as they go to their work in the mornings. has lost lbs. weight in last days. temp. . degrees to my observation . p.m. says he feels "done at the stomach." his voice is poor. expectorates somewhat freely. a small blob of green thickish mucus in ordinary white mucus came away in my presence. urine acid . no glucose. faint trace of albumin to heat and picric acid: also to nitric acid. the right lachrymal punctum is blocked; the tears run down the cheek; and i failed to get even a hair-thick wire into it. evening, pulse , temp. . degrees in bed with hot-water bottle. faeces most offensive, no bowel-excreta coming away except to enema. forty-ninth day. in bed, temp. . degrees, pulse , soft, steady, regular. no great emaciation of limbs. showed me some green expectoration. he says it is from salvarsan as it is exactly like what he was injected with! the motion to the enema as offensive as before, but the breath is less offensive to me: not so fetid. on this day patient completed weeks of fasting. feels sick and as if he would vomit. about midday he did vomit about a teaspoonful of dark green stuff, very bitter and acid (bile, i should call it, though he calls it "pure citric acid") and immediately after that he got rid of a motion without the use of the enema, brown, dark and very offensive still. i think the breath, however, is rather less offensive; and so i thought also two days ago. temp. , pulse , soft, steady, regular; about . p.m. in bed since fiftieth day of fast. not feeling very ill and not specially emaciated, though the buttocks are thinning; but legs and thighs and arms and forearms not specially thin. he came to me to be weighed on the forty-ninth day and weighed + / lbs. fifty-second day of fast. still in bed. condition much the same as to pulse, temperature, etc., and as to emaciation so far as observation goes. remained in bed, not because unable to be up, but because he thought it would be better for him to be resting. on the fifty-fourth day, as he still felt sick, i gave him, at his request, an emetic in the form of grains of copper-sulphate. this was followed by sickness after about an hour, when he got rid of a very little of the same green stuff as before. bile? but the difficulty is to understand how, after all this time of fasting, he should still feel sick and with inclination to vomit. on the fifty-fifth and fifty-sixth days of the fast he remained in bed, the condition being much the same. on thursday, the fifty-sixth day, he broke the fast at p.m., just weeks after beginning it. he had meant to go on for days, and i did not think that there would have been any danger in his doing so; but i did not press him to continue any longer. he took oranges on that day; and on the friday he took more. i advised him not to increase the quantity of food too quickly. the breath has been quite sweet during the last two days. he has been too weak to take enemata, so we cannot say if motions would still have been offensive. and as there is no weighing machine in his room, we don't know the exact loss of weight sustained during the fast, though there is no reason to think that it has averaged more than . lb. a day. up to the time of stopping the enemata, pieces of mucous membrane and mucus itself came away from the bowel, and the motions were very offensive. he seems to have a mucous enteritis without fever. on the fourth day after breaking the fast, patient took oranges, apples and a banana; and he ordered much more food, which, however, i advised him not to take. on this day his bowels were opened naturally, with a very offensive motion. but the breath was much sweeter, in fact not offensive at all. on the sixth day he came to my consulting-room and weighed lbs. pulse , soft, steady, regular. he had not slept all night and had had to be up no fewer than times to have his bowels opened. no diarrhoea, he said, but full motions, the first very offensive. breath not offensive. has dry pharyngitis and is complaining of sore throat. next day. weight lbs. bowels acted again, a.m., a.m., a.m., a.m. and p.m. large motions. i told him i thought he was taking too much food. pulse . not sleeping well. complained of sore throat. eighth day. weight lbs., a gain of lbs. a day for days. pulse at a.m. (his own statement), at . p.m. pulse , temp. . degrees. bowels acted at midnight, . a.m. and about a.m. went that day to have his photograph taken. the throat was better. tongue dry and leathery. it was plain to me that he was taking too much food. he was having a mixed diet and taking much and often. he said his "mouth was coming to pieces," and in fact the mucous membrane was glazed and peeling; also the lips. on the ninth day he returned home. the loss of weight can be seen from the following statement. on commencing the fast the weight was lbs. first day weight was lbs. sixth day " " + / " seventh day " " + / " twelfth day " " " fifteenth day " " + / " eighteenth day " " + / " twenty-fifth day " " + / " forty-seventh day " " + / " forty-ninth day " " + / " fast ended on fifty-sixth day. on the sixth day after breaking the fast the weight was lbs. on the next day it had risen to lbs. and on the following day to lbs. in the first days of the fast the loss of weight was . lbs., or an average loss of . lbs. daily ( . / =. lbs.) the loss of weight for the last days before the fast was broken is not known as patient was in bed, though it probably was at much the same rate as during the other times of the fast when the weight was taken on the scales. the following comparative measurements are interesting. of course he had been eating for a week after the termination of his fast, so that the measurements taken on that day would be higher probably than if they had been taken seven days before, when he broke the fast. bodily measurements. _at commencement_ _at termination_ _of fast._ _of fast._ forearm inches + / inches arm + / " + / " hips " + / " thigh + / " " pelvis + / " + / " calf[ ] + / " + / " neck + / " + / " chest " + / to + / " [ ] there was a bundle of varicose veins behind right calf. patient kept a diary during his fast, but it does not seem necessary to reproduce its statements here. it shows that he walked about during the time, notes the state of the weather as foggy or very foggy or freezing, mentions that water was taken, sometimes hot apparently, as on th march, "after glass of hot water, pulse , temperature + / degrees." no doubt drinking the hot water had elevated temporarily the mouth-temperature, as it does. the diary also notes that he felt weak, had a bath, or did not have a bath, notes the pulse-rate, etc., as also the effects of the daily enemata. on the twenty-ninth day of the fast he took a bottle of apenta water. such are samples of statements from the diary. a. rabagliati, m.a., m.d. _the remainder of this article deals with conclusions of great interest and value, and will appear in our next issue._--[eds.] healthy life recipes. salads and salad dressings. for salads it is not necessary to depend entirely upon the usual salad vegetables such as lettuce, watercress, mustard and cress. the very finely shredded hearts of raw brussel sprouts are excellent, and even the heart of a savoy cabbage. then the finely chopped inside sticks of a tender head of celery are very good; also young spinach leaves, dandelion leaves, endive, sorrel and young nasturtium leaves. then there are the onion family (for those who can take them), the tender kinds, such as spring onion, chive and shallot being very good when chopped finely and used as a minor ingredient in any salad. the root vegetables should also be added in their season, raw carrot, turnip, beet, artichoke and leek, all finely grated. a taste for all the above-mentioned vegetables, eaten raw, is not acquired all at once. it is best to begin by making the salad of the ingredients usually preferred and mixing in a small quantity of one or two of the new ingredients. for those who find salads very difficult to digest, it is best to begin with french or cabbage lettuce and skinned tomatoes only, or, as an alternative, a saucerful of watercress chopped very finely, as one chops parsley. any salad, however made up, should be served in as dainty and pleasing a fashion as possible. it is, perhaps, usually best to serve it ready chopped and shredded, and to allow each person at the table to take his or her own helping of "dressing." english people seldom serve salad in the french fashion--that is, quite dry, save that the dressing is well mixed in an hour before the meal. readers who have been to france may have seen french peasant women whirling a wire salad-basket round their heads in order to dry the materials after the cleansing has been done. when dry, the green-stuff is torn with the hands, the dressing (and the french know all about salad dressings) is added and the whole allowed to stand some little time, so that by the time the meal is served there is a complete blending of all flavours. not everyone likes this method; but it is certainly better than the customary method here, which too often leaves a little puddle of water at the bottom of the bowl. there are many ways of preparing good salad dressing without resort to vinegar, salt and pepper. the two prime necessities are ( ) really good oil and ( ) some kind of fresh fruit juice. most people prefer lemon juice or the juice of fresh west indian limes, well mixed into either olive oil, nut oil or a blended oil such as the "protoid fruit oil" or mapleton's salad oil. the ordinary "salad oils" obtainable at grocers are seldom to be recommended; they almost invariably contain chemical preservatives and other adulterants. it is better to have the best oil and use it sparingly if need be, than take any faked product just because it is cheap. with most people the addition of pure oil assists the digestion of the salad, as well as serving other purposes in the body. many excellent salad recipes and suggestions for novel yet simple "dressings" will be found in _unfired food in practice_, by stanley gibbon.[ ] [ ] s. net; s. + / d. post paid, from the office of _the healthy life_, amen corner, london, e.c. pickled peppercorns. _this, which is a regular feature of the healthy life, is not intended as a household guide or home-notes column, but rather as an inconsequent commentary on current thought._--[eds.] an interesting booklet by raymond blathwayt with samples of bath mustard will be sent free on application to j. & j. colman, ltd. (dept. ) norwich.--advt. in _punch_. rumours are also afloat that g.k. chesterton has written a brilliant booklet on eiffel tower lemonade, and that the attorney general has been commissioned to write a highly interesting brochure on american macaroni. * * * * * "i enclose you a photo of my baby, willie, aged fifteen months. he was given up by two doctors, and then i consulted another, who advised me to try ----'s food, which i did, and he is still having it. you can see what a fine healthy boy he is now, and his flesh is as hard as iron."--from an advt. in _lady's companion_. evidently a case of advanced arterio-sclerosis. * * * * * health biscuits. nice and tasty, handled by our salesmen daily.--advt. in _montreal daily star_. one reason, perhaps, why both the public and the sales have declined. * * * * * what would you give for a perfect skin? is d. too much? many perfect skins to-day are traced to a single sample. --advt. in _lady's companion_. the price is reasonable; but i think i would rather see a sample first, wouldn't you? * * * * * our special filling fast--headline in _daily news_. the correct antidote for the well-known "starvation of over-repletion." * * * * * cold anniversary raised pie and new potato salad.--from the _seventh anniversary menu of the eustace miles restaurant_. i am told that one old gentleman, misled by the chef's quite innocent use of adjectives, protested to a waitress that the day was really very warm; also that a youthful wag obliterated the initial c from his menu with a pen-knife and then inquired which was the better vintage, ' or ' . * * * * * but to contend that there is no difference between a good yellow man and a good white man is like saying that a vegetarian chop of minced peas is like a chop of the chump variety.--_new witness_. chop-chop--as the good yellow man might be tempted to say if he came upon this specimen of white wisdom. * * * * * canvassers can make a very good profit by selling a patent ladies' folding handbag, also wristlet watches.--advt. in _daily mail_. nevertheless, the only place for a patent lady is a registry office. * * * * * cakeoma pudding? you cannot know how delicious they are until you have tasted them.--advt. in _lady's companion_. one of the things that would never have occurred to you if you hadn't seen it expressed so clearly. * * * * * saxon.--how cruel of you. although i have not the honour of cap and gown, i do possess a classical dictionary. if i can help further, write again. regarding the recipe, it depends upon its nature. perhaps vera is the lady to whom you should address your question--_lady's companion_. my colleague, mr edgar j. saxon, denies all knowledge of this affair. but i do wish he would be a little more careful in future. peter piper. health queries. _under this heading dr knaggs deals briefly month by month, and according as space permits, with questions of general interest._ _correspondents are earnestly requested to write on one side only of the paper, giving full name and address, not for publication, but as a guarantee of good faith. when an answer is required by post a stamped addressed envelope must be enclosed._--[eds.] can malaria be prevented? a. de l. (lisbon) writes:--for five months i have been a strict "fruitarian," and as i am obliged now to go to mozambique (portuguese east africa) to remain there five rears, i should be much obliged to you if you kindly let me know what i must do to prevent the african fever and biliousness which seem to afflict all europeans in that part of the world. any hints you could give me as to maintaining health in such a climate would be most gratefully acknowledged. i do not think that it is possible for any european, whether he adopts fruitarian or ordinary diet, to entirely escape malaria, since it is caused by a minute parasite which is forced into the blood by a certain form of biting mosquito. the parasite will, however, surely gain less hold on one whose blood is clean and pure and whose vital force is strong, than on one who dissipates his strength by partaking of meat, alcohol, tea, coffee and other stimulants, or who otherwise gets his blood into a bad state by faulty diet generally. therefore, the thing this correspondent should do is to live as much as possible upon the simple frugal fare of the natives. he can take raw coker-nut freely and eat the fresh fruits which grow in this part of africa. if he can obtain pineapple or papaw he will find these excellent to help him to retain his health and strength in this country. unfired diet for a child: is it suitable? mrs l.b.f. writes:--my husband and i are much interested in _the healthy life_, deriving much benefit and good advice from its pages. it is the only magazine, we find, which answers questions that we have long been puzzling over. reading a work of the "montessori method" of training children last night i was disturbed to find i had, according to that book, been feeding my little boy, aged three years, all wrong. it says: "raw vegetables should not be given to a child and not many cooked ones. nuts, dates, figs and all dried fruits should be withheld. soups made with bread, oil, bread and butter, milk, eggs, etc., are the principal foods dr montessori recommends. she also advocates the use of sugar." our boy has nuts, ground and whole, all the fresh fruits and dried ones, salads, brown bread and nut butter, sometimes dairy butter, no milk, his food mostly uncooked, as we ourselves believe in. if dr valentine knaggs would give us his opinion on this i should be very grateful. the boy is healthy, but i notice a slight puffiness below the eyes of late in the morning. also his temper does not improve as he gets older. will he be having too much proteid (nuts) for one of his years, or is the temper natural as a result of bad discipline. his father is away all day, and mothers are, as a rule, soft marks, are they not? it is difficult to answer fully a question of this sort, as so much depends on the child's temperament and environment. a frail, delicate child with the promise of high mental development requires a finer and softer grade of nutriment than one of a coarse animal nature with strong, well-developed digestive organs. all healthy children, especially boys (as mr saxon will attest!), are full of mischief and restlessness, which it is the duty of a mother or a nurse to divert into right channels.[ ] the display of temper is probably an indication of this not being done, though it _may_ be due in part to the raw diet not suiting the child. [ ] this correspondent, and all mothers of difficult children, should study the works of mary everest boole, published by c.w. daniel, ltd.; also _the children all day long_, by e.m. cobham.--[eds.] the advice i would give would be to alter the diet and make it lighter. from my point of view, dr montessori has not given sufficient attention to the other side of the diet question, preferring to remain more on the side of orthodoxy. moreover, her own work has been done in italy, where a climate prevails which does not call for so free a use of vegetables and salads as is the case in our own cooler and bleaker clime. i suggest, as a beginning, the following diet might be tried, but it is necessarily impossible to guarantee good results unless the cause of the puffy eyes and temper have been definitely located by personal examination:-- _on rising._--a raw ripe apple, finely grated, or simply scraped out with a silver spoon. _breakfast at ._--a scrambled egg on a granose biscuit with a little finely chopped salad or finely grated; raw roots appetisingly served with a dressing of oil, lemon juice and a little honey. this to be followed by an "ixion" or "p.r." biscuit, with fresh butter. _dinner at ._--home-made cottage cheese, or cream cheese, or a nut meat (served cold out of the tin, or, better still, home-made). two casserole-cooked vegetables, done with a little fruit juice and lemon to retain colour. this to be followed by a baked apple with cream and a little home-made, unfired pudding made of dried fruits. _supper at ._--a slice of "maltweat" bread, and butter, and a cupful of clear vegetable soup, or some hot water with some lemon juice added, and slightly sweetened with a little honey. giddiness and head trouble. mrs l.b.f. also writes:--i sometimes think i must make dietetic mistakes. my husband thinks i am perfectly healthy, so i do not say anything of the giddiness in the morning and after eating, a drowsiness and slight pain at the back of the head and underneath one of my ears. also under my eyes is on some mornings quite swollen and puffed up. it is not so marked, but i am quite conscious of it. our diet consists mostly of a salad, with bread or baked potato and cheese or ground nuts or cooked brussels sprouts and a nut meat pie, apple pie and cream, with brown bread and butter, or a raw fruit meal, nuts, apples, grapes, figs, dates and no bread. two meals a day, first in the morning at eight o'clock, second at two or three in the afternoon. a glass of hot water with lemon at nine p.m., and the same in the morning. i do some exercises night and morning and am out in the fresh air often through the day. we live in the country and i have every chance of keeping myself healthy. perhaps i should say i do not eat many nuts, finding them rather difficult to digest. should i use an enema when i feel like this, or wait for natural results? the symptoms of which l.b.f. complains are in all probability due to flatulence and to general disturbances of the digestive process. perhaps it would be a good plan to make the diet lighter. the nuts could be omitted and cheese or eggs substituted. an evening meal would be helpful. as to the bowels, some senna and camomile tea at bedtime would help to clear them. unless there is distinct evidence of faecal retention in the colon it is better not to use the enema as a regular thing. _on rising._--a tumblerful of sanum tonic tea made with hot, preferably distilled, water. _breakfast._--an all-fruit meal consisting of nothing but apples, bananas, grapes, or orange, or any fresh ripe fruit that is in season. _dinner at . ._--a cooked meal consisting of two casserole-cooked vegetables, with grated cheese as a sauce dressing, with some twice-baked or well toasted bakers' bread, followed by a baked apple and cream. (omit nut meat pie and apple pie.) _tea meal at ._-- oz. of cottage cheese or cream cheese, wholemeal bread and butter, small plateful of finely grated raw roots with an appetising dressing containing some "protoid fruit-oil." _bedtime._--tumblerful of hot water (preferably distilled) to which senna leaves and german camomile flowers (very little) have been steeped to infuse; or a cupful of dandelion coffee could be taken if the bowels are regularly acting. long-standing gastric trouble. w.t. writes:--having tried a diet, recommended in _the healthy life_, for a month i find the nuts and cheese are far too heavy for the apparent weak condition of my stomach, also that the salads and casserole-baked vegetables are too irritating to the membrane of the stomach. i have no desire to return to flesh food and ordinary feeding, which i feel would not be good for me. from eggs i cannot obtain any good results. the continuance of loss of weight is worrying me, being down to eight stone from eleven stone in twelve months. i feel satisfied it is only a question of diet, if i could only strike the correct one. i am naturally most anxious to regain some of my lost strength and weight. i am at present taking bread and butter, cooked fruit, and occasionally an egg, boiled rice, vegetables and a little dried fruit. no matter how light i make my diet i still suffer after every meal with dilated stomach and irregular working of the heart. blood circulation is still bad and constipation is gradually getting worse. as before stated, i am anxious to succeed with the reformed diet, but i am really at a loss to know which way to proceed to make any progress. as i was in south africa twenty years, and only returned to england just before this catarrh set in, is the climate here against my progress, do you think? i am so sorry to take up so much of your time, but shall be grateful for any help you can give me which will be greatly appreciated. it is difficult to advise how best to proceed in this case as our correspondent really ought to seek medical advice. only in this way can he obtain really satisfactory guidance. for without knowing the state of his blood and the organs generally it is impossible to advise correctly. speaking generally, until salads and casserole-cooked vegetables can be taken freely there can be no possible permanent cure. in many such cases the best way to train the digestive organs into a healthy state is to keep to a diet consisting chiefly of dextrinised cereals, which must be eaten dry, with some vegetables and as little fresh fruit as possible. this to be continued until little by little the raw salad vegetables are found to agree; then the rest is easy. a diet on the following lines would probably be a good temporary measure:-- _breakfast._--one egg lightly boiled, poached or baked, with two granose biscuits and fresh butter, eaten dry. _dinner._--brusson jeune bread (one or two rolls) with butter, and small helping of vegetables, cooked at _first_ in the orthodox way. _supper._--plateful of boiled rice (cooked dry in the indian fashion[ ]) with a tablespoonful of good malt extract. no sugar, honey, stewed fruit, or dried fruit should be taken until improvement has set in. as little fluid as possible should be taken until the stomach has regained more tone and become more normal in size. [ ] see _the healthy life cook book_. s. net (post free, s. + / d.). severe digestive catarrh. miss s.l.p. writes:--i should like a little help as to diet. i have just had an attack of epidemic influenza with throat trouble, so that i feel very much run down and unfit for a diet too depleting in character. for over four years i have adopted a non-flesh diet on account of a tendency to chronic catarrh of the whole alimentary tract, due to rheumatic tendencies which affect me internally rather than externally. the continuous damp weather has produced much gastric irritation, and frequent acidity. i cannot discover a diet that is convenient and at the same time sufficiently nourishing. i lose flesh on what i take, and i have none to spare, though at one time i was inclined to be stout. my age is forty-eight. i take three meals a day. a light breakfast either of "maltweat" bread or "p.r." cracker biscuits and butter, with tomato or fresh fruit or occasionally an egg. for midday meal an egg or milled cheese, or nuts or cream cheese, with a baked potato and a conservatively cooked vegetable. occasionally i have a little salad and grated carrot, but unless i am better than usual i cannot digest these. the evening meal consists of "maltweat" bread or "p.r." cracker biscuits or granose flakes, with cream cheese. as a child i suffered constantly from colds in the head, but now my troubles are oftener internal. the action of the bowels is irregular. i depend chiefly upon an enema of warm water when constipation is present. i never drink tea, only hot water, or emprote and water, or occasionally vegetable juices or fruit juices. i find i am better without much fluid. so far as it is possible to judge from this letter, this correspondent is suffering not only from stomach and bowel catarrh, but her condition as a whole is unsatisfactory. the vital force is depleted and the nervous system is not doing efficient work. she needs suitable treatment to remove the acid and toxins with which the system is evidently clogged. this is not an easy task, for as soon as elimination begins trouble arises in the form of influenza or other similar derangements. these are probably little else but attempts on the part of nature to rouse the vital force of the body into action with a view to clearing out the clogging poisons. waste clearing should be done gradually. the skin should be made to act better by means of home turkish baths, or by wet-sheet packs. then mustard poultices can be applied _along the course of the spine_ and massage with suitable manipulations can be applied to the muscles and bones which make up the spine. the daily practising of the excellent and simple breathing and bending exercises described in muller's _my system for ladies_[ ] will be very helpful. by means such as these the body will be gradually cleared of its poisons, and so the nervous system will be made to do better work. the diet specified can be continued. h. valentine knaggs. [ ] s. d. post free from the office of _the healthy life_, amen corner, london, e.c. * * * * * _may we ask the co-operation of all our readers during the holiday season in the following way. on holidays you are bound to meet fresh people, and make new acquaintances, and even friends. we suggest you purchase a few extra copies of _the healthy life_ before you start and hand them on to any likely to be interested. people tell us the magazine is its own recommendation. this does not mean that you need not add your own. the circulation grows steadily, but it is far short of what it might easily be if every reader were to gain one fresh reader every month._--[eds.] more appreciations. i want to say how very interesting and helpful i find _the healthy life_, and it is always a pleasure to buy an extra copy to give to friends, for i always feel it will do them good to read it, and perhaps make regular subscribers of them. h. bartholomew, knebworth. the healthy life the independent health magazine. amen corner london e.c. vol. v august no. . _there will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--claude bernard. an indication. the pursuit of health, considered from the negative standpoint, is the flight from pain. and pain is the great mystery of life. james hinton, himself a well-known physician of his time, attempted to solve the mystery of pain by showing that it is the accompaniment of imperfection. that what is now experienced as pain might be exquisite pleasure given a higher stage of human development. but this, after all, only shifts the mystery one step farther. instead of the mystery of pain we have the mystery of imperfection. yet to image perfection is always to image something incapable of growth or further development. take, for example, a perfect circle. so long as it remains unbroken, flawless, the line (or infinite number of lines) composing it cannot be continued or extended. but given a break in the line and it may be continued round and round, up and up (or down and down) into an infinitely ascending spiral. this possibility of extension depends on a break, on an imperfection. it does not follow, of course, that every flaw in human nature is always the starting-point of new growth, every failure a stepping-stone to greater knowledge, but the possibility is there. it is for men to see that they do not neglect their opportunities.--[eds.] imagination in play. _regular readers will recognise in this wonderfully simple and suggestive article a continuation of the series previously entitled "healthy brains." the author of "the children all day long" is an intimate disciple of one of the greatest living psychologists, and she has a message of the first importance to all who realise that true health depends as much on poise of mind as on physical fitness._--[eds.] the fruit of imagination ripens into deeds actually done in the service of man: its flower brightens the whole of life and makes it fragrant, from the budding-time of children's play and laughter to the developed blossoms of the creative imagination which we call painting or poetry or music. play and art have this in common, that they are activities pursued for the sake of the activity itself, not as a means to any other object, not aiming at any material usefulness. actually, of course, there is nothing more useful, on every scale of usefulness, than the development of the individual in art or play, but these would never be really themselves while an ulterior purpose formed a background to them in consciousness. physical exercises devised for the sake of health are a more or less pleasant form of work; they do not take the place of play. our ordinary work is usually more or less one-sided and unbalanced in the demands it makes upon us; we therefore try to find what other set of movements will undo this unbalancement and give us back unbiased bodies. when that is done, and not till then, we get freedom, and it is at that moment that real "play" begins--the use of the freed muscles according to our own will and pleasure. the same thing is perhaps true in connection with our minds. we all see the fallacy of the old-fashioned hustlers' cry, "make your work your hobby; think of nothing else; let every moment be subordinated to the dominating idea of your career; put aside all sentimentalism, all laziness and self-will, all enthusiasm about things not in your own line of work." we have come to see that this kind of effort leads often to nervous breakdown and early death; always to a certain narrowing of sympathy and hardening of method even in the career itself. so we conscientiously "take up" a hobby or a sport and set aside some hour or day for indulgence in it. we make it a duty to lay aside for the time being all idea of duties; part of our work is to learn to rest. so far so good. but does all this go far enough? work imposed by any set of outer needs puts the whole being under a certain strain. the aim of remedial exercises, prescribed rest-times and legal holidays is to undo this strain, to unwind us from our coil by twisting us the other way. when this has been satisfactorily done, too often the person responsible thinks that this is enough. but it is really and truly at this moment that one is beginning one's real life. when the body is freed from strain and weariness is the time to leap and dance and sing and wrestle. when the mind is free from prejudice and weariness is the time for its original activity to begin; new thoughts spring up unbidden and the creative imagination lives and grows. (in the sphere of will, many great sages have said that an analogous sequence holds good. when the whole emotional and moral nature has thrown itself in a particular direction, and then an unwinding has taken place, the moment of completed renunciation has been said to be the dawn of some great new spiritual light.) who does not know the peaceful activity of a sunday evening, the fruitful quiet of a long railway journey or sea-voyage _at the end_ of a holiday? two friends walk slowly home together after an exciting expedition or debate; two girls give each other their confidence while brushing their hair after a dance. why is this so? nowadays people are very ready to answer the question by refusing the fact. it is waste of time not to be _doing_ something strenuously. rest is almost as strenuous as everything else; it is to be thorough while it is the duty on hand and is to fit exactly on to the work time, without overlapping but without interspace. in this way too often the imagination, the really individual part of the mind, is starved and atrophied. especially in childhood there ought to be a space left between useful work and ordered play for the individually invented games, the pursuits that are not for any definite end, for dreams and lived-out tales, when the child may make what he likes, do what he likes, and in imagination be what he likes. if we scrupulously respected this growing-time we should soon have a race of sturdier mettle altogether. just now this particular want is probably most nearly supplied among elementary school children than among those who have more "educational advantages"; they "go out to play" in the streets for hours every day, and one cannot help thinking that it is the vitality thus evolved that keeps most of them healthy and happy in spite of many hardships. in later life, if we really want to make something of our lives, we shall do well to insist an keeping such a margin of free time to ourselves. it need not be long. five minutes, if one really sails away in the ship of imagination, will take us to fairyland and back again. but the five minutes (or the day in the country, or the week of quiet, or whatever we take or can get) must really and truly be free; we must have the courage to seek for what we really want, and we shall have the inestimable reward of finding what we really are. e.m. cobham. how much should we eat?[ ] [ ] see july number. for some years i lived according to the advice given by "m.d." with regard to the quantity of proteid that should be taken. but experience led me to believe that it was wrong. in recent years my diet has consisted of the following quantities per annum:-- three to four bushels of wheat. seventy pounds of oats. one bushel of nuts (measured in the shells). and with these foods rich in proteid, i have taken plenty of raw vegetables and fruit, and three to four gallons of olive oil. i do not mention this as an ideal, in order to suggest another and better standard than that of "m.d." i do not think any such thing as a standard really exists or can exist. but i mention it to show how far i have travelled away from where i was. i take it that all food reformers will agree that the main reason for food reform is to make the body a more harmonious instrument for the true life of man, and that carries with it the belief that there is some correspondence, if we cannot yet see absolute unity, between the physical and the spiritual. now the law of life, according to christ, is one of continual progress towards perfection and i do not see how this will harmonise with the teaching of a fixed law for the body. all my experience and observation point to a progressive law for the body, and i do not know of a single fact contrary to it. my first point, then, is that there is no such thing as a standard of proteid needed by the body. all that can be said is this, that if you take a man who has been fed on a certain quantity for such and such a time and then feed him on a certain other quantity, alterations in the physical condition will appear. but who can say whether these changes are attributable merely to a deficiency or to a previous excess? if "m.d." and his patients take excessive food they naturally get trouble from stored poisons when they reduce the quantity. but why put all the trouble down to present deficiency instead of to previous excess? to this i can find no satisfactory answer. if we have got our bodies into so hopeless a condition that we cannot use our god-given instincts, tastes and feelings in the first place, the wisdom of troubling much about the continuance of bodily life would be doubtful; and, in the second place, one would need most overwhelming signs of knowledge to substitute for them. but where are they? there is no agreement between those who have been taught physiology. on the one hand, "m.d." gives a proteid standard, now impossible to myself, and i believe to many others, for it would involve eating a nauseating quantity; and, on the other hand, another doctor, presumably acquainted with the same physiology, tells me i cannot eat too little, so long as i do not persistently violate true hunger and taste. then another doctor gives quite a different standard, and a much lower one. if we discard our natural guides, which of the claimants to knowledge is to be followed, and is there any knowledge at all such as is claimed? imagine what a mockery it would have been to give such a standard as that of "m.d." to the agricultural labourer about the middle of last century, a typical one with a large family, and one who worked as men do not work to-day, and had to rear his family on a few shillings a week. how could such a one have provided more than a fraction of what "m.d." says is necessary, either for himself or his children? the broad fact is, that all the hardest work of the world has always been done by those who get the least food. as one who has had some experience of labour, i doubt if the workers could have done so much if it had not been for a spare diet. certain it is, that since they have more to eat, they are much less inclined to work. my contention, then, is that there is no fixed standard of proteid needed by the body, but that the quantity depends on the development that is in progress and is only discoverable by the natural guides of appetite and taste, ruled by reason and love of others. moreover, i contend that even if there were such a standard as "m.d." says physiology has found, it obviously is not known. i cannot help recognising in "m.d." one whom i gratefully love and respect. he helped me on the road, and now that i differ from him i do not forget it, and i ask his forgiveness if i seem to be arrogant. he thinks i cannot see what he sees because i am underfed, and i think he cannot see what i see because he is overfed. in a sense we are both right, and we form a beautiful illustration of the different states of mind that belong to different physical conditions. i urge the laymen like myself not to be afraid of that musty old ill-shaped monster called science[ ] when he is up against the eternal truths that belong to every simple untutored man. shun the monster as you would a priest, to whom he has a great likeness, and unite with me in a long strong pull to get "m.d." out of the rut in which the monster holds him, so that we may have him with us on the road, for he carries much treasure and we cannot do without him. a.a. voysey. [ ] i do not wish to be misunderstood. no sane man despises real science, but when the mixture of science and ignorance, which usually stalks about in the name of science, wants to usurp our heaven-born instincts we cannot but notice his ugly and monstrous shape. it is the function of science, or a true knowledge of details, to fill in the mosaic of the temple of wisdom, but the mosaic can never be the structure itself and is only useful and good when it is subservient to that structure and harmonious with it. camping out. food questions. "we have to consider," i said, "the question of what food to take and how to cook it." "camping out," said sylvia, "ought to be a complete holiday from the food bother. why not live on unfired food, such as tinned tongue, sardines and bottled shrimps?" thereupon felix laughed a great laugh, and said: "just try and do a thousand miles on sardines." felix is sylvia's brother, who has spent some twenty years in america, travelling for weeks through country that contained no people, and spending nearly two years in a single journey to dawson city and home again. he plainly knows far more about bed-rock camping than anyone else in the family and we allowed him to take the floor for a time. "the first thing is bread." said felix, "because you can't do without bread. you must take some yeast or else some baking-powder with you to make it rise, or you must bake it very quickly so that the steam aerates it. you might take a dutch oven with you, but it's nothing like the dutch oven that you know in this country. it is an iron pot on three legs, with an iron lid. you stand it in the fire and cover the lid with hot brands and you can cook anything inside it--ducks and chunks of venison, and bread of course." "but mr freeman has barred the oven," said sylvia, "and if we are not going a thousand miles from home perhaps we can do without it." "as you like," answered felix. "i only mention it so that you can get hold of the general principle. you can make very good bread in a frying-pan. you must mix the dough up stiff so that when the pan is nearly upright it won't tumble out. you fix the pan up with a prop behind it so that the dough faces the fire, quite close, and you draw some more fire behind it so that the back is warmed as well. when it burns a good crust on both sides it is done." "what are flap-jacks," i asked. "just pan-cakes made without eggs or milk," said felix. "you mix a quart of flour with a tablespoonful of baking-powder and put in water till it is just so thin that when you take up a spoonful and let it drop back you can see the shape of it for a few seconds before it melts into the rest. you fry the batter in bacon fat or butter just like pan-cakes, and the cakes are very good." [illustration: _a summer idyll_] "that's a good tip for us," i said, "and another good thing to take is cuddy biscuits, a kind of captain's biscuit. soak them a few minutes in water or milk and fry them. they're nice with tomatoes or anything, or by themselves." "mebbe," said felix, and his tone said, "mebbe not." "i'm only discussing general principles, and you've got to work your own way out in the light of them. i've known an outfit come away without a frying-pan. how do you make bread then?" we had to give it up, and felix went on: "open your flour sack, turn down the edge like it is in a baker's shop, make a little hole in the flour and pour in water to make a pond. mix in what flour you want to use and get your dough into the shape of a snake, wind it round a stick and cook it like that. you've got your bread then like a french roll, and very good it is." we all liked the idea of making bread every day and eating it hot. here was something to be had in camp that you could not get at home. and we liked the idea of learning our cooking by means of first principles. whether we liked it or not, felix liked talking about it, and he began to grow anecdotal. "once," he said, "i met a whole lot of men, ten of them i should think, camped on a cold frosty night with nothing to eat. they were trying to do a journey of thirty miles on rough prairie and their horses were tired and they could not get on. they had brought their lunch and eaten it long ago, and they told me they were starving. they had nothing to eat, nothing to do any cooking with and no wood to make a fire with. i never saw such hungry people. they were new settlers just out from england and it was up to me to do something for them. "'what have you got in that great waggon?' i asked. they told me they had some sacks of flour and two frozen quarters of beef, but there was nothing to cook it in and no wood to make a fire. "there was any amount of cow-dung on the prairie, and it was dry as chips. i set them collecting that and soon enough had a fire. i filled a bucket with water and put it on to boil. i chopped off some meat and put it in. then i made some dumplings and put them in. you just put them into boiling water, you know, and then they cook at once on the outside and don't come to pieces. if they boil too much they get pappy, and if not done through they're not good. most dumplings you eat in england are not done, but mine were just right and those ten hungry men had just as good a supper as anyone could wish for." "tell us about the coffee you used to make," said sylvia. "what horrible stuff it must have been." "the very best coffee ever i drank," said felix. "we used to make it in a pot that was nearly a yard high. we never turned out the grounds, but let them settle and put in a little more every time we made coffee, till the pot was so full that it wouldn't hold any more water." "i don't see anything against it," i said, when sylvia and gertrude were both expressing their horror. "there is no tannin or other bad principle in coffee and you never get anything worse out of it than you do at the first soaking." "the fellows that work the logs on the river have their own kind of coffee that they call drip coffee," said felix. "they have a tall pot like ours was and they tie the coffee in a sack above the water, so that the water never touches it, but the steam goes up and fetches it out in drops. they don't change the sack every time, but keep adding coffee till it won't hold any more." "the moral of which is?" said basil, who had for some time been growing impatient. "that there are plenty of ways of cooking an egg besides frying it," said felix, "and that a bit of common-sense is about the best article you can take with you out camping. take your food as raw as you can get it and know how to cook it. also know a good herb when you see it, and never overlook a chance of getting a meal from the country that will save your stores." c.r. freeman. _food reformers will have their own opinion about a diet of shrimps, sardines, tinned tongue and stale coffee when camping out: the most important part of the outfit is doubtless an adequate supply of common-sense._--[eds.] seasickness: some remedies. _in the april and may numbers of the present year we published an article by mr hereward carrington entitled "seasickness: how caused, how cured." the following supplementary suggestions by the same well-known writer will be useful to many readers._--[eds.] a very good plan, when you think of undertaking a voyage, is to begin to prepare for it several days in advance. for three or four days, before embarking, eat only very simple and somewhat laxative foods--such as fruits--so as to open the bowels well and tone up the system. this simple diet should be followed for the first two or three days aboard--of course not so rigidly, but taking care not to indulge in many heavy, greasy dishes. unfortunately, the food on board is usually very rich and plentiful, and tempts one to eat. if one suffers from seasickness, there is not this same temptation, to be sure; but the malady may certainly be warded off, in the majority of cases, if only reasonable care be taken of the diet before and during the voyage, and if instructions herein laid down be followed. as before stated, drugs are as a rule useless for the cure of seasickness; but on occasion a "seasick cure" of some kind may prove effective. the harm which results from the drug may perhaps be more than counterbalanced by the benefits which the system derives from the cessation of seasickness. a preparation of this kind which is very highly recommended by many travellers is known as "antimermal," and though none of these remedies are to be recommended with assurance, this one--and perhaps one or two others--might at least be tried, in cases of dire necessity, when seasickness has already supervened. it is hardly necessary to say that the patient should remain in the open air continuously, until all symptoms of seasickness have paused. _live_ in your deck chair until you feel quite well and able to get up and walk round. do not attempt to go downstairs into the dining-saloon to meals, if you feel in the slightest "squirmish." rather have some hot soup or broth of some kind sent up to you, and drink it sitting in your chair. do not be afraid to drink water at all times, even if you feel ill--as the water is easily returned, and it is less strain on the stomach to be able to bring up something than to find nothing in the stomach when an effort is made to eject what is not there. water will serve to allay this strain, and thus serve a useful purpose. in very severe cases of seasickness, the stomach of the patient should be emptied and washed out at once. this is usually an easy matter. have the patient drink one or two glasses of water, warm or cold, with a little salt or bi-carbonate of soda added--say a teaspoonful to a pint of water. this will have the desired result! in extreme cases of seasickness, dry cold, such as ice-bags, placed behind and about the ears, will sooth the patient, and help to allay his suffering. cold cloths to the forehead will also prove helpful. full baths had best be omitted, until the attack has worn off, as they are injudicious on account of the reactions they induce. in prolonged cases of seasickness, there is often a craving for acids and fruit juices. the continued absence or diminution of the acid contents of the stomach, and the privation from normal food, accounts in part for this, and it is highly proper to satisfy such a craving--providing due care is taken not to add to the stomach's distress by taking too much juice, or the juice of unripe fruit, or by swallowing the fibre of the fruit, which is allowable only when recovery is complete. hereward carrington. important. if readers who possess copies of the first number of _the healthy life_ (august ) will send them to the editors, they will receive, in exchange, booklets to the value of threepence for each copy. a symposium on unfired food. _in the november number we published a letter from a reader containing the excellent suggestion that readers who had experimented to any fair extent with unfired diet should be invited to contribute to a conference on the subject in _the healthy life_, and that the symposium should be gathered round the following points_:-- ( ) the effect of the diet in curing chronic disease. ( ) its effect on children so brought up--_e.g._ do they get the so-called "inevitable" diseases of chicken-pox, measles, etc., and _especially_ have they good (_i.e._ perfect) teeth? ( ) the effect of the diet in childbirth. ( ) the cost of maintaining a household in this way, as compared with the cost under ordinary conditions. ( ) is the diet satisfying, or is there a longing for conventional dietary (often found amongst food reformers)? ( ) is the diet quite satisfactory in winter? _two letters were published in the january number. two more in february. others will appear in future issues. we are anxious to receive a large number of personal experiences, but they must be brief, and classified under the above heads as far as possible._--[eds.] st albans. in response to your invitation i am sending you my experience with vegetarian dietary. although, as you will see, this has not been altogether "unfired," i think it should be of interest to many. ( ) i became a vegetarian at the time of my marriage, nearly three years ago, my husband being already a vegetarian of eleven years. i considered this a good opportunity to commence. previous to this i had for some time suffered from indigestion, which continued for a few months after marriage. i attribute the cure to the change of diet, and drinking hot water after meals. ( ) we have one child eighteen months old, totally breast fed for twelve months, and another four months: on breast and ixion food and some fruit juice. she has never had any disease whatever, and so far her teeth are perfect and she has cut them quite easily. she is a bonny, sturdy little girl, and very intelligent. ( ) with regard to childbirth, i previously followed the advice of dr alice stockholme in "tokology," avoiding flesh meats and bone-making food and adopting a diet of fruit (chiefly lemons) and rice, brown bread and nut butter, wearing no corsets and taking frequent baths. the effect during pregnancy was highly satisfactory. i enjoyed perfect health the whole time, free from the usual discomforts, and at childbirth i received similar results: a speedy and safe delivery. indeed, since marriage, my husband, baby and myself, have been singularly free from even minor complaints. ( ) as we do not have the specially prepared, expensive vegetarian foods (supposed to substitute meat), but mainly the simple foods, i consider the diet less costly than the meat diet. ( ) we are honestly quite free from the craving for meat or meat foods. ( ) in the summer-time we live principally on salads, cheese, rissoles, etc., made from beans, peas, lentils, etc., fresh fruits, brown bread and nut butter. in the very cold weather we seem to need rather warmer stuffs, such as porridge (carefully cooked) and cooked vegetables, etc. d. godman. * * * * * brighton. i have read with the greatest interest the correspondence in _the healthy life_ on the unfired diet. as the majority of your correspondents have not been living _exclusively_ on unfired food, or have only done so for short periods, may i suggest that some of your correspondents or contributors live on an _entirely_ unfired diet, _excluding dairy produce_, for a period of six or twelve months and then relate their experiences. in this way some valuable evidence would be obtained. at any rate i am prepared to do this myself. with reference to living on the unfired diet on d. a day, i have often had two unfired meals for less than d., and two meals a day are sufficient for anyone. of course to do this one has to buy the food which is in season and therefore cheap. dried fruit and nuts, followed by a cress salad with oil and lemon dressing, does not cost more than d. an unfired rissole made from grated carrot and flaked peanuts cost at most a penny, and if followed by dates or figs would be a sufficient meal, and d. would cover the cost. in conclusion, i have no difficulty in producing a "two course" unfired meal for d.--but perhaps i should have left the subject of cost for dr bell to deal with. yours faithfully, alfred le huray. more about two meals a day. with reference to my article, "two meals a day," which appeared in the may issue of _the healthy life_, several correspondents have asked me to give more particulars about my life and diet. i do so gladly; but i must be brief, as the demand upon space in this magazine is now very great. resolved into a single sentence, what all my correspondents wish to know is this: is a two-meal dietary best for all? to this question, however, a definite answer cannot be given, for the simple reason that scientific experimentation with respect to food quantities and times of meals, etc., has gone such a little way, so that it would be presumptuous to set a limit in regard to meals and food reduction. to my mind, apart from the question of the quantity of food to be taken, there is a great and important field of inquiry open with respect to the effect of rest upon the stomach and the intestines, upon the digestive and assimilative powers of the body. now the whole purpose of my article was to show that a reduction of one's dietary was a matter of training, of gradual adaptation, but also--and this is the important fact-of gradual strengthening. my theory is that the two-meal plan is possible owing to the immense economy in digestive energy that is effected through giving the stomach adequate rest, and also through keeping the blood stream pure and unclogged, almost absolutely free from surfeit matter. a rested stomach will get more nutriment out of a small amount of food-stuff than an overworked stomach will get out of a much larger quantity. but experimentation which is sudden and covers a few weeks only, is worse than useless, as it tends to disprove the very principles that a saner method of experimentation would probably establish. and if i can impress this fact upon the reader i shall have performed a good service. carefully undertaken, and properly graduated, i believe there are few people in these days who would not greatly benefit by a reduction in the number of meals and in the quantity of food they take. by means of a healthy and cheerful habit of introspection--not morbid and feverish--i am firmly convinced that by cutting down their meals most people would not only greatly improve their health, but their mental and spiritual condition as well, and also greatly increase their capacity for work ... and if in this way we can effect such an improvement in our life and condition it does not really matter whether we get to the two or even one meal basis or not. as to myself, my work is chiefly literary and my life moderately sedentary. but the fact is that i now have two moderate meals a day whereas i used to have four pretty good ones. but i have many friends whose work is mechanical, and demands much muscular energy, who are two-mealists. one lady i know, who is one of the healthiest, strongest and best physically developed persons i have ever met, is a two-mealist, and not only does she work at a mechanical occupation for ten hours a day, but on several evenings each week conducts a ladies gymnastics class as well. but in her case, as in mine, the two meal was an ideal that was gradually and slowly attained, and not a sudden reform. indeed, the main thing to remember is that it is all a matter of training, it being quite impossible to say where the limit is. for of one thing i am quite sure--viz. that most people, were they to adopt a slow process of food and meals reduction, on the lines i suggested in my article, would be astonished at the result. the number of people one meets, chiefly among those whose life is more or less sedentary, who say they can't work as they should, are subject to pains and heaviness in the head, constipation and indigestion, is simply appalling; and on questioning such people i come to the conclusion that in the majority of cases it is because they eat too much or too often. my meals are very simple, and the simpler they are the better i like them. i like a cold lunch about noon, and a hot meal about six. i have tried a wholly uncooked diet, but as yet my body does not seem ready for it: perhaps it will be after a little while. the first meal usually consists of wholemeal bread and fruit, green or vegetable salads, just according to my needs at the time. in winter i take a more liberal supply of dried fruits and nuts. pulses i eschew altogether. my second meal consists of a substantial entree with one or two conservatively cooked vegetables--occasionally i have a soup and a sweet in addition. but of course it is for everyone to find out his or her own ideal diet; and let me say that it is worth while to do so, even though it involves much confusion and perplexity during the period of experimentation. wilfred wellock. a ballade of skyfaring. ye whom bonds of the city chain, yet whose heart must with nature's be; ye who, bound to a bed of pain, dream there of torrent and tower and tree, here behold them--the magic key, turned by a thought in yon gates of blue, even now has revealed to me alps and mediterranean too. why of the bondage of earth complain? wide as heaven is our liberty! where are the streets and their smoke and stain when to the land of the lark we flee? where is the sight that we may not see, cloudland's citadel passing through? switzerland beckons with sicily, alps and mediterranean too. here, 'twixt walls with the marble's vein, oared on a river of gold are we; there we watch, on a sapphire main, white fleets voyage to victory. day unto day flashes grief or glee; night to night utters speech anew, figuring forest and lane and lea-- alps and mediterranean too. envoy prince whose course through the world is free, fare you better than dreamers do? here are the mountains and here the sea-- alps and mediterranean too. s. gertrude ford. from _lyric leaves_, by s. gertrude ford. cloth, s. d. net; s. d. post free from _the healthy life_, amen corner, e.c. this charmingly bound book makes an excellent holiday companion, for it contains many beautiful lyrics, all characterised by serious thought, generous human sympathies and a delicate imaginative quality. a remedy for longevity. once upon a time there was a little boy whose parents took things very seriously. they answered all his questions with painstaking precision. at a comparatively early age he could prove that fairies were non-existent. at the same time his toys were marvels of mechanical perfection. at the age of seven he was sent to a very efficient school, where, being naturally a bright boy, he gained high marks every term and passed all the examinations, for he had a wonderful and well-trained faculty for remembering exactly what his teachers had told him. when he left school he entered a london merchant's office, where his knowledge of arithmetic was of the greatest assistance in bringing him to the front. moreover, he could argue very tellingly with all the clerks and warehousemen, and always knew what the morning papers were saving about health, neck-ties or religion. in course of time he grew a moustache, joined the territorials, was made a partner in the firm, married a well-educated young lady and became a strong supporter of the local liberal club, where his opinions were so well known that it was unnecessary for anyone seriously to combat them. he was never known to vote for the conservative candidate or to lose his head. his concluding speech in the historic debate on the national health insurance act will always be remembered, by those who heard it, for its earnest defence of the medical profession. in fact, the mayor, who was in the chair, and was a doctor himself, warmly congratulated the speaker, who was evidently very pleased. ten years later he became a town councillor, opened several institutes for the care of the poor, and sent his second son to join the eldest at the same kind of school at which he (the father) had been so well trained. about the same date he bought a new edition of the encyclopaedia britannica and carefully compiled a list of facts and figures showing that idealists and all new-fangled ideas were the greatest danger to the increasing trade and expansion of the empire. at the age of fifty he took a house at surbiton and was continually congratulated on his hale and hearty appearance. his opinions were known and respected by all who met him. his sons were models of what the children of such a father should be, and they supported him in every argument. at the age of fifty-two he retired from business. a month later he had an idea; and it so interfered with all his opinions, and so affected his general health, that he died. edgar j. saxon. a significant case--ii. he stopped smoking tobacco on the second day, and does not mean to resume its use. of course he had no alcohol in any form during the fast, but he never has taken much alcohol, although he was not a pledged abstainer. the temperature was taken many times and seems to have been almost always subnormal, about degrees fahr., but this is not so unusual a condition as to call for comment. the chief cause of a subnormal temperature, in my opinion, is blocking of the body with too much food. no doubt in prolonged fasting the temperature may fall also; but sometimes a fast will be the cause of raising a subnormal bodily temperature, as happened in a case of mine in which on the twenty-eighth day of the fast there was a large elimination of urates by the kidneys and a rise of temperature from degrees to . degrees. subnormal bodily temperature has not received the attention which it deserves. it is usually one of the forerunners, or prodromata as they are called, of the onset of incurable diseases like cancer, bright's disease or apoplexy. the commonly accepted view that the heat of the body depends upon the food, and that people eat blubber in the arctic and antarctic regions to keep the bodily heat up, is one of the chief causes for neglect of the study of subnormal temperature. and it is quite surprising that physiologists have not thought it necessary to explain why nature has provided sugar and palm oil and cocoa-nut oil and ground-nut oil in the tropical regions, as well as abundance of olive oil in the warm temperate regions of the earth if these foods keep the bodily heat up. they ought to have been more abundantly supplied in the arctic and antarctic regions if the accepted view is correct. besides, if we must eat blubber to keep bodily heat up in the arctic regions when the outside temperature is or or more degrees lower than that of the body, what ought we to eat in the tropics to keep bodily heat down when the outside temperature is or even degrees above that of the body? physiologists have not explained this, although assuredly an explanation is wanted. but the true explanation, the correct explanation, would have demolished the doctrine that bodily heat is due to the food, and so it has not been given. it is too simple to imagine that the bodily heat is, like the body itself and all its functions, the effect of the life-force that inhabits the body and builds up the body so that the body shall be a fit dwelling-place for itself--this explanation is too simple and too idealistic for modern science, which is less and less disposed, we are told, to invoke the aid of a force of life to account for vital phenomena, although it assumes an attracting force to account for gravitating phenomena, and an electric and chemic force to account for electric and chemic phenomena. modern science (and ancient science, too, apparently) which sees well enough that an idealistic or a materialistic explanation would equally account for the nexus of the phenomena of the universe, deliberately and almost invariably prefers the materialistic explanation. she is anxious that we should be kept free of superstition. but the superstition that forces are the effects of things does not seem to distress her at all. and so we are told that gravitation is a property of matter, and are forbidden to think that perhaps gravitation, a force, procreates matter, a thing, in order that the effects of the fore may be perceived by dull sense. we are told that the function of the liver and the brain depends on the structure of the liver and the brain respectively and we are not allowed to think that perhaps the force of animal life, feeling the need of an instrument to secrete bile, on the one hand, and to secrete cerebral lymph to act as a vehicle for the conveyance of thought and emotion and higher things, on the other, introduces the liver with its elaborate structure and the brain with its still more complicated structure, in order that both the one function and the other may be well performed. and so, although all forms of kinetic energy (and among them zoo-dynamic, or the force of animal life) manifest warmth and luminosity as qualities, science attributes animal heat to chemic force and refuses to consider that perhaps zoo-dynamic uses chemico-dynamic for its own purposes, even if these purposes are unconscious, because the higher force always dominates the lower. properly speaking, science is out of her sphere, though she does not seem to know it, in making these suggestions. when she keeps herself to the investigation of facts, their exposition, their sequence and their laws, in her painstaking and accurate manner, we accept her revelations thankfully, and beg her to allow us to make our own philosophic and other explanations in attempting to account for the existence, sequences and relations of the facts of life. after his return home, patient continued to gain weight, as might have been expected. on the seventeenth day after ending the fast he weighed lbs. and on the nineteenth day lbs. on that day he received from a hospital a report that the reaction of the physiologico-pathological test was negative. this has naturally had a great effect on the patient; and it is worthy of very careful consideration. of course one negative result may not be conclusive although it was positive before the fast. but if the result should be repeated, and especially if it should prove to be permanent, the importance of the fact can hardly be exaggerated, since the suggestion arises in our minds that perhaps we may be able to cure profound blood-poisoning by fasting, neither the usual treatment nor the use of salvarsan enabling the investigator to say that the result of the pathological reaction was negative; but this has followed after a heroic fast of days. the result if confirmed would not be unique. quite recently i saw a specific ulcer close to the ankle-joint for which operation had been recommended. it seemed to me that operation would be likely to open the joint, and that therefore it was a risky proceeding. but under a restriction of the diet, putting the young man on barley-water for a few days and then advising him to eat once a day only, the ulcer became very much smaller, and no operation has had to be performed. blood-poisoning of this nature, of course, is not caused by improper nutrition, but it may readily be believed to be aggravated by the ordinary conventional over-feeding to which, so far as i can see, we are all subjecting ourselves, especially as persons who put themselves in the way of contracting blood-poisoning do not generally belong to the class of those who are attracted by the suggestion that it is noble to keep the body under, and that if we do not strive to keep the body under, it will be very likely to keep us under. although we shall be liable to be infected, however we live, still we may believe that we shall be more likely to be badly infected (if we put ourselves in the way of contracting disease) if we have been previously subjected to the bad effects of over-feeding. this consideration renders a possible cure by fasting, a not impossible suggestion. and if, therefore, we have in fasting the suggestion of a remedy which offers us the hope of eradicating such a fearful disease from the human system, it certainly behoves us to make use of it. as a rule it seems to me that bad forms of blood-poisoning of this nature are incurable. in three or four generations they destroy the strain affected by it, do what we will. meantime it shows all the signs and symptoms of a hereditary disease, for the children are born suffering, showing a coppery rash, and old before they are young. and when they get a little older they have no bridges to their noses, their teeth are ill-formed, their vision is imperfect, their intellects dull. it seems as if nature could not forgive crimes of this nature. she seems to treat them as the unpardonable sin. if we find cancer appearing in a family at years of age in or successive generations, there is no proof of heredity in that. inquire and see if like causes acting on like organisms in or successive generations have not produced the disease each time. the children are not born cancerous, and our efforts to prevent the disease may succeed. but children often _are_ born with specific disease, and there is no doubt at all about its being a hereditary disease. even now i should not like to sanction marriage in the case of this man who has heroically fasted for days, although he seems for the present to have got rid of his disease. but the outlook is hopeful, more hopeful than i thought, and in the hope that the suggestion may convey a message of hope to those who are willing to do penance for crimes against the body, i send out these remarks. the opinion expressed by the patient that he was getting rid of the salvarsan which had been injected into his blood to cure his disease is, of course, his own only. i offer no opinion upon it. but i think the whole case very instructive, and it will be deeply interesting to follow it up with special regard to the inquiry whether the pathological test remains negative. the reflective reader of these remarks will need no hint from me to suggest how a study of questions of this sort raises in our minds all sorts of other questions, physical, metaphysical, philosophical, social, religious; what are laws of nature, how they come to be what they are, whether they can be disregarded without paying the penalty, and whether we men are bond or free. each of us will settle these questions for ourselves, for each of us is responsible for his own conclusion. but as to the inevitableness with which such questions do rise in our minds, i take it there can be no difference of opinion. a. rabagliati. healthy homemaking. _for the benefit of new readers it seems well to explain that this series of articles is not intended for the instruction of experienced housewives. it was started at the special request of a reader who asked for "a little book on housekeeping, for those of us who know nothing at all about it; and put in all the little details that are presumably regarded as too trivial or too obvious to be mentioned in the ordinary books on domestic economy."_ xxi. hired help. it does not seem proper to conclude the present series of articles without touching upon the "servant problem," but i do not pretend to be able to solve it. it is a problem usually very difficult of solution by the homemaker of small means. if she has but few persons to cater for, and is not the mother of a young family, she is often very much better off without hired help, except for a periodical charwoman. but it is not always indispensable to the woman who has other duties besides housekeeping. i am not here concerned with the housewife who can afford to keep more than one efficient servant. indeed, i am hardly concerned with one who can employ a really good "general" at from l to l per annum. the person i am concerned with is the homemaker who can afford at most to employ an inexperienced young girl at from l to l per annum. i will draw the worst side of the picture first, for although it _is_ the worst side it is true enough, as so many harassed housewives know. the young "general" often comes straight from a council school where domestic economy had no place in the curriculum, and from a home in name only. such an one is usually slatternly and careless in all her ways, has no idea of personal cleanliness, and regards her "mistress" as, more or less, her natural enemy! she is "in service" only under compulsion, and envies those of her schoolmates whose more fortunate circumstances have enabled them to become "young lady" shop assistants, typists and even elementary school teachers. if she had her choice she would prefer labour in a factory to domestic work; but either a factory is not available, or the girl's parents consider "service" more "respectable" in spite of its hardships. its hardships? yes, it _is_ its hardships that account for its peculiar unpopularity. for there are hardships connected with domestic service in small households that do not apply to other forms of much harder labour. everyone who is familiar with the small lower middle-class household knows how often the life of the little "general" resembles that of an animal rather than a human being. all day long she drudges in a muddling, inefficient way, continually scolded for her inefficiency yet never really taught how to do anything properly. her work is never done, for she is always at the beck and call of her employers; yet she lives apart in social isolation, is referred to contemptuously as the "slavey," and even her food is dispensed to her grudgingly and minus the special dainties bought for sundays and holidays. this is domestic service at its worst, of course, but the prevalence of such "places" in actual fact is undoubtedly at the root of the young girl's objection to it. how can she help gleaning the impression that such work is "menial," when her employers more or less openly despise her? being human, how can she but envy those of her old friends who have their evenings to themselves? what contentment can she find in a life of drudgery unenlightened by intelligent interest in learning how to do something well? what wonder that all her hopes and ambitions become centred in the possession of a "young man," and that reason--stunted from its birth for lack of room to grow--being entirely absent from her choice, she marries badly and too young, and becomes the mother of a numerous progeny as helpless, hopeless, stunted and inefficient as herself? some conscientious women try to remedy this state of things by treating the girls they take into their homes as "one of the family." this _may_ answer well sometimes, but it has its drawbacks, both for the girl and the "family." husband and wife, brother and sister, inevitably find the constant presence of a stranger with whom they have little in common very irksome. while the girl herself is equally conscious of restraint when forced to spend her leisure time with her employers. she would usually infinitely prefer the solitude of the kitchen, if combined with a good fire, a comfortable chair and a story book. among the girls i have spoken to on the subject i have not found "socialist" households popular. one girl i met refused to stay in such a place for longer than three days, because she "never had the kitchen to herself." another told me that she found it intensely boring to take meals with the family, because she was not interested in the things they talked about. i think that the ultimate solution of the "servant problem" will not be that every woman will do all her own housework, but that domestic work will become, on the one hand, very much simplified and, on the other, will be put on the same footing as teaching, nursing or secretarial work. that we are beginning to move in this direction is evidenced by the coming into existence of schools of domestic economy, to which "ladies" do not disdain to resort for training. this will undoubtedly result in domestic labour becoming a much higher-priced commodity than it is now, the housewife will have to pay at least as much for three hours help per day as she now does for nine hours, but the fact that the help will be skilled, combined with the greater simplicity of housework, will surely more than compensate for this. but what is the homemaker of limited means, who must have some help, to do under present conditions? this we must consider next month. florence daniel. health queries. _under this heading dr knaggs deals briefly month by month, and according as space permits, with questions of general interest._ _correspondents are earnestly requested to write on one side only of the paper, giving full name and address, not for publication, but as a guarantee of good faith. when an answer is required by post a stamped addressed envelope must be enclosed._--[eds.] boils: their cause and cure. miss l.c. writes:--i should be deeply indebted to you if you would advise me in the following matter. i have been suffering from a recurrence of boils on different parts of my body during the last six months. i have consulted a local doctor, but he can find no reason for their appearance, but suggested i should try a mixed diet, to include some animal food, rather than adhere to vegetarianism as i have done for some two years past. my diet is about as follows:-- _on rising._--tumblerful of hot water. _breakfast_ (eight o'clock).--one egg, toasted bread (wholemeal) and butter, with either a little lettuce or marmalade and either weak tea or cocoa. _lunch_ (one o'clock).--steamed green or root vegetable, with cheese sauce or macaroni cheese or similar savoury, or nuts. boiled or baked pudding or stewed fruit with custard or blanc mange. _tea_ (four o'clock).--tea or cocoa, with or without a little bread and butter and cake. _supper_ ( o'clock).--vegetable soup, milk pudding and a little cheese, butter and salad and wholemeal bread. i am forty-nine years of age, lead a fairly active life, frequently taking walking exercise. i am very tall and weigh twelve stone. have had no serious illness, but been more or less anaemic all my life. if you can tell me whether there is anything wrong in connection with my diet and suggest the cause of, and treatment for, the boils i shall be exceedingly obliged. in order to help this correspondent to permanently get rid of these boils, we must first ascertain what those troublesome manifestations are and look to the causes which produce them. a boil is a small, tense, painful, inflammatory swelling appearing in or upon the skin, and is due to the local death or gangrene of a small portion of the skin's surface. this eventually comes away in the form of a core, and, until this has cleared away, the boil will not heal or cease to be painful. boils occur chiefly on the neck, arms or buttocks. if very large they are known as carbuncles, and if they occur on the fingers or toes they are described as whitlows. it is often the friction of a frayed-out collar or cuff, of tight waist clothing, or, in the case of whitlows, the introduction of some irritant or poison between the nail and the skin that determines the precise site at which they will come. boils, although rarely dangerous to life, are usually accompanied by pain severe out of all proportion to the extent of surface involved. this gives rise to much broken rest and loss of vitality, which at once ceases when the boil has finished its course. boils usually occur in series or crops. now large numbers of people wear collars and cuffs with frayed edges, or handle irritants with their fingers, but they do not necessarily contract boils or whitlows. therefore, we see that there must be other factors to be taken into consideration to account for their presence. the orthodox germ-loving practitioner may tell you that a boil is a purely local disorder and that a certain form of microbe, known as the _staphylococcus pyogenes_, is the cause of it. this germ, he asserts, lives normally on the surface of the skin and, when this surface becomes broken, it enters the part and infects it, thereby starting the boil. if this is true every person who wears old collars or dabbles his hands in dirt should without exception contract boils. this is obviously untrue. the factor to be considered, then, is this. what is it that induces boils in one person and not in another under identical circumstances? the answer is obvious. the boil is not a local disease at all, but is a manifestation of some constitutional defect, or of some impurity of the blood stream, which enables this microbe to find a congenial breeding ground. the people who suffer most from boils are young or middle-aged adults, and we usually find the two extremes among sufferers. there is the full-blooded, often overfed, individual and there is the pale, debilitated and emaciated person whose constitution is broken down by worry, overwork, sexual troubles, unhealthy surroundings or badly selected foods. if we inquire into the constitutional history of these cases we shall almost invariably discover that the digestive or assimilative processes of the body are not working smoothly. this may be due to the worry or overwork, or to unhealthy surroundings which dis-harmonise the digestive and nutritive functions, or to nervous exhaustion from one cause or another, or it may be due to the wrong diet, which is filling the colon (or large bowel) with fermenting poisons. when the body is clogged in this manner nature often proceeds to get rid of the accumulating waste through the skin. by a vigorous effort on the part of the life-force the impurity is thrown outwards to the surface. looked at in this light a boil is really a most salutary cleansing agent, and the nature-cure practitioner, who calls it a "crisis," often does everything in his power to produce boils when treating chronic diseases. the alternative is often some more deeply seated form of elimination, resulting in serious organic disease of the organs or tissues. one of the first signs of improvement in disorders like diabetes, consumption, arthritis, bright's disease, or even cancer, is the appearance of boils, showing that the vitality has improved to an extent sufficient to enable the foreign matter to be expelled by means of relatively harmless boils. the hydropathic expert also tries to induce this condition by means of his mustard and water packs. if our correspondent wants to rid herself of her boils she must adopt all means to improve her vitality and to cleanse her body of its impurities. she can do this along many lines. she can take a holiday and rest from her work; or by positive thinking she can set to work to get rid of her worries. she can learn to laugh as often as possible, and to breathe deeply, slowly and fully. if her house is unsanitary she should make it sanitary, or move elsewhere. then she must restrict her diet and take only those forms of food which create a minimum amount of poison in the system. _she must cleanse the colon daily_ with warm water enemas, and encourage the action of the kidneys in doing their rightful part in the elimination of poisons by the drinking of distilled water or a good herbal tea on rising, and of clear vegetable broth at night. clay packs, applied cold, are the best form of treatment for application to the boils themselves. they should never be cut or squeezed, as this only intensifies the trouble. hot applications, as poultices, are bad, because they induce the boil to mature prematurely, and also are conducive to reinfection of the skin in other parts. drugs or medicines are of very little use in the treatment of boils, because they do not go to the root of the trouble. the only remedy that i have found of any avail is yeast. in former times this was taken in the form of fresh or dried brewers' yeast, and it was, if unpleasant, a very effectual remedy. yeast yields a free supply of what is called nuclein and nucleinic acid. these, chemically, are identical with the same substances found in the human cells. nuclein is a powerful antiseptic. it has been found that the toxins or emanations from diphtheria and other deadly germs are precipitated and destroyed by nucleinic acid. it is for this reason that yeast extracts, such as marmite, often have a beneficial effect in disorders accompanied by the formation of pus matter. our correspondent's diet should be amended as follows:-- _on rising._--a cupful of unseasoned marmite. _breakfast._--one scrambled or lightly poached egg with stale, yeast-made, wholemeal bread and nut butter, with lettuce or other salad food. no marmalade; no tea or coffee. _lunch._-- to oz. of grated cheese or flaked pine kernels, finely shredded raw cabbage, or grated radishes, or grated raw roots with oil and lemon dressing. no cooked savouries, no puddings, nor stewed fruit with custard or blanc mange should be taken. _tea meal._--cupful of marmite, only. _supper._--clear, unseasoned, vegetable broth, with veda or wholemeal bread, or granose biscuits, with nut butter and some fresh fruit. _at bedtime._--a cupful of marmite. note.--the unseasoned marmite should be used, as the ordinary kind is rather heavily salted. a bad case of self-poisoning. mrs h.w. writes:--i should be very glad if you would give me enlightenment on one or two points about my diet. i am suffering from a somewhat dilated stomach, also a catarrhal condition of nose, throat and alimentary canal, with constipation and much flatulence in the bowels. my teeth are decaying quickly, my nails have got softer, and i have become anaemic and generally debilitated, being unable to properly assimilate my food. all my joints crack when moved, and the knee joints creak as well. is this a uric acid condition, or do you think it merely due to a lack of nourishment, causing a lack of synovial fluid? the joints are not swollen and not painful, they merely crack. my whole system seems to be over-acid, and my mouth gets sore and ulcerated. i have got very thin, having lost a stone in twelve months. i notice that you always advise for dilated stomach greatly restricting the liquid part of the diet. will you tell me just how much one _may_ drink in a day, because when i go without drinking my constipation and other troubles are worse and the urine gets thick and muddy. you also deprecate milk. this puzzled me until you explained to a correspondent last month in _the healthy life_. will you tell me if the same applies to dried milk--will it tend to increase intestinal trouble? i am anxious to know this because i have been relying somewhat on emprote and hygiama lately, for i had got so that i could scarcely digest anything. do you consider it better to use the enema than to take a mild aperient? i do not want to start with the enema again if i can possibly manage to do without, because i found that my bowels depended upon it. and that is why i want to ask if it is absolutely necessary when on an antiseptic diet to entirely avoid fruit. i find it so necessary to keep the bowels working naturally. i _do_ want you to answer me these questions, because i have got so worried and fearful (people's theories are so varied) that i scarcely dare eat any food at all. i am at present taking only two meals daily (i like the two-meal plan best): at eleven a.m. and p.m. i take a cup of weak coffee on rising, without milk or sugar--this warm drink seems to start the peristaltic action and i then get bowel action. i think of changing the coffee for sanum tonic tea or dandelion coffee. at eleven o'clock i have an egg with winter's "maltweat" bread and almond butter, and some conservatively cooked vegetable (celery or carrot or spinach). at six p.m. i have one or two baked apples, a teaspoonful or two of malted nuts, or emprote, and more "maltweat" bread and butter. at four p.m. i take a cup of barley water or carrot water, and at bedtime another cup of barley water. do you think that if i went on to a milk diet for a time it would do good? this correspondent seems to be suffering from auto-toxaemia, or self-poisoning in a severe form, and a condition of what is termed arterio-sclerosis or premature old age. associated with it are evidently symptoms of rheumatoid arthritis, which is affecting her joints and teeth. it is not one of ordinary gout or uric acid poisoning. the trouble no doubt has been caused by past errors of diet, so that the present efforts at reform have come too late to be of service to her. something more than diet is now needed to clear the acids and toxins from the system. it is not a simple case of digestive catarrh, for the whole body is affected. the present diet will answer very well as it stands. the first thing to do is to obtain a well-fitting dilatation belt. this must have leg straps and firmly support the lower half of the abdomen. the next thing is to promote skin action so as to encourage the clearing out of poisons along this line of elimination. vapour baths, wet-sheet packs or alkaline hot baths can effect this purpose. an alkaline hot bath should be of a temperature of degrees fahr. or more, and to the bath should be added / lb. of bicarbonate of soda and / lb. packet of "robin" starch. she should remain as long as possible in this so as to well clear the acids from the skin and induce as much skin action or perspiration as possible. the _first_ baths must be of very short duration, and she should be careful to avoid chill after the bath; it is best to lie prone and completely relaxed for half-an-hour at least after the bath. finally massage and swedish movements directed to the entire back will help to disencumber the central nervous system, which is evidently very badly depleted of its vital force. it is, of course, a pity the correspondent cannot get away to a properly organised nature-cure home and have the continuous attention and treatment which her condition really necessitates. h. valentine knaggs. correspondence. amanzimtoti, natal. _to the editors._ sirs, you will see that your little magazine finds its way even to this out-of-the-way corner of the globe, and you may be sure that it is appreciated. i am specially interested in dr v. knaggs' contributions and should like to ask him a few questions. may i say that i have some knowledge of chemistry and that i try and take an interest in the scientific aspects of food reform. ( ) p. . what grounds has dr knaggs for speaking so definitely about human magnetism and that of vegetables? how would he recognise or test for either, and where can i get further information (scientific) on the question of food magnetism. ( ) same page. dr knaggs says salt added to cooking vegetables converts organic salts into inorganic. i cannot follow that. _what_ organic salts are so converted? one or two examples would suffice. ( ) i have been reading dr rabagliati's _conversations with women concerning their health and that of their children_.[ ] in it he says that food is not the source (cause) of body energy, but is used merely to replace waste material. elsewhere i read that "professor atwater's investigations into nutrition have shown in a most convincing manner that the body derives _all_ its energy from the food consumed. this may be regarded as established." which of these definite and contradictory assertions does dr knaggs support, and why? where can i get information _re_ professor atwater's experiments and other recent works on similar subjects? to me the questions involved are intensely interesting, hence my queries. i hope they do not read as if i were hypercritical or sceptical. with all good wishes for the success of your healthy little magazine. i am, yours, etc., w. blewett. [ ] s. net. c.w. daniel, ltd., amen corner, london. we handed the above interesting letter to our contributor, dr h. valentine knaggs, and append his reply:-- human magnetism. there is very little information available from ordinary scientific sources anent the question of the life-force or of the animal magnetism which animates our bodies and is the motive force common to all organic structures whether animal or vegetable. we do know that fresh fruits and vegetables are strongly magnetic because the magnetism which they emit can be gauged by means of delicate galvanometers. it has been found that leaves, flowers and seeds are positively, and roots negatively, charged. we also know that the same conditions are found in the human subject, since dr baraduc, who is a celebrated french psycho-therapeutist, in his book, "the vibrations of human vitality," tells us that he has invented a machine called a biometer to test these very vibrations. i have had one of these machines myself and have experimented with it a great deal. by its aid we can make the machine work differently with different persons, and by careful tabulation of records dr baraduc has been able to elicit some very remarkable information about the magnetic currents which are constantly flowing into and out of the human body. if our correspondent really wants to know more about the wonders of human magnetism he should read some of the voluminous literature upon the subject published by the theosophical society. just recently also a dr kilner has invented a form of coloured screen by which he and others who have some psychic sight can actually see the magnetic emanations which flow through a person placed in a darkened room. salt-cooked vegetables. the one object of the vegetable kingdom is to build up, for the use of the animal or organic realm, the constituents found in the mineral or inorganic kingdom. these mineral constituents are dissolved, sorted out and built up in the right proportions for the use of animals when taken as foods. whenever these foods are not so eaten they are sent back again to the earth by the aid of microbes during the process of decay, to be again available for plant use. cooking is a process invented by man which is analogous to that of decay, for it dissolves and disintegrates the structures which nature has built up. when man eats food that is partially disintegrated he does not obtain from it the right sort of nutriment which nature intended him to have. to intensify the wrong-doings of the cook, man further hastens the disintegrating process by adding to the things that he cooks a due proportion of a common and very stable mineral, called salt. it is powerful, because it is not easily disintegrated. the salt greatly expedites the process of decay, whether in the natural form of fermentation, or whether by the application of heat, as in cooking. salt is used in nature to promote the flow of those electric and magnetic currents which are a manifestation of the universal life-force which pervades all things seen and unseen. it is an essential constituent of the sea because the ocean is the life-blood of the earth. it is an essential constituent of our own blood, because it is needed to make the blood stream a good conductor of magnetic currents. when you put this salt into water and then proceed to boil vegetables in it, it quickly sucks out all the life-force from them, and if persisted in reduces them to the state of minerals from which they were originally constructed. food and the source of bodily energy. dr rabagliati and professor atwater are, i believe, both right, but the former does not always explain himself clearly to the lay mind. the life-force or animal magnetism is the real source of bodily energy, and it manifests itself only when it has something that resists or regulates its flow. it does this just as certain forms of wire, or other materials, which possess indifferent conducting power, resist the flow of electricity through them. electricity cannot manifest as light in the usual electric lights used in our houses, as heat in the electric culinary appliances or stoves, or even as power in the motors which run our trams and trains, unless it be given the requisite apparatus to bring about the manifestation required. in exactly the same way life cannot manifest itself as consciousness, with its flow of thoughts, emotions and bodily activities, without the food which is daily supplied to the body. it consequently depends considerably upon how we select our daily rations as to how this vital force will manifest within us. h. valentine knaggs. holiday aphorisms. a sun bath needs no soap. * * * * * man was made for the weather, not the weather for man. * * * * * a long drink often makes a short walk. * * * * * you may bring a man to the sea, but you cannot make him think. * * * * * a tanned face doesn't make a healthy body. * * * * * dew paddling should be done in the dark. * * * * * the only things that bathing machines make are cowards. * * * * * it is better to board yourself than let others be bored by you. * * * * * "a bore is one who thinks his opinions of greater importance than your own." * * * * * people who throw pebbles into the sea shouldn't dive near shore. * * * * * a toothbrush is what many forget but few should need. * * * * * scotland yard is not in the grampians. * * * * * cheap food is often dearly bought. * * * * * lyons have no depots in skye. * * * * * orange-trees never yet sprang from scattered peel. * * * * * a pear in the hand is worth two in the can. peter piper. the healthy life the independent health magazine. amen corner london e.c. vol. v september no. . _there will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--claude bernard. an indication. food reformers sometimes forget that "man does not live by bread alone," not even when supplemented by an ample supply of fresh air and physical exercise. it has been pointed out by psychologists that the more highly organised and highly developed the creature, the less it depends on nervous energy obtained via the stomach and the more it depends on energy generated by the brain. true, the brain must be healthy for this, and one poisoned by impure blood, due to wrong feeding, cannot be healthy. but something more than clean blood is necessary. for, as change of physical posture is necessary to avoid cramped limbs, so periodic reversal of mental attitude (consideration from other than the one view-point) is necessary to the brain's health. again, change of air is often prescribed when the patient's real need is a change of the personalities surrounding him. while for the lonely country dweller a bath in the magnetism of a city crowd may be a far more efficacious remedy than the medicinal baths prescribed by his physician. for man lives by _every_ word that proceeds out of the mouth of god.--[eds.] fear and imagination. _regular readers will recognise in this article a continuation of the series previously entitled "healthy brains." the author of "the children all day long," is an intimate disciple of one of the greatest living psychologists, and she has a message of the first importance to all who realise that true health depends as much on poise of mind as on physical fitness. we regret that in the previous article, "imagination in play," the following misprints occurred:--p. , line from top, "movement" should be "moment"; p. , line from bottom, "admiration" should be "imagination."_--[eds.] some people are given to excusing their own uncharitable thoughts by saying, "i suppose i ought not to have minded her rudeness; i am afraid i am too sensitive." in the same way, people say, "oh, i _couldn't_ sleep in the house alone" (or let a child go on a water-picnic, or nurse a case of delirium or do some other thing that suggested itself), "i have too much imagination." in both cases the claim, though put in deprecating form, is made complacently enough. the correlative is: "you are so sensible, dear; i know you won't mind," which is a formula under cover of which many kindnesses may be shirked and many unpleasant duties passed on. the sensible, practical people who listen to these sayings sometimes attach importance to them, so that a habit has grown up of describing morbidly neurotic people as "over-sensitive" and cowardly ones as "too quick of imagination." ultimately, this leads to the thought that both sensitiveness and imagination are mental luxuries too costly for ordinary folk to grow, and that it is safest to check, crush or uproot them when we discover them springing up in others or in ourselves. is not this attitude of mind due to a misunderstanding? imagination is an _organ of activity_; it can be kept in the highest possible condition of health by having plenty of exercise; it should be working continually against resistance. a rabbit's gnawing tooth, if the opposing tooth be broken, may grow inwards and cause the creature's death, but the same activity of growth, if working under suitable conditions, enables him to go on living and gnawing at his food year after year without wearing his tools away. the problem, then, in economy of effort is: how shall we use whatever force of sensitiveness and imagination we have, so as to get its maximum efficiency of usefulness and its minimum pain and inconvenience? for many ages man has been dominated by fear. his way to freedom, now, is to step out through his cobweb chains and go right forward with courage and in faith. so we are told with relentless and almost tiresome reiteration. it is the fashion, one might almost say, to have cast off fear, and the one thing an honest "modern thinker" is afraid of is being afraid. (to less honest ones it is the thought of _being thought_ afraid that is a very real and present fear.) but, if this standpoint is right, is not fear at least a vestigial organ, a survival of a mental activity which served its purpose in times gone by? is it not even truer to go further still and say, as _each particular fear_ serves its purpose it may safely be discarded, but that, as far as our present knowledge goes, other grades of sensitiveness, finer shades of imagination of the type we have called fear, must take its place, to be discarded in their turn for yet other apprehensions? for if we lost the kind of perception that we associate with fear, if our imagination closed itself automatically to the suggestion of all sorts of ugly possibilities, should we not find ourselves soon in the midst of difficulties akin to those of the hero of the german tale of the man who felt no pain? we accept the evidence of pain as a guide to action; when we have decided on action we proceed to get rid of the pain as expeditiously, safely and permanently as we can. the same thing seems true of fear. over and over again we laugh at ourselves for fearing something that either never happened at all or happened in such a way as to be softened out of all likeness to the monstrous terror we had created. on the other hand, when misfortune falls heavily because of our lack of imagination in not foreseeing possible consequences of particular actions or events, we lament and complain: "if i could only have guessed! if i had only known!" fear pure and simple--the imagination of possible trouble--is a stage we can hardly yet afford to do without. but when it has roused our attention to a danger, its work is done. let us practise turning it into action; taking due precautions against accident, guarding against hurting a neighbour's feelings, watching some possibility of evil tendency in ourselves. then, and not till then, may we let it drop. it may pass; it has done its work. it is no longer our responsibility to foresee, it is our privilege to lay down the fear and live happily and at peace. even the dread perceptions of eternal laws come under the same method. "the fear of the lord is the beginning of wisdom," the _beginning_: the end is faith and love. e.m. cobham. +--------------------------------------------------------------+ | | | #to our readers.# | | | | readers who appreciate the independence and all-round nature | | of _the healthy life_ can materially assist the extension of | | its circulation by tactfully urging their local newsagent to | | have the magazine regularly displayed for sale. an | | attractive monthly poster can always be had free from the | | publishers, tudor street, london, e.c. | | | +--------------------------------------------------------------+ how much should we eat? _the article (signed "m.d.") with the above title which we published in the july number has, as we anticipated, aroused considerable discussion. one interesting criticism appeared in the august number. we now publish two further contributions, to be followed, in our next issue, by two further articles by dr rabagliati and mr ernest starr._--[eds.] i as one who has tried the low proteid diet, and came to grief on it, i desire to set my experience against that of mr voysey,[ ] and to assert that, if it is true for him, it certainly is not true for me. mr voysey indulges in many loose and generalised statements which do not help the average man or woman in the least. i imagine it is these that "m.d." has in mind when he advises a certain standard of diet, below which it is not safe to go. if mr voysey can, as horace fletcher can, exist on a very low proteid diet, that does not prove that all men and women can do the same and be healthily active; it only shows that he and fletcher are exceptions to the average person, and that it may be dangerous to follow their example. for most men, "m.d.'s" proteid standard is not so nauseating as he finds it. here is a specimen dietary for a day, for a man of ten stone, following, as most of us do, a sedentary occupation:-- oz. cheese. oz. bread. oz. vegetables and salad. oz. fruit. + / pints milk. will any average person say that that quantity, divided into three meals, would be nauseating to him? and is that diet so very expensive that it would be beyond the means of an agricultural labourer in any country? it is certainly no mockery. the cost to such a labourer would probably not exceed d. or d. of course the diet can be made as expensive as one chooses, and widely varied. [ ] see august number. who amongst ordinary men and women has a reliable natural taste that would be an infallible guide in all matters of food? and what a misleading statement that is which asserts "that all the hardest work of the world has always been done by those who get the least food." put it to the test on the average person and see where it leads to. my contention is that the average person, throwing over his or her accustomed meat diet, requires some definite guidance as to the quantity of proteid, such as dr haig's wide experience and much patient research have proved needful, or at least advisable, for the continuance of a healthy and vigorous life; and i will say that it does not help this average person in the least to put before him the misty statement that "the quantity depends on the development that is in progress, and is only discoverable by the natural guides of appetite and taste, ruled by reason and love of others." all very noble and very well in another place, but hardly meeting the case of the ordinary person who is seeking a healthy diet. nor can you "make the body a more harmonious instrument for the true life of man" by habitually underfeeding it. i thought that was a mediaeval notion that had been knocked on the head long ago. is there any man, lay or scientific, mr voysey notwithstanding, who can claim to have as wide an experience of diet in its relation to health and disease as "m.d.," to say nothing of the trained mind and long years of patient thought that have been exerted in dealing with the facts of this wide experience. for myself, i have come to see that, if "m.d." does not hold in his grasp the absolute truth in the matter of diet, he is nearer to it, and is a safer guide, than all your low proteid advisers, lay or otherwise, where they come much below "m.d.'s" standard. so, using mr voysey's phrases, i would urge laymen like myself to shun that weak-kneed manikin, the low proteid diet, and unite with me in a long strong pull to get him and others like him out of the rut in which that sorry weakling holds him. hy. bartholomew. ii the editors were quite right in saying that the article under this heading in the july issue would arouse discussion. my wife and i, having discussed "m.d." and many others with the title, feel constrained to put forth a warning against blind faith in anything which the faculty have to say on dietetics. there are of course brilliant exceptions, such as dr rabagliati, dr knaggs, dr haig, the late dr keith and others, who give chapter and verse for every statement made; but when we consider the excellent work of laymen such as albert broadbent, joseph wallace, horace fletcher, alice braithwaite, eustace miles, hereward carrington, edgar j. saxon, bernarr macfadden, arnold eiloart, ordinary folks like ourselves may be excused if we venture to give our experience as against that of "qualified" men. with your permission, then, we reply to "m.d.'s" five suggestions in the order he gives them:-- . food qualities are _not_ of extreme importance. . quantity tables may have been "settled" by physiologists to their own satisfaction many years ago; but very good reasons have since been given for altering, or even ignoring, them. . the particular number of grains of proteid to be consumed per day is not of serious moment. . that departure from the quantity specified has not led to disaster is proved by the fact that the human race still persists, in spite of the very varying eating customs found in different nations. the great majority being poor or ignorant, or both, know neither "tables" nor the need for them. . there can be no reply to such a general statement as: "the nature of this disaster may appear to be very various, and its real cause is thus frequently overlooked." in such matters an ounce of personal experience is worth a pound of cut-and-dried theory. we--my wife and i--have been reared in an atmosphere suspicious of doctors, both sets of grandparents having relied rather on herbs, water treatment, goodness of heart and faith in god; and their children have had too many evidences of medical ignorance to accept any dogmas. we are anti-vaccinators, nearly vegetarian, and, to come to the point, we have four children who will persist in thriving on a basis of always too little rather than too much of food. the respective ages are girl , boy , girl , boy . all have been brought up on these lines: never pressed to eat, but continually asked to chew thoroughly. foods "rich in proteid" put sparingly before them. milk has been well watered; and eggs, bacon and other tempting and rich foods only on rare occasions given to them. we would ask readers who can to make the following experiment: let your children have a good drink to start the day, and then run and play; don't offer food till asked for. you will almost to a certainty find, if you start this plan immediately after weaning, that day by day and year after year it is twelve to one o'clock before they inquire for "something to eat." we have done this for twelve years, with children of entirely different temperament and of both sexes. they go to school, poor things! breakfastless. during these twelve years light breakfast for father has been on the table--he goes without lunch--and not once in fifty do they ask to join him. nor, if invited, will they after three or four years of age. the have never had a fever which lasted more than a day or two, and they are all above average height and weight. they get fruit in season just as asked for, and as much to drink as they like, _but not at meal-times_. our experience is over a period of twelve years, and we have come to the conclusion that the infectious diseases so prevalent and death-dealing amongst children of all classes, rich or poor, are, in the main, the result of over-feeding. we find it wise to keep highly nutritious foods (like eggs, cheese, meat, etc.) away from children--that is, for regular consumption; a little occasionally may do no harm. you will have it borne in on our minds year by year, as your children grow up under such a plan, that dr rabagliati, hereward carrington and others are quite right. we do not get our strength, nor heat, from food. let the force of animal life (zoo-dynamic, i believe dr rabagliati calls it) have free play, and your children can't help growing up well and strong. in to-day's _london daily chronicle_ i see a special article by dr saleeby, under this heading: world's doctors versus disease. medical men meet to-day. the triumphs of three decades. we know how much this wonderful faculty knew thirty years ago about, _e.g._, fresh air for consumptives. there is not a word said in this article (which is a sort of programme of the weighty matters for discussion) on the relation of food to the body. that question probably of them believe was settled by the eminent physiologists who compiled those "food-tables" years ago--and in so doing went far to pave the way for the modern frightful increase of cancer, bright's disease, etc., as well as for "scientific" horrors like anti-toxin, tuberculin--not to mention compulsory eugenics! j. methuen. health through reading. do many people consider reading from the point of view of health of mind and body--of refreshment in times of struggle--of recuperation after knock-down blows of sorrow, disappointment or misfortune? let us begin by saying that some of the greatest books are not to be read by everybody at all seasons. when one's heart or ankles are weak, one does not start to climb mountains, or one may end as a corpse or a cripple. so with one's soul under shock or stress. personally, i can imagine nothing more cruel than the action of two women, one a story-teller of great repute among the "goody," who, to a specially stricken and lonely young widow, tendered as "bed-side books," victor hugo's _les miserables_ and browning's poignant _the ring and the book_. if they had wished to make her realise to the bitterest depths the awfulness of the world wherein she was left alone, and the blackest depravity of the human nature around her, they could not have done differently. _les miserables_ she read till she reached the dreadful scene where a vicious cad hurls snowballs at the helpless fantine. then the strong instinct of self-preservation made her put the book aside--not to touch it again for nearly thirty years. with _the ring and the book_ her mind was too wrung and too weary to wrestle--all it could receive was a picture of wronged innocence, and especially of the rampant forces of evil with which she was left to contend. with the same want of tact and judgment, if with unconscious cruelty, the gloomy, fateful _bride of lammermoor_ was selected out of all scott's novels for the reading of a very homesick youth, solitary in a strange country! yet we must always remember that, as in affairs of the body so of the spirit, "what is one man's meat may be another man's poison." some of the wisest and most successful nurses or doctors will occasionally permit an invalid to indulge in a longed-for diet which would certainly never be prescribed. they know that idiosyncrasy follows no exactly known rule. so we could tell of one who, amid the dry agnosticism of the later half of last century, had felt her faith, not indeed extinguished, but obscured and darkened. from the perusal of certain writers she had shrunk, perhaps with cowardice. they were put on such a pinnacle that she feared she would find no arguments fit to oppose to theirs. weakly, she locked the skeleton cupboard. then she was attacked by a malady which, while leaving her mind free and strong, she knew might be very speedily fatal. straightway she said to her husband: "in two or three days i shall probably 'know'--or cease from all knowing. there will not be long to wait. therefore bring me three books," which she named, works of authors of extreme agnostic views. rather reluctantly he complied with her wish. she went steadily through the joyless pages, turned the last with the significant remark: "if this is all they can say, well!--" the skeleton cupboard, once opened, was speedily swept out. she quickly recovered, but never forgot her experience. yet it must be remembered that this was the patient's own prescription, and was permitted by one who thoroughly understood her temperament. therefore, though one would never wish to overrule a strong personal desire, that is quite different from offering counsel and furtherance--or proving experiments upon oneself. a celebrated woman writer of the middle of last century was of opinion that young people of both sexes should not indulge in reading "minor poetry." "let them keep to the great poets, made of granite," was her graphic phrase. a woman of singularly self-controlled nature has confessed that the only time in her whole life that she experienced an unwholesome moral and emotional disturbance, after reading a book, was when, at about twenty-two years of age, she read emily bronte's _wuthering heights_. she dared not finish it: and when, some time later, a copy was presented to her, she caused it to be exchanged for another book, not wishing it even to be in the house with her. years afterwards, she read it again, quite unmoved. it may be added that her first reading was made in the course of a systematic study of english literature, which had already led her through the works of chaucer and fielding. she has herself asked: "is it possible that the strong and unpleasant effect was produced because the book was the production of another young woman, perhaps of somewhat 'sympathetic' temperament?" taken as a whole, probably most fiction and all highly emotional work of any sort should be indulged in sparingly by those in the danger-zone of life, or by any under special mental or moral stress. history, philosophy (with sustained chains of reasoning) and biographies (best, autobiographies) of active and strenuous lives, should be resorted to by those temporarily doomed to spells of suspense and involuntary inaction. invalids should be encouraged to read plutarch's _lives_ rather than the _memorials_ of other sufferers, however saintly! it may be broadly stated that, during the tragic episodes which seem to occur in all lives, the most wholesome reading is to be found in the books of the great world-religions--the bible, and the teachings of buddha, confucius and mahomet. the bible is of course a library in itself, and many of its books are suited to very widely different circumstances and temperaments. the psalms, the gospels, the epistle of st james, and parts of those great poems known as the "prophetical books" and the more personal and less doctrinal portions of paul's epistles are perhaps of widest application. from the words of buddha, confucius and mahomet there are many admirable selections--and one remembers a wonderful compilation of more than thirty years ago, called _the sacred anthology_, and wonders if it be out of print. it does not follow that these works should not be studied at other times than "tragic episodes." if this were more often the case, perhaps there would be fewer "tragic episodes"! next to these come such wonderful books of spiritual experience as a kempis's _imitation of christ_, the _pilgrim's progress_, the _devout life_ of francis of sales and others which will occur to the memory. allusion to the _pilgrim's progress_ brings us to the remark that no books are more truly wholesome than some that can be enjoyed by those of all ages, and of very varied types of "culture": in which the children can delight, and which refresh the aged and weary. like nature herself, they have hedgerows where the little ones can gather flowers, little witting of the farther horizons of earth and sky lifted up for the eyes of the elders. let the children read the _pilgrim's progress_ simply as "a story," its eternal verities will sink into their souls to reappear when they too are in _vanity fair_ or in bitter conflict with _apollyon_. for the same reason, the book of proverbs should be commended to youthful study. under wise supervision--or rather, in mutual study--it becomes at once a series of vivid pictures of primitive eastern life--for all allusions should be explained, where possible, pictorially--while at the same time the memory will be insensibly stored with shrewd common sense and knowledge of the world, to be turned to, and drawn upon, as needed. and then, while the children revel in the fun and the fancy of hans andersen's _fairy tales_, let the sorrowful or sore or wounded heart turn to them for solace, soothing or healing. hans andersen enjoys a very special "popularity" and yet some, who have learned to love and value him, doubt whether justice has yet been done to his work. because it is matchless for the young, it may be easily forgotten that it can be so, only by some quality which makes it matchless for all others. perhaps some of his most popular stories are not his most wonderful, but have simply caught the popular fancy, because of some artist's illustration, or some personal application to the writer's own history, as in the case of his _ugly duckling_. how many--or rather, how few!--can readily recall the pathos and wit of his _portuguese duck_ or the deep philosophy of his _girl who trod on a loaf_? it is told of hans andersen, a gentle soul in a homely exterior, which attracted the snubs and neglect which "patient merit of the unworthy takes," on some such occasion was once heard to murmur: "and yet i am the greatest man now in the world!" it was very naive of him to say so, even in a whisper, probably wrung from him only in self-defence, but perhaps he might have thought it, in solemn silence--and--not been so very wrong! it may have been part of the very transparency of his inspired genius that he could not keep the secret to himself! there is at least one reader who declares that she finds the seeds of all vital philosophy--ancient or modern--in his stories. how much he derived from those who went before him, it is not for us to say, but this disciple, herself a devoted student and admirer of the world's latest teacher, leo tolstoy, yet puts hans andersen above him, as having attained in practically all his work what tolstoy attained only occasionally--_i.e._ tolstoy's own ideal of what art should be and do. in such a paper as this little can be done beyond indicating on the broadest lines the kind of reading which tends to preserve or to restore mental health. away with your "problem" novels and "realistic" poems stated in the filthy material of moral gutters! hans andersen will take some birds, some flowers, some toys, and will state the same problems, and get the same eternal solutions, without making the inquirer run any risk of meanwhile catching moral malaria. isaiah will help us to build "castles" for the human race and for our own future, but he will take care that we shall remember that righteousness and unceasing vigilance and unflagging repair must go into the laying of foundations and the upholding of walls. david, even in his "cursing psalms," will exemplify for you the power of hate and vengeance in your own heart, and as he holds it up before you, you will see how small a thing it is, how mean, how ludicrous! as a man eats and drinks, so is his body: if he is a gross feeder, his body will be gross and sensual; if his food lacks nourishment, he will pine and fade. so it is with our minds and our morals. with whatever original "spiritual body" we may start, it needs spiritual sustenance, spiritual discipline, spiritual sufficiency and spiritual abstinence. too often we ill-use it, as bodies are ill-used, goading its weakness with fiery excitement, or gorging its greed with sickly sentiment, or emasculating it by empty frivolity. all who desire spiritual health must find out what books best promote it in themselves: and sometimes they are found, like wholesome herbs, in very lowly places. one good rule is never to recommend what we have not seen proved in ourselves, or on others. isabella fyvie mayo. the swan-song of september. this fine sonnet is from _lyric leaves_, poems by s. gertrude ford. s. d. net (postage d.). (c.w. daniel, ltd., tudor street, london, e.c.) sing out thy swan-song with full throat, september, from a full heart, with golden notes and clear! no rose will wreathe thee; yet the harebell's here, and still thy crown of heath the hills remember. bright burns thy fire, e'en to its latest ember, the sunset fire that lights thee to thy bier, flaming and failing not, albeit so near dun-robed october waits, and grey november. and though, at sight of thee, a chill change passes through wood and wold, on leaves and flowers and grasses, thy beauty wanes not; thou hast ne'er grown old; death-crowned as cleopatra, lovely lying even to the end; magnificently dying in pomp of purple and in glare of gold. s. gertrude ford. the quest for beauty. if you have travelled at all frequently on certain of the london "tube" railways you may occasionally have noticed, facing you in the carriage, a small framed poster which for beauty and imaginative power has, i should think, never been surpassed in advertising art. if the first sight of it did not make you catch your breath you will not, i am afraid, be interested in this article. the poster represents a rich landscape, in which noble tree-forms show sombre against a tumultuous sky--the latter an architectural mass of pale cloud, spanned by a vivid rainbow. across the lower part of the picture is a scroll, on which are written, in musical notation, two bars from chopin's twentieth prelude. at the top are the words, _studies in harmony_: it is an advertisement of somebody & co.'s wall-papers. in both colour and design this poster is very beautiful. it would be scarcely less so without the rainbow; but "the dazzling prism of the sky" not only intensifies the subtle harmony of colour throughout the picture: it turns the poster into a symbol. and the artist might well have stopped there; only, you see, he had an inspiration. when he wrote across the picture those eight descending chords from the immortal _largo_ he made of the poster--a poem. i do not know anything about the artist who conceived this advertisement of wall-papers. i do not even know his name. but i believe him to be the herald of an invasion. the invasion of life by beauty. do you think it a degradation of art that it should be enlisted by the makers of wall-papers? are there not too many ugly and discordant posters? do you consider trade and manufacture so sordid that they are beneath the ministrations of beauty? it doesn't matter a new penny whether you answer such questions with a nod or a no: the invasion has begun. it is irresistible. beauty is stooping--stooping to conquer. your ardent social reformer is too often obsessed with one idea. across his mental firmament he sees only one blazing word: injustice. and, fine fellow though he often is, he is inclined to be impatient with any talk of art or beauty. "how can beauty grow in these vile cities?" he cries. "what is the use of your music, your statuary, your fine pictures, your poetry, to the starving and the oppressed?" and he does not see that his passionate desire for justice is at root the quest for beauty, for fullness and harmony of life. his stormy sky shows no rainbow: yet it is there. and so is the stately music, the transmutation of colour into sound. and if his eyes could be opened to one and his ears to the other, there would be more power to his elbow. for beauty is inspiration and courage-- "my heart leaps up when i behold a rainbow in the sky...." and there is more than that in it. the cultivation of a sense of beauty, of harmony, makes reformers less harsh in their judgments, broadens their sympathies and helps to save them from becoming mere doctrinaires. if you have any love for the beautiful you simply cannot be happy about most utopias, though they be justice itself in civic form; and, when our "scientific" fabian has demonstrated to you how to organise the national life in all its parts into one vast smoothly working state mechanism you will shudder, and then laugh. and then, without any rudeness, you will say: "hang mechanism and a minimum wage! live men and women want living crafts, liberty and a maximum beauty!" and really, i am coming to see that there are a great many health-culture enthusiasts (not to mention food reformers) who see no rainbow in the sky and hear no music in the wind; and even if they did, ten to one they would see no connection between the two. i verily believe there are some poor souls who have studied food questions so closely that they cannot see the sun for proteid nor the sea for salts. in all meekness, and knowing the frailty of the human mind (i have written dozens of articles on diet!), i would prescribe for them a course of artistic wall-paper advertisements, combined with the letters of robert louis stevenson. he, poor fellow, had to battle against disease all his short life; but he managed to end one of his letters something like this (i quote from memory): "_sursum corda_! heave ahead! art and blue heaven! april and god's larks! a stately music.... enter god." a somewhat ecstatic utterance. a trifle too exclamatory. perhaps. you and i don't end our letters like that. (or do you?) more likely we say something about the weather down here being miserably cold (or damp, or dull, or changeable, or hot) and brave out the lie with "yours truly." but o for one little spark from the fire that shone in the soul of r.l.s. better to die young with a broken heart, if it were a heart as brave and gay as his, than beat methuselah by means of a mincing, calculating, cold-blooded attention to irritating self-made little rules. oh yes, i know well the value of little rules. and i know also that nature offers us only two alternatives--obedience or death (either sudden or slow). but then nature is something more than mistress and lawgiver. she is beauty. and in that aspect, as in all other aspects, nature is unescapable. we turn our backs on her only to find her awaiting us at the next turn in the road. looking at the matter all round, i don't think we can come to any other conclusion than that nature (or whatever you like to call it, her or him) is aiming at beauty all the time. so that we who are literally, if not figuratively, the children of nature, had best do likewise. some mystic or other has said that man's search for god is god's search for man. if he was right--and i think he was--it follows that man's quest for beauty is beauty invading life; and that the only healthy life worth the having is that which begins with "lift up your hearts!" and issues in "a stately music. enter god." edgar j. saxon. * * * * * _semper fidelis._ do two things worth doing, every day. be scrupulously polite and kind, rather than witty or entertaining. cherish cleanliness, sobriety, frugality and contentment. cultivate sweetness of disposition and tranquillity of mind. think before speaking, and so reduce your causes of regret. seek peace and be peaceable for _lis litem generat_. begin at home, let home always find you faithfully on duty. care carefully for those whom providence has entrusted to your care. and the reward of the faithful will abundantly yours, and your heaven will go with you wherever you go. "a.r." more holiday aphorisms. two's company, three's fun. * * * * * levity is the bane of wit. * * * * * braggers mustn't be losers. * * * * * never put on to-day what you can't put on to-morrow. * * * * * it's an ill mind that finds no one any good. * * * * * it's no use crying over spilt milk: you're better without it. * * * * * look before you sleep. * * * * * never put an excursion ticket in the mouth. * * * * * long hair never made true poets. * * * * * obesity always carries weight. * * * * * look after your manners and your friends will look after themselves. * * * * * cranks of a feather fight together. * * * * * all is not toil that blisters. * * * * * _to sea anglers_: a live catch is no better than a dead fish. * * * * * better a place in the sun than a plaice on a hook. peter piper. healthy homemaking. xxi. hired help (_continued_). what is the homemaker of limited means, who must have some help, to do under present conditions? well, meantime, there is only the young "general" for her, either the "daily girl" or one who "lives in." of the two i prefer the "daily girl," when she can be obtained. and the younger she can be obtained, other things equal, the better. she will have fewer bad habits to overcome. some housewives object to the daily girl on the score that she may bring dirt or infection from her home, and also because she can seldom arrive early enough to help get breakfast. but a little management overnight can reduce the labour of breakfast getting to a minimum, and if the "outings" of the girl who lives in are as frequent as they ought to be the risk of her carrying infection, etc., will always apply. the "daily girl" has definitely fixed hours of work and the same chance of enjoying a measure of home life, of keeping her friends and individual interests, as the typist or factory worker whose lot the domestic servant so often envies; while her employers are not faced with the alternatives of condemning a young fellow-creature to a solitary existence or forcing an unreal companionship which is equally irksome on both sides. it is true that the wages of the "daily girl" do not equal, in actual money, those of the factory worker, neither does she obtain the saturday half-holiday or the whole of sunday free. but to set against this she receives her entire board and, with a kindly mistress, is not tied down to staying her full time on days when she is "forward" with her work. the life of the young "daily girl," if her employer is a conscientious woman, need not be hard nor unpleasant; very little harder and no more unpleasant than the lot of the young "lady" who is paying from l to l per annum to learn cookery, laundry and housework at a school of domestic economy. properly conducted, the relations between employer and employee, "mistress" and "servant," are those of mutual aid. such relations _may_ be, and too often _are_, those of an inefficient little drudge for a "mistress" almost equally ignorant and inefficient. but when the employer is an intelligent woman with a sense of justice (i prefer a sense of justice to sentimental theories about sisterhood--people do not always treat their sisters justly) the weekly money payment and food will be but a small part of the girl's wage. in addition she will receive a training that will equip her for the "higher" branches of domestic service, or for homemaking on her own account. not every girl has the sense to appreciate this when she gets it, nor the intelligence to profit by it; while it is certainly rather trying to the employer when the girl is "all agog" to "better herself" as soon as she has gained a bare smattering of how to do certain things properly. but all this is "the fortune of war." some girls never cease to be grateful to their first teachers and leave them reluctantly, while other girls never realise that they have anything to be grateful for. when gratitude and affection come they are pleasant to receive. but the motive power of the really conscientious woman is not the expectation of gratitude or affection. a word to the unconventional homemaker. the young "general" is a bird of passage. age and experience bring with them the necessity of earning more, and if her first employer cannot periodically raise the girl's wages the latter must in time seek better paid employment, probably with a mistress who is not unconventional. it is unkind, therefore, to refrain from teaching the girl how she will be expected to do things in the ordinary conventional house. i do not mean that the employer ought to slavishly run her home on conventional lines for the instruction of her "help." but it is kinder, for instance, to help a girl regard a cap and apron with good-humoured indifference, or as on a par with a nurse's uniform, rather than as "a badge of servitude." it is kinder, too, to show her that it is not only "servants" who are expected to address their employers as "sir" and "ma'am," but that well-mannered young people in all conditions of life can be found who use this form of address to persons older than themselves. i do not suggest for one moment that any attempt should be made to delude a girl into the belief that she will not be expected, in conventional households, to behave with equal deference to persons younger than herself. such deception would be unpardonable. but it is anything but kind to allow a young girl to drift into careless and familiar habits of speech bound to lead to dismissal for "impudence" in her next "place." there is a type of person, for example, who seems to believe that, in order to show that he is "as good as anybody else," it is necessary to be rude and familiar. but good manners are not necessarily associated with servility. and it is no kindness to help to unfit a girl for getting her living in the world as it is. it may seem that, in this article, i am more concerned for the "hired help" than the homemaker for whom i am ostensibly writing. but the points i have touched on are just those about which i know many thoughtful women are puzzled. i cannot solve their individual problems for them, of course, i can only just barely indicate some of the thoughts that have come to me on a subject that is so intimately bound up with the whole of our present unsatisfactory social and economic conditions that it cannot be adequately discussed in a little tract upon domestic economy. florence daniel. the care of cupboards. there are three methods in general use of caring for cupboards. some housewives prefer their cupboard shelves of bare wood, to be well scrubbed with soap and water at the periodical "turn-out." others cover all shelves with white american cloth, which only needs wiping over with a wet house-flannel; while still others prefer to dispense with the necessity for wetting the shelves and line them with white kitchen paper, or even clean newspaper, which is periodically renewed. of the three methods i prefer the last, with the addition of a good scrubbing at the spring clean. the weekly or fortnightly scrubbing is apt to result in permanently damp cupboards, unless they can be left empty to dry for a longer time than is usually convenient. the use of american cloth is perhaps the easiest, most labour-saving method, but the cloth soon gets superficially marked and worn long before its real usefulness is impaired, so that the cupboard shelves never look quite so neat as after scrubbing or relining with white paper. the larder should be thoroughly "turned out" once a week. once a fortnight is enough for the store-cupboard and for china cupboards in daily use. while cupboards in which superfluous china and other non-perishable goods are stored, and that are seldom opened, need not be touched oftener than once or twice a year. in very small houses one cupboard often must house both china and groceries, thus combining the offices of storeroom and china cupboard. the larder, strictly speaking, is for the food consumed daily. but when larder and store-cupboard have to be combined, the groceries may be packed away on the upper shelves, which can be tidied once a fortnight; but the shelves doing duty for the larder proper should never be left for longer than a week. nothing betrays the careless housewife like an ill-smelling larder. all food should be examined daily and kept well covered. hot food should be allowed to cool before storing in the larder. in the summer time special precautions must be taken against flies, all receptacles for food which are minus well-fitting lids being covered with wire-gauze covers or clean butter muslin. if the shelves are lined with paper, care should be taken at the weekly change to examine the wood for stains caused by spilt food that has penetrated through the paper. these should not be just left and covered over, but well washed off. with ordinary carefulness, however, they need not occur. f.d. book reviews. _the new suggestion treatment._ by j. stenson hooker, m.d. cloth s. net (postage + / d.) c.w. daniel, ltd., tudor street, e.c. this book is a striking example of the new synthetic movement in the medical profession. it is an exposition for the general reader of certain basic principles of mental treatment and of the author's methods of applying these; it is also, in reality, an appeal to doctors generally to put aside prejudice and examine the immense potentialities of rational "suggestion" healing methods. after examining the main features and disadvantages of mere hypnotic treatment and passing under review present-day "mental science," the author explains wherein his method of mental treatment both avoids the dangers of hypnotism and reinforces ordinary self-suggestion. throughout there is the frank recognition that few forms of dis-ease are curable by one means alone; on the other hand, it is contended that most disorders, both mental and physical, are remarkably amenable to a rightly directed course of the new suggestion treatment, supplemented by other natural means. the narrowness of view that too often characterises the specialist is entirely absent from this book. it is throughout thoroughly broad, refreshingly sensible and profoundly convincing. _the cottage farm month by month_ (illustrated with original photographs). by f.e. green. cloth, s. net (postage d.). c.w. daniel, ltd., tudor street, london, e.c. here is a book of immediate social interest, of great practical value, and of uncommon literary quality. in the course of twelve chapters, bearing the titles of the months of the year, it reveals a welding together of two things which in many minds have unfortunately become divorced: the practical problems and arduous labour which no tiller of the soil can escape and--the keen delight of a poetical temperament in the ever-changing, yet annually renewed, beauties of earth and sky and running water. it escapes the dry technicalities of the agricultural text-book, while at the same time conveying innumerable valuable hints on practically every branch of "small farming"--advice which springs from the author's thorough knowledge based on long and often hard experience. on the other hand, while entirely free from that all too common defect of "nature-books"--hot-house enthusiasm--it will delight the most incurable townsman (providing his sense of beauty is not withered) by its joyous yet restrained pictures of open-air things. _simple rules of health._ by philip oyler, m.a. ( nd ed.). d. net. post free from the author, morshin school, headley, hants. an admirable epitome of what might be called "advanced health culture without crankiness." the author is an ardent advocate of simplicity in all things and--practises what he preaches. moreover, he is one of those who sees health from all points of view: he is as much concerned with what the english bible calls "a right spirit" as with a fit body and a responsive mind. it is a little book deserving of a wide circulation. correspondence. a remedy for sleeplessness. to the editors sirs, would you care to publish the following experience of a cure for sleeplessness:-- i had no difficulty in going to sleep, but usually awoke again at about two a.m. with palpitation, and it often took me two or three hours to go to sleep again. i cured myself in the following way: i left off supper and reduced my tea meal by half, and the result was continuous sleep; the symptoms, however, began to come back again after a time, so i gradually cut the tea meal right away, and half of the midday meal as well. the cure was then permanent and after a time i found that i could resume the tea meal again. at the present time i am having a tea meal of fruit only. in addition i should advise those who suffer from this complaint to keep cheerful, and to avoid excessive physical or mental fatigue and worry. yours faithfully, "a six months' reader." is pure lime juice obtainable? the editors have received the following letter from messrs rowntree & co., ltd.:-- "we note in your issue of july under the heading of 'lemon or orange squash' a note to the effect that bottled lemon squashes and lime cordials 'are not pure in the strict sense of the term, since they are bound to contain per cent. alcoholic pure spirit by government regulations.' we should be glad to know what is your authority for this statement. possibly it is a misprint, because obviously the government does not require anything of the kind. our own lemon squash and lime juice cordial are entirely free from any form of preservative, including alcohol. they are made up from pure lemon juice and lime juice respectively, with sugar, and contain no foreign ingredient." the statement complained of was based on an article entitled "fortified lime juice" which appeared in _the chemist and druggist_, th may (page ). on again referring to this article we find that the government regulation applies only to _exported_ lime juice. we regret having made this error, and are genuinely glad to have messrs rowntree's assurance that their own "lime juice cordial" and "lemon squash" are "entirely free from any form of preservative, including alcohol." nevertheless, we think our suspicions regarding the presence of preservatives in such articles are justifiable in view of the following authoritative statements made by _the chemist and druggist_ in the article referred to:-- "the british revenue authorities have drawn the line a little tighter in the discharge of their responsibility respecting the soundness of lime-juice intended for exportation or for use on board ship. the new rule henceforth is to grant a 'pass' certificate for unfortified lime-juice to last for fourteen days only, at the end of which time another certificate must be obtained. as this new regulation affects lime-juice in its natural condition before rum or any other spirit is added to it, only lime-juice manufacturers or importers are concerned in the matter.... _with such rapidly deteriorating liquid as lime or lemon juice the addition of the preservative spirit is a necessity, hence the sooner it is fortified the better._ the revenue authorities permit duty-free spirit to be used for this purpose, but in order that lime-juice manufacturers shall have this advantage of not paying duty on the spirit used the revenue authorities insist on approval of the juice and its subsequent fortification in bond under supervision of the crown.... in reference to the proportion of spirit used, previously the regulation was expressed in a permissive sense, but now the emphatic "must" is used. in the last government laboratory report it was stated that samples were examined, most of which were lime-juice, representing nearly , gallons. even the fortified article is re-tested if more than three months old in cask or two years old in bottle, and this re-testing resulted last year in a condemnation of several hundred gallons owing to deterioration during storage. this juice is principally for use in the mercantile marine to combat scurvy." from which it would appear that the use of _some_ kind of preservative is essential with such a rapidly deteriorating liquid as lime or lemon juice; and if not alcohol, there are innumerable chemical preservatives available. we wish we could rely on receiving assurances from other "lime juice" importers and manufacturers similar to that we have received from messrs rowntree. * * * * * _to people with strong convictions:_ a holiday is the best of all opportunities for appreciating the opposite point of view to our own: this is why everyone needs a day's holiday once a week. health queries. _under this heading our contributor, dr valentine knaggs, deals briefly month by month, and according as space permits, with questions of general interest to health seekers and others._ _in all queries relating to health difficulties it is essential that full details of the correspondent's customary diet should be clearly given._ _correspondents are earnestly requested to write on _one side only of the paper_, giving full name and address, not for publication, but as a guarantee of good faith. when an answer is required by post a stamped addressed envelope must be enclosed._--[eds.] faulty food combinations. h.e.h. writes.--i should like your opinion of the statement of the late mr a. broadbent, that fruit when taken with starchy food by dyspeptics delays digestion, and that the digestion of starchy foods and vegetables occupied only one-third of the time needed for the digestion of starch with fruit. i have lived on a strict vegetarian diet and observed the laws of hygiene for two and a half years, to rid myself of dyspepsia, with great success, having increased my weight by thirty-six pounds; for the last nine months of this time i have lived on a largely "unfired" diet, but am still troubled with acid risings and flatulence and cannot account for it. will you kindly enlighten me on the subject? i am a carpenter by trade and get eight hours in the open air every day. i take a tumbler of distilled water hot with the juice of one orange at a.m., breakfast at . a.m., dinner at noon and tea at p.m., all consisting of wallace unfermented bread and biscuits, various fruits (mostly apples, bananas and tomatoes) and nuts, about / oz. at a meal; also a little cheese, about oz. at a meal. the late mr a. broadbent was quite right, in my opinion, when he asserted that fruit taken with starchy foods delayed digestion. to reap the true benefit from fruit it must be taken alone. the dominant element in fruit is oxygen and the feature of oxygen is its power to start the process of oxidation in decomposing and disintegrating substances. it follows that when the stomach is filled with fermenting food-stuffs, or the tissues are clogged with the products derived from such, the oxidising action of fruit will be correspondingly intense. the naturist who applies the schroth cure for the purpose of curing chronic diseases uses fruit as his chief eliminating agent. the reader will remember that the peasant healer, schroth, made his patients take dry stale rolls alone for three whole days, with nothing whatever to drink, and on the fourth day, he gave them a full bottle of white wine, which then caused intense oxidation, with marked elimination of poisons. his methods, if successful, were drastic and weakening, and so the latter-day exponents of schrothism have modified this and give their patients zweiback or twice-baked bread instead of rolls, and on the third or fourth day make the patient partake freely of fresh fruit. this process of alternate dry days and fluid days is continued for some weeks until the cure is complete. i have merely referred to this matter to show the part played by fruit in the body. to a healthy person fruit is in truth a splendid regenerating food, but it should, whenever possible, be eaten alone. to a dyspeptic, fruit is often equally good, if _taken by itself_. the case of vegetables is different, and i hold with broadbent that salad or properly cooked vegetables do go well with cereals, because they contain, not oxygen and oxygen acids, but mineral elements like soda, lime and magnesia, which neutralise the acids and toxins which form in the body as a result of its work. the vegetable is just as active as the fruit as an eliminant, but it works on different lines. cereal foods, if eaten slowly in a dry condition are made alkaline by the saliva, so that the vegetables, which are also naturally alkaline, would harmonise well with cereals if eaten with them. our correspondent should modify his diet as follows, and then, i anticipate, he will cease to be troubled with his acid dyspepsia and flatulence. he should take his fruit alone, and take any of the crisp unsweetened wallace "p.r." biscuits in preference to the unfermented bread, which latter is often difficult to digest:-- _on rising._--a tumblerful of hot distilled water. _breakfast_ (at . ).--fresh fruit only. _lunch_ (at ).-- to oz. of cheese, preferably home-made curd cheese; salad of green leaf vegetables; "p.r." or ixion biscuits with fresh butter, or nut butter. _dinner_ (at ).-- to oz. of flaked pine kernels, finely grated raw roots or tomatoes, with pure olive oil; granose biscuits, or shredded wheat biscuits, and fresh butter. _at bedtime._--cupful of dandelion coffee or hot distilled water. neuritis. e.m.a. writes.--at the age of five years i had an attack of rheumatic fever through taking a severe cold, and have been troubled more or less with pains since that time, which i feel sure are caused through rheumatism of the nerves. i am now fifty-eight years of age and have been a vegetarian for six years. my diet is:-- a.m., cup of sanum tonic tea; a.m., cup of dried milk; a.m., half of an apple and a little crust of wholemeal bread; p.m. conservatively cooked vegetable, using "emprote" for sauce; p.m., cup of dried milk; p.m., a little green salad with st ivel lactic cheese (size of one large walnut); p.m., cup of dried milk. do you think dried milk is harmful to me? i should miss it very much were i to leave it off. i must mention how great a help _the healthy life_ magazine is to me in many ways. neuritis is a painful and wearying form of nerve trouble which mostly affects the arms and legs. it can, however, originate in any other part of the body through the spinal nerve centres. it may sometimes be due to injury, but the usual cause is some form of thickening or misplacement of the spinal structures, which induces pressure upon the nerves as they emerge through the apertures between the spinal bones. a careful examination of the back will show the site, and often the nature, of the thickening or encumbrance which is present. in our correspondent's case the thickening process doubtless occurred as an after effect of the attack of rheumatic fever. the best remedy is suitable osteopathic treatment for the spine, supplemented by _either very_ hot or _quite_ cold spinal sitz baths, by acetic acid skin treatment, or by any other means which will have the effect of disencumbering the spine. by means of our treatment we free the painful nerves from harmful pressure and promote an increased blood circulation in the parts affected. in this way the cause of the disorder is removed. a diet along the following lines would be better than the present one:-- a.m.--tumblerful of hot distilled water. . .--one raw egg beaten up with cream and vegetable juice or clear vegetable soup made without salt. wholemeal bread with plenty of butter and some celery or watercress. . p.m.--two conservatively cooked vegetables done without salt, with grated cheese as sauce and a granose biscuit with butter. .--tumblerful of hot distilled water only. . .-- oz. of cottage cheese or cream cheese, salad and granose biscuits, or "p.r." crackers, with butter. . .--a raw egg beaten up with cream and vegetable juice or soup. i think dried milk preparations are inadvisable in such cases as these (especially when taken as beverages, as the "milk sugars" present are very prone to ferment and to hinder the cleansing of the digestive tract), and that the required proteid is best obtained from eggs and curd cheese. fat is very necessary in nervous troubles; hence plenty of cream, fresh butter and cream cheese should be taken; also pure oil with the salad. malt extract. l.f.h. writes.--is malt extract a good thing to take daily with an ordinary non-flesh diet, two teaspoonfuls or so at breakfast? and is the desiccated or dry malt extract to be preferred to the ordinary sticky article? malt extract of good quality, containing an active form of diastase, is a good form of relish to take with meals. the diastase promotes starch digestion and makes a good addition to foods of the cereal order. the thick sticky form is the best because the diastase is then in an active condition. dried malt usually will have this diastase destroyed, hence, although much more convenient to handle, it is not so good dietetically as the sticky original extract. about sugar. c.t. writes.--i have read the article on sugar with considerable interest. i have noted nervous disorders, etc., manifest in cases of excessive consumption of manufactured sugar. i have been an abstainer from cane sugar (all commercial sugars, though _i do not know of any objection to milk, sugar_) for many years, regarding it as an unnatural excitant and stimulant as well as being inimical to digestion. as a physiologist i have taken immense interest in longevity, feeling that an active life past the age of ninety-five or a hundred, and upwards, carries with it, in evidence of right living, the force of demonstration, and more conclusively, in direct ratio to the advance of years. i firmly believe that all anomalies will ultimately admit of resolution. in this connection i could mention a number of strange and paradoxical cases for which, as yet, i have obtained no solution. i know of centenarians who began using "sugar" freely late in life. in one case, when past eighty, a new set of teeth (not odd "supernumeraries") appeared all round! how is it, again, that the natives of the west indies, when living on sugar (in its crude state, i suppose) have excellent teeth and perfect health? is not raw sugar better the less manufactured it is? on the other side, captain diamond, at , attributes his health in great measure to abstinence from sugar. most of these queries are answered in the completed book[ ] published this year. the point about "milk sugar" not being injurious he will find answered on page . [ ] _the truth about sugar_, s. net. (c.w. daniel, ltd.) "milk sugars" taken to excess with a mixed diet, or in the form of milk as a beverage, break down into lactic, butyric and other destructive acids under the influence of intestinal germs and thus do harm to the body. the natives of the west indies (page ) take the sugar cane in its natural state as a living vegetable food--a very different thing from the isolated and chemicalised sugar on our tables at home. moreover, the chewing required helps digestion. this is very different to the drinking rapidly of sugared beverages, which do not receive this necessary mouth preparation. one is quite prepared to admit that paradoxical cases do occur where sugar seems to agree well even with octogenarians, but they are, in my opinion, the exceptions, and i am constantly coming across cases where the free consumption of table sugars has proved very harmful to both old and young. ulceration of the stomach. a.l.m. writes.--our domestic servant, a girl aged twenty-four, is suffering from ulceration of the stomach and has had periodical attacks for the past six years. she has apparently, until she came to us, eaten and drunk very unwisely. she has been with us seven months and has been fed on a non-flesh diet since she came. for the last four weeks tea, coffee and cocoa have been forbidden, and as little sugar is consumed as possible. she had a very bad attack in august and we had to call in a doctor is we did not like the responsibility. he strongly recommended the hospital and an operation, which would ensure that there would be no repetition of the complaint. she decided to go and was there six weeks. after much experimenting there, inoculating and wondering whether it was tuberculosis, they operated and in due course she came back. we went to the sea for three weeks and shortly after our return the vomiting of blood and pains recommenced. after four days in bed she returned to light dishes, and a fortnight after another slighter attack came on, which in twenty-four hours. she takes hot boiled water five times a day. she suffers also from a horny skin on the palms of her hands, with deep cracks where the natural lines are. these periodically bleed. this skin exists also on her heels and the soles of her feet. before and after, an attack this skin seems to be worse than ever. i mentioned the fact of the recurring attacks since the operation to the doctor and he seemed surprised and said the matter must be constitutional and there was no hope for her. my own opinion is that pure food will put her right eventually, and that these attacks will recur in diminishing force until the poisons are eliminated front the system. her diet is at present as follows:-- _on rising._--half-pint of boiled water (hot). _breakfast._--either shredded wheat softened in hot milk or breakfast flakes and cold milk: followed by either bananas or apples. half-pint boiled water (hot). _lunch._--ordinary vegetarian cooked dishes, vegetables conservatively cooked, some fruit. half-pint boiled water (hot). _tea meal._--wholemeal bread (artox flour), usually non-yeast, nut butter. lettuces and radishes when obtainable. half-pint boiled water (hot). _before retiring._--half-pint of boiled water (hot). it has been shown by brandl and other investigators that ulceration of the stomach can always be produced in animals by feeding them with an excess of sugar foods. the same thing applies to human beings, who, if fed with an excess of sweetmeats, sugar, milk or soft mushy cereals, will first contract catarrh of the stomach, which will ultimately deepen into a condition of ulceration. the rationale of the process is this: fermentation and putrefaction of the foods eaten to excess produce in the stomach various acids and toxins. these become absorbed and pass into the liver. then the liver becomes clogged, its flow of blood is obstructed and this naturally retards the flow of food from the stomach. that organ becomes congested and inflamed and, when the lower end, or pylorus, is obstructed, this congested state may easily deepen into ulceration. we also nearly always find a tender spine, showing that the nervous system has equally participated in the conditions produced, and this nervous factor intensifies the trouble by retarding the due working of the digestive functions. what we have to do to cure a case of ulcerated stomach is _to withhold the foods which create fermentation_. then the liver will be allowed time to work off the poisons which are clogging its substance and when this has come about the stomach will slowly return to its normal condition. the diet which our correspondent cites is badly arranged. it is a mistake to give fluid _with_ the meals, and the mushy food at breakfast and the soft food at dinner should be changed to drier and crisper forms of nutriment. the following diet would be a distinct improvement:-- _on rising._--half-pint of boiled hot water, sipped slowly; or quarter-pint sanum tonic tea, taken hot. _breakfast._--a shredded wheat biscuit _eaten dry_ and well buttered; a lightly boiled egg and some finely grated raw roots, especially carrots and turnips. in a case of this sort it is best not to mix cereals with fruits. an alternative breakfast would consist of _fruit alone_ such as two apples, finely grated at first, or two bananas mashed and mixed with pure olive oil and sprinkled with flaked nuts but care must be taken that the pulped banana is well chewed. _lunch._--grated cheese, or cream cheese, with some finely chopped salad, or grated raw roots, or conservatively cooked vegetables (preferably roots or onions baked fairly dry by the casserole method) can be taken at this repast. follow with a slice or two of cold ordinary toast or rusks with butter. _tea meal._--half-pint of hot boiled water with a little lemon or orange juice added to it for flavouring. _supper_ (about . ).--stale standard bread with butter and curd cheese or an egg. the non-yeast bread should be avoided as in the weak state of the stomach it will not be properly digested; besides, the bran may irritate the lining in the present condition of the stomach. as soon as the stomach has regained its power of digesting food, and the ulcers have healed, then fine wholemeal biscuits of the wallace or ixion kind can be taken, but the unfermented bread had better be avoided. _at bedtime._--a half-pint of hot water. going to extremes in the unfired diet. w.o.c. writes.--as a bachelor who (not believing in, and therefore doing without domestic help) is anxious to reduce time spent on cooking to a minimum, i shall be glad if dr knaggs will tell me whether the use of the oven, pan and kettle are necessary to healthy diet. for instance ( ) would a diet of bread and butter, biscuits, cheese, fruit (fresh and dried), ordinary cold water and cold milk, be as healthy as a diet of hot vegetables, puddings, cocoashell, etc.? ( ) are cooked lentils, butter-beans, macaroni, etc., more beneficial taken hot than after they have cooled? ( ) could uncooked vegetables _of sufficient nutriment_ be substituted for these? i shall be glad if it is quite safe to live entirely on raw foods, whether fresh or "prepared." the use of the oven, pan and kettle is not essential to a healthy diet, but few people in this changeable, and often cold, depressing climate are willing to forgo their occasional use. one cannot get hot water for a drink without a kettle or a small saucepan and a gas ring, and hot water is often a very comforting and useful drink, especially where an effort is being made to break off the tea and coffee habit. a diet of bread and butter, biscuits, cheese, fresh and dried fruits is excellent, provided our correspondent also includes grated raw roots and salads as the medicinal part of the regimen, and keeps the fresh fruit to itself as one meal of the day. cold water or cold milk could also be taken in the place of hot water or hot milk, although i deprecate the use of milk as a beverage unless a person is willing to live entirely on milk like a baby does. the hot vegetables are uncalled for, provided the raw vegetables are substituted for them. the puddings can well be discarded. cocoashell beverages are useful in very many cases. beans or lentils can be eaten sparingly in a raw state if first soaked, then flaked in a dana machine, and afterwards flavoured with herbs or parsley. i certainly think that, if they _are_ to be cooked, the taste is better if eaten hot; but there is no reason why cold cooked lentils should not be eaten any more than is the case with an other form of cooked food. uncooked vegetables will not take the place of lentils, because they are of a different order of food-stuff. the uncooked vegetable would go well with the lentils as neutralising agents of the acids into which all nitrogenous foods break down in the body. most people will find that nuts, cheese and eggs are better sources of proteid than lentils or other "pulse foods." h. valentine knaggs. the healthy life the independent health magazine. amen corner london e.c. vol. v october no. . _there will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--claude bernard. an indication. just as there is a pride that apes humility, so there is an egotism that apes selfishness, a cowardice that apes stoicism and an indolence that apes effort. this is especially apparent in matters pertaining to health. how often, on the plea of not causing worry or expense to others, does a man or woman not put off taking necessary rest, or consulting a doctor, until a slight ailment that once would have yielded to treatment becomes an irreparable injury. such conduct is often admired as unselfish, but for unselfishness and stoicism a psychologist would read fear, indolence and egotism. fear of being thought hypochondriacal and fear of facing facts; shrinking from the exertion involved in the effort to become healthy and from the pain involved in witnessing the possible distress and anxiety of friends should the complaint prove serious--regardless of the fact that its neglect and resultant incurability would cause infinitely more distress; above all, that mental egotism which breeds in its victim an unreadiness to acknowledge that he does not _know_ what may be wrong and to take prompt steps to remedy his ignorance. it is not fair, of course, to attach too much blame to the patient. such faults as those cited above are in themselves symptoms of nervous disease. body and mind act and react upon one another. nevertheless, the practice of the virtues loses its meaning when there is no pull in the opposite direction.--[eds.] imagination in insurance. _regular readers will recognise in this article a continuation of the series previously entitled "healthy brains." the author of "the children all day long" is an intimate disciple of one of the greatest living psychologists, and she has a message of the first importance to all who realise that true health depends as much on poise of mind as on physical fitness._ it is an unpleasant subject, but have you ever faced the fact that your widow might be left in poverty? we all know the phrases that come so glibly from the lips of the insurance agent. perhaps the very fact that it pays companies to spend thousands a year on the salaries of agents, and other thousands on broadcast eye-catching advertisements, shows that there are many things which our imagination only accepts "against the grain." fire, storm, loss by theft or burglary, sickness, disablement and death we do not, by choice, dwell on these things in thought. now some people are inclined to pet this impulse of turning away. "do not think dark thoughts," they tell us, "the best insurance is unconsciousness, insouciance, denial. misfortune will pass you by if you do not look for it." perhaps there is something to be said for this method when it comes with absolute spontaneity from the innermost nature. but if for the radiant apprehension of beauty and health we substitute an effort to cling to the picture of good when our very bodies and nerves are warning us with suggestions of evil, we run grave risks. by adopting someone else's sense of freedom from danger and repressing our own conviction that for us a certain danger, more or less remote, exists, we are putting great pressure upon ourselves. at times of ill-health or accidental worry, a sleepless night may bring us an agonising succession of imaginative pictures, those very pictures which we have attempted to banish from our daily life. if we have still greater power of repression these grim images, forbidden throughout every moment of waking life, may reappear in dreams. (of the still more serious dangers of repression and of its relation to various forms of insanity, this is hardly the place to speak.[ ] it ought not to be necessary to appeal to alarming instances in order to make us attend to a suggested warning.) [ ] see bernard hart's illuminating treatment of the whole subject in _the psychology of insanity_, cambridge manuals of science. now if we decide to regard all fear as a suggestion of precaution, the emotional part of it to be laid aside as soon as it has fulfilled its function of arousing interest and directing action, it is easy to see the psychological justification for insurance. of course pecuniary insurance is but one instance of such sequences of action, though it happens to be a rather obvious one. in a different field, most of us know the delightful feeling of relief experienced after consulting a doctor about some symptom that has perhaps been troubling us for a long time. "may i safely do this? ought i to refrain from that?" and such perpetually recurring irritations to the attention are replaced by the knowledge that it is now the doctor's business to decide whether this or that is "serious," and that as long as we carry out his orders we may lay aside all worry about the matter. so in the case of fire insurance, what we are really buying with our annual premium is freedom from haunting questions as to the loss that would ensue if our house or shop or office were burnt down or damaged. whenever the thought comes, it may, as far as the money loss is concerned, be dismissed. we see then that instead of keeping the suggestion of such misfortunes before us, as some people might allege, the act of insurance substitutes for vague and recurrent fears a formal and periodical recognition of possibilities, a recognition, too, that contains within itself a precaution against some of the results of the misfortune should it ever occur. what we buy, at the cost of a fixed number of pounds or shillings of money and a few minutes of time once a year, is the right to put the dangers out of our consciousness altogether and yet leave no residuum of repressed fear to split up our personality or give us indigestion. if we choose, for some reason or other, to let our imagination dwell on the objective side of the possibility we have insured against, we shall find a pleasure in thinking of what can be done by many people working together. if we need help to meet some misfortune, it is ours as a right, not doled out to us through others' pity. and every year that we have made no claim we have the delight of knowing that we are helping those who need. the art of working together is yet in its infancy. but if even the present standard of method devised for money insurance were to be adopted in the deeper matters which we so often allow to trouble us, what an advance in mental development we should have made and what new possibilities of safe action would be opened up! e.m. cobham. * * * * * every youth should learn to do something finely and thoroughly with his hands.--_ruskin._ the scientific basis of vegetalism. this article has been translated from the french of prof. h. labbe, the head of the _laboratoire a la faculte de medecine_, in paris. it reflects a rather characteristic aloofness to any considerations other than scientific or economic. but it will well repay careful study.--[eds.] i vegetarianism has been the object of many attacks, and has also been warmly defended. most of its adepts have sought to give the value of a dogma to its practice. for quite a number of people "vegetarianism" is a kind of religion, requiring of its votaries a sort of baptism, and the sacrifice of many pleasures. it is this which justifies the infatuation of some, and the systematic disparagement of others. "vegetalism"[ ] cannot pretend to play a similar part, or to lend itself to ambiguity. to be a "vegetalist" is to choose in the vegetable kingdom, with a justified preference, foods susceptible of filling the energy-producing needs, and the needs of the reparation of the human system. "vegetalism" is a chapter of dietetic physiology which must utilise the precise methods and recent discoveries of the science of nutrition. [ ] the word "vegetarianism" implies a judgment of the qualities which such a diet entails. this word is derived, in fact, from the latin adjective "vegetus" (strong). the word "vegetalism," which we oppose to the preceding one, admits only the establishing of a fact, that of the choice--exclusive or preferred--of the nutritious matters in the vegetable kingdom. ii before putting "vegetalism" into practice the first point is to know whether the foods of "vegetal" origin contain, and are susceptible of producing regularly, the divers nutritive principles indispensable to the organisation of an alimentary diet. the principles are the following:--proteid or albuminoid substances; hydrocarbonated and sweet substances fatty substances; mineral matters, alkalis, lime, magnesia, phosphates and chlorides, etc. in most compound foods, no matter of what origin, mineral materials almost always exist in sufficient quantities. the most important amongst them, at all events, are found combined in liberal, even superabundant, portions in dishes of vegetal origin. the analysis of the ashes of our most common table vegetables fixes us immediately to this subject: leguminous plants supply from about three to six per cent. of ashes, rich in alkalis, lime and phosphates. potatoes, green vegetables and fruit as a whole absorbing considerable quantities of mineral elements. these are the elements of a nature to allow a precise reply to this question which we propose to expound briefly. iii in order to examine a food thoroughly, for the purpose of ascertaining if it can be advantageously introduced for consumption, whether albumins, fats, hydrate of carbon, or sugar, etc., or again an association of these principles in a composite article of food are in question, divers researches must be carried out before giving a final judgment. if a more or less complex article of food is in question, before considering it as a good nutriment, its centesimal composition, or its immediate composition, should be established; its theoretic calorific power should be known, and it should be measured if this has not yet been done. besides the calorific yield thus estimated _in vitro_, the real utilisation in the human organism of articles of food alone or mixed with other foods should be determined, taking simultaneously into account their effects, whether tonic, stimulating or depressing. from a different point of view it is no longer allowable to neglect before judging whether such and such a nutritive substance is advantageous, the valuation of what we have called, with prof. landouzy, the economic yield--that is to say, the price of the energy, provided by the unity of weight of the article of food. it is only in reviewing "vegetal" substances, taking these divers titles into consideration, that we shall be justified in attributing to the practice of "vegetalism," integral or mitigated, its definite value. iv only a few years ago, when schutzenberger, emulator and forerunner of fischer, armand gautier, kossel, first disjointed the albuminoid molecule, to examine one by one its divers parts, the composition of the various albumins was very little known. whether, therefore, albumins of the blood, or those of meat or eggs, were in question, these bodies were hardly ever separated, except through physical circumstances, amongst others by constant quantities of different coagulation. as to the centesimal formula and the intimate structure of the different protoid substances, they could be considered as closely brought together. from this fact, the physiological problem of the utilisation of albumin was simpler. no matter which article of food contained this albumin, its nutritive power by unity of weight remained the same. at the present time the number of albumins is no longer limited. it is not now physical characteristics founded difficult separations which arbitrarily distinguish those bodies from each other. the individuality of each of the albumins results from its formula of deterioration, under the influence of digestive ferments, or of chemical bodies acting in a similar way, as do mineral acids and alkalis. for want of constituary formula this methodical deterioration makes known the number of molecules (acids or other bodies) which are responsible for the structure of each albumin. these deleterious formula of proteid matter are not less suggestive than composition ones. they reveal notable differences between "vegetal" and animal albumins. to be sure, animal albumins (beef, veal, mutton, pork, etc.) which we are offered in an alimentary flesh diet, resemble more nearly the structure of our own bodily albumins than do the gluten of bread or the albumin of vegetables. this fact seems actually the best support of the theory which affirms the superiority of the flesh over the vegetable diet. such a remark is therefore well worth discussing by showing that the consequences which can be deduced from it are paradoxical, and rest upon hypothesis which, not very acceptable in theory, are hardly verified in practice. admitting that albumin plays in alimentary diet only the plastic part of reconstruction of used-up corporal matter, it might be advantageous to ingest but one albumin the composition of which is very similar to our own. by virtue of the law of least effort such a one in equal weights ought to be of more service than a foreign albumin, as it requires less organic work. for man, albumin of animal origin ought to be more profitable in equal weight than vegetable albumin. in the organism, indeed, albumin passes through a double labour. after the intestinal deterioration, followed by a passage through the digestive mucus membrane, a re-welding of the liberated acids takes place, with a formation of new albumin. if, therefore, alimentary albumin's mission is, not to be definitely burnt up in the organism, but to help in the plastication of the individual, the more its initial formula approaches the definite one to which it must attain, the more profitable it becomes, giving out less useless fragments and waste. animal albumin approaching more nearly to human albumin, is also the one whose introduction into the daily alimentary diet is most rational. this statement seems to be the defeat of vegetal albumin. but let there be no mistake. it consecrates at the same time the triumph of anthropophagy, for there could not be for man a more profitable albumin than his own, or that of his fellow-man! this should make us pause and reflect, before allowing this deduction to be accepted. besides, these arguments _ad hominem_ do not appear to us necessary for repelling such an interpretation of facts. modern works have shown us that the greater proportion of ingested albumin played, in fact, a calorific, and not a plastic, part. under these conditions one is justified in doubting whether there takes place with regard to the total albumins ingested a work of reconstruction thus complicated in the organism, after their first deterioration. evidently one may come to believe that this complicated labour applies only to the more or less feeble portion of albumin really integrated. practically speaking, the best criterion for judging the utilisation of an ingested albumin lies in the persistence of the corporal weight, allied to the ascertained fact of a stable equilibrium in the total azotized balance-sheet which is provided by the comparison of the "ingesta" with the "excreta." from this point of view there exists the closest similitude between the albumins of animal and those of vegetable origin; both, in fact, are capable of assuring good health and corporal and cellular equilibrium. however, the digestibility of vegetable albumins seems to remain slightly inferior to that of animal albumins. per cent. of the animal fibrine given in a meal are digested, where to per cent. only of vegetable albumins are absorbed and utilised. it is a small difference, but not one to be overlooked. we must say, however, that the method one employs in determining these digestibilities takes from them a part of their value, and renders difficult the comparison of results obtained. sensibly pure albumins are too often compared in an artificial diet. one deviates thus from the conditions of practical physiology. in fact, in ordinary meals, all varieties of foods are mixed together, acting and reacting upon each other, reciprocally modifying their digestibility. if one conforms to this way of acting towards alimentary albumins, the results change sensibly. in the presence of an excess of starch, under the shape of bread, for example, vegetable albumin seems to be absorbed in about the same proportions as animal albumin. if, in a flesh diet, animal albumins are always consumed nearly pure (lean meat containing hardly anything but albumin, besides a little fat, and an inferior quantity of glycogen) vegetable albumin is always, on the contrary, mixed with a number of other substances. this is doubtless one of the reasons which causes the digestibility of vegetable albumins to vary, the foreign nutritive matters being able to bring about, under certain circumstances, and in cases of superabundant ingestions, a real albuminous "saving" in the newest sense of the word. besides, a prejudicial question makes the debate almost vain. when it was admitted by such physiologists as voit, rubner and their school that from to grammes of albumin in the minimum were daily necessaries in the human diet, a variation of a few units in the digestive power presented some importance. nowadays the real utility of albumins is differently appreciated. the need of them seems to have been singularly exaggerated; first lowered to about gr. by a. gautier, it has dropped successively with lapicque, chittenden, landergreen, morchoisne and labbe, by virtue of considerations both ethnological and physiological, to grs., grs. and even to or grammes. the "nutritive relation"--that is to say, the yield from albuminoid matters to the total nutritive matters of diet--is thus brought down from / its primitive value to / or / at most. it follows that the slight inferiority found in the digestive powers of vegetable albumin appears unimportant. it is sufficient to add or more grammes of albumin to a ration already superabundant of from to grammes of vegetable proteins to bring back a complete equilibrium in the use of vegetable and animal varieties. the theoretical inferiority of vegetable albumin thus almost completely disappears. h. labbe. (_to be continued._) * * * * * if your system has become clogged, go slow--and fast. ode to the west wind. o wild west wind, thou breath of autumn's being, thou from whose unseen presence the leaves dead are driven like ghosts from an enchanter fleeing, yellow, and black, and pale, and hectic red, pestilence-stricken multitudes! o thou who chariotest to their dark wintry bed the winged seeds, where they lie cold and low, each like a corpse within its grave, until thine azure sister of the spring shall blow her clarion o'er the dreaming earth, and fill (driving sweet buds like flocks to feed in air) with living hues and odours plain and hill wild spirit which art moving everywhere; destroyer and preserver; hear, oh hear! thou on whose stream, 'mid the steep sky's commotion, loose clouds like earth's decaying leaves are shed, shook from the tangled boughs of heaven and ocean, angels of rain and lightning! there are spread on the blue surface of thine airy surge, like the bright hair uplifted from the head of some fierce maenad, even from the dim verge of the horizon to the zenith's height, the locks of the approaching storm. thou dirge of the dying year, to which this closing night will be the dome of a vast sepulchre, vaulted with all thy congregated might of vapours, from whose solid atmosphere black rain, and fire, and hail, will burst: oh hear! thou who didst waken from his summer dreams the blue mediterranean, where he lay, lulled by the coil of his crystalline streams, beside a pumice isle in baiae's bay, and saw in sleep old palaces and towers quivering within the wave's intenser day, all overgrown with azure moss, and flowers so sweet the sense faints picturing them! thou for whose path the atlantic's level powers cleave themselves into chasms, while far below the sea-blooms and the oozy woods which wear the sapless foliage of the ocean know thy voice, and suddenly grow grey with fear, and tremble and despoil themselves: oh, hear! if i were a dead leaf thou mightest bear; if i were a swift cloud to fly with thee; a wave to pant beneath thy power, and share the impulse of thy strength, only less free than thou, o uncontrollable! if even i were as in my boyhood, and could be the comrade of thy wanderings over heaven, as then, when to outstrip thy skiey speed scarce seemed a vision,--i would ne'er have striven as thus with thee in prayer in my sore need. oh lift me as a wave, a leaf, a cloud! i fall upon the thorns of life! i bleed! a heavy weight of hours has chained and bowed one too like thee--tameless, and swift, and proud. make me thy lyre, even as the forest is: what if my leaves are falling like its own? the tumult of thy mighty harmonies will take from both a deep autumnal tone, sweet though in sadness. be thou, spirit fierce, my spirit! be thou me, impetuous one! drive my dead thoughts over the universe, like withered leaves, to quicken a new birth; and, by the incantation of this verse, scatter, as from an unextinguished hearth ashes and sparks, my words among mankind! be through my lips to unawakened earth the trumpet of a prophecy! o wind, if winter comes, can spring be far behind? percy bysshe shelley. what makes a holiday? what is it makes a holiday? some people want paris, some monte carlo, one man cannot be satisfied without big game to hunt, another must have a grouse moor. the student has his sailing boat, the young wage-earner his bicycle, three girl friends look forward to their week in a hastings boarding-house. almost anything may be "a change"; most things, to someone or other, are "a holiday." what does it all mean? the sands of west sussex are wide and free, firm and smooth for walking with bare feet, lovely with little shells and sea-worm curves and ripple marks and the pits of razor-shells. above them are the slopes of shingle, gleaming with all colours in the september sun. farther up again, the low, brown crumbling cliffs crowned with green wreaths of tamarisk. the sea comes creeping up, or else the wind raises great white breakers; if the waves are quiet, old breakwaters, long ago broken themselves, smashed fragments here and there of concrete protections put by man, gaps in the cliff and changes in the coast-line, remind us of the vast force behind the gentle and persistent lap of water. the beach itself reminds us of it; there a flint and here a rounded pebble made out of brick or glass, worn down from man's rubbish to sea's proof of power. over it all are the children, brown-legged and bare-headed. (is it something in the weather this year that has given us the particular red-brown, suggestive of shrimp and lobster, that is the colour-vintage of ?) babies with oilskin waders, bathers, girls in vividly coloured coats walking along the sands; all make up the picture and give us once again the thrill of holiday. inland, the sussex lanes are green and the trees are broad and shady. thatched cottages are everywhere, and barns with heavy brows; yesterday i saw some pots put for shelter from the sun under the far-projecting thatch of a farmhouse. the gardens are full of sun-flowers and hollyhocks, fuchsia and golden rod; the walls are covered with jasmine and passion-flowers. old, old churches make us feel like day-flies. the yew in the churchyard five minutes' walk from here is said to be years old; the church itself is thirteenth century, but into its walls were built fragments of a former church, far older, on the same site. it carries us more than half-way back to the foundation of christianity. dim tales of heathen earls and norman kings hang around the villages, and the very floor of the sea beyond the land is richly laden with stores of half-forgotten memories. which of all these things makes these days my holiday? all of them, perhaps. present moving life, and long-past history, the mighty movement of nature and the changes of geologic time: sheer beauty too and the gaiety of amusements and excursions; do not all have their place in unwinding us from the tight coils we make for our working days? freedom to take from the world whatever is there of beauty and of interest--it really hardly matters what or where; freedom enhanced by sympathy, perhaps, for we seem to need some comrade in our play; so many days and nights following each other--no matter exactly how many--for letting ourselves go, and letting the world and all its power and wonder flow into us; that, whatever be place, time and conditions, is the making of a holiday. c +--------------------------------------------------------------+ | | | #to our readers.# | | | | readers who appreciate the independence and all-round nature | | of _the healthy life_ can materially assist the extension of | | its circulation by tactfully urging their local newsagent to | | have the magazine regularly displayed for sale. an | | attractive monthly poster can always be had free from the | | publishers, tudor street, london, e.c. | | | +--------------------------------------------------------------+ healthy life abroad. "hygie." _a new definition of neurasthenia._ we cull the following definition of neurasthenia from our french contemporary: neurasthenia is discouragement of the soul. being in a state of discouragement the soul ceases to take care of the body and allows it to become encumbered with waste products. the body in its turn becomes so defective that the soul is incapable of repairing the enfeebled organs and throws the body away into the water or leaves it somewhere to be crushed or abandons it by some other means. neurasthenia may be compared to an indolent mechanic. he neglects to oil his engine. it runs off the rails and is smashed. _fresh departures._ the vegetarian society of france has introduced three new sections into its organisation. the first is documentary, and aims at the collection, centralisation and classification of all information bearing on food reform. the second deals with domestic economy and hygiene. a number of ladies willing to devote themselves to the popularisation of the leading ideas of vegetarianism have joined this section. they offer advice and instruction to all who wish to familiarise themselves with food reform principles. the third section is concerned with physical training and outdoor games, with special reference to the relationship between these things and a non-flesh regimen. "vegetarische warte." _nietzsche as fruitarian._ "a simple life," wrote nietzsche in , "is very difficult at the present time," and went on to explain its difficulties and to suggest that even the most determined would be obliged to leave the discovery of the way to a wiser generation. he himself, however, took some steps upon the way during his stay in genoa, when he lived on bread and fruit and spent but a few shillings a week. eggs were occasionally included, and artichokes--and the little cookery he needed was done by himself over a spirit lamp. his winter in genoa, he declares, was the happiest in his life and saw the production of his "twilight of the gods." _food reform in russia._ the movement goes ahead rapidly in russia. hardly a town of any size but has now its vegetarian restaurant. this year the first russian vegetarian congress has been held. it seems to have been a very successful gathering. "seldom," writes one who was present, "have i experienced such a strong impression as was made upon me by this first vegetarian congress in moscow." unity seems to have been the prevailing note. papers were read on the general significance and the various aspects of vegetarianism, followed by discussions. amongst the various excursions undertaken was a pilgrimage to yasnaya polyana, including a visit to tolstoy's grave. a vegetarian exhibition has also been held in moscow. it included a fine show of fruits and vegetables, exhibits of various substitutes for leather, soaps made of vegetable oils, an abundance of russian and foreign vegetarian literature of all sorts, from the noblest reaches of theory to the most invaluable details of practice. the next congress is arranged for easter , at kiev. _a hopeful sign._ fifteen years ago the berlin municipal authorities stoutly refused professor baron's offer to found an orphanage which should be conducted on vegetarian principles. at the present moment it is being arranged that all school children shall be taught the value of vegetables and leguminous preparations and the wholesomeness of a diet that is relatively non-stimulating and practically meatless. d.m. richardson. the curtained doorways. in george macdonald's _phantastes: a faery romance for men and women_ it is told how a man found himself in the midst of a great circular hall built entirely of black marble. on every side and at regular intervals there were archways, all heavily curtained. hearing a faint sound of music proceeding from one of these hidden doorways he went towards it and, drawing aside the hangings, found a large room crowded with statuary, but no sign of an living creature. yet he was certain the music had proceeded from that particular archway. greatly puzzled, he let the curtain fall and stepped back a few paces. at once the music continued. stepping stealthily and quickly to the curtain, he again lifted it, and received a vivid impression of a crowd of dancing forms suddenly arrested: something told him beyond dispute that at the moment he had drawn the hangings aside what were now lovely but motionless statues had sprung each to its pedestal out of the mazes of an intricate dance. sound and movement had been frozen, in a flash of time, into a crowd of beautiful forms--in stone. no statue but seemed to tremble into immobility as the intruder's gaze turned this way and that no marble face but seemed to be aglow with the music that had died with his entry; no white limb but seemed to be tremulous with the rhythm of the dance that had ceased so suddenly. if the subtlety and imaginative truth of this story should lead you to read the whole book, i shall have had the privilege of introducing you to what is surely one of the finest and most delicately wrought fantasies in the english language, a fantasy so permeated with beauty and truth that you will neither wish nor need to look for the "moral". but whether you read _phantastes_ or not, i may be allowed to suggest that the incident i have attempted to describe conveys one of the secrets of healthy living. it is a trite saying, that health is harmony. but i plead for a much wider and fuller interpretation of harmony than is customary. _mens sana in corpore sano_--a sane mind in a healthy body--does not fill all the requirements of a healthy life. it is but an excellent theme, wanting orchestration. it is good to aim at a harmonious working of one's internal arrangements if one has had the misfortune or the folly to break that harmony. the physical basis of life must be attended to if we would be well. only, you cannot stop there without imperilling the whole scheme. again, it is good to train the body by means of exercise, play, singing and handicraft; all these things react both upwards and downwards, outwards and inwards. for example, one of the special virtues of tennis, if it be played at all keenly, is the necessity for making one's feet (those neglected members!) quick and responsive to the messages of eye and brain. in an increasingly sedentary age the rapidly growing popularity of tennis is, for this one reason alone, a good omen. but if you play tennis, or any other healthy outdoor sport, or learn how to sing, or how to breathe, or if you do muller's exercises daily, for the sole purpose of benefiting your liver or developing your muscles, or of "keeping fit," you will miss the real prize. it is good, also, to train the mind to be logical, critical and balanced: it is good to cultivate a retentive memory and to store up useful facts. but if while you are aiming at intellectual fitness and alertness you allow these good things to obscure other and better things, if, in short, you let means become ends, you will never be healthy, because you will miss half the joys of living. there are many very skilful performers on musical instruments. they have set themselves, or their parents have set them, to gain certain prizes, distinctions or qualifications. no music is now too difficult for them to execute. but that is exactly what they do--they execute it: destroy its head and heart by sheer mechanical perfection. they have mastered the piano, or the organ, or the violin, or their own voice; but music eludes them. you see why i began with that tale of the curtained doors, the mysterious music, and the quivering statuary. there is an elusive, haunting quality about life and all living things which, if we look for it and listen to it, imparts a glamour, a rhythm, a beauty to everything that is worth doing. the great danger is that in the pressure of work, the hurry of play, the pursuit of health, or the training of the mind we miss the very thing which can give meaning and value to all these things. the severely matter-of-fact people don't go near the curtained doors, and if they did, would discover only a lot of cold, lifeless statues. whoever heard of statues dancing? whoever heard of music without instruments? and yet this very sense of a lyrical movement imperfectly seen, and of a temporarily frozen music, is not only the very secret of all art: it is a slender guiding clue to the centre of everything.... and in the house of every man, and of every woman, are the curtained doorways. edgar j. saxon. how much should we eat? _this discussion arose out of the article with above title, by "m.d.," which was published in our july number._--[eds.] iii i lift my hat to m.d. and trust that, as i don't know him, the somewhat jarring difference that i have with his views will not be put down to personal feeling. a.a. voysey has put my first objection quite well from the layman's point of view. he says "there is no agreement between those who have been taught physiology." this is true. playfair's full diet is different from voit's. voit's is different from atwater's. atwater's is different from chittenden's. the custom of reducing the diets to calories, inasmuch as it introduces a false theory, has had a disastrous effect on progress, and has been a great hindrance to the attainment of knowledge. if the coal in the fireplace _were_ the cause of the heat of the fire (but is it?), there is no analogy between the elevation of the heat by hundreds and even thousands of degrees when the fire is lighted, and the elevation of half-a-degree or a degree which occurs when food is taken into the body, especially when we remember that a similar elevation of temperature occurs when work is performed by means of the body without eating or drinking at all. it is quite evident to every clear seer, or it ought to be, that the force of animal life or zoo-dynamic is the cause of the heat of the body, just as the electric force is the cause of the liberation of heat through the battery, and the chemic force is the cause of the heat of the fire, and that zoo-dynamic and electro-dynamic and chemico-dynamic are forms or species or varieties of the one omnipotent and eternal energy by which all things in this universe consist. the aggregate of all the particular forces makes up the eternal energy which is one. they are all species of the one, but it is convenient and even necessary for our limited intellects to consider them separately, for the indefinite number of the facts and also their intricacy and complexity stagger and overwhelm us unless we do; and indeed they stagger us even when we try to treat them and take them up separately for consideration and examination. but now for the proof of a.a. voysey's statement. ranke found he required grammes proteid; fat grammes; carbo-hydrate grammes to keep him going. these he could have got from oz. of lean meat or grammes, oz. of bread or grammes, oz. or grammes of butter and oz of fat (i do not, of course, suggest that it would have been wise for him to get them so). moleschott's demands are: proteid grammes, fat grammes, carbo-hydrate grammes. voit demands for hard work: proteid grammes, fat grammes, carbo-hydrate grammes. atwater demands for hard work the following:--proteid grammes, fat grammes, carbo-hydrate grammes. horace fletcher, we are told by professor chittenden, took for a time, when everything was accurately measured and weighed: proteid . grammes, fat grammes, carbo-hydrate grammes. cornaro lived on oz. of solid food and oz. of red wine a day for a period of something like years, from years of age to about , and had vigorous health during the time except when he transgressed his rule. of course, he was not a hard physical worker--_i.e._ he did not do the work of a navvy. but how, in view of these differences, can m.d. say: "these quantities were settled by physiologists many years ago, and no good reasons have since been adduced for altering them"? it is amazing to me to read such a statement. it reminds me of a statement by a distinguished physician in london during last year to the effect that we could not give a growing schoolboy too much food--we could not over-feed him. my opinion, on the other hand, after a long experience, during which time my eyes have not been shut, is that the large majority of the diseases of humanity are due to mal-nutrition and that the form of that mal-nutrition is over-feeding--not under-feeding. this opinion should be taken for what it is worth. but to test it we should ask ourselves: what is the reason for the necessity to take food into the body? is it to give strength and heat to the body? or is it to restore the waste of the body sustained by the action on it of the force of life or zoo-dynamic which inhabits it? the demands for food will vary and vary much according to the way in which we answer this question. as you allowed me to discuss this question in _healthy life_ in july and august of last year i must not take up your space by discussing it again. but the answer we give determines the amounts of food that we require to take, since, obviously, if the strength and heat of the body depend upon the food, the more food we take the more strength and heat shall we have; while, if the function of food in the adult or grown body is only to restore the waste of the body, the question is how much is the waste. there are various ways in which this question can be answered and i cannot go into them now; but i say, in my opinion, the waste is very much less than is commonly supposed. the body, i take it, is made by zoo-dynamic or the life-force to be a fit habitation for itself. the body must waste when the life-force acts through it, and that waste must be restored by food and sleep, or the body will die; since things (the body) cannot act as the medium of conveying forces (zoo-dynamic or the life-force) without wasting under their action. but so beautifully has the body been made by zoo-dynamic that it wastes very little, much less than is commonly supposed, by the action of zoo-dynamic through it. not seeing this, we ingest into the body far more than is required to restore its waste, and so we fall ill, for, obviously, if we ingest more than the quantity necessary for this purpose we choke the body up and render it inefficient for its purpose as an instrument for work. now this is precisely what seems to me to happen in life. as we are all under the double delusion that the strength of the body and its heat come from the food, we all with one accord put far too much food into the body, and when we find that we die, all of us, generation after generation, at from to years of age, we make up little proverbs to justify our unphysiological conduct and say that three score years and ten are the measure of the duration of life. m.d. says that "some twenty years ago most people lived fairly close to the old physiological quantities" (but what are these? for we have seen how they vary), "now they have been cut adrift from these and are floundering out of their depth." may i remind m.d. that people are now living longer than they did twenty years ago. how does he account for that? no doubt some of the increase in the length of life is due to the diminution of the birth rate, but still i suppose m.d. would admit that there is an increase in the duration of life over and above what can be accounted for in this way. if so, how does he account for it? m.d. says, further: "for the public it will now probably suffice if they insist on raising (or considering, a.r.) the question of quantity" (of food, a.r.) "wherever they suffer in any way." i agree with all my heart. but m.d. implies, if i read him aright, that the public should increase the quantity of their food when they suffer in any way. i, on the other hand, and rather unhappily for myself, am convinced that the raising of this question implies that it should be answered in the exact opposite way to that of m.d. and that we should diminish our food if we "suffer in any way." and i can point to nature's own plan as a corroboration of the truth of my view, for her plan when we suffer in any way is to fling us into bed and take away our appetite, or at least to diminish our appetite if we are not so ill as to require to remain in bed. the whole question of medical practice depends on the answer we give to this question, and therefore one might go on indefinitely with its discussion. neither the editors' space and patience nor my time allow of this; but i should like to ask m.d., with all respect, if he remembers what dr king chambers said of the starvation that comes of over-repletion? dr king chambers occupied one of the most prominent places as a consultant in london (very probably, i suppose) when m.d. was a very young man. my late lamented friend, dr dewey of meadville, pennsylvania, used the phrase "starvation from over-feeding," not knowing that dr king chambers had used practically the same expression before him. that i made the same discovery myself, and independently, is not, i take it, a sign of acuteness of intellect or of observation. the amazing thing is that every practitioner is not compelled to make the same discovery. but if it is a true discovery, then it follows that all the signs of lowered vitality referred to by m.d., while they _may_ be caused by under-feeding, may also be caused by over-feeding and may therefore require for proper treatment, not increase of the diet, but diminution of it. a low temperature, therefore, a slow pulse, languor, pallor, inanition, fatigue, good-for-nothingness, inefficiency, anorexia, anaemia, neurasthenia, etc., etc., may all be due to blocking of the body with too much food as well as to supplying it with too little. fires may be put out by heaping up too much coal on them. to make them burn briskly we ought to push the poker in and gently lift the coal so as to admit of the entrance of air. then in a while our fire will become brisk and bright. and so it may be in the body. nay, my opinion is that almost always these marks of depression are caused by blocking up of the body and that therefore the proper treatment is, as a rule, not increase but diminution of the diet. the place in the body in which the blocking first occurs is the connective tissues or the tissues that connect every part with every other. it is here that the lymph is secreted, and as the lymph joins the thoracic duct which conveys the products of digestion to the blood, it is obvious that lymph-secretion is a complementary digestive process and it is also obvious how blocking up of the connective tissues, which is the immediate cause of anorexia and inanition, usually comes to exist in the body. m.d. talks of "natural food." he seems to be a vegetarian? good. but is not the question of how much food we ought to eat equally urgent whether we are vegetarian or omnivorous? i think it is. i do not think that the chief cause of our illnesses to-day is taking wrong or unsuitable food. in my opinion we are ill mainly because we take suitable food too often and because we take too much of it. my answer to the question, therefore--"how much should we eat?--a warning"--turns on the previous question: what is the function performed by food in the body? as i think that this function in the grown body is only to restore the waste, the warning in my mind is far rather that we should take less than that we should (as m.d. advises us) take more. i agree with him in the view that "chronic starvation is insidious." but, as i believe that "chronic starvation" is usually a form of dr king chambers's "starvation from over-repletion" and of dr dewey's "starvation from over-feeding," i am bound to be of the consequent opinion that it is to be met, not by increase, but by diminution of the diet. this is one of my reasons for thinking that none of us ought ever to eat oftener than twice a day, under fifty years of age, and that after that we would do well to eat once a day only. i feel sure that if we altered our habits in these ways, we should add very much both to the duration and to the efficiency of life. this is not a question of dietetics only. the issue is of the most practical character. what an addition of five or ten or fifteen or twenty or twenty-five years to the average duration of life might mean to this people and still more to the people of the whole globe is unpredictable by mortal man. but it is evident that it would be of the very greatest import to humanity. this is the great issue of the discussion of this subject. it seems to me that illness might be enormously diminished and health and efficiency and happiness immensely increased. but i think that these boons might be obtained, not by indulging the body and its appetites, but only by the exercise of a wise restraint and government over it. it is at least very much to be desired that more agreement might be manifested in the opinions and practice of qualified physiologists so that the public might have clear guidance, and not as at present, be advised in ways so conflicting that they do not know what or whom to believe. a. rabagliati, m.d. * * * * * _to tourists:_ every little village has a little shop where you can buy nasty little sweets. pickled peppercorns. he was a native of liverpool, but had liver for many years in the isle of wight--_edmonton_ (canada) _journal_. funny he didn't go to poole and leave his liver behind him. * * * * * real flesh food found at last. --from an advt. in daily papers. evidently we have all been vegetarians and knew it not. * * * * * nothing can replace salt.--from an advt. in _punch_. many food reformers advantageously replace salt with nothing. * * * * * the golf craze has been greater this autumn than in any previous year. nobody is quite safe from the fever. it seizes those who mocked at it, and pays no respect to sex or age.--_british weekly_. by the time the next medical congress comes round it is expected that at least three distinguished bacteriologists will have discovered the golf-fever microbe. they will probably agree to call it _mashilococcus caddes_. * * * * * between lunch and dinner take another tumbler of water cold. take a glass of cold water half-an-hour after lunch, half-an-hour after tea, half-an-hour after dinner, and before going to bed at night. never drink between meals.--_woman's life_. all other methods failing, try putting your watch half-an-hour on after each meal. * * * * * i once got a circular from a man who grew potatoes containing his photograph, and, i think, an autobiography.--_musical standard_. not nearly so convenient as one of those automatic egg-stamping hens. * * * * * _stop-press news._ a "pocket clipper" has been invented (according to a certain catalogue) which can be used for the beard or hair at back of neck. but surely people who can do anything so clever as grow a beard on the back of the neck ought not to be tempted to clip it off. peter piper. healthy life recipes. more egg dishes. in our issue of may we published a number of special recipes for eggs. these were much appreciated. and even now this and other back numbers are asked for. we now give some further recipes. it should be remembered that eggs are a simple form of animal food and much purer than meat. they are also easily digested by most people. they therefore form a very useful substitute for flesh-foods, especially where the latter have only recently been discarded. the normal progress towards a more or less ideal diet involves, of course, the elimination of eggs as well as of other dairy products. but wise food reform proceeds always by steps. savoury baked eggs. melt a little butter, or vegetable fat, in an open earthenware baking dish; break into this as many eggs as required. cover thinly with grated cheese; add a knob of butter and bake till set. the dish can be placed direct on the table. egg on tomato.[ ] one egg, two medium-sized tomatoes, butter. skin the tomatoes; cut in halves and put them, with a small piece of butter, into a small stewpan. close lightly, and cook slowly until reduced to a pulp. break the egg into a cup, and slide it gently on to the tomato. replace the pan lid and the egg will poach in the steam rising from the tomato. [ ] this recipe is from _the healthy life cook book_, a new and revised edition of which is in contemplation. savoury egg fritters. six eggs, two large tomatoes, half-teaspoon mixed dried herbs, about three tablespoons ground biscuits ("ixion" or any of the unsweetened "p.r." kinds). hard boil three of the eggs and chop them finely. skin the tomatoes, mash them and add to the chopped eggs with the remaining eggs (well beaten), herbs and biscuit powder. should the mixture be too moist to mould add more biscuit powder; if too dry add a little water. cut and shape into finger shapes and either fry in olive oil or bake on buttered tin or open earthenware baking dish. (the last-mentioned is the best method, as the baking dish can be brought to the table as it is, and there is only one dish instead of two to wash up afterwards.) savoury egg patties. the above egg fritter mixture made rather moist may be used as a filling for savoury patties. make for these a short crust with / lb. of artox meal, oz. of nutter and water. slightly bake the shells of pastry (made thin) before adding the filling, and finish to a golden brown. serve these and the fritters with either brown gravy or white sauce. sweet egg souffle. five eggs, / lb. soft cane sugar, oz. ground rice, oz. of butter, rind of half a lemon. separate the yolks and whites of the eggs. beat up the yolks and sift in the ground rice, sugar and grated rind of the lemon. to this batter add the well-whisked whites. well heat the butter in a frying pan, turn in the batter and fry over gentle heat till set. fold over the edges and place on well-greased flat dish and bake for barely a quarter of an hour. sift over some soft cane sugar and serve very hot. snow eggs. three eggs, one and a quarter pints of milk, a teaspoon of soft cane sugar, vanilla flavouring. separate the yolks and whites of the eggs and whisk the whites to a very stiff froth with the sugar. put the milk into a saucepan and when it boils drop in whites of eggs in small pieces shaped between two dessert spoons. only a little should be cooked at a time in this way, and each should be allowed to poach for two minutes, and when done should be taken out with a slice and put on a sieve to drain. when all the whites are used in this way, strain the milk and add it to the well-beaten yolks. pour into a double saucepan and stir over the fire till the custard thickens; flavour with vanilla to taste. when _cold_ pour into a dish and lay the snow eggs on top. (kindly supplied by mrs edith wilkinson.) egg-raised cherry cake. oz. good "standard" flour, oz. nutter (or other nut fat), oz. cane castor sugar, oz. preserved cherries (glace), oz. well-washed sultanas, oz. ground almonds, four eggs, outer rind of lemon (grated). beat nutter and sugar to a cream; add eggs one by one, beating all the time; have ready the flour, with the fruit, grated lemon rind and ground almonds mixed in, and add gradually to the above mixture, beating all the time, and until of even consistency throughout. line a cake tin with double thickness of buttered paper, pour in the mixture and bake in moderate oven about one and a half hours. _any housewife who doubts the possibility of making light and dainty cakes without the now customary baking powder and baking soda, etc., should try the above recipe. no one could wish for a more excellent cake._ note on casseroles. now that casserole cookery (_i.e._ cooking in earthenware dishes, both open and covered) is becoming more widely known and practised, readers will be glad to know that many housewives believe in boiling new earthenware before using it, as this effectually toughens and hardens it. this is particularly efficacious in the case of ordinary brown kitchenware, the articles being placed in a large pan of cold water which is then brought slowly to the boil. after being allowed to boil for ten minutes remove the pan and allow the water to cool before taking out the ware. health queries. _under this heading our contributor, dr valentine knaggs, deals briefly month by month, and according as space permits, with questions of general interest to health seekers and others._ _in all queries relating to health difficulties it is essential that full details of the correspondent's customary diet should be clearly given._ _correspondents are earnestly requested to write on _one side only of the paper_, giving full name and address, not for publication, but as a guarantee of good faith. when an answer is required by post a stamped addressed envelope must be enclosed._--[eds.] excessive perspiration. miss r.e.n. writes.--i am troubled with excessive perspiration. i neither eat meat nor drink tea. i have a cold sponge bath down to my waist every morning, and i change all my clothes when i go to bed. my diet is, roughly, as follows: _breakfast._--oatmeal porridge with toast or bread and jam or golden syrup. hot water. _lunch._--peas, beans or lentils, eggs, cheese. vegetables: potatoes and onions, or carrots, cabbage, cauliflower, turnips. puddings, fruit or milk wholemeal bread, not much sugar except for sweetening fruits, etc. _tea meal._--wholemeal bread and butter, nuts, jam, cake, pastry; hot water. _at bedtime._--hot water or coffee. if our correspondent wishes to remedy this excessive perspiration she must get a hot towel-bath daily (all over),[ ] wearing porous linen-mesh underclothing next the skin. she should also discontinue the soft sugary and starchy foods, and not mix fruit with other foods (it is best taken by itself, say, for breakfast). she needs more of the cooling salad vegetables. the following diet would be a great improvement:-- _on rising._--half-pint of hot boiled water, sipped slowly. _breakfast._--wholemeal bread or biscuits and butter (all made without salt), with salad or grated raw roots. stop porridge, jam and golden syrup. avoid drinking at meals. _lunch._--two eggs, or oz. of curd cheese. two vegetables cooked in casserole without salt; wholemeal bread or biscuits and butter; a few figs, prunes, dried bananas, or raisins, washed but not cooked. avoid milk puddings or stewed fruits as too fermentative and heating. _supper meal._-- to oz. flaked nuts, some crisp "p.r." or "ixion" biscuits with nut butter. some fresh salad or grated roots. stop jam, cake and pastry. _at bedtime._--half-pint of hot boiled water, or clear vegetable soup, sipped slowly. [ ] the sanum oxygen baths are also excellent in a case of this kind. diet for ulcerated throat. mrs l.b. writes.--do you think it would be wise for a person suffering from ulcers in the throat and on other mucous membranes to adopt a diet devoid of meat, yeast and salt? it would certainly be wise to discard meat and salt in a case of this kind, but yeast is sometimes useful taken as "unflavoured marmite." the chief cause of ulcers is the abuse of the soft cereal and sugary foods. in a case of this sort i should advise a diet consisting exclusively of well-dextrinised cereals--_e.g._ granose, melarvi, etc.--with plenty of grated raw roots and finely chopped salads and tomatoes. this can be combined with curd cheese, raw or lightly cooked eggs, flaked nuts or brusson jeune bread as the proteid part of the diet. farming and sciatica. mrs a.c.b. writes.--for two months my husband, who leads an active open-air life, has had severe pain all down the back of his left leg. it is like neuralgia, and comes on worse when sitting. he has been a farmer all his life, but is anything but strong and constantly taking cold. are these pains likely to be due to wrong food? this pain is evidence of sciatica. chills alone will not produce sciatica, which has its real cause in the system being choked up with acids and toxins of various kinds. in such a case as this, warm water enemas should be taken freely to clear the colon well; sugar, milk and all starchy mushy foods should be strictly avoided; vegetables should be taken either as baked roots or as fresh salads; eggs and cheese should be substituted for meat; and plenty of fresh butter should be taken. boiled water, _between meals_, will be good, but nothing should be given to drink with food. salt, pickles, and greasy or highly flavoured foods should be avoided. temporary "bright's disease" and how to deal with it. miss e. would like to know what kind of diet is suitable for one who has been suffering from bright's disease following a serious illness. why should meat have any bad effect upon the kidneys? she does not take it, although her medical man advises the use of it at once. it is not an uncommon thing for people who have suffered from an acute septic fever to find albumen temporarily present in the urine. this is due to the irritant action of the toxins and other poisons (which the fever is the means of ejecting) upon the structure of the kidneys. the kidneys are filters and they remove the bulk of the soluble waste of the body. the practitioner frequently finds albumenuria in cases of scarlet fever, typhoid fever, diphtheria, etc., and the object of his treatment is to prevent this condition of kidney irritation from becoming an established disease (bright's disease). flesh foods, and especially meat extracts and meat soups, are the worst possible wherewith to feed these fever cases, because they throw so much extra work upon the kidneys. meat is composed mainly of proteids. it also contains the urinary wastes and the toxins (due to fear) which were in the animal's body and on the way to elimination when it was killed. this sufferer should take one meal per day consisting of fresh fruit only; the rest of the diet should consist of salad vegetables and finely grated raw roots, home-made curd cheese, dextrinised cereals (such as melarvi biscuits, shredded wheat, "p.r." crackers, granose biscuits, grape-nuts, twice-baked standard bread, etc.) and fresh or nut butter. phosphorus and the nerves. w.h.h. writes:--i should be very grateful if dr knaggs could help me with any information or hints regarding phosphaturia. i suffer much from this troublesome complaint. we have to remember that the nervous system is two-fold. the one, or conscious portion, consists of the brain and spinal cord, from which all the nerves or branches travel to all parts of the body and give us dominion over them. the other, or subconscious, called the sympathetic nervous system, lies on either side of the front of the spine as two long chains with centres, or ganglia, at intervals. this second system is not within our control and has to do with the regulation of our vegetative functions, including the bulk of the digestive process. all nerves, whether they come from the brain or from the sympathetic system, ranging to their smallest terminals, are built alike of cells, and these cells secrete a complex _fatty_ substance, called _lecithin_, whose dominant element is phosphorus. this phosphorus has to be supplied to the body with food, and as food, and it cannot be properly utilised or assimilated by the body or used by the nerves to build up their _lecithin_ unless it is eaten in the form of organic compounds. the tissues of the body are continually dying, as a result of work done, and are continually being replaced by fresh young tissues as needed. it is the function of the nerves to manage this work for us as well as to similarly arrange for reproduction. in order to control the functions of the various organs and tissues and to regulate the rate at which they reproduce themselves, the nerves extend their terminal branches, not only into every tissue, but into every microscopical unit of such tissue, and the part of the cell which represents the nerve terminal is the inner structure called the nucleus. now it will be obvious that the more the two nervous systems are worked the greater will be their depletion of _lecithin_ and the more need there will be for fresh supplies of phosphorus in the daily food rations. the person who works hard, whether it be manual labour or brain work, needs food and rest at intervals in order that the nerves may recuperate and replenish their stocks of _lecithin_. a goodly proportion of uncooked foods rich in phosphorus must be supplied to make good the wear and tear, and the digestion must equally be efficient if these food-stuffs are to become assimilated. cooking of food to a large extent breaks down the organic phosphorus salts and makes them inorganic. in this state they are of but little use to the body. poor digestion associated with putrefactive fermentation equally converts the organic salts into inorganic ones. these pass into the blood and are promptly eliminated by the kidneys as waste (_phosphaturia_) and thus they never reach the nerves at all. we must remember that phosphorus is usually found in natural foods bound up with the proteid and especially with that proteid which has to do with the reproduction of the species. for this reason man instinctively resorts to the use of egg-yolks, and to the various seeds (such as nuts, wheat, barley, etc.) because of their rich phosphorus content. these proteid-bound phosphorus salts can only be properly utilised when the hydrochloric acid of the stomach juice is well formed, for it converts them into acid salts which are readily absorbed. therefore to ensure free absorption we must always remember to give the phosphorus-containing foods with such meals as will cause free secretion of the gastric acid. when fermentation is active and the stomach juices are weakened the germs of the intestines rapidly break up the phosphorus constituents of the proteids and make them inorganic. therefore the first thing to do when a person is found to be suffering from _phosphaturia_ is to stop the intestinal fermentation by a right diet, clear the bowels of their accumulated waste poisons and give the nerves plenty of rest. another consideration to bear in mind is that the nerves need fat wherewith to build up the _lecithin_. an excessive fermentative sourness of the stomach makes the food so acid when sent into the bowels that the bile, pancreatic and other intestinal juices cannot neutralise them, and so the fats themselves are not emulsified and digested, which fully accounts for the mental depression and debility of which these patients complain. people who are suffering from "nerves" in any form need plenty of pure fat (fresh dairy butter, cream, nut butter, fruit-oils, etc.) and an abundance of natural fresh vegetable products at once rich in phosphorus and iron and in organic alkaline acid-neutralising earthy salts. these arrest fermentation and so enable the phosphorus and the fat to become duly assimilated. canary _versus_ jamaica bananas. r.b., lincoln, would like to know if there is very much difference, as regards food value, between the jamaica and canary banana. "i have heard it said that the jamaica is only fit for the dust-heap. well, i cannot very easily think it is so useless, and at the same time i have an idea that the canary is the better of the two. i should be very pleased to know if you think there is much difference between them." the difference between jamaica and canary bananas is due to the length of time necessary for them to reach us from their place of growth. it takes, i believe, nearly twice as long for a ship to travel from jamaica as from the canary islands. hence the fruit imported from the latter place can be picked in a much riper condition than would be the case with the jamaica article. this probably accounts for the better quality and flavour of the canary banana. besides this the climate may have some determining influence. to say that the jamaica bananas should be discarded because they are of a less satisfactory food value or because their flavour is less developed is uncalled for. the disparity in price is also very marked, so that the poor can readily procure the jamaica banana where they would not be in a position to afford the better class of fruit coming from the canaries. i have discussed this subject in p. of my book, _the truth about sugar_. h. valentine knaggs. correspondence. leytonstone _to the editors._ sirs, enclosed please find p.o. for a copy of _the healthy life_ to be sent to carnegie public library, close to midland station, leytonstone, also to the alexandra holiday home, y.w.c.a., alexandra road, southend-on-sea. at the latter home there are something like to visitors every year, many of whom are semi-invalids. no doubt the magazine will be scorned by many, yet i am quite certain that there are others amongst the number there who will gladly welcome the truths it teaches, and if only one or two are helped to live a more healthy and therefore more happy life, it will be quite worth while. please do not mention my name in either case. yours, etc., x. there is every reason why _the healthy life_ should be known and read in every public library in the united kingdom. in this we are entirely dependent upon those readers who are ready to follow the excellent example of the above correspondent. a year's subscription-- s.--is a very small price to pay for bringing the message of this magazine before the public in this way. we should like to hear from readers in all parts.--[eds.] +--------------------------------------------------------------+ | | | #back numbers# | | | | if readers who possess copies of the first number of _the | | healthy life_ (august ) will send them to the editors, | | they will receive, in exchange, booklets to the value of | | threepence for each copy. | | | +--------------------------------------------------------------+ the healthy life the independent health magazine. amen corner london e.c. vol. v november no. . _there will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--claude bernard. an indication. it was the slave-woman who laid her child under a bush that she might spare herself the pain of seeing it die! one of the commonest sources of mental and moral confusion is to mistake the egotistic shrinking from the sight of suffering with the altruistic shrinking from causing it and desire to relieve it. the so-called sensitive person is too often only sensitive to his or her own pain and, therefore, finds it difficult in the presence of another's suffering to do what is needed to relieve it. the healer, the health-bringer, the truly sympathetic person, does not even hesitate to inflict pain when to do so means to restore health.--[eds.] castles in the air. _regular readers will recognise in this wonderfully simple and suggestive article a continuation of the series previously entitled "healthy brains." the author of "the children all day long" is an intimate disciple of one of the greatest living psychologists, and she has a message of the first importance to all who realise that true health depends as much on poise of mind as on physical fitness._--[eds.] of all the occupations which imagination gives us, surely none is more popular or more delightful than the planning out of future days. pleasure and fame and honour, work and rest, comfort and adventure: all things take their turn in our romances. not all the castles are for ourselves alone. in childhood it is our school, our club, our town that is to be the centre of great events. the young man's castle is a nest to which he hopes to bring a mate. the mother sees the future coronet or laurel-wreath round the soft hair of her baby's head. and we all build castles for the world sometimes--at least for our own country or our own race. sometimes we knock them down and rebuild again in rather different shape--mr wells has taught us what a fascinating game it is. sometimes, especially perhaps in little, unimportant things, our imagination does centre chiefly around our own activities. what we mean to do, what we might do, what we would like to do: there must be something else besides selfishness and waste of time in the constantly recurring thoughts. who does not know the charm of looking down the theatre-list of the morning paper? one may be too busy or two poor to go often to the play, but the very suggestion of all the colour and interest is pleasant. who does not like looking over prospectuses of lectures and classes at the beginning of the winter session? "i _should_ like to go to that course on greek art. oh, it is on mondays, then that is no good. german, elementary and conversation. how useful that would be! gymnasium and physical culture; how i wish i had another evening in the week to spare!" railway books, again, and guides and travel bills--how delightful they are! it is easy to plan out tours for one's holidays up to the age of . "brittany; oh yes, i must go there one day. and norway, that must really be my next trip." the rockies, the cities of the east, coral islands of the pacific--they all seem to enrich our lives by the very thought of their possibilities. again, who does not love a library catalogue? to go through with a pencil, noting down the names of books one wants to read is a form of castle-building by no means to be despised. some people get the same pleasure out of house-hunting; they see an empty house and go and get the key in order to see over it. the chances of their ever living there are practically none, but the view gives a stimulus to their inventive activity: they plan out how they would furnish the rooms and fill the empty hearths with dreams. is not the same thing the explanation of shop-gazing? the woman who has bought her winter coat and hat does not as a rule refrain from looking any more into shop windows till the spring; instead, she clothes herself in imagination in all the beautiful stuffs she sees displayed, and if some of the things demand ballroom, racecourse, golf links or perhaps the alps for the background, why, so much the better, the suggestion puts, as it were, a view from the windows of her castle in the air. a garden--a dozen square yards or reckoned in acres--is full of material for our imagination; indeed, a seedsman's catalogue or a copy of "amateur gardening" will often be enough to start us; long lines of greenhouses will build themselves for us, or rockeries, or wild glens with streams in them, and the world will blossom round about us. sometimes it is ambition that calls us, personal or professional; we get beforehand the sweet taste of power upon the tongue. it may perhaps be sometimes the rewards of work, riches and honour and so on, but more often, i think, the dreams of youth circle round the work itself. we will be of use in the world, we will find new paths and make them safe for those coming after us to walk in, we will get rid of that evil and set up a ladder towards that good; we will heal, teach, feed, amuse, uplift or cherish the other human beings round about us. we will store only for the sake of distributing; we will climb only to be better able to give a helping hand. well, there are some danger signals at cross-roads of our dream-way, some precautions to be observed if we would not let romance obscure and hinder us in our search after reality. but none of these "castles" are bad in themselves. in so far as they quicken our attention power, deepen our thoughtfulness, make our activities more elastic and keep us from carelessness or sloth, they are surely all to the good as episodes in our development. e.m. cobham. the scientific basis of vegetalism. this article, the earlier part of which appeared in the october number, is from the french of prof. h. labbe, the head of the _laboratoire a la faculte de medecine_, in paris. it reflects a characteristic aloofness to a any considerations other than scientific or economic. but it will well repay careful study.--[eds.] v though the consumption of vegetable foods seems to offer a slight disadvantage from the point of view of albuminoid matters, this is not the case touching hydro-carbonated matters and sugars. the vegetable kingdom constitutes the almost exclusive source of these alimentary principles. one cannot indeed take much account of the consumption of the . -. per cent, of glycogen which exists in the animal muscle partaken of under the shape of butcher's meat. there is hardly enough in this for a large eater of between and grammes of meat, to find in hydrocarbonated matters the / or the / of the daily ration. hydrocarbons are necessarily borrowed from the vegetable foods. this is also the case with sugars which do not exist in the animal kingdom in appreciable quantities. it is the same thing with alcohol which is obtained only from the vegetable kingdom. vi as to fatty matters, animal foods, like vegetable products, are abundantly provided with them. moreover, from the point of view of digestibility and capability of assimilating, one may say that there is a quasi-absolute identity between animal and vegetable fats. the reason which would induce us to prefer either would not seem to be of a physiological nature. the economics, which we shall see further on, take this upon themselves, as the most serious reproach which can be made against the use of animal dishes is doubtless their dearness, and the reason which militates most in favour of the predominance of a vegetable diet is to a certainty its cheapness. vii such are, briefly expounded and refuted, the fundamental objections which can be brought against the vegetarian diet and the "vegetalian" customs. there exists, in fact, no serious physiological or chemical reason for not satisfying our needs solely with foods of vegetable origin. it may be interesting to note that, in reality, the most confirmed flesh eaters support their energy-producing needs mainly with vegetable products. in the mixed diet universally practised meat plays but a small part. in meat the waste in preparation and consecutive waste at table is considerable. to really introduce grammes of meat into the stomach, nearly grammes must be purchased, and expensively put into use. what do these grammes really bring in nutritive elements? meat. gr. (mod. fat.) at % albumin = gr. album., about. " " % fat = gr. fat, about. ----- gr. these grs. constitute barely the per cent. of the total weight of a ration, averaged in nutritive elements, calculated as follows:-- albumin fatty matters hydrates of carbon this is a very feeble proportion. if one turns to the calorific point of view, in order to estimate the share of energy useful to the organism, we arrive at much the same conclusion. the grs. of nutritive animal elements barely provide thermal units which can be utilised, while the total diet which we are considering brings a power of disposal of nearly , thermal units. it is, even then, barely per cent. of the total energy. the most convinced flesh eaters, those who buy grs. of meat a day for their consumption, must learn, willingly or unwillingly, that the animal element enters only in an infinitesimal part into their real substance and reparation. viii beyond this very feeble nutritive help is there, then, in meat, anything else which makes the use of this article of food necessary, agreeable or particularly strengthening? it is incontestible that meat contains stimulating substances, which, as prof. armand gautier has said, play the part of nerve tonics, and have perhaps a direct action on the circulation. these special meat matters are found concentrated in the gravy. meat gravy, in fact, beside a feeble proportion of albuminoid matters, or solubly derived quantities, polypeptides, etc., in notable proportion of liberated acids, contains a certain quantity of matters, qualified by the generic name of extractives; a notable quantity of these extractive matters being creatine and creatinine, as well as substances of which the fundamental nucleus is the puric grouping. these purins, by the name which e. fischer attributes to them, derive from a special grouping which it would be supposed exists in a hypothetic body, but which is not known in a state of liberty, purin. this first term gives rise to a series of bodies in lateral groups, of which the most interesting are caffeine and theobromine. amongst these substances the one which has the maximum of oxidation is no other than uric acid. caffeine and theobromine enjoy nervine properties and energetic vascular actions. these properties minutely studied are utilised every day for therapeutic purposes. it is probable that the other bodies of the series which are met with in the extract of meat enjoy analogous physiological properties. these substances are ingested without discernment, often in great excess, and daily, by people who consume meat. amongst these latter, many would not dare to drug themselves with a centigramme of pharmaceutic caffeine, whereas they absorb each day gr. and more, of its homologous constituents. therefore, in the same way as chocolate, tea and coffee, meat has a stimulating effect on the system. he who is accidentally deprived of it finds that he experiences a passing depression. this obviously proves that by the exaggerated use of meat, one drugs and doctors oneself without discernment. however this may be, the judicious part played by meat must apparently be reduced to that of a condiment food destined to produce in a measure the whipping-up which is useful, and sometimes indispensable to the system. we cannot here discuss the expediency of action and the harmlessness of the dose of substances reputed stimulating. but one can ask oneself whether, to attain this object of stimulation, carnivorous feeding is indispensable, and if vegetarianism could not supply the need. the reply is easy: the vegetable kingdom disposes of a variety of stimulating articles, such as tea, coffee, kola and cocoa. through their active substances these foods are nerve tonics of the first order, less dangerous in their use than meat, because more easily assimilated, of far more continuous effects, less mixed with other substances, sometimes noxious, and consequently more measurable. besides, in pulse food, quantities of purins are found as important as in meat. if the part they play has not been systematically studied from the point of view of their effects on the nervous organism, they still give rise to the same terminal products, such as uric acid. one can quite well argue that the pulse purins have physiological effects comparable to those of meat purins. on the other hand, vegetable purins have the considerable advantage of being less easily precipitated in the urine, after the human interorganic metabolism, than those resulting from the metabolism of flesh material. this explains why a frequent use of a vegetable diet offers appreciable advantages in the amelioration of arthritic diatheses so common amongst us. certain effects observed in these diatheses arise from the purins, from their localisation in the system, and their vitiated metabolism. the use of a moderate vegetable diet is the best means of treatment in order to relieve, to ameliorate, even to cure, arthritic diathesis. ix such are the certain physiological advantages which the predominant use of vegetable products are capable of offering. if one takes the pure energy-producing point of view, the superiority of the vegetarian diet becomes greater still. from the fine works of a. chauveau, modern physiology has shown us that muscle, in working, consumes sugary materials. these are provided by ingestions of sugar in a natural state, of dextrine or of starch; for a less important part, the glycogen of the system may also arise from hydrocarbonated cords existing in the molecule of certain albumins. therefore it is only in an infinitesimal part, due to the fibrine of meat, and to the small proportions of glycogen which it contains, that flesh diet intervenes in the direct production of kinetic energy. the demonstrations which have been essayed, touching the muscular superiority of vegetarians, appear superfluous to us. such experiments could only have a positive value if they were made on both series of antagonistic subjects, with alimentary powers of energy-producing equality. it should be distinctly understood that the vegetarian does not profit by any mysterious forces. the habit of preferring to nourish oneself with vegetable foods, can, at most, or at least, favour the physiological integrity of the subject, shield him against disease and assure his revictualment with foods recognised as active and easily measurable. one cannot leave alcohol out of the list of advantageous vegetable foods. in fact, provided one keeps to strictly limited doses, it may be included among the alimentary foods, on a footing comparable to that of sugar. if one knew how to use without misusing it, alcohol might become a daily food. x another order of ideas which one cannot pass by in silence at the present time militates in favour of vegetable alimentation. dietetics cannot neglect economic problems. a flesh diet is very costly. in large towns, like paris, at a time when everything is increasing in cost, one must be favoured by fortune to be able to indulge in the real luxury of consuming the calories of meat. as we said in , with prof. landouzy and m. labbe, in our inquiry into popular parisian alimentation, the calorific energy of meat comes, on an average, to between to times dearer than that of bread or pulse foods. the diet with a vegetable predominance may therefore, by those who adopt it, be considered as much less costly than a mixed one. does not this fact, then, deserve to be taken into consideration and compared--startlingly illustrative--to the ingenious calculation recently made by lefevre in his examination of vegetarianism? one acre of land planted for the purpose of breeding cattle produces three times less living strength than an acre planted with wheat! is it not criminal, or at any rate ill-judged, for the richness and health of the country to have, by the laws of a draconian protectionism, spurred the french agricultural population along the road to the breeding of cattle, thus turning it away from cultivation? these laws are the cause, on the one hand, of the high price of wheat, owing to the abandonment of its culture and the barriers opposed to its entrance, and on the other, of the dearness of meat, owing to the stock and the land which the cattle require. under these facts economists have indeed a direct responsibility, as for more than fifty years economic orthodoxy has presented meat as a necessity, whereas it is the least advantageous particle amongst so many others. in conclusion, let us hope that future distinctions of "vegetalists," vegetarians or flesh eaters may be completely abolished. _in medio stat virtus._ the dietetic regimen, the general adoption of which must henceforth be desired, must reject all preconceived and hereditary ideas, and unite in one harmonious use all foods with a hygienic end in view. the place of each one amongst them and its predominance over the others should be determined only by conforming to reasons at the same time physiological and economic. h. labbe. +--------------------------------------------------------------+ | | | #to our readers.# | | | | readers who appreciate the independence and all-round nature | | of _the healthy life_ can materially assist the extension of | | its circulation by tactfully urging their local newsagent to | | have the magazine regularly displayed for sale. an | | attractive monthly poster can always be had free from the | | publishers, tudor street, london, e.c. | | | +--------------------------------------------------------------+ health and joy in hand-weaving. _this article gains additional interest from the fact that it has been written by one who works her own loom and teaches others the ancient and healthy art of hand-weaving._--[eds.] hand-weaving is an art, a handicraft, one aspect of which we are apt to forget--namely, that it is a splendid health-giver. indeed, all who have felt the rhythm of the loom, as they throw the shuttle to and fro, and in blending colours and seeing the material grow thread by thread, can witness to the power of the work to banish both the large and small worries that eat away our health of mind and body. the hand-weaver learns to look upon his (or her) loom as a very good friend. the possibilities in weaving are immense, and the great difficulty that always confronts the weaver is the impossibility of letting gussets into the day: the end of the week comes all too soon. one very satisfactory thing about weaving is the fact that from the very first we can use the things woven, even those we learn on. first, there is plain weaving, with which we can make dress materials and many things for household use. then come fancy and striped materials, which require more knowledge and ingenuity. there are endless varieties in bands of different patterns thrown in with the shuttle, or shuttles, sometimes as many as a dozen of which may be in use at a time. these can be used for the purpose of ornamentation. in weaving these no end of play of colour can be made, by using many colours in rotation, either as the groundwork of plain material, under the patterns, or as the pattern itself. metal threads can also be used of various kinds, either as an entire texture, or to enrich the fancy bands. lastly, there is inlay weaving, by which we can put in by hand, with little separate bobbins, as we go along, any cross-stitch design, lettering, monograms, figures and designs of every description. anyone with a knowledge of carpentry can make his own loom, the construction being of a very simple nature. in fact, the orientals erect a few sticks, dig a hole in the ground to sit in, tie their warp up to a tree, and then produce the most charming work, both in texture and colour. the warp can also be made as these people often make theirs, by fixing it to sticks stuck into the ground, and walking backwards and forwards with the thread, singing as they go. yes, singing! i think we english folk might learn from them to put more joy into our work, that fountainhead of life and health. we are apt to take such a serious view of ourselves and of all we do. so often, too, we only feel the dull and quiet colours, instead of using the many brilliant ones that nature loves so well. once we begin working in, and appreciating, these we realise the exhilarating effect on our spirits. indeed, i think we are only beginning to realise what a great influence colour has upon us, and all that colour signifies, each colour having various meanings of its own. many people are now realising that we are surrounded by a halo of colour woven by our character--the most highly developed people being surrounded by clear, bright colours. it is strictly true that we are all weavers, every day of our lives. by following the laws of nature we make the finest texture composed of all the most glorious colours or qualities in the universe, so by degrees bringing ourselves, and others, into perfect harmony and peace. minnie brown. how much should we eat? _this discussion arose out of the article with above title, by "m.d.," which was published in our july number._--[eds.] iv in dealing with this vitally important question, we shall most of us, i take it, agree upon certain points. in the light of recent knowledge upon, and extended experience of the subject, one such point which now appears incontrovertible is that there are thousands die annually--directly or indirectly--through overfeeding where one dies through insufficient nourishment. and it may at once be said that, as regards these thousands, the death certificates are practically valueless as data in relation to erroneous dieting, so that in this way we can never get at a correct estimate as to the actual number of deaths due to overfeeding. bright's disease, gastric and intestinal affections, growths of various kinds, cancer, etc., are each in their turn certified as the "cause of death." most often, however, the initial cause is the overloading of the system with an amount of food beyond that which is necessary or healthful--and thereby clogging up the tissues, the organs and smaller bloodvessels. but it may be said: "how can you substantiate such a general and sweeping statement?" in the first place--and this is profoundly significant--other things being equal, it must be acknowledged by all unbiased people that the small and moderate feeders do not contract disease in anything like the proportion that big feeders do, and as a natural consequence live longer lives. further, it must surely be quite evident by this time that there is a sufficiently large enough number of people who are thus existing in good health--and steadily regaining it where it has been lost--on the lines of moderate feeding. and the number is accumulating at a rapid pace; more and more are coming into line with those of us who, having thus found health in themselves, their patients and friends, are preaching the practice of two meals a day, and sometimes only one where there is serious organic disease to combat--thus defying the dicta of those eminent physiologists who "settled" the question years ago. now i quite admit--it would be impertinence to do otherwise--that "m.d.'s" statements and views must not be ignored, must indeed be respected. and he tells us that he "heard of," in one day, three cases which "went wrong" through underfeeding; well, for those three cases we can point to hundreds who are _going right_ through eating just enough and not too much. i am prepared, on the other hand, to admit the danger of a continued semi-starvation diet; our difficulty is to define in each individual case what exactly would be a semi-starvation, and what a sufficient diet. it is impossible to have a fixed standard for everybody. after all, "the proof of the pudding is in the eating"; often it is a matter of experimenting for some little time, and in this way we could judge largely of the result of our dieting by our state of general health. on some main points of the question i am now absolutely convinced--viz.: . excessive bulk is always dangerous, often disastrous, causing sudden death in a large number of cases. . starchy foods are best strictly limited as we get along towards middle age and beyond. . a life which is largely mental or sedentary will be healthier and longer on a strictly moderate diet. . a life largely of physical labour must be dealt with on its own particular conditions. . at all times due regard, of course, must be paid to age, weight, etc. . on the whole, "eminent physiologists" have erred on the side of excess of proteid being advised. . middle age is the critical time of life in respect to a man's diet in other words, i would say in axiomatic form that as a man feeds at or about middle age, so will he be for the rest of his life. j. stenson hooker, m.d. v as a very interested reader of this discussion i should be very glad to know exactly what "m.d." means by _each pound_ of _bone_ and _muscle_ in the body weight? what proportion (approximately) is it to total body weight? i have been trying to keep up to dr haig's grains per lb. of "body weight" and find that it is too much for my digestive powers, which are very weak owing to chronic nervous dyspepsia. if i take per cent. or per cent. _less_ proteid my troubles are so greatly lessened that i feel that to continue to take the lower amount would mean perpetual relief. but there have been so many warnings, including m.d.'s, of the dangers of under-nutrition, that i am in a quandary; and others of your readers too. if m.d. means grains per lb. of _something less_ than total body weight, a lesser amount of proteid than i try to take may have his sanction, and be safe for me. jno. a. cookson. * * * * * there appears to be a sincere attempt in "m.d.'s" article to prove that a physiologist is the best guide in diet. but, as one can get the degree of m.d. without any scientific knowledge of dietetics, the inference that one would be likely to make from such an alarming article is erroneous. i say "alarming" because vague statements are made as to patients who were rescued just in time to be stimulated by over-feeding into a semblance of health, and we are treated to a list of very alarming symptoms in the last paragraph on p. . "m.d." says, "suppose that the animal fed for years on unnatural food has become so pathological that it can no longer take or digest its natural food." how grateful to m.d. for this statement will be those who long for an excuse to cling to the spoiled, boiled and unnatural dishes of which the popular diet mainly consists! and how they will continue to overeat themselves, content to avoid the truth regarding food quantities. living on a right and natural diet, a man or woman will correct the effects of wrong living. this will bring crises, and unless they know that this is nature's attempt to rid the body of unwanted and effete matter they may be duped into returning to their high feeding, either by those whom "m.d." calls diet quacks or by qualified quacks. i do not believe it possible for anyone to die for lack of indication that they were eating too little. the opposite is what people die of. if we carefully read dr rabagliati's article in the same issue we shall rightly ask what would be the results of analyses and measurements in such a case. about a year ago we had a young woman under our care who had suffered with deafness and other troubles for years. she had tried dietetic treatments, "uric-acid-free" and otherwise, and had at last been told that her deafness was incurable, being due to heredity and deficiency in the organs of hearing. she was extremely thin when she came to us, but we did not measure her, nor analyse unclean excreta, nor weigh her. she saw an m.d. who was in sympathy with the philosophy of fasting, and she fasted (taking water only) for days. she then had four days of fruit juice, and was so disappointed at having broken her fast prematurely that she continued it for another days, making in all-- days actual fasting. [_during this period she was living an almost complete out-door life._--eds.] during the fast many interesting phenomena were witnessed, chief among which was the discharge from ears and nose--significant indeed to all who study nature's ways. result: normal hearing restored. this was nearly twelve months ago; and, having heard of her recently, we find that, though she had had a cold, there has been no recurrence of deafness. i wonder what assistance measurements would have been in this true cure. the patient (an adult) weighed st. lbs. at the end of her fast and could then walk short distances. the way in which "m.d." dismisses "a little gout" in his last paragraph but one almost leads one to think that he is unaware of the failure of the natural defences of the body that must have gone on in a very serious degree before the manifestation of gout became possible. i respectfully submit this problem to "m.d.":--if a very thin patient can go without food entirely for days, with only benefit accruing, _how many centuries_ will it take for a fairly fat person to die through slightly under-eating? as dr haddon has said, the proteid myth will die hard, but there are physiologists who, with their faces to the light, are finding the truth of man's requirements in food and who know that absolute purity and simplicity are the ideals to be sought and that all food we eat more than is absolutely necessary is a diversion of energy to carnal channels. ernest starr. a doctor's reasons for opposing vaccination. in opposing vaccination i am aware that it is a thankless task to brave the abuse and antagonism which everyone who attempts to move forward in the work of medical progress is sure to encounter. in order that i may not be regarded as prejudiced against the dogma of vaccination, i will preface my remarks with the confession that i was at one time myself a confiding dupe of the "tradition of the dairymaids." while attending medical college i was told that inoculation with cow pox virus was a certain preventive of small-pox, and like most other medical students i accepted with childlike faith and credulity the dictum of my teachers as so much infallible wisdom. after an experience derived from treating a number of cases of post-vaccinal small-pox in patients who gave evidence of having been recently and successfully vaccinated, i awoke to a realisation of the unpleasant fact that "protective vaccination" was not all that was claimed for it. i thereupon began a study of the vaccination problem in all its bearings. after several years of reading, observation and experience i became fully convinced that "successful" vaccination not only fails to protect its subjects from small-pox, but that, in reality, it renders them more susceptible to this disease by impairing their health and vitality, and by diminishing their power of resistance. personally, i have known of recently vaccinated patients dying from small-pox while having the plainest foveated vaccine marks upon their bodies, and i have seen other individuals who had never submitted to vaccine inoculation have variola in its mildest and most benign type. in view of such experience i refused to ignore the evidence of my own senses, and determined to follow the dictates of reason instead of the dogmas of faith, and have, consequently, for the past fifteen years refused to pollute the blood of a single person with vaccine virus. i oppose vaccination because i believe that health is always preferable to disease. the principle and practice of vaccination involves the introduction of the contagion of disease at least twice, and, according to numerous authorities, many times, into the human organism. the disease conveyed by vaccination causes an undeniable impairment of health and vitality, it being a distinctly vaccine "lymph," is taken from a lesion on the body of a diseased beast, and inserted by the vaccinator into the circulation of healthy children. the performance of such an insanitary operation, in the very nature of the case, is a violation of the cardinal principles of hygiene and of sanitary science.... moreover, this operation is in direct controversion of the basic principles of aseptic surgery, the legitimate aim of which is to _remove_ from the organism the products of disease, but never to _introduce_ them. the prime aim of the modern surgeon is to make every wound aseptic and to keep it so. the careful operator employs every means at his command to clear the field of operations of all bacteria. he utilises every particle of the marvellously minute and intricate technique of asepsis to prevent the entrance through the wounded tissues of any disease elements before, during or after the operation. he fears sepsis equally with death, and yet, under the blighting and blinding influence of an ancient and venerated myth inherited from his ignorant and superstitious forbears of a pre-scientific age, he will deliberately inoculate the virulent infective products of diseased animal tissues into the circulation of a healthy person. and as if to cap the climax of his stupidity and inconsistency, he performs the operation under "aseptic precautions." the poisonous matter which nature wisely eliminates from the body of a diseased calf in an effort to save its life and restore it to health is seized upon by the vaccinator and implanted into the wholesome body of a helpless child. think of the unparalleled absurdity of purposely infecting the body of a healthy person in this era of sanitary science with the poison from a diseased beast, under the senseless pretext of protecting the victim of the ingrafted disease from the contagion of another disease! can inconsistency go further? i oppose the practice of vaccination because it is not known what vaccine virus is, except that it is a mixed contagion of disease. we hear much these days about "pure" virus and "pure calf lymph." nothing could be more absurd and meaningless than the flippant talk indulged in by vaccinators and the purveyors of vaccine virus about "pure calf lymph," a hybrid product of diseased animal tissues. "pure virus" translated into plain english is pure "animal poison." the phrase "pure calf lymph" is applied to an brand of vaccine virus now in use is a misnomer for two reasons. it is not "pure" and it is not "calf lymph." calf lymph is the normal nutrient fluid which circulates in the lymphatic vessels of the calf. lymph is described by physiologists as a "transparent, colourless, nutrient alkaline fluid which circulates in the lymphatic vessels and thoracic ducts of animal bodies." lymph is a physiological product, while the so-called "pure calf lymph" used by vaccinators is a pathological product, derived from a lesion on a diseased calf. the difference between calf lymph and so-called "pure calf lymph" is as great as is the difference between a food and a poison. the vaccine mixture now most generally used by the medical profession is known under the name of "glycerinized vaccine lymph," but it is not _lymph_ at all. it is made by utilising practically the entire lesion or pock on the heifer when it is in the vesicular stage. such a lesion is broken open and scraped with a volkmann spoon until the whole of the tissue is forcibly and roughly curetted away, consisting of pus, morbid serum, epithelium, fibrous tissue of the skin, and any foreign matter on or in it, constituting what is called "pulp." this pulp is then passed between glass rollers for trituration and afterwards mixed with a definite amount of glycerine and distilled water. this complex pathologic product of unknown origin is injected into the wholesome bodies of helpless children under the false but plausible name of "pure calf lymph." ... i oppose the practice of vaccination because under whatever pretext performed the implantation of disease elements into the healthy human organism is irrational and injurious. it is subversive of the fundamental principles of sanitary science, while the attainment of health as a prophylactic measure is rational and in harmony with the ascertained laws of hygiene and consistent with the canons of common-sense. i am firmly convinced that the absurd and unreasonable dogma which assumes to conserve health by propagating disease should receive the open condemnation of every scientific sanitarian. that this health-blighting delusion conceived in the ignorance of a past generation should find lodgment in the minds of intelligent people enjoying the light of the world's highest civilisation is to my mind inexplicable.... sanitation and isolation of the infected offer the only rational and effective antidote for these disorders. away, then, with the abominable and filthy subterfuge! give us health instead of disease. health is the great prophylactic. no man in perfect health can be truly said to be susceptible to the infection of small-pox, nor to that of any other zymotic disease. vigorous health confers immunity from disease-producing agents as nothing else can. it is usually after the vital functions have become impaired by the effects of vaccination or some other injurious cause that individuals become susceptible to small-pox infection. j.w. hodge, m.d. [_the above article can be obtained in pamphlet form from the publisher. wm. j. furnival, stone. staffs._--eds.] the new race. (_specially written for the healthy life._) a new race on the ruins of the old build we: a temple of the human form fairer than marble, since with life-blood warm, well crowned with its appointed crown of gold, russet or ebony; lines clear and bold beneath--a citadel no ills can storm, buttressed with health; a type to be the norm in that great age the world shall yet behold. for now the laws of health and heaven are seen in their identity, life's body and soul; though, like divorce, disease may come between what god hath joined; but at the human goal, where the new race rules, splendid and serene, sit health and holiness, made one and whole. s. gertrude ford. the play spirit. we all long for reality. most of the amusements in the world are imitations of the reality for which we long. they promise a satisfaction they are unable to give. drink, mechanical love-making, all snatched gratification of the senses, religious excitement, revivalist meetings, and so forth, most theatre-going and sports, all simulate the real glory of life. they bring an illusion of well-being. they produce a glow in the nervous system. they cause the outlines of everyday life as we know it to grow suffused. they give us a momentary sense of heightened power and freedom. we float easily in a happy world. a sort of relaxation has been achieved. the less common forms of amusement bring us nearer to the gateway of reality. for some, they have been the rivers leading to the ocean of truth itself. art, for instance, the interpretation of life in terms of beauty; the "artist," the man in whom sensuous perception is supreme, offers us a sublime aspect of reality. he dwells in the universe constructed for him by his senses and tells us of its glories. he achieves "freedom." the veil covering reality is woven for him far thinner than for common men. he sees life moving eternally behind the forms he separates and "creates." and to those of us who are akin to him, who are temperamentally artistic, he offers freedom of a kind. the contemplation of a work of art releases the tension of the nerves. to use the language of psychology it "arrests" us, suspends the functions of our everyday surface personality, abolishes for a moment time and space, allows the "free," generally suppressed subconscious self to come up and flood the surface intelligence, allows us for a moment to be ourselves. but, still, this momentary relaxation, this momentary "play," this holiday from the surface "i," remains an affair dependent upon suggestive symbols coming from "without." the supreme artist achieves freedom. we, who in matters of art are the imitative mass, can only have "change," a new heaven and earth, a fresh "culture." then there is love. that promises, at the outset, complete escape into freedom and reality. and supreme lovers, both of individuals and of "humanity," have indeed found freedom and the pathway to reality in love. but ordinary everyday people rushing idolatrously out to find themselves in others find in the end only another i. the religions perhaps work best and longest. but even here average humanity, where the mystical sense is feeble, are thrown back in the end upon ethics--and go somewhat grimly through life doing their duty, living upon the husks of doctrine, the notions and reports of other men. if the play spirit within us, that longing for the real joy of life, for real relaxation and re-creation, fares so poorly for most of us in the amusements large and small that life offers to our leisure moments, is it any better in the "games" the individual chooses for himself--hobbies, for instance? can these generally "instructive" and "useful," generally also solitary, occupations be called play? are they not merely a reversal of life's engine, rather than an unmaking and a remaking. they are merely a variant of life. they are very truly called a "change of occupation." they are led and dominated, commonly, by the intelligence. they contain no element of freedom. the same defect is found in all organised "games." * * * * * real play, like every other reality, comes from what our mechanical and practical intelligences have called "within." real play arises when the "i" is in direct contact with the myself, with life, with god, with the actuality moving beneath all symbolic representations. it is only when "i," the practical, intelligent, abstract-making, idealising, generalising, clever, separated "i," the "i" which has a past, a present and a future, renounces its usurpation of the steering apparatus, that play can be. "i," to play or to pray or to love, must be born again. "i" must relinquish all. "i" must have neither experience nor knowledge, neither loves nor hates, neither "thought" nor "feeling" nor "will"--nor anything that can arrest the action of the inner life. when this complete relaxation, which has its physical as well as its mental aspect, is achieved, then and then only can "i" rise up and play. then "i" shall rediscover all the plays in the world in their origin. "i" shall understand the war-dance of the "savage." "i" shall know something about the physical convulsions of primitive "conversion." the arts may begin to be open doors to me. "i" shall have stood "under," understood my universe, in the brief moment when "i" abandoned myself to the inner reality. the words of the great "teachers" will grow full of meaning. my own "experiences" will be re-read. i shall see more clearly with my surface intelligence what i must do. i shall be personal in everything, personal in my play. surface self-consciousness which holds me back from all spontaneous activity will disappear in proportion as "i" am immersed in the greater "me." look at that woman walking primly down the lane to the sea with her bathing-dress. she is a worker on a holiday. but she cannot play. she goes down every day to bathe in the cornish sea, the sea that on a calm sunny day is like liquid venetian glass and flings at you, under the least breeze, long, green, foam-crested billows that carry you off our feet if you stand even waist-high. she potters in the shallows and splashes herself to avoid taking cold. her intelligent "i" is uppermost. her world of every day never leaves her. she will go back to it as she came, unchanged. her wistful face betrays the seeker lost amidst unrealities. if the "i" were a little more intelligent, she might try to defy the surrounding ocean, to pit her powers against it, to swim. she would learn a most practical and useful and withal invigorating accomplishment. if her busy, watchful "i" could be arrested she might "see" the billows, the sky and the headlands reared on either side of her bay. she might dance into the water, and see her world dance back. she would fling herself amongst the wavelets where she stands and splashes. she might give herself up and know nothing but the beauty and strength around her. it would not teach her to swim, but she would have taken a step towards the great game of walking upon the waters. d.m. richardson. travels in two colours. one is often tempted to suspect that in some schools there is a deep-laid plot to destroy in the bud any love for poetry which children may possess. otherwise how is it that little boys and girls are made to commit to memory william blake at his highest reach of mystical fire, as in _tiger, tiger, burning bright_, or william wordsworth at his lowest ebb of uninspired simplicity, as in _we are seven_? these are very popular, apparently, as poems for children to recite; yet in the one case it is beyond any teacher's power to show children the unearthly flaming beauty which alone gives the poem its peculiar quality and undefinable power; and in the other the maudlin sentimentalism and almost priggish piety of the verses are positively dangerous to the child's health of mind. both types of recitation work out in the end to this--that when the child attains adolescence, and the great world of literature dawns on the hungry mind, an evil association of ideas has been established--the association of poetry, the highest of all arts, either with the saying of lines without meaning, or with the learning of "poems" devoid of what wholesome youth really desires or enjoys. people may wrangle all night as to whether the normal healthy child is at heart a mystic or a realist; whether he likes fairy tales because they show him a magical world where flowers can talk and umbrellas are turned into black geese, or because they tell of strange romantic things happening to a real human boy like himself; but there can be no shadow of doubt that much of the verse intended for children is either too clever in its humour to make them laugh, or too bald in its matter or tone to stir the romance that is never quite asleep in their hearts. there are really surprisingly few versifiers who have altogether avoided these errors. some of george macdonald's _poems for children_ are almost perfect, both as regards lyrical form, simplicity of language and in the unobtrusiveness of the inner truth they convey. for example, "the lightning and thunder they go and they come; but the stars and the stillness are always at home." but others come perilously near mere versified moralising. lewis carroll's nonsense verses in the two famous _alice_ books are supreme among their kind; but are they not sometimes just a shade too ingenious, or too adult in wit? probably stevenson, in those seemingly artless poems in _a child's book of verse_, comes nearest to a level perfection. who has ever approached him in his power to understand and express the small child's world, desires and delights, without a trace of the grown-up's condescension or self-consciousness? well, these great ones are no longer in the world; yet, with the recognition of their genius, there is the usual danger of bemoaning the lack of worthy successors. not but what there is some excuse for such lamentation; for this reason that every christmas there is a veritable flood of children's verse, a great deal of which is either painfully didactic, painfully sentimental, painfully funny or painfully foolish. what i wish to do at the moment is to call attention to the fact that there is one man alive in england--one of many, i do not doubt: but one at a time!--who is doing "nonsense verses" for children which are guiltless of all the faults i have indicated above. jack goring is known among some of his friends as "the jolly rhymster." he writes his verses first for his own children, and then publishes them from time to time for the pleasure of other children. the secret of his success is partly that he knows that even small children like a story to be an adventure; partly that he understands how their own romances, the things they picture or hum to themselves when well-meaning adults are not worrying them, or rather, trying to amuse them, begin--wherever they may end!--with a perfectly tangible object, such as a pillar-box, a rag-doll or a toy locomotive. one of "the jolly rhymster's" best things begins-- "finger-post, finger-post, why do you stand pointing all day with your silly flat hand?" --which is exactly the sort of question that a very small child in all probability does really ask itself when it has seen a finger-post day after day at a cross-roads. how the poem continues and where it ends you must find out for yourself. it's all in a book called _the ballad of lake laloo_. in the recently published volume[ ] that now lies before me, this telling of a tale of wonder which begins with an ordinary thing is again evident. nip and flip, aged six and four respectively, are the adventurers; and they make three voyages in this little book. in the first, _the fourpenny-ha'penny ship_, they circumnavigate the world. now please note how mr goring strikes the right note at the very outset: "nip and flip took a holiday trip on a beautiful fourpenny-ha'penny ship with a dear little handkerchief sail; and they sang, 'yo ho! we shall certainly go to the end of the world and back, you know, and capture the great seakale.'" [ ] _nip and flip._ by jack goring. illustrated by caterina patricchio. s. net (postage + / d.). c.w. daniel, ltd., tudor street, london, e.c. and there follows a picture (in black and gold) of this strange monster, just to make sure that no one will suppose they were out after a vegetable. the tale moves along, as such stories should, very rapidly. thus-- "and when they came to the end of the world, their dear little handkerchief sail they furled and put on the kettle for tea." but you have only just time to look at the tea things when-- "but alas! and alack about six o'clock the good ship strack on the almond rock and split like a little split pea." so the story goes on, through divers adventures, "from timbuctoo to timbucthree" and so at last home again. the next voyage is to the land of make-believe on a christmas eve, "in a long, long train of thought." in the course of this tale we are given a little picture of flip herself, and here it is for you to look at. only, in the book her shoes and stockings, the inside of her skirt, and the squiggly things on the top of her head are a bright golden colour. [illustration] the third voyage is all the fault of a toy monkey--"six three-farthings and cheap at the price"--and takes them among whales, mermaids, sea-serpents and other deep-sea creatures. here, then, are delightful little pictures on every page, which even a two-year-old will enjoy. and here are verses which most boys and girls under seven or eight will like to learn. and the best of it is that it doesn't matter a bit if they do "sing-song" them, for they are the kind of verses which only sound right from the lips of quite small children who have never been taught elocution. edgar j. saxon pickled peppercorns. soup.--oxtail from a.m.--from a restaurant menu. what it was in the early morning it would be indiscreet to inquire. * * * * * i learn that a serum for mumps is now being made at the pasteur institute. "a number of monkeys were inoculated with the serum," says _the times_ ( th july), "and a mild form of the disease was produced." it is an age of scientific progress, so we may expect news shortly of sera for toothache, hiccough, and the hump. it will not be necessary to inoculate camels for the last. * * * * * you will say--with mr arnold bennett, the distinguished playwright and novelist--"the tonic effect of ********* on me is simply _wonderful_."--from an advt. in _punch_. you may join in the chorus if you like, but you mustn't all expect to be simply _wonderful_ playwrights and testimonialists. * * * * * a strange shampoo.... "i make my chemist get the stallax for me," said she. "it comes only in sealed packages, enough to make up twenty-five or thirty individual shampoos, and it smells so good i could almost eat it."--_secrets of beauty_ column in _the daily sketch_. which only shows how careful one has to be. * * * * * in the days to come every army will fight on bloodless food.--_herald of the golden age_. when every army fights on bloodless food, we may be just as far from the golden age as we are now. * * * * * i am told that an obscure practitioner who sent up an account of some interesting discoveries, addressed to medical congress, dietetics section, london. has had his communication returned by the post office, marked _not known_. * * * * * there is no truth, it is said, in the rumour that a secret meeting was held during the congress to discuss the proposed raising of the rate of commission payable by surgeons to physicians. peter piper. healthy life recipes. some "emprote" recipes. exaggeration is popularly regarded as one of the vices of food reformers; but it is certainly no exaggeration whatever to say that mr eustace miles and the restaurant associated with his name have had a large share in bringing about the more sympathetic attitude towards "food reform" noticeable on all sides to-day. mr miles is no amateur in the gentle art of self-advertisement: he would be the first to admit it. but the advertisements have resulted undoubtedly in a very large number of people taking the first steps towards food reform, people who are repelled by the out-and-out "vegetarian" propaganda. there are those who view with disfavour the introduction of manufactured or artificial foods into the health movement; they think it hinders simplicity. there is a truth in this; but, on the other hand, it must be recognised that the great majority cannot be reached save by meeting them half-way. this applies to the flavours of foods, the digestibility of foods and the convenience of foods. few can go straight from beef to nuts. after generations of abuse the human digestive system has to be humoured if the ideal is to be approached. and in this invaluable work of meeting people half-way and of humouring their tastes and digestions, the restaurant in chandos street, london, the specially prepared foods made and sold there and the strongly individual, thoroughly sane and pleasantly straightforward advocacy of mr. eustace miles have been a very important factor. the idea behind "emprote"--the eustace miles proteid food--is that, being a blend, in powder form, of various kinds of proteid (the proteids of milk, of wheat, and so forth) it supplies the right kind of substitute for flesh foods not only because it is so easily assimilated, but because it is in a very convenient and easily kept form. we believe such foods have a very definite and necessary part in the progress of the individual from the customary unhealthy diet to the better ways of feeding. the following recipes illustrate some of the methods of using "emprote." they are taken from the booklet _ quick and easy recipes for healthy, meatless meals_, to be obtained for + / d. post free from chandos street, london, w.c.-- savoury cheese sandwiches. _note.--these savoury sandwiches can form a complete meal with a little salad (dressed with oil and lemon juice), or celery or lettuce or watercress or other salad material._ oz. of cheddar cheese; oz. of "emprote"; the juice of half a lemon; two tablespoonfuls of fresh tomato pulp or tomato chutney; a pinch of celery salt. prepare some slices of not too new bread and butter. mill the cheese, add to it the "emprote" and the celery salt, then add the tomato pulp or chutney and the lemon juice. mix all well together into a smooth stiff paste, and spread upon the slices, and form sandwiches, which may be eaten with watercress or lettuce or cucumber. if the material is too moist, mix in a little more "emprote," or else "procrums." macaroni cheese. one teacupful of macaroni; two tablespoonfuls of milled cheese one tablespoonful of butter; one dessertspoonful of flour; one tablespoonful of "emprote"; one large cupful of milk. boil the macaroni for half-an-hour in a little water. strain the macaroni and put it in the bottom of a buttered dish. (put the liquid in the stock-pot, to thicken a soup.) mill the cheese, and put half of it over the macaroni. in the small saucepan make a sauce of the butter, flour, milk and "emprote." pour this over the macaroni and cheese, sprinkle the rest of the cheese on the top, put in the pan to brown, then serve. stuffed vegetable marrow. mince two large onions very fine, and fry in oz. of butter; add oz. of "proto-savoury," one dessertspoonful of nutril, oz. of breadcrumbs (or "procrums"), and one egg. scoop the seeds from one large vegetable marrow, fill with the mixture, and bake for one hour. serve with apple sauce. _note.--"proto-savoury," "nutril," and "procrums" are special "e.m." products and are readily obtainable from health food stores, etc._ a nourishing gravy ready in a minute. when cutlets or croquettes are heated up, or when macaroni or vegetables or a vegetable stew (none of which are really adequate substitutes for meat) are to be made nourishing, mix some of the e.m. savoury (or mulligatawny, or blended) gravy powder, with hot water, to the thickness of gravy, and add to the dish. * * * * * new method of preparing fruit for the dinner-table. in cold weather fruit is often cold, and if heated in an oven may be injured partially or wholly. here is, perhaps, a new way of warming fruit which has been tried and proves satisfactory. wash the apples, pears, oranges, bananas and wipe them and place on a dish on the dinner-table. also place a jug of boiling water and a bowl upon the table. then when the fruit is required pour the hot water into the bowl and place the fruit in it and cover with a plate until warm enough to eat comfortably. bananas should be peeled before placing in hot water. "a.r." health queries. _under this heading our contributor, dr valentine knaggs, deals briefly month by month, and according as space permits, with questions of general interest to health seekers and others._ _in all queries relating to health difficulties it is essential that full details of the correspondent's customary diet should be clearly given._ _correspondents are earnestly requested to write on _one side only of the paper_, giving full name and address, not for publication, but as a guarantee of good faith. when an answer is required by post a stamped addressed envelope must be enclosed._--[eds.] eczema as a sign of returning health. mrs m.k. writes:--until the last few years i have been subject to sciatica and a certain amount of dry eczema. about a year ago my health greatly improved, with the exception of the eczema, which has much increased the last year, coming out in large angry spots which irritate. i am , small, spare and white, have never been strong until a year ago, have led a sedentary life, being an artist. three years ago i left off eating meat. my diet at present is: _on rising._--cup of hot rain-water. _breakfast_ ( a.m.)--unfired bread with butter and pine nuts; cup of weak tea, no sugar. _at ._--one raw apple. _dinner_ ( p.m.)--one lightly boiled egg or an omelette, with "artox" home-made bread, and butter conservatively cooked celery or broccoli; stiff milk pudding with eggs in it, or "artox" pastry. _tea_ ( p.m.).--weak china tea "artox" bread, and butter, and home-made plain cake. _supper_ ( . ).--slice of bread and butter; tumblerful of hot rain-water sipped at bedtime. i have not been able to digest uncooked vegetables, excepting lettuce; nor do i eat other fruit than apples; any sweet things cause acidity. i do not suffer with constipation. in this case it will be noted that the skin disease occurred simultaneously with a marked improvement in health. this shows that nature was adopting her usual plan of forcing the impurities outwards to the surface and that the change of diet made this possible. with her body less encumbered with waste a return of health became possible. the plan now to adopt is not to check this skin trouble but to cure it along safe lines by amending the diet and purifying the skin itself by means of warm alkaline baths. these baths, which should be taken twice a week at first, are made by adding a / lb. of bicarbonate of soda and a / lb. of "robin" starch to an ordinary hot bath at a temperature of degrees, which can be gradually increased to degrees as the correspondent can bear it. in this the bather stays for from ten to twenty minutes to well soak out the acids and the oily greasy waste from the surface. the starch is added because it moderates the action of the alkali and leaves a comfortable gloss on the skin after the bath is finished. the bath gradually clears the poisons from the skin and encourages the free action of perspiration, thus promoting the further elimination of waste acid poisons and at the same time clearing the skin and making it healthy. the next thing to do is to amend the diet so that as little waste as possible shall be formed. rice is the cereal that contains the least amount of waste of any kind and this should therefore be the cereal selected. the wholemeal, although good for most people, is not suited to this case. a strict salt-free diet is also necessary, as it is often the retention of salt in the system that leads to the presence of eczema. the following amended diet should suit the case, and it should be continued until the skin has quite cleared itself:-- _on rising._--cup of filtered boiled rain-water. _breakfast._--cottage cheese, oz.; rice, boiled or steamed without salt (large plateful), with granose biscuits or toasted "maltweat" bread. _at_ a.m.--more rain-water (not fruit). _lunch._--the same as breakfast. _tea._--hot rain-water only. _supper, . ._--the same as breakfast. when the skin is quite clear the correspondent can return to the wholemeal bread (but biscuits made with "artox" would be better than the yeastless bread), and also to a more varied diet generally, as at present. deafness. j.g. writes:--my hearing got bad about twenty years ago, caused i think by a cold in the head. when in bed i can hear the tick of a watch with the left ear but the other is almost stone deaf. i am not much at a loss in ordinary conversation, but in trying to hear people speak i lose much of what is said. although i have no real pain, my head is rarely clear, feeling full and congested. i have now and again a slight sensation of giddiness or reeling. the right ear runs some offensive matter, and there is always a hissing sound. i live what is, i think, a simple life, but i must confess to a little smoking. my general health is good. i am a working farmer and fairly active for one of my age ( ). my diet is generally as follows: _on rising._--one or two cups of warm water, sometimes with lemon juice. _breakfast._--an apple or orange, oatcake and dairy butter. baker's bread and one cup of tea. _lunch._--nil, or perhaps i should say that i eat an apple or orange before each meal or a bit of turnip or even cabbage. _supper._--potatoes with fish, and milk pudding. on some days it may be broth with meat cooked in it. _before retiring._--nothing but water, or at other times oatcake and one cup of milk. there does not seem to be much prospect of this correspondent recovering the hearing of his right ear, as the conditions have lasted so long. he might, however, certainly try by diet and hygiene to get rid of the unpleasant discharge and the noises. to effect this he should carefully syringe the ear once or twice a day with a weak solution ( grain to the ounce) of permanganate of potash, using an all-rubber ear-syringe. then he should get someone to well stretch the upper bones of the spine and to massage well the muscles at the back of the neck to induce, thereby, a better circulation in the nerves and blood-vessels which proceed from that part of the spine into the ears. in this way he will be able to ensure a removal of the clogging poisons which are lurking in the bad ear and thus promote less noises and a better health state of the ears generally. the diet should be amended as follows:-- _on rising._--one or two cups of warm water, with lemon juice added. _at . breakfast_.--apples, oranges or other fruit only. _take plenty of fruit at this meal and eat it at no other time._ _at . lunch._--one boiled egg or some cream cheese: oatcakes and butter or good wholemeal biscuits ("p.r." or "ixion" kinds) and butter, and a plateful of finely grated raw roots (carrots, turnip, etc.). _tea meal._--one cupful of hygiama, using water in place of milk. _dinner._--cheddar cheese or cottage cheese (the latter is best); potatoes and a green vegetable, cooked by baking or steaming, without salt. no broth or meat. (meat and especially meat broths are very undesirable in this case.) _before retiring._--hot water only. another case of deafness. j.a.b. writes:--i have been a reader of _the healthy life_ for the last six months, and am suffering from a complaint since i was three years old. when three years old i was attacked by scarlet fever and on getting better i had a discharge from my right ear. this continued for several years, then it would disappear and reappear at short intervals of say a few weeks. this last few years the discharge has disappeared for six months, only to reappear again for a week with severe pains in back over right shoulder and right side of neck. i always feel weak and tired when discharge reappears and sometimes experience pains in the head and cannot remember anything for a few minutes. this correspondent needs a suitable diet in order to purify his blood stream and to promote elimination of bodily poisons which are evidently affecting his ears. he also needs suitable massage and stretching movements applied to the upper part of the spine, which is functioning badly. then he can supplement this by taking turkish baths or wet sheet packs to promote a free action of the skin and thus clear away poisonous waste from the system. the same diet as recommended to the previous correspondent should be tried. concerning cottage cheese. mrs c.e.j. writes:--i have been making cottage cheese curdling the milk with lemon juice, as recommended in _the healthy life_. suppose the milk contains disease germs, would not this cheese be injurious, as the milk is not sterilised by being brought to boiling point? i have also been drinking the whey from the same, as it as given in _the healthy life beverage book_. i notice in a reply given in this month's issue that dr knaggs states that the whey of the milk is the dangerous element. since reading this answer i have been somewhat in doubt as to drinking the whey. i should like to know if it can be taken without harmful effects. ordinary unboiled milk, free from preservatives, is far less dangerous to health than boiled milk, because nature inserts in the raw milk certain germs known as the lactic-acid-producing bacilli, which protect us from the injurious germs. these lactic germs cause the milk to go sour and produce in this way the much-extolled soured or curdled milk. they convert the sugar of the whey into lactic acid by a process of fermentation. if milk is boiled it cannot go sour because the germs natural to it have been destroyed by the heat and it becomes necessary to introduce fresh lactic germs into the boiled milk as is done in the artificial production of curdled milk. failing this, milk will undergo, not lactic fermentation, but _putrefaction_, and thereby develop highly dangerous qualities. when a person takes soured milk its lactic acid acts as a powerful germ destroyer and in a certain concentration it actually kills the lactic germs as well. it also keeps down the disease-producing germs of putrefaction which work in an alkaline medium (opposite to acid) by depriving them of the sugar of the whey. boiled milk, if set on one side, in warm weather, speedily becomes alkaline and putrid or putrefactive. it is in this condition that, when babies take it, they are made dreadfully ill with diarrhoea and inflammation of the stomach and bowels. hence it is the chief cause of the appalling mortality among infants in hot weather. mrs f.k.j. need have no fear of any harm coming to her as a result of eating cottage cheese, but she should not take the whey unless she has decided to undergo a whey cure and take _nothing but whey_; in this latter case, there being no other foods taken, there will be no germs to act harmfully upon it. if there is much flatulence and stomach or bowel trouble sweet milk or whey will simply feed the germs which are the cause of the digestive trouble, or self-poisoning, and are thus far better discarded. diet for obstinate cough. miss n.s. writes:--for the last three weeks i have been troubled with a very bad cough it started in the first place with a cold in the head and then it got on my chest, and do what will i cannot get rid of it. i have been having honey and lemon juice, and also each morning have taken olive oil and lemon juice beaten up together, but without (apparently) any effect. i have bad coughing fits in the night and the next morning i do not feel up to much. i may say that i have not taken meat for about six years, and i try to follow the kind of diet advocated in _the healthy life_. i am years of age and a typist in an office, which is about miles from my home. i try to get out in the fresh air as much as possible to counteract any bad effects which may arise from my work. my people at home are very much opposed to my food reform sympathies and efforts. this correspondent should consult a sensible doctor about this cough and thus be on the safe side. it is unwise to allow a cough to become chronic without ascertaining the cause of it. coughs are often due to stomach and liver trouble, as distinguished from lung trouble. in either case a salt-free diet will greatly help. thus _breakfast._--all fresh fruit, nothing else but fruit. apples best. (_not_ stewed fruit). _lunch._--boiled or steamed rice, done without salt; about oz. cottage cheese or a poached egg; a little raw carrot, turnip or artichoke, finely grated, with dressing of fruit-oil beaten up with a raw egg. the grated roots must be well chewed; as a change they may be cut up and cooked in a casserole with very little water. _dinner._--potato baked in skin, with fresh butter, a little cheese, or flaked nuts, and a few plain rusks, or a saucer of p.r. breakfast food, dry, with cream. the honey and lemon juice should be disgarded in favour of liquorice (little bits being sucked at intervals) or of linseed tea. i have often found an obstinate cough yield to a diet which contains lactic acid buttermilk, combined with the use of the new oxygen baths. the lactic acid buttermilk can be obtained from any good dairy and should be taken in the morning fasting and at bedtime. water grapes. w.g.b. writes:--referring to article in january number entitled "grape juice for all," i think perhaps it would interest others besides myself if dr knaggs would give us his opinion on the value of what are commonly termed "water grapes," as compared with more expensive kinds. on the continent the grape cure is a popular method of treatment. it is especially good for those who are anaemic and underfed as well as for those who suffer in the opposite way from over-feeding. it depends upon which condition is present as to the kind of grapes selected for the cure. fully ripe grapes with but little acidity (water grapes) are best suited for persons suffering from anaemia and malnutrition. the unripe or sour grapes answer best for cases of over-eating associated with constipation, gout and allied disorders of nutrition. the excess of acid and cellulose helps the bowels and promotes elimination of the gouty poisons. our correspondent will note that for thin people who are pale and deficient in vitality the water grapes will be found most salutary. they are best taken alone at breakfast without the addition of any other form of food. cereal food in the treatment of neuritis. e.j.h. writes:--a friend of mine who is suffering from an attack of neuritis (not badly) is desirous of trying the diet of twice-baked standard bread as recommended by dr knaggs in an answer to a query in _the healthy life_ some months since. she has asked me if dr knaggs would limit the quantity of this bread taken in the course of the day. if dr knaggs will very kindly tell me this i shall be greatly obliged. neuritis is a form of rheumatism or gout which involves the nerves. its usual starting centre is the spine itself, from which all the nerves of the body spring. the diet needs to be greatly restricted so that the poisons can be eliminated. the most important foods to cut down are the cereals because they are very slow to digest and are apt to cause constipation with its attendant self-poisoning of the system with uric and other acids. horses and animals suffer from neuritis from over-feeding with cereals and beans, and the stockbreeder or horse expert usually restricts these foods and gives plenty of grass, hay, chaff and green clover, which corrects the trouble. the same thing applies equally to man. he should take his cereals in the form they are the most easily assimilated--namely, twice-baked or dextrinised. thus "pulled" or twice-baked bread, granose or melarvi biscuits, or rusks, or toasted "maltweat" bread are the best form of cereal for people suffering from neuritis. other treatment besides diet restriction is, of course, needed to cure neuritis, because we have to clear the clogged tissues of the poisons which are interfering with right nerve action. thus we can resort hot alkaline baths, turkish baths, massage and osteopathic stretching movements to help in this respect. h. valentine knaggs. +--------------------------------------------------------------+ | | | #back numbers# | | | | if readers who possess copies of the first number of _the | | healthy life_ (august ) will send them to the editors, | | they will receive, in exchange, booklets to the value of | | threepence for each copy. | | | +--------------------------------------------------------------+ the healthy life the independent health magazine. amen corner london e.c. vol. v december no. . _there will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--claude bernard. an indication. there are some statements, the very simplicity and truth of which create a shock--for some people. for instance, there are certain seekers after health who ignore and are shocked by the very obvious truth that "brain is flesh." a brain poisoned by impure blood is no fit instrument for the spirit to manifest through, and "mental suggestion" must inevitably prove of no avail as a cure if the origin of the impure blood be purely material. it is just as futile, on the other hand, to treat the chronic indigestion that arises from persistent worry, or indulgence in passion, by one change after another in the dietary. the founder of homoeopathy insisted that there was no such thing as a physical "symptom" without corresponding mental and moral symptoms. "not soul helps flesh more than flesh helps soul." thus the scientist and the poet come to the same truth, albeit by different ways.--[eds.] plain words and coloured pictures. while most of us would at first sight find fault with mr g.k. chesterton's sweeping advice-- "and don't believe in anything that can't be told in coloured pictures," many would probably end by endorsing it. but we should do so only because we were able to give a very wide and varied meaning to "coloured pictures." no one ever made a coloured picture of the "wild west wind"; but there are plenty of coloured pictures in which there is no mistaking its presence. we all believe in wireless telegraphy (now that it is an accomplished fact) which is, in itself, untranslatable into colour or line; but its mechanism can be photographed, and its results in the world of men and ships are in all the illustrated papers. music, which is pure sound, is to some the surest path to the reality behind this outward show things; yet to some at least of such music is indeed form and colour, even though the colours be beyond the rainbow. for in truth, everything worth believing in, all those things, those ideas, which renew the springs of our life, have form and they have colour. even to the colour-blind one word differeth from another in glory. this is no idle fancy, no mere subject for academic debate: it is the most practical subject in the world. for even as the body is fed not by food alone but by the living air, so is the spirit nourished not alone by right action but by inspiring ideas. ideas are pictures; and the best ideas are coloured pictures. hence the great value of words. it is idle to speak of "words, idle words," as though they were the transient froth on the permanent ocean of thought. they are the vehicle, the body of thought. if the thought be shallow or silly, the words will indeed be "idle." but if the idea be inspiring the words will be the channel of that inspiration. the greater part of this power in words is lost to us to-day. everything tempts us to hurry over words. we talk too quickly to be able to pay that respect to words which they deserve; and we read the newspaper, the magazine, the novel, the play, the poem, with the same disastrous haste. we devour the words but lose their essence. hence there is a grave danger that through this neglect we shut out one of the main streams by which our life must be fed if it is not to shrink into mere fretful existence. there is a curious idea in some minds that fine language consists of long words difficult to understand. nothing could be farther from the truth. most of the great words--the words of power, as the old kabalists called them--are short words, words in common use. and how common is the sound of them in the mouth of the preacher! not long ago i heard an intelligent and cultured man reading one of the many beautiful passages from the english bible:-- "ye dragons, and all deeps; fire and hail, snow and vapour; stormy wind fulfilling his word; mountains and all hills; fruitful trees and all cedars, ..." and he read it as though it were a draper's sale bill. and yet it needs but a very little imagination for such a passage to become a series of vivid pictures. fire, hail, snow, vapour, hills, mountains, cedars, dragons and deeps--every word is "a word of power" if only there is no hurry, if only each word as it comes is given time to call up the picture of the real thing before the inward eye. and you may hear children of fourteen and fifteen who have passed examinations in "english" recite line after line of, say, matthew arnold's _the forsaken merman_ with a glib self-assured colourlessness due solely to the fact that no teacher has ever taught them respect for simple words. and what simpler words could there be than these, for example-- "where great whales come sailing by, sail and sail, with unshut eye, round the world, for ever and aye"? simple, common words; yet if there is that leisurely attention to each one as it comes what an exhilarating picture arises of the great sea-beasts, and of "the round ocean and the living air." i am not pleading for the stylist's concentration on words which exalts them above the things they body forth. the most vivid and beautiful description of dawn in the english language-- "night's candles are burned out, and jocund morn stands tiptoe on the misty mountain tops" though spoken by the most sensitively vibrant voice in the world, can never come near the real dawn breaking across real mountains. but the point is that those two lines composed of simple english words have power, if we pay them respect, to create the dawn within the mind, and to supply the spirit with that beauty which is its very breath. if this patience with words, this respect for the familiar fine things of our native tongue, this desire to make them yield up their strength and beauty, if this has nothing to do with healthy living i don't know what has. william wordsworth's-- "and vital feelings of delight shall rear her form to stately height" is only a metrical expression of a great and practical truth. you do not need to be a "christian scientist" to know that ideas and emotions can affect the stoop of the shoulders or the lines of the mouth. other people besides "eugenists" have observed that ugly or mean-spirited parents seldom have beautiful children. but though the power of ideas is a commonplace, and though psychologists tell us how much we may improve mental concentration by letting the words of any sentence call up each its own picture, what they a omit to do is to recognise the need of the human spirit for beauty. you can concentrate your thought on the list of pickles in a grocer's price list: it is doubtless a good exercise. but the same exercise directed to some great phrase, such as emerson's _trust thyself: ever' heart vibrates to that iron string_; or some vivid lyrical image such as _all the trees of the field shall clap their hands_, or even a complete poem of simple words but permanent beauty, such as that one of wordsworth's beginning _i wandered lonely as a cloud_; this will not only improve concentration and sharpen memory: it will enrich the mind with ever-available sources of inspiration, courage and joy. edgar j. saxon. the world's wanderers. tell me, thou star, whose wings of light speed thee in thy fiery flight, in what cavern of the night will thy pinions close now? tell me, moon, thou pale and grey pilgrim of heaven's homeless way, in what depth of night or day. seekest thou repose now? weary wind, who wanderest like the world's rejected guest, hast thou still some secret nest on the tree or billow? percy bysshe shelley. cloud-capped towers. building castles in the air has always been one of the favourite amusements of mankind. to it we owe much, not only of the zest of life, but also of motive power for overcoming difficulties and reaching out towards new possibilities. yet all literature, and tradition that is earlier than any written literature, is full of a deep note of warning; over and over again we see in the dim past the shadow of a tower that was built in vain, of walls that were piled too high and toppled into ruin, of crests that tapped the thunder-clouds and drew down lightning to their own destruction. evidently man has seen danger in his own desire! the castle must be built with wisdom as well as with industry and boldness if it is to escape disaster and to become a storehouse, a safe defence or a vantage-ground for surveying earth and sky. there is one obvious precaution we should observe in building our castles, and that is to realise that all which we imagine and think about tends sooner or later to externalise itself and pass into action. every idea tends to glide into an ideal. nearly all thinkers have recognised this, and have seen that morality lies much farther back than action, farther back than conscious will. banquo had dreams of ambition, as had macbeth, but they dealt differently with them; while macbeth allowed his visions to lead him on to treachery and murder, banquo prayed against the temptations that came to him in sleep. to most of us imagination, sleeping or waking, comes in less dramatic form, but we should all think more sanely and act more wisely if we interposed a definite revision by the conscious mind and will of all our plans and ideals between their (perhaps quite automatic) formation in our imagination and their translation into fact. slack muscle should go with the daydream or picture of the future; we should not strike or clench or lift until we have decided that the action is right and just and wise. the girl who counted her chickens and broke the eggs is a true enough example: every doctor and coroner knows many instances of results far more tragic. but sometimes the vision has nothing in it but what is pure and good and noble. are there any dangers even here? there is this danger always, that we find the picture so lovely and so satisfying that we cannot summon up courage and energy to turn away from it towards the serious work which it suggests. the castle in the air is radiant and tall, but it is generally meant as a model for a tougher building made out of common earth, by toil and pain, amidst mud and dust. it is so much easier, as sordello knew, to imagine than to do. actual circumstances, real life, other people all this that lies round us is sterner stuff than our easily moulded material of dreams. who has not at some time or other lain sleepily in bed of a morning and gone through in thought the processes of getting up, until a louder call or an alarum bell has awakened the realisation that the task is not yet begun? who has not been tempted to shirk practice of some sort in thinking of a prize? who has not sometimes built expectation higher and higher until his demands of fate have become so great that, in despair of making good, he has let the whole plan slip away into the valley of forgotten dreams? these dangers, the almost involuntary carrying out of unworthy aims that have been cherished in thought and the loss of vigour for real achievement, due to too easy an indulgence in blameless aspiration, are fairly obvious and have long been recognised. there is another that has been seen from time to time and occasionally expressed.[ ] we have seen that too loose a dream-world may make the world in which we live seem dull and ordinary. but is not the converse at least as often true? if our thought-world is too narrow, too selfish or too weak, all our ordinary work, sound and compact though it may be, is stultified, misdirected, often wasted. we all know how in the industrial world something more than industry is needed; in the emotional world something more than a clumsy and unapprehending goodwill. we need a certain insight to turn these solid qualities of labour and feeling to the best account. "a man's reach should exceed his grasp," a great poet tells us, and even the birds or beavers do not go on quite blindly with their building, but, when effort on effort has been destroyed by wind and water or man's interference, they at last accommodate their instinct to circumstances so as to give themselves a better chance of fulfilling their deeper purpose. in many ways we have hardly outgrown the beaver stage: wars, accidents, disease, disputes--how many times must we try over again the same path which has led us before into trouble and disaster before we put our imagination seriously to work on the problem and try to find some more complete solution? of all the dangers of the use of the imagination, perhaps the greatest of all is the neglect to use it, the denial of it and its consequent starvation. e.m. cobham. [ ] mrs book sees an allusion to this danger, as well as to the first, in the warnings against covetousness in the tenth commandment. the play spirit[ ]: a criticism. [ ] see the article, "the play spirit," in the november issue. with your contributor's description of the play spirit, that happy leisure from self and its responsibilities in order that time and thought and heart may be filled with wider inspiration, most of your readers will, i think, entirely agree, and all of us will be grateful for the spirited claim on behalf of "play." the one criticism that occurs to the mind is that a touch of professionalism, of patronage towards the ordinary person, has crept into the author's thought and peeps out through many of the sentences. "common men" ... "ordinary everyday people" ... "average humanity," ... "a worker" who ... "cannot play"; does the writer of the play spirit really show us what is in their hearts? he is an artist in words, he is a keen admirer of other arts, he is interested in thinking; it seems all but impossible to him that anyone can have "freedom" without the power of expressing it, without even the consciousness of its possession. we are all too apt, i think, to imagine that our own discoveries of the mystery and magic of life are peculiar to ourselves, or shared only with a sympathetic few, passed on sometimes (by the _very_ few who have both will and power to do so) to such of the outsiders as are interested enough to enter into that enchanted garden and take gifts from it. but has not the supreme discovery of the greatest artists, philosophers and teachers been that the "everyday people" _do_ live as deeply and broadly as the thinkers and artists? they are inarticulate and cannot tell what they see, but to them life is made amusing, or interesting, or consecrated according to their temperament. who can say what the cornish sea means to that tired worker? at least it seems a boldness that is almost insolence to decide what it did _not_ mean to her! has not every life its revelations? is it not because we do _not_ see as god does that some one particular life which strikes across our path cannot reveal its revelation over again to us? surely "the commonplace is the highest place." or rather, there are no hierarchies of the soul. artist or seamstress or carpenter, we live by the glory that flows to us through whatever curtains of environment are round us. i have not a word of criticism for the writer's ideal. all that i would suggest is that the ideal is really present in the world, "common" as the "everyday" flowers at his feet. not all can sing or paint or write, but many more can laugh or run and all, perhaps, can love and pray. l.e. hawks. on learning to breathe.[ ] [ ] this is article has been specially written as a preface for _health through breathing_, by olga lazarus, shortly to be published ( s. net). to breathe correctly and sufficiently is to live more healthily. this dictum is incontrovertible, and it becomes my pleasant duty herein to demonstrate its truthfulness. and, after a careful perusal of the hundred exercises which the authoress has so clearly and succinctly described, i am still more convinced of the very great, one might almost say of the tremendous, importance of deep-breathing exercises. what has struck me so forcibly in this little book is the fact that there is no undue enthusiasm evident; no embellishment of the subject; no extravagant claims for the system advocated; just a plain sane, sober and intelligent description of procedures of immense value to all who would either keep, or improve, their health. the authoress has, as it were, laid before the reader a feast of good things in the way of physical culture, and leaves it at that. she seems to have brought into purview a splendid variation of the exercises, and indeed every mode of breathing and exercise likely to be beneficial--to those in health as out of it. reverting for a moment to the supreme importance of the subject, i may say that it has of late years come home to me more than ever, and with greater insistency, that innumerable ills of to-day are due to faulty breathing and lack of correct physical exercises generally. i wonder how many of us could conscientiously say that we devote fifteen or twenty minutes regularly every day to the system? and yet such a great deal could be done for health in that time! no, we "haven't time," or we "oversleep ourselves so often," or we make some such other flimsy excuse; but of course we ought to "make time," we ought not to "oversleep ourselves." the fact is, rather, that most of us are too lazy to go through the exercises, even though we may know of their transcendent benefit. in the words of the poet: "let us, then, be up and doing"--that is, up in time in the morning in order to be going through exercises such as described in this little volume. it is within my personal knowledge, and must be within the personal knowledge of every actively engaged physician, that but very few of us yet have any idea, in spite of all the teaching and the advocacy of it, of really deep and scientific breathing. if the system could be made quite general and enforced upon us--especially when young or adolescent--we should not see, as we do now, _thousands_ walking about the streets whose nostrils are too narrow through insufficient breathing, whose lungs are not properly inflated as they inspire; and, as a consequence, who have neither the bloom nor the carriage of health. perhaps if i show here how vastly important it is for us to have our blood well oxygenated, it may be some sort of encouragement for mrs lazarus's readers to persevere with and _work into their lives_ the system she advocates and describes. if we did not renew the oxygen in our lungs to a sufficient extent, we should die in a few minutes. we can do without food for many days; without water for less days, but only for a few minutes without oxygen. anything which tends to increase the intake of this vitally important element, whether deeper breathing or exercises, will have a very pronounced effect upon our general health. now deep breathing is, _par excellence_, the way to bring about this desirable condition. it may interest the readers of this little book if i remind them that in the ordinary way the total capacity of the lungs is about cubic inches; as a rule, the amount of air breathed amounts only to some or cubic inches, but this, by special effort, can be increased by some cubic inches. thus it is demonstrated how much more air we could take into the lungs by better and deeper breathing, thereby securing, sooner or later, a greater natural expansion of the lungs, with the result, of course, of improved health generally. it would surprise most people if they tested their breathing capacity by the aid of the spirometer, to discover how inefficiently they did breathe; in other words, how much below the normal was the amount of air they were usually inspiring. encouragement might also be found in the matter--incentive, that is, to learn how to breathe and exercise correctly and scientifically--if mention were here made categorically of the very profound influences upon certain physiological processes of our organisation which are brought about if we would but mend our ways in this respect. space will only allow of a few such to be detailed. . the circulation is improved and equalised. this implies much more than appears on the surface: it means that the blood is made to flow from any congested internal organ (such as the liver, stomach, etc.) towards the peripheries--that is, the extremities and everywhere where there is the capillary system--the changing-place between the venous and the arterial blood; thus we at the same time warm our extremities and relieve internal congestion. in other words, "to bring the blood to the surface" in many conditions of ill-health is of paramount importance. . it will strengthen the action of the heart and lungs. for lack of proper breathing exercises the heart's walls get thin, the expansive power of the lungs' tissue gets less, and as a consequence, when any little extra strain is thrown upon either, permanent damage is often the result. . in any tendency to constipation, indigestion and similar conditions, such exercises are especially beneficial, and that both by flushing the system with more oxygen and by mechanically exerting pressure on the different organs--thus giving those latter what is actually a good massaging! . indirectly, such exercises must of necessity be splendid for "nerves," as we thus get these supplied with a larger amount of purified blood, and of course this must result in better and heightened nerve and brain action. and all this--and much more which we have not space enough to deal with--being so, it might now be well asked, who and what class of individuals would benefit by these exercises. the list is a long one, and would include practically all growing children and adolescents--in order that adenoids, narrow chests, debility in general, malnutrition and a host of other abnormal states might be either cured or prevented. innumerable adults would also benefit by such exercises: those who are in health, in order to keep so; those who are depressed mentally, or who are suffering from constipation, dyspepsia, anaemia, obesity, debility, etc. even those who are "getting on" in years could, with care and caution, go through such exercises to advantage, providing, that is, that their heart, lungs and blood vessels are fairly normal; it is only where there is serious organic disease such exercises must be withheld. thus we have a big field for such a system which mrs lazarus has described so fully in this little work of hers; it deserves wide recognition, and my final word to the reader is not only to keep the book as a "boon companion," but to encourage others to purchase it and to carry out its most excellent teachings. j. stenson hooker, m.d. letters of a layman. .--doctors and health. medicine is a progressive science--and art, if we judge by the statistics given of the fall in the rate of mortality. even this, however, must be carefully analysed, because a good deal of the fall of mortality is due to the great reduction in the birthrate which has taken place in the last twenty years. still, after this has been allowed for, there is probably a balance in the doctors' favour--something to the good of the science and art of medicine. doubtless the science is improved and the practical advice offered by medical men is better and more effectual than it used to be. a layman, nevertheless, may be forgiven if, with all due deference, he is tempted to believe that many of the benefits attributed to medicine have been achieved through attention to sanitation--cleanliness and ventilation. of course this is due to the work of science, which necessarily includes the members of the medical profession, but it is not due to medical science _qua_ medical science. the terms 'sanitation' and 'sanitary' nearly always connote only ideas associated with cleanliness, free ventilation, etc. they scarcely connote ideas of food management, or, if they do, it is only to the extent of inferring that food shall not be adulterated or of bad quality--and perhaps that there shall be enough of it. such questions as what food shall we eat, and how much; what are the real reasons for taking food into the body, whether it is to give strength and heat to the body or only to supply the body's waste, as dr rabagliati contends--these and other relevant questions are usually left to unorthodox members of the medical profession to declare upon. they seem to be very important questions, but we do not find that they were discussed--or ever mentioned--at the thirty-fourth international medical congress, which completed its sittings several months ago. obviously, the practical questions of food supply are answered very differently, according as one _believes_ they must be answered one way or another, as, for instance, in dr rabagliati's or dr haig's way. but that they are questions not worthy of consideration by doctors in congress may be taken as an ominous sign. it must not be forgotten that we owe many valuable discoveries of medical science to qualified members of the profession, just as discoveries of mechanical science are made by men working at their respective trades. we have sorrowfully to admit, however, that nearly all the great achievements upon which medicine plumes herself are in the direction of increasing the doctors' power over his patient, and seldom of giving his patient power over disease. it is also true that the advocacy by unorthodox members of the profession of simple and natural remedies often involves them in a charge of charlatanism, and subjects them to persecution by medical associations. if the medical profession were all that it is supposed to be, it might be good that the reformer should suffer in solitude while his experiments and methods were subjected to adequate tests and criticism. if the associated physicians and surgeons jealously guarded the public from quackery while they impartially investigated every fresh discovery, the true reformer would welcome the protection afforded him from the "counter-currents of senseless clamour" within the doctors' own ranks, occasioned by party and vested interests. it may be true that "loneliness tends to save the seer from becoming a charlatan and to make of him a true reformer." but it is not that peculiar loneliness of the seer that the medical trade unions afford the reforming physician. that is inevitably and sufficiently accorded him by the "unwillingness of the masses to enter into the thoughts of the seers."[ ] an ignorant and inert people will always follow a charlatan, because they like to do things which are mysterious and involve no trouble on their part. [ ] the reason "why the prophet should be lonely" is perfectly elaborated in a chapter under that title in _logic taught by love_, from which i have quoted. the seer among doctors is boycotted by his fellow medicos _after_ he and his co-workers have tested their experiments for themselves, weeded out what is false from what is true, and proved their methods to be right. not only that, but too often it turns out that it is proper food selection, cleanliness, personal effort and restraint advocated by doctors as substitutes for serums and drugs, which excites the opprobrium of medical coteries. whereas, the misguided serum specialist, who ought to be saved from himself, and from whom the public ought to be protected, is given full medical honours--and facilities to become that most dangerous type of charlatan, the licensed one. there are doubtless many abstract questions of health and disease which orthodox and unorthodox doctors alike are unable satisfactorily to settle. but if that be admitted, then it is certainly not in the public interest that serum treatments should be accepted as almost the last words in medical science. more anti-social still is it to attempt to justify the compulsory orders of parliament that expensive sanatoria shall be built to cope with disease that might be more economically and more satisfactorily treated. is there not too little consideration given to theoretical issues underlying practical experience of disease? is there not too great an anxiety to force remedies at the public expense before all the bearings of the different questions and their phases have been considered? all new methods savour too much of compulsion. they all require the provision of large armies of officials to carry them out. it is interesting to note that the successors of the men who told us how grievously the church has failed because she is established, should be so anxious to more firmly establish the medical priesthood. modern statecraft calls out to us: 'we will appoint officials to inquire into and decide upon what is to be done, but we will make no inquiries into the real nature of this disease and that: we will find out remedies which, in the form of serums to be injected into the blood, shall counteract the effects of disease: we will also appoint, at your expense, doctors to perform these operations: we will force the man whose family may have the misfortune to contract a disease, which the doctors have not told him how to prevent, to submit them to such treatment.' but nothing is said about the desirability of exercising government over oneself, one's body and one's mind! and nothing is _said_ either, but it is suggested, that, if one accepts meekly coercive treatment by official doctors, one may probably be able to ignore the laws of life and health without having to pay the penalty. no sane and properly instructed citizens would be satisfied to have state officials compel them to do what they ought to do for themselves. it is because of this and because the suggestions and compulsions of modern medicine are in keeping with the prevailing philosophy that accumulates knowledge without wisdom, that we need such counteracting influences as are afforded by journals like _the healthy life._ layman. a doctor on doctors. "i charge that whereas the first duty of a physician is to instruct the people in the laws of health and thus prevent disease, the tendency has ever been towards a conspiracy of mystery, humbug, and silence." "i charge that the general tendency of the profession has been to depreciate the importance of personal and municipal cleanliness, and to inculcate a reliance on drug medicines, vaccination, and other unscientific expedients." alexander ross, m.d., f.r.s. +--------------------------------------------------------------+ | | | #to our readers.# | | | | readers who appreciate the independence and all-round | | advocacy of _the healthy life_ can materially assist the | | extension of its circulation by tactfully urging their local | | newsagent to have the magazine regularly displayed for sale. | | an attractive monthly poster can always be had free from the | | publishers, tudor street, london, e.c. | | | +--------------------------------------------------------------+ modern germ mania: a case in point. under the sensational heading, _doomed to carry germs: woman typhoid victim for life_, the following account appeared recently in _news of the world_:-- almost unique in medical history is the case of a woman typhoid carrier, who, it is said, will carry the bacilli with her through life. the case is described by dr barbara cunningham in a report of the manchester medical officer of health. in order that the woman shall cease to be a source of danger--as she has been keeping lodgers--the health authorities are giving her s. a week, and that, with her old-age pension of s., will be sufficient to keep her without lodgers. the case has aroused much interest in manchester. the principal restrictions on the part of the health department are that she must not cook or wash for anyone. anyone can, however, cook for her. in discussing the case dr martin, who for years was medical officer of health for gorton, remarked that in some cases of typhoid carriers the infection ceased to exist for a time, but it was unusual for it to exist year after year. "the reason for the woman referred to carrying the typhoid bacilli with her through life is," he added, "because of a peculiarity of constitution. there is no remedy to be found for it at present, and no means of freeing her from the germs, hence the reward offered by an american to anyone who can find a remedy for such cases. the germs themselves are proof against remedies, and they go on multiplying. the woman is incurable, and you cannot kill the germs without killing the woman. it is the first case, to my knowledge, where the health authorities have taken such measures to prevent a spread of the infection." the history of the affair is interesting. the woman's case had been reported to the authorities, and when her lodger became ill with typhus she was suspected, and was found to be giving off large numbers of typhoid bacilli. she was placed in monsall hospital for two months, during which time she was treated with gradually increasing doses of vaccine prepared in the public health laboratory, york place. when discharged, three separate tests were made as regards the typhoid bacilli. for one week after her discharge the organisms did not reappear, but during the second week a few colonies were grown, and in the third and fourth weeks the number increased. shortly after that her lodger developed enteric fever. this case is instructive, because it shows very clearly the utter futility of the modern method of treating infectious diseases by means of drugs and vaccines. it is well known that the infecting agent or microbe found in cases of typhoid fever originates in man himself, that, in fact, it is essentially a man-made disorder. dr budd, who was the first to fully investigate this important subject, brought together the most convincing considerations to show this. we know further that impure water and milk, shellfish and certain foods which are contaminated with sewage are capable of giving rise to epidemics of this complaint. this was shown in paris in may last, when a plumber carelessly connected a pipe along which seine water flowed to a drinking-water pipe. the typhoid germ is always present in seine water and this mistake cost the lives of twenty people. dr freeman, an american doctor, who has studied the habits of the typhoid germ, tells us that it does not survive so well outside the human body as does the tubercle microbe, but it can, nevertheless, do an incalculable amount of mischief when the local authorities are careless about the matter of sewage disposal. a great deal has been heard of late of what are termed typhoid carriers. there are apparently numbers of people who, while they appear to be in good health, yet harbour these germs and are thus liable to infect others with them; and the problem is what to do with them. the orthodox authorities, as happened in the case cited above, would like to isolate them indefinitely and even to pension them off for life, but this seems to be a hopeless way out of the difficulty. the remedy seems obvious to me. let us stop the drugs and serums and use common-sense hygiene of the body instead. this must be patent to anyone who has any knowledge of the subject; but why the authorities do not put it into execution i am at a loss to imagine. surely the right thing to do is to clear away the impurities in which the typhoid germs live. _by depriving them of the material or soil in which they grow and propagate we should practically starve them out of existence._ moreover, this seems to me to be a perfectly easy procedure. if this woman were handed over to me for treatment i should at once place her on an antiseptic diet consisting solely of salads, grated roots, fresh fruits, sour buttermilk and dextrinised cereals. the effect of this diet would be to cleanse and sterilise the entire digestive tract, and thus break up and clear away the soil in which the microbes are living. supplementary to this cleansing diet other means could be adopted to effect a general purification of the whole body. thus vapour baths could be used to promote skin action; beverages could be taken morning and night, consisting of distilled water with lemon juice or suitable herbal "teas" to promote free action of the kidneys; and colon-flushing treatment could be used to fully cleanse the colon, or large bowel. by combined treatment of this rational order, i am convinced that this woman would speedily become freed from her unpleasant visitors and would be enabled to return to her relations without, as it were, a stain upon her character. h. valentine knaggs. buried talent competition. the editors of _the healthy life_ are convinced that there are many men and women who can write well and interestingly on subjects relating to health in its many aspects; and they wish to unearth this talent. they therefore offer a _first prize_ of _two guineas_, a _second prize_ of _one guinea_, and a _third prize_ of _books_ (published at _the healthy life_ office) to the value of half-a-guinea, for the best essay, sketch or short story appropriate to the pages of _the healthy life._ please read the following conditions carefully:-- conditions. . each essay, short story, or sketch must contain _not less than words_, and _not more than words._ . each essay, short story, or sketch must be written (or typed) on one side of the paper only, leaving at least one inch of margin on which each words must be indicated in figures. . each attempt must be accompanied by the front cover (or top part of cover showing date) of either the december or january numbers. (where more than one ms. is sent in by one contributor, extra covers in proportion must be enclosed.) . the full name and address of the competitor must be written at the foot of last page, in addition to the competitor's _nom de plume_ (if any). . all essays, short stories or sketches must be sent in not later than the st of january , addressed _buried talent_, _the healthy life_, tudor street, london, e.c. . no one who is at present, or has ever been, a regular contributor to _the healthy life_ is eligible for a prize. . the editors reserve the right to publish any contribution sent in under this competition. . the decision of the editors will be final and no correspondence can be entered into with unsuccessful competitors. competitors are asked to note that legibility of handwriting will carry weight as well as intrinsic merit. healthy life recipes. soups. many cases of ill-health demand that the meals should be as dry as possible. having granted this, it will be admitted that there is quite a proper place for soups in ordinary everyday food reform catering. the chief objection to ordinary soups is that they are made on a basis of meat stock and flavoured with one of various "meat extract" preparations. meat stock, meat gravy and meat extract all alike represent the least desirable elements in flesh food, namely, the acids and tissue-wastes of the living animal at the moment of its death--acids and tissue-debris which were on their way to normal excretion via the lymph channels, veins, etc. it is therefore only common-sense to avoid such soup-bases, especially as the most excellent soups can be made without recourse to any animal product. the juices of vegetables, being rich in alkaline "salts" and other organic elements, are the natural cleansing agents in a rational diet. hence to obtain a maximum _remedial_ effect, vegetable soup should be taken in the form of a clear, unflavoured broth, quite apart from the solid meals, and preferably on retiring. but for the dinner or supper soup, some richness of flavour and creaminess of substance are pleasing and legitimate. the following recipes explain, first, how to prepare vegetable "stock," and then how to make rich, creamy nourishing soups, on the basis of that "stock." each recipe will, of course, suggest variations. how to make vegetable stock. put any fresh vegetables in season in a large stewpot--being careful not to include _overmuch_ cabbage or other coarse green leaves, as these give a rather strong flavour--with a quart or more of water, cover, and simmer gently for at least two hours. the outer leaves discarded when preparing vegetables for the table, the stalks and stems, and the peelings of apples, potatoes, etc., should all be used for stock, care being taken, of course, to cleanse them well first, cutting out any insect-eaten or decayed parts. almond cream soup. mix two tablespoonfuls of fine wholemeal or good "standard" flour into a smooth paste with a little water, add this to the hot stock (as above), and stir till soup is thickened. just before serving stir in a tablespoonful of almond cream (either "p.r." or mapleton's). _the addition of the almond cream gives the above a nutritive value, apart from the tonic and cleansing elements in the stock._ nourishing artichoke soup. pare, scrub and cut into small pieces, lb. of artichokes and put immediately into a pan with a pint of water or milk and water. boil till soft, then rub through a wire sieve, using a wooden spoon. put back in pan, add a little more water, a little chopped parsley, and a small piece of butter (or nut butter). bring to the boil, stirring well; stir in a tablespoonful of pinekernel cream ("p.r." or mapleton's), and serve at once. leek and celery soup. put four well-cleansed medium-sized leeks (cut up small), the outer parts of a head of celery (chopped), a quart of water and oz. unpolished japan rice, into a pan and simmer for two hours. rub through wire sieve, return to pan, bring to the boil, and serve. _this soup is not so much nutritive as cleansing and antiseptic._ taste or theory? fruit and the oxalic acid bogey. many and varied are the creeds of health reformers, but all may be included within two main camps. and the opposing battle-cries are instinct _versus_ intellect, taste _versus_ theory, _a priori versus a posteriori_, motives _versus_ purposes. some overlapping and confusion of creed may be found in both camps, but in the main one is filled with lovers of nature, the other with devotees of science. "we believe in simplicity," cries the nature-lover from the meadow where he is taking a sun-bath; "you are so complex, so artificial." "we believe in being 'sensible,'" retorts the devotee of science from the cabinet where he is taking an electric light bath, "you are so extreme." "not extreme--consistent. your treatment varies every month as the decrees of 'science' change." "but your treatment varies every minute as the wind and clouds change. i can keep mine constant with mathematical accuracy, or vary the light to a nicety by pressing a button." and so also is it with regard to diet. the person who talks learnedly about germs and calories (though he never saw a germ or measured a calorie in his life) will be found in the same camp with the electric light advocate, while this other who cultivates a taste in harmony with nature by consuming what he likes best of her unaltered products, he is found arm in arm with the sun-bather. but science will by no means allow him to eat his uncooked food in peace. "if we all adopt _that_ diet," her pseudo-disciples cry, "what is to become of the potatoes?" now, with regard to uncooked foods, it would seem that as little fault can be found with ripe fruit in its natural state as with any article of diet. yet even here "science" holds up a warning hand and is succeeding in scaring people away from one of the most harmless, most wholesome and most neglected of foods. leaving generalities, let us come to a specific case, an actual difficulty propounded to me by a sufferer, one who had spent her substance till she could spend no more in having various parts of herself examined and in learned prescriptions and processes of cure, but who found herself as far from health as ever. obsessed by certain theories of "science," this lady had acquired a dread of sugar _in every form_. hence her query addressed to me: "in your book, _no rheumatism_, you say that sugar is to be avoided. why, then, do you recommend fruit, which is mostly sugar?" i replied as follows: "the reason i recommend ripe uncooked fruit--in spite of its containing a certain quantity of sugar--is that it contains also purifying salts, and that for most people it is the pleasantest form in which these salts can be taken. moreover, fruit sugar appears to be more wholesome than that formed from starch. when you say that 'fruit is mostly sugar,' are you not leaving the water of the fruit out of account? as the water often amounts to per cent. this makes all the difference. taking the fruits generally grown in this country the average proportion of sugar is seven per cent. [this statement is based on the following figures given in goodale's physiological botany:-- apples contain . per cent. sugar pears " . " " plums " . " " strawberries . " " gooseberries . " " grapes are stated to contain . per cent, but often contain much less and sometimes even more.] "now a person eating fruit _ad lib._, but allowed other foods, will hardly ever eat more than a pound or two a day (generally less). but suppose him to eat two pounds. seven per cent. of this is + / oz. if he eats only lb. he takes + / oz. sugar. now compare this with the amount he gets from starchy foods, say, bread, which contains fifty per cent. of starch and sugar. as the starch, if it is to be assimilated, must be (and as a general rule practically all is) converted into sugar during digestion, we get from lb. of bread oz. of sugar (to be exact, nearly oz., because starch forms rather more than its own weight of sugar). but the weight of bread allowed for daily food, if no other starchy or sugary food is taken, is--according to orthodox physiology books-- lb., oz., yielding over oz. of sugar. now i reduce the starchy food to oz. or less (_no rheumatism_, p. ), yielding at most about + / oz. of sugar. you see, then, that the patient can now afford to take even lbs. of fruit, because this will bring his total of sugar up to only + / oz., as against oz. allowed by the orthodox. and if, as i recommend (p. ), fruits containing but little sugar (especially cucumbers) are taken, his total sugar under my regime will be even less than + / oz. "as so many people fail to distinguish between fruit sugar occurring naturally in fruit and ordinary separated and concentrated cane sugar, or even beet sugar separated by various chemicals--'shop sugar,' in fact--i translate for you a passage from dr carton's _trois aliments meurtriers_[ ]:-- [ ] _some popular foodstuffs exposed_, translated by d.m. richardson. s. net. daniel. "'let us proceed now to the study of the third deadly food. the sugar contained in vegetables and raw fruits is a living aliment, physiologically combined with the protoplasm of the vegetable cells, associated with ferments and with vitalised chemical salts. the absorption of this natural sugar is effected by a harmonious contact, by an exchange of energy between the living vegetable cells and our living digestive cells. "'the sugar of commerce, on the contrary, is a dead food which has lost all association with vegetable protoplasm, with vitalised mineral salts and with oxidising ferments which would render it physiological. it is nothing more than a drug, a dangerous chemical, because nature has nowhere presented it to us in this form.... its absorption involves an anti-physiological irritation which over-excites the viscera, and when repeated ends by profoundly altering them.'" "this is all very well," cries pseudo-science, "but people may eat too much fruit." "certainly, but then i warn them at once," quoth taste. "but they have an idea it is good for them, and they disregard your warnings." "if they 'have an idea' which runs counter to my warnings and my penalties, to say nothing of my promises and my rewards, then they can only get that idea from you, mr pseudo-science, with your theories and your figures and your long words." "why not from your relative, unnatural taste? anyhow, it is my duty to warn them." "if they don't heed my warning, they certainly won't heed yours," says taste. "but i can paint such a picture of the trouble they store up for the future if they persist in excessive fruit eating!" "never mind about persisting and storing up for the future. i punish excess in fruit eating as in everything else by prompt discomfort and pain." "but what do you know about oxalic acid?" "enough to avoid it. like every other poison it is repugnant to me." "yet fruit which is so nice in the mouth may ferment in the intestines and form that very poison. then what are you going to do about it?" "take care that not too much fruit is eaten another time." "but in the meantime the oxalic acid already formed must be neutralised at once." "no, no! it would be a pity to do that. oxalic acid is the latest fashion. what would your patients do without it? and what would you do without your patients?" "it must be neutralised at once. it can only be neutralised at the cost of abstracting lime from the system. result: oxalate of lime, forming calculus, or 'stone,' which you don't want, and tissues depleted of lime which you do want." "so you get your patients after all. in fact, having 'neutralised their oxalic acid' to escape you, they come back to you with two diseases instead of one. it seems to me you are a very profitable investment, mr pseudo-science." "really, mr taste, you would not, i presume, have me suppress the truth simply because it happens to be profitable?" "but is it the truth? what proof have you?" "i presume you are ignorant of the fact that animals have died with all the symptoms of oxalic acid poisoning, simply through taking too much sugar." "what kind of animals? you chose such as are used to taking shop sugar as part of their ordinary food, of course?" "well--no; not in that form. the subjects of the experiment were rabbits." "ah! and from these you draw deductions about man who has been eating artificial sugar for ages. how like a vivisectionist! but what doses of sugar did the rabbits get?" "about one-fortieth of the body-weight." "that would be as if a man of lbs. weight should take + / lbs. sugar at a meal! and since it is excessive fruit you are warning us against, can you tell me how many pounds of fruit--say, apples--one must take in order to get that amount of sugar in a day? no less than sixty pounds. really your warning seems a little superfluous." "it is all very well for you to scoff, mr taste, but if it were not for me you would know nothing about the latest diseases. i really believe you would be content to go right through life without knowing that you had a duodenum or an appendix." "quite" assented taste cheerfully. arnold eiloart, b.sc. a symposium on unfired food. _in november, , we published a letter from a reader containing the excellent suggestion that readers who had experimented to any fair extent with unfired diet should be invited to contribute to a conference on the subject in_ the healthy life, _and that the symposium should be gathered round the following points:--_ ( ) the effect of the diet in curing chronic disease. ( ) its effect on children so brought up--_e.g._ do they get the so-called "inevitable" diseases of chicken-pox, measles, etc., and especially have they good (_i.e._ perfect) teeth? ( ) the effect of the diet in childbirth. ( ) the cost of maintaining a household in this way, as compared with the cost under ordinary conditions. ( ) is the diet satisfying, or is there a longing for conventional dietary (often found amongst food reformers)? ( ) is the diet quite satisfactory in winter? _a number of interesting letters have been published this year, and we shall be glad to receive a large number of personal experiences, but they must be brief, and classified under the above heads as far as possible. the following is a striking piece of personal evidence._--[eds.] buckhurst hill, essex, _ th april ._ to the editors of _the healthy life._ dear sirs, as a slight contribution to the interesting discussion which is taking place in your magazine, will you allow me to give you a short summary of nearly sixty years experience of the effects, in my own case, of flesh eating, vegetarianism and the uncooked food diet. this is not a fairy tale, as some may be inclined to think, but a plain unvarnished statement of facts. the flesh-eating period lasted for seventeen years. when three months old i was the unfortunate victim of vaccination poisoning, and for years afterwards was continually in the doctor's hands. the best medical men in this country and america were consulted; for months daily visits were paid to a noted chicago specialist in the hope that he might be able to effect a cure, but it was a case of "love's labour lost," and, instead of improving, my condition grew steadily worse. during all these years, drugging was constantly going on, the pills and potions ordered were religiously swallowed, and, strange as it may seem, the ordeal was survived. flesh meat was eaten daily, and, of all the members of the medical profession consulted, not one of them ever hinted that a change of diet might be beneficial. when years of age my attention was drawn to an article in _the phonetic journal_ on the advantages of a non-flesh diet. by this time, being thoroughly tired of taking endless quantities of useless, poisonous and expensive drugs, i decided, there and then, to throw "physic to the dogs," making up my mind that if death did come, and it seemed to be staring me in the face, i would, at any rate, die a vegetarian. within six months the most dangerous symptom had completely disappeared and has never recurred, but, although greatly benefitting by the new diet, and enjoying on the whole fairly good health, yet there were frequent attacks of rheumatism, lumbago and neuralgia; dyspepsia, with its attendant pain and flatulence, often made life miserable; now and again the liver would rise up in rebellion, bringing in its train vertigo, blurred vision and severe headaches; constipation, that bane of modern life, was a source of endless trouble, in fact, for many years the enema had to be used once or twice a week, and last, but worst of all, came those sharp, shooting, lancinating pains, one of the premonitory symptoms of cancer. obviously, there was still something radically wrong somewhere, and on retiring from practice, a great deal of time and attention was devoted to the subject, innumerable experiments were made, and, ultimately, results obtained, the value of which cannot be exaggerated. five years ago the uncooked food diet was commenced, and from the very first week a steady improvement took place. the constipation vanished as if by magic; there has not been the slightest touch of rheumatism or neuralgia for at least three years the liver is now an unknown quantity, the dyspepsia is a thing of the past, and, most important of all, the cancer symptoms are entirely gone, and in their place has come an abounding health, vigour and vitality that is marvellous. the years seem to have "rolled back in their flight"; all the centres of life are rejuvenated; and the hopes, feelings and aspirations of youth sway me now as they did nearly half-a-century ago. work, mental or physical, is a perfect pleasure, and to feel fatigue is almost unknown. what a glorious gift life really is has never been realised till now, and the wealth of the indies would not induce me to go back to the flesh-pots, or live on cooked foods again. this diet gives two important advantages: firstly, the elimination of all excess of starchy matter prevents the formation of needless fat, and, secondly, the entire absence of artificially sweetened food removes one of the main causes of over-eating. will people ever learn that fat, instead of being a sign of health, is the very reverse, that every ounce of superfluous adipose tissue means more work for the heart, diminished vitality, lessened energy, and, when excessive, is not only a distinct menace to longevity, but to life itself? i never take more than two meals a day and very often only one, which consists of raw vegetables, nuts, olive oil and unfired bread; the second meal, when required, is a simple fruit salad. when a vegetarian the writer lived for years on a shilling a week; it costs rather more now, the oil, nuts, fruit and bread being more expensive than beans, rice, meal, etc., but the difference is so trifling that it is not worth talking about. whilst "fletcherising," deep breathing, distilled water, olive oil, fasting, saltless food, the open-air life, regular exercise, etc., were valuable allies, it was not until the powerful aid of uncooked food was invoked that the real benefits began to appear and life became a real joy. yours, etc., john reid, m.b., c.m. health queries. _under this heading our contributor, dr valentine knaggs, deals briefly month by month, and according as space permits, with questions of general interest to health seekers and others._ _in all queries relating to health difficulties it is essential that full details of the correspondent's customary diet should be clearly given._ _correspondents are earnestly requested to write on _one side only of the paper_, giving full name and address, not for publication, but as a guarantee of good faith. when an answer is required by post a stamped addressed envelope must be enclosed._--[eds.] _every inquiry must be accompanied by the front cover (or upper part of same showing date) of a recent number_ of _the healthy life_. onion juice as hair restorer. mrs m. mcc. writes:--in your book, _onions and cress_,[ ] on p. , it is stated that the juice of onions mixed with honey will change the colour of hair from grey to black. will you be kind enough to tell me in what proportion these should be mixed, as, of course, if not in a proper mixture, the hair would become so clogged. and will you also kindly tell me how one is to extract the juice from the onions, whether they are to be boiled or squeezed when raw. with regard to the use of a mixture of onion juice and honey as a hair restorative the reader of my little book must remember that it is largely a compilation of quotations from old herbal books, and it gives the history, use and folklore of these interesting edibles. i am not responsible for this recipe and cannot therefore vouch for its utility. we know, however, that onions contain a wonderful sulphured oil and that sulphur in one form or another is an important ingredient of most hair preparations which restore colour. the raw juice evidently should be used, and this can be extracted either by pounding and grating and then extracting the juice under pressure, or it can be readily obtained in any quantity by putting onions through the enterprise juice press. the amount of honey, i think, to be added to this juice should be very small, otherwise, as our correspondent surmises, the preparation would be very sticky and objectionable. would any reader care to try this and report upon it? [ ] _onions and cress_, d. net (postage d). sciatica. mrs m.g. writes:--my husband is a sufferer from sciatica; has had it for some years, on and off, but just lately he seems is to get it constantly--sometimes a little, sometimes a lot. he has been taking some salicylate of soda, and i have tried to persuade him to give it up. his age is . for his meals he takes, on rising, an apple or a cup of apple tea; an hour afterwards his breakfast, which consists of two tablespoonfuls of a proteid food mixed with distilled water, and a hard biscuit, two slices of whole meal brown bread, nut butter, and watercress or lettuce. during the morning he drinks barley water. for dinner, a salad and a few ground nuts and hard biscuits and an apple; sometimes home-made nut meat and spinach, hard biscuits and dried or fresh fruit. for tea, a salad or lettuce, tomatoes, onions and cress, and shredded wheat and wholemeal bread. last thing at night, a few steamed onions and distilled water. his bowels are in good condition, very regular, but he has this constant gnawing pain. if you can help me in any way as to a change in his diet, it will be a relief to me. i do not mind the trouble of preparing things for him. it is about two months ago that he has taken to drinking distilled water, which i make myself. his occupation is very sedentary, with long hours, sometimes from six in the morning till nine at night. he has a bicycle, and gets as much exercise as possible. from the description given one would assume that the sedentary occupation and long hours of work have caused this correspondent to fall into bad postural habits of sitting and standing, coupled with excessive depletion of his nervous energy. the diet given is on good lines and, with the addition of home-made curd cheese and eggs as proteid, might certainly be continued as it stands, especially as the bowel action is regular. what the correspondent does need is less hours of work; more physical exercises of a brisk back-stretching nature, and certain spinal stretching manipulations of an osteopathic nature. full deep breathing in fresh air will also be beneficial. the lower part of the spine, from which the sciatic nerves originate, needs the most attention. refined paraffin as a constipation remedy. mr e.h. writes:--will dr knaggs very kindly say whether refined paraffin, now being given so generally for the relief of constipation, may be regarded as a harmless method of overcoming this trouble or whether its use might lead to harmful results. i am told that this preparation of oil is not assimilated, and is therefore harmless, but i should much appreciate dr knaggs' opinion on this matter. the use of refined paraffin as a remedy for constipation is just now all the rage with the orthodox medical profession. there is nothing really to be said against its right use, provided it is made to serve as one of the means to an end. it has been proved that this paraffin, which is quite tasteless, odourless and easy to swallow, is not absorbed by the system but passes unchanged and unaltered through it. it acts therefore as a mere mechanical lubricant. the one thing to remember is that its use should be combined with a curative diet, so that it need not be taken indefinitely. ( ) dry throat; ( ) saccharine; ( ) dilated heart. mr l.s. writes:--i have read _the healthy life_ from the appearance of the first number, and i have studied the answers to correspondents, but have not observed a case identical with my own, hence my reason for troubling you. ( ) the back part of mouth next throat has a curious glazed appearance--no cough or expectoration. i am inclined to think it extends to and includes the stomach. i have always a good appetite, but am not well nourished; much under weight. age years; school officer; cycle miles a week. eat meat sparingly, not a pound a week. live principally upon eggs and bread and butter--(three eggs a day): "digestive tea" two and three times a day. . is saccharine less harmful than sugar for sweetening? . as the result of a nervous breakdown i had five years ago i suffer from a dilated heart, consequently--i suppose--i have palpitation occasionally, oftener when in bed. i don't think my heart is really normal since my breakdown five years ago. . would bathing myself with cold water over the region of the heart strengthen the muscles? would you please suggest anything for strengthening heart. are lemons or eggs injurious to the heart? . the throat symptoms indicate a dry, irritable, heated condition of the mouth and throat which, as the correspondent surmises, equally affects the stomach and the rest of the digestive organs. he should have a breakfast of fresh fruit only, take salads and grated raw roots with his meals and stop tea altogether. he can drink distilled water and vegetable or lemon drinks (unsweetened) instead. . saccharine is a mineral substance, a fossilised product of putrefactive action in the coal age. it is closely analogous to carbolic acid, which equally originates from microbic action. by leaving off sugar and replacing it by saccharine our correspondent gains nothing. he is simply leaping from the frying pan into the fire. it is best for him to cultivate a taste for unsweetened or even acid drinks. . a dilated heart is usually an after effect of a dilated stomach, which strains it, just as it does every other organ, whether in the chest or the abdomen. . bathing the chest with cold water is not desirable. what is needed is that the correspondent should drink as little fluid as possible and pay close attention to the condition of his digestive mechanism. if the organs are dilated or misplaced he should wear a belt and take suitable gentle osteopathic exercises. treatment for stammering. a.m.d. writes:--could you kindly give in _the healthy life_ magazine some suggestions as to the best method to follow in a case of stammering (slight) in a boy of ten or eleven years who has been rather left to himself, the hesitancy in speech being regarded as incurable? this boy should be trained by someone who understands how to cure stammering. the correspondent would do well to consult miss behncke of earl's court square, s.w., who makes a speciality of treating such cases. why the red corpuscles are deficient in anaemia. a.m.d. writes:--is there any way, independent of diet, of increasing the red corpuscles in the blood? i have tried walking nine miles a day, thus getting up free perspirations. what of this method? i did imagine that this resulted in a better condition of the skin, the latter losing in a measure the white and parched appearance. a deficiency of red corpuscles in the blood, which shows in anaemia, is usually caused by self-poisoning. when food ferments or putrifies in the colon, owing to faulty diet and other causes, certain toxins are created. these become absorbed into the blood and there destroy the red corpuscles. walking is a good form of exercise, but it will not suffice alone to remedy this type of anaemia unless the diet and general habits of the patient are so arranged that the unsanitary condition of the colon is also remedied. the correspondent will find, if she studies the replies to others in this magazine, many details as to diet, etc., for rectifying bad conditions in the bowels. the correct blending of foods. t.b.w. writes:--is it inadvisable for a dyspeptic (and sufferer from constipation) to eat salad, or cooked vegetables, and stewed fruit at the same meal; also, do i do right in eating bread and butter (preferably crust) or hard biscuits with stewed fruit or soft vegetables, etc.? would you please inform me the best still that i can obtain--preferably one that does not require much attention, and is fairly portable, and that does not cost much to work? i do not believe that it is right to mix salads or cooked vegetables with stewed fruits. it is better to take them at separate meals. it is, in my view, equally bad to take cereals (_i.e._ bread, biscuits, etc.) with stewed fruits. the reason is that cereals call for an alkaline form of digestion in the mouth which the acid fruits or the added sugar greatly retard. i believe strongly in the all-fruit breakfast or all-fruit supper, when fresh, dried, or even stewed dried fruits (possibly with some fresh cream) can be taken alone, without either cereals or vegetables. cereals go best with salads and cooked vegetables, because of the alkalinity of the latter which harmonises with the salivary secretion intended for the digestion of grains. the gem still is the best to buy. it is well made and does not need much attention. the large automatic commercial size is, however, the best if any quantity is needed, as it works throughout the day with practically no attention when properly adjusted. difficulties in changing to non-flesh diet. f.c.w. writes:--i shall be glad if you will inform me from your experience whether, after one has broken from the customary meat diet and adopted a "reform" diet, there is any real difficulty in reverting to the former state. i have seen it stated that vegetarian diet did not call into action all the natural powers of the digestive organs, and, this being so, the tendency was for them to become weakened so that the food reformer eventually found himself unable to digest meat. i believe some health culturists make practice of taking meat twice a week. i have been about seven or eight weeks on reform diet, and though better in some ways have to confess to a feeling of deficient energy and nerve power. i was once told by a doctor that i could not afford to do without the stimulating effect derived from meat. i propose making a test of the two methods, but should like to hear from you in reply to the above query. another new feature i have noticed on the new diet is a thinness of the teeth and a feeling of weakness in them generally. this correspondent omitted to supply his amended diet, so this was asked for and is as follows:-- _on rising_ ( . ).--cup of cold water. _breakfast_ ( a.m.).--porridge, boiled egg or white fish done in oven. turog brown bread and butter; a banana; cup of coffee. _lunch_ ( . , _at the home restaurant_)--nut or cheese savoury and one vegetable, a sweet dish, a few dates or a nut and fruit cake. _tea meal (in office at )._--bread and butter, piece of cake, large cup of cocoa. _supper._--one of following:-- (a) "force" with stewed prunes and junket; small piece of cheese with wholemeal biscuit. (b) milk pudding and stewed fruit; small piece of cheese and biscuit. (c) vegetable soup with toast. (d) bread and milk and fruit cake. _on retiring_ ( p.m.).--cup of hot milk. the correspondent adds further:-- i have only been about eight weeks on food reform and the general result, so far, is less susceptibility to draughts and ability to sleep with windows open top and bottom, which i could not do before, and a feeling of lightness and freshness. on the other hand, i have not the same nerve force or power. i am of a highly sensitive nervous disposition, and the latest trouble is with my teeth. i was told yesterday by a dentist that a non-flesh diet is harmful to them and that were one to eat meat only, there would be no trouble! perhaps it is owing to the dates and nut-and-fruit cakes which i have been eating, or to a general weakened condition due to want of finding my natural diet. i have a friend who is a fine specimen of physical development, and on his going on to food reform he had to have his teeth seen to. i suppose it would not be the softer diet giving his teeth less to do. i am at a disadvantage as i can get nothing specially prepared at home and can only add to my diet articles which i can prepare myself. i like my liquids fairly sweet and i like liquid foods. i am a catarrhal subject and when this starts at the back of the nose the hearing is affected. whenever a person changes from a meat diet to one that is of the non-flesh order the digestive organs have to learn how to adjust their secretions to the altered diet. this applies just as forcibly when a food reformer wishes to return to the "flesh-pots." after a long course of abstinence from meat the food reformer does find it difficult to return to it. this is due not so much to the difficulty in digesting it as to the violent stimulation and grossening of the body which it induces. i have never heard of any food reformer who discarded meat for ethical or humane reasons who willingly returned to meat so that he could if necessary be in a position to digest it. with regard to the loss of energy and nerve power the correspondent must distinguish between real weakness and absence of stimulation. the first effects of discarding meat show a deficient energy due to the absence of stimulation. when this has passed it gives place to a feeling of buoyancy and energy which is permanent. the dental weakness is aggravated, if indeed it is not actually _caused_, by the milk puddings, porridge, cake and sugared beverages which are a feature of this correspondent's diet, and to the absence of salad vegetables. if he amended his diet somewhat as follows he should make steady progress in energy and general fitness:-- _on rising._--tumblerful of cold water. _breakfast_ ( . ).--one lightly boiled, baked or poached egg; veda bread and butter, a little watercress or other salad. a small cup of hygiama in place of the sugared cocoa. _lunch_ ( . ).--nut or cheese savoury and one vegetable; baked pudding by preference for second course, or simply a nut and fruit cake; no dates. _or_ salad with grated cheese or cream cheese, or flaked pine nuts; followed by a piece of the excellent wholemeal cake supplied at the restaurant this correspondent frequents. _tea meal._--one cup of salfon cocoa (unsweetened), preferably without other food. _supper_ ( to ) (this meal is at present far too mushy).--cream cheese, veda bread with fresh butter or nut butter, salad, tomatoes, cucumber, etc., with dressing of pure oil and lemon juice. _or_ simply fresh ripe fruit, with dried fruit and cream; no cereals. _on retiring._--cupful of hot unsweetened lemon water, or weak barley water; no milk. h. valentine knaggs. correspondence. _all correspondence should be addressed (and all contributions submitted) to the editors, _the healthy life_, tudor street, london, e.c._ cottage cheese. wilderton, bournemouth. bournemouth. _to the editors_, dear sirs, _re_ mrs c.e.j.'s letter and the reply thereto: i should be inclined to doubt the wisdom of making this from unboiled or uncooked milk unless one had it from one's own cows and could supervise the dairy oneself. the average milk that comes into towns from country farms is--well, it's unthinkable. there's a saying that what the eye doesn't see the heart doesn't grieve over, but that doesn't alter the fact that the average cow is none too clean, the average milker's hands and clothes (to say nothing of his face, hat and head) none too clean, the milking-place none too clean, and the circumstances of transit such as don't make for cleanliness. i have put it very moderately, as those who know country dairy farms will admit. those who particularly want clean cheese from uncooked milk should buy it from a county council dairy farm or similar institution. yours truly, b.c. forder. will other readers do likewise? mrs e. bumpus writes ( th october ):-- i am ordering two copies each month from my local newsagent.... i thought he might be induced to show copies of your publication in his window. [an attractive blue poster is supplied each month free by the publishers to all genuine agents who apply for the same.--eds.] _the healthy life_ in the libraries. mr c.h. grinling writes ( th october ):-- i note the suggestion on p. of the october number of _the healthy life_. a friend enables me to ask you to send _the healthy life_ regularly for one year to the woolwich public library, william street, woolwich. i enclose s. the librarian will see that it appears on the magazine-room table regularly. [there is every reason why _the healthy life_ should be known and read in every public library in the united kingdom. in this we are entirely dependent upon those readers who are ready to follow the excellent example of the above and other correspondents. a year's subscription-- s.--is a very small price to pay for bringing the message of this magazine before the public in this way. we should like to hear from readers in all parts.--eds.] fruit-oils and nuts. westcliff-on-sea, nd oct. . _to the editors_, sirs, with reference to the last paragraph of "phosphorus and the nerves" on p. of the october number, i should be obliged if i could be informed through your correspondence columns ( ) what are the "fruit oils" recommended therein and ( ) how they are to be taken. ( ) is olive oil good to take? ( ) is it good for children? if so how is it to be administered? ( ) what nuts are richest in phosphorus? i enclose my card, and remain, yours truly, w.w. ( ) any olive oil that bears a thorough guarantee of purity (such as "minerva" olive oil, "creme d'or" olive oil, etc.); also any pure nut oil (such as supplied by mapleton's or the london nut food co.); also the pure blended oil sold as "protoid fruit oil." our advertisement pages should be studied for further details. ( ) suggestions were given on pp. xxxiii and xxxv of the november number. ( ) yes, excellent. ( ) yes, they usually take it more readily than adults, for the latters' palates are generally spoilt. for its use see _right diet for children_, by edgar j. saxon, s. net. ( ) almonds and walnuts. if the nuts are found difficult to digest try them in a finely prepared form, as in mapleton's almond cream, "p.r." walnut butter, or "protoid" almond butter.--[eds.] pickled peppercorns. lady cheylesmore was wearing a magnificent cock pheasant's plume. the eagle eye of the customs official caught sight of it and handed her a pair of scissors to help her detach it.--_daily news._ now we know what a really well-trained eagle eye can do. * * * * * perhaps the only remnant of the awful sameness characteristic of the typically english kitchen is the bacon and egg breakfast to which the average briton clings with wonderful tenacity. the mere possibility of infidelity to that national dish is enough to make one shudder. no one could be such an iconoclast as to suggest a variant from the traditional breakfast; it would be table-treason of the worst kind.--_daily telegraph._ a middle-aged briton named leary, of bacon and eggs got so weary, that for no other reason he committed high treason-- but whether he shuddered's a query. * * * * * silver-fox furs are rapidly becoming more and more rare, and this fact lends a special interest to the wonderful collection of these skins now being shown this week by revillon freres at regent street. these beautiful silver foxes, to the number of over a hundred, are grouped in eight large showcases on the ground floor, and represent the latest arrivals from revillon's canadian outposts, where they have special facilities for securing these rare skins.--_daily chronicle._ a ninth large showcase containing specimens of the steel traps in which "these beautiful silver foxes" are caught, and in which they remain till "collected," would give added interest to the collection at regent street. * * * * * sixty-six persons banqueted at gorleston on a single "sea-pie," which weighed lbs. prepared by an old smack skipper, it was built in three stories. the foundation consisted of beef bones, and inside were six large rabbits, half-a-dozen kidneys, thirty pounds of beef steak.--_daily chronicle._ not to be confused with the gorleston mausoleum. peter piper. a lecture on the preservation of _health_. by t. garnett, m.d. professor of natural philosophy and chemistry in the royal institution of great britain &c. second edition. [figure] such the reward of rude and sober life; of labour such. by _health_ the peasant's toil is well repaid; if _exercise_ were pain indeed, and _temperance_ pain. _armstrong_. _london_: printed for t. cadell, junior, and w. davies, strand. . (r. noble, printer, old bailey.) _to erasmus darwin, m.d._ _dear sir,_ _the first edition of this pamphlet having been introduced to the world under the sanction of your name, i take the liberty of prefixing it to the second; and am happy in having another public opportunity of expressing my thanks for the high gratification and instruction which i have received from the perusal of your medical and philosophical works._ _i am,_ _dear sir,_ _with much esteem,_ _your very obedient servant,_ _tho. garnett._ _royal institution,_ _april th, ._ _preface._ _most medical gentlemen will, it is supposed, agree that the greater part of the numerous train of diseases to which their patients are subject, have been brought on by improper conduct and imprudence. that this conduct often proceeds from ignorance of its bad effects, may be presumed; for though it cannot be denied that some persons are perfectly regardless with respect to their health, yet the great mass of mankind are too sensible of the enjoyment and loss of this greatest of blessings, to run headlong into danger with their eyes open._ _it was with the hope of making the laws of life more generally known, and better understood, and from thence deducing such rules for the preservation of health, as would be evident to every capacity, that the author was induced to deliver this lecture. it has been honoured with the attention of numerous audiences, in some of the most populous towns in england, where it has generally been read for the benefit of charitable institutions._ _the author flatters himself, that besides the benefit produced by his humble endeavours to serve these institutions, those endeavours have not totally failed in the grand object of preserving health; and with the hope that the influence of the precepts here given, may be farther extended, he has concurred in the ideas of those who have advised the publication of this lecture._ _it is to be feared, that notwithstanding all which can be done, disease will continue to be a heavy tax, which civilized society must pay for its comforts; and the valetudinarian will often be tempted to envy the savage the strength and soundness of his constitution. much however may be done towards the prevention of a number of diseases. if this lecture should contribute to the attainment of so desirable an end, it will afford the highest gratification to the author._ _the first part of the lecture is the substance of an essay which was read by the author before the royal medical society of edinburgh, intended as a defence of the general principles of the system of dr. brown, whose pupil he then was. it was, according to custom, transcribed into the books of the society, and the public have now an opportunity of judging how far dr. girtanner, in his first essay published in the journal de physique, about two years after, in which he gives the theory as his own, without the least acknowledgment to the much injured and unfortunate author of the_ elementa medicinae, _has borrowed from this essay._ _in public lectures, novelty is not to be expected, the principal object of the lecturer being to place in a proper point of view, what has been before discovered. the author has therefore freely availed himself of the labours of others, particularly of the popular publications of dr. beddoes, which he takes this opportunity of acknowledging._ _this lecture is published almost_ verbatim _as it was delivered. on this account the experiments mentioned are not minutely described, the reader being supposed to see them performed._ * * * * * a lecture, &c. the greatest blessing we enjoy is health, without it, wealth, honors, and every other consideration, would be insipid, and even irksome; the preservation of this state therefore, naturally concerns us all. in this lecture, i shall not attempt to teach you to become your own physicians, for when the barriers of health are once broken down, and disease has established itself, it requires the deepest attention, and an accurate acquaintance with the extensive science of medicine, to combat it; to attain this knowledge demands the labour of years. but, a majority of the diseases to which we are subject, are the effects of our own ignorance or imprudence, and it is often very easy to prevent them; mere precepts however, have seldom much effect, unless the reasoning upon them be rendered evident; on this account, i shall first endeavour, in as plain and easy a manner as possible, to explain to you the laws by which life is governed; and when we see in what health consists, we shall be better enabled to take such methods as may preserve it. health is the easy and pleasant exercise of all the functions of the body and mind; and disease consists in the uneasy and disproportioned exercise of all, or some of the functions. when dead matter acts upon dead matter, the only effects we perceive are mechanical, or chemical; for though there may appear to be other kinds of attraction, or repulsion, such as electric and magnetic, yet these come under the head of mechanical attraction, as producing motion; we may therefore lay it down as a law, that when dead, or inanimate bodies act upon each other, no other than mechanical, or chemical effects are produced; that is, either motion, or the decomposition, and new combination of their parts. if one ball strike another, it communicates to it a certain quantity of motion, this is called mechanical action; and if a quantity of salt, or sugar, be put into water, the particles of the salt or sugar will separate from each other, and join themselves to the particles of the water; the salt and water in these instances, are said to act on each other chemically; and in all cases whatever, in which inanimate, or dead bodies act on each other, the effects produced are, motion, or chemical attraction. but, when dead matter acts on those bodies which we call living, the effects are much different; let us take for example a very simple instance.--snakes, at least some species of them, pass the winter in a torpid state, which has all the appearance of death; now heat, if applied to dead matter, will only produce motion, or chemical combination; but if it be applied to the snake, let us see what will be the consequence; the reptile first begins to move, and opens its eyes and mouth; when the heat has been applied for some time, it crawls about in search of food, and performs all the functions of life. here then, dead matter, when applied to a living body, produces living functions; for if the heat had not been applied, the snake would have continued senseless, and apparently lifeless. in more perfect animals, the effects produced by the action of dead matter on them, are more numerous, and are different in different living systems, but are in general the following--sense and motion in almost all animals, and in many the power of thinking, and other affections of the mind. the powers, or dead matters, which are applied, and which produce these functions, are chiefly, heat, food, and air. the proof that these powers do produce the living functions, is in my opinion a very convincing one, namely, that when their actions are suspended, the living functions cease; take away, for instance, heat, air, and food from animals, and they soon become dead matter, and it is not necessary that an animal should be deprived of all these to put a stop to the living functions; if any one of them be taken away, the body sooner or later becomes dead matter: it is found by experience, that if a man be deprived of air, he dies in about three or four minutes; for instance, if he be immersed under water; if he be deprived of heat, or in other words, exposed to a very severe degree of cold, he likewise soon dies; or if he be deprived of food, his death is equally certain, though more slow. it is sufficiently evident then, that the living functions are owing to the action of these external powers upon the body. what i have here said, is not confined to animals, but the living functions of vegetables are likewise caused by the action of dead matter upon them. the dead matters, which by their action produce these functions, are principally heat, moisture, light, and air. it clearly follows therefore, from what i have said, that living bodies must have some property different from dead matter, which renders them capable of being acted upon by these external powers, so as to produce the living functions; for if they had not, the only effects which these powers could produce, would be mechanical, or chemical. though we know not exactly in what this property consists, or in what manner it is acted on, yet we see, that when bodies are possessed of it, they become capable of being acted upon by external powers, and thus the living functions are produced; we shall therefore call this property _excitability_, and in using this term it is necessary to mention, that i mean only to express a fact, without the least intention of pointing out the nature of that property which distinguishes living from dead matter, and in this we have the example of the great newton, who called the property which causes bodies in certain situations to approach each other, _gravitation_, without in the least hinting at its nature; yet, though he knew not what gravitation was, he investigated the laws by which bodies were acted on by it, in the same manner, though we are ignorant of excitability, or the nature of that property which distinguishes living from dead matter, we can investigate the laws by which dead matter acts on living bodies through this medium. we know not what magnetic attraction is, and yet we can investigate its laws; the same holds good with regard to electricity; if we ever should attain a knowledge of the nature of this property, it would make no alteration in the laws which we had before discovered. i shall now proceed to the investigation of the laws by which the excitability is acted on; but i must first define some terms which it will be necessary to use, to avoid circumlocution, and at the same time to give us more distinct ideas on the subject. when the excitability is in such a state as to be very susceptible of the action of external powers, i shall call it _abundant_, or _accumulated_; but when it is found not very capable of receiving their action, i shall say, it is _deficient_, or _exhausted_. i would not wish however, to have it thought, that by these terms i mean in the least to hint at the _nature_ of excitability, nor that it is _really_ one while increased, and at another diminished in quantity, for the abstract question is in no shape considered; we know not whether the excitability, or the vital principle, depends on a particular arrangement of matter, or from whatever cause it may originate; by the terms here used, i mean only to say, that the excitability is easily acted on when i call it abundant, or accumulated; at other times the living body is with more difficulty excited, and then i say, the vital principle is deficient, or exhausted. the laws by which external powers act on living bodies, will, on a careful examination, be found to be the following-- first, when the powerful action of the exciting powers ceases for some time, the excitability accumulates, or becomes more capable of receiving their action, and is more powerfully affected by them. if we examine separately the different exciting powers, which act on the body, we shall find abundant confirmation of this law. let us first consider light; if a person be kept in darkness for some time, and be then brought into a room in which there is only an ordinary degree of light, it will be almost too oppressive for him, and appear excessively bright; and if he have been kept for a considerable time in a very dark place, the sensation will be very painful. in this case, while the retina, or optic nerve, was deprived of light, its excitability accumulated, or became more easily affected by light; for if a person goes out of one room, into another which has an equal degree of light, he will feel no effect. you may convince yourselves of this law by a very simple experiment--shut your eyes, and cover them for a minute or two with your hand, and endeavour not to think of the light, or of what you are doing; then open them, and the day-light will for a short time appear brighter. if you look attentively at a window, for about two minutes, and then cast your eyes upon a sheet of white paper, the shape of the window-frames will be perfectly visible upon the paper; those parts which express the wood-work, appearing brighter than the other parts. the parts of the optic nerve on which the image of the frame falls, are covered by the wood-work from the action of the light; the excitability of these portions of the nerve will therefore accumulate, and the parts of the paper which fall upon them, must of course appear brighter. if a person be brought out of a dark room where he has been confined, into a field covered with snow, when the sun shines, it has been known to affect him so much, as to deprive him of sight altogether. let us next consider what happens with respect to heat; if heat be for some time abstracted, the excitability accumulates; or in other words, if the body be for some time exposed to cold, it is more liable to be affected by heat, afterwards applied; of this also you may be convinced by an easy experiment--put one of your hands into cold water, and then put both into water which is considerably warm; the hand which has been in cold water, will feel much warmer than the other. if you handle some snow with one hand, while you keep the other in your bosom, that it may be of the same heat as the body, and then bring both within the same distance of the fire, the heat will affect the cold hand infinitely more than the warm one. this is a circumstance of the utmost importance, and ought always to be carefully attended to. when a person has been exposed to a severe degree of cold for some time, he ought to be cautious how he comes near a fire, for his excitability will be so much accumulated, that the heat will act violently; often producing a great degree of inflammation, and even sometimes mortification. we may by the way observe, that this is a very common cause of chilblains, and other inflammations. when the hands, or any other parts of the body have been exposed to violent cold, they ought first to be put into cold water, or even rubbed with the snow, and exposed to warmth in the gentlest manner possible. exactly the same takes place with respect to food, if a person have for some time been deprived of food, or have taken it in small quantity, whether it be meat or drink; or if he have taken it of a less stimulating quality, he will find, that when he returns to his ordinary mode of living, it will have more effect upon him than before he lived abstemiously. persons who have been shut up in a coal-work from the falling in of the pit, and have had nothing to eat for two or three days, have been as much intoxicated by a bason of broth, as a person in common circumstances with two or three bottles of wine; and we all know that spirituous, or vinous liquors affect the head more in the morning, than after dinner. this circumstance was particularly evident among the poor sailors who were in the boat with captain bligh after the mutiny. the captain was sent by government to convey some plants of the bread-fruit tree from otaheite, to the west-indies; soon after he left otaheite, the crew mutinied, and put the captain and most of the officers, with some of the men, on board the ship's boat, with a very short allowance of provisions, and particularly of liquors, for they had only six quarts of rum, and six bottles of wine, for nineteen people, who were driven by storms about the south-sea, exposed to wet and cold all the time, for nearly a month; each man was allowed only a tea-spoon full of rum a-day, but this tea-spoon full refreshed the poor men, benumbed as they were with cold, and faint with hunger, more than twenty times the quantity would have done those who were warm, and well fed; and had it not been for the spirit having such power to act upon men, in their condition, they never could have outlived the hardships they experienced. all these facts, and many others which might be brought, establish beyond a doubt the truth of the law i have mentioned, namely, that when the powerful action of the exciting powers ceases for some time, the excitability accumulates, or becomes more capable of receiving their actions. the second law is, that when the exciting powers have acted with violence, or for a considerable time, the excitability becomes exhausted, or less fit to be acted on, and this we shall be able to prove by a similar induction. let us take the effects of light upon the eye; when it has acted violently for some time upon the optic nerve, it diminishes the excitability of that nerve, and renders it incapable of being affected by a quantity of light that would at other times affect it. when you have been walking out in the snow, if you come into your room, you will scarcely be able to see any thing for some minutes. look stedfastly at a candle for a minute or two, and you will with difficulty discern the letters of a book, which you were before reading distinctly; and if you happen to cast your eyes upon the sun, you will not see any thing distinctly for some time afterwards. let us next consider the matter of heat: suppose water to be heated lukewarm, if you put one hand into it, it will feel warm; if you now put the other hand into water, heated for instance to degrees or degrees, and keep it there some time, we will say, two minutes; if then you take it out, and put it into the lukewarm water, that water will feel cold, though still it will seem warm to the other hand; for, the hand which had been in the heated water, has had its excitability exhausted by the application of heat. before you go into a warm bath, the temperature of the air may seem warm and agreeable to you, but after you have remained for some time in a bath that is rather hot, when you come out, you feel the air uncommonly cool and chilling. let us now examine the effects of substances taken into the stomach; and as the effects of spirituous, and vinous liquors, are a little more remarkable than food, we shall make our observations upon them. a person who is unaccustomed to drink these liquors, will be intoxicated by a quantity that will produce no effect upon one who has been for some time accustomed to take them; and when a person has used himself to these stimulants for some time, the ordinary powers which in common support life, will not have their proper effects upon him, because his excitability has been in some measure exhausted by the stimulants. the same holds good with respect to tobacco and opium; a person accustomed to take opium will not be affected by a quantity that would completely intoxicate one not used to it; because the excitability has been so far exhausted by the use of that drug, that it cannot be acted on by a small quantity. these facts, with innumerable others, which will easily suggest themselves to you, prove the truth of our second proposition, namely, that when the exciting powers have acted violently, or for a considerable time, the excitability is exhausted, or less fit to be acted on. this exhaustion of the excitability, may, however, be either finite, or temporary; we see animals, while the exciting powers continue to act, at first appear in their greatest vigour, then gradually decay, and at last come into that state, in which, from the long continued action of the exciting powers, the excitability is entirely exhausted, and death takes place. we likewise see plants in the spring, while the exciting powers have acted on them, moderately, and for a short time, arrayed in their verdant robes, and adorned with flowers of "many mingling hues;" but, as the exciting powers which support the life of the plant, continue to be applied, and some of them, for instance heat, as the summer advances become increased, they first lose their verdure, then grow brown, and at the end of summer cease to live; because their excitability is exhausted by the long continued action of the exciting powers; and this does not happen merely in consequence of the heat of summer decreasing, for they grow brown and die, even in a greater degree of heat than that which in spring made them grow luxuriantly. these are examples of the finite, or irreparable exhaustion of the excitability, but we find also, that it may be exhausted for a time, and accumulated again. though the eye has been so dazzled by the splendour of light, that it cannot see an object moderately illuminated, yet, if it be shut for some time, the excitability of the optic nerve accumulates again, and we are again capable of seeing with an ordinary light. we find, that we are not always equally capable of performing the functions of life. when we have been engaged in any exertion, either mental or corporeal, for some hours only, we find ourselves fatigued, and unfit to pursue our labours much longer; if in this state, several of the exciting powers, particularly light and noise, be withdrawn; and if we are laid in a posture which does not require much muscular exertion, we soon fall into that state which nature intended for the accumulation of the excitability, and which we call sleep. in this state, many of the exciting powers cannot act upon us, unless applied with some violence, for we are insensible to their moderate action. a moderate light, or a moderate noise, does not affect us, and the power of thinking, which exhausts the excitability very much, is in a great measure suspended. when the action of these powers has been suspended for six or eight hours, the excitability is again capable of being acted on, and we rise fresh, and vigorous, and fit to engage in our occupations. sleep then, is the method which nature has provided to repair the exhausted constitution, and restore the vital energy; without its refreshing aid, our worn-out habits would scarcely be able to drag on a few days, or at most a few weeks, before the vital spring was quite run down; how properly therefore has the great poet of nature called sleep the chief nourisher in life's feast.-- 'sleep, that knits up the ravell'd sleeve of care, 'the death of each day's life, sore labour's bath, 'balm of hurt minds, great nature's second course, 'chief nourisher in life's feast.' from the internal sensations often excited, it is natural to conclude that the nerves of sense are not torpid during sleep; but that they are only precluded from the perception of external objects, by the external organs being rendered unfit to transmit to them the impulses of bodies, during the suspension of the power of volition; thus, the eye-lids are closed in sleep, to prevent the impulse of the light from acting on the optic nerve; and it is very probable that the drum of the ear is not stretched; it is likewise probable that something similar happens to the external apparatus of all our organs of sense, which may make them unfit for their office of perception during sleep. the more violently the exciting powers have acted, the sooner is sleep brought on; because the excitability is sooner exhausted, and therefore, sooner requires the means of renewing it; and on the contrary, the more weakly the exciting powers have acted, the less is a person inclined to sleep. instances of the first are, excess of exercise, strong liquors, or study, and of the latter, an under proportion of these. a person who has been daily accustomed to much exercise, whether mental or corporeal, if he omit it, will find little or no inclination to sleep; he may however be made to sleep by taking a little diffusible stimulus; for instance, a little warm punch, or opium: these act entirely by exhausting the excitability to that degree which is compatible with sleep; and when their stimulant effect is over, the person soon falls into that state. but though the excitability may have been sufficiently exhausted, and the action of the external powers considerably moderated, yet there are some things within ourselves, which stimulate violently, and prevent sleep; such as pain, thirst, and strong passions and emotions of the mind. these all tend to drive away sleep, but it may be induced, by withdrawing the mind from these impressions; particularly from uneasy emotions, and employing it on something which makes a less impression; sleep, in such cases, is frequently brought on by listening to the humming of bees, [ ] or the murmuring of a rivulet; by employing the mind on subjects which do not require much exertion, nor produce too much commotion; such as counting to a thousand, or counting drops of water which fall slowly. it sometimes happens, as has been well observed by dr. franklin, that an uneasy heat of the skin, from a want of perspiration, occasioned by the heat of the bed-cloaths, will prevent sleep; in this case, he recommends a method, which i believe will often succeed--namely, to get up and walk about the room till you are considerably cooled; when you get into bed again, the heat of the skin will be diminished, and perspiration become more free, and you will probably sleep in a very few minutes. [ ] by induction we have discovered two of the principal laws by which living bodies are governed; the first is, that when the ordinary powers which support life have been suspended, or their action lessened for a time, the excitability, or vital principle accumulates, or becomes more fit to receive their actions; and secondly, when these powers have been acted upon violently, or for a considerable time, the excitability is exhausted, or becomes less fit to receive their actions. there are therefore three states in which living bodies exist.-- first, a state of accumulated excitability. second, a state of exhausted excitability. third, when it is in such a state as to produce the strongest and most healthy actions, when acted upon by the external powers. from what i have said, it must appear, that life is a forced state, depending on the action of external powers upon the excitability; and that, by their continued action, if they are properly regulated, the excitability will be gradually and insensibly exhausted; and life will be resigned into the hands of him who gave it, without a struggle, and without a groan. we see then, that nature operates in supporting the living part of the creation, by laws as simple and beautiful as those by which the inanimate world is governed. in the latter we see the order and harmony which is observed by the planets, and their satellites, in their revolution round the great source of heat and light. '-----all combin'd 'and ruled unerring, by that single power 'which draws the stone projected, to the ground.' in the animated part of the creation, we observe those beautiful phenomena which are exhibited by an almost infinite variety of individuals, all depending upon one simple law, the action of the exciting powers on the excitability. i cannot express my admiration of the wisdom of the creator better than in the words of thomson. 'o unprofuse magnificence divine! 'o wisdom truly perfect! thus to call 'from a few causes, such a scheme of things; 'effects so various, beautiful, and great.' life then, or those functions which we call living, are the effects of certain exciting powers, acting on the excitability, or property distinguishing living from dead matter. when those effects, namely, the functions, flow easily, pleasantly, and completely, from the action of the exciting powers, they indicate that state which we call health. i have detained you a long time on this subject, but it is of importance to make you acquainted with these laws; for it is from a knowledge of them, that the rules for preserving health must be deduced; and having rendered them, as i hope, intelligible to you, i shall proceed to point out such necessary cautions for your conduct, as are easily deduced from them; and which experience confirms; and i shall follow an arrangement in the consideration of the subject, which naturally presents itself to us. the chief exciting powers which act upon us are, air and food; these i shall respectively consider, and afterwards make a few remarks on exercise. the air is the main-spring in the animal machine; the source of heat and activity, without which our blood would soon become a black and stagnant mass, and life would soon stop. it is now known, that only a part of atmospheric air, is necessary for respiration: the atmosphere near the surface of the earth, consists of two kinds of air; one, which is highly proper for respiration, and combustion, and in which, an animal immersed, will live much longer than in the same quantity of common air; and one, which is perfectly improper for supporting respiration, or combustion, for an instant. the first of these airs, has been called vital air, from its property of supporting life, and constitutes about one fourth of the atmosphere. [ ] the other, from its property of destroying life, is called azote, and forms of course the remaining three fourths of the atmosphere. these two airs may be separated from each other by various methods. if a candle be inclosed in a given quantity of atmospheric air, it will burn only for a certain time, and then be extinguished; and from the rising of the water in the vessel in which it is inclosed, it is evident that a quantity of air has been absorbed. what has been absorbed is the vital air, and what remains, the azote, which is incapable of supporting flame. if an animal be immersed in a given quantity of common air, it will live only a certain time; at the end of this time, the air will be found diminished, about one fourth being extracted from it, and the remainder will neither support flame nor animal life; this experiment might easily be made, but it seems a piece of unnecessary cruelty. by similar experiments to those i have mentioned, we get the azote pure; here is some, in which a candle has burnt out, and in which nothing but azote, or the impure part of the atmosphere is left. [ ] i shall plunge a lighted match into it, and you see it is instantly extinguished. some metals, and particularly manganese, when exposed to the atmosphere, attract the vital air from it, without touching the azote; and it may be procured from these metals by the application of heat, in very great purity. here is a bottle of that kind of air, which i have expelled by heat from manganese; i shall plunge a taper into it, and you will perceive that it burns with great brilliancy. an animal shut up in it, would live about four times as long as if shut up in an equal quantity of atmospheric air. if i take three parts of azote, and one of vital air, i shall form a compound which is similar to the atmosphere, and which is the mixture best suited to support the health of the body; for if there were a much greater proportion of vital air, it would act too powerfully upon the system, and bring on inflammatory diseases; it would likewise by its stimulus exhaust the excitability, and bring us sooner to death; and in the same manner that a candle burns brighter in vital air, and would therefore be sooner exhausted, so would the flame of life be sooner burnt out. on the contrary, if the atmosphere contained a much less proportion of vital air, it would not stimulate the body sufficiently; the excitability would morbidly accumulate, and diseases of debility would occur. combustion, putrefaction, and the breathing of animals, are processes which are continually diminishing the quantity of vital air contained in the atmosphere; and if the all-wise author of nature had not provided for its continual re-production, the atmosphere would in all probability have long since become too impure to support life; but this is guarded against in a most beautiful manner. water is not a simple element, as has been supposed, but is composed of vital air, and a particular kind of air which is called _inflammable_; the same that is used to fill balloons. it has been found by experiment, that one hundred pounds of water, are composed of eighty-five pounds of vital air, and fifteen of inflammable air. [ ] water may be decompounded by a variety of means, and its component parts separated from each other. vegetables effect this decomposition; they absorb water, and decompose it in their glands; and taking the inflammable air for their nourishment, breathe out the vital air in a state of very great purity; this may be ascertained by a very easy experiment. this vital air is received by animals into their lungs, gives them their heat, and communicates a red colour to their blood; when animals die for want of vital air, their blood is always found black. from what i have said, it is evident, that in large and populous towns, where combustion and respiration are continually performed on a large scale, the air must be much less pure than in the country, where there are few of these causes to contaminate the atmosphere, and where vegetables are continually tending to render it more pure; and if it was not for the winds which agitate this element, and constantly occasion its change of place, the air of large towns would probably soon become unfit for respiration. winds bring us the pure air of the country, and take away that from which the vital air has been in a great measure extracted; but still, from the immense quantity of fuel which is daily burnt, and the number of people breathing in large towns, the air very soon becomes impure. from the greater purity of the air in the country, proceeds the rosy bloom found in the rural cottage, which we in vain look for in the stately palace, or the splendid drawing room. here then are reasons for preferring the country, which no one will dispute, and whenever it can be done, such a situation ought always to be chosen in preference to a large town: this cannot be better enforced than in the words of dr. armstrong.-- 'ye, who amid the feverish world would wear 'a body free of pain, of cares a mind; 'fly the rank city, shun its turbid air; 'breathe not the chaos of eternal smoke, 'and volatile corruption, from the dead, 'the dying, sick'ning, and the living world 'exhaled, to sully heaven's transparent dome 'with dim mortality. 'while yet you breathe, away; the rural wilds 'invite; the mountains call you, and the vales; 'the woods, the streams, and each ambrosial breeze 'that fans the ever undulating sky.' but there are many whose occupations oblige them to reside in large towns; they, therefore, should make frequent excursions into the country, or to such situations as will enable them to enjoy, and to breathe air of a little more purity. i say _enjoy_, for who that has been for some time shut up in the town, without breathing the pure air of the country, does not feel his spirits revived the moment he emerges from the azote of the town. let not therefore, if possible, a single day pass, without enjoying, if but for an hour, the pure air of the country. doing this, only for a short time _every_ day, would be much more effectual than spending whole days, or even weeks in the country, and then returning into the corrupt atmosphere of the town; for when you have for a long time breathed an impure air, the excitability becomes so morbidly accumulated, from the want of the stimulus of pure air, that the air of the country will have too great an effect upon you; it will frequently, in the course of a day or two, bring on an inflammatory fever, attended with stuffing of the nose, hoarseness, a great degree of heat, and dryness of the skin, with other symptoms of a violent cold. large towns are the graves of the human species; they would perish in a few generations, if not constantly recruited from the country. the confined, putrid air, which most of their inhabitants breathe, their want of natural exercise, but above all their dissipation, shorten their lives, and ruin their constitutions. children particularly, require a pure air; every circumstance points out the country as the proper place for their education; the purity of the air, the variety of rustic sports, the plainness of diet, the simplicity and innocence of manners, all concur to recommend it. it is a melancholy fact, that above half the children born in london, die before they are two years old. to shew how indispensable fresh air is to children, i shall mention one example which sets the fact in the clearest light. in the lying-in hospital at dublin, infants, out of , died in the year , within the first fortnight after their birth, which is nearly every third child; they almost all died in convulsions; many of them foamed at the mouth, their thumbs were drawn into the palms of their hands, their jaws were locked, the face was swelled and looked blue, as though they were choaked. this last circumstance led the physicians to conclude that the rooms in the hospital were too close, and hence, that the infants had not a sufficient quantity of good air to breathe; they therefore set about ventilating them better, which was done very completely. the consequence has been, that not one child dies now where three used to die. fewer children indeed die convulsed now, than formerly; this is because the rich learn, either from books, or conversation with physicians, how necessary fresh air is to life and health; hence they keep their houses well aired; but the poor, and servants, are not made to comprehend this matter properly; and therefore from neglecting to open their windows, and breathing a foul, tainted air, the greatest part of their time, many disorders are brought on, and others rendered worse than they naturally would be. [ ] having considered the purity of the air, let us next take a view of the changes in temperature which it undergoes, and the effects which these have upon the constitution. we find the air sometimes considerably below the freezing point; nay, even so much as or degrees; it is then intensely cold; and on the other hand, the thermometer sometimes indicates a great degree of heat. we then find ourselves much relaxed, and our constitutions exhausted. to understand how this happens, let us consider for a moment the nature of heat, and cold.--heat is one of those stimuli which act upon the excitability, and support life: for if it was totally withdrawn, we should not be able to exist even a few minutes; and cold is only a diminution of heat. when heat is present, in a proper degree, or the atmosphere is about that degree of heat which we call temperate, it just gives such a stimulus, and keeps the excitability exhausted to such a degree, as to preserve the body in health; but if it continue for a considerable time to be much warmer than this temperature, the consequence must be, from the laws already laid down, an exhaustion of the excitability, and a consequent relaxation and debility; for, when the excitability has been exhausted by the violent application of heat, long continued, the common stimulant powers which support life, cannot produce a sufficient effect upon it, to give to the body that tone which is compatible with health. on the contrary, when the heat of the air falls below what we call temperate, or when cold is applied to the body, from the accustomed stimulus of heat being diminished, the excitability must accumulate, or become more liable to be affected by the action of the external powers. this, however, very seldom produces bad effects, unless the exciting powers be improperly or quickly applied; for we can bear a considerable diminution of heat without any bad consequences; and in all cases i hope i shall be able to make it appear, that much more mischief arises from the too great action of heat, than from the diminution of it. nature never made any country too cold for its inhabitants. in cold climates, she has made exercise, and even fatigue habitual to them, not only from the necessity of their situation, but from choice; their natural diversions being all of the athletic or violent kind. but the softness and effeminacy of modern manners, has both deprived us of our natural defence against the diseases most incident to our climate, and subjected us to all the inconveniencies of a warm one. people are afraid of going out into the cold air; but if they conduct themselves properly afterwards, they will never be in the least danger from it. indeed the action of cold, unless it be excessive, never produces any bad effects. many of you will, no doubt, think me here in an error; but i hope you will not long entertain that opinion. you will say that you have had frequent experience to the contrary; that you have often gone out into the cold air, and have caught dreadful colds. that this is owing to the action of cold, i will deny; nay, i will assert, that if a person go out into air which is very cold, _and remain in it_ for a very long time, he will never perceive any symptoms of what is called a cold so long as he remains there. a common cold is attended with a running of the nose, hoarseness, and cough, with a considerable degree of feverish heat, an dryness of the skin.--now it is universally agreed, that this disorder is an inflammation, or is of an inflammatory nature; it is an inflammation of the smooth, moist skin which lines the nostrils, and goes down the wind-pipe into the lungs; but as cold is only a diminution of heat, or a diminution of a stimulus acting upon the body, it is impossible that such a diminution can cause a greater action or excitement; we might as well expect to fill a vessel by taking water out of it. but let us see how a cold, as it is commonly called, is usually produced. when a person in cold weather goes out into the air, every time he draws in his breath, the cold air passes through his nostrils and windpipe into the lungs, and in thus diminishing the heat of the parts, allows their excitability to accumulate, and renders them more liable to be affected by the succeeding heat. so long as that person continues in the cold air, he feels no bad effects; but if he come into a warm room, he first perceives a glow within his nostrils and breast, as well as all over the surface of the body. soon afterwards, a disagreeable dryness and huskiness will be felt in the nostrils and breast. by and by a short, dry, tickling cough comes on. he feels a shivering, which makes him draw nearer to the fire, but all to no purpose; the more he tries to heat himself, the more chill he becomes. all the mischief is here caused by the violent action of the heat on the accumulated excitability. for want of a knowledge of this law, these disagreeable, and often dangerous complaints are brought on; when they might be avoided with the greatest ease. when you take a ride into the country on a cold day, you find yourselves very cold; as soon as you go into a house, you are invited to come to the fire, and warm yourselves; and what is still worse, to drink something warm and comfortable, to keep out the cold, as the saying is. the inevitable consequence of this, is, to bring on the complaints which i have just described, which might with more propriety be called, heats than colds. but how easily might these complaints have been avoided! when you come out of a very cold atmosphere, you should not at first go into a room that has a fire in it, or if you cannot avoid that, you should keep for a considerable time at as great a distance from the fire as possible, that the accumulated excitability may be gradually exhausted, by the moderate and gentle action of heat; and then you may bear the heat of the fire without any danger: but, above all, refrain from taking warm or strong liquors while you are cold. if a person have his hands or feet exposed to a very severe cold, the excitability of those parts will be so much accumulated, that if they should be brought suddenly near the fire, a violent inflammation, and even a mortification will take place, which has often happened; or, at any rate, that inflammation called chilblains will be produced, from the violent action of the heat upon the accumulated excitability of those parts; but, if a person so circumstanced, was to put his hands or feet into cold water, very little warmer than the atmosphere to which he had been exposed, or rub them with snow, which is not often colder than or degrees, the morbid excitability will be gradually exhausted, and no bad consequences will ensue. when a part of the body only has been exposed to the action of cold, and the rest kept heated; if, for instance, a person in a warm room sits so that a current of air coming through a broken pane, should fall upon any part of the body, that part will be soon affected with an inflammation, which is usually called a rheumatic inflammation. from what has been said, it will be easy to account for this circumstance. the excitability of the part is accumulated by the diminution of its heat; but at the same time, the rest of the body and blood is warm; and this warm blood acting upon a part where the excitability is accumulated, will cause an inflammation; to which, the more you apply heat, the worse you make it.--from these considerations, we may lay it down as a fact, and experience supports us in so doing, that you may in general go out of warm into cold air without much danger; but, that you can never return suddenly from the cold into the warm air with perfect impunity. hence, we may lay down the following rule, which, if strictly observed, would prevent the frequent colds we meet with in winter. _when the whole body, or any part of it, is chilled, bring it to its natural feeling and warmth by degrees._ but if, for want of observing this necessary caution, a cold, as it is called, should have seized a person, let us consider what is proper to be done. it will, from the preceding reasoning, appear very improper to make the room where you sit warmer than usual, to increase the quantity of bed-clothes, to wrap yourself up in flannel, or particularly to drink a large quantity of barley-water, gruel, or tea, almost boiling hot, by way of diluting, as it is called, and forcing a perspiration; this will infallibly make the disorder worse, in the same manner as confining inoculated persons in warm rooms would make their small-pox more violent. perhaps there would be scarcely such a thing as a bad cold, if people, when they found it coming on, were to keep cool, and avoid wine and strong liquors, and confine themselves for a short time to a simple diet of vegetable food, drinking only toast and water. instances are by no means uncommon, where a heat of the nostrils, difficulty of breathing, a short, tickling cough, and other symptoms, threatening a violent cold, have gone off entirely in consequence of this plan being pursued. colds would be much less frequent, were we to take more pains to accommodate our dress to the season: if we were warmly clothed in cold weather, our excitability would not be accumulated by the action of the cold. if a greater proportion of females fall victims to this disease, is it not because, losing sight, more than men, of its primary purpose, they regulate their dress solely by fantastic ideas of elegance? if happily, as is observed by dr. beddoes, our regret should recall the age of chivalry, to break the spell of fashion would be an atchievement worthy the most gallant of our future knights. common sense has always failed in the adventure; and our ladies, alas! are still compelled, whenever the enchantress waves her wand, to expose themselves half undressed, to the fogs and frosts of our climate. besides the effects of the air, we ought by no means to be indifferent with regard to what we take into the stomach as food and drink; since these have even a greater influence on our health, than the circumstances i have already mentioned. among the causes which excite the body, and support life, i have formerly mentioned food, or the matters taken into the stomach. it is from these matters that all the animal solids and fluids are formed; these are stimuli, which if totally withdrawn, we could not exist many days. these stimuli are subject to the same laws with all the others which act upon the body. when they act properly in concert with the other powers, they produce the healthy state; but if they act in an undue degree, whether that action be too great or too little, disease will be the consequence. when they act too feebly, the excitability will accumulate; and diseases of debility, attended with a very great degree of irritability, will take place: this has been instanced in those who have been without food for some time. persons who have been shut up in a coal-work by the falling-in of the pit, and have consequently been without food for some days, have had their excitability so much accumulated, as to be intoxicated with a bason of broth. to this source we may attribute many of the diseases with which the poor are afflicted; but they are by no means so common as diseases of an opposite nature, which arise from a too free use of food. i shall confine myself here to the consideration of what is more strictly called food, and afterwards consider the effects of strong liquors. when we take food in too great quantity, or of too nourishing a quality, it will either produce inflammatory diseases, such as pleurisy; or by exhausting the excitability, it will bring on stomach complaints, gout, and all the symptoms of premature old age. this follows so evidently from the laws we have investigated, that it is scarcely necessary to say more on the subject; and i am sure there are few who have not seen examples of it. be therefore temperate in eating, and eat only of such foods as are the plainest; and let a proper quantity of vegetable food be mixed with animal. if you value the preservation of health, never satiate yourselves with eating; but let it be a rule from which you ought never to depart, always to rise from table with some remains of appetite: for, when the stomach is loaded with more food than it can easily digest, a crude and unassimilated chyle is taken into the blood, pregnant with diseases. nor is the quantity the only object of attention; the quality of the food is to be carefully studied; made dishes, enriched with hot sauces, stimulate infinitely more than plain food, and therefore exhaust the excitability, bringing on diseases of indirect debility; such as the worst kind of gout, apoplexy, and paralytic complaints. "for my part," says an elegant writer, "when i behold a fashionable table set out in all its magnificence, i fancy that i see gouts and dropsies, fevers and lethargies, with other innumerable distempers, lying in ambuscade among the dishes." let it be therefore laid down as a rule by those who wish to preserve their health, and i have nothing to say to those who are indifferent on that head, to make their chief repast on one plain dish, and trifle with the rest. it is by no means uncommon for a medical man to have patients, chiefly among people of fashion and fortune, who complain of being hot and restless all night, and having a foul taste in the mouth every morning: on examination it is found, that in nineteen cases out of twenty, it has arisen from their having overloaded their stomachs, and at the same time neglected to take proper exercise; for it must always be observed, that more may be eaten with safety, nay, more is even necessary, when a person takes a good deal of exercise. when people take little exercise, and overload their stomachs, there lies within them a fermenting mass of undigested aliment; and it is not surprizing that this should irritate and heat the body during the night. this is likewise the foundation of stomach complaints, flatulencies, and all other symptoms of indigestion; which more frequently proceed from intemperance in eating and drinking than any other cause. the benefits arising from temperance are set in a striking light in the following allegory, which may be found in the adventurer. esculapius, after his deification or admittance among the gods, having revisited his native country, and being one day (as curiosity led him a rambling,) in danger of being benighted, made the best of his way to a house he saw at some distance, where he was hospitably received by the master of it. cremes, for that was the master's name, though but a young man, was infirm and sickly. of several dishes served up to supper, cremes observed that his guest ate but of one, and that the most simple; nor could all his intreaties prevail upon him to do otherwise. he was, notwithstanding, highly delighted with esculapius's conversation, in which he observed a cheerfulness and knowledge superior to any thing he had hitherto met with. the next morning, esculapius took his leave, but not till he had engaged his good-natured host to pay him a visit at a small villa, a few miles from thence. cremes came accordingly, and was most kindly received; but how great was his amazement when supper was served up, to see nothing but milk, honey, and a few roots, dressed in the plainest, but neatest manner, to which hunger, cheerfulness, and good sense, were the only sauces. esculapius seemed to eat with pleasure, while cremes scarcely tasted of them. on which a repast was ordered more suitable to the taste of our guest. immediately there succeeded a banquet composed of the most artful dishes that luxury could invent, with great plenty and variety of the richest and most intoxicating wines. these too were accompanied by damsels of the most bewitching beauty. cremes now gave a loose to his appetites, and every thing he tasted raised ecstasies beyond what he had ever known. during the repast, the damsels sung and danced to entertain them; their charms enchanted the enraptured guest, already flushed with what he had drank; his senses were lost in ecstatic confusion. every thing around him seemed elysium, and he was on the point of indulging the most boundless freedoms, when on a sudden their beauty, which was but a vizard, fell off, and discovered forms the most hideous and forbidding imaginable. lust, revenge, folly, murder, meagre poverty, and despair, now appeared in the most odious shapes, and the place instantly became a most dire scene of misery and confusion. how often did cremes wish himself far distant from such a diabolical company, and now dreaded the fatal consequence which threatened him. his blood ran chill at his heart, and joy and rapture were perverted to amazement and horror!--when esculapius perceived it had made a sufficient impression on his guest, he thus addressed him: "know, cremes, it is esculapius who has thus entertained you, and what you have beheld is a true image of the deceitfulness and misery inseparable from luxury and intemperance. would you be happy, be temperate: temperance is the parent of health, virtue, wisdom, plenty, and every thing that can make you happy in this or the world to come. it is indeed the true luxury of life, for without it life cannot be enjoyed." this said, he disappeared, and left cremes (instead of an elegant apartment) in an open plain, full of ideas quite different from those he had brought with him. on his return home, from the most luxurious, he became one of the most temperate men, by which wise method he soon regained health. frugality produced riches, and from an infirm and crazy constitution, and almost ruined estate, by virtue of this infallible elixir, he became one of the happiest men breathing, and lived to a healthy old age, revered as an oracle for his wisdom throughout all greece. if temperance be necessary with regard to food, it is still more so with respect to strong liquors; these diffusible stimuli, by quickly exhausting the excitability, soon blast the vigour, and sap the foundation of the strongest constitution. their immediate effects you know are stimulant; they raise the animal spirits, produce a cheerful state of mind, and if taken in greater quantity, cause intoxication, or that temporary derangement of the thinking powers which arises from too great a degree of excitement: but let us see what happens the next day; the animal spirits are exhausted, and the person thus situated, finds himself languid and enervated to a great degree; for it seems a law of the human body, that the spirits are never artificially raised, without being afterwards proportionably depressed; and to shew clearly that in this state the excitability is exhausted, the ordinary powers which in general support life, will not have their due effect; and a person thus situated finds most relief the next day, from taking some of the same stimulus which occasioned the exhaustion; because the common exciting powers can scarcely act upon his exhausted excitability. but though the excitability be in this way exhausted, it will in the course of a day or two be again accumulated, and it may, perhaps, be suspected that this exhaustion can do no harm to the constitution; but this is a premature conclusion, and quite contrary to fact and experience, as well as to reason; for, just in the same manner that a pendulum, made to vibrate in the arc of a circle, will never return exactly to the same height, but fall a little short of it every time; so, though the excitability may be again accumulated, it never can be brought back to what it was before; and every fresh debauch will shorten life, probably two or three weeks at least, besides debilitating the body, and bringing on a variety of diseases, with premature old age. those who drink only a moderate quantity of wine, so as to make them cheerful, as they call it, but not absolutely to intoxicate, may imagine that it will do them no harm. the strong and robust may enjoy the pleasures of the bottle and table with seeming impunity, and sometimes for many years may not find any bad effects from them; but depend upon it, if a full diet of animal food be every day indulged in, with only a moderate portion of wine, its baneful influence will blast the vigour of the strongest constitution. while we are eating, water is the best beverage. the custom of drinking fermented liquors, and particularly wine, during dinner, is a very pernicious one. the idea that it assists digestion, is false; those who are acquainted with chemistry know, that food is hardened, and rendered less digestible by these means, and the stimulus which wine gives to the stomach is not necessary, excepting to those who have exhausted the excitability of that organ by the excessive use of strong liquors. in these. the stomach can scarcely be excited to any action without the assistance of such a stimulus. if food wants diluting, water is the best diluent, and will prevent the rising, as it is called, of strong food, much better than wine or spirits. before i finish this subject, i shall say a few words on the pernicious custom of suffering children to drink wine, or other fermented liquors. nothing is more common than to see, even very young children come to the table after dinner, to drink a glass of wine. the least quantity produces violent effects on their accumulated excitability, and by quickly exhausting it, ruins their constitutions through life, and often renders them habitual drinkers. i can scarcely help attributing in some degree the many stomach complaints we meet with, among young people in the present age, and which were unknown to our forefathers, to the abominable practice of suffering children to drink fermented, or spirituous liquors. you must all have observed how soon children are intoxicated and inflamed by spirituous liquors; you may judge then, that if these liquors be only a slow poison to us, they are a very quick one to them. a glass of wine, on account of the accumulated excitability of children, will have more effect upon them, than a bottle will have upon an adult accustomed to drink wine. if therefore, the health of a child, and its happiness through life be an object, never suffer it to taste fermented, or spirituous liquors, till it be fifteen or sixteen years of age, unless a little wine be necessary as a medicine. it now only remains for me to take some notice of exercise. of all the various methods of preserving health, and of preventing diseases, which nature has suggested, there is none more efficacious than exercise; it puts the fluids all in motion, strengthens the solids, promotes perspiration, and occasions the decomposition of a larger quantity of atmospheric air in the lungs. hence, in order to preserve the health of the body, the author of nature has made exercise absolutely necessary to the greater part of mankind for obtaining the means of existence.--had not exercise been absolutely necessary for our well-being, says the elegant addison, nature would not have made the body so proper for it, by giving such an activity to the limbs, and such a pliancy to every part, as necessarily produce those compressions, extensions, contortions, dilatations, and all other kinds of motions, that are necessary for the preservation of such a system of tubes and glands.--and that we might not want inducement to engage us in such exercise of the body as is proper for its welfare, it is so ordered, that nothing valuable can be procured without it. not to mention riches and honors, even food and raiment are not to be come at without the toil of the hands and sweat of the brow. providence furnishes materials, but expects that we should work them up ourselves. the earth must be laboured before it gives its increase, and when it is forced into its several products, how many hands must they pass through before they are fit for use? manufactures, trade, and agriculture, naturally employ more than nineteen parts of the species out of twenty; and as for those who are not obliged to labour by the condition in which they are born, they are more miserable than the rest of mankind, unless they indulge themselves in that voluntary labour which goes by the name of exercise. of all the different kinds of exercise, there is none that conduces so much to health as riding; it is not attended with the fatigue of walking, and the free air is more enjoyed in this way than by any other mode of exercise. where it cannot be used, walking, or exercise in a carriage, ought to be substituted. the best time for taking exercise is before dinner, for the body is then more vigorous and alert, and the mind more cheerful, and better disposed to enjoy the pleasure of a ride or walk. exercise after a full meal disturbs digestion, and causes painful sensations in the stomach and bowels, with heart-burn, and acid eructations. but whatever mode of exercise you use, it ought not at first to be too violent. dr. armstrong has given us an excellent rule-- 'begin with gentle toils, and as your nerves 'grow firm, to hardier, by just steps aspire. 'the prudent, even in every moderate walk, 'at first but saunter, and by slow degrees 'increase their pace.' the end. r. noble. printer, old bailey. notes. [ ] hinc tibi, quae semper vicino ab limine sepes hyblaeis apibus florem depasta salicti, saepe levi _somnum_ suadebit inire susurro. virg. [ ] may not the heat, and want of perspiration, depend on an exhausted irritability of the subcutaneous vessels, which will be accumulated by the method here recommended? [ ] oxygen gas, according to the new nomenclature. [ ] the fixed air, or carbonic acid gas, formed during the combustion, having been separated by agitation in contact with lime water. [ ] strictly speaking, water is composed of the bases of these airs, the greatest part of the caloric being given out on their union. [ ] where manufactures are carried on to a great extent, the air is rendered still worse, and every precaution ought to be used to preserve the health of the inhabitants. places where manufactures are carried on, ought, therefore, to be constructed in such a manner as to be very lofty, and capable of being easily ventilated. night-working is undoubtedly a perversion of the laws of nature, renders the constitution feeble, and lays a foundation for bad health and disease: for it not only gives no time for ventilation, and in consequence the quantity of oxygen becomes more and more exhausted; but the number of candles used, contributes very much to contaminate the air. it has been found by experiment that a candle contaminates more air than a man. by persons who are interested in the welfare of the succeeding generations, night-work will never be urged, and it will be right to ventilate the manufactories every night, as well as during breakfast and dinner. * * * * * _lately published,_ elegantly printed in two volumes quarto, and illustrated by a map and fifty-two plates, from drawings taken on the spot by w. h. watts, who accompanied the author in the tour, price l. s. d. in boards, observations on a tour through the highlands and part of the western isles of scotland, particularly staffa and icolmkill: to which are added, a description of the falls of the clyde, of the country round moffat, and an analysis of its mineral waters. by t. garnett, m.d. member of the royal medical, physical, and natural history societies of edinburgh; the literary and philosophical society of manchester; the medical society of london; the royal irish academy; and professor of natural philosophy and chemistry in the royal institution of great britain. printed for t. cadell, jun. and w. davies, strand. * * * * transcriber's notes. the frontispiece contains the following text, and a portrait of the author: engraved by j. hopwood, from a picture by j. r. smith. thomas garnett, m.d. published march th , by cadell & davies, strand. in line of this text, the word transcribed as too appears as o in the original text, with blank space indicating the omission of the first two letters of the word. in lecture ix of dr. garnett's _zoonomia_, where the same example of the reaction of the eye to light is given, the word appears as too. transcriber's note: minor typographical errors have been corrected without note. dialect spellings, contractions and discrepancies have been retained. [illustration: lady curzon] the woman beautiful by mme. qui vive (helen follett stevans) chicago jamieson-higgins co. copyright, , by stevans and handy preface the woman beautiful is not a radiant creature of gorgeous plumage and artificial beauty, but a woman of wholesome health, good hard sense, sparkling vivacity and sweet lovableness. her beauty-creed hangs not from rouge pots and bleaches, but suspends like a banner of truth from the laws of wise, hygienic living. her cheeks are tinted with the glow that comes from good, well-circulated blood, her eyes are bright and lovely because her mind is so, and her complexion is transparent and soft and velvety for the reason that the true art is known to her. the woman beautiful is all sincerity. she doesn't like to sail under false colors and so insult old dame nature, whose kindnesses and benefits are so well meant and freely offered. table of contents page the complexion expression useless beauty washing the face facial eruptions and blackheads tan, sunburn and freckles complexion powders wrinkles recipes for the complexion care of the hair dressing the hair superfluous hair recipes for the hair the hands bathing the hands care of the finger nails recipes for the hands the eyes the girl who cries the eyelashes the eyebrows the teeth bathing diet sleep exercise stooped shoulders breathing massage dress the thin girl the plump girl the working girl the nervous one perfumes the woman beautiful the complexion the bloom of opening flowers, unsullied beauty, softness and sweetest innocence she wears, and looks like nature in the world's first spring. --_rowe._ bad complexions cause more heartaches than crushed ambitions and cases of sudden poverty. the reason is plain. ordinary troubles roll away from the mind of a cheery, energetic woman like water from a duck's back, but beauty worries--well! they have the most amazingly insistent way of sticking to one. you may say you won't think of them, but you do just the same. it was always thus, and thus it always will be. diogenes searched untiringly for an honest man--so they say. woman, bless her dear, ambitious heart, seeks with unabating energy the ways and means of becoming beautiful. after all, they're not so hard to find when once the secret of it is known. like the keys and things rattling about in her undiscoverable pocket, they're right with her. if she will but stop her fretting for a moment, sit down and think, then gird on her armor and begin the task--why, that's all that's needed. there are three great rules for beauty. the first is diet, the second bathing, and the third exercise. all can be combined in the one word health. but, alas! how few of us have come into the understanding of correct living! it is woman's impulse--so i have found--to buy a jar of cream and expect a miracle to be worked on a bad complexion in one brief night. how absurd, when the cause of the worry may be a bad digestion, impure blood or general lack of vitality! one might just as well expect a corn plaster to cure a bad case of pneumonia, or an eye lotion to remedy locomotor ataxia. the cream may struggle bravely and heal the little eruptions for a day or so, but how can it possibly effect a permanent cure when the cause flourishes like a blizzard at medicine hat or a steam radiator in the first warm days of april? cold cream, pure powders and certain harmless face washes are godsends to womankind, but they can't do everything! they have their limitations, just like any other good thing. you may have a perfect paragon of a kitchen lady, whose angel food is more heavenly than frapped snowflakes, but you can't really expect her to build you a four-story house with little dofunnies on the cupolas. of course not. angel cake is her limit! and that's the way with those lovely liquids and things on your pretty spindle-legged dressing table. they can do a good deal in the beautifying line, but they can't do everything. give them the help of perfect health and scrupulous cleanliness of the skin, and lo! what wonders they will work! there is but one way--and it's so simple--of making oneself good to look upon. resolve to live hygienically. there is nothing in the world which works swifter toward a clear, glowing, fine-textured and beautiful complexion than a simple, natural diet of grains and nuts and fruits. but you women--oh! it positively pains me to think of the broiled lobsters, the deviled crabs with tartar sauce, the pickles, and the conglomerate nightmare-lunches that you consume. and yet you're forever fussing over leathery skins, dark-circled eyes and a lack of rosy pink cheeks. oh, woman! woman! why aren't you wise? here are some rules. they're golden, too: eat with wisdom and good sense. that means to pension off the pie and its companion workers of physical woe. take a tepid sponge bath every day, either upon arising in the morning or just before going to bed. limit the hot scrubbings to one a week. exercise with regularity, and dress as a rational human being should. drink three pints of pure, distilled water every day. see that the bedroom is well ventilated, and don't heap up the pillows until you have a mountain range upon which to rest your poor, tired head. a flat bed and a low pillow help toward a fine, straight figure and a good carriage. keep your feet warm. give those pretty round yellow silk garters to the girl you hate, and invest in sensible hose supporters. if your circulation is defective, wear wool stockings. don't fret. bear in mind what sheridan said: "a night of fretful passion may consume all that thou hast of beauty's gentle bloom; and one distempered hour of sordid fear prints on thy brow the wrinkles of a year." then rest. don't, i beg of you, live on the ragged edge of your nerve force. you need quiet, and all you can get of it. we victims of civilization go through life at a breakneck gallop, and it's an immense mistake. anyhow, those who know say so. and it sounds reasonable. but, after all, the complexion is only a small part toward the making of a beautiful woman. the hair must be kept sweet and clean and healthy, and the teeth should be white and lovely. it was rousseau, you know, who said that no woman with good teeth could be ugly. then the hands and nails must have proper attention. deep breathing should be practiced daily and the body properly exercised. the carriage must be graceful, the walk easy and without effort, the eyes bright, the expression of the face cheerful and animated, the shoulders and head well poised--but all these are different stories. there's a chapter in each one of them. above all, remember this one rule: don't fret. don't wear a look of trouble and worry. above everything else, remember those delicious lines of the immortal bard: "you have such a february face, so full of frost, of storm, of cloudiness." and after remembering, refrain. expression. one of the first things to remember in the cultivation of beauty is expression. who doesn't enjoy looking upon the young girl, with a bright, cheerful face, laughing eyes and all that? everybody! and when the grumpy lady or the whiney lady or the lady of woes trots in and sullies your near landscape, how do you feel? just about as cheery as if she'd come to ask you to attend a funeral! my dear girls, it doesn't matter if you have got a freckle or two, or if your nose does tilt up just a little too much, if you have a jolly, bright face people will call you pretty. you can count on that every time. good nature is a splendid beautifier. it brightens the eyes, discourages approaching wrinkles, and brings the apple blossom tints into your cheeks. another thing to remember is this: keep the mind active. there's nothing that will make a stolid, bovine face like a brain that isn't made to get up and hustle. don't sit around and read lovey-dovey novels or spend your time chatting with that stupid woman next door. don't forget that life is short and there's not a moment to waste. when hubby discusses the question of expansion just pipe up and show him what you know about it. don't get into an argument with him, but let him see that you read the papers and that you know a thing or two about passing events. then don't stay cooped up in the house. go out every day, if it's only to the corner market, and if you have to wade through snowdrifts. in short, be up and doing. don't dwell on past griefs or griefs that have not yet arrived. study is mental development, and mental development usually means a bright, pleasing expression. useless beauty. as a general rule, the man of brains and good sense--and he's the only man worth considering seriously--heartily despises the useless beauty. by this i mean the woman who is always togged up and crimped and curled and looks as if she were not worth a row of pins except as a means of livelihood to the modistes and the milliners and the hairdressers! the kind of beauty that i like is the sort that is active, doing, achieving, and working for some good. i believe, and fully too, that we can all appear at our best and yet not look as if we were made of cut glass and dresden that would crack or break or peel off if the lake winds happened to take a fancy to blow our way. it may sound at a frightful variance from the general preaching of the beauty teacher, but--between you and me and the ice cream soda that we do not drink because it upsets our stomachs and ruins our complexions--i have simply no use whatever for the little girl who puts in the entire day (and half the night) fussing over her complexion, kinking her hair into seventeen little twists and curlycues, and dabbling lotions and things on her nose till you can't rest. a certain amount of all this is necessary, but don't give your life over to it. the waste of time is enough to make one want to be a patagonian lady whose sole adornments in the beautifying line consist of a necklace of elephant's teeth and a few patagonian babies. when beautifying gets to the stage where one has no time for mental refurbishing it ceases to be beauty culture, and is simply nonsense and loss of time. i can spot this class of women a block away. in my mind's eye i can see them fussing and primping for hours before they are ready to don their street clothes and get down into the shopping district for the day's work of pricing real lace and buying hairpins. and i always look around me and think of what a vast deal of work there is in this great, big, sorrowful old world, and what direful need there is of every one pitching in and helping. to me, the useless woman is not a pretty woman. she is an ornament, like the shepherdess on the mantelpiece or the spanish lady in the picture frame that hangs in the hallway. but the other woman--the pretty and the useful woman--oh, but she is a sight to make old eyes grow young. her gown is spotless, her hair all fluffy and lovely, her hat just at the correct angle. she steps along quickly, and you know by the very air about her that she is a worker, be she of the smart set or of the humdrum life that toils and spins from morn till eve. her eyebrows are not penciled, there is not a trace of rouge on her cheeks, but she is a healthy, well-built, active woman, whose very appearance of neatness, sweetness and buoyancy tells all who see her that she is a devotee of the daily bath, the dumb-bells, the correct and hygienic life. in half an hour any woman should be able to take her plunge, coddle her complexion, dress her hair, manicure her nails, and attend to her teeth. if more time be needed, then the work is hardly worth the while, for life is mighty short, my dears, and things that must be done pile up as the years go by. at night in fifteen minutes the face and hands can be well washed, the hair brushed and combed and plaited, the teeth well cleaned, and the complexion massaged with a little pure home-made cream. of course, when the hair is shampooed or the nails manicured with particular care, or the complexion subjected to a thorough cleansing by steam or massage, then more time is necessary. but the gist of it all is this: let us not spend so much time on the exterior effect that we will forget that which is most necessary to a beautiful woman--the bright, interesting mind, the love of learning things, the desire to be keeping apace with just a little bit of the world's progress, and, best of all, teaching oneself how to live wisely and well. there never was--to my way of thinking--a brainless, silly woman who was beautiful. it takes the light of intellect, the splendor of sweet womanliness, the glory of kindness, unselfishness and goodness to complete a perfect picture of "the woman beautiful." washing the face. a good old stand-by query is about the simple matter of keeping one's face clean. there is no manner of doubt but that the hard water which we have in the cities is responsible for many complexion ills, and that we must not use it too generously upon our complexions if we long for the colors of the rose and the lily in our cheeks. there is nothing in the world so excellent as rain-water for the skin, but it's a great bulging problem as to how those of us who live in yardless flats and apartments can manage to catch the elusive rain-drops. we might as well hope to lasso an electric car and hitch it onto our back porches for the babies to play in, i think. when city people persist in telling others to wash their faces in rain-water and thus secure beauty everlasting and glorious, i always have a mental picture of a frantic lady with golden locks a-streaming and her eyes brimful of wildness, rushing madly down the street with basins and things in her outstretched hands. it's all right if one has rain-barrels or cisterns, but, after years of perspiring and nerve-sizzling flat hunting, i have failed to find apartments provided with either of these luxuries. with folding beds built in the sleeping apartments and steam radiators with real steam in them, the landlords feel that their duties are done. but to return to our muttons. those who cannot have real rain-water should use the harder brand sparingly on their faces. a thorough scrubbing at night before going to bed is an absolute necessity, lest the pores of the skin become clogged with the smoke and dust of our murky atmosphere. a little castile soap and a camel's-hair face brush will assist the cleansing operation. to soften the water, i would advise the following delightful lotion: four ounces of alcohol. one ounce ammonia. one dram oil of lavender. one teaspoonful to a large basin of water is sufficient. to keep the skin free from harshness and on unpleasant terms with wrinkles and turkey tracks, a little pure cold cream should be used. if, in the morning, the skin has not absorbed all the oils of the cream, then wipe away with a cloth just slightly moistened. when at other times the face needs washing, let me suggest that this toilet milk be used. it is also excellent to apply before fluffing powder over the cheeks: milk of violets: cucumber juice, boiled and cooled, one ounce. spirit of soap, one ounce. rose-water or orange flower water, four ounces. by remembering that there are two tablespoonfuls to the ounce, the measuring will not be at all difficult. if one wishes a stronger perfume add a few drops of violet extract. whether rose-water or orange flower be used is left to one's own choice. they are equally excellent for the skin. facial eruptions and blackheads. with most women, pimples are caused by indigestion or constipation. unless the body throws off its waste material as it should, the poisonous matter will endeavor to find a way out through the pores of the skin. the face, being the most sensitive, is usually the first part of the body to be afflicted. the remedy for facial blemishes is found in exercise, baths and a careful diet. and that reminds me that i would like to remark right here that the combinations that girls and women get when they order lunches are appalling enough to raise the hair right off one's head, most particularly if one has any idea at all of the general rules of hygiene and health. it is just as easy to put beautifying foods into your stomach if you will but once make up your mind to it. and what a host of trouble it will save you! not only in cosmetics, but doctor bills. what you eat is the fuel that keeps the engine of life going. good food makes good strong muscles, pure blood and a fair, healthy, firm skin. if there are troublesome little blotches on your face then mend your eating ways, even though it breaks your heart to give up those awful and indigestible dainties that you dote on so religiously. in place of the pastries and the sweets and the pickles and the highly spiced dishes, substitute fruit and vegetables. save all those nickels and dimes that you invest in ice cream soda, and instead exchange them for lemons and oranges that will help drive away the unsightly pimples and red blemishes. if possible, make your entire breakfast of fruit, either cooked or raw. if the apples and oranges and peaches and pears do not make active the digestive organs, then go to a reliable druggist and have this harmless and excellent prescription filled: extract of dandelion, one dram. powdered rhubarb, q. s. divide into three and one-half grain pills and take one every night, or oftener if necessary. a state of nervousness will ofttimes bring a heart-wringing crop of eruptions to the surface of the skin, and this condition is best remedied by plenty of baths, lots of fresh air, exercise, and a stiff but cheerful determination to brace up and not have any nerves--which, by the way, is much easier said than done, as most of us know to our sorrow. no matter of what order the facial eruptions may be, they must be treated with the greatest gentleness possible. there is nothing in the world worse than rubbing them with a coarse towel, a proceeding strongly advised by the old-fashioned ones who--bless their hearts--are so likely to stick to old-timey notions till the cows come home, no matter what arguments may be brought up to convince them of their mistaken views. pimples must never be irritated. breaking or bruising the skin only adds to its diseased condition and general irritation. if the complexion is unsightly with red blotches, a solution of boric acid in boiling water, used warm, will be an effective lotion. its application should, of course, be combined with proper living as laid out above, care being taken as to diet, exercise and the tepid daily bath. a good cold cream should also be used. i have been told by many that continuous applications of creme marquise had done away with pimples and blackheads, and it is frequently found that nothing more than a sensible diet and some simple pure face cosmetic is needed. when the skin is merely inflamed--that is, red of color and very tender, there is nothing better than a soothing cream like this. listerine, witch hazel and eau de cologne are all good as external lotions for pimples. a paste of sulphur and spirits of camphor, which should be put on at night and washed off the following morning, will do good work, provided the beauty patient knows the laws of health. [illustration: mrs. ogden armour] when there are both blackheads and pimples the latter must first be gotten rid of. when the skin is perfectly free of these, then begin with a camel's hair face-scrubbing brush to do away with the blackheads. wash the face thoroughly with the brush every night just before going to bed, using warm water and pure castile soap. if the blackheads are very bad add alcohol to the water. that is very cleansing, but as it is also drying, a face cream must be smeared on immediately after the face is rinsed and wiped. for some days it may seem that the pores are large and coarse and open, but they are simply undergoing a cleansing process that in the end will bring a lovely white, perfect skin. whenever i hear women say that they never wash their faces, but use a cream instead, i always wonder if they really feel clean. i am sure i would not. fancy the state of our hands were we never to wash them! and the face, having more oil glands, is in still greater need of soap and water. however, let me say right here that no soap at all is better than a cheap scented soap, and unless the very best and purest soaps can be had it is much more desirable to substitute almond meal or something of the sort. treatment for blackheads calls for the same care of the health as does treatment for pimples. tan, sunburn and freckles. tan, like borrowing friends, and various other afflictions, is awfully easy to get, but really more than passing difficult to remove. it is delightful to sit on a big bowlder that dots a great, lovely, sandy waste and watch your hands gradually turn from their customary whiteness to a deep burnt orange. one has to have something to show for a trip out of town, one thinks, else the doubting thomases will arise and give vent to suspicions that one has been merely concealing oneself in an attic or back bedroom. it is pleasant, too, to go fishing, with a dainty, absurd little hat that, although it looks pretty, is about as useful as would be a beaten biscuit pinned to one's tresses. you feel your nose becoming unusually warm, and it begins to tingle and smart as if the pores were filling up with hot sand. all of which is quite in keeping with summer-resort existence, and you are as proud as lucifer when you trail back to town to show this cerise-tinted evidence of your outing. but the friends who you thought would envy you giggle and smirk and nudge each other and make suggestions that are supposed to be mirth-compelling. and then and there you decide to do differently next summer. a sunburned nose may be a treasurable possession away from town, but back among the hosts of the city it is a different matter. more than that, it is an affliction. if the weeks at the seashore or the lakes would only brown the summer girl it would not matter so much. but instead of making the skin a beautiful, poetical olive tint, it usually turns it to a hue which is best compared to the flaunting colors of the auctioneer's emblem. if the girl is reckless, if she runs here and there without a hat, and gives never a moment to the care of her skin, her own mother is not likely to recognize her unless the summer girl soon repents and mends her ways. what mischief old sol cannot do, the brisk winds will contribute. the result is usually a red-eyed, red-nosed, flakey-skinned little woman, whom one would never suspect of having been rollicking through a few weeks of midsummer joys. if her ears are not blistered, her nose is, and if her complexion is not harsh and rough from lack of care, it is bespeckled with freckles and covered with a deep layer of golden brown tan that has distributed itself like patches on a crazy quilt. there is not one woman in forty who can afford to ignore the ordinary precautions for preserving her complexion during the summer months. a parasol is the first necessity. a white gauze veil is another, although this can be dispensed with if the skin is not particularly sensitive to sun and wind. never, under any circumstances, must you bathe your face in soap and water before going out of door or just after coming in. this habit will make the freckles pop out in fine order. after coming in from a tramp or a fishing party bathe the face at once in half a cupful of sweet milk in which a pinch of soda has been dissolved. if this is inconvenient, as it often is when one is a hotel guest and not a cottager, then use a good face cream. strong soaps containing an excess of alkali are bad enough at any time, but during the hot weather they are particularly trying to almost any skin. too much care cannot be taken to get proper soaps. the following sedative lotion applied to the face will prevent its tanning or freckling to any extent, that is, if one takes proper care of one's skin: distilled witch hazel, ounces. prepared cucumber juice, ounces. rose-water, - / ounces. essence white rose, - / ounces. simple tincture of benzoin, one-half ounce. after rubbing this into the skin with the finger tips and letting the cuticle absorb it well, apply a pure vegetable powder. when the face becomes sunburned apply plenty of cold cream. but be sure that it is your own home-made cream, else you may be putting lard or something else on your face, which, in a most amazing short time, will produce a thrifty growth of tiny, fine hairs. and then you will wish you had never lived to see the coming of the "happy summertime." lastly, to remove freckles, quickly apply lemon juice with a camel's hair complexion brush. let the juice dry in and massage with creme marquise. complexion powders. whenever women fail for congenial topics of dispute they can always fall back on the old topic of the best face-powder. "i have used that delightful velvety 'blush rose' for years and years," says mrs. lovely, "and i think it is simply fine." "blush rose?" shrieks mrs. pretty. "why, i wouldn't use that for a-an-any-thing! my husband's brother-in-law, who worked in a drug store, once told me that 'blush rose' had lead and bismuth and ever so many other dreadful, awful things in it. now, i dote on 'velvety carnation.' i know that that is perfectly pure. and it sticks just like your husband's relatives--simply never lets go!" "'velvety carnation!'" repeats mrs. lovely. "you poor child. i don't wonder that you have such a time with your skin--" and so on until both charming disputants march airily away, each deciding that the other will soon be in her grave if such foolishness in the choice of a face powder is continued. women need not discuss finances or peace policies. they have their own little face-powder question that is good for all time to come, no matter whether we all go and settle in the philippines or hand these interesting islands back to spain with a "much-obliged, thank you." i have often thought how thankful we should all be that we are not dahomey ladies, who have no opportunities for these pleasant little arguments. we may have to put up with a good many discomforts in our life of civilization, but we don't miss quite everything in the way of joys. the formula for face powder which i am about to give is not only perfectly harmless, but of exceptional medicinal qualities. nothing is better for an irritated skin than boracic acid, so the girl with facial eruptions can feel perfectly safe in using this powder. oxide of zinc, in the quantity given, can do no possible injury; many of the manufactured preparations being made almost entirely of this ingredient. poudre des fees (fairy powder): ounce lubin's rice powder. ounces best, purest oxide of zinc. / ounce carbonate of magnesia, finely powdered. grains boracic acid. drops attar of rose. when purchasing your ingredients ask the druggist to powder each separately in a mortar. first put your rice powder through a fine sieve, and then through bolting cloth. do the same thing with the oxide of zinc, the magnesia and the boracic acid before adding them to the rice powder. when all are combined put twice through bolting cloth. after each sifting throw away any tiny particles that remain. it is very necessary that all the ingredients be made fine and soft and fluffy. add the oil of rose last. by putting in the tiniest suggestion of finely powdered carmine you can get the cream powder, and by putting in still more you will have the rose or pink tint. while blonds, with clear, perfect skins, can use either the white or the pink very nicely, cream is the more acceptable color for brunettes. consuelo powder: ounces of talcum. ounces of rice flour. - / ounces of the best zinc oxide. drops each of oils of bergamot, ylang-ylang and neroli. the three main ingredients should be sifted over and over again, and if flesh color is desired, a little carmine must be added, the sifting continuing. then add the perfumes and sift again, so as to avoid any lumps. a formula for violet powder is given in the chapter on perfumes. wrinkles. it doesn't matter whether or not you are afflicted with wrinkles, it's an excellent thing to give them some attention. freckles are bothersome and provoking, and red noses make us as cross as black cats, but wrinkles!--they are the worst of all, for with them comes the sickening realization that the freshness of one's complexion is beginning to fade, and that youth itself is slipping away. it is before the lines really appear that they should be considered, for then they're much more easily managed than when they--with their sisters and their cousins and their aunts, to say nothing of grandmas and babies--settle down for a nice long stay. wrinkles are worse than bogie men, and "they'll git you if yo' don't watch out!" wrinkles are unnecessary evils--anyway, until one gets to be a hundred or so. that is, if you are so lucky as not to have troubles enough to keep you awake six nights out of seven, which seems to be the case with most people these days. even then perhaps you can deceive yourself into believing that life is one big, lovely, roseate dream after all. worry is a paragon of a wrinkle-maker. and, by the way, did you ever know why? it is not so much for the reason that screwing up the face traces lines and seams in the skin as it is because the fretting upsets the stomach. it has a most depressing effect on that hyper-sensitive organ. haven't you often noticed what a finicky, doleful sort of an appetite you have whenever you are indulging in a fit of the blues? the physiological explanation is the very close alliance of the great sympathetic nerves, which make up a little telegraph line more perfect and complete than any yet constructed by man. the poor, worn brain is fagged and tired. this fact is immediately communicated to the stomach, which, in true sisterly fashion, mopes and sulks out of sheer sympathy. then, of course, with an unruly digestion, all sorts of complications begin. the eyes get dull, the face thin and sallow, the complexion bad, and the flesh flabby. at that stage the wrinkles, with their aforesaid relatives, sail in upon the scene. and there you are! and--ten chances to one--it's a cheerful time you'll have getting rid of them. that's why i say you must take them in hand before they arrive, and dole out discouragement to them by correct living and the necessary facial massage. the skin of the face wrinkles exactly for the same reason and by the same mechanism that the skin of an apple wrinkles. the pulp of the fruit under the skin begins to shrink and contract as the juices dry up, and, quite naturally, the skin which was once taut and smooth, now being much too large for the contents, puckers up and lays itself in tiny folds. it's the same way with the skin of the face. when the subcutaneous fat of the cheeks and brow--which, when we are young and plump and rosy, is abundant--begins to be absorbed and to gradually disappear, then the cuticle straightway starts in to shrivel and fall into minute lines. so it is wisdom to anticipate the coming of wrinkles and lay plans to ward them off. live after strict rules of hygiene, as told in the chapters on exercise, baths, sleep, diet, and dress. have a tonic method of living. invigorate your muscles and the skin of your body by sponge baths and brisk drying with a coarse bath towel. friction is a great beautifier. eat only that food which is going to do you some good, and take your exercise with regularity. add to this a happy, hopeful disposition of mind and a big fat jar of pure, properly-made skin food, then read the chapter on massage and follow the instructions given therein. if any wrinkles or crow's feet come and lodge with you after that, then i'll take off my hat to their perseverance. recipes for the complexion. in compounding face creams one cannot be too careful and painstaking. it is much like preparing a salad or a charlotte russe, either of which can be utterly ruined by lack of care--or too much fussing. the creme marquise is especially difficult for the woman who tumbles things together in a haphazard fashion. unless compounded just so carefully, it will be likely to crumble, but when done according to directions it makes a cosmetic that is absolutely unrivaled. the other creams which follow this formula are more easily made for the reason that they contain less fats and are therefore less apt to separate from the rose-water. the creme marquise is a whiter, harder preparation than any of the others. creme marquise: / ounce of white wax. - / ounces of spermaceti. - / ounces of oil of sweet almonds. - / ounces of rose-water. drop attar of rose. shave the wax and spermaceti, and melt in a porcelain kettle. add the almond oil and heat slightly, but do not let boil. remove from the stove and add the rose-water, to which the perfume has been added. beat until creamy, and put in jars. cease beating before the mass becomes really hard. be sure that your druggist weighs the wax carefully, for too much of this ingredient will spoil the creme by making it too firm. this delightful preparation should be applied immediately after washing the face, but can be used at any time. it is absolutely harmless. get the best materials--and see that your almond oil is the real thing instead of a cheap imitation, which acts almost as poison to the skin. strawberry cream: white wax, / ounce. spermaceti, / ounce. sweet almond oil, - / ounces. strawberry juice, / of an ounce. benzoin, drops. take large fresh berries. wash and drain thoroughly. macerate and strain the juice through a piece of muslin. heat the white wax, the spermaceti and the oil of almonds. remove from the fire and add the strawberry juice very quickly. beat briskly till fluffy, adding the three drops of benzoin just as the mixture begins to cool. put in jars and keep in a very cool place. this quantity will fill a three-ounce jar. apply every night as a cold cream. this is particularly excellent for sunburn. orange flower skin food: spermaceti, / ounce. white wax, / ounce. sweet almond oil, ounces. lanoline, ounce. cocoanut oil, ounce. tincture benzoin, drops. orange flower water, ounce. melt the first five ingredients in a porcelain kettle. take from the fire, and add the benzoin and the orange flower water, fluffing it with an egg-beater till cold. this recipe will make five ounces, quite enough to prepare at one time. for those who dislike oily creams it will be found delightful, as the skin absorbs it. the mission of the skin food is to do away with wrinkles. massage must, of course, accompany its application. for hollow cheeks or dry, rough skin it is unexcelled. its fattening qualities plumpen the tissues and so raise the lines of the face and gradually obliterate them. clover cream: spermaceti, ounce. white wax, ounce. oil sweet almonds, ounces. rose-water, - / ounces. powdered borax, grains. essence of clover, drops. dissolve the borax in the rose-water and add the essence of clover. melt the white wax, the spermaceti and the oil of almonds, using a porcelain kettle, as tin or iron is injurious to the oils. when melted remove from the heat and add the rose-water (all at once). then beat quickly with an egg-beater until the mixture is cold and firm. it is impossible for the rose-water to separate from the oils if directions are carefully followed. the recipe given above will fill an eight-ounce jar, so perhaps one-half the quantity should be tried at first. camphor cold cream: take one-half ounce each of spermaceti and white wax, melt and add three and one-fourth ounces of oil of sweet almonds, then add one-fourth ounce of camphor, broken into small pieces, and stir until dissolved. then pour in one and one-half ounces of distilled water in which fifteen grains of borax have been dissolved. stir until well mixed and beginning to thicken, then add four drops oil of rose, one drop oil of rose geranium, one drop oil of ylang-ylang, two drops tincture of musk, and two drops tincture of civet. continue to beat until cold. cold cream: white wax, / ounce. spermaceti, / ounce. orange flower water, ounces. almond oil, ounces. melt all together gently and pour into cups to cool. when cold pour off the water, remelt, and pour into jars to keep. oatmeal lotion: two tablespoonfuls fine oatmeal. boil and strain. when cold add one dessertspoonful of wine (white rhine preferred), and the juice of one lemon. fluff over the face before going to bed, not wiping it all away. this is excellent for sallow complexion. rose toilet vinegar: this toilet vinegar is made by taking one ounce of dried rose leaves, pouring over them half a pint of white wine vinegar, and letting stand for two weeks. then strain, throwing rose leaves away, and add half a pint of rose-water. it can be used either pure or diluted, and is especially good for an oily skin. lavender lotion (to soften water): ounces of alcohol. ounce of ammonia. dram oil of lavender. add one teaspoonful to two quarts of water. a stringent wash: place in a half-pint bottle one ounce of cucumber juice, half fill bottle with elderflower water, and add two tablespoonfuls of eau de cologne. shake well and add very slowly one-half ounce simple tincture of benzoin, shaking the mixture now and then. fill bottle with elderflower water. this is very whitening, but its best mission is that of making large, open pores less noticeable and disfiguring. cucumber milk: oil of sweet almonds, ounces. fresh cucumber juice, ounces. white castile soap, / ounce. essence of cucumbers, ounces. tincture of benzoin, drops. get the juice by slicing the cucumbers, unpeeled, boiling in a little water and straining carefully. the essence is made by mixing the juice with equal parts of alcohol. first dissolve the soap in the essence, add the juice, then the sweet almond oil very slowly, and finally the benzoin. shake well for half an hour if possible. this is a most effective remedy for tan and sunburn. care of the hair her luxuriant hair--it was like the sweep of a swift wing in visions.--_willis._ pretty hair can redeem a whole host of irregular features. with little waves and kinks, and clinging, cunning tendrils that lie close to the temples, a "crown of glory" will transform an ordinarily plain woman into one passably good to look upon. if you doubt this, just create a mental picture of yourself in the last stages of a shampoo! isn't it awful? the damp, straight locks hanging in one's eyes, and the long, fluffy strands, that aren't fluffy at all but as unwavy as a shower bouquet of macaroni, and the tag ends and whisps sprouting out here and there like a box full of paint brushes six ways for sundays--well, one is always mentally thankful at such times that one's "dearest and best" isn't anywhere around to behold the horrible sight. but after awhile the long, damp tresses are patted and fussed over until they are dry, and then they're combed out and curled up and kinked and twisted, and, oh, my countrymen, what a change is there! the harsh lines of the mouth are softened, the eyes look bright and pretty, the complexion comes out in all its sweetness like the glorious rainbow of a week ago. it makes all the difference in the world! but of course you will straightway exclaim: "that's all right to say about those lucky girls who have nice long tresses, but how about us poor mortals whose 'crown' consists of eighteen hairs of eighteen different lengths, and all of them falling out as fast as they can?" to be sure, conditions do--once in a while--alter cases. but i claim, and always will claim--till the day comes when beauty matters won't matter at all--that every woman can have pretty hair if she will take the time and use the good, uncommon sense which seems necessary to acquire it. you know, and i know, and every other woman knows, that women treat their hair as they treat their watches--to unpardonable abuse. of course, one's hair isn't dropped on the sidewalk or prodded with stickpins until the mainspring breaks, but it is subjected to even deeper and more trying insults. one night, when the little woman is in a real good, amiable mood, the tresses are carefully taken down, brushed, doctored with a nice "smelly" tonic, patted caressingly and gently plaited in nice little braids. the next night it is crimped until each individual hair has acute curvature of the spine; then it is burned off in chunks and triangles and squares; it is yanked out by the handfuls, it is wadded and twisted and tugged at and built up into an eiffel tower, and--after a few hours of such torture--the little woman takes out the sixty odd hairpins, shakes it loose, gets every hair into a three-ply tangle of its own, and then hops into bed! when she gets up in the morning she pulls out and combs out more hair than she can make grow in after seven months' careful treatment. i tell you that is the one great trouble with women. they will not stick to one particular method. if they feel like fussing and coddling they will, but if they're tired or cross or in a hurry to get to sleep, well, they just let their hair take care of itself. one's tresses need regular care just as do plants or babies or people. make up your mind that you have hit upon the best way to treat your hair and then stick to it, no matter whether school keeps or not. to disentangle the hair use only a coarse comb, being sure that every tooth is smooth and firm, so that it will not tear or split the silky fibers. the fine comb is a thing of horror, and has no place upon the dressing-table. it irritates the scalp, bringing forth a prosperity year crop of dandruff and attendant unhappiness. added to this, it splits the hair shafts and injures the roots. brushing the hair is sadly overestimated. a dozen or two strong strokes each night will remove the day's dust and dirt, will promote circulation and sweep out flaky matter. the brushing must be done firmly but gently, and not with the violent methods of a carpet sweeping machine. really, it is simply appalling the way some women dress their hair. a few tugs and yanks with a comb of uneven, unsmooth teeth, a scattering brushing back of scolding locks, some singes here and there with a red-hot curling iron, a twist, a roll, a pat and the application of a dozen hairpins, and the hairdressing for the day is done. instead, the comb should be used with gentleness, not dug into the scalp, as is the practice of some mistaken beskirted mortals. there is an old saying to this effect: "wash the scalp, but not the hair; comb the hair, but not the scalp," which saying, i leave to you, is good enough to paste in one's hat--or rather on the back of one's hair brush. after the brushing each night it is an excellent plan to part the hair into small strands and wipe off with a cloth slightly moistened. this is a sort of sponge bath which tones and invigorates the growth. combs should never be washed, but cleaned with a stout thread. brushes, however, must have frequent washings in warm ammonia water, taking care to keep the backs dry. they should never be put in the sunlight when wet, but left to dry in an open window. curling irons certainly do heaps of damage. any woman who has ever found herself suddenly bereft of a nice fluffy bang, and in its place a stubby little burned-off fringe, will say that this is true, while those numerous hair-crimping girls who have known the humiliating and painful experience of having a hot curling iron do frolics down their backs can add startling testimony, and, what is more, show disfiguring scars as proof. if the iron is used carefully and at proper heat, the hair is not injured. but certain it is that when the iron is smoking-hot it kills the life and lovely texture of the hair. besides, how very ugly and unkempt those burned little ends look! it was surely not of such that pope wrote: fair tresses man's imperial race ensnare, and beauty draws us with a single hair. soft papers in which the short locks are wound is a good method for the girl who singes her top-knot every time she tries to curl a few little tendrils. kid curlers are all right, providing the hair does not become entangled in the small ends, and so have to be torn when the hair is taken down. there is a certain secret in the hair-curling process which is too intangible for written description. the hair must not be wound tightly and the effect must be loose, fluffy and natural. the great necessity for keeping the hair perfectly trimmed is to rid it of the split ends, for hair cannot be nice under such conditions. when the nourishment within each hair shaft does not extend the full length, then the hair cracks into several finer hairs, and one of these perhaps resumes the growth. that leaves a rough, bad shaft. the best way to keep the hair clipped properly is to twist it in rolls and to singe off all the little ends that stick out. it is almost impossible to state positively how often the hair should be shampooed. oily hair needs a thorough washing every two weeks, while drier tresses should not be given a bath oftener than once a month. half the reason for falling hair, or hair that seems never to grow, is caused by improper shampooing. the scalp must be kept scrupulously clean. and i doubt very much whether the soap and soiled water can be thoroughly rinsed out without the use of running water, the bath spray being the most convenient means of getting this. how often, after washing one's hair, one finds a white, sticky substance clinging to the teeth of the comb! this should never be, and the hair must be continually washed until it is fluffy and soft and absolutely without any suggestion of the shampoo. when the hair is very oily a dessertspoonful of ammonia and a pinch of borax should be added to two quarts of warm water. this will soften the water and make the soap more easily rinsed out of the hair. the liquid verbena soap makes a delightful shampoo. recipe can be found at the end of this chapter. when shampooing, rub the lather through the strands gently, and with the finger tips remove all the little particles of dust and dandruff which may be clinging to the scalp. and may i gently suggest that you do not go at the task as if you were scrubbing a grease spot out of a rug? you must neither dig the scalp with your nails nor wring out your hair as you would a wash-rag. try not to get your hair into a more mussed-up and tangled condition than is absolutely necessary. after using the bath spray liberally dry with warm towels, then--if possible--get some one to vigorously massage the scalp. this will almost invariably prevent one from taking cold. never begin combing out your locks until they are nearly dry. a sun bath of twenty minutes is a good tonic. occasionally an egg shampoo is more beneficial than the usual one of soap. this is especially true when one has just recovered from a fever or when one's scalp is in an unhealthy condition or afflicted with dandruff. the rosemary formula is very effective. dandruff is nearly always the result of neglect. if the scalp is washed as frequently as it should be, dandruff is not so likely to accumulate, although it is a perfectly natural formation. when the hair is excessively oily or the scalp unusually crowded with dandruff, the weekly shampoo should not be neglected. blond hair should always be washed with the yolk of an egg, as that will make it keep its golden tints. mixing the egg with a pinch of borax and a pint of warm water is a good plan. hair dyeing is one of the mistakes of unwise femininity. all dyes containing either mercury or lead are very dangerous. but why should women dye their hair? goodness only knows. one might as well ask why women fib about their age, or why women shop three hours just to buy a pair of dress shields. there are some questions of life which we are destined never to solve. there is nothing lovelier than white hair. combine with it a fine complexion and a pair of animated brown eyes and you have as picturesque a beauty as ever awakened emotions in the heart of man. but, nevertheless, women moan and wail over every stray gray hair. they go off downtown and proceed to lug home a cartload of mysterious bottles which they keep religiously away from hubby's investigating eye. i won't tell the result of the experience, for it is too well known. it is a certain episode through which half the women of forty years have passed--sooner or later. when comes the desire to transform those little threads of silver into deeper shades remember the charming lines of bancroft: "by common consent gray hairs are a crown of glory, the only object of respect that can never excite envy." unknown washes, as well as dyes, do great mischief. good health, wholesome food and proper care of the scalp are the three most important essentials toward beautiful and luxuriant hair. there are some simple lotions, harmless and easily prepared, which will assist the growth and nourish the roots. dressing the hair. it has always been a double-turreted wonder to me why romancers are forever harping about heroines with "tresses in artistic disarray." all the tresses in such condition that i have ever gazed upon have looked most slovenly and ofttimes positively waggish. how any one can think that a girl with a tangled braid hanging down her back, a little wad over one ear, a ragged, jagged fringe edging its way into her eyes and half a dozen little wisps standing out here and there in haystack fashion--how one can even fancy that such a head as that is pretty is more than i can explain. clothes may make the man, but rational hairdressing goes a pretty long way toward making the woman. observe my lady in curl-papers and my lady togged up for a dinner party. comment is unnecessary, for you have all seen her--or yourselves, which is quite the same thing. those fortunate women to whom straight hair is becoming should never indulge in curls. there is nothing prettier than hair drawn loosely away from the face. it leaves displayed those lovely lines on the temples about which artists and poets go mad. as to the style of dressing one's hair, that must be left solely to one's taste. if the lines of the head, the shape of the face and the hair itself are studied a bit the solution of the most becoming coiffure is very easily solved. a head that looks like a wax image in a hairdresser's window is certainly anything but pretty. neither is it artistic, for the correctly crimped and waved side-locks are too mechanically planned to look at all natural. to nearly all women the plainer the mode of hairdressing the more becoming it is. that does not mean that you should comb your hair straight back and wad it into a funny little bump. quite the contrary. comb it back if you will, but have the coil loose and graceful. it is very bad for the hair either to be pulled back tightly or to be closely arranged. ventilation is necessary, and, by the way, caressing and smoothing the hair with the fingers is a good tonic for its growth and beauty. a few loose short curls about the face seem necessary to the good looks of the majority of women, but the heavy bang was shelved years ago. wasn't it hideous? but perhaps you are too young to remember. get out the family album, then, and see for yourself. [illustration: mrs. john jacob astor] there are certain rules for hairdressing that were just as good in eve's hairpinless age as they will be a hundred years hence. by keeping these rules in mind you can make a picture or a cartoon of yourself, just as you wish. the one thing to remember is that the lines and proportions of the face must be carefully considered and a mode of hairdressing adopted which will lessen and not exaggerate those lines and proportions. be alert to your defects, and do not forget that what may be essentially appropriate for one woman will be dismally inappropriate for another. suppose a woman has a square, heavy jaw. she is just the one who flings defiance at prevailing fashions and clings to the dear old straight bangs deep over her eyes. the heavy chin makes a straight line, the heavy fringe makes another, and the result is that her face is as perfectly square as rules and measurements could make it. let this deluded lady shake herself together and mend her ways. by making the top of her head appear wider the broad jaws will--according to all laws of reasoning--seem to be narrower. a few dainty puffs towering up prettily and a soft, fluffy fringe left flying out over the ears will not only add grace to the forehead but lighten the heaviness of the lower part of the face. a bow of ribbon or any other perky little headdress will detract from the straight cross lines. then there is the woman with the sharp chin, the woman of the wedge-shaped face. she invariably wears her hair over her ears and so elongates the v lines of her chin. by arranging the hair close to the sides of her head and putting it in a soft low coil on the top a much more pleasing effect can be got. the same rule for the heavy-chinned woman applies to the chubby, fat-faced feminine mortal. the "roly-poly" visage looks less "roly-poly" when the front hair is drawn back and up in pompadour style and the long tresses piled into a nice little tower. the pompadour mode of hairdressing also holds good with the girl whose eyes are set too high. this helps along the old-time idea that the eyes of a woman should be in the middle of her head--that is, that they must be set midway between the bottom of the chin and the top of the hair. for the women with eyes set too low an exactly opposite arrangement should be adopted. instead of drawing the hair away from the face, bring it down to it. part the hair and let it come low on the temples and brow. i have never seen anything or anybody look much funnier than does a woman with a sharp-pointed nose and a pysche knot. the nose bumps out in the front and the wad of hair sticks out in the back with a similarity that is positively convulsing to any one with half an eye for the humorous. it gives one an idiotic longing to take a measuring rule and find out the exact distance from "tip to tip." another waggish picture is made by the snub-nosed girl with her hair arranged à la madonna. these long hirsute lamberquins on either side of her face make the poor little nose appear even smaller, like unto a wee dab of putty or a diminutive biscuit. don't caricature your facial defects. don't get the lines of your head and face "out of drawing." don't twist your hair up after every new fashion that chances to come along. study the contour of your head from every side and then adopt that style of hairdressing which at once brings out the good points and conceals the bad ones. the most becoming coiffure is the one that gives the most artistic balance to the face. what will do for the fat, dumpy miss plump will make a human joke out of the lank, willowy miss slender. superfluous hair. if there is one blemish more than another that gnaws out our very heart supports and gives a good hard case of nervous chills, it is this. what woman can look at another so afflicted without a feeling of deep pity? there is something so masculine and altogether impossible in a bearded lady, even if she be merely a poor imitation of the real exhibited thing. unless proper means are taken to abolish it, superfluous hair should be left religiously alone. the more it is pulled out or irritated the lustier and heartier will be the growth that follows. as for cutting it--well! who does not know what the result is sure to be? a challenging kaiser william mustache, maybe, or perchance a herr most style of hirsute trimmings. in applying creams of any sort to the face, it is wisdom to leave the upper lip untouched with the cosmetic, although one may feel perfectly safe in using home-made emollients which do not contain animal fats. heat, rubbing and friction are all conducive to the pests, and such oils and fats as vaseline, glycerin, olive oil and mutton tallow or suet should never be used. depilatories likewise should be shunned. the powdered preparations are usually composed either of sulphite of arsenic or caustic lime, and merely burn the hair off to the surface of the skin. it seems quite impossible for any such powder to kill or dissolve the hair roots without injury. the sticky plasters, made of galbanum or pitch, and which are known as "heroic" measures, are equally undesirable, since they are not permanent cures any more than the depilatory powders. the worst feature of these cures is that for every hair pulled out or burnt off a coarser one takes its place, and for every tiny, downy growth a fully developed hair appears. of course, the plaster removes this soft lanuginous growth with the hardier one, and for that reason should be left severely alone. the tweezers are therefore less objectionable than the plaster, but this is such a painful way of getting happiness that i cannot advise it. there is no doubt but that electrolysis is the best cure. the only objection to this is that an incompetent operator will cause her patron considerable pain, and will also be likely to scar the skin. a dainty little woman who has been an expert in this work for years tells me that it is not at all necessary for the beauty patient to hold the little handles--i know not the technical term--of the battery, although this causes a little more careful work on the part of the operator. at the same time, it makes the operation less painful, and really not at all hard to endure. the general desire to have the work done quickly causes the scars. if the hairs are picked out here and there and not close together the skin can heal and the rest of the horrors be destroyed at the next sitting. to remove a very prolific growth several "seances" will be necessary. but the result will be clear, unscarred skin, and no future chance of the wee worries coming back to bring heart-hurts and mental agony. to those who have any timidity at all about the electric needle, there is peroxide of hydrogen and diluted ammonia. use one as a lotion one night and the other the next. this will often prove a permanent cure, while a better, less noticeable state is certain. the remedy is one, however, that will take time and patience. the superfluous hair will gradually become light-colored and almost white, and the ammonia will, if used persistently, deaden the growth. do not expect the bleach to take effect right away, for it won't. if the skin is at all irritated rub on pure, thick cream. recipes for the hair. liquid verbena soap: cut in small pieces one-half pound of pure imported castile soap. put in porcelain kettle with two quarts of warm water and dissolve by boiling. when cold it should be of the consistency of rather thin cream; if thicker, add more water. stir in one-fourth pint of alcohol and let stand several days in a warm room. all the alkali and impurities will settle to the bottom of the bottle, leaving the liquid as clear as crystal. pour off carefully, leaving the residue for kitchen purposes. perfume with a few drops of oil of verbena, or any scent one may prefer. a small quantity of this used in the shampoo is delightfully cleansing. shampoo for dandruff: yolk of one egg. one pint of warm water. one ounce spirits of rosemary. follow with thorough washing with liquid verbena soap. egg shampoo: shake the yolk of an egg in a pint of alcohol, strain and bottle. to a bowl of warm water add two tablespoonfuls of the liquid. dandruff cure and hair tonic: forty-eight grains resorcin. one-fourth ounce glycerine. alcohol sufficient to fill a two-ounce bottle. apply every night to the scalp, rubbing it in well. this is good for falling hair. lemon hair wash (for blond tresses): one ounce salts of tartar. juice of three lemons. one quart of water. apply a cupful to the hair and scalp just before the shampoo. quinine tonic for oily hair: one-half pint alcohol. one-half pint water. thirty grains of quinine. apply every other night, rubbing into the scalp. hair-curling fluid: mix one and one-half drams of gum tragacanth with three ounces of proof spirits and seven ounces of water. perfume with a drop or two of attar of rose. if too thick add a little rose-water. the hands "i take thy hand, this hand, as soft as dove's down, and as white as it; or ethiopia's tooth, or the fann'd snow, that's bolted by the northern blast twice o'er." --_shakespeare._ pretty hands--like sweet tempers and paragons of husbands--are largely a matter of care and cultivation. much more so, in fact, than most of us are aware. while tapering fingers and perfect palms count for considerable, the general beauty of the hand lies not in its correct outline so much as in the whiteness and velvety softness of the skin and the perfectly trimmed, well-kept nails. i have seen hands as plump as rotund little butter rolls, with fingers like wee sausages, and i have also gazed upon long, slender hands as perfect of form and proportion as any hand ever put into a gainsborough masterpiece. and both have been called beautiful. of course, we all know that the gainsborough model is perfection, but nevertheless we can content ourselves with the knowledge that really ideal hands are as rare as a few other nice things in this world, and that we can struggle along very well with our good imitations providing we are able to keep them clean and well groomed. the poets have raved their wildest over the beauty of women's hands from the time when adam had his first desire to write jingles--if he ever was so silly--to the present day of kipling's entrancing verse. shakespeare in his many tributes to the unfortunate young juliet spoke of the "white wonder" of her hands, and there has probably never lived a versifier who has not, at one time or another, gone into paroxysms of poetry over "lovely fingers," and "dainty palms," and all that. and i don't wonder, do you? for a woman's hand--when it is beautiful--is certainly a most adorable thing. it should be soft and yielding and caressing--with small, dainty joints, a satiny surface and carefully manicured nails of shell-pink tint. first of all, tight sleeves and very tight gloves must be condemned. next, relaxation and repose are to be cultivated. a beautiful hand that fidgets continually is not to be admired for anything beyond its ceaseless efforts to be doing. ben jonson once said: "a busy woman is a fearful nuisance," and it's more than likely that he had in mind some fussy dame whose nervous fingers were everlastingly picking at things and continually on the wiggle. the hand can easily be taught to move gracefully. the ordinary delsarte movements of swinging the wrist backward and forward, of raising the hands high above the head, and the general exercises for the cultivation of gesture and expression are all good and can bring about the habit of spontaneous relaxation and activity. no gestures at all, though, are better than awkward ones. large joints are very unsightly. it is said of the countess of soissons that she never closed her hands for fear of hardening the joints. funny, isn't it, to what extremes those old-time ladies went? and yet the nordauites say we are degenerates! of mme. crequy it is recorded that "she was a woman most resolute," and in proof of that assertion the chronicler says that if no lackey were within call she opened the doors herself--without fear of blistering her hands! it was the desire for dainty, delicate white hands that first gave nice little boys the task of trotting after stately dames and carrying my lady's prayerbook or fan. fancy one of those porcelain-like creatures of helplessness hanging onto the strap in a state street cable car! perish the thought! and what a jolly time mme. crequy would have had could she have indulged in a christmas shopping scrimmage. after a few tussels with the swing doors that bar our entrance to the big stores, mme. crequy would have blistered her hands to the queen's taste and the poultice stage. there's no chance of a doubt about that. bathing the hands. with the hands, as with almost everything else in the strife toward beauty culture, cleanliness is the first great essential. you cannot keep your hands smooth and pretty without an occasional hard scrubbing. unless the hands are unusually moist naturally, hot water should not be used. have the bath tepid--just warm enough to be cleansing. say a fond farewell to all highly-scented soaps and bring yourself down to a steady and constant faith in the pure white imported castile. i doubt very much if there is a soap manufactured which can equal this for its harmlessness and purity. the best way is to buy a large bar, letting it dry thoroughly, and cutting off small slices as they are needed. never fail to let the soapy water out of the basin and fill again with a clear rinsing bath. when drying be sure that the towel is not coarse or rough, and that it absorbs every particle of moisture. very gently press back the cuticle around the nail. a little orange-wood stick or a piece of ivory will assist you when the skin is inclined to stick close to the nail. let the hands have their most cleansing bath just before you go to bed, and then is the time to apply your cold cream or cosmetic jelly, which--in nearly all cases--is all that is needed to keep the hands soft and nice. wearing gloves at night is very uncomfortable and quite unnecessary. lotions can be put on an hour or so before one goes to bed, and by that time they are usually pretty well absorbed into the cuticle. if the hands are red use lemon juice, applying cold cream as soon as the juice is dry. for callous spots rub with pumice stone. care of the finger nails. there has been a great change in manicuring methods of late. the old steel implements of torture are banished, and the ivory instruments have long since taken their place. steel should never be put to the fingers, except to use the scissors when the nails are too long, or to trim the skin in order to free it from hangnails. the best operators no longer cut away the cuticle about the base of the nail, and the manicure who does that nowadays is not a student of the french method of manicuring, which supplanted every other some time ago. the same effect--and better, in fact--is got by simply pressing back the flesh with the end of an ivory or orange-wood instrument. the gouging and snipping, so irritating to a person of nerves, is thus avoided. however, if you only know how, you can manicure your nails at home and they will look every bit as well as if you trotted downtown and spent half a day and a nice big dollar. fill a china wash basin with a suds of warm water and castile soap. soak the hands for five minutes. with an old soft linen towel push back the skin around the nails. if there are hangnails snip them away carefully. cutting the cuticle at the base of the nail was a barbaric feature of a new science which disappeared when it became more rational and refined. never, under any circumstances, must the inside of the nail be scraped with a sharp instrument. another thing to be avoided is the vulgar application of pink nail cosmetics. who has not seen a pretty hand made hideous by nails all gummed up with red paste? oh, yes, and claw-like nails! they, too, have been "called in," now that progress, good sense and civilization go marching on at a two-step pace. the nails should be trimmed the same shape as the finger tips, and left neither too long nor too short. there's a happy medium that is easily discovered, because of its usefulness, its convenience, and its artistic beauty. a too-highly polished surface is also a vulgarity invented by the old-time manicure. a little powder rubbed briskly on the nail with a heavily padded polisher is a great improvement, but when the nails shine with door-knob brilliancy it's high time to call a halt. as for jagged, uneven nails--there's no excuse for them. recipes for the hands. cosmetic jelly: take thirty grains of gum tragacanth, soak in seven ounces of rose-water for two days, strain through muslin and add one-half ounce each of glycerin and alcohol, previously mixed. this dries in a moment after application. glycerin balsam: white wax, one-half ounce. spermaceti, one ounce. oil of sweet almonds, four and one-half ounces. glycerin, one and one-half ounces. oil of rose geranium, eight drops. melt the oils. remove from fire and beat in the glycerin and perfume. stir briskly until cold and white. creme duchesse: benzoinated mutton tallow, three ounces. oil of sweet almonds, one ounce. glycerin, two drams. rose-water, two drams. oil rose geranium, twenty drops. heat the tallow and oil of almonds in one vessel and the other three ingredients in another. mix the two and stir until cold. on account of the mutton tallow, which might possibly cause a growth of superfluous hair, this cream is not desirable as a face cosmetic. the benzoinated mutton tallow can be made by taking one-half pound of the tallow and one-half ounce of the benzoin, and keeping at a high temperature until the alcohol has completely evaporated. strain through muslin. almond meal: orris root in fine powder, four ounces. wheat flour, four ounces. white castile soap, powdered, one ounce. powdered borax, one ounce. oil of bitter almonds, ten drops. oil of bergamot, one fluid dram. tincture of musk, one-half fluid dram. mix well and pass through a sieve. to make the hands soft: take one quart of warm water, and in it soak one-half pound of oatmeal over night, then strain and add one tablespoonful of lemon juice and one teaspoonful each of olive oil, rose-water, cologne, glycerin and diluted ammonia. rub into the skin three times a day. to plumpen the hands: one-fourth ounce tincture of benzoin, eight ounces of rose-water, and four ounces of refined linseed oil. rub in morning and night. this is equally nice for the neck and arms. wash: rose-water, three ounces. bay rum, ounces. glycerin, one-half ounce. borax, one-half ounce. amandine: blanched bitter almonds, three and one-half ounces. powdered orris root, three-fourths ounce. powdered white castile soap, three-fourths ounce. glycerite of starch, one and three-fourths ounces. clarified honey, one ounce. oil of lavender flowers, one-half dram. oil of bergamot, one-half dram. oil of bitter almonds, four drops. beat the blanched almonds with a small quantity of water to a smooth paste, add the other ingredients, and mix intimately. a solution of cochineal will color it. the eyes "tell me, sweet eyes, from what divinest star did ye drink in your liquid melancholy?"--_bulwer lytton._ you would think, wouldn't you, that women would be good to themselves? but they aren't. not a bit of it! they abuse their complexions with cosmetics as deadly as mrs. youngwife's first plum pudding. they "touch up" their tresses with acids terrific enough to remove the spots of a leopard. they paddle around in the rain like ducks in petticoats and overshoes, and then sit down and chat with the woman next door for a whole hour, so that the damp skirts can more properly inaugurate a horrible cold that will settle down and stay for six weeks or more. and their eyes--but that's a story in itself. an oculist once said that every dot in a woman's veil was worth $ to the gentlemen of his profession. the eye is being constantly strained to avoid these obstacles in its way, and, of course, it is weakened and tortured. think of a woman paying $ . for something that will, in time, destroy her eyesight just as sure as fate! i leave it to you if she's not a ninny? but women do these things in spite of everything--except when the overworked eyes begin to pain, and then they're glad enough to do almost anything for quick relief. to keep one's eyes in good, healthy condition, rigid laws must be laid down and carried out, though the heavens fall and the floods descend and everything gets up and floats out into lake michigan. you must not read in bed, and you must kiss good-by to that becoming black veil of many dots and spots. when you crawl out of bed in the morning do not dig your fists into your eyes and rub and rub until, when at last you do open those sleepy "windows of the soul," there is two of everything in the room, and big black spots are whizzing through the air. pressure on the eyeball flattens the lens of the eye, and is sure to produce myopia, or shortsightedness. if the eyes are not inflamed at all they should be washed every morning in moderately cold water. in case of inflammation an application of hot water and milk in equal parts will be found most beneficial. dry with a piece of old, soft linen, being sure to wipe inward toward the nose so as not to issue invitations to those horrors of womankind--crow's feet! great care should be taken to keep all foreign substances, especially soap and other irritants, from the delicate skin of the lids, and particularly from the still more sensitive eyeballs. gaslight brings direful havoc to good eyes, especially when the flame is in a mood to flicker and splutter, as gas sometimes does. take a faint, wavering light and a piece of embroidery and you have as fine a recipe for premature blindness as can be unearthed in a month of sundays. sewing in the twilight is equally disastrous, as is the habit of facing the light when writing or reading. few women realize the great need of resting the eyes occasionally, and the unhappy result of trying them to the utmost limit. the very moment that the eyeballs ache work should be suspended, no matter how necessary or urgent. rose-water and plantain in equal parts makes a refreshing wash, and elderberry water is said to be good when there is a disagreeable itching. if the eyes are hot and watery use hot water which has been poured over rose leaves. witch hazel, that good old stand-by, is always refreshing and is especially good when combined with camphor water. it is best when applied at night and allowed to dry on the lids. weak tea, which is the eye tonic of our grandmothers, is also splendid. a lotion that has been tried over and over again and found excellent for tired and inflamed eyes, is made by rubbing one teaspoonful of pulverized boracic acid in fifteen drops of spirits of camphor and pouring over this two-thirds of a cup of hot water. stir and strain, and use as needed. to brighten the eyes, steep good green tea in rose-water, soak bits of absorbent cotton in the liquid, and bind on at night. for granulated lids--and what is more maddening and painful?--make an alum paste. this is done by rubbing a small piece of alum into the white of an egg until a curd is formed. apply to the lids upon retiring at night, tying a piece of soft linen over the eyes. so many girls say that they look a fright in eyeglasses, and ask if they should wear them. most certainly if the eyes are worn out and failing. an oculist of the very best reputation should be consulted. the fee does not exceed that of the quack, and the eyes are tested with greater thoroughness. glasses must be chosen with the utmost care, as ill-fitting lenses can make a great deal of trouble. they are worse than no glasses at all. then, after eyeglasses are put on, they must be changed now and then to suit the changing conditions of the sight. if the eyes are not in a bad state, wearing spectacles for a few months may strengthen them so that the glasses can be discarded. also, if the oculist knows his business as he should, he can give you much valuable information concerning the care of your eyes. the girl who cries. now, about the girl who weeps. you don't see many of her these days. women used to think that big, sad eyes, just ready to send forth a november gale of tears, was quite the proper thing, especially if there chanced to be a man about. women of experience--and who should really know--say that tears are worn-out weapons for bringing masculinity to time. we later-day mortals go in for everything that bespeaks strength and backbone and a certain amount of strong-mindedness. when little wifey wife begins to snivel nowadays, mr. husband doesn't upset the furniture in his efforts to kiss away the tears. he is quite likely to straighten up and say: "oh, brace up, pauline!" or else, "go look in the glass, my love, and see what a beautifully tinted nose you have!" yes, these are unromantic days, and there's no mistaking that fact! there's little room for the weepy, wailing woman whose big, inflated ambition is to dampen stunning neckties and deluge nicely laundered shirt-fronts. of course, women must have their good, comfortable cries once in a while, but if they're wise they will retire to their own rooms and have it out by themselves. this is not quite so satisfactory as the old-time methods, for the reason that loneliness does not inspire an exhibition of woe, and if one doesn't look out one is apt to forget what one is boo-hooing about. but, take it all in all, it's safer and more in keeping with fin de siecle rules and regulations. it used to be that a man would say: "well, it breaks me all up to see a woman cry. i just can't stand it!" but now it's different. instead, he remarks wearily: "anything but a yowling woman!" the poets have written lots of lovely things about tears. notwithstanding that fact, there is an old german proverb: "nothing dries sooner than a tear," which isn't so bad. and byron, you know, said that the busy have no time for tears. which, one must acknowledge, is quite true when one thinks how everybody is up and hustling these days. they're either wearing themselves down to skin and bone trying to earn a living and to reside in a $ flat with electric lights and a real back yard, or else they're gradually killing themselves in an effort to enjoy life and to have a good, jolly time all around. however, that's neither here nor there. so let's jog along to more timely topics. the eyelashes. who hasn't bumped into the woman who is woefully wandering around minus her eyelashes? my dear girls, you make the mistake of your life when you begin to snip and clip and tinker with those pretty little curtains that fall over your eyes. if eyelashes are cut in infancy they will grow longer, but when one gets big enough to wear long skirts and to do one's hair up high and wear a little bonnet with jet dofunnies on it, there's not much of a show for eyelashes being made longer by trimming. touching the lashes with castor oil will increase the growth, and moistened salt is also good. the eyebrows. the eyebrows must be kept well brushed, and by persistent care can be pinched into graceful lines. a heavy eyebrow can be trained with really little effort. the brush should be small and rather stiff and firm. it will at once cleanse and invigorate. i cannot approve of penciled eyebrows. a professional in the "make-up" art can touch the eyebrows here and there and bring a marvelous change. but for the ordinary amateur it is better left undone. besides, if coloring is applied, it is only a short time before the hair will fall out. and then won't you look pretty? eyebrows that meet over the nose are really very disfiguring, and the cure is so simple that there is no need of this blemish, providing, of course, that one can afford to take the necessary treatment. the electric needle is the only sure and certain cure, and two sittings will be sufficient to remove them for good and always. be sure that you patronize only the best operator, as you will surely regret it if you don't. sage tea, with a few drops of alcohol added, will darken the eyebrows without injury. cocoanut oil makes an excellent tonic to increase the growth. the teeth "some ask'd how pearls did grow, and where? then spoke i to my girl, to part her lips, and shew me there the quarrelets of pearl." --_herrick._ femininity may be heir to many beauty woes, but ugly teeth is one trouble which is often caused by sheer neglect. how many of us can recall the days of childhood and girlhood without remembering the fibs we told to escape cleaning our teeth? the blessed mothers implored and begged and threatened and fussed, but we went our way joyful and serene, making all due preparations for future unhappiness. but when the girl began to think more about her personal appearance, and less of the frivolities of advanced babyhood--oh, that we were all back at that jolly time of life!--things were very different. the neglected teeth got good attention then, but often the mischief had already been done. i trust that the younger readers of this volume on beauty will remember that this is hopelessly true, and something not to be forgotten--like yesterday's toasted marshmallows or to-day's lesson in political economy. i have heard it said that too much brushing will injure the teeth, but don't you believe it! the sooner you become accustomed to a moderately stiff brush, that will do its work well and thoroughly, the better. all foreign matter must be constantly removed, else decay will come as sure as fate. a perfect state of cleanliness cannot be unless the teeth have proper and constant attention. by this i do not mean that you must cease all other occupations and take up that of eternal scrubbing. simply keep your teeth clean. toothpicks must not be used excessively, cold water should not be applied--or very hot, either, for that matter--and all powders containing gritty substances must be tabooed. it is quite unnecessary for me to add that you must not bite thread or break nuts with your teeth, for all of us have had this bit of information dinned into our ears since the time when "little children should be seen and not heard" made life a worry and a care. i must confess, however, that i have seen women untie knots and do various bits of very remarkable mechanical work in this unique manner. my experience has been so broad in this particular line of observation that the expression "biting ten-penny nails" has never appeared to me to be much overdrawn. if one seriously desires fine, beautiful, white teeth--and who doesn't?--one must treat them well. just before going to bed, give them a thorough cleaning, using waxed dental floss to remove any large particles which may be between them. use only a pure powder, the ingredients of which you know. be sure that all powder is well rinsed away. see that your brush is kept scrupulously clean. upon arising in the morning rinse the mouth with diluted listerine. this makes an excellent wash, especially when the gums are tender and liable to bleed. brush the teeth with tepid water. after breakfast, luncheon and dinner, wash them again, letting the last cleansing be the most searching and thorough. once in a while it is wisdom to squeeze a little lemon juice onto the brush. this will remove the yellow appearance that often comes, and will also keep your teeth free from tartar. [illustration: princess henry of pless] every six months visit your dentist and have your teeth thoroughly examined. the smallest cavities should be filled at once, and the pain will be less than when these agonizing crevices get so large that you feel that it's a flip-up between going to a dentist or jumping into the lake. i know that most of us women are cowards when it comes to seances in dentist chairs, but all such things--like house-cleaning and writing letters to folks you don't like, and entertaining your husband's maiden aunt--all these things are heaps nicer when they're well over with. they are the events which we prefer should ornament the past instead of the future. to sweeten the breath: alcohol, twelve ounces. cinnamon, two and one-half drams. ginger, one-half dram. essence of peppermint, one dram. cloves, one-eighth dram. mix and leave in infusion for two weeks in a tightly covered vessel; filter and bottle. put one teaspoonful in a glass of water, and rinse the mouth with this every morning. recipe for violet tooth powder appears in the chapter on perfumes. bathing "even from the body's purity, the mind receives a secret sympathetic aid." --_thomson._ the road to beauty has never been better known than it was to the greek and roman women of centuries ago, yet they did not begin to have the resources in cosmetic arts that we have now. but they bathed incessantly, believing that cleanliness and health were the vital points in their endeavors to be lovely. they went in for athletic games to a large degree, and thereby hangs the secret of well-developed figures and fine, stately carriage. creamy lotions for the face, made mostly of almond oil and the oil of cocoanut, were their complexion solaces. no doubt these beauties of the past centuries had more time than we for their baths and games, but nevertheless let us make a strong, stern effort to follow in the wake of their excellent teachings. surely they proved the wisdom of them in their own incomparable beauty. speaking of baths reminds me of mme. tallien, the beautiful french woman, who lived in the time of the first napoleon. she went in for baths galore. let me tell you what she did. she gathered together all the strawberries or raspberries that the corner grocery could supply. these were mashed to a pulp and the bathtub filled. in this mme. tallien bathed until the idea of milk and perfumed baths appeared to her fancy. there were many absurd and useless fads those days as well as wise beautifying practices--just the same state of affairs as now confronts us. how much more rational than mme. tallien's notions were the methods of diana of poitiers, who, history tells us, was fresh and lovely at sixty-five! she left the berries and things to their rightful place, the breakfast table, and each morning took a refreshing bath in a big tub of clear rain-water. there has nothing yet been found, even in this progressive age of electric elixirs and beautifying compounds, that can equal this old-time aid to loveliness. with the delightfully convenient bath-rooms, that even the most ordinary apartment or flat has now, bathing is not a matter of trouble and bother, but is, instead, an invigorating pleasure. i believe firmly in the need of the daily bath. not the thorough scrubbing, mind you, but the quick sponging and the plunge. let the thorough scrubbing be at least twice during the week, and the five-minute plunges on other days. certain it is that one is much refreshed by the dipping luxury, and still more certain is the fact that in no other way can the flesh be kept healthy and firm. to those who are robust enough to stand it, the cold bath is very good, but i would not advise it as a general thing for women. for actual cleansing warm water and pure soap are necessary. the shock of cold water immediately closes the pores, and they then retain all the impurities that they should cast out. the temperature of the water for the daily tepid bath should be about seventy-five or eighty degrees, never more than that. whether or not the bath should be taken at night or in the morning is a question which each must decide for herself. while it has often been claimed that a bath at night will quiet the nerves and make one sleep sweetly, i have known many persons who found it an utter impossibility, as it caused them to be restless and wide-awake. one reason why the bath before going to bed is desirable is that a soothing emollient can be applied to the face, neck and hands, and thus will the skin be whitened and beautified. after a warm plunge the pores of the skin are opened and in excellent condition to absorb a good skin food or a pleasant cream. bath bags are simply luxuries. they are pleasant ones, to be sure, but they should never take the place of the flesh brush. it is best to follow the scrubbing with a gentle washing with a bath bag, for the almond meal and the orris root will give a charming, velvety appearance to the skin. they should never be used a second time, as the bran frequently becomes sour after a drying. so, if you are of an economical turn of mind, you will make your bath bags very small, just large enough to serve for one beauty bath. a little starch thrown into the bath will sometimes whiten the skin. salt is not cleansing at all, but is very invigorating and a pleasant tonic if one is worn out and languid. turkish baths are splendid complexion-makers, but must not be indulged in too frequently. if the skin is dry and feverish, a dry bath--or massage--with oil of sweet almonds will promote a healthy skin and bring about good circulation. constant bathing is the best remedy for excessive perspiration. but this is not really effective unless a little benzoin is added to the water, and the armpits well dried, and dusted with powder afterward. a good bathing powder for this purpose is made of two and one-half drams of camphor, four ounces of orris root and sixteen ounces of starch. reduce to a fine powder and tie in coarse muslin bags. remember that a coarse complexion, with black, disfiguring, open pores, can be almost entirely cured by keeping the pores of the body free from sebaceous matter. have the bathtub carefully scoured each day, as the oils and dust washed from the body invariably collect on the sides just where the water reached. for the thorough cleansing have the tub half filled with warm water. use a coarse rag, a bath brush and large, coarse towels. before stepping into the water wash the face and neck well with castile soap and a camel's-hair brush, this being particularly necessary when the pores are clogged and acne has formed. rinse thoroughly and dry with gentle pats. when using the brush, do not forget to let the scrubbing go well down onto the chest, lest your neck will be bleached white and nice only part of the way. once in the tub, go over the body briskly with the flesh brush, using plenty of good soap and not being at all sparing of elbow grease. this scrubbing is very invigorating, for it exercises the muscles and stirs up one's blood as well. after the scrubbing use the bath spray, letting the water get gradually chilled. the drying should be brisk and quick, and a warm robe of some sort must be donned while the hair is being combed for the night, the teeth brushed and the face anointed with a pure home-made cosmetic. then go to bed. if you don't find a prettier, fresher complexion with you next morning, then i'll miss my guess, and will take up another occupation than that of doling out beauty advice. quireda bath bags: one pound of fine oatmeal. one-half quart of new clean bran. two-fifths pound powdered orris root. two-fifths pound almond meal. one-fourth pound white castile soap, dried and powdered. one ounce primrose sachet powder. dipped in tepid water and used as a sponge these bath bags make a velvety lather that softens and whitens the skin in a way that warms the cockles of one's heart. diet _ "good food is the basis of good conduct, and consequently of happiness; more divorces are caused by hash than by infidelity."--_hetty green._ the object of eating is nourishment to build up the nerves, the muscles, the blood, the tissues, and, in fact, the whole body. judging by woman's mad devotion to things she should not eat, this is a piece of information which has never before been confided to her. let the food be well cooked, daintily served and delicately flavored--for all that aids digestion with persons of sensibility and refinement--but see to it that the ingredients are wholesome and of the best and freshest qualities. a fifteen-cent lunch at one of the tearooms, where dishes are prepared with some idea of the rules of hygiene, is much better than a twenty-five-cent course dinner at a cheap restaurant. this is a hint for the business girl who lunches downtown. ripe fruits, served upon green leaves, are always appetizing, even if there is nothing more than toast or rolls to go with them. cereals, such as rice, barley or hominy (they must be steamed for hours), served with rich cream, make ideal luncheons. a baked apple, a bit of rice pudding, or a custard--they, too, are worth the while and the price. eggs, either boiled or carefully scrambled, or made into an omelet, flavored with a dash of parsley, and chops or fish delicately broiled, are substantial viands. soups or broths, breads, fruits and an occasional salad make desirable luncheons. a noonday meal of creamed potatoes and green peas is not to be despised, and it's a godsend to the poor stomach that has been heroically tussling with cocoanut pudding, fruit cake and chocolate rich enough to own a castle in europe. such dishes as italian spaghetti, with tomato sauce and parmesan cheese, or celery or cress salad, with no other dressing than the best olive oil and a teaspoonful of vinegar, will do very well. there is no economy in buying badly cooked luncheons. seek quality, not quantity, and, so far as health and good looks go, you'll find yourself getting along famously. rich foods, especially pastries, can bring forth an array of facial eruptions that is positively maddening to the poor victim. ice cream soda, too, deranges the stomach and creates all sorts of disagreeable disturbances. hot bread and rolls, indulged in to an appalling extent in southern households, can do more real damage to a good, fair skin than all the winds and wintry blasts that ever shook chimneys or swept friskily around corners and alleyways. overeating not only brings indigestion and creepy dreams, but invariably makes the complexion coarse, high-colored and overruddy. that does not mean that one should nibble at things and not demolish a "good square meal." eating should be understood--rules laid down and religiously carried out. usually hygienic dishes and health foods comprise a complete list of one's special horrors. most girls who have tried them say so. but just the same, there are dozens--yes, hundreds--of nutritious viands that are decidedly more palatable and appetizing than the sweets and indigestible doughy nothings that not only make of you a physical wreck but set you to wishing most heartily that the man who invented mirrors had died of the measles in his early infancy. rice is a good old stand-by as a builder-up of a run-down constitution. but you don't like it? well, then, stew it with chicken sometime and you will soon discover what great possibilities are in this despised grain. oatmeal, as it is usually cooked, is a thing of horror, to be shunned and avoided and run away from. but oatmeal left to slowly simmer for a full hour, and served half liquid, fluffed over with a bit of powdered sugar and covered with rich cream, is fit for a queen--most especially if the royal lady is ambitious for a fair visage with sweet, soft skin and cheeks just touched with the crimson of health. a thick porterhouse steak, broiled quickly and well seasoned with salt, pepper and butter, or rare little chops of lamb, are always excellent tonics, as well as complexion tinters. very often a lack of beauty is nothing more than a lack of proper nourishment. the best cure in the world for a haggard, wan, white face is a proper understanding of good foods. sometimes a tonic of iron is needed to brace the wearied physical state. cod liver oil, which is so very disagreeable to most people, is the sure cure for the girl whose extreme slenderness causes her to lie awake nights to fret and worry. but when the oil is prepared with malt it is even better, and also less trying to swallow. a combination of malt and hypo-phosphates is excellent too, and will bring back the fire of energy to the eye, and the roses to the cheeks. a dessertspoonful taken before meals will stimulate and strengthen, and get the tired body into a better state to resist the wear and tear of ill health or overwork. one beautiful woman of my acquaintance declares that the secret of her radiant looks is simply lettuce and olive oil. she eats lettuce summer and winter, and this queer complexion cure has certainly worked like a charm in her case. she buys the crisp young head lettuce, being careful to use only the inner leaves. over this she pours two tablespoonfuls of the best olive oil and the very slightest dash of vinegar. salt and the least wee bit of sugar finish the salad. the good qualities of lettuce are usually destroyed by rich, mustardy dressings, that breed acute dyspepsia and desperate despair over good looks. but olive oil and lettuce is as good a combination for rugged health and a fair face as one can find in a year's search from cape horn to the yukon. others besides the lovely lady of whom i speak have found it so. the secret, though, is, i fancy, in the olive oil, which is an excellent aperient. a complexion-destroying habit is that of eating late lunches just before going to bed. an apple or an orange is a benefit--as is also plenty of cold, distilled water--but when it comes to gnawing chicken bones, devouring big slabs of rich cake or finishing up a dish of leftover salad, then is the time that kind relatives or guardians should step in, say a word and take a hand. the girl should be saved from herself at almost any expense. fruit is a panacea for many complexion ills. what a pity, then, that blind womankind persists in dabbing things on her nose instead of putting healthful, purifying beauty food into her stomach. there is no reason in the world why fruit should be considered a luxury. it should be used as a staple article of diet. surely that must have been the original intention. but alas, how many housewives will pay forty cents for a can of lobster that will upset stomachs, frazzle pleasant tempers, cause all sorts of complexion horrors and bring a perfect comet trail of nightmares and dyspepsia! and these same women will wrap themselves in a sanctimonious mantle of economy when the woman next door pays the same sum for a dozen great juicy oranges. grapes and apples are among the most nutritious fruits, and there is nothing in the world so good for a skin of oily surface or yellow hue as a grape diet. besides, grapes are extremely appetizing, are very easily digested and are sure to agree with even the most delicate stomach. ripe peaches have nearly all the merits of the grape, and, if in proper condition, are also quite unlikely to bring about indigestion or stomach disorders. there has never yet been concocted a better spring tonic than strawberries. the reason why they are particularly excellent to enrich and purify the blood is because they contain a larger percentage of iron than any other fruit. it is a shame ever to embarrass and humiliate the luscious things by imprisoning them in the indigestible layers of a shortcake. a fluff of pure powdered sugar and a dash of whipped cream and you have a toothsome dish fit for the most finicky god that ever graced olympia's pleasant realms. the woman who has a dingy, muddy skin must pin her faith to oranges, lemons and limes. these are simply unrivaled as complexion clearers. the juice of the grape fruit is fine, too. fruits of this class stimulate and make active the digestive organs, which, as you probably know, are the main seat of nearly all complexion ills. a breakfast of oranges and strawberries will do more toward making you a pretty, wholesome, healthy woman than almost anything else. to be perfectly wholesome, fruit with firm flesh, like plums or apples or cherries, must be thoroughly masticated. the skin of raw fruit should under no circumstances be eaten. it is covered invariably with multitudes of minute germs which always swarm upon the surface of the fruit and multiply rapidly under favorable conditions of warmth. before eating grapes or cherries all dust and impurities must be removed by careful washing in several waters. but to sum up the entire question of diet, eat what you know will agree with you, and choose the blood-making, nourishing foods. let fruit and vegetables predominate in your meals, but do not avoid meats entirely. cake is not harmful unless very rich, but greasy pastries--like pies and tarts and things of that sort--are simply utterly, hopelessly impossible! fats make the skin oily and coarse, pastries produce pimples and blackheads faster than you can doctor them away, and too much sweets will have about the same effect. instead of buying candies, save your money and acquire a fine complexion along with a bank account. it will pay in the end. sleep. "what a delightful thing rest is! the bed has become a place of luxury to me. i would not exchange it for all the thrones in the world."--_napoleon i._ if womankind half realized the beauty benefits of plenty of restful, refreshing sleep, all femininity would be crawling into bed at sunset. i've often wondered why the great sisterhood that is praying and working and fretting for physical loveliness does not understand that more real help comes from rational, hygienic living than can be squeezed out of all the cosmetic jars that ever enticed weak feminine hearts. beauty sleep! why, we've heard of it since the long-ago days when our blessed mothers sung it, lullaby-fashion, into our ears! as little girls it brightened the "sand-man" hour and made us go contentedly to bed. as women it should rightly continue its good work, and the dear lord knows we need it more now than we did then, for--perhaps--the crow's feet have begun to show their ugly little tracks and the fine complexion of early girlhood is losing its luster and brightness, and is growing a bit dull and yellowed--like a leaf first touched with the autumn chill. perhaps you won't believe it, but there are right ways of sleeping and wrong ways as well. the girl who curls up like a shrimp is the one who will be writing to me in a great flurry and worry, telling me that her shoulders are round, and that she simply can't make them nice and square as they should be for the new tailor-made that is to transform her into a happy little easter girl! the woman who is horrified to find wrinkles appearing like wee birds of omen does not have to tell me that she is a pillow fiend and sleeps with her head half a foot higher than her heels. it stands to reason that a pillow will push the flesh of the face up into little lines. there is no necessity for pillows at all, and girls don't need them for comfort any more than a little puppy dog needs patent leathers or overshoes. the bed should be hard and perfectly flat, with springs that do not sag or give and let the poor sleeper roll down in the middle in a jumbled-up heap. a hair mattress is the best for health and comfort, but others will do nicely if they are only perfectly flat and not too soft. the first thing to do, then, is to dispense with the pillow. if this change cannot be accomplished all at once, then let your pillow be gradually made smaller and smaller until none at all is desired. your sleep will be much better, and after the habit is once formed a pillow is looked upon with derision. i know foolish mothers who put their children to sleep on pillows as big as a school-girl's love for caramels, and the poor babies tumble and toss, and the next morning those mothers dose them for a pain in the "tum-tum." alack-a-day! babies don't need pillows--unless it be those little soft cushions of down that are as flat as pancakes. but to return from babies to beauty. if your sleep is restless and you awaken with a dull headache and the feeling of weariness that makes you want to begin the night over again so as to get refreshed, you may be sure that something is wrong--either you are worried or troubled or are working too hard for your own good. perhaps your digestion is out of order, or the room is not properly ventilated. it may be any of these things that keep you from getting the rest that is really so very necessary for health and comfort and good looks. heavy bedding is also distressing, and as good a maker of nightmares as deviled crabs or plum pudding. light blankets make the best covering. let the window be open at top and bottom, so as to have perfect ventilation. don't eat an indigestible lunch before retiring; this is the greatest of all beauty follies. lie on the abdomen, with your hands at your sides. this position will keep your shoulders back, will give you a good figure and a better carriage. when you have followed these directions and still find that you spend most of the night crawling around over your bed vainly seeking a comfortable and restful spot, then you can make up your mind that you need a good tonic and a doctor's counsel, for your nerves or your digestive organs are not as they should be. to sum it all up in a nutshell: you must sleep well, and you must sleep a great deal if you wish to be the "woman beautiful." sitting up late at night will cause grey hair as will nothing else. it makes those dark circles about the eyes, and causes the "windows of the soul," to lose half their luster and softness and beauty. who ever saw a pretty woman with dull, lifeless eyes? she wouldn't be pretty were she so afflicted. by sleeping properly, the body is kept stronger and fresher, and thus the complexion is benefited greatly. wrinkles do not come so soon, the skin does not take on that muddy, yellow hue as it would otherwise, and cheeks are pink and rosy with that greatest of all rouges--health. there's a heap of truth in all this. if you do not believe it, then give up late hours--be they for study or pleasure--and see if the problem won't work itself out nicely with you. i think it will. in fact, i am really quite sure of it. exercise "better to hunt in fields for health unbought then fee the doctor for a nauseous draught the wise for cure on exercise depend; god never made his work for man to mend." --_dryden._ it would have done your heart good to see her. she came into the room with the briskness of a march flurry of snow. her cheeks were poppy-red, her eyes sparkled with the mere joy of living. and she chuckled happily as she tucked back the curly scolding locks that were flying about, all helter-skelter, like feathers unloosed or fluffy chicks blowing away from the mother wing. "isn't it jolly?" she chirped, as she threw her muff on the floor and made a dive for peter jackson. peter jackson is a cat, as black as the ace of spades and as pugilistic a feline as ever walked a fence. "isn't what jolly?" i queried. "the weather or your sprightly self? do you know, you'd make a splendid poster now for some new-fangled cork-soled walking shoe? or perhaps a bearskin ulster for klondike wear. i'm sure a feather boa concern would pay a fortune for your picture. i would i were an artist man, with a little brush and a little pencil and a little palette with nice little paint puddles on it----" "what-in-the-world? here i start in to dilate upon the joys of exercise and off you go, just like a musical top with your buzz-buzz-buzz, and your incomprehensible talk about little painters and little palettes and little paint puddles. i'm sure it's not a bit nice of you." peter jackson was shoved to the floor. "but walking is jolly!" she piped, "and i've just had the very gloriousest tramp and i feel as fine as a--what is it they say? oh, as fine as a violin--i--i mean fiddle. i walked miles and miles--perhaps not quite so far--and the wind was blowing a blue streak right in my face. ugh! first it made me shiver and creep up into my collar. but bimeby i got nice and warmy, and my cheeks tingled. i felt as if i could walk from here to the place where the sun goes down. do you know, i never before realized how much fun it was to take a good tramp. i've half a mind to reform from my rôle of lazy-bones and walk every day, whether it snows, blows, cyclones, or turns warm, and fells us all with sunstrokes and heat prostrations." "health is the vital principle of bliss, and exercise of health," said i, quoting thomson. "oh, well," and my pretty, rosy-cheeked guest arose. "i must be going. you know how it is when one gets to preaching physical culture and spouting poetry. ta-ta!" and away she went, like the fleeting memory of last night's dream. * * * * * if women paid as much attention to exercise as do men there would not be so many wrinkles and stooped shoulders among the feminine sex, and old age wouldn't rap on the door ahead of time. the girl who goes in for outdoor sport, who isn't afraid of walking a block or two, who loves the cold air and who revels in wheeling and swimming and skating, is the one who won't be an old woman in appearance while she is still young in years. keep the muscles firm and healthy by exercise. this will not only improve your carriage and add to your general development, but will aid the digestive organs in their work and keep you animated and cheery. who of us does not know the inspiration of a walk in the open air after a few days spent in the close atmosphere of the house? fresh air is the elixir of life. we can't have too much of it, and--oh, my girls--think of the exceeding cheapness of it! it can be got for the asking, which is more than one can say for the various beauty pomades and lotions that beckon us toward poverty. walking and skating are the best exercises during the winter, but all kinds of exercises are acceptable, providing they are gone about in the proper manner. it is easy enough to see why thorough and regular exercise is absolutely necessary to health. we all know--at least, we all should know--that the general size of the human body depends on muscular development. the same bony frame which makes a slim-jim girl that tips the scales at seventy-five pounds can be padded with good solid flesh until it boasts of a triple chin, fingers like wee roly-poly puddings, and a full pounds in weight. the framework of the body counts little toward size. the muscles are like the various bits of machinery which go to make up a steam engine. in performing their work they produce heat and motion. the fuel which supplies this force is taken into the body as food, prepared for use in the intestinal tract, and from there carried by the blood to be stored up in the muscles and various tissues as latent force. through the circulation of the blood the whole body is heated by muscular exercise. it stands to reason that continual exercise of a certain kind will develop certain muscles. for instance, there's the arm of the blacksmith or the firmly developed legs of the danseuse. the same muscle that grows when used within certain limits will waste away when deprived of proper exercise. in physical culture the object is the symmetrical development of all the muscles, not one at the expense of the other. so, for that reason, don't pin your faith to dumb-bells and indian clubs and neglect more necessary exercise. if you do you will in time find yourself possessed of big sandow arms that will make the rest of you look as spindle-like as a last year's golden-rod stalk. walking is as good a form of exercise as anything yet discovered. but walking as most girls and women walk won't do you one bit of good. you might just as well spend your time trying to count backward or while away the hours talking fashions with the woman next door, for all the health or happiness or physical development that you will get out of it. corsets and bands and belts must be done away with. you must have full, free use of your lungs. then, don't wear heavy petti-coats that will retard the free movements of your legs and make your hips ache with their tiresome weight. dress warmly but as lightly as possible. above everything else don't stick your fingertips into a muff and waddle along like a little duck in sealskin and purple velvet trimmings. your arms must swing easily at your sides. thus equipped walking should not be a task, but a great, big, lovely joy, no matter if the frost does nip your nice little nose and make your cheeks feel as if they had been starched, dried, ironed and hung on the line to air. english women who come to america can tell us a thing or two about long walks. only the other day a pretty englishwoman with a complexion like apple blossoms casually divulged the information that a walk of ten or fifteen miles was an old, old story to her. so, when i say that three miles a day--the three miles ought really to be covered inside an hour--is not a bit too much to give one's muscles the necessary exercise, i hope you won't lean back in your chair and gracefully expire. some of you will gasp, no doubt, for a walk of five blocks to a suburban station is usually looked upon as a heroic martyrdom to circumstances and environments. alas, for woman's fickleness! and alas, for her playful habit of going to extremes! suppose, for instance, that polly jones says she is going to take a nice long walk every day of her life; that she knows the bountiful blessings and benefits of a brisk tramp, and that she will take that tramp in spite of obstacles as big as the auditorium or as immense as her longing for a cherry-colored silk petticoat. the first day--and, mind you, she has not walked a mile for weeks, the lazy girl--she covers five miles in an hour and ten minutes. and when she comes home she's such a wreck that the whole family is up in arms in a jiffy, and whisk out the tomahawks ready for war. that's the end of polly jones' pedestrian exercises. and daisy brown. she does quite the same thing, only not so violently. the first day she walks four miles, the next two, and then comes a trip around the corner to get arnica and liniments for her poor, aching bones. thus also terminates daisy's stern resolution to take daily constitutionals. but the wise woman. daisy's and polly's methods are not hers. far from it! when she begins to walk for health and beauty she dons loose, comfortable clothes, and with swinging arms and head well back, strides along briskly and easily. her first day's walk is scarcely a mile. the second tramp is longer; and gradually the distance is increased until the three miles are covered in about fifty minutes. the wise woman does not take her exercise in the afternoon, but in the morning, an hour or so after breakfast, when the day is young and everything seems bright and hopeful and cheery. then it is that the babies are out in their go-carts and carriages, and the "chillens" are trooping to school. it's heaps pleasanter than an afternoon walk when one has more of the worries and events of the day on one's mind. [illustration: queen helena of italy] it is the regularity of exercise--and living, in fact--that brings the best results. a stated time for baths, meals, rests and walks is the proper plan for those fortunate ones who are not rushed into a condition of decrepit antiquity trying to do fourteen different tasks in thirteen small, limited minutes. some of us, the very busy ones, cannot have the necessary rests during the day, but baths and exercise can usually be arranged and carried out. they should be, for they are of more vital import than most of us realize. running is splendid exercise, but we city folk have few opportunities for exhilarating fun of that sort. a woman sprinting for a cable car might quite as well be a trained bear in a pink mosquito netting petticoat for the sensation and giggles she creates. with a bonnet perched over one ear or dangling dizzily from an escaping empire knot she is neither a dignified nor an inspiring picture. so it's quite as well all around to run in one's own room. in fact, the best way to run is to run in one small spot and not go ahead. that sounds befuddled, but it is easily explained. get into loose clothes, throw open the window, place your hands on your hips and go through the movements of running. it is best to be in stocking feet or light slippers, else that odious woman in the flat below may knock on the steam pipe as a signal for peace and quiet. after fifteen minutes of mock running take an invigorating, tepid sponge bath with just a dash of benzoin in the water. after that comes vigorous friction with a rough towel. then take a nap if you can spare the time. of course one must guard against exposure to cold after one is heated by the exertion of exercise. dancing would be one of the best of exercises were it not for the close, ill-ventilated rooms, the tight clothes, the exposed shoulders and the nervous strain which is always on hand at large social affairs. as for skating, there is nothing better. it makes a woman feel like a new man. i say that quite consciously, as, in my opinion, to feel like a new woman--that poor, long-ridiculed creature--would be more humiliating than joyful. don't you think so? horseback riding is questionable exercise. the side saddle is apt to increase the tendency to curvature of the spine, while tight corsets prevent the good that would come to the heart and lungs and digestive organs. swimming is good, particularly for nervous, high-strung persons. and the wheel? well, that best of all exercises--for it is the best when indulged in by the wise woman, not the crooked-back, scorching, silly--is a story in itself. stooped shoulders "her grace of motion and of look, the smooth and swimming majesty of step and tread, the symmetry of form and feature, set the soul afloat, even like delicious airs of flute or harp." --_milman._ stooped shoulders is one beauty ill that is wholly unnecessary. any girl with real brains and a little energy and will power can make herself straight and bestow upon herself a good carriage. it is entirely a matter of doing and persevering. most of us know remedies for our small failings, but how many of us apply them persistently until a cure is brought about? few indeed, and more's the pity. when starting the reform always bear in mind that the chest must be held upward and outward. when this is done it is not necessary to keep the shoulders back in a forced, strained position, and so make little crowfeet in the back of your gown. the benefits of holding the chest thus are more than one--or two, either, for that matter. if practiced continually it will strengthen the lungs. it will also develop the chest and neck as no masseure of miracle-working fingers can ever hope to. breathing exercises are also excellent. incorrect positions during sleep cause many stooped shoulders. the big fat pillow of our grandmother's day is the worst kind of a horror. no pillow at all is best, and after one becomes accustomed to sleeping that way it will be found much more restful and altogether comfortable. the best position for sleep is to lie face downward, with the arms straight at the sides. of course, i am fully aware that most women sleep curled up like kittens, but they can change their ways if they will but try. the woman with straight, good shoulders never carries her arms heaped full of bundles, for that draws them forward and makes them droop as dismally as an ostrich plume in a blizzard. instead, the "budgets" are carried with the arms down at the sides. neither does she clutch the back of her skirt in that bantamlike fashion practiced by the woman of less judgment. the back breadths of her new tailor-made are grasped about six inches from the belt, and held up just so that they clear the ground. hats worn deep over the eyes are not desirable, this wise woman also knows, for however tightly they are pinned to one's back hair, they are mighty likely to keep one's body at an uncomfortable slant. the plump woman who wears her hose supporters pinned to the front of her corsets seldom knows that the constant pulling of the elastics has a tendency to make her shoulders droop. shoes of high heels and narrow toes are equally bad, for the wearer is plunged forward in an ungraceful and line-destroying attitude. the low-heeled, square-toed shoe--that is now in vogue--is the thing to wear, and blessed be the lord for at last bringing womankind to a rational understanding of what she should wear on her much-abused little feet! the tailor-made gown is serviceable as a promoter of good figures, for usually, unless one keeps one's shoulders back, the front of the bodice proceeds to lay wrinkles in itself and so spoil the good effect that women love as they do their pet jelly dishes and their dresden teacups. other things to be remembered are: always stand on the front or ball of the foot and keep the knees straight. carry yourself so that a string extended downward from your chest would reach the floor without touching another part of the body. do not push your head forward and do not be in a hurry so that you will waddle along like a little duckling with absolutely no grace or carriage. dress comfortably, have your clothing well fastened, and your gown loose enough to give your lungs opportunity for the full expansion that, for the sake of your health, they should have. make sofa cushions of your pillows and sleep always face downward, flat on the mattress. last, but not least, don't be a woeful lady and amble along in a disconsolate, sloppy-weather fashion that is so utterly hopeless that i could never set before me the awful task of suggesting a remedy. one of the secrets of happiness and success is cheerfulness. men and women and even babies like cheerful folk, while they will race their overshoes off trying to get away from the unhappy ones of dismal tales and many worries. be cheerful, even though the laundress has washed your best handkerchief into a real-lace sieve, or the rains and snows of december have descended upon your best sunday bonnet and made a pocket edition of a rag-bag thereof, or even if the gas range has blown itself and all the kitchen windows into the next block. be cheerful at all hazards! it pays! really it does! breathing "the common ingredients of health and long life are, great temp'rance, open air, easy labor, little care." --_sir philip sidney._ among the first lessons that the beauty student must learn is how to breathe properly. i know, my girls, that that sounds awfully stupid, but there are yards and acres of truth in it nevertheless, and the subject is well worth your while--you can depend upon that. haven't you ever noticed that most of the women who have gone in for vocal culture have round, pretty waists? almost invariably the singer is a woman of fine figure, well-poised head, firmly-set shoulders and easy carriage. and the reason is simple. she has learned from the beginning that she must breathe properly, that every breath must come from the abdomen and not from the chest, and that to breathe in that way she must hold up her chin and expand her lungs. we often mistake carriage for fine figure. it is the woman who poises her head well and who keeps her shoulders back that attracts the eye of other women. there is something brisk and energetic and active about her that makes of her a sight good to look upon; while another woman with perhaps a much better figure will trail about with a down-in-the-mouth air and a slow, doleful gait that will give one the blues and an absence of appetite for weeks to come. you cannot possibly breathe properly and have your shoulders stooped--at least you cannot make such a combination without a mighty big lot of discomfort. if you breathe as you should you will develop the chest and bust, give better lines to the shoulders and--unless you are naturally inclined to be plump and rotund--will make your waist become round and slender and pretty. if you doubt this, try for yourself and see. i wish that i could impress my readers with the fact that improper breathing brings many ills. breathing is a highly important function, and bad breathing not only produces symptoms of consumption, but makes the waist unduly large. the reason for this is that holding the chest up will keep all the internal organs in their proper places, and so not allow them to spread the waist in the unsightly way that usually denotes deficient vitality instead of the "greek health" upon which physicians are wont to dilate. good breathing strengthens muscles and makes the flesh firm. the reward is a perfect, round, slender figure and a trim waist. begin your breathing lessons in the morning just after getting out of bed, when you will have no tight skirts or bands to hinder the full expansion of the lungs. raise every window and get all of god's blessed air that you can, and, above all things, let not this practice cease when the winds of winter blow as if from greenland's icy mountains. the breathing exercise is all the better then. place your hands on your hips and walk slowly across the room, your chest held upward and outward, and every breath coming deeply from the abdomen. after three trips you will find yourself pretty well tired out. rest for a few moments and try again. the next morning make the exercises longer, and as soon as the muscles that hold your chest up become firm and strong there will be little exhaustion. vary the exercise by standing still, taking as long a breath as possible and holding it for several seconds. this practice, indulged in for five or ten minutes every day, is most beneficial. but the main motive in all breathing exercises is to get into the habit of standing straight with the shoulders held back and the chest up. "play" that you are trying to make your chest creep up and touch your chin. one of the greatest injuries that come from wearing tightly laced corsets is the compression of the ribs. the unyielding steel and buckram will not permit a variation in the waist measure as a deep breath is inhaled or expelled. the proper and healthful corset is the one that expands or contracts with each respiration of its wearer, and that is why i am such an enthusiastic devotee of the corset waist with the elastic bands on either side. it matters not one bit how tight the clothing may be, so long as it is given elasticity and is yielding. this is absolutely necessary to perfect health and the proper development of a woman's figure. with the breathing capacity increased, enlargement of the lungs and development of the chest are sure to be the results. but, be it understood, please, that this growth is not the work of a day or a week, or a month even. however, if it is continued religiously there will be a difference of five or six, or even seven, inches in your chest measure in the course of a year, to say nothing of the improvement in carriage and figure, and the health and strength that correct breathing will give. there are a number of things to remember. the first is that one must secure breath control, the next that the best authorities condemn thoracic or upper chest breathing. keep the chest up and out, and let the expansion be at the waist line. inhale slowly and smoothly as much air as you can, swelling out the lower chest at the sides just below the arm pits as the air is drawn in. hold this air five seconds. then exhale it slowly and gradually, crushing in the ribs gently with the hands as the air goes out. during the exhalation be sure to keep the upper chest still. do not let it sink, as it will be apt to if not restrained by an effort of the will. exhale again and hold the breath for ten seconds, then for fifteen seconds, and finally for twenty seconds. this exercise will do for the first day. increase the power of holding the breath by practicing regularly each day. be careful not to make any motion suddenly. in calisthenics of any kind the more slowly and carefully the exercise is performed the greater will be the benefit. but best of all, keep in mind that these breathing exercises are not only making you a pretty woman of pretty figure, but giving you that greatest of all beauty elixirs--health. massage "the love of beauty is one of the most firmly implanted qualities of the human mind, and only those who are mentally deficient fail to appreciate it. from the human standpoint there is no edifice so beautiful as that earthly temple which enshrines the soul."--_dr. cyrus edson._ massage is as old as the hills. most really good things are, i've found. the grecian and roman women preserved their wondrous, wholesome beauty by reveling in luxuriant baths and then undergoing vigorous massage by their stout-armed slaves. massage is a natural alleviator and comfort-giver. the first thing a baby does when he bumps his precious head is to rub the injured spot with his little fist. relief seems to come with friction. if one's temples hurt, the hands seem to itch and tingle to get to rubbing and smoothing out the aches there. and the reason for it is that friction makes active the nerves and blood vessels and exercises the tired or fretting muscles. massage is exercise. if we were to cease using our arms the muscles would shrink and soon become incapable of movement. the skin outside would, of course, be affected by the general warpings of the tissues, and the result would be everything that is dreadful to the mind feminine--crow's feet, wrinkles, sallowness and lack of the tints and colors of health. you who have enjoyed the pleasures of a turkish bath must know how new and robust and fresh you feel after the invigorating cleansing and pummeling by a strong and experienced masseuse. we all know about the system of decay and renewing which the skin constantly undergoes. it is much the same way with the muscles. the very tiny cells of which the muscles are composed are continually being repaired. as the wornout particles are rejected the new fiber is created. does it not stand to reason that massage will facilitate this process, make the flesh firmer, restore vigor to the muscles and give new life to the entire system? the muscles of the face, more than those of any other part of the body, are lazy and torpid. as the troubles of life descend, the wear and tear of bothersome existence begins to show. the circulation becomes defective, and this brings flabby tissues and a wrinkled, sallow skin. then, oh, woe! woe! one feels as if one might just as well be dead and gone as to be trailing through life so afflicted. massage means "i knead." while the professional masseuse should be well informed concerning the muscles of the face and neck, the location of the veins and arteries, and the general formation of the skin, the little home body who wishes to rub away a few wrinkles or turkey tracks can easily dispense with the acquiring of so much knowledge. with knowing what "not to do," she will get along very well, although it has always been my opinion that the simplest and most satisfactory way to learn to massage one's own cheeks and brow is to go to a first-class professional for one or two treatments. if you keep your eyes open you will easily learn the simplest and most effective movements. the first thing to remember is that massage will both create and reduce flesh, according to the treatment given and the time devoted to it. severe rubbing and rolling of the flesh between the fingers will gradually dissolve the fatty tissues. the flesh will then become soft and flabby, and the skin will be likely to fall into tiny lines unless an astringent wash, like weak alum water (used hot), is applied to tighten and harden it slightly, and so make the flesh firm. if the massage is continued, the flabby flesh will also be reduced, especially when the astringent wash is applied to help the hardening process. when the face is to be plumpened or wrinkles removed, then rub the skin very gently with a rotary motion, which is not a mere rubbing but a kneading as well, and follow with light tapping movements. never roll the flesh between the fingers unless reduction is the object. also, never massage oftener than once every twenty-four hours, and then only for fifteen or twenty minutes. so much for the don'ts. before beginning the massage have the face perfectly clean. wash with tepid water and pure castile soap. otherwise the dust and powder are kneaded into the pores and the result is frequently extremely irritating. the reasons for massage are many. it facilitates and stimulates the skin in its continual effort to throw off the tiny flakes of dried, dead cuticle. it is exercise for the muscles, and at the same time it inspires a livelier circulation of the blood. it is easy to understand then why massage is so beneficial for the face, and why it makes a rosy, healthy complexion. massage alone will remedy many a complexion ill, for when the muscles are sluggish and torpid, the tissues weak and flabby, the circulation as slow as the messenger boys in the funny papers, and the skin sallow and wrinkled, all in the world that is needed is a little gentle patting and coddling and rubbing into a less lifeless state. great care must be taken lest the skin become bruised and irritated. for this reason a cream or skin food is used. let me suggest that this emollient be of the good, pure, home-made kind, not the cheap cosmetic which has mutton tallow or lard as a principal foundation. the orange flower skin food (formula appears in the chapter on the complexion) is the best formula for this purpose, as it will, by absorption, fatten and build up the impoverished tissues, and at the same time strengthen, whiten and soften the skin. mineral oils must never be used. glycerin not only makes the complexion darker and rather yellow, but it dries the secretions of the skin very rapidly, and a dry, harsh surface is the sure result. vaseline--as we should know from its reputation as a hair tonic--will not prove a happiness to one. the skin food should be rubbed in all over the face and far down upon the neck with a firm, circular movement. when the cream is partially absorbed begin the manipulations, starting at the forehead. place the thumbs on the temples and in that way hold the skin firm and taut. with the tips of the first and second fingers of both hands rub the lines transversely. if there be wrinkles across the forehead, rub up and down, holding the skin tight at the top of the forehead with the first fingers and manipulating with the second and third. another movement which is excellent for wrinkles is to place the first finger of each hand crosswise of the wrinkles about half an inch apart. then push up a little fold. as the left hand finger pushes its way along the wrinkle, let the right hand one rub up and down, always keeping the line up into a little hill. in massaging the lines about the eyes the movement should begin by rubbing the eyelid from the nose outward half an inch beyond the end of the eye, then returning below the eye toward the nose. this will make the massage sweep back crosswise of the crow's feet. another movement is to hold the skin taut and then knead the lines firmly with the first and second fingers of the right hand. if the chin is fleshy and you wish to massage it down to smaller proportions, you must dissolve the fatty tissues by picking up the flesh between the thumb and forefinger and rolling and rubbing as much as you possibly can without injuring or breaking the skin. then, in order to keep the flesh from getting flabby the rotund little chin must be bathed in cold water, in which is a small pinch of alum, a piece the size of a bean being plenty for a pint of water. this alum bath, remember, is only to be applied when you are reducing the carbon or fat. the "kneading" movement is very beneficial. this is done very gently with the thumb and forefinger only--precisely the motion used in kneading bread. the smoothing manipulation for the wrinkles is probably better explained as an "ironing out" motion. all lines can stand these two movements. whenever the skin seems particularly dull of color and generally lifeless, then the patting comes in excellent play. this is merely a gentle tattoo over the entire face. electricity is an excellent accessory to massage--but that is another story. after the massage, wet a wash cloth in water slightly chilled, and lay over the face. this will close the pores nicely. dry and apply powder. i trust that my beauty students will easily understand the foregoing--it is certainly a difficult topic to explain lucidly. as i said before, it is a wise plan to go to some one who thoroughly understands the art and let her teach you. while massage can be given at home, it is more satisfactory if done by a professional whose knowledge of anatomy will assist her toward the best results. dress "be plain in dress, and sober in your diet; in short, my deary, kiss me! and be quiet." --_lady w. montague._ the world has its full share of silly women--more's the pity--but there is not one who can hold a candle to the girl who trots about in the cold, bleak days of winter clad in summery undergarments fit only for the warm atmosphere of a baker's oven in august. so long as these exhibitions of utter absurdity continue we cannot consistently harp upon woman's recently acquired good sense in dress. it seems more and more the fad for girls to boast that they have never worn a vulgar outfit of flannel undergarments, but it is quite observable that these same girls are the very ones who are eternally grunting and groaning and coughing and fussing. and how can they help it? you can't have good health if you keep yourself in a semi-refrigerated state. a sleeveless vest of silk is not sufficient to keep one's body warm, even though the prettiest bodice in christendom and the swellest of "coaties" cover it. skirts of white muslin, with pretty frills and lacey trimmings that fall in soft folds and ruffles around one's feet, are mighty dainty things for the summer girl--but is there a colder sound than that of a starched white petticoat in the dead of winter? bur-r-rr! it gives one the cold chills to even think of it! who has not beheld the stunningly gowned girl stalking majestically around the shopping district in a little tailor-made jacket topped off with a fur collarette? she tells herself that she is perfectly warm and comfortable, but you and i know better, my dear, for we have seen her unhappy efforts to crawl up into this same collarette, and we have beheld her shivering misery as a good stiff gust of january wind sends her flying around a corner. i am a firm believer in the tailor-made gown, and i am of the opinion that style often counts more than real beauty with women of stately carriage and pretty figure. but nevertheless, i believe first in keeping warm and in protecting one's health. the girl in the smart little jacket could well afford to wear a winter coat over it on the coldest days, and even then she would not swelter from the heat. really, it is torture for a woman of common sense to go along the shopping district and see her poor, miserable sisters who let comfort fly to the four winds of heaven while they revel madly in appearances. it's all very well, my girls, to look your best. but don't make sacrifices that will injure your health. i'd rather see a woman in a last winter's coat with the seams shiny than look upon a foolish but radiant creature in a bit of a cape that would keep her about as warm as would two good-sized cobwebs stitched together. the first woman would have the advantage of displaying evidence of real brains on the inside of her head. and beauty without brains isn't real beauty at all, but a sad, shop-worn, tear-wringing imitation. it is my opinion that in choosing underclothing for cold weather finely-woven cotton is the best of all. silk is not durable, and wool, even of the finest quality, will often prove irritating. besides, so many of us spend most of our time in steam-heated homes or offices that woolen garments keep one too warm. the cotton union suit makes a very desirable undergarment. this should be high-necked, long-sleeved, and made to come well down over the ankles. for the girl whose particular worry is a nose of flaming red, let me say that in fleece-lined stockings, calfskin boots and warm overshoes lies her only hope of a less flamboyant nasal appendage. there is no need of fourteen petticoats, notwithstanding the fact that really nice old ladies insist upon wearing that number. one skirt of silk or moreen, together with a tiny short one of white muslin and a pair of sensible, warm, woolen equestrian tights will make one more comfortable and will allay that immense swelling about the hips which much be-petticoated old ladies have. the tights, however, should be worn only when one is out of doors. during really cold weather no woman with sense enough to fill a one-grain quinine capsule will venture out of the house without thus properly clothing her lower limbs. let femininity come to the understanding that in proper dressing and rational eating she will find the first and best materials for building her house of beauty. it's all very well to wear pretty, fluffy, lace-trimmed undergarments, but if you think that a wan, white, pinched little face pays you for such extravagances in silliness, then you are a ninny. wear the fluffy things if you will, but put on the warm ones, too. in making a choice between the raiments of a ballet dancer and those of an eskimo lady, i'd point the finger of approval toward the latter--at least at those times when the thermometer is lounging around the zero point. the thin girl "beauty gives the features perfectness, and to the form its delicate proportions." --_willis._ diogenes and his lantern had an easy, simple task. if they had started out together to turn their searchlight of discovery upon a woman who was neither too fat nor too thin, no doubt they'd been poking around in other people's affairs ever since. i once heard of a woman to whom the idea of gaining or reducing flesh had never occurred, but she died before i got a chance to look at her, so of course i am rather doubtful as to the truth of the story. to my mind she should have been made president of something or other or else been put on exhibition where the rest of suffering womankind could have gone and feasted their eyes upon such an impossible paragon. if there is not a general wail about over-weight or under-weight, then it's a thin neck, or big hips, or an inclination to too much "tum-tum," or skinny arms, or cheeks like miniature pumpkins--and goodness only knows what else. and by the time one particular horror is massaged out of existence another crops up like a spook in the closet of a "fraidy-cat" girl, and then the business is begun all over again. therefore, say i this: don't worry yourself into your grave about too much flesh or a lack of it unless you find yourself taking on the extreme proportions of a skeleton lady, or a museum exhibit of unusual plumpness. a thin neck may be a bad thing--as all girls so afflicted can testify--but if that thin neck is rebellious, and pays absolutely no attention to tonics or massage or other coddling for which it should rightly be grateful, then merely say, "all right, if you insist!" and turn your attention to other things. what admirer of feminine beauty would not look upon a bright mind, quick, kindly wits, and sweet lovableness as a thousand times more acceptable than a neck as round and perfect as that of a venus? on the other hand, let me say that, if you will merely look after your health--exercise every day, be out of doors, eat proper foods and take your daily sponge bath--you will keep your chest broad and full, and your waist trim and neat. breathing exercises every morning are excellent for this happy condition of affairs. it is my firm belief that women could mold their bodies as they would if they only had patience and perseverance--not so much in flesh-gaining or flesh-losing, but in being wholesomely strong and healthy. this is most necessary, not only to prolong life and make it pleasanter and more livable in every way, but to be what god evidently intended--a robust, well-developed and perfectly formed woman. thin girls must be lazy and plump ones busy. if you work hard and have the usual load of worries that half the women lug about with them as they do their powder rags and their purses, then you may never hope to revel in a vast amount of fat. fretters are invariably thin; they simply worry off the flesh faster than nature can create it. when a woman is unusually slender it is her duty to get fat, not any more for the reason that she will look prettier with the angles filled out than for the reason that she will be stronger and healthier and in a better condition to resist illness and fatigue. she should have at least ten hours' sleep out of twenty-four, and this must be healthy sleep in a well-ventilated bedroom, on a hard mattress, and with no high pillows to make her stoop-shouldered and of ungainly figure. a nap during the day is a good thing if one can afford the time. absolute freedom from care and anxiety are necessary, but--alas--we cannot always regulate the antics of fate or circumstances that deny us these sweet privileges. the diet must be of the most nourishing, and should consist mostly of food containing starch and sugar, such as good fresh butter, rich milk, cream, fruits both raw and cooked, macaroni, fish, corn, sweet potatoes, peas, beans, ice creams, desserts without pastries, and nourishing broths. cereals, poultry, game, chocolate and sweet grapes are all excellent. avoid all spiced, acid or very salty foods. while plenty of outdoor life is most essential, a great deal of exercise is not. if there is any internal disease, especially the slightest inclination to dyspepsia or liver trouble, one cannot possibly gain flesh until the cause of the extreme slenderness is removed. when the body is plump in one part and fails in another, either massage or a gymnastic course is advised. dumb-bells and indian clubs will develop the arms; massage with a fattening emollient, together with loose clothing, tepid baths and breathing exercises, will increase the size of the chest and bust, while swimming, moderate bicycling and walking are good for nearly all plaints of the thin lady. but until these changes are brought about--and it will take lots of time--do not fret or worry. merely wear your clothing very loose, substitute a comfortable little waist for stiff, unwieldy corsets, and see that your gowns are made full and dainty. in this last particular you will have an immense advantage over the woman who would sell the shoes off her feet to be thin and "willowy." the plump girl "what's female beauty but an air divine, through which the mind's all-gentle graces shine? they, like the sun, irradiate all between; the body charms, because the soul is seen." --_young._ if one had to choose between being too fat or too lean, the wise woman would certainly take the smaller allowance of flesh. jack sprat might incite pleasant ridicule, but jack sprat's wife--lo! there would be naught but pity and tears for her! it is better by far to be the butt of jokes concerning "walking shoestrings" or "perambulating umbrella cases" than to waddle through life burdened to death with an excessive amount of flesh. the thin sister can pad out the angles, put frills and puffy things over the bony places, but alas for the fat one! she gets into clothes that are skin-tight, and she draws in her corset string until it snaps and gives at every breath and sneeze, and even then she does not look graceful and pretty, for the fat--like secrets--will out, and it rolls over and around like the little bumps and humps in a pudding bag. [illustration: lady naylor-leland] yet, after all, there's more hope for her than for her sister in misery. while some thin girls might revel in cod liver oil and nearly convert themselves into a hospital storeroom of tonics and fattening foods, they can't get round and rotund--the lord seems to will it that certain persons are to amble disconsolately through life minus the proper allotment of flesh. but with the overplump lady it all lies within herself as to whether she is to be stout and buxom or of more artistic and beautiful proportions. it is simply a matter of getting up and hustling, a condition of animation frequently foreign to her nature, but not at all impossible to even the most unwieldy. while a certain careful routine of living is necessary for a speedy change for the better, the two main points to remember are diet and exercise. to the girl who says: "but i can't diet. i get hungry. i love sweets and goodies, and have to have them," i must reply: "well, then, be fat." what is worth having is worth working for, and the woman who is too fat for her own comfort and personal appearance invariably has ahead of her the dreadful bogy of additional flesh as the years go on. and surely that should be enough to inspire her to mend her ways. in beginning the change--that is, in starting out on a regular system of dieting and exercising--you should remember that the reform must be worked gradually. one must go slowly into the more healthful manner of living. the severe methods of flesh-reducing cannot be too greatly deplored, and many a woman has lost her life by these extreme measures. i do not mean that they have died at their exercisers or that they fell exhausted because they did not have enough to eat, but that in their mad efforts to become thin quickly they undermined their health and laid a good foundation for physical disorders. good health, with too much plumpness, is preferable to beautiful proportions and the listlessness and pain of ill health. so you can follow my advice with the greatest safety, as health--to my way of thinking--is greater than beauty, for the last depends upon the first, invariably. to-morrow, when you get up, throw on a loose, warm wrapper, and then open the window. stand in the cool, crisp morning air, and expand your lungs a dozen times, holding your hands on your hips and raising yourself lightly on your toes. vary this by walking across the room, taking long, full breaths from the abdomen. this practice is equally good for the thin girl, or any other kind of a girl, for that matter. after airing your lungs close the window and run into the bath-room, where you should have a quick sponge bath, rubbing the body briskly with a heavy towel. a quick alcohol rub can follow, just as one pleases. for breakfast let there be fresh uncooked fruit, especially oranges. tea or coffee must be taken clear, as neither milk nor sugar should be indulged in by the beauty patient whose chief ambition it is to lose flesh. toast must always be eaten instead of bread, and butter used sparingly at all times. avoid fats, starchy cereals, flesh-producing vegetables and pastries. this is very simple, when you once make up your mind to it. do not fancy you are thus left with nothing whatever to eat--like mother hubbard's unhappy dog. meats, either cold or broiled, are good if eaten in moderation. poultry, fish and game are all right. asparagus, string beans, spinach and tomatoes are the most appetizing of vegetables, and in these four alone there will be sufficient variety, especially when salads of all sorts are included, although these must, of course, be taken without oil. young onions are also excellent, as are condiments, dried fruits and acidulated drinks. a hot lemonade, taken every night, is good, but it must have little sugar, else the effects of the acid will be overbalanced. as for exercise, walking is best of all. running is very beneficial, but the unique witticisms of the average small boy will probably keep this form of exercise confined strictly to the house. begin by walking half a mile for several days, then make the distance a mile, and keep increasing your daily walk until you cover at least five miles. that may sound like an impossibility, but don't you believe it, for it's not at all. in great britain a walk of fifteen miles is not considered half an effort, and who does not know that the english girls have the most superb complexions in the world? besides this, they are healthy, wholesome, well-developed women, and that counts a good deal in the race for beauty. if the five-mile walk is too exhausting, then take a longer time getting to the point, when it will be exhilarating instead of enervating. sleep must be limited to seven hours, and daily naps are strictly tabooed. to those who prefer, mechanical massage can be given, and this will take the place of long walks, although they are really preferable, as the fresh air is necessary. oxygen destroys or burns out carbon, and carbon is fat. the more exercise and fresh air, the more oxygen, and consequently destruction of fat by the one healthy means of remedying obesity. soda phosphates and the various fat-reducing preparations are not desirable. the only way to cajole willowiness of body into coming in your direction is to diet and to take plenty of exercise. do not drink much water. a little lemon juice added to it will make it less fattening. there, now, plump lady, are your rules! abide by them and your woes will surely disappear with a swiftness that will make you laugh. the working girl "labor is life!--'tis the still water faileth; idleness ever despaireth, bewaileth; keep the watch wound, or the dark rust assaileth." --_mrs. frances s. osgood._ it has often occurred to me that there are a vast number of plucky little bread-winning girls and women to whom even a tiny jar of creme marquise is a hopeless impossibility. for them is this chapter written. in the first place, we all feel pretty sure that--in the great, wonderful beginning of things--it was never meant that women should work. we can't help knowing this when we look about us every night at six o'clock and see the weary, patient, brave little faces that line either side of the elevated trains or the crowded street cars. women are not given to the solving of problems, so we won't go into the great "whys" or the "wherefores." that's a loss of time anyhow. but we will do heaps better than that. we will try to be hopeful and cheery, and learn how to make the best of the little happinesses that do come our way. the working girl--and we all take off our hats to her pluck--needs more than any other class of womankind to take care of her health. she is out in all kinds of weather, she works hard, and ofttimes struggles through a daily routine that is harrowing beyond everything. after hours there is mending to be done, or a thousand and one little duties to keep her busy until, tired out and nerve-weary, she goes to bed to gain rest and strength for the struggles of the morrow. she cannot afford the little luxuries of the toilet that are so dear and near to the heart of womankind the world over. the joys of having her hair "done" or her pretty cheeks massaged are not hers--and the pity of it is that often enough the fault lies not within herself, but in the unhappy circumstances of fate that have placed her among the less fortunate sisterhood. let a large bar of castile soap be the working girl's first investment. i say a "large" bar for the reason that it is much cheaper when bought that way. a good-sized piece of the pure white castile can be bought at some of the drug stores for fifteen or twenty cents. this should be cut into small cakes and put on a high shelf, where it will become dry and hard and so it will be more lasting. with plenty of warm water, a few good wash-rags and this pure soap you will have a beauty outfit that will be more beneficial than all the rouges and eyebrow pencils that were ever put into the windows of beauty shops. the bath should be daily. now do not say that you have not the time, for the sponge bath--which will make the blood tingle and the flesh glow--can be got through with in almost no time. it is most imperative that the secretions of the skin and the dust gathered during the day should be removed. when the body is not kept scrupulously clean the complexion is sure to suffer, for there the pores of the skin are most susceptible, and eruptions and blackheads come from very slight causes. when the hands become rough and tender, and will not stand soap, prepare a little almond meal. this, too, is very inexpensive, for, instead of the powdered almonds, you can use the pressed almond cake, which is nearly as good and very cheap, and in place of the orris root wheat flour can be used. take three ounces of the first and seven of the latter. if you can afford it, add a little powdered talcum. a cream for the face and hands, and one which can be used with perfect safety, is benzoinated mutton tallow. this is simply the best mutton tallow to which benzoin has been added, and both ingredients kept at a steady heat until the alcohol of the benzoin has been completely evaporated. about the hair: the greatest secret of luxuriant locks is absolute cleanliness. there are many women who vainly fancy that they keep their pretty locks perfectly clean, when they really do not at all. only plenty of running water can thoroughly rinse the soap or shampoo out. if the hair is at all sticky, or if a slight oily substance adheres to the comb, then the hair is not clean. (and let me say right here, combs and brushes too must be kept as scrupulously clean as the hair itself.) castile soap makes the best shampoo in the world, especially when a little piece is dissolved in warm water and a tiny bit of ammonia or alcohol added, although for dry hair neither the alcohol nor ammonia is at all necessary. if a tonic is needed, then use the sage tea, which, however, must not be put on light, blond tresses. common kerosene, if one can endure the odor, is an unsurpassed remedy for falling hair. rubbing the scalp every night with the finger tips until the flesh tingles and glows is a most inexpensive way of stimulating the circulation, and frequently makes the hair grow long and nice and fine. what one eats plays such a leading part in the beauty-getting efforts--but i have but little space left now to tell about that. summed up in a nutshell, it is this: eat very little pastry, and shun greasy foods or fat meats, like pork or bacon. pin your faith to vegetables and fruit. a luncheon of two apples is of greater nourishment, and more, real value to good looks, than a repast of mince pie and coffee--two unspeakable horrors to any one who regards health and beauty as worth the having or the striving for. as for the dress, i could write a seven volume treatise on that. it sounds prosy, i know, and very stupid, but let me tell you that it is the wise girl who buys for comfort, utility and wear, instead of style and elaborateness. a plain little fedora, if well brushed, makes a trimmer, neater appearance than a cheap velvet hat ornamented with feathers that have straightened out and flowers that have long since lost their glory in the rains and storms of autumn time. it is the same way with shoes and gloves. if one can possibly afford it, calfskin boots and heavy gloves should always be purchased. they will not only outwear two or three pairs of the lighter, less durable kind, but they will give warmth and comfort and a well-groomed look as well. the nervous one "the beautiful seems right by force of beauty; and the feeble wrong because of weakness."--_elizabeth barrett browning._ of all the unfortunates on the face of the globe there is none so worthy of real all-wool pity and yard-wide sympathy as the woman of nerves. yes, and her family needs a dash of consolation, too. one nervous woman can create more nervousness among other women than could a cageful of mice or a colony of cows suddenly let loose. it is not for herself that the fuss-budget should mend her ways, but for the great good of humanity at large. we are all of us more or less nervous, and it is really interesting to observe what strange outlets woman's natural nervousness chooses. "i'd walk from hyde park to the city hall at midnight and never be a bit scared. but let me stay in the flat alone after dark and i'm in a state of terror that would make you weep were you to behold me," confesses nervous lady no. . "i have nerves of iron," pipes up nervous lady no. . "except when there is a thunderstorm. then i wish i were as dead as julius cæsar." "well!" drawls nervous lady no. . "i don't believe in ghosts at all, but i'm scared to death of 'em. sometimes i not only keep the gas burning all night, but i sit up in bed so as to be right ready to run away from 'em." some people have contempt for the nervous ones. i have only pity. any one who has gone through the tortures of hearing imaginary burglars three nights in the week for ten or twelve years on an endless stretch needs consolation and then a good, straight talk on the beautiful convenience of horse sense. most women are always hearing burglars. probably one in a thousand turns out to be a real, live housebreaker. whenever the wise woman hears one fussing with the lock on the front door or trying to squeeze into the pantry window, she just says: "same old burglar. he'll be gone in the morning," and he always is. that's a heap better plan than arousing the household and suffering the unmerciful torture that a family given to ridicule can inflict. i heard a woman say the other day that she never knew what it was to be nervous until a certain ragman began to take pedestrian exercises up and down the alley back of her house. he carries a canvas bag over his shoulder, and he yells "eny ol' racks" until that woman locks herself in a closet and stuffs sofa cushions into her ears. his "eny ol' racks" has got on her nerves so that she is simply beside herself until that man takes himself and his yell out of hearing distance. to be sure, he yells through his nose, but why in the world that woman should make herself miserable about something she can't possibly help is a double-turreted mystery to me. the thing for her to do is to sit down placidly on the back porch and make up her mind that the ragman is not going to upset the tranquillity of her existence; that he hasn't any right to interfere with her happiness, and that she isn't going to be fool enough to let him. i'll wager a peseta against a gum drop that she could do it, too, and without half an effort, if she would only once be consistent and determined. there is no use in beating about the bush. i feel sorry for the nervous woman at all times and every day in the week, but there's no chance of a doubt that the nervous woman is mentally unbalanced for want of courage and lack of will power. some place, way back in the far corners of her intellect, there are numerous little sore spots that need the healing tonic of level-headedness and the bravery of belief in her own strength. those wise gentlemen of pellets and pills tell us that when there is a defect in the structure of the nervous system, some certain region of cells not well flushed with blood is usually at the bottom of the infirmity. the cure, they say, is discipline and training, good food, exercise and plenty of sleep and good fresh air. [illustration: mrs. j. r. de lamar] sunlight is a glorious medicine for the woman of nerves. if i had a nervous fuss-budget under my care, the first thing i would do would be to feed her well. i'd give her nourishing broths and daintily-served vegetables, and little steaks and chops and plenty of fattening cereals and drinks. i would bundle her off to the parks every morning with sealed orders not to come back until she was dead tired and as hungry as a small girl at a boarding school. i would impress upon her mind the great need of throwing worry to the winds and taking in good, long breaths of god's blessed fresh air. then, after feeding her some more, i'd make her take a nice, refreshing sponge bath and tumble early into bed. after several days of such treatment i'd corner her where she couldn't get away and lay down the laws. "now it's just with yourself," the lecture would begin with, "whether you are to be a jolly-hearted, wholesome-looking woman or a tailor-made gown with a bundle of nerves inside of it. no matter what comes, don't make yourself wretched by fretting. every one has troubles. you can't escape them. sometimes they come with a sweep-like tornadoes gone mad, and you'll say to yourself: 'my heavens! i wonder if i'll live through it all?' but you will, and between you and me, my dear, it's just as well to come out of the battle with a smiling face as with eight additional crow's feet and a new scolding lock of gray hair. just say to yourself: 'i will not grind my teeth because the man next to me in the street car is chewing a toothpick. i am not responsible for his lack of manners. i positively refuse to have fits because the woman in the flat next to mine plays the flute eight hours a day. if it's convenient i'll move; if it isn't i'll not make existence a daylight nightmare.' "school yourself!" i will continue. "get lots of starch in you and a backbone that is a backbone! don't fall down in a heap and mope over things you can't help. the agreeable things in life are as rare as sage-brush growing in gotham, while the disagreeable is bobbing up eternally. so brace up, my friend, and make the best of it. discipline yourself. keep your mind fresh and bright, and your body strong and healthy. if you have hard work to do then do it with the least possible expenditure of worry and nerve-force. be in the open air as much as you can, and above everything else dwell not on the unhealthy state of your nerves. let self-mastery be your shibboleth and 'no nerves' your prayer." perfumes "oh, how much more doth beauty beauteous seem, by that sweet ornament which truth doth give! the rose looks fair, but fairer we it deem, for that sweet odor which doth in it live." --_shakespeare._ women love delicate perfumes as they do silk stockings and violets. it's just "born in 'em," like their deep-rooted horror of mice and bills and burglars. from the time when the baby girl sniffs the sweetness of the powder puff as it fluffs about her soft, pretty neck until the white-haired lady lovingly fondles the lavender sachets that lie between the folds of her time-yellowed wedding gown, she loves sweet odors. the true gentlewoman never uses strong perfumes, yet her hats and clothing and handkerchiefs always send forth a faint scent of fragrant flowers. the odor is so very slight that it does not suggest the dashing on of perfume, but, instead, bespeaks scrupulous cleanliness of body and garments, with perhaps an added suggestion of the soft winds that blow over a clover field. no perfume at all is far better than too much, for who does not look with suspicious eyes upon the woman who, when passing one on the street, seems to be in an invisible vapor of white rose or jockey club--strong enough to work on the streets? there is a secret about it all, and such a simple one! it is merely choosing one particular odor and using it in every possible way. there is nothing sweeter than violet perfume, so suppose i illustrate with that? begin by using orris root for your teeth, combined, of course, with the other necessary ingredients. then, if you can afford it, get the expensive imported violet soaps, although as a matter of beautifying there is nothing better than the pure white castile. the odor of this, disliked by some, can be entirely done away with by using a little violet toilet water in the bath and touching the ear lobes with it afterward. then, between the folds of your gowns and in the crowns of your hats lay little violet sachets, always removing them before the gown or hat is worn, as the perfume must be faint and delicate. a few drops of essence of violet will scent your face powder, if it is not already perfumed, and bath bags of orris--and other good things--will add to your galaxy of sweet odors. if you use creme marquise or any of the other delightful cosmetics told about in our beauty book, add a little essence of violets to them while they are being mixed. putting it all in a nutshell: simply choose your favorite perfume and carry it out in every detail. for those who are fond of violet i will give the following recipes: creme de la violettes: place in a porcelain kettle one ounce each of white wax and spermaceti, cut in fine shavings. when melted add to this five ounces oil of sweet almonds and heat, but do not let boil. remove from fire and pour in quickly one and one-half ounces of rose-water in which ten grains of borax has been dissolved. beat briskly. when beginning to thicken, add one-half teaspoonful essence of violets. when nearly cold put in little jars. use as cold cream or any general face cosmetic. it is more effective when applied at night, just after the face is bathed in warm water and while the flesh is pink and moist. perfume--violettes de bois: essence of violets, five ounces. essence of acacia, one ounce. essence of rose, one ounce. extract of iris root, one ounce. oil of bitter almonds, five drops. violet lotion: alcohol, four ounces. ammonia, one ounce. essence of violets, one dram. add one teaspoonful of this to a bowl of water when bathing the face, neck and arms. hard water is the cause of many bad complexions, and this will remedy that particular trouble of the beauty-seeker. poudre de vicomtesse: talcum powder, seven and one-half ounces. finest starch, one and one-fourth ounces. powdered orris root, one and one-fourth ounces. oil of orris, ten drops. violet bath bags: two pounds of finely ground oatmeal. three ounces of almond flour. one cake of best white castile soap, shaved fine. one-quarter pound powdered orris root. take one yard of cheese cloth and make it into little bags about four inches square and fill with the mixture. these will make a soft white lather, and afterward the face, neck and arms should be rinsed in water containing a few drops of benzoin. larger bags can be made for the regular bath. for the teeth: one-fourth pound of prepared chalk, finely powdered. three-fourths ounce pulverized castile soap. one ounce powdered orris root. one-half dram oil of sassafras. one ounce pulverized sugar. violet sachet: black currant leaves, powdered, one-fourth pound. rose leaves, one-fourth pound. cassia buds, one-eighth pound. orris, ground, one-half pound. gum benzoin, one-eighth pound. grain musk, powdered, one-fourth dram. mix thoroughly and let stand for one week. violet toilet water: essence of violet, one and three-fourth ounces. essence of rose, one-half ounce. essence of cassie, one-half ounce. alcohol, ounces. essence de fleur d'oranges: one-half ounce pure neroli. one pint alcohol. one ounce essence of jonquille. violet sachet powder: eight ounces of orris root. five drops oil of bergamot. three drops oil of bitter almonds. four drops oil of rose. one fluid dram tincture of musk. mix thoroughly. lavender sachet powder: one pound powdered lavender. one-quarter pound gum benzoin (powdered). six ounces oil of lavender. mix. heliotrope sachet powder: one-quarter pound rose leaves. two ounces tonquin, ground fine. one-quarter pound pulverized orris root. one ounce vanilla (powdered). one-half grain musk. two drops oil of almonds. mix by fluffing through a sieve. how to add ten years to your life and to double its satisfactions by s. s. curry, ph.d., litt.d. can you wake as wake the birds? in their joy and singing share? stretch your limbs as do the herds, and drink as deep the morning air? quick as larks on upward wing, can you shun the demon's wiles, promptly as the robins sing, can you change all frowns to smiles? can you spurn fear's coward whine, meet each day with joyous song? then will angels guard your shrine, joys be deep and life be long. boston school of expression book department pierce bldg., copley square copyright by s. s. curry to those who loyally responded to the dream and to those who by thought, word or act will aid the school of expression to perform its important function in education. qui transtulit sustinet as ancient exile at the close of day, paused on his country's farthest hills to view those valleys sinking in the distant blue where all the joys and hopes of childhood lay; so now across the years our thoughts will stray to those whose hearts were ever brave and true, who gave the hope and faith from which we drew the strength to climb thus far upon our way. as he amid the rocks and twilight gray, saw rocks and steeps transform to stairs, and knew he wandered not alone; so may we too see this, our tentless crag where wild winds play a bethel rise, and we here wake to know that down and upward angels come and go. contents page why and wherefore i. significance of morning ii. supposed secrets of health and long life iii. what is an exercise? iv. program of exercises v. how to practice the exercises vi. actions of every day life vii. work and play viii. significance of night and sleep why and wherefore when over eighty years of age, the poet bryant said that he had added more than ten years to his life by taking a simple exercise while dressing in the morning. those who knew bryant and the facts of his life never doubted the truth of this statement. i have made inquiries lately among men who are eighty years of age, as to their method of waking up. almost without exception, i find that they have been in the habit of taking simple exercise upon rising and also before retiring. while studying voice in paris, over thirty years ago, my teacher was so busy that he had to take me before breakfast at an hour which, to a parisian, was a very early one. "vocal exercises may be more difficult at this time," he said, "but it is the best time. if we can start the day with the right exercise of the voice, the use of it all through the day will be additional right practice." later, when i studied with the elder lamperti in italy, i requested and secured an early hour in the morning for my lessons. in teaching i have always urged students to take their exercises the first thing in the morning. those who have taken my advice have later been grateful for the suggestion. if my own morning exercises are neglected, i feel as if i had missed a meal or had lost much sleep. i was never what is called physically strong; in fact, physicians have continually prophesied my downfall, yet all my life i have performed about three men's work, and by the use of a few exercises have probably doubled the length of my life. the subject of human development has always been of great interest to me. i have tried to investigate the various systems of gymnastics in all countries; and, teaching, as i have, about ten thousand the use of the voice and body in expression, i have studied training from a different point of view from that of most men. i have discovered that the voice cannot be adequately trained without also improving the body; that the improvement of the voice can be doubly accelerated if the body is considered a factor. i have also found, what is more important, that true exercises are all mental and emotional and not physical, and that both body and voice can never be truly improved except by right thinking and feeling. i, therefore, long ago came to certain conclusions which are not in accordance with common views. my convictions, however, have been the result, not only of experience, but of wide study and investigation. this book embodies a few points about health; without going deeply into the principles involved, a short programme is given, the practice of which has already accomplished marvelous results. the book embodies my own experiences, and obeys the scientific principles involved in training. it is meant to be a guide for home study and practice. the principles are applicable to everyone. it requires at first, patience, perseverance, and resolution at that moment in the day when we are most liable to be indifferent and negative, if not irresolute and discouraged. whoever resolutely undertakes to obey the suggestions will never regret doing so. in fact, it is not too much to claim that he will not only lengthen his life but double its satisfactions. every reader of the book is requested to become a member of the morning league, and whosoever does so and makes a report or writes to me fully about special weaknesses, habits, "besetting sins," or conditions will receive a letter of suggestions. this book and its companion, "the smile," are published as a part of the great work undertaken by the friends of the school of expression; the net receipts from the sale will go to the endowment fund of the institution. how to add ten years to your life i significance of morning "the year's at the spring and day's at the morn; morning's at seven; the hill-side's dew-pearled; the lark's on the wing; the snail's on the thorn; god's in his heaven-- all's right with the world!" song from "pippa passes" robert browning browning's "pippa passes" is a parable or allegory of human life. though called a drama by its author, it embodies, like all plays of the highest type, other than dramatic elements. in exalted poetry the allegoric, lyric, epic and dramatic seem to be blended. an effort to separate them often seems academic and mechanical. pippa, a poor little silk-winding girl, who has never known father or mother, opens the poem. it is the early morning and she wakes with joyous anticipation of her holiday, her only one. she goes forth, and we hear her singing and we see her influencing, from her humble position in the background, "asolo's four happiest ones," who are brought by the action of the drama into the foreground. her character and that of the other persons of the play are well-defined; but the real theme of the poem is the unconscious influence that she exerts upon others. the primary element of dramatic art is the meeting of people and the influence they exert upon each other. there is no direct influence seemingly exerted upon pippa herself save at one point and even that is scarcely a conscious one. we feel that she is a type of the human soul. specific scenes, though intensely dramatic, are entirely separated from one another. accordingly if it is a drama, it is a drama of an unusual type. it regards the events of only one day; still that day is not literal; it is a symbol of the life of everyone. it is new year's day, but every day is the beginning of a new year. it is a holiday, yet all life, when normally lived, is dominated by love and sympathetic service, and is full of happiness. pippa sings as everyone should sing with the spirit of thanksgiving and love. she welcomes the day with joy as everyone should welcome life and its opportunities. she lies down to sleep at night, as we all do; her sun drops into a "black cloud" and she knows nothing of what she has really accomplished or of the revelation that is coming on the morrow. moreover, observe that the link of unity in the play is found in the songs of pippa. one might easily conceive her beautiful character as embodying the very soul of lyric poetry. hence, in reading the poem, we are impressed from the first with allegoric, lyric and epic, as well as dramatic elements. observe more closely her awakening. note the beautiful description, the gradually lengthening lines, indicative of the coming morning. [see page .] she expresses joy as she meditates over her new year's hymn. into this devotional lyric browning has breathed the spirit of all true life and service. "now wait!--even i already seem to share in god's love: what does new-year's hymn declare? what other meaning do these verses bear? all service ranks the same with god: if now, as formerly he trod paradise, his presence fills our earth, each only as god wills can work--god's puppets, best and worst, are we; there is no last nor first. say not "a small event!" why "small"? costs it more pain that this, ye call a "great event," should come to pass, than that? untwine me from the mass of deeds which make up life, one deed power shall fall short in, or exceed! and more of it, and more of it! oh, yes-- i will pass each, and see their happiness, and envy none--being just as great, no doubt, useful to men, and dear to god, as they! a pretty thing to care about so mightily, this single holiday! but let the sun shine! wherefore repine? --with thee to lead me, o day of mine, down the grass path grey with dew, under the pine-wood, blind with boughs, where the swallow never flew nor yet cicala dared carouse-- no, dared carouse!" from "pippa passes" robert browning as pippa leaves her room in the full spirit of this hymn, full of joy, hope and love, she passes into the street. we hardly catch a glimpse of her until the close of the day, when she comes back and lies down to sleep: but we hear her songs and see the influence which she unconsciously exerts. this is the real theme of the poem. browning's poetic play reveals to us in four scenes the other side of life, the happier people to whom pippa referred in her soliloquy. we look first into the interior of the old house of which pippa has spoken with a kind of awe, and see the proud ottima who owns the mills where pippa is but a poor worker. in the dark gloom of one of the rooms ottima has become the sharer in a murder, and, under the influence of pippa's song, which is heard outside, she and her companion realize their guilt and are overcome with remorse. at noon we are introduced to a young artist, jules, who is just bringing home his bride, phene, whom he has married thinking her a princess, but who is really a poor, ignorant child. she has been employed unconsciously, to herself, and innocently used by some degraded artists as a means of rebuking the idealist, jules. by this cruel trick they mean to crush him and reduce him to their own sensual level. even letters which jules has received from the supposed princess have been written by these perversions of human beings--who call themselves artists. in her lovely innocence phene is thrilled by jules' tenderness. her intuition tells her that something is wrong as she falters in rendering the lines the cruel painters have given her to read to jules. we see the blow fall upon the young dreamer as he makes the fearful discovery. in the agony of his disappointment he is about to renounce phene forever as the artists, waiting outside to sneer at him, expect. the poor, innocent being, in whom his kindness and tenderness have stirred to life for the first time her womanly nature, is about to be cast out to a life of degradation and misery, when pippa passes, singing. her song awakens jules to a higher feeling, to a more human and heroic determination; and the painters, waiting outside, are disappointed. in the evening pippa passes luigi, an italian patriot. he is meditating over the afflictions of his country and upon a plan to help it, while his mother is trying to dissuade him from the daring undertaking. the police and spies are waiting outside. if he goes he will not be arrested; if he stays they have orders to arrest him at once. at the moment of his wavering, when he is almost ready to obey his mother, pippa's song arouses anew his patriotic being, and he resolutely goes forth to do a true heroic deed for his country. thus pippa saves him from imprisonment and death. night brings the last scene in the dramatic events of the world influenced by pippa's songs. a room of the "palace by the dome," of which pippa seems to stand in so much awe, opens before us. here we look into the face of the monsignor, for whom she expressed reverence in the morning, and we find that the monsignor and the dead brother whose home he comes to bless, are in reality pippa's own uncles. the poor little girl, with only a nickname, is a child of an older brother and the real heir to the palace, though of this she has never had the remotest dream. we see an insinuating villain tempting the monsignor to allow him to do away with pippa in a most horrible manner, and thus leave the monsignor in sole possession of his brother's property. during an intense moment pippa passes and her singing outside causes her uncle to throttle the villain and call for help. then we see, at the close of the day, the little girl, unconscious of her share in the life of others, come back to her room and fall asleep murmuring her new year's hymn which, in spite of appearances, she still trusts. we are left with the hope that she will awaken next day to realize who she is and come into her own. thus journey we all through life often forgetting that there is nothing small, that "there is no last nor first." we are conscious of noble aims, but oblivious of the real work we are doing and of our own identity. what, do you ask, has such a poetic drama to do with such a commonplace subject as health or the prolonging of life? the question implies a misconception. human development is not a material thing but is poetic and exalted. it has to do not merely with physical conditions but primarily with spiritual ideals. let us observe more closely how browning wakes pippa up. when she comes to consciousness she utters a cry of joy and thanksgiving; "day! faster and more fast, o'er night's brim, day boils at last." the joyous thanksgiving of this first moment is the key to pippa's life and to her influence through the whole day. such was the right beginning to her day and such is the right beginning for us all to every day of our lives. her faith and her hymn revealed the true ideals of this strange journey we call life. there is an old proverb: "guard beginnings." if a stream is poisoned at its head it will carry the deadly taint through its whole course. the most significant moment of life is the moment of awakening. the importance of morning has been more or less realized in the instinct of the human heart in every age. many of the myths of the early greeks refer to the miracle of the morning. aurora mirrors to us in a mystic way the significance of this hour to the greeks. athene was born by the stroke of the hammer of hephæstus on the forehead of zeus, and thus the stroke of fire upon the sky became the symbol or myth of all civilization. even daphne, pursued by apollo, and turned into a tree, is doubtless the darkness fleeing before dawn until the trees stand out clearly defined in the morning light. the dawn of day has always been considered a prophecy of the time when all ignorance will vanish before the light of truth. when we remember that men of the early ages had no other light but that of the sun, we can see how naturally the coming of morning impressed primitive peoples, and it is not much wonder that they adored and worshiped the dawn and the rising sun. we still speak of the dawn of a new civilization. morning is still the most universal figure of progress, the type of a new life. more than all other natural occurrences it is used as a symbol of something higher. may we not, accordingly, discover that from a psychological as well as a physiological point of view, for reasons of health and development, morning is the most significant and important time of the day! no human being at the first moment of awakening is gloomy or angry. everyone awakes in peace with all the world. it is a time of freedom. a moment later memory may bring to the mind some scene or picture that leads to good or bad thought, followed by emotion. this first moment of consciousness is the critical and golden moment of human life. how often has it been said to a child: "you must have gotten out of the wrong side of bed this morning." even animals and birds feel the significance of morning. who has not, at early dawn, heard a robin or some other bird begin to sing--"at first alone," as thomas hardy says, "as if sure that morning has come, while all the others keep still a moment as if equally sure that he is mistaken." soon, however, voice after voice takes up the song until the whole woodland is ringing with joyous tones. who, in such an hour, has not been deeply moved with the spirit and beauty of all life and the harmony and deep significance of all of nature's processes? if we observe the awaking of birds and animals more carefully, however, we find something besides songs. all the higher animals go through certain exercises on first waking. there seems a universal instinct which teaches that certain stretches, expansions and deep breathings are necessary at this time. in fact, these actions are so deeply implanted in the instinct of animals that they seem a kind of sacred acceptance of life, a species of thanksgiving for all that life brings. if we accept "pippa passes" as a parable of human life and pippa as a typical human being, may we not in her awakening find an example of this universal instinct? may we not find her first thoughts and feelings worthy of study and her example one to be followed? do we not, in fact, find here a beautiful illustration of the proper mode of meeting the sacredness of dawn? as a matter of fact, how do we actually greet the morning? do we awake as pippa did, with a joyous song of praise? do we pour out our hearts in gratitude that it brings a new day, a new life? do we give thanks for the new opportunities given us, the new possibilities of enjoyment, the new share in the life of the world? usually we have no thought about these things. most of us entirely forget the significance of the way or "the side we get out of bed." attention is rarely paid to the spirit in which we awaken children. it is often by means of an angry demand or an indulgent whine. they rise with the impression that it is a sin to awaken them and they begin the day with the feeling that the world is cruel. if we could spend the first few moments of every morning as pippa spent her first moments, the character of the whole life would be determined. it is the most important time of every day. is it not also the time when we are most apt to be tempted? has not man seemingly lost the significance of this sacred hour? why do so many, on waking up, begin to worry over the difficulties of the day? how many look back with regret to the preceding day and forward with a frown to the one newly born! why not smile as pippa smiled and meet our blessings with thanksgiving? there are certain physiological reasons why people feel so sluggish on first awaking:--the position in bed is cramped, the limbs are contracted, the circulation is impeded and the breathing is greatly hindered. when lying down, all the functions of the vital organs are lessened. many people are entirely too careless regarding the air of the room. it needs to be even purer and fresher during one's hours of repose than in those of waking. certain simple movements are taken by practically every animal on awaking under normal conditions. among these are yawning, deep breathing, expansion and stretching. these exercises form a part of the process of awaking. it is the change from the position of lying down to that of standing up. but we find that man rarely takes these exercises. between the moment of awakening and standing erect man possibly takes more time, whines more and does less than any other animal. of all the provisions of nature to meet this crucial moment in animal life the stretch seems to be most important. why men neglect the stretch is curious. man seems to lack something of the vigor of the animal instinct on awakening. he lives a more rational life, and it is necessary for him at this time to make certain decisions and exert firmness and resolution. science has carefully explained the stretch, but men seem to refuse to take the lesson. the stretch extends the body so that the veins, where congestion is most liable to take place and where pressure of blood is weakest, are so elongated that the blood flows more easily from the arteries, where the pressure is strongest, through the veins back to the heart and circulation is equalized and stimulated. the beneficial effects of the stretch can be felt by anyone who will take the pains on waking up in the morning to stretch easily, for a few minutes, then rest a few moments and note the effect. he will feel a great exhilaration all through the body. he will feel a sense of harmony. thanksgiving seems to arise from every cell at the fresh blood and life. the yawn is similar to the stretch. the yawn is a stretch of the lungs as the stretch is a yawn of the muscles. both of these exercises express a hunger for oxygen. whenever anyone is sitting in a cramped position or even in one position for a long time, the stretch or yawn is instinctive. the extension of the muscles of the body as illustrated in the stretch is one of the most necessary steps in normal adjustment. to speak of only one point: when a man sits his knees are bent, and the muscles in front of the leg are elongated and the muscles back of the knee are shortened. a stretch means simply the extension of these shortened muscles. all over the body we find a tendency to elongate certain muscles too much. this is true in the chest; true also of the face, at the corners of the mouth. the active use of the too elongated muscles will produce extension in those that are too much shortened. by doing this we bring about certain normal conditions and relations of parts. again we find that the stretch is activity of the extensor muscles. it is the action of the extensor muscles upon which health especially depends. at any rate, the extensor muscles are much more important to bring about the right relation of all parts and the right balance of sensitive muscles and the equalization of circulation than the activity of the flexor muscles. normal emotions, as we shall find later, are expressed through activity of the extensor muscles. abnormal emotions, such as anger, affect the flexor muscles of the body more. since nature has provided the stretch seemingly as the antidote for abnormal position, and especially abnormal position during sleep, in the programme of exercises it would seem most necessary to centre around some careful and scientific use of stretches. have you ever noticed a dog or cat wake up? observe their instinctive movements: the gradual but vigorous stretch in every direction, the deep breathing, the sympathetic extension and staying of the limbs at the climax, then the gradual giving up of the activity and the moment of restful satisfaction. stretching in this way is one of the primitive instincts in all animals. he who will observe the animals will feel that the time for practicing the exercises is on awakening, and the primary exercise to be taken is the stretch. how can we best occupy a part at least of the half hour or more that is usually wasted in worrying and fretting or in sluggish indifference, between the time when we first awake and the time we begin to dress? with all the knowledge of the human organism which has been revealed to us by modern science, with our truer understanding of the nature of men, of the effect of the mind upon the body, with our observation of the instinctive actions of the animals at such an hour, why can we not so occupy a few of these most precious moments of the day as to add to our vitality and enjoyment? at this moment of awakening, when your mind is free, you can so direct your attention as to receive joy instead of gloom, love instead of hate. you can exclude the thought of evil or you can yield and allow the tempter to desecrate your shrine. whichever choice you make, these first moments of your day's living will color the whole course of the coming hours. the feeling first accepted and welcomed will more or less continue and form a background to all your ideas and determine your point of view toward human events. the chief aim of this book is to present a simple programme giving, not only some exercises for this hour, but certain explanations which will inspire a sense of the importance of this hour and these movements. most people have no conception of the possibilities of human nature, of the fact that progress is the highest characteristic of a human being. no matter how old we are, we can always begin to climb upward; the main thing is our willingness to climb. do we understand how to use the least actions and the most neglected movements for the development of character and the satisfactions of life? the principles and exercises advocated in this book are not extravagant. again and again their benefits have been proven and many thereby have doubled life's satisfactions and its length. ii supposed secrets of health and long life before laying down a simple programme which will give one a common sense method of keeping well, living long, and making the very most of life, it may be well to study some of the innumerable theories regarding long life. if all the discussions upon health and long life, from the earliest time to the present, could be adequately chronicled they would form an interesting, if not an amusing history. in many of these, however, we should find the same serious thoughts which we may well consider and find by comparison a few points in which all agree as to what is necessary to health, happiness and length of days. note the theories that have been seriously advocated and which have had vogue among certain classes for a time,--such as the use of cold water every day as a remedy for all diseases. the cold water cure advocated wet sheet packs for fevers, and water, in some form, for all ailments. to live long some physicians have advised sleeping on the right side, others have advocated the use of raw food or food that has been cooked very slightly. some have contended that scientific food is the complete food found in nature, such as nuts; still others have advocated whole wheat bread! in our own time a method has been emphasized which has been called "fletcherizing." this, of course, is taken from the name of the gentleman, who has made it so illustrious by his books and his discussions of the subject. mr. fletcher's principle consists in holding or masticating the food until it is in a fluid form; even a liquid must be held in the mouth until it is of the same temperature as that of the body. many consider that the chief advantage of fletcherizing is that it makes a person eat less. this may be a part of the advantage. i once had the honor of sitting at dinner by the side of mr. fletcher and observed his methods. he did not eat more than one-third of the amount, for example, of ice-cream that the rest ate, but he stopped when the others did, and said, with a smile:--"i have had enough; what i have eaten will give me more nourishment than a larger amount would and it will not give me any trouble." there is great truth in some of these theories. we should eat less meat and more grain. we should not bolt the best food elements out of wheat; we should not bleach rice and take out its nutritious element. certainly, our lives are very unscientific. most men live merely by accident. the shortness of life is not surprising to one who understands how irrationally most of us live. others say, breathe deeply, naturally and constantly. still others have urged active life out of doors or an active participation in business. it is a well-known fact that many men have not lived long after retiring from their occupations. andrew carnegie said recently that he attributed his long life, health and strength to his activity. the story is told that he walked the floor of his room with deep anxiety and consternation the night after his offer was accepted to sell the carnegie steel works. he had not thought it possible that his price would be accepted, and he kept speaking to his old friend about the amount of money paid and the greatness of the responsibility. fortunately he did not retire, as most men do, but took an interest in every phase of modern life. he has used his money, as a sacred trust, according to his own best judgment, building libraries and giving organs, pensioning teachers who have given their lives for truth rather than for making money, and has furthered many other causes. one of the most common opinions is that long life depends upon "our constitution,"--upon what we receive from our ancestors. that is, long life is a gift, not an attainment. and we are in the habit of blaming our ancestors, near and remote, for our lack of strength and vitality. dr. oliver wendell holmes once made the remark that if one wished to live a long life he should be afflicted with some incurable disease. this was thought to be merely a joke, but it has foundation in fact. many men with poor constitutions live to a very advanced age. they study themselves and live simply. they realize that they are not strong and they do not indulge themselves, but reach out for health and strength in all ways. among all the practices which men have adopted through different ages for prolonging life we find many which are universally believed, though possibly not practiced. some discussion of these may give us courage and enable us to realize how unscientifically, how carelessly, most men live, and how indifferent we really are to our well-being. and yet we find wide-spread doubt as to the advisability of being too fastidious. some of the extravagant ideas have naturally given rise to such scepticism. on hardly any subject have men had such extreme views as they have regarding health or the prolongation of their own lives. i know one lady who ate a raw carrot every morning because it was yellow, and, as yellow is a spiritual color, this practice, it was advocated, would free one from materiality and, consequently, from all disease. i have known others who condemned all attention to proper food, exercise, and even to expression, because such attention would lead to faith in material means. webster said, "truth is always congruous, and agrees with itself; every truth in the universe agrees with every other truth in the universe; whereas falsehoods not only disagree with truth but usually quarrel among themselves." in accordance with this principle as a rule the untruthfulness of any view is seen in its failure to recognize anything else as true. no one will advocate any extreme and irrational habit. too much attention to food, too much attention to the care of the body and exercise will degrade even character. the morning exercises which are here recommended should be taken even as one washes his hands, as a matter of course. man is spiritual, and character is developed spiritually, and mere attention to the body does not secure health and strength. there is a great and easily demonstrated truth in the fact that people who believe in a spiritual life have endured untold hardships and have faced all kinds of conditions without injury. the power of mind over body, of spirit over matter, is too well attested to be doubted. however, man is slow and progress must be made gradually. the first step must be taken before the last can be taken. extravagant and wrong views prevent a great many people from doing anything. if we examine all the rules for securing health and the leading secrets of long life, we find that one of the earliest is temperance. a noted instance is socrates. during the great plague, when at least one-third of the population of athens died, socrates went about with impunity. this was no doubt due to the cheerfulness and temperance of his life. we know of his cheerfulness from accounts by zenophon and plato. possibly the most illustrious example, which has been recounted of the preservation of health and the prolonging of life through temperance, is luigi cornaro, who was born in venice in . after having, according to gamba, wasted his youth, his health was so broken and his habits so fixed that "upon passing the age of thirty-five he had nothing left to hope for but that he might end in death the suffering of a worn-out life." this man, by resolution and temperance, battled with his perverted habits and became strong and vigorous and happy, and lived to be over one hundred years of age. "the good old man," said graziani, "feeling that he drew near the end, did not look upon the great transit with fear, but as though he were about to pass from one house into another. he was seated in his little bed--he used a small and very narrow one--and, at its side, was his wife, veronica, almost his equal in years. in a clear and sonorous voice he told me why he would be able to leave this life with a valiant soul.... feeling a little later the failure of vital force, he exclaimed, 'glad and full of hope will i go with you, my good god!' he then composed himself; and having closed his eyes, as though about to sleep, with a slight sigh, he left us forever." a new edition of cornaro's discourses on the temperate life, by william f. butler of milwaukee, has recently been issued under the title of "the art of living long." the first of these discourses was written at the age of eighty-three, the second at eighty-six, the third at ninety-one, and the fourth at ninety-five. his treatises have been popular for all these centuries. he held that the older a man grows the wiser he becomes and the more he knows; and if he will, by temperance and regularity of life and exercise, preserve his strength, his powers of enjoyment will grow, as his own did, every year until the end. "men are, as a rule," says cornaro, "very sensual and intemperate, and wish to gratify their appetites and give themselves up to the commission of innumerable disorders. when, seeing that they cannot escape suffering the unavoidable consequences of such intemperance as often as they are guilty of it, they say--by way of excuse--that it is preferable to live ten years less and to enjoy life. they do not pause to consider what immense importance ten years more of life, and especially of healthy life, possess when we have reached mature age, the time, indeed, at which men appear to the best advantage in learning and virtue--two things which can never reach their perfection except with time. to mention nothing else at present, i shall only say that, in literature and in the sciences, the majority of the best and most celebrated works we possess were written when their authors had attained ripe age, and during these same ten latter years for which some men, in order that they may gratify their appetites, say they do not care." we see not only in this passage but in many other places evidence of the fact that cornaro lived a cheerful, contented life. the reform was evidently not merely in his eating and drinking but fully as much in the inner thought of his life. this is shown in many passages from his discourses. he says: "although reason should convince them that this is the case, yet these men refuse to admit it, and pursue their usual life of disorder as heretofore. were they to act differently, abandoning their irregular habits and adopting orderly and temperate ones, they would live to old age--as i have--in good condition. being, by the grace of god, of so robust and perfect a constitution, they would live until they reached the age of a hundred and twenty, as history points out to us that others--born, of course, with perfect constitutions--have done, who led the temperate life. "i am certain i, too, should live to that age had it been my good fortune to receive a similar blessing at my birth; but, because i was born with a poor constitution, i fear i shall not live much beyond a hundred years." according to the census of the united states not one man in twenty thousand attains the age of one hundred years. if we figure out carefully from these statistics, we find the average is only about one-third of this period of life. one of the social customs is that we must eat an extraordinary meal,--far more than we need, as if life's enjoyment depended on the low sense of taste,--as if every contract or matter of important business must have this as an introduction. theoretically speaking, many people believe in low living and high thinking, but it is very rare that we find one who practices it. the two simple rules of cornaro deserve our attention: to eat only what he wanted, that is, what he actually needed for the sustenance of his body, and to eat only those things which really agreed with him, that is, those which were really helpful to the sustenance of his life. if we should consider eating merely as a means and not an end, cornaro's idea that the normal age of a human being was one hundred and twenty years would not be such a wild dream. another almost universally recognized requisite is exercise in the open air, or regular, systematic, simple and vigorous activity of some kind. the necessity of thoroughly pure air must be emphasized from first to last. some think that the dullness felt by many people in the early morning is due to the impure air of cities, and to the failure to open windows. a lady once said to me, "when i am in the country i always sleep out of doors. then i have not the slightest disinclination to get up. i do it as naturally and as gladly as the animals." it is to be hoped that the rapid transit and the automobile will enable people to live farther out in the country, farther from air poisoned by smoke and gases. even in cities, however, one may have open windows and greater circulation of air than is common. some have gone so far as to place exercise over against temperance in eating, saying that if you take enough exercise you may eat and drink what you please. while there is some truth in this there is really no antagonism between them; in fact, they are usually found together. another view almost universally advocated, is to avoid drugs. the importance of this and its union with right exercise have been demonstrated in the impressive language of fable. "there is a story in the 'arabian nights' tales'," says addison, "of a king who had long languished under an ill habit of body, and had taken abundance of remedies to no purpose. at length, says the fable, a physician cured him by the following method: he took a hollow ball of wood, and filled it with several drugs; after which he closed it up so carefully that nothing appeared. he likewise took a mallet, and, after having hollowed the handle and that part which strikes the ball, he inclosed in them several drugs after the same manner as in the ball itself. he then ordered the sultan, who was his patient, to exercise himself early in the morning with these rightly prepared instruments, till such time as he should sweat; when, as the story goes, the virtue of the medicaments perspiring through the wood, had so good an influence on the sultan's constitution, that they cured him of an indisposition which all the compositions he had taken inwardly had not been able to remove. "this eastern allegory is finely contrived to show us how beneficial bodily labor is to health, and that exercise is the most effectual physic." another illustration is furnished us by sir william temple:-- "i know not," he says, "whether some desperate degrees of abstinence would not have the same effect upon other men, as they had upon atticus; who, weary of his life as well as his physicians by long and cruel pains of a dropsical gout, and despairing of any cure, resolved by degrees to starve himself to death; and went so far, that the physicians found he had ended his disease instead of his life." of all the methods advocated, possibly one of the most universally recognized is joyousness,--a hopeful attitude toward life, a cheerful, kindly relationship with one's kind. according to galen, Æsculapius wrote comic songs to promote circulation in his patients. "a physician," says hippocrates, "should have a certain ready wit, for sadness hinders both the well and the sick." we know, too, that apollo was not only the god of music and poetry but also of medicine. the poet, john armstrong, has explained this: "music exalts each joy, allays each grief, expels disease, softens every pain; and hence the wise of ancient days adored one power of physic, melody and song." sir charles clark, one of the greatest physicians of modern times, exercised a most exhilarating influence over his patients by his cheerfulness and jollity. it was probably one of the chief means of his wonderful success. "cheerfulness," says sir john byles, "is eminently conducive to health both in body and mind." a recent writer says of professor charles eliot norton that he was "not of a rugged constitution, yet he did an enormous amount of work and lived to a beautiful old age." this is attributed to the fact that he was never "blue." the cheerful kindliness of his face, his genial smile and kind words were sources of great inspiration to me when a teacher at harvard, and to all who met him. the more we investigate the theories of long life the more do we become impressed with a universal longing for a length of days. we find a deep, underlying instinct "that men do not live out half their days." everywhere, too, we find a certain expectation of "finding the fountain of youth," a hope in some way to conquer sickness and death. this desire is normal and natural. it may, sometime in future history, be realized. as we examine these theories we find, however wild they may seem at first, certain common sense views at the heart of all of them. no one need make a hobby of any one of them. temperance, regularity, repose, patience, and above all, cheerfulness, do not exclude each other, they rather imply one another. in many instances one can hardly be practiced without some of the others. the practice of one would unconsciously bring up the others. if we study carefully these theories, and especially if we study the lives of those who have not only professed theories but have faithfully practiced their principles and attained great health and age, we always find a combination of various methods. there is no doubt, for example, that cornaro completely reformed his life. the character of socrates was the secret of his good health. temperance to the greek did not mean total abstinence. it meant lack of extravagance; it meant what we mean by patience, by an unruffled temper,--it meant the right use of all the faculties and powers. what new hobby, you may ask, is the theme of this book? nothing that will interfere with the fundamental elements of the best ideas of all ages. first of all it is advocated that we go down deeper into all theories. temperance should not be applied merely to food and drink but must cover self-control, repose of life, purity and depth of thought, and a harmonious development of human nature. the book tries to draw attention to many important things which are usually overlooked or not considered necessary to health and life. the study of expression, to choose only one example, reveals to us, the necessity of a right poise of the body. one of the leading teachers of science in this country, after fighting tuberculosis for three years, changing climates and using all the help that science has provided, determined at last to go back to his work and to do his best even though he lost his life. making a constant and careful study of himself he again began his life as a teacher. he met with one with great knowledge of the human body, one who had studied it from many points of view. he was surprised when that expert said to him:--"your dieting will not do you much good, that is not your trouble. you do not sit right nor stand right, your chest is too low, it not only cramps your breathing but what is still more important, it cramps your stomach and all the other vital organs." the scientist eagerly asked what he could do to recover his strength, and he received a few valuable suggestions, which he followed, and in six months he was stronger than ever. as a student and teacher of human expression for nearly forty years, i have found most important connections between man's mind, body and voice. the right use of the voice is next to impossible unless a man stands properly. there are certain inter-relations between the simple conditions and actions of the body, and the conditions and the true use of the voice are determined by the way a man thinks and feels. a man must not only have right feeling but must express it. he cannot get right expression without right thinking. health, itself, is one of man's mental and emotional conditions. this book is an endeavor to study human unfoldment from an all-sided observation of the whole nature of man. man is a unity, and an endeavor to establish health from a mere material point of view has always failed. expression is a study from a higher point of view. the organism is studied from the point of view of its mental function. expression implies the subordination of the body to the actions of the mind. this gives a truer point of view for an all-sided human development. it also implies a study of the especial significance and use of certain primary acts of our lives:--such as the way we wake up in the morning and certain movements which are taken at that time by animals and normal beings. the stretches, yawnings and breathings, peculiar to that moment, are never lost by animals, but human beings, with their higher possibilities but greater power of perversion, lose the significance and helpfulness of this primarily instinctive movement. the study of expression also reveals to us that certain emotions are normal or positive and develop health and strength, while certain other emotions are negative and destructive of vitality as well as of manhood. we also find that the emotions we choose to express become our own and, therefore, we should choose normal conditions of mind and emotions, and express these consciously and deliberately, especially at the most negative time in the morning, when we first wake up. expression is one of the necessary elements of human development. we control emotions and control their expression. we welcome noble thoughts or noble feelings, and that which we welcome we become. this book shows the smile, laughter, the taking of breath and the simple stretch as most important exercises which are to be regularly taken. it also implies a deeper study into human co-ordinations; it tries to show a universal necessity of rhythm and is an endeavor to establish the higher principles of training in a way that makes them applicable to the most simple of human actions. the student is requested to study himself, to make a demonstration of every claim and of more than is claimed. the exercises are so simple that anyone can try and prove them, only let the trial be one continued long enough to be a real test. the moment you awake center attention upon a pleasant thought or take an attitude of joy, thanksgiving and love for all the world. have courage and confidence that all evils will vanish; express some normal feelings at once by the expansion of the chest, a deep full breath, an inward laugh or chuckle and an increased harmonious stretch of the whole body. everyone will be tempted to say that he cannot control his thoughts. he may say he does not wish to be a hypocrite and try to excuse himself for brooding over gloomy thoughts or the fear that he will not get through the day. such lack of courage, lack of faith, lack of thanks for the beauties of life are sins which cannot be too strongly condemned. we can and must at once put ourselves in a positive attitude of mind. we must begin our day with a song, with a smile. we must look upward, not downward. we must reject every discordant thought and accept accordant ones regarding the coming day. it is a new day which brings new life, new joys, new duties, it may be new trials, but these, instead of being accepted as obstacles, may be turned into opportunities. the indulgence of negative thoughts in the morning may become a habit. a great battle may have to be fought at first, but perseverance and promptness can correct such evil tendencies. it is at this time that the demon of regret and of disappointment is apt to lay hold of us; the blackest thought in our lives likely to meet us. observe that this was so of pippa. though she awoke with joy, and is held up as an ideal, as she goes on thinking the darkest shadow of her life comes to her. "if i only knew what was my mother's face--my father, too!" this thought, however, she puts out of her mind by resolution, by turning, as we always should turn at such an hour, to the source. "nay, if you come to that, best love of all is god's; then why not have god's love befall myself as, in the palace by the dome, monsignor?--who to-night will bless the home of his dead brother." here must begin the heroic endeavor to live. effort will be required for a time till the habit is formed. instantly control the attention and express it by action. give a positive welcome to the day and the light; express positive thanksgiving for the thought that you have strength and that you have the joy of work to do. it is in the morning that we should begin to live a new life, a simple life; it is then that we should eliminate all whines and abnormal desires and open our hearts to receive the strength of a new day. life, growth and development respond to joy. every flower seems to smile to meet the sun, and the little bird sings in the midst of its duties. some scientists are hoping to discover the germ of old age, and by destroying this to prolong life. the real germ, however, of old age is found in the doubt and worry which we allow to enter the holy of holies of the heart at the holiest hour of the day. if we guard the sacred shrine of thought and consciousness from impure, unkind and discouraging ideas at the moment of awaking it may be truly said that the enjoyments of life as well as its length will be doubled. the primary acts that express this joy are: first, expansion; second, taking a deep breath; third, stretching of the body; fourth, a smile or inward laugh. sometimes these take place so rapidly as to seem to be simultaneous, but close examination will reveal a sequence, though rapid. as in life we have to live a truth to know or understand it, so an act of expression embodies the emotion. true enjoyment is also always expansive. anger and negative emotions cause constrictions, while joy and love increase expansion. "as a man thinketh in his heart, so is he." it is the mind that makes the man. when we reject a negative thought and accept a positive one we begin the real battle of life. negative emotion, every moment it is expressed becomes stronger, and gradually takes complete possession of us. prof. james says that everyone should do something disagreeable every day, but there is great danger in accepting anything as disagreeable. we must not only do something disagreeable, but we must accept and do it as if it were an agreeable thing. this is most important. the attitude toward life makes all the difference. another great teacher has said, "when a wrong thought comes in, say, out of my house, you don't belong here!" remember that the field of consciousness is a sacred shrine. from it banish everything that is not full of joy and praise and comfort, that does not give you strength and courage. do as pippa did. do not let the devil take possession, as he is always ready to do at this time. this battle must be fought at once. there must be no delay. idea will link itself to idea by the law of association of ideas, and we shall soon form a habit of negative thoughts in the morning. the great point to note is that we should live rational lives, that we should give our attention and apply our own scientific knowledge and reason to the every-day duties of life, and not disregard the duty we owe to ourselves. men are continually doing something which they know to be wrong. they indulge in thoughts which they know will poison their minds and characters. they eat food which they know is not good for them. they pour into their stomachs stimulants which they know will dull their higher faculties and powers. some tell us that life is a continuous battle. it may be looked at in that way, but if we look at it from a more rational point of view it is a continual reaching up for higher enjoyment. every day and every hour we must be on our guard; our theories must be a rule of life to be really obeyed and lived. therefore, to apply our own knowledge to the restoration or maintenance of life demands that we avoid that which is injurious, and that we joyously, gladly accept that which is helpful. life is a sacred gift, a privilege, and an opportunity to be enjoyed, it is to be lifted up, and filled with high experiences. to accomplish all these ends, we should study those moments when we are in greatest danger,--those moments which are most important and when we are best able to control our attention and to command our feelings. the one supreme hour is the hour of awakening. if we can occupy a few minutes of this time in right thoughts, and right movements scientifically directed and as simple as those of the animals, the effect will be astonishing. to come down to a few specific things that everyone should practice in order to be stronger, to be more efficient, to enjoy more and to live longer, let us summarize a few general points. ( ) express joy first with laughter. if you cannot laugh aloud, laugh with an inner chuckle. it is not enough to have joy, it must be actively expressed to have an effect upon the organism. ( ) maintaining the joy and laughter, express, therefore, all harmonious extensions of the body, that is, all simple stretches. maintaining the laughter and the extension of the body, expand the chest and torso as much as possible. ( ) on waking up, take a thought of joy, of courage, of love toward all mankind, toward the day and its work. ( ) maintaining all previous conditions, take a full, deep breath. ( ) set free with the simplest movements every part of the body. ( ) co-ordinate the parts of the body concerned in every-day work, and sustain them with primary and normal activities. ( ) bring all the parts of the body into normal rhythm by alternative activity of the parts and in other ways. to have good health we must rejoice, laugh, extend, expand, breathe, co-ordinate the primary parts of the body, act rhythmically, set free all the parts of the body and all the primary activities of function. in short, this book tries to move everyone to study the simplest things, the simplest actions, the most normal duties of a human being, and to assert these and to exercise them the very first thing in the morning. iii what is an exercise? on account of the many misconceptions of the nature of human development, will it not be well, before beginning our program to consider seriously--what is training? what are some of its principles? what can we do with ourselves by obeying nature's laws? or, if these questions are too serious, too difficult for a short answer, should we not, at least, try to realize what is an exercise? to many persons, any kind of movement, any jerk or chaotic action, is an exercise. they think that the more effort put forth, the better. thus some teachers of voice contend that, to be an exercise, there must be muscular effort in producing tone. on the contrary, many movements are injurious; unnecessary effort will defeat some of the most important exercises. the exercise must obey the laws of nature. it must fulfill nature's intentions, stimulate nature's processes, awaken normal, though slumbering activity. an exercise is of fundamental importance to all human beings. man comes into the world the feeblest of all animals. he has the least power to do anything for himself, but he comes with possibilities of higher love and union with his fellow-men. he comes into the world with a greater possibility of unfolding than any other created being. accordingly an exercise is a means of progress, a simple action which a man must use for his own unfoldment. an exercise is a conscious step toward an ideal. man is given the prophetic power to realize his own possibilities. we can hardly imagine an exercise independent of the conscious sense of the highest and best attainments, of thereby making ourselves stronger and in some way better. this ideal is instinctive, even on the part of animals, in fact, the animal instinctively regards its own preservation, its own unfoldment and the reaching of its ideal type. a tree will cover up its wound and reach out its branches freely, spontaneously in the direction of the light and toward the attainment of its own type. with man the ideal is a matter of higher realization. we have the lower instincts in common with the animals but we have also something higher. there is inborn in us a conception that man transcends all present conditions. an exercise is a step towards the attainment of a chosen end. accordingly we have high exercises and low exercises; exercises on a mental and on a physical plane; exercises that may train men down to an abnormal type; exercises also that are intellectual, imaginative and spiritual. everywhere in nature there is a low and a high. in animals of a high order of unfoldment there is specific functioning of every part but in those of a low order the functions are confused. the organs are not so well differentiated. even in human beings, in the process of degeneracy a man loses a greater variety of his powers, and his very voice and body lose some of those characteristics which belong to the ideal member of the race. a true exercise always brings sound and specific parts into action. part is differentiated from part. all parts are made more flexible and more capable of discharging a function distinct from all other parts of the body. a true action of the hand cannot be performed by the foot nor can a foot become a hand except by a process of degeneracy. an exercise implies a struggle upward over against a drift downwards. an exercise is an aspiration. an exercise is a demonstration, it reveals a man's best to himself. it is a process of translating his dreams into reality. it is the only proof of himself, his intuitive language. an exercise is not physical but mental. never regard your exercises as merely physical. the expression "physical training" is a misnomer. all training is the action of mind. it may manifest itself in a physical direction, but training itself,--the putting forth,--is mental. it is the emotion we feel more than the movement that accomplishes results. no matter who laughs, consider your morning exercises sacred to you. make them a part of your very life and habits, and put into them your thought and the attitude of your mind toward your fellow-beings. you will be tempted to regard such movements as merely mechanical and artificial. you will be tempted to think they are just the ideas of some crank. put all this aside. begin your exercises joyously and happily, for the very pleasure of the action. remember that you are not a body in which you have a soul; you are a soul and have a body. the cause of everything, even of health, is in our minds. our awakening is not a physical matter. there is no power in the material body to move a finger. an exercise is bringing a mental action into manifestation. however physical an action may appear, its only significance is as an act of mind. an exercise is an expression. it is an act of being, not of body; it is activity of being in action of body. there is no such thing as physical expression. expression is not merely a reflex action. it is the emanation of activity. it is the union of thinking, feeling and willing. an exercise implies that we can choose what we are to express. it implies also that we can consciously regulate, guide or accentuate our mental, imaginative and emotional activities. here we find the importance also of expression as an educational view. repression and suppression may be injurious to health. expression is necessary even for the proper functioning of the vital organs. impression implies the conscious use of an impulse. it implies the ability to share our ideas, feelings or experiences with others. an exercise is a means of turning an impulse in a higher direction. it implies also the curbing of abnormal impulses. exercise implies stimulation of normal functioning. it is an endeavor, but one in accordance with principle. thus, an exercise is an expression of an aspiration. exercise implies many things. it implies that a man may be low down but that he can rise; it implies that if he begin early and work patiently enough he can control, soon or late, his nature. he can control the expression of his being and every manifestation of life if he will only come close enough to the fountain-head of thinking and feeling. he must be willing to demonstrate on an humble plane, and, while striving for the highest ideal, take the simplest exercise as the first step of the ladder. an exercise localizes function. every part of the body, even every muscle has certain functions to discharge. awkward men use the wrong part to perform a certain action; part interferes with part. a true exercise will train each part to discharge its own function and bring it into harmonious co-ordination with other parts. it will stimulate both growth and development but make growth precede development. while aspiration is universal it becomes conscious in a human being. we have definite ideals and not only instincts for their attainment, but we can adopt rational methods for their realization. we have not only an instinctive consciousness of what is normal but a deep intuition that we can improve every power of our being, every agent of our body and every tone of the voice. a simple, a most commonplace action, when done with aspiration becomes an exercise. in fact, everything that man does is part of the training. a true list of exercises must reflect the spirit of all life. a normal man can distinguish between a wrong and a right exercise, between that which will lift him upward and that which will cause degeneracy. when men give up to their lower appetites they strengthen the downward impulses, but the mind can be awakened and every little step will become a demonstration of higher possibilities. an exercise is a demonstration to a man of his possibilities. sometime the science of sciences will be that of training and education. all over the organic world we find tendencies toward degeneracy or downward; and we find everywhere aspirations or activities upward. every bird, every rose, every blade of grass is trying to reach an ideal. this universal upward tendency or process we call by some big words which confuse our minds and obscure the facts. an exercise is not only mental but emotional, not only expressive of thought but of normal emotion. the wise doctor looks at his patient. he does this not only to recognize the patient's condition but to see how much courage he has, how much joy, how gladly he accepts life. an exercise demands accentuation of extension. muscles should have a certain normal length and the power of relaxation to take a certain length. on account of abnormal positions, such as obtain during sleep, certain muscles become unduly elongated and others too short. to restore the balance of proper proportions those shortened need extension and the elongated need shortening. accordingly the so-called extensor muscles of the body need frequent action. the effect of these stretches is to harmonize the vital forces. when a man lies upon his bed, as has been said, he breathes less, the circulation is more or less impeded; hence, the dull feeling and unwillingness to rise. the stretch also equalizes the circulation. it affects the veins where the pressure of blood is weakest, where there is a more immediate indication of congestion, so that the bad blood flows away, and the good blood from the arteries where the pressure of blood is strong, flows in, and the processes of life go on with more decision. there is still another explanation why the stretch is so important. it is primarily activity of the extensor muscles and is vitally connected with all true expansion. the flexor muscles on account of the position in sitting and because of a lack of expansive activity, often become too short. they can be extended only by activity of the extensor muscles. the stretch is the special and instinctive action of the extensor muscles in response to a distinctive demand for freedom of the organs, or harmony of the whole myological mechanism. it is also, as has been said, closely connected with the circulation, and the activity of the vital organs. there is no more important exercise than stretching. its neglect is one of the strange things in training. one who wishes to be stronger, to have the normal possession of all his faculties, powers and organs, can be initiated and secure the result most rapidly, by the use of this simple and elemental exercise. an exercise is an act of expansion. the action of man's body consists of expansion, contraction and modulation, the latter being the union of the other two. true energy expresses itself primarily by expansion. life expands and any increase of new life and all positive emotions cause an increase of expansive activity in the body. the study of expansion reveals to us the fact that expansion and contraction furnish the many elements of all human action, but that expansion is first, that expansion expresses joy, exhilaration, animation in life, and that contraction, aside from its co-ordination with expansion in causing control in intensity, expresses antagonism, hate, anger, pain. accordingly this book assigns certain fundamental expansions, which everyone should practice and does practice if he obey his own deep instincts. negative emotions, such as fear, despondency, or antagonism, cause contraction and tend to constrict the vital organs. it can, of course, be seen at once that expansion is due to the activity of the extensor muscles. the stretch is, in the main, an expansion. at any rate, it is always associated, co-ordinated, when properly performed, with expansion. moreover, if we observe the action of animals and all true spontaneous actions in a human being, we observe that the activity of expansion begins in the centre of the body. it is at this point that we should initiate our expression. the actions in the middle of the body are more conditional than those in the feet, hands, or limbs, but the awakening of conditions should precede modulation. a certain activity of expansion and diffusion is the very basis of all conditions. all exercises should naturally begin with expansion. a true exercise means an increase of activity. moreover, not only does life expand, but all positive emotions, such as joy, love, courage, cause activity of the extensor muscles. these emotions, as is universally known, improve health. if we observe the structure of the torso, we find that the chest has no prop from below; that the ribs are placed at an angle with the spine, sloping downwards as low as forty-five degrees, while at times they may be lifted seventy-five or eighty degrees or more. the expansion of the chest lifts the ribs. if we study a skeleton, we see that it must be suspended, that it cannot be propped up. man, accordingly, stands and walks primarily on account of the active expansion of his whole chest. he is the one animal that has levitation, as will be shown later. we find that under the ribs in the torso are all the vital organs. the lungs, the heart, the stomach, all these depend for their normal position, their normal action upon the expansion of the chest. when a man stands, the tendency for the chest is to sag. there are no bones to elevate it. man has levitation as well as gravitation, and the expansion and elevation of the chest lie at the basis of all good position in standing, sitting and also walking. there are certain co-ordinate curves, beautiful, spiral, rhythmic, in a normal and healthy human being. these curves depend upon this expansion of the chest. all the best gymnastic exercises centre in the development of activity in the muscles concerned in keeping the chest elevated and harmoniously expanded. when we study the expression of this part, we find that it reveals energy and courage and all the noble, positive emotions of a human being. a passive chest expresses indifference, inactivity, fear, discouragement, a sense of weakness, unwillingness to awake and rise up to meet emergencies. a sunken chest, accordingly, is an indication of a tendency to disease, simply because it expresses a negative mental state or one favorable to the reception of abnormal conditions. the expansion of the chest, on the contrary, reveals that happy acceptance of life, that active, energetic determination to control abnormal conditions which will ward off all disease and eliminate all failure. this expansion of the chest, as we can see, is one of the most elemental actions of expansion of the human being. we shall observe later that this activity is directly concerned with erect posture. all actions in a normal condition co-operate or co-ordinate. this expansion frees the respiratory muscles and all the vital organs, gives man command of the elemental action of his body as a whole; that is, his erectness expresses higher emotions and experiences. an exercise implies co-ordination. an organism exists only by virtue of certain co-ordination of parts. training improves and extends this co-ordination. co-ordination is the simultaneous union of many different elements or actions in different parts of the body. an exercise is rhythmic. when exercises are performed in obedience to the law of rhythm, better results will follow. rhythm is a law of man's being. action and reaction imply a human being doing his little part and then accepting the greater work out of the heart of the universe. action and reaction, activity and passivity, the giving and the receiving, everything natural is rhythmic. absence of rhythm is death. an exercise is simple. the best exercise is the simplest in its movements. it is not the spectacular actions of an exercise that make it the best. as every exercise is a struggle upward it must necessarily be an emphasis of something elemental and normal. any movement is normal when it is part of the discharge of an elemental or distinctive action of any agent or part. the difference between accidental and elemental needs more discussion. working upon accidentals secures weak results, perverts and interferes with free function. working upon elementals brings freedom, power. iv program of exercises as all training is a reaching upward towards an ideal so an exercise is a single step and the first exercise should be the most primary action. the primary condition of all growth is a certain joyous awakening, an expansive enjoyment of life. take a joyous thought and express it in active laughter. no matter how dull or weary you feel when you first awake, joyously accept the new day. use the following exercises and actions as you would a cold wet towel on your face or hands. look on the sunny side at once and laugh. we can possess a feeling only by expressing it; we enter into possession of the day only by using it. it is easy to look at the light, easy to breathe, easy to stretch, to expand, easy to remember something joyous, easy to smile and easy to laugh. if your body feels weak and sluggish, and you have great indifference to movement there is all the more reason for promptness. if you will joyously extend your arms, expand, breathe deeply and laugh, you welcome life and joy and give them a chance to take possession of your being and body and you will soon feel courageous instead of gloomy, strong instead of weak, rested instead of weary. none of these exercises require a great expenditure of vitality. performed, as many of them are, lying down, however energetically you may do them they will bring little or no weariness. though the exercises do not require much vitality they should be practiced vigorously to accomplish the best results. . primary expansion and extension on waking, take a courageous, joyous attitude of mind. chuckling deeply, actively expand the whole body, take a deep breath and co-ordinate harmoniously as many parts as can be brought into sympathetic activity. stretch the arms upward and the feet downward as far as possible, and repeat at least twenty times. an old writer gave dilatation as one of the primary characteristics of life. a certain distention of all parts of the body is the beginning of the renewal of energy and a primary manifestation of life. we must give room to the life forces, feel the diffusion of energy into every part. the sense of constriction, due to lying in a cramped position, can be easily removed by this primary exercise. the chief elements in this primary distention of the body are found in the stretch and expansion of the torso, in deeper, fuller breathing, in the sense of diffusion of life, in greater satisfaction and in laughter. these elements should be practiced on waking up. the stretch should be in the nature of an indulgence, an instinctive longing on first awaking, a longing in common with all animals. it ought to be enjoyable and a help to sustain the laughter. count one for the active movement, or stretch, two for the staying of the active conditions, three for the gradual release of activity, and four for complete relaxation. the exercise, as most of the others, should be repeated twenty to twenty-five times, counting four for each of the preceding movements. this will require eighty to one hundred counts. each of the four actions of the muscles should be carefully distinguished and accentuated. counting four in this way for an exercise and for each of the first steps obeys the law of rhythm, accentuates all the elemental actions of the muscles and establishes primary conditions of healthful activity in all the vital organs. the simultaneous elements or actions in this first exercise are of such importance that it is well to practice each one separately, either before or after the general exercise. this distinct practice prevents the slighting of any of these elemental conditions, restores harmony and stimulates normal functioning of all organs. in fact, all these actions are really necessary conditions and should be present as elements of all exercises. the following exercises ( - ) are important, individual accentuations of the essential actions of this general exercise, and the conditions of all exercises. the student should carefully study his tendencies to omit or slight any one of these elements and accentuate carefully not only every step separately, but observe with especial care the one most needed. . initiatory exhilaration sustaining the extension and full breath, laugh heartily, with little or no noise, chuckle to yourself persistently for several minutes. centre the laughter in the breathing and the torso. joy and laughter must be considered the first condition of all exercise. the reasons have been explained. if you are still sceptical, observe and experiment. everything that is truly scientific can be proved or in some way demonstrated. as this is one of the basic principles of this book and its companion volume, "the smile," and as joy and laughter are met as the first exercise of our program, it may be well to summarize some of the arguments: exercise in laughter sets free the vital organs and brings all parts into harmonious, normal activity, stimulates the circulation, quickens the metabolism of the cells and causes elimination. each of these topics might receive many pages of discussion. you will be tempted to omit the practice of the chuckle, but it should be especially emphasized. it expresses and accentuates the permanent possession of the joyous thought. no other exercise can so stimulate a right attitude toward life, as well as restore the normal condition of the vital organs. it has also, as have all of these exercises, a beneficial effect upon the voice. in fact, all good exercises tend to improve the voice. this is one of the most important tests of an exercise,--does it affect easily, naturally and normally the vocal organs? . harmonic expansion sustaining laughter and extension, sympathetically and joyously elevate and expand the chest as far as possible. feel the breast bone separate farther from the spine, easily and naturally as in the expression of joyous courage. expand slowly, sustain the expansion, gradually release, then rest, that is to say, perform the exercise in the same quadruple rhythm of the harmonic extension. in this exercise you should feel a deepening of the chest chamber. it is well at first, until you get the exercises correctly, to place one hand at the back, the other on the chest, and in expanding to feel the two hands separate. this expansion should be sustained for several seconds. the release should follow gradually. there should be a repetition of the expansion; you should feel a sympathetic activity all through the chest and torso. sudden collapses should at all times be avoided, and they should especially be avoided in exercises of the chest and of the central organs. the free, expansive facility of the whole chest is the measure of the health, strength, grace and normal actions of a human being. it is of primary importance. . respiratory accentuation keeping the body extended, the chest well expanded, take a deep, full breath, hold it a moment and gradually release it, then wait a second without greatly lessening the expansion of the chest in this exercise be sure to accentuate the four elemental parts of an exercise. taking breath, the active stay of the breath, the gradual release and then the complete surrender of the direct respiratory muscles: that is, accentuate the four steps or elements as in most exercises and avoid the temptation to jerk and to exaggerate minor parts or actions. constrictions, inharmonious and unrhythmic jerks are always out of place in any exercise. the best results can be obtained only by observance of principles. do not force the breath out. allow it to pass out easily and normally. increase the inspiration rather than the expiration. the air will tend to pass out too quickly, reserve it and allow it to pass out steadily and regularly. we find that the taking of breath is associated with the result of expansion and vitally connected with the conception of impressions and expression, and so is a necessary part. the expanding of the chest causes greater room in the thoracic chamber and breath flows in naturally. this exercise, however, implies that we should consciously and deliberately accentuate expansion and the taking of breath. it aids in the realization of life and the diffusion of activity. man breathes over twenty-five thousand times in twenty-four hours. he can get along very well on two or three meals of food and six or eight glasses of water, but with as low as fourteen thousand breaths a day, he is flat on his back and has hardly enough power to move hand or foot. we live on air. this is one reason why the expansion of the chest is so important. it gives room for breath. in fact, in breathing we do not suck breath into the lungs. air presses fifteen pounds to the square inch to get into the lungs. expansion is, therefore, the primary element in breathing. we should, however, at times not only expand fully but consciously draw in breath. we can expand the chest while sustaining it and drink breath into the very depths of our lungs. thus the exercise requires us to take as much breath as possible, to retain it a moment, then slowly give it up and at last to relax completely the diaphragm, all the time sustaining the chest expansion. preserve still the quadruple rhythm. of course the exercise can be done with dual rhythm, and it will be helpful, but the accentuation of all four of the primary actions will accomplish more than double the beneficial results not only for health but for the voice. it develops the retental action of the breath. a true use of the voice demands a full chest. this exercise strengthens the muscles that reserve the breath and support the tone. the process of respiration is most directly necessary to all the actions of the human organs. it is an essential part of circulation. the breath we take meets the blood. the blood is carried from the heart through the lungs and back to the heart, then out through every organ of the body and back again to the heart. the whole circulation is a mighty process by which the blood receives sustenance, bears this to every organ of the body and carries back the refuse which is oxidized and given out by the lungs. the blood, according to the earliest tradition, is the life. all ancient writers on long life "regard the control of the breath as a fundamental sign." a person with little control of his breathing is doomed to a short life. nature has so constituted us that at the moment of some excitement, or the reception of some impression, or the instant we try to do something unusual, we take a greater amount of breath. in any exercise, always allow the breathing to act freely. observe that breathing is the initiatory act or condition of all human effort. it is a sign of the reception of an impression and is thus one of the conditional acts of expression. breathe deeply and freely at all times. a deliberative breathing exercise, such as the preceding, strengthens all the respiratory muscles and corrects abnormal tendencies. . primary co-ordination in levitation simultaneously lift and expand the summit of the chest as you actively extend the balls of the feet downwards. the opposition between the lifting of the chest and extending the balls of the feet takes place in all good positions in standing and walking. this exercise initiates or accentuates the co-ordination of the muscles used in standing. it tends also to harmonize and bring into unity all the conditions so far attained, and gives practical application to those parts of the body which are active all day, in standing, walking and in sitting. all exercises must be performed rhythmically. there are many elements in rhythm, one is activity and passivity, and another is the alternation of parts:--one limb is active and this helps alternation or rhythm. . harmonic and rhythmic extension lift the chest and extend the right foot downward, then lift the chest with the downward extension of the left foot, rhythmically alternating from one to the other. this is the first step in the development of rhythm. this alternation is still more akin to the action of the body in standing and walking. allow the hip to extend outward on the same side which is being extended. co-ordination, that is a simultaneous and sympathetic union of many parts in one action or a harmonious variation of a primary response in many parts, is one of the primary characteristics of the organism. it can be secured by a certain feeling that the whole nature shares in the exercise, that the whole body responds to the whole being of man. it is a direct expression of joy and sympathy. in an involuntary performance there is always less co-ordination than in a sympathetic motion. these are feelings vitally necessary to co-ordination and we must not only have and feel them, we must express them in the body. the alternation of exercises introduces rhythm, which has been found to be one of the most fundamental elements in training. rhythm consists of proportion in time. this proportion is in alternation: alternation of activity and passivity, and in alternation of one part with another, as in walking. rhythm is the continuity of co-ordinations. co-ordinations cannot be properly preserved without rhythm nor can there be rhythm without co-ordinations. the exercises to should all be included in no. . they should also be individually practiced in order to accomplish the best results and to avoid the omission of any of these primary elements which should be present in and co-ordinate every true exercise. after being practiced individually, exercise no. should be practiced several times with a greater co-ordinating union of all the elements. the feeling of satisfaction and joy should be realized at once. . co-ordination of primary conditions repeat exercise no. ; stretch first the right arm and also the leg, bend the left arm and left leg and so on in alternation. preserve all the movements. the difference between this exercise and no. is the stretching of each side in alternation. the same elements should be included. . primary co-ordinate voice conditions sustaining all the foregoing conditions; extension, expansion and diffusion of feeling, the retention of the breath and the simultaneous openness and relaxation of the throat, laugh low but heartily:--ha ha, he he, etc. the tone should be soft and pure. the softer the better. if there is any danger of waking or disturbing someone the exercise should not be omitted but practiced softly. joy must not only be felt, it must be expressed. this series of exercises is based upon the fact that the greatest exercises are expressive movements. the smile on the face and active laughter should be used as direct exercises, not only for the body but also for the voice. this exercise implies some understanding of the fundamental elements of vocal training. the primary co-ordination of voice conditions, that is, the sympathetic, harmonious and elastic retention of the breath causing the co-ordinate passivity at the throat has been explained in "mind and voice." this was my discovery and the mastery of it has helped thousands out of ministerial sore throats and other abnormal conditions, and, to my mind, is proved as a fundamental principle. it is of the utmost importance that this little exercise should be practiced in accordance with the principle. the great point of the exercise is the elastic, sympathetic retention of the greatest possible amount of breath and the simultaneous passivity and openness of the throat. the study of laughter or the best possible tone anyone can make will enable him to realize this deep but simple principle. the effect of this exercise is to centre the breath and to harmonize the activities of the whole man. the central organs should always be exercised before the organs of the surface. the laughter must be sincere, genuine, hearty and natural. no one can imagine what wonderful effects can be brought to the voice by such simple exercises as these. the voice is an index, not only to mental and emotional conditions but to health. the voice cannot improve truly without improving health. we reserve breath and have a certain sympathetic fullness due to retention of the breath in the middle of the body. simultaneously there is an openness of the whole throat and tone passage. all the organs of voice are thus brought into right conditions. when this condition is violated there is a misuse of the voice. vocal training consists in the use of such simple exercises as will establish all these conditions that have been mentioned, especially the last. the conditions of voice must be co-ordinated, the vocal organs must respond to thinking and feeling. we cannot ignore, we must demonstrate on every plane. man is given the greatest opportunity for progress. it is an opportunity he must take. there is no growth, no advance without labor. the labor may not be voluntary, it may not be hard, but man has his work to do. it is a joyous work. man has an instinctive desire for right exercise which will enable him to really unfold his faculties and demonstrate his powers. . freedom of vital organs lying as before, placing both hands flat upon the stomach, keeping the body extended and expanded, breathing full and free, manipulate in a circular, triple rhythm or backward and forward, in dual rhythm, all the vital organs. the thumbs may be placed up under the floating ribs. this exercise is usually given first in swedish medical gymnastics. it is especially for the stomach, though it has a vital action upon the liver and other organs. such manipulations are beneficial to a dyspeptic or to one suffering from congestion of the liver, or from constipation. it is a very important exercise and stimulates all the parts so that they will receive more benefit from the following exercises. when any particular part, such as the stomach or liver, is found a little tender or sore, special attention should be given to this spot. . freedom of the torso preserving primary conditions, turn the hips vigorously as far as possible one way and then the other. this gives a vigorous twist through the centre of the body. it affects the stomach, liver and all the vital organs, and if the chest is kept expanded and a full breath is retained, it greatly affects the diaphragm and action of the respiratory muscles. these movements may be taken also with dual and with quadruple rhythm. if done slowly and steadily, in true rhythm and sequence, they will accomplish surprising results, and bring about a deep harmony. if there is congestion the exercise should be performed twenty or twenty-five times. this exercise frees the torso and makes it flexible. it strengthens the diaphragm and, obeying one of the fundamental laws, exercises the central muscles of the body. do not give sudden jerks or sudden collapses, but steadily, definitely and vigorously pivot the hip. in many people, there are tendencies to congestion in the stomach, and in the neck and throat. this rotary action tends to remove these constrictions and to develop a certain flexibility in the whole torso. . freedom of neck and throat knead with both hands the whole throat and neck, moving every part and eliminating any soreness or stiffness. the night gown should be unbuttoned and the breast bare. the fingers should be used and also the palm of the hand and the thumb so that every part of the neck and throat shall be set free. in most persons spots will be found that have some tenderness or soreness, especially if there is any cold or sore throat, and these parts should receive careful attention and manipulation, which should be continued until the soreness is removed. persevere until the whole throat feels perfectly free and relaxed. it is often the case that some gland is weak and can be strengthened by this massage. this exercise and that of the manipulation of the stomach, as well as the exercises which follow, have a wonderful effect upon the voice. . freedom of neck and head pivot the head as far as possible to the right and then as far as possible to the left. this exercise is also best practiced in quadruple rhythm. the hands may be around the back of the neck. knead deeply and remove any congestion. the efficiency of this exercise may be increased by placing the hands on the neck so that at the moment of extreme pivot the hand may knead the parts. this action of the hand increases the effect and tends, in cases of congestion around the throat or ears, to give great assistance towards the elimination of all abnormal conditions. the other exercises for the manipulation of the throat tend to correct catarrhal conditions. . elevation and extension of lower limbs observing all the conditions, lift the right foot, knee straight, as high as possible, then slowly release it, then lift the left in the same way. the movement should also be done in quadruple rhythm. the lift should be slow, and there should be a decided staying of the activity, and then a very slow release; then complete rest. the effect of this exercise is to accentuate further the idea of rhythm; that is, it requires alternate activity and passivity in sequence or a continuity of co-ordinations. in performing this exercise almost an ache may be felt at the back of the legs, especially at the back of the knees. this is due to the fact that these muscles become too short in sitting and therefore need extension. this exercise gives extension to these muscles. similar aches will always indicate a lack of extension and call for special help and practice of the opposing muscles. of course, it can be seen that whenever parts of the body, such as the knees, are kept bent, the muscles at the front of the limb will grow too long and those at the back of it, too short. hence, when a man stands up there is a tendency to stand with the knee bent. old men have a lack of firm backward spring in the knee. it is the aim of several of the exercises to cure this. . extension of the back with the body well expanded, kept straight, breathing free and full, lift the hips bearing the weight upon the back of the shoulders and the heel. this exercise needs to be practiced with quadruple rhythm slowly. it gives wonderful exercise to the central muscles and organs of the torso. . elevation of lower limbs with the body well extended and all conditions sustained, lift both legs, knees straight, hold, slowly release, then completely rest. this exercise is the best help that can be given for a hollow back. it also brings activity into all the abdominal muscles. it will strengthen the muscles concerned in the support of the voice. if the chest is kept well expanded and the lungs full of breath, the exercise will have a wonderful effect upon the diaphragm and the respiratory mechanism. it will strengthen and deepen the breathing and make it more central and reposeful. . rhythmic alternation in extension combine the last two exercises and give them in alternation. first, lift the body, then rest, then lift both feet, then the body, and so on. this alternate movement will bring great relief. the muscles are more or less opposed; at any rate, the activity concerned in each exercise will receive a rest during the other action. this, of course, uses rhythm as an aid. true, natural rhythm is always helpful and should be introduced whenever possible. . rotary action of the feet with the heels resting upon the bed carry the balls of the feet in the widest possible circle. this exercise may be omitted, but it is very important for one who is lacking in freedom in the feet or who suffers from cold feet. it also brings into action the lower extremities and tends to further equalize the circulation. . mobility of the face rest a moment and feel a sense of satisfaction and then smile and place both hands upon the face, covering it as far as possible and knead the muscles, so as to eliminate every constriction and allow the diffusion of the smile to go into every part. do not laugh at this exercise but observe the effect. this exercise, however, should be practiced in union with the smile. pay especial attention to any part of the face where there are constrictions or tendencies to constriction, and especially any part that may seem to droop. where there has been a good deal of suffering or whining, or both, certain parts of the face, especially the corners of the mouth, are turned downward. this habitual action causes the muscles that lift the corners of the mouth to become too long while the corresponding muscles that draw the mouth down become abnormally short. kneading is, primarily, to give extension to the muscles that have become too short, and the laughter at the same time is to give exercise to the muscles that have become too extended or elongated. all parts of the face will be brought into proportion. crows' feet will be eliminated and the beauty and expression of the countenance greatly increased. where there seems to be no muscle between the skin and bone, as sometimes in the forehead, there must be manipulation, exercise of the weak muscles. in the case of the face we have to bring in so-called secondary motions. we have to use the hands in the way indicated to get any effect. of course, the effect will be temporary unless the disposition is changed. the mental and emotional actions are always the primary cause, but frequently the condition of the muscles has become such that it will take a long time to effect a change. the exercises, accordingly, are a wonderful help. if one-tenth of the power of this exercise to help the countenance were realized, it would not be neglected. one of my students opened a room and secured quite a following in facial massage by using these exercises. some cruder than this one were used, though good results were accomplished. this exercise, as here suggested, can be done by anyone alone. if people use it who have constricted countenances, they should carefully emphasize the smile. that has not been done and hence the best results have not been secured. the faithful practice of such an exercise and especially the study of the significance of the smile and the practice of laughter, in union with other exercises for the stimulation of vitality, will work wonders in the expressive mobility and beauty of the countenance. it is worth ten times all the cosmetics as a beautifier. it would banish "beauty parlors." it is not, however, for the restoration of beauty of the countenance, but to bring blood into parts that are not used. it has good effect upon catarrh, headaches and neuralgia. while resting the larger muscles of the body these two important exercises may be introduced, or they may be introduced as the last of the first series, while lying on the back. . freedom of the scalp placing the hands upon the head move the whole scalp freely and easily in all directions. this is really the only effective remedy for imperfection at the roots of the hair, falling hair, or baldness. it will cause natural and rich growth of hair. it is well, also, to pull the hair. one specialist gives this as the only remedy to prevent it from falling out. not only will such exercises improve the hair by improving the circulation around the roots, but it will make the muscles of these parts more flexible. . extension and freedom of the vital organs turn over, face downward, with the body well extended, bearing the weight upon the toes and the elbows, with the upper arm vertical, lift the hips and torso till the body is extended in a straight line. be sure that the upper arms are vertical and the fore-arms parallel with each other. try to keep the body as straight as possible and get the sense of extension. this may seem to be a severe exercise, but it is not dangerous. in fact, more than any other exercise it tends to correct abnormal conditions in the central portions of the body. it allows the vital organs to be suspended from another angle, rests them, and tends to restore all to normal conditions. this exercise should be performed in quadruple rhythm, steadily, and slowly. attention should be given to the complete rest at the climax. practice it a few times at first until the strength is sufficient to repeat it many times. it is an unusually important exercise in case of any constrictions. it strengthens also certain muscles of the torso which are apt to be neglected. this making a bridge of the body, supporting it by the upper arms which should be vertical, and the feet which should also be vertical, has a great effect upon all the internal organs of the torso. it affects any sort of displacement and any kind of congestion. the exercises may be practiced slowly, rising and then staying the activity for a little while, and then allowing the body slowly to descend. take a good rest as the exercise is rather vigorous for some persons, especially those who have any weakness through the torso. those whom the exercise taxes are they who especially need it. it should be repeated several times. . pivotal elevation of the head pivot the head as far as possible to the right, and then lift it backward. release and carry to the left, and lift it backward as far as possible. this exercise tends to strengthen the muscles at the back of the neck. it helps the extension of the chest, and strengthens those muscles which hold the head erect. . activity of the royal muscle lift the head as far back as possible, then slowly draw the chin in lifting the back of the head high. this exercise develops what sculptors call the royal muscle. this muscle is active, causes an erect head and gives a certain dignity to the carriage of the body and is usually associated with a properly expanded body. of course, it alone is not sufficient for a dignified carriage because there must be an expanded chest and the whole body must be normally erect. this muscle, however, plays an important part. it is at the summit of the line of gravity and affects not only the carriage of the head but has a sympathetic effect on the chest. when it is strong and vigorous it tends to make the whole body erect and to bring into sympathetic co-ordination all the muscles used in standing. . extension of hips and abdomen with the body well extended lift the right foot, knee straight, as far backward and upward as possible. then release, and lift the left foot in the same way. this exercise should be used alternately and given a good deal of activity. the heels may be extended or stretched downward as they are lifted. this will give greater extension to the muscles at the back of the leg. this exercise causes extension of certain muscles which are kept short when sitting. it is also beneficial for the back. . rotation of right shoulder turn over to the left side. vigorously rotate the right shoulder, carrying it in as wide a circle as possible. this rotary action of the shoulders may be repeated several times in different positions of the body. the exercise is important for the freeing of the whole torso. the shoulders of most people are rather weak. they should be strong and vigorous especially in brain workers because their action tends to affect the circulation of the blood toward the head. it has also an effect upon the summit of the lungs and certain regions which need freedom. the rotary action of the shoulders may be given best when lying on the side. the action of the shoulders, however, should not be neglected as it brings a harmonious circulation in the region of the throat. the exercise tends also to affect the whole summit of the chest. the active shoulder expresses animation and ardor in passion. a good strong shoulder is also an indication of vitality. the circular and rotary action of the shoulders, the feet, and the hips, is best performed with triple rhythm,--first, upward and forward; second, backward; third, release. the release may be quick and firm. triple rhythm has a very sympathetic and stimulating effect. the run is more of a triple rhythm, while the walk is dual. all forms of rhythm, all of the metres should be introduced into the various exercises. . rotation of left shoulder turn over to the right side, and rotate the left shoulder in the same way. whenever an exercise is taken for one side it should also be given for the other unless there is special reason for remedying some condition of one-sidedness. exercises for the centre of the body should always be given the preference. there should be as far as possible a series of exercises. thus far, the exercises are all used lying down. they may be taken in bed but, of course, it would be better if the bed were firm and not too soft, not too yielding and as level as possible. the exercises would often be more helpful if taken on the hard floor. it is better to sleep on a narrow cot as cornaro did. this prevents our doubling up the body and contracting the vital organs. everyone should lie down to sleep tall, or long, and as expanded as possible. another reason for sleeping on a cot is that there are no hindrances to lifting the arms behind the head in some of the first exercises. if we sleep on a bed, when we exercise, the body should be placed more or less across it so as to give more freedom to the arms, or the arms may be stretched out straight at the side although this is not so good. . elevation of chest and breathing sit erect, as tall as possible. expand the chest fully, carry the arms forward, then backward, gripping the hands almost under the shoulders, chest out as far as possible, taking a deep breath. repeat this rhythmically many times, sustaining as far as possible the expansion of the chest. it will be observed that there will come naturally a desire to sit up. it may be well before sitting up to turn on the back and rest a moment and feel the enjoyment of the actions that have been in the body. if the exercises have been properly practiced, there will be a sense of ease and satisfaction. . pivotal flexibility of chest sitting as erect as possible with actively expanded chest, pivot the shoulders and upper part of the torso as far as possible, first to the right and then to the left. this exercise may be performed to advantage with quadruple rhythm. this movement exercises almost the opposite muscles from exercise no. . it also has the same beneficial results in the extension of the chest, the removal of constrictions or interferences with the diaphragm, and has a beneficial effect also upon the stomach and all the vital organs. it is an important exercise for strengthening the muscles of breathing and deepening respiration. it should be repeated many times. . extension of muscles of the back stand, stretch arms upward as far as possible, then carry them in the widest possible circle. relax the back and all parts of the body so that the fingers come to the floor or near it. then return and carry the fingers as far back as possible. this exercise brings extension into all the muscles of the back. frequently, it is the best possible exercise to develop the chest since the extension of a muscle also stimulates its right contraction. the elbows and knees should be kept as straight as possible in this exercise. the wide circle should be made not only in coming down but in going back forward and over backward. this exercise causes great extension of the muscles. the muscles from the heel all up the back of the legs and even of the arms are affected. then in getting back the muscles of all the body receive a similar extension. this action is very helpful for the development of erectness of the body. it also causes alternation of the muscles and has a good effect upon the health. . extension of muscles at the side standing erect carry the hip out over the right foot, surrendering the whole body to the left side. allow the weight to be carried out over the left foot, the left hip being widely extended. this exercise tends to get freedom for muscles at the side and the hip so that the hip upon which the person stands will naturally sway out to the side, and the free hip will be surrendered, bringing the body very naturally into its spiral curves. . co-ordination in standing standing erect, expand the chest in opposition to the balls of the feet, and allow the body slowly to be lifted seemingly from the summit of the chest upward. allow it to return very slowly and steadily and to sink to the heels. repeat many times. this exercise should also be practiced upon each foot separately. it establishes right co-ordinations of the body in standing and helps in establishing accordant poise. all the muscles in the body which tend to bring the summit of the chest and the balls of the feet into right co-ordination are brought into sympathetic activity. it is really an important exercise for the development of a correct bearing and posture of the body. in going upward, be sure that the chest reaches upward and that the body is lifted by a species of levitation. keep the body as straight as possible from the heel to the centre of the neck, preserving a sympathetic expansion of the chest at all times. this exercise acts upon the whole body, tending to bring all parts into normal relationship. . extension of chest placing your hands against the sides of a narrow door way, allow your weight to come forward upon the hands, the knees straight. take a full breath, then carry the body back by action of the arms. this presses the shoulders back and causes expansion of the chest, and a deep breath should, of course, be taken. the exercise should be repeated many times. this exercise, as well as all others, should be practiced where the air is pure. observe that this exercise can be made more severe by placing the feet farther back from the door so that the weight of the body will fall more upon the hands. in this case the hands may be lower. they should be placed slightly below the shoulders. . harmony of respiration and circulation lift the arms as high as possible and grasp a pole which has been placed so that it can barely be grasped on tiptoe, and let your weight rest upon the hands, and endeavor to touch the floor with the heels. one can easily have a pole placed upon hooks as high as possible inside a closet. this exercise frees all the muscles of the back and carries the blood away from the head. it is an exercise especially recommended by baron posse for brain workers. after the exercises take a sponge bath, or if preferred, rub the chest and throat vigorously with a rough cloth with cold water. some people prefer an entire bath, but getting into very cold water often has a bad effect upon the circulation and breathing. the water should not be too cold at first until one becomes accustomed to the unusual stimulation. rub till dry and warm. injury may follow if there is not reaction. this program may be lengthened or shortened to suit individual needs. many exercises can be added by each one according to instinct. some, for example, those turning to the side, except possibly the relaxing of the shoulders, may be shortened. the exercises may be lengthened also by practicing one a longer period of time, making repetitions of a hundred or more. they may be shortened, too, by giving each movement a shorter period. each student must study himself and adapt the exercises according to need. feelings of enjoyment, however, are not a safe guide. we are so apt to let the dull and stupid feeling take possession in the morning and omit the exercises for the day. it takes resolution to perform them but in a few minutes the reward comes in a feeling of satisfaction and rest. the exercises are usually the best means of removing the feeling of dullness. that, indeed, is one of their chief aims. co-ordinating the performance and the joyous attitude of man will soon cause the exercises to be developed into a habit and one will feel the need of them as much as he feels the need of food. the exercises demand joy, expansion, extension, stretching, deep breathing, co-ordination of various parts and the specific accentuation of the movements and harmonious as well as rhythmic alternation. in general, a person can arrange from this program, shorter ones of from five minutes to thirty, according to individual needs. the principles underlying the exercises should be carefully considered. this will enable students to remember more easily and more correctly to practice the successive exercises. moreover, in the practice of the exercises, as has been said, the aim should be always kept in mind. thus the simplest action may be turned into the most important exercise by being practiced in accordance with principles and for a specific aim. to aid those who wish a shorter program, one that will not take over ten minutes, the following may serve as a helpful guide. . combine all exercises from one to seven:--laugh, expand the chest, breathe deeply, co-ordinating the balls of the feet with the chest, and stretch. emphasize all of these exercises. it may be wise to count say six specific, successive steps: , the expansion of the chest; , deep breathing; , laughter; , stretch; , gradual relaxation; , complete release. one should be sure that each of these elements is practiced correctly. it is wise at first to individualize them until they are normal and then such a combination becomes efficient and may be in fact advisable as a step in progress. . combine exercises nine and ten:--that is, knead the stomach in combination with the pivot of the hips. . exercises eleven and twelve in a similar way combine the kneading of the neck and throat with the pivotal action of the head. . sixteen may be practiced in a way to unite fourteen and fifteen. . eighteen and nineteen may be practiced as one. the movements, however, should be separated and may be alternated by passing from the face to the head. . exercise twenty, as many others, should always be practiced individually and separately. . twenty may be combined, but not so well with eleven and twelve. . all the sitting exercises may be omitted or combined with the standing exercises taken before the exercises on the pole. v how to practice the exercises since exercises are primarily mental it can be seen that it is not merely the movement but the mental and emotional attitude toward that movement, in short, the conditions of its practice, upon which the accomplishment of right results most depend. an exercise performed with a feeling of antagonism, gloom, or perfunctorily without thought, will not accomplish nearly as much as one practiced with sympathy and joy. only thinking and feeling will establish the co-ordinations. mere perfunctory performance of an exercise or a mechanical use of the will may produce certain local effects, and in this way may actually do harm, while the same exercise practiced with a feeling of joy and exhilaration will bring into co-ordination various parts, and, in fact, affect the whole organism. practice the exercises accordingly for the fun of the thing; laugh, feel a joyous exultation. joyous normal emotion acts expansively. the circulation is quickened and the vital organs are stimulated to normal action. without the awakening or enjoyment of life the vital forces show little response. if anyone will examine himself in a state of anger he will feel that it is the lower part of his nature that is dominating him. he can realize that his muscles and vital organs are constricted and cramped. who has not felt a deep feeling of bitterness, almost of poison, after a fit of anger? who has not felt a certain depression, at times even of sickness, after antagonism or giving up to despondency? there is also a feeling above negative emotions of certain dormant possibilities, certain affections and a better nature in the background. in all true exercises this sub-conscious, better self should be the very centre of the endeavor. so universally is true training and even the nature of an exercise misunderstood that it may be well to summarize a few points to secure intelligent practice. . practice with your whole nature. do not regard the performance of movements as a mere matter of will. expression requires a unity of the whole life of our being. regard an exercise as a means of bringing all your powers into life and unity. let practice be a means of demonstrating your own abilities, spontaneous and deliberative activities to yourself. . practice with an ideal in mind. the accomplishment of an endeavor implies the reaching or attainment of an ideal. practicing with no end in view accomplishes nothing. the goal must be an ideal. there is a universal intuition in an ideal man. there is an intuition deep in ourselves of our higher possibilities. the feeling that better things are possible inspires all human endeavor. movement merely for the sake of movement, mere haphazard practice, without an ideal, accomplishes but little. we want not only an instinctive ideal but we want one which is the result of thought and study. . practice hopefully and joyfully. that is to say, there should not only be thought and imagination in practice, there should be feeling,--a normal and ideal emotion. the realization of the possibility of attaining an ideal brings joy, hope, courage and confidence. . in every exercise feel a sympathetic expansion of the torso. it is not only necessary to feel joy, we must express it, and the primary expression of joy is expansion. expansion is needed not only as one of the exercises; it is more than this. it is a conditional element of all exercise. from first to last, in every movement, feel also a certain expansion of the chest. . in every exercise feel exhilaration of the breathing. increase of the activity of breathing in direct co-ordination with expansion is a part of the expression, not only of joy but courage, resolution, endeavor and all normal emotions. taking a full breath is given as one of the exercises, but here again we have a condition for all exercises. this is the reason why we should give attention to exalted emotion. it will diffuse through the whole body causing expansion and also quickening all the vital functions. respiration is the central function of the body. all the vital operations depend upon it. perfunctory exercises which do not stimulate breathing are useless and injurious. . accentuate the extension of the muscles of the body in all exercises possible. the kneading of the face helps the parts as well as being important in itself. if we rub the muscles while whining we tend to confirm the condition in the parts at the time. thus we may develop whines and frowns. it is very important, therefore, that there should be a cheery smile on the face during the manipulation, if the looks are to be improved by the exercise. in kneading the stomach and the diaphragm if we have a full chest, as in laughter, the manipulation will produce a far better effect upon the diaphragm than if we have little breath. in practicing an exercise, therefore, it is not only necessary to study which part most needs development or which muscle is weak, but it is just as necessary to notice which muscles need extension. . practice harmoniously. we should exercise all parts of the body in a similar way. if we exercise, for example, the action of the feet it is well also to practice rotary action of the arms, or at any rate, of the head. we should see to it that when we practice one part of the body the corresponding part of the body should be equally exercised. we should not give more exercise to one side or part, except when there are congested conditions. we should not give much more to the arms than to the legs unless we have to walk a great deal. . practice in such a way that every movement affects the central parts of the body. hence the program takes first the expansion of the chest and breathing and chuckling, also the transverse action of the torso. we should be cautious about performing violent exercises with the arms, or even with the feet, without simultaneous expansion of the torso because this is a central action which is conditional to all proper action of the limbs. contraction of the torso while working upon the limbs may draw vitality from the vital organs. gymnasts, as a class, die early because they are always performing feats. other dangers are found in the gymnasium, such as practicing exercises perfunctorily, using quick jerks and too heavy and labored movements which affect only the heavy muscles. the absence of rhythm and co-ordination, the presence of too antagonistic movements, the desire to make a show, too much work upon the superficial muscles are also frequent faults. another reason for the beginning of the day's exercise with joy is the fact that the positive emotions affect a man in the centre of his body. they are all expressed by sympathy and right expansion of the torso. this is not only central in expression, it is also central in training. the muscles affecting the more central organs should in every exercise in some sense cause co-ordinate actions in various parts. the expansive action of the chest is one of the chief exercises because it not only frees the vital organs but co-ordinates the normal actions of a man in standing and walking. observe that harmony demands that all parts be equally exercised, but unity demands that we begin our exercises at the center. the organic centrality of the whole body is of first importance. we should not only feel expansion of the chest in all exercises, but we should begin with exercises for the torso rather than with exercises for the limbs. we want to reach the deepest vital organs as a part of all exercises. sometimes a man goes into a gymnasium and works for the muscles of the arm, for example, while the muscles of his chest and around his stomach and diaphragm are weak. in this case the central muscles may grow weaker. exercises, not properly centred, will decrease harmony. i have found many people with lack of support of the voice and weakness of the diaphragm and the muscles relating to the retention of breath, but i have found very strong muscles in the arms, while the muscles in the center of the body were surprisingly weak. in following "external measurements" too much attention is often given to the muscles of the limbs that can be measured. it is easy to discover the fact that the lower limbs have more muscular development than the arms, but this is of little consequence compared with the weakness of internal and hidden muscles like the diaphragm. it cannot be too often emphasized that an organism necessarily is one. the parts sympathize with each other, and the higher the organism the more is this true. the voice expresses the whole being and body, and it not only calls for great activity of the central muscles, such as the diaphragm, but every part of the body seems to share in voice conditions. a human being with his legs cut off can never sing or speak as well as he could before he lost them. . as far as possible, always feel in all the muscles a sympathetic action with certain opposite parts that support or naturally co-operate with these. specific exercises must be directed to central and harmonious effects. for example, expanding the chest and extending the balls of the feet downward as far as possible co-ordinates the parts that are used in standing, though in a different way. it gives extension to the parts; and to extend muscles is often the best way to bring activity into them. formerly a horse was fed in a high trough in order to make him hold his head high, but no horse carries his head so high or has such a beautiful arch to the neck as the wild horse, that feeds on the ground. weak muscles may often be improved by giving them extension. this eliminates constrictions and brings more rhythm or balanced activity in opposition to other muscles or in union with them. the co-ordination must be felt. when there are co-ordinations there will be a sense of satisfaction in the vital organs. the exercises will not weary. they will not be a strain or tax the strength. they accumulate vitality rather than waste it. co-ordination must especially be studied and used consciously and deliberatively with reference to the chest. in the start of every exercise there should be, as has been said before, something of an increase of activity in the chest and the breath. . practice all exercises as rhythmically as possible. rhythm and co-ordination are the deepest lessons of life and are necessary to each other. activity and passivity must alternate in proportion as far as possible in all exercise. observe also that the active exertion of an exercise should determine the amount of the reaction. we should go as slowly in the recoil or eccentric contraction as we do in the concentric contraction. nature is always rhythmic. notice the beating of the heart, going on constantly for eighty or a hundred years. it acts and then re-acts. observe, too, the rhythm of the peristaltic action of the stomach. an exercise must obey this universal law of nature. jerks should never be permitted; but all be easy and gradual. even the surrender of a movement should be gradual. the eccentric action which results is more important in many cases than the concentric. for example, in the diaphragm we make voice by an eccentric action of the inspiratory muscles. we take breath by a concentric action of the diaphragm, we give out breath in making voice by eccentric contraction. rhythm, therefore, means primarily that there should be a rest after each exercise. if we feel very weary we should especially emphasize this rest. it is lack of this rest that causes strain and weariness and makes a person nervous. the normal effect of the exercises when practiced rhythmically, is to eliminate fatigue, correct nervousness and weakness. rhythmic movements accomplish ten times more than unrhythmic ones, even if unrhythmic movements do not produce unhealthy and abnormal results. observe that nature always responds to rhythm. the body will respond to rhythm. let the exercise be taken vigorously and definitely. let also the reactions or rests be equally definite and decided. vigor should never lead to constrictions or to great labor. if we lie on our back and stretch one side and then the other it is easier and we accomplish better results as a rule than we do by stretching both arms and feet simultaneously. it is hard to explain the sympathetic union of co-ordination and rhythm. i have never found any explanation or even reference to this. even dalcroze, who has so many good ideas regarding rhythm, has not grasped the principles of co-ordination of different parts of the body and especially the relation of co-ordination to rhythm. awkward people lack both co-ordination and rhythm and the two are vitally connected. by establishing co-ordinations we begin to establish rhythm, and by establishing rhythm we help in the co-ordinations. the principle of rhythm applies to all our human actions. we should walk rhythmically, and we should stand allowing all the rhythmic curves of the body to have their normal relationship. we shall always have the right rhythmic curves if we have the right centrality and co-ordinations. one of the greatest effects of music is due to the rhythm. all movements, however, have a rhythm of their own. . use in every exercise, as far as possible, all the primary actions of the muscles. we can distinguish four actions of the muscles. first, active contraction, shortening of the muscles sometimes called concentric contraction; secondly, we can stay the tension of the muscles at a certain point. this is called static contraction. third, we can allow the muscle gradually to release its contraction, that is, allow it to slowly lengthen. this is called eccentric contraction. fourth, we can take the will entirely out of a muscle and allow its complete quiescence. rhythm demands the presence of all these actions; and also all these elements in proportion. and in the practice of all exercises it is well to accentuate all four of these elements by counting. in the stretch for the whole body, for example, we can extend the limbs slowly as far as possible, and there will be a contraction of the extensor muscles. then we can stay the body when stretched to the fullest extent. then we can gradually release the action of these muscles and then completely rest. some of the exercises can be practiced with dual movements, first with activity and then release, but by varying the climactic action for a moment and gradually releasing, that is, by giving these a quadruple rhythm, we can accomplish better results than in the dual. in dual rhythm we are apt to collapse suddenly after a movement. in fact, it is harder to control the release of the contraction of the muscles than to control the gradual increase of their contraction. this is illustrated in the difficulty of retaining breath. breath is normally retained by sustaining the activity of the diaphragm, that is, its eccentric contraction. however, the body needs occasionally the complete surrender of muscles, but this should not be too sudden or jerky. the gradual surrender brings greater control and the higher type of development. when we use what are known as secondary movements, that is, when we use the hands to manipulate the stomach or when somebody else rubs us, we should restfully and completely give up the muscles and manipulate them or let them be manipulated in a state of rest. at times it may be well to manipulate a muscle when at full tension. when there seems to be a tendency to great constriction it may be well to manipulate a muscle during both contraction and relaxation and to test its relaxation. again if a muscle does not seem to act as far as possible the opposing one may be found too short and may be manipulated to allow greater extension. . practice thoughtfully. that is to say, study yourself. observe your needs. for example, stand against some perfectly straight post or door, with the heels and back of the head against it. where the back curves most, there will be room for the hand. now where do you feel the most constriction? give attention to such parts. even when lying on your back, by stretching the limbs and expanding the chest such wrong tendencies or faults in standing can be corrected. the chest can be set free when it is constricted. when it is carried too low you can directly separate the breast-bone from the spine. by sympathetic expansions of the torso and by manipulating with the hands the parts that are especially constricted, curvatures, even in the back, can be improved. in all cases in practicing expansion we should be careful that there is no increase in the curvature of the spine. the back should remain normal, or become more nearly normal if we find any perversions. a hollow back, as is well known, is more difficult to correct than a hollow chest, though both of them are abnormal. a hollow back can best be corrected by the lifting of the feet, and the extension of the muscles of the back. if the hand is placed under the back where there is the greatest curvature there will be felt a normal action upon this curve of the spine. one point which has been discussed is whether training can affect the bones, or only the muscles. the whole body can be affected by training if the right methods are used. in correcting something like a hollow back, which has been of long duration, not only the balance of the muscles but the very articulations and ligaments and even bones may be affected by patient and persevering practice. if there is congestion in the region of the throat, the pivotal action of the head is important, but the hands can be made to do a great deal of work also during the pivotal actions. such manipulation is one of the best remedies for sore throat, and also for dizziness, unless the dizziness is caused by a wrong condition of the stomach or liver, in which case the pivotal actions of the torso should be vigorously performed, with kneading by the hands, of the abdomen. if one limb is weaker than its mate it should be given more practice until balance is restored. if there is any muscle weak in any part of the body, we should find an exercise to strengthen it harmoniously. it can hardly be emphasized too often that the central muscles should be stronger than the surface muscles. whenever we find, for example, a weak diaphragm, we should use a greater number of exercises for it and be careful not to give too much attention to the arm muscles. it is not mere strength to lift a heavy weight that measures the degree of vitality or indicates length of life, but rather the harmony of all parts working together. the muscles connected with breathing should be stronger in proportion than the superficial muscles of the arms or lower limbs. people who perform one particular movement a great deal, such as a blacksmith in hammering, should study and use exercises for the parts that are habitually neglected. a little thought can correct every abnormal condition, even stiff joints and headache. by practicing patiently such tendencies may be practically eliminated. . practice progressively. exercises are often taken intemperately. the student begins with enthusiasm, feels uncomfortable results from the extravagance, and then gives up the exercises. begin carefully. patiently practice the movement at first ten or twenty times, counting four with each step and accentuating the stretches, each day increasing a little, and after a week or two the results will be surprising. let there be regularity even in the increasing of the exercises. we must take steps slowly, and gradually add others until we have the number which the normal condition of our system demands. study your own strength and the effects of the exercises upon you. there are many ways by which an exercise may be made progressive. first, by gradually increasing the vigor of the movement. for example, lifting the feet from the bed, one foot may be lifted at a time, which is easier, or both may be lifted only a few inches at first. second, the exercise may be performed more slowly and more vigorously. third, by repeating the exercise a greater number of times. fourth, by the addition of a greater number and variety of exercises. sometimes a person is lame from practice. this is usually due to the breaking of small, delicate fibres. these fibres may have grown together by monotony of movement and by extending them suddenly or violently they may have been wrenched apart too suddenly. muscular fibres should move freely. they will do so if we practice gradually, but violent practice may strain unused muscles and thus cause soreness. in general, the actions of muscles should be as varied as possible, but should be easily, progressively developed. every successive day, exercises should receive a little more vigor until normal conditions are established. some kinds of exercises may be omitted at first. we may leave out all the exercises sitting or those lying on the side. a few of the standing exercises may also be omitted. you will be tempted, however, to omit too much as a rule and then some special day to practice too many. even if you do get a little sore or lame or feel a little as if you had overdone it is better than under-doing, and nature will soon correct the abnormal condition. the next time you practice the exercise you can eliminate the bad effects of your former practice. in all cases of sickness, or weakness from any cause, special care must be given to gentle stretches and manipulation. the movements should be slow and steady. do not leave yourself in a state of pain but of enjoyment. remember that growth in nature is slow. the stronger the organism, like the oak, the slower the growth. a weed may grow almost in a night. be patient, therefore, do not worry,--be persevering and regular in all the habits of life. some constitutions need more exercise than others. those who are growing fleshy need quick, vigorous exercises, while those who are growing thin and emaciated need slow, steady ones, as do those who are nervous. . establish periodicity. all development in nature proceeds in a regular and continuous sequence. there are certain alternations and variations, but these take place at specific periods. the organism will adapt itself to regular periods. thus, if we take our meals regularly, we get hungry at the same time every day. we should go to bed at a regular hour; at that time the system demands rest and we become sleepy. parents are so anxious that their children have a good time that they frequently cultivate irregular habits and thus lay the foundation of future failure. health is greatly dependent upon regular hours for both work and recreation. anything that interferes with periodicity in the human body interferes with vital functioning. observe how regularly we breathe. there is a normal respiration, circulation, and beating of the heart which are practically the same for everyone. any variation from these regular rhythms is serious. this principle of periodicity applies to exercises as well as to anything else. some men have the habit of going to a gymnasium once a week. they take the exercises one day and neglect them for several days, then try to make up for lost time. the exercises in such cases are not enjoyed. they will be performed mechanically, if not perfunctorily: at any rate, satisfactory results will not follow. if we take exercises every day at about the same time, say upon waking in the morning and on going to bed at night, the system will come to long for them just as the stomach craves food. nature does not grow a little one day and then stop for a while; she does not grow a limb on one side and then another on the other side. all growth is continuous. of course, this continuity is rhythmic. there is a different action day and night, but this in itself is a form of periodicity. in the same way we have summer and winter. the tree feeds itself in summer and during the winter the life remains hidden at the root while the process of making the texture firm proceeds with rhythmic alternation. all phases of life and growth are periodic. if, for any reason, there is an unusually severe winter the plants are killed. if there is a long period of drought vegetation dies. a certain normal amount of rain as of air, food, or soil is necessary to the growth of the plant. one reason for practicing in the early morning is the fact that it will connect exercise with the natural habits of the individual. the time of waking up should be periodic and will be so if we retire regularly. the practice of exercises on first awakening or retiring will also tend to help the normal time and amount of sleep. if we take exercises on first waking, as suggested, we shall awake about the same time and with greater enjoyment. the system will come to expand naturally; every cell will leap like a dog that prances with joy when it sees its master getting ready to go for a walk. . practice regularly. not only should the time be regular, the amount of exercise also should be about the same each day. we should not give a half hour or an hour one day and neglect it entirely the next any more than we should eat one extraordinary meal and then go without anything to eat for two or three days. the same is true also regarding the kind of exercise. it may be helpful to change some of the exercises, but we should have exercises for all parts of the body. if we substitute one exercise for another we should take care to exercise all the parts equally. we may change the kind of food, but the degree of sustenance it contains should not greatly vary. . practice patiently. do not expect great results to come in a day, though you ought to feel some effect very quickly, yet it may take weeks, especially if there is any unusual weakness or abnormal condition. the slower and more varied the practice the better, other things being equal, because conditions are more important than the exercise and the normal adjustment of the various parts of the body is much more important than strengthening any local part. . practice slowly but decidedly and vigorously. the more slowly an exercise is practiced the deeper the effect. the lifting of the feet very slowly, for example, will have more effect upon the diaphragm than if done quickly. the holding of the chest high while lifting the feet slowly, causes wonderful action of the diaphragm and of the stomach and vital organs. slowness, however, does not mean hesitation, indifference, nor laziness. mere lazy, indifferent practice will accomplish nothing. let the movements be done slowly but decidedly and definitely. one should be careful if there is any particular part that causes pain. we should bring in secondary or kneading movements, with the hands. if the action is thoughtfully directed to the right part, if it is truly rhythmic and sympathetic, abnormal conditions will be removed. . exercise as well as sleep in the purest air possible. sleep with your windows open. let the air circulate across your room though not across your bed. let the air be as pure as that out of doors. perform your exercises in bed with your windows open and with but little covering. the vigorous exercises will bring greater warmth and you will feel the desire to throw off the blanket. some of the exercises, of course, as lifting the legs, cannot be performed so well without removing the covering. the method of practicing the exercises as well as the amount, number and character of them, depends greatly upon the health and the vitality of the individual, but there must be a continual advance in the vigor and the number of the exercises. vi actions of every-day life the benefit of exercises must be tested by the help they give to the actions of every-day life. the human body must perform certain movements which are continually necessary. these exercises enable us to do these movements with more grace and ease, with more pleasure to ourselves, with greater saving of strength and vitality, and in a way to give greater pleasure to others. . how to stand "man is the only animal," says sir william turner, "with a vertical spine." the bird stands upon two feet but the spine is not vertical. strictly speaking no animal stands erect except man. the primary aim of all true exercise for the improvement of health and the prolonging of life must affect the erectness of the human body and the counterpoise curves of the spine. the axis of the spine must be vertical. nearly all the exercises from the very first tend to accomplish this result. the expansion of the chest, the pivotal flexing of the torso, the lifting of the feet, the stretching, the co-ordinate action between the summit of the chest and the balls of the feet, and the exercises in sitting and standing, all tend to establish this most important condition. there must be activity at the summit of the chest. the head and the chest are the first to give up and sag. we can see that the skeleton has no bones below the breast bone to support it. the lower ribs are floating ribs and the other ribs have an angle downward. everything is arranged with reference to the expansion of the chest. this is the central activity in standing properly. we can see, as has been shown, that man is held up seemingly from above. man comes into stable equilibrium only when the body is supported from the summit of the chest. levitation opposes gravitation. it will be observed that the first exercises concern the expansion of the chest and when the exercises are properly performed, this expansion of the chest is indirectly sustained through them all. if we observe a person standing properly, we find that a line dropped through the centre of the ear will fall through the centre of the shoulder, the centre of the hip, and the centre of the arch of the foot. the things that cause bad positions are: the chest inactive, the hips sinking forward, the head hanging downward or lolling to the side, the body sinking to the heel, and weak knees; but all of these seem to be corrected when the chest is properly expanded and elevated. to stand well, therefore, one should stand upright; the chest well expanded so as to bring all parts into co-ordination and establish a true centrality in the body. in a certain sense, there seems to be an axis of the body by which it rests easily upon one foot while the other leg and hip are perfectly free. the body is also perfectly free to pivot and to pass the weight to the other foot. the recommendation to "stand tall" is more or less helpful, but there must be some qualification. stand tall, but not with rigidity or stiffness. the body must be elastically and sympathetically tall, and also sympathetically expanded, man must stand as if held up from above rather than from below, expanded and elevated by feeling and thought rather than by mere will. the centrality, ease and harmony of the poise are of more importance than the tallness. when one stands properly on one foot a spiral line from the top of the head to the foot is developed. the head inclines slightly toward the side that bears the weight, the torso slightly inclines in opposition and the active lower limb takes a slightly opposite inclination. this line which has been called the line of beauty is very common in nature. it is found all over the human body. when the face is animated with joy and gentleness, such spiral curves appear in all directions. the presence of this line is an element of a beautiful face and of a graceful body. the beneficial effects of such a poise are seen at once. the breathing is free. when a person stands in bad poise there is constriction of the respiratory muscles so that he is uneasy, he shifts from foot to foot. but when one stands in stable equilibrium, he stands restfully, easily and gracefully, and can move in any direction freely. his body also becomes expressive and acts under the dominion of feeling. . how to walk the character of a person's position in standing will determine the character of the walk. if one has learned to stand in stable equilibrium he will walk suggesting repose. if he stand in a discordant poise he will walk in a discordant chaotic way and will be continuously fighting to stand up. when a person stands in an accordant poise the walk is a progression forward and a levitation upward rhythmically and freely, the spiral lines alternating with every step. every line of the body acts rhythmically. there is not only rhythmical alternation of the lower limbs and of the movements of the weight from foot to foot but all the lines of the body alternate rhythmically. a good walk is the carrying out of a man's purpose. accordingly there is an attraction forward and upward at the summit of the chest. there are some abnormal walks where men seem to be drawn by the head, some walk as if drawn by the nose or chin, by the hips or by the knees or even the feet. the gravitation of the body forward toward the carrying out of one's purpose should be from the centre of gravitation and should be upward. "onward and upward, true to the line." man in his very walking seems to be a progressive being. to climb a declivity, he seems to move forward and upward. in a bad walk a man seems drawn downward. the poise of the body in standing and walking is most affected by this series of exercises. the co-ordination between the summit of the chest and the feet in rhythmic alternation, the simultaneous activity of the chest in all movements or exercises develop good positions in standing and natural actions of the body in walking. the extensions especially when in alternation bring the body also into the normal spiral lines and tend also to extend the muscles especially at the side so that the shoulder does not seem to be drawn down toward the hip, but acts with the torso freely. when exercises are practiced properly the whole bearing of the body will begin to improve. . how to sit badly as people stand, they sit possibly worse. most people sit in the most unhealthful as well as in the most ungraceful way. generally there is a complete "slumping" of the chest, the spine is brought into a wide, single curve instead of its counterpoise curves. all the exercises from the very first, have a bearing upon the establishment of the normal conditions of the spine. if the exercises are well practiced, especially the elevation and expansion of the chest, the spine is strengthened and its normally proportioned curves are established. bad positions in sitting are extremely common. book-keepers, editors, seamstresses and children in school need careful attention. special exercises should be given, such as the "harmonious expansion of the chest" in sitting and the use of the arms to develop the uprightness of the torso. bad positions in sitting are often due to a false sense of rest. muscles not acting harmoniously tend to completely collapse. many people sit without true rest, and are continually shifting their position in a vain search for rest. what is rest? the chief rest comes through the alternation of activity and passivity, that is, through rhythm. passivity alternating with activity brings rest to the human heart and is the best mode of rest. rest also results from normal functioning. a person can sit or stand in true poise, giving freedom to breathing, and be able to rest much more truly than in an unnatural, abnormal, collapsed condition. this can be well illustrated by the fact that when a person starts out to walk with the chest slumped, the head hung down and with all the vital organs cramped, he comes back more weary than rested. in walking we should, as has been shown, keep the chest well expanded, the body elevated, co-ordinating all the normal relations of parts. if we walk in this way it tends to rest rather than to weary us. therefore stand sympathetically expanded and easily tall. walk in the same way and sit in the same way. let there be a certain exhilaration and a sense of satisfaction. . how to lie down dr. lyman beecher said that one should always assume a horizontal posture in the middle of the day. the heart, he said, had less difficult work to pump the blood horizontally than vertically. henry ward beecher attributed his power to do a great deal more work than ordinary men to this habit of his life of always resting in the middle of the day. he justified his habit by quoting from his father, using even his father's antique pronunciation of "poster." there is no doubt truth in this. to one very active and who performs a great deal of work it brings a variety of positions and greater rhythm. it rests the vital organs. it brings a harmonious repose and relation of parts. even in lying down, we find abnormal conditions. some men cramp and constrict themselves. the chest is allowed to collapse and the whole body tends to be drawn together. grief or any negative emotion of feeling or condition destructive to health tends to act in this way. people, therefore, should lie down properly. they should lie down, as has been said, sympathetically and expansively long. they should directly manifest courage rather than shrinking, joy rather than sadness, with thankful animation rather than in a despairing state of mind. by the expression of joy and courage and peaceful repose and with a deep sense of the acceptance and realization of the good of life lying down will mean more. express this in the body by normal position, by expansion, no matter what attitude the body may occupy. man, whether he chooses or not, always expresses the state of his mind in the action of his body. and by cultivating the right mood and expressing the right feeling and so exercising the parts of his body as to express normally and more adequately that mood, men will develop not only health, strength and long life; but will also develop a nobler and stronger personality and more heroic and courageous endurance. the exercises, accordingly, should be applied to the simplest movements of every-day life. they must not be taken as something separate from life, but as an essential part of it, as necessary to life as a smile is to the face. vii work and play "blessed," says carlyle, "is the man who has found his work. let him seek no other blessing." a man out of work is one of the saddest of all sights. there possibly is a sadder one, the man who has lost the power to play. the child in whom the spirit of play has been crushed out is saddest of all. work is natural. one who does not love to work is greatly to be pitied. fortunately, such people are rare. when a man finds his work and becomes actively occupied with it he is happy. he, however, often overdoes it and the difficulty is not to work but to play. usually it is thought that there is antagonism between work and play. on the contrary, they are more alike than most people think. according to william morris, "art is the spirit of play put into our work." the union of work and play is absolutely necessary to human nature. by work we generally mean something that comes as a duty, something which we are compelled to do or something which we must do from necessity in order to win a livelihood. play is usually regarded as something that is pure enjoyment and spontaneous. a recent cartoon pictured a boy complaining because his mother had asked him to carry a small rug up to the top of the house, then portrayed the same boy, after a ten-mile trudge, climbing a steep hill with a load of golf sticks, the perspiration streaming down his face, saying, "this is fine!" the same task may therefore be regarded as work or play according to the point of view. the difference is the degree of enjoyment, the attitude or feeling toward the thing to be done. we can control our attention, we can look for interesting things in almost any effort. in either work or play we require a rhythmic alternation between enjoyment and resolute endeavor. the principles advocated in this book and its companion, "the smile," should prepare a man for the work and the play of life. exercises taken at any time should serve as a remedy for the evil effects of hard work of any kind. the exercises give the best preparation for work and because many of them are taken lying down they do not exhaust but accumulate energy. they also stimulate and develop a harmony and activity of man's whole being. the shortest and best answer that can be made to the question "how to work" is, to work rhythmically. this is the way nature works. there is action and reaction. the law of rhythm, which has already been explained, must be obeyed in our every-day tasks. it applies to every step we take. one of the best results of these exercises is that they develop a sense of rhythm. there are many violations of rhythm. one is continuing along one line too long. work can be so arranged as to be varied. we can work at one thing several hours and then we can deliberately drop it until the next day and take up some other phase of work. without rhythm, work becomes drudgery. a more specific violation of rhythm is a failure to relax and to use force only when needed. the greatest effect of force comes through action and reaction. sometimes a man uses unnecessary parts and uses them continually. that, of course, will cause weariness. there are hundreds of questions regarding such discussions in as many books in our day. mr. nathaniel j. fowler, jr., in "the boy," a careful book which is a treasure house of information, has gathered answers to leading questions from two hundred and eighty-three prominent men. many of these, in fact, most of them, advise a boy, when he is not satisfied with his work and is pretty sure that he is not adapted to it, to change his occupation. it is a difficult point upon which to give advice, but other things being equal, work should be enjoyed. when not enjoyed there should be a serious study of the man himself, a study of his attitude toward life, a study of his possibilities, a study of his opportunities, and also a study of what he is best fitted for, and an endeavor to find this. it is surprising, however, how far men can adapt themselves, even change their very nature in accomplishing a work which is laid upon them as a duty. one of the greatest artists of new england took care of his brothers and sisters and his father's farm, at a crisis, and kept a little shed outside the house where he painted at odd moments. he had an avocation as well as a vocation. he gave up his trip to study in europe as he wished to study; he did a vast amount of work which was regarded by many as drudgery, and he was compelled to study his art only at odd moments. despite all this, george fuller became one of the most illustrious and original of american artists. today his pictures are in all the leading museums, and command a high price. what is drudgery? dr. james freeman clark defined it as "work without imagination." anything can be made drudgery. a man can study art, or sing, paint pictures, edit newspapers, or write books and make his work drudgery. drudgery is working perfunctorily. it is work without aspiration, work without an ideal. no man can do anything well in life, without an ideal. if a man undertakes a certain work he must begin it by awakening and realizing the importance of that work in the world's life. he must form a definite ideal of the best possible way of doing that work and of its relation to the world. in short, no man can accomplish anything in a negative, indifferent attitude toward his work. he must look upon it from the side of its importance, the side of its beauty, the side that is interesting to him, the side that shows its influence and helpfulness toward the world. play, to the little child--and also to the hard working man--is more serious than work. when work begins to be perfunctory, play is the only remedy. in such a case a man is in a dangerous rut and must adopt a new rhythm. "all work, and no play, makes jack," or any other donkey, "a dull boy." the first principle of play must be to obey our higher impulses. to play means the ability to change our occupation. it means the ability to obey other impulses than perfunctory ones. some men regard play as something low. on the contrary, notwithstanding the "recapitulation" theory, play should be a new aspiration, a deeper assertion of freedom, a higher opportunity for suppressed energies. to play, certain feelings and conceptions of our nature must be awakened. play reveals character even more than work because it shows the latent impulses of the man. therefore, if in college, in school, or in childhood, in playing with companions, the right associations are brought to bear, the right persons are received as mates, then the very sympathy and contact with others will cause higher aspirations, deeper enjoyments, more spontaneous endeavor, and renewal of life. play is sub-conscious, it is giving way in some sense, to instinct; but it is deliberatively giving up. it implies enjoyment but it does not necessarily imply the gratification of low desire. something can be said in favor of athletics. a story is told of a gentleman who visited his nephew in a large private school. he went around the athletic field and asked the trainers about his relative. then the uncle found the boy in his room, digging. he said, "what are you doing here? none of the trainers see anything of you. what is the trouble?" the student answered, "i have been sick and i have been working hard to catch up." "get out of this," replied the uncle, "i went to preparatory school and to college to find friends, to get enjoyment, to learn how to play, to come in contact with men. that is the serious business of school and college." there are some who consider this the very worst of heresies. i used to think so myself; but contact with students in colleges and universities has enabled me at least to see the point of view of this gentleman. many times i have met men who were not getting the most out of their college or university course though you could not tell that from their scholarship or so-called "standing." they lacked the spirit of enjoyment, the power of initiative. they lacked the power of sympathetic touch with other men that makes greatly for success in life. to my mind there are some games which bring no sympathetic touch among men. mere games are not always worthy of the name of play. they become drudgery, and they cause certain constrictions. they fetter the whole life. they call for perfect silence, call for the exercise of great mechanical skill. frequently we find men playing games which are analogous, if not identical, with their work. games should be different from work. they should bring sympathetic enjoyment. they should bring exultation. a noted physiologist sent by his government to examine into the physical training of other countries visited a leading school in england and found the pupils one morning, during the best hours of the day, at play. approaching one of the boys, he asked for the principal, and was conducted very politely to the master. the visitor was greatly impressed by the boys. he asked the principal why it was that his boys were playing during the best part of the day. "ah," said the principal, "that is part of our method. we want the best time in the day to be devoted to their outdoor exercises and sports. we take the utmost care that the boys shall come into the most sympathetic spirit with each other, and anything that happens wrong on the playground is to us fully as serious as what happens in their studies." there is a universal conception that play is not serious. children are allowed to do just as they please. this is a mistake. froebel has taught the true spirit and importance of play. some people consider his explanations as being purely speculative, if not insane; but the great majority of those who have really studied child life agree with him. it is important what games the child is given. the play must be enjoyed. it should awaken creative energy. it should appeal to the imagination and feelings and not be a purely mechanical exercise of will. it is absolutely necessary for the unfoldment of character that the child come into touch with other minds, and also into contact with things. someone has summed up the whole principle in a sentence: "bring such objects before the child as will stimulate spontaneous activity." the objects may be animals, birds, leaves, flowers, balls, sticks, anything which can awaken human faculties or be turned into a tool. arts are given us rather for avocations, for our enjoyment, as a test of our ability to appreciate the different points of view. each art, as i have often tried to say, expresses something that no other art can say, and he is a cultivated human being who can read all the arts and enjoy them. the aim of art is to guide our energies in higher directions, and to stimulate our ideals. art develops attention and trains us to become interested in a great variety of directions. as a proof of this observe the great beauty of nature. we are stirred to go out of doors, to go into the woods and note the beautiful scene and the music of the pines that calls us. nature everywhere seems at play, seems to invite men to come out into her unlimited playground, the playground of universal principles and fullness of life. the poet, schiller, explained all art as being derived from the play instinct. it has been said that play is the overflow of life. life, love, joy, all noble ideals, must awaken spontaneity or they will not grow. all parts of man's nature must have expression and not be repressed. play is given to stimulate and to express the spontaneous in us, to manifest emotion and imagination and a sense of freedom. freedom is a necessity of all unfoldment. even the flower must bloom spontaneously from the energy within. the sun that calls forth the leaves on all the trees does so by warming the roots in the tree and bringing the gentle south winds which fan the waving branches into activity and cause the unfolding buds to be filled with spontaneous life. the whole world is full of joy and love. it is human ambition and jealousies that bring the hindrances. the rhythmic alternation and the necessary relation of work and play to each other can be seen in the very constitution of man. play alone may develop obedience to lower impulses; while work alone tends to repress the higher aspirations and spontaneous energies. even a man's health and strength as well as success depend upon the rhythmic alternation of work and play. while reading over the copy for this book for the last time, when in that agonizing state which some writers know, undecided whether to throw it into the fire or send it to the printers, i read at the suggestion of a friend, eleanor h. porter's little book, "pollyanna." that simple, wholesome story has given me courage. the fundamental lesson in it is that we should find always something about which to be glad, no matter how severe the trial or how disappointing the event. goethe gave as rules for a life of culture:--"every day see some beautiful picture, hear some beautiful piece of music, read some beautiful poem." these might develop culture in a narrow sense, but to broaden and deepen our lives we need every day to see something beautiful in nature, and in the lives and characters of our fellow beings. dr. howard crosby once remarked that by giving ten minutes to the telegrams of the newspapers any man should be able to keep in touch with the life of mankind. the boy scouts and the campfire girls are emphasizing some important phases of education and life which have been too often overlooked. one of the boy scout rules implies that every day a boy should perform some kindly act for others. the importance of a boy's stepping up to an elderly lady looking for an electric car and giving her assistance, or carrying a lot of bundles for someone cannot be too highly emphasized. these boys take no "tips." they are trained to serve for the sake of the serving. these suggestions and services awaken the higher nature of the boy or girl. such movements should be universally supported. one of the most important helps to the boys should not be overlooked. in offering their services they are led to express their best selves. it is important that they should learn to approach strangers with polite confidence and courage when offering assistance. i gave my seat once to a woman in a street car and at first i felt a little resentful because not by look or word did she express gratitude. as i glanced at the woman, however, i saw that she really desired to thank me but was embarrassed. she did not know how to do so. how few are taught the languages! if the boy scouts and the campfire girls do nothing else than to learn to express their willingness to serve they have made a wonderful gain for active, useful and successful lives. of course, the primary aim is the good deed, but are not the kind tone, word and polite bow fully as necessary? are they not the entering wedge and do they not appeal to the higher nature in the same way that the thought of being of service inspires the boy or girl? while doing is the great thing, yet it is necessary to say in union with doing. there is really no antagonism between expression in kind looks, tones or words, and acts. they are inseparably connected. these same principles apply also to the campfire girls. they must not only be trained to do things but trained to realize their own personalities and to draw out the best in others. then the actions will begin to be more expressive of the real personality of the boy or the girl and the seeing, doing and becoming will form an organic unity. someone has said that the great law of education is, first, to know; second, to do; third, to become. the doing implies not only action, but expression. certainly we do not become what we know till we do or express through word, tone and action. the most successful men in the world have certain principles to guide their every-day life. if we could only smile instead of frown, when people criticize or condemn us, how much more successful would be our lives! every day we can discover something interesting in our fellow-men. we can learn to listen. we should work when we work and play when we play. we should not play in a half-hearted way worrying about our work; and when we work we should do so with all our might. we ought to have regular periods of rest; we ought to avoid unpleasant topics in conversation. everyone should have a vocation as well as an avocation. may we not summarize all these suggestions into a few statements which will enable us to co-ordinate work and play, and aid us in our daily lives to obey the principles that should govern us from our first waking moments? every day: . smile when tempted to frown; look for and enjoy the best around you. . see, hear or read, that is, receive an impression from something beautiful in nature, art, music, poetry, literature or your fellow-men. . think, feel or realize something in the direction of your ideals and in some way unite your dreams with your every-day work and play. . express the best that is in you and awaken others to express the best in them. . serve some fellow-being by listening, by kind word or deed. . share in some of the great movements of the race. all these refer to an important point--that we should be teachable and should receive right impressions. this is of primary importance. breathing means the taking of breath. we should begin the day with joyous and glad acceptance of life and all that it brings. a spirit of thankfulness and acceptance is the true spirit of life. we, however, need active expression. as breathing implies not only taking breath but giving it out, so impression and expression are necessary elements of the rhythm of life. hence even these six things are incomplete. we should also exercise our higher faculties and powers, especially those we are not habitually using in our work. our whole nature should be active if we are truly to live. our higher faculties should not be regarded as concerned only in mere dreaming. our ideals should be connected with our daily work and contact with mankind if we are to cease drudging or working without imagination. accordingly by word, thought or act, we should express every day the best that is in us. moreover, fully as important as these, we should every day come into sympathetic touch with our fellow-beings and call forth the best in them. expression implies a neighbor,--some other being with whom we can communicate. do not think for a moment that such expression is empty. of course, we must go on and endeavor every day to serve someone by a kind act, but a kind word must not be despised. how many hearts are over burdened because they lack a sympathetic listener! to be a polite listener is one of the beautiful things in human life. remember, also, that many who have seen an opportunity and desired to do a kind act have failed from inability to express the wish by word, smile or bow. expression is not separate from impression. we must receive our impressions from every source, then we must express to others the best that is in us and become such sympathetic listeners that others will unfold the best in themselves and thus come into that plane where we can sympathetically participate in the lives of others. viii significance of night and sleep anyone who wishes for improvement in health, strength, grace, ease, or vitality, or, in fact, in anything, must realize especially the significance of the law of rhythm. rhythm is a law of the whole universe. the music of the spheres is no fable. observe, too, the rhythm of the seasons. everywhere there is a co-ordination of the finite and the infinite, the individual and the universal,--a unity of forces acting in a sequence of natural co-ordinations. of all the illustrations of rhythm one of the most important is the alternation of day and night. every plant awakes and rejoices with the sun and it recognizes the sunset and goes to sleep as the darkness comes. the few exceptions only prove the rule, and even these simply reverse day and night and are equally rhythmic. the value of day and night to man is well known. when there is a continuous work to be done it has been proven scientifically that those who work at night cannot accomplish so much as those who work by day. the very same man cannot do the same amount and grade of work in a night that he can do in a day. the human system is built up by various rhythms like that of day and night. there is a natural call for rest, for recuperation and the surrendering of all our voluntary energies that the spontaneous activities may have their turn. the psalmist, after he has gone all over the beauties of the world exclaims, "man goeth forth unto his work and to his labor until the evening." here he pauses, for the beauties of the evening seem to awe him for a moment into silence, and then he breaks forth into a universal paean of praise: "o, lord, how manifold are thy works! in wisdom hast thou made them all." night is a part of the normal rhythm of nature. every plant and every bird welcomes night as well as morning. serious and abnormal, indeed, is the state of one who cannot sleep. next to the importance of a right awakening in the morning is the peaceful, restful retirement at night. edison boasts of how little sleep he needs, and claims that sometime man will cease to sleep. he says that sleep is only a habit. as a matter of fact, by working rhythmically through all the hours of the day, by obeying the law of rhythm at all times, a man may possibly need less sleep, but the repose of unconsciousness seems a part of the creator's economy. "he giveth his beloved sleep." by living in obedience to the law of rhythm and especially by taking some rhythmic exercises before lying down, we can sleep better. almost innumerable are the suggestions, rules, or recipes on how to go to sleep. one says, "keep counting until you fall asleep." another says, "watch a flock of sheep jumping over a fence, counting each one as it jumps." a third says, "watch a bird sailing around in the sky. keep the mind upon it and watch it as it steadily sails until you are asleep." someone says, "repeat the twenty-third psalm over and over, the more rhythmic, the better." another says, "think of the sky. keep the mind upon its expanse." still another, "think of the infinite and eternal source of the universe." among all these suggestions we can find some truth. nearly all of them imply concentration of the mind. if attention can be focused and held at a point, the excited activity of thinking may be stopped and the body consequently brought into a state of acquiescence. they succeed, if they do succeed, because attention is turned from worries to something besides the antagonism, excitements and duties of the day. another element in the suggestions is their regularity. watching the sheep jump over a fence and counting one at a time, for example, affects the breathing and all the vital forces of the body. this causes rhythmic co-ordination of all the elements and the unity of this will, of course, bring sleep. the sense of harmony and rhythm and self-control should be gained; all antagonistic, chaotic and exciting thoughts and all worry should be eliminated as far as possible before lying down. when we lie down, we should turn our attention away from the excitements of the world to something calm and reposeful. accordingly there is nothing better than to repeat some of the exercises of the morning. these stretchings, practiced slowly and rhythmically, will equalize the circulation, the taking of deep breaths, very rhythmically, will tend to restore respiratory action and the other exercises will tend to eliminate constriction from local parts. observe the necessity once more of harmonious thought and positive emotion, for here again there will be a temptation to dwell upon the failures of the day. it is so hard to forget some unkind word, some failure on our part to grasp a situation at the right time. we can easily remember the wrong word we ourselves spoke and deeply regret our failure to enter into sympathetic touch with someone. in such an excited frame of mind, with the nerves wrought up at the thought of the day's work and with all these discordant pictures thronging into our consciousness, sleep becomes impossible. sometimes one is too weary to go to sleep, or sinks into a deep slumber which is not normal. the taking of breath is short and the giving up of the breath more sudden. this sleep will not be refreshing. nine times out of ten such a one will wake up in the morning feeling more weary than when he lay down at night. of course, if a man could sleep for an unusual number of hours, nature might in time restore him. the excitement of our civilization prevents normal conditions and therefore we must aid nature. man must understand the laws of life and so use them as to find rest properly. we need harmony in our thoughts, to let them dwell on what is sacred and beautiful that our sleep may be normal and that we may enter into the world of slumber with sympathetic conditions. we must, also, laughingly throw off negative thoughts and feelings and allow expansion and stretching to equalize the circulation. all the vital functions must be harmonized. as we perform these exercises once more we find various congestions that have resulted from the one-sidedness of our day's work,--congestions around the throat, parts of the body are weary, constricted, and cramped. by stretching ourselves we can harmoniously adjust the activities of our breathing and circulation. all parts can be restored to harmony and we can rest properly. after all, what is rest? it is not a mere slumping into inactivity. it is allowing the involuntary rhythm of our being, the sympathetic co-ordination of all the forces of our body to act normally. the rhythm of our volitional activities must be given up to the rhythm of the unconscious and involuntary life. before this rhythm can reign we must remove all constrictions from any part of the body. after taking these exercises we should feel the sympathetic enjoyment of all the cells of our bodies, then sleep will be refreshing, the rhythm of breathing will be normal and the circulation and vital processes will proceed easily and rhythmically. what are the differences in the practicing of exercises in the morning and evening? in the first place the exercises in the evening should be more steady, more regular, more harmonious, slower and more rhythmic. every exercise must soothe the excited nerves, the agitated brain, and the weary respiratory muscles, the heart, and all the circulatory system. release needs to be especially emphasized. after every stretch, for example, every part of the body must be relaxed. the reaction will take more time on account of the greater activity through the day. we should, therefore, take especial pains to accentuate the recovery or recoil of the muscles into sympathetic passivity and rest. the object is now not to stimulate as much as in the morning, but to allay all excitement, harmonize the co-ordination of all parts, remove all local activities in the different parts of the body, establish centrality of the vital functioning and the diffusion of blood and feeling into every part. it is well to practice the exercises on a hard floor before getting into bed. the more violent exercises should of course be omitted unless there has been a one-sided position during the day. for example, standing exercises will be beneficial for a person who has been sitting all day. we must practice intelligently, and carefully apply such exercises as are needed. harmony means the removing of constrictions and over-activity in certain parts which one finds upon exercising. these often need to be vigorously exercised so as to restore the harmonious condition. on lying down on the floor feel in stretching as if the body weighed a ton,--feel the weight of the arms, legs and head. often we lie down but soon the excitement of a thought brings us to our feet before we know it. eliminate all such exciting ideas, then let the stretch reach every part. let it be slow and steady and let the release be gradual. there should be a complete rest for quite a little period before the next activity. other things being equal, the activity should be less than one-third of the surrender not only in time but in attention. just before going to sleep it is well to practice a few stretches and to give full expansion to the chest and to take a few deep breaths slowly and rhythmically so as to establish a vigorous and normal rhythm, equalize circulation and bring all parts into harmonious freedom. in order to emphasize the rhythm in our evening exercises we should accentuate and prolong especially the passive rest between the movements. we should not only more gradually give up the actions of the movements, accentuating the static and eccentric contraction, but we should also feel more sense of surrender at the end of each movement. that is, we should feel a sense of weight and of rest at the end of each action, breathing easily, steadily and freely, all the time. the time of this rest at the end of the exercising should be prolonged more and more especially after we are in bed and have felt the satisfactory feeling all through the body of harmonious diffusion of energy and the removal of constrictions. this sense of satisfaction through all the body is fundamental and necessary in order to bring healthful and normal sleep. the harmonious extension of all parts of the body should be emphasized. all stretches are truly conducive to sleep. they allow life to permeate through the whole body. the exercises, before going to sleep, should be less rigorous unless there are constrictions and these should be removed by simultaneous and sympathetic co-ordination of all parts of the body rather than by vigorous movements. after any local movement the stretch should be renewed and the affirmation made of some thoughtful and beautiful idea--as love, joy, peace. it will be surprising how quickly help will come and weariness disappear. the entire body, in every cell, will be soothed and enjoy sweet repose. the affirmation of confidence, love, trust, and peace should follow as well as precede the evening exercises. we should make the going to sleep a sacred part of our lives. in giving up our consciousness we should be sure to surrender it to the positive forces of the universe. this is not an idle dream, nor a mere mystical fancy. even from a psychological point of view the emotion with which we go to sleep is apt to remain with us and get in its good or evil work in the unconscious, involuntary metabolism that takes place in all the cells. we must lie down to rest in peace. "dr. thomas hyslop, of the west riding asylum in england," according to professor james in "memories and portraits," "said last year to the british medical association that the best sleep-producing agent which his practice had revealed to him, was prayer. i say this," he added [i am sorry to say here that i must quote from memory], "purely as a medical man. the exercise of prayer, in those who habitually exert it, must be regarded by us doctors as the most adequate and normal of all pacifiers of the mind and calmers of the nerves. "but in few of us are functions not tied up by the exercise of other functions. relatively few medical and scientific men, i fancy, can pray. few can carry on any living commerce with god. yet many of us are well aware of how much freer and abler our lives would be, were such important forms of energizing not sealed up by the critical atmosphere in which we have been reared. there are in everyone potential forms of activity that actually are shunted out from use. part of the imperfect vitality under which we labor can thus be easily explained." have a few simple sentences full of thanksgiving, of peace and rest. the best are found in the bible. the words to moses, "my presence shall go with thee and i will give thee rest," may be given and repeated many times with a realization of their deep meaning and a personal application to the individual. not only repeat phrases, lines, and verses, full of beautiful thought, but change these into your own words. learn to articulate your own convictions and apply them to your own needs,--even paraphrase, for example, such a phrase as "he restoreth my soul" in the twenty-third psalm. for the word "soul" we can substitute anything according to the specific needs of the hour. we should, however, use nothing that is not in accordance with universal love and the highest spiritual ideals of man and of our conceptions of the universe. we must always remember that truth is universal. we can change "soul" also to "health," "strength" or "life," to "joy," to "success," to "confidence," to the body or any part of the body which may seem to be afflicted. there are in this psalm other good affirmations on going to sleep. take individual clauses and repeat them many times, such as "i will fear no evil, for thou art with me." one of the best affirmations is found in the first of the twenty-seventh psalm. "the lord is my light and my salvation. whom shall i fear? the lord is the strength of my life. of whom [or of what] shall i be afraid? one thing have i asked of the lord, that will i seek after, that i may dwell in the house of the lord [in a consciousness of his presence] all the days of my life, to behold the beauty of the lord, and to enquire in his temple [to commune with him in the sacred temple of my own soul]. "thou wilt keep him in perfect peace whose mind is stayed on thee." everyone should find his own, should find it in his experience, find it by personal investigation and study of the bible and through spiritual realization. we should live in peace with all men, be able to rejoice evermore, "to pray without ceasing"; that is, we should always be in an attitude to receive that which is good and never admit that which is negative;--hate, antagonism or fear,--but we should welcome love and that which we know expresses the "infinite presence." antagonism, hate, discords prevent us from living our hundred years. "certain classes of men shall not live out half their days." the last moment before going to sleep should be one of peaceful rest. say "not my will but thine" and give up everything to the infinite and eternal. my own best help is thanksgiving and praise. when i cannot give up the thoughts and conflicts of the day, i can bring my whole being into reposeful rhythm best by expressing thanks that i can be awake and that i have shared in the life of a day. i praise the infinite presence that i can know beauty when i see it, that i can understand truth and know that two times three are not seven and that i can participate in the goodness of the universe. then, before i know it, i have laid aside the conflicts of the day and have passed into peaceful and harmonious rest. this method of thanksgiving especially applies to those times when i wake up in the middle of the night. * * * * * returning to pippa, we find her retirement to her own room and her method of going to sleep no less suggestive as an example than her awakening. she met the first wakening moment with joy and praise as she resolutely put aside the dark thought of her life and went singing all through the day with the same spirit of thanksgiving and love for all mankind. now she comes back to her room weary and discouraged, as we nearly all do. she knows nothing of what her songs have accomplished, nothing of the wonderful influence that has been exercised. in her disheartened moment she sees the sunset in the dark cloud and thinking over the day she would like to know what she really has done. yet she checks herself and returns to her morning hymn and keeps her faith and trust. "results belong to the master, thou hast no need to measure them." she becomes very humble, willing, and submissive to the hard task of the morrow. little she dreams of the revelation that will come of the secrets of her own life and family. "we know not what we shall be." each of us at the close of life lies down without realizing our relation to the infinite, without realizing that we are children and heirs. blessed is he who feels that his hymn is also "true in some sense or other," that life is true and that each one performs some work and it is not for us to say whether it is great or small. they who wrought but one hour received the same wages as they who wrought the whole day. deeply symbolical, allegorical, and typical in the poetic sense of human life is pippa's closing thought as she lies down to sleep. "oh what a drear dark close to my poor day! how could that red sun drop in that black cloud? ah, pippa, morning's rule is moved away, dispensed with, never more to be allowed! day's turn is over, now arrives the night's. oh, lark, be day's apostle to mavis, merle and throstle, bid them their betters jostle from day and its delights! but at night, brother howlet, over the woods, toll the world to thy chantry; sing to the bats' sleek sisterhoods full complines with gallantry; then, owls and bats, cowls and twats, monks and nuns, in a cloister's moods, adjourn to the oak-stump pantry! now, one thing i should like to really know: how near i ever might approach all these i only fancied being, this long day: --approach, i mean, so as to touch them, so as to ... in some way ... move them--if you please, do good or evil to them some slight way. for instance, if i wind silk to-morrow, my silk may bind and border ottima's cloak's hem. ah, me, and my important part with them, this morning's hymn half promised when i rose! true in some sense or other, i suppose. god bless me! i can pray no more to-night. no doubt, some way or other, hymns say right. all service ranks the same with god, with god, whose puppets, best and worst: are we; there is no last nor first." [she sleeps] * * * * * the morning league of the school of expression is a band of the students, graduates and friends of the school of expression who are trying to keep their faces toward the morning. if you wish to join, when you wake get up out of the right side of the bed, that is, stretch, expand, breathe deeply and laugh. fill with joyous thoughts and their active expressions the first minutes of the day. note the effect, and consider yourself initiated. try as far as possible every day to realize the league's unfoldment suggestions . smile whenever tempted to frown; look for and enjoy the best around you. . think, feel or realize something in the direction of your ideals and, in some way, unite your ideals with your every-day work and play. . see, hear or read, i. e., receive an impression from something beautiful in nature, art, music, poetry, literature or the lives of your fellow-men. . express the best that is in you and awaken others to express the best in them. . serve some fellow being by listening, by kind look, tone, word or deed. . share in some of the great movements for the betterment of the race. that is, use your principles of expression to help in such movements as: . expression in life (text book, "the smile"); . expression and health (text book, "how to add ten years to your life"); . expression and education in the nursery; mothers' clubs; . voice in the home; . reading in the public schools; . speaking in high schools and colleges; . speaking clubs; . browning clubs (text book, "browning and the dramatic monologue"); . dramatic clubs; . religious societies; . boy scouts; . campfire girls; . peace movements; . women's clubs; and suffrage organizations; . reforms; . teachers' clubs; . school of expression summer terms; . preparation for the school of expression; . home studies; . advanced steps of the school of expression. send your name and address with ten nominations for members with $ . for the two league text books, "the smile" and "how to add ten years to your life," and you will be recorded a member. one set of books will do for a family, other books at teachers' or introductory prices. there are no fees. the entire net returns from the league books will be devoted to the endowment of the school of expression, the home of the league. write frankly and freely asking any counsel, and making any suggestions to the president of the league. dr. s. s. curry, pierce bldg. copley square, boston, mass. * * * * * morning league questions for report text-books--"the smile" and "how to add ten years to your life" after a week's exercise for a few minutes either on waking up or on retiring, write out a report of your experiences or answer the following questions. it is not necessary to repeat the questions, simply use figures. these questions follow the first series, published at the close of "the smile." . do you practice the exercises on waking in the morning? . what exercises do you usually take? how long? . what are some of the effects of these exercises? . how many times do you repeat each exercise? . do you practice exercises in dual, triple, or quadruple rhythm? . can you keep your chest expanded and laugh at the same time? . can you keep your chest fully expanded and pivot the torso? . do you feel great satisfaction after stretching? . what constrictions or congestions have you found? a. in the region of the stomach b. chest c. neck d. face e. scalp f. back . do you find any special weaknesses? . do you walk with expanded chest? . do you walk rhythmically? . can you keep your chest well expanded during the stretch? . do you practice exercises standing at an open doorway? . have you a pole from which you swing in your closet? . do you sleep well? . what exercises do you take on retiring? . do you relax completely in the middle of the day? . what chaotic movements have you discovered in your standing? in sitting? in walking? in lying down? . do you breathe through your nose or through your mouth, especially when asleep? . do you sleep with your windows wide open? . can you laugh out a tone? . taking a full breath and laughing, do your feel your throat passive? . can you co-ordinate an open throat and active retention of breath in laughing out a tone? . after walking a short distance do you feel exhilaration or depression? . do you use soft gentle tones in every day conversation? . when talking to someone who speaks in a high pitch can you act in the opposite way, and speak in your softest tones? . can you make tone as easily as you smile? for other questions, see "the smile." province of expression. principles and method of developing delivery. an introduction to the study of the natural languages, and their relation to art and development. by s. s. curry, ph.d., litt.d. $ . ; to teachers, $ . , postpaid. your volume is to me a very wonderful book,--it is so deeply philosophic, and so exhaustive of all aspects of the subject.... no one can read your book without at least gaining a high ideal of the study of expression. you have laid a deep and strong foundation for a scientific system. and now we wait for the superstructure.--professor alexander melville bell. it is a most valuable book, and ought to be instrumental in doing much good.--professor j. w. churchill, d.d. a book of rare significance and value, not only to teachers of the vocal arts, but also to all students of fundamental pedagogical principle. in its field i know of no work presenting in an equally happy combination philosophic insight, scientific breadth, moral loftiness of tone, and literary felicity of exposition.--william f. warren, d.d., ll.d., of boston university. lessons in vocal expression. the expressive modulations of the voice developed by studying and training the voice and mind in relation to each other. eighty-six definite problems and progressive steps. by s. s. curry, ph.d., litt.d. $ . ; to teachers, $ . , postpaid. it ought to do away with the artificial and mechanical styles of teaching.--henry w. smith, a.m., professor of elocution, princeton university. through the use of your text-book on vocal expression, i have had the past term much better results and more manifest interest on the subject than ever before.--a. h. merrill, a.m., late professor of elocution, vanderbilt university. the subject is handled in a new and original manner, and cannot fail to revolutionize the old elocutionary ideas.--mail and empire, toronto. it is capital, good sense, and real instruction.--w. e. huntington, ll.d., ex-president of boston university. imagination and dramatic instinct. function of the imagination and assimilation in the vocal interpretation of literature and speaking. by s. s. curry, litt.d. $ . ; to teachers, $ . , postpaid. dr. curry well calls the attention of speakers to the processes of thinking in the modulation of the voice. every one will be benefited by reading his volumes.... too much stress can hardly be laid on the author's ground principle, that where a method aims to regulate the modulation of the voice by rules, then inconsistencies and lack of organic coherence begin to take the place of that sense of life which lies at the heart of every true product of art. on the contrary, where vocal expression is studied as a manifestation of the processes of thinking, there results the truer energy of the student's powers and the more natural unity of the complex elements of his expression.--dr. lyman abbott, in the outlook. address: book dept., school of expression, pierce bldg., copley square, boston, mass. mind and voice. principles underlying all phases of vocal training. the psychological and physiological conditions of tone production and scientific and artistic methods of developing them. a work of vital importance to every one interested in improving the qualities of the voice and in correcting slovenly speech. pages. by s. s. curry, litt. d. $ . , postpaid. to teachers, $ . , postpaid. it is indeed a masterly and stimulating work.--amos r. wells, editor christian world. it is a book that will be of immense help to teachers and preachers, and to others who are using their vocal organs continuously. as an educational work on an important theme, the book has a unique value.--book news monthly. there is pleasure and profit in reading what he says.--evening post (chicago). fills a real need in the heart and library of every true teacher and student of the development of natural vocal expression.--western recorder (louisville). get it and study it and you will never regret it.--christian union herald (pittsburg). foundation of expression. fundamentals of a psychological method of training voice, body, and mind and of teaching speaking and reading. problems; choice passages. a thorough and practical text-book for school and college, and for private study. by s. s. curry, litt. d. $ . ; to teachers, $ . , postpaid. it means the opening of a new door to me by the master of the garden.--frank putnam. mastery of the subject and wealth of illustration are manifest in all your treatment of the subject. should prove a treasure to any man who cares for effective public speaking.--professor l. o. brastow, yale. adds materially to the author's former contributions to this science and art, to which he is devoting his life most zealously.--journal of education. may be read with profit by all who love literature.--denis a. mccarthy, sacred heart review. it gets at the heart of the subject and is the most practical and clearest book on the important steps in expression that i have ever read.--edith w. moses. how splendid it is; it is at once practical in its simplicity and helpfulness and inspiring. every teacher ought to be grateful for it.--jane herendeen, teacher of expression in jamaica normal school, n. y. best, most complete, and up-to-date.--alfred jenkins shriver, ll.b., baltimore. public speakers and especially the young men and women in high schools, academies, and colleges will find here one of the most helpful and suggestive books by one of the greatest living teachers of the subject, that was ever presented to the public.--john marshall barker, ph.d., professor in boston university. address: book dept., school of expression, pierce bldg., copley square, boston, mass. browning and the dramatic monologue. nature and peculiarities of browning's poetry. how to understand browning. the principles involved in rendering the monologue. an introduction to browning, and to dramatic platform art. by s. s. curry, litt. d., $ . ; to teachers, $ . , postpaid. it seems to me to attack the central difficulty in understanding and reading robert browning's poetry.... it opens a wide door to the greatest poetry of the modern age.--the rev. john r. gow, president of the boston browning society. a book which sheds an entirely new light on browning and should be read by every student of the great master; indeed, everyone who would be well informed should read this book, which will interest any lover of literature.--journal of education. spoken english. a method of co-ordinating impression and expression in reading, conversation, and speaking. it contains suggestions on the importance of observation and adequate impression, and nature study, as a basis to adequate expression. the steps are carefully arranged for the awakening of the imagination and dramatic instinct, right feeling, and natural, spontaneous expression. pages. by s. s. curry, litt. d., ph.d. price, $ . ; to teachers, $ . , postpaid. every page had something that caught my attention. you certainly have grasped the great principle of vocal expression.--edwin markham. those who aim at excelling in public utterance and address may well possess themselves of this work.--journal of education. the specialist in reading will wish to add it to his book-shelf for permanent reference.--normal instructor. a masterly presentation of ideas and expression as applied in a wide range of excellent selections.--the world's chronicle. little classics for oral english. a companion to spoken english. the problems correspond by sections with spoken english. the books may be used together or separately. the problems are arranged in the form of questions which the student can answer properly only by rightly rendering the passages. it is a laboratory method for spoken english, to be used by the first year students in high school or the last years of the grammar school. pages. by s. s. curry, litt. d. price, $ . ; to teachers, $ . , postpaid. i am using little classics for oral english in two classes and believe it is the most satisfactory text that i have used. the students seem to be able to get easily the principles from your questions and problems.--elva m. forncrook, st. nor. sch., kalamazoo, mich. a fine collection of fine things especially suited to young people. every teacher of reading and english in our secondary schools ought to have the book.--prof. lee emerson bassett, leland stanford university, cal. address: book dept., school of expression, pierce bldg., copley square, boston, mass. * * * * * what students and graduates think of the school of expression "we know that there is something big here. if only we can get it out to the world."--caroline a. hardwick (philosophic diploma), instructor in reading and speaking, wellesley college. "at no other institution is it possible to secure the training one secures at the school of expression. it is far broader than a mere training for speaking. it is a fundamental training for life."--florence e. lutz (philosophic diploma), instructor in pantomime, new york city. "the school of expression taught me how to live. i think its training of the personality is its greatest work."--f. m. sargent (dramatic artist's diploma). "i feel deeply indebted to the school for some of the best and most lasting inspiration i have received for my own work as a teacher of my fellow-men."--luella clay carson, pres. of mills college. "the success i have attained in my profession as a reader, i owe directly to the advanced methods of the school of expression."--caroline foye flanders (artistic diploma), public reader, manchester, n. h. "the school of expression of boston is the most thorough and best in the country. it is different from all other schools. i wish i could talk to any who intend taking a course of study.--i would say, go to the school of expression and if there is anything in you, they will bring it out; they will teach you to know yourself; they will show you what you are in comparison with what you may become, and they will begin with the cause and start from the bottom."--hamilton colman, member richard mansfield co. "when i was your student you held before me intellectual and ethical ideals which i am still trying to realize."--charles l. white, d.d., ex-president colby college. "the same principles of education which have installed manual training in public schools are even more applicable to the training of men's souls to rational self-expression. dr. curry will some day be recognized to have been an educational philosopher for having championed principles no less true of the spoken word than of every form of creative self-expression."--dean shailer mathews, university of chicago. "the whole world ought to learn about the school of expression and your discoveries."--rev. j. stanley durkee (speaker's diploma), boston. * * * * * books by s. s. curry, ph.d., litt.d. more than any man of recent years, dr. curry has represented sane and scientific methods in training the speaking voice.--dr. shailer mathews, university of chicago. of eminent value.--dr. lyman abbott. books so much needed by the world and which will not be written unless you write them.--rev. c. h. strong, rector st. john's church, savannah. foundations of expression. a psychological method of developing reading and speaking. practical problems. choice passages adapted to classes in reading and speaking. $ . ; to teachers, $ . , postpaid. lessons in vocal expression. the expressive modulations of the voice developed by studying and training the voice and mind in relation to each other. definite problems and progressive steps. $ . ; to teachers, $ . , postpaid. imagination and dramatic instinct. function of imagination and assimilation in the vocal interpretation of literature and speaking. $ . ; to teachers, $ . , postpaid. mind and voice. principles and methods in vocal training. pp. $ . ; to teachers, $ . postpaid. browning and the dramatic monologue. nature and peculiarities of browning's poetry. principles involved in rendering the monologue. introduction to browning, and to dramatic platform art. $ . ; to teachers, $ . , postpaid. province of expression. principles and methods of developing delivery. an introduction to the study of natural languages, and their relation to art and development. $ . ; to teachers $ . , postpaid. vocal and literary interpretation of the bible. introduction by prof. francis g. peabody, d. d., of harvard university. $ . ; students' edition, $ . , postpaid. classics for vocal expression. gems from the best authors for voice and interpretation. in use in the foremost schools and colleges. $ . ; to teachers, $ . , postpaid. spoken english. a psychological method of developing reading, conversation and speaking. a book for junior students or teachers. pages. $ . ; to teachers, $ . , postpaid. little classics for oral english. companion to spoken english. introductory questions and topics. may be used with spoken english or separately. questions and topics correspond. fresh and beautiful selections from best authors. pages. $ . ; to teachers, $ . , postpaid. the smile. introduction to action through an example. $ . . to members of the morning league, $ . , postpaid. how to add ten years to your life. nature of training with short, practical program. $ . . to members of the morning league, $ . , postpaid. write to dr. curry about the morning league; summer terms; home studies; school of expression; new books, or for advice regarding your life work. address: book department, school of expression, pierce bldg., copley square, boston, mass. . new zealand. mental defectives and sexual offenders. report of the committee of inquiry appointed by the hon. sir maui pomare, k.b.e., c.m.g., minister of health. * * * * * _laid on the table of the house of representatives by leave._ * * * * * constitution of the committee. hon. w. h. triggs, m.l.c., chairman. sir donald mcgavin, kt., c.m.g., d.s.o., m.d. (lond.), f.r.c.s. (eng.), director-general of medical services, defence department. sir frederick truby king, kt., c.m.g., m.b., b.sc. (public health) (edin.), director division of child welfare, department of health. j. sands elliott, esq., m.d., bac. surg. (edin.), chairman of the council of the n.z. branch of the british medical association. miss ada g. paterson, m.b., ch.b. (n.z.), l.m. (dublin), director division of school hygiene, department of health. c. e. matthews, esq., under-secretary for justice and controller-general of prisons, &c. j. beck, esq., officer in charge special schools branch, education department. secretary: j. w. buchanan, esq. * * * * * contents. part i.--introductory and historical. page section .--=origin and scope of inquiry=: mental deficiency, increase of; north canterbury hospital board and others suggest inquiry; committee, personnel; nature of inquiry; places visited and inspected; sittings, date and place of; witnesses examined, and work done; appreciation of services rendered; value of memoranda supplied by sir george newman, secretary of state for the united states, dr. e. s. morris (tasmania), dr. helen macmurchy (ottawa), and dr. eric clarke (toronto); secretarial services section .--=two distinct questions=: mental defectives and sexual perverts, comments on part ii.--problem of the feeble-minded. section .--=a menace to modern civilization=: feeble-minded, danger of unrestricted multiplication; lothrop stoddart's views; american army, psychological test of; results and deductions section .--=heredity= _v._ =environment=: genetics and heredity; heredity and environment, aspects reviewed; degenerate families, life-histories; dr. macgregor, deductions from his report; degenerate stocks imported, effect of; environmental factor, importance of; pre-natal and post-natal care, value of; housing problem; relationship of impaired nutrition, debility, and disease to impaired control; dietetics and child welfare; picture-shows, effect on children, and recommendations; venereal disease committees' report as to effect of syphilis, &c.; director division of school hygiene, attention drawn to report; excessive competition, effect on school-children section .--=illustrative cases of hereditary degeneracy=: juke family; kallikak family; new zealand cases cited; sir robert stout's comments section .--=elements of the problem=: basic phases, registration, educational care and training of feeble-minded children, oversight and supervision; educational curriculum for various groups; residential schools; farm and industrial colonies for segregation section .--=estimates as to numbers of mental defectives=: education department returns; retardation, problem of; feeble-minded and epileptic cases, return showing section .--=study of feeble-minded and delinquent children=: methods employed in other countries; united states of america; new zealand; need of psychological experts; tredgold, quotation from section .--=method of dealing with mental defectives in new zealand--present legal provision for notification and education of feeble-minded children and for care of custodial feeble-minded adults and children=: education act, ; provision of; "feeble-minded," definition of; mental defectives act, ; english mental deficiency act; public schools, special classes; epileptic children, education of; otekaike and richmond special schools; nature of institutions and training, with suggestions; caversham industrial school; weraroa boys' training-farm; committal, nature of; value of home life in comparison with institutional section .--=children's courts=: committee's recommendations; clinics for physical and psychological examination section .--=policy for the future=: notification; english commission, , basic principles laid down; register of feeble-minded; eugenics board; dr. gray's suggestions; psychiatrists, suggested appointment; eugenic board, proposed duties and powers; departments to control feeble-minded; marriage and carnal knowledge with feeble-minded; parents' and guardians' responsibilities section .--=the question of sterilization=: operations, nature of; x-rays, use of; american laws; dr. h. laughlin, chicago, views; central association for mental welfare of great britain, opinion on sterilization; evidence in support of sterilization; committee's opinion and recommendation; eugenic board's powers section .--=segregation= section .--=the question of expense=: cost to state for want of supervision, case cited; humanitarian and national aspects section .--=immigration=: introduction of feeble-minded and undesirables from overseas; medical inspection of intending immigrants; system in force; committee's suggestions; ordinary passengers from overseas, medical supervision of; "prohibited immigrants," definition of section .--=summary of findings and recommendations= part iii.--sexual offenders. section .--=scope and origin of the inquiry=: prisons board, resolution passed; medical and surgical reports; indeterminate sentence; segregation section .--=seriousness of the evil=: sexual offenders, numbers serving sentence; government statistician's return of persons sentenced section .--=types of offences=: sexual offences; various classes, with comments on; types found in prisons; inspector of prisons' opinion; sexual perverts, cure of section .--=suggested remedies=: corporal punishment; inspector-general of mental hospitals' recommendations; =sterilization and desexualization=; castration; sterilization; british medical association, n.z., motion passed; vasectomy and castration; committee's recommendation section .--=scientific treatment and segregation with indeterminate sentence=: medical examination; indeterminate sentence; women and children, protection of; mr. hawkins's evidence on control of sexual perverts section .--=summary of recommendations=: crimes act; prisons board, powers of; psychiatrist, appointment and duties; eugenic board, power to advise prisons board; sterilization; =concluding remarks= appendix.--=past mistakes in immigration=: extract from report on hospitals and charitable institutions of the colony, , by the late dr. macgregor, inspector-general. =the health of school children=: extract from the report of the director of the division of school hygiene, . =return showing sexual offenders= serving sentence in new zealand prisons, . =table showing the number of sexual offenders sentenced under respective headings in new zealand prisons. some illustrative histories= * * * * * the hon. the minister of health, wellington. sir,-- the committee of inquiry into mental defectives and sexual offenders appointed by you to inquire into and report upon the necessity for special care and treatment of mental defectives and sexual offenders in new zealand have the honour to submit herewith their report. part i.--introductory and historical. section .--origin and scope of inquiry. for a considerable time there has been a growing feeling of anxiety among the public owing to the number of mental defectives becoming a charge upon the state, and also the alarming increase in their numbers through the uncontrolled fecundity of this class. furthermore, owing to the frequency of sexual offences, many of a most revolting character, there was a strong demand that some action should be taken to prevent further acts of this nature; it being suggested that the law should be altered to make it possible for surgical operations to be performed upon these offenders. the north canterbury hospital board considered the need for action in this matter so great that they set up a committee to go into the question and take evidence, which was done, and various recommendations were made to the government. a perusal of departmental files reveals that many persons and social bodies have urged upon the government the desirability of setting up a committee or commission of inquiry to go into this subject. the minister of health duly considered the representations made, and appointed the following committee to inquire into the question:-- the hon. w. h. triggs, m.l.c. (chairman). sir donald mcgavin, kt., c.m.g., d.s.o., m.d. (lond.), f.r.c.s. (eng.). sir f. truby king, kt., c.m.g., m.b., b.sc. (public health) (edin.). j. sands elliott, esq., m.d., bac. surg. (edin.), chairman of the council of the british medical association (new zealand branch). miss ada g. paterson, m.b., ch.b. (n.z.), l.m. (dublin). c. e. matthews, esq., under-secretary for justice and controller-general of prisons, &c. j. beck, esq., officer in charge, special schools branch, education department. the function and duty laid upon the committee was as follows:-- ( .) to inquire and report as to the necessity for special care and treatment of the feeble-minded and subnormal, and to propose the general means by which such care and treatment, if any, should be provided. ( .) to inquire and report as to the necessity for the treatment of mental degenerates and persons charged with sexual offences, and to recommend forms of treatment for the various types of cases. the minister of health expressed his desire that the committee should hear such evidence and representations on the above-mentioned matters as might be necessary fully to inform the committee on the questions referred to it, and further suggested to the committee that the various organizations and persons likely to be interested should be notified that the committee would, at a certain place and date, hear any evidence they might desire to tender. the following places were visited and inspected by the committee: the myers special school, auckland; the waikeria prison reformatory; the tokanui mental hospital, waikeria; the new plymouth prison; the boys' training-farm, weraroa; the point halswell reformatory for women, wellington; the special school for girls, richmond, nelson; the mental hospital, nelson; the mental hospital, stoke, nelson; the te oranga home, burwood, christchurch; the paparua prison, templeton; the special school for boys, otekaike; the caversham industrial home for girls, dunedin; the borstal institution, invercargill. sittings were held at various centres in new zealand, and a large number of witnesses were examined, as shown in the following table:-- -------------------------+------------------------------------------ places and dates of | sittings. | witnesses examined or work done. -------------------------+------------------------------------------ wellington, rd may, |preliminary meeting. . (forenoon only) | wellington, th may, |dr. clark, school medical officer, napier. . (forenoon only) |mr. j. caughley, m.a., director of education. |professor j. tennant, professor of education, | victoria college. wellington, nd june, |mr. n. r. mckenzie, inspector of schools, . (forenoon only) | education department. |miss n. valentine, education department. |miss barlow, education department. |dr. elizabeth gunn, school medical officer, | wanganui. wellington, th june, |mrs. mchugh, health patrol, wellington. . (afternoon only) |father mcgrath, representing his grace the | archbishop of the roman catholic church. |mr. t. p. mills, superintendent, presbyterian | orphanage and probation officer. |dr. jeffreys, medical superintendent, porirua | mental hospital. auckland, th june, |dr. hilda northcroft } representing the . |dr. kenneth mackenzie } british medical |dr. e. roberton } association, | } auckland branch. |dr. mildred staley. |dr. j. r. macredy, school medical officer, | auckland. |canon f. w. young, council of christian | churches, auckland. |dr. fitt, professor of education, auckland | university. |mrs. nicoll. |mrs. watson. auckland, th june, |dr. milsom, representing the british medical . | association, auckland branch. |professor anderson, professor of moral and | mental philosophy, auckland university. |mr. j. cupit, juvenile probation officer. |mr. w. e. a. gibbs. |professor sperrin-johnson, professor of | biology, auckland university. |mr. h. binstead, lecturer on psychology, | training school, auckland. |rev. jasper calder. |mr. w. s. j. dales. |dr. wilkie, school medical officer, auckland. auckland, th june, |sister hannah, representing the national . | council of women. |miss m. girdler, st. mary's home, otahuhu. |mr. c. w. carter. |rev. t. k. jeffreys, presbyterian social | service association. |mr. j. w. poynton, s.m. |mr. n. law, headmaster, normal school. |dr. beattie, medical superintendent, | auckland mental hospital. |dr. d. n. murray, prison medical officer. |visit of inspection to the myers special | school, queen street, auckland. hamilton, th june, |dr. douglas. . |dr. f. s. pinfold. |mr. phillip goodwin, juvenile probation | officer. waikeria reformatory, |dr. h. l. gribben, superintendent, waikeria th june, . | reformatory, and medical superintendent of | the tokanui mental hospital. |dr. macpherson, tokanui mental hospital. |visit of inspection paid to waikeria | reformatory and tokanui mental hospital. new plymouth, |miss tootell, boarding-out officer, wanganui. th june, . |dr. r. c. brewster, gaol surgeon, new | plymouth. |mr. e. t. holden, secretary, new plymouth | hospital board. |visit paid to new plymouth prison. otekaike, nd july, |miss wylie, head teacher of special school. . |mr. william meikleham, manager of special | school. |visit paid to special school for boys and | farm at otekaike. dunedin, rd july, |mrs. joan murray, representing society for . | protection of women and children. |dr. e. irwin, school medical officer. |mr. j. lock, juvenile probation officer. |dr. a. m. mckillop, superintendent, mental | hospital, seacliff. |dr. a. r. falconer, medical superintendent, | dunedin hospital. |mr. g. m. galloway, representing the society | for protection of women and children. invercargill, th july, |mr. m. hawkins, inspector of the prisons . | department and superintendent of the | borstal institution. |mr. mccarroll, juvenile probation officer, | education department. |mr. pryde, secretary of the hospital board. |mr. mclean, hon. secretary of the prisoners | aid society. |visit of inspection paid to borstal | institution and farm. dunedin, th july, . |visit of inspection paid to caversham | industrial school for girls. dunedin, th july, . |dr. marshall mcdonald } representing the |dr. kenneth ross } british medical | } association, | } dunedin branch. |miss ralston, inspector of industrial and | special schools. |dr. stuart moore. |mr. a. m. paterson. christchurch, th july, |dr. f. v. bevan-brown, representing the . | british medical association, christchurch | branch. |dr. c. l. nedwill, prison medical officer. |miss cardale, representing the national | council of women. |dr. a. c. thomson, representing the british | medical association. |rev. p. revell, secretary, prison gate | mission. |mrs. herbert. |miss hunt, superintendent, addington | reformatory. |mr. j. a. blank, attendance officer, | education department. |miss baughan, official visitor to the | addington reformatory. christchurch, th july, |dr. crosbie, medical superintendent, . | mental hospital. |dr. levinge. |mr. gumming, juvenile probation officer, | timaru. |mr. william reece, member of the prisons | board. |professor chilton, professor of biology, | canterbury college. |mr. c. t. aschman, headmaster, normal school. |miss howlett, representing the national | council of women and women's christian | temperance union. |miss edwards, manager of the receiving home, | christchurch. |the hon. g. w. russell. |visit of inspection paid to te oranga home, | burwood. christchurch, th july, |dr. phillipps, school medical officer. . |professor shelley, professor of education, | canterbury college. |mr. a. bissett, juvenile probation officer, | christchurch. |visit of inspection paid to paparua prison, | templeton. wellington, th july, |colonel bray, secretary, men's department, . (forenoon only) | social service work, salvation army. |canon t. feilden taylor, social service | department of church of england. |professor kirk, professor of biology, | victoria college. |mr. f. s. shell, juvenile probation officer. wellington, th july, |dr. e. fenwick, representing the british . (forenoon only) | medical association, wellington branch. |mrs. brigadier glover, salvation army prison | officer and probation officer. |miss jean begg. |mr. r. w. bligh, white cross league | representative. wellington, th july, |visit of inspection to point halswell . | reformatory, wellington. levin, th august, . |visit of inspection to boys' training farm, | weraroa. nelson, nd august, |dr. gray, superintendent, mental hospital, . | nelson. |visit of inspection to special school for | girls, richmond. |visit of inspection to mental hospital, | stoke. |visit of inspection to mental hospital, | nelson. wellington, th |consideration of report. september, . | (forenoon only) | th september, . | " th september, . | " (afternoon only) | th september, . | " (afternoon only) | nd september, . | " (afternoon only) | th october, . | " (forenoon only) | th october, . | " (forenoon only) | nd october, . | " (forenoon only) | th october, . | " th october, . | " (forenoon only) | th october, . | " (forenoon only) | th november, . | " (forenoon only) | it will thus be seen that, apart from time spent in travelling, the committee have met on thirty-five days and have heard ninety-two witnesses in person. the committee would like to express their thanks to the witnesses, many of whom went to considerable trouble to collect information and prepare evidence. they are especially grateful to the british medical association for its willing co-operation and assistance; to the large number of members of the medical profession throughout the dominion who responded to the committee's request for information; to the authorities overseas for their response to requests for information; and to many other persons who by means of correspondence and literature have placed at the committee's disposal a large amount of information which has been of material assistance in the investigation; also to the various hospital boards throughout the dominion who so willingly placed their boardrooms at the disposal of the committee. sir george newman, the chief medical officer of the board of education and the ministry of health, england, very courteously supplied the committee with a valuable memorandum on the care of mental defectives in england and wales, while the secretary of state for the united states, through the good offices of the american consul-general, mr. edwin n. gunsaulus, kindly forwarded information supplied by the united states public health service regarding the legislation and regulations in force in various states where sterilization for eugenical purposes has been legalized. information of great value and interest has also been received from dr. e. s. morris, director of health, tasmania; from dr. helen macmurchy, department of health, ottawa; and from dr. eric clarke, toronto, assistant medical director, canadian national conference for mental hygiene. the committee further wish to make special mention of the services rendered by the secretary, mr. j. w. buchanan, whose work has been very heavy owing to the number of witnesses examined and the extent of ground covered in a comparatively short time. this would not have been possible but for the complete arrangements made by mr. buchanan, and the ability and energy which he showed generally in the discharge of his duties left nothing to be desired. section .--two distinct questions. before proceeding to the subject-matter of the committee's investigations and the conclusions arrived at it is necessary to point out as clearly and emphatically as possible that the questions submitted to the committee were entirely separate and distinct from each other. it is true that a certain proportion of mental defectives show their lack of self-control in regard to sex instincts and functions as in other respects. this is particularly the case with mentally defective girls, and constitutes one of the chief difficulties in dealing with them satisfactorily. some of this class find their way into prison on account of sexual offences, but it is very far from correct to suppose that all feeble-minded persons are sexual offenders, or that all sexual offenders are mentally defective. on the contrary, among sexual offenders of the worst type, those convicted of unnatural offences, are occasionally found to be persons possessing intellectual and artistic powers above the average. there is something wrong in their mental, moral, and emotional balance, as will be pointed out in the proper place, but, as a rule, it is not the "intelligence quotient" which is at fault. part ii.--problem of the feeble-minded. section .--a menace to modern civilization. the committee are of opinion that the unrestricted multiplication of feeble-minded members of the community is a most serious menace to the future welfare and happiness of the dominion, and it is of the utmost importance that some means of meeting the peril should be adopted without delay. the position is the more serious because, while the feeble-minded are extraordinarily prolific, there is a growing tendency among the more intellectual classes for the birth-rate to become restricted. an american writer, lothrop stoddart, in his striking book entitled "revolt against civilization," expresses the fear that the very foundations of civilization are being undermined. he finds reasons for great pessimism as regards the future in the results of the intelligence tests taken in the american army during the war. the american war department made psychological tests of , , officers and men, who were graded as follows:-- grade. percentage. mental age. a ½ - very superior intelligence. b - superior intelligence. c ½ average intelligence. (rarely capable of finishing high-school course.) c-- - low average intelligence. d inferior intelligence. d-- very inferior intelligence. assuming that these , , men are a fair sample of the entire population of , , (and stoddart says there is every reason to believe that it is a fair sample), this means that the average mental age of americans is only about fourteen; that , , , or nearly one-half of the whole population, will never develop mental capacity beyond the stage represented by a normal twelve-year-old child; that only , , will ever show superior intelligence; and that only , , can be considered "talented." "still more alarming," the author continues, "is the prospect of the future. the overwhelming weight of evidence indicates that the a and b elements in america are barely reproducing themselves, while the other elements are increasing at rates proportionate to their decreasing intellectual capacity; in other words, that intelligence is to-day being steadily bred out of the american population." the biologist davenport calculated that at present rates of reproduction , harvard graduates of to-day would have only fifty descendants two centuries hence, whereas , roumanians to-day in boston, at their present rate of breeding, would have , descendants in the same space of time. mr. lothrop stoddart emphatically scouts the view which is occasionally put forward to the effect that genius is a form of insanity, and that therefore one ought to be careful about discouraging the marriage even of epileptics and mentally unbalanced persons for fear a possible napoleon or julius cæsar or beethoven should be lost to the world. "careful scientific investigation," he says, "has clearly disproved this notion. for one thing, elaborate statistical studies of eminent persons have shown them to be less liable to insanity than the general population. of course, a considerable number of eminent men can be listed who unquestionably suffered from various neuropathic traits. but it was not those traits that made them eminent; on the contrary, these were handicaps. somewhere back in their ancestry a taint was introduced into a sound superior strain, and produced this disharmonic combination of qualities." section .--heredity _v._ environment. the committee feel bound to refer to the great strides made during the last half-century towards establishing laws and theories of genetics and heredity. unfortunately, terms such as the "integrity of the germ plasm" and "the mendelian law," while marking great advances in biological thought and science, have become too much associated in the public mind with a depressing and fatalistic notion that heredity determines everything and that environment can play but a very insignificant part in human evolution, development, and progress--physical, mental, or moral. such, of course, is not the case. in ultimate origin all evolution and all heredity are the outcome, summation, and expression of the effects of environmental influences, acting on the whole organism under certain laws of transmission. the laws of heredity, though as yet only partially determined, are already sufficiently ascertained to prove for practical purposes that, in order to promote integration and further progress in human evolution--not disintegration and degeneration--two things are essential and complementary. on the one hand, we must do everything possible in the direction of improving the nutrition, health, conditions of life, and habits of the community; and, on the other hand, we must promote and encourage parenthood on the part of the best and stablest stocks, and do everything in our power to discourage, or in the extreme cases even to prevent, proliferation of unfit and degenerate strains. for the purpose of the present inquiry we need merely state as a practical preliminary regarding heredity that it has been proved beyond question that if two feeble-minded persons marry they will most probably produce abundant offspring, of whom all may be subnormal, and a large proportion will become a burden on the state; and that if one such person is mated with a healthy individual an undue proportion of their children are likely to prove degenerate or defective, and the unsoundness will continue to make its appearance in succeeding generations. while local evidence confirmatory of this came before the committee, first place will be given to certain classic and exhaustive investigations and life-histories of degenerate families, going back many generations, such as no young country could possibly supply. however, the forcible and far-sighted report of the late dr. duncan macgregor (originally professor of mental science at otago university, and subsequently inspector-general of asylums, hospitals, and charitable aid), quoted in the appendix, shows clearly that some very degenerate stocks imported into this country under the active immigration policy of the "seventies" and "eighties" were already threatening, thirty-five years ago, to become a serious tax on the country, as well as tending to lower the high physical, mental, and moral standard established by the original pioneers and settlers. we shall now revert for the moment to the environmental factor. the first most pressing and immediate practical duty of the government and the community is to spare no pains to improve the status and environment of the family so as to promote the highest attainable standard of physical, mental, and moral health for the new generation--already in our midst or bound to arrive in the course of the next few years. it is becoming more and more widely recognized that by due attention to the pre-natal and post-natal care of mother and child an infinity of good can be done--indeed, a great deal is already under way in this direction throughout the dominion. but the committee are satisfied that much more ought to be done to ensure for children of the pre-school and school ages more generally favourable home conditions, and healthier environment and habits outside the home. in the meantime it is obvious that very little can be effected in the way of bettering the average heredity; but are we taking adequate measures in the direction of improving the environment of mother and child? the housing problem is still far from satisfactory; help in the home can scarcely be procured, and the rearing and care of children throughout the pre-school and school periods, in a large proportion of cases, is neither conducive to a high standard of nutrition, growth, and moral development, nor to the establishment of normal self-control, especially as regards sexual habits and manifestations. the committee cannot ignore the fact that the leading medical and psychological authorities lay it down as an axiom that the power of self-control is at its highest when the individual is physically active, well-nourished, and in perfect bodily health, and that impaired control always accompanies impaired nutrition, debility, and disease. it has been said, with profound wisdom and insight, that ultimately and fundamentally reproduction should be regarded as essentially "an exuberant phase of nutrition"; and there is no escaping the wide implication of schiller's aphorism that "love and hunger rule the world." in view of these considerations the committee feel compelled to refer to such serious handicaps to all-round health, control, and efficiency as the prevalence of wrong feeding habits--_e.g._, giving children food between meals and the insufficient provision of fresh fruit and vegetables in the daily diet and the abuse of sweets. other prominent and avoidable handicaps, seriously affecting many children throughout the dominion, which ought to receive more serious attention are insufficiency of sunlight and fresh air in the home and at school, insufficient daily outing and exercise, lack of adequate provision in the way of playgrounds and swimming-baths, and last, but not least, the highly injurious practice of frequenting "picture-shows." as the committee are called on to deal specially with the problem of increasing manifestations of sexual depravity they cannot pass by the fact that in the course of the last twenty years the younger members of the community have been spending a steadily increasing proportion of their time, during the most impressionable period of life, in what are liable to prove forcing-houses of sexual precocity and criminal tendencies. there is every reason for regarding the habit of "going to the pictures" without adequate restrictions as contributing seriously to precocious sexuality, and also to weakening the powers of inhibition and self-control in other directions--powers which are the distinctive attributes of the higher human being. alongside these considerations, the bodily harm done to the young by frequently spending their afternoons and evenings in hot, stuffy, overcrowded halls shrinks into insignificance, though serious enough in itself. the committee endorses the opinions expressed by education authorities, and by practically every organization throughout the dominion concerned with the welfare of children, upon the harmful effect of moving-picture shows as at present conducted. the committee sympathizes with proposals for reform along the following lines:-- ( .) stricter censorship, not only of films, but of picture posters, handbills, and advertisements. ( .) regulations as to the age of admission for children when unaccompanied by a responsible adult, and to such pictures as are not pronounced by the censor as suitable for children. ( .) proper safeguards for the morals of children and young persons within picture-theatres, including adequate supervision of the premises. the committee desire it to be clearly understood that in this report they have not particularly dealt with mental disabilities resulting from diseases such as syphilis, or toxic influences such as alcohol, drugs, &c. these questions have already been covered to some extent by the report of the venereal diseases committee, and in any case would involve too wide a field of investigation for the present inquiry. an authoritative summary taken from this year's report of the director of the division of school hygiene is quoted in the appendix as pointing out most of the faults and mistakes in environment and upbringing to which reference has been made, and because it draws special and much-needed attention to the injurious effects of overwork and excessive competition and the need for more sleep and rest. we would merely add to this very clear, practical statement that encouragement of excessive competition, inside or outside the school, for any purpose whatsoever, is costly and damaging to the whole being, and that, in the opinion of the committee, nothing needs to be impressed more strongly on parents and school-teachers than froebel's injunction, "give space and time and rest." section .--illustrative cases of hereditary degeneracy. _the juke family._ to show the close relationship existing between the criminal and the psychopath the record of the so-called juke family in america was compiled by r. l. dugdale. the descendants of one morbid couple were traced through five generations. whilst a small proportion were honest workers, the great majority were paupers, criminals, and prostitutes. of jukes practically one-fifth were born out of wedlock, were known to be syphilitic, had been in poorhouses, had been sentenced to prison, and of women of marriageable age were prostitutes. the economic damage inflicted upon the state of new york by the jukes in seventy-five years was estimated at more than $ , , , to say nothing of diseases and other evil influences which they helped to spread. a more recent investigation shows that , people have been studied; , were of juke blood and of "x" blood married into the juke family; of these, were paupers, while were criminals, and lives have been sacrificed by murder. in school-work did well, did fairly, while were retarded two or more years. it is known that never attended school; the school data for the rest of the family were unobtainable. there were intemperate and harlots. the total cost to the state has been estimated at $ , , . _the kallikak family._ the history of the kallikak family has been traced and fully described in detail by dr. goddard, and his study shows the hereditary nature and sociological bearings of feeble-mindedness. martin kallikak was a youthful soldier in the revolutionary war. at a tavern frequented by the militia he met a feeble-minded girl by whom he became the father of a feeble-minded son. in there were known direct descendants of this temporary union. it is known that of these were illegitimates; that were sexually immoral; that were confirmed alcoholics; and that kept houses of ill-fame. the explanation of so much immorality will be obvious when it is stated that of the descendants were known to be feeble-minded, and that many of the others were of questionable mentality. a few years after returning from the war this same martin kallikak married a respectable girl of good family. from this union individuals have been traced in direct descent, and in this branch of the family there were no illegitimate children, no immoral women, and only one man who was sexually loose. there were no criminals, no keepers of houses of ill-fame, and only two confirmed alcoholics. again the explanation is clear when it is stated that this branch of the family did not contain a single feeble-minded individual. it was made up of doctors, lawyers, judges, educators, traders, and landholders. _new zealand cases._ but it is not necessary to go to the records of older countries to find examples of this kind. unfortunately, this young dominion, whose history as a european settlement is comprised within the lifetime of its oldest inhabitants, is already reproducing some of the saddest problems of civilization which perplex the people of the old world. we started with every advantage in the shape of a favourable climate and rich natural resources. the original settlers were, for the most part, men and women of sturdy determination, enterprising spirit, and strong physique. in the "seventies" a vigorous public-works policy was inaugurated, and great efforts were made to introduce fresh population, the result being that undoubtedly a great impetus was given to settlement, and the country was fairly started on the road to prosperity. but, unfortunately, it is now only too apparent that insufficient care was taken in the selection of immigrants. the following extract from a statement made to the committee by sir robert stout, chief justice, and president of the prisons board, illustrates this point: "the prisons board has sometimes brought before it several persons of one family who have offended against our laws, and in the experience i had in and , when looking after our hospitals and charitable aid department in the general government, i found that people obtaining charitable aid had done so for three generations; that is, grandfather, father or mother, and children were all obtaining aid from the government because they were unable to maintain themselves. some of the cases were traced, and it was found that the grandfathers, or grandparents, had been originally in poorhouses in the homeland, and although they came to new zealand and had greater opportunities than they had in their homeland, yet their inability to provide for themselves continued." how serious the problem has already become will be seen from the following illustrative cases selected from a large number given in the evidence:-- _case no. ._ +--------------------------------+ | father: | mother: | | weak-minded. | weak-minded. | | | | +----------+----------+----------+ |female, | |born .| +----------+ |female, | |born .| +----------+ |female, | |born .| +----------+ |female, | |born .| +----------+ |female, | |born .| +----------+ |male, | |born .| +----------+ |male, | |born .| +----------+ |male, | |born .| +----------+ |female, | |born .| +----------+ all these children except one are feeble-minded, and when committed to the care of the state were found living under deplorable conditions. most of these children will require lifelong control in an institution. the total cost of maintaining this family will be approximately £ , . these children are cousins of another family under state control. there are four children, two of whom are simple-minded. the mother is feeble-minded, and the father died in a mental hospital. in this case the mothers of the children are sisters. _case no. ._ +----------------------------------+ | father: | mother: | | feeble-minded. | feeble-minded | | | and drunkard. | | | | +---------+-------------+----------+ |female, | |illegitimate,| |born . | +-------------+ |male, | |born . | +-------------+ |male, | |born . | +-------------+ |male, | |born . | +-------------+ |male, | |born . | +-------------+ |male, | |born . | +-------------+ |female, | |born . | +-------------+ |female, | |born . | +-------------+ |male, | |born . | +-------------+ |male, | |born . | +-------------+ |male, | |born . | +-------------+ all these children are feeble-minded and have been brought under state control shortly after birth. some are now in mental hospitals and some in special schools. all these children are lifelong custodial cases. the cost to the state for maintenance is approximately £ , , towards which amount the father has contributed but £ . _case no. ._ +----------------------------------------------------+ | father: | mother: | | old-age pensioner in | apparently weak mentally | | home for aged people. | and morally--at present | | | in reformatory home. | | | | +------------------+-------------------------+---------------------+ | . female. | female, female, male, | all these children | | prostitute | born born born | are illegitimate. | | residing with | . . . | reputed father a | | drunkard. | | drunkard and man of | | | male, | bad character. | | | born . | | +------------------+-------------------------+---------------------+ | . female. | male, male, female, | all these children | | prostitute and | born born born | are illegitimate. | | addicted to | . . . | in most cases the | | drink. | | father is unknown. | | | male, female, | | | | born . born . | | +------------------+-------------------------+---------------------+ | . female. | male, male, | both illegitimate. | | immoral and | born . born . | reputed fathers | | generally bad | | well-known bad | | character. | | characters. | | inmate of | | | | private | | | | reformatory. | | | +------------------+-------------------------+---------------------+ | . female. | female, female, | mother married a | | indifferent, | born born | widower with three | | married | . . | children. there are | | criminal, now | | three more the | | in prison. | female, born . | result of marriage | | | | maintained by the | | | | state. | +------------------+-------------------------+---------------------+ | . female. | female, female, | all delicate | | drunkard and | born born | neurotic types and | | married a | . . | difficult to | | drunkard | | manage. | | although man | female, female, | | | of good | born . born . | | | education. | | | | | female, born . | | +------------------+-------------------------+---------------------+ | . female. | male, born . | | | well-known | | | | prostitute, | | | | married member | | | | of notorious | | | | criminal | | | | family, and | | | | himself | | | | criminal. | | | +------------------+-------------------------+---------------------+ all these children, numbering twenty-one, were committed to the care of the state, in most cases shortly after birth. twelve of the children are illegitimate. the husband of daughter no. is also the father of one each of the offspring of daughters nos. and . most of the children are delicate and poorly developed, and at least six of them are definitely tubercular. the remainder are either neurotic or erratic in their conduct and have given a great deal of trouble in their upbringing. the total cost to the state for the maintenance of these children may be quoted at £ , , but of this amount £ has been recovered from the various men liable. it is difficult to assess the state's total commitment. if some of the children have to be maintained until they reach the age of twenty-one the additional cost will be £ , . there is the probability, too, that the offspring of these children will become charges upon the state. _case no. ._ +--------------------+---------------------+ | father: | mother: | | addicted to drink | drunkard and | | and degenerate. | morally deficient. | | | | +------------------------------------+----------------+ | | female, | | | born . | | +----------------+ | | male, | | | born . | |all these children are illegitimate |admitted special| |and are feeble-minded, requiring | school, . | |lifelong control. three are now +----------------+ |inmates of mental hospitals, and | female, | |in time the remainder of the | born . | |family at present in special +----------------+ |schools will be sent on to mental | male, | |hospitals. | born . | | +----------------+ | | male, | | | born . | | +----------------+ | | female, | | | born . | +------------------------------------+----------------+ | | male, | | | born . | |all probably feeble-minded. +----------------+ |not yet brought under | male, | |state control. | born . | | +----------------+ | | male, | | | born . | +------------------------------------+----------------+ an officer of the education department describes the home as "one of the dirtiest and most squalid homes i have seen." the cost (including past, present, and approximate future maintenance) to the state for the upkeep of this family is estimated at £ , . nothing has been paid by the parents towards the support of these children. in all probability, the remaining members of the family will be brought under state control at a probable cost of £ , . _case no. ._ +--------------------------------------------------+ | father: | mother: | | drunken waster; | feeble-minded helpless | | subnormal; | invalid. died shortly | | frequently in gaol. | after children committed | | | to care of state. | | | | +--------------------------------------------------+ |male, born . | |tubercular. partly | |self-supporting. | +------------------------+ |female, born . | |tubercular. suffers | |from epileptic seizures.| |inmate mental hospital. | |lifelong custody. | +------------------------+ |male, born . | |subnormal. may in | |time become partly | |self-supporting | |under favourable | |conditions. | +------------------------+ |male, born . | |mentally deficient. | |case for lifelong | |control. | +------------------------+ |male, born . | |mentally deficient. | |lifelong custodial | |case. | +------------------------+ |female, born . | |feeble-minded and | |badly nourished. case | |for permanent | |segregation. | +------------------------+ |male, born . | |very backward. may | |become partly | |self-supporting | |under favourable | |conditions. | +------------------------+ in the whole of this family was committed to the care of the state, and at least six of them will be lifelong cases. the cost to the state, computed up to twenty-one years in each case, is approximately £ , , but the additional future cost may easily be estimated at £ , , making in all the sum of £ , . the father was ordered to pay at the rate of s. a week, but the amount recovered from him to date is only £ . _case no. ._ +---------------------+-----------------------+ | father: | mother: | | subnormal. was a | has always been | | watersider, so | addicted to periodic | | dirty in habits | fits of insanity. | | that watersiders | has been in mental | | complained. a | hospital on several | | sexual case. | occasions. | | | | +--------------------------------+----------------+ | | female, | | | born . | | | subnormal. | | +----------------+ | | female, | | | born . | |these four children were | subnormal; | |committed to the care of |also delinquent.| |the state in . +----------------+ | | female, | | | born . | | | subnormal. | | +----------------+ | | female, | | | born . | | | subnormal. | |--------------------------------+----------------+ | | unknown | |not yet brought under +----------------+ |state control. | unknown | | +----------------+ | | unknown | +--------------------------------+----------------+ the approximate cost to the state of maintaining these four children will be £ , , less what is recovered from the father. up to the present the amount received from him is £ . should the other three children be brought under state control, the additional cost may amount to approximately £ , . this is a glaring case of persons being allowed to marry who are totally unfit to marry. a relative stated that the mother's mentality was in a shocking state at the time of marriage. the father has always been subnormal. the woman is too insane at times to attend to ordinary household duties or matters of ordinary personal cleanliness. at the time the children were committed the home was in a shockingly filthy condition, and at that time was one of the worst brought under the notice of the department in the district. the second girl (age fifteen) has had her hair cut for the sake of cleanliness by some kindly disposed well-wisher. the mother allowed the dirt to accumulate to such an extent that the whole of the girl's head was covered with a scab of dirt. she had to enter the hospital to have this removed. this was a most objectionable case. after the state took charge of these children the mother and father were still allowed to cohabit, with the result that three more children have been born. without doubt, these children will also be supported by the state. the father is a sexual case, and foster-parents of the children have objected to the father visiting them on account of the way he handles them. section .--elements of the problem. wallen, in his book "problems of subnormality," draws attention to three basic phases of the problem of the feeble-minded:-- "( .) the obligation of society to identify and register as early as possible all feeble-minded children. all students of social problems will concede that feeble-mindedness is one of the fundamental causes of our numerous social ills. it is a prolific source of poverty, destitution, all kinds of crimes against property and person, social immorality, illegitimacy, and of prolific and degenerate progeny. "there are few problems in present-day constructive social economics which are more important than the development of a state-wide and a nation-wide policy for the compulsory official identification and registration of feeble-minded children, particularly all those who come from homes where the conditions are not such as to guarantee continuous supervision and support. "( .) the proper educational care and training of feeble-minded children. the adequate discharge of this obligation involves segregating the feeble-minded in special classes as soon as they can be indubitably diagnosed and providing for them the type of training which will maximally develop those powers and aptitudes which they possess and which will maximally equip them for earning their livelihood. "( .) provision for continuous oversight and supervision over the feeble-minded." it is clear that if we wish to reduce the number of mentally defective and socially inadequate individuals we must not only consider measures for preventing as far as possible the transmission of hereditary defect, but must also provide for the youth of the country an environment and training calculated to encourage the development of its best powers. there is no doubt that unfavourable home conditions and unsuitable educational methods conspire to keep many children from realizing their full capabilities. this is especially true of the backward and feeble-minded. it is, moreover, wasteful and ineffective to force on children of poor mental receptivity and potentialities an educational curriculum devised for those of normal mentality, since the subnormal impede the general progress in an ordinary class, and in it they soon form a discouraged minority which learns to accept failure unquestioningly. untrained to perform the simple work which is within their power and in the achievement of which they might earn self-respect and happiness, they feel themselves to be aliens, and may cease to regard the laws of society in which they have no sense of membership. in such cases the community which might have benefited from their work had their potentialities been properly developed is burdened by their maintenance, and, further, if they are not law-abiding, has also the expense of segregating them in reformatories and gaols. hence it is clearly the duty of the state to adapt the educational curriculum to the requirements of various groups of children. the child who has been handicapped by illness and lack of opportunity, the child who is inherently dull and backward, must be distinguished from the child with nervous instability or definite mental defect. wherever possible, the training suitable for various improvable types of children should be arranged in connection with the ordinary public schools. but the curriculum must be modified to suit the need of the individual and should be directed with the object of making him a useful member of society. by this means these pupils are not deprived of that association with their normal fellows which is of such value as a preparation for their after-life in the community. for children whose homes are unsuitable or too remote from centres, who require more continuous supervision, or who tend to become delinquent, special residential schools will be necessary. these schools would also be used for those whose capabilities cannot be assessed without extended expert observation for a considerable period. the special school is to be regarded as a training-centre for such feeble-minded children as are expected as a result of the training received there to be fitted to take a place in the community and to perform useful work under adequate supervision. there is a danger of filling the special schools with children whose poor mental endowment renders them incapable of receiving benefit at all commensurate with the energy and expense devoted to them. such children are subjects for custodial institutions. institutional care is necessary for mentally defective persons whose helplessness or anti-social traits would render them either the victims of the unscrupulous or a menace to society. such individuals should be segregated in farm and industrial colonies, so that not only is the community freed from the responsibility of their presence, but they themselves are afforded opportunity of leading much happier and more useful lives, and of becoming, to some extent, self-supporting. all feeble-minded children within the community, whether in special classes, or on parole from an institution for the feeble-minded, or over school age, should be carefully supervised. it is clear that the problem of making provision for the feeble-minded and mentally abnormal in the community is first to be encountered in the schools, though there must be considered also a much smaller number of such low mental capacity that they have never sought admission there. in deciding the place of the feeble-minded in the community factors other than the degree of mental defect have to be considered. many feeble-minded individuals are capable of performing useful work, and provided they have no anti-social traits and can receive adequate care outside their permanent inclusion in an institution is undesirable, not only from consideration of their own well-being, but also from a social and economic standpoint. many feeble-minded individuals are so dependent upon routine that having once been trained in the regular performance of simple duties they find difficulty in breaking their methodical programme. in this way their lack of initiative is really protective, as it tends to keep them steadfastly at their labours. in the case of all feeble-minded persons living outside institutions, whether with relatives or otherwise, the state should, in the interest of both such feeble-minded individuals and of society, have the ultimate right of supervision. the magnitude of the task to be undertaken cannot be estimated unless we have some indication of how numerous are those for whom special measures must be adopted. the information given below must not be too literally interpreted, but will serve to throw some light upon existing conditions in new zealand. section .--estimates as to numbers of mental defectives. in the absence of a complete system of notification, which the committee consider is urgently necessary, any estimate as to the number of feeble-minded to be dealt with must be largely a matter of conjecture. from the annual report of the education department, however, interesting information is available showing the ages of the pupils in the several classes of the primary schools. the following table is considered worthy of reprinting in this report, for from the figures it supplies some idea may be formed of the number of backward and feeble-minded children attending primary schools. children of extremely low-grade mentality do not attend school as a rule, while feeble-minded children higher in the scale, discouraged by the unsuitable course of instruction and lack of sympathetic treatment, tend to leave school early. hence the number of feeble-minded children in any community must be considerably larger than the school records indicate. the following table shows the ages of pupils in the several classes of the primary schools. the numbers between the heavy horizontal lines represent those that, beginning school under six years of age spend an average of two years in the preparatory classes and one year in each of the standards. the numbers above the upper heavy lines have progressed at a greater rate than that indicated, and those below the lower lines have either begun school later or have progressed more slowly. the most arresting feature in the table (p. ) is the large number of children in classes lower than should be expected at their age. thus the preparatory classes had , pupils over the age of eight years. this number is certainly a considerable reduction on the total for the previous year, but it still represents no less than per cent. of the total roll of those classes. particular attention is being directed to the problem of retardation, and in some of the larger centres special classes for retardates have been established. it will also be seen that the actual number of children retarded three years or more, including the preparatory classes and up to standard iii--beyond which the higher grades of the feeble-minded do not progress as a rule--is , out of a total of , children attending school, or a trifle over per cent. in some countries three years' retardation is regarded as _primâ facie_ evidence of mental deficiency. probably new zealand has much the same proportion of mental defectives as other countries. this is stated by goddard to be between and per cent. of the population. a recent survey made by the education department of the children attending the primary schools in a typical area disclosed the fact that out of a total school population of , no fewer than pupils, constituting . per cent. of the total school enrolment, are retarded two years or more. some of these may be classed as dull normal; some may be suffering from remediable physical defects; others may be merely the victims of unfavourable circumstances, while others again may be what burt calls "late bloomers"--_i.e._, cases of slow development. many of them, however, will ultimately prove to be mental defectives. deficiency sometimes does not reveal itself definitely until the pre-adolescent period or early adolescence. of the total number on the school registers , or . per cent., are retarded three years or more. it is interesting to note from information supplied by mr. n. r. mckenzie, inspector of schools, that this is exactly the percentage of defectives discovered in the schools of a section of the city of toronto as the result of a psychological survey. it also corresponds with the number in the vancouver city schools, where nineteen special classes are operating with a school population of , --_i.e._, one class per , pupils. for the purpose of this report a preliminary survey from information supplied by social workers, school-teachers, police, hospital boards, &c., has been made by the education department of what may be regarded as the obviously feeble-minded and epileptic cases known to exist outside institutions in the dominion. the following figures show the number of such cases reported, but these figures are incomplete--the actual number must be greater:-- at th june, . feeble-minded. epileptic. age. male. female. male. female. under sixteen years over sixteen years ___ ___ __ __ _recapitulation._ males females _____ , _table showing ages of pupils in the several classes of the primary schools._ +---------------+---------------+---------------+---------------+ | | class p. | standard i. | standard ii. | | ages. +-------+-------+-------+-------+-------+-------+ | | boys. | girls.| boys. | girls.| boys. | girls.| +---------------+-------+-------+-------+-------+-------+-------+ | and under | , | , | .. | .. | .. | .. | | | | | | | | | | " | , | , | | | | | | | | | | | | | | " | , | , | , | , | | | | |================================ | | | " | , | , = , | , = , | , | | | | ================================| | " | , | , | , | , = , | , | | | | | | ================| | " | | | , | , | , | , | | | | | | | | | | " | | | | | , | , | | | | | | | | | | " | | | | | | | | | | | | | | | | " | | | | | | | | | | | | | | | | " | | | | | | | | | | | | | | | | " | | | | | | | | | | | | | | | | " | | .. | | | .. | | | | | | | | | | |over | .. | .. | .. | | .. | .. | +---------------+-------+-------+-------+-------+-------+-------+ |totals ( ) | , | , | , | , | , | , | +---------------+-------+-------+-------+-------+-------+-------+ +---------------+---------------+---------------+---------------+ | standard iii. | standard iv. | standard v. | standard vi. | |-------+-------+-------+-------+-------+-------+-------+-------+ | boys. | girls.| boys. | girls.| boys. | girls.| boys. | girls.| +-------+-------+-------+-------+-------+-------+-------+-------+ | .. | .. | .. | .. | .. | .. | .. | .. | | | | | | | | | | | .. | .. | .. | .. | .. | .. | .. | .. | | | | | | | | | | | | | .. | .. | .. | .. | .. | .. | | | | | | | | | | | | | | | .. | .. | .. | .. | | | | | | | | | | | , | , | | | .. | | | .. | |================ | | | | | | | , | , = , | , | | | | | |================================ | | | | | , | , = , | , = , | , | | | | | ================================= | | | , | , | , | , = , | , = , | , | | | | | ================================| | | | , | , | , | , = , | , | | | | | | | ================| | | | | | , | , | , | , | | | | | | | | | | | | | | | | | , | , | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | .. | .. | | | | | | +-------+-------+-------+-------+-------+-------+-------+-------+ | , | , | , | , | , | , | , | , | +-------+-------+-------+-------+-------+-------+-------+-------+ +---------------+-----------------+ | standard vii. | totals. | |-------+-------+--------+--------+ | boys. | girls.| boys. | girls. | +-------+-------+--------+--------+ | .. | .. | , | , | | | | | | | .. | .. | , | , | | | | | | | .. | .. | , | , | | | | | | | .. | .. | , | , | | | | | | | .. | .. | , | , | | | | | | | .. | .. | , | , | | | | | | | .. | | , | , | | | | | | | | | , | , | | | | | | | | | , | , | |===============| | | | | | , | , | | | | | | | | | , | , | | | | | | | | | | | | | | | | | | | | | +-------+-------+--------+--------+ | | | , | , | +-------+-------+--------+--------+ section .--study of feeble-minded and delinquent children. _methods employed in other countries._ in many parts of america and in some european countries the problem of the mentally backward and feeble-minded child receives close attention. the juvenile delinquent is also carefully studied. for children who fail to make good in school, or who are guilty of frequent misdemeanours, a system of intelligence testing and psychological analysis is carried out. a study is also made of family history and environmental influences. children who are "maladjusted to their environment" are kept under survey with a view to finding what is the difficulty and how it can be overcome. to quote from the "mental hygiene bulletin," published by the national committee for mental hygiene for the united states of america: "children showing definite problems are selected for more intensive study and treatment. the grossly mentally handicapped child, who is likely to become a social problem if not properly dealt with in childhood; the psychopathic and mentally maladjusted child, who later in life may develop mental disease; the child manifesting conduct disorders which may be the beginning of a delinquent or criminal career; the retarded child; the epileptic; the child with speech-defect or with some physical disability; the child with gross personality difficulties; the exceptionally brilliant child--all present problems that demand attention during the child's school life. such children are given a thorough physical examination, a careful psychiatric study, and an individual psychological examination, including a variety of psychological tests, not only to determine the child's intelligence rating, but, in so far as possible, his special abilities and disabilities. a social study is made of the child's home, school, and other environments to determine what factors may have unfavourably influenced the development of the child, and what forces may be utilized in securing the child's adjustments. the results of all these studies are given to the school authorities with recommendations relative to the needed adjustments." in new zealand there is need of increased facilities for the study of the individual child, and the services of psychological experts should be available in order to group children according to their mental equipment and special requirements. only those fully qualified to estimate accurately all the evidence available are fitted to decide the destiny of children. herein lies the danger of relying exclusively upon the use of mental tests. _mental tests_ are of definite value in enabling the observer to arrive at a conclusion regarding the general mental development of the subject, or to investigate some particular psychological function. a too exclusive dependence upon the result of the application of these tests, especially by a layman, would invariably lead to error. a comprehensive survey is necessary, taking into consideration such factors as family history, environment, physical condition, behaviour, temperament, &c. the observation, possibly for a considerable period of time, of an expert psychiatrist or psychologist may be necessary in order to arrive at an accurate estimate of the mental ability of the subject. in this regard we quote from tredgold, "mental deficiency": "there are, however, very many exceptions, particularly when we are dealing with the milder grades of deficiency, so that if serial tests are depended upon for the diagnosis of these cases they may be, and often are, very fallacious. i may say here that although it would, of course, be extremely valuable if we could devise tests which would accurately measure mental capacity, particularly that capacity and those qualities which are needed for social adaptation and maintenance, we have not yet succeeded in doing so. the mental factors which may be involved in this capacity for social adaptation, and which render the individual in need of care, supervision, or control, are many and varied, and there is even some danger that too much reliance upon serial tests may distract from the adequate investigation of these qualities and defects and lead to totally erroneous conclusions." there is no doubt, however, that in the hands of competent observers properly applied tests afford information of great value in assessing mental and moral capacity, but the observer must be competent. section .--method of dealing with mental defectives in new zealand. _present legal provision for notification and education of feeble-minded children, and for care of custodial feeble-minded adults and children._ the education act, , contains provision (see section ) for the establishment of special schools for the education and training of afflicted children (deaf, blind, feeble-minded, and epileptic) between the ages of six and twenty-one years, with provision in the case of inmates of special schools for extension of the period of detention where it is considered necessary in the public interest. for the purposes of this act,-- "'feeble-minded child' means a child who, not being an idiot or imbecile or otherwise a proper person to be sent to an institution under the control of the mental hospitals department, and not being merely backward, is by reason of mental or physical defect incapable of receiving proper benefit from instruction in an ordinary school, but is not incapable by reason of such defect of receiving benefit from instruction in a special school." "'epileptic child' means an epileptic child who is unfit by reason of severe or frequent epilepsy to attend an ordinary school, but is not idiot or imbecile or otherwise a proper person to be sent to an institution under the control of the mental hospitals department." section : "( .) it shall be the duty of the parent of any ... feeble-minded or epileptic child to provide efficient and suitable education for such child." "( .) if the parent of such child fails to provide such education for such child, or is deemed by the minister to be unable to provide such education, the minister may direct that such child be sent to such special school or other institution for the education of feeble-minded or epileptic children as he thinks fit." section : "every parent, teacher of a school (either public or private), constable, or officer of a charitable or kindred institution who is aware of the place of residence (either temporary or permanent) of a blind, deaf, feeble-minded, or epileptic child, and the householder in whose house any such child resides, shall send notification of the fact to the minister, giving name, age, and address of the child; and if any such person neglects or fails to comply with this provision, such person shall on conviction thereof be liable to a fine not exceeding one pound, or in the case of a second or subsequent offence, whether relating to the same or another child, not exceeding five pounds." section : "every public school shall be organized and conducted in accordance with regulations (a copy of which shall be conspicuously put up in the school): provided that the minister may, on the application of the board, sanction the establishment of special classes for backward children--that is, children who, through physical infirmity, absence from school, or otherwise, are below the average standard of education reached by other children of the same age." the mental defectives act, , divides mentally defective persons into six classes, as under:-- "'mentally defective person' means a person who, owing to his mental condition requires oversight, care, or control for his own good or in the public interest, and who, according to the nature of his mental defect, and to the degree of care, oversight, or control deemed to be necessary, is included in one of the following classes:-- "_class i:_ persons of unsound mind--that is, persons who, owing to disorder of the mind, are incapable of managing themselves or their affairs. "_class ii:_ persons mentally infirm--that is, persons who, through mental infirmity arising from age or decay of their faculties, are incapable of managing themselves or their affairs. "_class iii:_ idiots--that is, persons so deficient in mind from birth or from an early age that they are unable to guard themselves against common physical dangers, and therefore require oversight, care, or control required to be exercised in the case of young children. "_class iv:_ imbeciles--that is, persons who, though capable of guarding themselves against common physical dangers, are incapable, or if of school age will presumably, when older, be incapable, of earning their own living by reason of mental deficiency existing from birth or from an early age. "_class v:_ feeble-minded--that is, persons who may be capable of earning a living under favourable circumstances, but are incapable from mental deficiency existing from birth or from an early age of competing on equal terms with their normal fellows, or of managing themselves and their affairs with ordinary prudence. "_class vi:_ epileptics--that is, persons suffering from epilepsy." this is similar to the classification in the english mental deficiency act, which also includes the following definition:-- "'moral imbeciles'--that is, persons who from an early age display permanent mental defect, coupled with strong criminal or vicious propensities, on which punishment has little or no deterrent effect." in the opinion of the committee it is very important that a similar definition should be included in any amendment of the new zealand act. a magistrate may order the committal to an institution of any person coming within these definitions if he is satisfied that such person is mentally defective and two medical men give a certificate to that effect. persons coming under the description in classes i, ii, iii, or iv are committed to the mental hospitals, but there seems to be considerable reluctance both on the part of medical practitioners to certify and of magistrates to commit to a mental hospital epileptics and those described as "feeble-minded." evidence was given before the committee to the effect that there would not be the same disinclination to send these classes of patients to a special institution such as a farm colony or an industrial colony. apart from the residential special schools, special classes have been established in connection with public schools in each of the large centres of population throughout the dominion with promising results. the committee visited the special classes in one of the centres, and were impressed with the sympathetic attitude of the teachers towards their scholars and the happy appearance of the children, who seemed to be keenly interested and busy over their appointed tasks. there is as yet no special provision in new zealand for the education of epileptic children. fortunately, the number of these is apparently small, but, as in many cases it is undesirable for them to attend the ordinary classes of the elementary schools, the question of arranging for their tuition otherwise requires earnest consideration. following on legislative authority contained in the education act already referred to, provision for feeble-minded children, within the meaning of the act, was made by establishing the special school at otekaike, near oamaru, with accommodation for boys, and some years later a similar institution was opened at richmond, near nelson, with provision for about eighty girls. these institutions contain two separate divisions, providing for--( ) the training of children of school age, and ( ) the instruction of young persons over school age in handicraft and farm-work. both institutions have modern and well-equipped day schools with trained women teachers, and at otekaike the industrial division is provided with workshops and instructors in trades and handicrafts. the children are housed in modern and well-appointed cottage homes, each with accommodation for thirty-five, and are supervised by selected women attendants. the committee visited and inspected both otekaike and richmond, and were very favourably impressed with the healthy environment and careful management of these institutions, and with the humane and sympathetic methods adopted for the purpose of making the best of imperfect human material. at both places physical exercises, musical drill, and organized games form an important part of the training, and the teachers deserve commendation for the efficiency of the pupils in these respects and their general appearance of physical fitness. moral training and training in habits of personal cleanliness and prompt obedience form an important part of the curriculum, and the effects are noticeable in the quick movements and alert attitude of the inmates. the girls at richmond receive training in domestic work, needlework, knitting, darning, &c., according to their ability. the children are taught various kinds of handiwork, and by grouping them according to mental capacity they are given a school course modified to suit the individual. in the industrial division at otekaike, baskets, sea-grass furniture, and all kinds of wickerware and coir mats are well made, and are readily sold. bootmaking and repairing for the institution are also carried out by certain of the inmates under a practical man. attached to otekaike there is an area of land where farming, gardening, and fruitgrowing absorb most of the labour of the older inmates. at richmond the area of land available for cultivation is limited, but even so it occurred to the committee that something more might possibly be done in the direction of providing congenial and profitable work for the older girls, as, for instance, the growing of flowers for sale in the wellington markets. at otekaike, after training, the best types of the older inmates are placed out, usually with farmers in the district, and for the most part are leading useful lives under the supervision of the local juvenile probation officers of the education department. the matter of placing out girls from the school at richmond is obviously one of much greater difficulty. at both otekaike and richmond there is a growing group of custodial cases, due to the fact that in many instances the parents or guardians are either unable to provide proper protective measures for the children if released, or are unsuitable in other ways to have the control of them. on the other hand, there is reluctance on the part of medical practitioners to certify such cases for a mental hospital. it is very desirable, of course, that the special schools should be used as trying-out places for children whose mental equipment is questionable, but where after a reasonable trial it is evident that merely custodial care is required there should be some simple method of passing them on to farm colonies or suitable custodial homes. as a matter of fact, the school at richmond has its full complement of pupils, and as many cases have now to be refused admission it is urgently necessary that other provision should be made, especially for the older girls needing custodial care. mention should also be made of a visit paid by the committee to the industrial school at caversham, which deals with girls and young women who have failed to make good when placed out under supervision in the community. there is a small clothing-factory attached to the institution, which provides useful employment for certain of the better-type girls. it is stated that, even under present conditions, which are not altogether satisfactory, the majority of the caversham girls benefit from the training they receive to such an extent that they can be trusted to earn their living in the community under supervision. the committee, however, are of opinion that the buildings and site are most unsuitable for such an institution. little level space is available for recreation purposes, the property is overlooked at the back, and the location and general plan of the buildings are such that the utmost vigilance has to be exercised. for the inmates belonging to the reformatory section it is considered that such an institution should be situated in the country with sufficient suitable land to permit of gardening and farming on a small scale. this would afford healthful occupation for the inmates and contribute towards their support. such an institution should be so situated as to be readily accessible from all parts of the dominion. in the matter of the admission of young offenders over sixteen years of age to the caversham industrial school, and also to the boys' training-farm at weraroa, the committee found that in these cases the courts have no authority to commit direct, but must first sentence the young person to imprisonment and then recommend transfer to an industrial school. such a system is not only cumbersome, but is fundamentally wrong, and should be remedied as soon as possible. the courts should have discretionary powers to commit any young offender under eighteen years of age direct to an industrial school. at caversham there is a small proportion of the inmates who should be transferred to a borstal institution. this refers to the so-called "over-sexed" girl, and the girl with strong anti-social proclivities, who should be confined to an institution where there is provision for segregation and treatment of refractory cases. in many instances these young women should be kept under control for a considerable period. many are hopelessly immoral, and in the interests of society should not be allowed their liberty. that section of the caversham institution comprising children committed to the care of the state on account of destitution or unsuitable conditions in their homes would be better provided for in a separate receiving home. this would be in accord with the practice obtaining in all the other centres. the education department deals with all children committed to the care of the state for causes varying from destitution to delinquency. the procedure is for the police to charge the children and for the magistrate to commit them to the nearest receiving home, where they are kept under observation, trained in proper habits, and so forth, and as soon as possible, if they exhibit no anti-social traits, placed out in selected foster-homes. the department holds the view, shared by leading authorities, that home life, however humble, provided the foster-parents are suitable people, is better than institution life for the majority of the children who are cast on the state for sustenance and protection. the supervision of these cases, and the selection of employment for them when they become old enough, are carried out by the nurses, managers of receiving homes, and juvenile probation officers of the education department. several of these officers gave valuable evidence in the course of this inquiry. these officials not only look after the welfare of the children brought under state control, but also carry out a great deal of preventive work in the way of advising parents and supervising children, who by their timely and kindly intervention are saved from coming within the scope of the law. section .--children's courts. several witnesses before the committee pointed out the need for the establishment of special courts for children and juveniles. the committee recommend that such provision be made, and also that clinics be established providing for the physical and psychological examination of all children coming under the jurisdiction of these courts. the fuller knowledge thus acquired would be extremely valuable to the authorities dealing with the children. many countries have recognized this need and have established properly constituted courts for dealing with children and juveniles as apart and distinct from police courts. in this connection it is surprising to find that new zealand is lagging behind in that in the laws relating to the punishment of crime hardly any distinction in procedure is made between the child and the adult. it is true, of course, that a practice has grown up whereby children are dealt with in the police courts at a time apart from the hearing of adult cases, but the procedure of the criminal court has been retained--_i.e._, the young delinquent is charged with an offence, is required to plead, and if found guilty is liable to conviction. in the majority of such cases the charges are for minor offences and are dealt with summarily, but a child charged with an indictable offence and remanded to the supreme court for trial or sentence may in the interim be detained in prison. by arrangement between the departments concerned most of the cases of children and juveniles are investigated by the juvenile probation officer of the education department prior to the hearing, but these officers have no legal standing in any court, and are not even empowered to bring a destitute child before a magistrate for committal to the care of the state. this function must be carried out by a police constable. the children's court, as it is constituted in other countries, is a court of equity, and its principal function is to consider all children brought before it as cases requiring protection and care. it is the business of the court, by means of careful investigation in each case of conduct, school history, family history, and mental condition, to ascertain, if possible, the reason for misconduct, and either to eliminate or modify the causes, or to remove the child from the environment that has contributed to its present condition. the presiding magistrates are usually selected on account of their experience with children and knowledge of child psychology. in some of the courts in america women are selected for these positions. it is common knowledge that lack of mental balance, retardation, and physical defect are responsible for much juvenile delinquency, and it is therefore essential that if the children appearing before the courts are to be dealt with in a scientific manner there should be provision on the lines recommended above. section .--policy for the future. it seems to the committee that the dominion has now come to the parting of the ways in this matter, and unless the multiplication of the feeble-minded is to be allowed to go on in an ever-increasing ratio, with consequences dreadful to contemplate, the problem must be dealt with on broader lines, and in a more comprehensive fashion. in the first place, a comprehensive system of notification is essential so that a register as complete as possible may be made of the cases to be dealt with. the english commission for inquiring into the care and control of the feeble-minded, whose report appeared as far back as , laid down the basic principles of a sound policy in dealing with this question. their first principle was that persons who cannot take a part in the struggle for life owing to mental defect should be afforded by the state such protection as may be suited to their needs. their next principle was that the mental condition of these persons, and neither their poverty nor their crime, is the real ground of their claim for help from the state. their third principle was that if the mentally defective are to be properly considered and protected as such it is necessary to ascertain who they are and where they are. this, of course, is the object of the system of registration to which we have referred. lastly, the english commission held that the protection of the mentally defective person, whatever form it takes, should be continued as long as it is necessary for his good. these principles appear to us to be quite sound, and we have no hesitation in adopting them. _proposed eugenic board._ in regard to the method of compiling the register, some excellent suggestions were made by dr. theodore grant gray, medical superintendent of the nelson mental hospital. he proposed, first, that a government department or sub-department should be created to deal with all feeble-minded and mentally defective persons living outside institutions. it would deal not only with the feeble-minded, but it would act the part of a government "after-care association," in that it would keep in touch with all persons discharged from mental hospitals. one of its duties would be to keep a register of all feeble-minded, epileptic, and mentally defective persons living outside institutional care. dr. gray further suggests that the register should be compiled in the following manner:-- ( .) it would be a statutory duty of all school medical officers to report to the department the names of all feeble-minded or epileptic children in their districts. ( .) it would be the duty of the district education board to report any child of school age who was not attending school because of feeble-mindedness or epilepsy. ( .) it would be the duty of the superintendent, owner, or licensee of every hospital, private hospital, industrial school, or reformatory prison to notify the department upon the admission of any person suffering from feeble-mindedness or epilepsy. ( .) it would be the duty of the superintendent of every mental hospital to notify the name of every person discharged from a mental hospital. ( .) it would be the duty of every judge or magistrate in all cases brought before him in which there appears to be mental enfeeblement or epilepsy to call to his assistance an alienist, and, if the report is confirmatory, to order such person's name to be placed upon the register. n.b.--in the case of sections , , and the department would apply to a magistrate for an order to register the person concerned. in section the process would be automatic. * * * * * the committee consider the machinery suggested for the purpose of compilation of the register very suitable, subject to such modifications as may be found necessary in practice, but have come to the conclusion that it would be preferable for many reasons to keep cases of this kind, as far as possible, free from courts, a large part of whose work consists in trying persons charged with criminal offences, and to follow the plan which seems to be working very well in several american states--namely, to set up a board of experts to deal with these cases. the board, which might be called the eugenic board, should be a central board associated with a special department or sub-department, of which the head should be a man of sufficient personality, energy, and organizing-power to grapple effectively with this question--first, by taking the necessary steps to compile a reasonably exhaustive register, and afterwards, by co-ordination with cognate departments or by independent departmental action, to build up the necessary machinery to provide for the care, segregation, supervision, or treatment of the class with which his department is required to deal. the compilation of the register is a departmental matter, but legislative authority will be necessary, to provide for compulsory notification and to prescribe the means. a well qualified departmental officer should at once be detailed to take this matter in hand and formulate from the evidence given to the committee and from other sources of information the method and means of obtaining complete registration. the first step towards the formation of the board should be the early selection and appointment of a thoroughly trained and experienced psychiatrist. irrespective of the necessity for the employment of such a man as the scientific member of the proposed board, the committee are of opinion that the departments of health, mental hospitals, prisons, and the special schools branch of the education department are at present suffering from the lack of expert advice in this direction, and that it is high time the government had in its service at least one trained psychological expert, with recourse to the services of other men with similar training in the four centres. the eugenic board should be vested with power to examine all cases notified and, after due investigation, to place on the register-- ( .) such persons as in its judgment come within the definition in the mental deficiency act of feeble-minded; ( .) persons afflicted with epilepsy associated with automatism or other conditions rendering them especially liable to dangerous, immoral, or otherwise anti-social manifestations, and in the case of juvenile epileptics the mere frequency of fits rendering them unsuitable for attendance at ordinary schools; ( .) moral imbeciles as defined in the english mental deficiency act; and ( .) persons discharged from mental hospitals. it should be the function of the board to order or recommend to the minister the segregation, supervision, or treatment of the different classes. cases receiving adequate care in their homes would not, of course, be interfered with. the eugenic board, of course, should have power to remove any name from the register if it is of opinion that there is no longer any need for registration. there should be the right of appeal to a judge of the supreme court against the decision of the board to place a person on the register, and there should also be power to apply to a judge for the removal of the name from the register in cases where the board declines to do so. these provisions should, it is considered, effectively safeguard the liberty of the subject. the machinery necessary to deal adequately with this vital question--vital in its influence on the purity of our race--must be somewhat extensive, but use should be made as far as possible of existing governmental and private agencies and organizations. the work requires organization, and the first essential is, therefore, the appointment of an organizing head. unless such an appointment is soon made the matter will drift. the heads of the existing departments of state under whom such an organization might be placed have already more business to handle than they can comfortably overtake. some one must be selected to specialize on this work and this work alone. the question naturally arises as to the department of state to which the proposed sub-department for the care of the feeble-minded might best be attached. in the judgment of the committee the education of feeble-minded children should be continued by the education department, which has evolved a very successful system and is administering it well. after everything possible has been done in the matter of education a large proportion, as they grow up, will be quite unable to hold their own in the world, and for their own protection and safety, and in the interests of society, must be cared for in some institution, where they may be kept usefully occupied in gardening or farming, or in some handicraft which will serve to keep them in health and help to recoup the state some part of the cost of their maintenance. it is, of course, most essential that they should not be allowed to reproduce their kind, thus further enfeebling and deteriorating the national stock, adding to the burden of the community and to the sum of human misery and degradation. "to produce but not to reproduce" sums up the best scheme of life for these unfortunates. looking at all the circumstances of the case, it appears to the committee that it would be better if the compilation of the register, the provision of the farm and industrial colonies, and the after-care of adult feeble-minded patients coming under classes v and vi and "moral imbeciles" were entrusted to a special branch of the mental hospitals department. it is essential that the feeble-minded shall be kept separate from the insane, while the feeble-minded themselves, of course, require careful classification. it is very important that marriages with registered persons should be made illegal, and, as a corollary to this, that it should be made an indictable offence for any person knowingly to have carnal knowledge of a registered person. it should also be provided that any parent or guardian who facilitates or negligently allows any registered person to have carnal intercourse with another person shall be guilty of an indictable offence. section .--the question of sterilization. a question which has given the committee much anxious thought is as to whether sterilization should be adopted as a method of preventing the propagation of the feeble-minded. that it would be an effective method as regards the persons operated on goes without saying. the operation of vasectomy in the case of males is a very simple one, which may be performed with the aid of a local anæsthetic, and may be said for all practical purposes to be unattended by any risk to the patient. in the case of women a similar operation on the fallopian tubes, which is known as salpingectomy, is an abdominal operation and cannot be said to be entirely free from danger, although it is not regarded as very serious. except for the prevention of fertility, the operation does not interfere with the sexual powers of the patient and has little or no effect on sexual desires. it has been stated that a process of sterilization by means of x-rays can be applied to either sex. the only evidence available, however, shows that this method is still in the experimental stage, and the committee, for this reason, cannot recommend it, especially as there is a danger that it might damage the cells producing the internal secretions which influence the secondary sexual characteristics and so injuriously affect the general health and mentality. several states in america have passed laws providing for the sterilization of persons in state institutions who are--( ) insane, ( ) feeble-minded, ( ) criminalistic. in some of the states an appeal was made to the supreme court, and, the law being pronounced unconstitutional, no attempt was made to enforce it. in other states the law has been allowed to become a dead-letter. up to the st january, , the latest date dealt with by the most recently published work on the subject, there have been state institutions legally authorized to perform operations for sterilization, of which thirty-one have made more or less use of their authority, while ninety-three have not. the total number of operations performed up to the date mentioned was , , divided into classes as follows: feeble-minded, ; insane, , ; criminalistic, . of this total of , operations the state of california contributed no less than , , and in this state a single institution (the state hospital for the insane at patton) is responsible for no fewer than , cases. a bill introduced in into the senate to legalize sterilization of mental defectives, &c., was rejected. dr. h. h. laughlin, of the psychological laboratory of the municipal court of chicago, has devoted several years to the study of this question, and has recently published the result of his researches in a book entitled "eugenical sterilization in the united states." he publishes the texts of all the laws past and present, gives his idea of a model sterilization law, together with the necessary forms for putting it into effect. he also deals with the physiological and mental effects of sexual sterilization. a reviewer of his book, writing in the _journal of heredity_ of october, , states forcibly the case for the opponents of sterilization. he expresses the opinion that "the release of sterilized individuals with feeble inhibitions or anti-social tendencies is the equivalent to the creation of so-many new and virulent foci of venereal diseases and promiscuity." furthermore, the central association for mental welfare of great britain, which was formed in to act as a co-ordinating and representative body on all questions affecting mental defectives and their relations to the community, not long ago referred the question to their standing medical committee, who gave the considered opinion that "sterilization at the present time is not a practical proposition." the committee of the central association being in complete agreement with this view, the association decided not to advocate the policy of sterilization, because they consider that it would have only a limited influence in preventing the increase of mental deficiency, that it would be attended with certain harmful results in other directions, and because its adoption is impracticable. the association's statement on this subject goes on to say: "it is very important to remember that although propagation by defectives is one of the causes of mental deficiency, nevertheless this is by no means the only social menace attaching to their presence in the community. if left unguided and unprotected, their lack of stability and control may lead them to commit serious crime, such as theft, arson, assault, and even murder. their inability to maintain economic independence results in vagrancy and destitution. their helplessness in the face of obstacles frequently brings about their complete collapse at the first rebuff which they have to meet. the interest of the community can only be adequately protected by the segregation of a considerable proportion of these persons in suitable institutions. a sterilized defective would not be any less liable to these happenings than would one who was unsterilized. a defective woman, from the fact of her being sterilized and incapable of bearing children, would be more prone to illicit intercourse, to adopt a life of prostitution, and to spread venereal disease. it follows that segregation would still be needed in the case of a very large proportion of defectives, but, if they are segregated, sterilization is unnecessary. on the other hand, there can be very little doubt that any general adoption of sterilization would, in actual practice, lead to the non-segregation of a large number of defectives who should be under care and thus to an increase of the foul evils mentioned." having thus stated the arguments against sterilization the committee must now present the other side of the question. in the first place, it is evident that, as far as the united states is concerned, the extension of sterilization of the mentally defective has received a grave set-back by reason of the declaration of the supreme court of the united states that the laws in certain states permitting sterilization are unconstitutional. this ruling, of course, does not apply to new zealand. further, opponents of sterilization ask to be shown its good results; but obviously the results cannot emerge in one generation or in a comparatively short space of time, but only in the ultimate lessening of the proportion of mental defectives in the community by diminishing the hereditary supply. there is no doubt also that much confusion exists in the minds of the public as to the meaning of sterilization and desexualization or castration. the process of sterilization, as has been shown, involves only a simple and safe operation and has the sole effect of preventing reproduction. sterilization, therefore, should not be loaded with the objections which apply to the far-reaching effects of castration. the former, unlike the latter, is not prone to produce harmful effects upon the mind or morals of the sterilized individual. the assertion that "sterilization at the present time is not a practical proposition" is difficult to understand. it is certainly practicable, and is as likely to be favoured as opposed by public opinion, especially that section of the public that understands the difference between simple sterilization and desexualization. as regards the suggestion that sterilization may lead to new foci of venereal disease, it must be borne in mind that the unsterilized feeble-minded are already prone to sexual promiscuity, and there is no evidence that sterilization would increase this tendency. the opponents of sterilization offer as an alternative only permanent segregation to prevent the transmission of mental defect. it is evident, however, that the cost of the segregation of all mental defectives capable of reproducing other mental defectives would be exceedingly heavy. the committee advocates powers of segregation and of sterilization, these powers to be placed in the hands of the eugenic board, under proper safeguards and the right of appeal. sterilization in suitable cases is not a high price to pay for liberty. there are in our mental hospitals to-day men and women who suffer from recurrent insanity, who are admitted to the mental hospitals from time to time and discharged when they are better, and in the intervals between their admission cohabit with their wives or husbands, as the case may be, and bring more defective children into the world. if discretionary power were given to the board as suggested it should, and no doubt would, be exercised cautiously and tentatively. sterilization gives the patient liberty to do useful work in the community, is less drastic than segregation for life, and on the whole a much slighter interference with the rights of the individual, which are surely subordinate in such cases to the rights of the state. there are, of course, numbers of mental defectives who can never be allowed their liberty, and in the case of these the question of sterilization need not be considered. there are many cases of mentally defective girls, liberated from institutions in new zealand for the purpose of engaging in domestic service or other work, returning afterwards the mothers of illegitimate children, probably also mentally defective. unless such are to be maintained for years as wards of the state in institutions, should they ever again be allowed their liberty unless they undergo the operation of sterilization? this is the question: can the propagation of mental defect by mental defectives and the debasing of the race thereby be greatly checked if not completely prevented? the answer is assuredly, yes, by segregation and by sterilization. the committee recommends that both methods be placed in the hands of the eugenic board, with powers to discriminate as to which method is the more suitable for each individual case. the two methods are complementary, not antagonistic, and suitable safeguards for the liberty of the subject are provided. the committee recommends that the eugenic board should be given the power in suitable cases to make sterilization a condition of release from any of the institutions under the charge of the department of mental hospitals or removal of their names from the register on probation, but that in no case should the operation be performed without the consent of parents or guardians of the persons concerned. the committee consider that the persons so operated upon and liberated should be released on probation and kept under supervision for a reasonable period, and that they should be returned to institutional care if found to be leading an immoral life, or unable to support themselves, or for any other reason which the eugenic board may consider sufficient. if the recommendation as to sterilization being authorized under the conditions specified is adopted, the committee think it would be advisable to introduce some provision as in the american acts, making it unlawful to perform operations whose object is the prevention of reproduction in cases not authorized by the board unless the same shall be a medical necessity. section .--segregation. it will be neither possible nor desirable to segregate all mental defectives. feeble-minded children who are receiving adequate care and training in their own homes will, of course, be left there. when they reach the age of adolescence the question of their disposal should be considered by the board. in many cases the inmates of special schools, after they have received some training, would do well if returned to their homes or boarded out in selected foster-homes under supervision. the real difficulty arises, especially in the case of girls, when the age of adolescence is reached. in the opinion of the committee it is of the utmost importance that mental defectives should be prevented from reproducing. no person who has been placed on the register should be allowed to marry until the eugenic board has given its consent by removing the name from the register. it is altogether wrong to suppose that there is any unkindness in taking the feeble-minded, who are unable to battle for themselves, under the care of the state and preventing them from bringing forth another generation of defectives. the real unkindness consists in allowing such unfortunates to be brought into the world. in school, and still more in the after-struggle for existence, the feeble-minded find themselves the butts of their fellows, and the "inferiority complex" thus developed tends to make them sink lower in the scale both in intellect and morals. "on the other hand, it is the general experience of those who have had many years' practical experience with defectives that the majority are far happier in suitable institutions engaged in congenial occupations, and having the companionship of their mental equals, than when they are exposed to the difficulties of an outside world to which they are incapable of adapting themselves. in many cases, indeed, such freedom amounts to the infliction of positive cruelty." this statement is taken from the memorandum of the central association for mental welfare of great britain, to which reference has already been made, and this committee can, from their own observation, endorse the views thus expressed. it seems desirable, however, to point out the fallacy of a popular idea that the world could easily stamp out defectives and degenerates by merely adopting a vigorous policy of segregation and sterilization. even if it were possible by these means to prevent all manifest mental defectives from reproducing, it cannot be expected that this class will be thereby eliminated from the population, since mental defectives may be the offspring of apparently normal stocks, or may be descended from stock in which only minor manifestations of impaired nervous vitality, such as instability, eccentricity, &c., have hitherto been evident, and in a large proportion of cases they are no doubt the progeny of persons belonging to the higher grade of distinctly degenerate stock--persons who have not themselves necessarily shown any marked traits of instability or degeneracy, and to whom therefore sterilization or segregation would be inapplicable. section .--the question of expense. it will probably be objected that the plan for cutting off as far as possible further additions to the mental defectives of the dominion will involve increased expenditure. this is, unfortunately, the case; but will it not be a much more costly process to allow the present unrestricted multiplication of these defectives to continue in an ever-increasing ratio? if they are allowed to multiply, their unfortunate offspring will have to be provided for in one way or another--some by means of charitable aid, some in our prisons, some in our mental hospitals. take the case of the defective couple, case no. , page , themselves in receipt of charitable aid, who have already produced eleven children, all of whom are being provided for by the state, while, as the couple are still living together and the woman is still of child-bearing age, it is quite possible that the total may yet be increased. this family, it is estimated, will cost the state at least £ , . will any one seriously contend that it would not have been sound economy if this couple had been taken in the first instance, placed in separate farm colonies where they would have lived fairly useful lives, and been prevented from casting such an excessive burden on the state? we might take each of the cases quoted in an earlier part of this report, and many others which we have not quoted, and ask the same question in regard to each. there is no doubt whatever that from the purely financial point of view it is very much to the interest of the community that this problem should be taken boldly in hand at once while the evil is within fairly manageable proportions, instead of allowing it to grow into an intolerable burden. consider the humanitarian aspect. surely it is a kindly act to give the protective care of the state to those unfortunate persons who are unable to hold their own in the struggle for existence, and who, if left to their own devices, will fall miserably by the way and in many cases become a menace to society. lastly, there is the national question to be considered. surely it is important that our stock should be kept as sound and virile as possible, and that where a process of deterioration has been detected every attempt should be made to stop it as soon as possible and by every means in our power. section .--immigration. the committee feel very strongly that any attempt to check the multiplication of mental defectives in the dominion will to a large extent be labour thrown away if the greatest care is not at the same time taken to prevent the introduction of feeble-minded and other undesirable persons from overseas. the distance of new zealand from europe and the cost of the long passage have on the whole had a selective influence on the character of the immigrants and tended to keep up the standard of quality. as already mentioned, however, serious mistakes were made in the "seventies" of last century. very striking testimony to this effect is contained in the report of the late dr. macgregor, inspector-general of hospitals and charitable institutions, presented in , an extract from which appears in the appendix of this report. in the brief space of fifteen years the dire consequences of the mistakes made in previous immigration without due regard to its quality had already become apparent, and in the most impressive terms dr. macgregor, who was an exceedingly able and far-sighted public servant, pointed out that the evil done by the introduction of an undesirable class of immigrant is never finished. "the impaired health, low morality, and insanity descend to the offspring, and are a continued drain upon this community." the benefit of a well-regulated stream of immigration into this country is not open to question. a substantial addition to our population is now more than ever needed if this country is to progress and its resources are to be developed sufficiently to enable it to bear with ease the heavy burden imposed on the community by the great war. the point which it is desired to emphasize is that constant vigilance is necessary to keep up the standard of quality of the new-comers in view of the very natural desire to send off to a new land those who are physically or mentally unable to maintain themselves in the land of their birth. such vigilance, it need hardly be pointed out, is especially necessary at the present time when the volume of immigration is greatly increased owing to the condition of affairs in the mother-country. as a matter of fact, there seems no doubt that immediately after the conclusion of the war the system of control and medical inspection was not so strict as it should have been, especially in the case of the imperial government's overseas settlement scheme for ex-service men and women. the new zealand government, however, sent home an officer from the immigration department to rectify matters and to provide for a more thorough examination of assisted immigrants. under the system at present in force a special roster of medical referees has been compiled, and no person is accepted as an assisted immigrant without a certificate of physical and mental fitness from one of these doctors. the medical examiner, in the instructions, is particularly requested "to satisfy himself that the applicant is in every way a fit subject to pass a thorough medical examination, as applicants are liable to rejection both at the port of embarkation and at the port of arrival." finally, the doctor is required to sign the following statement: "having read and made myself conversant with the instructions contained in form ka supplied me, i certify that i have this day examined the above-named, and am of the opinion that ---- is in ---- health and of sound constitution. ---- is not suffering from any mental or bodily defect which in my opinion would unfit ---- for earning ---- own living as a ----." the form provides for a very complete examination, but as regards certain conditions, especially previous mental diseases, the examiner is necessarily dependent on the statements of the applicant. the committee were informed that new zealand has now the reputation with the imperial authorities of being the hardest and most exacting of all dominions regarding the health and physical fitness of immigrants. the committee think that, in addition to the precautions already taken, inquiry should be made, as far as may be possible, into the family and personal history of assisted immigrants, particularly as to whether they disclose any cases of insanity, epilepsy or feeble-mindedness, crime, or dependence on charitable aid. the committee are further of opinion that the time has now arrived when closer supervision should be exercised over those persons who come as ordinary passengers with the intention of remaining in the dominion. the immigration restriction act, , provides that "when any passenger arriving on board any ship is either lunatic, idiotic, deaf, dumb, blind, or infirm, and is likely to become a charge upon the public," the owner, master, or charterer of the ship shall be required to enter into a bond in the sum of £ for every such passenger, the person entering into the bond and his sureties being bound to pay to the minister all expenses incurred within the space of five years for the maintenance of such passenger. under the act the following are made "prohibited immigrants":-- "(_b._) any idiot or insane person." "(_c._) any person suffering from a contagious disease which is loathsome or dangerous." "(_d._) any person the date of whose arrival in new zealand is earlier than two years after the termination of any offence which, if committed in new zealand, would be punishable by death, or imprisonment for two years or upwards, not being a mere political offence, and no pardon having been granted." by order in council tuberculosis is gazetted as a contagious disease which is dangerous within the meaning of the act, and syphilis and leprosy are contagious and loathsome diseases within the meaning of the act. to any one who has seen a medical inspection of passengers arriving in an overseas vessel it is obvious that any degree of feeble-mindedness short of manifest imbecility or dementia would be liable to be admitted, and a good many cases of tuberculosis escape detection. other countries are now alive to the importance of greater care being taken to guard against the admission of these who are likely to lower the mental and physical standard of the race, and in the opinion of the committee stricter precautions should be taken in new zealand. the smallness of this country makes it all the more important that it should be occupied and developed by a selected population, while its attractiveness as a field of settlement and the limited amount of land available place it in a position of independence in which it is able to insist on the maintenance of a high standard of fitness on the part of those desiring to share in its advantages. section .--summary of findings and recommendations. the committee find-- ( .) that the unchecked multiplication of the feeble-minded and epileptic is leading to a continually growing addition to the sum of human misery, an ever-increasing burden on the state, and the serious deterioration of the race. ( .) that it would be sound economy, as well as in the best interests of humanity, to deal with the problem at once, even though it involve a substantial expenditure. the committee therefore recommend: ( .) that to the definitions in the new zealand mental defectives act, , there should be added a further definition--namely, that of "moral imbecile" contained in the english act. ( .) that a special branch of the mental hospitals department be established to deal with all classes of mental defectives who are not inmates of mental hospitals, and to act as an "after-care" department to look after patients discharged from mental hospitals. ( .) that a eugenic board be appointed, to include a skilled psychiatrist, another member of the medical profession, and to be presided over by a magistrate as chairman. ( .) that the duty of the department shall be to keep a complete register of persons coming under the following definitions in cases where the eugenic board has decided that the patients in their own interests or in the interests of society should be placed on the register:-- (_a._) mental defectives who are not inmates of mental hospitals who in the judgment of the eugenic board come within the definition of "feeble-minded" in section , class v, of the mental defectives act, . (_b._) persons afflicted with epilepsy associated with automatism or other conditions rendering them especially liable to dangerous, immoral, or otherwise anti-social manifestations, and in the case of juvenile epileptics the mere frequency of fits rendering them unsuitable for attendance at ordinary schools. (_c._) moral imbeciles as defined in the english mental deficiency act, . (_d._) persons discharged from mental hospitals. ( .) that the care of backward and feeble-minded children, so long as these remain in an educable stage, shall be the duty, as at present, of the education department. ( .) that the education department obtain the services of psychological experts with a view to creating a comprehensive system providing increased facilities for the study of the individual child in school, for the classification of children according to their mental capacities, and for the adaptation of the curriculum to the needs of special children. this may necessitate the establishment of an increased number of special classes, an extension of the residential special schools, and also provision for social readjustment of the children when required. ( .) that fuller provision be made in connection with our universities and training colleges for the education of teachers in child psychology and its practical application, and for their training for service in special classes and special schools. ( .) that full use be made of residential special schools for those cases who fail to benefit by attendance at special classes, but who are considered capable of training in manual work or handicrafts. the lower grades of the feeble-minded who require merely custodial care should, as a general rule, be excluded from special schools, but where there is any doubt as to a child's degree of mentality or aptitude for manual training admission to a special school for a probationary period should be arranged. ( .) that the education department shall report to the eugenic board those inmates of special schools found incapable of receiving benefit from further residence in such schools, and the eugenic board shall be empowered to place on the register such as they consider should be so dealt with. ( .) in regard to those on the register, the eugenic board shall have the power to order the removal of feeble-minded persons and moral imbeciles to a farm or industrial colony to be provided for the care and training of such persons. ( .) that any person alleged to be feeble-minded, or the parents or guardians of such person, shall have the right of appeal to a judge of the supreme court against the placing of his or her name upon the register, and the parents or guardians of any person on the register shall have the right to apply to a judge of the supreme court for the removal of the name of such person from the register, or for his or her release from any institution established under the act. ( .) the committee recommend the establishment of farm or industrial colonies where feeble-minded or delinquent persons who are custodial cases may be usefully and, as far as possible, profitably employed, and where they may receive the care and protection required by their condition. ( .) in regard to sterilization, the committee find that the operation of vasectomy in men can be carried out under local anæsthesia, and is free from risk. the analogous operation of salpingectomy in women is an abdominal operation, but the risk is not considered serious. these operations are effective in preventing procreation, but do not otherwise interfere with the sexual powers of the patient. in the case of persons suffering from recurrent insanity or idiopathic epilepsy, high-grade morons, and others who in the interests of themselves and of society ought not to be allowed to reproduce, but who do not for other reasons require custodial care, it is desirable that the operation of sterilization should be considered by the eugenic board. ( .) the committee recommends that the eugenic board should be given the power in suitable cases to make sterilization a condition of release from any of the institutions under the charge of the department of mental hospitals, or removal of their names from the register on probation, but that in no case should the operation be performed without the consent of parents or guardians of the persons concerned. ( .) the committee consider that the persons so operated upon and liberated should be released on probation and kept under supervision for a reasonable period, and that they should be returned to institutional care if found to be leading an immoral life, or unable to support themselves, or for any other reason which the eugenic board may consider sufficient. ( .) the committee consider that marriage with any registered person should be made illegal, and that it should be an indictable offence for any person to have carnal knowledge of any registered person. it should also be provided that any parent or guardian who facilitates or negligently allows any registered person to have carnal knowledge of another person shall be guilty of an indictable offence. ( .) in view of the fact that feeble-minded persons and others likely to become a burden on the community have in the past been introduced from overseas, the committee recommend that, in addition to the precautions already taken in regard to assisted immigrants, inquiry should be made into the family history, especially as to whether it discloses any cases of insanity, epilepsy, or feeble-mindedness, and that applicants unable to produce satisfactory evidence on this point should be excluded. the committee are further of the opinion that closer supervision should be exercised over persons who come as ordinary passengers with the intention of remaining in the dominion. part iii.--sexual offenders. section .--scope and origin of the inquiry. the second section of the order of reference requires the committee "to inquire and report as to the necessity for the care and treatment of mental degenerates and persons charged with sexual offences, and to recommend forms of treatment for the various types of cases." the committee's finding and recommendation in regard to the "care and treatment of mental degenerates" who have not been charged with criminal offences are embodied in the first part of this report. the origin of the inquiry, in so far as it concerns the care and treatment of mental degenerates and sexual offenders who appear before the courts, is to be found in the resolution of the prisons board first appearing in their annual report for the year and repeated in their reports for and . the resolution is as follows:-- "whereas an increasing number of sexual offences has been the subject of frequent and serious judicial comment, especially in cases where young children were the victims, or the very serious nature of the charge connoted a perversion dangerous to the moral well-being of society; and, as the experience of the board in dealing with prisoners of this class accords, as far as it goes, with the now generally accepted opinion that, with certain exceptions, persons committing unnatural offences labour under physical disease or disability, or mental deficiency or disorder, or both, which accounts for the sexual perversion and the morbid character of the offence charged: it is resolved by the prisons board strongly to recommend to the government an amendment of the crimes act under which such offenders could be dealt with scientifically-- "( .) before sentence is pronounced, by furnishing expert medical or surgical reports or evidence: "( .) by sanctioning an indeterminate sentence: "( .) by segregating persons so sentenced and subjecting them, under proper safeguards, to any medical or surgical treatment which may be deemed necessary or expedient either for their own good or in the public interest." the repeated occurrence of gross offences of the character described by the prisons board, both before and since the committee commenced its sittings, has focussed public attention more strongly upon the necessity for immediate action in regard to the more adequate treatment of this class of degenerate than upon the much larger and relatively more important class of mental defective covered by the first section of the order of reference. the bulk of the evidence heard by the committee and practically the whole of the information obtained from various sources bore more particularly upon the question of the care and prevention of the propagation of the mentally defective part of the population coming under the general designation of "feeble-minded." while, however, the evidence obtained regarding the prevalence of sex offences and the care and treatment of the offenders was not great in volume, it was eminently practical in character. apart from this, the flagrant cases reported in the daily press during the past few months in connection with the supreme court sessions in the various centres offer sufficient proof of the necessity for some drastic amendment of the law on the lines suggested by the prisons board. section .--seriousness of the evil. that the order for an inquiry into this question was by no means premature was made apparent to the committee by the presentation at its first sitting of a return furnished by the prisons department, which appears in the appendix to this report, page , showing the number of sexual offenders of the various classes who were actually serving sentences on the th may, . the total number of the sexual offenders in the prisons of the dominion on that date was . this number represented . per cent. of all the prisoners then in custody. unfortunately, this percentage has since been increased by recent commitments of cases of the most serious types. a return compiled by the government statistician (mr. malcolm fraser) shows that during the five years, - , there were persons sentenced in the supreme court for sexual offences as follows: rape, ; attempted rape, ; indecent assault on a female, ; indecent assault on a male, ; unlawful carnal knowledge, ; attempted unlawful carnal knowledge, ; incest, ; unnatural offence, : total, . section .--types of offences. it is obvious that included under the heading of sexual offences are cases which vary so greatly in their gravity and in their very nature as to have little in common. there is a great gulf between the lad convicted of unlawful carnal knowledge with a girl who is under the legal age of consent, but who in some instances may even be the actual instigator of the offence, and the miscreant who tampers with little girls of tender years, or sets himself deliberately to corrupt boys. it was this class which the prisons board had in mind when it passed the resolution quoted, and no doubt it is the class which the committee's order of reference is intended to cover. this class of offence is held in so much detestation by normal persons possessing ordinary healthy natural instincts that they find it impossible to consider the question from a judicial and coldly scientific point of view. it is evident, however, that this must be done if we are to entertain any hope of finding and applying an effective remedy to this cancer in the social organism. the evidence given before the committee leads them to the belief that the evil is much more prevalent than is generally supposed--that the cases which come before the court constitute only a percentage of those which actually occur. the ignorance of the general public in regard to these matters occasionally leads to an unjust attitude of mind towards some of the offenders brought before the courts. take the case of an old man charged with "exhibitionism." to the normal mind this seems a particularly disgusting proceeding, and the offender's age is regarded as an aggravation. the explanation is that the higher nerve-cells of the old man are degenerating, that he may be thus unable effectively to control his morbid sexual impulses, particularly if stimulated by an enlarged prostate. such a person is a subject for pity rather than punishment; he must be restrained from annoying others by his offensive behaviour, but it is really a case for medical treatment. another class to be considered is the confirmed homosexualist. there are well-known examples of men eminent in the arts and literature given to this unnatural practice, and of the offenders who come before the courts only a small proportion can be described as feeble-minded. the practice is not confined to the male sex, although for reasons which will be apparent it is only males who come before the courts charged with this specific offence. many parents are unaware that girls as well as boys may contract bad habits and fall into sexual abnormalities, but it is a fact which they ought to know in order that the danger may be guarded against. mr. hawkins, inspector of prisons, whose experience extending over forty years in charge of prisoners in new zealand makes his opinion of great weight, says there are two types of sexual offenders to be found in our prisons: first, there are those who yielded to sudden temptation, assaulted women or young female children, sometimes under circumstances exhibiting extreme brutality. in the majority of these cases, he says, the offenders are curable under a proper system of treatment, and it is seldom that they again offend. he goes on to say: "the real sexual pervert, however, who is continually tampering with young children is different, as is also the case when young boys are the victims. the worst pervert of all is the one who flagrantly offers himself for the purposes of sodomy. strange as it may seem, there are quite a number of such degenerates in our prisons to-day; middle-aged and elderly men being the chief offenders of this class. in my opinion segregation for life is the only course, and my years of experience among such a class have convinced me of this, their case being absolutely hopeless when this stage has been reached, and no cure is possible in such cases." this pessimistic view, unfortunately, is fully confirmed by the records of cases examined by the committee. long terms of imprisonment, though combined with the lash, have proved quite ineffective as a deterrent, even to the individual concerned. in some cases the offender within a short time after his release has been detected in the same practices and rearrested. still less does such a punishment act as a deterrent to other addicts, if for no other reason than that each individual cherishes the conviction that he will not be found out. records of a number of illustrative cases are set out in the appendix, pages - . section .--suggested remedies. as regards the infliction of corporal punishment which is often advocated, dr. murray, medical officer to the mount eden prison at auckland, who has had a good deal of experience with sexual offenders, said he had seen a good many flogged, and he did not think it had any effect as a deterrent. he added, "nothing will deter men once they have taken on that line. i think you will find in some cases where a person has been addicted to those practices before marriage he will drift again into the same course after a certain number of years. it seems a perversion they have no control over, and after a certain number of years it masters them." the general opinion of those who have been in touch with this problem for many years is well expressed in the following extract from a very valuable report furnished to the committee by dr. f. s. hay, inspector-general of mental hospitals, on the different questions coming within the scope of the inquiry:-- "as a member of the prisons board i have had the matter of the sexual offender brought under my notice and have come to some very definite conclusions. "i think that he should be brought to trial in the ordinary way, with perhaps suppression of publication of names of the offender and victim. if found guilty, he should be given an indeterminate sentence, and be removed to a farm reformatory prison, where he would be brought under skilled medical and lay observation, and his case studied in respect to--_mentality_, when if afterwards it is decided that he is mentally defective or deficient in terms of the act he can be transferred to the proper institution; _physical condition_, when if there is any disorder it can be remedied. if the disorder is causative (_e.g._, prostatic in the elderly) and surgical or medical interference is necessary, it will be carried out and its results carefully watched and reported on. "at present the sentences vary from, say, a year to ten years or more, the seriousness of the case being one determining factor; but often similar cases have years of difference in their sentences, and at the end of the sentence they once more enter the world, and a fair proportion repeat the offence. the people in the reformatory prisons can, with experience of a case lasting over some years, foretell the failure fairly accurately. "the degree of sexual perversion being measured by the amount of interference with children, which accounts for the measure of the sentence, means no essential difference in the intent or in the likelihood of repetition, and therefore scientifically the sentences should be equal. i suggest that they should be made equal by being made indeterminate. "those of whom the medical officer cannot report favourably would continue on. they could be given a right of revision. those of whom he can report very favourably could be released on probation, and so on. the essential feature is that no hurried diagnosis is made before trial, but diagnosis and prognosis are arrived at after months and maybe years of close observation and by a staff gaining experience daily." _sterilization and desexualization._ the increase of sexual offences during recent years and the disgust felt by all normally disposed people when contemplating cases of sexual perversion and assault upon young children have created a strong public opinion in favour of dealing with these offences as radically as circumstances will permit. demands are constantly made that the offenders should undergo "a surgical operation," which is intended to imply either castration or simple sterilization. the british medical association, at their annual conference held in auckland in april, , resolved that the following motion be adopted by the council: "that this conference can make no recommendation for surgical desexualization in the treatment of the adult sex pervert. the only safeguard for young children in this matter is the permanent segregation of the offender, either in prisons or in farm colonies. the conference emphasizes the importance of the sterilization of the chronic mentally or morally unfit that a future generation may benefit thereby." the committee therefore considers it necessary to set out as clearly as may be possible the result of such operations and its deductions from the evidence taken and authorities consulted as to the probability of the achievement of the result desired. to consider in the first place the operation of simple sterilization (vasectomy or salpingectomy). it is quite clear that this operation, when properly carried out, prevents procreation by the individual operated upon. although the knowledge of the loss of this power may modify the views of life held by the individual the operation _per se_ does not affect his physical or mental health. this would be anticipated, as the production of the internal secretion of the sexual glands in either sex (ovaries or testes) continues. sexual desire and capacity for coitus are not usually appreciably impaired by this operation, and it clearly could not be expected to restrain the sexual offender from the pursuit of his perverted modes of gratification. as, however, it appears that in a proportion of cases of sexual perversion the tendency is an hereditary one, these operations would, as in the case of the feeble-minded, tend to restrict the number of individuals in the community afflicted in this manner. the committee would therefore recommend that simple sterilization be considered by the eugenic board in relation to sexual perverts. _castration (desexualization)._ the operation of desexualization implies the removal of the sexual glands (ovaries or testes), and involves other considerations than the operation of simple sterilization. the loss of the internal secretion of these glands may produce physical and mental changes in the individual. these effects vary greatly in degree according to the age at which the operation is performed. the earlier it is done the more decided the result. if performed _before puberty_ the secondary sexual characteristics fail to develop. the voice does not change in the male; the development of hair is more sparse; the general physical development is less masculine; and mentally the individual is less aggressive. most pertinent of all as bearing upon the question under review, sexual desire and capacity do not develop, either at all, or at any rate, not to the same degree as in a normal individual. this result, however, is not constant, and depends principally upon the age at which the operation is performed. _after puberty_ the operation is very much less effective. the secondary sexual characteristics have been already established and persist. it occasionally occurs that certain mental effects are produced. in women these resemble, generally speaking, those occurring at the climacteric. in both sexes, however, mental disturbances may occasionally arise. the immediate effect upon sexual desire and capacity is slight. it would appear, however, from the small amount of evidence available on this point that the tendency is to a gradual diminution of sexual desire, possibly even to disappearance after some years. as it is generally after puberty that sexual perversion becomes manifest, it is clear that much cannot be expected from this operation. the problematic result and the extent of the mutilation restrain the committee from any suggestion that such an operation should be made compulsory. the committee feel that the information at present available in regard to sterilization or desexualization of sexual offenders is quite inadequate to permit of a sound and final judgment as to the value of the procedure. they recommend, therefore, that the whole question be remitted for careful investigation to the eugenic board which it is proposed should be set up. section .--scientific treatment and segregation with indeterminate sentence. after very careful consideration the committee have come to the conclusion that it is most desirable, in continuation of the system of prison reform which has been inaugurated with so much success in this country, that every person charged with a serious sexual offence should be carefully examined by a medical man and skilled psychiatrist before his trial, and evidence given to the court of any physical or mental defect having a bearing on the case. in the judgment of the committee, the best way of dealing with persons guilty of sexual crimes is by means of the indeterminate sentence. each case should be examined by a psychiatrist as well as by the prison medical officer, and the length of the period of detention should be determined by the prisons board after looking into the nature of the offence and considering the report of the psychologist and evidence as to the conduct of the prisoner while under detention. in cases of the worst type the indeterminate sentence would doubtless resolve itself into detention for life. at all costs the women and children of the community must be protected against this class of offender. the evidence of mr. hawkins as to this class is emphatic and very much to the point:-- "personally i have never yet seen a complete cure in the case of a real sexual pervert. years of imprisonment, to my own personal knowledge, have failed to do any good whatever. treat them kindly, give them useful work, and make their lives as pleasant as possible, but never let them loose on society again. even if this were done, the trouble with such individuals is by no means ended, as if it is intended to prevent them following their beastly tendencies constant unremitting supervision will be necessary. the average citizen has not the slightest conception of the utter depths of depravity to which a confirmed male sexual pervert will descend. instances of such depravity have occurred to my knowledge. many of the men referred to are not fit to live, but it must be remembered that in many instances the evil tendencies have been inherited, while in others environment has played a prominent part." the information placed before the committee, which is summarized in the foregoing paragraphs, leads to the conclusion that the requirements of the position are fairly well covered by the terms of the prisons board's resolution. section .--summary of recommendations. the committee recommend,-- ( .) that the crimes act be amended to provide for the passing of an indeterminate sentence upon persons convicted of sexual offences. the courts to be given full discretion as to whether the sentence shall be definite or indeterminate. ( .) that the prisons board be vested with the same power of recommendation for the release on probation or final discharge of prisoners under an indeterminate sentence as they have now in regard to all other prisoners. ( .) that a psychiatrist be appointed to advise the prisons department as to the classification and treatment, and that he be available to the courts for the examination, before sentence, of sexual offenders, or of offenders who are thought to be irresponsible on account of mental defect. ( .) that the prisons board be advised by the eugenic board in regard to the release on probation or final discharge of all sexual offenders or feeble-minded offenders coming under its jurisdiction. ( .) the committee feel that the information at present available in regard to sterilization or desexualization of sexual offenders is quite inadequate to permit of a sound and final judgment as to the value of the procedure. they recommend, therefore, that the whole question be remitted for careful investigation to the eugenic board which it is proposed should be set up. concluding remarks. it goes without saying that the work of the committee in pursuing their investigations has been of a very painful and depressing character. we need not refer to the depth of human degradation and the revolting pathological details which had to be explored in dealing with the second order of reference, beyond saying that the witnesses who faced the unpleasant task of giving evidence deserve the thanks of the public for discharging what they evidently felt to be a public duty. in the inquiry into the problem of the feeble-minded the most saddening experience of the committee was the sight of so many children deprived of their full share of the light of reason, often maimed and stunted in body as well as in intellect. the sight was made sadder still by the reflection that unless prompt and effective action is taken the multiplication of these degenerates will increase and the race will steadily deteriorate. professor william macdougall, the noted psychologist of harvard university, speaking at toronto recently in reference to the disregard of eugenic methods in america in maintaining and improving the national stock, said: "as i watch the american people speeding daily with invincible optimism down the path that leads to destruction i seem to be watching one of the greatest tragedies of history." new zealand is a young country already exhibiting some of the weaknesses of much older nations, but it is now at the stage where, if its people are wise, they may escape the worst evils of the old world. it has rightly been decided that this should be not only a "white man's country," but as completely british as possible. we ought to make every effort to keep the stock sturdy and strong, as well as racially pure. the pioneers were for the most part an ideal stock for a new offshoot of the mother-country. the great war revealed that from their loins have sprung some of the finest men the world has ever seen, not only in physical strength, but in character and spirit. it also revealed that an inferior strain had crept in and that new zealand was already getting its share of weaklings. surely our aim should be to prevent, as far as possible, the multiplication of the latter type, and to increase the elements of the mental, moral, and physical strength of the nation. in these beautiful and richly dowered islands we have a noble heritage--to be in keeping and to ensure the full development of their resources and enjoyment of their blessings the inhabitants should be of the highest type obtainable by human effort. this is the lesson which has been impressed upon the minds of the committee during their investigations, and they have been sustained in their saddening experience by the hope that this lesson will be taken to heart by both the parliament and the people of the dominion. w. h. triggs, chairman. d. mcgavin. f. truby king. j. s. elliott. ada g. paterson. chas. e. matthews. j. beck. j. w. buchanan, secretary. appendix. past mistakes in immigration. extract from report on hospitals and charitable institutions of the colony, , by the late dr. macgregor, inspector-general. many causes have conspired in our history as a colony to intensify the good-nature of our people--at any rate, so far as extravagance in vicarious charity is concerned. our sensitiveness to suffering has been greatly stimulated by the comparative absence from our towns of those sights of misery and squalor that deaden the feelings by familiarity; and the lavish life we have led since has made us free-handed to the poor and impatient of the trouble required to find out whether our charity was wisely or mischievously given. during our years of plenty, when borrowed money was being largely spent, and the prices of wool, &c., were high, i was in charge of the dunedin asylum, and remember with what forebodings i regarded the quality of the immigrants that were being poured into the country after the despatch of instructions in october, , to the agent-general "to grant free passages, and also, if necessary, advance expenses to port of embarkation and outfit." twenty thousand immigrants were, if possible, to be sent out in six months. with wonderful rapidity the results became apparent. from all parts came reports of the evil quality of the immigrants. the immigration minister, writing to the agent-general in june, , says: "i have already called your attention to the fact that the shipment by the ... included a number of girls out of the cork workhouse, and i took the opportunity of remarking on the very undesirable character of such immigration. a perusal of the report of the immigration officer at dunedin will, i think, convince you how very disastrous it is likely to prove to the cause of immigration if such modes of selection as those adopted by mrs. ---- (who was paid per emigrant) are under any circumstances permitted. the result in the colony of the landing and distribution of such women as these complained of, and of such immigrants as the "young men" whom mr. allen states he has ascertained to be professed thieves, and one of them a ticket-of-leave man, is naturally a feeling of indignation and dismay." no doubt this was an extreme case, but, nevertheless, it is plain that, what with the great influx of a low class of navvies during the height of our public works, and the vicious and degenerate people, of whom so many were introduced at this time, the average of our population in point of quality was considerably deteriorated. my experience as medical officer of our largest asylum for so many years has convinced me that the ultimate cost of this degraded class of people to this country is enormous. for instance, here is an account of two families and their asylum history:-- +--------+-------------------------------+---------------+-------------+ | | | cost per | | | | | head. rate, | | |number. | name. | £ per week | total cost. | +--------+-------------------------------+---------------+-------------+ | | | £ s. d.| £ s. d.| | | _family of b._ | | | |i | a.b. (brothers) | | | |ii | c.b. | | | |iii | d.b. | | | |iv | e.b. | | | |v | f.b. | | | | | |---------------+ | | | _family of c._ | | | |i | a.c., wife | | | |ii | b.c., husband of a.c. | | | |iii | d.c., daughter of a.c. | | | | | and b.c. | | | |iv | e.c., " | , | | |v | f.c., illegitimate daughter | | | | | of e.c. | | | |vi | g.c., husband of f.c., but no | | | | | blood relation | | | | | |---------------+ , | | | | |-------------| | | | |£ , | +--------+-------------------------------+---------------+-------------+ such people and their offspring are at this moment a fruitful source of those idle and useless persons who bring discredit on the cause of that portion of our people who cannot find employment. they fill our gaols, our hospitals, and our asylums, and, like a swarm of low parasitical organisms, they have, to an extent that is almost incredible, absorbed the outdoor relief that was meant for the self-supporting and struggling poor. i am sure that by far the largest proportion of the aid that has been so abundantly distributed by the various charitable agencies, especially in our large towns, has been spent in supporting a great many idle and vicious persons whose example has had the most pernicious effect in pauperizing the people. it should never be forgotten that the evil caused by the introduction of this class is never finished. the impaired health, low morality, and insanity descend to the offspring, and are a continual drain upon the community. the health of school-children. extract from the report of the director of the division of school hygiene, . the fundamental necessities of healthy growth are simple, and it is doubtful if there is any country in the world to-day where they are more universally procurable. fresh air, sunlight, food of the right type and amount, adequate sleep and rest, wholesome exercise, are available for all but that small section of the people already mentioned. sir frederick mott, in an address recently published in the _british medical journal_, quotes voltaire: "regime in diet is better than medicine. eat moderately what you know by experience you can digest, for that which you can digest only is good for the body. what is the medicine that makes you digest? exercise. what will repair your energy? sleep." to this text he adds the benefits of sunlight and pure air. reports from school medical officers continue to record that tea, white bread, and meat play the chief part in the dietary of many homes. fresh fruit and vegetables, even in rural areas, are not eaten sufficiently. frequent eating between meals takes away appetite and retards digestion. many children bring to school substantial "play-lunches" to be consumed at the mid-morning interval. others consume large quantities of sweets. healthy hunger they rarely know. a noteworthy fact is that in new zealand the consumption of sugar per head per annum is lb., as against rather more than half that quantity in britain and much less in other countries. apart from its directly deleterious influence on the teeth, the alteration of food values in the dietary necessitated by the inclusion of so much sugar results in digestive troubles and disturbed nutrition. in this country, with its many sources of supply, eggs, milk, cheese, butter, fresh fruit, and vegetables should be available in sufficient abundance and at low-enough prices to displace to a greater extent the meat that is such a prominent article of diet in many households. the value of rest, both physical and mental, for children is not adequately recognized. in the country many children work early and late at farm-work, as milking, &c., and in the city children earn money as newsboys, message-boys, &c. where the family exchequer needs to be augmented in this way excuse must be made, but in many comfortable homes children do not rest sufficiently. mr. cyril burt, psychologist for the london city council, was recently reported as deploring the tendency in modern education to attach undue value to the dramatic and theatrical. children who possess talent are made to drag it prematurely into the light of publicity. they are over-trained and over-stimulated. nearly all children are taught to regard frequent amusement as essential to happiness. to leave them to develop their own resources and allow them to find interest in simple and natural things would be to extend widely their chance of future happiness. it is the wrongly fed, insufficiently rested child that most readily develops physical deformity. the fatigued nervous system is expressed in general bodily slackness. there is deficient muscular and ligamentous tone. the typical faulty posture is thus acquired, with drooping head, flat chest, wing shoulders, prominent abdomen. vitality is depressed and the bodily mechanism out of gear. the grosser bony deformities so often found in older lands associated with rickets are rarely seen in new zealand, but less evident manifestations of faulty diet and regime are frequent. it is fortunate that in this country we cannot altogether escape, however we seek our pleasures in stuffy rooms or dark, ill-ventilated places of entertainment, those powerful and beneficial agents for promoting healthy growth--sunlight and fresh air. for the prevention of defect it is essential that the classroom should offer hygienic conditions--_e.g._, good lighting and ventilation, suitable furniture, &c. another contributory factor in poor physical development is the use of incorrect clothing and footwear. it is a common thing to find from six to eight layers of tight garments constricting the chest even in a child whose legs are scantily protected from cold. shoes which are too tight or too short, or which have heels so high as to prevent correct body-balance, are very harmful. clothing should offer adequate protection, but should not prevent the most absolute freedom of movement. sexual offenders in new zealand. the prisons department has furnished the following return of sexual offenders serving sentences in new zealand prisons in : the total number of sexual offenders, ; the total number of sexual offenders born in new zealand, ; the total number of sexual offenders born out of new zealand, ; the total number of persons in the prisons serving sentences exceeding three months, ; the total number of new-zealand-born prisoners, ; proportion of sexual offenders--new-zealand-born to total number of new-zealand-born criminals, . ; total number of prisoners born outside new zealand, ; proportion of sexual offenders born outside new zealand to prisoners born outside new zealand, . . table showing the number of sexual offenders sentenced under the respective headings in new zealand prisons as on st august, . carnal knowledge and attempted carnal knowledge. indecent assault. indecent act. indecent exposure. incest and attempted incest. sodomy and attempted sodomy. rape and attempted rape. manslaughter. [a] total [b] [footnote a: victim an old lady, aged , who died as the result of a struggle, in which prisoner committed rape upon her.] [footnote b: number includes prisoners who appear under more than one of the above headings, therefore the actual number of individual offenders total .] number of sentenced prisoners (exceeding three months) in custody on the st august, , was , therefore sexual offenders ( individuals) represent . per cent. of the sentenced prison population serving periods exceeding three months. carnal knowledge and attempted carnal knowledge. ____________________________________________________________ | age of |age of | age of | age of | age of |age of | |offender.|victim.|offender.| victim. |offender.|victim.| +---------+-------+---------+--------------+---------+-------+ | | | |several young | | | | | | | children | | | | | | | | | | | | - / | | | | | | | - / | | | | | | | | | | | | | | - / | | | | | | | | | | | | | | - / | | | | | | | | | | | | | | | | | | | +---------+-------+---------+--------------+---------+-------+ some illustrative histories. case no. . ____________________________________________________ |number of |age of | | |successive |offender | | |convictions.|when | offence. | | |offence | | | |committed.| | +------------+----------+----------------------------+ |a. | |indecent assault on a male | | | |idle and disorderly | | | |indecent assault on a male | | | | | | | | | | | |indecent assault on males | | | | (three charges) | +------------+----------+----------------------------+ __________________________________________________________________ | sentence. | sentenced|released|period at large | | | (date). | (date).| before arrest | | | | |on further charge. | +-------------------------+----------+--------+--------------------+ | years' hard labour | / / | / / | - / months. | | months' hard labour | / / | / / | years months. | | years' hard labour | / / | / / | - / years. | |and years' reformative| | | | |detention | | | | | years' hard labour | / / |still in| | | | | prison.| | +-------------------------+----------+--------+--------------------+ note.--offender was born at auckland and is the third eldest of a family of eight. he was evidently dull at school, as he passed the third standard only at the age of . at the age of he was charged with the offence of vagrancy, convicted and discharged. the victims in all his offences were children varying in age from to years. case no. . ______________________________________________________ |number of |age of | | |successive |offender | offence. | |convictions.|when offence| | | |committed. | | +------------+------------+----------------------------+ | b. | |theft (four charges) | | | |rogue and vagabond; vagrancy| | | |rape | +------------+------------+----------------------------+ _______________________________________________________________ | | | | | | sentence. |sentenced | released |period at large | | | (date). | (date). |before arrest | | | | |on further charge. | +---------------------+----------+----------+-------------------+ | month | / / | / / | year. | | months' hard labour| / / | / / | year months. | |hard labour for life | / / | / / | | +---------------------+----------+----------+-------------------+ note.--offender is a native of new zealand. the most serious of his offences (no. ) was committed on a girl ½ years of age. after serving six years of his term of life imprisonment the prisoner showed signs of being mentally unsound, and in march, , he was transferred to a mental hospital. he remained a patient in a mental hospital until march, , when he escaped. it was afterwards ascertained that he was aware of the fact that he was about to be returned to prison as being no longer an insane person--hence his escape. after his escape he married, and subsequently served two years with the expeditionary force. he was returned to new zealand as medically unfit and was arrested at auckland and returned to prison in august, . two members of his family--a sister and a brother--have been convicted of theft and "conducting a house of ill fame." this man was released on probation, on the certificate of an expert in mental diseases, after serving the full life term of twenty years, but soon after release gave clear indications of return to former criminal perversions, and his rearrest was ordered. case no. . ______________________________________________________________________ |number of |age of | | | |successive |offender | offence. | sentence. | |convictions.|when offence| | | | |committed. | | | +------------+------------+------------------+-------------------------+ | c. | |obscene exposure | months' hard labour | | | | " | months' hard labour | | | | " | months' hard labour | | | |wilful damage | days' hard labour | | | |obscene exposure | months' hard labour | | | |assault | months' hard labour | | | |obscene exposure | months' hard labour | | | |rogue and vagabond| month's hard labour | | | | " | months' hard labour | | | |obscene language | months' hard labour | | | |indecent assault | years' hard labour and | | | | on a female | years' reformative | | | | | detention | | | |indecent assault | years' hard labour | | | | on a male | | +------------+------------+------------------+-------------------------+ ________________________________________ |sentenced |released |period at large | | (date). | (date). |before arrest | | | |on further charge. | +----------+---------+-------------------+ | / / | / / | months. | | / / | / / | day. | | / / | / / | months. | |} / / | / / | months. | |} | | | | / / | / / | months. | | / / | / / | days. | | / / | / / | day. | | / / | / / | month. | | / / | / / | months. | | / / | / / | years month. | | | | | | | | | | / / |still in | | | |prison. | | +----------+---------+-------------------+ note.--c. is a single man, aged years, and a native of new zealand. he is a cabinetmaker by trade and said to be an excellent tradesman. he appears to have been in trouble since he was years of age, and has constantly been in prison, the majority of his offences being of a sexual nature. he is described as a highly dangerous criminal and a menace to society. case no. . _____________________________________________________________________ |number of |age of | | | |successive |offender | offence. | sentence. | |convictions.|when offence| | | | |committed. | | | +------------+------------+-----------------+-------------------------+ | d. | |theft | months' probation | | | |carnal knowledge | years' hard labour | | | | ( .) indecent |( .) years' reformative| | | | assault on a | detention; declared | | | | male | habitual criminal | | | | ( .) indecent |( .) years' reformative| | | | assault on a | detention | | | | female | | +------------+------------+-----------------+-------------------------+ +----------+---------+-------------------+ |sentenced |released |period at large | | (date). | (date). |before arrest | | | |on further charge. | +----------+---------+-------------------+ | / / | ---- | | | / / | / / | years months. | | | | | | / / |still in | | | | prison | | +----------+---------+-------------------+ note.--d. is a native of new zealand, aged years and married. his second offence, a very serious one, was committed on a female child of years, the child being subjected to great violence and raped. he was released from prison on license on th february, , when he married a respectable woman who knew nothing of his past history. she states that he was a good husband. there is one child of the marriage, a female of months. he is addicted to drink, and is said to have been under the influence of liquor when he committed his last offence. he is not a fit subject to be at liberty, as it was the merest accident that his last offence did not become as serious as that he committed in . offender has two brothers, both criminals. case no. . __________________________________________________________ |number of |age of | | |successive |offender | offence. | |convictions.|when offence| | | |committed. | | +------------+------------+--------------------------------+ | e. | |breaking, entering, and theft | | | |absconding | | | |breaking, entering, and theft | | | |drunk | | | | " | | | |sodomy | | | |( .) indecent assault on a male | | | |( .) common assault | +------------+------------+--------------------------------+ ____________________________________________________________________ | | | | | | sentence. |sentenced |released |period at large | | | (date). | (date). |before arrest | | | | |on further charge.| +--------------------------+----------+----------+------------------+ |committed to burnham | / / | ---- | | |returned to burnham | / / | ---- | | | months' hard labour | / / | / / | years months.| |fined s. and costs | / / | ---- | | |fined s. and costs | / / | / / | months. | |life | / / | / / | years months.| |( .) years' hard labour| / / | still in | | |( .) year's hard labour | " | prison.| | +--------------------------+----------+----------+------------------+ note.--e. is a native of new zealand, aged years and married, with one child. he is reported to suffer from injuries to the head caused by a fall from a tree when eleven years of age, and to be subject to uncontrollable fits of temper and loss of mental balance since that age. offender was educated in auckland, and passed the third standard only at the age of . he was committed to burnham at the age of for two years, from which institution he absconded on several occasions. according to his own statement, during his term at burnham the practice of sodomy was fairly common, and the boys often talked about it, but in his opinion did not regard it as a serious offence. he states they were flogged for it, but did not think much of that either, because they were flogged for many other things which he knew were not serious. he says he also met boys from another industrial school who were sent to burnham, who also did and talked about the same practice. altogether, therefore, he knew he was doing wrong, but he will not admit that he regarded it in any way as a serious offence. in he went to sea, and states that his chief companion was a member of the salvation army, also a seaman. he affirms that during all the time he was at sea he never heard the offence referred to. the men talked of women but never of sodomy. from to he apparently lived a reasonably good life. in he was convicted of sodomy and sentenced to life imprisonment. he was released on license on the th june, , and followed the occupation of gardener around auckland. he married in june, , and is at present serving a long sentence. offender alleges having made arrangements to be sterilized, but states doctor refused to perform operation. drink appears to have had some effect upon his life. case no. . ________________________________________________________ |number of |age of | | |successive |offender | offence. | |convictions.|when offence| | | |committed. | | +------------+------------+------------------------------+ | f. | | theft | | | | | | | | " | | | | " | | | | " | | | | | | | |breaking, entering, and theft | | | |vagrancy | | | |indecent assault | | | |escaping from custody | | | | | | | |indecent assault | | | | " | | | |indecent assault on a female | | | | (two charges) | | | | | | | | | +------------+------------+------------------------------+ ___________________________________________________________________ | | | | | | sentence. |sentenced | released |period at large | | | (date). | (date).|before arrest | | | | |on further charge. | +-------------------------+----------+----------+-------------------+ |to come up when called | / / | ---- | | | upon | | | | |sent to burnham | / / | ---- | | | days' hard labour | / / | ---- | | |to come up when called | / / | ---- | | | upon | | | | | months' hard labour | / / | / / | months. | | months' hard labour | / / | / / | year months. | | years' hard labour | / / | / / | months. | | months' hard labour, | / / | " | | | cumulative with above | | | | | years' hard labour | / / | / / | years months. | | years' hard labour | / / | / / | months. | | years' hard labour on | / / | still in | | | each charge, cumulative,| | prison.| | | and declared | | | | | habitual criminal | | | | +-------------------------+----------+----------+-------------------+ note.--f. is a native of new zealand, born in napier, february, , and is a labourer by occupation. he was convicted of theft at napier when a boy and sent to the burnham industrial school, from which place he escaped on several occasions. he was discharged from the school on the th april, , and since then has continued his criminal career, his further offences being of a sexual nature. he is given to tampering with little girls, and has on four occasions committed indecent assault of a more or less serious nature. he is undoubtedly a menace to society and not fit to be at large. offender is a temperate man, and when out of gaol appears to have wandered about the country doing an odd day's work here and there. his parents are dead. _approximate cost of paper._--preparation, not given; printing ( copies), £ * * * * * by authority: w. a. g. skinner, government printer, wellington.-- . _price s._ images generously made available by the internet archive/canadian libraries) a letter to _the lord chancellor_. a letter to the right honorable the lord chancellor, on the nature and interpretation of unsoundness of mind, and _imbecility of intellect_. by john haslam, m.d. late of pembroke hall, cambridge. _london:_ published by r. hunter, st. paul's church yard. *** . printed by g. hayden, little college street, westminster. a letter. my lord, the present address originates in an anxious wish for the advancement of medical knowledge, where it is connected with those maladies of the human mind, that are referable to the court, wherein your lordship has so long administered impartial justice. the disorders which affect the body are, in general, the exclusive province of the medical practitioner; but, by a wise provision, that has descended to us from the enlightened nations of antiquity, the law has considered those persons, whose intellectual derangement rendered them inadequate to the governance of themselves in society, or incapable of managing their affairs, entitled to its special protection. if your lordship should feel surprized at this communication, or deem my conduct presumptuous, the thirst of information on an important subject is my only apology; and i have sought to allay it in the pure stream that issues from the fountain-head, rather than from subordinate channels or distant distributions. although personally a stranger to your lordship, nearly thirty years of my life have been devoted to the investigation and treatment of insanity: of which more than twenty have been professionally passed in the largest receptacle for lunatics;--and the press has diffused, in several publications, my opinions and experience concerning the human mind, both in its sound state and morbid condition. the medical profession, of which i am an humble member, entertains very different notions concerning the nature of unsoundness of mind, and imbecility of intellect;--and this difference of opinion has been displayed on many solemn occasions, where medical testimony has been deposed. if a physician were to attempt to search into the existing records and procedures on insanity, to collect its legal interpretation, such investigation would probably be a waste of his time, the source of abundant, and perhaps of incurable error; but to these inconveniences he will not be subjected in attentively considering your lordship's judgments, of which i have availed myself on the present occasion, and which, having been taken down at the time they were delivered, may be presumed not materially incorrect. the documents to which i refer are the judgments of the d april, , and the th december, , on the portsmouth petitions, together with the minutes of conference between your lordship and certain physicians, on the th january, . in the judgment on the petition of , it is stated by your lordship,[a] "i have searched, and caused a most careful search to be made into all the records and procedures on lunacy which are extant. i believe, and i think i may venture to say, that originally commissions of this sort were of two kinds; a commission aiming at, and enquiring whether, the individual had been an idiot ex nativitate, or whether, on the other hand, he was a lunatic. the question whether he was a lunatic, being a question, admitting in the solution of it, of a decision that imputed to him at one time an extremely sound mind, but at other times, an occurrence of insanity, with reference to which, it was necessary to guard his person and his property by a commission issuing. it seems to have been a very long time before those who had the administration of justice in this department, thought themselves at liberty to issue a commission, when the person was represented as not being idiot ex nativitate, as not being lunatic, but as being of unsound mind, importing by those words, the notion, that the party was in _some such state_, as was to be contra-distinguished from idiotcy, and as he was to be contra-distinguished from lunacy, and yet such as made him a proper object of a commission, in the nature of a commission to inquire of idiotcy, or a commission to inquire of lunacy. from the moment that that had been established, down to this moment, it appears to me to have been at the same time established, that _whatever_ may be the degree of weakness or imbecility of the party to manage his own affairs, if the finding of the jury is only that he was of an extreme imbecility of mind, that he has an inability to manage his own affairs: if they will not proceed to _infer_ from _that_, in their finding, upon oath, that he is of unsound mind, they have not established, by the result of the inquiry, a case upon which the chancellor can make a grant, constituting a committee, either of the person or estate. all the cases decide that mere imbecility will not do; that an inability to manage a man's affairs will not do, unless that inability, and that incapacity to manage his affairs _amount_ to evidence that he is of unsound mind; and he must be found to be so. now there is a great difference between inability to manage a man's affairs, and imbecility of mind taken as _evidence_ of unsoundness of mind. the case of charlton palmer, in which this was very much discussed, was the case of a man stricken in years, and whose mind was the mind of a child;--it was, _therefore_, _in that sense_, imbecility, and inability to manage his affairs, which _constituted_ unsoundness of mind." the introduction of the term _unsoundness_, to denote a particular state of disordered mind, which is supposed to differ from idiotcy and lunacy, has been the source of considerable perplexity to medical practitioners; and, in my own opinion, opens an avenue for ignorance and injustice. the application of figurative terms, especially when imposed under a loose analogy, and where they might be supplied by words of direct meaning, always tends to error and confusion. when medical persons depose that the mind of an individual is unsound, (which character of intellect, if accredited by the jury, would induce them to find the commission,) they ought, at the same time, to define precisely what they mean by such term:--and the jury, when they "proceed to infer" this unsoundness, ought to be in possession of sufficient and well-defined premises, to warrant such inference. but where are these materials to be found? there is a strong presumption that this unsoundness remains an unsolved problem to the present hour, and it is exemplified in the difference of sentiment that prevailed on a late occasion,[b] between the most eminent of the medical profession; where the same opinions and conduct impressed certain physicians, that this nobleman was of sound mind, and others that his mind was thoroughly unsound: so that the jury were to _proceed to make their inference_ from the opposite testimony, deposed by the medical evidence, or to proceed to hold such evidence in little esteem from its contrariety on a subject which these physicians professed to illustrate. the term unsoundness, applied to designate a certain state of the human mind, hitherto undescribed, has not originated with medical persons; to them, therefore, we cannot refer for the solution of its import, and there can be no analogy between the definite unsoundness of animal and vegetable substances, and any condition of the intellect. timber is said to be unsound, and although we may be little acquainted with the cause by which it is produced, yet its actual state of rottenness is evident:--a horse is unsound, in consequence of some morbid affection that can be pointed out by the veterinarian:--a dentist can detect an unsound tooth:--a physician, from certain well marked symptoms, concludes that the lungs or liver of an individual are unsound:--particular doctrines are held to be unsound, because they deflect from such as are orthodox, and it is presumed there may be an unsound exposition of the law. the human mind, however, is not the subject of similar investigation; we are able to discover no virus by which it is contaminated--no spreading rottenness--no morbid leaven that ferments, or canker that corrodes it. although we may apply the word unsoundness, in a figurative or metaphorical sense, to the human mind, yet we cannot detect in it any of the marks or indications that characterize the unsoundness of substances acknowledged to be in that state: it is, therefore, under this conviction, and with the view of increasing our knowledge of the human intellect, that, on the behalf of the members of the medical profession, i venture to solicit your lordship, on the first opportunity that may occur, to elucidate the nature of this unsoundness of mind, so that physicians may be enabled thoroughly to ascertain its existence, and conscientiously depose to that effect, and also that it may be recognized by the jury, when they "proceed to make their inference," in order that, by their return, your lordship may appoint the proper committees of the person and property. respecting the human intellect, two very opposite opinions prevail among physiologists and metaphysicians. one party strenuously contends that the phenomena of mind result from the peculiar organization of the brain, although they confess themselves to be as "entirely ignorant how the parts of the brain accomplish these purposes, as how the liver secretes bile, how the muscles contract, or how any other living purpose is effected."--the other maintains that we become intelligent beings through the medium of a purer emanation, which they denominate spirit, diffused over, or united with, this corporeal structure. the former of these suppositions is held by many grave and pious persons to be incompatible with the doctrines of the christian religion; and if i am not mistaken, your lordship, on a late occasion, after having perused a work attempting to establish such principles, did incline, by "rational doubts," to suspect that these opinions were "directed against the truth of scripture." it is particularly fortunate that the arguments concerning the nature of unsoundness of mind and imbecility do not involve either of these presumptions:--if the most decided victory over their opponents were to be conceded to the fautors of organization, no advantage could be derived from their philosophy by lawyer or physician, whose object is to ascertain the existing state of an individual's mind, and not to detect the morbid alterations of the cerebral structure by the scrutiny of dissection: nor is it necessary, for the elucidation of the present subject, to contend for the pre-eminence of the spiritual doctrine, as it would be extremely difficult, and perhaps irreverent, to suppose, that this immaterial property, this divine essence, that confers perception, reverts into memory, and elaborates thought, can be susceptible of unsoundness. these high attributes, proudly distinguished from perishable matter;--this sanctuary, which "neither moth nor rust doth corrupt," cannot undergo such subordinate changes, without an obvious degradation. to the furtherance of that pure and substantial justice, which it has been the tenor of your lordship's ministry to award, these metaphysical disquisitions will in no manner contribute; nor will they assist the medical practitioner in the attainment of his object, which is to ascertain the competence of an individual's mind, to conduct himself in society, and to manage his affairs. by the abstract term mind, is to be understood the aggregate of the intellectual phenomena, which are manifested or displayed to the observer by conversation and conduct; and these are the only tests by which we can judge of an individual's mind. the boasted deciphering of the human capacities or moral propensities, by the appearances of the physiognomy, or by craniological surveys--the mysterious pastimes of anatomical prophets, will never be accredited in a court of justice while your lordship guides the helm. by conversation, is of course included the conveyance of thought by writing, which, on many occasions, is a more accurate criterion of the state of mind than oral expression. your lordship seems to consider that we have derived some advantages by the issue of a commission to ascertain this _unsoundness_ of mind, and without such due consideration, it is presumed you would not have adopted it; but the citation of your own accurate phraseology, as it appears in your judgment of , on the portsmouth petition, will best illustrate the subject. "it seems to have been a very long time before those who had the administration of justice in this department thought themselves at liberty to issue a commission, when the person was represented as not being idiot ex nativitate, as not being lunatic, but as being of unsound mind, importing, by these words, the notion, that the party was in _some such state_, as was to be contra-distinguished from idiotcy, and as was to be contra-distinguished from lunacy, and yet _such_ as made him a proper object of a commission in the nature of a commission to inquire of idiotcy, or a commission to inquire of lunacy." these words clearly imply a morbid state of intellect, which is neither idiotcy nor lunacy, termed _unsound mind_, and yet the legal remedy for the protection of the person and property of the possessor of this _unsound mind_ does not differ from that which is applied to idiot and lunatic. the process of law is the same. this undescribed state of unsoundness is contra-distinguished from idiotcy and lunacy; but we are left in the dark concerning the peculiar circumstances by which it is contra-distinguished, and under such defect the advantages of introducing a new and undefined term are not apparent. for what purpose "those who had the administration of justice in this department thought themselves at liberty" so to act, is not explained: but your lordship having adopted such practice, and highly commended the authority from whence it has been derived, can, doubtless, afford the necessary elucidation. for those venerable authorities of the law, who have preceded your lordship in this department of the administration of justice, i feel impressed with the utmost deference and respect; and these grateful sentiments will be rendered more intense whenever their reasons are promulgated. medical practitioners, who have devoted their lives to the consideration and treatment of insanity, are disposed to doubt concerning the existence of any intrinsic or positive unsoundness of mind, as contra-distinguished from idiotcy and lunacy. those who have accumulated the largest sum of experience in disorders of the intellect, have viewed the various forms under which they are manifested, as equally conducing to render an individual incapable of conducting himself and managing his affairs, whether the mental affection be termed madness, melancholy, insanity, mental derangement, non compos mentis, idiotcy, or lunacy; and, if it were necessary, a more ample catalogue might be introduced. physicians may, perhaps, be advantageously occupied in establishing nice shades of difference in the symptoms of mental disorder; and, if we do not already possess sufficient, may create new terms expressive of these modifications: and such extension of the nosological volume may have its practical utility: but the lawyer can have no interest in such speculations, he only looks to the medical evidence to demonstrate the existence of that _morbid_ condition of intellect that renders the individual incompetent to conduct himself in society, and to manage his affairs. speaking generally, the state of idiotcy is well understood, although cases of an intricate nature may occasionally occur: but there is considerable probability, that the interpretation that has adhered to the term lunacy, more especially in the estimate of the lawyer, has been the source of considerable error, and has also tended to introduce the middle and undefined epithet of unsoundness. the old physicians, for whom modern practitioners entertain less reverence than lawyers feel for their predecessors, concurred, that lunatics were not only persons of disordered mind, but that their intellectual aberrations corresponded with certain changes of the moon: and this lunar hypothesis which had beguiled the medical profession, will furnish a sufficient apology for its adoption by the lawyer. it is a necessary consequence, if the moon, at certain periods, shed a baneful influence on the human intellect, that the intermediate periods would be exempt from its contamination; or, speaking more technically, at certain phases of that luminary, a person would be visited by an insane paroxysm, and at others, experience a lucid interval. the belief in these alternations of insanity and reason, is perspicuously stated in your lordship's judgment of , on the portsmouth petition. "the question whether he was a lunatic, being a question admitting, in the solution of it, of a decision that imputed to him, at one time, an _extremely sound mind_, but at other times, an occurrence of insanity, with reference to which it was necessary to guard his person and his property by a commission issuing." notwithstanding it must be admitted that "there are more things in heaven and earth than are dreamt of in our philosophy;" yet, in the present times, our faith in the influence of the lunar aspects has considerably abated, and we employ the term lunatic as a familiar expression, to denote a person of insane mind, without any reference to its derivation, or supposed ascendency of the moon, which my own observations have tended to disprove:--but as the phrase lucid interval is, in its legal sense, connected with lunatic, some investigation of its meaning becomes absolutely necessary. if it were the real character of lunacy, after the visitation of the paroxysm, to leave the patient in the possession of an _extremely sound mind_, this disorder would be rendered much less formidable than we now consider it, and might in its effects be compared to those violent storms of thunder and lightning that purify the atmosphere and dispense salutary refreshment; and it is not improbable, that some, gifted by nature with mediocrity of talent, but of a philosophical turn and aspiring pretensions, might regard the occurrence of such paroxysm as a desideratum, rather than an evil, on account of the _extreme soundness_ they would experience afterwards: it is moreover evident, that however degraded the lunatic may be in the estimation of vigorous and enlightened intellects, yet this depreciated object, by the enjoyment of occasional periods of bright understanding, has abundant cause for taunt and triumph over the victim of unsoundness; whose state is "contra-distinguished from lunacy," and as far as has been hitherto ascertained, does not revel in the luxury of a lucid interval. but these vicissitudes of intellectual obscurity and lustre have no real existence;--they are not the offsprings of observation and experience, but the abortions of hypothesis and precipitate deduction. lunatics, from the excitation of various causes, become at times more violent or desponding, and these exacerbations are often succeeded by tranquillity and cheerfulness, they are more tractable, and less impelled to urge the subjects of their prevailing delusions: but this apparent quietude or assumed complacency, does not imply a renunciation of their perverted notions, which will be found predominant whenever they are skilfully questioned. inexperienced persons judge of the insane state from the passions or feelings that usually accompany this disorder, and infer its aggravation from the display of boisterous emotions or afflicting apprehensions: the medical practitioner considers these sallies as the mere concomitants of a perverted intellect. this view of the subject is justified by a fact, of too much importance to be omitted on the present occasion. many lunatics, whose dangerous propensities it has been prudent to control by a stricter restraint, and for a lengthened period, eventually become harmless, and are safely permitted to enjoy many indulgences incompatible with their former state: yet these persons retain their original delusions, although they have acquired the habit of arresting the impulses which these delusions prompted. it may therefore be inferred, that a lucid interval is equivalent to the complete recovery of the patient, and implies the absolute departure of _all_ those delusions from his mind, that constituted his lunacy:--leaving him in a condition to sustain a thorough examination, not shrinking from particular subjects, nor "blenching," though "tented to the quick;"--and clearly perceiving by contrast the delusions that had prevailed, and the reason that has supervened. the term interval, by which the duration of rational discourse and conduct is to be estimated, although of sufficiently precise meaning, is yet susceptible of the most extended signification; and we speak with equal correctness when we say the interval of a moment and of a thousand years. the time necessary to comprise a lucid interval has not, to the best of my belief, been limited by medical writers or legal authorities; it must however comprehend a portion sufficient to satisfy the inquirer, that the individual, whose intellect had been disordered, does not any longer retain any of the symptoms that constituted his malady; and this presumes on the part of the examiner an intimate knowledge of the unfounded prejudices, delusions, or incapacities with which the mind of the party had been affected, and also deliberate and repeated investigations to ascertain that they are wholly effaced. imbecility. there is another subject connected in a legal point of view with the nature of the human mind, and with the state of its morbid conditions, on which i respectfully solicit your lordship's elucidation. in your lordship's judgment of , on the portsmouth petition, it is laid down that "from the moment that (meaning this questionable and disputed unsoundness) had been established, down to this moment, it appears to me however to have been at the same time established, that _whatever_ may be the degree of weakness or imbecility of the party,--_whatever_ may be the degree of incapacity of the party to manage his own affairs, if the finding of the jury is only that he was of an extreme imbecility of mind, that he has an inability to manage his own affairs; if they will not proceed to infer from that, in their finding upon oath, that he is of _unsound mind_, they have not established by the result of the inquiry, a case upon which the chancellor can make a grant, constituting a committee either of the person or estate. all the cases decide that mere imbecility will not do: that an inability to manage a man's affairs will not do, unless that inability and that incapacity to manage his affairs, amount to evidence that he is of _unsound mind_: and he must be found to be so." a conclusion is here drawn that the establishment of _unsoundness_ necessarily involves, that the extreme degree of imbecility and incapacity of mind does not constitute this unsoundness: that is,--they may exist in the extreme degree, (or citing the words employed,) in any degree whatever, which implies the ne plus ultra, without any resulting unsoundness. this is a dictum, which proceeding from your lordship, the highest authority, is intitled to the utmost deference:--but it is not an inference from any acknowledged premises, nor established by the intervention of any corroborating argument. the very existence of this intrinsic unsoundness, is "down to the present moment" unproved, and all that can be inferred in this state of the question, is the accredited maxim that "nil agit exemplum litem quod lite resolvit." by the common consent of philosophers and physicians, mental imbecility in the extreme degree is termed idiotcy; and this state may exist "ex nativitate," or supervene at various periods of human life. when a child proceeds from infancy to adolescence, and from that state advances to maturity, with a capacity of acquiring progressively the knowledge which will enable him to conduct himself in society and to manage his affairs,--so that he is viewed as a responsible agent and considered "inter homines homo," such a being is regarded of _sound_ capacity or intellect:--but if in his career from infancy to manhood it is clearly ascertained that education is hopeless,--that the seeds of instruction take "no root, and wither away,"--that he is deficient in the capacity to attain the information requisite to pilot himself through the world and manage his concerns, such a person would be deemed an idiot, and it might be safely concluded that his intellect was _unsound_, by wanting those capacities that constitute the sound mind. according to your lordship's exposition he could not be pronounced _unsound_, because this word implies "_some such state_, as is to be _contra-distinguished_ from idiotcy." in order that a definite signification may be affixed to the expression "_some such state_," it will not, i trust, be deemed indecorous to ask, what particular condition of morbid intellect is to be understood by this "some such state?" the solution of this difficulty would be most acceptable to the practitioners of medicine, and in my own humble opinion of great relief to the jury, who are called upon to "proceed to infer" this state of unsoundness without any other premises than the words "_some such state_." although we are distinctly told by your lordship, that the extreme degree of imbecility or incapacity will not constitute this "_some such state_" that may be denominated unsoundness; yet i feel highly satisfied with the force and precision by which it is expressed in the words "_whatever degree_," which if a scale were constructed on which imbecility might be estimated, would imply the ultimate gradation; and whenever any subject can be regulated by definite quantity, expressed in numbers, it conveys the most certain information. your lordship may however judge of the surprize and disappointment i felt when i arrived at the following sentence in the same judgment, "all the cases decide that mere imbecility will not do; that an inability to manage a man's affairs will not do, unless that inability and that incapacity to manage his affairs amount to evidence that he is of unsound mind, and he must be found to be so." this, my lord, is an ample confession that there is a degree of mental weakness that _does_ amount to unsoundness, and in this opinion all philosophers and medical practitioners will unhesitatingly concur: but at the same time this admission wholly upsets the former doctrine, that no degree of imbecility "whatever" can constitute this required unsoundness. in your lordship's judgment on the portsmouth petition, delivered the th december, , it is stated, "it may be very difficult to draw the line between such weakness, which is the proper object of relief in this court, and such as amounts to insanity," and in the next sentence, "this is the doctrine of lord hardwicke, and i follow him in saying it is very difficult to draw the line between such weakness which is the proper object of relief in this court, and such as amounts to insanity." this is a second corroboration of an opinion that destroys the former doctrine. finally in the "minutes of conference between your lordship and certain physicians, held on the th january, , in the portsmouth case," there is an endeavour to explain the nature of _unsoundness_, and of imbecility or weakness;--but it is insufficient to direct the physician to any clue whereby his doubts can be solved, and unfortunately relapses into the original contradictory statement. "the commission which is usually termed a commission of lunacy, and which because it has that name, i observe many persons are extremely misled with respect to the nature of it, and which produced on a former occasion, with respect to this nobleman, a great mass of affidavits, in which they stated he was not an object of a commission of lunacy.--i say that these words are not much understood.--the law acknowledges the state of idiotcy, and the state of lunacy, which properly understood, is a very different thing from that sort of unsoundness of mind which renders a man incapable of managing his affairs or his person.--and it has now been long settled, not that a commission of lunacy is to be issued; but that a commission is to issue in the nature of a writ de lunatico inquirendo, and then the object of the commission is perfectly satisfied, if the jury shall find upon satisfactory evidence, that the party is of unsound mind, and incapable of managing his own affairs.--the finding of him incapable of managing his own affairs, is not sufficient to authorize further proceedings, but there must be a finding that he is of _unsound_ mind, and unable to manage his affairs:--incapacity to manage his affairs being considered as evidence of unsound mind:--yet there may be, (and that every man's mind will suggest) instances of incapacity to manage a man's affairs, and yet _no_ unsoundness of mind." that many persons are extremely misled with respect to a commission of lunacy, and too frequently concerning all other subjects, is fully admitted: and it is equally clear that the great mass of affidavits produced in , in favor of lord portsmouth's soundness of intellect (for i have attentively perused the whole catalogue) did not go into the investigation of the supposed difference between this hypothetical unsoundness and lunacy; but attested, as far as his lordship's conversation and conduct had been the subject of their observation and judgment, that he was not a man labouring under any infirmity, or morbid state of mind, that ought, by any legal restraint, to disqualify him from the management of himself and his affairs. with such opinions i have no concern; they can only be regarded as negative evidence, and cannot operate against manifold overt acts of insanity. in the progress of this respectful address, after numerous but unsuccessful endeavours to grapple with this _sort_ of unsoundness, suspicions have arisen that i have been pursuing a phantom;--at times i have fondly imagined it within my immediate grasp, but it has always evaded my seizure with unaccountable dexterity:--it even now appears that i could "clutch" it, as your lordship distinctly asserts that, "lunacy _properly understood_ is a _very different thing_ from that _sort_ of _unsoundness_ which renders a man incapable of managing his affairs or his person." this is at once coming manfully to the point; for the disclosure (whenever it may take place) of the circumstances that constitute lunacy properly understood, which means as it _ought_ to be understood, a very different thing from this sort of unsoundness, will be the solution of this desideratum,--and this development will impose a considerable weight of obligation on the medical profession. it now only remains to consider the last material sentence, delivered by your lordship at this conference, and which to my limited comprehension, appears, in the same breath, to affirm and deny the same position. "the finding of him incapable of managing his own affairs, is not sufficient to authorize further proceedings, but there must be a finding that he is of _unsound_ mind, and unable to manage his affairs:--incapacity to manage his affairs, being considered as evidence of unsound mind." with the citation of this memorable sentence,--unadulterated by any comment, i shall conclude this address to your lordship, submitting at the same time my own impressions on the subject:--that, to search for its correct exposition is reverential to the law: to crave its elucidation from its exalted minister is an act of respectful deference:--this solicitude is increased from the consideration that the written opinion of the medical practitioner is deposed on oath, and that he is examined by the commissioners and jury under the same awful responsibility:--therefore, when the solemnity of that obligation is contemplated, the anxiety for accurate information will scarcely require an apology. i am, my lord, with the utmost respect, your lordship's very obedient servant, john haslam. _no. , hart street, bloomsbury, may, ._ _works by the same author._ observations on madness and melancholy. illustrations of madness, with a plate. on the moral management of the insane. medical jurisprudence, as it relates to insanity. a letter to the governors of bethlem hospital. sound mind, or the physiology of intelligent beings. *** a new edition of the observations on madness and melancholy, with considerable additions, will shortly appear. *** printed by g. hayden, little college street, westminster. footnotes: [a] the following citation was introduced, with some comments, in my work on medical jurisprudence, as it relates to insanity, according to the law of england, , which is now out of print. [b] lord portsmouth's commission. [transcriber's note: other than one correction (p. , 'ideot' to 'idiot' in 'when the person was represented as not being idiot ex nativitate'), all archaic and unusual spelling (e.g. idiotcy) has been left as in the original.] note: project gutenberg also has an html version of this file which includes the original illustrations. see -h.htm or -h.zip: (http://www.gutenberg.net/dirs/ / / / / / -h/ -h.htm) or (http://www.gutenberg.net/dirs/ / / / / / -h.zip) keeping fit all the way how to obtain and maintain health, strength and efficiency by walter camp illustrated with many photographs taken under the direction of the author [illustration: three pioneers in senior service work left to right: colonel ullman, president, chamber of commerce, new haven, connecticut; ex-president william h. taft, and walter camp.] table of contents introduction an american citizen's creed part i. keeping fit all the way chapter i chapter ii chapter iii chapter iv chapter v chapter vi part ii. the daily dozen chapter vii chapter viii chapter ix chapter x chapter xi chapter xii chapter xiii introduction the number of men who "keep fit" in this country has been surprisingly few, while the number of those who have made good resolutions about keeping fit is astonishingly large. reflection upon this fact has convinced the writer that the reason for this state of affairs lies partly in our inability to visualize the conditions and our failure to impress upon all men the necessity of physical exercise. still more, however, does it rest upon our failure to make a scientific study of reducing all the variety of proposals to some standard of exceeding simplicity. present systems have not produced results, no matter what the reason. hence this book with its review of the situation and its final practical conclusions. an american citizen's creed i believe that a nation should be made up of people who individually possess clean, strong bodies and pure minds; who have respect for their own rights and the rights of others and possess the courage and strength to redress wrongs; and, finally, in whom self-consciousness is sufficiently powerful to preserve these qualities. i believe in education, patriotism, justice, and loyalty. i believe in civil and religious liberty and in freedom of thought and speech. i believe in chivalry that protects the weak and preserves veneration and love for parents, and in the physical strength that makes that chivalry effective. i believe in that clear thinking and straight speaking which conquers envy, slander, and fear. i believe in the trilogy of faith, hope, and charity, and in the dignity of labor; finally, i believe that through these and education true democracy may come to the world. part i keeping fit all the way chapter i it has long been a startling fact regarding americans that so soon as their school-days were over they largely abandoned athletics; until, in middle life, finding that they had been controverting the laws of nature, they took up golf or some other form of physical exercise. the result of such a custom has been to lower the physical tone of the race. golf is a fine form of exercise, but in an exceedingly mild way. no one claims that it will build up atrophied muscles nor, played in the ordinary way, that it will induce deep breathing; nor, except in warm weather, that it will produce any large amount of skin action. hence it is easy to imagine the condition of the man who at the end of his 'teens gave up athletics, and then did nothing of a physically exacting nature until he took up golf. now if in addition to his pastime and relaxation he will do something in the way of setting-up exercises to open up his chest and make his carriage erect, thus enabling his heart and lungs to have a better chance, he will more than double the advantages coming from his golf. he will then walk more briskly and will gain very much in physical condition. nature a hard mistress one thing that our middle-aged men, and in fact many of us who have not yet reached that way mark, have entirely forgotten is that nature is very chary of her favors. our primal mother is just and kind, but she has little use for the man who neglects her laws. when a man earns his bread by the sweat of his brow she maintains him in good physical condition. when he rides in a motor-car instead of walking she atrophies the muscles of his legs, hangs a weight of fat around his middle, and labels him "out of the running." if he persists in eating and not physically exerting himself, she finally concludes that he is cumbering the earth, and she takes him off with bright's or diabetes. it does not do him any good to tell her that he was too busy to walk and so had to ride, or that he had no time for exercising; she simply pushes him off to make way for a better man. the vicious circle nature has given man two ways (outside of the action of the bowels) of getting rid of impurities, one by means of the skin and the other by means of the kidneys. it is like a motor-car with two cylinders. if one stops the other will run on for a time, but its wear is increased. when a man stops exercising and ceases to carry off by means of his skin some of these impurities, he throws an additional load on his kidneys. when a man goes without exercise and begins to accumulate fat, that fat gradually deposits itself and not alone about the waist; it invades the muscular tissue all over his body even to his heart. as this accumulation grows there come with it a muscular slackness and a disinclination to exercise. the man is carrying greater weight and with less muscular strength to do it. no wonder that when he tries to exercise he gets tired. he is out of condition. hence he begins to revolve in a vicious circle. he knows that he needs exercise to help take off the fat, but exercise tires him so much, on account of the fat, that he becomes exhausted; usually he gives it up and lets himself drift again. as his abdomen becomes more pendulous his legs grow less active. as his energy wanes his carriage becomes more slack. he shambles along as best he can, if he is positively obliged to walk. his feet trouble him. altogether he is only comfortable when riding. when he has reached this state the insurance companies regard him as a poor risk, and instead of enjoying the allotted threescore and ten years of real life he falls short by a decade; and even then the last ten years are but "labor and sorrow." as the years go on the first thing that a man begins to lose through the inroads of age is his resistive power. he may seem in perfect health so long as there is no special change of conditions, but when he is placed in a position where he needs his resistive forces to throw off disease, he finds that he cannot command them. still another change is continually taking place; as the man goes on in life, little by little the control of his muscles leaves him. instead of running about as does the youth, recklessly and with never a thought of being tired, he begins to favor himself by walking in the easiest possible way, until soon he is balancing on one foot and then tilting forward on the other, making no muscular effort and preferring the motor-car or the trolley whenever it is at hand. as an inevitable result, some of the muscles atrophy, and even those that do not deteriorate speedily discover that they have no master, and they act when and how they please. the man who is continually giving orders to subordinates and having other men do things for him, soon finds that he is unable to accomplish things for himself; then, if he is thrown on his own resources, he is helpless. take a group of men, executives, who for a dozen years have been ordering other men about instead of obeying orders, and you will find that for the most part these captains of industry have lost per cent. of their muscular control. on the other hand, the man who is taking orders retains command over all his muscles, for he is daily and hourly training them to instant obedience. a group of privates will snap into "attention" at the word of command with splendid muscular control; the same number of officers would find great difficulty in doing this. now as the man loses muscular control he loses poise and carriage. his head rolls about in a slack way on his neck, and has a tendency to drop forward; the muscles of the neck and the upper part of the back grow soft from lack of use and control and he begins to become round-shouldered; his chest falls in as the shoulders come forward and the chest cavity is reduced. this means a gradual cramping of lungs, heart, and stomach. by way of compensation he lets out a hole or two in his belt and starts in to carry more weight there. in other words, he exchanges muscle for fat, and as the fat increases he has less and less muscular strength to carry it. it is as though in a motor-car one added hundreds of pounds of weight to the body and reduced the horse-power of the engine. pretty soon the man becomes so heavy around the waist that he notices his discomfort, and it produces exhaustion; now he becomes more and more averse to exercise, and the facia, or fat, having the better of the battle, begins to penetrate even the fiber of the muscles. the remedy the heart is a muscle, like all the others in the body, and fat may accumulate there. when this condition comes about the man is perforce obliged to be careful, for the heart muscle has lost its strength. as stated, the situation becomes a vicious circle: as the man adds fat he becomes more and more averse to exercise, and the less he exercises the fatter he gets. and yet all this can be prevented; nor is it necessary to take up any violent system of training, or to engage in tremendous gymnastic exercise. if the patient is willing to take reasonable physical training along scientific lines, a few hours a week will keep him in respectable shape, so that he may preserve not only his figure, but also his activity. it should be remembered that all the members of the body partake of the slackness that is apparent externally. thus organs that should be active in changing fat into energy lose their tone, and with that goes their ability to carry on their proper functions. the best work of the man himself is co-ordinated with the proper performance of the bodily activities. growth and strength depend upon and react upon the tissues, and while this process is less active as age comes on, it can be stimulated to the great advantage of both mind and body. what worry does every man who has reached a high place in his community or who has become a leader of note knows that executive work has a tremendous effect upon the nerves and body. if the man becomes run-down the smallest decision gives him difficulty; it seems weighted with enormous possibilities of disaster. a problem, which under normal conditions he would turn over with equanimity to his assistant, takes on, in his nervous state, a seriousness that leads to hours of worry. and yet if he goes away on a vacation he returns to find that nine-tenths of these troublesome things have been well taken care of during his absence. moreover, now that he has come back in a state of physical health and with nerves that are normal, he sees that these awful problems were simply exaggerated in his own mind by his overwrought physical condition. few people realize the effect of worry upon the digestion. an experiment was once tried upon a cat, which was fed a dish of milk, stroked until it purred, and played with for half an hour. the animal was then killed and the stomach examined; the milk was perfectly digested. another cat was taken and given a similar saucer of milk; then its fur was rubbed the wrong way and it was teased and annoyed as much as possible for half an hour. upon examining the stomach of the second cat it was found that not a step in the process of digestion had taken place. americanitis it is wise to study the condition that we might almost call "americanitis." the american youth, as shown in the olympic games, is not only a match in speed, strength, and stamina for the youth of other nations, but when it comes to the individual specialist even then the american-trained boy is his superior. we smash records regularly. we have been doing this for a decade with hardly a break. even those who criticize our tendency to develop individuals are obliged to admit that this continual advance in athletic prowess fosters the spirit of emulation among the masses. moreover, we are improving in the way of distributing our efforts, and more and more men in schools and colleges come out for physical training and development. we have not by any means perfected the system, but it is on the way. supplementing this general athletic development comes now the introduction into the curriculum of military drill. finally compulsory military education or at least the compulsory physical part of it, throughout the country will set up the youth of the coming race in a way hitherto unthought of. it is safe to say that the next decade will see our youth, and men up to the age of forty, in far better physical condition than is the case to-day. the price of success the men of this country, with their forcefulness and their ambition, their stern desire to succeed quickly and to work furiously if necessary to obtain that success, are apt to forget that nature meant man to earn his bread by the sweat of his brow; and that just so far as he departs from this primal method of supporting himself and his family he must pay toll. almost before he realizes it the american youth is a staid man of business. only yesterday he was a boy at play, and to-day he finds himself known by his first name or nickname only to a few old classmates whom he sees at his college reunions. he is judge this or honorable that. he has had no time to realize that somewhere he has lost fifteen or twenty years in this wild rush for fortune and fame. now in some hour of enforced reflection during a temporary illness he begins to count the cost, to think how little he has in common with that growing boy of his. but still he does no more than wish that he might have more time for play and could see his way to longer and less interrupted vacations. perhaps on his next period of relaxation he plunges into an orgy of physical exercise--plays to the point of exhaustion--enjoys it, too, and sleeps like a log. oh, this is the life once more! when he returns to town he determines to take more time for exercise; he will keep up his tennis or golf. but once back at work, he must make up for lost time. he returns with an improved appetite and he indulges it. soon his vacation benefits have worn off, together with his vacation tan. the muscles slacken again, the waist-line increases. he feels a little remorse over the way he has broken his good resolutions, but of course he cannot neglect his business. then, after a hard week, followed by some carelessness or exposure, he thinks that he has the grip or a cold. he is lucky if he stays at home and calls in his physician. he does not pick up. now, for the first time, he hears from the doctor words that he has caught occasionally about men far older than himself--"blood pressure." but he he is under fifty! the doctor says he must go slower. now begins a dreary round indeed! he has never learned to go slow! he is an old man at fifty. if lucky, he has made money. but what is the price? he has found precious little fun in those fifteen or twenty years since he was a boy. of course he has had his high living, his motor, his late hours. his cigars have been good, but he has never enjoyed them so much as he did the old pipe at camp. his dinners and late suppers can't compare with the fish and bacon of the woods. what a fool he has been! perhaps he has caught himself in time. if so he is in luck and nature may partially forgive him and give him a chance to "come back." he is well scared and he means to be good. but the scare wears off, and then, too, "business" presses him on again. and finally, still well this side of sixty, perhaps, nature taps him on the shoulder and says, "stop!" "but," he pleads, "i'll be good!" "you are in the way," she replies, "and the sooner you make place for wiser men the better i shall have my work done." but it is not alone the business world that is full of these untimely breakdowns. we lose many a man in the professional ranks with ten years of his best work before him, the man of ripened intellect, with his store of reading and experience--stopped oftentimes in the very midst of that masterpiece whose volumes would be read by future generations. executives whose value to corporations is increasing in a compound degree suddenly receive notice that the continually bent bow is cracking; almost immediately they lose their ambition and initiative, they become prematurely aged. these are indeed expensive losses! and all this could be saved at an expenditure of a few paltry hours a week devoted to the repair of the physical man; given that and we may safely promise that he shall round out the full measure of his mental labors. the men of this country are going the pace at a far more reckless rate than that of any other nation. philosophers like prof. irving fisher are sounding the warning. shall we heed it? chapter ii when dr. d.a. sargent, of harvard university, makes the charge that, "more than one-half of the male population between the ages of eighteen and forty-five years are unable to meet the health requirements of military service, and that, of the largest and strongest of our country folk pouring into our cities, barely one of their descendants ever attains to the third generation," it becomes a pretty serious charge. we are already familiar with the forgetfulness of physical condition by men over forty, but we had prided ourselves considerably over the belief that the majority of our youth would compare favorably with those of other countries. when one comes to sift the statement, he should remember that many disabilities for which the military examiners might reject a man are not so serious, after all, and that nothing has been said about the splendid physique of the large number of men who are accepted. the writer visited recently many of the training-camps, both military and naval; and when he came away he was quite prepared to agree with those who praise the flower of the flock as being superior to that they have seen on the other side. the point is that doctor sargent is absolutely right in asserting that we ought not to have had so many rejections. it is time for us to realize that a man who is out of balance physically should be looked after. moreover, men should not become out of balance. the truth of the matter is that our mechanical devices have gone so far toward taking the place of manual labor that we only have one line of physical development--our athletic sports. if, therefore, these are not made broad enough and thorough enough and accessible enough, we are likely to have just what is happening now--namely, a slump when it comes to measuring up to the standard instituted by the military authorities. our young men do flock to the cities and city life means crowded conditions, lack of outdoor exercises, vitiated atmosphere, and a minimum of sunshine and of the other elements that go to perfecting and keeping up a robust and enduring physique. the value of exercise now exercise is the most important factor toward counteracting these unnatural conditions. air, bathing, and diet aid, but we must have exercise in order to get the energetic contraction of the larger muscles of the body which goes so far toward regulating the physical tone. we must have what are called compensatory exercises, beginning as far down as the grammar-schools and continuing right through the universities and professional schools into general business and civic life. this war has opened our eyes; it should be a warning, and it ought to result in a far broader comprehension of what physical condition and physical education really mean. it is in this way only that we can meet the demands of modern civilization without an accompanying deterioration of the physical condition of our people. no one has set a finer example in this respect than president wilson himself, who, realizing the enormous strain that was coming upon him, has systematically and conscientiously prepared for it. early every morning, long before most washingtonians are so much as turning over for their pre-getting-up nap, the president is out and off around the golf-course. also doctor grayson has prepared a system of exercises for his use when outdoor work is impossible. preparing for emergencies in the summer of several members of the cabinet formed themselves into a club, with other prominent officials in washington, and kept themselves fit throughout the season by consistent morning exercise, four days a week. so far so good, only we should have realized more than a year ago the strain that was coming upon our men and taken measures to meet it, as germany did. dr. william c. woodward, who is chairman of the district police board in washington, did not overstate the matter when he said that the draft officers were weary, that the strain had begun to threaten their efficiency, and that they were thoroughly undermining their bodies in the effort to accomplish their tremendous task. every community has seen the same thing happen, and several of them can agree with doctor woodward that this has come close to being a really serious business calamity throughout the country. all these men should have been prepared by thirty or sixty days of physical training for this extra strain. again, the equitable life assurance society, in its september bulletin, calls attention to the fact that, out of approximately , , men who volunteered for the army and navy, only , were acceptable. furthermore, the equitable notes that these physical impairments not only will not correct themselves, but that they will get worse, and that a large percentage of our vast horde of physically sub-standard, low-priced men will drift into sickness and meet premature death because their power to resist disease is rapidly declining. the equitable calls, on this convincing evidence, for a thorough and permanent system of health education in our schools, saying: "with all of our wealth and intelligence and scientific knowledge in the field of health conservation, we are allowing a large proportion of our children to pass out of the schools into adult life physically below par." the equitable concludes with the remark: "some day we will give all american school children thorough physical training and health education. why not commence now?" from a famous physician's note-book dr. s. weir mitchell says: all classes of men who use the brain severely, and who have also--and this is important--seasons of excessive anxiety or grave responsibility, are subject to the same form of disease; and this is why, i presume, that i, as well as others who are accustomed to encounter nervous disorders, have met with numerous instances of nervous exhaustion among merchants and manufacturers. my note-books seem to show that manufacturers and certain classes of railway officials are the most liable to suffer from neural exhaustion. next to these come merchants in general, brokers, etc.; then, less frequently, clergymen; still less often, lawyers; and, more rarely, doctors; while distressing cases are apt to occur among the overschooled young of both sexes. here is a day's list: charles page bryan, former ambassador to japan, died in washington of heart failure at the age of sixty-one. judge arthur e. burr, judge of probate for suffolk county, dropped dead in the court-house at the age of forty-eight. hiram merrick kirk, municipal court justice, new york, died in the forty-seventh year of his age. lieut. william t. gleason dropped dead in the railroad station, salt lake city, as he stepped from a railroad train, at the age of forty. indeed, it is not only the men of military age who drop off under this strain, but the very vital strong men behind the lines. the road to efficiency it is an extraordinary thing that the people in this country, many of them coming from the most vigorous ancestry, should be willing to compress all their athletic enthusiasm into a very small period of their school and college life, and then to forget to take any exercise (except vicariously) until warned, sometime after forty, that nature will exact a price for such folly. it is certainly a puzzle to understand how men can willingly slip into fatness and flabbiness or nervous indigestion, forget entirely what a pleasure physical vigor is, fold their hands contentedly, with the statement that they haven't time for physical culture, and so, gradually, by way of the motor-car and the dinner-table, slide into physical decadence and a morbid condition of mind and body. and yet three or four hours a week, less than an hour a day, with the assistance of fresh air and water, and within a sixty-or ninety-day period, will start these people on the road to recovered health and vigor. all that is necessary is to get the proper action of the lungs, of the heart, and of the skin, and, finally, of the digestion; then the results will follow fast. a winter vacation the first time a good conservative new england business or professional man, who has worked hard all his life and who has attained a commanding position in the community, determines to break away and take a vacation in the winter--a thing he has heard about and sometimes wondered how other people could manage to do it--he meets with the surprise of his life. after boarding a train and traveling for twenty-four hours toward the south and sunshine, he begins to lose a little the feeling that he is playing "hookey" and is liable to be dragged home and birched. but he does wonder a little whether he won't have hard work in finding somebody to play with him. when, however, he disembarks from his train at his destination--we will say pinehurst--he has already begun to realize, through noting the other bags of golf-clubs on the train, that possibly he will be able to get some partners. when he arrives at the hotel, although it is early breakfast-time, he is astounded at the number of people there, and he is inclined to think that he has happened upon an unusual week or that this is the one place in the south where golfers congregate. by the time he has spent a day or two there and has found that, in spite of the three courses open, it is wise to post his time the day before or he is likely to kick his heels around the first tee for a couple of hours before he can get away, and when he looks over the crowded dining-room at night--well, he comes to the conclusion that most of the school have deserted and are playing truant, too! the gospel of fresh air a generation ago the people who preached the good gospel of fresh air were still viewed askance, although the new doctrine had begun to make some impression. the early settlers in this country lived an outdoor life perforce, and undoubtedly found all the excitement of a football game in fighting the indians; consequently, they attained proper physical development. the descendants of these settlers still retained a good deal of the outdoor habit, but in the third generation the actual drift city-ward began. this meant the absence of incentives to outdoor exercise, so far as life and the pursuit of happiness were concerned. hence, it became necessary to preach the gospel of fresh air. "oh, the joy with which the air is rife," sang adams lindsay gordon, one of the early preachers of this doctrine, and to-day thousands and tens of thousands are appreciating the truth of the saying. not alone the boy at school or college with his football, baseball, and rowing, but the middle-aged man with his golf and tennis, and the old man tramping through the woods with the rod and gun, as he used to do thirty years ago, and as he will do to the end--all these know what fresh air means. sunshine, through the medium of golf, has come to the life of thousands of middle-aged wrecks formerly tied to an office chair. no one can estimate the number of lives, growing aged by confinement in close rooms, by lack of exercise, and by the want of cheerful interest in something beside the amassing of dollars and cents, that have been saved and rendered happy through the introduction of this grand sport whose courses now dot the country from maine to california, from the top of michigan to the end of florida. twenty years ago in this country a man who came to his office in a golf suit would have been regarded as demented, to say the least. to-day the head of the house in many a large business refuses to permit anything to interfere with his saturday on the links. and this means that he and all the officers in the departments under him, instead of viewing with concern the interest of the men in outdoor sports--their devotion to baseball and football, to tennis, golf, and track athletics--are glad and willing that the great outdoors should have a real place in their lives. it is good business policy. something must make up to the later generations for the loss of the open air and outdoor work which the exigencies of the olden times demanded of our ancestors, and that something has come in the shape of physical exercise. but golf and long vacations are for the comparatively rich. they are makeshifts rendered possible only by circumstances. unlearned lessons if a man determined, because his horse or his dog showed exceptional intelligence, that he would endeavor to develop that intelligence by setting the animal at mental tasks, and so gave it only the exercise that would come from moving about the room, and no fresh air or sunshine, no road-work or hunting--well, we are all quite familiar with what the result would be. if a parent had a child who showed unusual mental precocity and thereupon forced the brain of that child, with no outdoors, no fresh air, no sunshine, and even to late hours, we all recognize that such action would be criminal. yet probably per cent, of our best executives, in their efforts to aid in the present emergency, are doing just what we are ready to condemn in the hypothetical cases given above. some of these men, while still able to whip up their will into going on from day to day with the same exhausting program, finally conclude that unless they take a vacation they are going to break down. the doctor tells them so and they know it. whereupon they rush off for a week or ten days; some of them enter upon an orgy of exercise, others relax into a somnolent state of lying around and thanking their stars that they can rest at last. they certainly do feel better and do improve, but they come back to work merely to begin the same old vicious round. they have had their lesson, but they have not learned it. chapter iii this is a young nation. it began with the great gods of life, liberty, and the pursuit of happiness. and it fought a good fight in the war of independence for freedom and equality. then came the lesser gods of material success. they broke the nation apart. but it survived. since the civil war we have grown rich and fat, flaccid and spineless. we are like a great, careless boy with a rich father; our crops and material resources symbolize the rich father who is able to pay for all his son's foolishness. and so the youth has never stopped to think. but underneath that careless exterior there are muscle and character. for what is the history of youth? if the youth is to become a real man he cannot be curbed to the extent of forgetting courage in an excess of caution. and the rush of our youth to the service showed this. the spirit of youth an englishman once writing of the tendency of the elders to blot out all the fire of youth with restrictive legislation, said, "it is a fearful responsibility to be young, and none can bear it like their elders." how can a youth whose blood is warm within sit like his grandsire carved in alabaster? he cannot and he will not, and that is the salvation of the race. it is the old story of the stag in the herd. he will see no other usurp his rights until he is too old to have any. let me tell you something of the history of these attempts by the elders to curb the everlasting spirit of youth. at one time they would have eliminated all the sports. but we didn't let croquet become the national game! you ask what this nation of ours will become, and in reply i ask you what will you make of your boys? statisticians tell us that per cent. of the men who go into business fail. do you want your boy to fold his hands and say that because the chances are against him he will not try at all? are you going to let him get such a maximum of old man's caution that he reduces to a minimum the young man's courage? make him strong and well, just as you wish the nation to be strong and sound. there will always be plenty of middle-aged failures to preach caution. teach your boy fair play and may the best man win. teach him that the true sportsman "boasts little, crows gently when in luck, puts up, pays up, and shuts up when beaten"; that he should be strong in order to protect his country. a boy may over-emphasize his sports, but he will get over that. they tell us about the good old times when boys at college spent all their time in study and loved one another. there never were any such times. the town-and-gown riots took the place of sports, that's all. economic losses we are all of us very much interested in the life of an automobile tire, and it seems to speak to us in terms we can readily understand. but only the particularly wise and successful men of our generation know and appreciate how valuable the life of a man is when expressed in those same terms of good hard dollars. many manufacturers in the last two or three years have awakened to the fact that when, they put in a man and he stayed with them only two or three months, or even, in the case of executives, two or three years and then dropped out, either to go elsewhere or on account of ill health, it was a very distinct loss. in other words, they had put a certain investment into the man and that investment should have been growing more valuable to them all the time. germany's general staff, previous to this war, was working overtime, just as our cabinet and national board of defense are doing now--namely, till midnight and beyond. but the german general staff was taken out into the thiergarten in the morning for from one to two hours of exercise as a beginning of the day. it therefore sifts itself down to this: if we had an ordnance officer who fired a gun, that was tested for but two hundred rounds without heating, five hundred times and thus cracked it, he would probably be discharged. if the superintendent in a factory doubled the number of hours he was running his automatic machinery, and instead of doubling the amount of oil actually cut it in half and thus ruined the machines, he would be regarded as a fool. yet we are letting our men, high in executive positions, heads of departments in the government, and leaders of manufacturing, transportation, and commercial interests, do this very thing. is it possible that we regard them as less valuable to us in this emergency than machines and guns, that we should burn them out for lack of lubricant and rest or physical conservation? warning examples a railroad president not long ago said that he had not the time to take exercise or rest, that his salary was fifty thousand dollars a year, and that his company had just given him a bonus of fifty thousand; hence he could not shirk his responsibilities. he paid the full measure and was buried in six months from the time of the warning. in one issue of the new york _evening post_ the following deaths were noted: president hyde, formerly of bowdoin, fifty-nine years of age. capt. volney chase, of the navy, fifty-six years of age. capt. campbell babcock, fifty years old. colonel deshon, fifty-three years old. our cabinet officers and executives and the members of the council of national defense are likely to forget, in the excess of their patriotism and loyalty, that there is one edict higher than that of the greatest government in the world. when nature gives an order there is no appeal to a higher court, and the excuse that a man has not the time to obey, or is doing something that his country most urgently needs, has no weight in that court. when nature touches a man on the shoulder and says, "stop!" he stops. the penalty of frayed nerves, overworked brains, and underworked bodies is failure of body and mind. the premonitory symptoms are irritability, quarreling, depression, fierceness and inefficiency of effort, and finally complete breakdown. three to four hours a week physical exercise under a scientifically tested plan and arrangement will keep these men fit. is the price in this emergency too high to pay? physical fitness a vital fact up to the time when this world conflagration started, a man's physical fitness was merely a matter of individual interest. the general health of the community was important, but that fact was not sufficiently pressing to do much more than attract the attention of the health boards, and perhaps a few recently organized and semi-philanthropic bodies. but suddenly there flamed out a war in europe, and at once the countries involved found that upon the physical fitness of the people would depend their lives and freedom. it was no longer an academic question. it became an immediate and vital fact. in september of the writer placed the following suggestion on the top of his syndicate athletic article: americans awake! guard your shores and train your men, teach your growing youth to fight; make your plans ere once again ships of foes appear in sight. teach new arts until you hold in your bounds all things you need. then you can't be bought or sold; from commercial bonds be freed! if manhattan rich you'd save, if your western golden gate-- train a field force, rule the wave. every day you're tempting fate! build the ships and train to arms, make your millions fighting strength that shall frighten war's alarms ere they reach a challenge length. he was immediately assailed as a militarist, and yet, had we but taken those preparatory steps, millions of lives might have been saved. chapter iv and thus we approach one of the problems which this book is designed to solve. there are eight million men in this country between the ages of forty-five and sixty-four. probably we may count upon another million from the men of sixty-four to seventy who would be "prospects," as the mining-men say. these men represent nine-tenths of the financial and executive strength of the united states. the senior service corps when i started the experiment of the senior service corps at new haven, in the spring of , all my men were over forty-five, and several of them had passed the seventy mark; yet all found increased health and efficiency from the prescribed regime. there was a distinct gain, not only in health, but in spirits and in temper. nerves that had been at high tension relaxed to normal. effort that had seemed exhaustive became pleasurable. the ordinary problems of business or finance, once so apt to be vexatious, lost their power to produce worry. in fact, these men had renewed their youth; they had altered the horizon-line of advancing age, across which only clouds of doubt and apprehension could be seen, to that of youth, radiant with the sunshine of hope and the promise of accomplishment. [illustration: initial hike of first senior service corps] this war has started some new thoughts and has given emphasis to others that may not be new but which have never been forced home. one of these is the value of physical efficiency. a social scientist said some twenty years ago that the "greatest nation of the future would be the one which could send the most men to the top of the matterhorn." nations now realize that in such a time as this all men up to forty may be required for the firing-line; and this means that all the men from forty to seventy must be rendered especially efficient and physically fit in order to stand back of the fighting forces as a dependable reserve--money, power, and brains. [illustration: hike of a senior corps] [illustration: these men, although over forty-five years of age, marched for over four hours without discomfort] the basic idea this was the idea of the development of the senior service corps--to take men who are over military age and make them physically fit for whatever strain may come. it has resulted in not only making them physically fit, but in practically renewing their youth. the experimental (new haven) company of a hundred, varying in age from forty-five to over seventy, in weight from to pounds, and in height from ft. in. to ft. in., after just completing ninety days' training, marched at the dedication of the artillery armory over four and one-half hours without physical discomfort. now, war or no war, the man of over military age would like to be fit, would like to feel that glow of youth which comes even to the man of fifty when he is physically in condition. nine-tenths of the men over forty-five can accomplish this, and they can do it by the expenditure of only three or four hours a week if they will follow with absolute care the rules demonstrated by a scientific experiment upon a company of one hundred men over a period of ninety days. this company of new haven professional and business men included the president of the chamber of commerce, the editor of the largest evening newspaper, the dean of yale university, the director of the gymnasium, the president of sargent & company, the owner of the poli theater circuit, the ex-mayor of the city, two judges, the treasurer of the savings-bank, the registrar of yale university, four professors, three doctors, and many leading corporation officials. at the end of this period these men were not only able to march for over four hours without discomfort, but without losing a man. moreover, they all gained in spirits, recovered their erect carriage, and found themselves enjoying their tasks. community physical development the plan developed by the national security league, under its committee on physical reserve, of assuring physical fitness for the nation, is capable of endless possibilities in application and development. the plan treats each as a separate unit and allows it to adapt the physical-fitness scheme to local conditions, favoring the appointment of neighborhood groups for instruction in physical drill and the "daily dozen set-up," assuring such conditions and applications of diet and hygiene as are particularly demanded by the individual community's conditions and demands. every individual detail and local development is left to the committee which each mayor or town or borough official appoints, on invitation of the league. [illustration: walter camp, president, and joseph c. johnson, secretary, of the original senior service corps established in new haven, connecticut, in the spring of ] the ideal toward which every community is working is the establishment, as an integral part of it, of a local fitness plant. this includes first, playgrounds laid out for all recreational sports, in their season. the ideal playground system will have enough room in walks and landscape-gardening for park development--sufficient to meet the community's maximum needs. community physical-fitness centers are growing up in which an adjacent lake or river provides facilities for rowing, canoeing, and recreational enjoyment through breathing the fresh air, while taking regular physical, conditioning exercises. such an ideal community plant has proven by no means a vision incapable of realization. to-day men and women realize painfully the need for one in their home community and are prevented from the fulfilment of their dream by only two obstacles--lack of funds and adequate organization of the plan. this work and these centers offer the greatest possibilities in the americanization scheme, perfection of which is a paramount duty for this country. [illustration: setting-up work of a company of one hundred] [illustration: doctor anderson leading a group in the yale gymnasium] not only do such plants transpose the astonishingly large percentage of the physically unfit of our foreign and domestic population and reclaim those whose physical imperfections have either become evident through the draft, or which are not known, but it affords the surest possible means of interesting this large element of our population in american institutions, of attracting them to the soundest and most beautiful features of american life, and of convincing them of their comradeship in the strength and sinew of american manhood; in short, of building the foundations of democracy on a base as stable as the eternal granite hills. an outline of the system the senior service program starts with setting-up exercises which open the chest, gently stimulate the heart, and start the blood coursing through the system, and follows with progressive walking, a little hill-climbing, and, later in the development, with some weight-carrying exercises. the system renews the resistive force of the body, tones up the muscles, opens the chest cavity so that the heart and lungs have more room and the breath is deeper and better, gives general exercise to the various muscles which have become more or less atrophied from disuse, and brings about a marked improvement in the mental outlook and in the animal spirits. the system is a combination of setting-up exercises with outdoor work, all carefully and precisely laid out after twenty years of experience in conditioning men. it should be followed absolutely, not partially or occasionally. it is far from severe. its strength lies in the cumulative effect rather than in any special effort at any one time. it should be said that a mental effort is requisite in this course as well as the physical one. the correlation between mind and muscle must be re-established. the man must become master of his body once more and retain that mastery. certain suggestions are also given specifically as to living--none of them irksome, but quite essential if the full result of the work is to be attained. this was the first experiment of its kind, and hence it has proven of especial interest. there are plenty of cases of individuals taking up exercise in one form or another and benefiting somewhat by it; but when twenty to one hundred men in a group have engaged in this senior service work, the result has proven remarkable in every instance. the question seems to be simply this: if you are over military age and wish to renew your youth, and are willing to pay the price by devoting some three or four hours a week to a scientifically tested system, and can secure a score of other men to do it with you, you can be absolutely assured of success. well, isn't it worth it? individual and group action thousands of men are beginning to realize what all this means. my mail for the last six months has been full of the inquiry. men of forty are rapidly awakening and are eager to devote these few hours to the task of keeping fit, and so increasing their efficiency. at the same time they are preventing these horrible and untimely punishments at the hand of mother nature. now there are two methods by which a man may still be young at sixty. one is an exceedingly hard route for most men to travel--namely, the individual practice of this scientifically tested formula and patient persistence in it. the other is by group action. the latter is far easier and its results are doubly effective. however, as in some cases group action may be impossible, this book furnishes the data for individual practice as well. all the exercises described are possible for the individual as well as for the group. should a man determine to follow them out alone, he must make up his mind that there shall be no interference with his carrying out his program with regularity and exactness. he must not for a moment believe that he can miss the exercises one day and then make up for the lapse by doubling them the next day. he must always follow the setting-up exercises with his walk and not do the setting-up in the morning and then wait till afternoon for his walk. it is the combination that produces the most effective results. [illustration: effect of thirty days of training upon a company. these men are carrying iron bars weighing nine pounds each] [illustration: practising and marching with iron bars weighing nine pounds each] in a group the leader constantly cautions the men as to carelessness or slackness. the individual having no leader must always keep his mind fixed upon the exact way in which his exercises should be performed. when he puts his hands behind his head in "neck firm" or "head" he must keep his elbows back and his head up, while the chest should be arched. when he bends forward in the prone position he must not allow his head to droop. when he raises his knees in alternate motions he must bring his knees well up. when he does the exercise of leaning up against the wall, by means of the extended arm and hand, he must keep the distance far enough from the wall to bring about a certain amount of real effort by the hand, arm, and shoulder. and so it goes. it is for this reason that all the exercises are so carefully described and the method and manner of walking, marching, or "hiking" receive so much attention. work and hygiene in a book recently published by one of the highest authorities on hygiene in the country, the following statements are made, statements which would prove of especial interest to those of us who have had the pleasure of being members of that "exclusive official washington club," or of the senior service: the problem of the mental worker is to get sufficient physical exercise to keep the mind and body at its maximum efficiency. this problem gets more and more acute as he gets older. the amount of work necessary to keep the man of sedentary habits in good condition is about to foot-tons. five hundred foot-tons is the amount of work a soldier would perform by marching twenty miles at three miles an hour on a level road. it is a fallacy to think that sufficient exercise can be taken once a week. in order to be efficient exercise must be regular and at relatively short intervals. all exercise should tend toward using all of the muscles of the body. in fatigue a person has lost control over his muscles. the process of getting into condition, therefore, is directed more toward strengthening the nervous system in its control work over the muscles rather than in increasing sheer muscular strength. pure creative mental work, although requiring no out-put of physical energy, is perhaps the most productive of fatigue. the brain gets more blood during physical activity and waste products are much better removed. the effects of exercise are particularly apparent in the lungs. more fresh air is brought to the lungs and the waste products are driven off. an attainable minimum for the average adult person might well consist of taking simple exercises in his room, and to get out of doors once a day and walk rapidly for at least half an hour. in addition, it is desirable for any one up to fifty years of age to take some kind of moderately violent exercise at least once a week. this should be sufficiently strenuous to induce perspiration. this is important for several reasons. in the first place, there is an old saying, which happens to be true, "never let your blood-vessels get stiff." in addition we should call on the tremendous reserve which nature gives to us, at least once in a while. [illustration: "counting off" a company in the yale gymnasium] [illustration: "head" position. group of one hundred, senior corps] water, walking, and food water plays a very important part in the life of man, for without it a person can live for only a short time. its importance is shown by experimental fasts lasting for thirty days where only water was taken, and when we consider that the body is composed of from to per cent, of water and that the amount which it throws off as waste has to be replaced through nutrition, we realize the value of water to life. the average person, therefore, should take from two to four quarts of water a day. [illustration: result of sixty days' training in carriage. the two men in front weigh and pounds respectively] [illustration: look and determination on first day's march, during which the men carried iron bars weighing nine pounds each] at middle age it is natural for most people to put on weight, unless they are especially active in their daily life. for, having acquired a habit of consuming a certain amount of food, it is absolutely essential to exercise and thereby offset the tendency of this food to make fat and increase the weight. walking can be enjoyed by everybody, and a four-or five-mile "hike" daily makes your credit at the bank of health mount up steadily. we should all learn that when we rob the trolley company of a nickel by walking we add a dime to our deposit of health. food, of course, is one of the main factors in one's general health, and we hear on all sides the opinions of people as to the causes of indigestion and the general ailments connected with eating. one thing is certain, however, and that is that pleasure has a favorable effect on the digestion. pleasant company at a meal, the dainty serving of the viands, and the attractiveness of the food combinations pave the way to a satisfactory repast, eaten with enjoyment and completely assimilated. a model dietary because diet is a real aid to physical well-being, the following table is offered as a rough suggestion for a typical dietary for a man leading a more or less sedentary life. but it will never replace exercise. breakfast approximate calories orange or grapefruit.................... two eggs................................ two vienna rolls........................ butter.................................. coffee with milk and sugar.............. total................................... luncheon approximate calories twelve soda crackers.................... one pint milk........................... --- total................................... dinner approximate calories soup (consomme)......................... roast beef.............................. potato.................................. string beans or peas.................... bread................................... butter.................................. apple pie............................... glass of milk........................... ---- total.................................. many people have adopted a so-called vegetarian diet, believing that it is better for the health than eating meat. undoubtedly food from the vegetable kingdom is a great benefit to the human system, but strict vegetarianism is not recommended by our medical men. nature apparently intended us to be omnivorous, and, in addition, vegetarianism may run too close to the dangers of carbohydrate excess. as man progresses after middle life he can unquestionably diminish materially the amount of meat in his diet. in recent years there has been a revival of the theory of prolonged mastication of a limited amount of food. this theory is sound in so far as it tends to overcome the bolting of food and over-eating, but there is a belief among our practitioners that there is little basis in science or experience for the extremes of this character. hygienic cure-alls among recent fads is the so-called buttermilk or sour milk diet as advocated by metchnikoff. the original theory was interesting and was, in part, that the bacteria derived from soured milk would drive out of the intestinal canal all the harmful germs. quite possibly there may be something in the theory, especially if large quantities of milk are taken with the lactic acid bacilli, but the beneficial effect of this change of bacteria is not convincingly of great consequence. fresh air it is now generally known that an abundant supply of moving, pure, fresh air is the proper and simple solution of the problem of the hygiene of the air. oxygen is the element of the air which sustains life. we inhale about seven pounds per day, two pounds of which are absorbed by the body. the air becomes dangerous, or infected, when the oxygen in the air is decreased to only or per cent., and when the oxygen reaches per cent. death occurs from asphyxiation. the human body requires about three thousand cubic feet per hour, and the great problem of ventilation is to give this amount of pure air, moving, and with the proper amount of moisture. it is a common belief that with each breath we take we are filling our lungs with fresh air. this is not the case, for we never do get our lungs filled with fresh air. what really happens is that we ventilate a long tube which has no intercommunication whatever with the blood. most of the time our lungs are filled with impure air, and we simply exchange a part of it for fresh air. the value of deep breathing deep breathing is undoubtedly extremely beneficial. most of us, due largely to the fact that nature leaves a considerable margin of safety, are able to carry on our ordinary activities without the requisite ventilation of the lungs, especially if we do not exercise. this, however, is injurious to the lungs, for it allows the blood to stagnate in them. exercise is nature's method of compelling ventilation in the lung area. deep breathing may be used as a substitute, but the other beneficial effects of exercise are lost. the skin and the various glands connected with it form a complex organism, the functions of which play a very important part in the work which the body has to do. the skin aids the lungs in their work of respiration; and, like the lungs, it throws off water and carbon dioxide and absorbs oxygen. the respiratory work of the skin, however, is only a minute fraction of that which the lungs do. the skin is a heat regulator, and in this, its most important work, it is aided by the two million or more sweat-glands which are distributed over almost the entire surface of the body. the skin and the sweat-glands work together to keep the blood at an even temperature, either by giving off heat or in preventing this process in case the outside air is too cool. the body temperature, as a rule, is higher than that of the outside air, so that heat is generally being given off by the skin. we are perspiring constantly, but usually to such a slight extent that the fact is hardly noticeable. the amount of heat which is thrown off at any time is proportional to the amount of the tissue burned up by muscular action. chapter v health, strength, and efficiency! surely every man in this great republic of ours wants to be healthy, strong, and efficient, but how is he to obtain and maintain this threefold blessing? it has been stated that scientific physical exercise, preferably taken in group association, will accomplish it. now to consider some of the practical details involved. the organization the organization may be composed of any number from sixteen to one hundred men, and about the smallest unit that should be undertaken is that of sixteen men. on the other hand, when the number gets above one hundred (or preferably ninety-six, in order that it may be divided into four companies of twenty-four each) it is better to start a second group under a separate leader. the first thing to do in the organization is to enroll at least one physician, who becomes the surgeon of the company. his name, together with that of the secretary of the unit, should be filed with the senior service corps, of new haven, connecticut, or with the national security league, of new york city, in order that any additional information or directions may be forwarded promptly. the division of labor in the work should be from ten to fifteen minutes of the setting-up exercises, and from forty-five to fifty minutes of the outdoor work. it has been found upon scientific test that this is the best division, and the outdoor work should follow the setting-up exercises immediately, since the men are then in condition to benefit from the fact that they have opened up their chest cavity and are taking in more fresh air and oxygen. the best way to start a unit is to get ten or a dozen leaders together at dinner or luncheon and organize; then pick out other men who are of importance in the community and add them to the charter number. the editors of the local papers are usually very glad to lend their powerful assistance toward the project. it is not necessary to have the outdoor work partake of the nature of military drill, but a certain amount of this, added after the second or third week, lends interest and also produces excellent results in muscular control. in order to understand the various prescribed movements and exercises the following explanations should be carefully studied, of course, in connection with the illustrative photographs. to the leader it is particularly necessary that the leader should thoroughly familiarize himself with the movements and positions, for many of the men will not take the trouble to study the manual by themselves, or they may be unable to spare time for anything but the actual drill. it is the leader's business to instruct, and the progress of his squad or company will be in direct proportion to his knowledge and capacity to inspire real interest in and enthusiasm for the work. each movement must be executed perfectly and exactly or the benefit therefrom will not be fully assured. much depends upon the leader; a man should be selected who has the gift of leadership. giving the commands in giving the commands care should be taken to discriminate between the explanatory and executive parts of the order, making a decided pause between. for example, in "forward march!" "forward" is the explanatory or warning word; then, after a perceptible pause, the executive word "march!" should be given in a crisp, decisive tone of voice. the command "attention!" is but one word, but it is the custom to divide it syllabically, thus, "atten-shun!" all other commands taken from the military manuals have their proper warning and executive words; for example: "count--off!" "about--face!" "right--face!" "company--halt!" "to the rear--march!" "double time--march!" etc. the exceptions are the commands, "rest!" "at ease!" and "fall out!" the orders for the exercise movements may be standardized by first giving the name of the movement, "arms cross," and then adding the words: "ready--cross!" to indicate the second or executive part of the command. for example: "arms cross. ready--cross!" the men taking the "cross" position at the last word. in this way the members of the squad are first warned as to just what they are expected to do; then, at the executive word, they all act together. the leader should see to it that the over-eager men do not anticipate the executive command. the only purely military formation used in this manual is that of the squad. nowadays, when military training is so universal, the meaning of the term is well known; there is sure to be some one in the company who can supply the necessary information about forming the squad and the simple movement of "squads right." to put it into untechnical language, it may be said that the squad consists of eight men, lined up four abreast in two ranks. the men should be arranged in order of height, the tallest being no. , front rank. no. of the front rank acts as corporal of the squad. [illustration: eyes right!] "squads right" looks like a complicated maneuver when studied according to the diagrams in the manuals, but it is not particularly difficult in practice. its use is to get the company out of the double line formation into a column of four men abreast, the usual marching formation. at the executive command, "march!" no. front rank acts as the pivot, and makes a right-angled turn to the right, marking time in that position until the three other men in the front rank have executed a right-oblique movement and have come up on the new line. the rear-rank men follow suit, but nos. and have to turn momentarily to the left in order to get behind the front-rank pivot men--to put it more simply, they follow no. in single file. it sounds confusing, but any old national guardsman can explain the movement in very short order. so soon as "squads right" has been completed the whole column takes up the march without further word of command. steps and marchings all steps and marchings executed from a halt (except right or left step) begin with the left foot. the length of the full step in "quick (or ordinary) time" is inches, measured from heel to heel, and the cadence is at the rate of steps to the minute. the length of the full step in "double time" is inches; the cadence is at the rate of steps to the minute. forward--march! at the warning command, "forward!" shift the weight of the body to the right leg, left knee straight. at the command, "march!" move the left foot forward inches from the right; continue with the right and so on. the arms swing freely. double time--march! the arms are raised to a position horizontal with the waist-line, fingers clenched. the run is as natural as possible. to the rear--march! at the command, "march!" given as, the right foot strikes the ground, advance and plant the left foot, turn to the right-about on the balls of both feet, and immediately step off with the left foot. company--halt! at the command, "halt!" given as either foot strikes the ground, plant the other foot as in marching; raise and place the first foot by the side of the other. if in "double time," drop the hands by the sides. mark time--march! at the command, "march!" given as either foot strikes the ground, advance and plant the other foot; bring up the foot in the rear and continue the cadence by alternately raising each foot about two inches and planting it on line with the other. being at a halt, at the command, "march!" raise and plant the feet in position as prescribed above. change step--march! at the command, "march!" given as the right foot strikes the ground, advance and plant the left foot; plant the toe of the right foot near the heel of the left and step off with the left foot. the change as the left foot strikes the ground is similarly executed. right--face! raise slightly the left heel and right toe; face to the right, turning on the right heel, assisted by a slight pressure on the ball of the left foot; place the left foot by the side of the right. "left face" is executed on the left heel in a corresponding manner. about--face! carry the toe of the right foot about half a foot-length to the rear and slightly to the left of the left heel (without changing the position of the left foot); face to the rear, turning to the right on the left heel and right toe; place the right heel by the side of the left. there is no left "about face." count--off! at this command all except the right files (the two men forming the extreme right end of the company as drawn up in two lines) execute "eyes right"; then, beginning on the right, the men in each rank count one, two, three, four--one, two, three, four, etc. as each man calls off his squad number he turns head and eyes to the front. the setting-up exercises attention! this is the regular military position. heels together, the feet at an angle of forty-five degrees; hands at the sides, thumbs along seam of the trousers; neck back, chin in, chest out. (see fig. .) [illustration: fig. .--attention] the movement calls for prompt control of the muscles; in fact, the expression is often used of "snapping into attention," meaning that the man comes into this position quickly and easily and with a distinct click of the heels. in the "daily dozen" referred to later in this book, this position is called "hands." arms cross (ready-cross!) this movement is taken from the position of "attention" by raising the arms from the sides and turning the palms down; it may be varied by turning the palms up. holding the arms in this position, at the same time turning the hands and keeping the neck straight and the chest arched, will develop all the muscles over the shoulder. (see fig. .) [illustration: fig. .--arms cross on the "cross" position the arms should be straight out horizontally from the body, with the elbows locked. at the same time, resistance should be placed against the head and neck coming forward at all. these should be held in exactly the same position as at "attention." the tendency is either to let the arms bend a little or to let them drop below the horizontal, or even to hold them slightly above the level.] from this position "shoulder-grinding" may be practised. this is executed by keeping the arms extended, turning the whole arm in a circle in the shoulder socket, and forcing the shoulder-blades back and together as the arms go back. the circle made by the hands should be about twelve inches in diameter. arms stretch (ready-stretch!) in this exercise the arms are raised to a position straight up above the head, with the hands extended. the palms may be together or facing front. (see fig. .) [illustration: fig. .--arms stretch] hips firm! (this order is given, "hips-firm!") the hands are placed on the hips, with thumbs back and fingers forward. the chest should be arched, the shoulders and elbows kept well back, and the neck pushed hard against the collar. (see fig. .) also the hips should be kept well back and the abdomen in. this gives the same poise as the "attention" position, but it puts more work on the shoulder muscles and so gives greater opportunity for arching the chest. in the "daily dozen" this position is called simply, "hips." [illustration: fig. .--hips firm] neck firm! (this order is given, "neck-firm!") maintaining the same position as in "hips firm," the hands are quickly raised and put against the back of the head (the finger-tips slightly interlaced) just where it joins the neck, exerting some pressure; at the same time the head and neck are forced well back. (see fig. .) [illustration: fig. .--neck firm] the elbows should not be allowed to come forward, but should be kept back and the chest should be arched. this gives extra work for the muscles of the neck, as well as for those of the arms and shoulders. in the "daily dozen" this is called simply, "head." (see fig. .) [illustration: fig. --incorrect position of shoulders in neck firm] arms reach (ready-reach!) while maintaining an erect position, the arms are stretched out forward parallel to each other, the shoulders being kept back and the chest not cramped. if the shoulders are allowed to come forward the exercise is valueless. (see fig. .) [illustration: fig. .--arms reach] arms bend (ready-bend!) in this position the arms are bent at the elbows, with the hands partially clenched, and brought up about to the point of the shoulders. the shoulders are held back firmly and the neck is pressed against the collar, while the chest is arched (fig. ). from this position the following movements are made with the hands clenched: arms cross (ready-cross)![ ] [illustration: fig. .--arms bend] a good exercise in rhythmic time may be developed by going through the following round of movements: "arms bend, arms cross, arms bend, arms stretch, arms bend, arms reach, arms bend, arms down." body prone (ready-bend!) assuming the position of "neck firm," press the hands against the back of the neck and bend body at the waist forward, at the same time keeping the head in line with the spinal column and the eyes up; then back again to the erect position. (see fig. a, chapter xi.) this gives excellent exercise for the muscles of the neck, and, if performed slowly, some exercise for the back. assuming the same position of "neck firm," bend the body slightly at the waist. this exercise should not be carried to an extreme, especially in the case of men who have reached middle age. in the "daily dozen" this is called "grasp." balancing (ready-balance!) assume the position of "attention," then, standing on the right foot and keeping the knees straight, advance the left foot forward about two feet from the ground. hold this position while balancing on the right foot, then back to "attention" again. (see fig. .) [illustration: fig. .--balancing] make the same motion, standing on the left foot. now standing on the right foot, advance the left foot and, instead of bringing it to the ground, swing it back and extend it at the same height to the rear, still balancing on the other foot. hold this position for a moment. after some practice this movement can be executed by standing on one foot and putting the other leg first forward and then back for several times. this exercise gives control over the muscles of the leg and balancing powers, and increases the ability to adjust the muscles so as to maintain the equilibrium. stride position (ready-stride!) this position calls for the separation of the feet sideways about a foot and a half apart (fig. ). now assume the "arms cross" attitude, and then, turning the body at the hips, bring first the right hand down to touch the floor, at the same time bending the right knee and keeping the left knee straight. come back to the regular position again. [illustration: fig. .--stride, first position] now bend the left knee, put down the left hand and touch the ground, turning the body at the hips. (see fig. .) [illustration: fig. .--stride, final position] in both of these movements keep the other arm extended backward. this produces a graceful exercise which is excellent work for the muscles of the body and shoulders. in the "daily dozen" this is called "the weave." assuming the "stride position," advance the right foot about a foot; then, with the arms in "cross" position once more, bend the forward knee and touch the ground with the hand, at the same time keeping the other arm extended backward. reverse this. this movement is also excellent for the muscles of the body and back. wall balance (ready-bend!) stand sideways to the wall about two feet and a half away; now extend both arms in the "cross" position, and then lift the foot that is farthest away from the wall and lean over until the extended fingers of the other hand touch the wall; push back into original position. move out a little farther from the wall and repeat. do this until the distance is as far as can comfortably be recovered by pushing the hand against the wall. reverse this exercise, so as to do it with the other arm. this is an excellent workout for the shoulder muscles as well as for the forearms, and gives some exercise to the body. stepping (ready-step!) standing erect at "attention," step to the right with the right foot about six inches, merely touching the toe to the ground, and bring the foot back to the "attention" position. the object of this movement is to give control of the muscles of the leg in addition to the balancing of the body. care should be taken to keep the body absolutely motionless while the exercise is in progress. the toe is only touched to the ground and the foot is brought immediately back into position. this movement has a quieting effect after more violent exercising. it can be done either sideways, forward, or back. running in place (mark time--march!) beginning with "marking time!" now raise the feet alternately from the ground, a little higher each time, until the knees come up practically to a level with the waist. then perform this same motion on the toes and shift into a run while still holding the same position--that is, while going up and down on the toes. men who have considerable weight around the waist-line should place their hands on the abdomen when performing this exercise. body-turning (ready-cross! ready-turn!) this movement consists in turning the body at the hips while keeping the feet and legs in the original position. it may be done from almost any of the positions already outlined, and is moderate work for the muscles of the waist. do it first with the arms in "cross" position, turning to the right as far as possible; then back to the "front," or original, position; then to the left as far as possible, and back to the "front," or original, position, taking pains that the turning is executed above the hips while the legs and feet hold their original position. a more pronounced method is given in the "daily dozen" in "wave" and "weave." heel-raising (ready-rise!) standing on both feet at "attention," raise the heels, and hold the position for a moment; then drop the heels again. repeat this. now, standing in "stride position," go up onto the toes again. drop the heels and repeat. this is an excellent exercise for the muscles of the calf. group exercises no. . attention! (or "hands!") hips: same position, but hands on hips, elbows back. neck (or "head"): same position, but hands on back of neck, elbows back. cross: same position, but arms extended full length out from body, palms down. grind: maintaining the "cross" position, turn palms up, and then make ten circles with hands, the diameter of the circle to be one foot (fig. ). in doing this keep the arms horizontally out from the body, and on the backward sweep try to make the shoulder-blades almost meet at the back. (see fig. , chapter xi.) rest ten seconds. deep breathing with hands on hips. [illustration: fig. .--"grind," showing how the palms of hands are turned up in this exercise] no. . attention! stretch: lift arms straight up above head, palms out. reach: bring arms down, extending them straight out in front. palms in, but keep shoulders back. fling: bend elbows out and bring hands in to chest, palms down. then to "cross," back to "fling" again, and so on ten times. (see fig. .) [illustration: fig. .--fling. correct position] wave: assume "reach" position. now bend the arms sharply at wrists and just let the fingers interlock. bring the inside of elbow close to head, keeping head up. then, by turning the body at the hips and keeping the back straight, cause the hands to make a complete circle of the diameter of a foot (fig. ). do this five times, and then reverse for five times. (see fig. , chapter xiii.) rest ten seconds. then deep breathing, lifting arms on inhalations and crossing them on exhalations. [illustration: fig. .--wave. excellent demonstration] no. . attention! stride: separate the feet by taking a step to right, bringing the feet about eighteen inches apart. [illustration: weave--common fault of not keeping shoulders and arms in line.] weave: turn the body at the hips while keeping the arms horizontally extended and bending the right knee slightly. bring the right hand down to the ground midway between the feet and let the left arm go up, keeping its horizontal position from the body, the spine doing the turning. hold this position five seconds; then up to "cross" position and turn the body the reverse way, bending left knee and bringing left hand to ground. hold five seconds, then up. repeat five times for each hand. (see fig. , chapter xiii.) curl: from "cross" position, clench the fists and bring arms in slowly to the side and up into the armpits, at the same time bending the body and head backward (fig. ). the fists should be clenched and the wrists bent, bring the hands in toward the chest, the elbows out, and inhaling. (see fig. , chapter xii.) [illustration: fig. .--"curl" position. excellent demonstration except that the elbows should be thrown back] forward: from the above position, gradually bring the body up to an erect position, extending the hands to a "reach" position, and slowly bend the body forward at the hips, exhaling at the same time, and letting the hands go back past the hips and as high behind the back as possible, keeping the head up and the eyes looking directly forward, not down. go down about to the level of the wrist, then back to "cross" position again, and repeat this backward and forward movement five times. no. . attention! (cross-crawl!) assume the "cross" position. crawl: while still keeping the neck back, the chin, and the chest arched, slowly lift the right hand and arm until it points directly upward, then curl in right arm over the head, at the same time dropping the left shoulder and sliding the left hand and arm down along the side of the left leg until the fingers reach directly to the knee, or as far as comfortable. now come back from this position. (see figs. and , chapter xii.) "cross" once more and raise the other arm in similar fashion. repeat this five times on each side. no. . attention! (cross-crouch!) crouch: assume the "cross" position of the arms and "stride" stand, feet about eighteen inches apart. now, keeping the head up and the neck back and back straight, bend the knees and come down slowly, not too far (fig. ), until fully accustomed to it, and up again. repeat this five times. (see fig. , chapter xii.) [illustration: fig. .--"crouch," showing erect position of body and back] no. . attention! heel-raising: lift the heels from the floor, maintain the position on the toes for a second, then back onto the heels once more. repeat some ten times, then take the "stride" stand and repeat ten times in this position. no. . attention! wing-work: raise the arms to the "cross." then lift arms straight over head, inhaling; then, bending body forward and keeping the neck straight, swing the arms backward at the shoulder, exhaling, and come forward until the body is about level with the waist; then up again (fig. ). picture the arms as looking like a bird's wings. repeat this five times in each direction. (see figs. , a, chapter xiii.) final deep breathing, with arm lifting as before. [illustration: fig. .--"wing" position, also back position of "curl." face should, however, be turned up] footnotes: [footnote : this is the same movement as in the ordinary "cross" position, except that the hands are kept clenched.] chapter vi a ten-day program first day attention! hips firm neck firm arms bend arms cross arms stretch arms reach mark time mark time on toes attention! stepping heels raise deep breathing (at "arms stretch") hike or outdoor work walk half-mile on level, each man at his own stride. [illustration: correct position of neck and shoulders in all reach exercises] walk in pairs--column of twos; the shorter men should be in front. second day attention! hips firm neck firm body prone hips firm stride stand body bend (side to left and right) attention! arms bend arms cross balancing (on one foot--to right and left) arms stretch mark time mark time on toes attention! heels raise stepping deep breathing hike or outdoor work walk three-quarters of a mile, column of twos, keeping step. starting at command, "forward--march!" beginning with left foot. leader calls "company--halt!" three or four times, and then "forward--march!" again. leader commands occasionally, "change step--march!" third day attention! arms bend arms cross stride stand turn body (on hips--right and left) attention! neck firm body prone body backward bend attention! balancing (on one foot--to right and left) mark time mark time on toes stride stand heels raise deep breathing hike or outdoor work [illustration: stooping. incorrect position, letting the head fall forward] walk a mile, column of twos, keeping step. last half-mile command men to stand up and keep their necks pressed back against their collars, chins in. fourth day attention! arms bend arms stretch palms front bring arms downward and backward attention! arms bend arms cross balancing (on one foot--to right and left) stride stand (foot advanced) bend knee and touch floor with hand (right and left) mark time mark time on toes stepping deep breathing hike or outdoor work walk a mile, marching step, column of twos, shorter men in front, but try to get them up to a thirty-inch stride. make a portion of the march slightly up-hill, and last half-mile with necks back, chin in, chest out. [illustration: letting shoulders come forward; common fault] [illustration: incorrect position of neck and shoulders; very common fault] [illustration: arms bend] fifth day attention! arms bend arms cross shoulder-grinding (moving hands in circle and backward) attention! stride stand arms cross balancing (on one foot--to right and left) crouch (quarter-bend) mark time mark time on toes faster attention! stepping deep breathing hike or outdoor work walk a mile and a quarter, column of twos. insist on thirty-inch stride, but put shorter men in front. make a little stiffer grade. no more talking in ranks. insist upon necks back, chins in, and chests out all the way. sixth day [illustration: stooping. incorrect position, letting the back bow up and shoulders drop] attention! arms bend arms wing arms fling arms cross shoulder-grinding attention! stride stand arms cross balancing (on one foot--to right and left) body-turning crouch (quarter-bend) attention! mark time mark time on toes faster running in place stepping deep breathing hike or outdoor work bring men into company line and "count off." explain "squad" formation. march mile and a quarter in column of squads. take a stiffer grade. no talking in ranks. keep to thirty-inch stride and give it a regular beat. no sloppiness. make it a firm, steady march, and keep urging the men to breathe deeply and steadily. seventh day attention! right face left face about face repeat attention! balancing (on one foot--to right and left) stride stand heel-raising body-bending sideways mark time mark time on toes faster running in place stepping deep breathing hike or outdoor work company formation. count off. "squads right--march!" mile and a quarter. silence in ranks. erect carriage. hips back. deep breathing. steady thirty-inch stride. stiff incline. no lagging, but take it much the same as on the level. on the way, in some five minutes after the grade has been covered, give them "double time" for about twenty steps. [illustration: effect of these exercises, showing even muscular development] eighth day attention! right face left face about face repeat attention! arms cross balancing (on one foot--to right and left) stride stand crouch (quarter-bend) attention! arms cross arms stretch palms front bring arms downward and backward mark time mark time on toes faster running in place stepping deep breathing hike or outdoor work company formation. count off. "squads right--march!" while marching explain to them "to the rear--march," and have them do it three or four times. distance mile and a half, with same hill work as before. give them "double time" for twenty steps twice during the march. ninth day attention! forward--march (three steps and come to "attention!") same steps backward same steps sideways make complete square (three steps forward, three to the right, three backward, and three to the left) hips firm neck firm body prone body backward bend body sideways bend mark time mark time on toes faster running in place stepping deep breathing hike or outdoor work get some bars of iron, one inch in diameter and three feet long. they should cost fifty cents apiece, and weigh about eight pounds. give half the company these bars to carry, and at the middle of the hike transfer them to the other half to bring home. distance mile and a half. no "double time." carry the bars by the middle in the hands, and then for a time behind the back and through the elbows, with the hands in front. tenth day attention! arms cross body and knee bend, turning on hips and touching floor with hand (first one and then the other. the right hand on bending right knee and the left hand on bending left knee). attention! hips firm neck firm body prone body backward bend attention! stride stand arms cross balancing (on one foot--to right and left) crouch (quarter-bend) attention! mark time mark time on toes faster running in place attention! stepping deep breathing hike or outdoor work carry bars, distance mile and a quarter, every man carrying his bar all the way. "double-time" them once during march for twenty steps. insist on erect carriage all the way, with neck back against collars. part ii the daily dozen a condensed system of either group or individual setting-up exercises chapter vii we may now consider the question of time-saving for those who may be obliged to largely forego pleasurable exercise and who yet desire to keep fit and well in spite of this deprivation. there are two divisions in this class, as may be shown in the case of the present world war. the first class embraces all the men in active service, with two subdivisions--officers who are over forty and officers and privates who are under that age. the second class comprises the men (and women, too, for that matter) who, unable to do service at the front, must support the troops in various ways behind the lines. it is said that it takes five men behind the line to support one man at the front, and, judging from the pressure that already has come upon our people, this is manifestly not an incorrect statement. these reserves must be kept in good physical condition, and with this end in view the writer has prepared a modified form of setting-up exercises which has been tested out with large numbers in actual practice. these exercises are intended to prepare the younger men for the more strenuous training which they are to undergo later; in the case of the older men, they are to be used before entering upon the ordinary day of business routine. after a great deal of study a system has been devised which answers the needs in both cases; it is not too strenuous for the older men, and it will add suppleness, vitality, and endurance to the physical assets of the younger men. a modern physical system we know how, in the stress of affairs brought about by war, not only individuals, but nations are suddenly awakened to the fact that what may have been good enough even a year ago is antiquated and out of date to-day. under the pressure of war we are driven, whether we wish it or not, to put to immediate test virtually every fact of our daily lives. we find that almost every machine and well-nigh every method may be improved--in fact, that it must be improved. boats, aeroplanes, guns, industrial processes, even the actual business of living itself, all are being submitted to the test of emergency and are being made over upon new lines. so it is with our setting-up exercises. we can no longer afford to waste time or motion or effort. we are teaching on an intensive scale and we must take nothing out of a man in preparation; rather we must add to his store of vitality and energy. perhaps we find that the routine of his ordinary work will strengthen sufficiently his legs and arms. this is astonishingly true. what we must now do is to supple him, to quicken his co-ordination, to improve his poise, and to put his trunk and thorax into better shape. we must give him endurance, quickness of response, and resistive force. this, therefore, being our problem, we eliminate the arm and leg exercises and go directly for the trunk and thorax. we must quicken co-ordination and improve the man's rapidity of response to command. and standing out above all is this major principle: "no vitality should be taken out of a man by these setting-up exercises; he should not be tired out, but rather made ready for the regular work of the day." out-of-date ideas this war in which we are engaged has brought to our people some all-compelling truths. and the greatest of these is that our men, the flower of our racial stock, are deficient physically when put to the test before examining-boards. when one sees some two thousand men examined by draft boards to secure two hundred men for our army, as happened in some cases, when one reads that in a physical examination for the sanitary police force in cleveland thirty-seven out of forty-two women passed and only twenty-two men out of seventy-two, one is ready indeed to believe that we have failed to produce men who can be called upon when the need arises to defend our country. [illustration: incorrect position, showing how most men slack in swedish exercises by letting the back bend] our athletic sports have produced the right spirit, as the rush of athletes to the service has shown. but our calisthenics, our general building-up exercises have apparently failed in the physical development of our youth. they are antique. permit me to illustrate. only recently professor bolen, the authority on swedish exercises, died and left behind him the record of his work. after twenty-five years of study he had decided that setting-up exercises were unnecessary in the case of a man's legs or arms or pectoral muscles, and that the attention should be devoted to the trunk--that is, to the engine itself. old-time fallacies here is what was once considered to be a reasonable morning "setting-up" exercise, and which, if coupled with a five-mile rapid walk and hopping first on one foot and then on the other for a half-mile, would prepare a man for his day's work. on rising, let him stand erect, brace his chest firmly out, and, breathing deeply, curl dumbbells (ten pounds each for a -pound man) fifty times without stopping. then placing the bells on the floor at his feet, and bending his knees a little and his arms none at all, let him rise to an upright position with them fifty times. after another minute's rest, standing erect, let him lift the bells fifty times as far up and out behind him as he can, keeping the elbows straight and taking care, when the bells reach the highest point behind, to hold them still there a moment. next, starting with the bells at the shoulders, let him push them up high over the head and lower them fifty times continuously. is it any wonder that we abandoned such "setting-up"? again, it was pointed out how, by special exercises, a man might increase his biceps two or three inches in a year and the calves of his legs an inch or two! now what was the average man to do this for? what was the object? to admire himself in the mirror? or did he intend to make of himself a professional weightlifter? practically the only real good in all this was the deep breathing, and that would not be lasting except in so far as a part of the exercises tended to open up the chest. how many of us have heard that fairy-tale that if we practised deep breathing for a few minutes daily our lungs would acquire the habit and we should continue it unconsciously when seated at our desks! a perfectly useless stunt just to show what we are _not_ attempting to do, here is a quotation illustrating perfectly the old-fashioned idea that health depends upon extraordinary muscular development: at our suggestion he began practising this simple raising and lowering of the heels. in less than four months he had increased the girth of each calf one whole inch. when asked how many strokes a day he averaged, he said that it was from fifteen hundred to two thousand, varied some days by his holding in each hand, during the process, a twelve-pound dumbbell, and then only doing one thousand or thereabouts. the time he found most convenient was in the morning on rising, and just before retiring at night. the work did not take much time; seventy strokes a minute was found a good ordinary rate, so that fifteen minutes at each end of the day was all he needed. we new recognize how silly are such exercises taken for the mere sake of adding an inch or two to an already serviceable muscle. penny-wise and pound-foolish it is poor gymnastics when the main object is to expend a certain number of foot-pounds of energy to secure increase in cardiac and pulmonary activity, without care being taken that these organs are in a favorable condition to meet the increased demand put upon them. it is poor gymnastics if we desire to astound the world by nicely finished and smoothly gliding combinations of complex movements fit to be put into the repertoire of a juggler, or by exhibitions of strength vying with those of a sandow, if we do not take into consideration the effects upon the vital functions. "look at these fellows," said the physician, "built like giants and rotten inside!" true, he was speaking of a lot of big negroes, but he found the same condition in others--men with stiff muscles and slow movements, men with shoulders pulled forward and no chest expansion, breathing wholly with their abdomens. as he put it, "those men will to-morrow be the recruits for another army, the one which fills the tuberculosis hospitals." nature's process what we want is suppleness, chest expansion, resistive force, and endurance; and these do not come from great bulging knots of muscle nor from extraordinary feats of strength. rapid shifts from severe training to a life of ease and indulgence is not nature's process. it is not the way in which she carries on her work. every step she makes is a little one. she seems never to reckon time as an essential in her economy. we should heed the lesson. the man who eats, drinks, and neglects all care of himself for a year, and then rushes madly into a period of severe physical exercise and reduction, may at the end of the month, if he possesses sufficient vitality, come out feeling fine. but if he repeats the process of letting himself go, nature puts on the fat more and more and a second severe reduction becomes necessary. and it is only a question of time as to the exhaustion of any man's vitality through these extremes. time the great element any one who has had the opportunity of talking with the men in authority who are bearing the burden of fitting a nation for the present emergency cannot fail to be impressed with the fact that time is the great element. we must really prepare our men, we must make them fit in the shortest space of time that will accomplish the result. and we must conserve our man-power. it is no longer a question of putting on such severe work as shall weed out all but the physical giants; we are not trying (as seemed to be the idea in the first plattsburg camps, before the war) to make the going so stiff as to leave us only per cent. of hardened men. we want every man who can be brought along rapidly into condition, and not the strongest only. hence the problem takes on a new phase. we all recognize that the quality and previous training of the men this country is sending into service have a very potent bearing upon the length of time required to make fighters of them. for, after all, the man whose training and discipline have been along a kindred line becomes serviceable much earlier than the man who has to acquire the necessary spirit and quality. no one who has listened to the coaches of our various college teams, or who has read either the preliminary prospects of a game or the account of it afterward, but must have been impressed with the continual repetition of emphasis upon the "fighting spirit." hence, when our athletes flock almost _en masse_ to the colors, it means that we are enlisting a large number of picked men who have been in training both mentally and physically, and who, under discipline, will make obedient, courageous, and enthusiastic fighters. but a large number of these have been out of college or out of strenuous athletics a year or two, or longer, and they need physical conditioning to get back. there is thus a new idea of considerable importance involved in these condensed setting-up exercises. for the world does move, and those who thought themselves up to date on boats, aeroplanes, drill, and the like have found even within a year that they must make acquaintance with advanced theories and new and improved methods. essential principles probably the most vital point is that the setting-up exercises should not "take it out of the men." if we find a man exhilarated and made eager to work at the end of his setting-up we have accomplished far more than if we tire him out or exhaust any of his store of vitality. if, in addition to this, we can reduce the amount of time occupied in these setting-up exercises and yet obtain results, we have saved that much more time for other work. because they did take it out of the men, the old-time conventional setting-up exercises were shirked and the leaders were unable to detect this shirking; men went through the motions, but slacked the real work. furthermore, all these systems tended to take a longer period of time than was necessary to accomplish the desired results, and made "muscle bound" the men who practised them. it has been found in sports and athletic games that over-developed biceps, startling pectoral muscles, and tremendously muscled legs are a disadvantage rather than an advantage. the real essential is, after all, the engine, the part under the hood, as it were--lungs, heart, and trunk. finally, if we give a man endurance and suppleness he becomes more available in time of need. another point of equal importance is that the setting-up exercises should be rendered as simple as possible. if we are obliged to spend a considerable period of time in teaching the leader so that he can handle setting-up exercises, extension of the number of leaders is rendered increasingly difficult. if, therefore, we can make this leadership so simple that a long course of instruction is not necessary, we save here, in these days of necessarily rapid preparation, a very material amount of time. still, further, it is found that many of the present setting-up exercises made an extraordinarily wide variation of effort between heavy and light men. the light man would put in only a small amount of muscular effort, whereas the heavy man, in the same length of time and under the same exercise, would be taxed far more than he could comfortably stand. again, in the point of age, similar variations necessarily exist. naturally it is out of the question to assume that the youth from eighteen to twenty-five and the man of fifty-five to sixty can take the same amount and the same kind of exercise. on the other hand, if we consider the work each is required to do in his daily routine, we can, so far as the setting-up exercises are concerned, bring the two points nearer together, especially if we regard these setting-up exercises in the proper light--a mere preparation for the more onerous tasks that are to follow. modern physical education bearing all these points in mind, we test out the setting-up exercises so that we may obtain a set answering the following requirements: first--reduce them to a period of eight or ten minutes once or twice a day. second--make them simple for leaders to learn. third--eliminate movements that, on account of the daily work, are unnecessary. fourth--render them more difficult of evasion or shirking. fifth--direct them specifically in the line of increased resisting power, endurance, and suppleness. sixth--make them of value in establishing co-ordination, muscular control, and more prompt response to command. seventh--equalize them for use by both heavy and light men. eighth--select the exercises in such a way that the set may be of nearly equal value to both enlisted men and officers, as well as to executives behind the lines. slacking in setting-up drills many of us have seen setting-up drills of various kinds. moving pictures of such drills show in a very striking way how much of the work not only could be slacked, but _is_ being slacked right along. in fact, high officers in our service have become so disgusted with the setting-up exercises as to consider abandoning them altogether. in some stations or cantonments a great many men were tired out with the setting-up exercises; so much so that they had neither life nor vitality for some little time for other work. for the sake of illustration, let us examine one particular movement. it consists of the men lying flat on the ground or floor; then, with straight back, lifting themselves by the arms; finally, giving a jump with the arms and clapping the hands together once, and then coming back to the original position. the non-commissioned officer who was leading this exercise weighed about pounds. it is easy to imagine the contrast between his doing this stunt and a heavy man of or pounds attempting it. it is unnecessary to describe in detail the parts of the setting-up exercise which tend to develop members which are already pretty thoroughly exercised in the daily routine of work and drill. the average man of the service needs expansion of chest capacity, which adds to his resistive power; a stronger, better-developed back; and suppleness and quickness and mobility of trunk. to develop these qualities we must have exercises which may be continued on board ship or near the front, and which can be carried on without apparatus. [illustration: leg-raising] [illustration: side-falling. this arm and body work places a handicap on a heavy man] the ordinary system of setting-up exercises has been growing out of favor for some time. athletic trainers have come to look with considerable suspicion upon the gymnasium-made candidate with big biceps and large knots of muscles. it was also found that, outside of weight-lifting and inordinate "chinning" and apparent great strength on the parallel bars, these men were not so valuable as the lesser muscled but more supple candidates. to put it briefly, it was found in actual practice that what was under the ribs was of more value than what lay over them. a call for work that will count even at the risk of repetition, some facts should be driven home. we are now working under conditions that should especially emphasize the fact of time-saving. we must take ourselves seriously, whether we are in the lines or behind the lines. in the eight million men in this country between the ages of forty-five and sixty-four are the country's greatest executives and financiers. we can no longer give these executives and financiers two months in the south in the winter and a long summer vacation. we can no longer let a plattsburg camp be a strenuous sifting out, a mere survival of the physically fittest. we need every man whom we can make available, and we need him with his vitality fully preserved and his endurance appreciably heightened. some are stronger, naturally, than others. in football parlance we are no longer trying to pick a team out of a squad of two hundred men; we are trying to get a hundred and seventy-five out of the two hundred that can stand a fair pace and have enough left to fight with when they get there. any one who has been in touch with affairs in washington, any one who has been engaged in our munition-plants and in our factories, any one who has worked upon liberty bond drives or red cross fund-raising, knows that if we are to support our boys on land and sea, these men who are trying to solve the problems of executive management, and who have the task of raising funds in thousandfold increased volume, must be also carefully conserved. for, after all, even though we spell patriotism with a capital p and government with a capital g, even though army and navy orders take precedence, there is one great mistress of all, dame nature! and when she taps a man on the shoulder and says, "quit!" that man stops; and when he offers the excuse that he has done it out of patriotism and loyalty she merely says: "i don't care why you did it, you have finished!" and there is no appeal to washington from her verdict. the big problem we shall soon hear the call for more men, men to fight and men to support the men who fight. the game is on. we are all in it now, either on the field or on the side-lines. we need to train for it fast and we have no time to waste. for, after all, it is condition that tells. it is the man who can stay, who can work at highest efficiency, and who can hold out the longest who is going to be most valuable. if we save even ten minutes a day in the setting-up exercises, we save, with a hundred thousand men, , hours daily toward perfecting their other knowledge. if we can make an able officer or a competent executive last a year longer or even six months under the increased strain, it gives us a year or six months more in which his understudy can gather the necessary experience to take up his task. [illustration: arm and body work. this exercise places a handicap on a heavy man] [illustration: alternate leg-raising] millions of our youth are going out to fight, but disease and exhaustion will kill more of them than will the guns of the enemy. thousands of men of the best brain-power in this country are going into committee-rooms and conferences every day from nine in the morning till twelve at night to devise better and more efficacious means of stopping the progress of the hun. if these men's brains are of value, and we know they are, then the more clearly they act and the longer they last, the better for the country. the need for a condensed system of calisthenics the demonstration, with a group of busy business executives and professional men, of the possibility of physical fitness at a small expenditure has been already mentioned. this idea has spread and many units of the senior service corps have been organized. the writer's services were later on drafted into national work. at the call of the secretary of the navy, he was asked to take a position on the naval commission to develop athletic sports and games and physical fitness in our men at the various naval stations. in one week alone requests came from over four hundred communities to establish units of this work among business and professional men. finding that it was impossible to answer all these calls, the writer devoted himself personally to a class in washington, consisting of several cabinet members, officials of the federal reserve board, and others, and these men profited extremely from the work. but this should be done on a far larger scale. the hon. daniel c. roper, who was a member of the original class in washington, requested the writer to come down and spend a month or six weeks in washington, to organize drill groups in the various departments, several of them, like the department of the interior, having received requests to the number of three hundred or four hundred from men who wished to make themselves better fit physically for the work of these strenuous days. this, together with the demands from so many communities throughout the country, show that we are all now awake to the necessity of this cardinal feature of the nation's welfare, the physical fitness and stamina of its youth and men. this new gospel cannot be spread by one individual missionary, although there is little doubt that, wherever the story is told, thousands of our overworked and under-exercised men are glad to avail themselves of the opportunity. [illustration: extra leg work. this exercise places a handicap on a heavy man] this is the reason why the author has been led to devise a set of exercises that can be put in small compass, as regards both instruction and time required. here follows a brief syllabus of the plan, in the hope of placing it within reach of men who can afford but little time for anything outside of their pressing office duties. we can no longer take delightful vacations of indefinite length to restore our waning vitality. the country needs every man and needs him at the best of his power. a reasonable program no matter how driven a man may be, it seems only reasonable to think that he should be able to spend ten minutes twice a day on a condensed system, or setting-up exercise, adding to it an outdoor walk of half an hour. by this means he can keep himself physically fit to bear the burdens which are falling more and more heavily upon the shoulders of us all. the men who are going to the front first should have every chance of conserving their vitality and increasing their resistive forces. those of us who must do work behind the lines should be kept equally fit for that larger work without which the machine must inevitably break down. the method is scientific and it has been tested on men of all ages from eighteen to seventy. it embodies the elimination of all wasted effort and concentration upon points of approved and essential worth. it is as much a man's duty to make himself fit and to keep himself in that condition as it is to carry on any other part of his work. this method should be adopted not only in every department at washington, but throughout the country; it should be taught in our schools and colleges, and so thoroughly that never again in a world-wide crisis shall we find ourselves physically unprepared. chapter viii vacillation and doubt are poison to the nerves. this is the reason why it is advisable to teach co-ordination, prompt response to the command of the brain over the muscles, and the general sense of self-control which comes to a man when he has only to think in order to turn that thought into quick action. one of the penalties of the executive position is that, although the man begins as a disciplined private, when he goes up higher and gradually reaches the point where he gives commands only, and never has any practice in obeying them, he gets the habit of pushing buttons to make other people jump, while there are no buttons pushed to make him jump. worry and fear now as to worry. it has been said, and not untruly, that one of the very largest causes of worry is bodily weakness. and in more than a majority of cases this weakness comes from poor physical condition. a good digestion and proper elimination seem to make the organism move smoothly, not alone with muscles, but with nerves. hence if we get the engine right, the lungs doing their duty, the skin acting as it should, and the bowels and kidneys taking off the waste products, we generally find a robust man, little given to that most expensive habit, "worry." fear is the forerunner of illness. there is nothing quite so effective in producing a bad condition of the human system as fear, and this fear is what worry develops into; later it becomes pure, downright cowardice. worry makes cowards. if a man has enough worry and anxiety, fear follows in its wake, and then the man becomes a mental and moral and often a physical coward. the fatal mistake the average man, when he is pressed to overwork, thinks that by cutting out some of his exercise and devoting that extra time to his work he can accomplish more. there never was a greater mistake; in the long run this method is the most expensive of all. no factory manager would think of running his automatic machines twice as long with half the amount of oil, and yet that is just what the man is trying to do in this case. the result is that he gradually piles up the various toxic products within himself until self-poisoning is inevitable. all his organs struggle to eliminate these poisons, but, being given no assistance, they gradually become less and less efficient, and then begins the payment of the penalty, for nature never forgives this kind of treatment. from a practical, useful running machine he retrogrades into something fit only for the scrap-heap. the history is the same in all cases, although it may be more or less prolonged. the discomfort, occasional slight illnesses, the gradual loss of effective thought and power to concentrate, lack of appetite, unreasonable temper, insomnia, nerve diseases, and perhaps a complete nervous and physical breakdown if the conditions are not recognized in time, are the varying punishments inflicted by nature. [illustration: arch work] i have referred to nature's order, "you must earn your bread by the sweat of your brow." almost every one, in these modern days of civilization, is earning his bread in some other way; well, he must make up for this by some kind of exercise or else nature will surely take her toll. when men were earning their bread by the sweat of their brows they were not always sure of getting a surplus of it, and that was not a half-bad thing. in fact, it was far better for the race than present conditions under which so many men have given up physical work altogether. but instead of cutting down on their food they double up on it. something out of a bottle the usual temporary panacea for these ills of the flesh is to get some so-called "specific" in the form of a medicine and gobble it religiously. thousands of men and women, who are unwilling to take five or ten minutes' exercise two or three times a day, will swallow something out of a bottle on a spoon before each meal, with a splendid satisfaction and confidence. perhaps temporarily it produces improved results. at any rate, it gives a sense of mental satisfaction, and that something stands off the trouble for a while. there is still another method which has some show of reason in it, although, after all, it does not compare with the wiser, saner course. a man or woman is persuaded that if he or she will only give up some particularly attractive self-indulgence the result will be increased health and vigor. for instance, there is a common belief that tea or coffee is the cause of many ills. perhaps this is true, but the giving up of tea or coffee will never cure the ills that come from lack of exercise, loss of fresh air, over-eating, and over-indulgence. the mere fact that a person is giving up something that he likes does not make him immune to the penalties which he incurs day after day by other offenses against the laws of nature. conserving the president's health rear-admiral carey t. grayson, personal physician and health director to president wilson, says: "you may make the statement, in so many words, that physical exercise has been the means of making a normal, physically perfect man of the president. and when a man is in a normal condition he is in perfect health and physical trim. that was the initial intention in this case, just to make the president physically fit, and to keep him so." richard m. winans says: "the admiral told me that when he first took charge of the president, mr. wilson was not a little averse to taking any sort of exercise. however, doctor grayson early succeeded in impressing upon mr. wilson that good health was an absolutely important factor in dealing with the grilling duties which would face him during the coming four years, and that his physical well-being was vital not only to himself, but to the welfare of the entire country." the president has a dislike almost akin to abhorrence for mechanical appliances intended to exercise the muscles of the body. there is not a dumbbell, or an indian club, nor a medicine-ball, nor a punching-bag, nor a turning-bar, nor a trapeze, nor a lifting or pulling apparatus, nor a muscle--exercising machine of any sort or description in the white house. the only mechanical device used by the president is a simple, unoffending golf-club. [illustration: spring work.] aside from his work in the open air, mr. wilson takes a number of physical exercises indoors, very few of which have ever been described in print. some of these exercises are taken as a substitute for outdoor recreations at times when weather conditions are too extreme. but the major part of them, and especially the more unusual of these exercises, are regularly practised as a part of his daily routine. as a matter of fact, they are pretty closely dove-tailed in with his office work. flexing exercises however, if the president really has a favorite among his various physical exercises, it is said to be that of "flexing." this he employs almost entirely as an indoor exercise, and it perhaps is the one he practises more often than any other. "flexing," as doctor grayson put it into its simplest every-day term, is nothing more nor less than just good, old-fashioned "stretching" expressed in a scientific and systematized form of exercise. it is the most generally and commonly executed muscular exercise, and it is practised by nearly all the animal kingdom. president wilson uses his flexing movements with a careful regard to system, and a great deal more regularly and frequently than any other of his varied physical exercises. particularly during his periods of concentration, when at work at his desk in the preparation of his messages to congress or in the drafting of notes to foreign governments, the president, at short intervals, will either settle back in his chair and flex his arms and hands and the muscles across his back and chest, or he will rise and stand erect for a more thorough practice of the flexing movements for a period of a minute or more. at these times he will throw his body into almost every conceivable posture--twisting, turning, bending, stooping, the arms down, forward, back, and over his head, the muscles of the limbs and entire body flexed almost to the point of tremor, the fingers spread, and the muscles rigidly tensed. in the opinion of doctor grayson, if business and professional men, particularly those who work at high tension in the cities, would pause in their work at frequent intervals during the day and give a few seconds of their time to the energetic practice of the flexing or stretching exercises, there would soon come to be not only less, but, possibly in time, no cases reported of this or that noted man, the famous lawyer, merchant, or financier, dropping dead at his desk or in his home or in the street, on account of apoplexy caused by hardened arteries. one of mr. wilson's principal physical movements is that of body-twisting. with the toes at a slight outward angle, the heels touching and the body erect, he begins the movement by twisting the body a little more than half-way around; then swinging back in an arc, at the same time bending at the hips, until he has completed the circle and reached a hip-bending position, with the fingers of one hand touching the floor, the other extended vertically. this gives a stretching movement to all of the muscles of the torso, side, back, and abdomen, as well as considerable play to the muscles of the legs and arms. the unpleasant self-awakening we as a nation, through the revelation of the draft, have been suddenly thrown upon the public screen as physically deficient. and that, too, when the echoes of the eagle screaming over successes in the world olympic games had hardly done sounding in our satisfied ears. naturally, we don't like it. deep down in our consciousness we are not only dissatisfied with the picture, but we feel that somehow it is distorted; we are hoping to prove that even a photograph does not always tell the truth, at least not the whole truth. yet in this search for the truth there are some facts that we must face and admit. the first of these is that as a race--blended, if you please, but still the people of a nation--we are ambitious and hurried. we act a great deal more than we think. cricket is too slow for us; only baseball has the fire and the dash we like. we haven't quite enough time even for that, and so we begin to leave the stands before the game is over, craning our necks as we walk along toward the exits for a last glimpse, and then rushing madly to get on the first car out. all this is typical of our life. we have had a measure of benefit from our athletics. they are a spur toward physical development as long as they last. but no sooner are school-days drawing to an end than we begin the mad rush--toward what? to see how fast we can make money or name or position. we take a final look backward at the last inning of these sports of ours, and then we rush out into the world of american hustle. the lucky ones prolong their playtime a little by a college course, but they, too, finally abandon sport in favor of business and let themselves go slack until they lose condition. a week or two in the summer, a fort-night's orgy of exercise, and then back to the grind of factory or desk. how can this way of living keep even a young man fit? golf has been a godsend to the older man whose pocket-book can stand it, but what about the youth? and when pressure comes on the older man he quickly gives up his golf at the demand of business. [illustration: arm and body work. this places a handicap on a heavy man.] [illustration: high-stride stoop falling.] why men don't keep fit men who have really kept themselves fit are few. those who have conscientiously started in to do this and then abandoned it are a host. there are valid reasons for this lamentable state of affairs. first--because the antiquated systems under which these men have attempted the task have ( ) occupied too much time; ( ) left men tired instead of refreshed; ( ) exercised muscles which get all they need in a man's ordinary pursuits. secondly--because the instructors who have taught these systems have laid stress upon ( ) mere increase in size of the muscles; ( ) ability to do "stunts" which are of no practical use to a man; ( ) unnecessary use of apparatus. thirdly--because they made necessary the services of a teacher to ( ) lead the exercises; ( ) keep track of their number and variety; ( ) give special treatment to produce results. but these mistakes are in the past. let us look toward a brighter, saner, and more productive future. chapter ix the following chapters give a set of exercises carefully tested upon thousands of men, and these exercises will be fully explained so that any individual reader may practise them daily and secure their full benefit. to each chapter are appended a few health hints, couched in language that is brief and to the point, in order that they may be readily remembered. the object is to make an efficient working-machine of the man without useless effort, to increase that man's resistive force against disease, to add to his suppleness and endurance, to give him poise and balance, and to develop co-ordination or control over his muscles. by doing this his power to work will be augmented, and at the same time any work that he does will be accomplished more readily and with less effort. finally his cheerfulness will be increased, and those who work with him or under him or about him will be spared the disagreeable experiences that accompany association with a man whose irritability and irascibility have become part of his daily habit. a shorthand method we call this system the "daily dozen set-up." it is a shorthand system of setting-up exercises for use on any and all occasions. the "daily dozen set-up" consists of twelve exercises which, for ease in memorizing, are divided into four groups of three exercises each. each exercise or movement is given a name, and the names of all the movements of a group commence with the same letter, thus: group i group ii group iii group iv . hands . grind . crawl . wave . hips . grate . curl . weave . head . grasp . crouch . wing these exercises are not difficult nor exhausting, and do not demand great strength for their proper execution. they are designed, both from a scientific and a practical point of view, to give exactly the right amount of exercise to every muscle of the body. they are intended to promote suppleness, and especially to strengthen those muscles which are seldom brought into play in ordinary daily life. a conscientious fifteen minutes a day with the "daily dozen" will soon do more for a man than any amount of skilled physical feats or "strong-man stunts." when one first practises these movements their effect will be felt on the little-used muscles of the neck, back, and stomach; yet they will not leave the pronounced muscular fatigue which follows the ordinary exercises and which does more harm than good. health maxims dress to be cool when you walk and warm when you ride. clean skin, clean socks, clean underwear every day. getting mad makes black marks on the health. sleep woos the physically tired man; she flouts the mentally exhausted. nature won't stand for overdrafts any more than your bank. in a squad it is the job of each individual to make himself fit, for it is his example that helps the rest. the leader may be no better than you, but some one must give the orders and set the pace. two things are essential to a clean skin; one is bathing and a rub-down, but the other is still more important, and that is perspiration. food, water, and oxygen are the fuel for running the human machine. you never saw a dog fill his mouth with food and then take a drink to wash it down. chapter x any setting-up exercises should be preparatory--that is, they should make men ready for the serious work of their day, and in no way exhaust any portion of their vitality. this modern "shorthand" method of setting-up leaves men in an exhilarated condition, and, instead of taking anything out of them, it prepares the body for any kind of work that may be required. each exercise starts from the position of "attention," which is thus described in the army manual: heels on the same line and as near each other as the conformation of the man permits. feet turned out equally and forming with each other an angle of about sixty degrees. knees straight without stiffness. [illustration: fig. .--hands the description of this exercise is the same as that given for the military command of "attention," and the following points should be carefully noted: it is not difficult to acquire a certain amount of accuracy in this position, but one of the easiest ways of getting men to assume it properly is to tell them to push their necks back. this seems more effective than to speak of holding the chin in with the head erect, or anything of that kind. if a man stands naturally and then forces the back of his neck back against his collar, he comes into very nearly the desired position of "attention" so far as his head and neck are concerned. the shoulders should be rolled a little downward and back, for that is the sensation which comes when one speaks of the shoulders being square. the chest should be arched and the abdomen drawn in somewhat. the effect is that of a man standing erect and feeling himself a little taller than usual.] body erect on hips, inclined a little forward; shoulders square and falling equally. arms and hands hanging naturally, backs of the hands outward; thumbs along the seams of the trousers; elbows near the body. head erect and straight to the front, chin slightly drawn in without constraint, eyes straight to the front. (see fig. .) each movement, with the exception of the "speed test" (a catch exercise with which any man may test his rapidity of action and co-ordination), should be executed in a slow and measured manner. these exercises do not depend upon snap for their effect, but upon the steady, deliberate, but not extreme stretching of the muscles. any tendency toward hurried, careless execution should be avoided in favor of uniformity of movement. group i hands: this is the same position as "attention." (see fig. .) [illustration: fig. .--hips the position called "hips" is that of "attention" with the hands placed on the hips, the fingers forward and the thumbs back, at the same time keeping the shoulders and elbows well back.] especial care should be taken to see that whenever, throughout the exercises, this position is taken--as at the completion of each movement--full control is retained over the arms; the hands should not be allowed to slap against the sides audibly. it is not difficult to acquire a certain amount of accuracy in this position, but one of the easiest ways of getting men to assume it properly is to tell them to "push their necks back." this seems more effective than to speak of holding the chin in with the head erect, or anything of that kind. if a man stands naturally and then forces the back of his neck back against his collar, he comes into very nearly the desired position of "attention," so far as his head and neck are concerned. the shoulders should be rolled a little downward and back, for that is the sensation which comes when one speaks of the shoulders being square. the chest should be arched and the abdomen drawn in somewhat. the effect is that of a man standing erect and feeling himself a little taller than usual. hips: the hands are placed on the hips, with shoulders, elbows and thumbs well back. (see fig. .) the position of "hips" is that of "attention" with the hands placed on the hips, the fingers forward and the thumbs back, at the same time keeping the shoulders and elbows well back. head: the hands are placed behind the neck, index finger-tips just touching and elbows forced back. (see fig. .) [illustration: fig. .--head in the position called "head" the body is still in the position of "attention," the neck pushed well back, the fingers and the hands just touching behind the neck, and the elbows not allowed to push forward but kept as far back as the shoulders.] in the position called "head" the body is still in the position of "attention," the neck pushed well back, the fingers and the hands just touching behind the neck, and the elbows not allowed to push forward but kept as far back as the shoulders. speed test: the above three exercises, "hands, hips, head," should be executed but a few times each, being preparatory to the "speed test." for this the pupil should concentrate his thought on running through the above set as rapidly as possible, at the same time making each position correct. health maxims success comes from service. don't make excuses. make good. if you feel tired, remember so does the other man. after a hearty meal, stand up straight for fifteen minutes. your squad is only as good as the poorer ones. don't be one of those. the success of the drill depends upon the concentration of each man of the squad. if you have a stake in life, it is worth playing the game for all there is in it. the man who gets things is the one who pulls up his belt a hole tighter and goes out after them. if you will save your smoke till after luncheon, you'll never have smoker's heart. a bath, cold if you please, hot if you must, with a good rub, starts the day right. chapter xi group ii grind: (the order is "shoulder grind. ready--cross. balance turn. grind!") assume the "cross"[ ] position. (see fig. , chapter v.) the palms are then turned up, with the backs of the hands down and the arms forced back as far as possible. (see fig. .) [illustration: fig. .--grind in the "grind" special precaution should be taken not to let the center of the circle, that the hands are making, come in front of the shoulders; an attempt should almost be made to make the shoulder-blades meet. this is particularly necessary on the reverse.] then to a measured counting--"one, two, three, four, five," up to ten--circles of twelve-inch diameter are described with the finger tips, the latter moving forward and upward, the arms remaining stiff and pivoting from the shoulders. on the backward movement of the circle the arms should be forced back to the limit. a complete circle should be described at each count. then reverse, going through the same process, the circles being described in the opposite direction. in the "grind" exercises special precaution should be taken not to let the center of the circle, that the hands are making, come in front of the shoulders; it should be straight out in the horizontal position; moreover, as the arm goes backward an attempt should be made to make the shoulder-blades almost meet. this is particularly necessary on the reverse--that is, when the hands are coming forward--for here the tendency, unless men keep the shoulders back, is to contract the chest. grate: (the order is "shoulder grate. ready--cross. grate!") assume the "cross" position. then at a count of "one" the arms are slowly raised, as a deep inhalation is taken, to an angle of forty-five degrees from horizontal; at the same time the heels are raised till the weight of the body rests on the balls of the feet. (see fig. .) [illustration: fig. .--grate the caution in the "grate" position is not to let the arms drop, even a fraction of an inch, below the horizontal, and not to let them go up above the angle of forty-five degrees, for in either of these cases there is a distinct rest given to the shoulder muscles. most of the ordinary exercises of this kind carry the arms above the head; this always releases the effort of the shoulder muscle and is therefore nearly valueless as an exercise for these members. another fault in this exercise is letting the head come forward. the neck should be kept back all the time.] at "two" the arms are slowly returned to "cross" as all air is exhaled and the heels are lowered to a normal position. care should be taken to see that the arms are not allowed to drop below the level of the shoulders or to rise more than forty-five degrees. the arms should be raised and lowered ten times. the caution in the "grate" position is not to let the arms drop, even a fraction of an inch, below the horizontal, and not to let them go up above the angle of forty-five degrees, for in either of these cases there is a distinct rest given to the shoulder muscles. most of the ordinary exercises of this kind carry the arms above the head; this always releases the effort of the shoulder muscle and is therefore nearly valueless as an exercise for these members. another fault in this exercise is letting the head come forward. the neck should be kept back all the time. [illustration: fig. a.--second position of grate] grasp: (the order is "head grasp. ready--cross. grasp!") assume the "cross" position. then place the hands behind the head. with head up and eyes front, and in time with the counting, "one, two, three, four," the body is bent forward from the waist as far as possible. (see fig. .) [illustration: fig. .--grasp in the "grasp" position it is not necessary to go to extremes on the backward movement; only so far as is really comfortable. in the forward movement the body should come down practically at right angles to the hips, but the head should not be allowed to drop forward. the head should be kept up, with the elbows back and the eyes looking to the front.] the body is returned to the upright in the same number of counts, and at an unusually slow "one" it is bent as far back as comfortable only from the waist, being returned to the upright at "two." care should be taken to see that this motion is slow and not jerky. the entire movement should be repeated five times. in the "grasp" position it is not necessary to go to an extreme on the backward movement; only so far as is really comfortable. in the forward movement the body should come down practically at right angles to the hips, but the head should not be allowed to drop forward. the head should be kept up, with the elbows back and the eyes looking to the front. health maxims vacillation and doubt are poison to the nerves. fear is the forerunner of illness. "eyes in the boat" is as good a maxim at drill as in a shell. when drinking a glass of water stand erect and take a full breath first; then drink with chest out and hips back and head up. the men who chase the golf-ball don't have to pursue the doctor. two hours of outdoor exercise by the master never yet made him over-critical of the cook. [illustration: fig. a.--forward position of grasp] nature never punished a man for getting his legs tired. she has punished many for getting their nerves exhausted. the best record in golf is the record she has made of restored health to the middle-aged. see how high you can hold your head and deeply you can breathe whenever you are out of doors. six to eight glasses of water a day, none with meals, will make you free of doctors. footnotes: [footnote : on the "cross" position, the arms should be straight out horizontally from the body, with the elbows locked. at the same time every resistance should be placed against the head and neck coming forward at all. these should be held in exactly the same position as at "attention." the tendency is either to let the arms bend a little, or to let them drop a little below the horizontal, or even to hold them slightly above the level.] chapter xii group iii crawl: (the order is "crawl. ready--cross. crawl!") assume the "cross" position. the left palm is then turned up, and on a count of "one, two, three, four" the left arm is raised and the right arm is lowered laterally until at "four" the right arm should be in a position of "hands," while the left arm should be extended straight up, with the palm to the right. (see fig. .) [illustration: fig. crawl, first position] [illustration: crawl in the "crawl" position it is not necessary, in the beginning of the exercise, to slide the hand down the hip any farther than is perfectly comfortable. but this distance should be gradually increased, and it will be found quite easy to do this as the muscles of the side become more and more supple.] then on the count of "one, two, three, four" the body is slowly bent sideways from the waist, the right hand slipping down the right leg to or beyond the knee, and the left arm bending in a half-circle over the head until the fingers touch the right ear. (see fig. .) at "four" the position of "cross" is quickly resumed, and at "two" of the next counting the right palm is turned up and the exercise is completed in the opposite direction. [illustration: fig. crawl, second position] in the "crawl" position it is not necessary, in the beginning of the exercise, to slide the hand down the hip any farther than is perfectly comfortable. but this distance should be gradually increased, and it will be found quite easy to do this as the muscles of the side become more and more supple. curl: (the order is "curl. ready--cross. curl!") assume the "cross" position. in this movement, at "cross" the feet are spread until the heels are about twelve inches apart. the left foot remains stationary, the right foot being moved to accomplish this. on a count of "one, two, three, four," at the same time inhaling slowly, the fists and lower arms are bent down from the elbows, which are kept pressed back, and the fists are slowly curled up into the armpits. this position should be reached at "three," when the head and shoulders should be forced back rather strongly, reaching the limit of motion at "four." (see fig. .) again on the count of "one, two, three, four," at "one" the arms are extended straight forward from the shoulders, with the palms down, and exhalation is begun. [illustration . curl. in the "curl" position the head and shoulders should be thrown well back and the fists should go well up into the armpits. keep the elbows back so that the entire thorax is lifted forward and up; at the same time take a deep inhalation.] at "two" the arms begin to fall and the body bends forward from the waist, head up and eyes front, until, at "four," the body has reached the limit of motion and the arms have passed the sides and have been forced back and up (as the trunk assumes a horizontal position) as far as possible. at this point the abdomen should be well drawn in at the finish of exhalation. (note that in this figure the feet are together, an incorrect position for this exercise.) for a third time, on a count of "one, two, three, four" the body is straightened, reaching an upright position, with arms straight forward at "three." "cross" is assumed at "four." as the body is straightened from the "wing" position, a full breath should be taken, the lungs being filled, slowly, to the maximum as "curl" is finally reached. this breath should be retained and then exhaled as the "wing" position is taken. inhale through the nose. [illustration: crawl. at this point the raised arm should be curved over the head] the entire movement should be repeated five times. in the "curl" position the head and shoulders should be thrown well back and the fists should go well up into the armpits. keep the elbows back so that the entire thorax is lifted forward and up; at the same time take a deep inhalation. crouch: (the order is "crouch. ready--cross. crouch!") assume the "cross" position. in this movement, at "cross" the feet are spread until the heels are about twelve inches apart. the left foot remains stationary, the right foot being moved to accomplish this. on a count of "one" the knees are bent, and, with the weight on the toes, the body is lowered nearly to the heels, keeping the trunk as nearly erect as possible. (see fig. .) [illustration . crouch. the "crouch" is intended for the acquisition of balance and poise, but is also good exercise for the legs. the back is kept straight and the balance preserved throughout.] this is done at "one," and at "two" the upright position is resumed. the entire movement should be repeated ten times. the "crouch" position is intended for the acquisition of balance and poise; at the same time it is good exercise for the legs. the back should be kept straight and the balance preserved as the body goes up and down. this will be a little difficult at first, but will soon become natural. health maxims worry makes cowards. happiness comes from health, not from money. co-operation with others is the life of the squad. drill is a mental as well as a physical discipline. work will take your mind off most of your ills. obesity comes from overloading the stomach and underworking the body. nine-tenths of the "blues" come from a bad liver and lack of outdoor exercise. wearing the same weight underclothing the year around will save you a lot of colds. your nose, not your mouth, was given you to breathe through. short shoes and shoes that don't fit cost a lot in the long run. blood pressure does not come to the men who walk a lot out of doors; instead it looks for those who sit and eat a lot indoors. two men in an eight-oared shell may be able to go faster than the other six, but they never win the race that way. chapter xiii group iv wave: (the order is "wave. ready--cross. arms up. wave!") assume the "cross" position. the arms are then stretched straight above the head, the fingers interlaced and the arms touching the ears. (see fig. .) [illustration: fig. .--correct position, start of wave] on a count of "one, two, three, four" a complete circle, of about twenty-four inches in diameter, is described with the hands, the body bending only at the waist. the trunk should be bent as far backward as forward, and as far to one side as to the other. (see fig. .) [illustration . wave. in the "wave" the tendency is to go too far forward and not far enough back, the result being an unsymmetrical motion. it is very easy to go forward, but more difficult to make the motion to the side and back. care should be taken that the arms are kept squarely against the ears. the motion should be like waving the mast of a ship, the hips representing the deck and the trunk, head, and arms up to the top of the hands, the mast.] the body should be forward at "one," to the right at "two," backward at "three," and to the left at "four." the motion should be steady and not in jerks. at "reverse" the same movement should be repeated in the opposite direction--i.e. to the left. as the movement is completed for the fifteenth time the body should be brought to an erect position, stretching the arms up as far as possible; and at "rest" the arms should drop slowly, laterally, to a "hands" position. five circles should be described in each direction. in the "wave" the tendency is to go too far forward, and not far enough back, the result being an unsymmetrical motion. it is very easy to go forward, but more difficult to make the motion to the side and back. care should be taken that the arms are kept squarely against the ears. the motion should be like waving the mast of a ship, the hips representing the deck, while the trunk, head, and arms up to the top of the hands, represent the mast. this movement, like the others, should not be extreme at first, but gradually increased after a week or so. weave: (the order is "weave. ready--cross. weave!") assume the "cross" position. in this movement, at "cross" the feet are spread until the heels are about twelve inches apart. the left foot remains stationary, the right foot being moved to accomplish this. on a count of "one, two, three, four" the body is turned to the left from the hips, the arms maintaining the same relation to the shoulders as at "cross," until at "one" the face is to the left, the right arm pointing straight forward (in relation to the feet) and the left arm straight backward. (see fig. .) [illustration: fig. .--weave, first position] at "two" the body is bent from the waist so that the right arm goes down and the left up; and at "three" the fingers of the right hand touch the ground midway between the feet. the left arm should then be pointing straight up, with the face still to the left. the right knee must be slightly bent to accomplish this position. (see fig. .) [illustration: fig. .--weave in the "weave" care should be taken that the arms and shoulders are kept in one line. the turn begins with the arms horizontal until they are nearly at right angles to the "cross" position. then the knee commences to bend and the body bends at the trunk, the hip turning in until the finger tips touch the floor. at that time the arms and shoulders should still be in the same relative position as at the start--namely, in "cross" position.] at "four" the position of "cross" is resumed, and on a count of "one, two, three, four" the same movement is repeated, this time with the left hand touching the ground. throughout the exercise care should be taken that the arms remain in the same straight line, making no separate movement, but changing their position only as the trunk and shoulders are moved and carry the arms along. after this exercise has been thoroughly mastered, the turning and bending movements made on the counts "one" and "two" should be combined--_i.e._, instead of making the entire turn, as described above, turn and bend simultaneously. the entire movement should be repeated ten times. in the "weave" care should be taken that the arms and shoulders are kept in one line. the turn begins with the arms horizontal until they are nearly at right angles to the "cross" position. then the knee commences to flex and the body bends at the trunk, the hip turning in until the finger-tips touch the floor. at that time the arms and shoulders should still be in the same relative position as at the start--namely, in "cross" position. wing: (the order is "wing. ready--cross. arms up. wing!") this is a finishing exercise consisting of deep breathing and is performed slowly. on a count of "one, two, three, four" the arms are raised laterally until they are extended straight upward at "one" and a full inhalation is reached. (see fig. .) at "two" the arms begin to fall forward and downward, and the body bends forward from the waist up, and eyes front, until, at "four" the body has reached the limit of motion and the arms have passed the sides and have been forced back and up (as the trunk assumes a horizontal position) as far as possible. (see fig. a.) [illustration: fig. .--wing in the "wing" position, which is a final breathing exercise, the breath should be taken well in as the arms are raised over the head; then exhaled as the body and arms swing forward, with a final crowding out of some of the residual air by forcing in the abdomen as the arms are raised over the back. start the inhalation again as the arms come forward.] [illustration: fig. a.--end of wing] on a count of "one, two, three, four" the body is straightened, reaching an upright position, with arms vertically extended, at "three." at "four" the arms are lowered to a "cross" position, but with palms up and arms and shoulders forced hard back. very slow counting is essential to the correct execution of this exercise. all air should be forced from the lungs as the body bends forward to the "wing" position, and they should be filled to capacity as the body is straightened and the arms brought down. inhale through the nose. the entire movement should be repeated five times. health maxims preparedness is nine-tenths physical strength and endurance. if you take more food than the digestion can handle, you not only tire the stomach, but the whole system. envy, jealousy, and wrath will ruin any digestion. you'll never get the gout from walking. tennis up to the thirties, but golf after forty. tight shoes have sent many a man to bed with a cold. leg weariness never yet produced brain fag. whenever you walk, stand up, with chin in, hips back, and chest out, and think how tall you are. courage and concentration will conquer most obstacles. the hurry of half a squad never brought the whole troop home. the army must have sound lungs and a good stomach quite as much as arms and ammunition. the freedom of life by annie payson call _author of "power through repose," "as a matter of course," etc._ _freedom_ _lord god of israel,-- where thou art we are free! call out thy people, lord, we pray, from egypt unto thee. open our eyes that we may see our bondage in the past,-- oh, help us, lord, to keep thy law, and make us free at last!_ _lord god of israel,-- where thou art we are free! freed from the rule of alien minds, we turn our hearts to thee. the alien hand weighs heavily, and heavy is our sin,-- thy children cry to thee, o lord,-- their god,--to take them in._ _lord god of israel,-- where thou 'art we are free cast down our idols from on high, that we may worship thee. in freedom we will live thy love out from our inmost parts; upon our foreheads bind thy law,-- engrave it on our hearts!_ _amen._ contents introduction the freedom of life how to sleep restfully resistance hurry, worry, and irritability nervous fears self-consciousness the circumstances of life other people human sympathy personal independence self-control the religion of it about christmas to mothers _introduction_ interior freedom rests upon the principle of non-resistance to all the things which seem evil or painful to our natural love of self. but non-resistance alone can accomplish nothing good unless, behind it, there is a strong love for righteousness and truth. by refusing to resist the ill will of others, or the stress of circumstances, for the sake of greater usefulness and a clearer point of view, we deepen our conviction of righteousness as the fundamental law of fife, and broaden our horizon so as to appreciate varying and opposite points of view. the only non-resistance that brings this power is the kind which yields mere personal and selfish considerations for the sake of principles. selfish and weak yielding must always do harm. unselfish yielding, on the other hand, strengthens the will and increases strength of purpose as the petty obstacles of mere self-love are removed. concentration alone cannot long remain wholesome, for it needs the light of growing self-knowledge to prevent its becoming self-centred. yielding alone is of no avail, for in itself it has no constructive power. but if we try to look at ourselves as we really are, we shall find great strength in yielding where only our small and private interests are concerned, and concentrating upon living the broad principles of righteousness which must directly or indirectly affect all those with whom we come into contact. i _the freedom of life_ i am so tired i must give up work," said a young woman with a very strained and tearful face; and it seemed to her a desperate state, for she was dependent upon work for her bread and butter. if she gave up work she gave up bread and butter, and that meant starvation. when she was asked why she did not keep at work and learn to do it without getting so tired, that seemed to her absurd, and she would have laughed if laughing had been possible. "i tell you the work has tired me so that i cannot stand it, and you ask me to go back and get rest out of it when i am ready to die of fatigue. why don't you ask me to burn myself, on a piece of ice, or freeze myself with a red-hot poker?" "but," the answer was, "it is not the work that tires you at all, it is the way you do it;" and, after a little soothing talk which quieted the overexcited nerves, she began to feel a dawning intelligence, which showed her that, after all, there might be life in the work which she had come to look upon as nothing but slow and painful death. she came to understand that she might do her work as if she were working very lazily, going from one thing to another with a feeling as near to entire indifference as she could cultivate, and, at the same time, do it well. she was shown by illustrations how she might walk across the room and take a book off the table as if her life depended upon it, racing and pushing over the floor, grabbing the book and clutching it until she got back to her seat, or, how she might move with exaggerated laziness take the book up loosely, and drag herself back again. this illustration represents two extremes, and one, in itself, is as bad as the other; but, when the habit has been one of unnecessary strain and effort, the lazy way, practised for a time, will not only be very restful, but will eventually lead to movement which is quick as well. to take another example, you may write holding the pen with much more force than is needful, tightening your throat and tongue at the same time, or you may drag your pen along the paper and relieve the tendency to tension in your throat and tongue by opening your mouth slightly and letting your jaw hang loosely. these again are two extremes, but, if the habit has been one of tension, a persistent practice of the extreme of looseness will lead to a quiet mode of writing in which ten pages can be finished with the effort it formerly took to write one. sometimes the habit of needless strain has taken such a strong hold that the very effort to work quietly seems so unnatural as to cause much nervous suffering. to turn the corner from a bad habit into a true and wholesome one is often very painful, but, the first pain worked through, the right habit grows more and more easy, until finally the better way carries us along and we take it involuntarily. for the young woman who felt she had come to the end of her powers, it was work or die; therefore, when she had become rested enough to see and understand at all, she welcomed the idea that it was not her work that tired her, but the way in which she did it, and she listened eagerly to the directions that should teach her to do it with less fatigue, and, as an experiment, offered to go back and try the "lazy way" for a week. at the end of a week she reported that the "lazy way" had rested her remarkably, but she did not do her work so well. then she had to learn that she could keep more quietly and steadily concentrated upon her work, doing it accurately and well, without in the least interfering with the "lazy way." indeed, the better concentrated we are, the more easily and restfully we can work, for concentration does not mean straining every nerve and muscle toward our work,--it means _dropping everything that interferes,_ and strained nerves and muscles constitute a very bondage of interference. the young woman went back to her work for another week's experiment, and this time returned with a smiling face, better color, and a new and more quiet life in her eyes. she had made the "lazy way" work, and found a better power of concentration at the same time. she knew that it was only a beginning, but she felt secure now in the certain knowledge that it was not her work that had been killing her, but the way in which she had done it; and she felt confident of her power to do it restfully and, at the same time, better than before. moreover, in addition to practising the new way of working, she planned to get regular exercise in the open air, even if it had to come in the evening, and to eat only nourishing food. she has been at work now for several years, and, at last accounts, was still busy, with no temptation to stop because of overfatigue. if any reader is conscious of suffering now from the strain of his work and would like to get relief, the first thing to do is to notice that it is less the work that tires him than his way of doing it, and the attitude of his mind toward it. beginning with that conviction, there comes at first an interest in the process of dropping strain and then a new interest in the work itself, and a healthy concentration in doing the merest drudgery as well as it can be done, makes the drudgery attractive and relieves one from the oppressive fatigue of uninteresting monotony. if you have to move your whole body in your daily work, the first care should be to move the feet and legs heavily. feel as if each foot weighed a ton, and each hand also; and while you work take long, quiet breaths,--breaths such as you see a man taking when he is very quietly and soundly sleeping. if the work is sedentary, it is a help before starting in the morning to drop your head forward very loosely, slowly and heavily, and raise it very slowly, then take a long, quiet breath. repeat this several times until you begin to feel a sense of weight in your head. if there is not time in the morning, do it at night and recall the feeling while you are dressing or while you are going to work, and then, during your work, stop occasionally just to feel your head heavy and then go on. very soon you become sensitive to the tension in the back of your neck and drop it without stopping work at all. long, quiet breaths while you work are always helpful. if you are working in bad air, and cannot change the air, it is better to try to have the breaths only quiet and gentle, and take long, full breaths whenever you are out-of-doors and before going to sleep at night. of course, a strained way of working is only one cause of nervous fatigue; there are others, and even more important ones, that need to be understood in order that we may be freed from the bondage of nervous strain which keeps so many of us from our best use and happiness. many people are in bondage because of doing wrong, but many more because of doing right in the wrong way. real freedom is only found through obedience to law, and when, because of daily strain, a man finds himself getting overtired and irritable, the temptation is to think it easier to go on working in the wrong way than to make the effort to learn how to work in the right way. at first the effort seems only to result in extra strain, but, if persisted in quietly, it soon becomes apparent that it is leading to less and less strain, and finally to restful work. there are laws for rest, laws for work, and laws for play, which, if we find and follow them, lead us to quiet, useful lines of life, which would be impossible without them. they are the laws of our own being, and should carry us as naturally as the instincts of the animals carry them, and so enable us to do right in the right way, and make us so sure of the manner in which we do our work that we can give all our attention to the work itself; and when we have the right habit of working, the work itself must necessarily gain, because we can put the best of ourselves into it. it is helpful to think of the instincts of the beasts, how true and orderly they are, on their own plane, and how they are only perverted when the animals have come under the influence of man. imagine baloo, the bear in mr. kipling's "jungle book," being asked how he managed to keep so well and rested. he would look a little surprised and say: "why, i follow the laws of my being. how could i do differently?" now that is just the difference between man and beast. man can do differently. and man has done differently now for so many generations that not one in ten thousand really recognizes what the laws of his being are, except in ways so gross that it seems as if we had sunken to the necessity of being guided by a crowbar, instead of steadily following the delicate instinct which is ours by right, and so voluntarily accepting the guidance of the power who made us, which is the only possible way to freedom. of course the laws of a man's being are infinitely above the laws of a beast's. the laws of a man's being are spiritual, and the animal in man is meant to be the servant of his soul. man's true guiding instincts are in his soul,--he can obey them or not, as he chooses; but the beast's instincts are in his body, and he has no choice but to obey. man can, so to speak, get up and look down on himself. he can be his own father and his own mother. from his true instinct he can say to himself, "you must do this" or "you must not do that." he can see and understand his tendency to disobedience, and _he can force himself to obey._ man can see the good and wholesome animal instincts in himself that lead to lasting health and strength, and he can make them all the good servants of his soul. he can see the tendency to overindulgence, and how it leads to disease and to evil, and he can refuse to permit that wrong tendency to rule him. every man has his own power of distinguishing between right and wrong, and his own power of choosing which way he shall follow. he is left free to choose god's way or to choose his own. through past and present perversions, of natural habit he has lost the delicate power of distinguishing the normal from the abnormal, and needs to be educated back to it. the benefit of this education is an intelligent consciousness of the laws of life, which not only adds to his own strength of mind and body, but increases immeasurably his power of use to others. many customs of to-day fix and perpetuate abnormal habits to such an extent that, combined with our own selfish inheritances and personal perversions, they dim the light of our minds so that many of us are working all the time in a fog, more or less dense, of ignorance and bondage. when a man chooses the right and refuses the wrong, in so far as he sees it, he becomes wise from within and from without, his power for distinguishing gradually improves, the fog lifts, and he finds within himself a sure and delicate instinct which was formerly atrophied for want of use. the first thing to understand without the shadow of a doubt, is that, man is not in freedom when he is following his own selfish instincts. he is only in the appearance of freedom, and the appearance of freedom, without the reality, leads invariably to the worst bondage. a man who loves drink feels that he is free if he can drink as much as he wants, but that leads to degradation and delirium tremens. a man who has an inherited tendency toward the disobedience of any law feels that he is free if he has the opportunity to disobey it whenever he wants to. but whatever the law may be, the results have only to be carried to their logical conclusion to make clear the bondage to which the disobedience leads. all this disobedience to law leads to an inevitable, inflexible, unsurmountable limit in the end, whereas steady effort toward obedience to law is unlimited in its development of strength and power for use to others. man must understand his selfish tendencies in order to subdue and control them, until they become subject to his own unselfish tendencies, which are the spiritual laws within him. thus he gradually becomes free,--soul and body,--with no desire to disobey, and with steadily increasing joy in his work and life. so much for the bondage of doing wrong, and the freedom of doing right, which it seems necessary to touch upon, in order to show clearly the bondage of doing right in the wrong way, and the freedom of doing right in the right way. it is right to work for our daily bread, and for the sake of use to others, in whatever form it may present itself. the wrong way of doing it makes unnecessary strain, overfatigue and illness. the right way of working gives, as we have said before, new power and joy in the work; it often turns even drudgery into pleasure, for there is a special delight in learning to apply one's self in a true spirit to "drudgery." the process of learning such true application of one's powers often reveals new possibilities in work. it is right for most people to sleep eight hours every night. the wrong way of doing it is to go to sleep all doubled up, and to continue to work all night in our sleep, instead of giving up and resting entirely. the right way gives us the fullest possible amount of rest and refreshment. it is right to take our three meals a day, and all the nourishing food we need. the wrong way of doing it, is to eat very fast, without chewing our food carefully, and to give our stomachs no restful opportunity of preparation to receive its food, or to take good care of it after it is received. the right way gives us the opportunity to assimilate the food entirely, so that every bit of fuel we put into our bodies is burnt to some good purpose, and makes us more truly ready to receive more. it is right to play and amuse ourselves for rest and recreation. we play in the wrong way when we use ourselves up in the strain of playing, in the anxiety lest we should not win in a game, or when we play in bad air. when we play in the right way, there is no strain, no anxiety, only good fun and refreshment and rest. we might go through the narrative of an average life in showing briefly the wonderful difference between doing right in the right way, and doing right in the wrong way. it is not too much to say that the difference in tendency is as great as that between life and death. it is one thing to read about orderly living and to acknowledge that the ways described are good and true, and quite another to have one's eyes opened and to act from the new knowledge, day by day, until a normal mode of life is firmly established. it requires quiet, steady force of will to get one's self out of bad, and well established in good habits. after the first interest and relief there often has to be steady plodding before the new way becomes easy; but if we do not allow ourselves to get discouraged, we are sure to gain our end, for we are opening ourselves to the influence of the true laws within us, and in finding and obeying these we are approaching the only possible freedom of life. ii _how to sleep restfully_ it would seem that at least one might be perfectly free in sleep. but the habits of cleaving to mistaken ways of living cannot be thrown off at night and taken up again in the morning. they go to sleep with us and they wake with us. if, however, we learn better habits of sleeping, that helps us in our life through the day. and learning better habits through the day helps us to get more rest from our sleep. at the end of a good day we can settle down more quickly to get ready for sleep, and, when we wake in the morning, find ourselves more ready to begin the day to come. there are three things that prevent sleep,--overfatigue, material disturbances from the outside, and mental disturbances from, within. it is not uncommon to hear people say, "i was too tired to sleep"--but it is not generally known how great a help it is at such times not to try to sleep, but to go to work deliberately to get i rested in preparation for it. in nine cases out of ten it is the unwillingness to lie awake that keeps us awake. we wonder why we do not sleep. we toss and turn and wish we could sleep. we fret, and fume, and worry, because we do not sleep. we think of all we have to do on the following day, and are oppressed with the thought that we cannot do it if we do not sleep. first, we try one experiment to see if it will not make us sleep, and when it fails, we try another, and perhaps another. in each experiment we, are watching to see if it will work. there are many things to do, any one of which might help us to sleep, but the _watching to see if they will work keeps us awake._ when we are kept awake from our fatigue, the first thing to do is to say over and over to ourselves that we do not care whether we sleep or not, in order to imbue ourselves with a healthy indifference about it. it will help toward gaining this wholesome indifference to say "i am too tired to sleep, and therefore, the first thing for me to do is to get rested in order to prepare for sleep. when my brain is well rested, it will go to sleep; it cannot help it. when it is well rested, it will sleep just as naturally as my lungs breathe, or as my heart beats." in order to rest our brains we want to lie quietly, relaxing all our muscles, and taking even, quiet breaths. it is good when we can take long, full breaths, but sometimes that is too fatiguing; and then we must not only take moderately long, breaths, but be careful to have them gentle, quiet, and rhythmic. to make a plan of breathing and follow it keeps the mind steadily concentrated on the breathing, and gives the rest of the brain, which has been working on other things, a chance to relax and find its own freedom and rest. it is helpful to inhale while we count seven, exhale while we count seven, then rest and breathe naturally while we count seven, and to repeat the series of three for seven times; but to be strict with ourselves and see that we only do it seven times, not once more nor once less. then we should wait a little and try it again,--and so keep on for a number of times, repeating the same series; and we should always be sure to have the air in our bedrooms as fresh as possible. if the breathing is steady and rhythmical it helps very much, and to inhale and exhale over and over for half an hour has a very pleasant, quieting effect--sometimes such exercises make us nervous at first, and, if we are very tired, that often happens; but, if we keep steadily at work, the nervousness disappears and restful quiet follows which very often brings restoring and refreshing sleep. another thing to remember--and it is very important--is that an overtired brain needs more than the usual nourishment. if you have been awake for an hour, and it is three hours after your last meal, take half a cup, or a cup of hot milk. if you are awake for another two hours take half a cup more, and so, at intervals of about two. hours, so long as you are awake throughout the night. hot milk is nourishing and a sedative. it is not inconvenient to have milk by the side of one's bed, and a little saucepan and spirit lamp, so that the milk can be heated without getting up, and the quiet simple occupation of heating it is sometimes restful in itself. there are five things to remember to help rest an overtired brain: . a healthy indifference to wakefulness. . concentration of the mind on simple things. . relaxation of the body. . gentle rhythmic breathing of fresh air. . regular nourishment. if we do not lose courage, but keep on steadily night after night, with a healthy persistence in remembering and practising these five things, we shall often find that what might have been a very long period of sleeplessness may be materially shortened and that the sleep which follows the practice of the exercises is better, sounder, and more refreshing, than the sleep that came before. in many cases a long or short period of insomnia can be absolutely prevented by just these simple means. here is perhaps the place to say that all narcotics are in such cases, absolutely pernicious. they may bring sleep at the time, but eventually they lose their effect, and leave the nervous system in a state of strain which cannot be helped by anything but time, through much suffering that might have been avoided. when we are not necessarily overtired but perhaps only a little tired from the day's work, it is not uncommon to be kept awake by a flapping curtain or a swinging door, by unusual noises in the streets, or by people talking. how often we hear it said, "it did seem hard when i went to bed tired last night that i should have been kept awake by a noise like that--and now this morning, i am more tired than when i went to bed." the head nurse in a large hospital said once in distress: "i wish the nurses could be taught to step lightly over my head, so that they would not keep me awake at night." it would have been a surprise to her if she had been told that her head could be taught to yield to the steps of the nurses, so that their walking would not keep her awake. it is resistance that keeps us awake in all such cases. the curtain flaps, and we resist it; the door swings to over and over again, and we resist it, and keep ourselves awake by wondering why it does not stop; we hear noises in the street that we am unused to, especially if we are accustomed to sleeping in the stillness of the country, and we toss and turn and wish we were in a quiet place. all the trouble comes from our own resistance to the noise, and resistance is nothing but unwillingness to submit to our conditions. if we are willing that the curtain should go on flapping, the door go on slamming, or the noise in the street continue steadily on, our brains yield to the conditions and so sleep naturally, because the noise goes through us, so to speak, and does not run hard against our unwillingness to hear it. there are three facts which may help to remove the resistance which naturally arises at any unusual sound when we are tired and want to get rest. one is that in almost every sound there is a certain rhythm. if we yield to the sound enough to become sensitive to its rhythm, that, in itself, is soothing, and what before was keeping us awake now _helps us to go to sleep._ this pleasant effect of finding the rhythm in sound is especially helpful if one is inclined to lie awake while travelling in sleeping cars. the rhythm of sound and motion in sleeping cars and steamers is, in itself, soothing. if you have the habit of feeling as if you could never get refreshing sleep in a sleeping car, first be sure that you have as much fresh air as possible, and then make up your mind that you will spend the whole night, if necessary, in noticing the rhythm of the motion and sound of the cars. if you keep your mind steadily on it, you will probably be asleep in less than an hour, and, when the car stops, you will wake only enough to settle comfortably into the sense of motion when it starts again. it is pleasant to notice the gentleness with which a good engineer starts his train at night. of course there is a difference in engineers, and some are much more gentle in starting their engines than others, but the delicacy with which the engine is started by the most expert is delightful to feel, and gives us many a lesson on the use of gentle beginnings, with other things besides locomotive engines, and especially in our dealings with each other. the second fact with regard to yielding, instead of resisting, in order to get to sleep is that listening alone, apart from rhythm, tends to make one sleepy, and this leads us at once to the third fact, that getting to sleep is nothing but a healthy form of concentration. if true concentration is dropping everything that interferes with fixing our attention upon some wholesome object, it means merely bringing the brain into a normal state which induces sleep when sleep is needed. first we drop everything that interferes with the one simple subject, and then we drop that, and are unconscious. of course it may take some time to make ourselves willing to submit to an unusual noise if we have the habit of feeling that we must necessarily be disturbed by it, and, if we can stop the noise, it is better to stop it than to give ourselves unnecessary tasks in non-resistance. then again, if we are overtired, our brains are sometimes so sensitive that the effect of any noise is like that of being struck in a sore spot, and then it is much more difficult to bear it, and we can only make the suffering a little less by yielding and being willing that it should go on. i cannot go to sleep while some one is knocking my lame arm, nor can i go to sleep while a noise is hitting my tired brain; but in such cases we can give up expecting to go to sleep, and get a great deal of rest by using our wills steadily not to resist; and sometimes, even then, sleep will come upon us unexpectedly. with regard to the use of the will, perhaps the most dangerous pitfall to be avoided is the use of drugs. it is not too much to say that they never should be used at all for cases of pure sleeplessness, for with time their power to bring sleep gradually becomes exhausted, and then the patient finds himself worse off than before, for the reactionary effect of the drugs leaves him with exhausted nerves and a weakened will. all the strengthening, moral effect which can be gained from overcoming sleeplessness in wholesome ways is lost by a recourse to drugs, and character is weakened instead of strengthened. when one has been in the habit of sleeping in the city, where the noise of the street is incessant, a change to the perfect silence of the country will often keep sleep off quite as persistently as noise. so with a man who has been in the habit of sleeping under other abnormal conditions, the change to normal conditions will sometimes keep him awake until he has adjusted himself to them, and it is not uncommon for people to be so abnormal that they resist rhythm itself, such as is heard in the rolling of the sea, or the rushing of a river. the re-adjustment from abnormal to normal conditions of sleeping may be made surely if we set about it with a will, for we have all nature on our side. silence is orderly for the night's rest, and rhythm only emphasizes and enhances the silence, when it is the rhythm of nature. the habit of resistance cannot be changed in a single day--it must take time; but if the meaning, the help, and the normal power of non-resistance is clearly understood, and the effort to gain it is persistent, not only the power to sleep, but a new sense of freedom may be acquired which is quite beyond the conception of those who are in the daily habit of resistance. when we lie down at night and become conscious that our arms and our legs and our whole bodies are resting heavily upon the bed, we are letting go all the resistance which has been left stored in our muscles from the activities of the day. a cat, when she lies down, lets go all resistance at once, because she moves with the least possible effort; but there are very few men who do that, and so men go to their rest with more or less resistance stored in their bodies, and they must go through a conscious process of dropping it before they can settle to sleep as a normal child does, without having to think about how it is done. the conscious process, however, brings a quiet, conscious joy in the rest, which opens the mind to soothing influences, and brings a more profound refreshment than is given even to the child--and with the refreshment new power for work. one word more about outside disturbances before we turn to those interior ones which are by far the most common preventatives of refreshing sleep. the reader will say: "how can i be willing that the noise should go on when i am not willing?" the answer is, "if you can see clearly that if you were willing, the noises would not interfere with your sleep, then you can find the ability within you to make yourself willing." it is wonderful to realize the power we gain by compelling and controlling our desires or aversions through the intelligent use of the will, and it is easier to compel ourselves to do right against temptation than to force ourselves to do wrong against a true conviction. indeed it is most difficult, if not impossible, to force ourselves to do wrong against a strong sense of right. behind an our desires, aversions, and inclinations each one of us possesses a capacity for a higher will, the exercise of which, on the side of order and righteousness, brings into being the greatest power in human life. the power of character is always in harmony with the laws of truth and order, and although we must sometimes make a great effort of the will to do right against our inclinations the ease of such effort increases as the power of character increases, and strength of will grows steadily by use, because it receives its life from the eternal will and is finding its way to harmony with that. it is the lower, selfish will that often keeps us awake by causing interior disturbances. an actor may have a difficult part to play, and feel that a great deal depends upon his success. he stays awake with anxiety, and this anxiety is nothing but resistance to the possibility of failure. the first thing for him to do is to teach himself to be willing to fail. if he becomes willing to fail, then all his anxiety will go, and he will be able to sleep and get the rest and new life which he needs in order to play the part well. if he is willing to fail, then all the nervous force which before was being wasted in anxiety is set free for use in the exercise of his art. looking forward to what is going to happen on the next day, or within a few days, may cause so much anxiety as to keep us awake; but if we have a good, clear sense of the futility of resistance, whether our expected success or failure depends on ourselves or on others, we can compel ourselves to a quiet willingness which will make our brains quiet and receptive to restful sleep, and so enable us to wake with new power for whatever task or pleasure may lie before us. of course we are often kept awake by the sense of having done wrong. in such cases the first thing to do is to make a free acknowledgment to ourselves of the wrong we have done, and then to make up our minds to do the right thing at once. that, if the wrong done is not too serious, will put us to sleep; and if the next day we go about our work remembering the lesson we have learned, we probably will have little trouble in sleeping. if macbeth had had the truth and courage to tell lady macbeth that both he and she were wicked plotters and murderers, and that he intended, for his part, to stop being a scoundrel, and, if he had persisted in carrying out his good intentions, he would never have "murdered sleep." iii _resistance_ a man once grasped a very hot poker with his hand, and although he cried out with pain, held on to the poker. his friend called out to him to drop it, whereupon the man indignantly cried out the more. "drop it? how can you expect me to think of dropping it with pain like this? i tell you when a man is suffering, as i am, he can think of nothing but the pain." and the more indignant he was, the tighter he held on to the poker, and the more he cried out with pain. this story in itself is ridiculous, but it is startlingly true as an illustration of what people are doing every day. there is an instinct in us to drop every hot poker at once; and probably we should be able to drop any other form of unnecessary disagreeable sensation as soon as possible, if we had not lost that wholesome instinct through want of use. as it is, we must learn to re-acquire the lost faculty by the deliberate use of our intelligence and will. it is as if we had lost our freedom and needed to be shown the way back to it, step by step. the process is slow but very interesting, if we are in earnest; and when, after wandering in the bypaths, we finally strike the true road, we find our lost faculty waiting for us, and all that we have learned in reaching it is so much added power. but at present we are dealing in the main with a world which has no suspicion of such instincts or faculties as these, and is suffering along in blind helplessness. a man will drop a hot poker as soon as he feels it burn, but he will tighten his muscles and hold on to a cold in his head so persistently that he only gets rid of it at all because nature is stronger than he is, and carries it off in spite of him. how common it is to see a woman entirely wrapped up, with a handkerchief held to her nose,--the whole body as tense as it can be,--wondering "why does it take so long to get rid of this cold?" to get free from a severe cold there should be open and clear circulation throughout the whole body. the more the circulation is impeded, the longer the cold will last. to begin with, the cold itself impedes the circulation; and if, in addition, we offer resistance to the very idea of having a cold, we tighten our nerves and our bodies and thereby impede our circulation still further. it is curious that the more we resist a cold the more we hold on to it, but it is a very evident fact; and so is its logical corollary, that the less we resist it the sooner it leaves us. it would seem absurd to people who do not understand, to say:-- "i have caught cold, i must relax and let it go through me." but the literal truth is that when we relax, we open the channels of circulation in our bodies, and so allow the cold to be carried off. in addition to the relaxing, long, quiet breaths help the circulation still more, and so help the cold to go off sooner. in the same way people resist pain and hold on to it; when they are attacked with severe pain, they at once devote their entire attention to the sensation of pain, instead of devoting it to the best means of getting relief. they double themselves up tight, and hold on to the place that hurts. then all the nervous force tends toward the sore place and the tension retards the circulation and makes it difficult for nature to cure the pain, as she would spontaneously if she were only allowed to have her own way. i once knew a little girl who, whenever she hit one elbow, would at once deliberately rub the other. she said that she had discovered that it took her mind away from the elbow that hurt, and so stopped its hurting sooner. the use of a counterirritant is not uncommon with good physicians, but the counter-irritant only does what is much more effectually accomplished when the patient uses his will and intelligence to remove the original irritant by ceasing to resist it. a man who was troubled with spasmodic contraction of the throat once went to a doctor in alarm and distress. the doctor told him that, in any case, nothing worse than fainting could happen to him, and that, if he fainted away, his throat would be relieved, because the fainting would relax the muscles of the throat, and the only trouble with it was contraction. singularly, it did not seem to occur to the doctor that the man might be taught to relax his throat by the use of his own will, instead of having to faint away in order that nature might do it for him. nature would be just as ready to help us if we were intelligent, as when she has to knock us down, in order that she may do for us what we do not know enough to do for ourselves. there is no illness that could not be much helped by quiet relaxing on the part of the patient, so as to allow nature and remedial agencies to do their work more easily. that which keeps relief away in the case of the cold, of pain, and of many illnesses, is the contraction of the nerves and muscles of the body, which impedes the curative power of its healing forces. the contraction of the nerves and muscles of the body is caused by resistance in the mind, and resistance in the mind is unwillingness: unwillingness to endure the distress of the cold, the pain, or the illness, whatever it may be; and the more unwilling we are to suffer from illness, the more we are hindering nature from bringing about a cure. one of the greatest difficulties in life is illness when the hands are full of work, and of business requiring attention. in many eases the strain and anxiety, which causes resistance to the illness, is even more severe, and makes more trouble than the illness itself. suppose, for instance, that a man is taken down with the measles, when he feels that he ought to be at his office, and that his absence may result in serious loss to himself and others. if he begins by letting go, in his body and in his mind, and realizing that the illness is beyond his own power, it will soon occur to him that he might as well turn his illness to account by getting a good rest out of it. in this frame of mind his chances of early recovery will be increased, and he may even get up from his illness with so much new life and with his mind so much refreshed as to make up, in part, for his temporary absence from business. but, on the other hand, if he resists, worries, complains and gets irritable, he irritates his nervous system and, by so doing is likely to bring on any one of the disagreeable troubles that are known to follow measles; and thus he may keep himself housed for weeks, perhaps months, instead of days. another advantage in dropping all resistance to illness, is that the relaxation encourages a restful attitude of mind, which enables us to take the right amount of time for recovery, and so prevents either a possible relapse, or our feeling only half well for a long time, when we might have felt wholly well from the time we first began to take up our life again. indeed the advantages of nonresistance in such cases are innumerable, and there are no advantages whatever in resistance and unwillingness. clear as these things must be to any intelligent person whose attention is turned in the right direction, it seems most singular that not in one case in a thousand are they deliberately practised. people seem to have lost their common sense with regard to them, because for generations the desire for having our own way has held us in bondage, and confused our standard of freedom; more than that, it has befogged our sense of natural law, and the result is that we painfully fight to make water run up hill when, if we were to give one quiet look, we should see that better things could be accomplished, and our own sense of freedom become keener, by being content to let the water quietly run down and find its own level. it is not normal to be ill and to be kept from our everyday use, but it is still less normal for a healthy, intelligent mind to keep its body ill longer than is necessary by resisting the fact of illness. every disease, though it is abnormal in itself, may frequently be kept within bounds by a certain normal course of conduct, and, if our suffering from the disease itself is unavoidable, by far our wisest course is to stand aside, so to speak, and let it take its own course, using all necessary remedies and precautions in order that the attack may be as mild as possible. many readers, although they see the common sense of such non-resistance, will find it difficult to practise it, because of their inheritances and personal habits. the man who held the hot poker only needed to drop it with his fingers; the man who is taken ill only needs to be willing with his mind and to relax with his nerves in order to hasten his recovery. a very useful practice is to talk to ourselves so quietly and earnestly as to convince our brains of the true helpfulness of being willing and of the impediment of our unwillingness. tell the truth to yourself over and over, quietly and without emotion, and steadily and firmly contradict every temptation to think that it is impossible not to resist. if men could once be convinced of the very real and wonderful power they have of teaching their own brains, and exacting obedience from them, the resulting new life and ability for use would make the world much happier and stronger. this power of separating the clear, quiet common sense in ourselves from the turbulent, willful rebellion and resistance, and so quieting our selfish natures and compelling them to normal behavior, is truly latent in us all. it may be difficult at first to use it, especially in cases of strong, perverted natures and fixed habits, because in such cases our resistances are harder and more interior, but if we keep steadily on, aiming in the right direction,--if we persist in the practice of keeping ourselves separate from our unproductive turbulences, and of teaching our brains what we _know_ to be the truth, we shall finally find ourselves walking on level ground, instead of climbing painfully up hill. then we shall be only grateful for all the hard work which was the means of bringing us into the clear air of freedom. there could not be a better opportunity to begin our training in non-resistance than that which illness affords. iv _hurry, worry, and irritability_ probably most people have had the experience of hurrying to a train with the feeling that something held them back, but not many have observed that their muscles, under such conditions, actually _do_ pull them back. if any one wants to prove the correctness of this observation let him watch himself, especially if it is necessary for him to go downstairs to get to the station, while he is walking down the steps. the drawing back or contracting of the muscles, as if they were intelligently trying to prevent us from reaching the train on time, is most remarkable. of course all that impeding contraction comes from resistance, and it seems at first sight very strange that we should resist the accomplishment of the very thing we want to do. why should i resist the idea of catching a train, when at the same time i am most anxious to do so? why should my muscles reflect that resistance by contracting, so that they directly impede my progress? it seems a most singular case of a house divided against itself for me to want to take a train, and for my own muscles, which are given me for my command, to refuse to take me there, so that i move toward the train with an involuntary effort away from it. but when the truth is recognized, all this muscular contraction is easily explained. what we are resisting is not the fact of taking the train, but the possibility of losing it. that resistance reflects itself upon our muscles and causes them to contract. although this is a practical truth, it takes us some time to realize that the fear of losing the train is often the only thing that prevents our catching it. if we could once learn this fact thoroughly, and live from our clearer knowledge, it would be one of the greatest helps toward taking all things in life quietly and without necessary strain. for the fact holds good in all hurry. it is the fear of not accomplishing what is before us in time that holds us back from its accomplishment. this is so helpful and so useful a truth that i feel it necessary to repeat it in many ways. fear brings resistance, resistance impedes our progress. our faculties are paralyzed by lack of confidence, and confidence is the result of a true consciousness of our powers when in harmony with law. often the fear of not accomplishing what is before us is the _only_ thing that stands in our way. if we put all hurry, whether it be an immediate hurry to catch a train, or the hurry of years toward the accomplishment of the main objects of our lives,--if we put it all under the clear light of this truth, it will eventually relieve us of a strain which is robbing our vitality to no end. first, the times that we _must_ hurry should be minimized. in nine cases out of ten the necessity for hurry comes only from our own attitude of mind, and from no real need whatever. in the tenth case we must learn to hurry with our muscles, and not with our nerves, or, i might better say, we must hurry without excitement. to hurry quietly is to most people an unknown thing, but when hurry is a necessity, the process of successive effort in it should be pleasant and refreshing. if in the act of needful hurry we are constantly teaching ourselves to stop resistance by saying over and over, through whatever we may be doing, "i am perfectly willing to lose that train, i am willing to lose it, i am willing to lose it," that will help to remove the resistance, and so help us to learn how to make haste quietly. but the reader will say, "how can i make myself willing when i am not willing?" the answer is that if you know that your unwillingness to lose the train is preventing you from catching it, you certainly will see the efficacy of being willing, and you will do all in your power toward yielding to common sense. unwillingness is resistance,--resistance in the mind contracts the muscles, and such contraction prevents our using the muscles freely and easily. therefore let us be willing. of course there, is a lazy, selfish indifference to catching a train, or accomplishing anything else, which leaves the tendency to hurry out of some temperaments altogether, but with that kind of a person we are not dealing now. and such indifference is the absolute opposite of the wholesome indifference in which there is no touch of laziness or selfishness. if we want to avoid hurry we must get the habit of hurry out of our brains, and cut ourselves off, patiently and kindly, from the atmosphere of hurry about us. the habit gets so strong a hold of the nerves, and is impressed upon them so forcibly as a steady tendency, that it can be detected by a close observer even in a person who is lying on a lounge in the full belief that he is resting. it shows itself especially in the breathing. a wise athlete has said that our normal breathing should consist of six breaths to one minute. if the reader will try this rate of breathing, the slowness of it will surprise him. six breaths to one minute seem to make the breathing unnecessarily slow, and just double that seems about the right number for ordinary people; and the habit of breathing at this slower rate is a great help, from a physical standpoint, toward erasing the tendency to hurry. one of the most restful exercises any one can take is to lie at full length on a bed or lounge and to inhale and exhale, at a perfectly even, slow rate, for half an hour. it makes the exercise more restful if another person counts for the breathing, say, ten slowly and quickly to inhale, and ten to exhale, with a little pause to give time for a quiet change from one breath to another. resistance, which is the mental source of hurry, is equally at the root of that most harmful emotion--the habit of worrying. and the same truths which must be learned and practised to free ourselves of the one habit are applicable to the other. take the simple example of a child who worries over his lessons. children illustrate the principle especially well, because they are so responsive that, if you meet them quietly with the truth in difficulties of this kind they recognize its value and apply it very quickly, and it takes them, comparatively, a very little time to get free. if you think of telling a child that the moment he finds himself worrying about his lesson he should close his book and say: "i do not care whether i get this lesson or not." and then, when he has actually persuaded himself that he does not care, that he should open his book and study,--it would seem, at first sight, that he would find it difficult to understand you; but, on the contrary, a child understands more quickly than older people, for the child has not had time to establish himself so firmly in the evil habit. i have in mind a little girl in whom the habit had begun of worrying lest she should fail in her lessons, especially in her latin. her mother sent her to be taught how not to worry. the teacher, after giving her some idea of the common sense of not worrying, taught her quieting exercises which she practised every day; and when one day, in the midst of one of her lessons, margaret seemed very quiet and restful, the teacher asked:-- "margaret, could you worry about your latin now if you tried?" "yes," said margaret, "i am afraid i could." nothing more was said, but she went on with her lessons, and several days after, during the same restful quiet time, the teacher ventured again. "now, margaret, could you worry about your latin if you tried?" then came the emphatic answer, _"no, i could not."_ after that the little girl would say: "with the part of me that worries, i do not care whether i get my latin or not; with the part of me that does not worry, i want to get my latin very much; therefore i will stay in the part of me that does not worry, and get my latin." a childish argument, and one that may be entirely incomprehensible to many minds, but to those who do comprehend, it represents a very real and practical help. it is, in most cases, a grave mistake to, reason with a worry. we must first drop the worry, and then do our reasoning. if to drop the worry seems impossible, we can separate ourselves from it enough to prevent it from interfering with our reasoning, very much as if it were neuralgia. there is never any real reason for a worry, because, as we all know, worry never helps us to gain, and often is the cause of our losing, the things which we so much desire. sometimes we worry because we are tired, and in that case, if we can recognize the real cause, we should use our wills to withdraw our attention from the object of worry, and to get all possible rest at once, in the confident belief that rest will make things clear, or at least more clear than they were when we were tired. it would be hard to compute the harm that has been done by kindly disposed people in reasoning with the worry of a friend, when the anxiety is increased by fatigue or illness. to reason with one who is tired or ill and worried, only increases the mental strain, and every effort that is made to reason him out of it aggravates the strain; until, finally, the poor brain, through kindly meant effort, has been worked into an extreme state of irritation or even inflammation. for the same reason, a worried mind should not be laughed at. worries that are aroused by fatigue or illness are often most absurd, but they are not absurd to the mind that is suffering from them, and to make fun of them only brings more pain, and more worry. gentle, loving attention, with kindly, truthful answers, will always help. by such attention we are really giving no importance to the worry, but only to our friend, with the hope of soothing and quieting him out of his worries, and when he is rested he may see the truth for himself. we should deal with ourselves, in such cases, as gently as we would with a friend, excepting that we can tell the truth to ourselves more plainly than we can to most friends. worrying is resistance, resistance is unwillingness. unwillingness interferes with whatever we may want to accomplish. to be willing that this, that, or the other should happen seems most difficult, when to our minds, this, that, or the other would bring disaster. and yet if we can once see clearly that worrying resistance tends toward disaster rather than away from it, or, at the very least, takes away our strength and endurance, it is only a matter of time before we become able to drop our resistance altogether. but it is a matter of time; and, when once we are faced toward freedom, we must be patient and steady, and not expect to gain very rapidly. theirs is indeed a hard lot who have acquired this habit of worry, and persist in doing nothing to gain their freedom. "now i have got something to worry about for the rest of my life," remarked a poor woman once. her face was set toward worrying; nothing but her own will could have turned it the other way, and yet she deliberately chose not to use it, and so she was fixed and settled in prison for the rest of her life. to worry is wicked; it is wickedness of a kind that people often do not recognize as such, and they are not fully responsible until they do; but to prove it to be wicked is an easy matter, when once we are faced toward freedom; and, to get over it, as i have said, is a matter of steady, persistent patience. as for irritability, that is also resistance; but there are two kinds of irritability,--physical and moral. there is an irritability that comes when we are hungry, if we have eaten something that disagrees with us, if we are cold or tired or uncomfortable from some other physical cause. when we feel that kind of irritability we should ignore it, as we would ignore a little snapping dog across the street, while at the same time removing its cause as quickly as we can. there is nothing that delights the devil more than to scratch a man with the irritability of hunger, and have him respond to it at once by being ugly and rude to a friend; for then the irritation immediately becomes moral, and every bit of selfishness rushes up to join it, and to arouse whatever there may be of evil in the man. it is simple to recognize this merely physical form of irritability, and we should no more allow ourselves to speak, or act, or even _think_ from it, than we should allow ourselves to walk directly into foul air, when the good fresh air is close to us on the other side. but moral irritability is more serious; that comes from the soul, and is the result of our wanting our own way. the immediate cause may be some physical disturbance, such as noise, or it may be aroused by other petty annoyances, like that of being obliged to wait for some one who is unpunctual, or by disagreement in an argument. there are very many causes for irritability, and we each have our own individual sensitiveness or antipathy, but, whatever the secondary cause, the primary cause is always the same,--resistance or unwillingness to accept our circumstances. if we are fully willing to be disturbed, we cease to be troubled by the disturbance; if we are willing to wait, we are not annoyed by being kept waiting, and we are in a better, more quiet humor to help our friend to the habit of promptness, if we are willing that another should differ from us in opinion, we can see more clearly either to convince our friend, if he is wrong,--or to admit that he is right, and that we are wrong. the essential condition of good argument is freedom from personal feeling, with the desire only for the truth,--whether it comes from one party or the other. hurry, worry, and irritability all come from selfish resistance to the facts of life, and the only permanent cure for the waste of force and the exhausting distress which they entail, is a willingness to accept those facts, whatever they may be, in a spirit of cheerful and reverent obedience to law. v _nervous fears_ to argue with nervous anxiety, either in ourselves or in others, is never helpful. indeed it is never helpful to argue with "nerves" at all. arguing with nervous excitement of any kind is like rubbing a sore. it only irritates it. it does not take long to argue excited or tired nerves into inflammation, but it is a long and difficult process to allay the inflammation when it has once been aroused. it is a sad fact that many people have been argued into long nervous illnesses by would-be kind friends whose only intention was to argue them out of illness. even the kindest and most disinterested friends are apt to lose patience when they argue, and that, to the tired brain which they are trying to relieve, is a greater irritant than they realize. the radical cure for nervous fears is to drop resistance to painful circumstances or conditions. resistance is unwillingness to endure, and to drop the resistance is to be strongly willing. this vigorous "willingness" is so absolutely certain in its happy effect, and is so impossible that it should fail, that the resistant impulses seem to oppose themselves to it with extreme energy. it is as if the resistances were conscious imps, and as if their certainty of defeat--in the case of their victim's entire "willingness "--roused them to do their worst, and to hold on to their only possible means of power with all the more determination. indeed, when a man is working through a hard state, in gaining his freedom from nervous fears, these imps seem to hold councils of war, and to devise new plans of attack in order to take him by surprise and overwhelm him in an emergency. but every sharp attack, if met with quiet "willingness," brings a defeat for the assailants, until finally the resistant imps are conquered and disappear. occasionally a stray imp will return, and try to arouse resistance on what he feels is old familiar ground, but he is quickly driven off, and the experience only makes a man more quietly vigilant and more persistently "willing." perhaps one of the most prevalent and one of the hardest fears to meet, is that of insanity,--especially when it is known to be a probable or possible inheritance. when such fear is oppressing a man,--to tell him that he not only can get free from the fear, but free from any possibility of insanity, through a perfect willingness to be insane, must seem to him at first a monstrous mockery; and, if you cannot persuade him of the truth, but find that you are only frightening him more, there is nothing to do then but to be willing that he should not be persuaded, and to wait for a better opportunity. you can show him that no such inheritance can become an actuality, unless we permit it, and that the very knowledge of an hereditary tendency, when wholesomely used, makes it possible for us to take every precaution and to use every true safeguard against it. the presence of danger is a source of strength to the brave; and the source of abiding courage is not in the nerves, but in the spirit and the will behind them. it is the clear statement of this fact that will persuade him the fact may have to be stated many times, but it should never be argued. and the more quietly and gently and earnestly it is stated, the sooner it will convince, for it is the truth that makes us free. fear keeps the brain in a state of excitement. even when it is not consciously felt, it is felt sub-consciously, and we ought to be glad to have it aroused, in order that we may see it and free ourselves, not only from the particular fear for the time being, but from the subconscious impression of fear in general. is seems curious to speak of grappling with the fear of insanity, and conquering it by being perfectly willing to be insane, but it is no more curious than the relation of the centrifugal and the centripetal forces to each other. we need our utmost power of concentration to enable us to yield truly, and to be fully willing to submit to whatever the law of our being may require. fear contracts the brain and the nerves, and interrupts the circulation, and want of free circulation is a breeder of disease. dropping resistance relaxes the tension of the brain and nerves, and opens the channels for free circulation, and free circulation helps to carry off the tendency to disease. if a man is wholesomely willing to be insane, should such an affliction overtake him, he has dropped all resistance to the idea of insanity, and thus also to all the mental and physical contractions that would foster insanity. he has dropped a strain which was draining his brain of its proper strength, and the result is new vigor to mind and body. to drop an inherited strain produces a great and wonderful change, and all we need to bring it about is to thoroughly understand how possible and how beneficial it is. if we once realize the benefit of dropping the strain, our will is there to accomplish the rest, as surely as it is there to take our hand out of the fire when it burns. then there is the fear of contagion. some people are haunted with the fear of catching disease, and the contraction which such resistance brings induces a physical state most favorable to contagion. there was once a little child whose parents were so full of anxious fears that they attempted to protect him from disease in ways that were extreme and ridiculous. all his toys were boiled, everything he ate or drank was sterilized, and many other precautions were taken,--but along with all the precautions, the parents were in constant fear; and it is not unreasonable to feel that the reflection upon the child of the chronic resistance to possible danger with which he was surrounded, had something to do with the fact that the dreaded disease was finally caught, and that, moreover, the child did not recover. if reasonably healthy conditions had been insisted upon, and the parents had felt a wholesome trust in the general order of things, it would have been likely to make the child more vigorous, and would have tended to increase his capacity for throwing off contagion. children are very sensitive, and it is not unusual to see a child crying because its mother is out of humor, even though she may not have spoken a cross word. it is not unusual to see a child contract its little brain and body in response to the fears and contractions of its parents, and such contraction keeps the child in a state in which it may be more difficult to throw off disease. if you hold your fist as tight as you can hold it for fifteen minutes, the fatigue you will feel when it relaxes is a clear proof of the energy you have been wasting. the waste of nervous energy would be much increased if the fist were held tightly for hours; and if the waste is so great in the useless tightening of a fist, it is still greater in the extended and continuous contraction of brain and nerves in useless fears; and the energy saved through dropping the fears and their accompanying tension can bring in the same proportion a vigor unknown before, and at the same time afford protection against the very things we feared. the fear of taking cold is so strong in many people that a draught of fresh air becomes a bugaboo to their contracted, sensitive nerves. draughts are imagined as existing everywhere, and the contraction which immediately follows the sensation of a draught is the best means of preparing to catch a cold. fear of accident keeps one in a constant state of unnecessary terror. to be willing that an accident should happen does not make it more likely to happen, but it prevents our wasting energy by resistance, and keeps us quiet and free, so that if an emergency of any kind arises, we are prepared to act promptly and calmly for the best. if the amount of human energy wasted in the strain of nervous fear could be measured in pounds of pressure, the figures would be astonishing. many people who have the habit of nervous fear in one form or another do not throw it off merely because they do not know how. there are big and little nervous fears, and each and all can be met and conquered,--thus bringing a freedom of life which cannot even be imagined by those carrying the burden of fear, more or less, throughout their lives. the fear of what people will think of us is a very common cause of slavery, and the nervous anxiety as to whether we do or do not please is a strain which wastes the energy of the greater part of mankind. it seems curious to measure the force wasted in sensitiveness to public opinion as you would measure the waste of power in an engine, and yet it is a wholesome and impersonal way to think of it,--until we find a better way. it relieves us of the morbid element in the sensitiveness to say, "i cannot mind what so-and-so thinks of me, for i have not the nervous energy to spare." it relieves us still more of the tendency to morbid feeling, if we are wholesomely interested in what others think of us, in order to profit by it, and do better. there is nothing morbid or nervous about our sensitiveness to opinion, when it is derived from a love of criticism for the sake of its usefulness. such a rightful and wise regard for the opinion of others results in a saving of energy, for on the one hand, it saves us from the mistakes of false and shallow independence, and, on the other, from the wasteful strain of servile fear. the little nervous fears are countless. the fear of not being exact. the fear of not having turned off the gas entirely. the fear of not having done a little daily duty which we find again and again we have done. these fears are often increased, and sometimes are aroused, by our being tired, and it is well to realize that, and to attend at once carefully to whatever our particular duty may be, and then, when the fear of not having done it attacks us, we should think of it as if it were a physical pain, and turn our attention quietly to something else. in this way such little nagging fears are relieved; whereas, if we allowed ourselves to be driven by them, we might bring on nervous states that would take weeks or months to overcome. these nervous fears attack us again and again in subtle ways, if we allow ourselves to be influenced by them. they are all forms of unwillingness or resistance, and may all be removed by dropping the resistance and yielding,--not to the fear, but to a willingness that the fear should be there. one of the small fears that often makes life seem unbearable is the fear of a dentist. a woman who had suffered from this fear for a lifetime, and who had been learning to drop resistances in other ways, was once brought face to face with the necessity for going to the dentist, and the old fear was at once aroused,--something like the feeling one might have in preparing for the guillotine,--and she suffered from it a day or two before she remembered her new principles. then, when the new ideas came back to her mind, she at once applied them and said, "yes, i _am afraid,_ i _am awfully afraid._ i am _perfectly willing to be afraid," _and the ease with which the fear disappeared was a surprise,--even to herself. another woman who was suffering intensely from fear as to the after-effects of an operation, had begun to tremble with great nervous intensity. the trembling itself frightened her, and when a friend told her quietly to be willing to tremble, her quick, intelligence responded at once. "yes," she said, "i will, i will make myself tremble," and, by not only being willing to tremble, but by making herself tremble, she got quiet mental relief in a very short time, and the trembling disappeared. the fear of death is, with its derivatives, of course, the greatest of all; and to remove our resistance to the idea of death, by being perfectly willingly to die is to remove the foundation of all the physical cowardice in life, and to open the way for the growth of a courage which is strength and freedom itself. he who yields gladly to the ordinary facts of life, will also yield gladly to the supreme fact of physical death, for a brave and happy willingness is the characteristic habit of his heart:-- under the wide and starry sky, dig the grave and let me lie. glad did i live and gladly die, and i laid me down with a will." there is a legend of the arabs in which a man puts his head out of his tent and says, "i will loose my camel and commit him to god," and a neighbor who hears him says, in his turn, "i will tie my camel and commit him to god." the true helpfulness from non-resistance does not come from neglecting to take proper precautions against the objects of fear, but from yielding with entire willingness to the necessary facts of life, and a sane confidence that, whatever comes, we shall be provided with the means of meeting it. this confidence is, in itself, one of the greatest sources of intelligent endurance. vi _self-consciousness_ self-consciousness may be truly defined as a person's inability to get out of his own way. there are, however, some people who are so entirely and absolutely self-conscious that everything they do, even though it may appear spontaneous and ingenuous, is observed and admired and approved of by themselves,--indeed they are supported and sustained by their self-consciousness. they are so completely in bondage to themselves that they have no glimpse of the possibility of freedom, and therefore this bondage is pleasant to them. with these people we have, at present, nothing to do; it is only those who have begun to realize their bondage as such, or who suffer from it, that can take any steps toward freedom. the self-satisfied slaves must stay in prison until they see where they are--and it is curious and sad to see them rejoicing in bondage and miscalling it freedom. it makes one long to see them struck by an emergency, bringing a flash of inner light which is often the beginning of an entire change of state. sometimes the enlightenment comes through one kind of circumstance, sometimes through another; but, if the glimpse of clearer sight it brings is taken advantage of, it will be followed by a time of groping in the dark, and always by more or less suffering. when, however, we know that we are in the dark, there is hope of our coming to the light; and suffering is nothing whatever after it is over and has brought its good results. if we were to take away the prop of self-approval entirely and immediately from any one of the habitually self-satisfied people, the probable result would be an entire nervous collapse, or even a painful form of insanity; and, in all changes of state from bondage to freedom, the process is and must be exceedingly slow. no one ever strengthened his character with a wrench of impatience, although we are often given the opportunity for a firm and immediate use of the will which leaves lasting strength behind it. for the main growth of our lives, however, we must be steadily patient, content to aim in the true direction day by day, hour by hour, minute by minute. if we fall, we must pick ourselves up and go right on,--not stop to be discouraged for one instant after we have recognized our state as a temptation. whatever the stone may be that we have tripped over, we have learned that it is there, and, while we may trip over the same stone many times, if we learn our lesson each time, it decreases the possible number of stumbles, and smooths our paths more than we know. there is no exception to the necessity for this patient, steady plodding in the work required to gain our freedom from self-consciousness. it is when we are aware of our bondage that our opportunity to gain our freedom from it really begins. this bondage brings very real suffering, and we may often, without exaggeration, call it torture. it is sometimes even extreme torture, but may have to be endured for a lifetime unless the sufferer has the clear light by which to find his freedom; and, unfortunately, many who might have the light will not use it because they are unwilling to recognize the selfishness that is at the root of their trouble. some women like to call it "shyness," because the name sounds well, and seems to exonerate them from any responsibility with regard to their defect. men will rarely speak of their self-consciousness, but, when they do, they are apt to speak of it with more or less indignation and self-pity, as if they were in the clutches of something extraneous to themselves, and over which they can never gain control. if, when a man is complaining of self-consciousness and of its interference with his work in life, you tell him in all kindness that all his suffering has its root in downright selfishness, he will, in most cases, appear not to hear, or he will beg the question, and, having avoided acknowledging the truth, will continue to complain and ask for help, and perhaps wonder whether hypnotism may not help him, or some other form of "cure." anything rather than look the truth in the face and do the work in himself which, is the only possible road to lasting, freedom. self-pity, and what may be called spiritual laziness, is at the root of most of the self-torment in the world. how ridiculous it would seem if a man tried to produce an electric burner according to laws of his own devising, and then sat down and pitied himself because the light would not burn, instead of searching about until he had found the true laws of electricity whose application would make the light shine successfully. how ridiculous it would seem if a man tried to make water run up hill without providing that it should do so by reaching its own level, and then got indignant because he did not succeed, and wondered if there were not some "cure" by means of which his object might be accomplished. and yet it is no more strange for a man to disobey habitually the laws of character, and then to suffer for his disobedience, and wonder why he suffers. there is an external necessity for obeying social laws which must be respected, or society would go to pieces; and there is just as great an internal necessity for obeying spiritual laws to gain our proper self-control and power for use; but we do not recognize that necessity because, while disregarding the laws of character, we can still live without the appearance of doing harm to the community. social laws can be respected in the letter but not in the spirit, whereas spiritual laws must be accepted by the individual heart and practiced by the individual will in order to produce any useful result. each one of us must do the required work in himself. there is no "cure," no help from outside which can bring one to a lasting freedom. if self-consciousness makes us blush, the more we are troubled the more it increases, until the blushing may become so unbearable that we are tempted to keep away from people altogether; and thus life, so far as human fellowship goes, would become more and more limited. but, when such a limitation is allowed to remain within us, and we make no effort of our own to find its root and to exterminate it, it warps us through and through. if self-consciousness excites us to talk, and we talk on and on to no end, simply allowing the selfish suffering to goad us, the habit weakens our brains so that in time they lose the power of strong consecutive thought and helpful brevity. if self-consciousness causes us to wriggle, and strain, and stammer, and we do not recognize the root of the trouble and shun it, and learn to yield and quietly relax our nerves and muscles, of course the strain becomes worse. then, rather than suffer from it any longer, we keep away from people, just as the blushing man is tempted to do. in that case, the strain is still in us, in the back of our brains, so to speak--because we have not faced and overcome it. stage fright is an intense form of self-consciousness, but the man who is incapable of stage fright lacks the sensitive temperament required to achieve great power as an artist. the man who overcomes stage fright by getting out of his own way, and by letting the character he is playing, or the music he is interpreting, work through him as a clear, unselfish channel receives new power for his work in the proportion that he shuns his own interfering selfishness. but it is with the self-consciousness of everyday life that we have especially to do now, and with the practical wisdom necessary to gain freedom from all its various discomforts; and, even more than that, to gain the new power for useful service which comes from the possession of that freedom. the remedy is to be found in obedience to the law of unselfishness, carried out into the field of nervous suffering. whatever one may think, however one may try to dodge the truth by this excuse or that, the conditions to be fulfilled in order to gain freedom from self-consciousness are _absolutely within the individual who suffers._ when we once understand this, and are faced toward the truth, we are sure to find our way out, with more or less rapidity, according to the strength with which we use our wills in true obedience. first, we must be willing to accept the effects of self-consciousness. the more we resist these effects the more they force themselves upon us, and the more we suffer from them. we must be willing to blush, be willing to realize that we have talked too much, and perhaps made ourselves ridiculous. we must be willing to feel the discomforts of self-consciousness in whatever form they may appear. then--the central point of all--we must know and understand, and not dodge in the very least the truth that the _root of self-consciousness is selfishly caring what other people think of us,--and wanting to appear well before them._ many readers of this article who suffer from self-consciousness will want to deny this; others will acknowledge it, but will declare their inability to live according to the truth; some,--perhaps more than a few,--will recognize the truth and set to work with a will to obey it, and how happily we may look forward to the freedom which will eventually be theirs! a wise man has said that when people do not think well of us, the first thing to do is to look and see whether they are right. in most cases, even though they way have unkind feelings mingled with their criticism, there is an element of truth in it from which we may profit. in such cases we are much indebted to our critics, for, by taking their suggestions, we are helped toward strength of character and power for use. if there is no truth in the criticism, we need not think of it at all, but live steadily on, knowing that the truth will take care of itself. we should be willing that any one should think _anything_ of us, so long as we have the strength of a good conscience. we should be willing to appear in any light if that appearance will enhance our use, or is a necessity of growth. if an awkward appearance is necessary in the process of our journey toward freedom, we must not resist the fact of its existence, and should only dwell on it long enough to shun its cause in so far as we can, and gain the good result of the greater freedom which will follow. it is because the suffering from self-consciousness is often so intense that freedom from it brings, by contrast, so happy and so strong a sense of power. there is a school for the treatment of stammerers in this country in which the pupils are initiated into the process of cure by being required to keep silence for a week. this would be a most helpful beginning in a training to overcome self-consciousness. we should recognize first that we must be willing to endure the effects of self-consciousness without resistance. secondly, we should admit that the root of self-consciousness lies entirely in a selfish desire to appear well before others. if, while recognizing these two essential truths and confirming them until they are thoroughly implanted in our brains, we should quietly persist in going among people, the practice of silent attention to others would be of the greatest value in gaining real freedom. the practice of attentive and sympathetic silence might well be followed by people in general far more than it is. the protection of a loving, unselfish silence is very great: a silence which is the result of shunning all selfish, self-assertive, vain, or affected speech; a silence which is never broken for the sake of "making conversation," "showing off," or covering selfish embarrassment; a silence which is full of sympathy and interest,--the power of such a silence cannot be overestimated. if we have the evil habit of talking for the sake of winning approval, we should practise this silence; or if we talk for the sake of calling attention to ourselves, for the sake of winning sympathy for our selfish pains and sorrows, or for the sake of indulging in selfish emotions, nothing can help us more than the habit of loving and attentive silence. only when we know how to practise this--in an impersonal, free and quiet spirit, one which is not due to outward repression of any kind--are we able to talk with quiet, loving, helpful speech. then may we tell the clean truth without giving unnecessary offence, and then may we soothe and rest, as well as stimulate in, wholesome ways; then, also, will our minds open to receive the good that may come to us through the words and actions of others. vii _the circumstances of life_ it is not the circumstances of life that trouble or weigh upon us, it is the way we take them. if a man is playing a difficult game of chess, the more intricate the moves the more thoughtfully he looks over his own and his opponent's men, and the more fully he is aroused to make the right move toward a checkmate. if, when the game became difficult, the player stopped to be depressed and disheartened, his opponent would probably always checkmate him; whereas, in most cases, the more difficult the game the more thoroughly the players are aroused to do their best, and a difficult game is invariably a good one,--the winner and the loser both feel it to be so,--even though the loser may regret his loss. but--the reader will say--a game of chess is a game only,--neither one's bread and butter nor one's life depend upon winning or losing it. if, however, we need to be cool and quiet and trustful for a game, which is merely an amusement, and if we play the game better for being cool and quiet and trustful, why is not a quiet steadiness in wrestling with the circumstances of life itself just as necessary, not only that we may meet the particular problem of the moment truly, but that we may gain all the experience which may be helpful in meeting other difficult circumstances as they present themselves. we must first convince ourselves thoroughly of the truth that circumstances, however difficult, are always--without exception, opportunities, and not limitations. they are not by any means opportunities for taking us in the direction that our own selfishness would have us go; they are opportunities which are meant to guide us in the direction we most need to follow,--in the ways that will lead us to the greatest strength in the end. the most unbelieving of us will admit that "there is a destiny which shapes our ends, rough hew them as we may," and it is in the stupid resistance to having our ends shaped for us that we stop and groan at what we call the limitations of circumstances. if we were quickly alert to see where circumstances had placed the gate of opportunity, and then steadily persisted in going through it, it would save the loss of energy and happiness which results from obstinately beating our heads against a stone wall where there is no gate, and where there never can be a gate. probably there is hardly a reader who will not recall a number of cases in which circumstances appear to have been only limitations to him or to his friends; but if he will try with a willing mind to find the gate of opportunity which was not used, he will be surprised to learn that it was wide open all the time, and might have led him into a new and better country. the other day a little urchin playing in the street got in the way of a horse, and just saved himself from being run over by a quick jump; he threw up his arms and in a most cheerful voice called out, "it's all right, only different!" if the horse had run over him, he might have said the same thing and found his opportunity to more that was good and useful in life through steady patience on his bed. the trouble is that we are not willing to call it _"all right"_ unless it is _the same,_--the same in this case meaning whatever may be identical with our own personal ideas of what is "all right." that expressive little bit of slang is full of humor and full of common sense. if, for instance, when we expect something and are disappointed, we could at once yield out of our resistance and heartily exclaim, "it is all right, only different," how much sooner we should discover the good use in its being different, and how soon we should settle into the sense of its being "all right!" when a circumstance that has seemed to us _all wrong_ can be made, through our quiet way of meeting it, to appear all right, only different, it very soon leads to a wholesome content in the new state of affairs or to a change of circumstances to which we can more readily and happily adjust ourselves. a strong sense of something's being "all right" means a strong sense of willingness that it should be just as it is. with that clear willingness in our hearts in general, we can adjust ourselves to anything in particular,--even to very sudden and unexpected changes. it is carrying along with us a background of powerful non-resistance which we can bring to the front and use actively at a moment's notice. it seems odd to think of actively using non-resistance, and yet the expression is not as contradictory as it would appear, for the strength of will it takes to attain an habitual attitude of wholesome non-resistance is far beyond the strength of will required to resist unwholesomely. the stronger, the more fixed and immovable the centre, the more free and adaptable are the circumferences of action; and, even though our central principle is fixed and immovable, it must be elastic enough to enable us to change our point of view whenever we find that by so doing we can gain a broader outlook and greater power for use. to acquire the strength of will for this habitual non-resistance is sometimes a matter of years of practice. we have to compel ourselves to be "willing," over and over again, at each new opportunity; sometimes the opportunities seem to throng us; and this, truly considered, is only a cause for gratitude. in life the truest winning often comes first under the guise of failure, and it is willingness to accept failure, and intelligence in understanding its causes, and using the acquired knowledge as a means to a higher end, that ultimately brings true success. if we choose, a failure can always be used as a means to an end rather than as a result in itself. how often do we hear the complaint, "i could do so well if it were not for my circumstances." how many people are held down for a lifetime by the habitual belief in circumstances as limitations, and by ignoring the opportunities which they afford. "so long as i must live with these people i can never amount to anything." if this complaint could be changed to the resolve: "i will live with these people until i have so adjusted myself to them as to be contented," a source of weakness would be changed into a source of strength. the quiet activity of mind required to adjust ourselves to difficult surroundings gives a zest and interest to life which we can find in no other way, and adds a certain strength to the character which cannot be found elsewhere. it is interesting to observe, too, how often it happens that, when we have adjusted ourselves to difficult circumstances, we are removed to other circumstances which are more in sympathy with our own, thoughts and ways: and sometimes to circumstances which are more difficult still, and require all the strength and wisdom which our previous discipline has taught us. if we are alive to our own true freedom, we should have an active interest in the necessary warfare of life. for life is a warfare--not of persons, but of principles--and every man who loves his freedom loves to be in the midst of the battle. our tendencies to selfish discontent are constantly warring against our love of usefulness and service, and he who wishes to enjoy the full activity of freedom must learn to fight and to destroy the tendencies within himself which stand in the way of his own obedience to law. but he needs, for this, the truthful and open spirit which leads to wise self-knowledge; a quiet and a willing spirit, to make the necessary sacrifice of selfish pride. his quiet earnestness will give him the strength to carry out what his clear vision will reveal to him in the light of truth he will keep his head lifted up above his enemies round about him, so that he may steadily watch and clearly see how best to act. after periods of hard fighting the intervals of rest will be full of refreshment, and will always bring new strength for further activity. if, in the battle with difficult circumstances, we are thrown down, we must pick ourselves up with quick decision, and not waste a moment in complaint or discouragement. we should emphasize to ourselves the necessity for picking ourselves up immediately, and going directly on, over and over again,--both for our own benefit, and the benefit of those whom we have the privilege of helping. in the japanese training of "jiu jitsu," the idea seems to be to drop all subjective resistance, and to continue to drop it, until, through the calmness and clearness of sight that comes from quiet nerves and a free mind, the wrestler can see where to make the fatal stroke. when the right time has arrived, the only effort which is necessary is quick, sharp and conclusive. this wonderful principle is often misused for selfish ends, and in such cases it leads eventually to bondage because, by the successful satisfaction of selfish motives, it strengthens the hold of our selfishness upon us; but, when used in an unselfish spirit, it is an ever-increasing source of strength. in the case of difficult circumstances,--if we cease to resist,--if we accept the facts of life,--if we are willing to be poor, or ill, or disappointed, or to live with people we do not like,--we gain a quietness of nerve and a freedom of mind which clears off the mists around us, so that our eyes may see and recognize the gate of opportunity,--open before us. it is the law of concentration and relaxation. if we concentrate on being willing, on relaxing until we have dropped every bit of resistance to the circumstances about us, that brings us to a quiet and well-balanced point of view, whence we can see clearly how to take firm and decided action. from such action the re-action is only renewed strength,--never painful and contracting weakness. if we could give up all our selfish desires and resistances, circumstances, however difficult, would have no power whatever to trouble us. to reach such absolute willingness is a long journey, but there is a straight path leading nearer and nearer to the happy freedom which is our goal. self-pity is one of the states that interferes most effectually with making the right use of circumstances. to pity one's self is destruction to all possible freedom. if the reader finds himself in the throes of this weakness and is helped through these words to recognize the fact, let him hasten to shun it as he would shun poison, for it is progressively weakening to soul and body. it will take only slight difficulties of any kind to overthrow us, if we are overcome by this temptation. imagine a man in the planet mars wanting to try his fortunes on another planet, and an angel appearing to him with permission to transfer him to the earth. "but," the angel says, "of course you can have no idea of what the life is upon the new planet unless you are placed in the midst of various circumstances which are more or less common to its inhabitants." "certainly," the martian answers, "i recognize that, and i want to have my experience on this new planet as complete as possible; therefore the more characteristic and difficult my circumstances are the better." then imagine the interest that man would have, from the moment he was placed on the earth, in working, his way through, and observing his experience as he worked. his interest would be alive vivid, and strong, from the beginning until he found himself, with earthly experience completed, ready to return to his friends in mars. he would never lose courage or be in any way disheartened. the more difficult his earthly problem was, the more it would arouse his interest and vigor to solve it. so many people prefer a difficult problem in geometry to an easy one, then why not in life? the difference is that in mathematics the head alone is exercised, and in life the head and the heart are both brought into play, and the first difficulty is to persuade the head and heart to work together. in the visitor from mars, of course, the heart would be working with the head, and so the whole man would be centred on getting creditably through his experience and home again. if our hearts and heads were together equally concentrated on getting through our experience for the sake of the greater power of use it would bring,--and, if we could trustfully believe in getting home again, that is, in getting established in the current of ordinary spiritual and natural action, then life would be really alive for us, then we should actually get the scent of our true freedom, and, having once had a taste of it, we should have a fresh incentive in achieving it entirely. there is one important thing to remember in an effort to be free from the bondage of circumstances which will save us from much unnecessary suffering. this has to do with the painful associations which arise from circumstances which are past and over. a woman, for example, suffered for a year from nervous exhaustion in her head, which was brought on, among other things, by over-excitement in private theatricals. she apparently recovered her health, and, because she was fond of acting, her first activities were turned in that direction. she accepted a part in a play; but as soon as she began to study all her old head symptoms returned, and she was thoroughly frightened, thinking that she might never be able to use her head again. upon being convinced, however, that all her discomfort came from her own imagination, through the painful associations connected with the study of her part, she returned to her work resolved to ignore them, and the consequence was that the symptoms rapidly disappeared. not uncommonly we hear that a person of our acquaintance cannot go to some particular place because of the painful events which occurred there. if the sufferer could only be persuaded that, when such associations are once bravely faced, it takes a very short time for the painful effects to disappear entirely, much unnecessary and prolonged discomfort would be saved. people have been kept ill for weeks, months and years, through. holding on to the brain impression of some painful event. whether the painful circumstances are little or great, the law of association is the same and, in any case, the brain impression can be dropped entirely, although it may take time and patience to do it. we must often talk to our brains as if we were talking to another person to eliminate the impressions from old associations. tell your brain in so many words, without emotion, that the place or the circumstance is nothing, nothing whatever,--it is only your idea about it, and the false association can be changed to a true one. so must we yield our selfish resistances and be ready to accept every opportunity for growth that circumstances offer; and, at the same time, when the good result is gained, throw off the impression of the pain of the process entirely and forever. thus may we both live and observe for our own good and that of others; and he who is practising this principle in his daily life can say from his heart:--"now shall my head be lifted up above mine enemies round about me." viii _other people_ however disagreeable other people may be,--however unjust they may be, however true it may be that the wrong is all on their side and not at all on ours,--whatever we may suffer at their hands,--we can only remedy the difficulty by looking first solely to ourselves and our own conduct; and, not until we are entirely free from resentment or resistance of any kind, and not until we are quiet in our own minds with regard to those who may be oppressing or annoying us, should we make any effort to set them right. this philosophy is sound and absolutely practical,--it never fails; any apparent failure will be due to our own delinquency in applying it; and, if the reader will think of this truth carefully until he feels able to accept it, he will see what true freedom there is in it,--although it may be a long time before he is fully able to carry it out. how can i remain in any slightest bondage to another when i feel sure that, however wrong he may be, the true cause of my discomfort and oppression is in myself? i am in bondage to myself, and it is to myself that i must look to gain my freedom. if a friend is rude and unkind to me, and i resent the rudeness and resist the unkindness, it is the resentment and resistance that cause me to suffer. i am not suffering for my friend, i am suffering for myself; and i can only gain my freedom by shunning the resentment and resistance as sin against all that is good and true in friendship. when i am free from these things in myself,--when, as far as i am concerned, i am perfectly and entirely willing that my friend should be rude or unjust, then only am i free from him. it is impossible that he should oppress me, if i am willing that he should be unjust or unkind; and the freedom that comes from such strong and willing non-resistance is like the fresh air upon a mountain. such freedom brings with it also a new understanding of one's friend, and a new ability to serve him. unless we live a life of seclusion, most of us have more than one friend, or acquaintance, or enemy, with whom we are brought into constant or occasional contact, and by whom we are made to suffer; not to mention the frequent irritations that may come from people we see only once in our lives. imagine the joy of being free from all this irritability and oppression; imagine the saving of nervous energy which would accompany such freedom; imagine the possibility of use to others which would be its most helpful result! if we once catch even the least glimpse of this quiet freedom, we shall not mind if it takes some time to accomplish so desirable a result, and the process of achieving it is deeply interesting. the difficulty at first is to believe that so far as we are concerned, the cause of the trouble is entirely within, ourselves. the temptation is to think:-- "how can i help resenting behavior like that! such selfishness and lack of consideration would be resented by any one." so any one might resent it, but that is no reason why we should. we are not to make other people's standards our own unless we see that their standards are higher than ours; only then should we change,--not to win the favor of the other people, but because we have recognized the superior value of their standards and are glad to put away what is inferior for what is better. therefore we can never excuse ourselves for resentment or resistance because other people resent or resist. there can be no possible excuse for resistance to the behavior of others, and it is safe to say that we must _never pit our wills against the wills of other people._ if we want to do right and the other man wants us to do wrong, we must pass by his will, pass under it or over it, but never on any account resist it. there has been more loss of energy, more real harm done, through this futile engagement of two personal wills than can ever be computed, and the freedom consequent upon refusing such contact is great in proportion. obedience to this law of not pitting our wills against the wills of other people leads to new freedom in all sorts of ways,--in connection with little, everyday questions, as to whether a thing is one color or another, as well as in the great and serious problems of life. if, in an argument, we feel confident that all we want is the truth,--that we do not care whether we or our opponents are in the right, as long as we find the right itself,--then we are free, so far as personal feeling is concerned; especially if, in addition, we are perfectly willing that our opponents should not be convinced, even though the right should ultimately prove to be on our side. with regard to learning how always to look first to ourselves,--first we must become conscious of our own resentment and resistance, then we must acknowledge it heartily and fully, and then we must go to work firmly and steadily to refuse to harbor it. we must relax out of the tension of our resistance with both soul and body; for of course, the resistance contracts the nerves of our bodies, and, if we relax from the contractions in our bodies, it helps us to gain freedom from resistance in our hearts and minds. the same resistance to the same person or the same ideas may return, in different forms, many times over; but all we have to do is to persist in dropping it as often as it returns, even if it be thousands of times. no one need be afraid of losing all backbone and becoming a "mush of concession" through the process of dropping useless resistance, for the strength of will required to free ourselves from the habit of pitting one's own will against that of another is much greater than the strength we use when we indulge the habit. the two kinds of strength can no more be compared than the power of natural law can be compared to the lawless efforts of human waywardness. for the will that is pitted against the will of another degenerates into obstinacy, and weakens the character; whereas the will that is used truly to refuse useless resistance increases steadily in strength, and develops power and beauty of character. again, the man who insists upon pitting his will against that of another is constantly blinded as to the true qualities of his opponent. he sees neither his virtues nor his vices clearly; whereas he who declines the merely personal contest becomes constantly clarified in his views, and so helped toward a loving charity for his opponent,--whatever his faults or difficulties may be,--and to an understanding and love of the good in him, which does not identify him with his faults. when we resent and resist, and are personally wilful, there is a great big beam in our eye, which we cannot see through, or under, or over,--but, as we gain our freedom from all such resistance, the beam is removed, and we are permitted to see things as they really are, and with a truer sense of proportion, our power of use increases. when a person is arguing with all the force of personal wilfulness, it is both pleasant and surprising to observe the effect upon him if he begins to feel your perfect willingness that he should believe in his own way, and your willingness to go with him, too, if his way should prove to be right. his violence melts to quietness because you give him nothing to resist. the same happy effect comes from facing any one in anger, without resistance, but with a quiet mind and a loving heart. if the anger does not melt--as it often does--it is modified and weakened, and--as far as we are concerned--it cannot touch or hurt us. we must remember always that it is not the repression or concealment of resentment and resistance, and forbearing to express them, that can free us from bondage to others; it is overcoming any trace of resentment or resistance within our own hearts and minds. if the resistance is in us, we are just as much in bondage as if we expressed it in our words and actions. if it is in us at all, it must express itself in one way or another,--either in ill-health, or in unhappy states of mind, or in the tension of our bodies. we must also remember that, when we are on the way to freedom from such habits of resistance, we may suffer from them for a long time after we have ceased to act from them. when we are turning steadily away from them, the uncomfortable effects of past resistance may linger for a long while before every vestige of them disappears. it is like the peeling after scarlet fever,--the dead skin stays on until the new, tender skin is strong underneath, and after we think we have peeled entirely, we discover new places with which we must be patient. so, with the old habits of resistance, we must, although turning away from them firmly, be steadily patient while waiting for the pain from them to disappear. it must take time if the work is to be done thoroughly,--but the freedom to be gained is well worth waiting for. one of the most prevalent forms of bondage is caring too much in the wrong way what people think of us. if a man criticises me i must first look to see whether he is right. he may be partly right, and not entirely,--but, whatever truth there is in his criticism, i want to know it in order that i may see the fault clearly myself and remedy it. if his criticism is ill-natured it is not necessarily any the less true, and i must not let the truth be obscured by his ill-nature. all, that i have to do with the ill-nature is to be sorry, on my friend's account, and help him out of it if he is willing; and there is nothing that is so likely to make him willing as my recognizing the justice of what he says and acting upon it, while, at the same time, i neither resent nor resist his ill-nature. if the man is both ill-natured and unjust,--if there is no touch of what is true in his criticism,--then all i have to do is to cease resenting it. i should be perfectly willing that he should think anything he pleases, while i, so far as i can see, go on and do what is right. _the trouble is that we care more to appear right than to be right._ this undue regard for appearances is very deep-seated, for it comes from long habit and inheritance; but we must recognize it and acknowledge it in ourselves, in order to take the true path toward freedom. so long as we are working for appearances we are not working for realities. when we love to _be_ right first, then we will regard appearances only enough to protect what is good and true from needless misunderstanding and disrespect. sometimes we cannot even do that without sacrificing the truth to appearances, and in such cases we must be true to realities first, and know that appearances must harmonize with them in the end. if causes are right, effects must be orderly, even though at times they may not seem so to the superficial observer. fear of not being approved of is the cause of great nervous strain and waste of energy; for fear is resistance, and we can counteract that terrified resistance only by being perfectly willing that any one should think anything he likes. when moving in obedience to law--natural and spiritual--a man's power cannot be overestimated; but in order to learn genuine obedience to law, we must be willing to accept our limitations and wait for them to be gradually removed as we gain in true freedom. let us not forget that if we are overpleased--selfishly pleased--at the approval of others, we are just as much in bondage to them as if we were angry at their disapproval. both approval and disapproval are helpful if we accept them for the use they can be to us, but are equally injurious if we take them to feed our vanity or annoyance. it is hard to believe, until our new standard is firmly established, that only from this true freedom do we get the most vital sense of loving human intercourse and companionship, for then we find ourselves working hand in hand with those who are united to us in the love of principles, and we are ready to recognize and to draw out the best in every one of those about us. if this law of freedom from others--which so greatly increases our power of use to them and their power of use to us--had not been proved absolutely practical, it would not be a law at all. it is only as we find it practical in every detail, and as obedience to it is proved to be the only sure road to established freedom that we are bound to accept it. to learn to live in such obedience we must be steady, persistent and patient,--teaching ourselves the same truths many times, until a new habit of freedom is established within us by the experience of our daily lives. we must learn and grow in power from every failure; and we must not dwell with pride and complacency on good results, but always move steadily and quietly forward. ix _human sympathy_ a nurse who had been only a few weeks in the hospital training-school, once saw--from her seat at the dinner-table--a man brought into the house who was suffering intensely from a very severe accident. the young woman started up to be of what service she could, and when she returned to the table, had lost her appetite entirely, because of her sympathy for the suffering man. she had hardly begun her dinner, and would have gone without it if it had not been for a sharp reprimand from the superintendent. "if you really sympathize with that man," she said, "you will eat your dinner to get strength to take care of him. here is a man who will need constant, steady, _healthy_ attention for some days to come,--and special care all this afternoon and night, and it will be your duty to look out for him. your 'sympathy' is already pulling you down and taking away your strength, and you are doing what you can to lose more strength by refusing to eat your dinner. such sympathy as that is poor stuff; i call it weak sentimentality." the reprimand was purposely sharp, and, by arousing the anger and indignation of the nurse, it served as a counter-irritant which restored her appetite. after her anger had subsided, she thanked the superintendent with all her heart, and from that day she began to learn the difference between true and false sympathy. it took her some time, however, to get thoroughly established in the habit of healthy sympathy. the tendency to unwholesome sympathy was part of her natural inheritance, along with many other evil tendencies which frequently have to be overcome before a person with a very sensitive nervous system can find his own true strength. but as she watched the useless suffering which resulted in all cases in which people allowed themselves to be weakened by the pain of others, she learned to understand more and more intelligently the practice of wholesome sympathy, and worked until it had become her second nature. especially did she do this after having proved many times, by practical experience, the strength which comes through the power of wholesome sympathy to those in pain. unwholesome sympathy incapacitates one for serving others, whether the need be physical, mental, or moral. wholesome sympathy not only gives us power to serve, but clears our understanding; and, because of our growing ability to appreciate rightly the point of view of other people, our service can be more and more intelligent. in contrast to this unwholesome sympathy, which is the cause of more trouble in the world than people generally suppose, is the unwholesome lack of sympathy, or hardening process, which is deliberately cultivated by many people, and which another story will serve to illustrate. a poor negro was once brought to the hospital very ill; he had suffered so keenly in the process of getting there that the resulting weakness, together with the intense fright at the idea of being in a hospital, which is so common to many of his class, added to the effects of his disease itself, were too much for him, and he died before he had been in bed fifteen minutes. the nurse in charge looked at him and said, in a cold, steady tone:-- "it was hardly worth while to make up the bed." she had hardened herself because she could not endure the suffering of unwholesome sympathy, and yet "must do her work." no one had taught her the freedom and power of true sympathy. her finer senses were dulled and atrophied,--she did not know the difference between one human soul and another. she only knew that this was a case of typhoid fever, that a case of pneumonia, and another a case of delirium tremens. they were all one to her, so far as the human beings went. she knew the diagnosis and the care of the physical disease,--and that was all. she did the material work very well, but she must have brought torture to the sensitive mind in many a poor, sick body. another form of false sympathy is what may be called professional sympathy. some people never find that out, but admire and get comfort from the professional sympathy of a doctor or a nurse, or any other person whose profession it is to care for those who are suffering. it takes a keen perception or a quick emergency to bring out the false ring of professional sympathy. but the hardening process that goes on in the professional sympathizer is even greater than in the case of those who do not put on a sympathetic veneer. it seems as if there must be great tension in the more delicate parts of the nervous system in people who have hardened themselves, with or without the veneer,--akin to what there would be in the muscles if a man went about his work with both fists tightly clenched all day, and slept with them clenched all night. if that tension of hard indifference could be reached and relaxed, the result would probably be a nervous collapse, before true, wholesome habits could be established, but unfortunately it often becomes so rigid that a healthy relaxation is out of the question. professional sympathy is of the same quality as the selfish sympathy which we see constantly about us in men or women who sympathize because the emotion attracts admiration and wins the favor of others. when people sympathize in their selfishness instead of sympathizing in their efforts to get free, the force of selfishness is increased, and the world is kept down to a lower standard by just so much. a thief, for instance, fails in a well-planned attempt to get a large sum of money, and confides his attempt and failure to a brother thief, who expresses admiration for the sneaking keenness of the plan, and hearty sympathy in the regret for his failure. the first thief immediately pronounces the second thief "a good fellow." but, at the same time, if either of these apparently friendly thieves could get more money by cheating the other the next day he would not hesitate to do so. to be truly sympathetic, we should be able so to identify ourselves with the interests of others that we can have a thorough appreciation of their point of view, and can understand their lives clearly, as they appear to themselves; but this we can never do if we are immersed in the fog,--either of their personal selfishness or our own. by understanding others clearly, we can talk in ways that are, and seem to them, rational, and gradually lead them to a higher standard. if a woman is in the depths of despair because a dress does not fit, i should not help her by telling her the truth about her character, and lecturing her upon her folly in wasting grief upon trifles, when there are so many serious troubles in the world. from her point of view, the fact that her dress does not fit _is_ a grief. but if i keep quiet, and let her see that i understand her disappointment, and at the same time hold my own standard, she will be led much more easily and more truly to see for herself the smallness of her attitude. first, perhaps, she will be proud that she has learned not to worry about such a little thing as a new dress; and, if so, i must remember her point of view, and be willing that she should be proud. then, perhaps, she will come to wonder how she ever could have wasted anxiety on a dress or a hat, and later she may perhaps forget that she ever did. it is like leading a child. we give loving sympathy to a child when it breaks its doll, although we know there is nothing real to grieve about there is something for the child to grieve about, something very real _to her;_ but we can only sympathize helpfully with her point of view by keeping ourselves clearly in the light of our own more mature point of view. from the top of a mountain you can see into the valley round about,--your horizon is very broad, and you can distinguish the details that it encompasses; but, from the valley, you cannot see the top of the mountain, and your horizon is limited. this illustrates truly the breadth and power of wholesome human sympathy. with a real love for human nature, if a man has a clear, high standard of his own,--a standard which he does not attribute to his own intelligence--his understanding of the lower standards of other men will also be very clear, and he will take all sorts and conditions of men into the region within the horizon of his mind. not only that, but he will recognize the fact when the standard of another man is higher than his own, and will be ready to ascend at once when he becomes aware of a higher point of view. on the other hand, when selfishness is sympathizing with selfishness, there is no ascent possible, but only the one little low place limited by the personal, selfish interests of those concerned. nobody else's trouble seems worth considering to those who are immersed in their own, or in their selfish sympathy with a friend whom they have chosen to champion. this is especially felt among conventional people, when something happens which disturbs their external habits and standards of life. sympathy is at once thrown out on the side of conventionality, without any rational inquiry as to the real rights of the case. selfish respectability is most unwholesome in its unhealthy sympathy with selfish respectability. the wholesome sympathy of living human hearts sympathizes first with what is wholesome,--especially in those who suffer,--whether it be wholesomeness of soul or body; and true sympathy often knows and recognizes that wholesomeness better than the sufferer himself. only in a secondary way, and as a means to a higher end, does it sympathize with the painful circumstances or conditions. by keeping our sympathies steadily fixed on the health of a brother or friend, when he is immersed in and overcome by his own pain, we may show him the way out of his pain more truly and more quickly. by keeping our sympathies fixed on the health of a friend's soul, we may lead him out of selfishness which otherwise might gradually destroy him. in both cases our loving care should be truly felt,--and felt as real understanding of the pain or grief suffered in the steps by the way, with an intelligent sense of their true relation to the best interests of the sufferer himself such wholesome sympathy is alert in all its perceptions to appreciate different points of view, and takes care to speak only in language which is intelligible, and therefore useful. it is full of loving patience, and never forces or persuades, but waits and watches to give help at the right time and in the right place. it is more often helpful with silence than with words. it stimulates one to imagine what friendship might be if it were alive and wholesome to the very core. for, in such friendship as this, a true friend to one man has the capacity of being a true friend to all men, and one who has a thoroughly wholesome sympathy for one human being will have it for all. his general attitude must always be the same--modified only by the relative distance which comes from variety in temperaments. in order to sympathize with the best possibilities in others, our own standards must be high and clear, and we must be steadily true to them. such sympathy is freedom itself,--it is warm and glowing,--while the sympathy which adds its weight to the pain or selfishness of others can really be only bondage, however good it may appear. x _personal independence_ in proportion as every organ of the human body is free to perform its own functions, unimpeded by any other, the body is perfectly healthy and vigorous; and, in proportion as every organ of the body is receiving its proper support from every other, the body as a whole is vigorous, and in the full use of its powers. these are two self-evident axioms, and, if we think of them quietly for a little while, they will lead us to a clear realization of true personal independence. the lungs cannot do the work of the heart, but must do their own work, independently and freely; and yet, if the lungs should suddenly say to themselves: "this is all nonsense,--our depending upon the heart in this way; we must be independent! it is weak to depend upon the other organs of the body!" and if they should repel the blood which the heart pumped into them, with the idea that they could manage the body by themselves, and were not going to be weakly dependent upon the heart, the stomach, or any other organ,--if the lungs should insist upon taking this independent stand, they would very soon stop breathing, the heart would stop beating, the stomach would stop digesting, and the body would die. or, suppose that the heart should refuse to supply the lungs with the blood necessary to provide oxygen; the same fatal result would of course follow. or, even let us imagine all the organs of the body agreeing that it is weak to be dependent, and asserting their independence of each other. at the very instant that such an agreement was carried into effect, the body would perish. then, on the other hand,--to reverse the illustration,--if the lungs should feel that they could help the heart's work by attending to the circulation of the blood, if the heart should insist that it could inhale and exhale better than the lungs, and should neglect its own work in order to advise and assist the lungs in the breathing, the machinery of the body would be in sad confusion for a time, and would very soon cease altogether. this imaginary want of real independence in the working of the different organs of the body can be illustrated by the actual action of the muscles. how often we see a man working with his mouth while writing, when he should be only using his hands; or, working uselessly with his left hand, when what he has to do only needs the right! how often we see people trying to listen with their arms and shoulders! such illustrations might be multiplied indefinitely, and, in all cases, the false sympathy of contraction in the parts of the body which are not needed for the work in hand comes from a wrong dependence,--from the fact that the pats of the body that are not needed, are officiously dependent upon those that are properly active, instead of minding their own affairs and saving energy for their own work. the wholesome working of the human organism, is so perfect in its analogy to the healthy relations of members of a community, that no reader should pass it by without very careful thought. john says:-- "i am not going to be dependent upon any man. i am going to live my own life, in my own way, as i expect other men to live theirs. if they will leave me alone, i will leave them alone," and john flatters himself that he is asserting his own strength of personality, that he is emphasizing his individuality. the truth is that john is warping himself every day by his weak dependence upon his own prejudices. he is unwilling to look fairly at another main's opinion for fear of being dependent upon it. he is not only warping himself by his "independence," which is puffed up with the false appearance of strength, but he is robbing his fellow-men; for he cannot refuse to receive from others without putting it out of his own power to give to others. real giving and receiving must be reciprocal in spirit, and absolutely dependent upon each other. it is a curious and a sad study to watch the growing slavery of such "independent" people. james, on the other hand, thinks he cannot do anything without asking another man's advice or getting another man's help; sometimes it is always the same man, sometimes it is one of twenty different men. and so, james is steadily losing the power of looking life in the face, and of judging for himself whether or not to take the advice of others from a rational principle, and of his own free will, and he is gradually becoming a parasite,--an animal which finally loses all its organs from lack of use, so that only its stomach remains,--and has, of course, no intelligence at all. the examples of such men as james are much more numerous than might be supposed. we seldom see them in such flabby dependence upon the will of an individual as would make them conspicuous; but they are about us every day, and in large numbers, in their weak dependence upon public opinion,--their bondage to the desire that other men should think well of them. the human parasites that are daily feeding on social recognition are unconsciously in the process of losing their individuality and their intelligence; and it would be a sad surprise to them if they could see themselves clearly as they really are. public opinion is a necessary and true protection to the world as it is, because if it were not for public opinion, many men and women would dare to be more wicked than they are. but that is no reason why intelligent men should order their lives on certain lines just because their neighbors do,--just because it is the custom. if the custom is a good custom, it can be followed intelligently, and because we recognize it as good, but it should not be followed only because our neighbors follow it. then, if our neighbors follow the custom for the same intelligent reason, it will bring us and them into free and happy sympathy. neither should a man hesitate to do right, positively and fearlessly, in the face of the public assertion that he is doing wrong. he should, of course, look himself over many times to be sure that he is doing right, according to his own best light, and he should be willing to change his course of action just as fearlessly if he finds he has made a mistake; but, having once decided, he will respect public opinion much more truly by acting quietly against it with an open mind, than he would if he refused to do right, because he was afraid of what others would think of him. to defy carelessly the opinion of others is false independence, and has in it the elements of fear, however fearless it may seem; but to respectfully ignore it for the sake of what is true, and good, and useful, is sure to enlarge the public heart and to help, it eventually to a clearer charity. individual dependence and individual independence are absolutely necessary to a well-adjusted balance. it is just as necessary to the individual men of a community as to the individual organs of the body. it is not uncommon for a person to say:-- "i must give up so-and-so; i must not see so much of him,--i am getting so dependent upon him." if the apparent dependence on a friend is due to the fact that he has valuable principles to teach which may take time to learn, but which lead in the end to greater freedom, then to give up such companionship, out of regard for the criticism of others would, of course, be weakness and folly itself. it is often our lot to incur the severest blame for the very weaknesses which we have most entirely overcome. many people will say:-- "i should rather be independently wrong than dependently right," and others will admire them for the assertion. but the truth is, that whenever one is wrong, one is necessarily dependent, either upon man or devil; but it is impossible to be dependently right, excepting for the comparatively short time that we may need for a definite, useful purpose. if a man is right in his mental and moral attitude merely because his friend is right, and not because he wants the right himself, it will only be a matter of time before his prop is taken away, and he will fall back into his own moral weakness. of course, a man can begin to be right because his friend is right;--but it is because there is something in him which responds to the good in his friend. strong men are true to their friendships and convictions, in spite of appearances and the clamor of their critics. true independence is never afraid of appearing dependent, and true dependence leads always to the most perfect independence. we cannot, really enjoy our own freedom without the growing desire and power to help other people to theirs. our own love of independence will bring with it an equal love for the independence of our neighbor; and our own love of true dependence--that is, of receiving wise help from any one through whom it may be sent--will give us an equal love for giving help wherever it will be welcome. our respect for our own independence will make it impossible that we should insist upon trying to give help to others where it is not wanted; and our own respect for true dependence will give us a loving charity, a true respect for those who are necessarily and temporarily dependent, and teach us to help them to their true balance. we should learn to keep a margin of reserve for ourselves, and to give the same margin to others. not to come too near, but to be far enough away from every one to give us a true perspective. there is a sort of familiarity that arises sometimes between friends, or even mere acquaintances, which closes the door to true friendship or to real acquaintance. it does not bring people near to one another, but keeps them apart. it is as if men thought that they could be better friends by bumping their heads together. our freedom comes in realizing that all the energy of life should come primarily from a love of principles and not of persons, excepting as persons relate to principles. if one man finds another living on principles that are higher than his own, it means strength and freedom for him to cling to his friend until he has learned to understand and live on those principles himself. then if he finds his own power for usefulness and his own enjoyment of life increased by his friendship, it would indeed be weak of him to refuse such companionship from fear of being dependent. the surest and strongest basis of freedom in friendship is a common devotion to the same fundamental principles of life; and this insures reciprocal usefulness as well as personal independence. we must remember that the very worst and weakest dependence is not a dependence upon persons, but upon a sin,--whether the sin be fear of public opinion or some other more or less serious form of bondage. the only true independence is in obedience to law, and if, to gain the habit of such obedience, we need a helping hand, it is truly independent for us to take it. _we all came into the world alone, and we must go out of the world alone, and yet we are exquisitely and beautifully dependent upon one another._ a great german philosopher has said that there should be as much space between the atoms of the body, in relation to its size, as there is between the stars in relation to the size of the universe,--and yet every star is dependent upon every other star,--as every atom in the body is dependent upon every other atom for its true life and action. this principle of balance in the macrocosm and the microcosm is equally applicable to any community of people, whether large or small. the quiet study and appreciation of it will enable us to realize the strength of free dependence and dependent freedom in the relation of persons to one another. the more truly we can help one another in freedom toward the dependence upon law, which is the axis of the universe, the more wholesome and perfect will be all our human relations. xi _self-control_ to most people self-control means the control of appearances and not the control of realities. this is a radical mistake, and must be corrected, if we are to get a clear idea of self-control, and if we are to make a fair start in acquiring it as a permanent habit. i am what i am by virtue of my own motives of thought and action, by virtue of what my mind is, what my will is, and what i am in the resultant combination of my mind and will; i am not necessarily what i appear from the outside. if a man is ugly to me, and i want to knock him down, and refrain from doing so simply because it would not appear well, and is not the habit of the people about me, my desire to knock him down is still a part of myself, and i have not controlled myself until i am absolutely free from that interior desire. so long as i am in hatred to another, i am in bondage to my hatred; and if, for the sake of appearances, i do not act or speak from it, i am none the less at its mercy, and it will find an outlet wherever it can do so without debasing me in the eyes of other men more than i am willing to be debased. the control of appearances is merely outward repression, and a very common instance of this may be observed in the effort to control a laugh. if we repress it, it is apt to assert itself in spite of our best efforts; whereas, if we relax our muscles, and let the sensation go through us, we can control our desire to laugh and so get free from it. when we repress a laugh, we are really holding on to it, in our minds, but, when we control it by relaxing the tension that comes from the desire to laugh, it is as if the sensation passed over and away from us. it is a well-known fact among surgeons that, if a man who is badly frightened, takes ether, no matter how well he controls his outward behavior, no matter how quiet he appears while the ether is being administered, as soon as he loses control of his voluntary muscles, the fear that has been repressed rushes out in the form of excitement. this is a practical illustration of the fact that control of appearances is merely control of the muscles, and that, even so far as our nervous system goes, it is only repression, and self-repression is not self-control. if i repress the expression of irritability, anger, hatred, or any other form of evil, it is there, in my brain, just the same; and, in one form or another, i am in bondage to it. sometimes it expresses itself in little meannesses; sometimes it affects my body and makes me ill; often it keeps me from being entirely well. of one thing we may be sure,--it makes me the instrument of evil, in one way or another. repressed evil is not going to lie dormant in us forever; it will rise in active ferment, sooner or later. its ultimate action is just as certain as that a serious impurity of the blood is certain to lead to physical disease, if it is not counteracted. knowing this to be true, we can no longer say of certain people "so-and-so has remarkable self-control." we can only say, "so-and-so represses his feelings remarkably well: what a good actor he is!" the men who have real self-control do exist, and they are the leaven that saves the race. it is good to know that this habitual repression comes, in many cases, from want of knowledge of the fact that self-repression is not self-control. but the reader may say, "what am i to do, if i feel angry, and want to hit a man in the face; i am not supposed to hit him am i, rather than to repress my feelings?" no, not at all, but you are supposed to use your will to get in behind the desire to hit him, and, by relaxing in mind and body, and stopping all resistance to his action, to remove that desire in yourself entirely. if once you persistently refuse to resist by dropping the anger of your mind and the tension of your body, you have gained an opportunity of helping your brother, if he is willing to be helped; you have cleared the atmosphere of your own mind entirely, so that you can understand his point of view, and give him the benefit of reasonable consideration; or, at the very least, you have yourself ceased to be ruled by his evils, for you can no longer be roused to personal retaliation. it is interesting and enlightening to recognize the fact that we are in bondage to any man to the extent that we permit ourselves to be roused to anger or resentment by his words or actions. when a man's brain is befogged by the fumes of anger and irritability it can work neither clearly nor quietly, and, when that is the case, it is impossible for him to serve himself or his neighbor to his full ability. if another person has the power to rouse my anger or my irritability, and i allow the anger or the irritability to control me, i am, of course, subservient to my own bad state, and at the mercy of the person who has the power to excite those evil states just in so far as such excitement confuses my brain. every one has in him certain inherited and personal tendencies which are obstacles to his freedom of mind and body, and his freedom is limited just in so far as he allows those tendencies to control him. if he controls them by external repression, they are then working havoc within him, no matter how thoroughly he may appear to be master of himself. if he acknowledges his mistaken tendencies fully and willingly and then refuses to act, speak, or think from them, he is taking a straight path toward freedom of life and action. one great difficulty in the way of self-control is that we do not want to get free from our anger. in such cases we can only want to want to, and if we use the strength of will that is given us to drop our resistance in spite of our desire to be angry we shall be working toward our freedom and our real self-control. there is always a capacity for unselfish will, the will of the better self, behind the personal selfish will, ready and waiting for us to use it, and it grows with use until finally it overrules the personal selfish will with a higher quality of power. it is only false strength that supports the personal will,--a false appearance of strength which might be called wilfulness and which leads ultimately to the destruction of its owner. any true observer of human nature will recognize the weakness of mere selfish wilfulness in another, and will keep entirely free from its trammels by refusing to meet it in a spirit of resentment or retaliation. real self-control, as compared to repression, is delightful in its physical results, when we have any difficult experience to anticipate or to go through. take, for instance, a surgical operation. if i control myself by yielding, by relaxing the nervous tension which is the result of my fear, true self-control then becomes possible, and brings a helpful freedom from, reaction after the trouble is over. or the same principle can be applied if i have to go through a hard trial with a friend and must control myself for his sake,--dropping resistance in my mind and in my body, dropping resistance to his suffering, yielding my will to the necessities of the situation,--this attitude will leave me much more clear to help him, will show him how to help himself, and will relieve him from the reaction that inevitably follows severe nervous strain. the power of use to others is increased immeasurably when we control ourselves interiorly, and do not merely outwardly repress. it often happens that a drunkard who is supposed to be "cured," returns to his habit, simply because he has wanted his drink all the time, and has only been taught to repress his appetite; if he had been steadily and carefully taught real self-control, he would have learnt to control and drop his interior _desire,_ and thus keep permanently free. how often we see intemperance which had shown itself in drink simply turned into another channel, another form of selfish indulgence, and yet the victim will complacently boast of his self-control. an extreme illustration of this truth is shown in the case of a well-known lecturer on temperance. he had given up drink, but he ate like a glutton, and his thirst for applause was so extreme as to make him appear almost ridiculous when he did not receive it. the opportunities for self-control are, of course, innumerable; indeed they constitute pretty much the whole of life. we are living in freedom and use, real living use, in proportion as we are in actual control of our selfish selves, and led by our love of useful service. in proportion as we have through true self-control brought ourselves into daily and hourly obedience to law, are we in the freedom that properly belongs to our lives and their true uses. when once we have won our freedom from resistance, we must use that freedom in action, and put it directly to use. sometimes it will result in a small action, sometimes in a great one; but, whatever it is, it must be _done._ if we drop the resistance, and do not use the freedom gained thereby for active service, we shall simply react into further bondage, from which it will be still more difficult to escape. having dropped my antagonism to my most bitter enemy, i must do something to serve him, if i can. if i find that it is impossible to serve him, i can at least be of service to someone else; and this action, if carried out in the true spirit of unselfish service, will go far toward the permanent establishment of my freedom. if a circumstance which is atrociously wrong in itself makes us indignant, the first thing to do is to drop the resistance of our indignation, and then to do whatever may be within our power to prevent the continuance of such wrong. many people weaken their powers of service by their own indignation, when, if they would cease their excited resistance, they would see clearly how to remedy the wrong that arouses their antagonism. action, when accompanied by personal resistance, however effective it may seem, does not begin to have the power that can come from action, without such resistance. as, for instance, when we have to train a child with a perverse will, if we quietly assert what is right to the child, and insist upon obedience without the slightest antagonistic feeling to the child's naughtiness, we accomplish much more toward strengthening the character of the child than if we try to enforce our idea by the use of our personal will, which is filled with resistance toward the child's obstinacy. in the latter case, it is just pitting our will against the will of the child, which is always destructive, however it may appear that we have succeeded in enforcing the child's obedience. the same thing holds true in relation to an older person, with the exception that, with him or her, we cannot even attempt to require obedience. in that case we must,--when it is necessary that we should speak at all,--assert the right without antagonism to what we believe to be their wrong, and without the slightest personal resistance to it. if we follow this course, in most cases our friend will come to the right point of view,--sometimes the result seems almost miraculous,--or, as is often the case, we, because we are wholesomely open-minded, will recognize any mistake in our own point of view, and will gladly modify it to agree with that of our friend. the trouble is that very few of us feel like working to remedy a wrong merely for the sake of the right, and therefore we must have an impetus of personal feeling to carry us on toward the work of reformation. if we could once be strongly started in obedience to the law from love of the law itself, we should find in that impersonal love a clear light and power for effective action both in the larger and in the smaller questions of life. there is a popular cry against introspection and an insistence that it is necessarily morbid, which works in direct opposition to true self-control. introspection for its own sake is self-centred and morbid, but we might as well assert that it is right to have dirty hands so long as we wear gloves, and that it is morbid to want to be sure that our hands are clean under our gloves, as to assert that introspection for the sake of our true spiritual freedom is morbid. if i cannot look at my selfish motives, how am i going to get free from them? it is my selfish motives that prevent true self-control. it is my selfish motives that prompt me to the false control of repression, which is counterfeit and for the sake of appearances alone. we must see these motives, recognize and turn away from them, in order to control ourselves interiorly into line with law. we cannot possibly see them unless we look for them. if we look into ourselves for the sake of freedom, for the sake of our greater power for use, for the sake of our true self-control, what can be more wholesome or what can lead us to a more healthy habit of looking out from ourselves into the lives and interests of others? the farther we get established in motives that are truly unselfish, the sooner we shall get out of our own light, and the wider our horizon will be; and the wider our horizon, the greater our power for use. there must, of course, be a certain period of self-consciousness in the process of finding our true self-control, but it is for the sake of an end which brings us more and more fully into a state of happy, quiet spontaneity. if we are working carefully for true self-control we shall welcome an unexpected searchlight from another mind. if the searchlight brings into prominence a bit of irritation that we did not know was there, so much the better. how could we free ourselves from it without knowing that it was there? but as soon as we discover it we can control and cast it off. a healthy introspection is merely the use of a searchlight which every one who loves the truth has the privilege of using for the sake of his own growth and wilfulness, and circumstances often turn it full upon us, greatly to our advantage, if we do not wince but act upon the knowledge that it brings. it is possible to acquire an introspective habit which is wholesome and true, and brings us every day a better sense of pro. portion and a clearer outlook. with regard to the true control of the pleasurable emotions, the same principle applies. people often grow intensely excited in listening to music,--letting their emotions run rampant and suffering in consequence a painful reaction of fatigue. if they would learn to yield so that the music could pass over their nerves as it passes over the strings of a musical instrument, and then, with the new life and vigor derived from the enjoyment, would turn to some useful work, they would find a great expansion in the enjoyment of the music as well as a new pleasure in their work. real self-control is the subjugation of selfishness in whatever form it may exist, and its entire subordination to spiritual and natural law. real self-control is not self-centred. in so far as we become established in this true self-control, we are upheld by law and guided by the power behind it to the perfect freedom and joy of a useful life. xii _the religion of it_ the religion of it is the whole of it. "all religion has relation to life and the life of religion is to do good." if religion does not teach us to do good in the very best way, in the way that is most truly useful to ourselves and to other people, religion is absolutely useless and had better be ignored altogether. we must beware, however, of identifying the idea of religion with the men and the women who pervert it. if an electrician came to us to light our house, and the lights would not burn, we would not immediately condemn all electric lighting as bosh and nonsense, or as sentimental theory; we should know, of course, that this especial electrician did not understand his business, and would at once look about to find a man who did, and get him to put our lights in order. if no electrician really seemed to know his business, and we wanted our lights very much, the next thing to do would be to look into the laws of electricity ourselves, and find out exactly where the trouble was, and so keep at work until we had made our own lights burn, and always felt able, if at any time they failed to burn, to discover and remedy the difficulty ourselves. there is not a man or woman who does not feel, at some time, the need of an inner light to make the path clear in the circumstances of life, and especially in dealing with others. many men and women feel that need all the time, and happy are those who are not satisfied until the need is supplied and they are working steadily in daily practical life, guided by a light that they know is higher than theory. when the light is once found, and we know the direction in which we wish to travel, the path is not by any means always clear and smooth, it is often, full of hard, rough places, and there are sometimes miles to go over where our light seems dim; but if we have proved our direction to be right, and keep steadily and strongly moving forward, we are always sure to come into open resting places where we can be quiet, gather strength, and see the light more clearly for the next stage of the journey. "it is wonderful," some one remarked, "how this theory of non-resistance has helped me; life is quite another thing since i have practised it steadily." the reply was "it is not wonderful when we realize that the lord meant what he said when he told us not to resist evil." at this suggestion the speaker looked up with surprise and said: "why, is that in the new testament? where, in what part of it?" she never had thought of the sermon on the mount as a working plan, or, indeed, of the new testament as a handbook of life,--practical and powerful in every detail. if we once begin to use it daily and hourly as a working plan of life, it is marvellous how the power and the efficiency of it will grow on us, and we shall no more be able to get along without it than an electrician can get along without a knowledge of the laws of electricity. some people have taken the new testament so literally that they have befogged themselves entirely with regard to its real meaning, and have put it aside as impracticable; others have surrounded it with an emotional idea, as something to theorize and rhapsodize about, and have befogged themselves in that way with regard to its real power. most people are not clear about it because of the tradition that has come to us through generations who have read it and heard it read in church, and never have thought of living it outside. we can have a great deal of church without any religion, but we cannot have religion without true worship, whether the worship is only in our individual souls, or whether it is also the function of a church to which we belong, with a building dedicated to the worship of the lord to which we go for prayer and for instruction. if we could clear ourselves from the deadening effects of tradition, from sentimentality, from nice theory, and from every touch of emotional and spurious peace, and take up the new testament as if we were reading it for the first time, and then if we could use it faithfully as a working plan for a time, simply as an experiment,--it would soon cease to be an experiment, and we should not need to be told by any one that it is a divine revelation; we would be confident of that in our own souls. indeed that is the only way any one can ever be sure of revelation; it must come to each of us alone, as if it had never come to any one before; and yet the beauty and power of it is such that it has come to myriads before us and will come to myriads after us in just the same way. but there is no real revelation for any one _until he has lived what he sees to be true._ i may talk like an angel and assert with a shining face my confident faith in god and in all his laws, but my words will mean nothing whatever, unless i have so lived my faith that it has been absorbed, into my character and so that the truths of my working plan have become my second nature. many people have discovered that the lord meant what he said when he said: "resist not evil," and have proved how truly practical is the command, in their efforts to be willing to be ill, to be willing that circumstances should seem to go against them, to be willing that other people should be unjust, angry, or disagreeable. they have seen that in yielding to circumstances or people entirely,--that is, in dropping their own resistances,--they have gained clear, quiet minds, which enables them to see, to understand, and to practise a higher common sense in the affairs of their lives, which leads to their ultimate happiness and freedom. it is now clear to many people that much of the nervous illness of to-day is caused by a prolonged state of resistance to circumstances or to people which has kept the brain in a strained and irritated state so that it can no longer do its work; and that the patient has to lay by for a longer or a shorter period, according to his ability to drop the resistances, and so allay the irritation and let his brain and nervous system rest and heal. then with regard to dealing with others, some of us have found out the practical common sense of taking even injustice quietly and without resistance, of looking to our own faults first, and getting quite free from all resentment and resistance to the behavior of others, before we can expect to understand their point of view, or to help them to more reasonable, kindly action if they are in error. very few of us have recognized and acknowledged that that was what the lord meant when he said: "judge not that ye be not judged. for with what judgment ye judge, ye shall be judged: and with what measure ye mete, it shall be measured to you again. and why beholdest thou the mote that is in thy brother's eye, but considerest not the beam that is in thine own eye? or how wilt thou say to thy brother, let me pull out the mote out of thine eye; and, behold, a beam is in thine own eye? thou hypocrite, first cast out the beam out of thine own eye; and then shalt thou see clearly to cast out the mote out of thy brother's eye." it comes with a flash of recognition that is refreshingly helpful when we think we have discovered a practical truth that works, and then see that it is only another way of putting what has been taught for the last two thousand years. many of us understand and appreciate the truth that a man's true character depends upon his real, interior motives. he is only what his motives are, and not, necessarily, what his motives appear to be. we know that, if a man only controls the appearance of anger and hatred, he has no real self-control whatever. he must get free from the anger itself to be free in reality, and to be his own master. we must stop and think, however, to understand that this is just what the lord meant when he told us to clean the inside of the cup and the platter, and we need to think more to realize the strength of the warning, that we should not be "whitened sepulchres." we know that we are really related to those who can and do help us to be more useful men and women, and to those whom we can serve in the most genuine way; we know that we are wholesomely dependent upon all from whom we can learn, and we should be glad to have those freely dependent upon us whom we can truly serve. it is most strengthening when we realize that this is the true meaning of the lord's saying, "for whosoever shall do the will of god, the same is my brother, and my sister, and mother." that the lord himself, with all his strength, was willing to be dependent, is shown by the fact that, from the cross, he said to those who had crucified him, "i thirst." they had condemned him, and crucified him, and yet he was willing to ask them for drink, to show his willingness to be served by them, even though he knew they would respond only with a sponge filled with vinegar. we know that when we are in a hard place, if we do the duty that is before us, and keep steadily at work as well as we can, that the hard problem will get worked through in some way. we know that this is true, for we have proved it over and over; but how many people realize that it is because the lord meant what he said when he told us: to "take no thought for the morrow, for the morrow will take thought for the things of itself." i am reasoning from the proof of the law to the law itself. there is no end to the illustrations that we might find proving the spiritual common sense of the new testament and, if by working first in that way, we can get through this fog of tradition, of sentimentality, and of religious emotion, and find the living power of the book itself, then we can get a more and more clear comprehension of the laws it teaches, and will, every day, be proving their practical power in all our dealings with life and with people. whether we are wrestling with nature in scientific work, whether we are working in the fine arts, in the commercial world, in the professional world, or are dealing with nations, it is always the same,--we find our freedom to work fully realized only when we are obedient to law, and it is a wonderful day for any human being when he intelligently recognizes and finds himself getting into the current of the law of the new testament. the action of that law he sees is real, and everything outside he recognizes as unreal. in the light of the new truth, we see that many things which we have hitherto regarded as essential, are of minor importance in their relation to life itself. the old lady who said to her friend, "my dear, it is impossible to exaggerate the unimportance of things," had learned what it meant to drop everything that interferes, and must have been truly on her way to the concentration which should be the very central power of all life,--obedience to the two great commandments. concentration does not mean straining every nerve and muscle toward obedience, it means _dropping every thing that interferes._ if we drop everything that interferes with our obedience to the two great commandments, and the other laws which are given us all through the new testament to help us obey, we are steadily dropping all selfish resistance, and all tendency to selfish responsibility; and in that steady effort, we are on the only path which can by any possibility lead us directly to freedom. xiii _about christmas_ there was once a family who had a guest staying with them; and when they found out that he was to have a birthday during his visit they were all delighted at the idea of celebrating it. days before--almost weeks before--they began to prepare for the celebration. they cooked and stored a large quantity of good things to eat, and laid in a stock of good things to be cooked and prepared on the happy day. they planned and arranged the most beautiful decorations. they even thought over and made, or selected, little gifts for one another; and the whole house was in hurry and confusion for weeks before the birthday came. everything else that was to be done was postponed until after the birthday; and, indeed, many important things were neglected. finally the birthday came, the rooms were all decorated, the table set, all the little gifts arranged, and the guests from outside of the house had all arrived. just after the festivities had begun a little child said to its mother: "mamma, where is the man whose birthday it is--" "hush, hush," the mother said, "don't ask questions." but the child persisted, until finally the mother said: "well, i am sure i do not know, my dear, but i will ask." she asked her neighbor, and the neighbor looked surprised and a little puzzled. "why," she said, "it is a celebration, we are celebrating his birthday, and he is a guest in the house." then the mother got interested and curious herself. "but where is the guest? where is the man whose birthday it is?" and, this time she asked one of the family. he looked startled at first, and then inquired of the rest of the family. "where is the guest whose birthday it is?" alas i nobody knew. there they were, all excited and trying to enjoy themselves by celebrating his birthday, and he,--some of them did not even know who he was! he was left out and forgotten! when they had wondered for a little while they immediately forgot again, and went on with their celebrations,--all except the little child. he slipped out of the room and made up his mind to find the man whose birthday it was, and, finally, after a hard search, he found him upstairs in the attic,--lonely and sick. he had been asked to leave the guestroom, which he had occupied, and to move upstairs, so as to be out of the way of the preparations for his birthday. here he had fallen ill, and no one had had time to think of him, excepting one of the humbler servants and this little child. they had all been so busy preparing for his birthday festival that they had forgotten him entirely. this is the way it is with most of us at christmas time. whenever we think of a friend, or even an acquaintance, we think of his various qualities,--not always in detail, but as forming a general impression which we associate with his name. if it is a friend whom we love and admire, we love, especially on his birthday, to dwell on all that is good and true in his character; and at such times, though he may be miles away in body, we find ourselves living with him every hour of the day, and feel his presence, and, from that feeling, do our daily tasks with the greater satisfaction and joy. every one in this part of the world, of course, knows whose birthday we celebrate on the twenty-fifth of december. if we imagine that such a man never really existed, that he was simply an ideal character, and nothing more,--if we were to take christmas day as the festival of a noble myth,--the ideal which it represents is so clear, so true, so absolutely practical in the way it is recorded in the book of his life, that it would be a most helpful joy to reflect upon it, and to try and apply its beautiful lessons on the day which would especially recall it to our minds. or, let us suppose that such a man really did exist,--a man whose character was transcendently clear and true, quiet, steady, and strong,--a man who was full of warm and tender love for all,--who was constantly doing good to others without the slightest display or self-assertion,--a man who was simple and humble,--who looked the whole world in the face and did what was right,--even though the whole respectable world of his day disapproved of him, and even though this same world attested in the most emphatic manner that he was doing what was dangerous and wicked,--a man with spiritual sight so keen that it was far above and beyond any mere intellectual power,--a sight compared to which, what is commonly known as intellectual keenness is, indeed, as darkness unto light; a man with a loving consideration for others so true and tender that its life was felt by those who merely touched the hem of his garment. suppose we knew that such a man really did live in this world, and that the record of his life and teachings constitute the most valuable heritage of our race,--what new life it would give us to think of him, especially on his birthday,--to live over, so far as we were able, his qualities as we knew them; and to gain, as a result, new clearness for our own everyday lives. the better we knew the man, the more clearly we could think of him, and the more full our thoughts would be of living, practical suggestions for daily work. but now just think what it would mean to us if we really knew that this humble, loving man were the creator of the universe--the very god--who took upon himself our human nature with all its hereditary imperfections; and, in that human nature met and conquered every temptation that ever was, or ever could be possible to man; thus--by self-conquest--receiving all the divine qualities into his human nature, and bringing them into this world within reach of the hearts and minds of all men, to give light and warmth to their lives, and to enable them to serve each other;--if we could take this view of the man's life and work, with what quiet reverence and joy should we celebrate the twenty-fifth of december as a day set apart to celebrate his birth into the world! if we ourselves loved a truthful, quiet way of living better than any other way, how would we feel to see our friends preparing to celebrate our birthday with strain, anxiety, and confusion? if we valued a loving consideration for others more than anything else in the world, how would it affect us to see our friends preparing for the festival with a forced sense of the conventional necessity for giving? who gives himself with his gift feeds three,-- himself, his hungry neighbor, and me." that spirit should be in every christmas gift throughout christendom. the most thoughtless man or woman would recognize the truth if they could look at it quietly with due regard for the real meaning of the day. but after having heard and assented to the truth, the thoughtless people would, from force of habit, go on with the same rush and strain. it is comparatively easy to recognize the truth, but it is quite another thing to habitually recognize your own disobedience to it, and compel yourself to shun that disobedience, and so habitually to obey,--and to obey it is our only means of treating the truth with real respect. when you ask a man, about holiday time, how his wife is, not uncommonly he will say:-- "oh, she is all tired out getting ready for christmas." and how often we hear the boast:-- "i had one hundred christmas presents to buy, and i am completely worn out with the work of it." and these very women who are tired and strained with the christmas work, "put on an expression" and talk with emotion of the beauty of christmas, and the joy there is in the "christmas feeling." just so every one at the birthday party of the absent guest exclaimed with delight at all the pleasures provided, although the essential spirit of the occasion contradicted directly the qualities of the man whose birthday it was supposed to honor. how often we may hear women in the railway cars talking over their christmas shopping:-- "i got so and so for james,--that will do for him, don't you think so?" and, when her companion answers in the affirmative, she gives a sigh of relief, as if to say, now he is off my mind! poor woman, she does not know what it means to give herself with her gift. she is missing one of the essentials of the true joy of christmas day. indeed, if all her gifts are given in that spirit, she is directly contradicting the true spirit of the day. how many of us are unconsciously doing the same thing because of our--habit of regarding christmas gifts as a matter of conventional obligation. if we get the spirit of giving because of him whose birthday it is, we shall love to give, and our hearts will go out with our gifts,--and every gift, whether great or small, will be a thoughtful message of love from one to another. there are now many people, of course, who have this true spirit of christmas giving, and they are the people who most earnestly wish that they had more. then there are many more who do not know the spirit of a truly thoughtful gift, but would be glad to know it, if it could once be brought to their attention. we cannot give in a truly loving spirit if we give in order that we may receive. we cannot give truly in the spirit of christmas if we rush and hurry, and feel strained and anxious about our gifts. we cannot give truly if we give more than we can afford. people have been known to give nothing, because they could not give something expensive; they have been known to give nothing in order to avoid the trouble of careful and appropriate selection: but to refrain from giving for such reasons is as much against the true spirit of christmas as is the hurried, excited gift-making of conventionality. even now there is joy in the christmas time, in spite of the rush and hurry and selfishness, and the spirit of those who keep the joy alive by remembering whose birthday it is, serves as leaven all over the world. first let us remember what christmas stands for, and then let us try to realize the qualities of the great personality which gave the day its meaning and significance,--let us honor them truly in all our celebrations. if we do this, we shall at the same time be truly honoring the qualities, and respecting the needs of every friend to whom we give, and our gifts, whether great or small, will be full of the spirit of discriminating affection. let us realize that in order to give truly, we must give soberly and quietly, and let us take an hour or more by ourselves to think over our gifts before we begin to buy or to make them. if we do that the helpful thoughts are sure to come, and new life will come with them. a wise man has described the difference between heaven and hell by saying that in heaven, every one wants to give all that he has to every one else, and that in hell, every one wants to take away from others all they have. it is the spirit of heaven that belongs to christmas. xiv _to mothers_ most mothers know that it is better for the baby to put him into his crib and let him go quietly to sleep by himself, than to rock him to sleep or put him to sleep in his mother's arms. most mothers know also the difficulty of getting the baby into the right habit of going to sleep; and the prolonged crying that has to be endured by both mother and baby before the habit is thoroughly established. many a mother gets worn out in listening to her crying child, and goes to bed tired and jaded, although she has done nothing but sit still and listen. many more, after listening and fretting for a while, go and take up the baby, and thus they weaken him as well as their own characters. a baby who finds out, when he is two months old, that his mother will take him up if he cries, is also apt to discover, if he cries or teases enough, that his mother will let him have his own way for the rest of his life. the result is that the child rules the mother, rather than the mother the child; and this means sad trouble and disorder for both. strong, quiet beginnings are a most valuable help to all good things in life, and if a young mother could begin by learning how to sit quietly and restfully and let her baby cry until he quieted down and went to sleep, she would be laying the foundation for a very happy life with her children. the first necessity, after having seen that nothing is hurting him and that he really needs nothing, is to be willing that he should cry. a mother can make herself willing by saying over and over to herself, "it is right that he should cry; i want him to cry until he has learned to go to sleep quietly by himself he will be a stronger and a more healthy man for getting into all good habits as a child." often the mother's spirit is willing, or wants to be willing, but her nerves rebel if, while she is teaching herself to listen quietly, she will take long, quiet breaths very steadily for some time, and will occupy herself with interesting work, she will find it a great help toward dropping nervous resistance. children are much more sensitive than most people know, and readily respond to the mother's state of mind; and even though the mother is in the next room, if she is truly dropping her nervous resistance and tension, the baby will often stop his crying all the sooner, and besides, his mother will feel the good effects of her quiet yielding in her care of the baby all day long. she will be rested instead of tired when the baby has gone to sleep. she will have a more refreshing sleep herself, and she will be able to care for the baby more restfully when they are both awake. it is a universal rule that the more excited or naughty the children are, the more quiet and clear the mother should be. a mother who realizes this for the first time, and works with herself until she is free from all excited and strained resistance, discovers that it is through her care for her children that she herself has learned how to live. blessed are the children who have such a mother, and blessed is the mother of those children! it is resistance--resistance to the naughtiness or disobedience in the child that not only hurts and tires the mother, but interferes with the best growth of the child. "what!" a mother may say, "should i want my child to be naughty? what a dreadful thing!" no, we should not want our children to be naughty, but we should be willing that they should be. we should drop resistance to their naughtiness, for that will give us clear, quiet minds to help them out of their troubles. all vehemence is weak; quiet, clear decision is strong; and the child not only feels the strength of the quiet, decisive action, but he feels the help from his mother's quiet atmosphere which comes with it. if all parents realized fully that the work they do for their children should be done in themselves first, there would soon be a new and wonderful influence perceptible all about us. the greatest difficulty often comes from the fact that children have inherited the evil tendencies of their parents, which the parents themselves have not acknowledged and overcome. in these cases, most of all, the work to be done for the child must first be done in the parents. a very poor woman, who was living in one room with her husband and three children, once expressed her delight at having discovered how to manage her children better: "i see!" she said, "the more i hollers, the more the children hollers; now i am not going to holler any more." there is "hollering" of the voice, and there is "hollering" of the spirit, and children echo and suffer from both. the same thing is true from the time they are born until they are grown up, when it should be right for them to be their own fathers and mothers, so far as their characters are concerned, that they can receive the greatest possible help from their parents through quiet non-resistance to their naughtiness, combined with firm decision in demanding obedience to law,--a decision which will derive its weight and influence from the fact that the parents themselves obey the laws to which they require obedience. thus will the soul of the mother be mother to the soul of her child, and the development of mother and child be happily interdependent. it is, of course, not resisting to be grieved at the child's naughtiness,--for that grief must come as surely as penitence for our own wrongdoing. the true dropping of resistance brings with it a sense that the child is only given to us in trust, and an open, loving willingness leaves us free to learn the highest way in which the trust may be fulfilled. file was produced from images produced by core historical literature in agriculture (chla), cornell university.) the rural science series edited by l. h. bailey rural hygiene the macmillan company new york · boston · chicago atlanta · san francisco macmillan & co., limited london · bombay · calcutta melbourne the macmillan co. of canada, ltd. toronto rural hygiene by henry n. ogden, c.e. professor of sanitary engineering in college of civil engineering, cornell university special assistant engineer, new york state department of health new york the macmillan company _all rights reserved_ copyright, , by the macmillan company. set up and electrotyped. published january, . norwood press j. s. cushing co.--berwick & smith co. norwood, mass., u.s.a. preface the following pages represent an attempt to put before the rural population a systematic treatment of those special subjects included in what is popularly known as hygiene as well as those broader subjects that concern the general health of the community at large. usually the term "hygiene" has been limited in its application to a study of the health of the individual, and treatises on hygiene have concerned themselves almost entirely with discussing such topics as food, clothing, exercise, and other questions relating to the daily life of a person. of late years, however, it has become more and more evident that it is not possible for man to live to himself alone, but that his actions must react on those living in his vicinity and that the methods of living of his neighbors must react on his own well-being. this interdependence of individuals being once appreciated, it follows that a book on hygiene must deal, not only with the question of individual living, but also with those broader questions having to do with the cause and spread of disease, with the transmission of bacteria from one community to another, and with those natural influences which, more or less under the control of man, may affect a large area if their natural destructive tendencies are allowed to develop. being written by an engineer, the following pages deal rather with the structural side of public hygiene than with the medical side, and in the chapters dealing with contagious diseases emphasis is attached to quarantine, disinfection, and prevention, rather than to etiology and treatment. the book is not, therefore, a medical treatise in any sense, and is not intended to eliminate the physician or to give professional advice, although the suggestions, if followed out, undoubtedly will have the effect of lessening the need of a physician, since the contagious diseases referred to may then be confined to single individuals or to single houses. it has not been possible, within the limits of this one book, to describe at length the various engineering methods, and while it is hoped that enough has been said to point the way towards a proper selection of methods and to a right choice between processes, the details of construction will have to be worked out in all cases, either by the ingenuity of the householder or by the aid of some mechanic or engineer. finally, it may be said that two distinct purposes have been in mind throughout,--to promote the comfort and convenience of those living in the rural part of the community who, unfortunately, while most happily situated from the standpoint of health in many ways, have failed to give themselves those comforts that might so easily be added to their life; and in the second place, to emphasize the interdependence of the rural community and the urban community in the matter of food products and contagious diseases, an interdependence growing daily as interurban communications by trolley and automobile become easy. cities are learning to protect themselves against the selfishness of the individual, and city boards of health have large powers for the purpose of guarding the health of the individuals within their boundaries. the scattered populations of the open country are not yet educated to the point at which self-protection has made such authority seem to be necessary, and it is left largely to an exalted sense of duty towards their fellow-men so to move members of a rural community as to order their lives and ways to avoid sinning against public hygiene. in order to develop such a sense of honor, it is primarily necessary that the relation of cause and effect in matters of health shall be plainly understood and that the dangers to others of the neglect of preventive measures be appreciated. as a single example, the transmission of disease at school may be cited. measles, scarlet fever, whooping cough, and diphtheria are all children's diseases, easily carried and transmitted, and held in check only by preventing a sick child from coming in contact with children not sick. no law is sufficient. the matter must be left to the mother, who will retain children at home at the least suspicion of sickness and keep them there until after all traces of the disease have passed away. the health conditions in the open country, judged by the standard of statistics, are quite as good as those of the city. the comforts of country life are as yet inferior, and it is hoped that this book may do something to advance the standard of living in the families into which it may enter. h. n. ogden. ithaca, new york, november , . contents chapter i vital statistics of rural life pages death-rate. ideal death-rates. death-rates in new york state. accuracy of records. effect of children. death-rates of children. small cities. tuberculosis. diphtheria, influenza. pneumonia. old age - chapter ii location of a house--soil and surroundings damp soils. location of house. objections to trees. space between houses. composition of soils. cancer and soil conditions. topography. effects of cultivation. made ground. water in soil. drainage. ground water - chapter iii construction of houses and barns with reference to healthfulness shutting out soil air. position of outfall for drains. dampness of cellar walls. use of tar or asphalt. dry masonry for cellar walls. damp courses. the cellar floor. cellar ventilation. the old-fashioned privy. cow stables. use of concrete - chapter iv ventilation effects of bad air. modifying circumstances. dangers of polluted air. effect of changes in air. composition of air. organic matter in air. fresh-air inlet. position of inlet. foul-air outlet. size of openings. ventilation of stables. cost of ventilation. relation of heating to ventilation - chapter v quantity of water required for domestic use modern tendencies. quantity of water needed per person. quantity used in stables. maximum rate of consumption. variation in maximum rate. fire stream requirements. rain-water supply. computation for rain-water storage. computation for storage reservoir on brook. deficiency from well supplies - chapter vi sources of water-supply underground waters. ordinary dug well. construction of dug wells. deep wells. springs. extensions of springs. supply from brooks. storage reservoirs. ponds or lakes. pressure or head - chapter vii quality of water mineral matter. loss of soap. vegetable pollution. animal pollution. well water. danger of polluted water - chapter viii water-works construction methods of collection. spring reservoirs. stream supplies. dams. waste weirs. gate house. pipe lines. pumping. windmills. hydraulic rams. hot-air engines. gas engines. steam pumps. air lifts. tanks. pressure tanks - chapter ix plumbing installation. supply tank. main supply pipe. hot-water circulation. kitchen sinks. laundry tubs. hot-water boiler. water-back, wash-basin, bath-tub. cost of plumbing installation. house drainage. trap-vents. water-closets - chapter x sewage disposal definition of sewage. stream pollution. treatment of sewage on land. surface application. artificial sewage beds. subsurface tile disposal. automatic syphon. sedimentation. underdrains - chapter xi preparation and care of milk and meat bacteria in milk. effects of bacteria. diseases caused by milk. methods of obtaining clean milk. city milk. dangers of diseased meat. the slaughter-house - chapter xii foods and beverages the human mechanism. digestive processes. teachings of the digestive operations. balanced rations. human appetite. effect of individual habits. cooking. muscular and psychic reactions. consumption of water. condiments and drinks. tobacco. the drug habit - chapter xiii personal hygiene exercise. clothing. bathing. mouth breathing. eyes. teeth. sleep - chapter xiv theories of disease effects of dirt. blood resistance. cell disintegration. heredity. age and sex. occupation. direct cause of disease. parasites. bacterial agencies. antitoxins. natural immunity. chemical poisons. external causes - chapter xv disinfection disinfecting agents. antiseptics. deodorizers. patented disinfectants. disinfecting gases. sulfur. formaldehyde. liquid disinfectants. carbolic acid. coal-tar products. mercury. lime. soap. heat. dry heat. boiling water. steam. drying, light, and soil - chapter xvi tuberculosis and pneumonia tuberculosis. individual resistance. precautions by the consumptive. cure of consumption. pneumonia--the germ. weather not the cause of pneumonia. preventives in pneumonia. infection of pneumonia - chapter xvii typhoid fever cause of the disease. the bacillus. methods of transmission of typhoid. construction of wells in reference to typhoid. milk infection by typhoid. infection by flies. other sources of typhoid fever. treatment of typhoid fever - chapter xviii children's diseases after effects. preliminary symptoms. contagiousness. quarantine for scarlet fever. measles. characteristic eruption of measles. whooping cough. precautions against spread of whooping cough. chicken pox - chapter xix parasitical diseases malaria. mosquitoes and malaria. elimination of mosquitoes. limitation of mosquito infection. yellow fever. characteristics of the disease. hookworm disease. pellagra. bubonic plague - chapter xx diseases controlled by antitoxins smallpox. value of vaccination. characteristics of smallpox. treatment of smallpox. diphtheria. cause of the disease. production of diphtheria antitoxin. symptoms of diphtheria. rabies. tetanus - chapter xxi hygiene and law principle of laws of hygiene. self-interest, the real basis of law. quality of water. regulations governing foods. basis of pure food laws. protection of milk. laws governing quarantine - list of figures fig. page . map of new york state . bad conditions about a dwelling . grading that turns water away from the house . modes of laying out drains . exterior wall-drains . interior cellar-drains . wall modes of making air-space . water-tight wall . rough-backed wall . even-backed wall . modes of making water-proof cellar walls . water-proofing of cellar walls . cellar-wall forms . letting in fresh air . ventilating device . ventilating device . ventilation by means of coal stove . coal-stove ventilation . coal-stove ventilation . outlets into walls . cow-barn ventilation . how a pump works . air-lift pump . diagram of a spring . water finding its way from a hillside . the sinking of wells . mode of sinking a well . a well that will catch surface water . a well properly protected . a properly protected well . well-drilling apparatus . sinking a well by means of a water-jet . an enclosed spring . a spring extension . a reservoir for home use . stream draining a privy . contamination of a creamery from the water supply . a protected spring-chamber . concrete core in a dam . section of a flood dam . section of a flood dam . a joint in tile pipe . windmill and water tank . installation of a ram . means of securing fall for hydraulic ram . a hot-air engine . a gas engine . pump operated by belt . duplex pump operated directly by steam . raising water by means of compressed air . wooden tank . iron tank . hand pump applied to air-tank . engine applied to air-tank . windmill connection with tank . construction of a wooden tank . hot-water attachment to the kitchen stove . enameled iron sink . enameled iron laundry tubs . leveling the drain . water-supply installation . a trap . washout water-closet . washdown water-closet . syphonic closet . syphon-jet closet . sewage beds . plan of sewage beds . plan of subsurface irrigation field . section of "miller" syphon . plan and section of a septic tank . section of a septic tank with syphon chamber . plan of sewage disposal for a single house . school girl with adenoids . outdoor sleeping porch for tuberculous patients . mortality from pulmonary tuberculosis . spring infected by polluted ditch rural hygiene chapter i _vital statistics of rural life_ it is commonly supposed that good health is the invariable accompaniment of country life; that children who are brought up in the country are always rosy-cheeked, chubby, and, except for occasional colds, free from disease; that adults, both men and women, are strong to labor, like the oxen of the psalmist, and that grandfathers and grandmothers are so common and so able-bodied that in practically every farmhouse the daily chores are assigned to these aged exponents of strong constitutions and healthy lives. if, however, we are honest in our observations, or have lived on a farm in our younger days, or have kept our eyes open when visiting in the country, we will remember, one by one, certain facts which will persistently suggest that, after all, life on the farm may not be such a spring of health as we have been led to believe. we will remember the frequency of funerals, especially in the winter, and the few families in which all the children have reached maturity. we will remember the worn-out bodies of men and women, bent and aged while yet in middle life. it is worth while, then, at the beginning, to find out, if we can, just what are the conditions of health in rural communities, in order to justify any book dealing with rural hygiene; for it is plain that if health conditions are already perfect, or nearly so, no book dealing with improved methods of living is needed, and the wisdom of the grandparents may be depended on to continue such methods into the next generation. _death-rate._ the usual method of measuring the health conditions of any community, such as a city, town, county, state, or country, is to compute the general death-rate, as it is called; that is, the number of deaths occurring per population. for example, in , with its estimated population of , , , there occurred in new york state , deaths, or . deaths for every population. sixteen and two-tenths is, then, the general death-rate for the state for that year. this method of determining the health of a community is crude and should not be too strictly relied upon for proving the healthfulness implied. the rate is at best only an average, and takes no account of anything but death, one death being a greater calamity, apparently, than a dozen persons incapacitated from disease. then, too, this death-rate is greatly affected by peculiarities of the community in age, sex, nationality, and occupation, and by local conditions of climate, altitude, and soil. the effect of these local conditions can best be explained after a consideration of the general death-rate and its definite values in different places. in the united states, as a whole, or, more exactly, in that part of the united states which keeps such records of deaths as to be reliable (about one half), the annual average death-rate for the five-year period - was . , and this may be compared with the death-rate in other countries shown in the following table for the same period:-- table i. death-rates in various countries australia . austria . belgium . denmark . england . france . germany . italy . japan . netherlands . new york state . norway . spain . sweden . united states . _ideal death-rates._ there are special reasons why the australian death-rate should be low, but, neglecting this one country entirely, it will be seen that norway, denmark, and sweden have rates of . , . , and . , respectively; rates which may be considered as good as any country can attain at the present time. but the united states, as a whole, has about one more death per than these countries, and new york state two more per population. this means that in new york state there are , more deaths each year than if the population were living in sweden under swedish conditions and laws. or, expressed in another way, it means that in sweden one out of every sixty-five persons dies each year, and in new york one out of every fifty-eight persons. the rate in new york state is high because the state contains a large number of cities, and concentration of population generally implies all kinds of bad and unsanitary conditions. as a rule, a higher death-rate may be expected in a densely populated community than in a sparsely settled one, and we should therefore expect a rural community to show a lower death-rate than a city or urban community. it is not a fair estimate of the health of any rural locality, such as a county where no large cities exist, to compare its death-rate with the average of the state, or with the average rate of some other county which contains a large city. this fact is plainly brought out by the statistics in table ii, from the several sanitary districts into which the state of new york is divided, as shown on the map, fig. :-- table ii. showing varying death-rates in different parts of new york state ====================================================== | death rate in sanitary districts --------------------------- | - | | ------------------------------------------------------ new york state | . | . | . maritime | . | . | . hudson valley | . | . | . mohawk valley | . | . | . west central | . | . | . lake ontario and western | . | . | . east central | . | . | . southern tier | . | . | . adirondack and northern | . | . | . ====================================================== _death-rates in new york state._ [illustration: fig. . map of the state of new york showing the sanitary districts] the maritime district includes the four counties of new york city and comprises about half the population of the state. its population is almost entirely quartered under distinctly urban conditions, in some parts with a congestion not equaled in any other city of the country. it would naturally, therefore, have a high death-rate, and that it is no higher than it is makes it a matter for congratulation. and yet the rate in new york city is higher than in the other principal large cities of the world. for example, the rates for the five-year period - in berlin averaged . , in paris . , and in london . , new york being . for the corresponding period. the excess in new york is due in part to local conditions and in part to a less active oversight in matters of public health. similarly, the hudson valley district, which embraces the large cities along the hudson, has a higher death-rate than the state average, whereas the other six districts have low rates, chiefly because of the large proportion of agricultural land and small towns. the last district should be noted particularly, since its rate is remarkably low and its number of cities very small, compared with the area included. the conclusion may be properly drawn, therefore, that statistics confirm the general impression that life in the country is healthier than life in the city. _accuracy of death-rate records._ one factor must be considered, however, since it plays an important part in drawing conclusions from these kinds of statistics, and that is, the accuracy of the records. in a city in which every one must be buried in a public cemetery, and when the physician, the undertaker, and the sexton all have to keep records which must agree, it is not easy for any burial to occur without the fact being recorded and later registered in the census office at washington. but in the country, a person may be killed by accident, for example, and buried in a private lot without the undertaker recording it at all. the result is that the total number of deaths seems fewer and the death-rate seems smaller than the facts warrant, so that a false idea of the healthfulness of the community obtains. that errors of this sort have existed in the past can be seen by examining the death-rates for new york city and those for regions outside that city for the past ten years:-- table iii. death-rates in new york city and elsewhere in new york state, - ======================================= new york outside difference --------------------------------------- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ======================================= the decrease in the city rate is to be expected, since with greater knowledge of sanitary matters, more precautions against disease would naturally be taken. but it is not likely that the country is becoming more careless, although the tendency to concentrate population even in rural hamlets may have an effect. it is rather more likely that the reports are made more carefully and that the records are more complete now than formerly. the apparent increase in the number of deaths in rural communities is, therefore, due to greater attention in reporting deaths rather than to any real increase in the number. if the difference between the rural community death-rate and the rate in all the cities of more than population in new york state be shown, the difference between the city rate and the country rate is even less than that shown in the table, being only . deaths in for . this shows that the boasted superiority of the country over cities is not very great; that it is marked only in the case of a very large city like new york; that, as the size of the city decreases, the difference disappears, and that the country rate in the united states is high when compared with the general rate of other countries like denmark or even england, where the general rate includes the large cities. _effect of children on death-rate._ an interesting sidelight on the apparent tendency of the country to have an increasing death-rate, year by year, is shown by the meager figures which are available on the subject of the number of small children in the different towns. the chief clerk in the census office, mr. william s. rossiter, has investigated the proportion of children in two rural counties of new york state, otsego and putnam, and has discovered the startling fact that while the population in those counties has hardly changed since , the proportion of young children has decreased almost one third in the forty years ending with , as shown by the following table:-- table iv. table showing percentage of children in otsego and putnam counties, - =========================================================================== ------------------------------------------------------------------ total total white under white under county population years per cent population years per cent --------------------------------------------------------------------------- otsego , , . , , . putnam , , . , , . ------------------------------------------------------------------ total , , . , , . =========================================================================== this shows that while in , when the total population was about , , the number of children was about , or . per cent, in , when the total population was , or nearly the same, the number of children was only , or a reduction in numbers of nearly children. in many of the small cities of new york state, the fact that there is a constantly decreasing number of children in the community is well recognized, the greater proportion of the population being past middle life. the death-rate, therefore, is lower, from this very fact. _death-rates of children._ that the general death-rate is directly affected by the number of children living in a community is shown by the following table:-- table v. showing deaths from all causes in the united states for the years - , at various age periods ================================================ no. at each per cent of total age age population ------------------------------------------------ aggregate , ---- under year , . under years , . - years , . - years , . - years , . - years , . - years , . - years , . - years , . - years , . - years , . and over , . ================================================ this table shows two things: first, that children have a hard time reaching five years, as nearly one third of all the children born in any year die under five years, and second, that from five to twenty years is the healthiest--that is, safest--time of a person's life, since after twenty the constitutional diseases make themselves felt so that death becomes almost uniformly distributed from twenty to eighty. it is plain, then, that in any community a change in the relative proportion of children born in any year would change the death-rate, since with a smaller number of infants there could not be so many to die. no statistics are available to determine the number of small children in the country as compared with that in the city, but it is probable that they are in excess in the latter, since the highest birth-rates are found in the congested districts of cities where foreigners congregate. if this is so, it will account for and justify a higher rate of death in the city because of the larger number of children, as has been explained above, and the lower rate in the country may be due, not to better sanitary surroundings, but solely to fewer children. according to statistics, the death-rate of children is almost per cent higher in cities than in rural districts, and it is a general impression that most deaths in the country are from old age. english statistics show, however, and those of the united states would probably show the same thing, that while a baby born in the city is more likely to die before its first birthday than a baby born in the country, they have equal chances to finish a month of life and that the city child has better chances to live out the first week. the advantages of the country, therefore, do not begin to operate until after the first month of the baby's life, and there is a decidedly greater chance of the child's living in the city the first week on account, probably, of better and quicker medical attendance. _typhoid fever and the death-rate._ turning now to special diseases and comparing the number of deaths caused by special diseases in the country and in the city, it is to be noted, first of all, that a greater difference exists in the case of certain special diseases in the country and in the city than was found in the general death-rate. in the case of typhoid fever, basing the comparison on the statistics of the census office of the united states, we find, first, that, at present, the difference in the death-rates from typhoid fever in cities and in rural districts is very small. it is also to be seen (from the following table) that in both city and in rural districts, the rate is steadily decreasing, although in neither has the rate yet fallen to what would, in other countries, be considered a reasonable and proper death-rate. the first line of the table is the actual death-rate from typhoid fever per , population, based on the total population resident in all the united states where vital statistics are kept; the second line gives the same data for cities not included in registration states;[ ] the third line is based on figures for cities in registration states;[ ] and the fourth line is based on the statistics for rural districts and villages of less than population:-- table vi. showing death-rates per , population from typhoid fever in places indicated ============================================================================== year ------------------------------------------------------------------------------ the registration area . . . . . . . . . registration cities . . . . . . . . . cities in registration states . . . . . . . . . rural part of registration states . . . . . . . . . ============================================================================== [footnote : states in which full credit is given by u. s. census office for vital statistics collected from all parts of the state.] this table shows that, taking the united states as a whole, the typhoid-rate in rural districts is generally less than in cities and that in cities the rate is excessively high. when it is remembered that by filtration of public water-supplies the typhoid-rate may be brought down to about per , , and that cities with pure water-supplies will not exceed that rate, it is plain how serious is the danger from typhoid in such cities as cohoes or oswego. the following table from statistics taken in new york state shows the same conditions as table vi.-- table vii. showing death-rates from typhoid fever per , population in new york state as indicated ============================================================================== year ------------------------------------------------------------------------------ cities average . . . . . . . . . rural districts . . . . . . . . . average of city population -- . . . . . . . . average of rural population -- . . . . . . . . ============================================================================== the first line is the death-rate in cities, found by taking the ratio of all the deaths from typhoid in cities to the population in those cities, and the second line is a similar ratio for rural districts. if the actual rates of the several cities be averaged, a method which has the effect of giving the rate found for a city of , equal value in the average with one of , , , the third line of the table is obtained; and in the same way, by averaging the death-rates of the counties of the state, excluding cities, the fourth line is obtained. these last two lines show that the average of the city rates is noticeably higher than the average of the rural rates, and that, while since the average of the rural districts has remained uniform, the death-rate in cities has been continually decreasing. it is, then, not fair to say, despite frequent but careless statements by writers on typhoid fever, that this disease is a country disease, and that it is transmitted to the city by the vacationist who finds the disease lurking in the waters of the farm well. some years ago it was pointed out that the period of maximum development of typhoid fever is in the fall, and the conclusion was drawn that the disease was particularly prevalent then because that season is the end of the vacation period. that this is not true, or at any rate not entirely true, may be seen from the consideration of two facts, viz. first, that the death-rate in the country districts is low compared with the rates in cities, and second, that those stricken with the disease on their return to the city are quite as apt to have traveled through other cities and to have taken water from other places than farm wells. _typhoid in small cities._ as a matter of fact, the greatest danger from typhoid fever is neither in the country nor the large city, but in the village or small city. here the growth and congestion of population has made necessary the introduction of a water-supply, and in many cases this has not been supplemented by the construction of a sewerage system. the ground becomes saturated with filth, percolating, in many cases, into wells not yet abandoned, and the introduction of the typhoid germ brought in from outside is all that is needed to start a widespread epidemic. table viii. mortality from typhoid fever in the cities of new york state, showing total deaths from typhoid fever and deaths per , population =============================================================================== |average | |rate per| | , | rate per , |for ten | ---------------------------------------------------------- city |years | | | | | | | | | | ------------------------------------------------------------------------------- | _cities using unfiltered lake water:_ auburn | . | . | . | . | . | . | . | . | . | . | . dunkirk | . | . | . | . | . | . | . | . | . | . | . geneva | . | . | --- | . | . | . | . | . | . | . | . ------------------------------------------------------------------------------- | _cities using unfiltered river water:_ cohoes | . | . | . | . | . | . | . | . | . | . | . lockport | . | . | . | . | . | . | . | . | . | . | . niagara | | | | | | | | | | | falls | . | . | . | . | . | . | . | . | . | . | . north | | | | | | | | | | | tonawanda| . | . | . | . | . | . | . | . | . | . | . ogdensburg| . | . | . | . | . | . | . | . | . | . | . oswego | . | . | . | . | . | . | . | . | . | . | . rome | . | . | . | . | . | . | . | . | . | . | . tonawanda | . | . | . | . | --- | . | . | . | . | . | . ------------------------------------------------------------------------------- | _cities using filtered river water:_ albany | . | . | . | . | . | . | . | . | . | . | . binghamton| . | . | . | . | . | . | . | . | . | . | . elmira | . | . | . | . | . | . | . | . | . | . | . pough- | | | | | | | | | | | keepsie | . | . | . | . | . | . | . | . | . | . | . rensselaer| . | . | . | . | . | . | . | . | . | . | . watertown | . | . | . | . | . | . | . | . | . | . | . watervliet| . | . | . | . | . | . | . | . | . | . | . ------------------------------------------------------------------------------- | _cities using well or spring water:_ corning | . | . | . | . | . | . | . | . | . | . | . cortland | . | . | . | . | . | --- | . | . | . | . | . fulton | . | . | --| . | . | . | . | . | . | . | . ithaca | . | . | . | . | . | . | . | . | . | -- | . olean | . | . | . | . | . | . | . | --- | . | . | . jamestown | . | . | . | . | . | . | . | . | . | . | . schen- | | | | | | | | | | | ectady | . | . | . | . | . | . | . | . | . | . | . -------------------------------------------------------------------------------- | _cities using water from streams and reservoirs:_ amsterdam | . | . | . | . | . | . | . | . | . | . | --- glens | | | | | | | | | | | falls | . | . | . | . | . | . | . | . | . | . | . glovers- | | | | | | | | | | | ville | . | . | . | . | . | . | . | . | . | . | . johnstown | . | . | . | -- | . | . | --- | . | . | --- | . newburgh | . | . | . | . | . | . | . | . | . | . | . new | | | | | | | | | | | rochelle | . | . | . | . | . | . | . | . | . | . | . plattsburg| . | . | . | . | . | . | --- | . | . | . | --- troy | . | . | . | . | . | . | . | . | . | . | . utica | . | . | . | . | . | . | . | . | . | . | . port | | | | | | | | | | | jervis | . | . | . | . | . | . | . | . | . | . | --- little | | | | | | | | | | | falls | . | . | . | . | . | . | . | --- | . | . | . oneida | . | . | . | . | . | --- | . | --- | . | --- | . ------------------------------------------------------------------------------- | _cities using filtered surface water:_ hornell | . | . | . | . | . | . | . | . | . | . | . hudson | . | . | . | . | . | . | . | . | . | . | . kingston | . | . | . | . | . | . | . | . | . | . | . middleton | . | . | . | . | . | . | . | . | . | . | . mount | | | | | | | | | | | vernon | . | . | . | . | . | . | . | . | . | . | . oneonta | . | . | . | . | . | . | . | . | . | . | . yonkers | . | . | . | . | . | . | . | . | . | . | . =============================================================================== another reason for the prevalence of this disease in small cities is that the organization of their health boards is much less effective than that of larger cities. individuals have not yet learned to sacrifice their own wishes for the sake of the community, and the local health officer, however much he may desire to do his duty, is not upheld by public opinion, and is therefore powerless. in order to show the condition existing in the small cities of the state of new york, the preceding table has been prepared, showing the average death-rate for the cities of the state for the past ten years, excluding, however, the cities of new york, buffalo, rochester, and syracuse, all of which have well-organized health boards, and where no epidemic of typhoid fever may be expected. remembering that a rate of per , is a normal rate, it will be easily seen how excessive is the amount of typhoid fever in most of the cities of new york state. table ix. showing deaths from tuberculosis per , population in the united states =============================================================================== | | | | | | | | | ------------------------------------------------------------------------------- the registration| | | | | | | | | area | . | . | . | . | . | . | . | . | . registration | | | | | | | | | cities | . | . | . | . | . | . | . | . | . cities in | | | | | | | | | registration | | | | | | | | | states | . | . | . | . | . | . | . | . | . rural part of | | | | | | | | | registration | | | | | | | | | states | . | . | . | . | . | . | . | . | . =============================================================================== _tuberculosis death-rate._ turning now to tuberculosis, the death-rate in cities is very markedly higher than in rural districts, and the superiority of the country as a place to live is hereby plainly demonstrated. the preceding table shows the death rate from tuberculosis in cities for the years - , the data being taken from the united states census reports. the death-rate in the cities is evidently about per , greater than in the rural districts, due, of course, to the crowding in city tenements. this is true for nearly all cities, although the difference is more marked in some parts of the country than in others. in massachusetts, for example, the death-rate in rural districts is slightly higher than the death-rate in cities, but tuberculosis is much more prevalent in that state than in any other part of the country. in new york state the rate in cities is about per , greater than in rural districts, due, presumably, to the larger number of manufacturing centers in this state. in new york city the rate is constantly more than , and in in the borough of the bronx it was nearly . _diphtheria as affecting the rate._ diphtheria is another disease that exacts heavier toll from the cities than from the country, about three times as many deaths occurring in the former as in the latter. _influenza, and its effect on death-rate._ influenza is, on the other hand, markedly severe on people in rural districts, the death-rate there being more than twice as high as in the cities. it is easy to see why this is. lack of sidewalks, lack of protection, lack of uniform temperature in the houses, and the lack of care in the first stages of illness, all tend to increase the death-rate from this disease. _pneumonia._ the death-rate from pneumonia, on the other hand, is higher in the city, the vitality and power of resistance of victims probably being reduced under average city conditions. _other diseases._ diseases that are induced by water, all referred to under typhoid fever, but extending into such complaints as diarrhoea and enteritis, are much more severe in cities than in the country. such an excess of general intestinal diseases shows again that a polluted water-supply is not peculiar to the country, but is responsible for an excessive death-rate in the city. most of the constitutional diseases also have higher death-rates in the city than in the country. bright's disease, for example, for the five years - , had an average rate in cities of . per , , while for the same five years in the rural districts the rate was only . . _old age and the death-rate._ further showing the advantage of country life, it is to be noted that the number of deaths from old age in rural districts is nearly double that in cities. for example, in the same period already referred to the death-rate in cities of persons over sixty was . , while in the rural districts, for the same period, it was . ,--nearly double. _the need for attention to rural hygiene._ one must conclude, therefore, that the chances of living are increased through residence in the country or in rural districts, and one is therefore led to ask why, if conditions there are superior to those in the city, is it necessary to deal with the question of rural hygiene, and why attempt to improve conditions which are already evidently superior to those in cities. the answer to this must lie in the statement that the death-rate does not tell the whole story of public health. so far as the real welfare of a community is concerned, the standard should be that of the efficiency of the lives in the different age periods rather than the length of those periods. by efficiency in such a connection is meant not merely a life that is free enough from disease to permit the full number of working days in the year, and the full number of years in the man's life usually devoted to toil, or all together a life that contributes something of value to the world, whether produce from the farm or books evolved from the brain; but efficiency here means that composite development of the whole man--body, mind, and spirit--which we believe must have been intended when man was created with this threefold nature. it is in this composite development that those living in the country are sadly lacking in efficiency. not to the same extent as twenty-five years ago, but still too often is the farmer so exhausted by bodily toil that he has left no strength for the cultivation of either mind or spirit. for the brief period of spring and summer, the good farmer in the eastern states works himself harder than any slave of old. up with the sun, or earlier, he follows through the long day the hardest kind of manual labor. when the end of the day comes, after fifteen hours' physical strain, his weary body demands sleep, and no vitality is left for mental improvement. in the winter, on the other hand, a lack of exercise is enforced, and the resulting interference with normal functions is so great that he lives the winter through in a sort of hibernation. he is nearly poisoned by lack of ventilation in the small living room, where the one stove makes living possible; he gets fat and indolent, and then with relaxed muscles plunges into furious labor again when spring comes round. "no wonder," says woods hutchinson, "that by forty-five he has had a sunstroke and 'can't stand the heat' or has a 'weak back' or his 'heart gives out' or a chill 'makes him rheumatic.'" such a life is not efficient any more than a steam engine is efficient when half the time it is run at such high speed that it tends to shake itself to pieces and the other half of the time it stands idle. nor are the conditions under which farmers' wives live any better. statistics show that the highest percentage of insanity in any class of persons in the united states (due chiefly to overwork, overworry, and lack of proper amusements and recreation) is to be found among farmers' wives. an ideal life is not one which merely rounds out the allotted span, but one which, during that span, is measurably free from ailments and disabilities and in a condition to claim a share in the joy of living which belongs to every human being by reason of his existence. such lives, to be sure, are seldom found, and no system of statistics yet devised has been able to take account of those ailments. insurance companies, which make good losses for inability to work and which return the cost of medicines and doctors' bills, give the only information on the subject. from these, it has been shown that for each death in a community there are a little more than two years of illness. or, expressed differently, for every death occurring in a village, there are two persons constantly ill during the year. or, still differently, there are, on the average, thirteen days' sickness per year for every person in a community. it is the aim of all hygienic efforts to prevent not merely premature death, but also the inefficiency of unhealthy living, and it is the latter condition rather than the former which generally prevails in rural communities. as we have seen, the death-rates in the country, except for pneumonia, are not noticeably higher than in the city. but by minor ailments, with the resulting loss of daily efficiency, the rural communities are sadly overburdened. as irving fisher says in his report on national vitality:-- "but prevention is merely the first step in increasing the breadth of life. life is to be broadened not only negatively by diminishing those disabilities which narrow it, but also positively by increasing the cultivation of vitality. here we leave the realm of medicine and enter the realm of physical training.... beyond athletic sports in turn comes mental, moral, and spiritual culture, the highest product of health cultivation. it is an encouraging sign of the times that the ecclesiastical view of the middle ages, which associated saintliness with sickness, has given way to modern 'muscular christianity.'... this is but one evidence of the tendency toward the 'religion of healthymindedness' described by professor james. epictetus taught that no one could be the highest type of philosopher unless in exuberant health. expressions of emerson's and walt whitman's show how much their spiritual exaltation was bound up with health ideals. 'give me health and a day,' said emerson, 'and i will make the pomp of emperors ridiculous.' it is only when these health ideals take a deep hold that a nation can achieve its highest development. any country which adopts such ideals as an integral part of its practical life philosophy may be expected to reach or even excel the development of the health-loving greeks." chapter ii _location of a house--soil and surroundings_ in attempting to develop a system of rural hygiene, by means of which the full value of the advantages of pure air and sunlight, of healthful exercise and sound sleep, may be realized, the first step should be a proper location of the house. for, while it is possible to have good health in houses not advantageously located, and while the influence of unsanitary surroundings is not as great as was formerly supposed, yet there can be no question but that some influences, whether they be great or small, must result directly from the situation of a dwelling. for example, it has been noticed that a house whose cellar was damp was an unhealthy house to live in, and early text-books on hygiene quote statistics at length to prove this fact. the early theories connecting ill-health with conditions in and around the house have been handed down, and to-day some are accepted as true, although by the modern science of bacteriology most of the early notions have been upset. for example, it was considered dangerous to breathe night air in the vicinity of swamps, and in one of the rollo books, so much read by the children of the last generation, uncle george requires rollo, on a night journey through the italian marshes, to stay inside the coach with the windows closed in order not to breathe the night air and so contract malarial fever. we know to-day that malarial fever comes only from mosquitoes, that night air has nothing to do with disease, and we hear the general advice of doctors that, except where it means the admission of mosquitoes, we should always sleep with our windows open in order to breathe as much night air as possible, because the night air is purer than any other air. these early traditions have not only concerned themselves with damp cellars and night air, but they have insisted that even the vicinity of a swamp or pond might lead to disease, and the state department of health of new york is in constant receipt of complaints because of alleged danger to health on account of some pond or swamp in the vicinity of houses. again, one tradition says that a house should not be located in the midst of a dense growth of trees, because the shade of the trees, however welcome in summer, will generate and maintain a condition of dampness in the house and, therefore, be injurious to the health of the inmates. another tradition is that a house ought not to be located in a valley, but that a hilltop, or at least a sidehill elevation, is preferable, the possible dampness of the valley being alleged again as the reason. to-day, so far as is known, there is no direct evidence of dampness being primarily responsible for any disease, although, heretofore, such diseases as typhoid fever, yellow fever, bilious fever, malarial fever, cholera, and dysentery have all been attributed to miasms springing from damp soil. to-day we are assured by experts that none of these diseases are induced by dampness alone. one could spend his days immersed in water up to his chin and never contract any sickness of the types mentioned merely through that act. later on, we shall show how the presence of swamps in the vicinity of a house is objectionable because of their providing breeding places for insects, but the dampness itself never has and never will cause disease. as a concrete example, it may be noted that the country of holland, in large part lying below the level of the sea, with drainage canals and ditches everywhere in evidence, is, in spite of such manifest possibilities of dampness, one of the most healthy countries in the world, as already pointed out in chapter i. this fact not only emphasizes the small effect of surface waters and damp soils in promoting disease, but also magnifies the value of cleanliness for which the dutch people are so famous. _damp soils._ why is it, then, that damp soils and damp cellars are objected to? chiefly, because of the inconvenience and discomfort they occasion. a damp cellar means conditions favorable to the development of mildew and rot; prevents vegetables from keeping a normal length of time; accounts for moldy, decaying odors throughout the house, and is generally disagreeable. one is tempted to say that such a condition is also unhealthy, and it is quite possible that a person living over a damp cellar which contains accumulations of decaying vegetables, and breathing air loaded with organic compounds, may gradually lose his normal vitality, and become thereby more readily susceptible to specific diseases, but the diseases themselves will not come from the dampness alone. [illustration: fig. --bad conditions about a dwelling.] the discomfort and inconvenience, however, are quite sufficient reasons to make it eminently desirable to have the house and the cellar dry. with this in mind, the selection of the house site should be carefully made. instinctively, and with reason, the immediate neighborhood of low, swampy, marshy ground, of stagnant ponds, or of sluggish streams should be avoided. it should not be necessary to warn prospective builders that low land, subject to inundation, even though this may happen only occasionally, is not a wise choice of a building site. figure shows an inundation in a small village of new york state in . floods are expected each spring and counted on as a part of the year's experience. the resulting exposure and the inevitable effluvia following the receding waters are both objectionable factors in hygienic living. similarly, the vicinity of a stream carrying organic matter, such as sewage from a town above, should undoubtedly be avoided on account of possible odors in summer. not long ago, the writer was told by the owner of a productive farm, situated below a small city in new york state, that in the summer time the windows of his house had all to be kept tightly shut at night, because of the effluvia from a stream a thousand feet distant, which carried the sewage from the city above. _location of house._ a deep and narrow valley should be avoided, not so much because of the possible dampness in the valley, but because of the noticeably lessened amount of sunlight which such a location involves. for such a house, the morning sun comes up much later, and the afternoon sun disappears much earlier, and, since sunlight is the best foe to disease, the more sunlight enters a house, the healthier are those who live in it. on the other hand, the top of a hill exposes a house to strong and cold winds, not desirable on any account, and involving a large expense for heating in winter. sloping ground, therefore, facing the south if possible, or better, some knoll which rises above the general surface of a southern slope, affords an ideal location. if the slope is toward the south, north winds are kept off, and every ray of the life-giving winter's sun is captured. if the house itself faces due south, the windows on the north have no sunlight. if, on the other hand, the house faces southeast or southwest, then all sides of the house will receive direct sunlight at some time of the day. _objections to trees._ the vicinity of trees is not to be regarded as altogether evil, since they provide both shade in summer and a screen against winds in the winter. no disease comes from dampness because of their presence, and the worst thing which may be charged against a thick growth is that it keeps out the sun. practically two points may, however, be urged against trees growing too close to a house. if near enough for leaves to drop on the roof, rain troughs and leaders become stopped up and cause trouble. a thick growth directly over a shingle roof allows organic matter to accumulate on the shingles, so that vegetation develops and the roof decays more rapidly than if exposed to sun and wind. again, and it is no trivial matter, a house whose roof is easily accessible from trees is apt to become infested with squirrels, who get into the attic, run through the walls, and become a great nuisance. for these reasons, then, trees should be far enough away from the house to allow the sun to enter the windows freely and to keep away from the roof objectionable animals, large and small. _space between houses._ it is a law or custom as ancient as the romans that requires a proprietor to build his house so that the eaves should not overhang on the land of his neighbor. our grandfathers, with the same idea, used to say that a man should be able to drive his team around his house on his own land. in our day it is highly desirable that a house should be built so as to leave as much land under control between the buildings and the lot line as possible. this, of course, does not apply to houses built on a farm of a hundred acres or more, but rather to the house in a small village where a few hundred people live closely together, under rural conditions. in such a village the water-supply usually comes from wells, and the wastes of the household are discharged into privies and cesspools. there is no law, unfortunately, which restricts the location of either of these two essential structures, and it is quite possible for a well, built within a few feet of a property line, to be ruined in quality by a cesspool, built later, on the other side of the line. it seems very unjust that, after the trouble and expense of building a well, a neighbor may render it worthless by the location of his cesspool, and yet, unless one can prove a direct underground connection between well and cesspool, no law is applicable to prevent the construction of the latter. besides such a menace to health, there are other objections to the immediate vicinity of neighbors which can be avoided by a judicious interposition of space. for example, the writer listened through a long evening, recently, to a hearing before a city commissioner of health, where one householder and a crowd of witnesses complained of the noise made by a kicking horse in an adjacent stable. the one witness who was not disturbed by the noise, and who lived in the vicinity, was unexpectedly found to be deaf. it is wisdom also to have a reasonable space between a house and the highway, chiefly because the dust of the road is thereby kept from the house. there are people who find much enjoyment in watching passers-by on the road, and with them front windows would be as close to the road as possible, but it is wiser to have a front yard of at least fifty feet depth when possible. finally, the location on a sidehill, even when otherwise advantageous, is to be regarded with suspicion if the subsoil strata are horizontal and neighbors up the slope have cesspools in use. the writer knows of several cesspools, built in rock, which, so far as their owners were concerned, have worked successfully for many years, but the water leeching away through the rock was finally discovered to be the cause of continual dampness in neighboring cellars, on lower ground, to the manifest discomfort of those occupying the houses. _composition of soils._ having thus discussed the location of the house with reference to its surroundings, let us now more carefully examine the character of the soil or earth foundation on which the house shall be built. all soil is made up of varying proportions of mineral and vegetable matter in the interstices of which there are usually to be found more or less air, water, and watery vapor. the mineral substances of soil include almost all of the known minerals, although many of them are found in exceedingly small quantities. the most common and the most important mineral elements of the soil of new york state are carbon, silicon, aluminum, and calcium, which combine in various ways to make either sand, sandstone, clay, shale, limestone, or other rock. the particular form which these mineral elements assume is of interest in choosing a location for a house, for two reasons:-- in the first place, it has been asserted that the mineral constituents of a soil directly affect the health of persons living on that material. for instance, the earlier writers on hygiene gravely pointed out that very hard granite rocks, when weathered and disintegrated, became permeated by a fungus and caused malaria. we are, however, now so sure of the cause of malaria that we only laugh at a theory upheld by scientists of only twenty years ago. some constitutional diseases, including goiter and cancer, have been supposed to flourish in localities where an excess of calcium exists in the soil, and it is true that these diseases do have an unusual prevalence in certain limited districts; but no modern scientist ventures to say whether the boundaries of those districts are determined by the character of the soil constituents or by some other predisposing factor. the truth is that, in matters not absolutely determined by science, many theories usually have to be evolved and proved worthless before the real cause is found. in the matter of appendicitis, for instance, it was formerly asserted that the seed of grapes was responsible for the local inflammation, and that one could never have appendicitis if such seeds were not swallowed. this theory is to-day almost forgotten, and one eminent surgeon has asserted that the prevalence of this disease in a district depends on the calcium in the soil, since it is to that mineral that hard water is due, although this has not been substantiated. no information is to-day available by which the fitness of a soil for securing sanitary conditions of building can be determined. _cancer and soil conditions._ in the case of cancer, however, while no final conclusions can be drawn, there is some definite indication that the soil conditions have connection with the occurrence and continued appearance of cancer. it is known that this dread disease is abnormally prevalent in certain districts of the world where topography and climate are fairly alike. for example, the entire region between the danube and the alps from vienna westward and between the jura and alps to geneva furnishes the highest mortality from cancer in all europe. the subsoil is clay with a thin covering of surface soil, the hillsides draining on to level valleys with meandering watercourses that frequently inundate and supersaturate the already moist soil. this condition seems to prevail wherever cancer is abnormally prevalent. in england, in northwestern france, and in spain the topography described in every case accompanies a high death-rate from cancer. it is of great interest to find that in new york state the two districts that are conspicuously affected by this disease have the same topography. the unadilla valley and some parts of the allegheny valley are noted for their cancer houses, and in both localities we find the same kinds of hillsides and water-soaked valleys as in germany and france. it has also been noted that the older geological formations are free from the disease and that an occasional inundation does not seem to be a factor. altogether there seems to be some ground for assuming a connection between cancer and soil conditions, at any rate until scientists have determined the real cause of the disease in those localities where it is now so markedly prevalent. _topography._ the soil, however, with its mineral characteristics, does indirectly affect the health of the householder because different kinds of rock form themselves naturally into different surface formations, some healthy and some unhealthy. for example, localities where granite rock abounds and comes near the surface are usually healthy because the surface slope is great enough to carry off all drainage water rapidly. the air therefore is dry and not influenced by the immediate vicinity of swamps. the drinking water is soft, and malarial breeding places are usually absent. limestone rock, on the other hand, is commonly laid down in horizontal strata, and while a succession of strata may frequently give rapid slopes, marshes are very common, existing even on the tops of the hills. the drinking water is always to be suspected as to quality because, in the first place, it is hard from absorption of lime, and in the next place, cavities and seams in the rock allow polluting material to travel for long distances. sandstone, being porous, may be considered a healthy foundation, and sands and gravels of all sorts are usually free from marshy land. gravel has always been assumed to be the healthiest soil on which a house could be built, provided the ground water reaches its highest stage three or four feet below the cellar bottom. sand is equally desirable except in the cases where vegetable matter has been mixed with the sand, rendering decay imminent. water drawn from such sands in the form of springs will contain large quantities of nitrates which may lead to excessive development of vegetable life and may have on the human system the same laxative effect as comes from drinking swamp water. clays and heavy alluvial soils are not usually considered desirable soils on which to build. water does not run from such soils; they hold moisture, and hence are always damp, and marshes are very apt to exist in the vicinity. _effects of cultivation._ it was formerly thought that extensive cultivation was objectionable from the standpoint of health, that manured fields in the vicinity of a house were undesirable, and that the turning up of a well-manured field with a plow in the spring was a very likely source of fever. it is a very common belief to-day that when water pipes are to be laid in city streets, thereby disturbing the soil and bringing fresh earth to the surface, typhoid or other fevers may be expected. there is, however, no ground for this belief, and the fact that laborers and their families live healthily in the midst of the thousands of acres of sewage-irrigated fields near berlin, where the heavily manured fields are constantly being plowed, is a sure proof of this. the earlier text-books on hygiene all assert, however, the contrary; parkes, for instance, says that irrigated lands, especially rice fields, which give a great surface for evaporation and also exhale organic matter into the air, are hurtful, and in northern italy the rice grounds are required to be three quarters of a mile from the small towns to protect the village inhabitants against fevers. there is no ground, however, for such a requirement. no evidence can be found that men who work in sewers and who breathe sewer air all the time are especially unhealthy. statistics show that the laborers on the sewage fields of paris and berlin are actually healthier than the average person living within those cities. no reason can be assigned, based on our present knowledge of bacteriology, why upturned earth or manured fields should be unhealthy except as the breeding of insects may be encouraged thereby. the two essentials, however, which should be considered are: first, the topography or the formation of the soil in order that the surface water may run off freely, and second, the character of the soil so that ground water may not remain too near the surface. whether the soil is rock or gravel makes very little difference. _made ground._ one kind of soil, however, is distinctly objectionable, although, fortunately, in the country such a soil is unusual: that is, a soil made up of refuse, whether it be garbage, street sweepings from a near-by city, or factory refuse. the writer has in mind one enterprising landowner and farmer who offered a near-by city the free privilege of dumping the city garbage on his land. this was done for several years, and the low-lying districts of his farm were all filled to a more advantageous level. this garbage was then covered with about a foot of dirt and the land sold in building lots to enterprising laborers determined to own their own homes. according to the old theories of hygiene, the occupants of such houses should have died like rats, but no particular excess of sickness in the one hundred houses so located could be observed. one must, however, believe, as we shall see later, that the repeated breathing of air drawn from such polluted soil must be unhealthy, even though the mortality records fail to show it. it is interesting in this connection to note that the organic matter in soil gradually disappears, just as a body buried in a grave will finally decompose. experiments show that such organic matter as wheat straw or cloth in small pieces rots and decays in about three years. but this depends very largely on an excess of air. if the soil is open and the organic matter loose, oxidation takes place rapidly; but if a large pile of organic matter is buried in clay soil, it will take decades for it to disappear. the vegetable matter in soil is usually produced by the decay of plants which have either grown on the soil or have been washed down into its voids. a great deal was formerly written on the relation between this organic matter and the prevalence of malaria, and some earlier writers believed that the amount of malaria in a district was dependent upon the amount of vegetable débris in the soil. since we have learned that malaria is carried by mosquitoes, we are less interested in the amount of organic matter in the soil. its mere presence is not likely to be injurious. _water in the soil._ only the hardest rocks are entirely solid, the others containing a certain percentage of voids or interstices. these voids are filled with air or water, as the case may be, and we may stop for a moment to inquire the effect of the presence of this air and water. in loose sands the amount of voids is to per cent of the total volume, in sandstone about per cent, and in other rock reduced amounts. the volume of air, therefore, in the soil under a cellar to a depth of four or five feet, amounts to a good many cubic feet and would not be worth inquiring into except for the fact that it is continually in a state of motion. when the ground water, perhaps normally five feet below the cellar bottom, rises in the spring, this ground air is forced out, and in a cellar without a concrete foundation it rises into the cellar and penetrates into the house. a house artificially warmed by stoves is continually discharging heated air from the tops of the rooms and colder air is being brought in from below to take its place. this air comes from the ground below, and in open soil may come from a great depth. a case has been noted where gas escaping from a main in a city street twenty feet from a cellar wall was, by the suction due to heat, drawn into the cellar and thence into the rooms of the house. it is possible that air from cesspools and broken drains in the vicinity of a house may, in this same way, contribute to the atmosphere breathed within the walls of the house. gravelly and sandy soils, therefore, in order to maintain the superiority which they furnish for building construction, should not be polluted, since any pollution in the vicinity influences the quality of air which may get into the house. the method of preventing such ingress is plainly to water-proof the outside walls of the cellar and provide an air-tight floor over the cellar bottom. methods of doing this will be discussed in the next chapter. _moisture in soils._ the presence of water in the soil has usually been considered to be unhealthy because of the impression that it led to certain fevers. the writer has heard, for instance, of an attack of malaria being caused by a short visit to a damp vegetable cellar; and it is one of the triumphs of the century that the malarial parasite has been discovered, and the old theory of the dangers of moisture been done away with. a damp cellar has always been considered to be undesirable, but just why nobody knows. a damp cellar causes molds to form rapidly, thus destroying vegetables and other material which might naturally be stored there, but that the presence of moisture in a cellar in itself produces any organic emanation leading to disease is not true, although dampness is essential to the growth of certain organisms. in the latter part of the nineteenth century, dr. bowditch, of boston, showed that consumption developed most where the surrounding soil was moist, and generally it is the impression that dry air is the only proper air for a consumptive person to breathe. this theory, however, is being rapidly exploded, and patients now remain outdoors in any weather, and no kind of air is objected to by physicians, provided it is outdoor air. some little time ago the writer was called by a board of health to investigate a certain swamp which had some odor, was considered a blot on the landscape in an unusually picturesque village, and was said to be responsible for a long list of contagious diseases. a house-to-house inquiry in the vicinity showed that among some dozen families, only one illness in the last few years could be remembered, and that was an old lady who had been on the verge of the grave for forty years. it is curious to note the many examples which are cited by the earlier sanitarians to prove the dangerous effect of damp soil. for example, pettenkofer, a very prominent german hygienist, says that in two royal stables near munich, with the same arrangements as to stalls, feed, and attendance, and the same class of horses, fever affected the horses very unequally. in one stable, fever was continually prevalent; in the other, no fever was found. horses sent from the unhealthful to the healthful stables did not communicate the disease. the difference between the two places, says pettenkofer, was that in the healthful stables the ground water was five to six feet below the surface, while in the unhealthful ones it was only two and a half feet from the surface. a system of drainage by which the ground water was brought to the same level under both stables made them equally healthful. the writer cannot help but feel that some other factor was involved, and while he has no doubt that excessive dampness in stables or cellars is undesirable, he does not believe that such dampness can be directly the cause of fevers of any sort. it is not desirable, however, to live over a wet cellar nor to maintain a house in a constant condition of dampness, partly on account of its bad effect on the house and partly because such dampness may, by reducing the vitality of the household, become a predisposing factor in disease. _drainage._ from whatever source dampness may come, it can be guarded against by giving to the surface of the ground in the vicinity of the house, on all sides, sufficient slope away from the walls so that there will be no tendency for water to accumulate against the cellar walls. on the top of a hill this is very easy to do, and the natural surface grade takes care of the surface water without difficulty. on a sidehill or in a valley artificial grading has to be resorted to, except on one side. [illustration: fig. .--a grading that turns water away from the house.] too much emphasis cannot be laid on the necessity for grading the ground surface away from the house. in some cases it may be sufficient to dig a broad shallow trench protected from wash by sods (fig. ). in other cases it may be desirable to pave the ditch with cobble stones or to build a cement gutter. in constructing such a surface drain, proper allowance must be made for the accumulation of snow and the resulting amount of water in the spring, so that the distance in which the ground slopes away from the house ought to be, if possible, at least ten feet, so that there can be no standing water to penetrate the house walls. the slope necessary to carry surface water away need not be great. a fall of one foot in one hundred will be ample, even on grassy areas, and if the surface is that of a macadam road or the gutters of a drive, this grade may be cut in two. a slope of more than one foot in one hundred is permissible up to a maximum of seven or eight feet per hundred, more than this being æsthetically objectionable and tending to make the house appear too high. whenever gutters are built in driveways or ditches to intercept water coming down the slopes, a suitable outlet must be provided to carry the water thus collected either into underground pipes, by which the water is led to some stream or gulley, or directly into some well-marked surface depression. _ground water._ the soil always contains water at a greater or less depth, and the elevation of this "ground water," as it is called, varies throughout the year partly with the rainfall and partly with the elevation of the water level in the near-by streams. it is not at all unusual for this ground water to rise and fall six feet or more within the year, high levels coming usually in the spring and fall, and low levels in the late summer and winter. it is easily possible, then, that a house cellar may seem dry at the time of construction in summer and may develop water to a foot or more in depth after occupancy. the presence of such an amount of water in a cellar, whether injurious to health or not, is objectionable, and a subsoil trench should be provided in order to limit the height to which ground water may rise. if a system of drainpipes is led around a house extending outward to include the surrounding yard, then the ground water will always be maintained at the level of those pipes, provided the system has a free outlet. indeed, the question of an outlet for a drainage system is a most important factor, and no system of underdrains can be effective unless a stream or gulley or depression of some kind is available into which the drains may discharge. it is for this reason, quite as much as for any other, that the location of a house on a perfectly level bottom land is objectionable, since the ground there may be normally full of water with no existing depression into which it may be drained. in the next chapter the proper method of laying drains close to the cellar wall, for the purpose of taking away the dampness from those walls, is described, but another system of drains is desirable, covering more area and more thoroughly drying the ground, provided the ground water needs attention at all. these drains should be laid like all agricultural drainage; and while substitution of broken stone, bundles of twigs, wooden boxes, or flat stone may be made, the only proper material to be used is burnt clay in the form of tile. these tiles are made in a variety of patterns, but the most common in use to-day is one which is octagonal outside and circular inside. they are about one foot in length and may be had from two to six inches inside diameter. the ordinary size for laterals is four-inch diameter, while the mains into which these laterals discharge are generally of six-inch diameter. these tiles are laid in trenches about fifteen feet apart, although in porous soil, such as coarse sand or gravel, this distance may be increased to twenty feet. if the tiles are laid more than four feet below the surface, this distance may be increased, and if the tiles are five feet deep, the distance apart of the several lines may be fifty feet. the grade of the line must be carefully taken care of, and while it is possible to lay a line of tile with a carpenter's level and a sixteen-foot straightedge, it is much safer to have an engineer's or architect's level and set grade stakes, as in regular sewer work. a fall of one fourth of an inch to the foot is a proper grade, although a greater slope is not objectionable. it is sometimes desirable in soft ground to lay down a board six inches wide in the bottom of a trench on which to rest the tile, but, unless the ground is very soft, this is not necessary. care must be taken, however, if the board is not used, to have the bottom of the trench very carefully smoothed so that a perfectly even grade in the tile is maintained. there are three ways of laying out a line of trench as shown in the following sketches (fig. ). it is usually sufficient to run parallel lines of tile from fifteen to fifty feet apart over the area which it is desired to drain, and let the ends of these lines enter a cross line which shall carry off the water led into it. this cross line should be six inches in diameter as a general rule, unless there is more than a mile of small drains, in which case the size of the cross pipe ought to be increased to eight inches. this cross line then becomes the main outlet, and great care must be taken to see that it has a perfectly free delivery at all times of the year. in cities and sometimes in small villages it is possible to discharge this outlet pipe into a regular public sewer, provided the sewer is deep enough, and provided the municipal ordinances allow such a connection. otherwise, the outfall must be carried to a natural depression. [illustration: fig. .--modes of laying out drains.] in level ground, the problem of finding a suitable outlet is a serious one, and in many cases impossible of solution, so that the householder, being unable to find an outlet, must put up with the ground water and be as patient as possible during its prevalence. it does not do to trust one's eye to find a practicable outlet, since even a trained eye is easily deceived. an engineer with a level can tell in a few moments where a proper point of discharge may be found, and it is absurd to begrudge the small amount which it will cost, in view of the large expense involved in digging a long trench to no purpose. some years ago the writer was able to note the conditions in a house where the cellar excavation went three feet into limestone rock. the strata were perfectly level and the cellar floor of natural rock was apparently all that could be desired, smooth and flat, without involving any expense for concrete. one wall came where a vertical seam in the rock existed, and since this natural rock face was smooth and vertical and just where the cellar wall should go, it seemed unnecessary to dig it out and lay up masonry in its place. so it was left and the house built. when the spring rains came, however, the cellar was turned into a pond, water dripping everywhere from the vertical rock face, and coming up through the cellar bottom like springs. it cost a great deal more then to make the changes and improvements necessary in order to secure a dry cellar than it would have done at the outset. this serves as an illustration of the need of taking every precaution at the beginning to insure a dry and well-drained soil around and below the cellar walls. chapter iii _construction of houses and barns with reference to healthfulness_ any liability to disease that may come from faulty construction of habitations is likely to spring from a polluted subsoil. such pollution vitiates the air drawn from that soil and is a source of danger on account of the resulting impurity of the whole atmosphere within the house. _shutting out soil air._ we have already seen (chapter ii) how it is possible for soil charged with organic matter to deliver, either through suction from a heated house or on account of a rising ground water, soil air into the cellar, and also that moist air may enter the house in the same way. in order to prevent this, it is plainly necessary to interpose some air-tight or water-tight layer between the house and the soil, and also, since perfection in this layer is impossible, to make provision for draining away any water which may accumulate against the walls. ordinary builders do not lay much emphasis on the importance of either of these precautions, and while one may often see cellar walls roughly and carelessly coated on the outside, with tar or asphalt, a thoroughly water-tight coating is not a common practice. similarly, while draintile are often laid around a house, they are either laid so near the surface as to be useless or else they have no porous filling. [illustration: fig. .--exterior wall-drains.] to prevent moisture from entering the cellar, the first provision should be a tile drain (not less than four inches in diameter) laid completely around the house (see fig. ) on a grade of not less than six inches in one hundred feet. this drain at its highest point ought to be one foot below the bottom of the concrete floor of the cellar, and more than this, of course, at the lower end. this should be laid before or at the time the foundations for the house are being built, although it is possible to dig the necessary trenches and lay the tile after the house is built. if the available grade is small, this drain may be laid in two lines directly under the cellar floor as shown in fig. . at the points _a_ the bottom of the tile should be at least a foot below the dirt on which the cellar floor will be laid, and at the point _b_, about two feet. this drainpipe is best laid with regular sewer pipe and without cement in the joints. then coarse gravel should be filled in around this tile so as to allow water to enter the pipe without carrying soil that later might settle in the pipe. [illustration: fig. .--interior cellar-drains.] _position of outfall._ there is always a question of where this drain shall end and into what it shall discharge, for in some soils this drainpipe may discharge continually. to allow the drain to empty on the ground means that its outer end will be broken; that if discharge takes place just before freezing weather, the drain will fill with ice and be broken, so that some other method must be devised. if the outer end can be laid into a brook where the velocity prevents the water from freezing, or where the outer end can be kept below water, a satisfactory disposal is found. otherwise, it is better to discharge into a small covered cesspool, provided the soil is sufficiently porous to take care of the water, and provided the level of the ground water allows the construction of such a cesspool. in any case, it should be at some distance from the house, so that if it overflows, the water will not seep back to the cellar walls. by water-proofing the main wall and then backfilling against the wall with coarse gravel or broken stone, the same results as with open areaways are obtained and at a much smaller cost. _dampness of masonry walls._ one fact peculiar to all kinds of masonry and known to all careful observers is that stone work, brick work, and concrete will allow dampness to permeate, whether it comes from water-bearing soil or a driving rain. one objection to concrete-block houses has been that a hard rain would cause moisture to form on the inside. brick buildings have the same defect when the walls are built solid. an air-space in the cellar walls is the only way of insuring a dry cellar, if the bottom of the cellar is below the level of the ground water. a four-inch course of hollow brick may be used on the inside, or the wall may be actually divided into two walls with a space between. [illustration: fig. .--wall modes of making air-space.] figure (after warth) shows three different ways by which an air-space is secured and the two component parts of the wall held together. in the top view, the two walls, one eight-inch and one four-inch, are held together by wire ties, leaving an air-space of about four inches. in the middle drawing the walls are tied together by making the air-space three inches wide and then lapping the brick laid as headers over both walls. in the bottom view special terra-cotta blocks are used which pass through both walls. there can be no question of the value of such construction in eliminating dampness from the inside wall, but, it must be admitted, the cost of the walls is increased somewhat. _use of tar or asphalt on the wall._ instead of an open space, nowadays, it is more customary to thoroughly plaster the outside of the cellar wall, and then paint it with a tar paint put on hot, which will adhere fairly well to the cement or masonry. asphalt cannot be very readily used for this purpose unless it is an asphalt oil with but little bitumen paste. a paving asphalt, for example, even applied hot, does not adhere to the masonry, but slides down the walls as fast as it is applied. a successful method, however, of using such asphalt is to build the cellar wall in two parts, separated about half an inch, and filling in the intervening space with liquid asphalt. in this way, the asphalt is held in position, and is an absolute prevention of dampness. another method used successfully in the construction of one of the large railroad stations in boston consists in painting the outside of the wall with tar and then pressing into the hot tar several layers of tar paper, the separate sheets overlapping in a special coating of tar. these sheets are thus made continuous around the building and under the basement so that no water can enter the building. [illustration: fig. .--water-tight wall.] a cross-section of one of the depressed tracks entering the boston station is shown in fig. . the heavy black line represents ten thicknesses of tar paper, each one thoroughly painted with a thick paint of hot tar. it should be noticed that this water-tight coating is inclosed between masonry walls, so that the coating cannot be injured. it is possible theoretically by these methods to build an underground cellar so truly water-tight that it could be set down in a lake, where it might float like a boat and not leak a drop, and there may be some locations that require such construction, such as a low river valley or an old salt marsh or a city flat, where no adequate drainage is provided. but practically such construction will always be found expensive, and is, in most cases, unnecessary and ineffective, as already indicated, and where the percolating water cannot be tolerated, involves the installation of some kind of pump to throw out the water that will inevitably, in larger or small quantities, pass through the best water-proofing. it is, therefore, the part of wisdom to place reliance on draining the water away from the house rather than on water-proofing the cellar wall. _dry masonry for cellar walls._ it may not be out of place to add a word of caution against the practice of building cellar walls of loose stone, without mortar. they make no pretense of being water-tight, they offer no resistance to the entrance of rats, and they soon yield to the pressure of the earth and present that wobbly, uncertain appearance of cellar walls seen in rural districts. nor should the idea that the interior is to be visible and the exterior invisible blind the builder to the fact that it is far more important to have the outside smooth. if smooth, there are no projecting surfaces for water to collect in, no edges for the frozen earth to cling to and by expansion tear off from the wall. if smooth, the joints in the masonry can be pointed or filled with mortar, and thus a suitable surface for the tar or asphalt is provided. [illustration: fig. .--rough-backed wall.] in fig. (after brown) is shown a cellar wall with rough, irregular back, and it is easy to see how water would readily find its way down to one of the projecting stones and then along such a stone, through the wall into the cellar. with such a wall the action of the frost is more severe than with a wall with a smooth back, so that the wall in fig. is gradually pulled apart by alternate freezings and thawings. figure (after brown), on the other hand, shows the cellar wall as it should be with smooth, even exterior, along which the water passes easily, with gravel backing, through which the water escapes to the drainpipe. [illustration: fig. .--even-backed wall.] _damp courses in walls._ [illustration: fig. .--four modes of making water-proof cellar walls.] another important means of keeping moisture from the cellar walls is to provide what is called a damp course at about a level with the top of the cellar floor. where the soil is naturally damp, and where the cellar wells are not adequately water-proof, a second damp course should be provided at the level of the ground so that moisture from the damp cellar walls may not pass up into the above ground portion, which is naturally dry. these damp courses, in their simplest form, consist in bringing the masonry level around the building, and painting the top surface with liquid coal tar. [illustration: fig. .--waterproofing of cellar walls.] another method is to paint the masonry with liquid asphalt, and then imbed in this paint a thickness of asphalt-covered building paper which is again painted with asphalt. this may be done in the horizontal layer where it could not conveniently be done vertically. four different ways used in france for securing dry cellar walls are shown in fig. . the heavy black line represents the damp course, which, when added to the effect of the interwall space, which is shown in all the drawings but the first, and there replaced by a deep drain, insures absolute freedom from all moisture within the cellar. figure shows sections recommended by dr. george m. price, and indicates clearly the location of the damp course. _the cellar floor._ the floor of the cellar, in the same way, must be kept from dampness, and this is best done by covering the cellar floor with a layer of concrete, one part cement, three parts sand, and six parts broken stone; or, one part cement and eight parts gravel may be used. care should be taken, however, that the gravel does not contain an excess of sand, and it is always well in using gravel for concrete to check the proportion of these two materials. this may be done as follows: sift the gravel through an ash sieve so that it is free from sand; fill a ten-quart pail even full with the gravel and then pour in water to the top of the pail, keeping account of the amount of water poured in. this volume of water gives the proper amount of sand to use with the gravel for concrete, and if more sand than this was present in the original gravel, it should be sifted out until the proper proportion is reached. concrete is not water-tight, and the concrete floor of the cellar must be treated in some way to prevent water or moisture rising through this floor. one method is to cover the concrete thus laid with a denser mixture of cement and sand, put on three fourths of an inch thick, and made by mixing equal parts of sand and cement; or the asphalt layer already referred to in the cellar walls may be carried across the cellar, putting, as before, a paint layer on the concrete, then paper, then another paint layer, making it continuous and without a break from outside to outside. on top of this, to prevent wear and tear, a floor of brick, laid flat, or a two-inch layer of concrete may be laid. _cellar ventilation._ the great importance of the cellar as that part of the house where, if anywhere, unhealthy conditions exist, justifies this prolonged discussion, and before leaving the subject, ventilation in the cellar should receive a word of encouragement. too many cellars are damper than need be, are musty and close, full of odors of decaying vegetables and rotting wood, entirely from lack of ventilation. the cellar windows are small and always, closed. the cellar door is seldom opened, and never with the idea of admitting air. the impression on entering such a cellar is of a tomb. the cellar, even in that part devoted to storing vegetables, needs ventilation as much as the house does, for the cellar air finds its way up into the house, and an unventilated cellar means a house with air deficient in oxygen and overloaded with carbonic acid, a condition which causes pale faces and anæmic bodies. far better and healthier is it to open all the cellar windows, covering them with coarse netting to keep out animals and with fine netting to keep out insects, and let the disease-killing oxygen and sunlight in. malaria comes from the cellar, whenever the malarial mosquito can find there a breeding place. the writer has seen many cellars in which mosquitoes were living the year through in entire comfort, utilizing the moisture and warmth of the cellar to enjoy the winter months and up and ready for their mission at the first sign of spring. a cistern in the cellar is objectionable on this account, and if one exists, it should be covered with mosquito netting. _the old-fashioned privy._ another source of ill-health as well as of temporary discomfort is the typical construction and continued use of an outside closet or privy. the physical shrinking from the use of the ordinary building is most reasonable. as generally constructed, great draughts of air (presumably for ventilation) are continually passing through the small building, and when the temperature of the outside air is at zero, or thereabouts, only the strongest physique can withstand the exposure involved without serious danger of consumption, influenza, and pneumonia, or at least inviting those diseases by reducing the vitality of the body. two improvements suggest themselves and should be put into effect wherever this primitive construction must continue to be used. in the first place, the building itself should not be fifty or a hundred feet away from the house, so that every one is exposed to rain, snow, slush, and ice in making the journey thither. but some corner of the woodshed or barn should be utilized or the small building should be moved up by the back door and connected therewith by a roofed passage. the barn location is objectionable if it involves outdoor exposure in going from the house to the barn. a liberal use of earth in the privy vault will eliminate odors, and a water-tight box or bucket makes a frequent removal of the night soil practicable. in the second place, a small stove ought to be provided to warm the closet in the coldest weather. then the dislike to suffer from the cold, which leads so many to postpone nature's call, will be avoided, and the consequent digestive disorders which come from constipation and intestinal fermentations prevented. _cow stables._ in matters of health, aside from ventilation, which is discussed in the next chapter, there is little to be said concerning the other buildings on the farm. barns for hay are not involved. a few words may profitably be devoted to barns for stock, involving, as they do, by their construction, the health of the stock. one enthusiastic farmer writes that it is possible for farmers to keep their stock at all times under conditions which are an improvement upon the month of june. he believes that the cow stable should be as comfortable for the cows as the house is for the owner, subject to no fluctuations of temperature, and that, in this way, the health as well as the comfort and milk production of the cows would be maintained. light should be listed as the first essential of healthy stables, light to kill disease-producing bacteria, to make dirty corners and holes impossible, and to react on the vitality of the animals. compare this with some stables where fifteen, twenty, or thirty head are stabled in an underground dugout with two or three small windows not giving more than four square feet in all. stable windows should be set, like house windows, in two sashes and capable of being raised or lowered at will. in winter a large sash may be screwed over the regular window to keep out frost and moisture, provided there is some independent method of ventilation. for good healthy conditions, a cow needs about cubic feet of space, with active ventilation. in old stables, with poor construction, as little as cubic feet per cow was allowed, and when stables were made tight with matched boards and building paper, cubic feet was found to be too small, and it was recommended that one cubic foot be allowed for each pound of cow. but when tried by wealthy amateurs, it was found that this was too large; the stables were damp and cold in winter and became a predisposing factor in the development of tuberculosis. between the two extremes, and , is the practical average named above, namely, cubic feet of air space for each cow. for the health of the cow as well as for the good quality of the milk the stable should be built with special reference to being kept clean. the ceiling should be dust-tight, so that if hay is stored above, it will not sift through. the part of the barn where the cows are kept should be separated from the rest of the barn by tight partitions and a door into the cow stable. nothing dusty or dirty should accumulate. the floor of all stables for cows, horses, hens, and pigs should be of concrete to insure the most sanitary construction. planks absorb liquids and wear out rapidly under the feet of the stock. concrete can be kept clean, is nonabsorptive, and if covered with some non-conducting material, like sawdust, shavings, or straw, is a perfectly comfortable floor for the animals. _use of concrete._ no development of recent times has tended more toward the improvement and greater comfort of house building than the use of concrete. in the earlier houses, the cellar walls were so badly built and the connection between the top of the cellar wall and the timber sill of the house was so poor that the winter's wind blew through above to the manifest discomfort of those in the house. the writer remembers sitting in the best room of a well-to-do farmer, and watching, with great interest, the carpet rise and fall with the gusts of wind outside. to avoid such unhappy consequences, farmers have been accustomed to bank up the house outdoors in the fall with dry leaves, spruce-boughs, or manure, usually to a point on the woodwork. this, of course, closes the cellar windows for the winter for the sake of keeping out the wind. a concrete wall, at the present price of cement, using gravel for the mixture instead of stone, need cost but little more than the price of the cement and the labor involved, and a tight cellar wall may thereby be obtained. if the soil in which the cellar is dug is firm enough, the outside of the excavation can be made so that no form on that side will be required, but it is always better to make the excavation about two feet more than necessary, to put forms inside and outside, and, after their removal, plaster or wash the wall with a thick cream of cement and water. in carrying the wall above the ground, forms must be used with great care to secure a smooth surface, and fig. shows two methods suggested by the atlas cement company. [illustration: fig. .--cellar-wall forms.] there are so many forms of construction where concrete is not merely a convenience but a great advantage in the matter of health around the house, and particularly a house in the country, that there would be no end if one once began enumerating and describing the various methods and processes involved. besides the cellar walls and cellar floor, there are outside the house, silos, manure bins, walks, curbing, steps, horse-blocks, hitching and other posts, watering troughs, and drainpipe, all successfully made of this useful material. in the barn, the barn floor, the gutters, the manger and watering troughs, cooling tanks, and sinks are also made of cement. while it is possible to differentiate between the methods and the mixtures for these various purposes, it will not be greatly in error if the construction always follows the following principle. use enough cement to fill the voids in the gravel or in the sand and stone mixture employed, and have enough sand in the gravel or with the stone to fill the voids in the stone. this is readily determined, as already suggested, by the use of water. the water, which will occupy the voids in the stone, represents the necessary sand. when this amount of sand and stone is well mixed, the water then permeating the interstices represents the necessary cement, though it is a good plan to add about per cent extra to allow for imperfect mixtures. the mixing should always be done so thoroughly that when put together dry, no variation can be seen in the color of the mixture. it is surprising to see how readily a streak of unmixed dirt or of unmixed cement can be detected in a pile by the difference in the color which it presents. such mixtures should always be made dry first and then the water added and again mixed until the result is of a perfectly firm consistency. such a mixture can be applied to any of the purposes mentioned, and, in general, it is better to have too much water than not enough. the only difficulty with a very wet mixture is that the forms require to be made nearly water-tight, whereas with dry mixtures the same attention to the forms is not necessary. if the concrete is to be used in thin layers, as in pipe or watering trough, where a smooth surface is wanted, better results are usually obtained by using a dry mixture and fine gravel and tamping the mixture with unusual thoroughness. it is always unsafe to smooth up or re-surface a piece of concrete. the difference in texture of the surface coat causes it to expand and contract differently from the mass of concrete underneath, and inevitably a separation occurs. if it is desired to put on a sidewalk, for instance, a smooth top coat, the consistency of the two kinds of concrete should be alike, and the top coat should be applied almost immediately after the bottom layer is put in place. where concrete is used to hold water, a coat of neat cement should always be put on with a broom or a whitewash brush, mixing the neat cement with water in a pail, and it does no harm to go over the surface three or four times, the object being to thoroughly close the pores in the concrete. for floors of cellars or barns, the dirt should be evened off and tamped and then the cement concrete should be spread evenly over it, and tamped just enough to bring the water to the surface. when partially dry, a better finish is obtained by lightly troweling the concrete. in a cellar or barn, it is not necessary to divide up the area into squares or blocks as is done with sidewalk work, but the entire area may be laid in one piece. in order to keep the surface level, however, it may be found convenient to lay down pieces of " x " scantling, the tops of which shall be on the desired level of the finished floor. by filling in behind these scantlings, which can be moved ahead as the filling progresses, the exact level desired can be obtained. usually four inches thick will be a proper depth of concrete for this purpose. chapter iv _ventilation_ the average individual breathes in and out about eighteen times a minute, taking into his lungs the air surrounding him at the time and expelling air so modified as to contain large amounts of carbonic acid, organic vapor, and other waste products of the lungs. the volume of air taken in is about the same quantity as that expelled and amounts to eighteen cubic feet per hour. fortunately, the air expired at a breath is at once rapidly diffused throughout the surrounding atmosphere, so that, even if no fresh air were introduced, the second breath inhaled would not be very different from the first. but after a certain length of time the air becomes so saturated with the waste products of the lungs that it is no longer fit to breathe, and it is evident that in order to keep the air in a room so that it can be taken into the lungs with any reasonable degree of comfort, there must be a continual supply of fresh air admitted with a proper provision for discharging polluted air. if this is not done, there is, so far as the lungs are concerned, a process established similar to that which is occasionally found when a village takes its water-supply from a pond and discharges its sewage into the same pond. not long ago, the writer found in the adirondacks a hotel built on the side of a small lake which pumped its water-supply from the lake, and discharged its sewage into the same lake only a few feet away from the water intake. that the hotel had a reputation of being unhealthy, and that it had difficulty in filling its guest rooms, is not to be wondered at, and yet individuals will treat their lungs exactly as the hotel treated its patrons. _effects of bad air._ in order to establish a proper relation between the amount of impurities diffused through the air and the physiological effect on individuals breathing that air, certain observations have been noted and certain experiments have been made which prove without question the injurious effect of vitiated air. professor jacob, late professor of pathology, yorkshire college, leeds, gives the following example on a large scale, to show the results of insufficient ventilation: "a great politician was expected to make an important speech. as there was no room of sufficient dimensions available in the town, a large courtyard, surrounded with buildings, was temporarily roofed over, some space being left under the eaves for ventilation. long before the appointed time several thousand people assembled, and in due course the meeting began; but before the speaker got well into his subject, there arose from the vast multitude a cry for air, numbers of people were fainting, and every one felt oppressed and well-nigh stifled. it was only after some active persons had climbed on the roof and forcibly torn off the boards for a space about twenty feet square that the business of the meeting could be resumed." remembering that the process of breathing is for the purpose of supplying oxygen to the blood and that the absorption of oxygen in the lungs is the same process which goes on when a candle burns, the following experiments were made by professor king of the university of wisconsin, to show the effect of expired air on a candle flame. he took a two-quart mason jar and lowered a lighted candle to the bottom, noting that the candle burned with scarcely diminished intensity. through a rubber tube, he breathed gently into the bottom of the jar, with the result that the candle gradually had a reduced flame and was finally extinguished. he observed also that if the candle were raised as the flame showed signs of going out, the brilliancy of the flame was restored, while lowering the candle tended to extinguish the flame. even when the candle was raised to the top of the jar, the flame was extinguished after sufficient air had been breathed into the jar. clearly, then, he argued, air once breathed is not suitable for respiration, unless much diluted with pure air. he argued from this that if a candle using oxygen for combustion could not burn in expired air, therefore an individual using oxygen for the renewal of the blood could not be properly supplied in a room partially saturated with the expired products of the lungs. professor king also experimented with a candle burning in a jar on which the cover had been placed, and found that the candle was extinguished in thirty seconds, and he argued that if a candle was thus extinguished on account of the carbonic acid given off, so a person shut up in an air-tight chamber would similarly be extinguished in the course of time. to prove that expired air is poisonous to animal life, professor king experimented on a hen, placing the same in a cylindrical metal air-tight chamber eighteen inches in diameter and twenty inches deep. the hen became severely distressed for want of ventilation and died at the end of four hours and seventeen minutes. in the wisconsin agricultural experimental station, an experiment was conducted for fourteen days on the effect of ample and deficient ventilation on a herd of cows. the stable was chiefly underground and had two large ventilators which could be opened or closed at will. the food eaten, the water drunk, the milk produced, and weight of the cows were recorded each day. for a part of the time the cows were kept continuously in the stable with all openings closed, and then the ventilators were opened, the alternate conditions being repeated at intervals of four days. the amount of food consumed was practically the same under both conditions. the quantity of milk given was greater with good ventilation. the chief difference was in the amount of water consumed, since with the insufficient ventilation the cows drank on the average . pounds more water each, daily, and yet lost in weight . pounds at the end of each two-day period. examination of the animals themselves also showed that a rash had developed on their bodies which could be felt by the hand and which was apparently very irritating, since it was so rubbed by the animals as to cause the surface to bleed. the evident teaching of the experiment is that under conditions of poor ventilation, it was impossible for the lungs to remove waste products to as great an extent as usual, and, therefore, the demand for additional water was felt in order to stimulate greater action on the part of the kidneys to care for these waste products. that this was not a successful substitute was shown by the loss of weight in the animals, and by the irritation of the skin which evidently was trying to eliminate some of the remaining impurities through its surface. _modifying circumstances._ fortunately for mankind, it has not been customary, nor even possible, to build dwellings or stables approaching the air-tightness of a fruit jar. air has great power of penetration, particularly when in motion, and a wind will blow air through wooden walls, and even through brick walls, in considerable quantity. it is practically impossible to build window casings and door frames so that cracks do not exist, through which air may find its way. when, however, in the wintertime, storm windows have been put on, or when, as occasionally happens, to keep out drafts, strips of paper are pasted carefully around all window casings, or when rubber weather strips are nailed tight against the windows and doors, conditions are obtained which resemble the mason fruit jar, and under those conditions, a person living continuously in such a room is experimenting on himself as professor king did with the candle. another reason why it is difficult to make a room an air-tight chamber is that if a stove or fire-place be in the room, a strong suction is produced through the flame, and such suction requires the entrance of outside air. it is a common experience that a fire-place in a room otherwise tight will refuse to draw and will smoke persistently until a door or window is opened, when, a supply of air being provided, the fire is made bright and active. fortunately, the vitiation of the air in a room is never so severe as that in an experimental chamber, and there are few examples which can be cited of men or women dying from lack of ventilation in an ordinary room. but the serious aspect of inadequate ventilation is not that it actually induces death, but that it decreases the powers and activities of the various organs of the body; that it interferes with their normal processes, that it loads up in the body an accumulation of organic matter which is normally oxidized by fresh air and which, if not oxidized, obstructs the activities of other organs of the body. _danger of polluted air._ unfortunately, it is not possible to detect by the physical senses that point at which the human organism suffers from insufficient ventilation. some years ago, dr. angus smith built an air-tight chamber or box in which he allowed himself to be shut up for various lengths of time in order to analyze his own sensations on breathing vitiated air. he found that, far from being disagreeable, the sensation was pleasurable, and he says, "there was unusual delight in the mere act of breathing," although he had remained in the chamber nearly two hours. on another occasion he stayed in more than two hours without apparent discomfort, although after opening the door, persons entering from the outside found the atmosphere intolerable. he placed candles in the box, which were extinguished in a hundred and fifty minutes, and a young lady, who was interested in the experiment, going into the box as the candles went out, breathed it for five minutes easily; she then became white, and could not come out without help. nor is it possible to conclude from the experiments and observations cited that the body remains indifferent to polluted air until the latter has reached a certain definite saturated condition. there can be little doubt but that a degree of pollution far short of that necessary to produce death has a weakening effect on the human organism, and that by means of the increased functional activity of other organs doing work intended for the lungs the resistance to disease is much impaired. life is a continual struggle of the bodily tissues against the attacks of the micro-organisms and their tendencies to destroy life; hence inadequate ventilation or any other condition which interferes with the normal action of the organs of the body causes weakness and affords opportunity for the attack of some disease-producing germ. it stands to reason that an individual whose lung tissues have become soft and incapacitated must be more liable to succumb to disease than another whose lung capacity is large and whose blood has been continually and sufficiently oxygenated. perhaps no more impressive proof of this is seen than in the ravages of consumption, which is so prone to attack those whose vitality is diminished by living in unhealthy and unventilated cellars or in crowded tenements. statistics are very definite on the subject of tuberculosis among indians, who rarely suffer from the disease when living in tents or on the open prairie, but when they become semi-civilized and crowd together in houses heated through the winter months by stoves, the germs of tuberculosis take firm hold, and the deaths from this disease are greater in proportion to population among this race than anywhere else. _effect of change in air._ this discussion illustrates another law of disease which makes the necessity for ventilation particularly great among rural communities where for nine months in the year outdoor life is freely enjoyed, namely, that when either an individual or people are brought under changed conditions, perhaps not unwholesome to those accustomed to them, those unaccustomed will suffer severely. so a lack of ventilation during the winter months in a farmhouse is very serious in its consequences to those who have had the full enjoyment of fresh air through the rest of the year. reference has already been made (in chapter ) to the prevalence of influenza in rural communities, and it is quite probable that this would be largely eliminated if the lungs were not deprived of their oxygen as they are in most houses on the farm. _composition of air._ ordinary air contains about . per cent of carbon dioxid; that is, four parts in ten thousand parts of air, the other nine thousand nine hundred ninety-six being made up of oxygen and nitrogen. of course, it is not possible to express any definite value for the amount of carbon dioxid which is objectionable in air, because, in the first place, it is not certain that the carbon dioxid in itself is the cause of diminished vitality due to insufficient ventilation, and, in the next place, insufficient ventilation affects different people in different ways. but it is known that in the lungs the life-giving oxygen is changed to carbon dioxid, and that just as carbon dioxid gas will prevent the combustion of a candle flame, so carbon dioxid gas will destroy the life of man. when a deep well is to be cleaned out, the decomposition of organic matter in the bottom of the well will have, in all probability, caused the formation of this same carbon dioxid gas, and it is not uncommon for a man descending into such a well to be overcome by the gas, which, in some cases, even causes death. for this reason, it is common to lower into a well, before it is entered by a man, a candle or lantern, on the probability that if the lantern can stand it, certainly the man can, while if the lantern goes out, it is wise to avoid the risk of having a man's life put out in the same way. _organic matter in air._ the stuffy and close feeling perceived in an ill-ventilated room is, however, due to the organic matter from the lungs, which is expired along with the carbon dioxid, and some chemists have argued that this amount of organic vapor ought to be measured instead of the carbon dioxid. at the present time there is no simple and direct method of measuring organic vapor, and because this vapor increases in the atmosphere proportionately to the carbon dioxid gas, it is much simpler to measure the latter. then it is impossible to fix a standard of carbon dioxid because a person whose lungs are well developed and whose blood is well oxygenated, or, as we say, one who has good red blood can stand, even if uncomfortable, a few hours of a bad atmosphere without suffering serious discomfort, while an anæmic or poor-blooded person would be affected to a greater degree. it is for this reason that in any house no living room, especially one heated by a coal stove, should be shut up tight against fresh air. this is the reason why the women of the family, who have to breathe the same air over and over all day, are pale and weak and easily susceptible to disease, while the men, who are out of doors most of the time, and when indoors are made restless by the bad air, suffer much less from the ill effects. experiments seem to show that when the amount of carbon dioxid in the air has doubled, that is, when the expired air mixed with the air in the room has increased the proportion of carbon acid from four parts in ten thousand to eight parts in ten thousand, that the air is seriously affected, and that such ventilation ought to be provided that no greater amount than this could occur. this is such a condition that the room smells "close" or stuffy to a person coming in from outdoors, indicating organic emanations as well as an excess of carbonic acid gas. the question then is: how may this condition be avoided in an ordinary house, or in an ordinary stable, because the health of the cattle on a farm, judging at least by the character of the buildings provided, is quite as important as the health of the farmer's family. we must take it for granted that no such elaborate schemes are possible as in public buildings or schools, where fans are provided, either to force air into the several rooms or else to suck it out. the ventilation of the house must be more simple and easily adjusted and must depend on the principle of physics that warm air rises and that if the warm air of a room is to be removed, air must in some way be supplied to take its place. the two essentials for ventilation are opportunity for the ingress and the egress of air--ingress for fresh air and egress for polluted air. _fresh-air inlet._ in the construction, of a dwelling house, special and adequate preparation for the admission of fresh air is seldom provided, so that the existing openings must be used for the purpose. this means that in the summertime an open window will furnish all the fresh air which a room receives and, when the temperature of the outside air is approximately that of the living room, such provision is ample and satisfactory. but in the wintertime, when the outside air is cold, the average person will prefer to suffer from the bad effects of impure air rather than admit cold air which may cause an unpleasant draft. [illustration: fig. .--letting in fresh air.] one of the simplest and best methods of providing an inlet for fresh air, without at the same time allowing blasts of wind to enter the room, is to fasten in front of the lower part of the window a board which shall just fill the window opening; then, raising the lower sash a few inches will allow fresh air to enter both at the bottom, where the board is placed, and at the middle of the window between the sashes (see fig. ). persons sitting close by a window thus arranged may feel a draft even under these conditions, since the cold air thus admitted will sink at once to the floor and then gradually rise through the room to the ceiling, but unless one sits too near the window, this is an admirable method of admitting fresh air. another method, where steam or hot-water radiators are placed in the room, is to connect the outer air, either through the lower part of the window or through the wall of the room just below the window opening, with a space back of the radiator, so that the cold air entering will pass around and through the radiator and so be warmed as it enters. [illustration: fig. .--ventilating device.] the picture (fig. , after jacobs) shows the arrangement of the radiators in one of the buildings of the university of pennsylvania. a is the opening in the wall below the window; _d_ is a valve which regulates the amount of air entering through the opening; _r_ is the radiator; _b_ is a tin-lined box which surrounds the radiator; _t_ is a door in front of the box, which when raised allows the air of the room to be heated and to circulate through the radiator. by adjusting the two valves _d_ and _t_, air of any desired temperature can usually be obtained. figure (after billings) shows an english device intended for the same purpose. the valve _d_ in this case operates to admit air, either through the radiator or to the space between the radiator and the wall, in order to vary the temperature of the entering air. the valve _t_ may be open or closed, and its position, together with that of the valve _f_, determines the proportion of the room air which is reheated. [illustration: fig. .--ventilating device.] the writer remembers one schoolhouse where these methods were used successfully, the radiators being placed directly in front of the window and inclosed at the back, sides, and top, except for an opening to the outer air through the wall, properly controlled by a damper. in the writer's own office the radiators are by the side of the window and are boxed in, the connection being made with the outside air through a wooden box entering under the radiator. this is an admirable method, provided the radiator has sufficient surface to warm the fresh air admitted. another excellent arrangement is to provide a narrow screen similar to that used for protection against flies, but with the screening material of muslin cloth instead of wire cloth. this muslin will break up the current of air so completely that no draft is felt by persons sitting even close to the open window. _position of inlet._ the inlet for fresh air, if connecting directly with the outside air, should not be at the top of the room, since then the inlet would not serve to admit air, but rather to allow the warm air of the room to escape, and a burning match would inevitably show a draft outward instead of inward. neither is it desirable to have the fresh-air inlet near the floor of the room unless the entering air is warm, because cold air admitted will flow across the floor and remain there, not disturbing the warm upper layers. the effect then is not to improve the ventilation, but only to chill the feet of persons sitting in the room. the position of the window lends itself, therefore, to admission of fresh air, since it is neither at the top nor at the bottom of the room, but at the level most suitable for such admission. _foul-air outlet._ very few houses have any provision for the outlet of spent air, and if ventilation is thought of at all, the only idea usually is to provide, in part at least, for the admission of air and to make no adequate arrangement for its egress. whenever a stove or fire-place is in use, the mere burning of fuel requires the consumption of air, and in cases where apparently no air is admitted to the room, insensible ventilation is at work bringing into the room, through the walls and through cracks around the doors and windows, the necessary air for combustion. [illustration: fig. .--ventilation by means of coal stove.] it may be proved by the laws of physics that a coal stove burning freely in a room causes adequate ventilation; and that only where the dampers of the stove are closed, so that not merely is the supply of fresh air diminished, but also the products of combustion are thrown out into the room, is there danger from lack of ventilation. the stovepipe in this case furnishes the necessary outlet for the impure air, and the following suggestion has been made in order to utilize this outlet, even when the fire is not burning freely or when the damper in the stovepipe is closed. if the stovepipe from a stove is carried horizontally, as it usually is, an elbow must be provided to raise the pipe to the stove hole in the chimney. then providing a t connection at the point marked _a_ in fig. (after billings), the lower part of the _t_ may be carried to within a foot of the floor with a damper at the points _b_ and _c_. when the fire is burning freely, the damper at _c_ is closed, and ventilation is secured through the stove, the damper at _b_ being open. when the damper at _b_ is closed and the fire checked, then the damper at _c_ may be opened and the impure air drawn up the chimney from the level of the floor. this, it is said, is an effective arrangement for drawing off the polluted air of a room. [illustration: fig. .--coal-stove ventilation.] another method is to surround the stove with a sheet-iron casing, as shown in fig. (after billings), the top of the casing having a pipe leading into the chimney independently from the stovepipe. the casing becomes warm and heats the room by radiation, just as the stove does, but if the damper in the flue from the casing be opened partly, a strong draft along the floor and into this casing will be developed and the foul air thereby discharged into the chimney. it will be easily possible, of course, to carry away all the heat from the stove in this method, and the damper in the flue of the casing must be carefully regulated to carry away only the desired amount of foul air. [illustration: fig. .--coal-stove ventilation.] still another method of using the heat of a stove to secure ventilation is shown in fig. (after billings). here the stove is surrounded with a sheet-iron jacket extending from the floor to about six feet above that level. a pipe is carried from the outside air up through the floor directly under the stove. by regulating the damper in this pipe the supply of fresh warmed air entering the room can be regulated. doors in the casing must, of course, be provided for the purpose of taking care of the fire, and of allowing air from the room near the floor to be heated instead of the outside air. a most objectionable method of providing an outlet for polluted air from a room is to have a register in the ceiling with the ostensible purpose of warming the room above. it was the writer's misfortune once to stay a week in the country, in a room over the kitchen where this method of heating was employed, and the odors of cabbage, onions, and codfish which permeated the upper room, and clung there all night, still remain as a most unpleasant memory. _size of openings for fresh air._ as an indication of the size of the openings needed, it has been said that in order to provide the necessary air movement, and yet to restrict the velocity of the moving air so that no objectionable drafts will be experienced, at least twenty-four square inches sectional area should be allowed as an inlet for each person, so that one square foot is required for six persons. this is, perhaps, a theoretical requirement. certainly, it is more area than is likely to be obtained in actual ventilation. the space between two windows, for instance, is about one inch by thirty inches,--barely enough, according to this rule, for one person, and yet that opening is sufficient to appreciably improve the quality of the air in a room occupied by three or four persons. taking into account the necessary air required by lamps or gas burners, the inlet flue should have at least ten square inches area for each person, so that the ordinary single register should provide the necessary amount of air for a living room. when, as happens in houses where a studied effort is made to preserve the health of the inhabitants, an outlet is cut into the wall and a flue carried up through the roof, the flue should be preferably near the floor and on the side of the room opposite the window or inlet. with such an arrangement (see fig. ) the air entering rises at first, but sinks at once because of the temperature, so that the direction of the air currents are diagonally across the room from the ceiling to the floor, thus renewing and changing all the air particles except those directly over the outlet. where the air is introduced mechanically, that is, forced into the room, it is better to have the inlet and outlet on the same side, so that the entering air is shot in at the top, flowing across the room, then sinking and coming back, just below the point where it entered. [illustration: fig. .--outlets into the walls.] _ventilation of stables._ all that has been said on the subject of ventilation in houses applies equally well to the ventilation of stables, and a little book by professor king of the university of wisconsin, entitled "ventilation," deals most thoroughly with the principles and practices of ventilation, not merely for dwellings but also for stables. professor king proves by his experiments that the condition of cattle is much improved and that the milk-giving qualities are increased by a proper supply of fresh air, and in the book referred to, he gives a number of examples of the proper construction to provide adequate ventilation. it is most convincing to see how unscientific is the old-fashioned underground stable, the sole idea of which was to conserve the animal heat by crowding together the cows and by absolutely excluding the outside air. for further details of his work, its principles and practices, the reader is referred to the book, which may be obtained from the author at madison, wisconsin. _cost of ventilation._ to ventilate a house is expensive, and to ventilate a barn requires not only a certain expenditure of money but also a considerable amount of judgment. it is evidently cheaper to heat the same air in a room over and over than to be continually admitting cold fresh air, which will have to be warmed. this extra cost is, however, not excessive, when the movement of the air currents is properly controlled. the cost of warming the air necessary for ventilation for five persons should not be, at the rate of cubic feet of air to each person, more than ten cents a day in zero weather, with coal at five dollars a ton. enough coal will have to be burned in addition to compensate for radiation, or, in other words, it requires a certain amount of coal to keep an empty room warm in winter without any question of ventilation, and in some badly built houses this amount is large. _relation of heating to ventilation._ it does not follow because much heat is lost in this way that the ventilation is good, since the heated air may ascend to the ceiling and there escape without influencing the ventilation. in fact, one of the first principles of ventilation is that as soon as regular inlets and outlets are provided, all other openings ought to be rigidly closed. then and then only can the warmed pure air be admitted as desired, at the points intended, and the full value of the heat utilized. especially is this control of openings important in ventilating barns. here each animal is a natural heater, warming the air by direct contact and by rapidly breathing in and out large volumes of air which are thereby changed to a temperature of over ninety degrees fahrenheit. the air around their bodies being warmed rises to the ceiling and spreads out to the two sides and is there gradually cooled and at the same time mixed with fresh air which enters at the top, so that the cow is constantly supplied with freshened air. a flue is needed to carry the foul air up through the roof, and fresh-air inlets in the outer walls on both sides are required, and with these openings carefully controlled and with no others interfering, the stable may be well ventilated, as shown in fig. (after king). [illustration: fig. .--cow-barn ventilation.] in all cases where ventilation is to be practiced, the walls and ceiling should not merely be tight in themselves, but they should be double, and the strictest attention paid to limiting the amount of heat lost by radiation. all the heat used ought to be concerned in ventilation, and in that only. to secure air-tight walls and ceiling, the studding and joists should be boarded in, both on the inside and out, and the space between should be filled with shavings, straw, dry moss, or any similar fibrous substance. the outside sheathing must be well laid and must be water-tight in order that rain shall not penetrate to the inside of the wall, and the roof must be tight so that the ceiling filling does not get wet and rot. the choice, therefore, so far as ventilation of either house or barn goes, lies between a poorly built, loose-jointed structure without artificial ventilation and with poor economy in heat, and a well-built, air-tight structure, with ample ventilating pipes, carefully and intelligently planned and built. the first is healthy so far as pure air is concerned, but drafty and uncomfortable. the second is more expensive to build, but insures lasting health and comfort. then the choice cannot but fall on the building which is easy to warm, healthful to live in, and readily ventilated. chapter v _quantity of water required for domestic use_ until the last few years it has been a sad commentary on the intelligence of the average farmer that but few attempts have been made to supply the farmhouse with running water, adequate to the needs of domestic use. the men of the farm long ago realized that carrying water for stock in pails was both laborious and time-consuming, and very few barnyards have not had running water leading into a trough to supply the needs of cattle. in many cases this supply has been extended into the barn, and in some cases into individual stalls, so that the farmer has long since eliminated the necessity of hauling water for his stock. perhaps, because the farmer did not himself carry the water, but rather his wife, he has until recently not concerned himself with any extension of the water-supply into the house, and so long as the well in the yard did not run dry, he felt that his duty had been done. to be sure, bringing water from the well to the house in mid-winter involves much exposure and sometimes real suffering; occasionally the farmer has been moved on this account to have the well located in the woodshed or on the back stoop, avoiding the long outdoor trip, but increasing the dangers of pollution to the water. it would be interesting to make a census of the farm water-supplies in any county for the purpose of estimating the intelligence of the farm-owners, since one cannot but feel that such a primitive water-supply argues, in most cases, an undeveloped or one-sided intelligence on the part of the property owner. _modern tendencies._ happily, such primitive methods of bringing water to the house are being superseded by satisfactory installations, and one by one, each farmhouse is being provided with running water in the kitchen sink and with a bath-room containing all the modern conveniences. one cannot deny that this costs money, both because of the pipe line necessary to bring the water to the house and because of the plumbing fixtures required in the house. again, a water-supply in the house involves a well-heated house, since pipes not kept warm will, in the winter, inevitably freeze, ruining the pipe line and perhaps the ceilings and walls of the house itself. but if the owner of a house has any money to expend in improvements, surely no better way of adding to the comfort and health of his family can be found. an abundant supply of water increases the self-respect of the whole family and has been known even to change the temper of an entire household. for another reason, also, it is a good investment, inasmuch as the quality of the water supplied from a spring on a hillside is, generally speaking, better than that of a well surrounded by barnyards and privies. it has been said that the civilization of a community is measured by the amount of soap that it consumes, and it is almost the same thing to say that the refinement of a household is measured by the amount of water it uses. the poorer a family, the greater struggle it is to keep up the appearance of cleanliness, and no surer sign of rapid progress on a downhill road can be found than neglect of those practices which tend toward personal neatness. as the life of the farmer, then, becomes easier, as his condition becomes more prosperous, and as his family make more requirements, so, inevitably, is there in the farmhouse a greater demand for water in the kitchen, in the laundry, and in the bath-room. _quantity of water needed per person._ just how much water is needed in any house is not easy to predict, unless, at the same time, it is known, not merely the present habits of the family, but also their capacity to respond to the refining influence of unlimited water. it has been shown by measuring the amount of water used in families of different social standing in cities of new england that the amount of water varies directly with the habits and social usages of the family. for example, in newton, massachusetts, where there are a large number of small houses with the water-supply limited to a single faucet, it was found that the water used amounted to seven gallons per day for each person in the house, while in houses supplied with all modern conveniences, the consumption of water was at the rate of twenty-seven gallons per day for each person. in fall river, the conditions were much the same except that the poorer houses generally had one bath-tub and one water-closet, the amount of water used being eight and a half gallons per head per day, while the most expensive house in the city used twenty-six gallons per head per day. in boston, the poorest class apartment houses used water at the rate of seventeen gallons per head per day, the moderate class apartment houses at the rate of thirty-two gallons, first-class apartment houses at the rate of forty-six gallons, and the highest class apartment houses at the rate of fifty-nine gallons per head per day. the difference in these rates is easily understood by considering the habits of the individuals who make up the different classes referred to. in the poorer class of houses, the workers of the family are gone all day, and are too tired when home to spend much time in bathing. the children of such households are washed only occasionally, and the external use of water is generally regarded as an unnecessary trouble. in those families, on the other hand, where the necessity for daily toil is not so pressing, where bathing is more frequent, and where ablutions during the day are more often repeated, the amount of water used is much larger. another factor that affects the measured amount of water used in a family is the number of plumbing fixtures. at first sight, it would not seem possible that because there were two wash-basins in a house, an individual should use more water than if there were only one basin. nor would it seem possible that an individual would take more baths with three bath-rooms available than if only one existed, and yet the number of fixtures does influence the individual who washes his hands frequently. with a wash-basin on the same floor, for instance, he washes often, whereas if it were always necessary to go upstairs for the purpose, his hands would go unwashed. also, the more fixtures there are, the greater is the amount of leakage, since every faucet will, in the course of time, begin to leak unless the packing is continually replaced. the amount of leakage is, therefore, in direct proportion to the number of fixtures. the amount of water used then, per head per day, varies from seven to sixty gallons, but only by an intimate knowledge of the habits of the household can one predict the amount of water likely to be used. perhaps as an average in a house having a kitchen sink and a bath-room containing a wash-basin, bath-tub, and water-closet, a fair estimate of the water used would be twenty-five gallons per head per day. this amount must be multiplied by a maximum number of persons to be in the house at any time, and then this number must be increased by the amount of water used in the barn and in the yard, if these are to be supplied from the same source as the house. _quantity used in stables._ the amount of water used in the barn is even more than that used in the house, a variant depending on the habits of the manager. the minimum quantity needed per day is determined by the number of pailfuls of water which each head actually drinks multiplied by the number of head. but besides this there are many other uses to which water may reasonably be put in connection with stock. on a dairy farm, there is the water needed to wash cans and bottles and in some cases to furnish a running stream of cold water for the aerator. in some stables a large amount of water is used for washing harnesses and carriages; in others, but a small amount goes for such purposes. some farmers have concrete floors in cow stables and pig pens and use a hose frequently to wash these floors clean. other stables never see a stream of water and only see a shovel at infrequent intervals. the amount of water used outside the house is too uncertain a quantity to estimate on the average, but its influence and importance must not be overlooked. _maximum rate of water-use._ it should now be noted that the quantity of water already referred to is the average quantity used through the twenty-four hours and does not mean the rate at which the water comes from the faucet. for example, three persons in a house use water, according to the above statement, at the rate of seventy-five gallons per day, but a whole day has minutes, and if seventy-five gallons be divided equally among the number of minutes, it means one gallon in every twenty minutes, or one quart in five minutes. it is obvious that no water-supply system for a house, designed to supply water at the average rate for the twenty-four hours would be satisfactory, since no person would care to wait all day for the amount. to wait five minutes to draw a quart of water would try the patience of any one, and while the total amount of water used in the house will be seventy-five gallons, provision must be made by which it can be drawn in small amounts at much higher rates. practically all of the amount is used in the daylight hours or in twelve hours out of the twenty-four, so that the rate would be twice the average rate, and with this correction, two quarts of water could be drawn in five minutes. but even this is too slow, and if one were to take a quart cup to a kitchen faucet and note the time necessary to fill the measure with the water running at a satisfactory rate, he would find that unless the cup was filled in about ten seconds it would be considered too slow a flow. since it is possible for more than one fixture to be in use at the same time, the pipes ought to be able to deliver the total amount running from different faucets open at the same time, and if it is considered possible for three faucets to run at once, as, for instance, the kitchen faucet, bath-room faucet, and barn faucet, then the supply pipe must be able to deliver, under our assumption, three quarts in ten seconds, or at the rate of about six thousand gallons a day. it is necessary, therefore, to distinguish carefully between the total quantity of water used per day and the rate at which such water is used. the first of these requirements governs the size of the reservoir from which the water comes or the yield of the well or spring, or the capacity of a pump from a pond to a distributing tank; the other requirement governs the size of the pipe or faucet or the capacity of a pump which supplies direct pressure. it should be noted also that with ordinary fixtures, the rate of delivery and the corresponding sizes of the fixtures are not affected by the number of persons in the house, whereas the first requirement, that is, the total quantity of water used per day, is directly affected by the number of persons. _variation in maximum rates of water-use._ the quantity of water used, however, is not uniform throughout the day or the week. it is commonly known, for instance, that on monday, or wash-day, when the well is the only supply, a great deal more water has to be carried on that day than on any other day in the week, and this same increased demand for water is made when the water comes in pipes into the house. probably about half as much water again is used on monday as on other days. again, in the hot weather of summer, more water is used for bathing and laundry purposes than in cold weather. but, on the other hand, there is a great tendency in cold weather to let the water run in a slow stream from faucets in order to prevent freezing. this has been found to just about double the amount of water used. it is only a reasonable safeguard, therefore, if it has been decided that the family needs are such as to require twenty-five gallons per head per day, to provide for double that amount in order to meet the demands of excessive daily consumption or of the hot and cold weather extremes. _fire streams._ if a water-supply is to be installed for any house, the possibility of providing mains of sufficient size for adequate fire protection should always be considered, although it may not be found to be a necessary expenditure. in case of a fire a large amount of water is needed for a few hours, entirely negligible if it is computed as an average for the year, but a controlling factor in determining the size of mains or the amount of storage. a good-sized fire stream delivers about gallons per minute, and for a house in flames, four streams are none too many. the rate of delivery, therefore, for a fire should be at least gallons per minute or a rate of nearly a million gallons per day, and if it is assumed that the fire might burn an hour before being extinguished, , gallons of water would be used. if a spring or tank is the source of supply, the storage should be , gallons, and the pipe line from the tank to the hydrants must be large enough to freely deliver water at the rate of gallons per minute. if the distance is not over feet, a four-inch pipe is sufficiently large; but if the distance involved (from the reservoir or tank to the farthest hydrant) is more than about feet, four-inch pipe is not large enough. this is because the friction in a large line of pipe is so great that the water cannot get through in the desired quantity. a four-inch pipe, discharging gallons a minute, would need a fall of one foot in every four feet, while a six-inch pipe would need a fall of only one in thirty. of course, if the reservoir from which the water comes is at such an elevation that the greater fall is obtainable, the smaller pipe may be used. it is more than likely, though, that the reservoir is about feet or more away, and the entire fall available only about thirty feet or one foot in one hundred. then an eight-inch pipe would have to be used. whether fire-protection piping, therefore, is a wise investment or not, depends largely on the cost of installation. a four-inch cast-iron pipe laid will cost about forty cents per running foot, while an inch pipe, large enough for everything except fires, will cost about ten cents, so that the excess cost per foot for the sake of fire protection is thirty cents, for a distance up to feet (when the grade is to ) or $ . if the grade is not to , then the pipe must be six-inch, and the excess cost is fifty cents or the cost for feet will be $ . if the distance is greater than and the fall not great, so that an eight-inch pipe has to be used, the excess cost is sixty-five cents a foot, or $ for a -foot line. it is sometimes possible to economize by building a large tank containing about , gallons and using only a small pipe to fill, but always keeping the tank full. such a tank would contain cubic feet or would be twenty-two feet square and ten feet deep, or it may be twenty-five feet in diameter and ten feet deep. this tank would have to be erected in the air, higher up than the top of the buildings, and would require heavy supports and a great expenditure. unless, therefore, a convenient knoll or sidehill is available on which to build a concrete tank, the large pipe direct from the water-supply must be provided for fire protection. whether it is worth while depends on the cost of insurance and whether it is considered cheaper to pay high rates for insurance or to spend the large sum for protection. a third choice is also open, namely, to carry no insurance and to install no fire hydrants and to run the inevitable risk of losing the house by fire. perhaps the decision is a mark of the type of man whose property is concerned. _rain water-supply._ it will often happen that no pond or brook is available for a water-supply, and if water is obtained, it must come directly from the rain. apparently, this is quite feasible, since an ordinary house has about square feet area on which rain water might be caught and carried to a tank. in the eastern part of the united states, the annual rainfall is, on the average, - / vertical inches per month, or the volume of water from the roof will be cubic feet. this is nearly gallons a day, or enough for three or four people. the rain from the house and barns might be combined, making perhaps square feet, and giving an ample volume of water for the needs of a dozen people. in discussing the size of tank necessary to hold rain water for a family supply, it must be remembered that for many weeks at a time no rain occurs, and that a tank must be large enough to tide over these intervals of no rainfall. in the temperate zone there is no regularity in the monthly rates of rainfall. in the eastern part of the united states, the months of june and september are usually the months of least precipitation, although the general impression, perhaps, is that july and august have less rainfall than any other months. the truth is that, while wells and rivers are low in july and august, the actual rainfall for those months is not below the normal, and the low flows in the streams are caused by excessive evaporation and by the demands of growing crops. although june and september have usually less rainfall than other months, in boston the fall has been as high as . inches in june and . inches in september. again, in boston, typifying the eastern part of the united states, and taken because of the great length of rainfall statistics available there, the two months of highest rainfall on the average are march and august, and yet, in each month, in some particular year, the rainfall has been the lowest for any of the twelve months in the year. as shown by statistics, the average rainfall in each month, taking a period of forty years or so, is practically constant for each month, and it is only the deviations from the average which would make trouble in a supply tank depending upon rainfall. fortunately, statistics also show that while a month whose average rate of rainfall is three inches may be as low as three tenths of an inch, it is not often that two months of minimum rainfall come together, and in looking over the rainfall statistics the writer finds that for any three consecutive months, including the minimum, the amount of rainfall is generally two thirds of the monthly average for that year; and this is stated in this way because it gives what seems to the writer a basis for determining a fair and reasonable capacity of a rain-water storage tank. it depends, one will notice, on the average annual rainfall; that is, on the depth to which the rainfall would reach in any year if none ran off. this varies from about ten inches in the southeastern part of the united states to one hundred inches in the extreme northwest, the average for the eastern part of the country being about forty-five inches, so that the monthly average is . inches. _computation for rain-water storage._ with this for a basis, it may be determined how large a storage tank ought to be, assuming a family of five persons using water at the average rate of gallons per head per day or gallons each day. doubling this amount to take care of emergencies and of the extra water used in hot weather, let us say that gallons a day must be provided, or gallons a month. if we could be sure of starting at the beginning of any month with the tank full and that exactly thirty days would be the period of no rainfall, then a tank holding gallons would be the proper size. unfortunately, with any month, as august, in which the rainfall may be practically zero, the preceding month may also have been so short of rain that the consumption was equal to or even more than the rainfall, and the month of august would start with no rain in the tank. but if we take a three-month period, those inequalities will be averaged and the supply will be, so far as one can foresee, ample in amount; that is, we shall take the supply required in three months, namely, , gallons, and subtract from it the amount of water furnished in the three months, which is presumably two thirds of the average rainfall on the area contributing to the tank. the normal rainfall in three months is three times - / inches, or - / vertical inches, and if this falls on a roof area of, say, square feet, the total amount of water is cubic feet or , gallons, and two thirds of this is . the tank, then, must hold the difference between the , gallons and , or , gallons, whereas a month's supply would be gallons. the actual tank, therefore, is made to hold a little less than two months' supply. such a tank would be ten feet deep and fourteen feet square, a good deal larger tank, of course, than one ordinarily finds with a rain water-supply; but the estimate of the use of water has been high and a long period of rainfall has been assumed, so that there is little likelihood of a house with this provision being ever without water. _computation for storage reservoir on a brook._ in determining the quantity of water that may be taken from a small stream the area of the watershed answers the same purpose as the area of the roof which delivers water into a tank, the only difference being that from the roof all the water is always delivered, except a small proportion that evaporates at the beginning of a rain in summer. from the surface of a watershed, on the contrary, a large amount, and in some cases all of a stream, will be absorbed by the ground and by the vegetation and will never be delivered into the stream which drains an area. on large streams it is fair to assume that, on the average, only one half of the rainfall on the area will reach the stream, while with sandy soils this may be as small as per cent. from december to may inclusive, when the ground is frozen, when there is no vegetation to absorb the water, and when evaporation is very light, practically all of the rainfall reaches the streams. from june to august, on the other hand, when the soil becomes rapidly parched, when vegetation is most active, and when evaporation is high, frequently no rainfall reaches the streams and the ground water sinks lower and lower, so that often streams themselves dry up. it is necessary, therefore, in providing for a definite quantity of water to be taken from a reservoir built on a small stream, to make the reservoir large enough to furnish water from june to september without being supplied with rain. this does not call for a very large dam or a very large storage, and three months' supply will usually be ample. we have already estimated above that the quantity of water needed for three months will be , gallons, or about cubic feet. if the reservoir is built in a small gulley or ravine, its width may be twenty-five feet. if the length of the reservoir or pond formed by the dam is feet, then the reservoir will furnish cubic feet for every foot of depth, and a reservoir of that size holding one foot of water will tide over a dry season. evaporation during these same three months will use up about a foot and a half in depth over whatever area the reservoir covers, so that two and a half feet in depth must be provided above the lowest point to which it is desirable to draw off the water. it would be well to allow a depth of at least ten feet in order to avoid shallow, stagnant pools, and if this depth is provided, even more than the two-and-a-half foot depth mentioned might be withdrawn in extremely dry seasons, though perhaps at some reduction in the quality of the water. _deficiency from well supplies._ a large number of water-supplies in the country, perhaps the largest number, at present comes from wells, either dug or drilled. it often happens that after plumbing fixtures have been installed with a pump to raise the water to the necessary elevated tank, the increased consumption causes the well to run dry for a number of weeks in the summer. the question then arises, shall the well supply be supplemented or shall an entirely new supply be developed? there are two methods of supplementing a dug well supply, and it may be of advantage to point them out. if the sand or gravel in which the water is carried is fine, it may be that the water will not at times of low water enter the well as fast as the pump takes it out. such a well always has water in it in the morning, but a short pumping exhausts the supply. one remedy here is to provide a more easy path for the water, and that can be done by running out pipe drains in different directions. if there are any evidences that the underground water flows in any direction, then the drains should preferably run out at right angles to this direction, to intercept as much water as possible. the drains must be laid in trenches and be surrounded with gravel, and of course the method is inapplicable if the well is more than about fifteen feet deep, because of the depth of trench involved. [illustration: fig. .--how a pump works.] another remedy is to sink the well deeper, hoping to find a more porous stratum or to increase the head of water in the well. in one well, the writer remembers seeing two lengths of twenty-four-inch sewer pipe, that is, four feet, that had been sunk in the sandy bottom of the well by operating a posthole digger inside and standing on the top of the pipe to furnish the necessary weight for sinking. still another remedy is to drive pipe down in the bottom of the well, hoping to find artesian water which will rise into the well from some lower stratum. this method has been successfully employed in the village of homer, new york, where the public supply formerly came from a dug well twenty feet in diameter. the supply becoming deficient, pipe wells were driven in the bottom and an excellent supply of water found fifty feet below the surface, the water rising up in the dug well to within eight feet of the surface of the ground. if the well is a driven well and the water in the casing falls so low that the ordinary suction pump will no longer draw, two remedies may be applied. a so-called deep-well pump may be used; that is, a pump which fits inside the piping and can be lowered down to the water level. the ability to bring up water then depends on the power to work the pump and on the presence of the water. figure shows the principle on which this pump works. at some point, it may be three or four hundred feet below the surface of the ground, a valve _a_ opening upward is set in the well so that it is always submerged. just above this is a second valve fastened to the lower end of the long pump rod which reaches up to the engine or windmill which operates the pump. at each up stroke water is lifted by the closed valve _b_ and sucked through the open valve _a_. at each down stroke, the water is held by the closed valve _a_ and forced up through the open valve _b_. [illustration: fig. .--pump installation.] the other method of developing a greater quantity of water from a deep well is to use air pressure to force the water either the entire distance to the tank or to a point where the suction of an ordinary pump can reach it, as indicated in fig. . in this method an air blower is needed, and since this means an engine for operation, it is not generally feasible, but is suited to occasional needs, where an engine is already installed for other purposes and is therefore available. the operation is very simple. an air pipe leads from a blower and delivers compressed air at the end of the air pipe, which must be below the level of the water in the well. the pressure of the air then causes the water to rise, the distance depending on the pressure at which the air is delivered. chapter vi _sources of water-supply_ having arrived at the quantity of water necessary to supply the needs of the average household, we must next investigate the possible sources from which this quantity can be obtained. before the advantages of running water in the house are understood, a well is the normal and usual method of securing water, although in a few cases progressive farmers have made use of spring water from the hillsides. it is rare, indeed, for surface water, so called, to be used for purposes of water-supply until after modern plumbing conveniences have been installed. then the use of surface water becomes almost a necessity because of the large volume of water needed. the only drawback to its use is its questionable quality. without modern plumbing, a well meets the requirements of family life, but does not answer the demands of convenience. with modern plumbing, a well is found to be pumped dry long before the domestic demands are satisfied. the result is an attempt to secure an unfailing supply, and for this a surface supply is sought. let us divide, then, the possible sources of water for domestic consumption into two groups, those found under the surface of the soil and those found on or above the surface. in the first group will come wells and springs, and in the second group will come brooks, streams, and lakes. _underground waters._ springs result from a bursting out of underground waters from the confined space in which they have been stored or through which they have been running. thus in fig. is seen how water falling on the pervious area _a-b_ is received into the soil and gradually finds its way downward between impervious strata which may be clay or dense rock. at the point _b_, where the cover layer has, for any reason, been weakened, the pressure of the water forces its way upward and a spring is developed at the point _c_. or, conditions may be as shown in fig. , where the confined water, instead of being forced upward by pressure, flows slowly out from the side of a hill, making a spring at the point _d_, while the water enters the pervious stratum at the point _a-b_ as before. [illustration: fig. .--diagram of a spring.] [illustration: fig. .--water finding its way from a hillside.] [illustration: fig. .--the sinking of wells.] if the water is held in the ground as in the first case, it is possible to develop the spring artificially; that is, to drill through or bore through the overlying impervious strata so as to allow the escape of the water. when this happens, the water bursts forth exactly as in a natural spring except that under some conditions the pressure may be sufficient to force the water rising in a pipe instead of through the ground to flow above the surface of the ground as a fountain or jet, making what is known as an "artesian well." a true well, on the other hand, may be put down in the ground and through strata where springs could never develop; that is, where no pressure exists in such a way as to bring the water to the surface, as in fig. . the well here is sunk until it reaches the water, and it is safe to say that one can always reach a layer of water in the ground by a well if the well is deep enough. the flow of underground water is, however, always very uncertain and confusing, and even in localities where water would naturally be expected in quantity, as, for instance, in the bottom of a valley filled with glacial drift, much disappointment is often experienced because the expected water is not found. the city supply of ithaca, new york, is a case in point. for six miles south of the lake there is a broad, almost level valley filled many hundred feet deep with glacial drift and presumably filled with water flowing at some unknown depth below the surface into the lake. when the city was recovering from the typhoid fever epidemic which, in , committed such ravages, well water seemed to the panic-stricken citizens the only safe water. geologists were called in, and they gravely asserted that the valley contained glacial drift to a great depth and that an ample supply of pure water could be counted on. it was known that water was met all through this valley at depths of from six to twelve feet and then that there would be found a layer of finely powdered silt to a depth of about one hundred feet, when another layer of water would be found, and that all the private wells reached this layer. when tested by the city, however, it was found that this water-bearing stratum was of too fine material to yield its water freely, and the supply from the depth was altogether inadequate. in one section of the town large quantities of good water were found at a depth of about three hundred feet, and the city thought that other wells of the same depth should add to the quantity, but experiment showed that this three hundred-foot water was limited to one particular section, and after a considerable expenditure of money, an underground water-supply for the city was given up. _ordinary dug well._ the ordinary well at a farmhouse is what is known as a shallow well or sometimes a "dug well," usually ten to twenty feet deep. this type does not usually pierce any impervious layer and thus reach a water-bearing stratum, otherwise inaccessible. the water is found almost at the surface, and the depth of the well is only that necessary to reach the first water layer. a very good example of this kind of well is to be found on the south shores of long island sound, where a pipe can be driven into the sand at any point, and at a depth of a few feet an abundant and cheap supply of water may be secured. the amount of water that such a well can furnish depends upon the area from which the water comes and upon the size of the particles of sand or gravel through which the water has to percolate, it being evident that the finer the material, the more difficult for the water to penetrate. the writer remembers superintending the digging of trenches in the streets of a city where the texture of the soil varied continually from clay to sand and even to gravel, all saturated with subsoil water into which wells could have been dug. it was very striking to see how the coarseness of the material affected the quantity of water that had to be pumped from the trenches,--the finest sand requiring only one hand pump at a time, while the coarse gravel required either a dozen men or a steam pump to keep a short trench reasonably free from water. the same conditions exist when a well is in operation, modified by the fact that the coarse material yielding a larger supply will be most quickly exhausted unless the area drained is very large. a shallow well is most uncertain as to its quantity and is likely to be of doubtful quality. there are, however, some examples of shallow well supplies which furnish large amounts of water; as, for instance, the one at waltham, massachusetts, or at bath, new york,--the latter, a dug well some twenty feet in diameter and about twenty-eight feet deep, furnishing a constant supply of good water to a village of about people. _construction of dug wells._ the construction of shallow wells requires little comment. ordinarily, they are dug down to the water, or to such a depth below the level of the water as is convenient, by the use of an ordinary boat pump to keep down the water, and then are stoned up with a dry wall. such a well for a single house requires an excavation of about eight feet diameter, with an inside dimension of about five feet. [illustration: fig. .--mode of sinking a well.] if the soil at the bottom of the well is sandy, it is possible to take a barrel or a large sewer pipe and sink it into the bottom of the well in the water by taking out material from the inside and loading the outside to keep it pressed down into the sand. this same plan may be used to sink the whole body of the well wall, first supporting the lower course of masonry on a curb, so called (see fig. ). this curb is usually made of several thicknesses of two-inch plank well nailed together, the plank breaking joints in the three or four layers used. it is a good plan to have this shoe or curb extend outwardly beyond the walls of the well so that some clearance may be had, otherwise the dirt may press against the walls so hard as to hold it up and prevent its sinking. while this arrangement may be put down in water, it requires some sort of bucket which will dig automatically under water and has not been therefore a customary method except for large excavations where machinery can be installed. there is no reason, however, why the method might not be used for a single house. [illustration: fig. .--a well that will catch surface waste.] in whatever way the well is dug, one point in the construction that needs to be emphasized is that the wall should be well cemented together, beginning about six feet below the surface and reaching up to a point at least one foot above the surface. this is to prevent pollution from the surface gaining direct access to the well, and if this cementing is well done for the distance named, it is not likely that any surface pollution in the vicinity of the well could ever damage the water. figure shows the section of a well where no such precautions have been taken, and it is evident that not only surface wash, but subsurface pollution may readily contaminate the water. figure (after imbeaux), on the other hand, shows a shallow well properly protected by a good wall and water-tight cover. figure shows a photograph also of this latter type of well. even if a cesspool or privy is located dangerously near the well, in the second case the fact that the contaminating influence must pass downward through at least six feet of soil before it can enter the well is a guarantee that the danger is reduced to the smallest possible terms. [illustration: fig. .--a well properly protected.] _deep wells._ deep wells are of the same general character as shallow wells. usually, the ground on which the rainfall occurs is more distant, so that the source of the water is often unknown, and usually, also, the stratum from which the water comes is overlaid by an impervious one. [illustration: fig. .--a properly protected well.] it often happens that there are several layers of water or of water-bearing strata alternating with more or less impervious strata, and that wells might be so dug as to take water from any one of them. indeed, not infrequently in driving down a pipe to reach water, a fairly satisfactory quantity is obtained at a certain level, and then, in order to increase the supply, the pipe is driven further, shutting off the first supply and reaching some other, less abundant. deep wells are reached usually by wrought-iron pipe driven into the ground. sometimes this is done by taking a one-and-one-quarter inch pipe, with its lower end closed and pointed, and driving it with wooden mauls into the ground. when it has gone six or eight feet, it is pulled up, cleared from the earth, and replaced, to be driven six feet again. [illustration: fig. .--well-drilling apparatus.] with ordinary soil, the pipe is easily withdrawn with a chain wrench, and two men will drive one hundred feet in a couple of days. when water is reached, a well point is put on through which water may percolate without carrying too much soil. this type of well is suitable for use in soft ground or sand, up to depths of about one hundred feet, and in places where the water is not abundant. it is most useful for testing the ground to see where water may be found and by pumping from such a well to see what quantity of water may be expected. this type is often used as a shallow well, and the author has seen such wells driven only a dozen feet. such a well has no protection against pollution, and an ordinary dug well is better for shallow depths. a driven well always has a disadvantage also from the ever present danger that the iron pipe will rust through at the top of the ground water and so admit to the well the most polluted part of the drainage. for larger supplies and for greater depths, a machine like a pile-driver has to be used for forcing down the pipe. this is not usually removed, but driven down as far as possible, and when the limit of the machine has been reached, a smaller size is slipped down inside the driven pipe, to be in turn driven to refusal. in rock, that is, if the well has to penetrate a layer of rock, a drill is used that will work inside of the pipe last driven, and by alternately lifting and dropping the drill, and at the same time twisting it back and forth, a hole through rock may be made many hundred feet below the surface of the ground. figure shows a cut of a common type of well-drilling machine. in some soils, not rock, it is necessary to keep the drill going in order to churn up or soften the earth so that the pipe may be lowered. the churned-up soil is removed by a sand pump, which is a hollow tube with a flap valve at the lower end opening inwards and a hook on the upper end. by alternately drilling, pipe-driving, and pumping the wet material, length after length of pipe can be forced into the ground until water of a satisfactory quantity is reached. very often a jet of water is used to wash out the dirt from the interior of the well instead of a sand pump. as shown by fig. water under pressure is forced down the small pipe _a_ which runs to the bottom of the well. the large pipe _b_ can then, as the sand is loosened by the water, be driven down by the one thousand-pound hammer _m_. the water and sand together flow up in the space outside the small pipe and inside the large pipe, overflowing through the waste pipe _w_. this type of well has been very largely used throughout new york state; on long island, in connection with the brooklyn water-supply; along the erie canal, in connection with the barge canal work, and in new york city, in connection with building foundations. [illustration: fig. .--sinking a well by means of a water-jet.] sometimes, when a shallow dug well does not furnish the required quantity of water, the amount of water can be increased by driving pipe wells down into water strata below the one from which the dug well takes its supply, so that water will rise to the strata penetrated by the dug well. this has been done to increase the public supplies at addison and homer in new york state. unfortunately, much uncertainty exists in the matter of the yield of driven wells, and an individual undertakes a deep well usually with great reluctance on account of the expense involved and the uncertainty of successful results. in level ground, conditions are not likely to vary in the same valley, so that if one well is proved successful, the probabilities are that wells in the vicinity will be equally so, and yet, at some places, the contrary has proved to be true. one may estimate the cost of putting down four-inch driven wells as approximately one dollar per foot besides the cost of the pipe, which will be about fifty cents per foot. the cost of one-and-one-half-inch pipe would be considerably less than fifty cents, the cost of driving varying not so much with the size of the pipe as with the soil conditions. the writer recently paid ninety dollars for driving two one-and-one-half-inch wells to a depth of about one hundred feet, the above cost including that of the pipe; the soil conditions, however, were very favorable. in ithaca the cost of driving one-and-one-quarter-inch pipe is fifteen cents per lineal foot up to about fifty feet deep with the cost of the pipe fifteen cents per foot additional. below fifty feet deep the cost increases, since the labor and time required for pulling up the pipe is largely increased, and at the same time the rate at which the pipe will drive is notably diminished. the question of pumping from wells will be considered in a later chapter, together with methods of construction and operation. _springs._ springs should be the most natural method of securing water-supply for a detached house, since no expense is involved except that of piping the water to the building. in europe, spring water-supplies have been greatly developed in furnishing water for large cities. vienna, for example, with its population of nearly two millions, obtains its water-supply from springs in the alps mountains, and many smaller cities do likewise. but in this country springs have been little used for water-supplies, partly because of the uncertain quantity furnished and partly because of difficulty in acquiring title to the water rights. if an individual, however, has on his farm, or within reach, a spring furnishing a continuous supply of water, it would seem quite absurd not to make use of such a heaven-sent blessing. care must be taken always that a spring is not contaminated by surface drainage, and for this reason, as with shallow wells, the wall surrounding the inclosed spring should be extended above the ground and made impervious to water for at least six feet below the surface. in some cases it may be wise to convert an open spring into an underground one, putting a roof over all and then covering with earth and sod. figure shows a type suggested by the french engineer, m. imbeaux. [illustration: fig. .--an inclosed spring.] very often a larger supply from a spring may be obtained by collecting into one basin a number of separate and smaller springs. a swampy or boggy piece of ground is often the result of the existence of a number of springs, and if drains are laid to some convenient corner of the field, and a well dug there, into which the drains will discharge, not only will the swamp be drained, but an ample supply of water in this way be obtained. it would, of course, not be wise to have cows pasture in this part of the field, nor, even when the ground has been dried out, should this field be manured or cultivated. it should rather be fenced and left to grow up in underbrush, dedicated to the farm water-supply. _extensions of springs._ [illustration: fig. .--a spring extension.] again, if the water comes from a stratum w-w, as shown in fig. , a large additional yield can be obtained by extending the spring from the point where it breaks out along the edge of the water-bearing stratum on each side. this extension or gathering conduit can be made by building rough stone walls on each side of the ditch, covering with flat stones so as to form a pervious channel to intercept the water and lead it to the chamber from which the supply pipe to the house leads out. the ground-water level will then be altered as shown by the broken line in the draining. more simply it may be made by digging a trench along the hillside at the same level as the spring, or into the spring if necessary to find the water, and then laying draintile surrounded by coarse gravel or broken stone in the trench. in the western part of the country much knowledge has been gained by investigating and experimenting on this kind of spring water development, only there the springs have been made artificially by digging down to meet the underground flow of water. for example, in the arkansas river valley, california, where it was suspected that water was flowing underground, a trench was dug transversely across the valley, and at a depth of six feet sufficient water was found to amount to , gallons per day for each one hundred feet of trench. on the south platte river, near denver, much the same thing has been done, and in a trench eighteen feet deep, water is collected at the rate of a million and a quarter gallons per day for each one hundred feet of trench. other examples of the same sort might be given. for a single house, the spring need usually only be extended by means of a short trench, and three-inch terra-cotta tile should be laid in the trench and surrounded by gravel and then covered over. the spring receiving water from these tiles should be inclosed, as will be described in a later chapter. _supply from brooks._ whenever a spring is not available and at the same time a supply of running water by gravity is determined on for a house, recourse is generally had to brooks which may find their way down the hillsides in the vicinity. in many instances the water in such brooks is practically spring water and is the overflow of actual springs. where the brook is not subject to contamination between the spring and the point at which the supply is taken, the latter is as truly spring water as the former, and if a long length of pipe is saved, there can be no objection to the brook supply. on the other hand, it is suggestive, at least, of misrepresentation for a summer hotel or boarding house to advertise that their water-supply comes from springs when really it comes from an open brook miles away from the spring which may be indeed the origin of the brook, but with so many intervening opportunities for contamination that the pure original source is unrecognizable. there are two obvious drawbacks to the use of brooks: ( ) that the quality of the water is, in many cases, objectionable, and ( ) that brooks are very apt to dry up in summer on account of their limited watersheds. the discussion on the first point will be postponed to a later chapter, and we have now to consider the question of quantity only. the wisest plan before deciding on a brook supply is to measure the volume of water which flows in the brook at the time when it is lowest, probably about the middle of august. the actual volume of water needed for the household is not large, although its required rate of flow may be high and, as already pointed out, a stream which furnishes water at the rate of one quart in five minutes is sufficient for a family of three persons, a rate which is almost a drop-by-drop supply. such a stream would require a reservoir somewhere in order to supply the faucets at the proper rate, and for a single family a small cistern or even a barrel sunk in the ground would be sufficient for this purpose. an objection to the utilization of so small a flow in connection with the smaller storage is that the temperature of the water in summer is so raised that vegetation and animal growths take place easily and freely, so that the taste and smell of such water is most disagreeable. these consequences can be avoided even with the low flow by increasing the storage, since the larger quantity of water has been found to resist the bad effects of the low flow and high temperature. figure shows a small reservoir actually in use to supply water for a single house. [illustration: fig. .--a reservoir for home use.] _storage reservoirs._ but even if the stream actually dries up for two or three months, it is still possible to use it for water-supply, provided a suitable location for a dam and pond can be found where storage, as described in the preceding chapter, can be secured. for this reason as well as for the greater benefit to the quality of the water, brooks flowing through rough, wooded, and uninhabited country are to be preferred as a source of water-supply to brooks flowing through flat agricultural land, and in many cases, where their flow is largely due to springs, the brooks themselves may compare favorably with springs in quality. _ponds or lakes._ water may be properly taken from ponds or lakes whenever the danger from pollution is negligible. no better source of supply can be imagined than a pond in the midst of woods, far away from human habitation, presumably furnishing an unlimited supply of pure soft water. sometimes water from such ponds contains large amounts of vegetable matter, the result of decomposition of swampy or peaty material, as, for instance, from the ponds in the dismal swamp of virginia, so that the water has a yellow, coffee-colored appearance. the appearance of such water is suspicious, but it need not be feared unless something more pernicious than the coloring matter is present. as the country becomes more settled, ponds are more and more likely to become contaminated and hence unfit for a water-supply, and this possibility must be taken into account in planning for a water-supply. it would be most shortsighted to carry a long line of pipe from a house to a pond several miles away, only to have the pond made unfit for use within a few years by the growth of the community around the pond. the possibility of coöperation ought not to be overlooked, however. it is quite possible that half a dozen householders might be so located with respect to each other and to a pond that an arrangement could be made whereby the owner of a small pond would agree to fence it around and dedicate it to the purposes of a water-supply, doing this as his share. the others might then well afford to pipe the water to one house after another, including that of the owner of the pond. water from a pond or lake has one great advantage over water from a brook, namely, that contaminating substances in the pond settle out, so that pond water, especially if the pond is deep, is always of much better quality than running water. for this same reason, water taken from a reservoir on a stream is much better water than that in the stream above the reservoir indicates, and pollution is much less to be feared where the reservoir exists. _pressure for water-supplies._ the value of a high pressure in the water-pipes of a house has been much overestimated. for a number of years the water-supply in the writer's residence came from a tank in the attic, the pressure in the bath-room being not more than ten feet, and while the water flowing through a three fourths inch pipe was noticeably slow, it was not so slow as to discredit the supply. a height or head of twenty feet above the highest fixture in the house would be better and ought to be secured whenever possible. this head is obtained by having the source of supply higher than the highest fixture, not merely the twenty feet mentioned, but also an additional height necessary to offset the frictional losses caused by the running water. the loss from this source in case of fire supply has already been referred to, but for purely domestic supplies the loss is appreciable. the maximum rate as already indicated is not more than gallons per day, whereas the fire rate both for single houses and for a small hamlet is about a million gallons a day. for the lower rate, as well as for rates one half and twice this rate, the friction loss in vertical feet per feet run in small pipes is shown in the following table:-- table x. showing loss of head by friction, for different quantities of flow, and in different sizes of pipes ======================================================================== rate of flow | | | | | in gallons | | | | | per day | / " pipe | / " pipe | / " pipe | " pipe | - / " pipe -------------+-----------+-----------+-----------+---------+------------- | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . ======================================================================== the table shows how much additional elevation is needed over the feet already referred to. for example, suppose it is decided that a rate of quart in seconds is to be maintained from three faucets or a rate of gallons per day. suppose that a pond feet away is found to be feet above the highest faucet in the house, and it is a question what size pipe ought to be used. by the table a -inch pipe loses . feet per feet or feet in the feet, an impossible amount when only feet are available, although the size would be entirely proper if the difference of level was feet or anything greater. a - / -inch pipe, however, loses only . foot in or feet per mile, so that the - / -inch pipe would be necessary, although that size would answer even if the pond were a mile and a quarter away. when water from a well is pumped to an elevated tank there is the same necessity of providing about feet difference in level between the tank and the highest fixture, but the length of pipe involved being small, the friction losses are not great. it should be noted even here that too small a pipe may reduce the pressure, a / -inch pipe causing a loss of feet in a -foot pipe line. if a tower is built by the side of the house, the distance down to the ground, across to the house, and up to the second floor would hardly be less than feet, and this is a loss of - / feet, which means that the tank would have to be set higher in the air by this amount. with a / -inch pipe, it should go . feet, and with a -inch pipe but a foot higher than the level necessary to make the water flow out of the faucet at the rate already specified. chapter vii _quality of water_ a pure water-supply has always been regarded as desirable and its value can hardly be overrated, from the standpoint of health, happiness, or economy. from the earliest history, no crime has been so despicable as that of deliberately poisoning a well from which the public supply was obtained, and in the past no charge more quickly could stir the populace to riot. in strassburg in two thousand jews were burned for this crime charged against them; and as late as the parisian mob, frantic on account of the many deaths, insisted that the water-carriers who distributed water from the seine, shockingly polluted with sewage as it was, had poisoned the water, and many of the carriers were murdered on this charge. yet no water, as used for drinking purposes, is absolutely pure, according to the standards of chemistry. distilled water is the nearest approach to pure water obtainable, and it is said by physicians that such water is not desirable as a habitual and constant beverage. the human body requires certain mineral salts particularly for the bones and muscles, and while these salts are provided in a large measure by food, a number are also furnished by drinking water. on the other hand, a wonderful natural process is accomplished by distilled or approximately pure water in that the water tends to dissolve, to add to itself, and to carry away whatever excess of solids may exist in the body. for certain kidney diseases, for example, pure water is prescribed, not merely as a means of preventing further accretions, but for the purpose of dissolving and removing the undesirable accumulations already existing. practically, considerable latitude is possible in the matter of the purity of drinking water, and no particular harm is to be apprehended by the constant use of either a water containing as little as ten parts per million of total solids or of water containing as much as three hundred parts per million of total solids. the human body, in this as in so many other ways, is so constituted as to be able to adjust itself to varying conditions of food, and, until an excessive amount of ingredients are absorbed, no great harm is done. there are, however, certain definite substances--animal, vegetable, and mineral--which, when found in water, are decidedly objectionable, and it is not the amount of foreign matter in a water-supply, but its character, which is of importance in a water to be used for drinking. _mineral matter in water._ the mineral matter is the least objectionable as it is also the most common, since all water is forced to partake, more or less, of the nature of the rocks and soil over which it passes. good waters contain from twenty to one hundred grains per gallon of mineral salts; that is, of various chemical substances which are able to be dissolved by water. if the amount is much in excess of one hundred parts, the water is noticeably "hard," and this may increase to a point where the water cannot be used. for example, the writer once superintended the locating and drilling of a well which passed through a bed of sodium sulphate or gypsum, just before reaching the water, so that as the latter rose in the well it dissolved and carried with itself a large amount of this salt, so much that the water was useless. water containing more than one hundred grains per gallon of such salts as magnesium sulphate or sodium phosphate is a mineral water rather than a good drinking water, and while an occasional glass may do no harm or may even have desirable medicinal effects, such a water is not fit for constant drinking. it is worth noting that many attempts have been made to show the relative effect of various hard waters on the health. a french commissioner reported that apparently people in hard-water districts had a better physique than in soft-water districts. a vienna commissioner also reported in favor of a moderately hard water for the same reason. it is to-day believed by many that children ought to have lime in water; that is, ought to drink hard water to prevent or ward off "rickets" or softening of the bones. an english commissioner, on the other hand, has concluded that, other things being equal, the rate of mortality is practically uninfluenced by the softness or hardness of the water-supply. this same commissioner has also shown that in the british isles the tallest and most stalwart men were found in cumberland and in the scotch highlands, where the water used is almost invariably very soft (thresh's "water-supplies"). it has been asserted that certain diseases, not necessarily causing death, are caused by hard water, as calculus, cancer, goiter, and cretinism; but, as already pointed out in chapter ii, no satisfactory proof has ever been established. one must conclude that within reasonable limits there is little to choose between a hard and soft water for drinking purposes, although a change from a soft water to a hard, or _vice versa_, usually produces temporary derangements. _loss of soap._ for washing purposes the value of a soft water is more marked. when a hard water is used, a certain amount of soap is required to neutralize the hardness before the soap is effective, and this takes place at the rate of about ounces of soap to gallons of water for each part of calcium carbonate per gallon, or about ounces of soap to , gallons for each part per million increase in hardness. the village of canisteo, new york, has a hard spring water, the hardness being recorded by the state department of health as . parts calcium carbonate in a million parts of water. clifton springs water has a hardness of . catskill, new york, which gets its water from a stream running down from the hillside, has a hardness of . or . parts less than canisteo. mr. g. c. whipple says ("value of pure water") he has found that pound of soap is needed to soften gallons of water when that water has a hardness of parts per million, and that each additional part requires pounds of soap to soften a million gallons. if clifton springs and catskill should each use , gallons per day, the additional cost of the hard water, at five cents a pound for soap, would be × . × . = $ . , provided all the village water were neutralized with soap. probably not over one fiftieth part of the water is so neutralized, so that the added cost of soap is actually about $ . a day. whipple expresses this cost as _h_/ = _d_, where h is the hardness in parts per million and _d_ is the cost in cents for every gallons used for all purposes. thus canisteo water costs . / = . cents per gallons used, while catskill costs only . / or . cent on account of soap. this discussion is intended to suggest a comparison between a well of hard water and a surface supply of soft water, when both are available. it should arouse an interest in securing a soft water as well as a clear water, and the advantages of the softer water, in so far as soap consumption alone is concerned, are seen to be not inconsiderable. _vegetable pollution._ the vegetable and animal matter is organic in its origin and nature, and their effect on water may be taken up together. vegetable pollution is generally the result of decayed leaves, roots, bark, and such other vegetable tissue as would be likely to be found where the water-supply flows through a swamp or accumulates in hollows and depressions. this sort of water is likely to have a brownish or yellowish brown color, to have a slightly sweetish taste, and to be soft, that is, free from mineral solids. usually such water can be used for drinking purposes without serious consequences. Æsthetically, it is objectionable because of its color, and the city of boston has expended many thousands dollars in building channels around swamps and in providing artificial outlets for swamps, so that the color of the water collected on the watershed shall not show the color induced thereby. water from the dismal swamp of virginia is so discolored as to look like coffee, and yet, in the vicinity, it is much prized for drinking, and formerly great pains were taken to fill casks with this water when in preparation for a long sea voyage. such matter always has a marked influence on a chemical analysis of the water, shows large amounts of nitrogenous matter, and apparently indicates a polluted supply; but, if the reason for this apparent pollution lies in the presence of a swamp, no danger to health therefrom is to be apprehended. such water also is less subject to decay or putrefaction, and if a water-supply for a house is to be taken from a small pond, a gathering ground containing swamps is likely to furnish a more satisfactory water, color alone excepted, than one free from such swamps. _pollution of water by animals._ animal pollution usually comes from the presence on the watershed of domestic animals, that is, cows, sheep, and horses, or from manure spread on fields draining into the brook, or from barns or barnyards close by the water. it is the presence of this sort of pollution that furnishes the other kind of organic matter not to be distinguished by chemical analysis from the organic matter just referred to, but vastly more objectionable. drainage from houses and barns is responsible for the same kind of animal pollution, and while it is difficult to prove by statistics that such pollution is always dangerous to health, it is sufficiently repulsive from an æsthetic standpoint to be done away with whenever possible. such pollution applies only to surface water, such as brooks or lakes, and the best method of detecting and evaluating this pollution is to make a careful inspection of the watershed. if it is proposed to use the water from a certain stream for drinking purposes, the first step should be to examine carefully the area draining into the stream, to detect, if possible, all opportunities for animal wastes to find their way directly into the stream and to note whether fields sloping rapidly to the streams are manured; to see whether the stream flows through pasture land in which cows are kept, and especially to note whether houses with their accompanying outbuildings are near enough the brook so that water may at any time wash impurities down into the stream. whenever a brook flows through woodland free from all animal pollution and not subject to pollution before entering the wood, the water is probably as pure as that in any spring or well. on the contrary, when the water in a brook flows through a meadow used for pasture or through gullies, the sides of which are manured, or in the vicinity of houses and barns, the water is probably unfit for drinking purposes. this can be realized by standing at the edge of a barnyard and watching the rain falling first on the roof of the barn, then in larger quantities from the eaves on to the manure pile into the yard below, then accumulating in pools of reddish black concentrated liquid, until the volume is sufficient to form small rills which gradually assemble into a fair-sized stream. similarly, the pig-pen drainage is washed out from under or even through the building, and, after combining with the barnyard drain, is carried into the stream near by. the very idea of drinking such filth is nauseating in the extreme. it is common for small slaughter-houses to be built on the side of a stream, so that the offal, carrion, and refuse of the place may be carried off without effort on the part of the owner, and there are a number of such places where brooks, used as places of deposit for slaughter-house refuse, discharge directly into the reservoirs of water works. but this sort of animal refuse is not the most serious pollution. the leachings and washings from privies and cesspools, carrying, as they do, germs of contagious diseases, are most to be dreaded, and when a privy (with no vault underneath) is built on the side of a steep ravine and is so located that the natural drainage of the sidehill on which it is built cannot help but run around and through the building, then the pollution of the stream in the gulley is not only direct and inevitable, but of a deadly sort (see fig. ). fortunately, the germs thus carried into the stream suffer the vicissitudes of all life exposed to the attacks of hostile forces. at the time of freshets the streams carry mud in abundance, which mud is continually settling out of the water as opportunity offers, and with this settlement of mud there occurs also the settlement of the germs. also the pathogenic or disease-producing germs are usually weaker and more susceptible than the putrefactive and other organisms which are found in the water in great abundance after any rain storm, and which tend to inhibit or destroy the pathogenic germs. but some will survive, and, with favoring conditions, may pass through the water-pipe to the house, causing sickness, if not death. [illustration: fig. .--stream draining a privy.] any inspection of the watershed, therefore, should look to the elimination of the dangers above described, and to the location of barns and barnyards, pig-pens and poultry yards, privies and cesspools, so that no direct drainage into the stream shall be possible. it is out of the question for any surface water-supply to be pure, since the mere fact of the passage of water over the soil inevitably results in the collection of organic matter; and it is no exaggeration to say that the time will inevitably come in this country, as it has already in germany, when no surface supply will be considered satisfactory unless the water is filtered. the only alternative is water gathered from areas that are owned by the individual and on which, therefore, all dwellings may be prohibited, all cultivated land avoided, and where the primeval forest may be restored, making the watershed equal to that from which forest streams emerge. but usually, in the case of a single house, it will not be possible entirely to eliminate the dangers of surface pollution, although an inspection will show the dangers, and possibly some of them may be avoided. certainly any direct drainage into the streams should be cut out, as well as the drainage from barnyards in the immediate vicinity of the point where the water is taken out. just what percentage of pollution may be eliminated in this way it is impossible to determine, but it is not too much to say that no brook or pond should be used for a water-supply of a house unless _every known pollution_ of an organic nature has been removed. under the most favorable circumstances there will be enough accidental contamination to make the water at times dangerous, and no added risks ought to be assumed. in looking over a watershed the possibility of sewage entering the stream is, of all pollutions, the most to be avoided. to adequately investigate the quality of a stream, the inspector must satisfy himself as to the point of discharge of the sewer of every house on the watershed, and this must be done personally, without apparently reflecting on the statements of the owner of the house. if any such points of discharge are found, the sewage should be either diverted into some other watershed, or spread out over the ground away from the stream, or purified by some artificial treatment before discharge, or else the creek water cannot be used. the next point to be noted in the source of the water-supply is the presence and location of privies. these nuisances should be as far back from the banks of the streams as possible to eliminate all danger since the surface of the ground always slopes toward some stream, and pollution may be carried for considerable distances over or through the soil. water-tight boxes can be provided so that no possible pollution of the surface-wash can occur, and if periodically the contents of these boxes be hauled away and buried, the privy loses its dangerous character. the city of syracuse has installed on the watershed of skaneateles lake a most admirable system of collection of privy wastes, and the lake water is thoroughly protected, although there are several hundred privies on the watershed. cesspools, in general, are not dangerous if they are located fifty feet or more from the stream and if no overflow occurs. barnyards ought not to drain directly into streams, but when, as in so many cases, the stream flows through the barnyard, the only remedy is to move either the stream or the barnyard, and it is difficult to persuade even a well-disposed neighbor to do either. it is sometimes possible to appeal to his sense of right; but, too often, the neighbor feels that it is his land, his barn, his drain, even his brook, and he will do whatever he pleases with them, whether the water further down stream is to be used for drinking purposes or not. the question resolves itself into an inspection of the watershed and a determination of the existing conditions. if those are tolerable, the water may be used. if evident contamination is present, the water must usually be given up, and some other source of supply sought. _well water._ the pollution of wells, if it exists at all, is usually very pronounced, and it is probably safe to say that, except where buildings, drains, or cesspools have been crowded too close to wells, or where some manifest and gross cause of pollution exists, a well water is safe to drink. to protect properly a well from gross pollution, two precautions should be observed. the wall of the well should be built up in water-tight masonry, so that surface wash cannot enter the well except at a depth of at least six feet, and second, this water-tight masonry should be carried above the surface of the ground at least six inches and the well then covered with a water-tight floor so that no foreign matter can drop through the floor into the well or can be washed in by the waste water from the pump (see figs. , , ). if these precautions are taken, it is safe to say that nine tenths of the pollution occurring in isolated wells would be stopped. besides the above, a well may be polluted by a stream of underground water washing the contaminating matter through the soil. experiments have been made to show this very plainly. a large number of bacteria were placed six feet below the surface just in the top of the underground stream of water. within a week they were found in considerable numbers in the water of the soil one hundred feet distant, but when the same number of bacteria were placed in the soil four feet below the surface above the level of the ground water, none of them found their way into the water of the soil. this experiment shows the folly of building a cesspool in the vicinity of a well when they both go down to the same water level, since the contents of the cesspool will be carried into the well if the underground stream flows in the proper direction. a shallow cesspool, however, would not be open to the same objection. it is always difficult to detect the direction or flow of underground water, and various technical and delicate methods have been selected to make this determination. a very simple test, however, is to dig a hole at the point where pollution is suspected, carrying the hole down to where ground water is reached, and then to throw a gallon of kerosene oil into the hole, and if the ground-water flow is toward the well, the presence of kerosene in the well water will make the fact known. this would not, however, prove that the actual contamination would produce disease, since a liquid like kerosene can find its way through the pores of the soil to much greater distances than bacteria can be carried. but, to be on the safe side, water from such a well should not be used. to make sure of the quality of the water proposed for a water-supply, it is wise to have such water examined by a chemist. the chemist will make certain determinations of ammonia and other chemical combinations, and will report his findings with an interpretation or explanation of the result. what he finds is not the presence or absence of disease or disease germs, but substances that suggest or involve the presence of organic pollution. a test is made for the number of bacteria, and a well of spring water which contains more than about fifty in a cubic centimeter is a suspicious water. surface water, on the other hand, may contain two or three hundred without being necessarily bad, the types of bacteria being harmless. generally, a chemist will also determine the presence of the colon bacillus which is found in the intestinal tract of man or warm-blooded animals. wherever this is found, in even such a small quantity as one cubic centimeter of water or less, there is strong presumption that the water has been polluted by human wastes and is therefore not fit to drink. _dangers of polluted water._ since no evidence of the danger of drinking polluted water can be so graphically expressed as by a direct reference to epidemics caused by the unwise use of such water, it will not be out of place to refer briefly to some of the instances in which a direct connection has been traced between a specific pollution of a certain water and disease or death resulting from it. although, as has already been explained, an infected water causes various kinds of intestinal disorders, particularly among children, the most characteristic evidence of pollution occurs when the noxious material comes directly from a typhoid fever patient, so that this same disease can be recognized as transmitted to another individual or family. this transmission of typhoid fever, while in some cases very plainly due to other agencies than water, as, for example, milk, oysters, and flies, yet, by far the largest proportion of the transmitted cases comes through the agency of polluted drinking water, and there are many examples both of contaminated wells and streams which emphasize this possibility beyond all question. two historic investigations of epidemics which have thoroughly convinced sanitarians that typhoid fever is a communicable disease and that water is the vehicle for its transmission may be briefly cited. in dr. thorne reported an epidemic in the town of caterham, england, which he had investigated, and disclosed the following facts: the population of the village was . the first case of fever appeared on january . others followed in rapid succession, until the number reached , of whom in due time died. the possibility of infection was carefully looked into. the influence of sewer air was ruled out because there were no sewers. the milk supply was proved unobjectionable. no theory of personal or secondary infection could account for the widespread prevalence, particularly as only one isolated case had occurred during the preceding year, and this had been imported. of the first persons attacked, lived in houses supplied with the public water-supply, and the other two were during the day in houses supplied with public water. further, in the caterham asylum, with nearly patients, not a single case appeared, their water coming from driven wells. investigation of the water-supply showed the undoubted cause of the epidemic. the public water-supply was derived from three deep wells, connected by tunnels in the chalk. in one of these tunnels, from january to the end of the month, a laborer worked, who, though unattended by a physician, was evidently suffering from mild typhoid fever, the symptoms of the disease being carefully detailed by dr. thorne. the laborer at the time of his going to work had a severe diarrhoea, and while in the tunnel was obliged to make use of the bucket, in which the excavated chalk was hauled to the top. he admitted that at times the bucket, in being hauled up, would oscillate in such a way as to spill part of its contents and thereby pollute the water of the well below. two weeks from this accidental pollution the epidemic began, and there can be little doubt of the relation of this mild case of typhoid to the epidemic which followed. a second illustration may be cited at butler, pennsylvania, which occurred in . the water-supply of butler, a borough of , people, comes from a reservoir on the creek which flows through the phase. on account of the gross pollution of the water at the pumping-station, a long supply pipe has been laid from the reservoir directly to the pumps. the water also was filtered through a filter of the mechanical type. through some accident the filter was thrown out of service for eleven days, between october and , , and unfortunately, on account of the failure of the reservoir dam, the water was at that time being taken directly from the creek at the pump well, and had been since august . only ten days after the filter was shut down, the epidemic broke out in all parts of the town. between november and december there were cases and deaths. in the subsequent investigation it developed that not only was the stream generally polluted by the sewage at various points above the intake, but that there had been several cases of typhoid fever on the watershed, some on a brook that enters the creek within one hundred feet of the filter plant. as at caterham, the inference is patent that the introduction of some specific infection into the drinking water was the direct cause of the general epidemic. the occasional outbreaks of typhoid fever which occur in single families are not so easy to explain, particularly since the small number of persons affected does not usually call for a widespread interest on the part of those experienced in such epidemics. in the twenty-seventh annual report of the new york state department of health, the following description of an outbreak in a small hamlet, where the cause seems to have been the use of a pond for a wash tub by some italian laborers, thereby transmitting the disease germs from their clothes to the water afterwards used in a creamery, is given. the diagram, fig. , shows that the creamery secured its water for the purpose of washing cans from a small pond by means of a gravity pipe line. the foreman of the creamery, who boarded at the residence marked _a_, first contracted typhoid fever. a week later an employee at the creamery also contracted the fever, the residence of the latter being marked _b_ on the diagram. about six weeks later the railroad station agent, living at the point marked _c_, contracted the fever, and two weeks later his wife was attacked with the same disease. the residences at _b_ and _c_ are only about three hundred feet apart, both families taking their water-supplies from a spring between the two, but nearer _b_. during the summer previous to this outbreak a gang of italian laborers, engaged in double-tracking the central new england railroad, were housed in box cars standing on one track of the railroad. one of the members of the gang was reported to have been taken ill with a fever and was at once removed, it was supposed, to a hospital in new york. it was the practice of the italian laborers to bathe and wash their clothes in the upper of the two ponds from which water is supplied to the creamery by the pipe line. all the persons who contracted the fever were supplied with milk from the creamery. the foreman, who was the first to contract the fever, used water from the creamery and from the well at the house where he boarded. the other families, as already mentioned, used water from the spring. the conclusions, therefore, are that the creamery in some way became infected with typhoid fever, probably through the water-supply from the pond, and that the first two cases were due directly to this cause; that the station agent and his wife contracted the fever because of the infection of the spring, either from some small stream which is the outlet of the ponds or from some infection due to the illness of the owner of the house _b_ near by. the report concludes as follows: "the use of water for creamery purposes from a pond exposed to such unwarranted and unchecked pollution as is shown here, or the permitted abuse of a water-supply for a creamery, appears little less than criminal negligence on the part of those responsible for the management of the creamery." [illustration: fig. .--contamination of a creamery from the water-supply.] another report in this volume of the new york state department of health illustrates very well how a spring or well may be contaminated, and is taken from a report on an outbreak at kerhonkson, ulster county. the report reads as follows: "the village of kerhonkson is built mainly on the side of a mountain of solid rock covered by a thin top soil of variable depth. owing to its rocky nature, only one or two wells exist throughout the whole place; such a thing as a drilled well has never been seriously considered. "the inhabitants obtain their drinking water from a well on the property adjacent to and above the present school building, and known as the "brown" well, and from a clear spring at the bottom of the hill in the rear of the village store and known all over the region as the loundsbury spring. "the school building is an old-fashioned two-story ramshackle affair with overhanging eaves, especially designed to obstruct light and darken the upper schoolroom. the building is in the center of a pine grove × feet in size, which also obstructs the light and tends to dampen the building. at the extreme ends of this school lot are two privies for the boys and girls, built on loose stone foundations, innocent of mortar or cement, which allows the water in heavy storms to wash out the fecal contents of from nearly a hundred pupils down upon the habitations below. were the wells existing in the village as carelessly constructed as the brown well and the various privy vaults which i have inspected, the loss of life from typhoid fever would be terrible indeed. "obtaining the names of all the patients who had suffered from this disease, i found that all but three were kerhonkson public school pupils, and all had drunk the water of the before-mentioned well on the brown property. two out of these three cases were mothers of pupils who had been stricken with the fever and who had nursed the children through their long and exhausting illnesses and afterward had been attacked by the disease themselves, while the third and remaining case was a puzzler. this boy had never been a pupil of the school in question, nor had he partaken of any of the water of the suspected well. he was a pupil of another school entirely and lived in an adjoining village a considerable distance away. a special visit to him, however, developed the fact that some time before his illness he had come to the village store in kerhonkson to purchase goods and had drunk water from the loundsbury spring. "two years ago two cases died of typhoid fever on the property on which the brown well is situated. their stools were treated with lime and buried on the hill behind the house. three cases of the same fever have occurred in the same house this season. the well in question is laid up with stone and cement and was supposed to be tight and impervious to surface water contamination. investigation, however, proved that there were openings in the stone work in the side toward the privy. on examining the privy it was found that the foundation was composed of loose stones without cement or mortar that would readily allow the fecal contents to be washed down toward the well, the privy being about three feet higher than the well, the natural descent of the land being about one foot in twenty-five, the distance between privy and well being only about eighty feet. another factor favoring the well contamination from this privy is that any filth washed downward from the privy toward the well would be stopped by the wall of the house proper and carried directly toward the well which lies close to the southeast corner of the house. thus all of the conditions point to privy contamination of this well which should be at once cemented up on the inside, thoroughly cleansed and purified, before its use should be permitted, while all the privies in question should be provided with vaults of brick eight inches thick with eight-inch brick floors all laid with cement, and their inside surfaces lined with cement at least one inch thick, to prevent any further possible contamination." in view of the imminent danger always possible wherever human wastes are directly discharged into streams, whether from privies or sewers, it is obvious that water so contaminated should never on any account be used as drinking water. it does not follow, because a stream so contaminated has been used for months or years without producing any evidence of disease, that the water is safe. unless an excessive amount of organic matter is so transmitted, no evidence will be found that such pollution has existed through any outbreak of disease. but if once the discharges become affected through a person having typhoid fever, then the result of the infection is apparent immediately. if, therefore, an inspection of the stream above the point where it is proposed to take the water-supply shows the existence of privies, as shown by fig. , the water should not be used for domestic supply, although a number of individuals may have been using the water for years without bad effects. it is a case in which prevention is much wiser than cure, and while economy and convenience may indicate such a polluted stream to be a desirable source of supply, a proper regard for health conditions will rule it out absolutely. chapter viii _water-works construction_ construction methods and practices which lend themselves to the development of the water-supply for an individual house may be divided into three parts, namely:-- ( ) construction at the point of collection, whether this point be a well, spring, brook, or reservoir; ( ) the pipe line leading from the collection point to the buildings; ( ) constructions involved in the house, other than the plumbing fixtures. taking up these different points in order, we may note at the outset that it is possible to employ either very simple or very complicated construction. _methods of collection of water._ the common method is to lay a galvanized iron pipe in a ditch as far as a spring and there to protect the end of the pipe with a sieve or a grating and to leave it exposed in the water with no efforts expended on the spring itself. in a brook with waterfalls or with good slope, it is not uncommon to project a large pipe or a wooden trough into the stream at the top of a waterfall and so carry a certain amount of the water into a tub or basins from which the small pipe leads to the house. on the shores of a lake or pond the galvanized iron pipe is laid out on the bottom of the lake with the end protected by a strainer. in all these cases the simplest method is the best, provided the supply of water is not needed in the winter; but such simple methods as just described fail when frost locks up the surface flow of the stream. then the pipe throughout its entire length must be in a trench below the frost line at the entrance to the spring as elsewhere. to permit this, the spring must also be deep, or else so inclosed that the pipe leading into the spring can be covered by earth banked up against it. not long ago the writer saw a pipe taking water from a small lake recently improved by a stone wall. instead of conveying the water-pipe down under the wall the unwise stone mason had built the wall around the pipe and the pipe line was frozen up through the entire winter following. such simple methods also fail when the supply of water is not adequate, since, in order to secure a large quantity from a stream whose flow is periodic and irregular, some storage must be provided, and storage usually requires more or less elaborate construction work at the reservoir. another reason for more elaborate construction at a spring is to prevent surface contamination, and it is always desirable to roof over a spring in order to protect it from surface flows. the writer has seen, as an example of objectionable construction, a spring in the bottom of a ravine or gully down which, in time of rain, torrents of water passed, although in a dry season the spring was the only sign of water in the vicinity. it could not but happen that this torrent of water, which carried all kinds of pollution from the road above, practically washed through the spring, destroying its good quality. in such a case, another channel for the gulley water ought to have been made, or else the spring dug out and roofed over, so that the torrential water could pass above it. in other cases, the spring is found at the lowest point in a general depression, so that, while no stream passes through the spring, the spring is a catch-all for the surface drainage in the vicinity. in such cases the water should be protected by a bank of earth around the spring, behind which the drainage should be led off through a special pipe line if necessary. _spring reservoirs._ in protecting the spring and in building up around it in order to put it underground, concrete is the most suitable material, although a large sewer pipe or a heavy cask or barrel will answer the purpose. it is usually sufficient to dig out the spring to a depth of four or five feet, and with a pump it is possible to keep the water down, so that the concrete walls may be laid. in building these walls, it is important to notice from which side the spring water comes, and on that side holes should be left in the wall. these openings may properly be connected with agricultural tile drains laid out from the spring in different directions, serving both to drain the ground and to add volume to the spring. it is often possible instead of pumping out water during construction to drain a spring temporarily, in places where the ground slopes rapidly, by carrying out a drainpipe from the lowest level; this drain is to be later stopped up. the size of this spring reservoir depends on the average rate of flow of the spring and on the quantity of water used. if there is always an overflow from the spring, that is, if it always at all times of the year furnishes more water than is required by the house at that time of day when the greatest demand is made, then a two-foot sewer pipe is just as good as a concrete chamber ten feet square. but if at times the spring is low, so that the flow during the night must be saved to compensate for the excess consumption during the day, or if the rate at which the water is drawn at certain hours is greater than the average rate at which the spring flows, then storage must be allowed for in preparing the spring to act as a reservoir. we have already estimated that a family of ten persons might use five hundred gallons of water a day, and the most exacting conditions would never require the spring to hold more than one day's supply. this would mean a chamber four feet deep and in area four by five feet. if the average supply of the spring is less than the average consumption of the family, then the spring must become a storage basin for the purpose of carrying water enough over the dry season, and the capacity of the basin must be computed from the number of days' storage required. it may not be out of place to suggest again the possibility of increasing the yield of the spring by laying draintile in a ditch running along the permeable stratum. these pipes may run fifty or one hundred feet each way from the main spring, so long as they continue to find ground water. the walls of such a spring reservoir as here suggested for depths of six to eight feet need not be more than nine inches thick, whether built of brick or concrete. for greater depths the thickness should be increased to twelve inches. [illustration: fig. .--a protected spring-chamber.] the roof of the spring-chamber may be of plank, but this is temporary and undesirable. it is far better, for all spans up to ten feet, to make the roof a flat slab of concrete six inches thick, imbedding in the concrete in the bottom of the mass some one-half-inch iron rods, spaced about a foot apart each way and extending well into the side walls. the size of these rods should increase with the size of the chamber, making them three-quarter-inch rods up to a nine-foot span, and one-inch rods up to a twelve-foot span. there should be some way of getting into the spring, preferably by an opening in one corner so arranged as to carry the side walls of the opening or manhole up above the ground, where it may be protected with an iron cover locked fast (see fig. , after imbeaux). besides the outlet pipe from the spring, which will naturally pass through the side walls about halfway between top and bottom in order to get the best water, there should be a drainpipe from the lowest part of the inclosure, the valve of which can be reached through a valve box coming to the surface. in the figure the drainpipe is shown by the dotted line, and the twofold chamber is for the purpose of allowing an examination of the spring to be made at any time. the concrete used in this work should be of good quality, one part of cement to five parts of gravel or to four parts of stone and two parts of sand. a concrete bottom, although sometimes used, is not necessary. the position of the drain, of the house pipe, and of the several collection pipes must not be overlooked when the wall is being built, since it is much easier to leave a hole than to dig through the concrete afterwards. _stream supplies._ if the volume of a stream is more than enough for the maximum consumption, nothing is needed but to carry the intake pipe from the shore out under water and protect the end with a strainer. in this case, however, the stream may freeze down to the level of the strainer and even around the strainer, so that the supply of water in winter would be cut off. to avoid this possibility the intake pipe ought to be in a pool of water so deep that it never freezes, and this means sometimes creating a pool for this very purpose. if storage is to be provided, a reservoir must be built, and this intake pipe would naturally be placed at least two feet below the surface of the water. _dams._ if the stream is not deep, or if there is not a pool of satisfactory depth, or if the minimum flow of the stream is not adequate for the maximum needs of the consumers, a dam across the stream becomes a necessity. there are two or three types of dams suitable for a reservoir on a small stream, and they may be described briefly. a dirt dam is not generally desirable, since in most cases the dam must also be used as a waste weir; that is, the freshets must run over the dam. this means that unless the crest of the dam is protected with timber or masonry the dam will be washed out; as happened, indeed, in the terrible flood at johnstown, pennsylvania, several years ago. if it is possible to carry the overflow water of the stream away in some other channel than over the dam, then a dirt dam is not objectionable, although always a dirt dam is best with a masonry core. a very good dam can be made by driving three-inch tongue-and-grooved planking tight together across a gulley and then filling in on each side so that the slope on each face is at least two feet horizontal for every foot in height. this last requirement means that if the dam is ten feet high, the width of the dam at the base shall be at least forty-five feet, the other five feet being required to give the proper thickness to the dam at the top. [illustration: fig. .--concrete core in a dam.] in the second type of dam this central timber core is replaced with a thin wall of concrete as shown in fig. , from six to twelve inches thick, sufficing to prevent small animals burrowing through the dam and at the same time to make the dam more nearly water-tight. sometimes stone masonry is used, building a light wall to serve as the true dam, and then holding up this light wall with earth-filling on each side. if neither plank, stone, nor concrete can be used, the central core is made of the best earth available, a mixture of clay and sand preferably, and special pains are taken in the building to have this mixture well rammed and compacted. the writer has recently heard of a dam on a small stream being made by the continual dumping of field stone from the farm into the brook at a certain definite place. this stone, of course, assumed a slope at each side and settled in place from year to year as the dam grew. the mud and silt of the stream filled up the holes between the stones, so that the dam was finally practically water-tight. this made a cheap construction and had the additional value of serving to use up stones from the fields. it was necessary, since the spring floods poured over the top of this dam, to protect the top stones, and a plank crest was put on, merely to keep the dam from being washed away. the third type of dam is entirely of concrete or stone masonry, concrete to-day being preferable because more likely to be water-tight. the problem with a concrete dam is to get a foundation such that the impounded water will not leak out under the dam, imperiling the very existence of it. the ideal foundation, of course, is rock, and in a great many locations can be found in the small gulleys where the limestone and shale peculiar to this region will answer as well as more solid rock for dams not more than ten feet high; but with gravel banks on the sides or with soft sandy bottom, or where the clay soil becomes saturated with water at times, the gulley offers great difficulties for the construction of a dam. it will be wise, under such conditions, to carry a cut-off wall, not necessarily more than twelve inches thick, well into the bank, that is, about ten feet on each side, and under the dam this cut-off wall ought to go down until it reaches another stratum of sand or clay or rock. this cut-off wall, then, surrounding the main dam, shuts off the leakage, and the dam itself can be built without danger of undermining. in many large dams this cut-off wall is carried down more than a hundred feet, especially where the depth of water behind the dam is great. for small dams, a row of plank driven down behind a timber sill across and in the bed of the stream will often be sufficient. [illustration: fig. .--section of a flood dam.] the cross section of the main dam, in cases where flood water in the spring runs over the dam, should be such that the bottom thickness is about one half the height, and fig. (after wegman) shows a suitable cross-section of a dam ten feet high. figure (after wegman) shows a cross-section intended to carry the water over the dam, especially in times of flood, without danger of erosion. sometimes, in a narrow gorge with rock sides, it is possible to save masonry by building the dam in the form of an arch upstream, the resistance to the force of the water being then furnished by the abutment action of the rock sides, instead of by the weight of the dam, as in ordinary construction. for a dam ten feet high, the necessary thickness of the curved dam would probably not be more than twelve inches, while the ordinary gravity dam would be three or four feet thick. the workmanship on the former, however, must be of a very superior order. [illustration: fig. .--section of a flood dam.] it is never desirable to allow the water flowing over the dam to fall directly on the ground in front, since the falling water will rapidly carry away this soil and undermine the front of the dam. for this reason, the lower section of the dam is made curved, as shown in fig. , giving the water a horizontal direction as it leaves the dam instead of a vertical. a plank floor is often added to carry even further from the dam any possible erosion (fig. ). where it can be done, it is a good plan to provide a small body of still water below the dam, so that the force of the falling water may be distributed through the water on to the soil below. there are other forms of dams often used. for example, brush dams, formerly common, are made by cutting off the tops of trees and dropping them in place and loading them with stones so as to make a mass of interwoven branches. these branches hold together particles of earth which are dumped in and form a dam. another dam that has been much used in rural communities is the old-fashioned crib dam, where logs are piled up crib fashion, held together at the corners by iron pins, a bottom spiked on, and the crib then filled with stone, a succession of these cribs across the stream forming the dam. dirt is filled in on each side of this crib work, and, in some cases, cross timbers are set in, and both sides of the dam covered with tongue-and-grooved planking. but such dams are not permanent, and their construction involves an expense nearly equal to that of a permanent structure, and consequently they are not to be recommended. _waste weirs._ when the dam is made of earth with or without a core wall and when no opportunity exists for carrying the waste water around the dam, a waste weir of masonry through the dam must be provided, so that freshets may be carried off without destroying or washing out the earth work. the size of this weir is a matter of considerable concern, since its ability to carry off the high water is fundamental. the capacity of such waste weirs depends on the volume of flood-water, and this, in turn, depends on the area of the watershed. this volume cannot be predicted with any absolute certainty, but, in general, it may be said that the maximum run-off in the eastern part of the united states, from small areas not exceeding twenty-five square miles, will be about one hundred cubic feet per second per square mile, so that the freshet flow for a watershed of twelve square miles would be twelve hundred cubic feet per second. ordinarily, the height of the weir is taken to be from two to four feet and the length made sufficient to care for the volume of discharge. if the depth of water flowing over the weir is taken at one foot, the length of weir in feet necessary to carry the flood flow may be computed by multiplying the number of square miles of watershed by thirty. then an area of twelve square miles would need a length of waste channel of three hundred sixty feet; in most cases, for small dams, longer than the dam itself. if the depth be taken at two feet, then the number of square miles of watershed must be multiplied by ten to get the length of weir, so that a shed of twelve square miles would mean a weir one hundred twenty feet long. the factor for a depth of three feet on the weir is six, making for the same area the length of weir seventy-two feet, and for four feet depth the factor is four. there is no more important part of the construction of a dam than that involved by a proper design of a waste weir, since a failure either to provide proper area or to so build as to withstand the erosive action of the running water will inevitably wash away the dam. when the valley is narrow and the watershed large, the waste weir will occupy the entire width of the dam, and then it becomes necessary to construct the dam in masonry. on the other hand, when the watershed is small and the width of the valley great, then it is proper to make the waste weir only a certain portion of the entire width of the dam, making the rest of the dam either masonry or earth, as may be convenient. _gate house._ in connection with a reservoir and at the back of the dam at the bottom of the bank, it is convenient to have what is called, in larger installations, a "gate house"; that is, a masonry or wooden manhole through which the water-pipe leading out from the reservoir passes and in which a gate is placed to shut off the water. in larger installations, it is usually possible to admit water at this point from different levels of the reservoir into the water-pipe, so as always to get the best quality of water, but for a small plant that is not necessary. a gate or valve, however, should always be provided, and while this may be on the bank of the pond with the intake pipe extending twenty or thirty feet into the pond, the valve should not be omitted. the end of the pipe extending into the pond should be placed about two feet above the bottom of the pond, instead of resting in the mud, in order to get a better quality of water. _pipe lines._ in bringing the water from the spring or pond to the house, some kind of a pipe line must be provided. such a pipe line is made of various materials; hollow wooden logs, vitrified tile, cast-iron pipe, wrought-iron pipe, and lead pipe having all been used. the last-named pipe is now too expensive for use in any great lengths. hollow wooden pipes are employed occasionally, but, except in unusual localities, they also are more expensive than other forms, and are short lived on account of their tendency to decay. cast-iron pipe, commonly used for municipal water-supplies, is not made in small sizes and may be excluded from the possibilities for an individual house. there remains only tile and wrought-iron pipe. under certain conditions, the use of tile pipe is to be recommended, since it may be installed even in large sizes at a comparatively low cost, the objection to it being that it is very difficult to make the joints water-tight, and practically impossible when the pressure is greater than ten feet. it is more difficult to make joints in a pipe line of small diameter water-tight than in a pipe line of larger diameter, because the space for the cement in the former is so small. the writer has tried both four-inch and six-inch pipe, and while the four-inch line can be laid with tight joints, it requires much more careful and conscientious effort on the part of the workman than with six-inch pipe. the joints must be thoroughly filled with cement, not very wet, so that it can be rammed or packed with a thin stick into every part of the joint. merely plastering the cement over the surface of the joint will always result in a leaking joint. it often happens that a water-supply coming from a distance of a mile or so runs at first nearly level, so that, except for surface pollution, the water might be carried in an open ditch. an open ditch is, however, far better replaced by vitrified tile, six inches in diameter, which entirely prevents surface pollution, and which costs only about ten cents a running foot. when the slope of the ground exceeds the natural fall of the water, so that a pressure inside the pipe is created, iron pipe must be used. if vitrified pipe is used, the joints must be made with the greatest care, and every precaution taken to prevent leakage. figure shows a section of a joint in tile pipe. [illustration: fig. .--a joint in tile pipe.] in using iron pipe large enough to furnish the amount of water required, due regard must be paid to friction in the pipe. in flowing through a pipe of small size, water loses a great deal of head by friction. this friction between the sides of the pipe and the water, which must be duly considered in a pipe of small size, increases very rapidly as the velocity of the flow increases. it is always a great temptation to use a small pipe, since the cost of the pipe increases rapidly as the diameter increases, but it is penny wise and pound foolish to lay a line of pipe several thousand feet long to furnish water to a house and find when completed that the amount of water furnished by the pipe is on account of friction only a small dribble. in a previous chapter we estimated that the flow of water, in order to furnish three faucets at a reasonable rate, ought to be at least two thousand gallons a day or about one and a half gallons a minute, and the effect of a reduced size of pipe on the head necessary to carry a definite amount of water was shown. the cost of cast-iron pipe should not be more than thirty cents per running foot for four-inch pipe and fifty cents per running foot for six-inch pipe. to this must be added the cost of about seven pounds or ten pounds respectively of lead for each joint and the cost of all the labor involved. the price of terra-cotta pipe is much less, as already indicated, so that it is quite worth while to expend some additional effort on making the tile pipe joints water-tight, if it allows the cheaper pipe to be substituted for the more expensive iron pipe. _pumping._ although the present methods of securing water for isolated farm buildings will not corroborate the statement it is safe to say that the proper method of obtaining a water-supply is always to make use of a pond or stream at such an elevation that water will flow to the house by gravity, provided this is possible. only when the conditions are such that a gravity supply is impossible and water from a well or stream at some lower elevation becomes inevitable is pumping properly resorted to. the advantage of a gravity supply is twofold. first, the daily charges for maintenance are practically nothing, so that when once the intake and the pipe line have been installed, there will be no additional charges. when pumping is resorted to, on the other hand, there must be a daily expenditure which, even if small, in the course of a year amounts to the interest on a large sum of money. for example, suppose that the cost for supplies for a small pumping engine was only ten cents per day, not counting in the cost of labor. this would amount to $ . a year, which at per cent is the interest on $ . it would be $ cheaper, therefore, to borrow $ , at per cent, to pay for a gravity supply rather than to pay $ for a pump which costs ten cents a day to run. this same reasoning may be applied to the cost of different kinds of pumps. one pump may cost $ more than another, but the saving in fuel and repairs may be sufficient to more than justify this additional cost. second, a gravity supply is to be preferred because of its greater reliability. it is hardly possible to imagine any excuse for a gravity supply failing to deliver its predetermined quantity of water regularly day after day. a pumping plant, on the other hand, both breaks down and wears out. valves are continually requiring to be repacked, nuts drop off and have to be replaced, pieces of the machinery break and require repairs, so that with the best machinery it is almost inevitable that for many days in the year the water-supply is interrupted by some failure of the machinery. in planning water works for cities, an engineer weighs and estimates the value of a continuous service, and even if the gravity supply costs somewhat more than the pumping system, it is in many cases adopted because the greater cost is supposed to be compensated for by the greater reliability of the supply. _windmills._ perhaps the cheapest source of power for pumping water is a windmill, and in many cases it proves entirely serviceable. it has two drawbacks which are self-evident. unless the wind blows, the mill will not work, and, unfortunately, at those times of the year when a large supply of water is most to be desired, that is, during the hot summer months, the wind is particularly light. it is necessary, therefore, when using wind as a source of power, to provide large storage which will tide over the intervals between the times of pumping. again, the wind may blow frequently enough, but may be so light as not to turn the large vanes necessary to pump rapidly and easily the large amount of water needed. nothing less than a twelve-foot mill ought to be erected, and, to be efficient, the wind must blow at the rate of twelve to sixteen miles an hour. [illustration: fig. .--windmill and water tank.] a windmill of the best design is made entirely of steel with small angle irons for posts for the tower, and with the mill itself made of galvanized iron. it requires a good foundation and must be well anchored to the masonry piers by strong bolts set well down into the masonry. if the mill is set directly over the well and the storage tank supported on the tower, a very compact arrangement is accomplished and the danger from frost is the only difficulty to be apprehended. however, the tank is often placed in the attic, some distance from the well, to which it is connected by suitable piping. the location of the windmill requires careful consideration in order that it may receive the prevailing winds in their full force and at the same time be properly located with reference to the well. it must be remembered that the surface of the wheel is exposed to the full fury of a storm, and both the wheel and the tower must be strong enough to withstand such storms. figure shows windmill and water tank in the vicinity of ithaca, new york. _hydraulic rams._ a hydraulic ram is the cheapest method of pumping water, provided that the necessary flow with a sufficient head to do the work is available. it requires about seven times as much water to flow through the ram and be wasted as is pumped, so that if it is desired to pump five hundred gallons a day, the stream must flow at the rate of about thirty-five hundred gallons per day to lift the necessary water. the two disadvantages of a ram are, first, that a fall of water is not always obtainable or that the stream flow is not always sufficient, and second, that the action of the ram is subject to interruptions on account of the accumulation of air in summer and on account of the formation of ice in winter. in fact, in winter it is necessary to keep a small fire going in the house where the ram is at work in order that this interruption may not take place. its great advantage is that it requires no attendance, no expense for maintenance, and practically nothing for repairs. it operates continuously when once started, and, except for the occasional interruption on account of air-lock, is always on duty. [illustration: fig. .--installation of ram.] usually the water is led from above the dam or waterfall in a pipe to the ram and flows away after passing through the ram, back into the stream. the water pumped is generally taken from the same stream and is a part of the water used to operate the ram. this is not necessary, however, and double-acting rams are manufactured which will pump a supply of water from a source entirely different from that which operates the ram. the following table from the rife hydraulic engine manufacturing co. gives the dimensions and approximate costs of rams suitable for pumping against a head not greater than about thirty feet for each foot of fall available in the drive pipe:-- table xi ======+=======================+=======+=========+===============+ | | | | gallons per | | dimensions | size | size| minute | |-------+-------+-------| of | of| required | | | | |drive- | delivery| to operate | number| height| length| width | pipe | -pipe | engine | ------+-------+-------+-------+-------+---------+---------------+ | ' " | ' "| ' "| - / "| / " | - / to | | ' " | ' "| ' "| - / "| / " | to | | ' " | ' "| ' "| " | " | to | | ' " | ' "| ' "| - / "| " | to | | ' " | ' "| ' "| " | - / " | to | | ' " | ' "| ' "| " | " | to | | ' " | ' "| ' "| " | " | to | | ' " | ' "| ' "| " | " | to | | ' " | ' "| ' "| - " | " | to | ======+=======+=======+=======+=======+=========+================+ =======+===========+========+========+======= |least feet | |price |price | of fall | |single- |double- number |recommended| weight |acting |acting -------+-----------+--------+--------+------- | | | $ | $ | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | =======+===========+========+========+======= if the length of the discharge pipe is more than a hundred feet, the effect of friction is to reduce the amount of water pumped, but rams will operate successfully against a head of three or four hundred feet. the writer remembers an installation in the northern part of new york state, where two large hydraulic rams furnish the water-supply supply for an entire village, pumping every day several hundred thousand gallons. figure shows an installation by the power specialty co. of new york, using the fall of some rapids in a brook to pump water into a tank in the attic of a house. [illustration: fig. .--means of securing fall for hydraulic ram.] in fig. are shown two methods of securing a fall for hydraulic rams, recommended by the niagara hydraulic engine co. the first method shows no drain pipe, but a long drive pipe; while the second method puts the ram in an intermediate position, with considerable lengths of each. there are other methods of utilizing the fall of a stream, but usually they involve a greater outlay for the construction of a dam and other appurtenances. an old-fashioned bucket water wheel may be used, which, though not efficient, utilizes the power of the stream. the wheel may be belted or geared to a pump directly or may drive a dynamo, the power of which may in turn be transmitted to the pump. the objection to such construction usually is that during the summer the small streams which could be made of service at slight expense run dry or nearly so, while the expense of damming and utilizing a large stream where the water-supply is always sufficient is too great for a single house. _hot-air engines._ the simplest kind of a pump worked mechanically is the rider-ericsson hot-air engine (see fig. ), which is made to go by the expansive force of hot air. the fuel used may be wood, coal, kerosene oil, gasolene, or gas, the amount used being very moderate and the daily expense of maintenance very small. [illustration: fig. .--a hot-air engine.] for a number of years the writer used one of these machines to pump water from a tank in his cellar to a tank in the attic, so that running water could be had throughout the house. with an engine and pump costing $ , it was necessary to pump twice a week for about an hour to supply the attic tank and to furnish the necessary water for the family. the following table shows the dimensions, the capacity, and the fuel consumption of the different styles of pumps made by this company:-- table xii =========+===========+===========+=========+==========+============+====== | suction | | | | | | and | | | | anthracite | size of | discharge | capacity | cu. ft. | kerosene | coal per | cylinder | pipe | per hour | of gas | per hour | hour | price ---------+-----------+-----------+---------+----------+------------+------ " | / " | gal. | | qt. | lb. | $ " | " | gal. | | qt. | lb. | " | - / " | gal. | | qt. | lb. | " | - / " | gal. | | qt. | lb. | =========+===========+===========+=========+==========+============+====== _gas engines for pumping._ during the last few years, on account of the great demand for gas engines for power boats and automobiles, the efficiency and reliability of these engines depending upon the explosive power of the mixture of gas and air has greatly increased. to-day, probably no better device for furnishing a satisfactory source of power in small quantities at a reasonable cost can be found. one engine might readily be used in several capacities, pumping water during the day or at intervals during the day when not needed for running feed cutters; and possibly running a dynamo for electric lights at night. it would be easy to arrange the gas engine so that a shift of a belt would transfer the power of the engine from a dynamo to a pump or to other machinery. in this case the pump is entirely distinct and separate from the engine, and while the gas engine may be directly connected with the pump and bolted to the same bed plate, if the engine is to be used for other purposes than pumping, an intermediate and changeable belt is desirable. the term "gas engine" is properly restricted to engines literally consuming gas, either illuminating gas or natural gas; but the term is also applied to engines using gasolene as a fuel. the same principle is used in the construction of oil engines where kerosene oil is the fuel instead of gasolene, and it is probable that the latter engines are safer; that is, less subject to dangerous explosion than the former. whichever fuel is used, the engine may be had in sizes ranging from one half to twenty horsepower and are very satisfactory to use. any ordinary, intelligent laborer with a little instruction can start and operate them, and except for occasional interruptions they may be depended upon to work regularly. the cost of operation with different fuels may be estimated from the following table, which also shows the cost when coal is used as in an ordinary steam plant, the data being furnished by the otto gas engine works:-- table xiii =================+=================+====================+=============== | | fuel consumption | cost of fuel | | per brake h.-p. | per brake fuel | price of fuel | hours | h.-p. hours -----------------+-----------------+--------------------+--------------- gasolene | c per gal. | . gal. | . c -----------------+-----------------+--------------------+--------------- illuminating gas | $ . per | cu. ft. | c | cu. ft. | | -----------------+-----------------+--------------------+--------------- natural gas | c per | to cu. ft. | . to c | cu. ft. | | -----------------+-----------------+--------------------+--------------- producer gas, | | | anthracite | | | pea coal | $ . per ton | lb. | . c -----------------+-----------------+--------------------+--------------- producer gas, | | | charcoal | $ . per ton | lb. | . c -----------------+-----------------+--------------------+--------------- bituminous coal, | | | ordinary | | | steam engine | $ . per ton | to lb. | . to . c =================+=================+====================+=============== a photograph of a small ( h.p.) gas engine made by the foos gas engine co. with pump complete is shown in fig. . this pump will lift forty gallons of water per minute, with a suction lift up to twenty-five feet, to a height of about seventy-five feet above the pump. the pump gear can be thrown out of connection with the engine, so that the latter can be used for other purposes where power is desired. _steam pumps._ [illustration: fig. .--a gas engine.] the use of a steam pump would probably not be considered for a single house unless a small boiler was already installed for other purposes. not infrequently a boiler is found in connection with a dairy for the purpose of furnishing steam and hot water for washing and sterilizing bottles and cans. where silage is stored in quantity, a steam boiler and engine are often employed for the heavy work of cutting up fodder. in both these cases it may be a simple matter to connect a small duplex pump with the installed boiler, as is done frequently in creameries, for the sake of pumping the necessary water-supply for the house. whenever extensive improvements are contemplated, it is well worth while to consider the possibilities of one boiler operating the different kinds of machinery referred to. in fig. is shown a small pump, made by the goulds manufacturing co., capable of lifting forty-eight gallons of water per minute against a head of a hundred feet. the diameter of piston is four inches and the length of stroke is six inches. it is operated by a belt from a steam engine used for other purposes as well. [illustration: fig. .--pump operated by belt.] [illustration: fig. .--duplex pump, operated directly by steam.] table xiv ==========+==========+========+=============+=============+=========+ diameter | diameter | length | | | gallons of steam | of water | of | gallons per | revolutions | per cylinders | pistons | stroke | revolution | per minute | minute ----------+----------+--------+-------------+-------------+---------+ | / | | . | | . | | | . | | . - / | | | . | | . | | | | | - / | - / | | . | | . - / | - / | | . | | . - / | - / | | . | | . | | | | | | - / | | . | | . | | | . | | . | - / | | . | | . | | | | | - / | - / | | . | | . | - / | | . | | . - / | - / | | . | | . | | | | | - / | - / | | . | | . | - / | | . | | . | - / | | . | | . ==========+==========+========+=============+=============+=========+ ==========+======================================+================== | size of pipes for | approximate | short lengths to be | space occupied | increased as length increases | feet and inches +-------+---------+---------+----------+--------+--------- diameter | | | | | | of steam | steam | exhaust | suction | delivery | | cylinders | pipe | pipe | pipe | pipe | length | width ----------+-------+---------+---------+----------+--------+------ | / | / | - / | | | | / | / | - / | | | - / | / | / | | - / | | | | | | | | - / | / | / | | - / | | - / | / | - / | - / | | | - / | / | - / | - / | | | | | | | | | | | - / | - / | | | | | - / | - / | | | | | - / | - / | | | | | | | | | - / | - / | | | | | | | - / | - / | | | - / | - / | | | | | | | | | | | - / | - / | | | | | | - / | | | | | | - / | | | | | ==========+=======+=========+=========+==========+========+====== [illustration: fig. .--raising water by means of compressed air.] figure shows a cut of a small duplex worthington pump which operates by steam, not requiring any intermediate engine. to show the variety of pumps made and the way in which the proportions vary with the capacity of the pumps, the preceding table is given of pumps of small capacity designed to work with low steam pressure. _air lifts for water._ compressed air is also a source of power for raising water from a deep well; but it is neither economical in first cost of apparatus nor in operation. the principle is shown by the diagram of fig. , and explains without words how air pressure may be carried down into the well through one pipe and thereby force the water of the well up into another pipe far above its natural level. the machinery needed involves an engine or motor and an air compressor, the latter taking the place of the ordinary pump. it has the single advantage that it avoids the maintenance of valves and similar deep-well machinery at a great distance below the ground, the air pump not requiring any mechanism in the well. in fig. is shown a plant installed by the knowles pump co. for a hotel where the air compressor furnished compressed air to raise the water from the deep well into a tank, whence a steam pump lifts the water to a reservoir, not shown. [illustration: fig. .--wooden tank.] _water tanks._ the standard form of wooden tank in which water may be stored and from which it may be delivered to the house fixtures is pictured in fig. . figure shows a galvanized iron tank for the same purpose. the tables appended, taken from catalogues of firms building such tanks, show the dimensions, weights, and costs of the two kinds of tanks. table xv. dimensions and list prices of water tanks. wooden stave tanks ======+=======+=========+=====+======+=============+=============+============= | | | | | - / in. | -in. | -in. length| | | |price | cypress | cypress | pine of | dia. | | no.|galv. +------+------+------+------+------+------ stave,|bottom,|capacity,|of |hoops,|weight| |weight| |weight| feet| feet | gallons |hoops|extra | lb. | price| lb. | price| lb. | price ------+-------+---------+-----+------+------+------+------+------+------+------ | | | |$ . | |$ . | |$ . | |$ . | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . - / | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . | - / | | | . | | . | | . | | . - / | - / | | | . | | . | | . | | . | | | | . | | . | | . | | . - / | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . - / | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . - / | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | . | | . | | . | | | | . | | | | . | | . | | | | . | | | | . | | . | | | | . | | | | . | | . | | | | . | | | | . | | . | | | | . | | | | . | | . | | | | . | | | | . | | . | | | | . | | | | . | | . | | | | . | | | | . | | . ======+=======+=========+=====+======+======+======+======+======+======+====== galvanized iron tanks =====+========+==========+==========+========+======== | height | diameter | capacity | weight | no. | ft. | ft. | bbl. | lb. | price -----+--------+----------+----------+--------+-------- | | | | | $ . | | | | | . | | | | | . | | | | | . | | | | | . | | | | | . | | | | | . | | | | | . | | | | | . | | | | | . =====+========+==========+==========+========+======== there are many combinations and forms of these structures, and a detailed description of their characteristic construction and cost would occupy too much space for this present work. by referring to the pages of any agricultural, architectural, or engineering magazine, advertisements may be found of firms who build such towers and who may be depended upon for satisfactory work. [illustration: fig. .--iron tank.] if the tank is to be placed inside a building, it may be built of steel or of wood, although a lining of lead, copper, or galvanized iron is of advantage in the latter case. if the tank is out of doors, protection against frost must be carefully attended to, both to prevent an ice cap forming in the tank--the cause of many failures of tanks--and to prevent standing water in the connecting pipes being frozen. if the tank is to be placed inside the building, care must be taken to have it water-tight and to have the supports of the tank ample for the excessive weight which will be thereby imposed. wooden tanks are likely to rot, and if left standing empty, become leaky. they are, therefore, less worth while than iron tanks. [illustration: fig. .--hand pump applied to air-tank.] _pressure tanks._ a simple and very satisfactory method of storing water, and at the same time making provision for pumping water, is to place in the cellar or in a special excavation outside the cellar a pressure tank similar in shape to an ordinary horizontal boiler. the water in this tank is forced up into the house through the agency of compressed air, pumped in above the water, either by hand or by machinery, and in some cases automatically regulated so that the air pressure in the tank remains constant, no matter whether the tank contains much or little water. the village supply of babylon, long island, is on this principle, the tanks there being eight feet in diameter and one hundred feet long,--much larger, of course, than is needed for a single house. [illustration: fig. .--engine applied to air-tank.] the accompanying diagram and figures show the method of installing this system, which is known generally as the kewanee system, although a number of other firms than the kewanee water supply co. are prepared to furnish the outfit necessary. [illustration: fig. .--windmill connection with tank.] how the air-tank may be used in connection with a hand force pump is shown in fig. . the water is pumped from a well into the tank, usually in the cellar, whence it flows by the pressure in the tank to all parts of the house. figure shows the tank with a gas engine and a power pump substituted for the hand pump. figure shows the using of a windmill in connection with the tank and also shows the relation of the tank to the fixtures in the rest of the house. chapter ix _plumbing_ a generous supply of water for a house brings with it desires for the conveniences necessary to its enjoyment. as soon as running water is established in a house, the kitchen sink fails conspicuously to fulfill all requirements, and a wash-tub seems a sorry substitute for a modern bath-room. a single pipe supplying cold water only, no matter how pure the water or how satisfactory in the summer, does not afford the constant convenience which an unlimited supply of both cold and hot water offers, and the introduction of running water is usually followed by an addition to the kitchen stove whereby running hot water may be obtained as well as running cold water. the next step is the equipment of a bath-room, affording suitable bathing facilities and doing away with the out-of-door privy. _installation of the plumbing._ these things are reckoned as luxuries, not among the necessities of life, and it must be understood at the outset that such conveniences cost money, both for original installation and for maintenance; the water-back in the stove will become filled up with lime if the water is hard, the boiler will become corroded and have to be replaced, the plumbing fixtures will certainly get out of repair and need attention, and there will be, year by year, a small but continuous outlay. again, it is idle to propose installing plumbing fixtures unless the house is properly heated in winter time, and this calls for a furnace for at least a portion of the house. usually the kitchen is kept warm enough through the winter nights, so that running water may be put in the kitchen without danger from frost; although the writer knows of a house where it is the task of the housewife each winter night to shut off all water in the cellar and to clean out the trap in the sink drain in order to prevent freezing in both the supply pipe and drainpipe. usually a water-pipe may be carried through the cellar without danger of freezing, but in most farmhouses heated by stoves, except in the kitchen and sitting room, water-pipes would, the first cold night, probably freeze and burst. various makeshifts have been employed to secure the convenience of a bath-room without adding to the expense by installing a furnace. in one house the bath-room was placed in an alcove off from the kitchen, with open space above the dividing partition, so that the kitchen heat kept the bath-room warm. this is not an ideal location for a bath-room, but, in this case, it avoided the necessity for an additional stove or furnace. in another house the bath-room was placed above the kitchen, with a large register in the floor of the former, so that the kitchen heat kept the room warm; and in still another case the bath-room was over the sitting room, and a large pipe carried the heat from the stove below into the room above. the stovepipe also went through the bath-room and helped to provide warmth. it is better, all things considered, to defer the installation of a bath-room until a furnace can be provided, since then there is no danger of frozen water-pipes at intermediate points where the cold reaches the pipes. a full list of fixtures and piping required is as follows:-- st. a tank in the attic to store water in case the main pipe-flow or pump-capacity is small. this tank, of course, is not needed if the direct supply from the source is at all times adequate for the full demand. d. a main supply pipe from the outside source or from the attic tank connecting with and supplying the kitchen sink, the hot-water boiler through the kitchen stove, the laundry tubs, the bath-tub, the wash-basin, and the water-closet tank. it is wise, in order to save expense, to have all these fixtures as close together as possible; as, for instance, the laundry tub in the basement directly under the kitchen sink and the bath-room fixtures directly over the kitchen sink. d. a hot-water pipe leading out of the hot-water boiler to the kitchen sink, to the laundry tubs, and to the bath-tub. although not essential, it is desirable to carry the hot-water pipe back to the bottom of the hot-water boiler, so that the circulation of hot water is maintained. this will avoid the necessity of wasting water and waiting until the water runs hot from the hot-water faucet whenever hot water is desired. th. the necessary fixtures, such as faucets, sinks, tubs, wash-basins, kitchen boiler, water-back for the stove, water-closet, tank, and fixtures. these may be now taken up in order and described more in detail. _supply tank._ the attic tank may be of wood or iron, and its capacity should be equal to the daily consumption of water. its purpose, as already indicated, is to equalize the varying rates of consumption from hour to hour and between day and night. the minimum size of this tank would be such that the flow during the night would just fill the tank with an amount of water just sufficient for the day's needs. of course, the additional supply entering the tank during the day would reduce the size somewhat, but the basis for computation given is not unreasonable. several accessories must be provided for such a tank. an overflow is essential, and this is best accomplished by carrying a _pipe out through a hole in the roof_. this must be ample in size, provided with a screen at the inside end, and be examined frequently to make sure that the overflow remains open. a light flap valve to keep out the cold in winter is also a desirable feature for the overflow pipe. the tank must be water-tight, and while it is possible to make a wooden tank water-tight, it is wiser to line a wooden tank with lead or sheet iron. the latter can be painted at intervals, so that it will not rust, and is safer than wood alone to prevent leakage. care must be taken to give sufficient strength to the wooden tank; it should never be made of less than two-inch stuff, and should not depend upon nails or screws alone for holding the sides together. figure shows a suitable way to put together such a tank. certain firms that make windmills and agricultural implements generally can furnish wrought-iron tanks, warranted to be water-tight, of suitable size to go in an attic. such a tank, as we have already said, should hold about five hundred gallons and should therefore be a cube four feet on a side or its equivalent. it needs to be very carefully placed in the house, or else its weight will cause the attic floor to sag. a tank of the size named will weigh a little more than two tons, and such a weight, unless special precautions are taken, cannot be placed in the middle of an attic floor without causing serious settlement, if not actual breaking through, of the floor. [illustration: fig. .--construction of a wooden tank.] a good way of placing such a tank is to nail the floor joists onto the bottom of the rafters, so that a truss is formed, and the box or tank is properly supported on the floor and also hung from the rafters by iron straps bolted both to tank and rafters. if possible, this tank should be placed directly over a partition carried through to the cellar, in which case no settlement is possible. _main supply pipe._ the main supply pipe, except when pressure is very great, is most satisfactory when made of three-quarter-inch galvanized iron pipe. even with a high pressure, half-inch pipe is unsatisfactory because of the great velocity with which the water comes from the faucets and because the high pressure causes the packing in the faucets to wear out rapidly. this three-quarter-inch pipe should have a stop-and-waste, as it is called, just inside the cellar wall, so that if the house is not occupied at any time, the valve may be shut and the water in the pipes drawn off, to prevent possible freezing. the pipe should never be carried directly in front of a window or along the sill of the building unless protected by some kind of wrapping. the laterals and the different fixtures are taken off from this main supply pipe as it rises through the house, and the pipe is capped at the top. _hot-water circulation._ to provide hot water, a branch must be taken off at the level of the kitchen stove and run into the hot-water boiler at or near the bottom. the circulation in the tank and through the house is then provided for by a separate circuit running from the bottom of the hot-water tank to the water-back and back into the tank at a point about halfway up. the house circuit is then run from the top of the boiler around through the house, and if a return pipe is provided, it comes back and enters at the bottom. this hot-water pipe is also of galvanized iron and should be of the same size as the main supply pipe (see fig. ). [illustration: fig. .--hot-water attachment to the kitchen stove.] the fixtures may be as elaborate as the purse and taste will allow, but some general instruction may not be out of place. there are many types of faucets, all good, and differing from each other only in some minor detail of construction. experience with the so-called self-closing faucets or bibbs has not been entirely satisfactory, since, with high pressure, the packing very quickly wears out. similarly, experience with those faucets that open and shut by a single turn of a handle shows that frequent renewals of packing are necessary. the simplest, most reliable, and the easiest faucets to repair are those in which the valve is screwed down onto the valve seat, which is a plane, and where the water-tightness is made by the insertion of a rubber or leather washer that can always be cut out with a knife from a piece of old belting or harness. the faucets may be nickeled or left plain brass, and the advantage of the added expense of nickel is in the appearance alone. if the faucets themselves are nickel, then the piping also should be nickel; that is, brass nickel-plated. galvanized iron piping and brass faucets do not, to be sure, have the same satisfactory appearance as highly finished nickeled faucets, but the one is quite as serviceable as the other. _kitchen sinks._ in providing a sink for the kitchen, choice lies between plain iron and enameled iron. for special work, sinks have been made of galvanized iron, of copper, slate, soapstone, and of real porcelain. there is hardly any limit to the cost of a porcelain sink, and while an enameled iron sink with fittings costs from $ to $ , a cast-iron sink of the same size will cost only $ or $ . a good quality of white enameled iron sink, of size suitable for a kitchen, with white enameled back and a drainboard on the side, costing $ , is very attractive as an ornament, but it serves no more useful purpose than a $ sink and a fifty-cent drainboard. figure shows an enameled iron sink, containing sink, drainboard, and back all in one piece. this is pure white, and when fitted with nickel faucets makes a very attractive fitting. _laundry tubs._ if running water is to be put in a house, stationary tubs for the laundry, into which water runs by a faucet and which can be emptied by pulling a plug, are certainly worth their cost over movable wooden tubs in the labor saved. stationary tubs may be made of wood, of enameled iron, or of slate. [illustration: fig. .--enameled iron sink.] wooden tubs are not as desirable as the others because in the course of time they absorb a certain amount of organic matter and have a persistent odor. they are, however, very inexpensive, a man of ordinary ability being able to build them himself at the cost of the wood only. enameled iron tubs of ordinary size cost, with the fixtures, from $ to $ apiece, and a set of three slate tubs costs $ . to these figures must be added the expense of the piping to bring both hot and cold water to the tubs, together with the two faucets and the drainpipe connections necessary. figure shows three white enameled iron laundry tubs costing about $ installed. _hot-water boiler._ the kitchen boiler is to-day almost always made of galvanized iron and is placed on its own stand, usually back of the kitchen stove, although it may stand in an adjoining room,--the bath-room, for instance,--and aid in keeping that room warm. such a tank costs about $ , to which must be added the necessary piping, and it is always desirable to put a stop-cock on the cold-water supply entering the tank. then if the tank bursts, the cold water may be shut off without doing harm. [illustration: fig. .--enameled laundry tubs.] a drainpipe from the bottom of the tank is also desirable to draw off the accumulations of sediment. _water-back, wash-basin, bath-tub._ the water-back is merely a hollow box made to fit the front of the fire box in the stove, usually shaped so as to replace the front fire brick. the cold water comes in at the bottom of the box, is heated by contact with the fire, and the hot water goes out through the other pipe into the boiler. the wash-basin in the bath-room is either marble, enameled iron, or porcelain. the marble basins with a slab can be had for about $ . , while the enameled iron basins cost from $ to $ . to this must be added the cost of faucets and piping, together with the drain and the trap that belongs with the drain. the enameled iron basins which are being used to-day more than ever before have proved very satisfactory, have but little weight, can be fastened to the wall without difficulty, and take up less room than the old marble basin. a fancy porcelain basin costs about $ , and is no better for practical use than either of the others. much the same kind of material may be used for bath-tubs, although warning ought to be given to avoid the use of the old-fashioned tin-lined bath-tub. this lining will easily rust or corrode, is very difficult to keep clean, and while the first cost is less than the enameled iron tub, it has no other advantage. an enameled iron tub five and a half feet long will cost from $ to $ without fixtures. _cost of plumbing installation._ a fair estimate of the cost of the plumbing in a house, including all the fixtures mentioned except the tank in the attic, including also the plumber's bill, is $ . this requires very careful buying, and implies an entire absence of brass or nickel-plated piping. if a high grade of fixtures, including nickel fittings and nickel piping, wherever it shows, is used, the cost of the fixtures alone, not including labor or piping other than mentioned, will be from $ up. _house drainage._ the term "plumbing" is generally used to include both the water-supply in the house, with all the fixtures pertaining thereto, and the carrying of the waste water to a point outside the house; it remains, therefore, to discuss the waste pipes connected with the plumbing fixtures. [illustration: fig. .--leveling the drain.] the house-drain, or the pipe which carries the wastes from the house to the point of final disposal, is generally made of vitrified tile, and in ordinary practice is five inches inside diameter. the lower end of this drain discharges into a cesspool, or settling tank, or into a stream, as local conditions permit. this house-drain should be carefully laid in a straight line, both horizontally and vertically, for two reasons. in the first place, the velocity of flow in a straight pipe will be greater, and therefore the danger of stoppage will be decreased, and in the next place, if a stoppage does occur in the pipe, it can be cleaned out better if the pipe is straight than if it is laid with numerous bends. such a pipe should have a grade of at least one quarter inch to a foot, and this is conveniently given by tacking a little piece of wood one half inch thick on one end of a two-foot carpenter's level and then setting the pipe so that with this piece of wood resting on the pipe at one end and the end of the level itself on the pipe at its other end, the bubble will be in the middle. figure shows the carpenter's level in position on a level board, which rests on the hubs of three pipes. the joints of this pipe should be made with portland cement mixed with an equal part of sand, and the space at the joint completely filled. when nearing the house, it is very desirable that a manhole should be built so that if a stoppage occurs, it may be cleaned out without taking up the pipe. in city houses a running trap is always inserted just outside the house with a fresh-air inlet on the house side of the trap, as shown in fig. . but for a single house this is not necessary, and it is wiser to omit the running trap. the soil-pipe begins at the trap or at the cellar wall and runs up through the roof of the house, so that any gas in the drain or soil-pipe may escape at such a height as not to be objectionable. through the cellar wall and up through the house the soil-pipe should be of cast-iron, which comes in six-foot lengths for this special purpose. y's are provided by which the fixtures are connected to the soil-pipe, and the top of the pipe is covered with a zinc netting to keep out leaves and birds. this soil-pipe weighs about ten pounds per foot and is almost always four inches inside diameter. the length necessary is easily computed, since it runs from the outside cellar wall to the point where the vertical line of pipe rises and from that point in the cellar extends to the roof. such a pipe may be estimated at two cents a pound with something additional for the y's. [illustration: fig. .--water-supply installation.] the soil-pipe must be well supported along the cellar wall on brackets or hung from the floor joists by short pieces of chain or band iron. special care must be taken to support the pipe at the elbow, where it turns upward, since a length of thirty feet of this pipe, weighing three hundred pounds, has to be provided for. it is a good practice to build a brick pier from the cellar bottom up to and around the elbow to support it firmly in the masonry. the joints in this drainpipe should be made with lead, ramming some oakum into the joints first and then pouring in enough lead melted to the right degree to provide an inch depth of joint. after the lead cools, it must be expanded or calked by driving the calking tool hard against it. to prevent rain finding its way between the soil-pipe and the roof, a piece of lead is generally wrapped around the soil-pipe for a distance of twelve inches or so above the roof, and then a flat piece of lead extending out under the shingles is slipped over and soldered fast to the other lead piece. the fixtures are connected to the iron pipe usually by lead pipe, the lead pipe being first wiped onto a brass ferrule, the ferrule being leaded into the y branch. these y branches are usually two inches in diameter and the lead pipe usually one and one quarter inches. between the soil-pipe and the fixtures a trap must be provided with a water-seal of about an inch. _trap-vents._ in city plumbing it is customary to vent traps; that is, to carry another system of pipes from the top of the trap nearest the fixture up to and through the roof. on most roofs, where modern plumbing has been installed, are seen two pipes projecting, one the soil-pipe and the other the vent-pipe, indicating the location of a bath-room below (see fig. ). in a single house, however, and particularly in view of experiments made recently on the subject of trap siphonage, these trap-vents seem hardly necessary. they were formerly insisted upon because of the feeling that by the passage of a large amount of water down the soil-pipe, sufficient suction might be induced to draw out the water from some small trap on the way, thereby opening a passage for sewer gas into the room. experiments have shown that it is practically impossible to draw off the water from a trap in this way, and that the system of vent-pipes does little more than add to the cost. the traps themselves, however, are essential, and great care should be taken to see that each trap is in place and has a seal of the depth already mentioned. the best trap to use in any fixture is the simplest, and a plain s trap answers every purpose. it is always wise to have a clean-out at the bottom of the trap; that is, a small opening which can be closed with a screw plug, so that when the trap becomes clogged, it can be easily opened and cleaned (see fig. ). [illustration: fig. .--a trap.] _water-closets._ a great many kinds of water-closets have been made and used, with various degrees of success. the old-fashioned pan-closet becomes easily clogged, allows matter to decompose in the receptacle under the valve, and, in spite of its being cheaper, should not be used. the long-hopper closet is also objectionable, for the same reason. a recent bulletin of the maine state board of health, which gives the relative merits of the different forms now available, very directly and briefly, is here repeated:-- "the choice of a water-closet should be made from those which have the bowl and trap all in one piece, which are simple in construction, are self-cleansing, and have a safe water-seal. none should be considered except the short-hopper, the washout, the washdown, the syphonic, and the syphon-jet closets. "short-hopper closets not many years ago were considered desirable, but other styles costing but little more are better. [illustration: fig. .--washout water-closet.] "the washout closet (fig. ) has too shallow a pool of water to receive the soil, and the trap below and the portion above the trap do not receive a sufficient scouring from the flush. [illustration: fig. .--washdown water-closet.] "the washdown closet (fig. ) is an improvement over the washout. having a deep basin, a deep water-seal, smaller surfaces uncovered by water, and a more efficient scouring action, it is more cleanly. the washdown closet is really an improved short hopper. [illustration: fig. .--syphonic closet.] "of late years the principle of syphonic action has been applied to the washdown closet. figure shows the outline of a syphonic closet. it will be seen that the basin, as in the washdown closet, has considerable depth and holds a considerable quantity of water; but it differs in having a more contracted outlet. when the closet is flushed, the filling of this outlet forms a syphon, and then the pressure of the air upon the surface of the water in the basin drives the water into the soil-pipe with much force. at the breaking of the syphon, enough water is left in the trap to preserve the seal. [illustration: fig. .--syphon-jet closet.] "in the syphon-jet closet (fig. ) there is added to the mechanism of the syphon closet a jet of water which helps to drive the contents of the bowl more rapidly into the outlet. these two closets, syphon and the syphon-jet, are preferable to those of any other style. among other advantages they are more nearly noiseless than any other kinds. "recapitulating, it may be said, while the short-hopper and the washout closets may not deserve absolute condemnation, the advantages of the washdown, syphon, and the syphon-jet closets are so much greater that they should be chosen in all new work." properly to flush out the closet, a water-pipe connection must be made from the supply main. it would be quite possible to connect directly to the closet rim where the flush enters, but there are two objections urged against this. sometimes, when the pressure is low and water is being drawn in the kitchen, if a faucet in the bath-room is opened, not only will no water come, but air is drawn into the pipe by the force of the running water below. a direct connection with a water-closet, it is conceivable, might allow filth to be drawn up into the water-pipe under certain conditions. the other objection is that the small pipe generally used in a house does not deliver water fast enough for effective flushing. it is common, therefore, to put in, just back of or above the closet, a small copper-lined wooden tank which holds about three gallons and which can be discharged rapidly through a one-and-a-quarter-inch pipe. this tank with fittings costs about $ , and in a great many cases is probably unnecessary. it has the advantage, however, of allowing a small flow to enter the tank whenever emptied, to be automatically shut off by a float valve when filled. if the house has a tank supply or if the pressure is strong enough to insure a positive flow at all times, there can be no objection in a single family, where the flushing action will be insisted on by the mistress of the house in the interests of cleanliness, to making a direct connection between the closet and the house supply pipe. an automatic shut-off bibb would then be used on the water-pipe, allowing the water to flow freely as long as the bibb was opened, but closing automatically when released. chapter x _sewage disposal_ the subject of sewage disposal for a single house in the country does not at all present the elaborate problem that is suggested when the disposal of sewage of a city is under discussion. in the first place, the amount of sewage to be dealt with is moderate in quantity; and in the second place the area available on which the sewage may be treated is in almost all cases more than ample for the purpose. nor is there the complication that arises with city sewage, due to the admixture of manufacturing wastes. the material to be handled is entirely domestic sewage and varies only according to the amount of water used in the house, making the sewage of greater or less strength according as less or more water is used. sewage from a single house differs only in one respect disadvantageously from city sewage, namely, in the fact that the sewage, not having to pass through a long length of pipe, comes to the place of disposal in what is known as a fresh condition; that is, no organic changes have taken place in the material of which the sewage is composed. _definition of sewage._ the great bulk of sewage is water, and, in quantity, the amount of sewage to be cared for is about equal to the amount of water consumed in the household, although this will depend somewhat on the habits of the family. if, for example, part of the water-supply is used for an ornamental fountain in the front yard, or if in the summer time a large amount of water is used for sprinkling the lawns, that water is not converted into sewage, and the amount of the latter is thereby diminished; but, ordinarily, it is safe to say that the quantity of water supplied to the house and the quantity of sewage taken away from the house is identical, and since it is much easier to measure the water-supply than the sewage flow, the former is taken as the quantity of sewage to be treated. in the course of its passage through the house, however, the water has added to it a certain amount of polluting substances, largely derived from the kitchen sink, where dirt from vegetables and particles of vegetable material, together with more or less soap, are carried by the waste water from the sink into the drain. in the bath-room, also, some small amount of organic matter is added to the water, but the proportion of such matter to the total volume of water used is very small, probably not exceeding one tenth of one per cent. this small proportion is nevertheless sufficient to become very objectionable if allowed to decompose, and the problem of sewage disposal for a single house is to drain away the water, leaving behind the solids so disposed that they shall not subsequently cause offense by their putrefaction. the process of decay is normal for all organic matter and is due to the agency of certain bacteria whose duty it is, providentially, to eliminate from the surface of the earth organic matter which otherwise would remain useless, if not destructive, to man. it is impossible to leave any vegetable or animal matter exposed to the air without this process of decay at once setting in. apples left in the orchard at the end of the season inevitably are reduced and disappear in a short time. dead animals, whether large or small, in the same way succumb to the same process of nature, and it has been pointed out that, unless this provision did exist, the accumulation of such organic wastes since the settlement of this country would be so great as to make the country uninhabitable. fortunately, however, this inevitable process breaks down the structure of all organic material, partly converting fiber and pulp into gas, partly liquefying the material and converting the remainder into inorganic matter which is of vast importance as food for plant life. a cycle is thus formed which may be best illustrated in the case of cows which feed on the herbage of a meadow, the manure from the cows furnishing food for the grass which otherwise would soon exhaust the nutriment of the soil. _stream pollution._ the first fundamental principle of sewage disposal, therefore, is to distribute the organic matter in the sewage so that these beneficent bacteria may most rapidly and thoroughly accomplish their purpose. during the last fifty years, a great deal of study has been expended on this problem, and while it has not as yet been entirely solved, certain essential features have been well established. the most important factor promoting the activity of these agents of decay is the presence of air, since in many ways it has been proved that without air their action is impossible. thus it has been shown that discharging sewage into a stream, whether the stream be a slow and sluggish one or whether it be a mountain stream churned into foam by repeated waterfalls, has little other power to act on organic matter than to hold it for transportation down stream, or to allow it to settle in slower reaches until mud banks have been accumulated which will be washed out again at the first freshet. experiments have shown that the agencies to which certain diseases are attributed, commonly known as pathogenic bacteria, are frequently, if not always, found in sewage, and that when these bacteria are discharged into streams they may be carried with the stream hundreds of miles and retain all their power for evil, in case the water is used for drinking purposes. no right-minded person to-day will so abuse the rights of his fellow-citizens as deliberately to pour into a stream such unmistakable poison as sewage has proved itself to be. the fact is so well known that it is not worth while pointing out examples. it is enough to say that some of the worst epidemics of typhoid fever which this country has known have been traced to the agency of drinking water, polluted miles away by a relatively small amount of sewage. in a number of states, laws have been passed which expressly prohibit the discharge of sewage, even from a single house, into a stream of any sort, even though the stream is on the land of the man thus discharging sewage and where it would appear as if he alone might control the uses of that stream. unfortunately, the machinery of the law does not always operate to detect and punish the breakers of the law, but any law which, as in this case, has so positive a reason for its existence, and violation of which is so certain to bring disaster on persons drinking the water of the stream below the point where the sewage is discharged, any law which appeals for its enforcement so directly to the common sense and right feeling of all intelligent people, seems hardly to need legal machinery for its enforcement. it must depend, as indeed all laws must depend, upon the intelligent support of the community, and surely no law would commend itself more urgently than this one forbidding the pollution of drinking water. in spite of the fact that the lack of air in the water will prevent bacterial action, there are, nevertheless, many cases where the discharge of sewage into a stream may be permitted as being the best solution of the disposal problem, provided always that the stream is not used and is not likely to be used for drinking water. such cases occur where the stream is relatively large and where the level of the stream is fairly regular, so that there is no likelihood of the deposit of organic matter on the banks during the falling of the stream level. examples of this sort might be cited in the vicinity of the mohawk or hudson river, or in the vicinity of any of the larger rivers of any populous state, since although the water of the mohawk is used by the city of albany for drinking purposes, yet the amount of organic matter which inevitably finds its way into such rivers precludes its use for drinking without filtration. into the hudson below albany there can hardly be any question of the propriety of discharging sewage from a single house. again, houses in the vicinity of large bodies of still water may without question be allowed to discharge into those lakes. for example, houses in the vicinity of lake ontario or lake michigan, or even of much smaller lakes, should not contribute any offensive pollution to the waters of the lake. in new york state, some of the smaller lakes are used as water-supplies for cities, as, for example, owasco lake for the city of auburn and skaneateles lake for the city of syracuse, and, acting under the statutes, special laws have been passed by the state department of health, forbidding any discharge of any kind of household wastes into these lakes. the same is done in other states. here, again, it is a question of the drinking supply which is being considered, and not a question of the possibility of any nuisance being committed. _treatment of sewage on land._ if no stream suitable for the reception of sewage is available, then the sewage must in some way be treated on land before it passes into the nearest watercourse. for the second fundamental principle about the treatment of sewage is that of all places the action of putrefactive bacteria is most energetic in the surface soil and that it is there that the organic matter of sewage can be most rapidly accomplished. experiments already referred to have shown not only this, but also that their activity is most noticeable in the surface layers of the soil and that their action continues for scarcely two feet downward, and it is customary to assume that the largest amount of work done is accomplished in the top twelve inches. further than this, it has been established that in order to persuade the bacteria involved to do their work as promptly as possible, the application of sewage to any particular locality should be made intermittent; that is, that a resting period should be given to the bacteria between successive applications of sewage. for example, one can recall without difficulty the conditions on the ground at the back of the house where the kitchen sink-drain commonly discharges. at the beginning of summer perhaps a rank growth of grass starts up vigorously in the vicinity, and the path of the surface drain can be traced by the heavy vegetation along the line of the drain. if the slope of the surface away from the house is considerable, no other effect may be noticed through the season, since the surface slope carries away the sewage, spreading it out over the ground so that the soil really has a chance to breathe between successive doses. but if the ground is flat, it will be remembered that before many weeks the sewage ceases to sink into it; the ground becomes "sewage-sick," as they say in england, and a thick, dark-colored pool of sewage gradually forms, which smells abominably. if a piece of hose a dozen feet long had been attached to the end of the drain and each day shifted in position so that no particular spot received the infiltration two days in succession, it is probable that no such pondage of sewage would occur, but that the mere intermittency of the application thereby secured would permit the successful disposal of this sink waste throughout the season. the same effect is to be noted in some cesspools where, because of the great depth to which they are dug and because no overflow into the surface layers of the soil is provided, the pores of the ground around the cesspool become clogged and choked, and the cesspool becomes filled with a thick, viscous, dark-colored, objectionable-looking, and evil-smelling liquid. the three principles which will avoid these conditions are, as already stated, plenty of air, presence of bacteria normally found in the surface layers of the soil, and intermittency of application. in order to secure the operation of these three principles in the application of sewage onto land, the sewage must be made to pass either over the surface of the land in its natural condition in such a way that the sewage may sink into the soil and be absorbed and at the same time give up its manurial elements to whatever vegetation the soil produces; or, as a modification of this principle, the sewage may be required to pass through an artificial bed of coarse material by which the rate of treatment may be considerably increased. in the latter case, although probably the greater part of the action of the bacteria takes place in the top twelve inches, it is customary to make the beds about three feet thick, chiefly in order to prevent uneven discharge of the sewage through the bed. finally, wherever, for æsthetic reasons, it is desirable that the sewage should not be in evidence, either before passing through the natural soil or exposed in an artificial bed, the practice may be resorted to of distributing the sewage through agricultural tile drain laid about twelve inches below the surface. in this way, the sewage is scattered through the top soil, where bacteria are most active, without being apparent, and a front lawn thus treated would not give any indication of its use. taking up now in order these three methods of treatment, we may consider some of the details of construction. in spreading the sewage over the lawn or in distributing it on the surface, due regard must be paid to the kind of soil. clay soils and peaty soils are useless for the purpose of sewage disposal unless as the result of continuous cultivation a few inches of top soil may have accumulated on the clay. this top soil is adapted to sewage purification, provided the quantity applied is not excessive. _surface application on land._ two methods of operation may be pointed out. the sewage (and this is the simplest method of disposal possible) may be brought to the upper edge of a small piece of ground, usually sowed to grass, and allowed merely to run out over the surface of the ground. there should be, however, some method of alternating plots of ground, one with another, so that the sewage is turned from one to the other every day. each plot will then have one day's application of sewage and one day's rest, and this would complete the disposal, were it not for the interference of rain and cold. the winter season practically puts a stop to this method of treatment, and rainy weather reduces the power of the soil to absorb sewage. for these two reasons, it is desirable to have one plot in reserve, or three in all, and the area of each plot should be based on the amount of sewage contributed. for a family of ten persons using twenty-five gallons of water per day the total area provided should be one tenth of one acre, or an area seventy feet square divided into three plots. figure shows six beds arranged to care for the sewage of a public institution in massachusetts. as a guide to the amount of land needed, it will be safe to provide at the rate of one acre for each forty persons where the soil is a well-worked loam but underlaid with clay. the effect of this irrigation on the grass will be to induce a heavy, rank growth which must be kept down by repeated cutting or by constant grazing. both methods are practiced in england, and it may be said in passing that no injury to stock from the feeding of such sewage-grown grass has been recorded. the grass cut from such areas (and the cutting is done every two weeks through the whole summer) is packed into silos and fed to cattle through the winter with advantage. or, if grazing is resorted to to keep the grass down, the herd is alternated with the sewage from one field to the other, so that the bed which has received sewage one week is used for pasture the next week, and the number of head which can thus be fed is astonishing. in order to secure an even flow of sewage over such grass land as is here contemplated, there must be a gentle slope to the field, and the ditch or drain bringing the sewage to the field should run along its upper side. openings from the drain, controlled by simple stop planks, are provided at intervals of about ten feet, and no attention is needed further than the opening and closing of these admission gates. [illustration: fig. .--sewage beds.] another method of applying sewage to the surface of the ground is to lead it in channels between narrow beds on which vegetables have grown. these beds are made about eight feet wide with two rows of root crops, such as turnips or beets, set back about two feet from the edge. the beds are made by properly plowing, the channels between the beds being back-furrowed. here, again, the principle of intermittent application is essential, and the area to be provided is the same as already given for the surface irrigation. three beds should be provided, as before; but, in general, no provision need be made for carrying off the sewage at the lower end of the beds, since it may be safely assumed that all of the sewage will be absorbed by the soil. of course, a sandy soil will absorb more water than a clay soil, and if the soil is entirely clay, it is not suitable for such treatment. sewage passed over the surface of clay soil, however, will, in the course of a few months, so modify the clay as to convert it into a loam, and in this way increase its absorptive power. when possible, it is desirable to have a plot of plowed ground over which the sewage may pass before reaching the beds, so that the grosser impurities may be left behind and harrowed in or plowed under. if proper regard is paid to intermittent application, no danger from odors need be feared, and the repeated plowing in will increase immensely the fertility of the soil. nor need one be afraid that all of the manurial elements will be left behind on this plowed ground. about two thirds of the organic matter in sewage is in solution, and this will be carried onto the beds just as if passage over the plowed ground had not occurred. _artificial sewage beds._ in order to secure a higher rate of discharge of sewage through the soil it is best to arrange an artificial bed which shall be made of coarse, sandy material which will allow a rate of at least times that already given. the best material out of which to make such an artificial bed is a coarse sand; that is, a sand whose particles will not pass through a sieve which has meshes to the inch and which would pass through a sieve of meshes to the inch. such an ideal sand will purify sewage at the rate of , gallons per acre per day, or an acre will take care of the sewage of at least persons. this means that it is necessary to provide about square feet for each person in the family, or a family of persons could have all the sewage taken care of on an area feet square. the same principle of intermittency of application, however, must be observed by dividing the bed into three parts, so that the sewage may be alternated from one bed to another. practice has indicated that it is better to shift from bed to bed about once a week and to deliver the sewage onto each bed intermittently; that is, to discharge a bucketful at a time with short intervals between, rather than to allow a small stream to flow continuously onto a bed. such a bed should be about feet deep, as already stated, and preferably should have light concrete side walls and bottom, as shown in the sketch (fig. ). ordinarily, the surface of the sand will be level, and the dose of sewage applied to the bed will cover it a fraction of an inch deep, and in the course of an hour or so will disappear into the sand and reappear in the underdrains as clear water. [illustration: fig. .--sewage beds.] in cold weather a thin sheet of sewage spread out over the surface of the sand would freeze before penetrating the bed; therefore, in the winter time, it is usual to furrow the beds; that is, dig furrows across the beds or inches wide at the bottom and about inches deep, so that in the bottom of these furrows the sewage may be, partly at least, protected against frost. it has been found that, if sewage is discharged intermittently,--that is, in bucketfuls into such furrows,--the beds open and allow the filtration of the sewage. to be sure, the purification effected in cold weather is not quite that accomplished in warm weather, but the results are sufficiently satisfactory, and no nuisance ensues. _subsurface tile disposal._ the other method of distributing sewage over land is by means of draintile placed in shallow trenches, so that the sewage may leach out into the soil through the open joints of the pipe. these draintiles receive the sewage intermittently, and by the constant rush of water are presumably filled throughout their length. the sewage then gradually works out of the joints into the surrounding soil, and the pipes are empty and ready to receive another dose when next delivered. two essential points must be considered in the successful operation of such a plant: the grade of the tile and the length of the tile. the grade of the tile must be properly adjusted to the porosity of the soil; that is, in open, porous, and gravelly soils a grade must be steeper than in loamy and dense soils. the reason is manifest. in a gravel soil, the sewage is at first rapidly absorbed, so that as the sewage goes down the pipe line the first joints take up the water and deliver it to the soil, where it disappears, and probably no flow reaches the end of the line at all. this means that the soil surrounding the first joints does the work which the entire pipe line was intended to do and thus becomes overworked. when overworked, the soil always refuses to do anything, so that when the succeeding joints take up the sewage and in their turn become overworked, the line is useless. if, on the other hand, the grade had been steep enough to carry the sewage down the pipe line gradually so as to secure a uniform distribution, then the same or approximately the same amount of sewage would be taken out of the pipe at each joint, securing a long life for the system. in loamy soil, on the contrary, there is not the same absorption at the joints, and so on a steep grade there is the tendency for all the sewage to follow down the pipe line to the lower end and there escape to clog the soil and thus spoil the system. as a general average, it may be said that the proper grade for such a subsurface distribution pipe line in a fairly good sandy loam should be inches in feet; less than this as the loam becomes clay and more as the loam becomes gravel. the other essential point for the successful operation of this method of distribution is to provide a proper length of pipe for the number of persons contributing sewage. the soil itself will absorb about the same amount as when the sewage is spread over the surface, so that a family of ten persons would require, as before, an area about feet square. the pipe lines may be laid in different sections, provided the different lines of pipe are not nearer together than feet. on an area feet square there would be, therefore, lines of pipe each feet long, or lineal feet of pipe in all, or feet per person. the writer generally allows feet in well-cultivated soil as a reasonable length of pipe for each person in the family. if the soil is sandy, this may be reduced one half, but need not be increased under any conditions, since a soil requiring a greater length of pipe than feet per person would be so dense as to be unfit for use. to properly arrange the lines of pipe on a sloping ground requires careful study of the inclination of the ground and of the relation of direction of lines of pipe to slope. usually the slope of the ground is greater than the inches per feet just referred to, but by laying out the lines of pipe across the slope instead of with it any grade desired may be obtained. nor is it necessary that these lines of draintile be run in straight lines; they may very properly follow the curving slope, the proper grade being always carefully maintained. [illustration: fig. .--plan of subsurface irrigation field.] common agricultural tiles three inches in diameter and costing about two cents per running foot are suitable material for these distribution lines. the sewage enters these distribution lines from a larger pipe, usually six inches in diameter, and a difficult adjustment is presented that each branch tile line shall receive its own proportionate share of the sewage. if only one line of tile is provided, say feet long for members in the family, then all the sewage goes into that line with no question of distribution arising, but if a number of short parallel lines must be used, as shown in the sketch (fig. ), the difficulty of subdividing the sewage properly among the different branch lines becomes very great. for that reason the writer prefers to use not more than two lines, with the possibility of delivering the sewage alternately in the one and the other. in this way, the bed not receiving sewage is resting, while the other bed is acting, and also the outlet for the sewage is always definitely known. and particularly in the case of these subsurface tile, the necessity for the intermittent dosing is apparent, since with small, constant trickling discharges the difficulty of distribution through the long length of tile is gradually increased, and usually saturation of the soil occurs from joint to joint, as already described. therefore it becomes most necessary, in this case, for the best results on the soil not merely to alternate the beds receiving sewage, but also to effect the intermittent discharge onto the beds or through the pipes although the sewage itself may flow very uniformly in volume. _automatic syphon._ this intermittent discharge is accomplished by constructing on the pipe line from the house and before it reaches the beds an "automatic syphon," as it is called, the operation of which may be described as follows: as the sewage enters the tank containing the syphon and rises outside the syphon-bell, air is compressed between the water surface inside the bell and the water left inside the syphon-leg. with greater and greater height of water outside, this compression inside becomes greater and forces the water in the syphon-leg lower and lower. finally, the water sinks so low as to allow the compressed air to escape suddenly around this bend, instantly relieving the compression, and the water outside rushing in to fill up the space occupied by the air starts the syphon (see fig. ). [illustration: fig. .--section of "miller" syphon.] this syphon, in size suitable for a single house, costs about $ delivered, and will always be available to secure an intermittent dosing of the bed or pipe line. usually the chamber in which this syphon is placed holds about one hour's flow, so that it may be estimated that this syphon will discharge on the bed every sixty minutes. the exact interval of time is not essential nor, perhaps, important, although it may be noted that the coarser the material,--that is, the nearer uniform all the sand particles are to the largest size passing the ten-mesh size,--the smaller must be the dose applied, but the more frequently must the application be made. this has been very thoroughly studied in massachusetts, and the views of experts on this subject may be found in the report of that board. such an intermittent discharge may be made and often is made by a hand valve leading out from this chamber in institutions or in private houses where some one constantly is available for the purpose. thus it becomes the duty of the man in charge every hour or perhaps three times a day to pull the valve and allow the sewage to discharge (see fig. ). an overflow pipe should always be provided, so that if he forgets to pull the valve, the sewage will still find its way into the system rather than out on the ground. [illustration: fig. .--plan and section of a septic tank with valve.] _sedimentation._ as a matter of economy of operation, it has been found desirable to take out from the sewage before the treatment already described as much of the solid matter as may be reasonably done, and for this purpose sedimentation is made use of. most of the solids in sewage are slightly heavier than water, so that if they be allowed to stand in the water for a short length of time, they will settle to the bottom of the tank and allow the liquid above to pass on, considerably clarified. it has been found worth while to do this, since all three processes described are interfered with if the solids taken out by sedimentation are allowed to be deposited either upon the surface of the ground, giving rise to odors as well as to objectionable appearances, or onto the surface of the sand beds, which they clog up, or in the three-inch tile drain, which may be filled in a short time. it has been further found by experience that if these sedimentation tanks are made large, really larger than necessary for sedimentation, in some way a large proportion of the matter accumulating in the tank will disappear, so that the amount of sediment to be taken out of the tank is not as large as might be expected. in fact it is usual for such tanks to run one or two years without cleaning, although the amount of solids shown by chemical analysis to have been removed from the sewage would fill the tank twice over. it has been found that a tank, in order to do successful work in separating solids and in eliminating as much as possible of the sediment, needs to be of a capacity to equal about one day's flow of the sewage, and this is a good basis for computation. here, again, the fact that the sewage from a single house is considerably fresher than the sewage from a city must be remembered, since, while many cities build tanks holding only one third or one fourth of their daily flow with good results, in the case of a single house this is not possible, and the tanks, if built at all, ought to hold at least the full day's flow. ten persons, at gallons each, furnish gallons per day or cubic feet. the tank, then, must be large enough to hold this volume, and suitable proportions generally require that the tank be at least times as long as wide. a certain allowance must always be made for deposit in the bottom and for the accumulation of scum on the top, so that an extra foot or more of depth is desirable. the tank, then, to furnish the required feet, might be made feet wide, feet deep, and feet long, and probably in no case would a tank much smaller than this be used. [illustration: fig .--section of a septic tank with syphon chamber.] there are two or three details of tank construction which may be suggested, although almost any kind of tank will answer the purpose. it is desirable in order that the surface scum may not be disturbed, and in order that the inflowing sewage may distribute itself as uniformly as possible across the tank, to attach an elbow to the entering pipe so that the sewage enters about halfway between the top and bottom of the tank (see fig. ). similarly, at the outlet or weir an elbow should be provided because it is not desirable to allow the floating matter of the surface to be carried onto the bed, and a pipe taking off liquid, open halfway between top and bottom, will carry away but little of either the surface scum or bottom sediment. such a tank must be built of concrete or masonry or timber, although the latter is not to be recommended because of its short life. the walls of an ordinary tank may be built inches thick at the top and inches to inches thick at the bottom, the latter being necessary if the depth is over feet. the tank should have inches of concrete on the bottom, and the roof may be made of flagstone or of concrete slabs in which some wire mesh has been buried. it is not necessary to ventilate this tank, although it is desirable to have perhaps a foot of air-space between the water level and the roof of the tank. during the first few months of its operation such a tank is very likely to smell badly, and, if ventilators are provided, the presence of the tank will be well known by the odors sent off. after the tank has been in operation two or three months these odors gradually disappear, due presumably to the fact that the surface of the water in the tank has become coated with a thick blanket through which odors cannot penetrate. on the other hand, there have been a few cases recorded where the production of gas in a septic tank was so great that an explosion occurred, tearing off the roof and otherwise doing considerable damage. the full plant, therefore, will consist of the settling tank, receiving the raw sewage from the house and discharging it into a small tank holding about one hour's flow and containing the automatic syphon apparatus for intermittent discharge. this dosing tank must provide for one hour's flow at the maximum rate of flow, and should hold about one fourth of the total daily flow. then the ground area, either natural or artificial, which receives the intermittent discharge from the dosing tank, completes the installation (see fig. ). [illustration: fig. .--plan of sewage disposal for single house with details of receiving tank.] _underdrains._ the question of installing underdrains will arise only in cases where the ground water, always to be found below the surface somewhere, comes up so high as to affect the disposal of sewage. usually no underdrains will be needed unless the ground water gets up to within three feet of the surface, and, in a number of cases, underdrains have been laid under a sewage filter at considerable expense, only to find when the filter was in operation that they were never in use. in clay soils the underdrain is not necessary. in fact, it may be noticed that the underdrain is not for the purpose of taking care of the sewage, but rather of draining off the soil-water and preventing its interference with the action of soil on sewage. this principle will indicate where underdrains are necessary and where not. when used, underdrains should be laid from three to four feet below the surface in parallel lines about fifteen feet apart and on grades of not less than one foot in one hundred. it is always better to have the underdrains too large than too small, and drains less than three inches in diameter should not be used, and they should increase in size to four inches and then to six inches as the separate drains are brought together. the writer has seen a six-inch underdrain running full of ground water collected within a distance of a hundred feet, but this was in gravel soil through which the water passed very freely. no exact rules can be given for the size of the underdrains, but it will be noticed that, since water passes through clay soil slowly and through gravel soil rapidly, larger pipes must be used where the soil is coarse. chapter xi _preparation and care of milk and meat_ milk has long been considered to be one of the most important human foods, particularly for the young, combining within itself all the essential elements necessary for the production of cell tissue and for animal vitality. in composition, it is about per cent water, the remaining per cent being divided between fat, casein, and sugar in equal parts, with a small addition of salt. as is well known, milk is the sole food upon which it is possible to sustain life for long periods, and while this applies directly to infants, it is by no means confined to them. many examples can be given of men and women of mature life who, either on account of some digestive disorder or some mental bias, have confined themselves absolutely to a diet of about two quarts of milk a day and have lived thereon for months and years without suffering from lack of nutrition. in recent years, due to the advocacy of the eminent scientist, metchnikoff, who asserts that researches in the pasteur institute have shown that certain diseases of advanced age are due to auto-intoxication from the larger intestine and that the consumption of fermented milk acts as an antiseptic, neutralizing this bacterial intoxication, the consumption of fermented milk, or buttermilk, or koumiss, has very largely increased. it is, in fact, rather remarkable to find that in large cities, business men whose digestions have been ruined are devoting themselves to unlimited quantities of buttermilk in the hope that their former excesses and absurdities in the way of food may be counteracted and health restored. between these two extremes--the use of milk for the very young and for the aged and infirm--milk plays an important part as food. the consumption of milk in new york state, according to statistics, amounts to about a pint a day for each person for that part of the country. as an article of food, milk has the advantage already referred to, namely, that besides its nutritive power it has a curative effect greatly augmented by fermentation, the modification so vigorously advocated by metchnikoff. another advantage which milk possesses as an article of food is that, by sterilization and storage in closed vessels, it may be kept for days and even months in good condition. at the time of the paris exposition, milk was sent from america and exhibited alongside of french milk with no preservatives except heat used for removing the bacteria in the milk and then cold storage for keeping others out, and two weeks after the original bottling the milk was in good condition. to meet the need of ailing babies, advantage was taken of this valuable property of milk, by which it could be shipped from dairies near new york to the isthmus of panama, and used continually with good results although more than a week old. _bacteria in milk._ the great disadvantage which milk sustains as an article of food is that the same composition that makes it so useful as a diet for man, also renders it a most admirable culture medium for the rapid development of all kinds of bacteria. some of these bacteria are, without doubt, benign in their effect upon man; as, for example, the particular species used to produce koumiss and other varieties of fermented milk now recommended by physicians. but there are many other kinds of bacteria that find life in milk congenial, whose effect upon the human system is not salutary, and, if milk infected with those varieties is used for feeding infants, the result is quite likely to be a disturbance of their digestive system, producing diarrhea and cholera infantum and possibly death. it was at one time common to add to milk certain antiseptics for the purpose of preventing the growth of bacteria, and, except that the preservatives acted quite as injuriously upon man as upon the bacteria, the results, so far as merely keeping the milk went, were all that could be desired. the chemicals added were borax, boracic acid, salicilic acid, sodium carbonate, and other similar disinfectants. gradually, however, it has come to be known that, inasmuch as the milk when first drawn from the cow's udder is sterile, that is, contains no bacteria, and since it is quite possible to prevent the introduction of bacteria into milk during the processes of milking, straining, and bottling, there is no need of the addition of preservatives, provided particular care is exercised in handling the milk. _effects of bacteria._ since this care involves the expenditure of both additional time and money, questions at once arise whether such expenditure is necessary, whether the introduction of a few bacteria into the milk is objectionable, and what the results are upon the persons drinking milk containing bacteria. for our present purpose, the kinds of bacteria which find their way into milk may be divided into two classes, namely, those that are normally in milk and which tend to produce souring, and those which accidentally enter and are able to produce disease in persons drinking the milk. the first kind probably enter the milk from the air or from the surface of the milk-pail, and in the milk increase in numbers very rapidly and have the same effect in the milk and on persons drinking the milk as any large amount of organic matter. the second kind of bacteria are known as pathogenic; that is, are the direct cause of disease when taken into the human system. under ordinary circumstances, this latter class will not be found in milk, since these kinds of bacteria must come from some infected person, and if no such person is in contact with the milk at any stage, then it is impossible for the milk to become so polluted. however, those interested in preventing the spread of disease through polluted milk argue that if the conditions in a stable and dairy are so unclean that large numbers of the normal milk bacteria can enter the milk and increase in numbers there, then conditions would be favorable for the introduction of pathogenic bacteria whenever the milker or bottle-washer or the strainer or any of the helpers became sick. to show the difference in the effect of a clean stable and dairy as compared with an ordinary one, it is only necessary to say that in investigating the quality of the milk supply of a certain city recently, the writer found one stable where the milk analyses showed from half a million to a million bacteria per c.c.,[ ]--that is, per half-teaspoonful,--and this was occurring in the dairy regularly from month to month as the analyses were made. another stable in the same city showed just as regularly a bacterial count in the milk of from to per c.c., the difference being due solely to the way in which the stables and dairies were kept,--in the one case with no regard to cleanliness and in the other with the very best attention paid thereto. certainly, if dirt is so much in evidence that a million bacteria can enter the milk in every c.c., no particular pains can be taken in such a stable to keep out disease germs; while in the clean stable, where so few germs enter, disease germs could hardly find any opportunity for lodgment. [footnote : c.c. = cubic centimeter, or centister. a centimeter is about / of an inch (. ). cubic inch is about - / c.c.] the following example may be given to indicate the effect of impure milk upon a community. the vital statistics of the city of rochester, including the deaths of children under five years, show that from to , during the summer, infants died at the rate of per , population. the health officer of the city undertook to improve the quality of the milk, and from to , statistics show that the number of children dying, under five years, was only at the rate of per , ,--a manifest saving due, without doubt, to the improvement in the quality of the milk. by repeated examinations of the dairies, by rigid enforcement of certain rules governing the distribution of milk, and by detailed lessons to mothers in the tenement-house districts on the care of milk, the quality of the milk was so improved as to make the reduction in the death-rate already pointed out. the honorable nathan strauss, of new york city, has taken up the same idea, and, by supplying the poor with milk properly heated so as to destroy the bacteria which may have been introduced by careless handling, has also saved hundreds of thousands of children from premature death. _diseases caused by milk._ many infectious diseases are propagated by milk, not only among children, whose chief food is found in this supply, but also among those of more mature age who, though drinking only a small quantity, are apparently more easily affected. four diseases are particularly to be noted in connection with the consumption of milk, namely, typhoid fever, scarlet fever, diphtheria, and tuberculosis. _typhoid fever from milk._ one of the most striking illustrations of the spread of typhoid fever through milk occurred this last year in the city of ithaca, new york. the city proper lies in a valley between two hills, the milkmen having their farms on both sides of the valley to the east and west, on the hill slopes. one milkman on the west, with a large route, delivered his own milk only in part and bought an additional supply from a farmer on the east. in the family of the latter occurred a case of typhoid fever in september, pronounced by the local physician to be sunstroke, but evidently typhoid fever, since other cases of secondary infection developed in the same family and were then pronounced typhoid. the milk from this east-side farm was taken down the hillside and turned over to the west-side farmer, who distributed his own milk in his trip from his farm across the valley, his route being so timed as to allow him thus to dispose of all his own milk. having then loaded up with the east-side supply, he started back across the valley, distributing the milk which was evidently polluted, since on his return route house after house developed typhoid fever, with no cases on the first part of the route and with no other cases in town except those on this milk route. forty-four cases developed in all, with two deaths. the reports of the massachusetts state board of health give a number of cases of the same sort, all showing that milk is easily infected by persons suffering from even mild attacks of typhoid fever, attacks so slight as perhaps not to be recognized or to be worth submitting to a physician, but which are responsible for bacteria passing from the hands or mouth to a can cover or ladle, and so to the milk. _diphtheria._ diphtheria seems to be well established as a disease transmissible by milk, although its occurrence is not so frequent as that of typhoid fever. not long since, the writer was much interested in an epidemic of this sort described by a physician who was convinced that the bacteria responsible for the mild form of the disease occurred largely in the nose and throat passages. he noted that as the result of these growths a constant exudation from both passages was present, and that a man with this disease, working over the milk, might easily allow the milk to be polluted by this exudate dropping from his nose. the result was a general distribution of a mild form of diphtheria among those using the milk. _scarlet fever._ many examples have also been given of the distribution of scarlet fever through the agency of milk, the specific contagion probably being discharged by the patient from his nostrils, mouth, or from the dry particles of skin so characteristic of this disease. unfortunately, mild cases of scarlatina are very apt to occur, so mild that a physician is not called in, and the only positive proof of the disease consists in the subsequent "peeling," although the nasal passages may have been alive with germs. _tuberculosis._ so far as tuberculosis is concerned, nothing seems to be definitely proved. there is little fear of milk becoming infected from tuberculous patients or of the disease being transmitted through milk from one person to another, as with the three other diseases mentioned. the possibility of infection here lies in the fact that a cow, like man, is susceptible to tuberculosis as a disease, and undergoes the same course of prolonged suffering and death. the interesting question is whether the disease may be transmitted from a cow to a man through the cow's milk. with all the refinements suggested by science as to the virulence of the disease thus transmitted, with a study of the comparative symptoms of the two diseases, of the progress of the disease in the cow when the germs are found in the milk, and of the possibility of eliminating these germs by heating or otherwise, the danger from diseased cows is still unsettled. so far as present knowledge goes, it is probably conservative to say that although tests made on cows by inoculation with tuberculin show that a large proportion of the animals in the various dairy herds are more or less affected by tuberculosis, yet only a small proportion of the milk from such cows shows the presence of the tuberculosis bacillus. so far as statistics can be given on this subject, it seems probable that not more than ten per cent of the cows reacting under the tuberculin test would show tubercular bacilli in the milk, or would develop tubercular reactions if the milk were used in inoculations. the reason for this is probably that the tubercular growth in the cow does not naturally attack the milk glands until the disease is well advanced, and when the general appearance of the cow indicates severe illness, so that any careful milkman would not use the particular milk, even if the milk flow did not cease. it is not reasonable to assume that all milk from tubercular cows is itself infected, nor yet that all children drinking milk so infected will contract the disease. but the mere possibility of demonstrating that a small percentage of tubercular cows will cause human tuberculosis is sufficient to justify all possible precautions against tubercular animals and against the distribution of tubercular milk. in this connection it is worth while noting that the cows most affected by tuberculosis are those confined in small crowded stables, with no fresh air, with no exercise, and with insufficient or improper food. unfortunately it is not possible to trace the connection between the particular animal responsible for the disease in a human being, since the period required for the development of the disease is so great that the possible time of onset is forgotten and the cause of the disease entirely out of mind. it can only be said, therefore, that laboratory experiments have demonstrated the presence of the tuberculosis bacillus in milk from tubercular cows, and that this bacillus is known to produce tubercular lesions in man. it is wise, therefore, to eliminate the milk of tubercular cows if healthy milk is to be provided. _methods of obtaining clean milk._ aside from the infection of milk by specific disease-producing bacteria, the milkman of to-day must be very careful to avoid a milk which shall contain large numbers of bacteria of any type which, while not producing any specific disease, nevertheless causes changes in the chemical composition of the milk, which make it at the same time unfit as an article of food for individuals and shows the possibility of other kinds of infection. there are two axioms to be followed if good clean milk is to be produced, and those are that the milking and straining shall be done in clean stables, from clean cows, by clean persons; and the other that the milk shall be cooled to a temperature of fifty degrees or less as soon as received from the cow. neither of these requirements is difficult to attain, but they constitute the sole reason why some milk contains a million or more bacteria and other milk less than a thousand; and it is quite possible by enforcing these two requirements to change the number of bacteria in milk from the large figure to the small one. probably it is in the stable where the cows are milked that the most important factor in producing large numbers of bacteria is to be found. not long ago the writer saw a number of stables, the ceilings of which were poles on which the winter supply of hay was stored and the atmosphere was noticeably dust-laden. a good milk could not be furnished from such a stable, and therefore it may be set down as the first requirement that the ceiling of the stable should be entirely dust-tight. some of the best stables in the country for this reason have no loft of any sort above the cattle, but if the ceiling is tight,--that is, made with tongue-and-groove boards and then painted,--there can be no objection to the storage of hay in the loft. hay should not be taken from the loft or fed to the cows just before milking, because the very moving of a forkful of hay through the air of the stable stirs up so large a number of bacteria in the air that quantities of them will later fall into the milk-pail. _light and air_ in a stable are both important, not so much for the quality of the milk as for the health of the cows that furnish the milk. ventilation and sunlight are both excellent antiseptics. the ordinary rule for the amount of window area per cow as given by the united states department of agriculture is four square feet of window surface. but it is not easy to definitely state any fixed amount of window area, since the value of the window is in its disinfecting power on the bacterial life of the stable, and this is greater or less as the windows receive the direct sunlight or are hidden under eaves where no sunlight reaches them. the next factor in the production of good milk is the condition of the _walls of the stable_. like the ceiling, they should be absolutely free from dust, and should be smooth, so that they may be brushed or even washed clean. for this reason, walls with ledges are objectionable, and all horizontal surfaces in a stable are undesirable. tongue-and-groove sheeting should never be laid horizontally, but rather vertically, and a smooth brick or concrete wall is better than wood in any case. the same care must be taken to have the floor clean and dry. a floor of saturated wood, containing millions of bacteria which are stirred up by the milker moving around, causes many of those millions to be deposited in the milk-pail. a concrete floor for the stalls and drains is the ideal construction, and both should be thoroughly cleaned morning and night, so that no dried refuse may remain as the living place for bacteria. nor should the manure thrown from the stalls be left in the vicinity of the barn, but carried away at least feet, in order that the barnyard may be kept dry and clean, that no smell from the manure may reach the milk, and that the flies which come from manure piles may be kept at least that distance from the cows. the next factor in the production of clean milk is the _condition of the cow herself_, not in the matter of her actual health, but in the matter of the cleanliness of her skin at the time the milking is done. if the udder and sides of the cow have been coated with manure, it is certain that more or less will fall into the milk-pail at the time of milking, and the "cowy taste" of the milk is easily accounted for in this way. in a modern stable, the milkman is careful to clean the cow ten or fifteen minutes before the milking is done by sponging or washing her belly, sides, and udder with a damp cloth or with a cloth moistened with a disinfecting solution. in one set of experiments, for instance, , bacteria per c.c. were found in the milk when the cow was rubbed off before the milking and , when the preliminary cleaning was omitted. in another case, milk from four dirty cows gave an average of , bacteria, while other cows of the same herd, milked by the same man, but carefully cleaned before milking, gave only per c.c. the care involved brings its own reward, and it is in most cases a lack of knowledge or an indifference to results which causes the malign effects above noted. only a few weeks ago, the writer watched the hired man start the milking and was disgusted to see the old-fashioned practice followed of squeezing a little milk onto the man's filthy hands and then the handful of milk rubbed around on the cow's teats to drip filthy and bacteria-laden into the milk-pail along with the milk itself. one other factor is involved which, while scoffed at by some of the old-time farmers, has nevertheless proved its value, and that is the use of the _narrow-topped milk-pail_. it is startling when tested by bacterial growths under the two conditions to see how many more bacteria will be found in the wide open pail than in the narrow-topped one, and while, of course, some milkers may not be able to use a pail the top of which is only six inches in diameter, it is quite worth while for milkers who do not know how to use a narrow-topped pail to learn. the size of the opening is not the whole consideration in the matter of the milk-pail. the way it is washed is even more important. if it is merely rinsed out in cold water and then washed in warm water, it is far from clean, and milk poured into such a pail and then poured out will by that process have gathered to itself thousands of bacteria. for example, some experiments have shown that milk in well-washed pails had, on the average, , bacteria per c.c., while that collected in pails of the same sort under identical conditions, except that the pails had been steamed, contained only bacteria per c.c. perhaps the most important factor in the care of these utensils is the necessity of killing the bacteria left in them by the milk itself. ordinary washing will not do this. either the washing must be done with some sterilizing agent, like strong salsoda, which must then, of course, be thoroughly rinsed out, or else the inside of the pail must be filled with absolutely boiling water or with steam. the advantage of the latter is that no contamination is possible by the water itself, whereas in washing out the disinfectant the water, unless pure, contaminates the surface again. to show the effects of clean pails, an experiment was made in which milk was drawn from a cow and found to have bacteria per c.c. it was then poured rapidly from one to another of six other apparently clean pails. at the end of the sixth pouring, the milk was found to be so changed that the number of bacteria had increased to , per c.c. the strainer for a milk-pail is preferably made of cheesecloth, since this can always be easily boiled between milkings, and so sterilized. a wire strainer through which the milk has to pass, and where the milk is often stirred by the finger of the milker to make it pass through more rapidly, is in no sense as satisfactory as cheesecloth. the straining should be performed as soon as each pail is filled with milk, and pails of milk should never be allowed to stand around in the barn back of the cows, but rather should be taken at once to the milk-room, where it can be strained before any further contamination takes place. then the milk should be cooled, and this, to be effective, must be done in such a way that the temperature of the milk shall at once fall to fifty degrees or less. it is well known that a forty-quart can of milk lowered into spring water cools slowly on the outside, but that hours will pass before the inside of the can has its temperature lowered appreciably. meanwhile, bacterial growth has started, and that milk can never be as good as when cooled quickly throughout. special apparatus is made in which the milk is spread out in very thin sheets over a surface cooled by ice or cold water to a low temperature. in this way all the milk is at once lowered in temperature and may then be kept in spring water until time for shipment. many examples can be given of the value of this kind of cooling. a few years ago, the cornell university agricultural experiment station determined that a certain milk when fresh contained, about bacteria per c.c., and fifteen hours later at room temperature had , , and twenty-seven hours later had soured with an innumerable number of bacteria. another part of the same milk, however, kept at fifty degrees fahrenheit, showed absolutely no increase in bacteria for twenty-seven hours, and was still sweet with only , bacteria at the end of three days. _city milk._ the value of pure milk is not a matter of individual opinion on the part of the farmer, but it is a vital point with thousands and millions who are dependent upon the farmer for this life-giving food. unfortunately, to-day the relation between the consumer and the milkman is so remote that it is almost lost sight of, and in place of the personal relationship which formerly existed, which made the milkman proud of his milk and the consumer proud of her milkman, there is to-day an absolute disregard of the interests of the other side in almost all cases. even in the smaller cities, consolidated milk companies are being established by which the former independent milkmen are bringing milk to the central station in large cans, where it is dumped into vats along with the milk from a dozen other milkmen. some may be good and some bad, but what is the use, each one says, of my taking particular pains when my neighbor produces milk of such poor quality? the result is that it is all far from good and likely to deteriorate rather than to improve. to be sure, at the central station it is bottled and distributed to the consumer in apparently clean glass jars, but this is not the same cleanliness that one gets when the bottling is done five minutes after the milk comes from the cow. when the milk supplied to the larger cities is furnished as in new york, the impossibility of controlling the quality of the supply becomes apparent. the farmer brings to the shipping station his two or three large cans of milk, representing the night's and morning's milkings. these are loaded on a train along with hundreds of others, a few chunks of ice are thrown on top, and the train is started for new york, from points as far as two hundred and fifty miles away, reaching the city in the early evening. there it is received and hauled to milk stations, where it is distributed in different-sized cans and bottles, and the next morning, thirty-six hours old, distributed to the babies of the city as fresh milk. thanks to the energetic inspection practiced by the officers of the department of health of new york city, who have emptied hundreds of quarts of milk into the city gutters merely because the temperature of the milk was higher than that prescribed, the quality of the milk is not so bad as it might be. in fact, the writer has bought apparently good milk on long island, shipped down from new york city, because the local supply was deficient in quantity and inferior in quality, although the latter would naturally be supposed to be fresh and the other was certainly forty-eight hours old on its receipt. cleanliness and care are the two watchwords for good milk, and both practices ought to be observed faithfully by the milk producer, whether he has in mind the health of his own family or the health of the dwellers in the city hundreds of miles away. _dangers of diseased meat._ next to milk, the product of the farm which has most to do with the health of those to whom farm products are sent is the meat which comes from the cows, sheep, and pigs, and makes a large part of the farmer's produce. to be sure, the amount of meat thus sent to market from the farm is by no means as great as in former years, since even the smallest village to-day has representatives of swift and co., schwartzman and sulzenberger, jacob dold, and others of the great western packing houses. there is still, however, a great deal of local butchering, and it is important that the farmer himself should know the characteristics of meat and should be so impressed with the dangers of diseased meat that the temptation to unload a bad carcass on the unsuspecting public may be overcome. there is nothing more certain in sanitary science than that the application of heat destroys animal parasites and micro-organisms, so that, except for diminishing the nutritive value, there is comparatively little real danger in eating diseased meat when cooked, and the fearful ravages of bad ham have been largely due to occasions where the ham has been eaten raw or semi-raw. there are two points to be noted in an animal about to be killed, namely, whether the animal is healthy, that is, free from disease,--and whether it is in proper condition, neither too young nor too old, is well-grown and well-nourished. among the diseases to which animals are subject, some are objectionable because of the possibility of the direct transmission of their disease to those eating the flesh, while others are objectionable because the flesh is spoiled and so causes irritation in the stomach and intestines of those eating it. among the former diseases may be mentioned trichinosis, tuberculosis, and measles of pigs. in the latter category are animals suffering from such diseases as epidemic pneumonia, foot-and-mouth disease, texas fever, anthrax, hog cholera, and others in which a general toxic condition of the animal's system results from the disease. toxins are thus formed in the body which may pass to the human being eating the flesh, and in this way poisons called ptomaines are produced, resulting in so-called toxic poisoning. it is not the function of this book to describe the symptoms peculiar to each of these diseases, and it is here sufficient to say that the flesh of no animal apparently suffering from any disease should be used for food. the unhealthy animal can usually be recognized by a casual examination, without undertaking to define the specific disease from which the animal is suffering, characterized by such an examination. when sick, according to parkes, the coat of the animal is rough or standing, the nostrils are dry or covered with foam, the eyes are heavy, the tongue protrudes, the respiration is difficult, the movements are slow and uncertain, and the various organs of the body perform their functions abnormally. on the other hand, the healthy animal moves freely, has a bright eye and moist nostril and a clear skin, the respiration is not hurried and the breath has no unpleasant odor, the circulation is tranquil, and the appetite good, thirst not excessive, and, if ruminant, when in repose, chews the cud. there is, however, one exception to this general rule, and that is in the case of tuberculosis, since the most scientific observations have failed to trace any connection between the inception of tuberculosis in man and the eating of meat from tuberculous animals, or to show any evil effects to man from eating the flesh of cows affected in the first stages of tuberculosis. the regulations of the united states department of agriculture on this point are as follows:---- "all carcasses affected with tuberculosis and showing emaciation shall be condemned. all other carcasses affected with tuberculosis shall be condemned, except those in which the lesions are slight, calcified, or encapsulated, and are confined to certain tissues ... and excepting also those which may ... be rendered into lard or tallow." the regulations referred to say in substance that when the lesions occur in a single part of the body, as in the neck, liver, lungs, or in certain specified combinations, the meat may be used; but that where the lesions affect more than one or two parts of the body, the carcass must be rendered at a temperature of not less than degrees fahrenheit for four hours into lard or tallow. this really means that an animal only slightly affected with tuberculosis, where the lesions are slight and are confined to the tissues of certain organs only, may be used for food. this has been decided only after very careful reading of all known facts, and is particularly important in view of the opposition to the use of milk of tuberculous cows. the tuberculin test, on which depends the determination of tuberculosis in cows, is so delicate that a very slight lesion is sufficient to cause a reaction. the lesions are so slight as in many cases to be entirely overlooked by the ordinary butcher. the united states regulations allow such a carcass to be butchered and used for food after the cow has been condemned by the tuberculin test as a milk-producing animal. this does not mean, of course, that those parts of the body affected by the tuberculosis lesions shall be used, but, since these lesions are usually segregated, they can readily be cut out without reference to the rest of the body. the other point to be noted in selecting or rejecting animals for slaughter is their general condition. this means that they should be of the proper weight,--that is, not emaciated, but with a proper amount of fat,--that the flesh should be firm and elastic and the skin supple. nor should they be either too young or too old. a prominent example of the first error is in the sale of calves under three weeks old, known as "bob-veal," and while some sanitarians will not object to eating calves under three weeks old, the consensus of opinion is that to be fit for food a calf should be at least that age. fortunately, it is for the interest of the butcher to hold the calf until it has arrived at a certain weight, and the stringent laws of most states prohibiting the sale of bob-veal make it dangerous and expensive for the farmer to slaughter young calves unless they are of the right age. the most common example of the direct transmission of disease from animals to men is through the development of the parasite in a pig, known as "trichinosis." this disease is due to a minute worm scarcely visible to the naked eye which lives in the muscles of men, dogs, swine, and other animals, and also under other conditions in their intestines. millions of the young trichinæ may live in the flesh of a pig without producing any particular difference in the appearance of the flesh. after four or five weeks, they become incased in small white spherical capsules which later, after a year or so, become entirely calcified. in this form they live for years in the flesh of the pig and do no harm in that condition. if, however, this flesh be eaten by man without being cooked so thoroughly as to destroy the little worm (about one twenty-fifth of an inch long) which has been living in these capsules, then they become distributed around the stomach of the person eating that flesh, enter the intestines, and attach themselves to the membranes there. they grow very rapidly, and broods of from to young worms are produced from each one of the entering worms, and, since there may be a quarter of a million or more in an ounce of pork, it is not surprising that the total number deposited in the intestines from a single meal of raw pork is enough to produce great distress, characterized by vomiting and diarrhea. fortunately, the disease is not necessarily serious, since after the development of the young worms (and it is at this period when the suffering of the human patient is at its height), the worms begin to form capsules again, as in the pig, and when inclosed, are again inocuous. professor sedgwick says that persons in robust health may be able to survive the attack of half a million or more of these flesh worms and recover, but there is a limit to human endurance, and the numbers often contained in the muscles of man from this source are almost incredible. in some severe cases, the numbers contained in human bodies have been estimated by reliable authorities to be as high as forty to sixty millions. not long ago, the writer was impressed with the severity of this disease by having brought to his attention an epidemic in a herd of swine caused, presumably, by feeding waste which contained rinds of western pork, infected with trichinæ and many examples may be found of regular epidemics caused by persons eating raw ham infected with this disease. fortunately the means of prevention is very simple and implies merely the thorough cooking of the meat. if persons will avoid eating raw or underdone swine flesh in any of its varieties, no danger need be apprehended. in general, it should be remembered that any animals dying of diseases are not fit for food, and this applies to all animals, from the largest to the smallest. animals dying by accident, of course, are exceptions, but if diseased animals, animals dying a natural death, and animals out of condition are eliminated, the quality of food supplied from any individual farm may be approved so far as the animal itself is concerned. _the slaughter-house._ there is, however, the further question of the sanitary condition of the slaughter-house and the care of the meat after being dressed. it may be that one gets accustomed to the sight of the filthy barns or out-houses so often used for slaughtering. places infected with flies and other insects, overrun with rats, and the effluvia of which is easily noticeable at a distance of half a mile, are not uncommon and suggest their own condemnation. while it is not possible to directly associate any particular disease with such a condition of the slaughter-house, yet such conditions must result in a rapid development of putrefactive bacteria, in the deposit by flies of different micro-organisms brought from the festering heaps of offal and manure in the vicinity, and must prevent the maintenance of the flesh in the clean and wholesome condition in which it may have been up to the time of hanging in such a place. a well-kept slaughter-house will have the ceilings, side walls, and partitions frequently painted, or else scrubbed and washed. the floor of the building, particularly, should be made water-tight, with proper drains so that the blood shall not remain on the floor to saturate the wood and develop decay. an abundance of clean water should be provided, so that the area may be thoroughly washed as often as used, with proper drains provided for carrying away the dirty water. the ventilation of the building should be complete, and provision should be made for lifting and moving carcasses without handling. in most small slaughter-houses, the obnoxious practice prevails of maintaining a herd of swine to consume the entrails of the slaughtered animals, and a more fearsome and disgusting spectacle than a dozen lean, active hogs fighting over recently deposited entrails and wallowing up to their bellies in filth can hardly be imagined. nor is this any fanciful picture. the writer has seen it over and over again, the income from the hogs thus fed being one of the principal assets of the establishment. such hog meat is not fit for food. the refuse from the slaughter-house ought to be carried away and buried; its fertilizing value will not be lost if it be put in the garden, and the effect of the prompt removal of this refuse will be to improve the character of the entire slaughter-house. chapter xii _foods and beverages_ before discussing the question of suitable foods for individual needs or the ill-health which is so likely to follow an unrestrained or unwise diet, it will be well to trace briefly the passage of food through the human body, with the various changes which take place in its mass from the time it enters the mouth _until_ it is absorbed by the stomach. _the human mechanism._ in a little book by hough and sedgwick entitled "the human mechanism," the authors point out that in many respects the human body is like any machine developing energy by the conversion of certain kinds of raw material. thus, as the steam engine will use up coal in the development of mechanical energy, so the human body will absorb food and convert it into vital energy, and it is quite as important that the human body shall have its source of energy properly adjusted to its needs as that the steam engine shall be fired with coal possessing a reasonable amount of heat-producing particles. the human body requires this supply of raw material for several different purposes. in the first place, the very fact of living uses up each minute a number of cells of various kinds in various organs. each breath taken, each heart beat, each muscular motion, all tend to the destruction of tissue and involve its reconstruction. violent exercise uses up cell tissue very rapidly, so much so that a football player will commonly lose from five to ten pounds in weight during a well-contested game. it is a fundamental principle of training for any athletic event involving hard exercise, that suitable food in large quantities must be provided, and a young man training for football or rowing will eat beefsteak, eggs, and other hearty food to an astonishing amount, all of it going chiefly to repairing worn-out and used-up tissue. in the second place, food is needed to supply material for growth, and so it is that a growing boy eats out of all proportion to his size, and the fact that he seems to be, as it is said, hollow clear to his feet, is only his rational endeavor to supply the material needed for his growing body. in the third place, food must be supplied for the work to be done by the body, as distinguished from the loss of tissue due to the performance of the work, and finally, food must be provided in order to maintain the bodily temperature, a larger amount being naturally required where the difference between the temperature of the body and the outside air is very great, as in the arctic regions. the human body being a special kind of machine, the raw material supplied must be adapted to the needs of the machine, and while a lump of coal admirably supplies energy for a steam boiler, no one would think of feeding a lump of coal to a human being, simply because, by experience, we know that suitable energy is not thereby developed. in the matter of suitability of foods, much depends upon the local supply. it is not to be supposed, for example, that the eskimos eat meat and fat altogether because it is the best article of food for them, but rather because it is the only food available. it would be foolish to prescribe fresh fruit or even white bread for the eskimos because it is out of the question for them to get such food. but, in general, it is possible for the average individual to choose his supply of raw material in accordance with the needs which his experience has pointed out and with the teachings of scientific investigators on this subject. raw material, however, is not converted into energy by any simple operation. the human body is made capable of taking raw material of most varied kinds and transforming it into nutriment capable of being absorbed by the system and made over into cell tissue. it will be worth while to indicate the steps of this complex process. _digestive processes._ the mouth plays the first part in the scheme of transformation, and here two operations are performed. first the food is crushed and ground by the teeth, exactly as when, in some chemical processes, a fine grinding is essential for the subsequent transformation. in this country, this preliminary process is often sadly neglected, so much so that a distinguished investigator, named horace fletcher, has, within the last few years, established a school for the cultivation of the habit of chewing, with the idea that if this practice could be encouraged and at least twenty chews taken with every mouthful, the health of the individual would be vastly improved and sick persons even cured merely through this practice. the other function of the mouth is to mix with the food the saliva which drops from small glands in the back of the mouth into the food. the action of the saliva is partly to lubricate the food, so that it will slip down easily, and no better proof of this can be found than trying to eat a cracker rapidly without chewing. but it also acts on starch which is not digested easily unless mixed with this ferment. the action of the saliva on starch is to convert it into sugar, which is easily absorbed later on. curiously enough, most persons would be more apt to chew a piece of meat thoroughly than to chew a piece of bread, and yet the meat contains practically no starch and therefore does not need the action of the saliva, whereas bread is chiefly made up of starch and therefore needs the saliva as an essential for digestion. the food then passes down into the stomach, which is a sort of storehouse, preparatory to the really important steps in digestion. here, the food is acted upon by another element known as gastric juice, which is supplied by small glands found in the membrane of the stomach. the mixture of food and gastric juice is made very thorough by the continual agitation of the food, so that the mass is softened as well as thoroughly mixed. the effect of the gastric juice is to act upon that portion of food known as proteids. examples of almost pure proteids are found in the fiber of beef and other meat, in the yolk of eggs, and in cheese. some vegetables, such as peas, also contain large quantities, and coarse flour and oatmeal contain considerable percentages. the effect of the gastric juice on this proteid matter is to break up the complex molecules into small molecules which then pass into solution, making the mass leaving the stomach a uniformly mixed semiliquid substance of about the consistency of thick pea soup. the food then enters the smaller intestine, at the beginning of which the juices from the pancreas are added. the pancreas is a gland which furnishes a strongly alkaline liquid neutralizing the acid of the gastric juice, so that the gastric agent, pepsin, loses its power. from this gland comes a material which can act on all kinds of food and which is by far the most important of the digestive juices. when thoroughly mixed with the bile and pancreatic juice, the contents of the intestine are gradually absorbed, in so far as their condition allows, by the surface of that organ and are carried away by the ducts designed for that purpose to the various organs, while that part not suited for absorption is eliminated. _teachings of the digestive operations._ the matter of hygienic eating, therefore, consists in supplying the various organs, the mouth, the stomach, and the smaller intestine with proper food in proper quantity, so that the body itself may be properly nourished from the food supplied. a great deal of scientific investigation in this connection has been made to ascertain any relation which may exist between the different kinds of food and their availability for the body. scientists have divided all food into four classes, namely, proteids, carbohydrates, fats, and inorganic salts, and they have agreed on the following general statements with reference to these four classes. examples of almost pure proteids have already been given, and it may here be added that carbohydrates are typically shown by the starchy particles found in potatoes or wheat. chemically, the difference consists in the fact that proteids contain nitrogen whereas carbohydrates do not. fats are self-explanatory, and the group of inorganic salts includes such material as salt, lime, phosphates, and other minerals needed by the body but not requiring digestion. just what function each one of these four groups plays in the nutrition of the human body is not definitely understood, but it seems that the proteids are particularly useful in building up cell tissue, that the carbohydrates are particularly useful in providing for muscular energy, that the fats are particularly useful in keeping up the normal warmth rather more by laying on a blanket of fat over the bones than in actually consuming the food in the creation of heat. these statements are not absolute, since experiments have shown that some tissue-building can go on even if proteids are rigorously excluded from the diet, and on the other hand that muscular work, while accompanied by a large consumption of carbohydrates in the body, may come from proteids entirely. this may explain why men can live and even do a reasonable amount of work eating meat and fat altogether, as in the arctic regions, or dry bread and fruit in other regions, the above facts being complicated by the influence of muscular exercise on the activity of the digestive system. no principle of hygiene is better established than that men undergoing hard physical exercise need and will take care of a larger amount of coarse food than those occupied in sedentary work. in cold weather what is required is not really more fat as food, but more food. it has been found that there is a limit to the amount of meat food which the body can absorb, and, further, that the excess is not easily disposed of, as with starchy food, and tends to load up the liver and other organs with the waste products, resulting in general disturbances of the whole body. it is commonly known, for instance, that high-livers, as they are called, are likely to be troubled with diseases like indigestion, rheumatism, or gout,--diseases which are the result of overburdening those organs just mentioned. _balanced rations._ table xvi ==================================+====================================== | weight in grammes condition +-----------+-----------+-------------- | proteid | fat | carbohydrates ----------------------------------+-----------+-----------+-------------- child up to - / years (average) | . - . | . - . | . - . child from to years | | | (average) | . - . | . - . | . - . man (moderate work) | . | . | . woman (moderate work) | . | . | . old man | . | . | . old woman | . | . | . atwater (man, light exercise) | . | . | . chittenden (man, light exercise) | . | . | . ==================================+===========+===========+============== a well-designed food ration, therefore, will be one which will provide the body with the proper amount of food material wisely adjusted to the occupation and the digestive ability of the individual. it has been, in the past, a matter of very exact computation to determine how many ounces of proteid food, how many ounces of starchy food, and how many of fatty foods should be consumed during the day, and experiments have been made in asylums, prisons, and on companies of soldiers with a view to proving the theoretical figures. it has always been found that an overdose of proteids results in inability to absorb the excess, and it has been assumed that a ratio of proteids to carbohydrates of one to four is approximately the proper proportion. for instance, koenig ( ) shows the minimum daily need of food stuffs at different ages and two american authorities, atwater and chittenden, have also laid down standards; all three being shown in the preceding table. the following table taken from rough and sedgwick's book, already referred to, gives the percentage composition of some of the more common foods:-- table xvii ============+=======+=========+========+=======+======+====== | water | proteid | starch | sugar | fat | salts ------------+-------+---------+--------+-------+------+------ bread | | | | | | wheat flour | | | | . | | . oatmeal | | . | | . | . | rice | | | | . | . | . peas | | | | | | potatoes | | | | | . | . milk | | | -- | | | . cheese | | | -- | -- | | lean beef | | | -- | -- | | fat beef | | | -- | -- | | mutton | | | -- | -- | | veal | | | -- | -- | | white fish | | | -- | -- | | salmon | | | -- | -- | . | . egg | | | -- | -- | . | . butter | | -- | -- | -- | | ============+=======+=========+========+=======+======+====== it will be noted that meats, cheese, and such vegetables as peas are high in proteids, while certain other vegetables, as rice and white flour, are high in starch or carbohydrates. according to the table given above, a man at moderate work requires . ounces of proteids and . ounces of carbohydrates per day. if, then, the carbohydrates were to be made up entirely from potatoes, per cent of which is starch and he should need . ounces, he must have / of . or ounces of potatoes per day, an amount equal to about pounds. if, however, with the potatoes, he should eat half a pound of bread, of which about half is carbohydrates or ounces, the amount of potato necessary would be cut down, and so on with as many combinations as one might choose to make. it is curious, however, that when different kinds of food are available, one naturally combines different articles of food, so as to make up the well-balanced daily ration, so that the different parts may have the proper proportion. for instance, butter is always used with bread in order to add to the proteid and starch of the bread the necessary fat. with potatoes or rice, either butter or gravy or meat is always used because potatoes and rice are lacking in proteids as well as in fats which the meat supplies. bread and cheese are well known to make up a good combination, and the table shows why: the bread furnishing the starch and the cheese the proteid and fat. eggs alone are a very poor article of diet since no starch at all is present, and therefore it is that when eggs are eaten for breakfast, as is so generally the custom to-day, either a generous helping of cereal ought to be given with the egg or else a generous supply of bread or toast ought to be included in the breakfast. milk is generally considered an ideal article of food, and yet it contains no starch, and it is undoubtedly because of this fact that milk and bread is more palatable as well as more nutritious than milk alone. _human appetite._ one other factor needs to be considered in this matter of selecting one's daily food, and that is the respect which must be paid to the appetite. the most carefully balanced ration will fail to satisfy the ordinary human being unless it is served attractively and unless sufficient variety is provided. to be sure, soldiers in the army are furnished a carefully computed ration consisting of so much meat, either fresh or salt, so much bread, and so much vegetable food, and the variety being small, the soldier has to put up with his dislike to the same food day after day. the need of fresh vegetables has been proved by the results of a continuous diet of salty food on certain classes of men, such as sailors. it is well known that a failure to provide fruit or fresh vegetables results in the disease known as scurvy, for which, practically, the only cure is a changed diet. the writer has no doubt but that in many farmhouses a very similar condition, perhaps not so pronounced, exists on account of this very lack of variety in the daily menu. he remembers to this day a week's experience in the house of a well-to-do farmer in the early spring when the winter vegetables were exhausted and before summer vegetables appeared, when the dishes offered three times a day throughout the week were salt pork in milk sauce and boiled potatoes. providence intended the different digestive organs of the human body to work, and there is no possibility of condensed or concentrated foods taking the place of ordinary victuals, as has been suggested. the stomach must have some bulky material on which to work, and similarly the intestine must be comfortably filled in order to exert its forward movements. it is in the same way intended that each organ shall supply the necessary digestive juices to take care of the different kinds of foods taken into the system. it is just as important that the liver should be called upon to act on a certain amount of fat as that the gastric juice should break up the molecules of the proteid, and just as important as both of these is the fact that the saliva should flow freely to decompose the starch before it enters the stomach. it is not intended, however, that the healthy individual should deliberately overload any part of the digestive system. if a child, in a hurry to get to school, swallows bread and milk without chewing and without allowing the starch to be acted upon in the mouth, then an overburden is placed on the pancreatic gland, making that organ less capable of its regular work. and if, again, the food is drenched in fat, if everything is fried, or if butter is used in large quantities, the liver becomes overworked and cannot keep up with the demands, and digestive troubles follow. _effect of individual habits._ assuming that the amount and quality of food have been properly adjusted, that each of the several constituents is in proper proportion, and that a suitable variety is maintained, there are still other phases to be considered before the nourishment of the individual may be considered satisfactory. nature has furnished man with a guide both to the quantity and quality of food that should be taken into the system,--that is, his desire for food, or his appetite,--and, in general, this guide may be safely trusted both as to the quantity and quality, although, in the latter, the appetite is not so trustworthy as that of the lower animals. unfortunately, the appetite is easily distracted by the general conditions of health, and when once the healthy tone of the system has been relaxed, the appetite becomes misleading. for instance, a person not indulging in muscular exercise, but sitting still all day and eating candy or other sweets, has no desire for food, and the lack of appetite in this case indicates, not a failure of the need of food, but abnormal conditions of the system. also the conditions of housing, lack of ventilation, excessive heat, excess in the use of stimulants or of food, all affect and interfere with the guidance of a normal appetite. some persons go to the other extreme, and, having been in their earlier years accustomed to heavy exercise and generous feeding, forget that in a more quiet life, less breaking down of the tissue occurs and therefore less food is required. their appetite is a poor guide since it leads them to immoderate eating, resulting in time in an overloading of the organs and the probable poisoning of the system. _cooking._ good cooking is as important as any other part of the process of digestion, and, in fact, cooking may be said to be the first step, since there the breaking down of the food tissue occurs, whereby subsequent action by the juices of the body is made easier. for instance, beef may be cooked so long and in such a way as to dry and harden the fibers, making it almost impossible for subsequent digestion; and on the other hand, it is possible to so stew or boil or steam tough meat as to make it quite easily absorbed by the stomach. cereals, if properly boiled at the right temperature, and for the right length of time, will have the starch granules so broken up that the saliva will act easily on the broken granules. raw vegetables containing starch are not acted upon in the mouth and are digested afterwards only with great difficulty, while cooked vegetables are a most desirable article of diet. a great deal is said nowadays about overeating, and horace fletcher affirms that the average man would be much healthier and much stronger if he ate not more than two meals and generally only one meal a day. the relation between the amount of food eaten or the amount of food absorbed or utilized and the need for food cannot be determined for the average but only for the individual. there is no doubt but that men or women doing muscular work require greater amounts of food than those not so engaged. it is a common practice to increase the amount of oats which a horse consumes when the horse has hard work to do and to cut down the amount of grain when the horse stands in the stable. it is curious that this practice, so well known to give good results, is not applied to the human animal as well. but very few men will be found voluntarily to diminish the amount of their breakfast or dinner because on that day or on the following day they are going to stay in the house instead of engaging in vigorous outdoor labor. no discussion on foods would be complete without a repetition of the frequently given warning, against fried meats and vegetables. frying coats the outside of the food with a layer of fat not easily penetrated by the digestive juice and not acted on in the stomach. therefore, all fried food, unless thoroughly chewed and then only when the frying is done in very hot fat so that it remains on the outside of the whole piece, will pass through the stomach without being acted upon. frying is a quicker process than roasting, an advantage which appeals to the american notion of haste, but it is better to begin the preparation of the meal earlier and cook the meat by roasting or stewing and the vegetables by boiling or baking rather than to postpone the preparation of the meal until ten minutes before the hour and then fry everything. _muscular and psychic reactions._ another factor in the power of the body to utilize the food values is the condition of the body at the time of the meal. if the individual is exhausted or even tired, no complete digestion is possible, and particularly is this true if the exercise has involved excessive perspiration. so in hot weather, a heavy meal should not be eaten until after a half hour's rest and after copious water drinking to compensate for that loss of perspiration. studies on the digestion of foods and on other matters pertaining thereto have shown that the smell of food, or the mere suggestion of food, stimulates the organs for the production of the digestive juices. it is directly and literally correct, therefore, to say that one's mouth waters for this or that food because the thought or anticipation of the food, if pleasant, will actually cause the saliva to form and flow in the mouth. this is true of the other digestive juices as well, so that an appetizing fritter, for instance, showing the rich, brown crust will stir up the bile, and when the fried cake reaches the opening into the intestine, the bile will be there ready to act. this has been demonstrated by putting into the stomach of sleeping dogs various kinds of foods and finding that no digestive juices whatever were produced, although with the dog awake and seeing the food before eating, the juices began to flow in the usual fashion. it follows, then, that the enjoyment of food is quite as important as any other digestive function, and on the contrary, the eating of all sorts of foods with no interest or attention is the best way to induce subsequent indigestion. the fact, then, that a business man eating at a quick-lunch counter does not get the full enjoyment and benefit from his meal as compared with those who sit leisurely over a well-appointed table does not result altogether from the difference in the viands, but rather in the different attitude toward the meal. it would undoubtedly be a great gain in every household if more attention could be given to a cheerful intercourse at meal times--not for the better relationship which would follow, but merely for the effect on the digestion. after meals, violent exercise is not desirable because thereby vitality is taken away from the muscles of the stomach and intestines and is used up in the other muscles; but it is vigorous exercise after heavy meals only that is condemned, since moderate exercise after ordinary meals is not objectionable. nor is there any evidence, unless the meal has been excessive, that mental exercise after a meal does any harm. the amount of mental tissue used up in the ordinary processes of mental work is not great enough to call for any large diminution of the supply of blood to other parts of the body. _consumption of water._ a move in the right direction to-day undoubtedly is the tendency to increase the quantity of water to drink. the body is nine-tenths per cent water, and while a large part of the water in the tissues is made chemically by combinations of hydrogen and oxygen, there must be a constant replenishing of the liquids of the body. the ordinary person ought to drink, or consume with his food in some way, at least two quarts of water a day, and many difficulties with the liver, kidneys, and other organs would be avoided if this amount of water daily were imbibed. probably the contention that water should not be taken at meals is not particularly tenable except as the continual swallowing of water increases the tendency to swallow food without chewing, a childish habit sure to lead to distress later. but, to eat one's dinner or part of one's dinner and then drink a glass of water cannot reasonably be assumed to interfere with any digestive process. it is quite likely, in fact, that the greater dilution of the mass in the stomach will tend to easier absorption later on. _condiments and drinks._ there are certain kinds of foods which, though not strictly included in the four elements of food already named, yet are so common as to deserve special mention. chief among these are the condiments and drinks, particularly coffee and tea. so far as the nutritive value of such materials as salt and pepper, vinegar or spices, goes, they are practically negligible, and yet, undoubtedly, these flavors play an important part in the suggestion of pleasure and therefore in the excitement leading to the excretion of the digestive juices. if one ate salt pork and boiled potatoes always, eating would be a tiresome affair, and it is quite likely that such a sameness of food would fail to excite subsequent digestion, merely from the monotony of the affair. salt, however, has a particular rôle in that the human body craves this mineral, and, while its exact value in the body is not clearly known, a certain amount of it must always be provided. the wild tribes of africa, for instance, away from deposits of salt consider it their most valuable possession and will go to great lengths to procure it. animals, in the same way, go great distances for a supply of salt. coffee and tea are generally consumed merely for the pleasure which the warm drink gives. both, however, have a certain stimulating effect on the nervous system, and when a tired woman refuses food but drinks cup after cup of strong tea, the exhilarating effect can be produced only at the expense of nerves and muscular tissue which must be later atoned for. similarly, when a man under stress drinks strong black coffee to keep up, he must pay the penalty for the stimulant. the natural forces of the human body are able to do normally a certain amount of work, their ability to perform this work being directly proportioned to the energy derived from the food-supply taken into the body. no amount of tea, coffee, or alcohol will add to the living tissue of the system; it merely goads the nerves and muscles to further action, however tired and unwilling they may be. when the stimulant is stopped, or after a time in spite of the stimulant, the exhausted nerves and muscles refuse to continue, and the depleted body stops work and may even die. a certain amount of stimulants at infrequent intervals for particular occasions may do no harm, but the pity of it is that the habit once started, the ultimate effects are forgotten in the apparent relief of the moment. in the case of tea, besides the stimulating effect, a certain substance known as tannin is developed, particularly when the tea is boiled, and this substance is really harmful on account of its strong astringent property, which acts injuriously on the membrane of the stomach. the bitter taste of the tannin is disguised when milk is used with the tea, and it has been pointed out that tea used without milk or cream is safer than tea with milk, because without the milk the bitter taste would prevent the tea being boiled so long. alcohol is stimulating in its nature, because of its setting free from their usual control by the will the unconscious elements of the brain; while the effect of alcohol on the system as a whole is, as has been carefully proved by scientific investigation, unfortunate in every respect. whether the alcohol be in the form of whisky or brandy or gin or in such milder forms as wines, beers, and hard cider, the continued use of even a small quantity acts adversely on the memory, on the will, on the intellect, on the inventive power, and on all the mental processes. it has a deteriorating effect on all the muscular tissue throughout the body, and while this is sufficiently deplorable, its effect on the mind is by far the more serious. no idea is more false than that a small amount of alcohol aids in the performance of work of any sort, and experience in the army, navy, and in exploring expeditions all go to show that the use of alcohol in any form reduces the capacity, both for activity and endurance. as a protection against cold, it is worse than useless, and the feeling of warmth which drinking alcohol in any form produces, does not manufacture heat in the body, but is rather a source of danger on account of the reaction of the whole system. _tobacco._ the use of tobacco may or may not be injurious to the human system, and it is said by those accustomed to its use that it is for them a source of great enjoyment and comfort. the essential poison of tobacco is known as nicotine, and experiments are very readily made with this substance, extracted from the plant, to show its deadly character on the heart and nerve cells of animals. it is easy to demonstrate that the use of tobacco affects the heart, since the common "out-of-breath feeling" which comes to users of tobacco when climbing hills or running is well known. no young man training for an athletic event would think of smoking, on account of the danger to his wind. no boy should smoke, because nothing should be allowed to interfere with the fullest development of the heart and nervous system, and without question tobacco is a potent factor in influencing both. in many individual cases it has been shown that the use of tobacco in excess has a bad effect on digestion, while in other cases the trembling hand and inattentive mind indicate the result on the nervous system. no general law or rule can be laid down, and each man must act as his own individual constitution seems to require. _the drug habit._ the use of drugs is, in some cases, so persistent and leads to such dire results that it is well worth while to enter a protest against such practices. the poor creatures who have become fast victims of the morphine habit or the opium habit or the cocaine habit, or of any one of a dozen which might be named, will not be affected by anything that may be said here. but a word of warning may serve to restrain those who are only at the beginning of this downward path of which the end is positive and certain. the use of drugs once begun is sure to increase until, stupefied by their action, the victim becomes a sot, unfitted for work and a burden to himself, his relatives, and his friends. not less dangerous is the use of so-called patent medicines. in most cases, patent medicines are swindles, pure and simple, containing no remedial ingredients and acting only as stimulants. an advertisement some time since, which claimed to cure not only tuberculosis but also cancer, falling of the womb, hair, or eyelids, insanity, epilepsy, drunkenness, disorderly conduct, and pimples was printed in many newspapers. this remarkable remedy was found by analysis to contain ninety-nine parts of water to one part of harmless salts. many of the vaunted remedies contain morphine or alcohol in such large quantities as to be dangerous, the more so because their presence is not suspected. such remedies as dr. bull's cough syrup, boschees german sirup, dr. king's new discovery for consumption, shiloh's consumptive cure, piso's consumptive cure, peruna, duffy's malt whisky, warner's safe cure, and paine's celery compound are all by analysis said to contain large amounts of morphine, chloroform, or alcohol. consumptives cannot be cured by any drug now known, and any person who believes it is mistaken. cancer still baffles the skill of the most clever and the best-trained scientists. it is perfect folly to believe that any drug or man can cure either disease by a few pills or by a few bottles of medicine. the wise man or woman will avoid patent medicines unless they carry their formula on their label _and unless they are prescribed by some reputable physician_. chapter xiii _personal hygiene_ whatever the conditions under which one lives, or whatever his abstract knowledge of foods and sanitation, the health of the individual resolves itself at last into a question of his personal habits; and some of these personal questions must be considered in a book of this character. _exercise._ one of the commonly accepted facts of hygiene is that, for the best development and for the perfect health of the human body, a certain amount of exercise should be taken by each part of the body. this is true not only for the larger muscles, such as those of the arms and legs, but also for the muscles of those internal organs less frequently considered. experiments have been made by tying up some part of the body, such as the forearm, with the result that, in the course of a few weeks, its functions have been so lessened that its usefulness is temporarily at an end. but the general effect of exercise on the body, aside from the beneficial results on the particular muscles engaged, is to promote the building up of new lung tissue. oxygen is received from the lungs through the blood and is carried to the different parts of the body, where it serves the useful purpose of carrying off the waste products of the different organs. if the lung action is inadequate, if deep breathing in fresh air is not practiced, or if, through laziness, no exercise is taken, then the amount of oxygen supplied will be deficient and the body will be loaded up with the toxic products resulting from decomposition. the exact effect of exercise upon the lung action may be seen from the fact that under ordinary circumstances a man breathes about cubic inches of air per minute. if he is walking at the rate of miles an hour, he inhales air at times this rate, and if he is walking at the rate of miles an hour, inspiration increases to seven times this rate, or cubic inches of air passes through his lungs per minute instead of , as when at rest. of course, it is assumed that in the country a person has no lack of exercise, and that of all men the farmer is in least need of exercise. but, as a matter of fact, the exercise which he gets is irregular and confined to certain sets of muscles, rather than to the development of the whole body. agility, for instance, quickness of action and immediate control of the muscles, is far less common in the country than is supposed, although there is probably no lack in the actual power of the muscles. it is common observation that among farmers an erect carriage is less frequently seen than an awkward, shuffling gait. the fact is, that exercise, to be beneficial, should affect not one set of muscles, but all the muscles of the body, because the continuous exercise of one set, while leading first to growth, results later in demolition and waste. when, however all the muscles of the body are exercised, there is no demolition or waste, but a healthy growth throughout. regular exercise is beneficial, not merely to the muscles involved, but also to the other organs of the body. exercise sharpens the appetite, makes digestion more perfect, and increases the absorptive power of the intestinal membranes; conversely, lack of exercise, which is found in the country in the winter, lessens both the digestive power and the appetite. _clothing._ little need be said on this subject, since the amount of clothing needed varies so greatly with the vitality of the individual. it has already been pointed out that in rural communities the death-rate from pneumonia, bronchitis, and similar respiratory troubles is much higher than in urban communities, and it is quite possible that deficient or unsuitable clothing is practically responsible for this. the object of clothing is twofold: to protect the body against the weather, particularly against changes in the weather, and secondly, to protect the body against injury. included in the former are the defenses against the elements of cold, wet, and heat; while the protection against injury is chiefly a matter of shoes. as has been pointed out, a large part of the food consumed by the body is utilized in the production of heat, whereby the body temperature is maintained at about degrees fahrenheit. a large part of this heat is continually being lost from and through the skin by radiation and evaporation, and evidently some regulating influence must be provided so that the amount of heat given off may be adjusted to variations of the external temperature. to be sure, the skin itself acts as a regulator, since a rise in temperature causes the blood vessels on the surface to distend so that a larger quantity of blood is distributed over the surface and thereby more freely evaporated. fall of temperature, on the contrary, causes a contraction of the blood vessels and therefore a reduction in the evaporation. but this is not sufficient where external temperature undergoes wide variations, as in the northern and central parts of the united states, and a modification of the clothing is a necessary supplement. the main object of clothing, then, is not to keep out cold or heat, but to preserve and make uniform the evaporation from the body. it is an agent of the same sort as food in so far as the body temperature is concerned, and without doubt light clothing requires a greater amount of food; while, on the other hand, warm clothing will make possible a lighter diet. the best non-conductor of heat is still air, and if one could always remain in quiet air, no clothing of any sort would be necessary, even in the most severe weather, because the air itself would serve as a garment and would prevent radiation from the body. therefore, loose, porous garments containing air in their folds and pores are much warmer than a single, tightly woven garment, and the same material made up in three or four thicknesses will give the body far more warmth than an equal weight of texture made up in a single thickness. similarly, a tight garment is much less warm than a loose one. a practical demonstration of this fact is found in the comparative lack of warmth in an old, much-washed, quilted, bed blanket which is very heavy but quite lacking in warmth compared with a light fluffy woolen blanket, newly purchased. much has been written on the advantages of woolen underwear, on the ground that since clothing is intended to retain the body heat and since wool acts as a more effective non-conductor of heat than either cotton or linen, therefore the woolen undergarment is of the greatest value. another argument urged in favor of woolen undergarments is that they check the chill resulting from excessive perspiration, since the non-conducting power of wool prevents any rapid evaporation of perspiration responsible for the lower temperatures. for this reason, woolen undergarments are always recommended for those climbing mountains or in occupations where violent exercise is likely to be followed by rest or quiet in cold air. the objection to woolen undergarments at all times is that with sensitive skins irritation may take place, and the odd saying of josh billings becomes pertinent, namely, that "the only thing that a wool shirt is good for is to make a man scratch and forget his other troubles." underwear woolen only in part may take the place of all-wool garments and have the further advantage of being less expensive. the amount of clothing worn in winter depends, or should depend, on the character of the occupation of the wearer. formerly, heavy woolen underclothes were almost universally worn throughout the winter without regard to the employment of the individual. when an out-of-door occupation was pursued a large part of the time or when the temperature indoors was hardly above freezing, then heavy clothing was essential; but now that much time is spent in a well-heated house or office, heavy clothing is as objectionable as overheated rooms, and the comfort and health of the body will be much better preserved by not increasing the weight of clothing except when exposed to the outer air. it must be remembered, however, that old persons, whose circulation is impaired and who are forced to lead sedentary lives, will always have difficulty in maintaining the body heat unless the outer temperature is high, and for such, woolen undergarments are very useful. the outer garments in winter, to be efficient, must have two qualities, namely, an impervious surface so that winds may not penetrate and a loose open weave in which air may be held so that warmth may be secured. rubber boots, although very common in the country, are not desirable as a foot covering, because they do not allow the perspiration to evaporate, but rather hold the foot in a moist condition very detrimental to it. rubber-cloth overshoes or arctics are much better than rubber boots, and felt overshoes are equally satisfactory. chilblains are fostered by the use of rubber boots, and cloth shoes are a great relief when the feet are thus affected. _ventilation of bedroom._ since the agitation for fresh air has become so extensive and the knowledge of the dangers of tuberculosis so widespread, much more attention has been given to the ventilation of bedrooms, and whereas formerly the night air was religiously excluded from a sleeping room, it is not at all uncommon now for a window to be kept wide open, even through the coldest nights of winter. from what has already been said on the subject of ventilation, it is plain that to breathe over and over one's expired air is not healthy, and while it is possible that a bedroom may be so large that the concentration of the organic matter in the air may not affect an individual sleeping in the room, yet in most cases it must be admitted that the bedroom is so small or the number of people in the bedroom so large that this possibility does not exist. it is, again, possible that the structure of the house may be so poor that it is not necessary to open a window to get plenty of fresh air; the writer remembers sleeping in rooms where, with the windows shut, paths of snow across the floor in the morning showed the intimate connection between the inside and the outside of the room. but the tendency nowadays is to build better houses, to cover the walls with paper, to put on double windows, and even to paste up the cracks to make the room as air-tight as possible. to sleep in such a room without a window open may not be committing suicide, but it is a deliberate method of reducing the vitality, of insuring a headache or a numbed and stupid mental condition, and of loading up the system with poisons which ought to be eliminated by the oxygen which fresh air supplies. it would add many years to the lives of the people of this country if, from childhood up, the habit was formed of sleeping with the window open. nor need one fear that a cold would result from such exposure. a cheesecloth screen in the window prevents any draft and yet allows perfect ventilation. the face is trained to all kinds of exposure without any danger of catching cold, and there is no reason why, if the bed clothing be sufficient, the night air should not be thoroughly enjoyed without danger. of course, the bed clothing must be sufficient; two lightly woven blankets are always better than one heavy one. wool is better than cotton; if a cotton quilt is used, it should be loose and not tied tightly. _bathing._ an important function of the skin is to expel objectionable elements coming from the breaking down of the cells and from digestive processes; the skin is quite as important a factor in getting rid of this waste matter as those other processes more commonly considered in this connection. this action goes on most energetically when the secretion of perspiration is abundant and when the temperature of the surrounding air is so high that perspiration does not evaporate as rapidly as discharged. all these secretions contain more or less solid material which, unless removed, accumulates on the surface of the skin to clog up the glands and, in some cases, to putrefy and decay. it is this decay of organic matter on the surface of the skin which causes the odors plainly noticeable in a crowd, particularly in the winter time. this accumulation can be prevented only by frequent bathing and by wearing clean clothes, and there is no surer indication of a proper self-respect than the habit of cleanliness, both as to one's person and one's clothes. there is also the very practical feature that cleanliness is an effective method of discouraging infection and disease, partly by the removal of scurf and partly by the greater healthfulness of the skin thereby induced. baths have always served as therapeutic agents, and evidences of their use may be found in roman paintings and in egyptian sculpture to-day. but from our standpoint it is their hygienic importance that is insisted upon. ordinarily, the temperature of the bath should be between and degrees, and enough soap should be used to counteract the oily nature of the deposits on the skin. unfortunately, facilities for bathing, except in summer, have not been generally supplied to detached houses in the country. plumbing in most houses has been lacking, but in these days bath-rooms are being installed with surprising rapidity, and the conveniences resulting are enjoyed as soon as they are understood. only a few days ago, the writer was told of a small village of perhaps two or three hundred persons where this last summer one house, the first in the village, was provided with a bath-room, to the great interest of all the villagers. the convenience and comfort involved were immediately appreciated, and the plumber, who came in from a neighboring city twenty miles away, secured contracts for and installed twelve bath-rooms in twelve houses before he was allowed to leave the village. this same interest is everywhere noticeable, and the lack of bathing throughout the winter, formerly, alas, so common, is now giving way to a greater cleanliness, thereby improving the health and character of the inhabitants. a great deal has been written about the value of a cold bath, particularly in the morning, and many people, from a sense of duty, suffer what is almost torture taking a shower bath or a cold plunge bath on rising. when a cold bath (which should not last more than a few seconds) is followed by a good reaction, that is, when after drying, a distinct glow is felt, there is no objection to its use, and undoubtedly it has a tonic effect for those whose vitality is able to endure the shock. but cold baths for their tonic effect are desirable only when the individual is assured of their lasting benefits. nor must one judge of the effects by the immediate results, inasmuch as the splendid feeling which follows may be succeeded by a period of depression lasting the rest of the day; in which case, the total effect of the cold bath is bad rather than good. baths for cleanliness are everywhere desirable, and their frequency should depend upon the individual, his constitution, habits, and work; upon the season and temperature; and on the conveniences for bathing in the house. baths for tonic effect are not necessary, and if not a pleasure, may very properly be omitted. one other point to be noted is that no practice is of more value in reducing the ravages of contagious diseases than a frequent and conscientious washing of one's hands. for germs are most certainly transmitted from one person to another, and it is accomplished more frequently by the hands than by any other part of the body. the invitation, therefore, to a guest to wash his hands before dinner is really an invitation for him to disinfect himself or to get rid of the germs which he is carrying, in order that the host and his family may not be infected during the meal. the guest owes it to his host always to accept the invitation, whether he thinks he needs it or not. doctors recognize the necessity, and it is surprising to observe how many times during the day a doctor washes his hands, even though he may not come in contact with any particularly infectious disease. an ordinary man, on the other hand, washes his hands only when he thinks they are dirty, although his daily occupation may expose the skin of his hands to infection many times worse than that which the doctor experiences. _mouth breathing._ children have sometimes wondered why they were made with both mouths and noses, since they could breathe equally with either, and many years have gone by before they realized that breathing through the mouth was not intended, but that the exclusive province of the nose was to furnish air to the lungs. the reason for nose breathing rather than mouth breathing is twofold. in the first place, no provision for removing or filtering out germs from the air is made in the mouth, whereas in the nose the crooked passages, the moist surfaces, and the hairlike growths all tend to strain out any germs normally in the inspired air. further, breathing through the mouth has a tendency to induce inflammation in the tonsils and in the air passage connecting with the ear. this inflammation develops into those growths known as adenoids, which, when enlarged sufficiently, close the nostril entirely and prevent its normal use. a recent examination made by the new york board of health of school children, all in some way abnormal, showed that had either adenoids or enlarged tonsils. example after example could be given of school boys and girls whose mental and moral development has been markedly retarded because of mouth breathing. one need only look at a child or adult who constantly keeps his or her mouth open to be impressed by the listless, vacant, inert appearance of the face thus disfigured. figure shows a photograph of a schoolgirl just before an operation and the characteristic expression due to adenoids is plainly marked. earache is largely due to adenoids or to inflammation that rapidly leads to adenoids, and mr. william h. allen, secretary of the bureau of the new york municipal research, reports that in villages of new york state, per cent of the children living there were found to be mouth breathers. whenever a child is unable to breathe through his nose, is slow in talking, and then speaks with a stuffy accent, calls "nose" "dose," has a narrow upper jaw, and is either deaf or has inflamed eyes, it is practically certain that enlarged tonsils and a well-developed growth of adenoids are present and should be removed. not merely do these growths interfere with the mental and physical development of the child, but they also make him more susceptible to contagious diseases, particularly those of the lungs and bronchial tubes. [illustration: fig. .--schoolgirl with adenoids.] the removal of adenoids is a simple operation, lasting not over a minute, and the result of the operation is in some cases almost miraculous. the medical inspectors of the new york city schools consider the removal of adenoids as a most important part of their work, and groups of children are regularly taken from the schools by the principal to the clinic at the hospital, where one after another tonsils are cut off or adenoids are removed, all fright and commotion being avoided by the gift of five cents as a reward. _eyes._ another evidence of advancing knowledge in matters pertaining to sanitary hygiene is shown in the greater attention given to the eyes, particularly of children. such incidental troubles as headache, sleeplessness, or biliousness are frequently due to weak or strained eyes, and in the case of school children a great deal of the alleged insubordination, backwardness, and truancy of the children is caused by their being unable to see written instructions or explanations. it is not likely that this increased difficulty with the eyes is a new thing, but rather that both physicians and laymen are more careful as well as more expert in diagnosing the trouble. the new york state board of health in the fall of sent out cards for testing the eyes of school children to incorporated towns. the results of using these cards in schools were returned and showed clearly that nearly half the children of school age in the state had optical defects. a similar test in massachusetts recently discovered per cent of the school children with defective vision, and this knowledge in itself is an advance inasmuch as it suggests to each individual or to all parents that deficient vision is common and that good eyesight is not a thing to be assumed. in the country it is more difficult, perhaps, to realize these deficiencies, because the constant outdoor life acts as an offset to the strain during the time when close work is required, and perhaps the distance from a competent oculist serves to postpone the time of consultation, but no greater folly can be indulged in than to suffer inflamed eyes, persistent headache, and imperfect vision, if it is possible in any way to secure the services of an oculist. never is it worth while to buy from a jeweler, a grocer, or a hardware store a pair of spectacles, much less to buy them from an itinerant peddler, since an oculist, with his particular apparatus, can measure the seeing ability of each eye and fit each eye with the necessary lens to restore normal vision. it is better to have no glasses than to have glasses that are wrong. _teeth._ a curious result of the recent studies among school children with defective eyes and ears has been the discovery that bad teeth were quite as important in their relation to general health as either bad eyes or ears. one eye specialist went so far as to say that the teeth of school children should be attended to first, because thus many of the eye troubles would disappear. as has already been pointed out, the first, step in digestion is taken in the mouth, and careful chewing is not less important than the other parts of the digestive process. if one's teeth are not adapted to chewing, if they are bunched, crowded, loose, or isolated, the appearance of the teeth is the least objectionable feature. the real importance comes from the fact that with such teeth perfect mastication is impossible. the teeth themselves harbor germs which actually infect the food and favor its putrefaction. with decayed teeth, infectious diseases find a ready entrance to the lungs, nostrils, stomach, glands, ears, nose, and membranes. at every act of swallowing, germs are carried into the stomach. mouth breathers cannot get one breath of uncontaminated air, and dental clinics, organized and conducted in the interests of the health of school children, have been altogether too little inaugurated. the use of a toothbrush should be encouraged in children as soon as they are four years old, and its habitual use twice a day is most desirable for every one. only regular examination by the dentist can keep the teeth in good condition, and periodic visits at least once a year to a dentist's office, not to the kind advertised by indians where they are willing to extract teeth without pain, free, but where a regularly qualified dentist practices, should be the habit. armenian children, who prize and covet beautiful teeth, are taught to clean their teeth always after eating, if only an apple or a piece of bread between meals, and while probably our american customs would hardly make this possible, there is no question but that a persistent and frequent use of the toothbrush will help much in reducing dentist bills. _sleep._ from many standpoints sleep is the most wonderful attribute of the human body. our familiarity, from our earliest years, with sleep, closes our eyes to its strange, its awful power. we know that every human being, once in twenty-four hours, will normally close his eyes and for a certain length of time be as oblivious to things present as if already in the sleep of death. it is a common belief that sleep is nature's provision for restoring tired muscles and jaded nerves, and for building up new tissue in cell and corpuscle. excessive exertion produces a numbness and exhaustion so that the body becomes "dead tired," and sleep brings back life and elasticity. and yet some parts of the body, some muscles and some organs, do not stop work during sleep, and apparently feel no bad results for their continuous lifelong exertion. thus, the lungs, whose muscular action is estimated at the rate of one thirtieth of a horse power, have no rest day or night, seemingly without weariness. similarly, the heart is continually forcing blood under a pressure of about three pounds through the arteries without cessation from birth to death. why do the muscles of the arm and leg tire and need sleep as a restorer, while those of the heart and lungs are independent of sleep? dr. w. h. thomson, in his book on "brain and personality," finds an answer to this question in the fact that the latter do their work independently of the human consciousness, while the former are stimulated and directed by the will. he points out that fatigue comes in proportion to the intensity of the mental effort expended. a baby, to whom everything is strange, whose consciousness is absolutely zero at birth, however well developed his body, sleeps five sixths of the time because of the mental efforts needed in his simplest bodily acts. brain work, the most absorbing task of consciousness, is always the most compelling in the matter of sleep. not the muscles themselves but the attention, the skill, the mental effort required to direct those muscles, dr. thomson says, constitute the reason for sleep, a reason which, to those who labor only with their hands, must seem unutterably sad. he says that while muscle work is the commonest and the simplest, so it is also the most poorly paid and the most degrading, and that while brain work is ennobling and the highest type of labor, it is so difficult of attainment and produced only by such grievous toil that most of us shirk it, even while reproaching ourselves at our lack of capacity and purpose. the pathetic burden of unfulfilled possibilities, he says, is the curse of labor, and only in sleep does man have temporary oblivion through which, for a time, he forgets his work and, as it were, uses sleep as an anæsthetic for the pain of labor, to rise therefrom each morning ready to carry his burdens for another day. lack of sleep, to those whose brains are active, speedily brings nervous disaster, and the consciousness, from being the active superintendent of the body, becomes inert, and the body drifts like a boat without a pilot. lack of sleep to those whose work is muscular means a numbness in the nerve cells which guide those muscles, so that they disobey the will or act unreasonably and without direction. but too much sleep, like over-indulgence in any anæsthetic, is only shirking that duty and avoiding that effort to which the higher life calls us, and the sluggard who sleeps more than the tired nerves need is allowing himself to sink deeper and deeper into a slough of despond. he forgets his toil in sleep, but it is only by active, conscious effort when awake that his work may be lifted to the higher plane where the brain is active, where work ceases to be mechanical and a burden, and where that greatest reward of personal satisfaction can be obtained. chapter xiv _theories of disease_ disease may be defined as an abnormal condition of the human body, and since there is no one condition of the human body which can be satisfactorily described as normal, there is, therefore, no exact definition of disease. what is disease for one person because of a departure from his normal health might not be recognized as disease in another person of different normal vitality. nor is it possible to assign any particular and special cause for disease since the condition recognized as disease is the result, usually, not of one but of a series of causes or circumstances more or less connected and linked together, and in many cases not obviously associated with the resulting disease. thus, in records of death, it is very common to see reported pneumonia as the cause underlying and fundamental, when the cause was really typhoid fever, the patient yielding to the former disease because of the enfeebled condition due to the latter. again, many children contract diseases like measles or whooping cough because of reduced vitality due to insufficient nourishment, lack of clothing, and neglect, and their illness is said to be due to measles or whooping cough when under proper conditions of care and attention they would not have the disease at all. the causes of disease therefore may be divided into two classes, direct and indirect. in the latter class are to be included such causes as environment, heredity, age, and occupation. in the former class are to be found such causes as the introduction of disease germs into the system; the action of poisons, whether introduced into the alimentary canal or into the lungs, and such external conditions as excessive heat and cold and accident. _effects of dirt._ at one time it was thought that diseases could spring up in the midst of dirt, and one of the strong arguments for keeping houses clean, for removing manure piles, and cleaning up back yards, was the fear that without such care diseases might be induced in those living near by. this is possible in a certain sense, but unless the seed or germ of the disease is present in a pile of dirt there need be no fear of the disease being developed. there is, however, a probability that by the organic decay and the consequent pollution of the atmosphere the vitality, energy, and resistance of the individual in the vicinity may be weakened. it is well known, for instance, that prisoners confined in damp dark cells lose vitality, and when released, have but little of their former physical strength. in the chapter on ventilation, it has been shown that persons confined in a small room and breathing their own exhaled air may in time become unconscious and die, and therefore it is reasonable to believe that persons living in the immediate vicinity of decaying animal or vegetable matter will suffer a loss of vitality and will have less resistance to disease. _blood resistance._ it is well known that there are present in the body certain agencies which act as guardians of the body against disease; that there are certain corpuscles of the blood and certain liquids circulating through the system which immediately attack and if in sufficient numbers or strength drive out the advancing enemy, so that "taking a disease" in most cases means that the activity of these resisting organisms is not forceful enough to successfully combat the germs of the disease. these agencies, whether circulating liquids or cells or corpuscles, are most active in the healthy body, and anything that tends to reduce the general health, such as exposure, overexertion, imperfect nourishment, overeating or overdrinking, or lack of sleep, tends to diminish their activity and so makes the individual more susceptible to disease. _cell disintegration._ although disease is caused by the attacks of germs, another and far more important cause of disease is the breaking down or overstimulation of some particular organ. this is very plainly seen in diseases involving the stomach or intestines, where habitual excesses in eating lead, sooner or later, to consequent inflammation, disease, and death. this is also true of the lungs; merely living in an atmosphere full of dust will irritate the lungs to such a degree as to cause inflammation. cancer is presumably the result of local inflammation, although the cause of the original suppuration is unknown. similarly, appendicitis starts from some irritating cause, resulting in inflammation and the formation of pus. in very many cases the cell-disintegration seems to be a matter of heredity. _heredity._ heredity, the second of the indirect causes of disease seems to be assuming less importance as it is more studied. probably in but few cases is heredity more than a chance factor in the causation of disease. heredity, formerly considered to be the most important cause of consumption, is now understood to have little to do with this widespread epidemic, although it is agreed that children brought up in the family with a consumptive mother and father are more likely to contract the disease than if they were segregated. it is a providential arrangement that children inherit the tendencies of both father and mother, and that the good qualities of one parent are known to offset the bad qualities of the other; probably for this very important physiological reason marriage between near relatives, where both parents would be inclined to the same weaknesses, has always been proscribed. however, even with the characteristics of the father offsetting peculiarities of the mother, it is possible for the traits of a parent to be reproduced in children, and this applies to mental traits as well as to physical. in some families there exist tendencies toward nervous diseases, such as epilepsy and insanity, although it is not accurate to say that either disease is naturally inherited. it has been observed that a tendency to cancer, to scrofula, and to rheumatism runs in certain families, but this is hardly more than saying that in certain families, where the predisposition in this direction by one parent is not offset by the tendencies of the other parent, the physical condition of the child is such as to encourage the development of diseases. _age and sex._ as indirect causes of disease, age and sex cannot be overlooked. it is well known, for instance, that certain diseases belong essentially to childhood, measles and scarlet fever being markedly prevalent among children under ten years of age. in fact, it has been said by experts that if measles could be kept from children under five years old, the disease would be practically stamped out, since beyond that age they are less susceptible and the course of the disease is much milder. no greater mistake can be made than in exposing children to so-called "children's diseases" because of a desire "to have it over with." not only is such exposure foolish, since it is quite possible to escape the disease altogether if in the first few years of life it is avoided, but also inviting death, since the mortality of the disease becomes markedly less and less as the age of the patient advances. many of the diseases of children are due to imperfect and incomplete development; either the lungs or the stomach or some other organ is not equal to its work, and the child remains an invalid or dies. many children die from imperfect nutrition, especially in the second summer, when teething is at its height, on account of the ignorance of the mother and on account of unsanitary surroundings. no movement is more promising in the way of prolonging the lives of children than that recently inaugurated in new york which undertakes to teach mothers, of foreign nationality in particular, how to dress, bathe, feed, and bring up their children. another reason why disease occurs more frequently among children is, as will be seen later, that one attack of a disease frequently confers immunity upon the patient, so that, for example, a child having scarlet fever is not likely to have the disease later on in life; but this is no argument for exposing one's self to contagion, since it is quite possible that even the first attack may be avoided. tuberculosis or consumption is preëminently a disease of youth, as is also typhoid fever. it is very rare for the latter disease to appear in children or in adults over forty-five, and for the former to develop until maturity. in old age, diseases occur due to the gradual failure of the different organs to perform their normal functions. some of these diseases are connected with the heart and the circulation, others with the liver or with the mucous membranes, so that among those advanced in life, rheumatism, gout, cancer, and diseases of the kidneys are very apt to occur. one of the objects of sanitation is to eliminate disease due to bacteria and to prolong the normal life, so far as is possible, past the early period when diseases are easily contracted. it is not hoped that death can in any case be prevented, but hygiene will have done its utmost when death occurs only among the aged and when the diseases then causing death are only those which are consequent upon the wearing out of the body. so far as sex is concerned, the ordinary rules of hygiene or the violation of those rules seem to have but little concern. it is generally understood that males are on the average shorter-lived, by a few months, than females, and all statistics support this position. some diseases, like typhoid fever, attack males more than females in the ratio of three to two, while cancer attacks females to a greater extent than males at about the same ratio reversed. generally speaking, however, excepting in so far as their occupations and manners of living make different their vital resistance, the principles of hygiene are not affected by the incident of sex. _occupation._ inasmuch as this discussion is a part of rural hygiene and is assumed to apply to only one occupation, namely, that of cultivating the soil, or of raising stock, it may not be considered pertinent to discuss the effect of occupation on disease. it is worth while pointing out, however, that occupation is a very important factor as an indirect cause of disease, and that one's chances of life are vastly greater in the open country surrounded by hygienic conditions than in a city in crowded quarters, confined for long hours each day at some unhealthy occupation. as a general warning, it may be stated that a factory containing a dust-laden atmosphere is most undesirable, and this is particularly so when the dust is mineral dust. in the country, the only comparison of conditions possible is between that of the outdoor worker and that of the indoor worker; enough has already been said upon the value of fresh air and its improving effect on the vital resistance to make further repetition unnecessary. unfortunately, in the past the occupation known under the general term of farming has not made itself conspicuous in statistics for healthfulness; but this has been undoubtedly due not to the lack of the value of the outdoor part of the farmer's life, but to the monotony of the work and to the very bad conditions found indoors, particularly in the winter. when this indoor life has been modified so that plenty of fresh air is supplied day and night, and when reasonable attention is paid to the demands of the body in the matter of food and drink, then the duration of life of farmers will rank high in comparison with other occupations. _direct causes of disease._ the direct causes of disease may be due to the introduction into the human body of a specific microörganism which, if not met by the antagonistic agencies, finally pervades the whole system with its progeny or its virus. the microörganisms thus responsible for disease are commonly divided into two classes, namely, parasites and bacteria. in the first group are included those parasites that cause tapeworm, malaria, trichinosis, and hookworm; in the second group those bacteria that cause typhoid fever, cholera, erysipelas, diphtheria, and probably smallpox, measles, scarlet fever, chicken pox, and a number of others presumably similar. _parasites as causes of disease._ the introduction of worms into the body must come either from impure drinking water, from impure food, or from the bites or stings of insects. when introduced into the body, those parasites that are inimical to man and produce abnormal conditions interfering with usual physiological functions may or may not develop further. in some cases, as in malaria, the very act of hatching the malarial brood is sufficient to throw the host on whom the brood will feed into a violent chill. in other cases, as with the hookworm, while eggs are produced in the human body, they have no directly detrimental effect, the objectionable feature of their residence being due to the fact that the continual draught which they make upon the blood vessels of the intestine reduces the vitality, causing anæmia. in other cases, as with the guinea worm, found in africa and south america, the worm wanders from the stomach, which it enters toward the surface of the body, and finally breaks through, causing ulcers or abscesses. in still other cases, as with that form of filaria which causes elephantiasis, the adult worm or the embryos are present in the lymphatics in such numbers as to interfere with circulation, causing the fearful swellings characteristic of the disease named. finally, in such cases as trichinosis and tapeworm, there is usually but little inconvenience to the human being harboring them, except when their number becomes very large. then there may be diarrhoea, loss of appetite, and other digestive disturbances. the different tapeworms are generally responsible for nothing more than indigestion and nervousness. these latter parasites are, however, formidable in so far as their size is concerned. the mature pork tapeworm is about ten feet long, although the eggs, seen in the pork flesh, giving it its name of "measly," are only about a thousandth of an inch in diameter. the fish tapeworm, when mature, measures about twenty-five feet in length, while the beef tapeworm is about the same length. these worms can develop only in the bodies of the animals named, and find their way into the human body only through the medium of imperfectly cooked meat. if proper precautions be taken in these directions, if only water is used for drinking which is known to be free from such parasites and their eggs, and if insects like mosquitoes and fleas are kept away by screening windows and doors, and if meat be always thoroughly cooked, the dangers of diseases from parasites will be reduced to a minimum. _bacterial agencies._ by far the most important of the living agencies concerned with the direct production of disease are those small vegetable organisms known as bacteria. not all bacteria, by any means, produce disease; in fact, it is not too much to say that the majority of bacteria are benefactors to the human race. their chief agency is not to cause disease, but to prevent it, and they do this because they are able to transform the waste products of animal life, which would normally be dangerous to health, into harmless mineral residue. they are really the scavengers of the earth's surface, not actually carrying off garbage, but rather transforming it, and, in the process, not merely destroying it, but changing it so as to make it available for plant-food. it is through the agency of bacteria that the air, which is being continually overloaded with carbonic acid from the lungs of animals, is reduced and taken up by plants so that an equilibrium is maintained. otherwise, the atmosphere would be more and more vitiated with carbonic acid and organic vapors, and every one would die as if shut up in an air-tight room. but, because of bacteria, neither is the surface of the earth overloaded with waste organic matter nor do streams, however much polluted, continue to flow without some improvement being traced in their quality. in some of the ordinary manufacturing processes, bacteria are all-important, as in making vinegar, wines, cheese; in fact, in any of the fermented food products. in agriculture, they are entirely responsible for supplying an adequate amount of food material to growing plants. fresh manure is not suitable for plant-food and would be of no value on the fields or in the garden except as improved and modified by bacterial action. one of the greatest discoveries of their importance recently made has to do with the way in which peas and beans are able to absorb nitrogen from the air through the agency of bacteria. one knows that plowing under a crop of peas or clover enriches the soil, and that peas or clover make the best growth for this purpose. the reason is that these plants, through the activity of bacteria, are able to absorb nitrogen from the air and afterwards to convert it into food material. but with all these good qualities a few bacteria, gone bad, perhaps, are associated with diseases, and by a series of experiments, chiefly those of a frenchman named pasteur and of a german named koch, and of their followers, it has been ascertained that certain bacteria, and those only, will cause certain diseases. these diseases, that is, these caused by bacteria, are generally spoken of as epidemic or contagious, of which typhoid fever and cholera are examples. all contagious diseases cannot at present be definitely associated with bacteria, probably for the reason that the methods employed to find the bacteria have not been adequate. for instance, the bacteria of smallpox has never been found, although the disease is so characteristically one of bacterial origin that no one can doubt the cause. similarly, the bacteria responsible for measles, scarletina, and whooping cough have never been discovered, although the cause of each is also presumably bacterial. more definite information on the subject of the individual and responsible bacteria will be given in the subsequent chapters dealing with specific diseases. inquiries into the method of growth and into the life history of specific bacteria serve our present purpose only as they teach methods for the prevention of the disease. for example; when it was found that the parasite of yellow fever, in the course of its life, spent fourteen days in the mosquito's body in such a condition that the mosquito during that time was harmless, it made possible exposure to mosquitoes laden with yellow fever for a period of thirteen days from the time of the preceding case. _antitoxins._ but the methods of combating the different diseases when once contracted in the human body, based on the knowledge obtained of the life history of these germs, have been the most important result of their biological study. a large part of this knowledge has been acquired by the study of animals which have been found susceptible and so available for experimental investigation, and it may be that the impossibility of studying measles, for instance, in animals, may be one reason why the germ has never been discovered. there is no evidence that animals suffer spontaneously from such diseases as typhoid fever, asiatic cholera, leprosy, yellow fever, smallpox, measles, and so on; but it seems that in animals, as in man, the disease is the direct result of the life and growth in the animal of the characteristic disease-producing germ. the fact that diphtheria or tuberculosis can be experimentally given to rabbits or guinea pigs is without doubt the chief source of our knowledge of those diseases, although, in general, it is impossible to produce diseases in any animal which will be, clinically, precisely like the disease as it appears in man. the converse of this is also true, namely, that when it has been found impossible to experimentally inoculate an animal with a disease supposed to be bacterial in nature, then but very little of that disease is known. the most important result of bacterial studies has been the production of what are known as antitoxins, and no more wonderful discovery has ever been made. to understand as best we may the principle involved, it is necessary to explain the process of bacterial attack. when bacteria capable of producing disease are introduced into the system, either through the mouth or into the lungs or into the blood through some skin abrasion, the bacteria, finding there a congenial habitat, thrive, grow, and multiply. in some cases, this bacterial growth results only in breaking down the cell tissues at the point or in the vicinity of the place where growth occurs; for instance, if a cut is made with a dirty knife, that is, one carrying bacteria on the blade, and is not immediately washed out with an antiseptic solution, bacteria will grow and pus will form in the cut. similarly, a splinter, if not removed and cleansed, will produce a pus-forming wound. but unless a very extensive suppuration starts, the difficulty is all local. so it is with consumption, when the bacteria are localized in the lungs and by their growth destroy the lung tissue without, at least for many weeks, affecting the general health. there are germs, however, like typhoid fever and diphtheria, which do not produce any particular local disturbance with the growth of bacteria, but the whole body becomes sick, the circulation of the blood is affected, and a general disturbance ensues. this is due to the action of a poison, called a toxin, which is set free as a result of the growth of the bacteria in some one part of the body, which poison is then carried by the blood throughout the entire system, inducing fever and a general debility. just how these toxins are formed is not certain. they are not the bacteria themselves. this we know because the disease-producing bacteria can be grown in broth and the mixture can be strained through fine porcelain, fine enough to strain out the bacteria. yet it has been found that the clear liquid passing the porcelain filter is capable of producing disease and is a deadly poison without the presence of any bacteria at all. during the incubation period of a disease, as, for example, in the three-week period when typhoid fever is developing, these poisons are being formed and are being scattered through the body, and it is during this time that the fight takes place between these poisonous forces and the defending forces always present in the human system. as already pointed out, these defensive forces are powerful or not, according as the general health of the individual is good or bad, and we see the familiar sight of persons said to be run down taking a disease, while those not so depleted of vitality are able to resist or remain immune. so certain are scientific men of this power and of the fact that the power resides generally in the white corpuscles of the blood that, in the presence of a dangerous infection, a person's blood may be examined, and, if the white corpuscles are not present in sufficient quantity, proper means must be taken for developing this element in the blood, or else the person must take himself away from the infection, if the infection is to be avoided. as a result of the conflict between the toxins and the defensive forces of the body, certain vital processes are set free in the blood and in the cells which seem to possess a highly specialized power of defense against any subsequent attack. pasteur, in his researches on the subject of rabies, developed this power of resistance by inoculating into rabbits the rabies infection of a monkey. monkey rabies is not a severe form and is scarcely felt by the ordinary rabbit, but if the infective material (usually part of the spinal cord) of the monkey-infected rabbit is transferred to a second rabbit, the disease becomes more severe; and if the disease is passed from animal to animal, it may be built up into as severe a form as desired, up to the maximum. pasteur found that by inoculating an individual with a one-day rabbit, that is, with the weakest brand of infection killing a rabbit in one day, and the next day with a two-day rabbit, that the person could receive this two-day inoculation without discomfort or danger because of the greater antagonism acquired by the preceding inoculation. continuing the inoculations for fourteen days and making the strength of the infection stronger each day, at the end of the period it was found that the fourteenth inoculation, strong enough to produce the disease and kill a fresh subject, had, on account of the preceding inoculations, produced ability to withstand or counteract the actual disease developing perhaps at the same time. fortunately, in the case of this disease, the shortest period for its development is fifteen days, and often it is a month or more after the bite of the dog before the disease develops. by successive inoculation of increasing strength for fourteen days, the system will have acquired a habitude to the disease which prevents the normal effects. diphtheria is prevented in much the same way, except that in this case horses are used, their blood being strengthened to resist the disease by successive inoculations of the diphtheria poison. it is probable that all the bacterial diseases which exert their influence through the transmission of toxins in the blood may be counteracted by the production of an antitoxin when once the method of building up this antitoxin has been learned. at present, rabies, tetanus, diphtheria, and cerebrospinal meningitis are the four diseases for which antitoxin is made commercially and generally used. for a great many years, scientists have labored without success to find an antitoxin for consumption, and within the last year extensive experiments have been made in the american army on the use of antitoxin for typhoid fever. _natural immunity._ it may be worth noting that not all resistance to specific diseases needs to be acquired in the roundabout way just described. the state of being free from disease is known as immunity, and the way of securing immunity just described is known as artificial immunity. this artificial immunity may also be obtained in the course of events by having the disease as a child, thereby generating the antitoxin in one's own body instead of in the body of some cow or horse or rabbit. there is, however, a natural immunity which is due to long-continued environment or to protracted heredity. the negroes in the south have, by a lifelong proximity and struggle with the disease, acquired a practical freedom from typhoid fever, although it remains with the negro sufficiently to form a focus for the spread of the disease among others not equally immune. creoles in yellow-fever districts have a natural immunity from the hookworm disease, although probably the class are responsible for its generous transmission to the poor whites with whom they associate. racial immunity from certain diseases may be shown by statistical studies. _chemical poisons._ instead of the introduction of toxins into the body by the agency of bacteria, it is quite possible for chemical poisons, not formed originally by bacteria, to be set free in the body. sulphate of copper, for instance, is essentially a mineral poison which acts on the human system in such a way as to produce death, and certain other mineral substances may be mentioned, such as phosphorus, arsenic, and mercury, which are well-known poisons. there are also many vegetable products, not bacterial, which are poisonous in their nature, that is, distributing to the blood and lymphatics certain substances in solution which act on the cells of the various organs of the body in such a way that the activity of those organs is stopped. opium, cocaine, alcohol, and some of the coal-tar products used for headaches, as phenacetin, are deadly poisons when a limited dose is exceeded. there are also certain poisons engendered in the body itself whose action is similar to that of chemical bodies and which can hardly be called bacterial. these poisons represent generally stages in the process of nutrition where for some reason the normal process is arrested and chemical bi-products are set free. also, tissue which has been thrown off, in or by any organ, begins to decompose, thereby sending throughout the system the poisons of decomposition. inflammation too generally results in the breaking down of the cells and the distribution of the resulting poisons. of late years, much has been said of the poisonous property of the body waste not disposed of by excretion, and the theory of auto-intoxication, so-called, has received many adherents. the great scientist, metchnikoff, has even gravely contended that it would be well for children to have their larger intestine removed entirely, because in that organ putrefaction occurs, the cause of the auto-intoxication he would try to prevent. _external causes._ the external causes responsible for disease are due to conditions of weather so severe as to be outside the possibility of self-protection. excessive heat is responsible each year for deaths from sunstroke, and other conditions of weather are often the direct causes of disease, if not of death. accidents are the indirect cause of death, and there will always be a small proportion of the deaths occurring each year due to violence or accident. but, inasmuch as these deaths are clearly preventable, it is the duty of those interested in rural hygiene to study the reasons for accidental death, and, if the number of such accidents can be reduced, to strive for that reduction. as an example, it may be mentioned that each year a number of deaths in new york state, and probably in other states, occur from accidents at culverts and bridges, due to insufficient protection in the way of railings and fences. a method of reducing the deaths from accidents, therefore, would include a proper survey of all the roads of a vicinity to make sure that no danger exists in this regard. other precautions against preventable accidents will readily suggest themselves. chapter xv _disinfection_ inasmuch as more than per cent of all deaths are due to bacterial or to various infectious diseases, it is of considerable interest to study the various means by which these germ diseases may be prevented. in this chapter it is proposed to discuss the different ways in which the active agents concerned in the spread of disease may be captured and put to death. it has already been pointed out that infectious diseases can be acquired only by the introduction of the specific germs into the human body, either through the mouth or lungs or through some skin abrasion. further than this, it is quite as definitely known that the vitality of the germ after leaving a diseased person depends primarily upon its condition at the time of leaving the body and afterwards upon the environment which that germ finds outside of the affected person, while waiting for a chance to make its next human resting place. it is evident, therefore, that if during the interval which elapses between the time when the germs leave a sick person and the time when they enter another person some method could be found by which these germs could be killed, the progress of the disease would be effectually stopped. this, in the most general sense, is what is meant by disinfection. it is a determined effort to destroy the carriers of disease while temporarily absent from the human body which is their natural home. this process of killing bacteria, however, is not so simple a matter as it might at first seem. they are, unfortunately, such minute beings that they cannot be seen, so that the warfare is waged against an invisible enemy, not, however, to be despised on that account. the methods of warfare must be uncertain, since the exact location of the enemy cannot be known, and it is manifestly impossible to disinfect the universe. what is done is to fix upon the location or surroundings where the original patient was confined, and, assuming that the germs, if any, which have escaped ready for further infection are somewhere near, to poison the air and the wall and floor of the room in question so that happily the germs may be killed. _disinfecting agents._ the various agents used to destroy those germs which are carriers of disease may be divided into two groups, namely, heat in its various forms, and chemicals. literally, the word "disinfection" means "doing away with infection," so that to disinfect a room is to do away with the infection present in the room. it has, however, come to have a more general meaning than this and is commonly used instead of the word "destroy," so that a disinfecting solution is the same thing as a destroying solution, applied, of course, to bacteria. it has already been explained that by far the majority of bacteria are useful if not essential to human life, and one of the difficulties in employing disinfecting or destroying solutions is that they put an end at the same time to both useless and useful bacteria. as an example, the fermentation processes in the human intestines are accompanied if not produced by certain kinds of bacteria, although on occasion these harmless or useful bacteria may develop into most obnoxious germs, producing unpleasant fermentation. it might be easy enough for a doctor to make a patient swallow some antiseptic solution, like carbolic acid or corrosive sublimate or nitrate of silver, for the purpose of getting rid of certain undesirable bacteria in the intestines, but it does not need a doctor to know that for a patient to swallow such active poisons as these would not merely kill the harmful bacteria and the good ones as well, but probably the patient himself. _antiseptics._ there is another word often used in connection with bacteria, namely, "antiseptic," and the common significance of this word applies to a substance which interferes with or retards the growth of bacteria without actually destroying them. doctors, for instance, use antiseptic instead of disinfecting solutions on wounds, not because they do not wish to kill the pus-forming bacteria, but because the antiseptic solution will prevent their growth and not be, as a disinfecting solution, harmful to the cells which he is trying to repair. it would be folly, for example, to inject a strong per cent solution of carbolic acid into a wound on the arm produced by a saw, because all the energy of the vital forces at the seat of the wound are needed for repairs, and there is none to spare for so active a detergent as carbolic acid. an antiseptic, on the other hand, is mild enough so that it does not act on the tissue at all, but merely prevents any undesirable growth of bacteria. _deodorizers._ there are substances used, perhaps not so much around country houses as around city houses and in water-closets, which are neither disinfectants nor antiseptic, but act as deodorizers only. such a substance, for example, may be thrown into the kitchen sink, not at all for the purpose of killing bacteria, but for disguising the smell from the cesspool into which the sink-wastes discharge. it has no disinfecting properties and is good for nothing unless the material is so scented as to be agreeable on that score. one of the frauds perpetrated on the public is the preparation and sale of the various appliances designed and regulated to produce a perpetual smell and claimed on that account to be either disinfecting or antiseptic agents. the smell is worth nothing. _patented disinfectants._ the poison of the disinfectant or antiseptic, whether it be in liquid or in gas form, is the essence of the material, and since the value of disinfectants is based on the crude raw materials which any one can buy, it is clearly unnecessary to buy expensive patented solutions for disinfectants when ordinary lime or carbolic acid are equally as good and can be had at much lower prices. a disinfecting solution, to be successful in its action, must be reasonably proportioned in volume to the amount of material to be disinfected, whether this be a liquid or clothing or the air of a room. it is the height of absurdity, for instance, to pretend to disinfect the air of a large room by burning a tablespoonful of sulfur on a shovel in the center of a room without even taking the trouble to close the door. it is absurd to attempt to disinfect the bed linen in a single pailful of hot water, since even if the water was hot at the beginning, it would be so reduced in temperature by the first piece that went in that its efficacy would be lost for everything else. it is equally absurd that a liquid from a bottle, no matter how much advertised, can effectually disinfect a room, either by a gentle sprinkling of the liquid on the walls and floor or by a more thorough spraying of the air with an atomizer containing the liquid. _disinfecting gases._ two gases are available for use in disinfection, and these are valuable particularly in killing germs left in a room after a patient suffering from an infectious disease has been removed. the diseases referred to in the following chapters are all of this nature, and one of these two gases ought to be used in every case; otherwise the room may continue to harbor germs of the disease for months or years with the possibility of infecting a future tenant at a time when his vitality was such as to make him an easy prey. nor must the contents of the room be overlooked. the writer was recently told of a large family where one child had scarlet fever, recovering in september. the sick room was thoroughly disinfected, but the careful housewife, fearing damage to her blankets, had taken them to the attic before disinfection began. in the cold weather of february these blankets were brought down, and in six days the two children sleeping under them had contracted the disease. _sulfur as a disinfectant._ when sulfur is burned, a gas is formed known as sulfurous acid, and until the last few years, it was the most common of all disinfecting agencies. the writer well remembers that when about to visit a city in south america infested with yellow fever, he was seriously advised to fill the inside of his shoes with sulfur as a precaution against the disease. he might as well have worn a red ribbon on his hat so far as any protection went, but it illustrates the confidence formerly shown in sulfur as a disinfectant. it is now known that in the dry, powdered state, sulfur is of no value unless, perhaps, the germs be smothered with the sulfur flour. when burned, however, the gas given off has a certain disinfecting property, although this is limited. it has almost no power of penetrating into curtains, blankets, and upholstered furniture, although the penetration is decidedly increased if these objects are moistened either by steam or by water vapor. the proper amount of sulfur to be burned for any room is at the rate of pounds per cubic feet of air space in the room. thus, if a room be feet by feet and feet high, containing cubic feet, it would be necessary to burn / of pounds, or - / pounds. before undertaking to disinfect a room with sulfur, it should be made thoroughly air-tight, and this must be done carefully, not merely by closing the larger and obvious openings, like doors and windows, but by pasting strips of paper over every crack which might allow air to escape. thus the four edges of the window sash must be pasted up, and a strip must close the crack between the two sashes. all the doors but the one reserved for exit should be pasted up from the inside, and finally this last door pasted up on the outside. if the floor has settled away from the base-board, the cracks thus made must be pasted up. in short, the room must be made absolutely air-tight. the room should be left thus closed for at least twenty-four hours, and since there is some danger from fire, a proper provision should be made for the burning sulfur. this can be done by placing an old milk pan (a most convenient object in which to burn the sulfur) on a couple of bricks, which may be set inside a wash tub with perhaps three or four inches of water in the tub. the most convenient way of ignition is to moisten the sulfur with a little alcohol which can be readily set on fire. since clothes of every sort are more effectually acted upon when moist, they should be sprinkled with a hand atomizer just as the sulfur is lighted, and this should always be done in the case of any stuffed furniture or hangings. anything that can be removed should be taken out and sterilized by steam, since live steam is the only disinfecting agent which will penetrate such things as mattresses, pillows, and rolled-up bundles of every sort, and with these last even steam is not certain. it is far safer to send a mattress to the cleaner to be steamed than to try to sterilize such bulky objects at home. it requires about twenty-four hours with the room tightly closed to generate enough gas so that the bacteria which may have found their way onto the walls or floor or ceiling or into the air of a room will be surely killed. after that time the room can be opened and then the usual household cleansing processes carried out as an additional safeguard. it is a wise measure in the case of infectious diseases, even after a room has been fumigated with sulfurous gas, to wipe off the woodwork and the walls, if their construction allows it, with a solution of carbolic acid, since in this way the germs which have accumulated on the woodwork will certainly be killed. _formaldehyde disinfectant._ formaldehyde is the other gas which is commonly used for disinfecting the air of a room. it is most readily produced by buying solidified formaldehyde and then decomposing it by the action of heat. formaldehyde candles, as they are called, may be purchased at almost any drug store, and while special forms of generating stoves may be found in the open market, an ordinary heating apparatus of almost any sort will answer the purpose of decomposing the solid formaldehyde. about ounces of the formalin should be used for each cubic feet of space. with this agent, however, as with sulfur, the penetrating power of the gas is not very great, and such things as mattresses and clothing should be sent to a steam sterilizer rather than be trusted solely to the power of the formaldehyde. in using this gas, the same care about pasting up cracks and crevices in the room should be followed as already prescribed for the use of sulfur, and, as with sulfur, a reasonable precaution against fire should be taken by placing the apparatus in a tub of water or in a large pan of sand where accidents cannot happen. the room should be kept closed for at least twelve hours, and then should be thoroughly aired, and if the room is to be used again soon, the disagreeable odor may be removed by the free use of ammonia, either sprinkling it around in the room or by placing about saucers of ammonia. _liquid disinfectants._ more common than gases and most readily suggested as disinfectants are certain liquids which have been proved both by laboratory experimentation and by actual experience to have the power of killing bacteria when brought into contact with them. those liquids which have commended themselves particularly have additional advantages in not destroying fabrics, metals, or tissue with which they are brought in contact and in being purchasable at moderate prices. there is little choice between a number of such liquids, and the number of modifications or combinations which are made and bottled and sold under some fancy name is legion. but the label, the name, and the additional price add nothing to the value of the basic chemical from which they are all compounded, and except for their convenience, they have little to recommend them. _carbolic acid as disinfectant._ carbolic acid is one of the most useful of these liquids, and in its various forms appears in almost all disinfectants. it may be obtained from the drug store in two forms, either as a crystal or as a concentrated solution. a per cent solution, that is, one pint of carbolic acid to six gallons of water, is the proper strength for all such uses as wiping off wooden surfaces, furniture, floors, etc. a stronger ( per cent) solution is used when it is intended to destroy organic matter containing large quantities of germs. this is practically a saturated solution, so that if a bottle be partly filled with the crystals of carbolic acid and then completely filled with water, the water will absorb enough of the carbolic acid to make a per cent solution, and the water may be poured on and off as long as the crystals remain. this per cent solution is the proper strength to receive sputum from tuberculous patients, material ejected from the stomach in diphtheria, and fecal matter from typhoid and cholera patients. this strong solution should not be used on the living human body, since it is powerful enough to eat directly into the flesh, and being a violent poison, it should be kept out of the way of the household and carefully labeled to avoid accidents. carbolic acid has no value at all in the way of disinfecting the air, although fifty years ago surgeons were accustomed to use a spray of carbolic acid around the operating table before an operation in order to destroy any germs of the air lingering in the vicinity. it is equally futile to pour carbolic acid into sewers or to stand it around on the mantelpiece for the purpose of disinfecting a room. nor are sheets wet in carbolic acid and hung over doorways and at the end of passages anything more than a remnant of medievalism. _coal-tar products._ there are certain preparations made from coal-tar which, either alone or combined with carbolic acid, have very strong disinfecting properties and which are the bases of most of the patented disinfecting solutions now sold. they are commonly called cresols or creosols and a per cent solution of any of the three ordinary forms will destroy bacteria in a few hours. they are commonly used for receiving organic excretions of sick persons in the same way as carbolic acid is used, and have about three times the power of carbolic acid to destroy bacteria. they have one great advantage besides the strength mentioned, in that they are not materially affected or interfered with by the presence of albuminous material. carbolic acid in the presence of albuminous material, like sputum, for instance, has the strength of the disinfectant partly used up in combining with this albuminous material so that the strength remaining for disinfection is weakened, and the result is not as satisfactory as it would otherwise be. the coal-tar products, on the other hand, are not so interfered with, and the solution acts in full strength upon the bacteria. _mercury for disinfectant._ corrosive sublimate, or bichloride of mercury, is one of the most active poisons known and is as effective in dealing with the microscopic organisms known as bacteria as it is in dealing with the larger animals for which it has been used for years past,--the destruction of bed-bugs. for general cleaning purposes, such as scrubbing woodwork, floors, and walls, it should be used in strength of about part to parts of water. this means that for ounce of corrosive sublimate ounces of water or gallons must be taken. this solution is very active in its effect on all metal, so that it must be kept in brassware or earthenware, and when mixed with the material which it is intended to disinfect, it must be kept from tin or iron. this solution is also affected by albuminous material, although this may be counteracted by the addition of salt. it is a good plan, therefore, to add to the solution salt at the rate of about teaspoonfuls to each gallon of solution. on account of the very poisonous action of this solution great care must be taken to keep it away from children, and it has been suggested that it is desirable to add some coloring matter to the liquid, since without this it may be mistaken for clear water. _lime for disinfecting._ chloride of lime is one of the most useful as well as one of the cheapest disinfectants available. it costs about $ a ton, although by the pound this wholesale price would not be obtained. it is effective in a per cent solution, that is, pound of chloride of lime to pounds or gallons of water. to be effective, the solution must be well stirred into the organic matter to be disinfected, since it is the chloride rather than the lime which is the disinfecting agent. saucers or soup plates of chloride of lime standing around the room have no effect upon the germs in the air and on the floor and are of no more value than sulfur, or roses for that matter. chloride of lime is commonly known as bleaching powder, and its effects on clothes or on any substance which can be eroded is well known. it is, therefore, not a suitable material for disinfecting towels, because the action is on the towel as well as on the bacteria, differing in this respect from mercury, which does not hurt the fiber of clothes. milk of lime is produced by slaking ordinary building lime until a fine white powder is obtained, about an equal quantity of water to the amount of lime to be slaked being necessary. when the powder has formed and steam has ceased to be given off, then about four gallons of water should be added to each gallon of the powder and the mixture well stirred. this will probably always leave some lime in the bottom of the vessel, since limewater is a saturated solution, and these proportions furnish more lime than is necessary. if not too thin, it is a good whitewash and is a most important agent when used as a whitewash in disinfecting walls and ceilings of such rooms as hospitals and cellars and other places where have been contagious diseases. milk of lime is an admirable disinfectant in the sick room and generally in houses where infectious diseases have been. it may be poured down drains, into water-closets and privies, and used liberally in all places where bacteria may be supposed to thrive. it must come into intimate contact, however, with the bacteria, and merely sprinkling a little lime dry around the borders of a gutter or drain is of no value. the writer saw, not long ago, a chicken yard where the inspector of a health department had undertaken to secure disinfection by a generous sprinkling of white lime powder around the yard. such a procedure, however, is not effective, but in a drain the dry powder might be of value because it would later become effective when washed in solution into the drain. ordinarily, the dry powder is to be avoided. _soap as an antiseptic._ no better antiseptic exists than ordinary soap, not altogether because of the properties of the soap, but because of the action of the soap combined with hot water. washing soda, dissolved in water and used for boiling clothes which have become polluted, adds to the disinfecting power of the hot water the disinfecting properties of the soap, and the result is most effective. ammonia has not the same value as the soda or potash soap, although it has the power of destroying bacteria in the course of a few hours. it may not be out of place to emphasize the value of soap, not particularly in times of epidemic or contagious disease, but as a continual safeguard against infection. a large proportion of the contagious diseases are probably the result of infected fingers or hands coming in contact with the mouth and leaving there the germs of infection. one of the first things a surgeon learns, in order to avoid any possible infection of wounds or of openings which he makes for an operation, is to thoroughly wash his hands in order to remove therefrom all possible germs. he scrubs his hands, particularly his finger nails, with soap and water and then bathes them in a solution of bichloride of mercury before touching the patient in any place where infection might occur. the difficulty, even with this great care, of freeing their hands from bacteria has been found to be so great that, in late years, surgeons have preferred to use, during operations, thin rubber gloves which can be boiled before using and can be soaked in a stronger antiseptic than the hands could bear. it is extraordinary, from the standpoint of self-infection, to see how men can be so careless as to sit down to dinner, after having worked in places where their hands have come in contact with all sorts of organic filth, without stopping to wash those hands even in cold water. it is certainly providential that disease germs are as uncommon as they are, for with the careless habits of most people in putting their hands to their mouths, the death-rate from infectious diseases would be much higher than it is except for the fact that most of the germs thus introduced into the mouth are not disease-producing. _disinfecting by heat._ better than any chemical agent known to be a destroyer of bacteria is heat in one form or another. this may be steam or hot water or dry heat. if a high enough temperature is maintained for a sufficient length of time, the action is absolutely destructive to all germs. fire does, of course, destroy bacteria along with whatever material the bacteria are concealed in, but such a disinfectant is of little value for ordinary purposes, since the object of disinfection is to destroy bacteria without destroying the surface on which they are lodged. in some old buildings, where consumption or smallpox, for example, has become permanent, it may be that the surest way of killing all the bacteria is to burn up the house. _dry heat._ unfortunately, even a moderate heat cannot always be applied. one's hands, for example, can neither be heated in an oven to the necessary temperature for destroying bacteria in their pores, nor can they be immersed in boiling water or steam for a sufficient time to secure thorough disinfection. therefore, with the body, chemical means for disinfection must be employed. also when it is desired to disinfect a liquid, such as beef broth, in which the experimenter desires to grow some particular species to the exclusion of all others, dry heat is inapplicable because it would evaporate the liquid, nor is chemical disinfection possible because of its antiseptic effect on the bacteria to be cultivated. moist heat, therefore, must be used. when dry heat is used, it is usually for the disinfection of glassware or earthenware or metallic objects, the quality of which will not be affected by the necessary temperature, namely, degrees centigrade, or about degrees fahrenheit. this temperature must be maintained for at least an hour, and it is not certain even then to penetrate in full power to the middle of blankets or comfortables. except for glassware to be used in a laboratory, dry heat, such as would be obtained by a kitchen oven, is not to be recommended. _boiling water._ boiling water, on the other hand, is the most effective and penetrating disinfecting agent available. one has only to expose an object to boiling water for five minutes to absolutely kill all disease-bearing bacteria contained, and since bed linen, clothes, blankets, and such articles as are naturally used in a sick room have to be washed after a patient's recovery, it requires but very little additional trouble to subject the soiled articles to that temperature of the water which will secure disinfection at the same time. but the water must be boiling. the mere fact that it was once boiling water gives it, half an hour later, no disinfecting properties, and complete disinfection can be secured only by actually boiling the garments or articles for at least five minutes. the apparatus necessary therefore--and no better piece of disinfecting apparatus can be secured anywhere--is a good old-fashioned wash boiler. the action is more certain, that is, more penetrating, if a little washing soda is added to the water at the rate of a tablespoonful of soda to a gallon of water. this solution is admirable for washing dishes, spoons, knives, forks, and other eating utensils used by sick persons. it is always a mistake to wash dishes from the sick room in the same vessel with other dishes. they should not only be washed separately, but they should be washed in boiling water, and preferably in a soap solution as just described. _steam._ for some purposes, steam is better even than hot water; its effect on cotton and woolen garments is not so disastrous. a comfortable or blanket, for instance, may be subjected to steam without losing its elastic quality, and for small garments, an ordinary steamer, such as is used for puddings, answers admirably. cities use steam sterilizers because of the greater convenience in furnishing steam to a large tank as compared with filling and emptying a tank with water and then providing sufficient heat to boil that water. the exposure to steam should last from half an hour to an hour, depending on whether the objects to be disinfected are small, open, and loose, or large, compact, and dense. some articles, like bales of rugs, rolls of wool, and large bundles of cloth, cannot be sterilized at the center by ordinary steam, and while it is not likely that infection at the centers of such tightly rolled bundles has occurred if exposure took place while rolled up, yet it is certain that the disinfection does not reach these centers. in the case of such bundles as rugs from infected countries, where any single rug may become the medium of infection, it is requisite to thoroughly sterilize all parts of the bundle. for this purpose, it is necessary not merely to expose the articles to live steam, but to have the live steam under pressure so that it is forced into the inside of the packages by an excess of external pressure. this is probably not available in an ordinary house, where boiling must continue to be the method of disinfection. _drying, light, and soil._ before leaving this chapter, three agencies for disinfection may be pointed out, not perhaps to be depended on, but in order that the kindly provisions of nature may be appreciated. all germs removed from the body, which is their natural home, and exposed to the air are subject to drying and thus are killed. unfortunately, this does not become true except after long periods of time, nor is it equally true with all germs, but it is certainly one of the methods by which the evil effects of disease germs may be lessened. the germ of consumption lasts as long as any germ, and yet this, when dried in the street, loses its vitality after about a week. similarly, the typhoid fever germs, unless kept in a moist condition, dry up and die in a few days. with the drying, however, comes the danger that in the process they may be lifted by the wind and carried in the air to the mouths or nostrils of well persons, so that it is not wise to depend solely on this method of disinfection. sunlight is more positive than the wind, and the exposure to direct sunlight of a bottle filled with disease germs will kill them all in two or three hours. the surface layers of a pond never have as many bacteria in them as the lower layers, partly on account of the sedimentation, but largely because they are killed by the direct action of sunlight. the bacillus of consumption and bacillus of diphtheria are both killed in an hour or so by direct sunlight. this is one reason why living rooms should have sunny exposure and why, on the other hand, disease thrives in dark tenements. the soil is the third natural method of disinfection, not because the soil itself destroys bacteria, but because in the soil are to be found millions of non-harmful germs and these germs are hostile to the disease-producing germs, so that they destroy their virulence. it is on this principle that the wastes from typhoid fever patients are buried in the garden, the presumption being that the bacteria there present will destroy the typhoid fever germs before they can escape and do any harm. while this action undoubtedly exists, it is not positive enough to depend upon, and disinfection by the use of chemicals should always be practiced. chapter xvi _tuberculosis and pneumonia_ these two common widespread diseases affecting the lungs may be discussed together, although they are not closely related in origin or effects. _tuberculosis._ that form of tuberculosis known as consumption is at present the most prevalent and the most dreaded of all infectious diseases. in , in the registration area of the united states (about one half of the whole country), it caused , deaths. deaths from other infectious diseases are shown in the following table, together with the population:-- table xviii. showing deaths from various infectious diseases in the united states, population of registration area , , deaths in registration area , deaths from tuberculosis , deaths from pneumonia , deaths from diarrhoea (chiefly of babies) , deaths from cancer , deaths from typhoid fever , deaths from diphtheria and croup , deaths from scarlet fever , deaths from whooping cough , deaths from measles , deaths from smallpox deaths from hydrophobia deaths from leprosy deaths from bubonic plague deaths from yellow fever pneumonia is second in fatality, the two diseases of pneumonia and tuberculosis carrying off , persons, or about one fifth of all persons dying in the year. while these have both been great plagues to humanity from the very earliest days, it is only within the last ten years that their ravages have been appreciated and, especially with tuberculosis, their causes actively combated. there are two phases to be considered in discussing tuberculosis or consumption, namely, first, the method of prevention and second, the method of cure. it follows also that, since the cure of advanced cases is impossible and since every case which exists is a menace to the health of the community on account of the danger of the spread of the disease, the prevention is far more important than the cure. until the discovery by robert koch, in , of the germ causing consumption, little could be done in the way of prevention, but since that time, only one quarter of a century ago, we have learned and applied the knowledge that, in the vast majority of cases, the disease is spread by the sputum of consumptive patients, which becomes dry, forms dust, and so is carried into the air to be breathed by persons not otherwise affected. it seems so simple a method, then, to prevent the spread of consumption. all that need be done is to take care of the expectorations of persons suffering with the disease. it is thoroughly believed by experts that if this were done carefully and faithfully, the disease would be stamped out within a few years, and the slogan of a certain sanitary organization is "complete control of tuberculosis in ." too much emphasis cannot be placed on the direct and simple method of infection, and while other factors enter, as will be shown later, a thorough recognition and control of tuberculosis sputum would practically stamp out the disease. the following circular, issued by the committee on the prevention of tuberculosis of the charity organization society of new york city, indicates the procedures advised by them to prevent the spread of the disease and, as will be seen, the essence of the axioms there expressed are summed in the words "don't spit!":-- don't give consumption to others. don't let others give it to you. _how to prevent consumption._ the spit and the small particles coughed up and sneezed out by consumptives, and by many who do not know that they have consumption, are full of living germs too small to be seen. these germs are the cause of consumption. don't spit on the sidewalks; it spreads disease, and it is against the law. don't spit on the floors of your rooms or hallways. don't spit on the floors of your shop. when you spit, spit in the gutters or into a spittoon. have your own spittoons half full of water, and clean them out at least once a day with hot water. don't cough without holding your handkerchief or your hand over your mouth. don't live in rooms where there is no fresh air. don't work in rooms where there is no fresh air. don't sleep in rooms where there is no fresh air. keep at least one window open in your bedroom day and night. fresh air helps to kill the consumption germ. fresh air helps to keep you strong and healthy. don't eat with soiled hands; wash them first. don't neglect a cold or a cough. to be sure, the precept of "don't spit," as applied in cities, has other reasons for enactment than to prevent tuberculosis. spitting is a filthy habit, and its practice should be decried on the score of cleanliness whether on the streets or in any public place, so that the signs now seen in street cars and railroad trains, in halls and office buildings, are intended not altogether for consumptive patients, but also for those who need laws to force them to observe ordinary rules of cleanliness and decency. it is, however, the main step towards doing away with consumption, and the faithful observance of the injunction ought to be insisted upon quite as much in the individual home as in a city street or public building. case after case has been cited of instances where one consumptive patient in a family has spread the disease through the household, and, at intervals of a year or so, one after another of the family has succumbed to the attacks of the consumptive germ, when by proper precautions and suitable care of the sputum of the first sick person, the other deaths might have been prevented. _individual resistance to tuberculosis._ there is a remarkable difference in the ability of individuals to withstand the attacks of this disease, and it will be found always that the first to succumb are those whose vitality has been in some way depleted. the women of the family, who are generally confined to the house, who do not have their lungs reënforced by a continual influx of fresh air, who are tired and worn out with their household duties, give themselves an easy prey to the attacks of the bacteria, while the men and boys, who are more outdoors, who are vigorous and strong, throw off the attack and are not affected. it is a significant fact that by examination, dead bodies, so far as was known, not afflicted with tuberculosis in life, have, to the extent of per cent, been found to have evidences of consumption in their lungs; that is, the edges of the lungs have been found affected, although the vitality of the individual was such that the action of the germ had been stayed before any serious injury was done. most of us, at one time or another, have had, unknowingly, mild cases of consumption. it would be strange, indeed, if we did not, in view of all the tuberculous infection flying around in the air. but most of us are able to successfully combat the disease, so that the germs are destroyed before they are able to affect the entire body. the other part of prevention consists in building up and holding up the vitality of the individual to a point where the vital forces can successfully oppose the attacks of the germs. probably the decrease in the number of cases of consumption in the last quarter of a century has been due quite as much to the improved sanitary conditions of living, whereby the germs have been unable to secure a foothold in the individual, as to any precautionary measures taken against the germ itself. _precautions by the consumptive._ but the chief factor in the future restriction of the disease, as in the past, must be the disinfection of the germs immediately after they are thrown off from the consumptive patient, and it is well worth while to emphasize just what the consumptive should do or have done for him in order that he may not be responsible for the further spread of the disease. in the first place, when he spits, he must appreciate and act on the fact that the sputum is alive with consumptive germs, each one of which may possibly transmit the disease to whoever may come in contact with it. the patient must keep in mind continually that this sputum is poison, a deadly poison, and that it is his duty to see that every particle of it is disinfected or destroyed by one of the methods already indicated. he may expectorate into a vessel filled with a carbolic acid solution or he may expectorate into a vessel filled with water which may afterwards be boiled. he may use a cloth or paper, like a japanese napkin, which may later be burned in the fire. but, above all things, he must not expectorate anywhere and everywhere, regardless of the consequences. the consumptive patient must not cough without holding a handkerchief over his mouth, since small particles of sputum may become dislodged and distributed in this way. the eating utensils used by a consumptive patient must not in any way be allowed to infect other people. the consumptive must have his own dishes reserved exclusively for him, and they must be, after each meal, carefully disinfected. with these precautions and with avoidance of such practices as kissing or otherwise directly infecting others, there is no reason why a consumptive patient should be in any way an object of dread or why he should not live with his family in as much comfort as he can obtain, in perfect safety to himself and to them. _cure of consumption._ the chief factor in the cure of consumption is the time at which the attempt at cure is started. consumption is not an incurable disease, as was once thought, and there is no reason for so considering it. there is no such thing as galloping or quick consumption as distinguished from slow or lingering consumption, since the consumptive germ is the same in all people. the same germ may act differently in different people, and if one's power of resistance, as happens with those accustomed to drinking liquor, is low, the action of the germ is rapid, although the disease is identical with the form in which death comes only after years and years. if taken in time, that is, before the germ has so infected the body as to be beyond all possible restraint, as large a proportion of consumptive patients may recover as of patients from typhoid fever or diphtheria or any other infectious disease, but the cure must be started early. for instance, at one of the sanitariums in the adirondacks, out of patients admitted, who had the disease in an incipient stage, complete recovery was had in cases, the disease was arrested in the case of others, and in only was the treatment not effective. where the disease had become advanced, however, it was found that out of cases, only apparently recovered and were improved to some extent. these are the significant facts in an institution for incipient cases only, where advanced cases, such as are met with by the practicing physician, are not received. unfortunately, the ordinary physician does not always recognize the disease in its first stages, and a person may suffer for months with consumption, and even pass the time when the cure of the disease would be possible, without its being recognized. such sick persons are treated for catarrh, for an obstinate cold and bronchitis, for grippe or malaria, whereas a proper diagnosis of the disease would be a recognition of the early stages of consumption and thus would prompt the patient to start at once on the necessary methods for cure. nor is it possible to recognize the disease by any one definite indication. the cough which was once thought to be the deciding symptom is very often absent until the last stages of the disease. expectoration of blood is similarly one of the last symptoms, exhibited only when too late for remedial measures. the presence of the tuberculosis bacillus or "t. b." in the sputum is also not generally found until the tissue of the lungs has become well advanced towards destruction, too late for remedy. experts in diagnosis attach great importance to family history, and have learned to expect the disease in persons when exposure to contagion is inevitable. they will recognize the disease from evidence not discernible to regular practitioners. for instance, if one member of a family is known to be affected, any chronic indisposition in another member, involving, perhaps, a daily rise in the temperature of the body, not sufficient to arouse alarm, but apparent in the listless behavior of the person, may be enough to suggest the beginning of the disease. an expert may detect the clogging up of the lung tissue by an examination of the lungs themselves, and probably this direct examination, with a record of the daily rise and fall of temperature, particularly if the suspected patient has a listless feeling and a gradual loss of weight, would be sufficient to suggest the ordinary remedies. the three remedies, which are nature's own methods, are good food, fresh air, and rest. it is difficult to say which of these three items is the most important. certainly no hope of building up the resistance of the patient against the inroads of the disease can be expected unless the patient is thoroughly nourished. one of the sad facts in connection with those unfortunates whose fight against tuberculosis is nearly over and who in desperation have fled to arizona, hoping that the dry air might afford relief, is that the lack of nourishing food, inevitable in those deserts, hastens on the disease, so that the expected benefits from the dry air are entirely offset. likewise, in tenement-house districts in cities, the fight against consumption is practically useless because of the impossibility of securing for those starved or underfed helpless ones the nourishing food necessary. in the country, this part of the treatment ought to be the simplest, and yet one fears that the habit of eating through nine months of the year only salted and dried foods has not furnished patients in the country with the kind of nourishment necessary. experience indicates that eggs and milk should be the bulwark on which the patient must depend for food, and in the sanitariums of new york state it is not uncommon for patients to be stuffed with two dozen raw eggs every day in addition to other food. the next important factor is rest, since the effect of tuberculosis is to break down lung tissue, and for the prevention of this it is necessary to give the forces of the body every aid in preventing this destruction. all exercise taken by a tuberculous patient means the withdrawing of that much blood from the lungs, where is the strategic point of the disease, to the part of the body being exercised, and one of the most striking features of sanitarium treatment is the absolute rest enjoined on the patients. flat on their backs, day and night for months, without so much exercise as walking across the room, is the ordinary treatment, and the effect of disobedience is plainly seen in the rise in temperature or increase in fever which follows a violation of these rules. even when the patients are allowed to sit up, they do not sit straight, but rest on couches or reclining chairs, so that their heads are down and their feet up, making the passage of the blood to the lungs easier. even where the patient, determined to recover, is not able to place himself in the hands of a hospital physician, he can adopt this important method of arresting the disease by strictly avoiding exercise and exertion of every sort. the massachusetts general hospital in boston has tuberculosis clinics, where patients who are not far enough advanced in the disease to require absolute rest are inspected daily, their condition noted, and advice given for the following twenty-four hours. one of the most common violations of the prescriptions given is overexertion, and yet the rest condition is essential for building up the diseased lung. the third method of treatment involves fresh air, in order to improve the oxygenating character of the blood. if one remembers that the oxygen in the blood is the chief scavenger of the body and that the vitality of the red corpuscles and their abundance is an essential factor in curing the disease, it will be seen why fresh air is so important. the tendency to-day is to insist on fresh air and to lay less stress on the climate than was formerly done. it was not uncommon a few years ago for a physician, recognizing consumption, to send his patient away, partly because he honestly believed the climate of arizona or colorado or the sandwich islands was better than that where the patient lived, and partly, without doubt, because he was glad to get rid of a disease which he knew it was not in his power to cure. to-day, unless the patient can go to a properly equipped and maintained sanitarium, physicians recognize that conditions may be as beneficial at home as elsewhere and, provided the three factors mentioned--good food, rest, and fresh air--can be obtained, the chances for recovery are better because of better care at home than elsewhere. but fresh air is essential, and this means that the patient must spend twenty-four hours a day in the open. he must eat and sleep out of doors. he must not go into the house when it rains, nor when it snows, and even with the thermometer at zero he must still stay out, wrapping himself up, to be sure, so that his body is not cold, but breathing into his lungs the life-giving, vitalizing, oxygen-bearing air. the side porch of a house may be very easily transformed into a room with a cot bed and an easy chair, where the consumptive may stay continually, and while it is convenient to have a window or a door opening from the porch into a room where the patient may be dressed and bathed, this is not essential, although customary in sanitariums. if no side porch exists, it is possible to build such a porch, and the picture shows how such a construction may be added to even a small house in the city (fig. ). if this is out of the question, the windows of a room may be left open all the time, or the patient may lie on a bed, the head of which either extends through the window or is arranged to admit fresh air by a specially devised window tent. educational campaigns have been vigorously prosecuted for the past ten years, and gradually through the world is spreading a growing appreciation of the dangers of this disease. the effect of this increasing knowledge is reflected by a continually decreasing number of deaths in proportion to the population. the following diagram (fig. ) shows how this law is obeyed in new york state, the downward tendency of the line since being very plainly marked. [illustration: fig. .--outdoor sleeping porch for tuberculosis patients.] the results being so manifest, the prophecy of dr. biggs of new york, written in , is certainly justified:-- "in no other direction can such large results be achieved so certainly and at such relatively small cost. the time is not far distant when those states and municipalities which have not adopted a comprehensive plan for dealing with tuberculosis will be regarded as almost criminally negligent in their administration of sanitary affairs and inexcusably blind to their own best economic interests." [illustration: fig. .--mortality from pulmonary tuberculosis. deaths per , population.] _pneumonia.--the germ._ in new york state in the year , the largest number of deaths from any specific disease was due to consumption, the number of deaths in the rural population alone being . the next largest number of deaths in the rural communities, and always a close second to consumption, was from pneumonia, the number being ; so that pneumonia justly ranks as highly important in the list of diseases which are at present most deadly in their effect on the human race and against which a vigorous fight should be made. while pneumonia, like tuberculosis, is due to the action of a specific organism, the germ itself is not so generally infectious; that is, the germ has not the power of remaining vigorous when out of the human body in the same way as has the germ of consumption. like tuberculosis, the germ is expectorated and remains virulent when dried into dust, but the germ is much more sensitive to temperature changes and does not live longer than two or three hours when dried and exposed to the sun. it is, very curiously, a normal resident in the mouths of at least one third of all healthy persons, and it is only necessary for the body of these persons to become weakened for the germ to be able to secure a foothold and produce the disease. unlike tuberculosis, which attacks chiefly those in the vigor of life, from fifteen to forty-five years of age, pneumonia attacks generally the very young and the very old; those under five and those over forty-five, the time of life when the vital resistance is the least. _weather not the cause of pneumonia._ one of the sources formerly believed to be largely responsible for pneumonia, that is, exposure to severe weather, is curiously negatived by the fact that children and old people are not those generally exposed to weather. perhaps no fallacy in any disease has been more prevalent than that pneumonia is usually contracted by exposure to wet or to cold. it has, indeed, been noticed that the disease has been practically non-existent under conditions where it would be prevalent if exposure alone were the cause. for instance, in the arctic zone, where the temperatures are very low and where no adequate provision against the rigors of a severe climate are possible, pneumonia is practically unknown. during napoleon's retreat from moscow, when thousands of soldiers died from physical exposure, from frost bite and starvation, where if exposure were the predisposing cause of pneumonia, it would have raged as an epidemic, it seldom appeared, proving this opinion. perhaps one reason why the disease has been supposed to result from exposure is the undoubted fact that it is chiefly prevalent in the winter and spring rather than in the summer. this argument is, however, modified by the fact that the majority of cases do not occur in january or february when the temperature is lowest, but in march, when the opening of spring is in sight. the reason for this is evident when we remember that the cause of the disease is a germ, generally present in the body and needing only a reduced vitality for its successful inroad on the human system. when, therefore, a person shuts himself up in an overheated house, without ventilation, takes insufficient exercise, and lives with an apparently determined effort to do everything possible to reduce his bodily vigor, then it is no wonder that the germ, almost in exultation, finds an opportunity for successful development. _preventives in pneumonia._ much as in tuberculosis, then, the best remedy and the best prevention for pneumonia is a careful attention to the needs of the body in order that it may preserve its normal vigor. regular hours, sufficient sleep, and good food will, in most cases, keep the body in such a condition that pneumonia need not be dreaded, no matter what the exposure or what the temperature. further than this, if the disease does once start and gain a foothold in the lungs, the best cure is, as with tuberculosis, a plentiful supply of oxygen or fresh air in order to remove the toxins formed by the disease and give the lung tissue an opportunity to recover. formerly medical men treated pneumonia by confining the patient in an overheated room in which steam was generated, with the idea that the lungs would be most helped by an atmosphere of moist heat. now, a pneumonia patient is supplied with all the fresh air possible, the windows of the sick room, even in winter, being kept continually open, and every effort being made to give the patient fresh air even when every breath means a shooting pain, and apparently untold suffering. in some of the new york city hospitals, the ward for pneumonia patients is on the roof, and children and babies suffering with pneumonia are at once taken there, even with snow piled all around the tent in which they are kept. the nurses and physicians are obliged to don fur coats, and heavy blankets must be provided to keep the patients from freezing to death; but the pneumonia germ, under these conditions, is worsted almost as if by magic, and within a few hours after leaving the warm wards of the hospital the patients start on the road to recovery. the remedy, then, for the cases of pneumonia which occur in new york state each year, is an improved regulation of the health conditions of the separate families throughout the state--a better hygienic regulation of the everyday life. care must be taken to provide better ventilation in the houses, more fresh air in the sitting room and in the sleeping rooms, more outdoor life in the winter time, and more exercise by which the blood circulation will be kept active. then more varied and more suitable food must be consumed, food which will be capable of absorption by the tissues and not clog the intestines and poison the system. more bathing, by which the pores of the skin can be relieved of the organic matter which otherwise clogs them and prevents their effective action in the removal of waste products, must be indulged in. with these three factors properly evaluated, with more fresh air, with better food, with ample bathing, pneumonia need not be dreaded, since then it would attack only those few whose constitutional vigor was impaired, and in the course of a generation or two the number of these would be so decidedly diminished that pneumonia would find no one susceptible. _infection of pneumonia._ it must not be forgotten that a pneumonia patient is a source of infection quite as much as is a tuberculous patient, and the same precautions against infection should be followed. the nurse should be particularly careful not to infect herself. she should be careful to exercise enough self-control always to get daily exercise and fresh air and must, as a matter of self-protection, avoid overfatigue. the eating utensils, food refuse, and soiled clothing may all be infectious and must be sterilized by boiling as soon as removed from the sick room. the severe epidemics which have occurred from pneumonia have occurred in camps where sanitary conditions are grossly violated. under such conditions pneumonia has become a most alarming epidemic, sometimes called the black death. in a single house, however, disinfection of the wastes of the patient and a proper care of the personal hygiene of the rest of the family will avoid the spread of the disease, and if the patient has sufficient vitality, sustained by good food and fresh air, he will recover without serious after affects. chapter xvii _typhoid fever_ the two diseases already described, tuberculosis and pneumonia, are by far the most serious of all the infectious diseases, being responsible in new york state alone, in , as already stated, for deaths. no other infectious disease even approximates the virulence and deadliness of these two, and while some of the constitutional disorders, such as bright's disease, diarrhoea, and irregularity of the circulation, each result in from to deaths, the cause and prevention of these are so little understood as to baffle the hygienist. there are a number of contagious diseases which, while comparatively unimportant in the number of deaths, yet are of concern because the cause of the disease is so well known that the means of prevention is quite within our power. of these, typhoid fever, in new york state in , among the rural population alone resulted in deaths, a rate of . per , population. the facts substantiate the assumption that for every person dying with typhoid fever there are ten cases of it, so it is a fair statement that in the rural part of new york state, in , there were not far from persons afflicted with this disease. perhaps one of the reasons why so determined a fight against this particular disease, involving only cases of illness during the year, has been made, is on account of the length of the illness in each case and on account of the fact that the disease usually attacks those in the very prime of life, from to years. it is also to be economically considered by reason of the loss of time involved in an illness of nearly two months and the loss of money implied in the nursing, doctors, and medicine. the movement against the disease is most encouraging because the line of attack is well known, and there is, humanly speaking, no reason at all why the disease should not be stamped out. _cause of the disease._ typhoid fever is a modern disease, and only for the last fifty years has it been recognized in medicine. it is caused by bacteria, and its manifestations are the results of bacterial growth in the body, chiefly in the smaller intestine. here the toxin produces a violent poison which results in an attack of fever, lasting about six weeks. owing to the bacterial growth, serious failings, commonly known as perforations, may develop after a severe attack, in the membranes and linings of the intestine, and the resulting inflammation is not infrequently the immediate cause of death. it is a thoroughly established fact that the disease is caused by a special type of bacteria and that if the bacteria could be killed outside the body, no transmission of the disease could occur. it is also true that if the disease germs could be destroyed within the body the patient would recover immediately, provided the toxins had not been already distributed through the system. there are, therefore, two possible methods of doing away with typhoid fever, one by eliminating all possibility of transmission outside of the body of the patient and the other by killing the germs while in the body of the patient. the latter plan is not feasible, since no antiseptic has been found which will kill the germs without killing the patient. it has been discovered that a drug called utropin will act on the germs when located in certain parts of the body, as in the kidneys; but this drug, although very effective in destroying germs in those organs, has no effect elsewhere. in general, we must eliminate the disease by preventing its transmission from the sick to the well. _the bacillus of typhoid._ unfortunately, the typhoid fever germ is comparatively hardy and is not so easily killed by unfavorable environment as is the germ of pneumonia, for instance. it lives in water and in the soil, although probably it does not increase in numbers in either place. nor will it live in the soil or in water indefinitely, and a great deal of study has been expended in trying to determine just how long typhoid fever germs will live under different conditions. it has been found, for example, that drying kills the typhoid bacillus in a few hours, although a few may survive for days. experiments have also shown that it cannot leave a moist surface. it cannot, for instance, jump out of cesspools and drains and take to flight through the air, conveying the disease. there is no possibility of contracting typhoid fever because a drain near the house is being cleaned out, since, so far as is known, the typhoid fever germ does not get into the air. the direct rays of the sun will kill typhoid fever germs within a few hours, although the value of this sort of disinfection is limited, because where typhoid fever germs are apt to accumulate, the turbidity of the water prevents the penetration of the sun's rays for more than a few inches. it has been found that a high temperature kills typhoid fever germs, and even so moderate a temperature as degrees fahrenheit is sufficient to destroy them. this is the principle employed in pasteurizing milk, since it is assumed, justly, that by raising the temperature of the milk to degrees fahrenheit, for ten minutes, it will be possible to kill any typhoid fever germs present. boiling, of course, since this involves a temperature of degrees, will kill the germs, and it is for this reason that wherever a water is suspected of typhoid pollution, it should be boiled before being used for drinking. it has been found that in distilled water, that is, in water where no available food is to be had, the germs will live about a month, and that in water with organic matter present, but without other bacteria, this period may be extended two or three times. in water rich in organic matter, but where other antagonistic bacteria are also present, the typhoid germs are usually driven out or killed at the end of three or four days. it is not unreasonable to expect that at least half of the germs discharged into a stream will live a week, and if the stream has a uniform current, so that the germs are continuously carried downstream, they will be found below the point of infection, a distance equal to that which the stream will flow in a week. this is important because it shows how unlikely it is that the germs once placed in water will die out or disappear without infecting those who subsequently drink the water. there is evidence that the typhoid germs, like all other germs for that matter, are likely to settle to the bottom of a lake or pond, and so a stream passing through a pond will lose a large part of the bacterial pollution with which it entered. this is not positive enough, however, to insure a good water-supply, since in the spring the heavy flow of the stream will wash this deposited material out through the pond, carrying the infectious matter downstream. in addition, the upheaval of the settled material from the bottom of the lake, which occurs twice a year on account of the variation in temperature at different depths, will bring the settled germs to the top. it has been found also that just as a high temperature destroys the germs, so a low temperature has the same effect. typhoid fever germs in ice are practically harmless after two weeks, and since in natural ice the impurities of the water are largely eliminated mechanically, so that frozen water is purer than the water itself, there is very little chance, even when ice is cut from a polluted pond, for typhoid germs to be found alive after being in an ice house for three or four months. in the ground, the life of the bacteria is longer, and while experiments do not agree very well as to the exact length of time that the germ may live there, there seems to be evidence that they may live several months, if not a year or more. cases have come under the observation of the writer which seemed to show that certain well waters were polluted by germs which could only have been deposited in the near-by soil nearly a year before the time of the consequent outbreak. entirely to deprive the germs of life, therefore, it is necessary, inasmuch as they are so widely distributed, to act promptly and at once disinfect the fecal discharges from the patient rather than to wait until those discharges have been thrown into a stream or onto the ground and then attempt disinfection. there is probably no more important thing in stopping the spread of typhoid fever than to practice carefully disinfection in the sick room, using bichloride of mercury and chloride of lime, as already described in chapter xv. since, however, such disinfection is not always practiced and since care must be taken to avoid the introduction of the germs into the system, it is well to know how, assuming that they have not been killed in the sick room, they make their way from that place to a healthy individual. _methods of transmission of typhoid._ there are three main avenues used by the germ, namely, water, milk, and flies, and of these three, the first is by far the most important and includes probably per cent of all the cases. the reason for this is twofold. first, that water is so universally used, and second, that it is so easily and generally polluted. there are many historic examples which show definitely that water once polluted by typhoid germs is able to spread the disease far and wide. the epidemic in ithaca, new york, is a good example and ranks as one of the most serious that this country has ever known. the water-supply of the city is taken from a small stream, six mile creek, which is a surface water with a drainage area of about square miles. the stream is polluted to a large extent. about persons live on the watershed, and there are many houses practically on the bank of the stream which runs for a large part of its course at the bottom of a valley with steep side slopes. at the time of the epidemic, , a dam was being built on the stream about half a mile above the waterworks intake, and while no proof of the fact could be found, it was generally supposed that some of the italians working on the dam were affected with typhoid fever and had polluted the water. however, there were on the banks of the stream, farther up, no less than seventeen privies, and it was known that there were at least six cases of typhoid fever during the season just previous to the epidemic. during the month of december, , a heavy rain occurred, so that any pollution on the banks would naturally have been washed down into the stream. on the th of january, the epidemic broke out through the town and by the middle of february there were some cases reported in a population of , . the number of deaths from this epidemic was , and there is reason to suppose that the number of cases was double the number reported by the physicians. after the water from the creek was shut off and after the citizens had been persuaded to boil all water used, the epidemic stopped and the installation of a filtration plant has prevented any recurrence of the epidemic. in , a severe epidemic occurred in lowell, massachusetts, and was traced to an infection of the river from which the city's water-supply was taken. this was definitely shown to have come from a small tributary of the merrimac river, and the particular infection responsible for the epidemic was traced to a small suburb named north chelmsford, where one case of typhoid fever occurred in a factory, the privy of which was located directly on the bank of the small tributary. in , an epidemic of typhoid occurred at newport, rhode island, through the pollution of a well, and about persons were affected, most of whom lived within a radius of feet of the well and all of whom used the well water. the well was a shallow one with dry stone sides and a plank cover, and surrounding the well were about privies, the nearest one only feet away. the water in the well was feet below the surface of the ground. it was found that a month before the epidemic broke out, there had been cases of typhoid fever in houses adjacent to the well, and that discharges from the typhoid patients found access to the privy vault which was only feet from the well. it was practically certain that the well was infected by the leechings of these privies, particularly from the one only feet away. [illustration: fig. .--spring infected by polluted ditch.] another example of the way in which underground waters, such as springs, may become contaminated is described by whipple as occurring at mount savage, maryland, in . through this village ran a small stream known as jennings run, which was grossly contaminated with fecal matter. in july, , a woman who had nursed a typhoid patient in another town came home to mount savage, ill with the disease. she lived in a cottage on the hillside above the stream, and the drainage of the cottage was conveyed through an iron pipe onto the ground just above the stream. figure (after whipple) shows the relative positions of the cottage and stream. heavy rains occurred during the first week in july which probably washed the infectious matter from the ground into the ditch and then through the ground into a spring just below down the slope. a week afterwards twenty workmen who had been drinking water from the spring came down with the fever and new cases occurred daily for a week or two. an interesting epidemic occurred in massachusetts, caused by a farmer's boots carrying infectious matter from recently manured fields onto the well cover, whence it was washed into the well by repeated pumping. the moral of these incidents is very plain, namely, that where any possibility of the infection of drinking water occurs, that water ought either to be avoided or else to be thoroughly sterilized before using. this applies particularly to the old-fashioned well,--the kind with loose board covers and chain pumps. _construction of wells in reference to typhoid._ two points already mentioned are essential if well water is to be kept pure. one is to line the well with a water-tight masonry lining, and the other point is to have the cover of the well made with a thoroughly water-tight coating. this does not always give full protection, since in some cases polluting matter may pass through even ten feet of soil. this would be particularly true if the well was in a fissured or seamed rock, and very recently the writer found a well dug in a laminated granite, where a near-by sewer, leaking at the joints, contaminated the water of the well, although the well was cased with an iron casing twenty-five feet deep. the sewage escaped into a crack in the rock and followed the crack down vertically and horizontally into the well. limestone is even more dangerous if any pollution exists in the vicinity. in cases where a well goes down to a horizontal layer of limestone and where a privy vault is dug to the same rock, it is found that pollution will follow the surface of the rock horizontally a long distance, and this condition of things always makes a well water suspicious. in sand or fine gravel, on the other hand, the danger of contamination is almost negligible; on long island, for example, the cesspools and well are both dug ten or fifteen feet deep and only fifty feet apart without any trace of contamination being detected. _milk infection by typhoid._ milk is responsible for perhaps per cent of the cases of infection. although the infection is always foreign to the milk itself,--that is, enters the milk only after the milk is drawn from the cow,--milk frequently becomes infected because infected water has been added to it or because the cans have been washed in infected water, or because some persons in contact with a typhoid patient have had their hands infected and then handled the milk or the milk utensils. there are a number of epidemics which have been clearly traced to milk polluted in one of these ways. in somerville, massachusetts, for example, in , cases occurred, of which were on the route of a single milkman. it was found that the milkman had two sons, one of whom had typhoid fever just before the outbreak. this son washed the milk cans and mixed the milk in a milk house in the city, and the inference was that in some way this man infected the milk, probably in one of the mixing cans. in stamford, connecticut, in , an epidemic occurred which caused cases and deaths. ninety-five per cent of all the cases occurred among those who took milk from one dealer, and it was probable that in this case the infection came from using a badly polluted water to wash the cans. in montclair, in , a small epidemic involving cases occurred, where the health officers decided, after having found out that the cases were all among those customers taking milk in pint bottles, that the infection came from a house on the route, where typhoid fever had occurred. it appeared that this family infected the bottles left at their house, and since the milkman failed to sterilize the bottles before re-filling them, the infection was passed on to others also taking milk in pint bottles. _infection by flies._ flies also transmit typhoid fever chiefly because they are essentially such unclean insects. they are born in filth and they delight in living in filth, and if privies and cesspools and manure piles and garbage piles could be shut out from flies, the fly pestilence would be at an end. the feet of the flies are suction tubes, and when a fly lights on any object, it causes more or less of that material to stick to his feet, and then when he flies elsewhere, he may leave the particles on the object on which he alights. this has been proved by allowing a fly, caught in the house of a typhoid fever patient, to walk over a gelatine plate, leaving on the plate not merely his tracks, but the germs which his feet had carried. when the plate was exposed in an incubator, it was found that, within two or three days, millions of bacteria had grown from the number deposited by the one fly. it is believed that the number of cases of typhoid which occurred in our spanish-american war, at the military camps, and which were so disastrous, were due largely to flies. among the , soldiers quartered in military camps at that time, there were , cases of typhoid fever, and the number of those which were fatal constituted per cent of all the deaths from disease during this campaign. it was shown by the commission appointed to investigate the matter that the spread of the disease was not due to water or to food, but in most cases to the direct transmission of the germs through the agency of flies. in the japanese and russian war, where in the japanese army of over a million men only deaths from typhoid occurred, strict measures were taken to do away with all the breeding places of flies, and major seaman, who writes most interestingly on the success of the japanese in avoiding typhoid, describes the ways in which the japanese soldiers made flycatchers of themselves and waged war against flies quite as actively as against the russians. _other sources of typhoid fever._ there are other sources of the disease; for instance, there have been a number of small epidemics undoubtedly caused by infected oysters. one of the unpleasant habits of the oystermen is to bring in oysters from the ocean and leave them for a few days in shallow water where they may plump up or fatten, and they have found by experience that this fattening occurs more rapidly in dirty water. if the oysters are fattened in sewage-polluted water, the typhoid germs get inside the shell in the oyster liquor and are thus transmitted to those persons who eat the oysters raw. some kinds of food may transmit the disease: lettuce and celery, for instance, if washed in contaminated water or handled by persons with unclean hands or perhaps fertilized with manure containing typhoid germs. finally, it is possible to acquire the disease by direct contact--not that the germs of typhoid are in the air in the room where a typhoid fever patient is lying, but rather that the nurse in some way soils her hands and then infects herself by putting her fingers in her mouth, or handles dishes or food afterwards used by other people, and so infects those others. it is not uncommon, for example, to see food partly consumed by a sick person given to children, or it may be that a child in the sick room is fed dainties prepared for the use of the patient. the result of such division of food is very apt to be a division of the sickness to the injury of the child. _treatment of typhoid fever._ so far as present knowledge extends, the disease is one best treated by being let alone, with some moderate modification. when germs have been swallowed and when the vitality of the individual is such that the disease is contracted (happily, as has already been said, only about per cent of those into whom the germ effects an entrance are inoculated), the first stage in the disease is a multiplication of the germs. this constitutes what is known as the incubation period, and lasts about ten days. during this time, the individual feels uneasy, has more or less headache and backache, and loses mental energy. the typhoid bacillus during this time spreads into almost every organ and tissue of the body, and towards the end of the period, when the resisting forces of the body have been proved unable to counteract the attack and the fever is well developed, the condition of the patient is deplorable. the bacteria are everywhere throughout the system, although they are especially active in the small intestines. this inflammation may produce ulceration and the blood vessels may be attacked, so that hemorrhages or even peritonitis may occur. a slight rash appears on the body, and a peculiar appearance of the tongue is to be found in severe cases. in from two to four weeks, the battle has been decided, and if the resisting forces prevail, the fever stops, and the patient begins to get well. this means probably, not that the bacilli are all dead, but that the patient has developed in his blood a sufficient antidote to the poison, so that the effects of the latter are no longer noticeable. the period of recovery, if the patient does recover, is most tedious, since the condition of the alimentary canal is such that great care must be exercised lest serious disorders there occur, and, although the patient is excessively hungry and really in great need of nourishing food, no greater folly can be committed than in allowing his desire for food to lead to indiscretion. injudicious exposure or fatigue will also cause a relapse, and while recovery is usually a simple matter, it is only so when under the eye of a judicious and careful nurse. the only treatment required is plenty of water for drinking, to make up for the enormous loss by perspiration from the skin, which helps to wash out the poisons from the body. then baths, where such methods of treatment can be used, as in hospitals, are also used both to lower the skin temperature and to add water to the surface. sponge baths in water or alcohol are valuable and in some cases tub baths with the temperature as low as degrees are used. then a proper diet to keep up the strength of the patient, liquids always, and usually milk, forms the only other treatment possible. no drug is of any avail, and uninterrupted watchful care is the only way of combating the disease. in concluding this chapter, it may be mentioned that certain army officers interested in medical work have discovered what they believe to be an antitoxin for typhoid fever, and they have inoculated hundreds of soldiers as a preventative. the results are not yet conclusive, but there seems to be great promise. it is hoped that the time may come soon when people will be so educated that there will be no opportunity of the germs escaping from the sick room, and that food and drink will be so cared for that there will be no possibility of infection. the writer feels that it is in these last two methods of prevention rather than in the use of antitoxin that the hope of the future lies. chapter xviii _children's diseases_ there are four diseases, scarlet fever, measles, whooping cough, and chicken pox, which are recognized as belonging preëminently to the period of childhood and which are supposed to be the result of bacterial contagion, although, curiously, the specific bacteria concerned in any one of these four diseases has not been detected. they may be rationally grouped together for two reasons. first, because of their attacking, in the majority of cases, children under the age of fifteen years, and second, because the first stages of these diseases are very similar, so that the recognition of them is not easy except for the practiced physician. it must not be thought, however, that because these are diseases of childhood and because a majority of children have them at one time or another, without great suffering and without serious after effects, they are on that account to be despised. scarlet fever, for instance, is to-day probably the most dreaded of children's diseases, not because so many children die of it,--although the death-rate is large, about per cent of the cases finally succumbing,--but because of the large number of complications and consequences which are directly due to this disease. measles, also, though not to the same extent, is frequently followed by serious after results. in the united states, about , children die every year of measles and about half as many die of scarlet fever. it is a significant fact that the death-rate is much higher among younger children, so that if, by carefully keeping children from the possibility of infection, the disease can be postponed until they are well along in years, the danger of fatal termination is much reduced. the following table, for instance, shows the number of deaths from measles and scarlet fever at different ages, and it is very evident from this table that if the former disease is contracted by a child under five years old, the danger of death is four times as great as if it were postponed until the child were ten years old:-- table xix. table showing deaths and percentages from measles and scarlet fever for different ages in united states registration area for ====================================+===================================== measles | scarlet fever ------------+----------+------------+-------------+----------+------------ | | per cent of| | | per cent of age period | number of| total | age period | number of| total | deaths | deaths | | deaths | deaths ------------+----------+------------+-------------+----------+------------ all ages | | | all ages | | under yr. | | | under yr. | | - yr. | | | - yr. | | - yr. | | | - yr. | | - yr. | | | - yr. | | - yr. | | | - yr. | | - yr. | | | - yr. | | - yr | | | - yr. | | under yr. | | | under yr. | | under yr.| | | under yr.| | over yr. | | | over yr. | | over yr. | | | over yr. | | ============+==========+============+=============+==========+============ the table shows also that the dangerous age period for scarlet fever is later than for measles. it indicates that while per cent of all deaths from measles are of children under five years of age, only per cent of the deaths from scarlet fever are in that period; but that the number of deaths of the latter between five and nine years is so great that the percentage of deaths under fifteen is the same in both cases. the moral is plain, namely, that a child should be carefully protected from infection by measles until he is five years old and from scarlet fever until fifteen, if the danger to the child's life is to be reduced to a minimum. _after effects of scarlet fever and measles._ in themselves, these diseases may not be severe, children often having mild attacks of scarlet fever, called scarletina, and apparently suffering only from a cold, but exposure, by which a cold is developed either during or after the disease, may lead to serious troubles. inflammation of the kidneys often occurs, which may develop into chronic bright's disease and ultimately cause death. inflammation of the ear is another incident of scarlet fever, in which abscesses are formed, resulting not infrequently in permanent deafness. the consequences of measles are not so serious usually, and a more common after effect is trouble with the lungs or bronchial tubes. pneumonia, croup, and bronchitis very often follow measles, due, as already indicated, to exposure before the body has regained its normal condition. in both scarlet fever and measles the eyes are apt to be affected, and it is very important in both diseases to keep the patient in a darkened room and to forbid use of the eyes in reading or other close work. on account of the complications following scarlet fever and measles, as well as for their greater death-rate, these diseases are more serious than the other two included in this discussion,--whooping cough and chicken pox. _preliminary symptoms._ the beginning of each of these four diseases is much the same, and the symptoms are likely to be mistaken for those of an ordinary cold. in all of them, the first indication of illness is redness and itching on the inside of the nose and throat with snuffling and discharging from both eyes and nose. sometimes the throat is affected, and the patient complains of sore throat. then the cheeks become flushed, headache may follow, and fever begins, so that the patient is in a sort of stupor, unwilling to do anything and glad to lie in bed. in severe cases vomiting may accompany or precede the outbreak of fever. at the outset, the probable reason for the similarity of these four diseases as well as their likeness to a common cold is that the germs responsible for all of them enter the body through the nose and throat and begin their attack upon the membranes there. the action of the germ is followed by the formation of poisons or toxins which are distributed by the blood through the body, causing the fever and what are known as "general symptoms." at the beginning it is not possible to determine to which particular germ the distress of the patient is due, and probably the continued prevalence of these diseases is chiefly owing to the fact that in the early stages and in mild cases throughout, the sufferer is allowed to be at large with every opportunity for spreading the disease. _contagiousness._ if, whenever a child has a cold accompanied by a fever, the mother would promptly put him in bed in a room by himself, keeping the other children of the family away from the sick room and the invalid under restraint until all possibility of transmitting the disease is over, the number of cases would be greatly diminished. unfortunately, there seems to be a general impression that such precautions are useless, and that sooner or later every child must have these children's diseases. this is a mistaken notion, and the table already referred to is sufficient evidence to prove the error of this way of thinking. all these diseases are affections of the whole body, caused by poisons generated by germs, for which so far scientists have found no antidote. the reason is plain. the germ itself is not known, and no animal has been discovered on which scientists can experiment. if we could only produce measles in a rabbit, for instance, we could very soon detect the germ and would no doubt be able to procure an antidote to the measles poison. but this has not been done, and therefore in measles and in the other diseases mentioned we can only hope that the sick person will be able to generate in his own body sufficient antidote to secure his own recovery. physicians therefore are almost helpless in treating these diseases. they keep the patient in bed in order that all his strength may be kept for fighting the disease. they insist on ventilation in abundance, so that oxygen may be applied to the lungs in large quantities in order to neutralize the poison. they advise sponge baths in cold water and alcohol to allay the fever, and they prescribe nourishing, easily digested food, such as milk, eggs, fruit, and plenty of water to drink. in the hope of diminishing the chances of infection, particularly in measles and scarlet fever, they recommend antiseptic sprays for the nose and throat and antiseptic ointments, such as carbolized vaseline for the skin when peeling or desquamation is going on. _quarantine for scarlet fever._ scarlet fever, while the most violent, is also the shortest lived, in the majority of cases not more than three or four days, although the full period of recovery is much longer. the peculiarity of this disease lies in the abundant peeling which takes place usually from the entire body and particularly from the hands and feet; in fact, in a number of cases where the disease is light, the peeling from the hands and feet is the only positive proof that the malady has been scarlet fever. during this process of peeling contagion seems most active; therefore, although recovery seems entire so far as the fever is concerned, the patient should remain strictly isolated during this time. it is a slow process, lasting from two to five weeks, and is very tiresome for the child who feels perfectly well; yet, in the interests of other children, the child must be kept strictly at home until at least a week after the last sign has disappeared. it is also for the child's own sake very desirable to observe this quarantine, since it is during this period of recovery that most of the complications of scarlet fever occur, and if the patient is kept under observation, either in his sick room or on some porch where atmospheric exposure is not too great and where the child is certain to eat nothing harmful, the chances for avoiding lung troubles and digestive disturbances are minimized. there is such a striking difference in the severity of cases of scarlet fever that the name "scarletina" was for a long time applied to mild cases with the feeling that possibly it represented an altogether different disease. at the present time the disease is more intelligently diagnosed, and while there is vast difference in the severity of the sickness, it is all the same thing. of the ordinary cases, about per cent terminate fatally; that is, in a village or a community where a hundred cases occur, there would be five deaths. if the epidemic, however, is of the severe form, a larger percentage of deaths occur, often reaching per cent of those affected. it has been noted that as an epidemic progresses, the disease becomes more serious, and a death-rate of only per cent may, in the course of an epidemic lasting several months, gradually increase to one of or per cent. for this reason strong efforts ought to be made to stamp out an epidemic while it is in the first stages. besides the possibility of contagion from the skin as it comes off, to prevent which the antiseptic ointment is used, contagion also occurs through clothing used in the sick room. in fact, the contagiousness of scarlet fever is probably as malignant as any other infectious disease. it has been observed that a year after a case of scarlet fever in a house, the unpacking of a trunk or the unrolling of a bundle would set free the contagion and would result in new cases of the disease. the writer learned recently of a family in which a child had died of scarlet fever and some of its clothing had been packed away in the attic. a younger sister grew up, married, moved away, and some twenty years after the death of the child, came back to her former home on a visit with her own little girl. the grandmother, visiting the attic, found the clothing packed away so long before, gave it to her grand-daughter to wear, and in ten days the child was dead with the same disease. there are a number of cases where scarlet fever seems to have been carried by infected milk, and great care must be taken on dairy farms to avoid any possibility of this kind of infection. to prevent the disease being transmitted after apparent recovery, thorough disinfection should be practiced. the patient's body should be very carefully and completely and continuously covered with antiseptic ointment which prevents the distribution of the contagion in small particles of skin. the sick room, after the patient's recovery, should be thoroughly disinfected, and all bedding steamed or boiled. all the surfaces in the room should be washed with a solution of carbolic acid, in , or corrosive sublimate, in . _measles._ if the disease is measles, one may expect a general epidemic, since its power of direct contagion is nearly equal to scarlet fever, although the fatality is much less. it is unfortunate that so little pains are taken to prevent the spread of this disease and fortunate that, except in the case of very young children, the effect of the illness is only a temporary inconvenience. curiously, however, if measles attacks savage tribes where it has been before unknown, the severity of the disease is very great. cases are on record where measles have broken out on the frontier and whole villages were wiped out; where the insignificant measles, so innocuous in civilized communities, became a plague similar to a scourge of the middle ages. it apparently has been modified by its passage through generations of individuals, just as any bacterial disease germ is modified by successive transmission through the bodies of different animals. when, however, the disease breaks out in a community which has not suffered from the disease for many years, it is, on that account, likely to appear in a far more virulent form. _characteristic eruptions of measles._ measles, like scarlet fever and chicken pox, is an eruptive disease; that is, is accompanied with a rash, differing slightly in the three diseases of which the presence of the rash and its progress over the body is one of the distinguishing features. in scarlet fever, for instance, the rash appears first on the neck and chest or back and spreads outward to the extremities. in measles, the rash appears on the extremities, beginning on the face usually, and spreads to the chest and trunk. in scarlet fever, this rash appears as fine scarlet pin points scattered around on the reddened skin, and on the second or third day the entire body may look like a boiled lobster. in measles, the rash appears as blotches, while the skin is not flushed but retains its natural color. in chicken pox, the rash appears generally on the body first and consists of small red pimples which develop into whitish blisters about as large as a pea and well separated. they are much more distinct and separated than the rash of scarlet fever and measles, and are much more likely to be mistaken for smallpox pustules than for an ordinary eruptive rash. one of the old-time fancies connected with these eruptive diseases is the belief that an abundant eruption is a sort of guarantee against the severity of the disease. the old nurse was careful to keep the child in bed, well covered, steamed in fact, until the eruption appeared, and it was commonly thought that nothing should be done to check the rash or to prevent its coming out. this is not sustained by later science, and the appearance of the rash, whether it strikes in or strikes out, has nothing to do with either the disease or with its severity. no possible connection can be traced between the dissemination of the poison through the system by the action of the bacteria and the appearance of the skin, which is a minor factor in the disease. it may be worth while to repeat that the greatest danger from measles consists in the possibility of lung complications, and infinite care should be taken to keep the patient shielded from drafts and free from overexertion until recovery is complete. like scarlet fever, the skin peels off, although not to the same extent, and the small particles are capable of transmitting the disease. probably, also, the secretion from the nose and throat will transmit the disease, so that it is the height of folly to allow a sick person to use a handkerchief, for example, and then to use the same handkerchief to wipe the baby's nose when he comes into the sick room. all dishes and clothing of every sort should be boiled or steamed, and to be rendered harmless they should be soaked in a disinfecting solution before being taken from the sick room. the room itself, after being vacated, should be disinfected and the walls washed, as already prescribed. _whooping cough._ whooping cough is unlike the other three diseases in that it is a nervous trouble, and probably the germ or the poison formed by the germ attacks the nervous system, and particularly one great nerve connecting the lungs and stomach. this is why the spasm of coughing is frequently followed by vomiting, and the only remedy which is of value in whooping cough is a nerve depressant which will diminish the activity of the nervous system without at the same time interfering with the strength or vigor of the patient. on account of this connection between the lungs, whose spasmodic ejection of air seems to threaten the entire collapse of the little patient, and the stomach, so alarming do the repeated fits of vomiting appear that often this feature of the disease is even more serious than the coughing, pathetic as it is with younger children. in some cases the stomach cannot retain nourishment long enough to feed the body, and the child literally wastes away unless the period of the disease runs out before the child starves to death. it is often weeks instead of days before the disease can be recognized. then, if it develops in its usual form, begins the coughing so characteristic of the malady and the hard straining whoop so painful to listen to. occasionally this coughing may be severe enough to cause a rupture of a blood vessel; but ordinarily, unless the stomach is affected by sympathy, no great danger need be feared. fresh air, moderate exercise, good food, and some mild nerve depressant is all that can be done. the disease is very contagious and is usually transmitted directly from the sick person to the well person. it may, however, be carried in clothing, particularly in handkerchiefs and towels. like measles, if it gains a foothold in an uncivilized community, it attains the size of an epidemic or plague with very fatal results. it seems to have a great power over girls and children, particularly those whose vitality is below the normal. like measles, one does not generally have two attacks of this disease. in the winter, and this is the time when the whooping cough is most common, it is often followed by lung troubles, such as bronchitis and pneumonia. the death-rate from whooping cough is as large as from scarlet fever and measles combined, but chiefly because the disease is common among the smallest children. it is not unusual for babies under a year old to have whooping cough, and when their vitality is low, they scarcely ever recover. _precautions against spread of whooping cough._ probably the disease does not become contagious until the cough starts, and there is no reason why the disease should not be arrested in the first victim, provided proper isolation is practiced. the idea of a child with whooping cough, even when he whoops only once or twice a day, being allowed to attend school and mingle with the other scholars and to distribute the disease among them seems in these days of sanitary knowledge almost criminal. as soon as the first whoop occurs the child should be put in a room by himself and kept there until the last whoop has been whooped, and no other child should be allowed to go into the room, and the nurse or mother who is in charge should be careful about contact with other children after coming from the sick room until she has changed her outer garment. a big apron with long sleeves, fitted closely around the neck, which may be slipped on and off easily, is an admirable protection. the same precautions about disinfecting dishes, napkins, towels, handkerchiefs, and bedding should be observed here as already referred to. _chicken pox._ chicken pox is the mildest of eruptive diseases. it has no relation to smallpox, so that the theory sometimes held, that an attack of chicken pox prevents any attack of smallpox later, is a mistake. instances are on record where a person has had both diseases almost at the same time. the appearance of the eruption is the characteristic feature of this disease, and it is so well distinguished that there is no danger of failing to recognize it. it is not common in grown people, and while it should not arouse suspicion in children, it is so uncommon in adults that a suspected case is probably a mild case of smallpox, and should always be quarantined as such. with children, the accompanying cold and fever is often very mild, so that the appearance of the rash is the first and only symptom of the disease. the eruption is a progressive thing, each day's crop coming to full bloom and dying out as the next day's crop develops. this is, by the way, a distinguishing characteristic of this disease, differentiating it from smallpox where the pustules are more persistent and where the breaking out is more general. the pustules are sometimes extremely irritating, and it is very hard to keep children from scratching, the results of which may leave deep scars and so should be avoided. an antiseptic ointment should be used as with scarlet fever and measles, carbolized vaseline being suitable, although sometimes a strong solution of soda is substituted. it is not common to disinfect in chicken pox to the same extent as in the other diseases, the contagion being apparently in the air rather than in clothing and short lived. in new york state, in , no deaths are recorded from chicken pox, and it is because of this lack of fatal results that the disease is regarded so indifferently and no particular pains taken to prevent its spread. chapter xix _parasitical diseases (malaria, yellow fever, hookworm, bubonic plague, and pellagra)_ _malaria._ from time immemorial, malaria (or fever-and-ague) has been one of the great plagues of humanity. no advance outpost of civilization but has suffered, more or less severely, from this disease. dickens, in one of his novels, describes graphically the disease as it existed in the early american settlements, and vividly portrays its ravages, both mental and physical, among the pioneer settlers. certain sections of the world have been especially noted for the prevalence of this disease, making extensive regions practically uninhabitable. the vicinity of rome, with its swampy marshes and low-lying areas, has been one of these plague spots. the jungles and swamps of the equator and the coastline of africa and south america and the valley lands of the mississippi river have all been noted as most dangerous districts for human beings to live in. even in civilized communities the ravages of the disease have, under conditions most conducive to malaria, been fearful, so that only most urgent requirements of mining, manufacturing, or similar material processes have prevented the obliteration of entire communities. the cause of the heavy death roll resulting from a bold defiance of the reputation of these localities--a defiance bravely adopted by hardy pioneers, by agents of trading companies, and by representatives of governments--has been, up to the last ten years, assigned to the water-laden condition of low-lying ground. swamps and stagnant pools, moisture-laden air, and a hot climate have been universally considered to be the cause of the fever, and the transmission of the disease has been supposed to be due to the passage through the moist air of the germs of the disease, although the exact form and behavior of these germs was unknown. certain specifics have been proved by experience to have some value. for instance, it has been found that planting a row of trees between the house and a pool from which malaria might come has been of aid in warding off the disease. in a number of cases a thick row of eucalyptus trees, so associated in the popular mind with this purpose that they are known as the malaria tree, have been planted as a tight hedge with apparently very useful results. drainage or filling up the low lands has always been found to reduce the prevalence of the disease. many years ago the use of quinine in large doses was found to be a specific, and the writer well remembers, on the occasion of his visit to a malarial region, buying quinine at the grocery store by the ounce in the same way that one would buy spices or tea, the dose being a teaspoonful. why quinine should prevent the daily or periodical chills characteristic of the disease was not known, or why a row of eucalyptus trees interfered with the development of the disease was not known, and people generally were content to rest with the knowledge of these facts only. _mosquitoes and malaria._ [illustration: fig. .--resting positions for ordinary mosquito (left) and malarial mosquito (right).] in the year , however, english scientists, working in the roman campagna, demonstrated conclusively that which had been vaguely suggested before, namely, that the cause of malaria is a parasite composed of little more than an unformed mass of protoplasm, not floating in the air at all, but transmitted only by the bite of a mosquito. by a series of most interesting experiments, conducted by them and by other scientists in other parts of the world, it has been definitely proved that when a mosquito bites an individual suffering from malaria, the mosquito draws up into his body, along with the blood of the bitten person, some of the malarial parasites. in the body of the mosquito, the parasite develops, requiring for a full-grown specimen about seven days; then, if the mosquito bites another person, the parasite is injected into the skin of the victim, and in the course of about a week a good case of malaria ensues. fortunately, only a small proportion of the number of mosquitoes in the world are capable of nourishing the malaria parasite. under ordinary conditions about per cent of all mosquitoes found are malarial, and a particular name has been given to those capable of transmitting the disease. the ordinary mosquito is known as the "culex," while the malarial kind is known as "anopheles." figure shows the characteristic attitude of the two kinds by which the one can be distinguished from the other when resting on a wall or ceiling. as will be noticed in the drawing, the culex carries his body parallel to the wall with his hind legs crossed over his back. the harmful mosquito, the female anopheles, always hangs on by her front legs and has her body at an angle of about forty-five degrees to the surface to which she clings, her hind legs hanging down. the wings of the harmless mosquito are usually mottled, while the wings of the malarial mosquito are of an even color. the details of the behavior of the parasite on its long journey from the original malarial patient through the body of the mosquito and into the body of the person bitten is full of interest to the scientist, who must, however, be provided with a good microscope to follow such minute bodies; but the methods of avoiding the disease are more pertinent to our present purpose. while quinine is still recognized as the particular antidote for the malarial poison, efficient as we know now because it is poisonous to the parasite and not because it has any particular effect on the person, of late years more and more stress is being laid on the elimination of the mosquito. naturally, if the mosquito can be destroyed and the transmission of the disease thus prevented, there will be no further need of quinine. the general impression that swampy land is favorable to the development of malaria is correct, but not because the damp air is itself pernicious. the significance of the damp ground lies solely in the fact that mosquitoes in one stage of their existence require water for their development. they breed only in water and always deposit their eggs in water, on the surface of which the eggs float in very small layers. the eggs hatch into larvæ or wrigglers, which also must remain in water for development, and it is not until the third stage, that of the full-grown mosquito, that the animal leaves the water which was his birthplace. obviously, therefore, if there is no water there can be no mosquitoes. _elimination of mosquitoes._ another pertinent fact discovered by scientific research is that the development of the malarial mosquito is confined to the vicinity of stagnant pools, because in fresh water, where fish are to be found, the eggs and larvæ of the mosquito are a most acceptable fish food. one of the most practical ways, therefore, of getting rid of possible mosquitoes is to make sure that the pond always contains a number of fish. woods hutchinson gives the following interesting description of the way this fact was discovered:-- "it was early noted that mosquitoes would not breed freely in open rivers or in large ponds or lakes, but why this should be the case was a puzzle. one day an enthusiastic mosquito student brought home a number of eggs of different species, which he had collected from the neighboring marshes, and put them into his laboratory aquarium for the sake of watching them develop and identifying their species. the next morning, when he went to look at them, they had totally disappeared. thinking that perhaps the laboratory cat had taken them, and overlooking a most contented twinkle in the corner of the eyes of the minnows that inhabited the aquarium, he went out and collected another series. this time the minnows were ready for him, and before his astonished eyes promptly pounced on the raft of eggs and swallowed them whole. here was the answer at once: mosquitoes would not develop freely where fish had free access; and this fact is an important weapon in the crusade for their extermination. if the pond be large enough, all that is necessary is simply to stock it with any of the local fish,--minnows, killies, perch, dace, bass,--and presto! the mosquitoes practically disappear." [illustration: fig. .--top view is of larva of anopheles. bottom view is of larva of culex.] another factor in the development of the mosquito from the egg to full-grown mosquitohood is that in the larvæ stage air must be supplied, curiously enough, through the tail which projects slightly above the surface of the water as the larvæ hang head downwards (see fig. ). if the surface of the water is covered with some impervious material, the mosquito larvæ will be suffocated, and it has been found that oil lends itself most readily to this desirable purpose, applied at the rate of one ounce per fifteen square feet of water surface. the oil spreads out over the surface in a very thin film, but persistent enough to keep off the air supply from the mosquito larvæ. this method, about which much has been written and said, is perhaps the one most commonly employed, and its results have been most satisfactory. in the vicinity of the city of newark, new jersey, for instance, is an area of about acres, miles long and about miles wide, practically all marshland. in ditches were dug throughout this marsh in such a way that the surface water was drained off, drying the ground so that hay can now be cut where formerly rubber boots were necessary to get onto the ground at all. the consequence has been that the mosquitoes have practically disappeared from this region, formerly frightfully infested, and the cost of the miles of small ditches dug has been amply repaid by the freedom from malaria as well as from the nuisance of the ordinary mosquito. other campaigns have been waged, using kerosene or crude petroleum for the coating of ponds or pools. wherever clear water exists the kerosene treatment is probably best. where marshland is found, through which the kerosene penetrates with difficulty, drainage is a more useful method. the size of the pools required for the development of the mosquito is very small. thousands of mosquitoes may be formed in the amount of water contained in an old tomato can, and barrels half full of rain water or pools of water in the vicinity of an old pump or in the barnyard will afford golden opportunities for mosquitoes looking for a place to lay their eggs. while the ordinary culex requires from one to two weeks only for the complete transition from egg to mosquito, so that a pool filled with rain water and not dried up within that period will be sufficient to develop a brood, the malarial mosquito requires much longer--two or three months--for the full completion of her development. it is, therefore, a simple problem for an individual householder to search out the pools which remain filled with water for a period of two months, and either stock them with fish, drain them entirely, or coat them with kerosene. no hesitation need be felt about the result of this treatment. it will positively eliminate all malaria in the vicinity if the work is thoroughly done. _limitation of mosquito infection._ the distance that the malarial mosquito can fly is of interest as indicating the distance which one must go from a house, hunting for available pools. all mosquitoes are unable to fly against the wind, so that, as already noted, one side of a swamp may be comparatively free from malaria, while the other side may be overrun with it, merely on account of the direction of the prevailing winds. some mosquitoes that breed in salt marshes may be carried for miles, so that a land breeze will bring millions of the pests to seashore cottages which, with a sea breeze, are quite free from them. the anopheles has a habit of clinging to weeds, shrubs, and bushes when the wind blows, so that it is seldom carried more than about two hundred yards from the place where it is hatched. if all pools of water, therefore, within this radius are disposed of, the elimination of malaria will logically follow. if one is obliged to be in a region where malaria is common, the disease can be avoided absolutely by protecting one's self from mosquitoes, and since the anopheles prefer the early morning and evening hours, it is at those times of the day particularly when precautions must be taken. it was once thought that the night air caused malaria, and this had some foundation in fact, because it is in the early evening that the anopheles is on the wing. by staying in the house after sundown and by carefully screening the doors and windows, one may live in a malarial country with perfect immunity. volunteers have lived for months in the worst malarial regions in the world without a trace of the disease, the only precaution being to keep the doors and windows screened and to prevent mosquitoes from biting. an interesting experiment was made some years ago by sending a malarial mosquito by mail from italy to england, where an enthusiast allowed himself to be bitten by the insect. he had had no trace of malaria before, but a week after the mosquito's bite he came down with the disease. it has also been noted that in such parts of the country as greenland and alaska, where mosquitoes are as thick as in the far-famed new jersey marshes, malaria does not result from the mosquito bites unless a malaria patient from other countries starts the infection. the disease itself may be mild or severe. it takes about a week after the mosquito bites before the symptoms appear, and sometimes the attack is postponed for weeks or months. chills are the usual accompaniment of the disease; in children under six, convulsions are more common. the chill lasts from a few minutes to an hour, and directly after the chill comes the fever, which lasts three or four hours. the attacks usually occur every other day and sometimes every two days, generally at the same time of day. when persons have lived for a long time in malarial regions, the intermittency of the chill and fever is less noticeable and the continuous character of the fever often leads the disease to be mistaken for typhoid. the intermittent regularity of the fever, however, although between attacks the temperature never falls to normal, distinguishes this type of malarial fever from true typhoid. the positive determination of the disease is possible by an examination of the patient's blood, in which the malarial parasite can readily be found. quinine is the remedy and the only remedy, and, fortunately, it does no harm, even before the character of the disease is positively known. the chill seems to be due to the development of a new brood of parasites in the blood of the malarial patient, and in order that the quinine shall have its effect on the blood, it must be swallowed three or four hours before the time of the expected chill, and then it will probably prevent, not the next chill but the one after. if the quinine cannot be taken directly with reference to an expected chill, then it must be taken regularly, sometimes for months before the chills cease. _yellow fever._ yellow fever, although not common in this country, is interesting as being almost exactly similar in its mode of infection to malaria. it is transmitted through a parasite, as is malaria, and can only be passed along through the agency of another kind of mosquito, known as stegomyia. in there was a serious outbreak of this pestilence in the cities of our southern coast, and the terrors of the plague of the middle ages were revived for a number of months. trains going out of the infected regions were stopped by crowds armed with guns and the passengers prevented from proceeding, lest the disease might spread. no goods or freight were allowed to pass out from the infected area, and the prejudice against intercourse with the outside world went so far that guards even forbade the carrying of disinfectants to the victims. like malaria, the disease is one requiring a hot climate, generally because it is favorable to mosquito growth. it is most common in the seacoast cities of the south, and is probably transmitted often by mosquitoes brought on board ship. since havana has been cleaned up by americans, the danger formerly existing from intercourse with that city has ceased, although only three years ago the writer stopped in a hotel at havana, where two persons had died of yellow fever a week before. the smell of disinfectants in the hotel was so great that not a fly or insect of any sort was visible, and no other hotel in the city could have been safer or more comfortable. it has been proved positively that yellow fever cannot be transmitted by direct contact, since, in the interests of science, volunteers have slept in beds from which the dead from yellow fever had just been removed without contracting the disease. that the infection is due only to mosquitoes is proved by the fact that later, when bitten by mosquitoes, they succumbed to the disease. it requires about two weeks for the disease to pass through its regular stages in the body of the mosquito, so that there is no possibility of its transmission for that time after the mosquito has come in contact with a yellow fever patient. the symptoms of yellow fever are characteristic and very severe. the eyes first become bloodshot and, in the course of two days, yellow, whence the name of the disease. severe vomiting is also characteristic, the discharge being sometimes discolored like coffee or even tar and known as black vomit. the skin appears yellow, a condition which lasts for some time and is particularly noticeable if by the pressure of the finger on the skin the blood is made to recede. among persons previously in good health, the death-rate is about that of typhoid fever, but among those in unfavorable surroundings and among those given to the use of alcohol, the rate will be much higher. practically, it may be expected that this disease, like malaria, will disappear from the face of the earth. when the only requirement is the destruction of the mosquitoes and when mosquitoes can be so easily killed as already explained, it is only a question of time before mosquitoes and the diseases they cause will be stamped out. in havana, before , the number of the deaths yearly was about . in the year after the american intervention, when colonel gorgas, by military command, insisted on the thorough cleaning of the houses and the general use of kerosene in all drains and cesspools, there was not one single death. _hookworm disease._ the third parasitical disease common in some parts of the united states has received much attention during this last year and is known as the hookworm disease. it is a new discovery in medical science, and whereas the physical condition of the victim is usually a clear indication of the disease, a positive diagnosis is always obtained by the use of the microscope. several years ago it was announced in the united states that the laziness and shiftlessness of the poor whites living in the sand lands and pine barrens of the south was due, not to any inherent cussedness but to the presence of a parasite in the intestine, known in italy and germany as the hookworm, the disease being called uncinariasis. the development of the disease is interesting. the worm, which is about an inch long and looks not unlike a bit of thread, lays eggs by the thousand in the intestinal tract of a human victim. afterwards they pass out in the excreta and, favored by heat and moisture, develop in the soil in about three days into minute larvæ. these larvæ have a most extraordinary power of attaching themselves to and penetrating into the human skin and body. they may also enter the human body in a drink of water or on unwashed vegetables. in infected regions the soil becomes fairly alive with these larvæ, and it is hardly possible for a child to walk barefoot outdoors without becoming infected. when the larvæ have penetrated the hand or foot, they begin a long and circuitous journey through the body, moving from the extremities through the veins to the heart and thence to the lungs. from here they are carried through air cells into the bronchial tubes, thence along the mucous membrane up the windpipe and down into the stomach and finally, from the stomach, they pass out into the intestines, the goal of their long journey. this all takes time, and probably from the time they enter the skin to the time they begin their murderous work on the lining of the intestines requires about two months. in the intestine the larvæ develop into adults; but before this final stage an intermediate existence is reached, at which time they attach themselves to the mucous lining and bore into it, presumably for the purpose of making a nest in which later to lay their eggs. the burrowing parasite causes a great loss of blood, and it is on account of the resulting anæmia that the poor whites show always such incapacity, indifference, and apparent laziness. that this disease is of importance in considering the hygienic condition of the country is apparent when it is pointed out that in the southern part of the united states, chiefly in the rural districts, there are at least two million persons at present infected with the disease, and that should these hookworms be blotted out of existence, two million incapables would be changed into two million active americans, ready to raise the southern districts to a commercial elevation which their natural resources seem to justify. the treatment of the hookworm disease is simple, and the donation by mr. rockefeller of $ , , is intended to be sufficient to furnish the opportunity at least for a complete cure of all the cases. it has been found that a small dose of a preparation of thyme known as thymol stupefies the parasites with which it comes in contact, so that they unloose their claws and are set free in the intestine after its use. a dose of epsom salts shortly after clears them out, and except for the loss of blood, the disease is finished. sometimes, however, in long-continued cases the worms have penetrated so far into the membrane that the use of thymol cannot withdraw them. in fact, in autopsies, it has been found necessary to take tweezers and to use considerable force in order to pull them out. the prevention of the disease is really the cure of the disease, an apparently simple matter, as already described. an improvement of sanitary conditions so as to make impossible further pollution of the soil should be also undertaken. wherever the disease has prevailed in this country or in europe, it has been because of an utter neglect and disregard of what are now known as ordinary sanitary conveniences, and the report of the country life commission, although many charges were made against the conditions of living in different parts of the country, was far from telling the whole story in the matter of the shortcomings in parts of the southern states. there is, therefore, every reason why the farmer and others living in the country should be urged to make themselves comfortable with all known modern sanitary appliances. this is desirable, first, for the sake of others on whom their sins of unhygienic living might be visited, and then for their own sake, because there such sins would also have an effect to a degree tenfold more severe. _pellagra._ another disease peculiar to country life, and which has only within the last few years been recognized, is known as pellagra. not yet is it even known through what agency the disease is transmitted, but it has been beyond question established that in some way corn is responsible for its spread. apparently, spoiled corn is necessary, and while presumably the corn itself is not the agent, the parasite or organism that is responsible lives only on corn which has been spoiled. scientists have long worked on the disease, and it would be a merely speculative pursuit, one of interest to scientists and medical men only, except for the fact that within the last few years it has broken out in this country and is increasing to a most alarming degree. the disease itself is almost hopeless when once established, physicians being yet utterly unable to grapple with it; and while in italy, spain, and egypt it has been known for a century, there is still a death-rate of over per cent, and these deaths occur after most horrible suffering and agony. as in rabies, the parasite, if it is a parasite, acts through a poison which penetrates to the nervous centers, producing mental disturbances culminating in an active insanity. at the same time, the agent attacks the skin, whence its name "pell'agra," which means "rough skin," so that the body appears as if it were affected with a severe attack of eczema, large patches of skin peeling off and leaving the raw surface. in fact, in one of the illinois hospitals, only a few years ago, some insane persons, infected with this disease, died, and because the effect of the disease on the skin was not known, the nurse in charge was accused of scalding the patients with boiling water, the appearance of the skin being the only proof. the nurse was discharged, although, without doubt, she was innocent, and the appearance of the skin was due solely to the disease. it has been estimated that there are at present in the united states five thousand victims of pellagra, with the number constantly increasing, although physicians of standing make estimates largely in excess of this. apparently preventive measures must consist in eliminating the possibility of the use of spoiled corn. indications are that the disease appears only when such corn has been used, and in parts of mexico where corn is always roasted before being used, pellagra is never known. it has been described as a disease of the poor, because the disease has flourished chiefly in districts where poverty is so extreme that corn, and spoiled corn at that, is the only food within reach. usually, where a mixed diet with meat is possible, pellagra never appears. in other places, as in italy, where the peasants live on a porridge of corn meal cooked in great potfuls, a week's supply at a time, and during the week exposed to dirt and flies and often spoiled before eating, pellagra is most common. experiments have shown that in these districts, by excluding corn from the diet and furnishing a substantial fare, the disease has been banished. unfortunately, the taint of the disease passes from parent to child and even to the third and fourth generation, and the physical deformities commonly seen in pellagrous districts are due to this hereditary taint. dr. babcock, superintendent of the city hospital at columbia, south carolina, after discussing the disease, sums up by saying, "pellagra is a fact, and the united states is facing one of the great sanitary problems of modern times." _bubonic plague._ the bubonic plague, or "the plague," as the importance of the disease has caused it to be called, is one of the oldest of known epidemics. in the third century it spread through the roman empire, destroying in many portions of the country nearly one-half of the people. its immediate origin is a bacillus causing symptoms similar to blood poisoning, although in some cases, where the lungs are attacked, the disease has some of the characteristics of pneumonia. a description of this disease is included here because, while bacterial in its nature, it is transmitted largely, if not entirely, by fleas and by a particular species of flea known as the rat flea. these fleas harbor the plague bacilli in their stomachs and inject them into the bodies of those they bite, in the same way that the anopheles or stegomyia mosquito transmits malaria or yellow fever. elaborate experiments made in india in show conclusively that close contact of plague-infected animals with healthy animals does not give rise to any epidemic, so long as the passage of fleas from infected to healthy animals is prevented. when opportunity, however, was given for fleas to pass from one animal to another, the bacillus and the disease was generally carried over. it has also been found that while this species of fleas have their normal residence on the body of rats, they will also desert a rat for man, if the infected rat is dying and no healthy rat is in the vicinity to receive them. it is, then, obvious that to eliminate the disease, the most direct and positive course is to destroy the rats which are the home of the disease. in india, where the plague appeared in , causing about deaths, it rapidly increased in virulence until in it caused , , deaths. the ports of the pacific coast became much alarmed, and when cases of the disease were actually found in san francisco in , the matter was so terrifying that the united states marine hospital service was at once instructed to stamp out the disease if possible. this procedure was directed almost entirely against rats. deposits of garbage on which rats might feed were removed, rat runs and burrows were destroyed and filled in, and stables, granaries, markets, and cellars where rats might abound were made ratproof by means of concrete. rats were trapped and poisoned by the thousand, nearly a million being thus disposed of. as a result of such thorough work, the plague was stayed, and in not a single case of the disease among human beings was found, and although , rats captured were examined, only four cases of rat plague were found. in southern california, however, the fleas deserted the rats for ground squirrels, and one county in particular, contra costa county, had an epidemic which caused the squirrels to die by the thousands. the attention of the scientists was thus turned to the squirrel as a host of the flea, and a warfare similar to that against the rat has been for a year past carried on against the infected squirrels. between september , , and april , , ground squirrels were killed and examined for plague infection, and from june to august , , the work being continued, squirrels were found to have the plague. now that the relation between fleas and their hosts and the transmission of the disease is known, there need be but little fear in the future of this old enemy of man again getting control and spreading without hindrance throughout a whole country. chapter xx _diseases controlled by antitoxins (smallpox, rabies, tetanus)_ _smallpox._ a hundred years ago, the most dreaded disease in this country or in europe was smallpox; and even yet writers of fiction, when they desire to expose their hero to the most harrowing conditions possible, leave him in a deserted hut with a man dying of smallpox. but to the educated person of to-day smallpox is encountered absolutely without dread, since it has been robbed of its terrors by the introduction of vaccination. as far back as , lady mary montague, writing home to england, described the eastern method of taking smallpox deliberately, under comparatively agreeable conditions, in order that severe cases of the disease might be prevented. why one attack of the disease should prevent a subsequent case was not known, nor why inoculation with other virus than that of the disease itself should be efficient was not known. but the fact was thoroughly established then that in some way, in the process of the disease and recovery, there was left in the body some substance or agency which was sufficiently powerful to ward off subsequent attacks. in , dr. jenner discovered that a disease very similar to smallpox existed in the cow, and that if the scab from a pustule on the cow was used for inoculation instead of similar material from a smallpox patient, the resulting disease would be less severe and the protection against subsequent attacks equally efficient. since that time, therefore, cowpox matter or vaccine has been used to develop a mild form of disease for the express purpose of preventing subsequent attacks. this is the fundamental principle involved in all antitoxin treatment, and the only difference between vaccination and the injection of diphtheria antitoxin is that with vaccination the disease and the consequent protection is developed in the individual during the course of the disease, while with diphtheria the first attack of the disease and the resulting protective agencies are developed first in the horse and then the essential elements of the blood are introduced into the patient, thereby increasing his resistance to the disease. smallpox, of all diseases, formerly claimed the largest number of deaths. a hundred years ago, persons marked with smallpox were a common sight. among the indians, whole tribes were wiped out with it. it is computed that in europe, during the eighteenth century, , , people died of smallpox. in england, the death-rate was per , . as late as , boston was visited by severe epidemics of smallpox. _value of vaccination._ owing to vaccination, the extent and intensity of the disease has continually grown less until to-day attacks of smallpox are not serious and the results are seldom fatal. for this reason and because of the chronic objection of uneducated persons to submit to governmental or outside restrictions, there has been, in recent years, a serious outcry against vaccination, with the result that in new york state, during the year , there were in certain parts of the state epidemics of smallpox with, however, but two deaths. the disease may, however, at any time become serious, and, because of its virulent contagiousness, no objection ought to be made to reasonable requirements in the matter of vaccination. vaccination is usually not the cause of any serious inconvenience or illness, and, while some slight swelling of the arm may result, the protection afforded is so great in comparison with the temporary inconvenience that the latter ought not to be even considered. the protection afforded by a successful vaccination lasts usually from two to seven years, and it is understood that after ten years the protection is certainly lost, and in the presence of a smallpox epidemic one ought to be re-vaccinated after the minimum time named. whether every person always ought to be vaccinated at intervals of five years or so is open to discussion. if one were on a desert island in a large or small community without intercourse with the outside world, vaccination would be of no value since smallpox would be impossible. there are communities where smallpox has been for years unknown, and consequently where the need for vaccination is not apparent. on the other hand, where smallpox is prevalent in the vicinity, and the disease is continually recurring, it is of the greatest importance, in order that it may be promptly suppressed, that every individual lend himself readily to vaccination. whatever harmful results formerly came from vaccination were due to a lack of cleanliness on the part of the person vaccinated or in the vaccination material itself. more care is now used in disinfecting the surface of the arm and in protecting the exposed skin after the inoculation. if the vaccination "takes," a certain amount of inflammation follows, the spot on the arm suppurates, the suppuration, however, disappearing at the end of about three weeks. if this does not occur, that is, if the vaccination does not take, it may be either because the vaccine was not good or because of the unsusceptibility of the person. in the largest proportion of cases, however, the difficulty is with the vaccine or with the doctor who does the inoculating, and when smallpox is prevalent in the vicinity a person should be re-vaccinated until the vaccination does take. the disease itself, while disagreeable, is not as hopeless as was formerly thought. there is no particular heroism in being physician or nurse to a smallpox patient now, inasmuch as vaccination absolutely prevents contraction of the disease, and the isolation practiced is the most serious objection from the standpoint of the attendants. _characteristics of smallpox._ the disease first shows itself as does measles and scarlet fever, with the appearance of a severe cold accompanied with a high fever. on the second day a rash resembling that of measles and scarlet fever breaks out on the body; this preliminary rash almost immediately disappears and is followed by the real characteristic smallpox eruption, usually about the fourth day. this eruption appears first on the forehead or face and then on the other extremities, the hands and feet. in mild cases, it is very difficult to distinguish between smallpox and chicken pox, and the only safe measure is to consider all cases of chicken pox in adults to be smallpox, as they probably are, since the former disease almost never attacks grown-up people. the pustules which form in smallpox are first hard and red, and then two or three days later they are tipped with little blisters which later fill with pus and appear yellow. about the tenth day of the eruption this yellowish matter exudes, forming the scar or scab which later dries up and falls off. often this eruption is accompanied by excessive swelling of the face, so that the eyes become closed, it is impossible for the patient to eat, high delirium prevails, and the task of the nurse in such cases is an unenviable one. although usually the pustules are separate and distinct, sometimes in severe cases they run together, so that the hands and face present one distorted mass of suppuration and crust. the disease is particularly prevalent among negroes, perhaps because they are seldom vaccinated, and in recent epidemics in new york state it has been chiefly through negroes that the disease has been kept alive. the method of prevention for this disease is almost entirely vaccination. just how the disease spreads is not clearly understood, although it is supposed that it is transmitted chiefly by clothing, dishes, and other articles in contact with the infection. these should, therefore, be thoroughly disinfected. the hope of eliminating the disease, however, comes rather in the use of vaccination. in new york state, in , only two deaths from smallpox occurred, although twenty years before, with the smaller population, the number of deaths ran up into the hundreds. _treatment of smallpox._ the actual treatment of a case of smallpox consists in little more than providing suitable food, in sponging the body to reduce the fever, and in anointing the skin to allay the irritation of the pustules. as in measles, the eyes are badly affected, and a darkened room is essential for the comfort of the patient as well as for the avoidance of permanent injury to the eyes. carbolic acid solutions or ointments are to be used continually on the surface of the body, relieving the irritation and to some extent preventing pitting, which is a lasting mark of the disease. _diphtheria._ diphtheria was also formerly a much-dreaded disease, physicians standing helpless before severe attacks and in all cases unable to do more than suggest ameliorating remedies. the disease usually begins with a cold, sore throat, and local inflammation, which develops sometimes with alarming rapidity. in the days of our grandmothers, the first thing that the anxious mother did when a child complained of sore throat was to get a spoon and look for white patches in the back of the throat. with severe cases of diphtheria which these white patches foretold, the growths of membrane would be so rapid as to obstruct the breathing, and the child--for the disease is preëminently one of childhood would be in danger of dying of strangulation. the doctor's remedy for this condition was to make an incision in the throat below this accumulation and insert a tube through which the breathing might continue. the writer will never forget having lived through a sickness and death of this sort in his family, seeing as a boy a bottleful of the membrane which the doctor was taking away after the death of the victim, and, while doubtless the size of the bottle and the amount of the membrane has been magnified by the lapse of years, it still remains to him as a terrible visitation and an inevitable cause of death. _cause of the disease._ the immediate cause of diphtheria has been known only within recent years. sewer air was for a long time thought to be responsible, and overcrowding or congestion in tenements was believed to be a fruitful source of the disease. some years ago, when diphtheria had been epidemic in one of the state institutions and when experts had been called in to suppress the disease, the elaborate reports which they made dwelt on the quality of the drinking water and on the method of disposal of the sewage as if those factors would account for the disease. about twenty-five years ago, it was shown definitely that the disease was due to certain bacteria, and that while the membrane in the throat was the result of the rapid development of these bacteria, yet the mortality from the disease was not due to the suppression of the act of breathing, but to the development of a poison by the bacteria which went into the circulation of the body and produced death, just as any poison, as strychnine, for example, would do. when once this fact was accepted, namely, that the disease was dangerous because of the poisons involved, scientists undertook to find a way to neutralize these poisons, and it was soon discovered that such neutralizing substances could be grown in the blood of guinea pigs. it was found that if a small dose of diphtherial toxin was injected into a guinea pig,--a dose small enough so that the guinea pig would recover,--it could then be given a larger dose from which it would also recover. this process might be repeated, until at the end of several weeks it could be given a dose the size of which would have been sufficient to have killed it almost instantly at the beginning, and which it could take and enjoy at the end of the series. the point was that evidently, as with smallpox, successive inoculations resulted in the formation in the body of some substance or agent capable of neutralizing the poisons of the disease, subsequently formed. the guinea pig is so small that the amount of restraining substance available made it desirable to find a larger animal, and the horse, equally susceptible to the disease with the guinea pig, was selected as the animal best suited for producing what is now known as diphtheria antitoxin. _production of diphtheria antitoxin._ in laboratories, to-day, sound horses incapable of ordinary labor are devoted to this life-saving task, and, without serious injury or inconvenience to themselves, they develop artificially in their blood this agent which neutralizes the effect of the diphtheria germ. the blood of the horse, when removed, precipitated, and strained, contains this property which is used almost exactly as vaccine in the case of smallpox, except that in the case of diphtheria the development of the disease is so slow that it is not necessary to use this treatment until the disease has appeared. in smallpox, on the other hand, the disease is so rapid that when contracted it is too late for vaccination to be of much value. in new york state, the department of health furnishes this horse antitoxin free of expense to health officers to use with persons or families unable to purchase the preventative, so that no longer does any need exist for the continuance of diphtheria as a cause of mortality. if the disease is early recognized and a proper amount of antitoxin injected, that is, forced in under the skin so that it may be absorbed by the blood, the probability is that in all cases the patient will recover. it is equally useful with vaccine as a preventative of disease, and in a school, for instance, where diphtheria has broken out, it is only a reasonable precaution to use antitoxin freely to prevent infection of those exposed to the disease. to make use of the antitoxin at the proper stage of the disease, early recognition is important, and fortunately science here can be of great service. by wiping out the throat with a sterilized swab of cotton, the bacteria present in the throat, if any, will adhere and may be wiped off onto a gelatine substance in which the germs can grow. in twelve hours, they will have developed, if present, so that with a microscope they can be positively recognized. in massachusetts, and particularly in the city of boston, the board of health maintains a laboratory with a medical expert in charge, to whom physicians may refer these smears for diagnosis. no excuse exists, therefore, in such a city for failure to recognize and prevent the further development of diphtheria, since every wise physician would take a sample of mucus from a throat in case of any irritation there, the board of health would furnish accurate diagnosis, and the use of antitoxin will prevent the disease. _symptoms of diphtheria._ the disease itself acts on the human body through the formation of poisons which the bacteria generate by their growth. if the germs have secured a foothold in the upper throat, then the well-known membrane is formed and the toxins produced spread through the blood and cause headache and fever, even before any experience of sore throat is felt. the temperature rises very high, the child begins to vomit, and the pulse becomes weak, and after about seven days a large percentage of these throat cases begin to improve. the membrane breaks off, the fever declines, and the child begins to recover. if the localized attack is in the larynx, a harsh cough is one of the symptoms, and this is soon followed by a serious difficulty in breathing. the poisons are formed, as before, in the blood, and, while a surgical operation has been performed often in the past to afford relief from the tendency to strangulation, the bacterial poisons are not affected thereby, and, while the operation might be successful, the child was quite apt to die as the result of the poisons. now, in either case, antitoxin is administered at the very outset of the attack, with the result that the poisons are counteracted, the temperature drops rapidly, the membrane is apparently at once affected and lessened, and the child recovers at once. no greater boon to the human race in the matter of disease has ever been discovered, and it is certainly most absurd for parents to refuse the use of this wonderful antidote. not long since, the writer found a family of four children in a home where diphtheria was rampant. the mother and two children were sick with diphtheria in its worst form, and the father refused to allow the doctor to administer the antitoxin even to those sick, much less to those who had been, up to that time, only exposed. apparently there was no direct law requiring the administration of the antitoxin, and the physician in attendance and the health officer were obliged to stand by and wait for the death of the children, which actually happened, knowing that a dose of the antitoxin ready at hand could have been administered and the children's lives, in all probability, saved. the diphtheria poison is so virulent that in many cases it acts on the different organs of the body, particularly on the kidneys and the heart, and the recovery from this poison may take weeks. it is very necessary, therefore, for the patient to be kept quiet, and this can best be done in bed, for at least three weeks after the crisis has passed. the nervous system is often affected, so that the child may squint or stutter or perhaps not be able to see, but these effects are usually temporary and pass away as the effect of the poison disappears. _rabies._ rabies is the third assumed bacterial disease which is reacted upon by the administration of an antitoxin. when it occurs in man, it is generally known as hydrophobia, although it is the same disease as that known as rabies in dogs, skunks, wolves, and other animals. the virus of the disease is in the saliva of the animal, so that when a dog bites another animal or human beings, the poison is injected into the wound made with the teeth. the actual germ has not been found, and while there is no doubt that it originates with some specific bacterium, it is probable that the transmitted disease is due rather to the toxin of the germ than to the germ itself. the greatest number of cases, by far, are caused by the bites of dogs, and the most obvious and plainest method of preventing the disease is to prevent dogs from biting. that this is efficient in stamping out the disease has been proved by the records of cases in england and germany. there, a quarantine on all the dogs in the country, that is, the strict enforcement of laws requiring muzzling, has eliminated the disease except on the borders of other countries where such quarantine is not enforced. in new york state, the number of cases of rabies is increasing at an alarming rate, as determined by the examinations made on dogs' heads at the new york state veterinary college in ithaca. whereas a few years ago one suspected case a month was the average number sent in, during this last year, , there have been sent to the laboratory, at times, as many as five or six a day, the number being larger in the warm weather. when the disease appears in the dog, one manifestation of it is that the animal runs over large areas of country, perhaps within a radius of twenty-five or thirty miles, and in this mad race the dog may infect other dogs throughout the entire distance. it is, therefore, of small value to muzzle dogs only in a particular village, since the dogs while muzzled may be bitten by an outsider. there is no reason why the disease could not be stamped out of a state in six months by muzzling all the dogs. but muzzling the dogs in a village here or in a town there is really only temporizing with the trouble. hydrophobia in man requires usually from two to six weeks to develop, so that there is a long period in which to utilize preventive measures, and it is on this account that children may be sent, as happens frequently, to new york city or to paris to be treated by what is known as "pasteur treatment." this treatment involves the inoculation of the rabies virus which has first been passed through a series of rabbits, in the course of which the virus has become exceedingly strong. the treatment of the human being consists in successive inoculations with virus of various strengths, beginning with the weakest and ending with the most powerful rabbit virus. after this has been done, the effect of the bite of the mad dog has been neutralized, so that in most cases the disease has been robbed of its power. of the cases treated at the pasteur institute in , numbering , there were six deaths, and these six were among those whose arrival at the institute was so late that the treatment could not be begun in time. _tetanus._ the fourth disease for which an antidote in the form of antitoxin has been developed is tetanus, commonly known as lockjaw. this is a bacterial disease caused by a specific germ, the peculiarity of which, in its progress, is a long-continued spasm of certain muscles of the body. the germs are commonly found in dirt, garden soil being always full of them, and whenever the skin is broken by any object, such as a rusty nail or a knife not clean, lockjaw may be the result. rather curiously, it is particularly likely to develop after gunpowder wounds, and the number of cases of tetanus after the fourth of july is notable. this special prevalence of the disease is so well recognized that health officers usually lay in a large stock of antitoxin about the first of july, awaiting the inevitable demand for it. the disease is most commonly contracted from wounds which occur in the hands or the feet, although it may be the result of wounds in other parts of the body. very often the wound may be so insignificant as to escape the attention, as a pin prick, and yet be followed by an attack of tetanus. formerly, the universal treatment for injuries from which tetanus was feared was to firmly cut out all portions of the flesh and skin which might have been infected. sometimes cauterization was employed, as was done also with cases of rabies, and, if it were possible to reach the virus in the wounds before it escaped into the blood, such a method of treatment would be quite reasonable, but it is quite beyond hope to prevent infection in a jagged wound by cutting out adjacent flesh, with no regard to the dissolved poison. the more reasonable treatment is to inject the antitoxin, which neutralizes the poison and prevents, or at least minimizes, the disease. chapter xxi _hygiene and law_ one of the fundamental principles of society is that each individual must, in his methods of living, conduct himself with a due regard for the rights, comfort, and health of others in the same society. a single man or a single family living alone on a desert island requires no restrictions of conduct, since there are no fellow-beings on whom his violations of good conduct might react. the inhabitants of small villages with small families on large lots are but little concerned with laws governing social intercourse, since, at best, the amount of that intercourse is inconsiderable. but, as population becomes greater, as congestion increases, and as civilization and its requirements develop, the need for law governing the interrelations of individuals becomes imperative. such laws deal with the moral life under many phases, and the courts exist for the enforcement of such laws as the people themselves, through their legislatures, demand for their own self-protection. one of the primitive laws found necessary, even among uncivilized people, is that against theft, and, whether committed in the barbarous tribes of africa or on the frontier plains of the west, the act is recognized as being contrary to the greatest good of the community, and, if detected, is severely punished. as civilization advances, the code of laws found necessary becomes more and more complex, and, although use has made obedience to such laws almost second nature, it is hardly possible to-day to escape the immediate restraint of such laws for more than a moment at a time throughout any period of twenty-four hours. _principle of laws of hygiene._ it is particularly the laws which pertain to health and hygiene which we shall consider in this chapter. the principle on which laws relating to hygiene are passed is that while nominally a person is always free to do with his own whatever he may choose, yet as a member of a community he must choose to do only that which shall not injure or affect the health or comfort of his neighbors. this principle was not at first invoked to prevent violations of laws of health, but rather to prevent the inconvenience which might come to a neighbor or to the public at large by some unreasonable though apparently legitimate use of individual property. as an example we may mention the law of new york state requiring each owner of property in the country to cut grass, weeds, and brush along the highway twice each year. although this interferes with the right of the owner to have the land which belongs to him left as he chooses, it is legal because of the greater convenience and comfort it contributes to the larger number of persons traveling along the highway. the state does not assume the right to interfere with the acts of individuals so long as such acts affect only their own individual well-being, but when those actions affect others, then the police power of the state may be invoked. it is on this principle that the law prohibits suicide, assuming that no man can live or die without affecting the interests of other people. this is plainly so in the case of the head of a family or in the case of a man upon whom others are dependent and whose death removes their support and causes those supported to become dependent upon the state or county. this principle has been extended so as to include the cases where a method of living, a lack of care, or even a mere appearance in public may adversely affect the health of others in the same community. if, for example, a member of a family has diphtheria or smallpox, and such a child is isolated so that no danger of the spread of the disease exists, the state would not, in general, insist upon the use of any preventive or curative inoculation; but if a child with incipient diphtheria or whooping cough goes to school where other children may be infected and the disease spread, the state, acting through its board of education, would have a perfect right to send the child home and prevent its enjoying school privileges until recovery from the disease. it is on this principle that the state says that no child in new york state may attend school unless vaccinated, the law reading, "no child, not vaccinated, shall be admitted into any of the public schools of the state, and the trustees of the schools shall cause this provision of law to be enforced." this law has been questioned and brought before the supreme court for review, and it was held by the judges that the protection to the community implied is of sufficient importance to justify its enactment. for like reason, other restrictions governing the control of contagious diseases is a function of the police power of the state in which the rights of the individual must yield to the greater good of the community. the writer remembers a particularly malignant case of smallpox where the efforts of the local board of health had been concentrated on the enforcement of quarantine, and where by the aid of policemen, day and night, it was hoped that the disease was being confined in the one house; yet, after the death of the patient, and when apparently efforts for protection might be relaxed, a wake was held in the house, in the very room of the patient, which might have resulted in the spread of the disease through the entire town. regulations, therefore, covering the conduct of funerals and of burials should be agreed to, since they are intended to prevent the spread of disease. _self-interest the real basis of law._ many practices which are required by law in cities where the population is crowded are not required or are not enforced in country districts, since there the failure to carry out protective measures reacts only on those immediately concerned. disinfection of rooms in which contagious diseases have occurred is one such provision. it rarely happens that a health officer of a country community concerns himself with seeing that a case of scarlet fever, for example, is prevented from spreading by a thorough disinfection of the rooms. that seems to be left to the good sense of the individual. it is hardly conceivable that a mother with three or four children (when one child has been sick with a contagious disease) will neglect ordinary and reasonable precautions to prevent the spread of that disease to the rest of the family. it is inconceivable, when the small amount of trouble and expense is considered, that the parents of a family, after a case of diphtheria, will neglect to fumigate and disinfect the clothing and bedding which may be thus infected, particularly if such clothing or bedding is to be used by other members of the family; and yet instances are recorded where a child has died of scarlet fever and a year later another child, perhaps wearing some of the clothes of the previous victim, has been seized with the disease and has followed its brother or sister to the grave. cases of tuberculosis have been known to follow each other almost year after year, as one member of a family after another occupied a room where the infection persisted, either in the carpet or furniture, which was never properly disinfected. such cases must be left to the good sense, intelligence, and understanding of the persons concerned. the police power can never in this age take the place of an enlightened sense in the community, nor are laws, as a matter of fact, of any use except as they are sustained and enforced by public sentiment. quality of water there is another way in which the police power of the state exercises control over rural communities, and that is in the matter of food which the country generally supplies to the city. perhaps the pollution of water, which is, after all, one kind of food, is as important as any matter covered by health laws. in most cities to-day the pollution of streams is prohibited on two grounds, first, that the streams are public property, even though for a part of their course they may be owned individually. the sum of the parts making up the whole stream involves so many individuals as to imply public ownership, and inasmuch as one individual is limited in his uses of the stream by the principle already referred to, he cannot, even on his own land, do what he pleases with a stream or with its waters. when streams are navigable, according to the law of this country, no private ownership can exist, for the waters are controlled and owned by the federal government. this latter body, in general, does not undertake to control the quality of such waters, but there are many laws covering the quantity of water in such streams, limiting the amounts that can be withdrawn, restricting the filling up or silting of such streams, and qualifying the bridging or damming of such waterways. in small streams, such as are generally found in rural communities, the vital principle of ownership is always limited by the requirement that no owner shall so interfere with the normal quantity or quality of water in the stream as to prevent their full enjoyment by the next man downstream whose rights are equal with his own. this means, in the matter of quantity, that while one individual may water stock in a stream or may pump water from a stream for household use, he may not withdraw from the stream the entire volume to use for irrigation, nor may he, as a riparian owner, sell the water to some city near by which might take out all the water of the stream. the quality of a stream, likewise, may only to a certain extent be interfered with. if a stream flows through a meadow, cows pastured in the meadow have a natural right to wade in the brook, and if, in so doing, a certain amount of pollution is added to the waters of the brook, no one downstream can justly complain. if, however, a sewer is carried from barns or houses into a brook which is later used for drinking purposes, the quality of the water is affected, and such a discharge is so revolting to the senses that complaint to the courts would result in an order to find some other method of disposing of such wastes. in new york state, the legislature has delegated to the department of health certain rights in the matter of the protection from pollution of the waters of the state, particularly when those waters are used for drinking purposes. upon application from the water company, this department, having carefully inspected the watershed, will prepare a complete and elaborate series of rules, giving in detail just what an individual may or may not do on the watershed, and, when enacted, these rules have all the force of law. they are, however, like all laws, subject to the constitutional limitations, and particularly to the clause of the constitution which provides that "no state shall make or enforce any law which shall deprive any person of property without due process of law." this means that if any law prevents an individual enjoying reasonable use of his own property, or if the deprivation of such use is for the special benefit of some special community or company, then that special body must be prepared to make compensation for that deprivation, although if it were for the general good of the community of which the individual was a member, no compensation might be required. regulations governing foods laws covering the sale of adulterated foods are of two kinds, namely, those enacted by the national government at washington, and those enacted by the local authorities, either state or municipal. the laws enacted by the national government, which are comprehended in the recently enacted national pure food law, deal particularly with the adulteration and misbranding, not only of foods, but of all sorts of medicines and liquor. their effect, however, is limited entirely to such articles as make up interstate commerce. if an article is made and sold within the boundaries of any single state, it is not subject to the national law, nor could this national law be applied to the production or sale of any article from a farm unless that article was well enough known to be generally distributed. for example, maple sirup, widely advertised and generally sold, would be subject to the provisions of the national law. butter and cheese, sold locally, would not be subject to such a law. it is evident, therefore, that this law does not usually apply to farm products, unless, as in the case of some sausages, for example, a widely advertised campaign has been instituted to promote their sale. there are, however, in the different states, laws which do apply locally and which prohibit adulteration of all sorts. in new york state, for example, the law says that no person shall, within the state, manufacture, produce, compound, brew, distill, have, sell, or offer for sale any adulterated food or product, and the law further specifies that an article shall be deemed to be adulterated:-- " . if any substance or substances has or have been mixed with it so as to reduce or lower or injuriously affect its quality or strength. " . if any inferior or cheaper substance or substances have been substituted wholly or in part for the article. " . if any valuable constituent of the article has been wholly or in part abstracted. " . if it be an imitation or be sold under the name of another article. " . if it consists wholly or in part of diseased or decomposed or putrid or rotten animal or vegetable substance, whether manufactured or not, or in the case of milk, if it is the produce of a diseased animal. " . if it be colored, or coated, or polished, or powdered, whereby damage is concealed, or it is made to appear better than it really is, or of greater value. " . if it contain any added poisonous ingredient, or any ingredient which may render such article injurious to the health of the person consuming it. provided that an article of food which does not contain any ingredient injurious to health shall not be deemed to have been adulterated, in the case of mixtures or compounds which may be now, or from time to time hereafter, known as articles of food under their own distinctive names, or which shall be labeled so as to plainly indicate that they are mixtures, combinations, compounds, or blends, and not included in definition fourth of this section. " . if it contains methyl or wood alcohol or any of its forms, or any methylated preparation made from it." these provisions, just mentioned, are provisions of the new york state health law, and violations are in defiance of that law, the penalties for which are specifically stated to be $ for every such violation. there is also in new york a police code that prohibits adulteration of food, and in this code the adulteration of maple sirup or fruit juices or spoiled articles of food of all sorts, of milk from which part of the cream has been removed, and the sale of any article which is printed or labeled in such a way as to misrepresent the article, is called a misdemeanor, the penalty for which is left to the discretion of the judge and which would, under ordinary conditions, be a fine of several hundred dollars or imprisonment in a county jail for a term of months, or both. _basis of pure food laws._ adulteration of food may be considered from two points of view, the hygienic and the economic, and, while the laws are generally intended to preserve the public from impure food on account of the economic loss involved thereby, the hygienic aspect is really the more important. adulterations which are plainly injurious to health are very few in number, and it is rather desirable that the economic phase should be the one to command attention of legislators, since, when that objection to adulteration has been so voiced as to result in laws prohibiting adulteration, the health of the public will be promoted by the elimination of objectionable foodstuffs. the long-continued discussion over the use of benzoate of soda in foods is an example of this twofold aspect; some, arguing against its use, protested that when long continued, it had a decidedly injurious effect upon the health of those eating or drinking it; others objected to the chemical, but contended that its use enabled spoiled fruits, like tomatoes, to be substituted for fresh fruits, and the price of the latter obtained where the value of the former only was given. no one seriously thinks that butter with a small amount of butter color added could have any injurious effect upon the human system, yet it is, in the eyes of the law, an adulteration because its appearance indicates a quality of the butter which it does not naturally possess. protection of milk the one article of food produced on the farm about which the greatest amount of agitation has been centered has been the adulteration of milk, as well as the question of the production of milk under unclean conditions. the responsibility for pure milk rests on the department of agriculture of the state, on the department of health of the state, on the department of health of the city where the milk is sold, and on the board of health in the village or town where the milk is produced. in a way, these four departments divide the responsibility for the milk, and, as in all cases of divided responsibility, the very fact of the number subtracts from their efficiency. the local board of health of the village or town where milk is produced is not usually interested or concerned particularly in the question of its quality. if a case of contagious disease in any farmhouse occurs, the local health officer should see that a proper quarantine is established and that the individuals in such a house are instructed in the danger of contamination and in the necessity of avoiding infection in the dairy. it is, however, the board of health in the city where the milk is consumed who have a particular responsibility. such a board has no jurisdiction or authority over matters outside of their city, so that their executive cannot go out into the country, into the district of another health board, and order improvements made in the methods of production. all that a city board can do is to enact and publish restrictions under which milk must be sold in that city. this is the method pursued in the city of new york, where tons of milk are consumed every day and where manifestly the jurisdiction of the city officials cannot extend over the thousands of farms located in the five states from which the milk supply is drawn. in new york city the local sanitary code provides that no milk shall be received, held, kept, offered for sale, or delivered in the city of new york without a permit from the board of health, and the board makes this permit depend upon the sanitary conditions existing at the dairy or farm where the milk is produced or handled. in order to find out whether the conditions at the dairies and farms throughout these five states are in a sanitary condition, the city has a force of twenty-five inspectors who are continually engaged in traveling among the farms and in reporting on their condition. if a farm is found where the cows are diseased, or if the buildings in which the cows are stabled or in which the milk is cooled and strained are not clean or are lacking in proper ventilation or otherwise unhygienic, or if the water-supply is bad, the farmer is notified that conditions are such that the city of new york will refuse to receive his milk. he is not forced to clean up, and no orders are given him, but the attitude of the city authorities is made plain, and then it is left to him to decide whether it may not be wise for him to accept the suggestions made by the inspectors. dr. darlington, late health commissioner of the city of new york, reported in , after two years of inspection, that out of , dairies inspected, only were shut out on account of unclean conditions, although many more were warned with the result that remedial measures were at once taken. the same sort of procedure may be adopted by any city, and is, in fact, practiced by a number. another method of securing a better grade of milk which results in forcing farmers to clean up the barn and barnyard, at the same time allowing the local official to remain within the strict letter of the law, which gives him no direct authority over conditions on farms outside a city, is to limit the number of bacteria found in samples of milk supplied by the dealer. a common rule is that no milk shall be distributed which contains more than , bacteria per c.c., and when milk contains a number in excess of this, the milkman is warned, and if, at the next sampling, the number is still higher, the milkman is notified that his milk will no longer be received. experience has shown that a reasonable regard for cleanliness in the stable and dairy room, with a prompt cooling of the milk, will limit the bacterial growth to this standard, and the requirement, meaning, as it does, only a decent regard for such cleanliness as a self-respecting dairyman would recognize as essential, works no hardship on any one. new york city prints its dairy rules on linen and has them tacked up in every cow barn concerned in the city milk supply, and while they have merely the force of suggestions only, practically they have the force of law in that a disobedience to these rules is likely to involve the refusal of the milk from that particular dairy. laws governing quarantine it is much to be regretted that, in these days of scientific knowledge, when the exact and fundamental causes and processes of diseases are so clearly known to medical men and when laws based on this knowledge have been enacted for the purpose of reducing mortality and preventing the spread of disease, ignorant individuals should allow their prejudices to stand in the way of compliance with the spirit of these laws. in new york state, section of the public health law requires the local board of health to isolate all persons and things infected with or exposed to infectious diseases. they are required to prohibit and prevent all intercourse and communication with or use of infected premises, places, and things, and to require and, if necessary, to provide the means for the thorough purification and cleansing of the same before general intercourse with the same or use thereof shall be allowed. the penal code of the state further provides that a person who, having been lawfully ordered by a health officer to be detained in quarantine and not having been discharged, willfully violates any quarantine law or regulation is guilty of a misdemeanor, punishable by fine or imprisonment or both. in spite of this prohibition, it is very rare to find that a person in a quarantined house feels any personal obligation. he stays in or out, if obliged to by a policeman, or, if the sentiment among the neighbors is aroused in favor of quarantine, he waits until dark enough to escape observation. in new york, two years ago, a case of diphtheria broke out in the family of a christian scientist. the health officer visited the house, offered to use antitoxin, which was refused, and instructed quarantine. the mother and one daughter died, and the healer was imprisoned for entering the house in defiance of the quarantine law. this case illustrates how the moral obligation may be distinctly repudiated because of religious prejudice. but even religious belief must be subservient to the laws governing the community in which a man chooses to live, and, so long as the residence continues, the laws governing quarantine, as all other laws, must be obeyed. in this case another count against parents may be found. section of the penal code provides "that a person who willfully omits without lawful excuse to perform a duty by law imposed upon him to furnish food, clothing, shelter, or medical attendance to a minor is guilty of a misdemeanor." it would seem, therefore, that the law is provided by which fanaticism may be overruled in the interests of the health of children, although it must be said that this phase of the law is generally disregarded. again, in spite of the ample proof to the contrary, there are to be found persons who refuse to be vaccinated even in the midst of a smallpox epidemic. a law in new york state provides that no unvaccinated child shall attend public schools, the law being mandatory upon the school trustees. if this law were faithfully carried out, smallpox would entirely disappear from the state within a few years. other instances might be cited to show how the force of the law is invoked to minimize the effects of unhealthy living and to prevent that perfect individual liberty which a few irresponsible persons would assume to themselves. but it will always remain for the good sense of the individuals to direct their actions in such a way as to inflict no evil on the community. unfortunately, laws are generally the result of some calamity. a law prohibiting child labor is passed only after the evil effects of such labor have been demonstrated by sad experience. laws forbidding the sale of diseased meat or of spoiled fruit are passed only after repeated cases of illness have demonstrated the need of such laws. laws involving quarantine are the result of epidemics which have showed plainly, at the cost of valuable lives, perhaps, the need of such quarantine. it is the aim of hygiene, whether rural or urban, to raise the standards of living to such a degree that not only will any violation of health laws seem unreasonable and obnoxious, but also every instinct, of the individual will, even without specific laws, direct him so to live that no hygienic offense will be directed towards those with whom he comes in contact. only in this way will the present violations of the requirements of hygienic living be avoided, and the normal man be enabled to live as he should in absolute harmony with his environment. index accuracy of death-rate records, . adenoids, . advantages, of gravity water-supply, , ; of hydraulic rams, ; of pond or lake water over brook water, . age and sex in disease, . aim of hygiene, . air, for breathing, ; for consumptives, ; in soils, . air-lifts for pumping, , . air-space in cellar walls, . alcohol as a stimulant, . allegheny valley and cancer, . amount of food required, . analysis of proposed water-supply, . animal heat in barn, ; pollution of water, . animals, fit for butchering, ; in the study of disease, . "anopheles" mosquito, . antiseptics, ; in milk, . antitoxin, ; and disease, ; for diphtheria, ; for hydrophobia, ; for tetanus, ; for typhoid fever, . apparatus for driving wells, . appendicitis, . appetite for food, . application of sewage to land, . area for subsurface sewage disposal, . artificial sewage beds, . asphalt for cellar walls, . auto-intoxication, . automatic sewage syphon, . babylon, l. i., water-supply, . bacillus of typhoid fever, . back of cellar walls, . bacteria, and parasites, ; and sewage purification, ; in milk, . bacterial agencies, . bad air and its effects, . balanced rations, . barn ventilation, . barnyard drainage, . bathing for hygienic purposes, . beneficent bacteria, . billings's suggestion for ventilation, . billings's ventilation by stoves, . blankets, . blood resistance and disease, . bob-veal, . boiler for hot water, . boiling water for disinfection, . boston, mass., water used in, . box radiators at window, . bright's disease in the country, . brooks as water-supply, . brush dam, . bubonic plague, . bucket water wheel, . cancer and soils, ; in europe, . carbohydrates and digestion, . carbolic acid as disinfectant, . carbon dioxid in the air, . causes of typhoid fever, . cell disintegration, . cellar, floors, ; in limestone rock, ; ventilation, ; walls of dry masonry, . cellars and their drainage, . cement joints for well walls, . cesspools and wells, . changes in air breathed, . chemical poisons, . chicken pox, ; preliminary symptoms of, . children, as affecting the death rate, ; in otsego and putnam counties, . children's diseases, . chloride of lime, . city milk, . cleanliness of stables, . clean milk, , . clean stables and their effects, . clothing, . coal-tar disinfectants, . coffee and tea, . cold baths, . composition, of air, ; of soils, . computations for rain-water storage, . concrete, core for dam, ; dam, ; for spring-chamber, ; in cellar floor, ; in stables, ; method of mixing, . construction, of air-tight barns, ; of dug wells, ; of houses, ; of septic tanks, . consumption and bad ventilation, . contagion in children's diseases, . contagious diseases, . cooking and digestion, . cooling of milk, , . corn and pellagra, . corrosive sublimate, . cost, of driven wells, ; of flush tank, ; of fuel for pumping, ; of operating gas engines, ; of plumbing, ; of ventilation, ; of water pipe, . cows and ventilation, . cow stables, ventilation of, . creamery and typhoid fever epidemic, . creosols, . crib dam, . "culex" mosquito, . curb for well, . cure of hookworm disease, . cut-off wall for dam, , . damp cellars, . damp courses in house walls, . dampness, and disease, ; of cellar walls, . damp soils, ; and their effects, . dams for reservoirs, . danger, from drainage of barns and barnyards, ; from leachings from privies and cesspools, . dangers, of polluted air, ; of polluted water, . death-rate, from typhoid fever, ; from typhoid fever in new york state, ; of babies in rochester, ; records, accuracy of, . death-rates, at various ages, ; in general, ; in new york state, ; in rural communities, ; in various countries, ; of children, ; outside of new york city, . deaths from measles and scarlet fever, . decomposition in sewage, . deep well pump, . deep wells, . deficiency of water from well supply, . definition of sewage, . deodorizers, . detection of animal pollution, . diagnosis of diphtheria, . digestion and its requirements, . digestive processes, . dimensions of hydraulic rams, . diphtheria, ; and milk, ; antitoxin, , ; in the country, . direct causes of disease, . dirt and disease, . dirt dam, . disadvantages, of hydraulic rams, ; of windmills, . disease, the causes of, . diseases caused by milk, . disinfecting, agents, ; a room, directions for, ; gases, . disinfection, ; by heat, ; for chicken pox, ; for consumption, ; for measles, ; for scarlet fever, ; for whooping cough, . disposal of sewage and water-supply, . distilled water, . dogs and hydrophobia, . "don't spit" axioms, . drafts from windows prevented, . drainage, ; around the house, , . drain, for house on side hill, ; from house plumbing, . drains leading to dug well, . driven well, in dug well, ; machinery, . driven wells, . drugs and their immoderate use, . dry heat for disinfection, . dry masonry for cellar walls, . dug wells, . dust and its dangers, . earache, . effect of bad ventilation, ; of hard water on health, ; of vegetable pollution of water, . elimination, of dangers of surface pollution, ; of mosquitoes, . enameled iron for plumbing fixtures, . epidemic diseases, . epidemics of typhoid fever, . eruption of measles, . eucalyptus trees and malaria, . evaporation from reservoirs, . exercise, after meals, ; of the body, . expectorations in cases of consumption, . exposure, and pneumonia, ; of a house, . external causes of disease, . eyes and their troubles, . factory life and disease, . fall river, mass., water used in, . faucets for plumbing, . field-stone dam, . filter beds for sewage in winter, . filtration of sewage, . finishing concrete surfaces, . fire protection and water-supply, . fire streams and water flow, . fish as destroyers of mosquitoes, . fixtures for plumbing, . fleas and the bubonic plague, . fletcher, and chewing, ; and his two meals, . flies and typhoid fever, . floods and stone dams, . floor of cellars, . flow of underground water, , . flush tank for water-closet, . food, for consumptives, ; for various body needs, . food adulteration laws, . foods and beverages, . "foos" gas engine, . formaldehyde, . forms for concrete cellar walls, . foul-air outlet for ventilation, . foundation for dam, . freezing in plumbing, . fresh-air inlet for ventilation, . friction with fire streams, . fried foods, . fuel for pumping, . galvanized iron water tanks, . garbage for filling low ground, . gas engines for pumping, . gastric juice, . gate house for reservoirs, . goiter and soils, . goulds manufacturing co. pumps, . grade, for house drains, ; for cellar drains, ; of subsurface tile, . ground water, . growth of mosquitoes, . habit and food, . hand basin in bath-room, . hands to be washed frequently, . hand valves for sewage tanks . hard water, . health departments, . heat, and plumbing, ; as a disinfectant, . heating and ventilation, . heredity and health, . homer, n. y., water-supply, . hookworm disease, , . hot-air engines for pumping, . hot-water boiler, . hot-water circulation, . house drainage, . house drains, . hydraulic rams, . hydrophobia, . hygiene, and its laws, ; and its true purpose, . ice and typhoid fever, . ideality of life, . immunity--natural and artificial, . importance of bacteria, . impurity of surface water-supply, . indians and ventilation, . indirect causes of death, . infection in pneumonia, . influenza in the country, . inlet for fresh air, , . inspection of dairies, . installation of plumbing, . intermittent application of sewage on land, . iron pipe for conveying water, . irrigation and sickness, . irritation of cell tissue, . ithaca typhoid epidemic, . joints in soil-pipe, ; in tile pipe, . kerosene and mosquitoes, . kewanee water supply co. tanks, . king of ventilation, . king's experiments on ventilation, . kitchen sinks, . kitchen stove and hot water, . koch and consumption, . land treatment of sewage, laundry tubs, . law and hygiene, . laws against impure food, . lesions of tuberculosis, . level for house drain, . light, as a disinfectant, ; in cow stables, . lime for disinfecting, . liquid disinfectant, . location, of a house, ; of a house on a side hill, ; of privies and cesspools, ; of windmill, . long island wells, . loss of head by friction, . lowell typhoid epidemic, . lungs, air required by the, ; developed by exercise, . made ground and health, . malaria, , ; caused by soil formation, ; from cellars, . malarial attacks, . manure from cow stables, . maximum rate of water consumption, . measles, and its virulence, ; preliminary symptoms, . meat and its dangers, . mercury as a disinfectant, . metchnikoff's theory of auto-intoxication, . methods of collection of water, ; of securing fall for hydraulic rams, . milk, and its adulteration, ; and its care, ; and typhoid fever, ; of lime, ; supply of rochester, n. y., . milk-pail for clean milk, . mineral matter in water, . minimum rainfalls, . mixing concrete, . moisture and its dangers, . montclair typhoid epidemic, . mosquitoes, and malaria, ; and yellow fever, . mount savage typhoid epidemic, . mouth breathing, . muslin cloth to prevent drafts, . narrow-topped milk-pail, . natural immunity, . need for rural hygiene, . newton, mass., water used in, . new york state, death-rates in, . night air and malaria, . objectionable construction work at a spring reservoir, . objections to brooks as source of water-supply, . occupation and disease, . old age mortality in the country, . openings for ventilation, size of, . organic matter, in soil, ; in the air, . outfall for cellar drain, . outlet, for drains, ; for foul air, . ownership in streams, . oxygen in the air, . oysters and typhoid fever, . pancreatic juice and digestion, . parasites as causes of disease, . pasteurization for typhoid fever, . patented disinfectants, . patent medicines, . peeling, in measles, ; in scarlet fever, . pellagra, . pipe lines, . plank dam, . pleasure in eating, . plumbing, ; and heating, ; and water consumption, . pneumonia, ; germ, ; in the country, . pollution, of streams, ; of water, ; of water by animal matter, ; of wells, . ponds or lakes as water-supply, . position of fresh-air inlet, . precautions on part of consumptive, . preparation of rabies antitoxin, . pressure for water-supplies, . pressure tanks, . prevention of pneumonia, . principle of hygienic law, . privy, construction of, . process of bacterial attack, . production of diphtheria antitoxin, . protection, against mosquitoes, ; against smallpox, . proteids in food, . ptomaines, . pump for deep well, . pumping water, . purity of water-supply, . quantity of water in stables, ; of water per person, ; of water used, . quarantine, regulations, ; for scarlet fever, . quinine and malaria, , . rabies, ; antitoxin, . radiators by windows, . rain-water, storage, ; supply, . rates of water consumption, . rations for daily use, . register in the ceiling, . remedies, for consumption, ; for pneumonia, . reservoir, for brook supply, ; on a brook, . resistance, of body to disease, , ; to tuberculosis, . rest for consumptives, . results of measles and scarlet fever, . rochester and the milk supply, . rock formations and hygiene, . roof of spring-chamber, . rubber boots, . running trap for main drain, . rusting of driven-well casing, . saliva from mouth, . sand filter beds for sewage, . scarlet fever, and milk, ; preliminary symptoms of, ; quarantine, . scarlatina, . school vaccination, . scurvy and fresh vegetables, . sedimentation of sewage, . septic tanks, . sewage disposal, . sewage-sick land, . sewage treatment on land, . sewer pipe in wells, . sewers and sickness, . sex and age in disease, . shallow wells, . sinks, for kitchen, ; and their discharges, . size, of openings for fresh air, ; of pipe for conveying water, ; of spring reservoir, ; of waste weir, . slaughter-houses, . sleep, . smallpox, ; and chicken pox, ; instead of chicken pox, . smoking and its effects, . soap, as an antiseptic, ; its relation to hard and soft water, . soil, air and its exclusion, ; for disinfection, . soil-pipe in house, . somerville typhoid epidemic, . sources of water-supply, . space between houses, . spring-chamber, . spring, extensions, ; reservoirs, . springs, ; and their formation, . squirrels, and the bubonic plague, ; in the attic, . stables, and dirty milk, ; and water consumption, ; for clean milk, ; space required per cow, ; ventilation, . stamford typhoid epidemic, . steam, for disinfection, ; pumps, . "stegomyia mosquito," . sterilization of milk, . stone dam, . storage, on a brook, ; reservoirs, ; tank for rain-water, . stoves used in ventilation, . strainer for milk-pail, . stream, pollution, ; supplies, . subsurface, irrigation field, ; sewage disposal, . sulfur as a disinfectant, . sunlight as a disinfectant, . supply tank for domestic plumbing, . surface use of land for sewage treatment, . swamps and malaria, . symptoms of diphtheria, , ; of smallpox, ; of yellow fever, . syphons, for automatic discharge, ; for septic tanks, . systems of house drainage, . tanks, for sedimentation, ; for water storage, . tannin in tea, . tapeworm, . tar, for cellar walls, ; paper for water-proofing, . tea as a drink, . teeth and their care, . tetanus, . thymol for hookworm disease, . tile pipe line, . tobacco and its effects, . topography and hygiene, . toxic action, . transmission of typhoid fever by polluted water, . traps for plumbing, . trap-vents, . treatment, of hydrophobia, ; of sewage on land, ; of smallpox, ; of typhoid fever, . trees and the hygienic home, . trichinosis, , . tuberculosis, ; and milk, ; death-rates, ; in the country, ; in the united states, . tuberculous meats, . typhoid bacillus, . typhoid fever, , ; and milk, ; epidemic at butler, pa., ; epidemic at caterham, england, ; epidemic at kerhonkson, n. y., ; epidemics, ; in ice, ; in new york state, ; in small cities, ; in spanish-american war, ; rates in the country, . unadilla valley and cancer, . uncinariasis, . underdrains for sewage disposal, . underground waters, . underwear, . united states department of agriculture and diseased meat, . university of pennsylvania radiators, . use of cement in well walls, . vaccination, . variation in maximum rates of water use, . vegetable, beds and sewage, ; pollution of water, . ventilation, ; experiments on hens, ; by stoves, ; of bedrooms, ; of cellars, ; of stables, ; through walls, . vents for traps at fixtures, . vitality of the typhoid germ, . volume, of sewage, ; of space in cow stables, . vomiting in whooping cough, . walls for spring reservoirs, , . wash-basin in bath-room, . washing, milk-pails, ; soda for disinfection, . wash-tubs, . waste weirs, . water, in the soil, ; needed for house, ; transmission of typhoid fever, ; used per head, ; with meals, . water-closets, . water-proofing of cellar walls, . water-supply and intelligence, . water tanks, . water-tight masonry for wells, . weather and pneumonia, . wells, and cesspools, ; and typhoid fever, ; on long island, . well supplies, . whooping cough, . will power and sleep, . windmills, , . windmill with pressure tanks, . window openings for ventilation, . winter care for sewage beds, . wooden tank for water, . work of a farmer's day, . worthington pump, . yellow fever, . * * * * * the following pages contain advertisements of a few of the macmillan books on kindred subjects. cyclopedia of american agriculture edited by l. h. bailey director of the college of agriculture and professor of rural economy, cornell university. _with full-page plates and more than illustrations in the text; four volumes; the set, $ . net; half morocco, $ . net; carriage extra_ volume i--farms volume iii--animals volume ii--crops volume iv--the farm and the community "indispensable to public and reference libraries ... readily comprehensible to any person of average education."--_the nation._ "the completest existing thesaurus of up-to-date facts and opinions on modern agricultural methods. it is safe to say that many years must pass before it can be surpassed in comprehensiveness, accuracy, practical value, and mechanical excellence. it ought to be in every library in the country."--_record-herald, chicago._ cyclopedia of american horticulture edited by l. h. bailey _with over original engravings; four volumes; the set, $ . net; half morocco, $ . net; carriage extra_ "this really monumental performance will take rank as a standard in its class. illustrations and text are admirable.... our own conviction is that while the future may bring forth amplified editions of the work, it will probably never be superseded. recognizing its importance, the publishers have given it faultless form. the typography leaves nothing to be desired, the paper is calculated to stand wear and tear, and the work is at once handsomely and attractively bound."--_new york daily tribune._ * * * * * published by the macmillan company - fifth avenue, new york books on agriculture on selection of land, etc. thomas f. hunt's how to choose a farm $ net e. w. hilgard's soils: their formation and relations to climate and plant growth net isaac p. roberts' the farmstead net on tillage, etc. f. h. king's the soil net isaac p. roberts' the fertility of the land net elwood mead's irrigation institutions net f. h. king's irrigation and drainage net william e. smythe's the conquest of arid america net edward b. voorhees' fertilizers net edward b. voorhees' forage crops net h. snyder's chemistry of plant and animal life net h. snyder's soil and fertilizers. third edition net l. h. bailey's principles of agriculture net w. c. welborn's elements of agriculture, southern and western net j. f. duggar's agriculture for southern schools net g. f. warren's elements of agriculture net t. l. lyon and e. o. fippen's the principles of soil management net hilgard & osterhout's agriculture for schools on the pacific slope net on plant diseases, etc. george massee's plant diseases net j. g. lipman's bacteria in relation to country life net e. c. lodeman's the spraying of plants net h. m. ward's disease in plants (english) net a. s. packard's a text-book on entomology net stevens & hall's diseases of economic plants net on production of new plants l. h. bailey's plant-breeding net l. h. bailey's the survival of the unlike net l. h. bailey's the evolution of our native fruits net w. s. harwood's new creations in plant life net on garden-making l. h. bailey's manual of gardening net l. h. bailey's vegetable-gardening net l. h. bailey's horticulturist's rule book net l. h. bailey's forcing book net a. french's book of vegetables net on fruit-growing, etc. l. h. bailey's nursery book net l. h. bailey's fruit-growing net l. h. bailey's the pruning book net f. w. card's bush fruits net j. t. bealby's fruit ranching in british columbia net on the care of live stock d. e. lyon's how to keep bees for profit $ net nelson s. mayo's the diseases of animals net w. h. jordan's the feeding of animals net i. p. roberts' the horse net george c. watson's farm poultry net c. s. valentine's how to keep hens for profit net o. kellner's the scientific feeding of animals (translation) net h. r. lewis' poultry laboratory guide net on dairy work henry h. wing's milk and its products net c. m. aikman's milk net harry snyder's dairy chemistry net w. d. frost's laboratory guide in elementary bacteriology net i. p. sheldon's the farm and the dairy net chr. barthel's methods used in the examination of milk and dairy products net on economics and organization j. mclennan's manual of practical farming net l. h. bailey's the state and the farmer net henry c. taylor's agricultural economics net i. p. roberts' the farmer's business handbook net george t. fairchild's rural wealth and welfare net s. e. sparling's business organization net in the citizen's library. includes a chapter on farming kate v. st. maur's a self-supporting home net kate v. st. maur's the earth's bounty net g. f. warren and k. c. livermore's exercises in farm management net on everything agricultural l. h. bailey's cyclopedia of american agriculture: vol. i. farms, climates, and soils. vol. ii. farm crops. vol. iii. farm animals. vol. iv. the farm and the community. to be complete in four royal vo volumes, with over illustrations. price of sets: cloth, $ net; half-morocco, $ net. * * * * * _for further information as to any of the above, address the publishers_ * * * * * published by the macmillan company - fifth avenue, new york books of general interest a self-supporting home by kate v. st. maur _cloth, illustrated, mo, $ . net_ each chapter is the detailed account of all the work necessary for one month--in the vegetable garden, among the small fruits, with the fowls, guineas, rabbits, cavies, and in every branch of husbandry to be met with on the small farm. the book is especially valuable and simple for the beginner. "one of the most sensible, practical books of the kind ever published."--_louisville courier-journal._ how to keep bees for profit by d. e. lyon _cloth, illustrated, mo, $ . net_ dr. lyon is an enthusiast on bees. his work is a practical one. in it he takes up the numerous questions that confront the man who keeps bees, and deals with them from the standpoint of long experience. how to keep hens for profit by c. s. valentine _cloth, illustrated, $ . net_ by the well-known writer on poultry raising in the new york _tribune farmer_. manual of practical farming by dr. john mclennan _cloth, illustrated, mo, $ . net_ a book "worthy of a hearty welcome," says the new york times, a help to orderly, practical farm management, an application of economic scientific methods to the common matters of the farm. manual of gardening by l. h. bailey _cloth, illustrated, mo, $ . net_ this new work is a combination and revision of the main parts of two other books by the same author, _garden making_ and _practical garden-book_, together with much new material and the result of the experience of ten added years. the book of vegetables and garden herbs by allen french _cloth, illustrated, mo, $ . net_ a practical book "from the ground up." it gives complete directions for growing all vegetables cultivatable in the climate of the northern united states. it represents a departure in vegetable-garden literature. it does not generalize. the illustrations, numbering about , are all from original drawings. * * * * * published by the macmillan company - fifth avenue, new york nerves and common sense by annie payson call _author of "power through repose," "as a matter of course," "the freedom of life," etc._ _new and enlarged edition_ many of these articles first appeared in "the ladies' home journal," and i am glad to take this opportunity of thanking mr. edward bok--the editor--for his very helpful and suggestive titles. annie payson call. contents i. habit and nervous strain ii. how women can keep from being nervous iii. "you have no idea how i am rushed" iv. "why does mrs. smith get on my nerves?" v. the trying member of the family vi. irritable husbands vii. quiet _vs._ chronic excitement viii. the tired emphasis ix. how to be ill and get well x. is physical culture good for girls? xi. working restfully xii. imaginary vacations xiii. the woman at the next desk xiv. telephones and telephoning xv. don't talk xvi. "why fuss so much about what i eat?" xvii. take care of your stomach xviii. about faces xix. about voices xx. about frights xxi. contrariness xxii. how to sew easily xxiii. do not hurry xxiv. the care of an invalid xxv. the habit of illness xxvi. what is it that makes me so nervous? xxvii. positive and negative effort xviii. human dust xxix. plain every-day common sense xxx. a summing up chapter i _habit and nervous strain_ people form habits which cause nervous strain. when these habits have fixed themselves for long enough upon their victims, the nerves give way and severe depression or some other form of nervous prostration is the result. if such an illness turns the attention to its cause, and so starts the sufferer toward a radical change from habits which cause nervous strain to habits which bring nervous strength, then the illness can be the beginning of better and permanent health. if, however, there simply is an enforced rest, without any intelligent understanding of the trouble, the invalid gets "well" only to drag out a miserable existence or to get very ill again. although any nervous suffering is worth while if it is the means of teaching us how to avoid nervous strain, it certainly is far preferable to avoid the strain without the extreme pain of a nervous breakdown. to point out many of these pernicious habits and to suggest a practical remedy for each and all of them is the aim of this book, and for that reason common examples in various phases of every-day life are used as illustrations. when there is no organic trouble there can be no doubt that _defects of character, inherited or acquired, are at the root of all nervous illness._ if this can once be generally recognized and acknowledged, especially by the sufferers themselves, we are in a fair way toward eliminating such illness entirely. the trouble is people suffer from mortification and an unwillingness to look their bad habits in the face. they have not learned that humiliation can be wholesome, sound, and healthy, and so they keep themselves in a mess of a fog because they will not face the shame necessary to get out of it. they would rather be ill and suffering, and believe themselves to have strong characters than to look the weakness of their characters in the face, own up to them like men, and come out into open fresh air with healthy nerves which will gain in strength as they live. any intelligent man or woman who thinks a bit for himself can see the stupidity of this mistaken choice at a glance, and seeing it will act against it and thus do so much toward bringing light to all nervously prostrated humanity. we can talk about faith cure, christian science, mind cure, hypnotism, psychotherapeutics, or any other forms of nerve cure which at the very best can only give the man a gentle shunt toward the middle of the stream of life. once assured of the truth, the man must hold himself in the clean wholesomeness of it by actively working for his own strength of character _from his own initiative._ there can be no other permanent cure. i say that strength of character must grow from our own initiative, and i should add that it must be from our own initiative that we come to recognize and actively believe that we are dependent upon a power not our own and our real strength comes from ceasing to be an obstruction to that power. the work of not interfering with our best health, moral and physical, means hard fighting and steady, never-ending vigilance. but it pays--it more than pays! and, it seems to me, this prevailing trouble of nervous strain which is so much with us now can be the means of guiding all men and women toward more solid health than has ever been known before. _but we must work for it!_ we must give up expecting to be cured. chapter ii _how women can keep from being nervous_ many people suffer unnecessarily from "nerves" just for the want of a little knowledge of how to adjust themselves in order that the nerves may get well. as an example, i have in mind a little woman who had been ill for eight years--eight of what might have been the best years of her life--all because neither she nor her family knew the straight road toward getting well. now that she has found the path she has gained health wonderfully in six months, and promises to be better than ever before in her life. let me tell you how she became ill and then i can explain her process of getting well again. one night she was overtired and could not get to sleep, and became very much annoyed at various noises that were about the house. just after she had succeeded in stopping one noise she would go back to bed and hear several others. finally, she was so worked up and nervously strained over the noises that her hearing became exaggerated, and she was troubled by noises that other people would not have even heard; so she managed to keep herself awake all night. the next day the strain of the overfatigue was, of course, very much increased, not only by the wakeful night, but also by the annoyance which had kept her awake. the family were distressed that she should not have slept all night; talked a great deal about it, and called in the doctor. the woman's strained nerves were on edge all day, so that her feelings were easily hurt, and her brothers and sisters became, as they thought, justly impatient at what they considered her silly babyishness. this, of course, roused her to more strain. the overcare and the feeble, unintelligent sympathy that she had from some members of her family kept her weak and self-centered, and the ignorant, selfish impatience with which the others treated her increased her nervous strain. after this there followed various other worries and a personal sense of annoyance--all of which made her more nervous. then--the stomach and brain are so closely associated--her digestion began to cause her discomfort: a lump in her stomach, her food "would not digest," and various other symptoms, all of which mean strained and overwrought nerves, although they are more often attributed merely to a disordered stomach. she worried as to what she had better eat and what she had better not eat. if her stomach was tired and some simple food disagreed with her all the discomfort was attributed to the food, instead of to the real cause,--a tired stomach,--and the cause back of that,--strained nerves. the consequence was that one kind of wholesome food after another was cut off as being impossible for her to eat. anything that this poor little invalid did not like about circumstances or people she felt ugly and cried over. finally, the entire family were centered about her illness, either in overcare or annoyance. you see, she kept constantly repeating her brain impression of overfatigue: first annoyance because she stayed awake; then annoyance at noises; then excited distress that she should have stayed awake all night; then resistance and anger at other people who interfered with her. over and over that brain impression of nervous illness was repeated by the woman herself and people about her until she seemed settled into it for the rest of her life. it was like expecting a sore to get well while it was constantly being rubbed and irritated. a woman might have the healthiest blood in the world, but if she cut herself and then rubbed and irritated the cut, and put salt in it, it would be impossible for it to heal. now let me tell you how this little woman got well. the first thing she did was to take some very simple relaxing exercises while she was lying in bed. she raised her arms very slowly and as loosely as she could from the elbow and then her hands from the wrist, and stretched and relaxed her fingers steadily, then dropped her hand and forearm heavily, and felt it drop slowly at first, then quickly and quietly, with its own weight. she tried to shut her eyes like a baby going to sleep, and followed that with long, gentle, quiet breaths. these and other exercises gave her an impression of quiet relaxation so that she became more sensitive to superfluous tension. when she felt annoyed at noises she easily noticed that in response to the annoyance her whole body became tense and strained. after she had done her exercises and felt quiet and rested something would happen or some one would say something that went against the grain, and quick as a wink all the good of the exercises would be gone and she would be tight and strained again, and nervously irritated. very soon she saw clearly that she must learn to drop the habit of physical strain if she wanted to get well; but she also learned what was more--far more--important than that: that _she must conquer the cause of the strain or she could never permanently drop it._ she saw that the cause was resentment and resistance to the noises--the circumstances, the people, and all the variety of things that had "made her nervous." then she began her steady journey toward strong nerves and a wholesome, happy life. she began the process of changing her brain impressions. if she heard noises that annoyed her she would use her will to direct her attention toward dropping resistance to the noises, and in order to drop her mental resistance she gave her attention to loosening out the bodily contractions. finally she became interested in the new process as in a series of deep and true experiments. of course her living and intelligent interest enabled her to gain very much faster, for she not only enjoyed her growing freedom, but she also enjoyed seeing her experiments work. nature always tends toward health, and if we stop interfering with her she will get us well. there is just this difference between the healing of a physical sore and the healing of strained and irritated nerves with the one our bodies are healed, and things go on in them about the same as before. with the other, every use of the will to free ourselves from the irritation and its cause not only enables us to get free from the nervous illness, but in addition brings us new nerve vigor. when nervous illness is met deeply enough and in the normal way, the result is that the nerves become stronger than ever before. often the effect of nervous strain in women is constant talking. talk--talk--talk, and mostly about themselves, their ailments, their worries, and the hindrances that are put in their way to prevent their getting well. this talking is not a relief, as people sometimes feel. it is a direct waste of vigor. but the waste would be greater if the talk were repressed. the only real help comes when the talker herself recognizes the strain of her talk and "loosens" into silence. people must find themselves out to get well--really well--from nervous suffering. the cause of nervous strain is so often in the character and in the way we meet circumstances and people that it seems essential to recognize our mistakes in that direction, and to face them squarely before we can do our part toward removing the causes of any nervous illness. remember it is not circumstances that keep us ill. it is not people that cause our illness. it is not our environment that overcomes us. it is the way we face and deal with circumstances, with people, and with environment that keeps our nerves irritated or keeps them quiet and wholesome and steady. let me tell the story of two men, both of whom were brought low by severe nervous breakdown. one complained of his environment, complained of circumstances, complained of people. everything and every one was the cause of his suffering, except himself. the result was that he weakened his brain by the constant willful and enforced strain, so that what little health he regained was the result of nature's steady and powerful tendency toward health, and in spite of the man himself. the other man--to give a practical instance--returned from a journey taken in order to regain the strength which he had lost from not knowing how to work. his business agent met him at the railroad station with a piece of very bad news. instead of being frightened and resisting and contracting in every nerve of his body, he took it at once as an opportunity to drop resistance. he had learned to relax his body, and by doing relaxing and quieting exercises over and over he had given himself a brain impression of quiet and "let go" which he could recall at will. instead of expressing distress at the bad news he used his will at once to drop resistance and relax; and, to the surprise of his informant, who had felt that he must break his bad news as easily as possible, he said "anything else?" yes, there was another piece of news about as bad as the first. "go on," answered the man who had been sick with nerves; "tell me something else." and so he did, until he had told him five different things which were about as disagreeable and painful to hear as could have been. for every bit of news our friend used his will with decision to drop the resistance, which would, of course, at once arise in response to all that seemed to go against him. he had, of course, to work at intervals for long afterward to keep free from the resistance; but the habit is getting more and more established as life goes on with him, and the result is a brain clearer than ever before in his life, a power of nerve which is a surprise to every one about him, and a most successful business career. the success in business is, however, a minor matter. his brain would have cleared and his nerve strengthened just the same if what might be called the business luck had continued to go against him, as it seemed to do for the first few months after his recovery. that everything did go against him for some time was the greatest blessing he could have had. the way he met all the reverses increased his nerve power steadily and consistently. these two men are fair examples of two extremes. the first one did not know how to meet life. if he had had the opportunity to learn he might have done as well as the other. the second had worked and studied to help himself out of nerves, and had found the true secret of doing it. some men, however, and, i regret to say, more women, have the weakening habit so strong upon them that they are unwilling to learn how to get well, even when they have the opportunity. it seems so strange to see people suffer intensely--and be unwilling to face and follow the only way that will lead them out of their torture. the trouble is we want our own way and nervous health, too, and with those who have once broken down nervously the only chance of permanent health is through learning to drop the strain of resistance when things do not go their way. this is proved over and over by the constant relapse into "nerves" which comes to those who have simply been healed over. even with those who appear to have been well for some time, if they have not acquired the habit of dropping their mental and physical tension you can always detect an overcare for themselves which means dormant fear--or even active fear in the background. there are some wounds which the surgeons keep open, even though the process is most painful, because they know that to heal really they must heal from the inside. healing over on the outside only means decay underneath, and eventual death. this is in most cases exactly synonymous with the healing of broken-down nerves. they must be healed in causes to be permanently cured. sometimes the change that comes in the process is so great that it is like reversing an engine. if the little woman whom i mentioned first had practiced relaxing and quieting exercises every day for years, and had not used the quiet impression gained by the exercises to help her in dropping mental resistances, she never would have gained her health. concentrating steadily on dropping the tension of the body is very radically helpful in dropping resistance from the mind, and the right idea is to do the exercises over and over until the impression of quiet openness is, by constant repetition, so strong with us that we can recall it at will whenever we need it. finally, after repeated tests, we gain the habit of meeting the difficulties of life without strain--first in little ways, and then in larger ways. the most quieting, relaxing, and strengthening of all exercises for the nerves comes in deep and rhythmic breathing, and in voice exercises in connection with it. nervous strain is more evident in a voice than in any other expressive part of man or woman. it sometimes seems as if all other relaxing exercises were mainly useful because of opening a way for us to breathe better. there is a pressure on every part of the body when we inhale, and a consequent reaction when we exhale, and the more passive the body is when we take our deep breaths the more freely and quietly the blood can circulate all the way through it, and, of course, all nervous and muscular contraction impairs circulation, and all impaired circulation emphasizes nervous contraction. to any one who is suffering from "nerves," in a lesser or greater degree, it could not fail to be of very great help to take half an hour in the morning, lie flat on the back, with the body as loose and heavy as it can be made, and then study taking gentle, quiet, and rhythmic breaths, long and short. try to have the body so loose and open and responsive that it will open as you inhale and relax as you exhale, just as a rubber bag would. of course, it will take time, but the refreshing quiet is sure to come if the practice is repeated regularly for a long enough time, and eventually we would no more miss it than we would go without our dinner. we must be careful after each deep, long breath to rest quietly and let our lungs do as they please. be careful to begin the breaths delicately and gently, to inhale with the same gentleness with which we begin, and to make the change from inhaling to exhaling with the greatest delicacy possible--keeping the body loose. for the shorter breaths we can count three, or five, or ten to inhale, and the same number to exhale, until we have the rhythm established, and then go on breathing without counting, as if we were sound asleep. always aim for gentleness and delicacy. if we have not half an hour to spare to lie quietly and breathe we can practice the breathing while we walk. it is wonderful how we detect strain and resistance in our breath, and the restfulness which comes when we breathe so gently that the breath seems to come and go without our volition brings new life with it. we must expect to gain slowly and be patient; we must remember that nerves always get well by ups and downs, and use our wills to make every down lead to a higher up. if we want the lasting benefit, or any real benefit at all when we get the brain impression of quiet freedom from these breathing exercises, we must insist upon recalling that impression every time a test comes, and face the circumstances, or the person, or the duty with a voluntary insistence upon a quiet, open brain, rather than a tense, resistant one. it will come hard at first, but we are sure to get there if we keep steadily at it, for it is really the law of the lord god almighty that we are learning to obey, and this process of learning gives us steadily an enlarged appreciation of what trust in the lord really is. there is no trust without obedience, and an intelligent obedience begets trust. the nerves touch the soul on one side and the body on the other, and we must work for freedom of soul and body in response to spiritual and physical law if we want to get sick nerves well. if we do not remember always a childlike attitude toward the lord the best nerve training is only an easy way of being selfish. to sum it all up--if you want to learn to help yourself out of "nerves" learn to rest when you rest and to work without strain when you work; learn to loosen out of the muscular contractions which the nerves cause; learn to drop the mental resistances which cause the "nerves," and which take the form of anger, resentment, worry, anxiety, impatience, annoyance, or self-pity; eat only nourishing food, eat it slowly, and chew it well; breathe the freshest air you can, and breathe it deeply, gently, and rhythmically; take what healthy, vigorous exercise you find possible; do your daily work to the best of your ability; give your attention so entirely to the process of gaining health for the sake of your work and other people that you have no mind left with which to complain of being ill, and see that all this effort aims toward a more intelligent obedience to and trustfulness in the power that gives us life. wholesome, sustained concentration is in the very essence of healthy nerves. chapter iii _"you have no idea how i am rushed"_ a woman can feel rushed when she is sitting perfectly still and has really nothing whatever to do. a woman can feel at leisure when she is working diligently at something, with a hundred other things waiting to be done when the time comes. it is not all we have to do that gives us the rushed feeling; it is the way we do what is before us. it is the attitude we take toward our work. now this rushed feeling in the brain and nerves is intensely oppressive. many women, and men too, suffer from it keenly, and they suffer the more because they do not recognize that that feeling of rush is really entirely distinct from what they have to do; in truth it has nothing whatever to do with it. i have seen a woman suffer painfully with the sense of being pushed for time when she had only two things to do in the whole day, and those two things at most need not take more than an hour each. this same woman was always crying for rest. i never knew, before i saw her, that women could get just as abnormal in their efforts to rest as in their insistence upon overwork. this little lady never rested when she went to rest; she would lie on the bed for hours in a state of strain about resting that was enough to tire any ordinarily healthy woman. one friend used to tell her that she was an inebriate on resting. it is perhaps needless to say that she was a nervous invalid, and in the process of gaining her health she had to be set to work and kept at work. many and many a time she has cried and begged for rest when it was not rest she needed at all: it was work. she has started off to some good, healthy work crying and sobbing at the cruelty that made her go, and has returned from the work as happy and healthy, apparently, as a little child. then she could go to rest and rest to some purpose. she had been busy in wholesome action and the normal reaction came in her rest. as she grew more naturally interested in her work she rested less and less, and she rested better and better because she had something to rest from and something to rest for. now she does only a normal amount of resting, but gets new life from every moment of rest she takes; before, all her rest only made her want more rest and kept her always in the strain of fatigue. and what might seem to many a very curious result is that as the abnormal desire for rest disappeared the rushed feeling disappeared, too. there is no one thing that american women need more than a healthy habit of rest, but it has got to be real rest, not strained nor self-indulgent rest. another example of this effort at rest which is a sham and a strain is the woman who insists upon taking a certain time every day in which to rest. she insists upon doing everything quietly and with--as she thinks--a sense of leisure, and yet she keeps the whole household in a sense of turmoil and does not know it. she sits complacently in her pose of prompt action, quietness and rest, and has a tornado all about her. she is so deluded in her own idea of herself that she does not observe the tornado, and yet she has caused it. everybody in her household is tired out with her demands, and she herself is ill, chronically ill. but she thinks she is at peace, and she is annoyed that others should be tired. if this woman could open and let out her own interior tornado, which she has kept frozen in there by her false attitude of restful quiet, she would be more ill for a time, but it might open her eyes to the true state of things and enable her to rest to some purpose and to allow her household to rest, too. it seems, at first thought, strange that in this country, when the right habit of rest is so greatly needed, that the strain of rest should have become in late years one of the greatest defects. on second thought, however, we see that it is a perfectly rational result. we have strained to work and strained to play and strained to live for so long that when the need for rest gets so imperative that we feel we must rest the habit of strain is so upon us that we strain to rest. and what does such "rest" amount to? what strength does it bring us? what enlightenment do we get from it? with the little lady of whom i first spoke rest was a steadily-weakening process. she was resting her body straight toward its grave. when a body rests and rests the circulation gets more and more sluggish until it breeds disease in the weakest organ, and then the physicians seem inclined to give their attention to the disease, and not to the cause of the abnormal strain which was behind the disease. again, as we have seen, the abnormal, rushed feeling can exist just as painfully with too much and the wrong kind of rest as with too much work and the wrong way of working. we have been, as a nation, inclined toward "americanitis" for so long now that children and children's children have inherited a sense of rush, and they suffer intensely from it with a perfectly clear understanding of the fact that they have nothing whatever to hurry about. this is quite as true of men as it is of women. in such cases the first care should be not to fasten this sense of rush on to anything; the second care should be to go to work to cure it, to relax out of that contraction--just as you would work to cure twitching st. vitus's dance, or any other nervous habit. many women will get up and dress in the morning as if they had to catch a train, and they will come in to breakfast as if it were a steamer for the other side of the world that they had to get, and no other steamer went for six months. they do not know that they are in a rush and a hurry, and they do not find it out until the strain has been on them for so long that they get nervously ill from it--and then they find themselves suffering from "that rushed feeling." watch some women in an argument pushing, actually rushing, to prove themselves right; they will hardly let their opponent have an opportunity to speak, much less will they stop to consider what he says and see if by chance he may not be right and they wrong. the rushing habit is not by any means in the fact of doing many things. it asserts itself in our brains in talking, in writing, in thinking. how many of us, i wonder, have what might be called a quiet working brain? most of us do not even know the standard of a brain that thinks and talks and lives quietly: a brain that never pushes and never rushes, or, if by any chance it is led into pushing or rushing, is so wholesomely sensitive that it drops the push or the rush as a bare hand would drop a red-hot coal. none of us can appreciate the weakening power of this strained habit of rush until we have, by the use of our own wills, directed our minds toward finding a normal habit of quiet, and yet i do not in the least exaggerate when i say that its weakening effect on the brain and nerves is frightful. and again i repeat, the rushed feeling has nothing whatever to do with the work before us. a woman can feel quite as rushed when she has nothing to do as when she is extremely busy. "but," some one says, "may i not feel pressed for time when i have more to do than i can possibly put into the time before me ?" oh, yes, yes--you can feel normally pressed for time; and because of this pressure you can arrange in your mind what best to leave undone, and so relieve the pressure. if one thing seems as important to do as another you can make up your mind that of course you can only do what you have time for, and the remainder must go. you cannot do what you have time to do so well if you are worrying about what you have no time for. there need be no abnormal sense of rush about it. just as nature tends toward health, nature tends toward rest--toward the right kind of rest; and if we have lost the true knack of resting we can just as surely find it as a sunflower can find the sun. it is not something artificial that we are trying to learn--it is something natural and alive, something that belongs to us, and our own best instinct will come to our aid in finding it if we will only first turn our attention toward finding our own best instinct. we must have something to rest from, and we must have something to rest for, if we want to find the real power of rest. then we must learn to let go of our nerves and our muscles, to leave everything in our bodies open and passive so that our circulation can have its own best way. but we must have had some activity in order to have given our circulation a fair start before we can expect it to do its best when we are passive. then, what is most important, we must learn to drop all effort of our minds if we want to know how to rest; and that is difficult. we can do it best by keeping our minds concentrated on something simple and quiet and wholesome. for instance, you feel tired and rushed and you can have half an hour in which to rest and get rid of the rush. suppose you lie down on the bed and imagine yourself a turbulent lake after a storm. the storm is dying down, dying down, until by and by there is no wind, only little dashing waves that the wind has left. then the waves quiet down steadily, more and more, until finally they are only ripples on the water. then no ripples, but the water is as still as glass. the sun goes down. the sky glows. twilight comes. one star appears, and green banks and trees and sky and stars are all reflected in the quiet mirror of the lake, and you are the lake, and you are quiet and refreshed and rested and ready to get up and go on with your work--to go on with it, too, better and more quietly than when you left it. or, another way to quiet your mind and to let your imagination help you to a better rest is to float on the top of a turbulent sea and then to sink down, down, down until you get into the still water at the bottom of the sea. we all know that, no matter how furious the sea is on the surface, not far below the surface it is absolutely still. it is very restful to go down there in imagination. whatever choice we may make to quiet our minds and our bodies, as soon as we begin to concentrate we must not be surprised if intruding thoughts are at first constantly crowding to get in. we must simply let them come. let them come, and pay no attention to them. i knew of a woman who was nervously ill, and some organs of her body were weakened very much by the illness. she made-up her mind to rest herself well and she did so. every day she would rest for three hours; she said to herself, "i will rest an hour on my left side, an hour on my right side, and an hour on my back." and she did that for days and days. when she lay on one side she had a very attractive tree to look at. when she lay on the other she had an interesting picture before her. when she lay on her back she had the sky and several trees to see through a window in front of the bed. she grew steadily better every week--she had something to rest for. she was resting to get well. if she had rested and complained of her illness i doubt if she would have been well to-day. she simply refused to take the unpleasant sensations into consideration except for the sake of resting out of them. when she was well enough to take a little active exercise she knew she could rest better and get well faster for that, and she insisted upon taking the exercise, although at first she had to do it with the greatest care. now that this woman is well she knows how to rest and she knows how to work better than ever before. for normal rest we need the long sleep of night. for shorter rests which we may take during the day, often opportunity comes at most unexpected times and in most unexpected ways, and we must be ready to take advantage of it. we need also the habit of working restfully. this habit of course enables us to rest truly when we are only resting, and again the habit of resting normally helps us to work normally. a wise old lady said: "my dear, you cannot exaggerate the unimportance of things." she expressed even more, perhaps, than she knew. it is our habit of exaggerating the importance of things that keeps us hurried and rushed. it is our habit of exaggerating the importance of ourselves that makes us hold the strain of life so intensely. if we would be content to do one thing at a time, and concentrate on that one thing until it came time to do the next thing, it would astonish us to see how much we should accomplish. a healthy concentration is at the root of working restfully and of resting restfully, for a healthy concentration means dropping everything that interferes. i know there are women who read this article who will say; "oh, yes, that is all very well for some women, but it does not apply in the least to a woman who has my responsibilities, or to a woman who has to work as i have to work." my answer to that is: "dear lady, you are the very one to whom it does apply!" the more work we have to do, the harder our lives are, the more we need the best possible principles to lighten our work and to enlighten our lives. we are here in the world at school and we do not want to stay in the primary classes. the harder our lives are and the more we are handicapped the more truly we can learn to make every limitation an opportunity--and if we persistently do that through circumstances, no matter how severe, the nearer we are to getting our diploma. to gain our freedom from the rushed feeling, to find a quiet mind in place of an unquiet one, is worth working hard for through any number of difficulties. and think of the benefit such a quiet mind could be to other people! especially if the quiet mind were the mind of a woman, for, at the present day, think what a contrast she would be to other women! when a woman's mind is turbulent it is the worst kind of turbulence. when it is quiet we can almost say it is the best kind of quiet, humanly speaking. chapter iv _why does mrs. smith get on my nerves?_ if you want to know the true answer to this question it is "because you are unwilling that mrs. smith should be herself." you want her to be just like you, or, if not just like you, you want her to be just as you would best like her. i have seen a woman so annoyed that she could not eat her supper because another woman ate sugar on baked beans. when this woman told me later what it was that had taken away her appetite she added: "and isn't it absurd? why shouldn't mrs. smith eat sugar on baked beans? it does not hurt me. i do not have to taste the sugar on the beans; but is it such an odd thing to do. it seems to me such bad manners that i just get so mad i can't eat!" now, could there be anything more absurd than that? to see a woman annoyed; to see her recognize that she was uselessly and foolishly annoyed, and yet to see that she makes not the slightest effort to get over her annoyance. it is like the woman who discovered that she spoke aloud in church, and was so surprised that she exclaimed: "why, i spoke out loud in church!" and then, again surprised, she cried: "why, i keep speaking aloud in church!"--and it did not occur to her to stop. my friend would have refused an invitation to supper, i truly believe, if she had known that mrs. smith would be there and her hostess would have baked beans. she was really a slave to mrs. smith's way of eating baked beans. "well, i do not blame her," i hear some reader say; "it is entirely out of place to eat sugar on baked beans. why shouldn't she be annoyed?" i answer: "why should she be annoyed? will her annoyance stop mrs. smith's eating sugar on baked beans? will she in any way--selfish or otherwise--be the gainer for her annoyance? furthermore, if it were the custom to eat sugar on baked beans, as it is the custom to put sugar in coffee, this woman would not have been annoyed at all. it was simply the fact of seeing mrs. smith digress from the ordinary course of life that annoyed her." it is the same thing that makes a horse shy. the horse does not say to himself, "there is a large carriage, moving with no horse to pull it, with nothing to push it, with--so far as i can see--no motive power at all. how weird that is! how frightful!"--and, with a quickly beating heart, jump aside and caper in scared excitement. a horse when he first sees an automobile gets an impression on his brain which is entirely out of his ordinary course of impressions--it is as if some one suddenly and unexpectedly struck him, and he shies and jumps. the horse is annoyed, but he does not know what it is that annoys him. now, when a horse shies you drive him away from the automobile and quiet him down, and then, if you are a good trainer, you drive him back again right in front of that car or some other one, and you repeat the process until the automobile becomes an ordinary impression to him, and he is no longer afraid of it. there is, however, just this difference between a woman and a horse: the woman has her own free will behind her annoyance, and a horse has not. if my friend had asked mrs. smith to supper twice a week, and had served baked beans each time and herself passed her the sugar with careful courtesy, and if she had done it all deliberately for the sake of getting over her annoyance, she would probably have only increased it until the strain would have got on her nerves much more seriously than mrs. smith ever had. not only that, but she would have found herself resisting other people's peculiarities more than ever before; i have seen people in nervous prostration from causes no more serious than that, on the surface. it is the habit of resistance and resentment back of the surface annoyance which is the serious cause of many a woman's attack of nerves. every woman is a slave to every other woman who annoys her. she is tied to each separate woman who has got on her nerves by a wire which is pulling, pulling the nervous force right out of her. and it is not the other woman's fault--it is her own. the wire is pulling, whether or not we are seeing or thinking of the other woman, for, having once been annoyed by her, the contraction is right there in our brains. it is just so much deposited strain in our nervous systems which will stay there until we, of our own free wills, have yielded out of it. the horse was not resenting nor resisting the automobile; therefore the strain of his fright was at once removed when the automobile became an ordinary impression. a woman, when she gets a new impression that she does not like, resents and resists it with her will, and she has got to get in behind that resistance and drop it with her will before she is a free woman. to be sure, there are many disagreeable things that annoy for a time, and then, as the expression goes, we get hardened to them. but few of us know that this hardening is just so much packed resistance which is going to show itself later in some unpleasant form and make us ill in mind or body. we have got to yield, yield, yield out of every bit of resistance and resentment to other people if we want to be free. no reasoning about it is going to do us any good. no passing back and forth in front of it is going to free us. we must yield first and then we can see clearly and reason justly. we must yield first and then we can go back and forth in front of it, and it will only be a reminder to yield every time until the habit of yielding has become habitual and the strength of nerve and strength of character developed by means of the yielding have been established. let me explain more fully what i mean by "yielding." every annoyance, resistance, or feeling of resentment contracts us in some way physically; if we turn our attention toward dropping that physical contraction, with a real desire to get rid of the resistance behind it, we shall find that dropping the physical strain opens the way to drop the mental and moral strain, and when we have really dropped the strain we invariably find reason and justice and even generosity toward others waiting to come to us. there is one important thing to be looked out for in this normal process of freeing ourselves from other people. a young girl said once to her teacher: "i got mad the other day and i relaxed, and the more i relaxed the madder i got!" "did you want to get over the anger?" asked the teacher. "no, i didn't," was the prompt and ready answer. of course, as this child relaxed out of the tension of her anger, there was only more anger to take its place, and the more she relaxed the more free her nerves were to take the impression of the anger hoarded up in her; consequently it was as she said: the more she relaxed the "madder" she got. later, this same little girl came to understand fully that she must have a real desire to get over her anger in order to have better feelings come up after she had dropped the contraction of the anger. i know of a woman who has been holding such steady hatred for certain other people that the strain of it has kept her ill. and it is all a matter of feeling: first, that these people have interfered with her welfare; second, that they differ from her in opinion. every once in a while her hatred finds a vent and spends itself in tears and bitter words. then, after the external relief of letting out her pent-up feeling, she closes up again and one would think from her voice and manner--if one did not look very deep in--that she had only kindliness for every one. but she stays nervously ill right along. how could she do otherwise with that strain in her? if she were constitutionally a strong woman this strain of hatred would have worn on her, though possibly not have made her really ill; but, being naturally sensitive and delicate, the strain has kept her an invalid altogether. "mother, i can't stand maria," one daughter says to her mother, and when inquiry is made the mother finds that what her daughter "cannot stand" is ways that differ from her own. sometimes, however, they are very disagreeable ways which are exactly like the ways of the person who cannot stand them. if one person is imperious and demanding she will get especially annoyed at another person for being imperious and demanding, without a suspicion that she is objecting vehemently to a reflection of herself. there are two ways in which people get on our nerves. the first way lies in their difference from us in habit--in little things and in big things; their habits are not our habits. their habits may be all right, and our habits may be all right, but they are "different." why should we not be willing to have them different? is there any reason for it except the very empty one that we consciously and unconsciously want every one else to be just like us, or to believe just as we do, or to behave just as we do? and what sense is there in that? "i cannot stand mrs. so-and-so; she gets into a rocking-chair and rocks and rocks until i feel as if i should go crazy!" some one says. but why not let mrs. so-and-so rock? it is her chair while she is in it, and her rocking. why need it touch us at all? "but," i hear a hundred women say, "it gets on our nerves; how can we help its getting on our nerves?" the answer to that is: "drop it off your nerves." i know many women who have tried it and who have succeeded, and who are now profiting by the relief. sometimes the process to such freedom is a long one; sometimes it is a short one; but, either way, the very effort toward it brings nervous strength, as well as strength of character. take the woman who rocks. practically every time she rocks you should relax, actually and consciously relax your muscles and your nerves. the woman who rocks need not know you are relaxing; it all can be done from inside. watch and you will find your muscles strained and tense with resistance to the rocking. go to work practically to drop every bit of strain that you observe. as you drop the grossest strain it will make you more sensitive to the finer strain and you can drop that--and it is even possible that you may seek the woman who rocks, in order to practice on her and get free from the habit of resisting more quickly. this seems comical--almost ridiculous--to think of seeking an annoyance in order to get rid of it; but, after laughing at it first, look at the idea seriously, and you will see it is common sense. when you have learned to relax to the woman who rocks you have learned to relax to other similar annoyances. you have been working on a principle that applies generally. you have acquired a good habit which can never really fail you. if my friend had invited mrs. smith to supper and served baked beans for the sake of relaxing out of the tension of her resistance to the sugar, then she could have conquered that resistance. but to try to conquer an annoyance like that without knowing how to yield in some way would be, so far as i know, an impossibility. of course, we would prefer that our friends should not have any disagreeable, ill-bred, personal ways, but we can go through the world without resisting them, and there is no chance of helping any one out of them through our own resistances. on the other hand a way may open by which the woman's attention is called to the very unhealthy habit of rocking--or eating sugar on beans--if we are ready, without resistance, to point it out to her. and if no way opens we have at least put ourselves out of bondage to her. the second way in which other people get on our nerves is more serious and more difficult. mrs. so-and-so may be doing very wrong--really very wrong; or some one who is nearly related to us may be doing very wrong--and it may be our most earnest and sincere desire to set him right. in such cases the strain is more intense because we really have right on our side, in our opinion, if not in our attitude toward the other person. then, to recognize that if some one else chooses to do wrong it is none of our business is one of the most difficult things to do--for a woman, especially. it is more difficult to recognize practically that, in so far as it may be our business, we can best put ourselves in a position to enable the other person to see his own mistake by dropping all personal resistance to it and all personal strain about it. even a mother with her son can help him to be a man much more truly if she stops worrying about and resisting his unmanliness. "but," i hear some one say, "that all seems like such cold indifference." not at all--not at all. such freedom from strain can be found only through a more actively affectionate interest in others. the more we truly love another, the more thoroughly we respect that other's individuality. the other so-called love is only love of possession and love of having our own way. it is not really love at all; it is sugar-coated tyranny. and when one sugar-coated tyrant' antagonizes herself against another sugar-coated tyrant the strain is severe indeed, and nothing good is ever accomplished. the roman infantry fought with a fixed amount of space about each soldier, and found that the greater freedom of individual activity enabled them to fight better and to conquer their foes. this symbolizes happily the process of getting people off our nerves. let us give each one a wide margin and thus preserve a good margin for ourselves. we rub up against other people's nerves by getting too near to them--not too near to their real selves, but too near, so to speak, to their nervous systems. there have been quarrels between good people just because one phase of nervous irritability roused another. let things in other people go until you have entirely dropped your strain about them--then it will be clear enough what to do and what to say, or what not to do and what not to say. people in the world cannot get on our nerves unless we allow them to do so. chapter v _the trying member of the family_ "tommy, don't do that. you know it annoys your grandfather." "well, why should he be annoyed? i am doing nothing wrong." "i know that, and it hurts me to ask you, but you know how he will feel if he sees you doing it, and you know that troubles me." reluctantly and sullenly tommy stopped. tommy's mother looked strained and worried and discontented. tommy had an expression on his face akin to that of a smouldering volcano. if any one had taken a good look at the grandfather it would have been very clear that tommy was his own grandson, and that the old man and the child were acting and reacting upon one another in a way that was harmful to both; although the injury was, of course, worse to the child, for the grandfather had toughened. the grandfather thought he loved his little grandson, and the grandson, at times, would not have acknowledged that he did not love his grandfather. at other times, with childish frankness, he said he "hated him." but the worst of this situation was that although the mother loved her son, and loved her father, and sincerely thought that she was the family peacemaker, she was all the time fanning the antagonism. here is a contrast to this little story an old uncle came into the family of his nephew to live, late in life, and with a record behind him of whims and crotchets in the extreme. the father and mother talked it over. uncle james must come. he had lost all his money. there was no one else to look after him and they could not afford to support him elsewhere where he would be comfortable. they took it into account, without offence, that it was probably just as much a cross to uncle james to come as it was to them to have him. they took no pose of magnanimity such as: "of course we must be good and offer uncle james a home," and "how good we are to do it!" uncle james was to come because it was the only thing for him to do. the necessity was to be faced and fought and conquered, and they had three strong, self-willed little children to face it with them. they had sense enough to see that if faced rightly it would do only good to the children, but if made a burden to groan over it would make their home a "hornets' nest." they agreed to say nothing to the children about uncle james's peculiarities, but to await developments. children are always delighted at a visit from a relative, and they welcomed their great-uncle with pleasure. it was not three days, however, before every one of the three was crying with dislike and hurt feelings and anger. then was the time to begin the campaign. the mother, with a happy face, called the three children to her, and said "now listen, children. do you suppose i like uncle james's irritability any better than you do?" "no," came in a chorus; "we don't see how you stand it, mother." then she said: "now look here, boys, do you suppose that uncle james likes his snapping any better than we do?" "if he does not like it why does he do it?" answered the boys. "i cannot tell you that; that is his business and not yours or mine," said the mother; "but i can prove to you that he does not like it. bobby, do you remember how you snapped at your brother yesterday, when he accidentally knocked your house over?" "yes!" replied bobby. "did you feel comfortable after it?" "you bet i didn't," was the quick reply. "well," answered the mother, "you boys stop and think just how disagreeable it is inside of you when you snap, and then think how it would be if you had to feel like that as much as uncle james does." "by golly, but that would be bad," said the twelve-year-old. "now, boys," went on the mother, "you want to relieve uncle james's disagreeable feelings all you can, and don't you see that you increase them when you do things to annoy him? his snappish feelings are just like a sore that is smarting and aching all the time, and when you get in their way it hurts as if you rubbed the sore. keep out of his way when you can, and when you can't and he snaps at you, say: 'i beg your pardon, sir,' like gentlemen, and stop doing what annoys him; or get out of his way as soon as you can." uncle james never became less snappish. but the upright, manly courtesy of those boys toward him was like fresh air on a mountain, especially because it had become a habit and was all as a matter of course. the father and mother realized that uncle james had, unconsciously, made men of their boys as nothing else in the world could have done, and had trained them so that they would grow up tolerant and courteous toward all human peculiarities. many times a gracious courtesy toward the "trying member" will discover good and helpful qualities that we had not guessed before. sometimes after a little honest effort we find that it is ourselves who have been the trying members, and that the other one has been the member tried. often it is from two members of the family that the trying element comes. two sisters may clash, and they will generally clash because they are unlike. suppose one sister moves and lives in big swings, and the other in minute details. of course when these extreme tendencies are accented in each the selfish temptation is for the larger mind to lapse into carelessness of details, and for the smaller mind to shrink into pettiness, and as this process continues the sisters get more and more intolerant of each other, and farther and farther apart. but if the sister who moves in the big swings will learn from the other to be careful in details, and if the smaller mind will allow itself to be enlarged by learning from the habitually broader view of the other, each will grow in proportion, and two women who began life as enemies in temperament can end it as happy friends. there are similar cases of brothers who clash, but they are not so evident, for when men do not agree they leave one another alone. women do not seem to be able to do that. it is good to leave one another alone when there is the clashing tendency, but it is better to conquer the clashing and learn to agree. so long as the normal course of my life leads me to live with some one who rubs me the wrong way i am not free until i have learned to live with that some one in quiet content. i never gain my freedom by running away. the bondage is in me always, so long as the other person's presence can rouse it. the only way is to fight it out inside of one's self. when we can get the co-operation of the other so much the better. but no one's co-operation is necessary for us to find our own freedom, and with it an intelligent, tolerant kindliness. "mother, you take that seat. no, not that one, mother--the sun comes in that window. children, move aside and let your grandmother get to her seat." the young woman was very much in earnest in seeing that her mother had a comfortable seat, that she had not the discomfort of the hot sun, that the children made way for her so that she could move into her seat comfortably. all her words were thoughtful and courteous, but the spirit and the tone of her words were quite the reverse of courteous. if some listener with his eyes shut had heard the tone without understanding the words he might easily have thought that the woman was talking to a little dog. poor "mother" trotted into her seat with the air of a little dog who was so well trained that he did at once what his mistress ordered. it was very evident that "mother's" will had been squeezed out of her and trampled upon for years by her dutiful daughter, who looked out always that "mother" had the best, without the first scrap of respect for "mother's" free, human soul. the grandchildren took the spirit of their mother's words rather than the words themselves, and treated their grandmother as if she were a sort of traveling idiot tagged on to them, to whom they had to be decently respectful whenever their mother's eye was upon them, and whom they ignored entirely when their mother looked the other way. it so happened that i was sitting next to this particular mother who had been poked into a comfortable seat by her careful daughter. and, after a number of other suggestions had been poked at her with a view to adding to her comfort, she turned to me and in a quaint, confidential way, with the gentle voice of a habitual martyr, and at the same time a twinkle of humor in her eye, she said "they think, you know, i don't know anything." and after that we had a little talk about matters of the day which proved to me that "mother" had a mind broader and certainly more quiet than her daughter. i studied the daughter with interest after knowing "mother" better, and her habitual strain of voice and manner were pathetic. by making a care of her mother instead of a companion, she was not only guilty of disrespect to a soul which, however weak it may have been in allowing itself to be directed in all minor matters, had its own firm principles which were not overridden nor even disturbed by the daughter's dominance. if the daughter had only dropped her strain of care and her habit of "bossing" she would have found a true companion in her mother, and would have been a healthier and happier woman herself. in pleasant contrast to this is the story of a family which had an old father who had lost his mind entirely, and had grown decrepit and childish in the extreme. the sons and daughters tended him like a baby and loved him with gentle, tender respect. there was no embarrassment for his loss of mind, no thought of being distressed or pained by it, and because his children took their father's state so quietly and without shame, every guest who came took it in the same way, and there was no thought of keeping the father out of sight. he sat in the living-room in his comfortable chair, and always one child or another was sitting right beside him with a smiling face. instead of being a trying member of the family, as happens in so many cases, this old father seemed to bring content and rest to his children through their loving care for him. very often--i might almost say always--the trying member of the family is trying only because we make her so by our attitude toward her, let her be grandmother, mother, or maiden aunt. even the proverbial mother-in-law grows less difficult as our attitude toward her is relieved of the strain of detesting everything she does, and expecting to detest everything that she is going to do. with every trying friend we have, if we yield to him in all minor matters we find the settling of essential questions wonderfully less difficult. a son had a temper and the girl he married had a temper. the mother loved her son with the selfish love with which so many mothers burden their children, and thought that he alone of all men had a right to lose his temper. consequently she excused her son and blamed her daughter-in-law. if there were a mild cyclone roused between the two married people the son would turn to his mother to hear what a martyr he was and what misfortune he had to bear in having been so easily mistaken in the woman he married. thus the mother-in-law, who felt that she was protecting her poor son, was really breeding dissension between two people who could have been the best possible friends all their lives. the young wife very soon became ashamed of her temper and worked until she conquered it, but it was not until her mother-in-law had been out of this world for years that her husband discovered what he had lost in turning away from his wife's friendship, and it was only by the happy accident of severe illness that he ever discovered his mistake at all, and gained freedom from the bondage of his own temper enough to appreciate his wife. if, however, the wife had yielded in the beginning not only to her husband's bad temper but also to the antagonism of her mother-in-law, which was, of course, annoying in many petty ways, she might have gained her husband's friendship, and it is possible that she might, moreover, have gained the friendship of her mother-in-law. the best rule with regard to all trying members of the family is to yield to them always in non-essentials; and when you disagree in essentials stick to the principle which you believe to be right, but stick to it without resistance. believe your way, but make yourself willing that the trying member should believe her way. make an opportunity of what appears to be a limitation, and, believe me, your trying member can become a blessing to you. i go further than that--i truly believe that to make the best of life every family should have a trying member. when we have no trying member of our family, and life goes along smoothly, as a matter of course, the harmony is very liable to be spurious, and a sudden test will all at once knock such a family into discord, much to the surprise of every member. when we go through discord to harmony, and once get into step, we are very likely to keep in step: be willing, then, make yourself willing, that the trying member should be in the way. hope that she will stay in your family until you have succeeded in dropping not only all resistance to her being there, but every resistance to her various ways in detail. bring her annoying ways up to your mind voluntarily when you are away from her. if you do that you will find all the resistances come with them and you can relax out of the strain then and there. you will find that when you get home or come down to breakfast in the morning (for many resistances are voluntarily thrown off in the night) you will have a pleasanter feeling toward the trying member, and it comes so spontaneously that you will be surprised yourself at the absence of the strain of resistance in you. believe me when i say this: the yielding in the non-essentials, singularly enough, gives one strength to refuse to yield in principles. but we must always remember that if we want to find real peace, while we refuse to yield in our own principles so long as we believe them to be true, we must be entirely willing that others should differ from us in belief. chapter vi _irritable husbands_ suppose your husband got impatient and annoyed with you because you did not seem to enter heartily into the interests of his work and sympathize with its cares and responsibilities and soothe him out of the nervous harassments. would you not perhaps feel a little sore that he seemed to expect all from you and to give nothing in return? i know how many women will say that is all very well, but the husband and father should feel as much interest in the home and the children as the wife and mother does. that is, of course, true up to a certain point, always in general, and when his help is really necessary in particular. but a man cannot enter into the details of his wife's duties at home any more than a woman can enter into the details of her husband's duties at his office. then, again, my readers may say: "but a woman's nervous system is more sensitive than a man's; she needs help and consolation. she needs to have some one on whom she can lean." now the answer to that will probably be surprising, but an intelligent understanding and comprehension of it would make a very radical difference in the lives of many men and women who have agreed to live together for life--for better and for worse. now the truth is man's nervous system is quite as sensitive as a woman's, but the woman's temptation to emotion makes her appear more sensitive, and her failure to control her emotions ultimately increases the sensitiveness of her nerves so that they are more abnormal than her husband's. even that is not always true the other day a woman sat in tears and distress telling of the hardness of heart, the restlessness, the irritability, the thoughtlessness, the unkindness of her husband. her face was drawn with suffering. she insisted that she was not complaining, that it was her deep and tender love for her husband that made her suffer so. "but it is killing me, it is killing me," she said, and one who saw her could well believe it. and if the distress and the great strain upon her nerves had kept on it certainly would have made her ill, if not have actually ended her life with a nervous collapse. the friend in whom she confided sat quietly and heard her through. she let her pour herself out to the very finish until she stopped because there was nothing more to say. then, by means of a series of gentle, well-adapted questions, she drew from the wife a recognition--for the first time--of the fact that she really did nothing whatever for her husband and expected him to do everything for her. perhaps she put on a pretty dress for him in order to look attractive when he came home, but if he did not notice how well she looked, and was irritable about something in the house, she would be dissolved in tears because she had not proved attractive and pleased him. maybe she had tried to have a dinner that he especially liked; then if he did not notice the food, and seemed distracted about something that was worrying him, she would again be dissolved in tears because he "appreciated nothing that she tried to do for him." now it is perfectly true that this husband was irritable and brutal; he had no more consideration for his wife than he had for any one else. but his wife was doing all in her power to fan his irritability into flame and to increase his brutality. she was attitudinizing in her own mind as a martyr. she was demanding kindness and attention and sympathy from her husband, and because she demanded it she never got it. a woman can demand without demanding imperiously. there is more selfish demanding in a woman's emotional suffering because her husband does not do this or that or the other for her sake than there is in a tornado of man's irritability or anger. you see, a woman's demanding spirit is covered with the mush of her emotions. a man's demanding spirit stands out in all its naked ugliness. one is just as bad as the other. one is just as repulsive as the other. it is a radical, practical impossibility to bring loving-kindness out of any one by demanding it. loving-kindness, thoughtfulness, and consideration have got to be born spontaneously in a man's own mind to be anything at all, and no amount of demanding on the part of his wife can force it. when this little lady of whom i have been writing found that she had been demanding from her husband what he really ought to have given her as a matter of course, and that she had used up all her strength in suffering because he did not give it, and had used none of her strength in the effort to be patient and quiet in waiting for him to come to his senses, she went home and began a new life. she was a plucky little woman and very intelligent when once her eyes were opened. she recognized the fact that her suffering was resistance to her husband's irritable selfishness, and she stopped resisting. it was a long and hard struggle of days, weeks, and months, but it brought a very happy reward. when a man is irritable and ugly, and his wife offers no resistance either in anger or suffering, the irritability and ugliness react upon himself, and if there is something better in him he begins to perceive the irritability in its true colors. that is what happened to this man. as his wife stopped demanding he began to give. as his wife's nerves became calm and quiet his nerves quieted and calmed. finally his wife discovered that much of his irritability had been roused through nervous anxiety in regard to his business about which he had told her nothing whatever because it "was not his way." there is nothing in the world that so strengthens nerves as the steady use of the will to drop resistance and useless emotions and get a quiet control. this woman gained that strength, and to her surprise one day her husband turned to her with a full account of all his business troubles and she met his mind quietly, as one business man might meet another, and without in the least expressing her pleasure or her surprise. she took all the good change in him as a matter of course. finally one day it came naturally and easily to talk over the past. she found that her husband from day to day had dreaded coming home. the truth was that he had dreaded his own irritability as much as he had dreaded her emotional demanding. but he did not know it--he did not know what was the matter at all. he simply knew vaguely that he was a brute, that he felt like a brute, and that he did not know how to stop being a brute. his wife knew that he was a brute, and at the same time she felt throughly convinced that she was a suffering martyr. he was dreading to come home and she was dreading to have him come home--and there they were in a continuous nightmare. now they have left the nightmare far, far behind, and each one knows that the other has one good friend in the world in whom he or she can feel entire confidence, and their friendship is growing stronger and clearer and more normal every day. it is not the ceremony that makes the marriage: the ceremony only begins it. marriage is a slow and careful adjustment. a true story which illustrates the opposite of this condition is that of a man and woman who were to all appearances happily married for years. they were apparently the very closest friends. the man's nerves were excitable and peculiar, and his wife adjusted herself to them by indulging them and working in every way to save him from friction. no woman could stand that constant work of adjustment which was in reality maladjustment, and this wife's nerves broke down unexpectedly and completely. when our nerves get weak we are unable to repress resistance which in a stronger state we had covered up. this wife, while she had indulged and protected her husband's peculiarities, had subconsciously resisted them. when she became ill her subconscious resistance came to the surface. she surprised herself by growing impatient with her husband. he, of course; retorted. as she grew worse he did not find his usual comfort from her care, and instead of trying to help her to get well he turned his back on her and complained to another woman. finally the friction of the two nervous systems became dangerously intense. each was equally obstinate, and there was nothing to do but to separate the woman died of a broken heart, and the man is probably insane for the rest of his life. it was nothing but the mismanagement of their own and each other's nerves that made all this terrible trouble. their love seemed genuine at first, and could certainly have grown to be really genuine if they had become truly adjusted. and the saddest part of the whole story is that they were both peculiarly adapted to be of use to their fellow-men. during the first years of their life their home was a delight to all their friends. tired nerves are likely to close up a man or make him irritable, complaining, and ugly, whereas the tendency in a woman is to be irritable, complaining, and tearful. now of course when each one is selfishly looking out for his or her comfort neither one can be expected to understand the other. the man thinks he is entirely justified in being annoyed with the woman's tearful, irritable complaints, and so he is--in a way. the woman thinks that she has a right to suffer because of her husband's irritable ugliness, and so she has--in a way. but in the truest way, and the way which appeals to every one's common sense, neither one has a right to complain of the other, and each one by right should have first made things better and clearer in himself and herself. human nature is not so bad--really in its essence it is not bad at all. if we only give the other man a real chance. it is the pushing and pulling and demanding of one human being toward another that smother the best in us, and make life a fearful strain. of course there is a healthy demanding as well as an unhealthy demanding, but, so far as i know, the healthy demanding can come only when we are clear of personal resistance and can demand on the strength of a true principle and without selfish emotion. there is a kind of gentle, motherly contempt with which some women speak of their husbands, which must get on a man's nerves very painfully. it is intensely and most acutely annoying. and yet i have heard good women speak in that way over and over again. the gentleness and motherliness are of course neither of them real in such cases. the gentle, motherly tone is used to cover up their own sense of superiority. "poor boy, poor boy," they may say; "a man is really like a child." so he may be--so he often is childish, and sometimes childish in the extreme. but where could you find greater and more abject childishness than in a woman's ungoverned emotions? a woman must respect the manliness of her husband's soul, and must cling to her belief in its living existence behind any amount of selfish, restless irritability, if she is going to find a friend in him or be a friend to him. she must also know that his nervous system may be just as sensitive as hers. sometimes it is more sensitive, and should be accordingly respected. demand nothing and expect nothing, but hold him to his best in your mind and wait. that is a rule that would work wonderfully if every woman who is puzzled about her husband's restlessness and lack of interest in home affairs would apply it steadily and for long enough. it is impossible to manufacture a happy, sympathetic married life artificially--impossible! but as each one looks to one's self and does one's part fully, and then is willing to wait for the other, the happiness and the sympathy, the better power for work and the joyful ability to play come--they do come; they are real and alive and waiting for us as we get clear from the interferences. "why doesn't my husband like to stay with me when he comes home? why can't we have nice, cozy times together?" a wife asks with sad longing in her eyes. and to the same friend the husband (who is, by the way, something of a pig) says: "i should be glad to stay with nellie often in the evening, but she will always talk about her worries, and she worries about the family in a way that is idiotic. she is always sure that george will catch the measles because a boy in the next street has them, and she is always sure that our children do not have the advantages nor the good manners that other children have. if it is not one thing it is another; whenever we are alone there is something to complain of, and her last complaint was about her own selfishness." then he laughed at what he considered a good joke, and in five minutes had forgotten all about her. this wife, in a weak, selfish little way, was trying to give her husband her confidence, and her complaint about her own selfishness was genuine. she wanted his help to get out of it. if he had given her just a little gracious attention and told her how impossible it was really to discuss the children when she began the conversation with whining complaint, she would have allowed herself to be taught and their intercourse would have improved. on the other hand, if the wife had realized that her husband came home from the cares of his business tired and nervous, and if she had talked lightly and easily on general subjects and tried to follow his interests, when his nerves were rested and quiet she might have found him ready and able to give her a little lift with regard to the children. it is interesting and it is delightful to see how, as we each work first to bear our own burdens, we not only find ourselves ready and able to lighten the burdens of others but find others who are helpful to us. a woman who finds her husband "so restless and irritable" should remember that in reality a man's nervous system is just as sensitive as a woman's, and, with a steady and consistent effort to bear her own burdens and to work out her own problems, should prepare herself to lighten her husband's burdens and help to solve his problems; that is the truest way of bringing him to the place where he will be glad to share her burdens with her as well as his own. but we want to remember that there is a radical difference between indulging another's selfishness, and waiting, with patient yielding, for him to discover his selfishness himself, and to act unselfishly from his own free will. chapter vii _quiet vs. chronic excitement_ some women live in a chronic state of excitement all the time and they do not find it out until they get ill. even then they do not always find it out, and then they get more ill. it is really much the same with excitable women as with a man who thinks he must always keep a little stimulant in himself in order to keep about his work. when a bad habit is established in us we feel unnatural if we give the habit up for a moment--and we feel natural when we are in it--but it is poison all the same. if a woman has a habit of constantly snuffing or clearing her throat, or rocking a rocking chair, or chattering to whoever may be near her she would feel unnatural and weird if she were suddenly wrenched out of any of these things. and yet the poisoning process goes on just the same. when it seems immaterial to us that we should be natural we are in a pretty bad way and the worst of it is we do not know it. i once took a friend with me into the country who was one of those women who lived on excitement in every-day life. when she dressed in the morning she dressed in excitement. she went down to breakfast in excitement. she went about the most humdrum everyday affairs excited. every event in life--little or big--was an excitement to her--and she went to bed tired out with excitement--over nothing. we went deep in the woods and in the mountains, full of great powerful quiet. when my friend first got there she was excited about her arrival, she was excited about the house and the people in it, but in the middle of the night she jumped up in bed with a groan of torture. i thought she had been suddenly taken ill and started up quickly from my end of the room to see what was the trouble. "oh, oh," she groaned, "the quiet! it is so quiet!" her brain which had been in a whirl of petty excitement felt keen pain when the normal quiet touched it. fortunately this woman had common sense and i could gradually explain the truth to her, and she acted upon it and got rested and strong and quiet. i knew another woman who had been wearing shoes that were too tight for her and that pinched her toes all together. the first time she wore shoes that gave her feet room enough the muscles of her feet hurt her so that she could hardly walk. of course, having been cramped into abnormal contraction the process of expanding to freedom would be painful. if you had held your fist clenched tight for years, or months, or even weeks, how it would hurt to open it so that you could have free use of your fingers. the same truth holds good with a fist that has been clenched, a foot that has been pinched, or a brain that has been contracted with excitement. the process leading from the abnormal to the normal is always a painful one. to stay in the abnormal means blindness, constantly limiting power and death. to come out into a normal atmosphere and into a normal way of living means clearer sight, constantly increasing power, and fresh life. this habit of excitement is not only contracting to the brain; it has its effect over the whole body. if there is any organ that is weaker than any other the excitement eventually shows itself. a woman may be suffering from indigestion, or she may be running up large doctor's bills because of either one of a dozen other organic disturbances, with no suspicion that the cause of the whole trouble is that the noisy, excited, strained habits of her life have robbed her body of the vitality it needed to keep it in good running order. as if an engineer threw his coal all over the road and having no fuel for his engine wondered that it would not run. stupid women we are--most of us! the trouble is that many of us are so deeply immersed in the habit of excitement that we do not know it. it is a healthy thing to test ourselves and to really try to find ourselves out. it is not only healthy; it is deeply interesting. if quiet of the woods, or, any other quiet place, makes us fidgety, we may be sure that our own state is abnormal and we had better go into the woods as often as possible until we feel ourselves to be a part of the quiet there. if we go into the woods and get soothed and quieted and then come out and get fussed up and excited so that we feel painfully the contrast between the quiet and our every-day life, then we can know that we are living in the habit of abnormal excitement and we can set to work to stop it. "that is all very well," i hear my readers say, "but how are you going to stop living in abnormal excitement when every circumstance and every person about you is full of it and knows nothing else?" if you really want to do it and would feel interested to make persistent effort i can give you the recipe and i can promise any woman that if she perseveres until she has found the way she will never cease to be grateful. if you start with the intention of taking the five minutes' search for quiet every day, do not let your intention be weakened or yourself discouraged if for some days you see no result at all. at first it may be that whatever quiet you find will seem so strange that it will annoy you or make you very nervous, but if you persist and work right through, the reward will be worth the pains many times over. sometimes quieting our minds helps us to quiet our bodies; sometimes we must quiet our bodies first before we can find the way to a really quiet mind. the attention of the mind to quiet the body, of course, reacts back on to the mind, and from there we can pass on to thinking quietly. each individual must judge for herself as to the best way of reaching the quiet. i will give several recipes and you can take your choice. first, to quiet the body:-- . lie still and see how quietly you can breathe. . sit still and let your head droop very slowly forward until finally it hangs down with its whole weight. then lift it up very, very slowly and feel as if you pushed it all the way up from the lower part of your spine, or, better still, as if it grew up, so that you feel the slow, creeping, soothing motion all the way up your spine while your head is coming up, and do not let your head come to an entirely erect position until your chest is as high as you can hold it comfortably. when your head is erect take a long, quiet breath and drop it again. you can probably drop it and raise it twice in the five minutes. later on it should take the whole five minutes to drop it and raise it once and an extra two minutes for the long breath. when you have dropped your head as far as you can, pause for a full minute without moving at all and feel heavy; then begin at the lower part of your spine and very slowly start to raise it. be careful not to hold your breath, and watch to breathe as easily and quietly as you can while your head is moving. if this exercise hurts the back of your neck or any part of your spine, don't be troubled by it, but go right ahead and you will soon come to where it not only does not hurt, but is very restful. when you have reached an erect position again stay there quietly--first take long gentle breaths and let them get shorter and shorter until they are a good natural length, then forget your breathing altogether and sit still as if you never had moved, you never were going to move, and you never wanted to move. this emphasizes the good natural quiet in your brain and so makes you more sensitive to unquiet. gradually you will get the habit of catching yourself in states of unnecessary excitement; at such times you cannot go off by yourself and go through the exercises. you cannot even stop where you are and go through them, but you can recall the impression made on your brain at the time you did them and in that way rule out your excitement and gain the real power that should be in its place. so little by little the state of excitement becomes as unpleasant as a cloud of dust on a windy day and the quiet is as pleasant as under the trees on top of a hill in the best kind of a june day. the trouble is so many of us live in a cloud of dust that we do not suspect even the existence of the june day, but if we are fortunate enough once or twice even to get to sneezing from the dust, and so to recognize its unpleasantness, then we want to look carefully to see if there is not a way out of it. it is then that we can get the beginning of the real quiet which is the normal atmosphere of every human being. but we must persist for a long time before we can feel established in the quiet itself. what is worth having is worth working for--and the more it is worth having, the harder work is required to get it. nerves form habits, and our nerves not only get the habit of living in the dust, but the nerves of all about us have the same habit. so that when at first we begin to get into clear air, we may almost dislike it, and rush back into the dust again, because we and our friends are accustomed to it. all that bad habit has to be fought, and conquered, and there are many difficulties in the way of persistence, but the reward is worth it all, as i hope to show in later articles. i remember once walking in a crowded street where the people were hurrying and rushing, where every one's face was drawn and knotted, and nobody seemed to be having a good time. suddenly and unexpectedly i saw a man coming toward me with a face so quiet that it showed out like a little bit of calm in a tornado. he looked like a common, every-day man of the world, so far as his dress and general bearing went, and his features were not at all unusual, but his expression was so full of quiet interest as to be the greatest contrast to those about him. he was not thinking his own thoughts either--he was one of the crowd and a busy, interested observer. he might have said, "you silly geese, what are you making all this fuss about, you can do it much better if you will go more easily." if that was his thought it came from a very kindly sense of humor, and he gave me a new realization of what it meant, practically, to be in the world and not of it. if you are in the world you can live, and observe, and take a much better part in its workings. if you are of it, you are simply whirled in an eddy of dust, however you may pose to yourself or to others. chapter viii _the tired emphasis_ "i am so tired, so tired--i go to bed tired, i get up tired, and i am tired all the time." how many women--how many hundred women, how many thousand women--say that to themselves and to others constantly. it is perfectly true; they are tired all the time; they do go to bed tired and get up tired and stay tired all day. if, however, they could only know how very much they increase their fatigue by their constant mental emphasis of it, and if at the same time they could turn their wills in the direction of decreasing the fatigue, instead of emphasizing it, a very large percentage of the tired feeling could be done away with altogether. many women would gladly make more of an effort in the direction of rest if they knew how, and i propose in this article to give a prescription for the cure of the tired emphasis which, if followed, will bring happy results. when you go to bed at night, no matter how tired you feel, instead of thinking how tired you are, think how good it is that you can go to bed to get rested. it will probably seem absurd to you at first. you may say to yourself: "how ridiculous, going to bed to get rested, when i have only one short night to rest in, and one or two weeks in bed would not rest me thoroughly." the answer to that is that if you have only one night in which to rest, you want to make the most of that night, and if you carry the tired emphasis to bed with you you are really holding on to the tired. this is as practically true as if you stepped into a bog and then sat in it and looked forlorn and said. "what a terrible thing it is that i should be in a bog like this; just think of having to sit in a black, muddy bog all the time," and staying there you made no effort whatever to get out of it, even though there was dry land right in front of you. again you may answer: "but in my tired bog there is no dry land in front of me, none at all." i say to that, there is much more dry land than you think--if you will open your eyes--and to open your eyes you must make an effort. no one knows, who has not tried, what a good strong effort will do in the right direction, when we have been living and slipping back in the wrong direction. the results of such efforts seem at times wonderful to those who have learned the right direction for the first time. to get rid of the tired emphasis when we have been fixed in it, a very strong effort is necessary at first, and gradually it gets easier, and easier, until we have cast off the tired emphasis entirely and have the habit of looking toward rest. we must say to ourselves with decision in so many words, and must think the meaning of the words and insist upon it: "i am very tired. yes, of course, i am very tired, but i am going to bed to get rested." there are a hundred little individual ways that we can talk to ourselves, and turn ourselves toward rest, at the end of the day when the time comes to rest. one way to begin, which is necessary to most of us, is to stop resisting the tired. every complaint of fatigue, whether it is merely in our own minds, or is made to others, is full of resistance, and resistance to any sort of fatigue emphasizes it proportionately. that is why it is good to say to ourselves: "yes, i am tired; i am awfully tired. i am willing to be tired." when we have used our wills to drop the nervous and muscular contractions that the fatigue has caused, we can add with more emphasis and more meaning, "and i am going to bed to get rested." some one could say just here: "that is all very well for an ordinarily tired person, but it would never do me any good. i am too tired even to try it." the answer to that is, the more tired you are, the more you need to try it, and the more interesting the experiment will be. also the very effort of your brain needed to cast off the tired emphasis will be new to you, and thought in a new direction is always restful in itself. having learned to cast off the tired emphasis when we go to bed at night, we can gradually learn to cast it off before we go to meals, and at odd opportunities throughout the day. the more tired we are, the more we need to minimize our fatigue by the intelligent use of our own wills. who cares for a game that is simple and easy? who cares for a game when you beat as a matter of course, and without any effort on your part at all? whoever cares for games at all cares most for good, stiff ones, where, when you have beaten, you can feel that you have really accomplished something; and when you have not beaten, you have at least learned points that will enable you to beat the next time, or the next to the next time--or sometime. and everyone who really loves a game wants to stick to it until he has conquered and is proficient. why not wake up, and realize that same interest and courage in this biggest game of all--this game of life? we must play it! few of us are cowards enough to put ourselves out of it. unless we play it and obey the rules we do not really play at all. many of us do not know the rules, but it is our place to look about and find them out. many more of us think that we can play the game better if we make up rules of our own, and leave out whatever regular rules we do know, that do not suit our convenience. but that never works. it only sometimes seems to work; and although plain common sense shows us over and over that the game played according to our own ideas amounts to nothing, it is strange to see how many work and push to play the game in their own way instead of in the game's way. it is strange to see how many shove blindly in this direction, and that direction, to cut their way through a jungle, when there is the path just by them, if they will take it. most of us do not know our own power because we would rather stay in a ditch and complain. strength begets strength, and we can only find our greater power, by using intelligently, and steadily, the power we have. chapter ix _how to be ill and get well_ illness seems to be one of the hardest things to happen to a busy woman. especially hard is it when a woman must live from hand to mouth, and so much illness means, almost literally, so much less food. sometimes one is taken so suddenly and seriously ill that it is impossible to think of whether one has food and shelter or not; one must just be taken care of or die. it does not seem to matter which at the time. then another must meet the difficulty. it is the little nagging illnesses that make the trouble--just enough to keep a woman at home a week or ten days or more, and deprive her of wages which she might have been receiving, and which she very much needs. these are the illnesses that are hard to bear. many a woman has suffered through an illness like this, which has dragged out from day to day, and finally left her pale and weak, to return to her work with much less strength than she needs for what is before her. after forcing herself to work day after day, her strength comes back so slowly, that she appears to go through another illness, on her feet, and "in the harness," before she can really call herself well again. there are a few clear points which, if intelligently comprehended, could teach one how to meet an illness, and if persistently acted upon, would not only shorten it, but would lighten the convalescence so that when the invalid returned to her work she would feel stronger than before she was taken ill. when one is taken with a petty illness, if it is met in an intelligent way, the result can be a good rest, and one feels much better, and has a more healthy appearance, than before the attack. this effect has been so often experienced that with some people there is a little bit of pleasantry passed on meeting a friend, in the remark: "why, how do you do; how well you look--you must have been ill!" if we remember when we are taken ill that nature always tends towards health, we will study carefully to fulfill nature's conditions in order to cure the disease. we will rest quietly, until nature in her process toward health has reached health. in that way our illness can be the means of giving us a good rest, and, while we may feel the loss of the energy of which the disease has robbed us, we also feel the good effects of the rest which we have given to organs which were only tired. these organs which have gained rest can, in their turn, help toward renewing the strength of the organs which had been out of order, and thus we get up from an illness looking so well, and feeling so well, that we do not regret the loss of time, and feel ready to work, and to gradually make up the loss of money. of course, the question is, how to fulfill the conditions so that this happy result can be attained. in the first place, _do not fret._ "but how can i help fretting?" someone will say, "when i am losing money every day, and do not know how many more days i may be laid up?" the answer to that is: "if you will think of the common sense of it, you can easily see that the strain of fretting is interfering radically with your getting well. for when you are using up strength to fret, you are simply robbing yourself of the vitality which would be used directly in the cure of your illness." not only that, but the strain of fretting increases the strain of illness, and is not only preventing you from getting well, but it is tending to keep you ill. when we realize that fact, it seems as if it would be an easy matter to stop fretting in order to get well. it is as senseless to fret about an illness, no matter how much just cause we may feel we have, as it would be to walk west when our destination was directly east. stop and think of it. is not that true? imagine a child with a pin pricking him, kicking, and screaming, and squirming with the pain, so that his mother--try as carefully as she may--takes five minutes to find the pin and get it out, when she might have done it and relieved him in five seconds, if only the child had kept still and let her. so it is with us when mother nature is working with wise steadiness to find the pin that is making us ill, and to get it out. we fret and worry so that it takes her ten or twenty days to do the good work that she might have done in three. in order to drop the fretting, we must use our wills to think, and feel, and act, so that the way may be opened for health to come to us in the quickest possible time. every contraction of worry which appears in the muscles we must drop, so that we lie still with a sense of resting, and waiting for the healing power, which is surely working within us, to make us well. _we can do this by a deliberate use of our wills._ if we could take our choice between medicine, and the curative power of dropping anxiety and letting ourselves get well, there would be no hesitancy, provided we understood the alternatives. i speak of fretting first because it is so often the strongest interference with health. defective circulation is the trouble in most diseases, and we should do all we can to open the channels so that the circulation, being free elsewhere, can tend to open the way to greater freedom in the part diseased. the contractions caused by fretting impede the circulation still more, and therefore heighten the disease. if once, by a strong use of the will, we drop the fretting and give ourselves up entirely to letting nature cure us, then we can study, with interest, to fulfill other necessary conditions. we can give ourselves the right amount of fresh air, of nourishment, of bathing, and the right sort of medicine, if any is needed. thus, instead of interfering with nature, we are doing all in our power to aid her; and when nature and the invalid work in harmony, health comes on apace. when illness brings much pain and discomfort with it, the endeavor to relax out of the contractions caused by the pain, are of the same service as dropping contractions caused by the fretting. if one can find a truly wise doctor, or nurse, in such an illness as i refer to, get full instructions in just one visit, and then follow those directions explicitly, only one visit will be needed, probably, and the gain from that will pay for it many times over. this article is addressed especially to those who are now in health. it is perhaps too much to expect one in the midst of an illness to start at once with what we may call the curative attitude, although it could be done, but if those who are now well and strong will read and get a good understanding of this healthy way of facing an illness, and get it into their subconscious minds, they will find that if at any time they should be unfortunate enough to be attacked with illness, they can use the knowledge to very real advantage, and--what is more--they can, with the right tact, help others to use it also. to see the common sense of a process and, when we have not the opportunity to use the laws ourselves, to help others by means of our knowledge, impresses our own brains more thoroughly with the truth, especially if our advice is taken and acted upon and thus proved to be true. it must not be forgotten, however, that to help another man or woman to a healthy process of getting well requires gentle patience and quiet, steady, unremitting tact. chapter x _is physical culture good for girls?_ a number of women were watching a game of basket-ball played by some high-school girls. in the interim for rest one woman said to her neighbor: "do you see that girl flat on her back, looking like a very heavy bag of sand?" "yes," the answer was; "what under the sun is she doing that for? she looks heavy and lazy and logy, while the other girls are talking and laughing and having a good time." "you wait and watch her play," responded the first woman. and so they waited and watched, and to the astonishment of the friend the girl who had looked "lazy and logy," lying flat on her back during the rest-time, was the most active of the players, and really saved the game. when the game was finished the woman said to her friend with surprise in her voice: "how did you see through that, and understand what that girl was aiming for?" the answer was: "well, i know the girl, and both she and i have read kipling's 'the maltese cat.' don't you remember how the best polo ponies in that story, when they were off duty, hung their heads and actually made themselves looked fagged, in order to be fresher when the time came to play? and how 'the maltese cat' scouted the silly ponies who held their heads up and kicked and looked alert while they waited? and don't you remember the result?" "no, i never read the story, but i have certainly seen your point prove itself to-day. i shall read it at once. meanwhile, i want to speak to that clever girl who could catch a point like that and use it." "take care, please, that you do not mention it to her at all," said the friend. "you will draw her attention back to herself and likely as not make her lose the next game. points like that have got to be worked on without self-consciousness, not talked about." and so the women told the child they were glad that her side won the game and never mentioned her own part in it at all. after all she had only found the law that the more passive you can be when it is time to rest, the more alert you are and the more powerful in activity. the polo pony knew it as a matter of course. we humans have to discover it. let us, just for the interest of it, follow that same basket-ball player a little more closely. was she well developed and evenly trained in her muscles? yes, very. did she go to gymnasium, or did she scorn it? she went, twice a week regularly, and had good fun there; but there was just this contrast between her and most of the girls in the class: jane, as we will call her, went to gymnasium as a means to an end. she found that she got an even development there which enabled her to walk better, to play better, and to work better. in gymnasium she laid her muscular foundation on which to build all the good, active work of her life. the gymnasium she went to, however, was managed in an unusual way except for the chest weights, which always "opened the ball," the members of the class never knew what work they were to do. their minds were kept alert throughout the hour and a half. if their attention wavered they tripped or got behind in the exercise, and the mental action which went into the movement of every muscle made the body alive with the healthy activity of a well-concentrated, well-directed mind. another point which our young friend learned at gymnasium was to direct her mind only on to the muscles that were needed. did you ever try to clench your fist so tight that it could not be opened? if not, try it, and relax all over your body while you are keeping your fist tight closed. you will see that the more limp your body becomes the tighter you can keep your fist clenched. all the force goes in that one direction. in this way a moderately strong girl can keep a strong man hard at work for several minutes before he can make any impression on the closed hand. that illustrates in a simple way the fact that the most wholesome concentration is that which comes from dropping everything that interferes--letting the force of mind or body flow only in the direction in which it is to be used. many girls use their brains in the wrong way while on the gymnasium floor by saying to themselves, "i cannot do that." the brain is so full of that thought that the impression an open brain would receive has no chance to enter, and the result is an awkward, nervous, and uncertain movement. if a girl's brain and muscle were so relaxed that the impression on the one would cause a correct use and movement of the other how easy it would be thereafter to apply the proper tension to the muscle at the proper time without overtaxing the nerves. some one has well said that "it is training, not straining, that we want in our gymnasiums." only when a girl is trained from this point of view does she get real training. this basket-ball player had also been taught how to rest after exercise in a way which appealed to her especially, because of her interest which had already been aroused in kipling's polo pony. she was taught intelligently that if, after vigorous exercise, when the blood is coursing rapidly all over the body, you allow yourself to be entirely open and passive, the blood finds no interruptions in its work and can carry away the waste matter much more effectually. in that way you get the full result of the exercise. it is not necessary always to lie down to have your body passive enough after vigorous exercise to get the best results. if you sit down after exercise you want to sit without tension. or if you walk home from gymnasium you want to walk loosely and freely, keeping your chest up and a little in advance, and pushing with the ball of your back foot with a good, rhythmic balance. as this is the best way to sit and the best way to walk--gymnasium or no gymnasium--to look out for a well-balanced sitting and a well-balanced walk directly after vigorous exercise, keeps us in good form for sitting and walking all the time. i know of a professor in one of our large colleges who was offered also a professorship in a woman's college, and he refused to accept because he said women's minds did not react. when he lectured to girls he found that, however attentively they might seem to listen, there was no response. they gave nothing in return. of course this is not true of all girls, and of course the gentleman who refused the chair in the woman's college would agree that it is not true of all girls, but if those who read the anecdote would, instead of getting indignant, just look into the matter a little, they would see how true it is of many girls, and by thinking a little further we can see that it is not at present the girls' fault. a hundred years ago girls were not expected to think. i remember an anecdote which a very intelligent old lady used to tell me about her mother. once, when she was a little girl, her mother found some fault with her which the daughter knew to be unjust, and she answered timidly, "but, mother, i think--" "abigail," came the sharp reminder, "you've no business to think." one hundred years ago it was only the very exceptional girls who really thought. now we are gradually working toward the place where every girl will think. and surely it cannot be very long now before the united minds of a class of college girls will have the habit of reacting so that any man will feel in his own brain a vigorous result from lecturing to them. this fact that a girl's brain does not react is proved in many ways. most of the women who come to nerve specialists seem to feel that they are to sit still and be cured, while the men who come respond and do their part much more intelligently--the result being that men get out of "nerves" in half the time and stay out, whereas girls often get out a little way and slump (literally slump) back again before they can be helped to respond truly enough to get well and keep themselves well. this information is given only with an idea of stirring girls up to their best possibilities, for there is not a woman born with a sound mind who is not capable of reacting mentally, in a greater or less degree, to all that she hears, provided she uses her will consciously to form the new habit. now this need of intelligent reaction is just the trouble with girls and physical culture. physical culture should be a means to an end--and that is all, absolutely all. it is delightful and strengthening when it is taught thoughtfully as a means to an end, and i might almost say it is only weakening when it is made an end in itself. girls need to react intelligently to what is given them in physical training as much as to what is given them in a lecture on literature or philosophy or botany. how many girls do we know who take physical culture in a class, often simply because it is popular at the time, and never think of taking a long walk in the country--never think of going in for a vigorous outdoor game? how many girls do we know who take physical culture and never think of making life easy for their stomachs, or seeing that they get a normal amount of sleep? exercise in the fresh air, with a hearty objective interest in all that is going on about us, is the very best sort of exercise that we can take, and physical culture is worse than nothing if it is not taken only as a means to enable us to do more in the open air, and do it better, and gain from it more life. there is one girl who comes to my mind of whom i should like to tell because she illustrates truly a point that we cannot consider too carefully. she went to a nerve specialist very much broken in health, and when asked if she took plenty of exercise in the open air she replied "yes, indeed." and it was proved to be the very best exercise. she had a good horse, and she rode well; she rode a great deal, and not too much. she had interesting dogs and she took them with her. she walked, too, in beautiful country. but she was carrying in her mind all the time extreme resistance to other circumstances of her life. she did not know how to drop the resistance or face the circumstances, and the mental strain in which she held herself day and night, waking or sleeping, prevented the outdoor exercise from really refreshing her. when she learned to face the circumstances then the exercise could do its good work. on the other hand, there are many forms of nervous resistance and many disagreeable moods which good, vigorous exercise will blow away entirely, leaving our minds so clear that we wonder at ourselves, and wonder that we could ever have had those morbid thoughts. the mind acts and the body reacts, the body acts and the mind reacts, but of course at the root of it all is the real desire for what is normal, or--alas!--the lack of that desire. if physical culture does not make us love the open air, if it does not make us love to take a walk or climb a mountain, if it does not help us to take the walk or climb the mountain with more freedom, if it does not make us move along outdoors so easily that we forget our bodies altogether, and only enjoy what we see about us and feel how good it is to be alive--why, then physical culture is only an ornament without any use. there is an interesting point in mountain-climbing which i should like to speak of, by the way, and which makes it much pleasanter and better exercise. if, after first starting--and, of course, you should start very slowly and heavily, like an elephant--you get out of breath, let yourself stay out of breath. even emphasize the being out of breath by breathing harder than your lungs started to breathe, and then let your lungs pump and pump and pump until they find their own equilibrium. the result is delightful, and the physical freedom that follows is more than delightful. i remember seeing two girls climbing in the high rocky mountains in this way, when other women were going up on ponies. finally one of the guides looked back, and with an expression of mild astonishment said "well, you have lungs!" this was a very pleasant proof of the right kind of breathing. there are many good points for climbing and walking and swimming and all outdoor exercise that can be gained from the best sort of physical culture; and physical culture is good for girls when it gives these points and leads to a spontaneous love for outdoor exercise. but when it results only in a self-conscious pose of the body then it is harmful. we want to have strong bodies, free for every normal action, with quiet nerves, and muscles well coordinated. then our bodies are merely instruments: good, clean, healthy instruments. they are the "mechanism of the outside." and when the mechanism of the outside is well oiled and running smoothly it can be forgotten. there can be no doubt but that physical culture is good for girls provided it is given and taken with intelligent interest, but it must be done thoroughly to be done to real advantage. as, for instance, the part the shower-bath plays after exercising is most important, for it equalizes the circulation. physical culture is good for girls who have little or no muscular action in their daily lives, for it gives them the healthiest exercise in the least space of time, and prepares them to get more life from exercise outdoors. it is good for girls whose daily lives are full of activity, because it develops the unused muscles and so rests those that have been overused. many a hardworking girl has entered the gymnasium class tired and has left it rested. chapter xi _working restfully_ once met a man who had to do an important piece of scientific work in a given time. he worked from saturday afternoon at o'clock until monday morning at o'clock without interruption, except for one hour's sleep and the necessary time it took for nourishment. after he had finished he was, of course, intensely tired, but instead of going right to bed and to sleep, and taking all that brain strain to sleep with him he took his dog and his gun and went hunting for several hours. turning his attention to something so entirely different gave the other part of his brain a chance to recover itself a little. the fresh air revived him, and the gentle exercise started up his circulation, if he had gone directly to sleep after his work, the chances are that it would have taken him days to recover from the fatigue, for nature would have had too much against her to have reacted quickly from so abnormal a strain--getting an entire change of attention and starting up his circulation in the fresh air gave nature just the start she needed. after that she could work steadily while he slept, and he awakened rested and refreshed. to write from saturday afternoon until monday morning seems a stupid thing to do--no matter what the pressure is. to work for an abnormal time or at an abnormal rate is almost always stupid and short sighted. there are exceptions, however, and it would be good if for those exceptions people knew how to take the best care of themselves. but it is not only after such abnormal work that we need to know how to react most restfully. it is important after all work, and especially for those who have some steady labor for the whole day. every one is more or less tired at the end of the day and the temptation is to drop into a chair or lie down on the sofa or to go right to bed and go to sleep. don't do it. get some entire, active change for your brain, if it is only for fifteen minutes or half an hour. if you live in the city, even to go to walk and look into the shop windows is better than nothing. in that way you get fresh air, and if one knows how to look into shop windows without wanting anything or everything they see there, then it is very entertaining. it is a good game to look into a shop window for two or three minutes and then look away and see how well you can remember everything in it. it is important always to take shop windows that are out of one's own line of work. if you live in the country, a little walk out of doors is pleasanter than in the city, for the air is better; and there is much that is interesting, in the way of trees and sky, and stars, at night. as you walk, make a conscious effort to look out and about you. forget the work of the day, and take good long breaths. when you do not feel like going out of doors, take a story book--or some other reading, if you prefer--and put your mind right on it for half an hour. the use of a really good novel cannot be overestimated. it not only serves as recreation, but it introduces us to phases of human nature that otherwise we would know nothing whatever about. a very great change from the day's work can be found in a good novel and a very happy change. if the air in the theaters were fresher and good seats did not cost so much a good play, well acted, would be better than a good novel. sometimes it freshens us up to play a game after the day's work is over, and for those who love music there is of course the greatest rest in that. but there again comes in the question of cost. why does not some kind soul start concerts for the people where, for a nominal admission, the best music can be heard? and why does not some other kind soul start a theater for the people where, for a very small price of admission, they can see the best plays and see them well acted? we have public libraries in all our cities and towns, and a librarian in one large city loves to tell the tale of a poor woman in the slums with her door barred with furniture for fear of the drunken raiders in the house, quietly reading a book from the public library. there are many similar stories to go with that. if we had really good theaters and really good concerts to be reached as simply and as easily as the books in our public libraries, the healthy influence throughout the cities would be proportionately increased. the trouble is that people cater as much to the rich with their ideas of a national theater as the theatrical syndicate itself. i could not pretend to suggest amusements that would appeal to any or every reader, but i can make my point clear that when one is tired it is healthy to have a change of activity before going to rest. "oh," i hear, "i can't! i can't! i am too tired." i know the feeling. i have no doubt the man who wrote for nearly two days had a very strong tendency to go right to bed, but he had common sense behind it, and he knew the result would be better if he followed his common sense rather than his inclination. and so it proved. it seems very hard to realize that it is not the best thing to go right to bed or to sit and do nothing when one is so tired as to make it seem impossible to do anything else. it would be wrong to take vigorous physical exercise after great brain or body fatigue, but entire change of attention and gentle exercise is just what is needed, although care should always be taken not to keep at it too long. any readers who make up their minds to try this process of resting will soon prove its happy effect. a quotation from a recent daily paper reads, "'rest while you work,' says annie payson call,"--and then the editor adds, "and get fired," and although the opportunity for the joke was probably thought too good to lose, it was a natural misinterpretation of a very practical truth. i can easily imagine a woman--especially a tired out and bitter woman--reading directions telling how to work restfully and exclaiming with all the vehemence of her bitterness: "that is all very well to write about. it sounds well, but let any one take hold of my work and try to do it restfully. "if my employer should come along and see me working in a lazy way like that, he would very soon discharge me. no, no. i am tired out; i must keep at it as long as i can, and when i cannot keep at it any longer, i will die--and there is the end." "it is nothing but drudge, drudge for your bread and butter--and what does your bread and butter amount to when you get it?" there are thousands of women working to-day with bodies and minds so steeped in their fatigue that they cannot or will not take an idea outside of their rut of work. the rut has grown so deep, and they have sunken in so far that they cannot look over the edge. it is true that it is easier to do good hard work in the lines to which one has been accustomed than to do easy work which is strange. nerves will go on in old accustomed habits--even habits of tiresome strain--more easily than they will be changed into new habits of working without strain. the mind, too, gets saturated with a sense of fatigue until the fatigue seems normal, and to feel well rested would--at first--seem abnormal. this being a fact, it is a logical result that an habitually tired and strained mind will indignantly refuse the idea that it can do more work and do it better without the strain. there is a sharp corner to be turned to learn to work without strain, when one has had the habit of working with it. after the corner is turned, it requires steady, careful study to understand the new normal habit of working restfully, and to get the new habit established. when once it is established, this normal habit of work develops its own requirements, and the working without strain becomes to us an essential part of the work itself. for taken as a whole, more work is done and the work is done better when we avoid strain than when we do not. what is required to find this out is common sense and strength of character. character grows with practice; it builds and builds on itself when once it has a fair start, and a very little intelligence is needed if once the will is used to direct the body and mind in the lines of common sense. intelligence grows, too, as we use it. everything good in the soul grows with use; everything bad, destroys. let us make a distinction to begin with between "rest while you work" and "working restfully." "rest while you work" might imply laziness. there is a time for rest and there is a time for work. when we work we should work entirely. when we rest we should rest entirely. if we try to mix rest and work, we do neither well. that is true. but if we work restfully, we work then with the greatest amount of power and the least amount of effort. that means more work and work better done after the right habit is established than we did before, when the wrong habit was established. the difficulty comes, and the danger of "getting fired," when we are changing our habit. to obviate that difficulty, we must be content to change our habit more slowly. suppose we come home saturday night all tired out; go to bed and go to sleep, and wake sunday almost more tired than when we went to bed. on sunday we do not have to go to work. let us take a little time for the sole purpose of thinking our work over, and trying to find where the unnecessary strain is. "but," i hear some one say, "i am too tired to think." now it is a scientific fact that when our brains are all tired out in one direction, if we use our wills to start them working in another direction, they will get rested. "but," again i hear, "if i think about my work, why isn't that using my brain in the same direction?" because in thinking to apply new principles to work, of which you have never thought before, you are thinking in a new direction. not only that, but in applying new and true principles to your work you are bringing new life into the work itself. on this sunday morning, when you take an hour to devote yourself to the study of how you can work without getting overtired ask yourself the following questions:-- ( ) "what do i resist in or about my work?" find out each thing that you do resist, and drop the contractions that come in your body, with the intention of dropping the resistances in your mind. ( ) "do i drop my work at meals and eat quietly?" ( ) "do i take every opportunity that i can to get fresh air, and take good, full breaths of it?" ( ) "do i feel hurried and pushed in my work? do i realize that no matter how much of a hurry there may be, i can hurry more effectively if i drop the strain of the hurry?" ( ) "how much superfluous strain do i use in my work? do i work with a feeling of strain? how can i observe better in order to become conscious of the strain and drop it?" these are enough questions for one time! if you concentrate on these questions and on finding the answers, and do it diligently, you will be surprised to see how the true answers will come to you, and how much clearer they will become as you put them into daily practice. chapter xii _imaginary vacations_ once a young woman who had very hard work to do day after day and who had come to where she was chronically strained and tired, turned to her mother just as she was starting for work in the morning, and in a voice tense with fatigue and trouble, said:-- "mother, i cannot stand it. i cannot stand it. unless i can get a vacation long enough at least to catch my breath, i shall break down altogether." "why don't you take a vacation today?" asked her mother. the daughter got a little irritated and snapped out:--- "why do you say such a foolish thing as that, mother? you know as well as i that i could not leave my work to-day." "don't be cross, dear. stop a minute and let me tell you what i mean. i have been thinking about it and i know you will appreciate what i have to say, and i know you can do it. now listen." whereupon the mother went on to explain quite graphically a process of pretense--good, wholesome pretense. to any one who has no imagination this would not or could not appeal. to the young woman of whom i write it not only appealed heartily, but she tried it and made it work. it was simply that she should play that she had commenced her vacation and was going to school to amuse herself. as, for instance, she would say to herself, and believe it: "isn't it good that i can have a vacation and a rest. what shall i do to get all i can out of it? "i think i will go and see what they are doing in the grammar school. maybe when i get there it will amuse me to teach some of the children. it is always interesting to see how children are going to take what you say to them and to see the different ways in which they recite their lessons." by the time she got to school she was very much cheered. looking up she said to herself: "this must be the building." she had been in it every school day for five years past, but through the process of her little game it looked quite new and strange now. she went in the door and when the children said "good morning," and some of them seemed glad to see her, she said to herself: "why, they seem to know me; i wonder how that happens?" occasionally she was so much amused at her own consistency in keeping up the game that she nearly laughed outright. she heard each class recite as if she were teaching for the first time. she looked upon each separate child as if she had never seen him before and he was interesting to her as a novel study. she found the schoolroom more cheerful and was surprised into perceiving a pleasant sort of silent communication that started up between her pupils and herself. when school was over she put on her hat and coat to go home, with the sense of having done something restful; and when she appeared to her mother, it was with a smiling, cheerful face, which made her mother laugh outright; and then they both laughed and went out for a walk in the fresh air, before coming in to go to bed, and be ready to begin again the next day. in the morning the mother felt a little anxious and asked timidly: "do you believe you can make it work again today, just as well as yesterday?" "yes, indeed and better," said the daughter. "it is too much fun not to go on with it." after breakfast the mother with a little roguish twinkle, said: "well, what do you think you will do to amuse yourself to-day, alice?" "oh! i think--" and then they both laughed and alice started off on her second day's "vacation." by the end of a week she was out of that tired rut and having a very good time. new ideas had come to her about the school and the children; in fact, from being dead and heavy in her work, she had become alive. when she found the old tired state coming on her again, she and her mother always "took a vacation," and every time avoided the tired rut more easily. if one only has imagination enough, the helpfulness and restfulness of playing "take a vacation" will tell equally well in any kind of work. you can play at dressmaking--play at millinery--play at keeping shop. you can make a game of any sort of drudgery, and do the work better for it, as well as keep better rested and more healthy yourself. but you must be steady and persistent and childlike in the way you play your game. do not stop in the middle and exclaim, "how silly!"--and then slump into the tired state again. what i am telling you is nothing more nor less than a good healthy process of self-hypnotism. really, it is more the attitude we take toward our work that tires us than the work itself. if we could only learn that and realize it as a practical fact, it would save a great deal of unnecessary suffering and even illness. we do not need to play vacation all the time, of course. the game might get stale then and lose its power. if we play it for two or three days, whenever we get so tired that it seems as if we could not bear it--play it just long enough to lift ourselves out of the rut--then we can "go to work again" until we need another vacation. we need not be afraid nor ashamed to bring back that childlike tendency--it will be of very great use to our mature minds. if we try to play the vacation game, it is wiser to say nothing about it. it is not a game that we can be sure of sharing profitably either to ourselves or to others. if you find it works, and give the secret to a friend, tell her to play it without mentioning it to you, even though she shares your work and is sitting in the next chair to you. another most healthy process of resting while you work is by means of lowering the pressure. suppose you were an engine, whose normal pressure was six hundred pounds, we will say. make yourself work at a pressure of only three hundred pounds. the human engine works with so much more strain than is necessary that if a woman gets overtired and tries to lighten her work by lightening the pressure with which she does it, she will find that really she has only thrown off the unnecessary strain, and is not only getting over her fatigue by working restfully, but is doing her work better, too. in the process of learning to use less pressure, the work may seem to be going a little more slowly at first, but we shall find that it will soon go faster, and better, as time establishes the better habit. one thing seems singular; and yet it appeals entirely to our common sense as we think of it. there never comes a time when we cannot learn to work more effectively at a lower pressure. we never get to where we cannot lessen our pressure and thus increase our power. the very interest of using less pressure adds zest to our work, however it may have seemed like drudging before, and the possibility of resting while we work opens to us much that is new and refreshing, and gives us clearer understanding of how to rest more completely while we rest. all kinds of resting, and all kinds of working, can bring more vitality than most of us know, until we have learned to rest and to work without strain. chapter xiii _the woman at the next desk_ it may be the woman sewing in the next chair; it may be the woman standing next at the same counter; it may be the woman next at a working table, or it may be the woman at the next desk. whichever one it is, many a working woman has her life made wretched by her, and it would be a strange thing for this miserable woman to hear and a stranger thing--at first--for her to believe that the woman at the next desk need not trouble her at all. that, if she only could realize it, the cause of the irritation which annoyed her every day and dragged her down so that many and many a night she had been home with a sick headache was entirely and solely in herself and not at all in the woman who worked next to her, however disagreeable that woman may have been. every morning when she wakes the woman at the next desk rises before her like a black specter. "oh, i would not mind the work; i could work all day happily and quietly and go home at night and rest; the work would be a joy to me compared to this torture of having to live all day next to that woman." it is odd, too, and true, that if the woman at the next desk finds that she is annoying our friend, unconsciously she seems to ferret out her most sensitive places and rub them raw with her sharp, discourteous words. she seems to shirk her own work purposely and to arrange it so that the woman next her must do the work in her place. then, having done all in her power to give the woman next her harder labor, she snaps out a little scornful remark about the mistakes that have been made. if she--the woman at the next desk--comes in in the morning feeling tired and irritable herself, she vents her irritability on her companion until she has worked it off and goes home at night feeling much better herself, while her poor neighbor goes home tired out and weak. the woman at the next desk takes pains to let little disagreeable hints drop about others--if not directly in their hearing at least in ways which she knows may reach them. she drops hint to others of what those in higher office have said or appeared to think, which might frighten "others" quite out of their wits for fear of their being discharged, and then, where should they get their bread and butter? all this and more that is frightful and disagreeable and mean may the woman at the next desk do; or she may be just plain, every-day _ugly._ every one knows the trying phases of her own working neighbor. but with all this, and with worse possibilities of harassment than i have even touched upon, the woman at the next desk is powerless, so far as i am concerned, if i choose to make her so. the reason she troubles me is because i resist her. if she hurts my feelings, that is the same thing. i resist her, and the resistance, instead of making me angry, makes me sore in my nerves and makes me want to cry. the way to get independent of her is not to resist her, and the way to learn not to resist her is to make a daily and hourly study of dropping all resistances to her. this study has another advantage, too; if we once get well started on it, it becomes so interesting that the concentration on this new interest brings new life in itself. resistance in the mind brings contraction in the body. if, when we find our minds resisting that which is disagreeable in another, we give our attention at once to finding the resultant contraction in our bodies, and then concentrate our wills on loosening out of the contraction, we cannot help getting an immediate result. even though it is a small result at the beginning, if we persist, results will grow until we, literally, find ourselves free from the woman at the next desk. this woman says a disagreeable thing; we contract to it mind and body. we drop the contraction from our bodies, with the desire to drop it from our minds, for loosening the physical tension reacts upon the mental strain and relieves it. we can say to ourselves quite cheerfully: "i wish she would go ahead and say another disagreeable thing; i should like to try the experiment again." she gives you an early opportunity and you try the experiment again, and again, and then again, until finally your brain gets the habit of trying the experiment without any voluntary effort on your part. that habit being established, _you are free from the woman at the next desk._ she cannot irritate you nor wear upon you, no matter how she tries, no matter what she says, or what she does. there is, however, this trouble about dropping the contraction. we are apt to have a feeling of what we might call "righteous indignation" at annoyances which are put upon us for no reason; that, so-called, "righteous indignation" takes the form of resistance and makes physical contractions. it is useless to drop the physical contraction if the indignation is going to rise and tighten us all up again. if we drop the physical and mental contractions we must have something good to fill the open channels that have been made. therefore let us give our best attention to our work, and if opportunity offers, do a kindness to the woman at the next desk. finally, when she finds that her ways do not annoy, she will stop them. she will probably, for a time at first, try harder to be disagreeable, and then after recovering from several surprises at not being able to annoy, she will quiet down and grow less disagreeable. if we realize the effect of successive and continued resistance upon ourselves and realize at the same time that we can drop or hold those resistances as we choose to work to get free from them, or suffer and hold them, then we can appreciate the truth that if the woman at the next desk continues to annoy us, it is our fault entirely, and not hers. chapter xiv _telephones and telephoning_ most men--and women--use more nervous force in speaking through the telephone than would be needed to keep them strong and healthy for years. it is good to note that the more we keep in harmony with natural laws the more quiet we are forced to be. nature knows no strain. true science knows no strain. therefore _a strained high-pitched voice does not carry over the telephone wire as well as a low one._ if every woman using the telephone would remember this fact the good accomplished would be thricefold. she would save her own nervous energy. she would save the ears of the woman at the other end of the wire. she would make herself heard. patience, gentleness, firmness--a quiet concentration--all tell immeasurably over the telephone wire. impatience, rudeness, indecision, and diffuseness blur communication by telephone even more than they do when one is face to face with the person talking. it is as if the wire itself resented these inhuman phases of humanity and spit back at the person who insulted it by trying to transmit over it such unintelligent bosh. there are people who feel that if they do not get an immediate answer at the telephone they have a right to demand and get good service by means of an angry telephonic sputter. the result of this attempt to scold the telephone girl is often an impulsive, angry response on her part--which she may be sorry for later on--and if the service is more prompt for that time it reacts later to what appears to be the same deficiency. no one was ever kept steadily up to time by angry scolding. it is against reason. to a demanding woman who is strained and tired herself, a wait of ten seconds seems ten minutes. i have heard such a woman ring the telephone bell almost without ceasing for fifteen minutes. i could hear her strain and anger reflected in the ringing of the bell. when finally she "got her party" the strain in her high-pitched voice made it impossible for her to be clearly understood. then she got angry again because "central" had not "given her a better connection," and finally came away from the telephone nearly in a state of nervous collapse and insisted that the telephone would finally end her life. i do not think she once suspected that the whole state of fatigue which had almost brought an illness upon her was absolutely and entirely her own fault. the telephone has no more to do with it than the floor has to do with a child's falling and bumping his head. the worst of this story is that if any one had told this woman that her tired state was all unnecessary, it would have roused more strain and anger, more fatigue, and more consequent illness. women must begin to find out their own deficiencies before they are ready to accept suggestions which can lead to greater freedom and more common sense. another place where science and inhuman humanity do not blend is in the angry moving up and down of the telephone hook. when the hook is moved quickly and without pause it does not give time for the light before the telephone girl to flash, therefore she cannot be reminded that any one is waiting at the other end. when the hook is removed with even regularity and a quiet pause between each motion then she can see the light and accelerate her action in getting "the other party." i have seen a man get so impatient at not having an immediate answer that he rattled the hook up and down so fast and so vehemently as to nearly break it. there is something tremendously funny about this. the man is in a great hurry to speak to some one at the other end of the telephone, and yet he takes every means to prevent the operator from knowing what he wants by rattling his hook. in addition to this his angry movement of the hook is fast tending to break the telephone, so that he cannot use it at all. so do we interfere with gaining what we need by wanting it overmuch! i do not know that there has yet been formed a telephone etiquette; but for the use of those who are not well bred by habit it would be useful to put such laws on the first page of the telephone book. a lack of consideration for others is often too evident in telephonic communication. a woman will ask her maid to get the number of a friend's house for her and ask the friend to come to the telephone, and then keep her friend waiting while she has time to be called by the maid and to come to the telephone herself. this method of wasting other people's time is not confined to women alone. men are equal offenders, and often greater ones, for the man at the other end is apt to be more immediately busy than a woman under such circumstances. to sum up: the telephone may be the means of increasing our consideration for others; our quiet, decisive way of getting good service; our patience, and, through the low voice placed close to the transmitter, it may relieve us from nervous strain; for nerves always relax with the voice. or the telephone may be the means of making us more selfish and self-centered, more undecided and diffuse, more impatient, more strained and nervous. in fact, the telephones may help us toward health or illness. we might even say the telephone may lead us toward heaven or toward hell. we have our choice of roads in the way we use it. it is a blessed convenience and if it proves a curse--we bring the curse upon our own heads. i speak of course only of the public who use the telephone. those who serve the public in the use of the telephone must have many trials to meet, and, i dare say, are not always courteous and patient. but certainly there can be no case of lagging or discourtesy on the part of a telephone operator that is not promptly rectified by a quiet, decided appeal to the "desk." it is invariably the nervous strain and the anger that makes the trouble. there may be one of these days a school for the better use of the telephone; but such a school never need be established if every intelligent man and woman will be his and her own school in appreciating and acting upon the power gained if they compel themselves to go with science--and never allow themselves to go against it. chapter xv _don't talk_ there is more nervous energy wasted, more nervous strain generated, more real physical harm done by superfluous talking than any one knows, or than any one could possibly believe who had not studied it. i am not considering the harm done by what people say. we all know the disastrous effects that follow a careless or malicious use of the tongue. that is another question. i simply write of the physical power used up and wasted by mere superfluous words, by using one hundred words where ten will do--or one thousand words where none at all were needed. i once had been listening to a friend chatter, chatter, chatter to no end for an hour or more, when the idea occurred to me to tell her of an experiment i had tried by which my voice came more easily. when i could get an opportunity to speak, i asked her if she had ever tried taking a long breath and speaking as she let the breath out. i had to insist a little to keep her mind on the suggestion at all, but finally succeeded. she took a long breath and then stopped. there was perhaps for half a minute a blessed silence, and then what was my surprise to hear her remark: "i--i--can't think of anything to say." "try it again," i told her. she took another long breath, and again gave up because she could not think of anything to say. she did not like that little game very much, and thought she would not make another effort, and in about three minutes she began the chatter, and went on talking until some necessary interruption parted us. this woman's talking was nothing more nor less than a nervous habit. her thought and her words were not practically connected at all. she never said what she thought for she never thought. she never said anything in answer to what was said to her, for she never listened. nervous talkers never do listen. that is one of their most striking characteristics. i knew of two well-known men--both great talkers--who were invited to dine. their host thought, as each man talked a great deal and--, as he thought--talked very well, if they could meet their interchange of ideas would be most delightful. several days later he met one of his guests in the street and asked how he liked the friend whom he had met for the first time at his house. "very pleasant, very pleasant," the man said, "but he talks too much." not long after this the other guest accosted him unexpectedly in the street "for heaven's sake, don't ask me to dine with that smith again--why, i could not get a word in edgewise." now, if only for selfish reasons a man might realize that he needs to absorb as well as give out, and so could make himself listen in order to be sure that his neighbor did not get ahead of him. but a conceited man, a self-centered man or a great talker will seldom or never listen. that being the case, what can you expect of a woman who is a nervous talker? the more tired such a woman is the more she talks; the more ill she is the more she talks. as the habit of nervous talking grows upon a woman it weakens her mind. indeed, nervous talking is a steadily weakening process. some women talk to forget. if they only knew it was slow mental suicide and led to worse than death they would be quick to avoid such false protection. if we have anything we want to forget we can only forget it by facing it until we have solved the problem that it places before us, and then working on, according to our best light: we can never really cover a thing up in our minds by talking constantly about something else. many women think they are going to persuade you of their point of view by talking. a woman comes to you with her head full of an idea and finds you do not agree with her. she will talk, talk, talk until you are blind and sick and heartily wish you were deaf, in order to prove to you that she is right and you are wrong. she talks until you do not care whether you are right or wrong. you only care for the blessed relief of silence, and when she has left you, she has done all she could in that space of time to injure her point of view. she has simply buried anything good that she might have had to say in a cloud of dusty talk. it is funny to hear such a woman say after a long interview, "well, at any rate, i gave him a good talking to. i guess he will go home and think about it." think about it, madam? he will go home with an impression of rattle and chatter and push that will make him dread the sight of your face; and still more dread the sound of your voice, lest he be subjected to further interviews. women sit at work together. one woman talks, talks, talks until her companions are so worn with the constant chatter that they have neither head nor nerve enough to do their work well. if they know how to let the chatter go on and turn their attention away from it, so that it makes no impression, they are fortunate indeed, and the practice is most useful to them. but that does not relieve the strain of the nervous talker herself; she is wearing herself out from day to day, and ruining her mind as well as hurting the nerves and dispositions of those about her who do not know how to protect themselves from her nervous talk. nervous talking is a disease. now the question is how to cure it. it can be cured, but the first necessity is for a woman to know she has the disease. for, unlike other diseases, the cure does not need a physician, but must be made by the patient herself. first, she must know that she has the disease. fifty nervous talkers might read this article, and not one of them recognize that it is aimed straight at her. the only remedy for that is for every woman who reads to believe that she is a nervous talker until she has watched herself for a month or more--without prejudice--and has discovered for a certainty that she is not. then she is safe. but what if she discover to her surprise and chagrin that she is a nervous talker? what is the remedy for that? the first thing to do is to own up the truth to herself without equivocation. to make no excuses or explanations but simply to acknowledge the fact. then let her aim straight at the remedy--silence--steady, severe, relaxed silence. work from day to day and promise herself that for that day she will say nothing but what is absolutely necessary. she should not repress the words that want to come, but when she takes breath to speak she must not allow the sentence to come out of her mouth, but must instead relax all over, as far as it is possible, and take a good, long, quiet breath. the next time she wants to speak, even if she forgets so far as to get half the sentence out of her mouth, stop it, relax, and take a long breath. the mental concentration necessary to cure one's self of nervous talking will gather together a mind that was gradually becoming dissipated with the nervous talking habit, and so the life and strength of the mind can be saved. and, after that habit has been cured, the habit of quiet thinking will begin, and what is said will be worth while. chapter xvi _"why fuss so much about what i eat?"_ i know a woman who insisted that it was impossible for her to eat strawberries because they did not agree with her. a friend told her that that was simply a habit of her mind. once, at a time when her stomach was tired or not in good condition for some other reason, strawberries had not agreed with her, and from that time she had taken it for granted that she could not eat strawberries. when she was convinced by her friend that her belief that strawberries did not agree with her was merely in her own idea, and not actually true, she boldly ate a plate of strawberries. that night she woke with indigestion, and the next morning she said "you see, i told you they would not agree with me." but her friend answered: "why, of course you could not expect them to agree right away, could you? now try eating them again to-day." this little lady was intelligent enough to want the strawberries to agree with her and to be willing to do her part to adjust herself to them, so she tried again and ate them the next day; and now she can eat them every day right through the strawberry season and is all the better for it. this is the fact that we want to understand thoroughly and to look out for. if we are impressed with the idea that any one food does not agree with us, whenever we think of that food we contract, and especially our stomachs contract. now if our stomachs contract when a food that we believe to disagree with us is merely mentioned, of course they would contract all the more when we ate it. naturally our digestive organs would be handicapped by the contraction which came from our attitude of mind and, of course, the food would appear not to agree with us. take, for instance, people who are born with peculiar prenatal impressions about their food. a woman whom i have in mind could not take milk nor cream nor butter nor anything with milk or cream or butter in it. she seemed really proud of her milk-and-cream antipathy. she would air it upon all occasions, when she could do so without being positively discourteous, and often she came very near the edge of discourtesy. i never saw her even appear to make an effort to overcome it, and it is perfectly true that a prenatal impression like that can be overcome as entirely, as can a personally acquired impression, although it may take a longer time and a more persistent effort. this anti-milk-and-cream lady was at work every day over-emphasizing her milk-and-cream contractions; whereas if she had put the same force into dropping the milk-and-cream contraction she would have been using her will to great advantage, and would have helped herself in many other ways as well as in gaining the ability to take normally a very healthful food. we cannot hold one contraction without having its influence draw us into many others. we cannot give our attention to dropping one contraction without having the influence of that one effort expand us in many other ways. watch people when they refuse food that is passed them at table; you can see whether they refuse and at the same time contract against the food, or whether they refuse with no contraction at all. i have seen an expression of mild loathing on some women's faces when food was passed which "did not agree with them," but they were quite unconscious that their expressions had betrayed them. now, it is another fact that the contraction of the stomach at one form of food will interfere with the good digestion of another form. when cauliflower has been passed to us and we contract against it how can we expect our stomachs to recover from that contraction in time to digest perfectly the next vegetable which is passed and which we may like very much? it may be said that we expand to the vegetable we like, and that immediately counteracts the former contraction to the vegetable which we do not like. that is true only to a certain extent, for the tendency to cauliflower contraction is there in the back of our brains influencing our stomachs all the time, until we have actually used our wills consciously to drop it. edwin booth used to be troubled very much with indigestion; he suffered keenly from it. one day he went to dine with some intimate friends, and before the dinner began his hostess said with a very smiling face: "now, mr. booth, i have been especially careful with this dinner not to have one thing that you cannot digest." the host echoed her with a hearty "yes, mr. booth, everything that will come to the table is good for your digestion." the words made a very happy impression on mr. booth. first there was the kind, sympathetic friendliness of his hosts; and then the strong suggestion they had given him that their food would agree with him. then there was very happy and interesting talk during the whole time that they were at table and afterward. mr.. booth ate a hearty dinner and, true to the words of his host and hostess, not one single thing disagreed with him. and yet at that dinner, although care had been taken to have it wholesome, there were served things that under other conditions would have disagreed. while we should aim always to eat wholesome food, it is really not so much the food which makes the trouble as the attitude we take toward it and the way we test it. all the contractions which are made by our fussing about food interfere with our circulation; the interference with our circulation makes us liable to take cold, and it is safe to say that more than half the colds that women have are caused principally by wrong eating. somewhat akin to grandmother's looking for her spectacles when all the time they are pushed to the top of her head is the way women fuss about their eating and then wonder why it is that they cannot seem to stand drafts. there is no doubt but that our food should be thoroughly masticated before it goes into our stomachs. there is no doubt but that the first process of digestion should be in our mouths. the relish which we get for our food by masticating it properly is greater and also helps toward digesting it truly. all this cannot be over-emphasized if it is taken in the right way. but there is an extreme which perhaps has not been thought of and for which happily i have an example that will illustrate what i want to prove. i know a woman who was, so to speak, daft on the subject of health. she attended to all points of health with such minute detail that she seemed to have lost all idea of why we should be healthy. one of her ways of over-emphasizing the road to health was a very careful mastication of her food. she chewed and chewed and chewed and chewed, and the result was that she so strained her stomach with her chewing that she brought on severe indigestion, simply as a result of an overactive effort toward digestion. this was certainly a case of "vaulting ambition, which o'erleaps itself, and falls on the other." and it was not unique. the over-emphasis of "what shall i eat? how much shall i eat? how often shall i eat? when shall i eat? how shall i eat?"--all extreme attention to these questions is just as liable to bring chronic indigestion as a reckless neglect of them altogether is liable to upset a good, strong stomach and keep it upset. the woman who chewed herself into indigestion fussed herself into it, too, by constantly talking about what was not healthful to eat. her breakfast, which she took alone, was for a time the dryest-looking meal i ever saw. it was enough to take away any one's healthy relish just to look at it, if he was not forewarned. now our relish is one of our most blessed gifts. when we relish our food our stomachs can digest it wholesomely. when we do not our stomachs will not produce the secretions necessary to the most wholesome digestion. constant fussing about our food takes away our relish. a gluttonous dwelling upon our food takes away our relish. relish is a delicate gift, and as we respect it truly, as we do not degrade it to selfish ends nor kill it with selfish fastidiousness, it grows upon us and is in its place like any other fine perception, and is as greatly useful to the health of our bodies as our keener and deeper perceptions are useful to the health of our minds. then there is the question of being sure that our stomachs are well rested before we give them any work to do, and being sure that we are quiet enough after eating to give our stomachs the best opportunity to begin their work. here again one extreme is just as harmful as the other. i knew a woman who had what might be called the fixed idea of health, who always used to sit bolt upright in a high-backed chair for half an hour after dinner, and refuse to speak or to be spoken to in order that "digestion might start in properly." if i had been her stomach i should have said: "madam, when you have got through giving me your especial attention i will begin my work--which, by the way, is not your work but mine!" and, virtually, that is what her stomach did say. sitting bolt upright and consciously waiting for your food to begin digestion is an over-attention to what is none of your business, which contracts your brain, contracts your stomach and stops its work. our business is only to fulfill the conditions rightly. the french workmen do that when they sit quietly after a meal talking of their various interests. any one can fulfill the conditions properly by keeping a little quiet, having some pleasant chat, reading a bright story or taking life easy in any quiet way for half an hour. or, if work must begin directly after eating, begin it quietly. but this feeling that it is our business to attend to the working functions of our stomachs is officious and harmful. we must fulfill the conditions and then forget our stomachs. if our stomachs remind us of themselves by some misbehavior we must seek for the cause and remedy it, but we should not on any account feel that the cause is necessarily in the food we have eaten. it may be, and probably often is, entirely back of that. a quick, sharp resistance to something that is said will often cause indigestion. in that case we must stop resisting and not blame the food. a dog was once made to swallow a little bullet with his food and then an x-ray was thrown on to his stomach in order that the process of digestion might be watched by means of the bullet. when the dog was made angry the bullet stopped, which meant that the digestion stopped; when the dog was over-excited in any way digestion stopped. when he was calmed down it went on again. there are many reasons why we should learn to meet life without useless resistance, and the health of our stomachs is not the least. it would surprise most people if they could know how much unnecessary strain they put on their stomachs by eating too much. a nervous invalid had a very large appetite. she was helped twice, sometimes three times, to meat and vegetables at dinner. she thought that what she deemed her very healthy appetite was a great blessing to her, and often remarked upon it, as also upon her idea that so much good, nourishing food must be helping to make her well. and yet she wondered why she did not gain faster. now the truth of the matter was that this invalid had a nervous appetite. not only did she not need one third of the food she ate, but indeed the other two thirds was doing her positive harm. the tax which she put upon her stomach to digest so much food drained her nerves every day, and of course robbed her brain, so that she ate and ate and wept and wept with nervous depression. when it was suggested to her by a friend who understood nerves that she would get better very much faster if she would eat very much less she made a rule to take only one helping of anything, no matter how much she might feel that she wanted another. very soon she began to gain enough to see for herself that she had been keeping herself ill with overeating, and it was not many days before she did not want a second helping. nervous appetites are not uncommon even among women who consider themselves pretty well. probably there are not five in a hundred among all the well-fed men and women in this country who would not be more healthy if they ate less. then there are food notions to be looked out for and out of which any one can relax by giving a little intelligent attention to the task. "i do not like eggs. i am tired of them." "dear, dear me! i ate so much ice cream that it made me ill, and it has made me ill to think of it ever since." relax, drop the contraction, pretend you had never tasted ice cream before, and try to eat a little--not for the sake of the ice cream, but for the sake of getting that knot out of your stomach. "but," you will say, "can every one eat everything?" "yes," the answer is, "everything that is really good, wholesome food is all right for anybody to eat." but you say: "won't you allow for difference of tastes?" and the answer to that is: "of course we can like some foods more than others, but there is a radical difference between unprejudiced preferences and prejudiced dislikes." our stomachs are all right if we will but fulfill their most simple conditions and then leave them alone. if we treat them right they will tell us what is good for them and what is not good for them, and if we will only pay attention, obey them as a matter of course without comment and then forget them, there need be no more fuss about food and very much less nervous irritability. chapter xvii _take care of your stomach_ we all know that we have a great deal to do. some of us have to work all day to earn our bread and butter and then work a good part of the night to make our clothes. some of us have to stand all day behind a counter. some of us have to sit all day and sew for others, and all night to sew for ourselves and our children. most of us have to do work that is necessary or work that is self-imposed. many of us feel busy without really being busy at all. but how many of us realize that while we are doing work outside, our bodies themselves have good, steady work to do inside. our lungs have to take oxygen from the air and give it to our blood; our blood has to carry it all through our bodies and take away the waste by means of the steady pumping of our hearts. our stomachs must digest the food put into them, give the nourishment in it to the blood, and see that the waste is cast off. all this work is wholesome and good, and goes on steadily, giving us health and strength and new power; but if we, through mismanagement, make heart or lungs or stomach work harder than they should, then they must rob us of power to accomplish what we give them to do, and we blame them, instead of blaming ourselves for being hard and unjust taskmasters. the strain in a stomach necessary to the digesting of too much food, or the wrong kind of food, makes itself felt in strain all through the whole system. i knew a woman whose conscience was troubling her very greatly. she was sure she had done many very selfish things for which there was no excuse, and that she herself was greatly to blame for other people's troubles. this was a very acute attack of conscience, accompanied by a very severe stomach ache. the doctor was called in and gave her an emetic. she threw a large amount of undigested food from her stomach, and after that relief the weight on her conscience was lifted entirely and she had nothing more to blame herself with than any ordinary, wholesome woman must have to look out for every day of her life. this is a true story and should be practically useful to readers who need it. this woman's stomach had been given too much to do. it worked hard to do its work well, and had to rob the brain and nervous system in the effort. this effort brought strain to the whole brain, which was made evident in the region of the conscience. it might have come out in some other form. it might have appeared in irritability. it might even have shown itself in downright ugliness. whatever the effects are, whether exaggerated conscience, exaggerated anxiety, or irritability, the immediate cause of the trouble in such cases as i refer to is in the fact that the stomach has been given too much to do. we give the stomach too much to do if we put a great deal of food into it when it is tired. we give it too much to do if we put into it the wrong kind of food. we give it too much to do if we insist upon working hard ourselves, either with body or brain, directly after a hearty meal. no matter how busy we are we can protect our stomachs against each and all of these three causes of trouble. if a woman is very tired her stomach must necessarily be very tired also. if she can remember that at such times even though she may be very hungry, her body is better nourished if she takes slowly a cup of hot milk, and waits until she is more rested before taking solid food, than if she ate a hearty meal. it will save a strain, and perhaps eventually severe illness. if it is possible to rest and do absolutely nothing for half an hour before a meal, and for half an hour after that insures the best work for our digestion. if one is pretty well, and cannot spare the half hour, ten or fifteen minutes will do, unless there is a great deal of fatigue to be conquered. if it is necessary to work right up to mealtime, let up a little before stopping. as the time for dinner approaches do not work quite so hard; the work will not lose; in the end it will gain--and when you begin work again begin lightly, and get into the thick of it gradually. that gives your stomach a good chance. if possible get a long rest before the last meal, and if your day is very busy, it is better to have the heartiest meal at the end of it, to take a good rest afterward and then a walk in the fresh air, which may be long or short, according to what other work you have to do or according to how tired you are. i know many women will say: "but i am tired all the time; if i waited to rest before i ate, i should starve." the answer to that is "protect your stomach as well as you can. if you cannot rest before and after each meal try to arrange some way by which you can get rid of a little fatigue." if you do this with attention and interest you will find gradually that you are less tired all the time, and as you keep on steadily toward the right path, you may be surprised some day to discover that you are only tired half the time, and perhaps even reach the place where the tired feeling will be the exception. it takes a good while to get our misused stomachs into wholesome ways, but if we are persistent and intelligent we can surely do it, and the relief to the overstrained stomach--as i have said--means relief to the whole body. resting before and after meals amounts to very little, however, if we eat food that is not nourishing. some people are so far out of the normal way of eating that they have lost a wholesome sense of what is good for them, and live in a chronic state of disordered stomach, which means a chronic state of disordered nerves and disposition. if such persons could for one minute literally experience the freedom of a woman whose body was truly and thoroughly nourished, the contrast from the abnormal to the normal would make them dizzy. if, however, they stayed in the normal place long enough to get over the dizziness, the freedom of health would be so great a delight that food that was not nourishing would be nauseous to them. most of us are near enough the normal to know the food that is best for us, through experience of suffering from food which is not best for us, as well as through good natural instinct. if we would learn from the normal working of the involuntary action of our organs, it might help us greatly toward working more wholesomely in all our voluntary actions. if every woman who reads this article would study not to interfere with the most healthy action of her own stomach, her reward after a few weeks' persistent care would be not only a greater power for work, but a greater power for good, healthy, recuperative rest. chapter xviii _about faces_ watch the faces as you walk along the street! if you get the habit of noticing, your observations will grow keener. it is surprising to see how seldom we find a really quiet face. i do not mean that there should be no lines in the face. we are here in this world at school and we cannot have any real schooling unless we have real experiences. we cannot have real experiences without suffering, and suffering which comes from the discipline of life and results in character leaves lines in our faces. it is the lines made by unnecessary strain to which i refer. strange to say the unquiet faces come mostly from shallow feeling. usually the deeper the feeling the less strain there is on the face. a face may look troubled, it may be full of pain, without a touch of that strain which comes from shallow worry or excitement. the strained expression takes character out of the face, it weakens it, and certainly it detracts greatly from whatever natural beauty there may have been to begin with. the expression which comes from pain or any suffering well borne gives character to the face and adds to its real beauty as well as its strength. to remove the strained expression we must remove the strain behind; therefore the hardest work we have to do is below the surface. the surface work is comparatively easy. i know a woman whose face is quiet and placid. the lines are really beautiful, but they are always the same. this woman used to watch herself in the glass until she had her face as quiet and free from lines as she could get it--she used even to arrange the corners of her mouth with her fingers until they had just the right droop. then she observed carefully how her face felt with that placid expression and studied to keep it always with that feeling, until by and by her features were fixed and now the placid face is always there, for she has established in her brain an automatic vigilance over it that will not allow the muscles once to get "out of drawing." what kind of an old woman this acquaintance of mine will make i do not know. i am curious to see her--but now she certainly is a most remarkable hypocrite. the strain in behind the mask of a face which she has made for herself must be something frightful. and indeed i believe it is, for she is ill most of the time--and what could keep one in nervous illness more entirely than this deep interior strain which is necessary to such external appearance of placidity. there comes to my mind at once a very comical illustration of something quite akin to this although at first thought it seems almost the reverse. a woman who constantly talked of the preeminency of mind over matter, and the impossibility of being moved by external circumstances to any one who believed as she did--this woman i saw very angry. she was sitting with her face drawn in a hundred cross lines and all askew with her anger. she had been spouting and sputtering what she called her righteous indignation for some minutes, when after a brief pause and with the angry expression still on her face she exclaimed: "well, i don't care, it's all peace within." i doubt if my masked lady would ever have declared to herself or to any one else that "it was all peace within." the angry woman was--without doubt--the deeper hypocrite, but the masked woman had become rigid in her hypocrisy. i do not know which was the weaker of the two, probably the one who was deceiving herself. but to return to those drawn, strained lines we see on the people about us. they do not come from hard work or deep thought. they come from unnecessary contractions about the work. if we use our wills consistently and steadily to drop such contractions, the result is a more quiet and restful way of living, and so quieter and more attractive faces. this unquietness comes especially in the eyes. it is a rare thing to see a really quiet eye; and very pleasant and beautiful it is when we do see it. and the more we see and observe the unquiet eyes and the unquiet faces the better worth while it seems to work to have ours more quiet, but not to put on a mask, or be in any other way a hypocrite. the exercise described in a previous chapter will help to bring a quiet face. we must drop our heads with a sense of letting every strain go out of our faces, and then let our heads carry our bodies down as far as possible, dropping strain all the time, and while rising slowly we must take the same care to drop all strain. in taking the long breath, we must inhale without effort, and exhale so easily that it seems as if the breath went out of itself, like the balloons that children blow up and then watch them shrink as the air leaves them. five minutes a day is very little time to spend to get a quiet face, but just that five minutes--if followed consistently--will make us so much more sensitive to the unquiet that we will sooner or later turn away from it as by a natural instinct. chapter xix _about voices_ i knew an old german--a wonderful teacher of the speaking voice--who said "the ancients believed that the soul of the man is here"--pointing to the pit of his stomach. "i do not know," and he shrugged his shoulders with expressive interest, "it may be and it may not be--but i know the soul of the voice is here--and you americans--you squeeze the life out of the word in your throat and it is born dead." that old artist spoke the truth--we americans--most of us--do squeeze the life out of our words and they are born dead. we squeeze the life out by the strain which runs all through us and reflects itself especially in our voices. our throats are tense and closed; our stomachs are tense and strained; with many of us the word is dead before it is born. watch people talking in a very noisy place; hear how they scream at the top of their lungs to get above the noise. think of the amount of nervous force they use in their efforts to be heard. now really when we are in the midst of a great noise and want to be heard, what we have to do is to pitch our voices on a different key from the noise about us. we can be heard as well, and better, if we pitch our voices on a lower key than if we pitch them on a higher key; and to pitch your voice on a low key requires very much less effort than to strain to a high one. i can imagine talking with some one for half an hour in a noisy factory--for instance--and being more rested at the end of the half hour than at the beginning. because to pitch your voice low you must drop some superfluous tension and dropping superfluous tension is always restful. i beg any or all of my readers to try this experiment the next time they have to talk with a friend in a noisy street. at first the habit of screaming above the noise of the wheels is strong on us and it seems impossible that we should be heard if we speak below it. it is difficult to pitch our voices low and keep them there. but if we persist until we have formed a new habit, the change is delightful. there is one other difficulty in the way; whoever is listening to us may be in the habit of hearing a voice at high tension and so find it difficult at first to adjust his ear to the lower voice and will in consequence insist that the lower tone cannot be heard as easily. it seems curious that our ears can be so much engaged in expecting screaming that they cannot without a positive effort of the mind readjust in order to listen to a lower tone. but it is so. and, therefore, we must remember that to be thoroughly successful in speaking intelligently below the noise we must beg our listeners to change the habit of their ears as we ourselves must change the pitch of our voices. the result both to speaker and listener is worth the effort ten times over. as we habitually lower the pitch of our voices our words cease gradually to be "born dead." with a low-pitched voice everything pertaining to the voice is more open and flexible and can react more immediately to whatever may be in our minds to express. moreover, the voice itself may react back again upon our dispositions. if a woman gets excited in an argument, especially if she loses her temper, her voice will be raised higher and higher until it reaches almost a shriek. and to hear two women "argue" sometimes it may be truly said that we are listening to a "caterwauling." that is the only word that will describe it. but if one of these women is sensitive enough to know she is beginning to strain in her argument and will lower her voice and persist in keeping it lowered the effect upon herself and the other woman will put the "caterwauling" out of the question. "caterwauling" is an ugly word. it describes an ugly sound. if you have ever found yourself in the past aiding and abetting such an ugly sound in argument with another--say to yourself "caterwauling," "caterwauling," "i have been 'caterwauling' with jane smith, or maria jones," or whoever it may be, and that will bring out in such clear relief the ugliness of the word and the sound that you will turn earnestly toward a more quiet way of speaking. the next time you start on the strain of an argument and your voice begins to go up, up, up--something will whisper in your ear "caterwauling" and you will at once, in self-defense, lower your voice or stop speaking altogether. it is good to call ugly things by their ugliest names. it helps us to see them in their true light and makes us more earnest in our efforts to get away from them altogether. i was once a guest at a large reception and the noise of talking seemed to be a roar, when suddenly an elderly man got up on a chair and called "silence," and having obtained silence he said, "it has been suggested that every one in this room should speak in a lower tone of voice." the response was immediate. every one went on talking with the same interest only in a lower tone of voice with a result that was both delightful and soothing. i say every one--there were perhaps half a dozen whom i observed who looked and i have no doubt said "how impudent." so it was "impudent" if you chose to take it so--but most of the people did not choose to take it so and so brought a more quiet atmosphere and a happy change of tone. theophile gautier said that the voice was nearer the soul than any other expressive part of us. it is certainly a very striking indicator of the state of the soul. if we accustom ourselves to listen to the voices of those about us we detect more and more clearly various qualities of the man or the woman in the voice, and if we grow sensitive to the strain in our own voices and drop it at once when it is perceived, we feel a proportionate gain. i knew of a blind doctor who habitually told character by the tone of the voice, and men and women often went to him to have their characters described as one would go to a palmist. once a woman spoke to him earnestly for that purpose and he replied, "madam, your voice has been so much cultivated that there is nothing of you in it--i cannot tell your real character at all." the only way to cultivate a voice is to open it to its best possibilities--not to teach its owner to pose or to imitate a beautiful tone until it has acquired the beautiful tone habit. such tones are always artificial and the unreality in them can be easily detected by a quick ear. most great singers are arrant hypocrites. there is nothing of themselves in their tone. the trouble is to have a really beautiful voice one must have a really beautiful soul behind it. if you drop the tension of your voice in an argument for the sake of getting a clearer mind and meeting your opponent without resistance, your voice helps your mind and your mind helps your voice. they act and react upon one another with mutual benefit. if you lower your voice in general for the sake of being more quiet, and so more agreeable and useful to those about you, then again the mental or moral effort and the physical effort help one another. it adds greatly to a woman's attraction and to her use to have a low, quiet voice--and if any reader is persisting in the effort to get five minutes absolute quiet in every day let her finish the exercise by saying something in a quiet, restful tone of voice. it will make her more sensitive to her unrestful tones outside, and so help her to improve them. chapter xx _about frights_ here are two true stories and a remarkable contrast. a nerve specialist was called to see a young girl who had had nervous prostration for two years. the physician was told before seeing the patient that the illness had started through fright occasioned by the patient's waking and discovering a burglar in her room. almost the moment the doctor entered the sick room, he was accosted with: "doctor, do you know what made me ill? it was frightful." then followed a minute description of her sudden awakening and seeing the man at her bureau drawers. this story had been lived over and over by the young girl and her friends for two years, until the strain in her brain caused by the repetition of the impression of fright was so intense that no skill nor tact seemed able to remove it. she simply would not let it go, and she never got really well. now, see the contrast. another young woman had a similar burglar experience, and for several nights after she woke with a start at the same hour. for the first two or three nights she lay and shivered until she shivered herself to sleep. then she noticed how tightened up she was in every muscle when she woke, and she bethought herself that she would put her mind on relaxing her muscles and getting rid of the tension in her nerves. she did this persistently, so that when she woke with the burglar fright it was at once a reminder to relax. after a little she got the impression that she woke in order to relax and it was only a very little while before she succeeded so well that she did not wake until it was time to get up in the morning. the burglar impression not only left her entirely, but left her with the habit of dropping all contractions before she went to sleep, and her nerves are stronger and more normal in consequence. the two girls had each a very sensitive, nervous temperament, and the contrast in their behavior was simply a matter of intelligence. this same nerve specialist received a patient once who was positively blatant in her complaint of a nervous shock. "doctor, i have had a horrible nervous shock. it was horrible. i do not see how i can ever get over it." then she told it and brought the horrors out in weird, over-vivid colors. it was horrible, but she was increasing the horrors by the way in which she dwelt on it. finally, when she paused long enough to give the doctor an opportunity to speak, he said, very quietly: "madam, will you kindly say to me, as gently as you can, 'i have had a severe nervous shock.'" she looked at him without a gleam of understanding and repeated the words quietly: "i have had a severe nervous shock." in spite of herself she felt the contrast in her own brain. the habitual blatancy was slightly checked. the doctor then tried to impress upon her the fact that she was constantly increasing the strain of the shock by the way she spoke of it and the way she thought of it, and that she was really keeping herself ill. gradually, as she learned to relax the nervous tension caused by the shock, a true intelligence about it all dawned upon her; the over-vivid colors faded, and she got well. she was surprised herself at the rapidity with which she got well, but she seemed to understand the process and to be moderately grateful for it. if she had had a more sensitive temperament she would have appreciated it all the more keenly; but if she had had a more sensitive temperament she would not have been blatant about her shock. chapter xxi _contrariness_ i know a woman who says that if she wants to get her father's consent to anything, she not only appears not to care whether he consents or not, but pretends that her wishes are exactly opposite to what they really are. she says it never fails; the decision has always been made in opposition to her expressed desires, and according to her real wishes. in other words, she has learned how to manage her father. this example is not unique. many of us see friends managing other friends in that same way. the only thing which can interfere with such astute management is the difficulty that a man may have in concealing his own will in order to accomplish what he desires. wilfulness is such an impulsive quantity that it will rush ahead in spite of us and spoil everything when we feel that there is danger of our not getting our own way. or, if we have succeeded in getting our own way by what might be called the "contrary method," we may be led into an expression of satisfaction which will throw light on the falseness of our previous attitude and destroy the confidence of the friend whom we were tactfully influencing. to work the "contrary method" to perfection requires a careful control up to the finish and beyond it. in order never to be found out, we have to be so consistent in our behavior that we gradually get trained into nothing but a common every-day hypocrite, and the process which goes on behind hypocrisy must necessarily be a process of decay. beside that, the keenest hypocrite that ever lived can only deceive others up to a certain limit. but what is one to do when a friend can only be reached by the "contrary method"? what is one to do when if, for instance, you want a friend to read a book, you know that the way to prevent his reading it is to mention your desire? if you want a friend to see a play and in a forgetful mood mention the fact that you feel sure the play would delight him, you know as soon as the words are out of your mouth you have put the chance of his seeing the play entirely out of the question? what is one to do when something needs mending in the house, and you know that to mention the need to the man of the house would be to delay the repair just so much longer? how are our contrary-minded friends to be met if we cannot pretend we do not want what we do want in order to get their cooperation and consent? no one could deliberately plan to be a hypocrite understanding what a hypocrite really is. a hypocrite is a sham--a sham has nothing solid to stand on. no one really respects a sham, and the most intelligent, the most tactful hypocrite that ever lived is nothing but a sham,--_false_ and a sham! beside, no one can manage another by the process of sham and hypocrisy without sooner or later being found out, and when he is found out, all his power is gone. the trouble with the contrary-minded is they have an established habit of resistance. sometimes the habit is entirely inherited, and has never been seen or acknowledged. sometimes it has an inherited foundation, with a cultivated superstructure. either way it is a problem for those who have to deal with it,--until they understand. the "contrary method" does not solve the problem; it is only a makeshift; it never does any real work, or accomplishes any real end. it is not even lastingly intelligent. the first necessity in dealing truly with these people is _not to be afraid o f their resistances._ the second necessity, which is so near the first that the two really belong side by side, is _never to meet their resistances with resistances o f our own._ if we combat another man's resistance, it only increases his tension. no matter how wrong he may be, and how right we are, meeting resistance with resistance only breeds trouble. two minds can act and react upon one another in that way until they come to a lock which not only makes lasting enemies of those who should have been and could be always friends, but the contention locks up strain in each man's brain which can never be removed without pain, and a new awakening to the common sense of human intercourse. if we want a friend to read a book, to go a journey, or to do something which is more important for his own good than either, and we know that to suggest our desire would be to rouse his resistance, the only way is to catch him in the best mood we can, say what we have to say, give our own preference, and at the same time feel and express a willingness to be refused. every man is a free agent, and we have no right not to respect his freedom, even if he uses that freedom to stand in his own light or in ours. if he is standing in our light and refuses to move, we can move out of his shadow, even though we may have to give up our most cherished desire in order to do so. if he is standing in his own light, and refuses to move, we can suggest or advise and do whatever in us lies to make the common sense of our opinion clear; but if he still persists in standing in his own light, it is his business, not ours. it requires the cultivation of a strong will to put a request before a friend which we know will be resisted, and to yield to that resistance so that it meets no antagonism in us. but when it is done, and done thoroughly, consistently, and intelligently, the other man's resistance reacts back upon himself, and he finds himself out as he never could in any other way. having found himself out, unless his mulishness is almost past sanity, he begins to reject his habit of resistance of his own accord. in dealing with the contrary minded, the "contrary method" works so long as it is not discovered; and the danger of its being discovered is always imminent. the upright, direct method is according to the honorable laws of human intercourse, and brings always better results in the end, even though there may be some immediate failures in the process. to adjust ourselves rightly to another nature and go with it to a good end, along the lines of least resistance, is of course the best means of a real acquaintance, but to allow ourselves to manage a fellow-being is an indignity to the man and worse than an indignity to the mind who is willing to do the managing. our humanity is in our freedom. our freedom is in our humanity. when one, man tries to manage another, he is putting that other in the attitude of a beast. the man who is allowing himself to be managed is classing himself with the beasts. although this is a fact so evident on the base of it that it needs neither explanation nor enlargement, there is hardly a day passes that some one does not say to some one, "you cannot manage me in that way," and the answer should be, "why should you want to be managed in any way; and why should i want to insult you by trying to manage you at all?" the girl and her father might have been intelligent friends by this time, if the practice of the "contrary method" had not tainted the girl with habitual hypocrisy, and cultivated in the father the warped mind which results from the habit of resistance, and blind weakness which comes from the false idea that he is always having his own way. if we want an open brain and a good, freely working nervous system, we must respect our own freedom and the freedom of other people,--for only as individuals stand alone can they really influence one another to any good end. it is curious to see how the men of habitual resistance pride themselves on being in bondage to no one, not knowing that the fear of such bondage is what makes them resist, and the fear of being influenced by another is one of the most painful forms of bondage in which a man can be. the men who are slaves to this fear do not stop even to consider the question. they resist and refuse a request at once, for fear that pausing for consideration would open them to the danger of appearing to yield to the will of another. when we are quite as willing to yield to another as to refuse him, then we are free, and can give any question that is placed before us intelligent consideration, and decide according to our best judgment. no amount of willfulness can force a man to any action or attitude of mind if he is willing to yield to the willful pressure if it seems to him best. the worse bondage of man to man is the bondage of fear. chapter xxii _how to sew easily_ it is a common saying that we should let our heads save our heels, but few of us know the depth of it or the freedom and health that can come from obedience to it. for one thing we get into ruts. if a woman grows tired sewing she takes it for granted that she must always be tired. sometimes she frets and complains, which only adds to her fatigue. sometimes she goes on living in a dogged state of overtiredness until there comes a "last straw" which brings on some organic disease, and still another "straw" which kills her altogether. we, none of us, seem to realize that our heads can save not only our heels, but our hearts, and our lungs, our spines and our brains--indeed our whole nervous systems. men and women sometimes seem to prefer to go on working--chronically tired--getting no joy from life whatever, rather than to take the trouble to think enough to gain the habit of working restfully. sometimes, to be sure, they are so tired that the little extra exertion of the brain required to learn to get rid of the fatigue seems too much for them. it seems easier to work in a rut of strain and discomfort than to make the effort to get out of the rut--even though they know that by doing so they will not only be better themselves, but will do their work better. now really the action of the brain which is needed to help one to work restfully is quite distinct from the action which does the work, and a little effort of the brain in a new direction rests and refreshes the part of the brain which is drudging along day after day, and not only that, but when one has gained the habit of working more easily life is happier and more worth while. if once we could become convinced of that fact it would be a simple matter for the head to learn to save the heels and for the whole body to be more vigorous in consequence. take sewing, for instance: if a woman must sew all day long without cessation and she can appreciate that ten or fifteen minutes taken out of the day once in the morning and once in the afternoon is going to save fatigue and help her to do her sewing better, doesn't it seem simply a lack of common sense if she is not willing to take that half hour and use it for its right purpose? or, if she is employed with others, is it not a lack of common sense combined with cruelty in her employer if he will not permit the use of fifteen minutes twice a day to help his employees to do their work better and to keep more healthy in the process of working? it seems to me that all most of us need is to have our attention drawn to the facts in such cases as this and then we shall be willing and anxious to correct the mistakes. first, we do not know, and, secondly, we do not think, intelligently. it is within our reach to do both. let me put the facts about healthy sewing in numerical order:-- first--a woman should never sew nor be allowed to sew in bad air. the more or less cramped attitude of the chest in sewing makes it especially necessary that the lungs should be well supplied with oxygen, else the blood will lose vitality, the appetite will go and the nerves will be straining to bring the muscles up to work which they could do quite easily if they were receiving the right amount of nourishment from air and food. second--when our work gives our muscles a tendency steadily in one direction we must aim to counteract that tendency by using exercises with a will to pull them in the opposite way. if a man writes constantly, to stop writing half a dozen times a day and stretch the fingers of his hand wide apart and let them relax back slowly will help him so that he need not be afraid of writer's paralysis. now a woman's tendency in sewing is to have her chest contracted and settled down on her stomach, and her head bent forward. let her stop even twice a day, lift her chest off her stomach, see that the lifting of her chest takes her shoulders back, let her head gently fall back, take a long quiet breath in that attitude, then bring the head up slowly, take some long quiet breaths like gentle sighs, gradually let the lungs settle back into their habitual state of breathing, and then try the exercise again. if this exercise is repeated three times in succession with quiet care, its effect will be very evident in the refreshment felt when a woman begins sewing again. at the very most it can only take two minutes to go through the whole exercise and be ready to repeat it. that will mean six minutes for the three successive times. six minutes can easily be made up by the renewed vigor that comes from the long breath and change of attitude. stopping for the exercise three times a day will only take eighteen--or at the most twenty-minutes out of the day's work and it will put much more than that into the work in new power. third--we must remember that we need not sew in a badly cramped position. of course the exercises will help us out of the habitually cramped attitude, but we cannot expect them to help us so much unless we make an effort while sewing to be as little cramped as possible. the exercises give us a new standard of erectness, and that new standard will make us sensitive to the wrong attitude. we will constantly notice when our chests get cramped and settled down on our stomachs and by expanding them and lifting them, even as we sew, the healthy attitude will get to be second nature. fourth--we must sew with our hands and our arms, not with our spines, the backs of our necks, or our legs. the unnecessary strain she puts into her sewing makes a woman more tired than anything else. to avoid this she must get sensitive to the strain, and every time she perceives it drop it; consciously, with a decided use of her will, until she has established the habit of working without strain. the gentle raising of the head to the erect position after the breathing exercise will let out a great deal of strain, and so make us more sensitive to its return when we begin to sew, and the more sensitive we get to it the sooner we can drop it. i think i hear a woman say, "i have neither the time nor the strength to attend to all this." my answer is, such exercise will save time and strength in the end. chapter xxiii _do not hurry_ how can any one do anything well while in a constant state of rush? how can any one see anything clearly while in a constant state of rush? how can any one expect to keep healthy and strong while in a constant state of rush? but most of my readers may say, "i am not in a constant state of rush--i only hurry now and then when i need to hurry." the answer to that is "prove it, prove it." study yourself a little, and see whether you find yourself chronically in a hurry or not. if you will observe yourself carefully with a desire to find the hurry tendency, and to find it thoroughly, in order to eliminate it, you will be surprised to see how much of it there is in you. the trouble is that all our standards are low, and to raise our standards we must drop that which interferes with the most wholesome way of living. as we get rid of all the grosser forms of hurry we find in ourselves other hurry habits that are finer and more subtle, and gradually our standards of quiet, deliberate ways get higher; we become more sensitive to hurry, and a hurried way of doing things grows more and more disagreeable to us. watch the women coming out of a factory in the dinner hour or at six o'clock. they are almost tumbling over each other in their hurry to get away. they are putting on their jackets, pushing in their hatpins, and running along as if their dinner were running away from them. something akin to that same attitude of rush we can see in any large city when the clerks come out of the shops, for their luncheon hour, or when the work of the day is over. if we were to calculate in round numbers the amount of time saved by this rush to get away from the shop, we should find three minutes, probably the maximum--and if we balance that against the loss to body and mind which is incurred, we should find the three minutes' gain quite overweighted by the loss of many hours, perhaps days, because of the illness which must be the result of such habitual contraction. it is safe to predict when we see a woman rushing away from factory or shop that she is not going to "let up" on that rate of speed until she is back again at work. indeed, having once started brain and body with such an exaggerated impetus, it is not possible to quiet down without a direct and decided use of the will, and how is that decided action to be taken if the brain is so befogged with the habit of hurry that it knows no better standard? one of the girls from a large factory came rushing up to the kind, motherly head of the boarding house the other day saying:-- "it is abominable that i should be kept waiting so long for my dinner. i have had my first course and here i have been waiting twenty minutes for my dessert." the woman addressed looked up quietly to the clock and saw that it was ten minutes past twelve. "what time did you come in?" she said. "at twelve o'clock." "and you have had your first course?" "yes." "and waited twenty minutes for your dessert?" "yes!" (snappishly). "how can that be when you came in at twelve o'clock, and it is now only ten minutes past?" of course there was nothing to say in answer, but whether the girl took it to heart and so raised her standard of quiet one little bit, i do not know. one can deposit a fearful amount of strain in the brain with only a few moments' impatience. i use the word "fearful" advisedly, for when the strain is once deposited it is not easily removed, especially when every day and every moment of every day is adding to the strain. the strain of hurry makes contractions in brain and body with which it is impossible to work freely and easily or to accomplish as much as might be done without such contractions. the strain of hurry befogs the brain so that it is impossible for it to expand to an unprejudiced point of view. the strain of hurry so contracts the whole nervous and muscular systems that the body can take neither the nourishment of food nor of fresh air as it should. there are many women who work for a living, and women who do not work for a living, who feel hurried from morning until they go to bed at night, and they must, perforce, hurry to sleep and hurry awake. often the day seems so full, and one is so pressed for time that it is impossible to get in all there is to do, and yet a little quiet thinking will show that the important things can be easily put into two thirds of the day, and the remaining third is free for rest, or play, or both. then again, there is real delight in quietly fitting one thing in after another when the day must be full, and the result at the end of the day is only healthy fatigue from which a good night's rest will refresh us entirely. there is one thing that is very evident--a feeling of hurry retards our work, it does not hasten it, and the more quietly we can do what is before us, the more quickly and vigorously we do it. the first necessity is to find ourselves out--to find out for a fact when we do hurry, and how we hurry, and how we have the sense of hurry with us all the time. having willingly, and gladly, found ourselves out, the remedy is straight before us. nature is on the side of leisure and will come to our aid with higher standards of quiet, the possibilities of which are always in every one's brain, if we only look to find them. to sit five minutes quietly taking long breaths to get a sense of leisure every day will be of very great help--and then when we find ourselves hurrying, let us stop and recall the best quiet we know--that need only take a few seconds, and the gain is sure to follow. _festina lente_ (hasten slowly) should be in the back of our brains all day and every day. "'t is haste makes waste, the sage avers, and instances are far too plenty; whene'er the hasty impulse stirs, put on the brake, festina lente." chapter xxiv _the care of an invalid_ to take really good care of one who is ill requires not only knowledge but intelligent patience and immeasurable tact. a little knowledge will go a great way, and we do not need to be trained nurses in order to help our friends to bear their illnesses patiently and quietly and to adjust things about them so that they are enabled to get well faster because of the care we give them. sometimes if we have only fifteen minutes in the morning and fifteen minutes at night to be with a sick friend, we can so arrange things for the day and for the night that we will have left behind us a directly curative influence because our invalid feels cared for in the best way, and has confidence enough to follow the suggestions we have given. more depends upon the spirit with which we approach an invalid than anything else. a trained nurse who has graduated at the head of her class and has executive ability, who knows exactly what to do and when to do it, may yet bring such a spirit of self-importance and bustle that everything she does for the invalid's ease, comfort, and recuperation is counteracted by the unrestful "professional" spirit with which the work is done. on the other hand, a woman who has only a slight knowledge of nursing can bring so restful and unobtrusive an atmosphere with her that the invalid gains from her very presence. overwhelming kindness is not only tiresome and often annoying, but a serious drag on one who is ill. people who are so busy doing kindnesses seldom consult the invalid's preferences at all. they are too full of their own selfish kindliness and self-importance. i remember a woman who was suffering intensely from neuralgia in her face. a friend, proud of the idea of caring for her and giving up her own pleasure to stay in the darkened room and keep the sufferer's face bathed in hot water, made such a rustling back and forth with her skirts in getting the water that the strain of the constant noise and movement not only counteracted any relief that might have come from the heat, but it increased the pain and made the nervous condition of the patient much worse. so it is with a hundred and one little "kindnesses" that people try to do for others when they are ill. they talk to amuse them when the invalids would give all in their power to have a little quiet. they sit like lumps and say nothing when a little light, easy chatting might divert the invalid's attention and so start up a gentle circulation which would tend directly toward health. or, they talk and are entertaining for a while in a very helpful way, but not knowing when to stop, finally make the patient so tired that they undo all the good of the first fifteen minutes. they flood the room with light, "to make it look pleasant," when the invalid longs for the rest of a darkened room; or they draw the shades when the patient longs for the cheerfulness of sunlight. they fuss and move about to do this or that and the other "kindness" when the sick person longs for absolute quiet. they shower attentions when the first thing that is desired is to be let alone. one secret of the whole trouble in this oppressive care of the sick is that this sort of caretaker is interested more to please herself and feel the satisfaction of her own benefactions than she is to really please the friend for whom she is caring. another trouble is common ignorance. some women would gladly sacrifice anything to help a friend to get well; they would give their time and their strength gladly and count it as nothing, but they do not know how to care for the sick. often such people are sadly discouraged because they see that they are only bringing discomfort where, with all their hearts, they desire to bring comfort. the first necessity in the right care for the sick is to be quiet and cheerful. the next is to aim, without disturbing the invalid, to get as true an idea as possible of the condition necessary to help the patient to get well. the third is to bring about those conditions with the least possible amount of friction. find out what the invalid likes and how she likes it by observation and not by questions. sometimes, of course, a question must be asked. if we receive a snappish answer, let us not resent it, but blame the illness and be grateful if, along with the snappishness, we find out what suits our patient best. if we see her increasing her pain by contracting and giving all her attention to complaining, we cannot help her by telling her that that sort of thing is not going to make her well. but we can soothe her in a way that will enable her to see it for herself. often the right suggestion, no matter how good it is, will only annoy the patient and send her farther on in the wrong path; but if given in some gentle roundabout way, so that she feels that she has discovered for herself what you have been trying to tell her, it will work wonders toward her recovery. if you want to care for the sick in a way that will truly help them toward recovery, you must observe and study,--study and observe, and never resent their irritability. see that they have the right amount of air; that they have the right nourishment at the right intervals. let them have things their own way, and done in their own way so far as is possible without interfering with what is necessary to their health. remember that there are times when it is better to risk deferring recovery a little rather than force upon an invalid what is not wanted, especially when it is evident that resistance will be harmful. quiet, cheerfulness, light, air, nourishment, orderly surroundings, and to be let judiciously alone; those are the conditions which the amateur nurse must further, according to her own judgment and, her knowledge of the friend she is nursing. for this purpose she must, as i have said, study and observe, and observe and study. i do not mean necessarily to do all this when she is "off duty," but to so concentrate when she is attending to the wants of her friend that every moment and every thought will be used to the best gain of the patient herself, and not toward our ideas of her best gain. a little careful effort of this kind will open a new and interesting vista to the nurse as well as the patient. chapter xxv _the habit of illness_ it is surprising how many invalids there are who have got well and do not know it! when you feel ill and days drag on with one ill feeling following another, it is not a pleasant thing to be told that you are quite well. who could be expected to believe it? i should like to know how many men and women there are who will read this article, who are well and do not know it; and how many of such men and women will take the hint i want to give them and turn honestly toward finding themselves out in a way that will enable them to discover and acknowledge the truth? nerves form habits. they actually form habits in themselves. if a woman has had an organic trouble which has caused certain forms of nervous discomfort, when the organic trouble is cured the nerves are apt to go on for a time with the same uncomfortable feelings because during the period of illness they had formed the habit of such discomfort. then is the time when the will must be used to overcome such habits. the trouble is that when the doctor tells these victims of nervous habit that they are really well they will not believe him. "how can i be well," they say, "when i suffer just as i did while i was ill?" if then the doctor is fortunate enough to convince them of the fact that it is only the nervous habit formed from their illness which causes them to suffer, and that they can rouse their wills to overcome intelligently this habit, then they can be well in a few weeks when they might have been apparently ill for many months--or perhaps even years. nerves form the habit of being tired. a woman can get very much overfatigued at one time and have the impression of the fatigue so strongly on her nerves that the next time she is only a little tired she will believe she is very tired, and so her life will go until the habit of being tired has been formed in her nerves and she believes that she is tired all the time--whereas if the truth were known she might easily feel rested all the time. it is often very difficult to overcome the habit which the nerves form as a result of an attack of nervous prostration. it is equally hard to convince any one getting out of such an illness that the habit of his nerves tries to make him believe he cannot do a little more every day--when he really can, and would be better for it. many cases of nervous prostration which last for years might be cured in as many months if the truth about nerve habits were recognized and acted upon. nerves can form bad habits and they can form good habits, but of all the bad habits formed by nerves perhaps the very worst is the habit of being ill. these bad habits of illness engender an unwillingness to let go of them. they seem so real. "i do not want to suffer like this," i hear an invalid say; "if it were merely a habit don't you think i would throw it off in a minute?" i knew a young physician who had made somewhat of a local reputation in the care of nerves, and a man living in a far-distant country, who had been for some time a chronic invalid, happened by accident to hear of him. my friend was surprised to receive a letter from this man, offering to pay him the full amount of all fees he would earn in one month and as much more as he might ask if he would spend that time in the house with him and attempt his cure. always interested in new phases of nerves, and having no serious case on hand himself at the time, he assented and went with great interest on this long journey to, as he hoped, cure one man. when he arrived he found his patient most charming. he listened attentively to the account of his years of illness, inquired of others in the house with him, and then went to bed and to sleep. in the morning he woke with a sense of unexplained depression. in searching about for the cause he went over his interviews of the day before and found a doubt in his mind which he would hardly acknowledge; but by the end of the next day he said to himself: "what a fool i was to come so far without a more complete knowledge of what i was coming to! this man has been well for years and does not know it. it is the old habit of his illness that is on him; the illness itself must have left him ten years ago." the next day--the first thing after breakfast--he took a long walk in order to make up his mind what to do, and finally decided that he had engaged to stay one month and must keep to his promise. it would not do to tell the invalid the truth--the poor man would not believe it. he was self-willed and self-centered, and his pains and discomforts, which came simply from old habits of illness, were as real to him as if they had been genuine. several physicians had emphasized his belief that he was ill. one doctor--so my friend was told--who saw clearly the truth of the case, ventured to hint at it and was at once discharged. my friend knew all these difficulties and, when he made up his mind that the only right thing for him to do was to stay, he found himself intensely interested in trying to approach his patient with so much delicacy that he could finally convince him of the truth; and i am happy to say that his efforts were to a great degree successful. the patient was awakened to the fact that, if he tried, he could be a well man. he never got so far as to see that he really was a well man who was allowing old habits to keep him ill; but he got enough of a new and healthy point of view to improve greatly and to feel a hearty sense of gratitude toward the man who had enlightened him. the long habit of illness had dulled his brain too much for him to appreciate the whole truth about himself. the only way that such an invalid's brain can be enlightened is by going to work very gently and leading him to the light--never by combating. this young physician whom i mention was successful only through making friends with his patient and leading him gradually to appear to discover for himself the fact which all the time the physician was really telling him. the only way to help others is to help them to help themselves, and this is especially the truth with nerves. if you, my friend, are so fortunate as to find out that your illness is more a habit of illness than illness itself, do not expect to break the habit at once. go about it slowly and with common sense. a habit can be broken sooner than it can be formed, but even then it cannot be broken immediately. first recognize that your uncomfortable feelings whether of eyes, nose, stomach, back of neck, top of head, or whatever it may be, are mere habits, and then go about gradually but steadily ignoring them. when once you find that your own healthy self can assert itself and realize that you are stronger than your habits, these habits of illness will weaken and finally disappear altogether. the moment an illness gets hold of one, the illness has the floor, so to speak, and the temptation is to consider it the master of the situation--and yielding to this temptation is the most effectual way of beginning to establish the habits which the illness has started, and makes it more difficult to know when one is well. on the other hand it is clearly possible to yield completely to an illness and let nature take its course, and at the same time to take a mental attitude of wholesomeness toward it which will deprive the illness of much of its power. nature always tends toward health; so we have the working of natural law entirely on our side. if the attitude of a man's mind is healthy, when he gets well he is well. he is not bothered long with the habits of his illness, for he has never allowed them to gain any hold upon him. he has neutralized the effect of the would-be habits in the beginning so that they could not get a firm hold. we can counteract bad habits with good ones any time that we want to if we only go to work in the right way and are intelligently persistent. it would be funny if it were not sad to hear a man say, "well, you know i had such and such an illness years ago and i never really recovered from the effects of it," and to know at the same time that he had kept himself in the effects of it, or rather the habits of his nerves had kept him there, and he had been either ignorant or unwilling to use his will to throw off those habits and gain the habits of health which were ready and waiting. people who cheerfully turn their hearts and minds toward health have so much, so very much, in their favor. of course, there are laws of health to be learned and carefully followed in the work of throwing off habits of illness. we must rest; take food that is nourishing, exercise, plenty of sleep and fresh air--yet always with the sense that the illness is only something to get rid of, and our own healthy attitude toward the illness is of the greatest importance. sometimes a man can go right ahead with his work, allow an illness to run its course, and get well without interrupting his work in the least, because of his strong aim toward health which keeps his illness subordinate. but this is not often the case. an illness, even though it be treated as subordinate, must be respected more or less according to its nature. but when that is done normally no bad habits will be left behind. i know a young girl who was ill with strained nerves that showed themselves in weak eyes and a contracted stomach. she is well now--entirely well--but whenever she gets a little tired the old habits of eyes and stomach assert themselves, and she holds firmly on to them, whereas each time of getting overtired might be an opportunity to break up these evil habits by a right amount of rest and a healthy amount of ignoring. this matter of habit is a very painful thing when it is supported by inherited tendencies. if a young person overdoes and gets pulled down with fatigue the fatigue expresses itself in the weakest part of his body. it may be in the stomach and consequently appear as indigestion; it may be in the head and so bring about severe headaches, and it may be in both stomach and head. if it is known that such tendencies are inherited the first thought that almost inevitably comes to the mind is: "my father always had headaches and my grandfather, too. of course, i must expect them now for the rest of my life." that thought interpreted rightly is: "my grandfather formed the headache habit, my father inherited the habit and clinched it--now, of course, i must expect to inherit it, and i will do my best to see if i cannot hold on to the habit as well as they did--even better, because i can add my own hold to that which i have inherited from both my ancestors." now, of course, a habit of illness, whether it be of the head, stomach, or of both, is much more difficult to discard when it is inherited than when it is first acquired in a personal illness of our own; but, because it is difficult, it is none the less possible to discard it, and when the work has been accomplished the strength gained from the steady, intelligent effort fully compensates for the difficulty of the task. one must not get impatient with a bad habit in one's self; it has a certain power while it lasts, and can acquire a very strong hold. little by little it must be dealt with--patiently and steadily. sometimes it seems almost as if such habits had intelligence--for the more you ignore them the more rampant they become, and there is a rubicon to cross, in the process of ignoring which, when once passed, makes the work of gaining freedom easier; for when the backbone of the habit is broken it weakens and seems to fade away of itself, and we awaken some fine morning and it has gone--really gone. many persons are in a prison of bad habits simply because they do not know how to get out--not because they do not want to get out. if we want to help a friend out of the habit of illness it is most important first to be sure that it is a habit, and then to remember that a suggestion is seldom responded to unless it is given with generous sympathy and love. indeed, when a suggestion is given with lack of sympathy or with contempt the tendency is to make the invalid turn painfully away from the speaker and hug her bad habits more closely to herself. what we can do, however, is to throw out a suggestion here and there which may lead such a one to discover the truth for herself; then, if she comes to you with sincere interest in her discovery, don't say: "yes, i have thought so for some time." keep yourself out of it, except in so far as you can give aid which is really wanted, and accepted and used. beware of saying or doing anything to or for any one which will only rouse resentment and serve to push deeper into the brain an impression already made by a mistaken conviction. more than half of the functional and nervous illnesses in the world are caused by bad habit, either formed or inherited. happy are those who discover the fact for themselves and, with the intelligence born from such discovery, work with patient insight until they have freed themselves from bondage. happy are those who feel willing to change any mistaken conviction or prejudice and to recognize it as a sin against the truth. chapter xxvi _what is it that makes me so nervous?_ the two main reasons why women are nervous are, first, that they do not take intelligent care of their bodies, and secondly, that they do not govern their emotions. i know a woman who prefers to make herself genuinely miserable rather than take food normally, to eat it normally, and to exercise in the fresh air. "everybody is against me," she says; and if you answer her, "my dear, you are acting against yourself by keeping your stomach on a steady strain with too much unmasticated, unhealthy, undigested food," she turns a woe-begone face on you and asks how you can be "so material." "nobody loves me; nobody is kind to me. everybody neglects me," she says. and when you answer, "how can any one love you when you are always whining and complaining? how can any one be kind to you when you resent and resist every friendly attention because it does not suit your especial taste? indeed, how can you expect anything from any one when you are giving nothing yourself?" she replies, "but i am so nervous. i suffer. why don't they sympathize?" "my dear child, would you sympathize with a woman who went down into the cellar and cried because she was so cold, when fresh air and warm sunshine were waiting for her outside?" this very woman herself is cold all the time. she piles covers over herself at night so that the weight alone would be enough to make her ill. she sleeps with the heat turned on in her room. she complains all day of cold when not complaining of other things. she puts such a strain on her stomach that it takes all of her vitality to look after her food; therefore she has no vitality left with which to resist the cold. of course she resists the idea of a good brisk walk in the fresh air, and yet, if she took the walk and enjoyed it, it would start up her circulation, give her blood more oxygen, and help her stomach to go through all its useless labor better. when a woman disobeys all the laws of nervous health how can she expect not to have her nerves rebel? nerves in themselves are exquisitely sensitive--with a direct tendency toward health. "don't give me such unnecessary work," the stomach cries. "don't stuff me full of the wrong things. don't put a bulk of food into me, but chew your food, so that i shall not have to do my own work and yours, too, when the food gets down here." and there is the poor stomach, a big nervous centre in close communication with the brain, protesting and protesting, and its owner interprets all these protestations into: "i am so unhappy. i have to work so much harder than i ought. nobody loves me. oh, why am i so nervous?" the blood also cries out: "give me more oxygen. i cannot help the lungs or the stomach or the brain to do their work properly unless you take exercise in the fresh air that will feed me truly and send me over the body with good, wholesome vigor." now there is another thing that is sadly evident about the young woman who will not take fresh air, nor eat the right food, nor masticate properly the food that she does eat. when she goes out for a walk she seems to fight the fresh air; she walks along full of resistance and contraction, and tightens all her muscles so that she moves as if she were tied together with ropes. the expression of her face is one of miserable strain and endurance; the tone of her voice is full of complaint. in eating either she takes her food with the appearance of hungry grabbing, or she refuses it with a fastidious scorn. any nervous woman who really wants to find herself out, in order to get well and strong, and contented and happy, will see in this description a reflection of herself, even though it may be an exaggerated reflection. did you ever see a tired, hungry baby fight his food? his mother tries to put the bottle to his mouth, and the baby cries and cries, and turns his head away, and brandishes his little arms about, as if his mother were offering him something bitter. then, finally, when his mother succeeds in getting him to open his mouth and take the food it makes you smile all over to see the contrast: he looks so quiet and contented, and you can see his whole little body expand with satisfaction. it is just the same inherited tendency in a nervous woman that makes her either consciously or unconsciously fight exercise and fresh air, fight good food and eating it rightly, fight everything that is wholesome and strengthening and quieting to her nerves, and cling with painful tenacity to everything that is contracting and weakening, and productive of chronic strain. there is another thing that a woman fights: she fights rest. who has not seen a tired woman work harder and harder, when she was tired, until she has worn herself to a state of nervous irritability and finally has to succumb for want of strength? who has not seen this same tired woman, the moment she gets back a little grain of strength, use it up again at once instead of waiting until she had paid back her principal and could use only the interest of her strength while keeping a good balance in reserve? "i wish my mother would not do so many unnecessary things," said an anxious daughter. a few days after this the mother came in tired, and, with a fagged look on her face and a fagged tone in her voice, said: "before i sit down i must go and see poor mrs. robinson. i have just heard that she has been taken ill with nervous prostration. poor thing! why couldn't she have taken care of herself?" "but, mother," her daughter answered, "i have been to see mrs. robinson, and taken her some flowers, and told her how sorry you would be to hear that she was ill." "my dear," said the fagged mother with a slight tone of irritation in her voice, "that was very good of you, but of course that was not my going, and if i should let to-day pass without going to see her, when i have just heard of her illness, it would be unfriendly and unneighborly and i should not forgive myself." "but, mother, you are tired; you do need to rest so much." "my dear," said the mother with an air of conscious virtue, "i am never too tired to do a neighborly kindness." when she left the house her daughter burst into tears and let out the strain which had been accumulating for weeks. finally, when she had let down enough to feel a relief, a funny little smile came through the tears. "there is one nervously worn-out woman gone to comfort and lift up another nervously worn-out woman--if that is not the blind leading the blind then i don't know. i wonder how long it will be before mamma, too, is in the ditch?" this same story could be reversed with the mother in the daughter's place, and the daughter in the mother's. and, indeed, we see slight illustrations of it, in one way or the other, in many families and among many friends. this, then, is the first answer to any woman's question, "why am i so nervous?" because you do not use common sense in taking exercise, fresh air, nourishment, and rest. nature tends toward health. your whole physical organism tends toward health. if you once find yourself out and begin to be sensible you will find a great, vigorous power carrying you along, and you will be surprised to see how fast you gain. it may be some time before nature gets her own way with you entirely, because when one has been off the track for long it must take time to readjust; but when we begin to go with the laws of health, instead of against them, we get into a healthy current and gain faster than would have seemed possible when we were outside of it, habitually trying to oppose the stream. the second reason why women are nervous is that they do not govern their emotions. very often it is the strain of unpleasant emotions that keeps women nervous, and when we come really to understand we find that the strain is there because the woman does not get her own way. she has not money enough. she has to live with some one she dislikes. she feels that people do not like her and are neglectful of her. she believes that she has too much work to do. she wishes that she had more beauty in her life. sometimes a woman is entirely conscious of when or why she fails to get her own way; then she knows what she is fretting about, and she may even know that the fretting is a strain that keeps her tired and nervously irritated. sometimes a woman is entirely unconscious of what it is that is keeping her in a chronic state of nervous irritability. i have seen a woman express herself as entirely resigned to the very circumstance or person that she was unconsciously resisting so fiercely that her resistance kept her ill half of the time. in such cases the strain is double. first, there is the strain of the person or circumstance chronically resisted and secondly, there is the strain of the pose of saintly resignation. it is bad enough to pose to other people, but when we pose to other people and to ourselves too the strain is twice as bad. imagine a nerve specialist saying to his patient, "my dear madam, you really must stop being a hypocrite. you have not the nervous strength to spare for it." in most cases, i fear, the woman would turn on him indignantly and go home to be more of a hypocrite than ever, and so more nervously ill. i have seen a woman cry and make no end of trouble because she had to have a certain relative live in the house with her, simply because her relative "got on her nerves." then, after the relative had left the house, this same woman cried and still kept on making no end of trouble because she thought she had done wrong in sending "cousin sophia" away; and the poor, innocent, uncomplaining victim was brought back again. yet it never seemed to occur to the nervous woman that "cousin sophia" was harmless, and that her trouble came entirely from the way in which she constantly resented and resisted little unpolished ways. i do not know how many times "cousin sophia" may be sent off and brought back again; nor how many times other things in my nervous friend's life may have to be pulled to pieces and then put together again, for she has not yet discovered that the cause of the nervous trouble is entirely in herself, and that if she would stop resisting "cousin sophia's" innocent peculiarities, stop resisting other various phases of her life that do not suit her, and begin to use her will to yield where she has always resisted, her load would be steadily and happily lifted. the nervous strain of doing right is very painful; especially so because most women who are under this strain do not really care about doing right at all. i have seen a woman quibble and talk and worry about what she believed to be a matter of right and wrong in a few cents, and then neglect for months to pay a poor man a certain large amount of money which he had honestly earned, and which she knew he needed. the nervous conscience is really no conscience at all. i have seen a woman worry over what she owed to a certain other woman in the way of kindness, and go to a great deal of trouble to make her kindness complete; and then, on the same day, show such hard, unfeeling cruelty toward another friend that she wounded her deeply, and that without a regret. a nervous woman's emotions are constantly side-tracking her away from the main cause of her difficulty, and so keeping her nervous. a nervous woman's desire to get her own way--and strained rebellion at not getting her own way--bedazzles or befogs her brain so that her nerves twist off into all sorts of emotions which have nothing whatever to do with the main cause. the woman with the troublesome relative wants to be considered good and kind and generous. the woman with the nervous money conscience wants to be considered upright and just in her dealings with others. all women with various expressions of nervous conscience want to ease their consciences for the sake of their own comfort--not in the least for the sake of doing right. i write first of the nervous hypocrite because in her case the nervous strain is deeper in and more difficult to find. to watch such a woman is like seeing her in a terrible nightmare, which she steadily "sugar-coats" by her complacent belief in her own goodness. if, among a thousand nervous "saints" who may read these words, one is thereby enabled to find herself out, they are worth the pains of writing many times over. the nervous hypocrites who do not find themselves out get sicker and sicker, until finally they seem to be of no use except to discipline those who have the care of them. the greatest trouble comes through the befogging emotions. a woman begins to feel a nervous strain, and that strain results in exciting emotions; these emotions again breed more emotions until she becomes a simmering mass of exciting and painful emotions which can be aroused to a boiling point at any moment by anything or any one who may touch a sensitive point. when a woman's emotions are aroused, and she is allowing herself to be governed by them, reason is out of the question, and any one who imagines that a woman can be made to understand common sense in a state like that will find himself entirely mistaken. the only cure is for the woman herself to learn first how entirely impervious to common sense she is when she is in the midst of an emotional nerve storm, so that she will say, "don't try to talk to me now; i am not reasonable, wait until i get quiet." then, if she will go off by herself and drop her emotions, and also the strain behind her emotions, she will often come to a good, clear judgment without outside help; or, if not, she will come to the point where she will be ready and grateful to receive help from a clearer mind than her own. "for goodness' sake, don't tell that to alice," a young fellow said of his sister. "she will have fits first, and then indigestion and insomnia for six weeks." the lad was not a nerve specialist; neither was he interested in nerves--except to get away from them; but he spoke truly from common sense and his own experience with his sister. the point is, to drop the emotions and face the facts. if nervous women would see the necessity for that, and would practice it, it would be surprising to see how their nerves would improve. i once knew a woman who discovered that her emotions were running away with her and making her nervously ill. she at once went to work with a will, and every time something happened to rouse this great emotional wave she would deliberately force herself to relax and relax until the wave had passed over her and she could see things in a sensible light. when she was unable to go off by herself and lie down to relax, she would walk with her mind bent on making her feet feel heavy. when you drop the tension of the emotion, the emotion has nothing to hold on to and it must go. i knew another woman who did not know how to relax; so, to get free from this emotional excitement, she would turn her attention at once to figures, to her personal accounts or even to saying the multiplication table. the steady concentration of her mind on dry figures and on "getting her sums right" left the rest of her brain free to drop its excitement and get into a normal state again. again it is sometimes owing to the pleasant emotions which some women indulge in to such an extreme that they are made ill. how many times have we heard of women who were "worn to a shred" by the delight of an opera, or a concert, or an exciting play? if these women only knew it, their pleasure would be far keener if they would let the enjoyment pass through them, instead of tightening up in their nerves and trying to hold on to it. nature in us always tends toward health, and toward pleasant sensations. if we relax out of painful emotions we find good judgment and happy instincts behind them. if we relax so that pleasant emotions can pass over our nerves they leave a deposit of happy sensation behind, which only adds to the store that nature has provided for us. to sum up: the two main reasons why women are nervous are that they do not take intelligent care of their bodies, and that they do not govern their emotions; but back of these reasons is the fact that they want their own way altogether too much. even if a woman's own way is right, she has no business to push for it selfishly. if any woman thinks, "i could take intelligent care of my own body if i did not have to work so hard, or have this or that interference," let her go to work with her mind well armed to do what she can, and she will soon find that there are many ways in which she can improve in the normal care of her body, in spite of all the work and all the interferences. to adapt an old saying, the women who are overworked and clogged with real interferences should aim to be healthy; and, if they cannot be healthy, then they should be as healthy as they can. chapter xxvii _positive and negative effort_ did you ever have the grip? if you ever have you may know how truly it is named and how it does actually grip you so that it seems as if there were nothing else in the world at the time--it appears to entirely possess you. as the irishman says, the grip is "the disease that lasts fur a week and it takes yer six weeks ter get over it." that is because it has possessed you so thoroughly that it must be routed out of every little fiber in your body before you are yourself again, and there are hidden corners where it lurks and hides, and it often has to be actually pulled out of them. now it has been already recognized that if we relax and do not resist a severe cold it leaves us open so that our natural circulation carries away the cold much more quickly than if we allowed ourselves to be full of resistance to the discomfort and the consequent physical contraction that impeded the circulation and holds the cold in our system. my point is this--that it is comparatively easy to relax out of a cold. we can do it with only a negative effort, but to relax so that nature in her steady and unswerving tendency toward health can lift us out of the grip is quite another matter. when we feel ourselves entirely in the power of such a monster as that is at its worst, it is only by a very strong and positive effort of the will that we can yield so that nature can guide us into health, and we do not need the six weeks of getting well. in order to gain this positive sense of yielding away from the disease rather than of letting it hold us, we must do what seems at the time the impossible--we must refuse to give our attention to the pain or discomfort and insist upon giving our attention entirely to yielding out of the contractions which the painful discomforts cause. in other words, we must give up resisting the grip. it is the same with any other disease or any pain. if we have the toothache and give all our attention to the toothache, it inevitably makes it worse; but if we give our attention to yielding out of the toothache contractions, it eases the pain even though it may be that only the dentist can stop it. once i had an ulcerated tooth which lasted for a week. i had to yield so steadily to do my work during the day and to be able to sleep at all at night that it not only made the pain bearable, but when the tooth got well i was surprised to find how many habitual contractions i had dropped and how much more freedom of action i had before my tooth began to ulcerate. i should not wish to have another ulcerated tooth in order that i might gain more freedom, but i should wish to take every pain of body and mind so truly that when the pain was over i should have gained greater freedom than i had before it began. you see it is the same with every pain and with every disease. nature tends toward health and if we make the disease simply a reminder to yield--and to yield more deeply--and to put our positive effort there, we are opening the way for nature to do her best work. if our entire attention is given to yielding and we give no attention whatever to the pain, except as a reminder to yield, the result seems wonderful. it seems wonderful because so few of us have the habit of giving our entire attention to gaining our real freedom. with most of us, the disease or discomfort is positive, and our effort against it is negative or no effort at all. a negative effort probably protects us from worse evil, but that is all; it does not seem to me that it can ever take us ahead, whereas a positive effort, while sometimes we seem to move upward in very slow stages, often takes us in great strides out of the enemy's country. if we have the measles, the whooping cough, scarlet fever--even more serious diseases--and make the disease negative and our effort to free ourselves from it positive, the result is one thousand times worth while. and where the children have the measles and the whooping cough, and do not know how to help nature, the mothers can be positive for the children and make their measles and whooping cough negative. the positive attitude of a mother toward her sick child puts impatience or despair out of the question. do not think that i believe one can be positive all at once. we must work hard and insist over and over again before we can attain the positive attitude and having attained it, we have to lose it and gain it again, lose it and gain it again, many times before we get the habit of making all difficulties of mind and body negative, and our healthy attitude toward conquering them positive. i said "difficulties of mind and body." i might better have said "difficulties of body, mind and character," or even character alone, for, after all, when you come to sift things down, it is the character that is at the root of all human life. i know a woman who is constantly complaining. every morning she has a series of pains to tell of, and her complaints spout out of her in a half-irritated, whining tone as naturally as she breathes. over and over you think when you listen to her how useful all those pains of hers would be if she took them as a reminder to yield and in yielding to do her work better. but if one should venture to suggest such a possibility, it would only increase the complaints by one more--that of having unsympathetic friends and being misunderstood. "nobody understands me--nobody understands me." how often we hear that complaint. how often in hearing it we make the mental question, "do you understand yourself?" you see the greatest impediment to our understanding ourselves is our unwillingness to see what is not good in ourselves. it is easy enough in a self-righteous attitude of what we believe to be humility to find fault with ourselves, but quite another thing when others find fault with us. when we are giving our attention to discomforts and pains in a way to give them positive power, and some one suggests that we might change our aim, then the resistance and resentment that are roused in us are very indicative of just where we are in our character. another strong indication of allowing our weaknesses and faults to be positive and our effort against them negative is the destructive habit of giving excuses. if fault is found with us and there is justice in it, it does not make the slightest difference how many things we have done that are good, or how much better we do than some one else does--the positive way is to say "thank you" in spirit and in words, and to aim directly toward freeing ourselves from the fault. how ridiculous it would seem if when we were told that we had a smooch on our left cheek, we were to insist vehemently upon the cleanliness of our right cheek, or our forehead, or our hands, instead of being grateful that our attention should be called to the smooch and taking soap and water and at once washing it off. or how equally absurd it would be if we went into long explanations as to how the smooch would not have been there if it had not been for so and so, and so and so, or so and so,--and then with all our excuses and explanations and protestations, we let the smooch stay--and never really wash it off. and yet this is not an exaggeration of what most of us do when our attention is called to defects of character. when we excuse and explain and tell how clean the other side of our face is, we are putting ourselves positively on the side of the smooch. so we are putting ourselves entirely on the side of the illness or the pain or the oppression of difficult circumstances when we give excuses or resist or pretend not to see fault in ourselves, or when we confess faults and are contented about them, or when we give all our attention to what is disagreeable and no attention to the normal way of gaining our health or our freedom. then all these expressions of self or of illness are to us positive, and our efforts against them only negative. in such cases, of course, the self possesses us as surely as the grip possesses us when we succumb entirely to all its horrors and make no positive effort to yield out of it. and the possession of the self is much worse, much deeper, much more subtle. when possessed with selfishness, we are laying up in our subconsciousness any number of self-seeking motives which come to the surface disguised and compel us to make impulsive and often foolish efforts to gain our own ends. the self is every day proving to be the enemy of the man or woman whom it possesses. god leaves us free to obey him or to choose our own selfish way, and in his infinite providence he is constantly showing us that our own selfish way leads to death and obedience to him leads to life. that is, that only in obedience to him do we find our real freedom. he is constantly showering us with a tender generosity and kindness that seems inconceivable, and sometimes it seems as if more often than not we were refusing to see. indeed we blind ourselves by making all pains of body and faults of soul positive and our efforts against them negative. if we had a disagreeable habit which we wanted to conquer and asked a friend to remind us with a pinch every time he saw the habit, wouldn't it seem very strange if when he pinched us, according to agreement, we jumped and turned on him, rubbing our arm with indignation that he should have pinched? or would it not be even funnier if we made the pinch merely a reminder to go on with the habit? the lord is pinching us in that way all the time, and we respond by being indignant at or complaining at our fate, or reply by going more deeply into our weaknesses of character by allowing them to be positive and the pinches only to emphasize them to us. one trouble is that we do not recognize that there is an agreement between us and the lord, or that we recognize and then forget it; and yet there should be--there is--more than an agreement, there is a covenant. and the lord is steadily, unswervingly doing his part, and we are constantly failing in ours. the lord in his loving kindness pinches--that is, reminds us--and we in our stupid selfishness do not use his reminders. as an example of making our faults positive and our effort to conquer them negative, one very common form is found in a woman i know, who has times of informing her friends quite seriously and with apparent regret of her very wrong attitudes of mind. she tells how selfish she is and she gives examples of the absolute selfishness of her thoughts when she is appearing to do unselfish things. she tells of her efforts to do better and confesses what she believes to be the absolute futility of her effort. at first i was quite taken in by these confessions, and attracted by what seemed to be a clear understanding of herself and her own motives, but after a little longer acquaintance with her, made the discovery, which was at first surprising to me, that her confessions of evil came just as much from conceit as if she had been standing at the mirror admiring her own beauty. selfish satisfaction is often found quite as much in mental attitudes of grief as in sensations of joy. finally this woman has recognized for herself the conceit in her contemplation of her faults, and that she has not only allowed them to be positive while her attitude against them is negative; she has actually nursed them and been positive herself with their positiveness. her attitude against them was therefore more than ordinarily negative. the more common way of being negative while we allow our various forms of selfishness to positively govern us is, first in bewailing a weakness seriously, but constantly looking at it and weeping over it, and in that way suggesting it over and over to our brains so that we are really hypnotizing ourselves with the fault and enforcing its expression when we think we are in the effort to conquer it. such is our negative attitude. now if we are convinced that evil in ourselves has no power unless we give it power, that is the first step toward making our efforts positive and so negativing the evil. if we are convinced that evil in ourselves has not only no power but no importance unless we give it power, that is a step still farther in advance. the next step is to refuse to submit to it and refuse to resist it. that means a positive yielding away from it and a positive attention to doing our work as well as we can do it, whatever that work may be. there is one way in which people suffer intensely through being negative and allowing their temptations to be positive, and that is in the question of inherited evil. "how can i ever amount to anything with such inheritances? if you could see my father and what he is, and know that i am his daughter, you would easily appreciate why i have no hope for myself," said a young woman, and she was perfectly sincere in believing that because of her inherited temptations her life must be worthless. it took time and gentle, intelligent reasoning to convince her that not only are no inherited forms of selfishness ours unless by indulging we make them ours, but that, through knowing our inheritances, we are forewarned and forearmed, and the strength we gain from positive effort to free ourselves fully compensates us for what we have suffered in oppression from them. such is the loving kindness of our creator. this woman of whom i am writing awoke to the true meaning of the story of the man who asked, before he went with the lord jesus christ, first to go back and bury his father. the lord answered, "let the dead bury their dead, and come thou and follow me." when we feel that we must be bound down by our inheritances, we are surely not letting the dead bury their dead. and so let us study the whole question more carefully and learn the necessity of letting all that is sickness and all that is evil be negative to us and our efforts to conquer it be positive; in that way the illness and the evil become less than negative,--they gradually are removed and disappear. why, in the mere matter of being tired, if we refuse to let the impression of the fatigue be positive to us, and insist upon being positive ourselves in giving attention to the fact that now we are going to rest, we get rested in half the time,--in much less than half the time. some people carry chronic fatigue with them because of their steady attention to fatigue. "i am tired, yes, but _i am going to get rested!"_ that is the sensible attitude of mind. nature tends toward health. as we realize that and give our attention to it positively, we come to admire and love the healthy working of the laws of nature, and to feel the vigor of interest in trying to obey them intelligently. nature's laws are god's laws, and god's laws tend toward the health of the spirit in all matters of the spirit as surely as they tend toward health of body in all natural things. that is a truth that as we work to obey we grow to see and to love with deepening reverence, and then indeed we find that god's laws are all positive, and that the workings of self are only negative. chapter xxviii _human dust_ when we face the matter squarely and give it careful thought, it seems to appear very plainly that the one thing most flagrantly in the way of the people of to-day living according to plain common sense--spiritual common sense as well as material--is the fact that we are all living in a chronic state of excitement. it is easy to prove this fact by seeing how soon most of us suffer from ennui when "there is not anything going on." it seems now as if the average man or woman whom we see would find it quite impossible to stop and do nothing--for an hour or more. "but," some one will say, "why should i stop and do nothing when i am as busy as i can be all day long, and have my time very happily full?" or some one else may say, "how can i stop and do nothing when i am nearly crazy with work and must feel that it is being accomplished?" now the answer to that is, "certainly you should not stop and do nothing when you are busy and happily busy;" or, "although your work will go better if you do not get 'crazy' about it, there is no need of interrupting it or delaying it by stopping to do nothing--but _you should be able to stop and do nothing,_ and to do it quietly and contentedly at any time when it might be required of you." no man, woman, or child knows the power, the very great power, for work and play--there is with one who has in the background always the ability to stop and do nothing. if we observe enough, carefully enough, and quietly enough, to get sensitive to it, we can see how every one about us is living in excitement. i have seen women with nothing important to do come down to breakfast in excitement, give their orders for the day as if they were about running for a fire; and the standard of all those about them is so low that no one notices what a human dust is stirred up by all this flutter over nothing. a man told me not long ago that he got tired out for the day in walking to his office with a friend, because they both talked so intensely. and that is not an unusual experience. this chronic state of strain and excitement in everyday matters makes a mental atmosphere which is akin to what the material atmosphere would be if we were persistently kicking up a dust in the road every step we took. every one seems to be stirring up his own especial and peculiar dust and adding it to every one else's especial and peculiar dust. we are all mentally, morally and spiritually sneezing or choking with our own dust and the dust of other people. how is it possible for us to get any clear, all-round view of life so long as the dust stirring habit is on us? so far from being able to enlarge our horizon, we can get no horizon at all, and so no perspective until this human dust is laid. and there is just this one thing about it, that is a delight to think of: when we know how to live so that our own dust is laid, that very habit of life keeps us clear from the dust of other people. not only that, but when we are free from dust ourselves, the dust that the other men are stirring up about us does not interfere with our view of them. we see the men through their dust and we see how the dust with which they are surrounding themselves befogs them and impedes their progress. from the place of no dust you can distinguish dust and see through it. from the place of dust you cannot distinguish anything clearly. therefore, if one wishes to learn the standards of living according to plain common sense, for body, mind, and spirit, and to apply the principles of such standards practically to their every-day life, the first absolute necessity is to get quiet and to stay quiet long enough to lay the dust. you may know the laws of right eating, of right breathing, of exercise, and rest--but in this dust of excitement in daily life such knowledge helps one very little. you constantly forget, and forget, and forget. or, if in a moment of forced acknowledgment to the need of better living, you make up your mind that you will live according to sensible laws of hygiene, you go along pretty well for a few weeks, perhaps even months, and then as you feel better physically, you get whirled off into the excitement again, and before you know it you are in the dust with the rest of the world, and all because you had no background for your good resolutions. you never had found and you did not understand quiet. did you ever see a wise mother come into a noisy nursery where perhaps her own children were playing excitedly with several little companions, who had been invited in to spend a rainy afternoon? the mother sees all the children in a great state of excitement over their play, and two or three of them disagreeing over some foolish little matter, with their brains in such a state that the nursery is thick with infantile human dust. what does the wise mother do? add dust of her own by scolding and fretting and fuming over the noise that the children are making? no--no indeed. she first gets all the children's attention in any happy way she can, one or two at a time, and then when she has their individual attention to a small degree, she gets their united attention by inviting their interest in being so quiet that they "can hear a pin drop." the children get keenly interested in listening. the first time they do not hear the pin drop because johnnie or mollie moved a little. mother talks with interest of what a very delightful thing it is to be for a little while so quiet that we can hear a pin drop. the second time something interferes, and the third time the children have become so well focused on listening that the little delicate sound is heard distinctly, and they beg mother to try and see if they cannot hear it again. by this time the dust is laid in the nursery, and by changing the games a little, or telling them a story first, the mother is able to leave a nursery full of quiet, happy children. now if we, who would like to live happily and keep well, according to plain common sense, can put ourselves with intelligent humility in the place of these little children and study to be quiet, we will be working for that background which is never failing in its possibilities of increasing light and warmth and the expanse of outlook. first with regard to a quiet body. indigestion makes us unquiet, therefore we must eat only wholesome food, and not too much of it, and we must eat it quietly. poor breathing and poor blood makes us unquiet, therefore we should learn to expand our lungs to their full extent in the fresh air and give the blood plenty of oxygen. breathing also has a direct effect on the circulation and the brain, and when we breathe quietly and rhythmically, we are quieting the movement of our blood as well as opening the channels so that it can flow without interruption. we are also quieting our brain and so our whole nervous system. lack of exercise makes us unquiet, because exercise supplies the blood more fully with oxygen and prevents it from flowing sluggishly, a sluggish circulation straining the nervous system. it is therefore important to take regular exercise. want of rest especially makes us unquiet; therefore we should attend to it that we get--as far as possible--what rest we need, and take all the rest we get in the best way. we cannot expect to fulfill these conditions all at once, but we can aim steadily to do so, and by getting every day a stronger focus and a steadier aim we can gain so greatly in fulfilling the standards of a healthy mind in a healthy body, and so much of our individual dust will be laid, that i may fairly promise a happy astonishment at the view of life which will open before us, and the power for use and enjoyment that will come. let us see now how we would begin practically, having made up our minds to do all in our power to lay the dust and get a quiet background. we must begin in what may seem a very small way. it seems to be always the small beginnings that lead to large and solidly lasting results. not only that, but when we begin in the small way and the right way to reach any goal, we can find no short cuts and no seven-league boots. we must take every step and take it decidedly in order to really get there. we must place one brick and then another, exactly, and place every brick--to make a house that will stand. but now for our first step toward laying the dust. let us take half an hour every day and do nothing in it. for the first ten minutes we will probably be wretched, for the next ten minutes we may be more wretched, but for the last five minutes we will get a sense of quiet and at first the dust, although not laid, will cease to whirl. and then--an interesting fact--what seems to us quiet in the beginning of our attempt, will seem like noise and whirlwinds, after we have gone further along. some one may easily say that it is absurd to take half an hour a day to do nothing in. or that "nature abhors a vacuum, and how is it possible to do nothing? our minds will be thinking of or working on something." in answer to this, i might say with the irishman, "be aisy, but if you can't be aisy, be as aisy as you can!" do nothing as well as you can. when you begin thinking of anything, drop it. when you feel restless and as if you could not keep still another minute, relax and make yourself keep still. i should take many days of this insistence upon doing nothing and dropping everything from my mind before taking the next step. for to drop everything from one's mind, for half an hour is not by any means an easy matter. our minds are full of interests, full of resistances. with some of us, our minds are full of resentment. and what we have to promise ourselves to do is for that one-half hour a day to take nothing into consideration. if something comes up that we are worrying about, refuse to consider it. if some resentment to a person or a circumstance comes to mind, refuse to consider it. i know all this is easier to say than to do, but remember, please, that it is only for half an hour every day-only half an hour. refuse to consider anything for half an hour. having learned to sit still, or lie still, and think of nothing with a moderate degree of success, and with most people the success can only be moderate at best, the next step is to think quietly of taking long, gentle, easy breaths for half an hour. a long breath and then a rest, two long breaths and then a rest. one can quiet and soothe oneself inside quite wonderfully with the study of long gentle breaths. but it must be a study. we must study to begin inhaling gently, to change to the exhalation with equal delicacy, and to keep the same gentle, delicate pressure throughout, each time trying to make the breath a little longer. after we have had many days of the gentle, long breaths at intervals for half an hour, then we can breathe rhythmically (inhale counting five or ten, exhale counting five or ten), steadily for half an hour, trying all the time to have the breath more quiet, gentle and steady, drawing it in and letting it out with always decreasing effort. it is wonderful when we discover how little effort we really need to take a full and vigorous breath. this half hour's breathing exercise every day will help us to the habit of breathing rhythmically all the time, and a steady rhythmic breath is a great physical help toward a quiet mind. we can mingle with the deep breathing simple exercises of lifting each arm slowly and heavily from the shoulder, and then letting it drop a dead weight, and pausing while we feel conscious of our arms resting without tension in the lap or on the couch. but all this has been with relation to the body, and it is the mental and moral dust of which i am writing. the physical work for quiet is only helpful as it makes the body a better instrument for the mind and for the will. a quiet body is of no use if it contains an unquiet mind which is going to pull it out of shape or start it up in agitation at the least provocation. in such a case, the quiet body in its passive state is only a more responsive instrument to the mind that wants to raise a dust. one--and the most helpful way of quieting the mind--is through a steady effort at concentration. one can concentrate; on doing nothing--that is, on sitting quietly in a chair or lying quietly on the bed or the floor. be quiet, keep quiet, be quiet, keep quiet. that is the form of concentration, that is the way of learning to do nothing to advantage. then we concentrate on the quiet breathing, to have it gentle, steady, and without strain. in the beginning we must take care to concentrate without strain, and without emotion, use our minds quietly, as one might watch a bird who was very near, to see what it will do next, and with care not to frighten it away. these are the great secrets of true strengthening concentration. the first is dropping everything that interferes. the second is working to concentrate easily without emotion. they are really one and the same. if we work to drop everything that interferes, we are so constantly relaxing in order to concentrate that the very process drops strain bit by bit, little by little. an unquiet mind, however, full of worries, anxieties, resistances, resentments, and full of all varieties of agitation, going over and over things to try to work out problems that are not in human hands, or complaining and fretting and puzzling because help seems to be out of human power, such a mind which is befogged and begrimed by the agitation of its own dust is not a cause in itself--it is an effect. the cause is the reaching and grasping, the unreasonable insistence on its own way of kicking, dust-raising self-will at the back of the mind. a quiet will, a will that can remain quiet through all emergencies, is not a self-will. it is the self that raises the dust--the self that wants, and strains to get its own way, and turns and twists and writhes if it does not get its own way. god's will is quiet. we see it in the growth of the trees and the flowers. we see it in the movement of the planets of the universe. we see god's mind in the wonderful laws of natural science. most of all we see and feel, when we get quiet ourselves, god's love in every thing and every one. if we want the dust laid, we must work to get our bodies quiet. we must drop all that interferes with quiet in our minds, and we must give up wanting our own way. we must believe that god's way is immeasurably beyond us and that if we work quietly to obey him, he will reveal to us his way in so far as we need to know it, and will prepare us for and guide us to his uses. the most perfect example we have of a quiet mind in a quiet body, guided by the divine will, is in the character of the lord jesus christ. as we study his words and his works, we realize the power and the delicacy of his human life, and we realize--as far as we are capable of realizing--the absolute clearness of the atmosphere about him. we see and feel that atmosphere to be full of quiet--divine human love. there is no suffering, no temptation, that any man or woman ever had or ever will have that he did not meet in himself and conquer. therefore, if we mean to begin the work in ourselves of finding the quiet which will lay our own dust from the very first, if we have the end in our minds of truer obedience and loving trust, we can, even in the simple beginning of learning to do nothing quietly, find an essence of life which eventually we will learn always to recognize and to love, and to know that it is not ourselves, but it is from the heavenly father of ourselves. some of us cannot get that motive to begin with; some of us will, if we begin at all, work only for relief, or because we recognize that there is more power without dust than with it, but no one of us is ever safe from clouds of dust unless at the back of all our work there is the desire to give up all self-will for the sake of obeying and of trusting the divine will more and more perfectly as time goes on. if we are content to work thoroughly and to gain slowly, not to be pulled down by mistakes or discouragements, but to learn from them, we are sure to be grateful for the new light and warmth and power for use that will come to us, increasing day by day. chapter xxix _plain every-day common sense_ plain common sense! when we come to sift everything down which will enable us to live wholesome, steady, every-day, interesting lives, plain common sense seems to be the first and the simplest need. in the working out of any problem, whether it be in science or in art or in plain everyday living, we are told to go from the circumference to the center, from the known to the unknown, from simplest facts to those which would otherwise seem complex. and whether the life we are living is quiet and commonplace, or whether it is full of change and adventure, to be of the greatest and most permanent use, a life must have as its habitual background plain every-day common sense. when we stop and think a while, the lack of this important quality is quite glaring, and every one who has his attention called to it and recognizes that lack enough to be interested to supply it in his own life, is doing more good toward bringing plain common sense into the world at large than we can well appreciate. for instance, it is only a fact of plain common sense that we should keep rested, and yet how many of us do? how many readers of this article will smile or sneer, or be irritated when they read the above, and say, "it is all very well to talk of keeping rested. how is it possible with all i have to do? or with all the care i have? or with all i have to worry me?" now that is just the point--the answer to that question, "how is it possible?" so very few of us know how to do it, and if "how to keep rested though busy" were regularly taught in all schools in this country, so far from making the children self-conscious and over-careful of themselves, it would lay up in their brains ideas of plain common sense which would be stocked safely there for use when, as their lives grew more maturely busy, they would find the right habits formed, enabling them to keep busy and at the same time to keep quiet and rested. what a wonderful difference it would eventually make in the wholesomeness of the manners and customs of this entire nation. and that difference would come from giving the children now a half hour's instruction in the plain common sense of keeping well rested, and in seeing that such instruction was entirely and only practical. it has often seemed to me that the tendency of education in the present day is more toward giving information than it is in preparing the mind to receive and use interesting and useful information of all kinds: that is, in helping the mind to attract what it needs; to absorb what it attracts, and digest what it absorbs as thoroughly as any good healthy stomach ever digested the food it needed to supply the body with strength. the root of such cultivation, it seems to me, is in teaching the practical use and application of all that is studied. to be sure, there is much more of that than there was fifty years ago, but you have only to put to the test the minds of young graduates to see how much more of such work is needed, and how much more intelligent the training of the young mind may be, even now. take, for instance, the subject of ethics. how many boys and girls go home and are more useful in their families, more thoughtful and considerate for all about them, for their study of ethics in school? and yet the study of ethics has no other use than this. if the mind absorbed and digested the true principles of ethics, so that the heart felt moved to use them, it might--it probably would--make a great change in the lives of the boys and girls who studied it--a change that would surprise and delight their parents and friends. if the science of keeping rested were given in schools in the way that, in most cases, the science of ethics seems to be given now, the idea of rest would lie in an indigestible lump on the minds of the students, and instead of being absorbed, digested and carried out in their daily lives, would be evaporated little by little into the air, or vomited off the mind in various jokes about it, and other expressions that would prove the children knew nothing of what they were being taught. but again, i am glad to repeat--if instruction, _practical_ instruction, were given every day in the schools on how to form the habit of keeping rested, it would have a wonderful effect upon the whole country, not to mention where in many individual cases it would actually prevent the breaking out of hereditary disease. nature always tends toward health; so strongly, so habitually does nature tend toward health that it seems at times as if the working of natural laws pushed some people into health in spite of chronic antagonism they seem to have against health--one might even say in spite of the wilful refusal of health. when one's body is kept rested, nature is constantly throwing off germs of disease, constantly working, and working most actively, to protect the body from anything that would interfere with its perfect health. when one's body is not rested, nature works just as hard, but the tired body--through its various forms of tension that impede the circulation, prevent the healthy absorption of food and oxygen, and clog the way so that impurities cannot be carried off--interferes with nature's work and thus makes it impossible for her to keep the machine well oiled. when we are tired, the very fact of being tired makes us more tired, unless we rest properly. a great deal--it seems to me more than one-half--of the fatigue in the world comes from the need of an intelligent understanding of how to keep rested. the more that lack of intelligence is allowed to grow, the worse it is going to be for the health of the nation. we have less of that plain common sense than our grandfathers and grandmothers. they had less than their fathers and mothers. we need more than our ancestors, because life is more complicated now, than it was then. we can get more if we will, because there is more real understanding of the science of hygiene than our fathers and mothers had before us. our need now is to use _practically_ the information which a few individuals are able to give us, and especially to teach such practical use to our children. let us find out how we would actually go to work to keep rested, and take the information of plain common sense and use it. to keep rested we must not overwork our body inside or outside. we must keep it in an equilibrium of action and rest. we overwork our body inside when we eat the wrong food and when we eat too much or not enough of the right food, for then the stomach has more than its share of work to do, and as the effort to do it well robs the brain and the whole nervous system, so, of course, the rest of the body has not its rightful supply of energy and the natural result is great fatigue. we overwork our body inside when we do not give it its due amount of fresh air. the blood needs the oxygen to supply itself and the nerves and muscles with power to do their work. when the oxygen is not supplied to the blood, the machinery of the body has to work with so much less power than really belongs to it, that there is great strain in the effort to do its work properly, and the effect is, of course, fatigue. in either of the above cases, both with an overworked stomach and an overworked heart and lungs, the complaint is very apt to be, "why am i so tired when i have done nothing to get tired?" the answer is, "no, you have done nothing outside with your muscles, but the heart and lungs and the stomach are delicate and exquisite instruments. you have overworked them all, and such overwork is the more fatiguing in proportion to what is done than any other form, except overwork of the brain." and the overtired stomach and heart and lungs tire the brain, of course. of the work that is given to the brain itself to overtire it we must speak later. so much now for that which prevents the body from keeping rested inside, in the finer working of its machinery. it is easy to find out what and how to eat. a very little careful thought will show us that. it is only the plain common sense of eating we need. it is easy to see that we must not eat on a tired stomach, and if we have to do so, we must eat much less than we ordinarily would, and eat it more slowly. so much good advice is already given about what and how to eat, i need say nothing here, and even without that advice, which in itself is so truly valuable, most of us could have plain common sense about our own food if we would use our minds intelligently about it, and eat only what we know to be nourishing to us. that can be done without fussing. fussing about food contracts the stomach, and prevents free digestion almost as much as eating indigestible food. then again, if we deny ourselves that which we want and know is bad for us, and eat only that which we know to be nourishing, it increases the delicacy of our relish. we do not lose relish by refusing to eat too much candy. we gain it. human pigs lose their most delicate relish entirely, and they lose much--very much more--than that. unfortunately with most people, there is not the relish for fresh air that there is for food. very few people want fresh air selfishly; the selfish tendency of most people is to cut it off for fear of taking cold. and yet the difference felt in health, in keeping rested, in ease of mind, is as great between no fresh air and plenty of fresh air as it is between the wrong kind of food and enough (and not too much) of the right kind of food. why does not the comfort of the body appeal to us as strongly through the supply of air given to the lungs as through that of food given to the stomach? the right supply of fresh air has such wonderful power to keep us rested! practical teaching to the children here would, among other things, give them training which would open their lungs and enable them to take in with every breath the full amount of oxygen needed toward keeping them rested. there are so many cells in the lungs of most people, made to receive oxygen, which never receive one bit of the food they are hungry for. there is much more, of course, very much more, to say about the working of the machinery of the inside of the body and about the plain common sense needed to keep it well and rested, but i have said enough for now to start a thoughtful mind to work. now for keeping the body well rested from the outside. it is all so well arranged for us--the night given us to sleep in, a good long day of work and a long night of rest; so the time for rest and the time for work are equalized and it is so happily arranged that out of the twenty-four hours in the day, when we are well, we need only eight hours' sleep. so well does nature work and so truly that she can make up for us in eight hours' sleep what fuel we lose in sixteen hours of activity. only one-third of the time do we need to sleep, and we have the other two-thirds for work and play. this regular sleep is a strong force in our aim to keep rested. therefore, the plain common sense of that is to find out how to go to sleep naturally, how to get all the rest out of sleep that nature would give us, and so to wake refreshed and ready for the day. to go to sleep naturally we must learn how to drop all the tension of the day and literally _drop_ to sleep like a baby. _let go into sleep_--there is a host of meaning in that expression. when we do that, nature can revive and refresh and renew us. renew our vitality, bring us so much more brain power for the day, all that we need for our work and our play; or almost all--for there are many little rests during the day, little openings for rest that we need to take, and that we can teach ourselves to take as a matter of course. we can sit restfully at each one of our three meals. eat restfully and quietly, and so make each meal not only a means of getting nourishment, but of getting rest as well. there is all the difference of illness and health in taking a meal with strain and a sense of rush and pressure of work, and in taking it as if to eat that one meal were the only thing we had to do in the day. better to eat a little nourishing food and eat it quietly and at leisure than a large meal of the same food with a sense of rush. this is a very important factor in keeping rested. then there are the many expected and unexpected times in the day when we can take rest and so _keep rested._ if we have to wait we can sit quietly. whatever we are doing we can make use of the between times to rest. each man can find his own "between times." if we make real use of them, intelligent use, they not only help us to keep rested, they help us to do our work better, if we will but watch for them and use them. now the body is only a servant, and in all i have written above, i have only written of the servant. how can a servant keep well and rested if the master drives him to such an extent that he is brought into a state, not where he won't go, but where he can't go, and must therefore drop? it is the intelligent master, who is a true disciple of plain common sense, who will train his servant, the body, in the way of resting, eating and breathing, in order to fit it for the maximum of work at the minimum of energy. but if you obey every external law for the health and strength of the body, and obey it implicitly, and to the letter, with all possible intelligence, you cannot keep it healthy if the mind that owns the body is pulling it and twisting it, and _twanging_ on its delicate machinery with a flood of resentment and resistance; and the spirit behind the mind is eager, wretched, and unhappy, because it does not get its own way, or elated with an inflamed egoism because it is getting its own way. all plain common sense in the way of health for the body falls dead unless followed up closely with plain common sense for the health of the mind; and then again, although when there is "a healthy mind in a healthy body," the health appears far more permanent than when a mind full of personal resistance tries to keep its body healthy, even that happy combination cannot be really permanent unless there is found back of it a healthy spirit. but of the plain common sense of the spirit there is more to be said at another time. with regard to the mind, let us look and see not only that it is not sensible to allow it to remain full of resistance, but is it not positively stupid? what an important factor it should be in the education of children to teach them the plain common sense needed to keep the mind healthy--to teach them the uselessness of a mental resistance, and the wholesomeness of a clean mind. if a child worries about his lessons, he is resisting the possibility of failing in his class; let him learn that the worry _interferes_ with his getting his lesson. teach him how to drop the worry, and he will find not only that he gets the lesson in less time, but his mind is clearer to remember it. by following the same laws, children could be taught that a feeling of rush and hurry only impedes their progress. the rushed feeling sometimes comes from a nervous unquiet which is inherited, and should be trained out of the child. but alas! alas! how can a mother or a father train a child to live common sensibly without useless resistance when neither the mother nor the father can do that same themselves. it is not too late for any mother or father to learn, and if each will have the humility to confess to the child that they are learning and help the child to learn with them, no child would or could take advantage of that and as the children are trained rightly, what a start they can give their own children when they grow up--and what a gain there might be from one generation to another! will it ever come? surely we hope so. chapter xxx _a summing up_ give up resentment, give up unhealthy resistance. if circumstances, or persons, arouse either resentment or resistance in us, let us ignore the circumstances or persons until we have quieted ourselves. freedom does not come from merely yielding out of resentment or unhealthy resistance, it comes also from the strong and steady focus on such yielding. _concentration and relaxation are just as necessary one to another to give stability to the nerves of a man--as the centrifugal and centripetal forces are necessary to give stability to the earth._ as the habit of healthy concentration and relaxation grows within us, our perception clears so that we see what is right to do, and are given the power to do it. as our freedom from bondage to our fellowmen becomes established, our relation to our fellowmen grows happier, more penetrating and more full of life, and later we come to understand that at root it is ourselves--our own resentment and resistance--to which we have been in bondage,--circumstances or other people have had _really_ nothing to do with it. when we have made that discovery, and are steadily acting upon it, we are free indeed, and with this new liberty there grows a clear sense and conviction of a wise, loving power which, while leaving us our own free will, is always tenderly guiding us. no one ever really believed anything without experiencing it. we may think we believe all sorts of beautiful truths, but how can any truth be really ours unless we have proved it by living? we do not fully believe it until it runs in our blood--that is--we must see a truth with our minds, love it with our hearts and live it over and over again in our lives before it is ours. if the reader will think over this little book--he will see that every chapter has healthy yielding at the root of it. it is a constant repetition of the same principle applied to the commonplace circumstances of life, and if the reader will take this principle into his mind, and work practically to live it in his life, he will find the love for it growing in his heart, and with it a living conviction that when truly applied, it always works. some one once described the difference between good breeding and bad breeding as that between a man who works as a matter of course to conquer his limitations--and a man to whom his limitations are inevitable. there is spiritual good breeding and natural good breeding. the first comes from the achievement of personal character--the second is born with us--to use or misuse as we prefer. it is a happy thing to realize that our freedom from bondage to circumstances, and our loving, intelligent freedom from other people, is the true spiritual good breeding which gives vitality to every action of our lives, and brings us into more real and closer touch with our fellow-men. courtesy is alive when it has genuine love of all human nature at the root of it--it is dead when it is merely a matter of good form. in so far as i know, the habit of such freedom and good breeding cannot be steadily sustained without an absolute, conscious dependence upon the lord god almighty. file was produced from images produced by core historical literature in agriculture (chla), cornell university) [transcriber's notes: inconsistencies with regards to hyphenated words have been left as in the original. inconsistencies in spelling and other unexpected spelling have been retained as in the original book.] the young farmer's practical library edited by ernest ingersoll health on the farm by h. f. harris the young farmer's practical library edited by ernest ingersoll cloth mo illustrated cents _net_ each. =from kitchen to garret.= by virginia terhune van de water. =neighborhood entertainments.= by renÉe b. stern, of the congressional library. =home water-works.= by carleton j. lynde, professor of physics in macdonald college, quebec. =animal competitors.= by ernest ingersoll. =health on the farm.= by dr. h. f. harris, secretary, georgia state board of health. =co-operation among farmers.= by john lee coulter. =roads, paths and bridges.= by l. w. page, chief of the office of public roads, u. s. department of agriculture. =farm management.= by c. w. pugsley, professor of agronomy and farm management in the university of nebraska. =electricity on the farm.= by frederick m. conlee. =the farm mechanic.= by l. w. chase, professor of farm mechanics in the university of nebraska. =the satisfactions of country life.= by dr. james w. robertson, principal of macdonald college, quebec. health on the farm a manual of rural sanitation and hygiene by h. f. harris secretary of the georgia state board of health =new york= sturgis & walton company _all rights reserved_ copyright by sturgis & walton company set up and electrotyped. published july, introduction by the general editor this is the day of the small book. there is much to be done. time is short. information is earnestly desired, but it is wanted in compact form, confined directly to the subject in view, authenticated by real knowledge, and, withal, gracefully delivered. it is to fulfill these conditions that the present series has been projected--to lend real assistance to those who are looking about for new tools and fresh ideas. it is addressed especially to the man and woman at a distance from the libraries, exhibitions, and daily notes of progress, which are the main advantage, to a studious mind, of living in or near a large city. the editor has had in view, especially, the farmer and villager who is striving to make the life of himself and his family broader and brighter, as well as to increase his bank account; and it is therefore in the humane, rather than in a commercial direction, that the library has been planned. the average american little needs advice on the conduct of his farm or business; or, if he thinks he does, a large supply of such help in farming and trading as books and periodicals can give, is available to him. but many a man who is well to do and knows how to continue to make money, is ignorant how to spend it in a way to bring to himself, and confer upon his wife and children, those conveniences, comforts and niceties which alone make money worth acquiring and life worth living. he hardly realizes that they are within his reach. for suggestion and guidance in this direction there is a real call, to which this series is an answer. it proposes to tell its readers how they can make work easier, health more secure, and the home more enjoyable and tenacious of the whole family. no evil in american rural life is so great as the tendency of the young people to leave the farm and the village. the only way to overcome this evil is to make rural life less hard and sordid; more comfortable and attractive. it is to the solving of that problem that these books are addressed. their central idea is to show how country life may be made richer in interest, broader in its activities and its outlook, and sweeter to the taste. to this end men and women who have given each a lifetime of study and thought to his or her specialty, will contribute to the library, and it is safe to promise that each volume will join with its eminently practical information a still more valuable stimulation of thought. ernest ingersoll. table of contents chapter page i importance of our subject ii care of the person iii sanitation in and about the house iv hygiene of infancy and childhood v proper eating--the secret of good health vi bread and its relations vii meats, sugars and milk viii food-value of vegetables ix danger in fruits and pickles x drinks--proper and harmful xi importance of good cooking xii seven avoidable diseases xiii hygiene of the sick room xiv emergencies and accidents xv what to do when poisoned appendix health on the farm chapter i importance of our subject notwithstanding the extraordinary advances in a material way that have been accomplished in this country within the last few decades, it is a significant and most alarming fact that progress in hygienic matters has lagged far behind. why this is, it would be very difficult to say,--for the reason that the causes are perhaps many. chief among these, probably, is the fact that our progress along industrial lines has occupied the entire time of the majority of our best intellects, and it is also in no small degree the consequence of a fatalism that regards disease as a direct visitation of providence and therefore a thing which man may not avoid. another cause in some instances is the pride of our people in their homes and respective localities, which causes them to repel with indignation the suggestion that any special measures are necessary in order to conserve the public health where they reside. ignorant as the average man is of the causes that produce sickness and the means by which this result is accomplished, he is naturally not in a position to form a correct judgment concerning such matters, and as a consequence, sees no reasons for taking the precautions that are necessary in order to ward off disease. this ignorance, it must be confessed with sorrow, is in a measure the fault of the medical profession, which has not in the vast majority of instances lived up to its ideals in this connection. petty and unworthy rivalry has played an extremely important part in this failure of medical men to do their duty in this particular--none of the physicians of a community being, as a rule, willing that others should instruct the public, however vital this might be for the general good. as a consequence, that class of vultures known as medical quacks has furnished to the laity by far the greater proportion of their instruction on hygienic subjects, with the result that the average man has a greater misconception and less real knowledge of such matters than of anything else in which he is vitally interested. another, and very curious explanation for our general disregard of the laws of health is that our strong belief in ourselves impels us to think that however much others may suffer from things generally regarded as unhygienic, we, ourselves, will be immune. this belief is fostered by the fact that in early life there often seems no end to our capacity to endure, and we find ourselves constantly defying without apparent harm, what we are told by others is directly contrary to all rules of proper living. but it is unfortunately true also that the reserve force and great power of resistance that enables us to do these things begins to wane towards the end of the third decade of life, and we, therefore, find ourselves sooner or later breaking down after we have become thoroughly convinced that we were made of iron, and that while other people might not be able to do as we were, it could not possibly result in evil in our own cases. what a pity it is that the young will not learn from the experience of those who have gone before them! could they only do so, how much suffering and woe could be avoided in this world. unfortunately, however, there are few men so constituted that they are willing to be guided by the experience of those who have preceded them, and there is but a faint possibility, therefore, that any good can be accomplished by warning the coming generation of the troubles in store for them should they not heed the advice of those who have suffered before them. notwithstanding this, the writer feels that these words of warning should be spoken to the young, since they, alas, are the only ones to be benefited by such advice. _as you value your happiness materially, and as you desire a healthy old age and a long life, inform yourselves as to the few simple laws that govern human existence, and attempt so far as lies in your power to follow them. if you do not do this, disaster will follow as surely as the night follows the day._ _apathy of the public as to hygiene._--as a partial consequence, probably, of all the reasons mentioned, along with others, there exists in the popular mind a curious apathy concerning hygienic matters--an apathy so great that it is scarcely possible to get the average man to discuss, much less to put in practice the all-important laws that govern health. as a result of the work of the various state boards of health and of the public health and marine hospital service, this condition of affairs happily shows some signs of abatement, and we certainly have reasons to believe that the future promises great things along these lines. no sign of this change is more significant than the awakening of the press of the country to the vast importance of instructing the public in health matters, and their changed attitude toward the charlatans and quacks who live by promising the impossible. largely subsidized by the infamous vendors of patent medicine, our newspapers and magazines still lend their columns to these human vampires who prey pre-eminently on the ignorance and credulity of the hopelessly-diseased poor; but within recent years some of our foremost journals show signs of an awakening of conscience, and a very few have even gone so far as to exclude advertisements of this character altogether. it has been said, certainly with more or less truth, that we are creatures of our surroundings, but whether we accept this in its broadest sense or not, there can be no question that our well being is most intimately connected with those things with which we come into every day contact. _nothing is more important for us to recognize than that our diseases are contracted from neighboring subjects just in proportion as we are closely associated with them._ from our fellowmen we contract, as everyone knows, a large number of diseases, either by direct contact or by means of the air that surrounds us. from the earth we get hook-worms and other animal parasites, either by coming directly in contact with it or through eating uncooked fruits and vegetables. from water we get typhoid fever, dysentery, cholera, and many other parasitic diseases. from our food we likewise contract dangerous maladies such as tapeworms from uncooked meats and fish and the deadly trichina from raw hog meat. with decomposed breads we take the poisons that produce pellagra, kak-ke, ergotism and acrodinia. from uncooked fruits and vegetables we get dysentery, typhoid fever, cholera, and parasitic diseases. spoiled beans give us the deadly lathyrismus. from decomposed meat and fish we get ptomaine poisoning. mosquitoes convey to us malaria, yellow fever and a parasite known as the filaria. the dreaded sleeping-sickness of africa comes through the bites of a small fly; the bedbug is believed to be the means of conveying a frightful disease known as kala-azar, and the house-fly often brings to us the germs that produce typhoid fever, dysentery, and probably other diseases as well. the bubonic plague, which is one of the most frightful diseases known, is conveyed to man by the rat and mouse.[ ] hydrophobia is usually contracted from the bite of the dog, and it is a well-known fact that this animal often harbors a minute tapeworm, a single egg of which, when swallowed by the human being, is often followed by death. both dogs and cats probably convey diphtheria, and both unquestionably often have within their intestinal tracts tapeworms that occasionally infect children. with the exception of the rare disease known as glanders, the horse is not believed to be directly responsible for any of the maladies from which the human being suffers, but it is well established that fully per cent. of house-flies hatch in the manure of these animals, and they, therefore, become indirectly responsible for some of the most serious diseases affecting the human being. it is thus seen that almost every object with which man comes in intimate contact is capable of conveying to him the poison of one or more diseases. if it were possible for us to separate ourselves completely from everything with which we are ordinarily associated there can be no question that the span of human life would be greatly increased, and that death from bacterial and parasitic diseases generally would no longer occur. all this is said not with the object of startling the reader, but to warn him of the dangers that surround him on every hand, and to urge a recognition of that which can so materially prolong his life. fortunately these sources of infection may be almost entirely done away with by a few simple rules of life, and the health and longevity of mankind must necessarily be directly proportionate to the care with which we observe them. it is now in order to discuss in detail the subject of personal hygiene. footnote: [ ] see the volume in this library, _animal competitors_, by ernest ingersoll, for the agency of rats and mice in the introduction and dissemination of plague and other diseases; and the means of destroying these pests of the farm. chapter ii care of the person it is happily the case that in america the importance of personal cleanliness is more thoroughly understood, and is more generally practiced than any of the other important hygienic procedures. while it is true that there are many--particularly those of foreign extraction, and who live for the most part in the larger cities--to whom an occasional bath appeals only as a painful necessity, a very large percentage of those born in this country bathe regularly. it should be thoroughly understood that a daily bath is essential, not only from the standpoint of cleanliness, but from the fact that this practice is in the highest degree conducive to health. it should never be forgotten that by cleanliness infectious materials are removed from the surface of the body, and at the same time the skin is put into a condition to eliminate from the system those waste products which it is its special function to remove. the close relationship of the proper activity of the skin to health is perhaps not generally sufficiently appreciated--for it is true that the body cannot remain normal when the secretory power of its glands is impaired, and that even death quickly follows when they cease to functionate altogether. _advice as to bathing._--much difference of opinion exists as to the proper temperature of the water for bathing, some holding that it should be quite cold, while others are equally positive that it should be warm. unfortunately it is impossible to give fixed rules concerning this somewhat important matter, for there is every reason to believe that it should be determined in each individual case according to circumstances, and that, therefore, both may be right. some persons unquestionably do better with one, and some with the other. it has been established clearly that the cold bath is highly stimulating, and where not too prolonged, and when followed by vigorous rubbing, is undoubtedly healthful for a large number of people. the cold bath is often used by physicians in the treatment of diseases of low vitality. many persons however, are unpleasantly affected by bathing in water of a temperature much below that of the body; particularly is this true of women, and the like may be said of thin and nervous persons of the other sex. it is claimed by the advocates of the cold bath that those who practice this procedure daily are practically immune from colds, but this, certainly, is not always true; on the contrary the writer has seen instances where the cold bath has unquestionably led to chronic nasal catarrh, with increased tendency to inflammatory conditions of the air passages. it is also the case that baths of this description tend in some persons to prevent a normal accumulation of fat beneath the skin, and keep individuals of this kind unnaturally lean. the warm bath is perhaps, on the whole, more popular than the cold, since it is preferred usually by children and women, and is practiced by a considerable proportion of adult males. it is unquestionably somewhat enervating, and at best fails entirely to give the agreeable stimulation experienced by those who take a cold plunge. it is, however, to be preferred in those instances where cold water produces disagreeable effects, and if the bath be not too long continued it is followed by no ill results. persons who become lean under cold baths not uncommonly take on flesh when they begin to use warm ones. it is unquestionably true that the latter is to be preferred in hot climates. the sea bath is invigorating not only from the water being cool, but as a consequence of the pleasurable excitement with which it is attended. its greatest disadvantage lies in the fact that there is a tendency to overdo it, many persons remaining in the water for hours. ten or fifteen minutes is as long as the average person should indulge in sea-bathing, and it is a question if even those who are young and vigorous should remain in the water longer than half an hour. bathing of any kind should be indulged in before meals, the best time being before breakfast in the morning. _care of the teeth._--nothing in connection with the subject of personal hygiene is of more importance than keeping the teeth properly cleansed. the fact is not generally appreciated that sound teeth stand in a most intimate relationship with good health, and that disastrous consequences are sure to follow sooner or later where these most important structures are neglected. while it is true that in a person of vigorous health one or two decayed teeth do not, as a rule, occasion obvious trouble at once, ill effects are sure sooner or later to be felt. for one thing, a person without good teeth cannot chew his food well. those who begin by neglecting what at first are slight defects in the teeth seem to acquire in the course of time a sort of habit of doing this, and ultimately disregard and fail to have corrected the more serious diseases of the dental structures. nothing is more common than for the practicing physician to find patients with one or more teeth partially gone, or, even worse, with only the exposed roots remaining. where cavities exist, food is constantly forced into them, and undergoing decomposition, the breath of their owner becomes foul, and portions of decayed food mixed with multitudes of bacteria are constantly swallowed; sooner or later there inevitably follows under such circumstances catarrhal conditions of the stomach, which reaches a point in some individuals where the health is seriously threatened. not only do bad teeth produce trouble in the way just mentioned, but there is every reason to believe that germs that produce disease--particularly those that cause consumption--not uncommonly find their way to the interior of the body through the resulting cavities. it is the duty of everyone to properly cleanse the teeth at least once daily--to do so after each meal would be even still better. this should be done with a moderately soft brush, with which it is unnecessary to use tooth-powders or lotions--though many prefer to do so. where something of the kind is desired, ordinary lime-water is perhaps as satisfactory as anything else; peroxide of hydrogen, diluted eight or ten times with water, to which a pinch or two of ordinary cooking soda has been added, undoubtedly aids the cleansing process, and has the advantage that it leaves a pleasant after-taste in the mouth. in brushing the teeth care should be taken that every part of the tooth receives attention, it being not sufficient, as is so often done, merely to brush the front. it should be the practice of everyone to have the teeth looked over at least once a year by a good dentist, as even where cleansing is diligently performed decay frequently sets in on their inner sides. the utmost care should be taken of the permanent teeth especially, and as long as it is possible to prevent it no one should be allowed to pull them. there can be no doubt that life is shortened by the early loss of the permanent teeth in most, if not in all, cases--not to count loss in health and happiness that follows their absence. _clothing,--material and color._--clothing will be considered in this article only as regards its function of properly protecting the body, which it does by preventing the escape of heat, thus keeping the body warm, or, under other circumstances, by keeping out excessive heat or cold. materials of which clothing is made differ very greatly in their ability to accomplish the object just mentioned, some being comparatively poor conductors of heat and hence fulfill the desired function admirably, while others, for opposite reasons, are of comparatively little value for this purpose. in general it may be said that structures of animal origin, such as wool and silk, are much poorer heat conductors than those obtained from the vegetable world, and as a consequence the former are justly held in much higher esteem as material for clothing than the latter. it should not be forgotten, however, that the protective value of a fabric also depends upon the manner in which it is woven, since those that are loosely constructed are much warmer, other things being equal, than those that are put together more closely; this depends upon the fact that in the former there are innumerable small cavities between the fibers in which air is contained, and as this substance is a very poor conductor of heat, it follows that a garment made loosely and containing many such chambers is warmer than where the number is less. it may well be the case that a fabric constructed of a material which is a poor conductor of heat and closely woven may be actually cooler than another composed of a substance which is a much better conductor of heat but of a loose texture. the efficiency of different materials of which clothing is made also depends upon their capacity to absorb water. this may be done in two ways: the water may simply collect between the fibers, in which case it may be in a large measure removed by wringing, or it may be actually absorbed into the substance composing the fabric, and, as a consequence, the latter, even though containing much moisture, do not appear damp. fabrics made from vegetable materials, as cotton or linen, have little power of actually absorbing water, and hence they become wet on the slightest addition of moisture, while on the other hand those of animal origin have the capacity of absorbing water, and appear dry even after the addition of this substance in considerable amounts. a person, therefore, dressed in cotton fabrics will find after active perspiration has begun that his clothing quickly becomes moist, while if he have on woolen garments this will not occur. it is particularly noteworthy that water is gradually removed by evaporation from animal fabrics, which causes a general cooling without producing a chill; it is therefore readily understood that woolen clothing is much to be preferred where active exercise is being taken. color is also of some importance in determining the value of a fabric for protecting the body from the sun's heat. within recent times we have learned a great deal respecting the wonderful penetrating power of the invisible light rays, and we have every reason to believe that these modify to a very considerable degree every process going on within the body. the violet and ultra-violet rays are those that unquestionably exert most influence, and it has been suggested that they may be broken up and rendered innocuous by covering the body with materials having a reddish-yellow color. it is not necessary to put these materials on the outside where they would be conspicuous, but they may be used as lining for hats and clothing; and there are good reasons to believe that if their use were generally adopted suffering and actual loss of life from overheating would be greatly reduced, particularly in warm countries. _work and rest._--very slowly the people of our country are beginning to realize that it is quite as necessary to rest as to work, though unfortunately in some quarters a strenuous life is urged as being only secondary in importance to possessing a big family; that there is an intimate association between the two there can be no doubt, since the latter beyond peradventure would entail the former. it has ever been the habit and misfortune of sages now and then to desert the field of their own peculiar activities and to make incursions into unknown regions--generally giving advice with a dogmatism and finality proportionate to their ignorance of the subject under discussion. as a matter of fact the average american works entirely too much, and while he sometimes accumulates an immense fortune with astounding rapidity, to his sorrow he often learns later that he has likewise acquired a damaged heart, premature thickening of his blood-vessels or nervous dyspepsia with all of its attendant evils. descended as we are in a large measure from the most vigorous and adventurous europeans of the last few centuries, and coming into possession of a new world where everything was to be done, this tendency to overwork is most natural,--and for this reason is all the more to be combated. that we have been able so successfully to carry the burden for several generations is indeed remarkable, but there are not wanting numerous indications that the strain is beginning to tell. if we do not call a halt, and devote more time to rest and agreeable pastimes, disastrous consequences are sure to follow, and we will become in the course of time a race of neurasthenics and degenerates. attention should likewise be directed to the fact that men do not develop to the highest point of mentality who devote their entire time to work, as leisure is absolutely essential for thought and the development of all that is best in man. let us then cast aside the shallow and ignorant preachments of those who do not understand the subject, and devote a reasonable time to the reading of good books, to thought, to the cultivation of the arts and sciences, and to pleasurable pastimes. in these particulars we are far behind europe, and we shall never take our place as an intellectual people until we radically change our method of life. a nation must dream before becoming great. let it not be understood from the foregoing that the writer would in the slightest degree minimize the necessity for a reasonable amount of work, for he thoroughly appreciates that without labor neither the individual nor the nation itself could remain sound--it is only urged that excessive work is quite as much to be feared as none at all. _health and labor._--as to the number of hours that should be devoted to labor no rule can be laid down. it all depends on the age, physical and mental vigor of the individual, and likewise, to a considerable degree, on the character of the work. occupations requiring intense mental or physical strain can only be kept up for short periods of continuous application, while, on the other hand, quite naturally, those of a less strenuous nature would permit longer hours. the young man, in pride of perfect bodily and mental vigor, too often assumes, because he has been able in the past to do pretty much anything that pleased him without ill-effect, that he can continue to do the same through life. no greater mistake could be made. anything that has a tendency to undermine the health, repeated sufficiently often, will ultimately cause a complete breakdown. how often do we see the strength and beauty of early manhood blighted and turned to premature old age and death as a consequence of disregarding the warnings that have just been given! how frequently do we observe young men rejoicing in the emancipation from home and school and spurred on by the fatal delusion that while others might suffer they will not, becoming in the end the victim of that arch enemy of early manhood, consumption! every practicing doctor has seen this, not once, but hundreds of times, and in the vast majority of instances he can say with truth that the frightful result is a consequence of overwork--too often associated with nocturnal dissipation. the man who works during the day, and devotes his nights to alcohol and gay company when he should be sleeping, will assuredly, sooner or later--and usually sooner--suffer the inevitable consequences. to those who live sedentary lives, active out-door exercise is very essential, but inasmuch as this little volume is being written for those who live a saner and more healthful existence, it is not deemed necessary to discuss here this phase of the subject. _value of sleep._--closely connected with the subject just discussed is sleep. here also we have no rules, or laws, from which we can clearly determine the amount required in individual cases. overwise philosophers have asserted that seven hours for a man, eight hours for a woman, and nine hours for a fool, was the allotted time for sleep. as a matter of fact, the necessity for repose varies greatly in different individuals, some of them requiring less while others demand more. it is a safe rule to follow that every man should sleep as long as he naturally desires, for nature is a much better mentor than any man could be--however learned. the majority of men require at least eight hours of sleep for the day and night, and this should be secured if possible at such a time as will permit it to be undisturbed; hence it is that man usually prefers to sleep at night, and, all things considered, it is probably the time best suited for his repose. we read many marvelous stories of certain great men who required little or no sleep. within recent years the press has frequently contained articles recounting the extraordinary fact that a certain prominent inventor of this country lived daily on a mere spoonful or so of food, and only slept a few hours now and then when there was nothing else particularly to do. such stories should be accepted only on absolute proof, as, irrespective of their utter improbability, one may observe that they are generally insisted upon in and out of season with a pertinacity that would indicate that they were conceived and are scattered abroad with the sole idea of impressing the general public with what a marvelous and unusual person the individual in question is. there can be no reasonable doubt that they are merely evidences of childish vanity and puerile mendacity, and are only referred to here for the reason that young persons, ignorant of the laws of health, might attempt to emulate them, with results that could be but disastrous. _nothing so preserves youth, health, and good looks as a sufficient amount of sleep, and it is pre-eminently the secret of long life._ reference will be made in the chapter on the hygiene of infancy to the necessity of children sleeping as much as is possible. it will do no harm to say again here that nothing is so essential for the proper development of the body as sleep, _and that it is absolutely a crime to awaken a child except under circumstances of absolute necessity._ _precautions in respect to eating._--a sufficient amount of sleep, and a proper quantity of digestible and nutritious food, thoroughly cooked and carefully masticated, are the things which above all others are most important for the maintenance of health. in the chapter on foods, the nutritive values and digestibility of the various articles eaten by man will be discussed with sufficient thoroughness to instruct the reader as to a wholesome dietary; it is, therefore, not necessary here to go into the matter fully, but the subject is so important that a few general remarks will not be out of place. eating should never, so far as is possible, be hurried. nothing is more important for the proper digestion of food than its thorough mastication, and this can only be accomplished when sufficient time is allowed for eating. it is not necessary that this be done to the extreme advocated by some, but it is certainly of the highest importance that the food be so thoroughly chewed that it is reduced to fine particles, and that it should be so soaked in saliva that it may be swallowed without the aid of liquids of any kind. it is also desirable that food should not be taken while the individual is tired, so that it is a good plan where this condition exists for one to lie down for a short time before eating. regularity in eating is likewise of importance, it being best to take the meals at stated periods; the consumption of food at irregular hours often leads to indigestion and is a practice which should not be indulged in. it is highly desirable to have food served under agreeable circumstances, digestion being accomplished in a much more satisfactory manner if pleasant conversation be indulged in during the meal, and if the food be of an appetizing character. nothing is of more importance in connection with this subject than to have the food properly prepared. not only is thorough cooking important from the standpoint of making foods digestible, but as is shown in another part of this volume, grave and sometimes fatal diseases are contracted by a neglect of this important procedure. fruits, contrary to what is generally thought, contain but little nourishment, and severely tax the digestive powers of those who have a tendency to dyspepsia. when eaten at all, they should be perfectly ripe and fresh, and should always be taken after meals rather than before. _drinks,--coffee, tea, milk, etc._--much misconception exists, among people generally, and even among the medical profession, concerning the proper amount of water that should be drunk. while this substance is unquestionably the most wholesome of all drinks, there exists no necessity for taking it in great quantities at times when the system does not call for it. it would perhaps be a good rule for all to form the habit of drinking little while eating, the reason for which will be explained hereafter. coffee is exceedingly popular both on account of its delicious odor and taste when properly made, and for the reason that it is highly stimulating. while it is borne by young and vigorous persons of either sex with apparent impunity, there frequently comes a time in life when it can no longer be drunk without ill effects. as a general rule, dyspeptics do not bear it well. tea, if properly prepared, is a most palatable beverage, and one that is generally better borne than coffee. it is more wholesome when taken without lemon juice, and like coffee it is less disposed to produce trouble if largely diluted with milk, or if taken without cream or sugar. cocoa and chocolate are often used as substitutes for tea or coffee, and where they agree with the individual are perhaps as wholesome as either. both, however, contain considerable quantities of fat, and as they are frequently prepared with cream, or very rich milk, they are not as a rule well borne. while milk might be considered as being almost as much a food as a drink still the fact that it is fluid, and that it contains a very large percentage of water, causes it to be regarded as a beverage. when taken slowly--and this precaution is particularly necessary where it is fresh and sweet--milk is a drink that should be regarded as being on a par with water. it contains no injurious substances, but sour milk should, as a rule, be avoided by dyspeptics. the cardinal principle in taking beverages of any kind at mealtime is that they should be drunk alone after the food has been swallowed, as when they are taken with the purpose of softening the latter, mastication is seriously interfered with and the proper soaking of the food in the saliva prevented. _alcoholic beverages._--alcoholic drinks are so fully discussed in a latter part of this book that here it may merely be stated that they cannot be regarded as having food-value to any degree, and so far as the matter is at present understood, appear to be entirely superfluous, and even positively injurious. if taken at all, they should be consumed in extreme moderation, after meals rather than before. the young especially should be particularly warned against the use of all beverages of this class. _a word on "soft drinks."_--mention should also be made of those drinks commonly sold at soda-fountains. the vast majority of them may be taken occasionally without any appreciable ill effects, but the habitual use of beverages containing considerable quantities of syrup is not entirely wholesome. particularly is this true where the drink contains stimulating drugs, such as do some of those most advertised. some of them are, if no worse, the equivalent of a strong cup of coffee, and should, therefore, no more be taken every hour or two during the day than a cup of the substance just mentioned. if their use is persisted in, it is sure to be followed by indigestion, and in many instances nervous disorders of even a serious character. the reader should also be warned against the use of drinks containing medicine for the relief of pain--particularly those that are advertised as remedies for headache. practically without exception, all such drinks contain coal-tar preparations that greatly depress the heart, and have in a number of instances been followed by death. drugs of this character should be taken with the utmost circumspection, and only on the prescription of a competent physician. _tobacco._--tobacco, of all nerve sedatives, is the most universally used. in moderation it could not be said that it is followed by any apparent ill effects in the majority of people, but if used in excess oftentimes sets up serious disturbances. it is peculiarly injurious to boys, and should never be indulged in until manhood is reached. some persons seem to possess a natural immunity to the ill effects of nicotine, and appear to be able throughout their lives to chew or smoke tobacco in any amount without harmful results; such instances are, however, rare--its excessive use being usually followed by symptoms that may be of a serious nature. of the two methods of use perhaps smoking is less open to objection, though it is unquestionably true that chewing is not so apt to cause disturbances of the heart. smoking affects the stomach, but not to the extent that chewing does. chapter iii sanitation in and about the house the bearing of intelligently located houses of proper construction on health is not so generally understood, even by physicians, as the facts warrant, and, of course, is even less well recognized by the non-medical public. it is true that some attention has been given to the matter of _location_, but even in this connection there prevails a woful ignorance among all classes as to just how the diseases are transmitted that are most influenced in this way. as a result of recent advances in medicine it has been clearly shown that at least some of the diseases that are most influenced by locality may be easily avoided, and as a consequence we find that the views of the modern sanitarians have necessarily undergone a certain amount of change in this direction. on the other hand recognition of the necessity of hygienic _construction_ has not been sufficiently accentuated,--since it is possible by proper attention to the details of building to do away entirely with at least two of the diseases that have heretofore been the principal drawbacks to life in all tropical and sub-tropical countries. much importance likewise attaches to houses being thoroughly ventilated, and to their being sufficiently roomy to properly accommodate their inmates. the following table shows the striking relationship that mortality bears to over-crowding:-- relation of death-rate to density of population. city. mean number average death-rate of inhabitants per , inhabitants. to each house. london berlin paris st. petersburg vienna many other statistics could be quoted, but all follow the general trend of those just given. _choice of site._--in our rural districts the inhabitants have a wide latitude in the matter of the selection of the location for their houses, and it is usually the case that our people are sufficiently intelligent to make the best use of their opportunities in this direction. it may, however, be mentioned that it is generally considered that building-sites in the neighborhood of cemeteries are not favorable locations, nor should houses be erected in the vicinity of a manufacturing plant that gives off injurious gases, or obnoxious materials of other kinds. inasmuch as we now know that malaria is transmitted by a certain mosquito, and that by properly screening the house their attacks may be avoided, the necessity no longer exists for avoiding the vicinity of lakes and rivers as building-sites; such localities being as a rule pleasant and often picturesque, they would naturally under ordinary circumstances be selected, and there now remains no reason why this may not be done,--provided that the house is so constructed that mosquitoes can be effectually prevented from gaining entrance. of much importance is the selection of a locality where good and pure water can be easily procured, as otherwise disastrous consequences are sure to follow. the soil should be of a light and porous character, easily permeable by water, and free from the decomposing remains of excretions of man or animals. there is much reason for the belief also that the level of the ground-water plays a somewhat important part in the salubrity of any given locality, and it is generally considered that this should be at least ten feet below the surface. it is generally thought, and probably with truth, that those sites are most healthful which have their location on a basis of granite, or other rock-foundation; in such localities there is usually a considerable slope of the general surface of the ground, with the result that water rapidly runs off after rains, and consequently stagnant pools, which might serve as a breeding place for mosquitoes and bacteria, do not form. soils through which water easily permeates are likewise, as a rule, healthy, though this depends in a measure upon whether or not they contain a very considerable proportion of vegetable matter. clay foundations are healthful where there is a considerable slope to the surface of the ground, but where this does not exist the soil is damp, owing to its impermeability, and often has stagnant pools upon its surface. marls and alluvial soils are not regarded as being wholesome, but it is not unlikely that their bad reputation is largely due to the fact that they generally exist in the neighborhood of rivers and other considerable bodies of water where mosquitoes are numerous. there are no reasons going to show that cultivated lands are unhealthy--even where they receive yearly abundant additions of manure. where it is necessary to build in damp localities the site should be thoroughly drained, and the space upon which the house is constructed should be carefully covered with some impermeable cement. _building materials._--of all building materials, the one most commonly employed in america is wood. this arises from the fact that in the past we have had unlimited quantities of timber from which lumber could be procured at a price so reasonable that no other material could ordinarily be considered. that the wooden house has some advantages cannot be denied; its walls rapidly cool following the torrid days that so commonly occur during the summer in almost all portions of the united states, and it is usually well ventilated as a result of the numerous fissures naturally existing in its structure. next to wood, bricks are most commonly used for building purposes, and have many advantages, among which are their handsome effect, their stability, and their being poor conductors of heat; the last mentioned is of considerable importance, since it keeps both heat and frost from rapidly permeating the interior, and as a consequence houses constructed of this material are cooler in summer and warmer in winter. other materials occasionally used are concrete, granite, marble, and sandstone, any of which, on account of their durable character and the beauty that they lend to structures made from them, may be selected for building purposes, but inasmuch as they are rarely used in rural districts, a detailed consideration of their peculiar advantages for building purposes is not deemed here necessary. the internal wall-coating of houses deserves more consideration than is commonly accorded it, since the dyes used for coloring wall-paper and curtains in some instances contain noxious materials. chief among those that are dangerous are the bright green pigments which commonly contain arsenic as their principal constituent; where these or other poisonous substances are employed in interior decorations the air, wherever the room is kept closed, may become more or less impregnated with poisonous gases, and serious consequences to the inmates may ensue. _screening indispensable to health._--nothing is more important in connection with house construction than having every opening thoroughly screened. we have learned that both malaria and yellow fever are transmitted always by certain kinds of mosquitoes, and it therefore, becomes a matter of the greatest importance to effectually prevent the entrance of these insects. it cannot be too strongly insisted upon that we absolutely know that the statement just made is correct, and that avoiding the diseases referred to becomes as a consequence entirely a matter of preventing the entrance of mosquitoes into houses. [illustration: fig. . anopheles. (malarial mosquito.)] [illustration: fig. . culex. (common mosquito.)] the _anopheles_ mosquito, which is the one that transmits malaria, often exists in localities where the more common varieties do not occur, and on account of the habits of this insect their presence is liable to be overlooked. they seldom attempt to bite during the day, and it is only rarely the case that they try to do so at night in a well lighted room;--particularly where movement of any kind is going on. during the day this mosquito remains perfectly quiet in the dark corners of the house, and is very fond of resting on cobwebs, presenting, when doing so, an appearance strikingly similar to that of fragments of leaves, soot or of other natural objects that are frequently found suspended on such structures. on account of these peculiarities and for the further reason that the insect bites mainly just following daybreak, when the victim is profoundly unconscious in sleep, its presence often remains undetected, and as a consequence we occasionally hear from those who do not take the trouble to inform themselves that malaria exists in this or that locality where mosquitoes do not occur. the yellow-fever mosquito bites for the most part during the day, but will do so at any time when there is light. in districts where this disease occurs it is quite as important to prevent its entrance as that of the malarial mosquito. not only does screening prevent malaria and yellow fever, but it keeps out flies and other insects that unquestionably bring with them the germs of other diseases. there now remains no doubt that several affections, notably typhoid fever and dysentery, are frequently communicated by means of the common house-fly, which spends its time alternately on the fecal material around privies or in other filth, and in our kitchens and dining-rooms; it is one of the most astounding evidences of the power of habit, in the face of common sense and ordinary decency, that we have not long ago taken active steps to rid ourselves of its disgusting presence. fortunately in screens we have a perfect barrier to the entrance of flies, and no house can be considered complete without being thoroughly equipped with these all-necessary appliances. it is scarcely possible to overestimate the economy that results from the use of screens; among the various means employed for conserving the public health they take first rank, and undoubtedly insure those who live in houses to which they have been added an immunity against the costly effects of disease that could scarcely be computed. a house would be more habitable without chairs, beds, or tables than screens, since in the absence of the former we may be healthy, though somewhat uncomfortable, but without the latter serious disorders are pretty certain, sooner or later, to make their appearance. it is of considerable importance to use a screen the mesh of which is sufficiently fine. where mosquitoes exist, the screen should be of such fineness that at least sixteen, or better eighteen meshes be in each inch of the gauze. where it is absolutely certain that mosquitoes are not to be feared, the spaces may be somewhat larger--but always of such size as will prevent the entrance of the smallest fly. _air-space required._--it is of much importance from a hygienic standpoint that the rooms of dwellings should be sufficiently large. the height should never be less than eight feet, and the living-room should be made as large as circumstances will permit. bed-chambers should contain at least , cubic feet of air space for each adult, with somewhat less for children, though it should never be forgotten that the more the better; this means that each person should have the equivalent of a room which is at least x x feet. _heating._--americans are extravagant in the matter of heating to a degree that astonishes the average foreigner, and it is by no means sure that we do not go to unhygienic extremes in this direction. it is not, perhaps, true that the excessive heat itself could be considered as especially hurtful, but it is too often the case that the conditions required to secure the degree of heat preferred by us are incompatible with proper ventilation, and hence are to be condemned. it is generally considered that the temperature of living-rooms should be somewhere about °f.; for many persons this is lower than would be entirely comfortable, and as a consequence our houses in the winter are frequently kept nearer °f. than the figure just given. the reader should be urged to see to it that, at whatever temperature his habitation is kept, a sufficient amount of ventilation be secured. there are many different methods of heating, the most satisfactory of which are by means of hot water or steam; a modified form of the latter is the so-called vapor method, which in recent years has proven extremely satisfactory. hot air, supplied by a furnace is also extensively used, and for the reason that by this method fresh air from the outside is constantly brought into the house, it is theoretically to be commended; practically, however, a considerable difficulty is experienced in securing an equable distribution of this heat throughout the various parts of the house, and as a consequence it has not achieved the popularity that it would otherwise have done. inasmuch as the installation of plants for heating by the methods just referred to entails quite an expense, and for the further reason that they require coal for satisfactory operating, they have not been employed in the rural districts of america to any considerable extent. the farmer, for the most part, depends on the old open fireplace where wood is plentiful and the weather does not become excessively cold, while in those portions of the country where the temperatures in winter go very low, the stove is generally employed. of the two methods, the former is much the more hygienic where it can be used successfully, but over a greater portion of the united states this cannot be done owing to the cold winter climate. the principal objection to the stove lies in the fact that the heat that comes from it is very dry, and that where its walls have to be heated excessively, unpleasant odors are apt to be generated; the former is usually and ought always to be obviated by keeping upon the stove a vessel of water, the vapors from which moisten the atmosphere, and the latter by having the stove of such size that it will not require excessive heating in order to warm the room in which it is placed. wherever possible the open fireplace is to be preferred to the stove for the reason that it very thoroughly ventilates the room. _ventilation._--in order that the health of the inmates may be conserved proper ventilation of all habitations is essential. however cold the weather may be, an abundance of fresh air should be allowed to enter all parts of the house. in the average wooden dwelling there are so many cracks that good ventilation is generally secured without opening doors or windows, but where the construction does not permit this, openings for the entrance of air should be left in the most convenient and suitable places. windows may be slightly raised and draughts prevented by proper screening, or what is even better, rooms should be so constructed that they have openings at the top and at the bottom to allow free ventilation. openings towards the upper portion of rooms are especially important in hot weather, as the warm air rises to the ceiling and escapes only very slowly where such exits do not exist. lowering windows from the top aids materially in allowing the hot air to escape, but this is not altogether so satisfactory as having openings higher up on the walls, or in the ceiling. _disposal of sewage._--no problem that confronts the dweller in the rural district is of greater importance than the proper disposal of sewage. it is unfortunately impossible in most instances for the farmer to have in his house a system of water-works, and, therefore, all dish-waters and slops are thrown into the yard, and a privy is used instead of a modern water-closet. where the lay of the land is such that water readily runs off, or the soil is of a character that permits rapid absorption, throwing slops on the ground around the house may not constitute a danger to the inmates, but nothing is more certain than that the old fashioned privy is a dire menace to the health of all those in its vicinity. not only are infectious materials brought into houses by flies, from fecal matter and other excretions, but they are carried away by the rains and sometimes contaminate sources of water-supply. it is furthermore extremely probable that bacteria in particles of dust from dried fecal material may be carried by the winds from privies into wells and houses, and as a consequence diseases may be spread; of perhaps still more importance--and certainly of far greater moment all over the southern portions of the country--is the fact that hook-worm disease and other infections caused by animal parasites are transmitted from man to man as the result of our adherence to the old fashioned privy. as will be explained in the chapter devoted to the common communicable diseases, the eggs of the hook-worm pass from the intestine along with the feces of those who are victims of this parasite and reaching the ground, hatch out in the course of a few days minute hook-worm embryos, which crawl away and permeate the soil in the vicinity; later collecting in little pools that form after rains, or in dew-drops during the night, they attach themselves to the skin of barefooted children who come in contact with such collections of water, and boring into the body ultimately, through a circuitous route, reach the intestines. here they undergo further development, and in a short time become mature hook-worms, which in their turn lay eggs, and the life cycle begins over again. it is thus seen that a child having hook-worm disease becomes a menace, on account of the privy, to its brothers and sisters, and of course quite commonly receives back into its own body, worms that had previously escaped as eggs. in the same way eggs of the two common tapeworms pass out with the feces, and the offal containing them being eaten by hogs in the one case, or being scattered in the vicinity and taken in with grass by cows in the other, have their shells dissolved off as soon as they reach the stomachs of these animals, and there are liberated small embryos that bore through the walls of the stomach and later find their way into the muscular tissues of these beasts, and there lie dormant until eaten by man with imperfectly cooked meat; after being swallowed, the embryo parasite passes to the intestine and soon becomes a fully developed tapeworm. particular reference at this point should be directed to the evil effects, which are even still greater than those that come from the privy, of permitting children and hired helpers to scatter their feces indiscriminately in corners of the yard, the apple-orchard, or in the horse-lot; under such circumstances, where hook-worm disease is once introduced, the soil in the course of a short time becomes thoroughly permeated with the embryos of this worm, and, as a consequence, all of the children who play in the infected area barefooted, as is customary in the country, are sooner or later infected with these parasites. it is thus seen that soil-pollution from fecal material is a most dangerous thing, and, particularly in the southern portion of the united states, deserves the most earnest consideration of everyone. we should see to it that our children only evacuate their bowels in properly constructed closets; and it is the duty of the head of every family to provide such a place for the accommodation of those who are dependent on him. _proper construction of out-door privies._--the most practical and generally satisfactory device heretofore invented for the disposal of the sewage of communities unprovided with water-works is what is known as the rochdale, or dry-closet, system. by this system a privy, at a distance from the dwelling, is constructed in the ordinary manner, with the exception that instead of being open at the back it is tightly closed. in the space beneath the seat receptacles are placed for receiving the urine and feces. these may consist of pails of wood or better of galvanized iron; or a single box occupying the whole space. if wooden receptacles are used, they should be thoroughly coated on the inside with tar, to prevent both leakage and the soaking of the liquids into the wood. one such structure, which the writer knows has been wholly satisfactory has a brick foundation with walls two feet high around the front and sides, within which rests a shallow tarred box. it ensures perfect cleanliness. in any case this space under the seat is tightly closed, being guarded by doors that open outward, through which the pails or box may be introduced and removed for emptying. each privy contains a box in which is placed either wood ashes or dry powdered earth, with a small shovel by which a sufficient quantity of the dust to cover the deposit is thrown into the pail after each evacuation. it is remarkable how completely this shovelful of earth or ashes destroys all disagreeable smell. the privy should be provided with at least two opposite windows, both of which should be thoroughly screened. the entrance should have a door that is closed with a spring, so that it cannot be carelessly or accidentally left open when vacant. at intervals the pails containing the feces are removed, and the contents are carried to a distance and buried. another plan that is quite satisfactory where iron pails are used, is to place a quantity of water in the vessels for receiving the feces, and then to pour in a small quantity of kerosene; the latter substance forms a layer over the water that keeps out flies, and does away largely with the disagreeable odors that are likely to emanate. if any contagious disease exists among those who use such a closet, the fecal material should be carefully sterilized before being removed, as by means of corrosive sublimate, carbolic acid, chlorinated lime, or any one of the many commercial disinfectants containing crysylic acid, all of which may be obtained at any drug store. if carbolic acid or other liquid antiseptics be used the amount by volume should be equal to about five per cent. of the material to be treated; the proportion of corrosive sublimate should be at least to , where this disinfectant is used. along with whatever antiseptic is chosen, water should be added in sufficient quantity to permit the whole to be rendered semi-fluid, and the mixture should then be thoroughly stirred, and the chemical left to act for some hours before emptying the receptacle. by far the most satisfactory method of sterilizing infected material, however, is by boiling, since disease-germs are killed by such a temperature in a few moments. where iron receptacles are used, therefore, the simplest method is to set them upon an open fire in the yard for a little while. a privy constructed after the manner just described possesses some advantages even over the regulation water-closets that are used in cities, since they are cheaper in original cost, require less repairs, and are uninjured by a freezing temperature. the amount of care required to keep them in proper condition is not excessive, and they are so infinitely superior from a hygienic standpoint to the old-time privy that no sort of comparison is possible. it should always be remembered that the principal advantages of this closet are that where it is used we are able to collect all of the evacuations, which may then be properly deodorized with soil or ashes, and that it may then be finally disposed of in such a way that it cannot be reached by hogs or other animals; of very great importance also is the screening of the closet, since only in this way is it possible to prevent flies from gaining entrance to the fecal material in the receiving pails. _water supply._[ ]--in the location of houses and schools an eye should always be had to selecting a site where it is possible to obtain good, pure water. to those fortunate dwellers in the mountainous regions of our country this is usually a matter of little difficulty, since it is always possible to find a location in the neighborhood of which the purest spring water may be obtained. in less favored regions the well becomes the main reliance, while cisterns are used in some portions of our country, in which water is collected during the rainy seasons of the year. of the two, the former is undoubtedly to be preferred, provided a pump be used instead of the old fashioned bucket. the writer is strongly of the opinion that a very large proportion of the contamination to which sources of water-supply are subject comes from the bucket being drunk from or handled by persons with contagious diseases, or from germs being blown into the well with dust, or carried in by means of insects and small animals. it is inconceivable that any appreciable amount of contamination from the surface can reach the underground streams that supply wells in localities that are thinly populated, though it is unquestionably true that a well might be infected as a result of the entrance of surface-water where its top is not properly protected. on the other hand we have in an open well or cistern every facility afforded for the entrance of bacteria. it is unquestionably of the utmost importance that wells be carefully covered over, and every precaution should be taken to prevent surface-water leaking into them around their edges. in order to comply with these conditions a pump is essential, since it is the only means by which water can be brought to the surface without exposing the contents of the well to contamination. it is likewise of the first importance to have the walls of the well curbed to a sufficient depth to prevent the possibility of seepage from the surface. it is, of course, also quite necessary that the well be of sufficient depth--the lower we go the more likely are we to secure a perfectly pure water. in regions where the water rises to within eight or ten feet, or less, of the surface, the possibility of the well being contaminated during the rainy season by seepage is considerably increased, and the waters of such wells should be used only after analyses have shown that they are pure; where this cannot be done, the water should be boiled before being drunk. of course, the possibilities of contamination are greatly increased if the locality be thickly inhabited. as has been before remarked, cisterns are more liable to contamination from the air than are wells, chiefly owing to the fact that they are supplied by water that is conducted into them by gutters from the tops of houses. there is no question that during the dry seasons dust containing many kinds of bacteria is deposited all over the tops of houses and remains there until washed away by the rains. while it is true that the sunlight quickly kills most germs that produce disease a certain number of them would inevitably escape, and having gained entrance to a cistern, would be likely to multiply and later cause trouble. it is thus seen that however pure the rain-water may originally have been--and it is among the purest of all waters--it is likely to become contaminated in the process of collection, and may ultimately in this way become the source of disease. where any doubt exists as to the purity of such water it should be boiled before use. surface-streams also occasionally supply drinking-water in rural districts, and while the use of such waters may not always be attended by danger, their contamination by disease-producing germs is much more to be feared than when they are derived from wells or springs; where streams arise from and keep their course through uninhabited districts the probabilities are strong that their waters are pure and fit for use, but where they run through cultivated fields, and particularly where they pass in the neighborhood of houses, their waters should never be looked upon as being drinkable,--except after being boiled or properly filtered. inasmuch as adequate filtration is exceedingly difficult to carry out, and requires a somewhat extensive and costly plant, this is, as a rule, not feasible for the dweller in country districts, and boiling, therefore, remains the only satisfactory method of rendering the water fit for use where doubt exists as to its purity. _location of pens and stables for animals._--animals should always be housed at some little distance from the dwelling. while it is true that man does not often contract directly diseases from hogs, sheep, horses and cattle, there are some maladies of a most serious character that come to us in this way, and we should, therefore, always guard against their occurrence by removing ourselves as far as is possible from sources of possible infection. the matter also has an æsthetic side, as odors of a disagreeable character may prove very annoying where animals are kept too close to the house. it is likewise of importance that stables should be, if possible, on lower ground than the dwelling, since during rains materials from their dung may be washed around and under the house, and may possibly gain access to the well. every care should be taken to keep hog-pens and stables clean, since otherwise very foul smells are engendered that oftentimes find their way to neighboring houses. there is also a suspicion that some of the germs that produce disease find the conditions suitable for their stables and pig-sties. in this connection it might be well to warn those unacquainted with the subject against the _all too common practice_ of close association with dogs, since it is well established that in addition to hydrophobia they may transmit, while apparently in perfect health, maladies of a deadly character to the human being. it cannot be too often emphasized that the less intimate our association with the lower animals is, the greater the likelihood of our escaping many serious diseases. footnote: [ ] this subject is fully treated in another volume of this library, entitled _home water-works_, written by prof. carleton j. lynde. it shows where water should be sought, and how it may be supplied under perfectly safe conditions to the household, with descriptions of machinery, estimates of expense, etc. this thoroughly practical book meets a widely recognized need for information, and is written by a specialist. thousands of men living in rural parts of the united states and canada, out of reach of a public water-system, have equipped their homes with water-supply conveniences equal to any found in the cities. thousands more who could well afford to do so and who could do so advantageously, have not done so for various reasons--because the idea has not occurred to them, or because they did not know how to go about it, or because they mistakenly thought the expense too great. to all such this book should prove of the greatest practical help. chapter iv hygiene of infancy and childhood no characteristic of the caucasian mind is more marked, and none more universally affects his actions than a constant, gnawing suspicion that the things going on around him are not being done in the proper way, and consequently an irrepressible desire to experiment, and if possible, to change everything. such a spirit is unquestionably the basis of what we call progress, and, in so far as it conduces to the health and happiness of mankind, is entitled to our most hearty commendation. on the other hand, it cannot be denied that too often we endeavor to bring about changes with but an imperfect understanding of the basic principles at issue, and naturally, under such circumstances, our efforts are crowned with anything but success. in other words, an enlightened investigation of the whys and wherefores of any existing state of affairs may and often does, lead to improvement, while, on the other hand, ignorant meddling is likely to be followed by disastrous consequences. nowhere do we see the bad results of false conceptions more marked than in our treatment of infants and children. particularly do young infants suffer in this way, as they are pounced upon as soon as they enter the world by every old "granny" and negro "mammy" in the neighborhood, and plied with abominable concoctions that would be productive of homicide if we were to attempt forcibly to administer them to grown men, and whose only effect on the defenseless little sufferer is to cause colic and indigestion. many times has the writer seen a wee, tiny little mortal, who was too young and weak to even protest, bundled up with a mountain of flannels in the hottest weather of july and august. true to the superstition that the warmer we kept an infant the better, too frequently we see them confined to hot stuffy rooms when they should be out in the sunshine, or under the trees. instead of being allowed to gain health and strength in the forests, which are the schoolhouses of nature, the miserable little wretch is later sent to a public school as soon as he or she can be trusted to go alone on the streets, and the tiny victim too frequently contracts diphtheria, scarlet fever, whooping-cough, measles, or some other disease as a reward of merit. truly we see to it that the helpless innocents early realize the truth of the melancholy and hopeless biblical lament that "man's days here are few and full of trouble." we should rear our children with as little interference as possible, allowing them the utmost freedom compatible with their safety, and permitting them to do those things that nature and instinct demand. above all let them sleep as much and as long as they will, insist that they live in the open air, and encourage them in every possible way to perfect their physical education by those active amusements that they instinctively prefer. after they have established a sound and rugged constitution ample time will be left for them to develop mentally. _feeding of nursing infants._--the most important thing in connection with the feeding of infants is to always remember that nature has provided in their mother's milk, when sufficiently abundant and normal in quality, everything in the way of food and drink that they require. during the three days that usually intervene between birth and the coming of the milk in the mother's breast, infants may be given from time to time small quantities of pure water, but under no circumstances should anything else be allowed. during this period the child may be put to the breast four or five times in the twenty-four hours, for, while it gets but little in the way of nourishment, there is even at this time a watery fluid secreted in the breast that goes far towards supplying everything that the infant needs for the time being. a child should never nurse longer than twenty minutes at one time. it is likewise of importance that the time of nursing be strictly regulated. particularly during the first year it is of the utmost importance to watch with an intelligent eye the growth and development of the child. where the milk agrees with it it has a good color and gains regularly in weight; it cries but little, and is good natured, and thoroughly contented. should it, on the other hand, lose weight, appear fretful and listless, and sleep badly, there is something wrong, and the mother should at once have her milk examined by a competent physician. in case the mother does not give sufficient nourishment there is no objection to partially feeding the infant on modified cow's milk--the method of the preparation of which will be considered later on. where colic occurs it generally means that the infant is getting a diet too rich in albuminous foods, which should be corrected by advising the mother to take an abundance of out-door exercise, and to avoid all causes of worry so far as is possible. vomiting freely is a very common occurrence in small children, and is usually the result of too much food being taken at a time. it also occurs, particularly some time after feeding, as a result of indigestion, which is frequently the consequence of the milk being too rich in fats. wherever an infant shows signs of trouble it is well to advise the mother to use a diet less rich in meats, and to caution her against over-eating. children should be weaned at the end of their first year. this had best be brought about gradually, by, in the beginning, feeding the child once daily, and then gradually increasing the frequency, at the same time proportionately leaving off the nursing. where children are not thriving, it is often a good practice to wean earlier, in which case modified cow's milk, taken from a bottle, must be substituted. _artificial feeding._--while it is true that children often thrive for a time on the various baby-foods with which the market is so abundantly supplied, it is, nevertheless, the case that where fed in this way they are very apt to develop rickets or scurvy, and not uncommonly show evidences of bad nutrition in loss of weight and strength, becoming peevish and fretful, and sleeping badly. much better than any of the artificial foods is properly modified cow's milk, which, with care, may be prepared in such a manner as to take the place of mother's milk in the vast majority of instances. in order, however, that this be successfully carried out, much care and attention is necessary. at this point it is well to stress the fact that the mother's milk differs from that of the cow in some quite important particulars, and it is only by intelligently taking these differences into consideration that it is possible for us to prepare an artificial food that will be satisfactory. principal among these differences are that cow's milk contains three times as much albuminous material as that of the human being, and that it is less rich by about half in milk-sugar; furthermore, the former is acid in reaction, while the latter is neutral, or faintly alkaline. it will be seen, then, that in order to prepare a modified cow's milk that will approximate that of the human being it is necessary to dilute it with water sufficiently to cause the albumin to approach in proportion that of mother's milk, and at the same time some alkali must be added to neutralize the excessive acidity. modified milk prepared, however, from the whole cow's milk, would contain much less fat than is desirable, so that we must use in making it the upper third of the whole milk after it has been allowed to remain undisturbed for a number of hours; in other words, in making modified cow's milk we use a large proportion of the cream, with a less amount of the other constituents. the following table for calculating the proper proportion of milk to be used at the various periods of the infant's life may be recommended, as it gives quite as satisfactory results as those that are more elaborate; it also gives the frequency of feeding and the proper amounts that should be used. the table was devised by dr. c. e. boynton, of atlanta, georgia. fat quantity no. of percentage ounces at feedings in intervals desired. feeding. hours. by day. premature . / to / - to - / hrs. - day . to - / - to " - " . to " - week . to - / " - " . to - / " - " . - / to - / " - month . to - / " - " . to - / " - " . to " - month . to " - month . to " - " . to " - " . to " in making calculations from this table it is assumed that the milk from the upper third of the bottle, after it has been allowed to sit for at least four hours, contains % of fat, and this is therefore called % milk. the calculation is made as follows:-- % milk is to the fat percentage desired, as the amount which we wish to make up is to x. for example, if we wish to prepare twenty ounces of milk for an infant two months old, we will note by referring to the table that % is the amount of fat that is desirable for a milk for a child of this age, and the formula will be constructed as follows:-- : :: :x. x = / . x = . six ounces is then the amount of % milk that must be used for making twenty ounces of modified milk,--this being mixed with one ounce of lime-water and thirteen ounces of boiled water. it should never be forgotten that while milk modified by the foregoing formula is suitable for most children, it is by no means always satisfactory, and we may, therefore, be compelled to do a considerable amount of experimenting in some cases before arriving at the correct formula. suppose the infant is twelve months old, we would get according to the rules just stated the following equation:-- : :: :x. x = / . x = . eight ounces would then be the amount of milk required for preparing twenty ounces of modified milk for an infant of this age. in preparing modified milk according to the formulas just given, it must be remembered that in all instances only that portion is to be used which collects in the upper third of a bottle of milk that has been allowed to sit undisturbed in a refrigerator for at least four hours. the lime-water is for the purpose of correcting the acidity of the milk. it is of much importance to select the milk from a healthy cow in all instances where it is to be fed to infants, and where possible, it should be examined by a competent laboratory man in order to determine if it answers the proper requirements. the writer has often seen milk from apparently healthy cows, which seemed in every way good, that showed on microscopic examination pus cells and a harmful germ (streptococcus). it is not desirable to have a milk for this purpose that is too rich in fats, and for this reason a cow of the ordinary mixed breed is more satisfactory than the blooded jerseys or alderneys. not only is it essential to get the proper kind of milk, but the utmost care is necessary in handling it. it should, of course, be as free as possible from every source of contamination, and should be strained thoroughly as soon as milked. it should then be bottled, and chilled at once by being placed in cold water, and after being properly sealed, should be placed in a refrigerator at a temperature of about °f., where it should remain undisturbed for four hours before the top portion is skimmed off for making the modified milk. after the modified milk has been prepared it should be returned to the refrigerator, where it should be kept until required for feeding. it is best not to use milk that has been in the refrigerator longer than twenty-four hours, or at most forty-eight hours, and then only if kept at a proper temperature. the modified milk should be poured directly from the receptacle in which it is kept into the feeding-bottle, and the latter should then be placed in warm water until its content is milk-warm, at which time it is ready to be given to the child. it is highly necessary in feeding infants by the bottle to remember that cleanliness in everything connected with the process only makes success possible, and in no particular does this apply with greater force than in connection with the proper care of the bottle and nipple. in every case immediately after use they should both be put in water, which should then be brought to a boiling temperature, and both should then be kept in a saturated solution of boric acid. the nipple, after being placed on the bottle, should not come in contact with anything but the infant's mouth. bottles that have no neck are much to be preferred to others, as they can be readily cleansed. there is on the market at the present time a bottle called the "hygeia," which possesses the necessary qualifications in a perfectly satisfactory way. when children who have nursed at the mother's breast reach the age of weaning it is of importance to remember that they cannot eat without digestive disturbances the modified cow's milk of a strength that would otherwise correspond to their age; they should invariably under such circumstances begin with a milk prepared by the formula used for a child several months younger, after which the proportion of milk may be gradually increased until it is used in a pure state. during very warm weather it is well to reduce the amount of fat by using the whole milk instead of the top portions, as heretofore described. the same precaution should be followed where children have acute diseases, and the total quantity taken should be less than under ordinary circumstances. where infants have acute indigestion, accompanied by vomiting and diarrhoea, all milk should be for the time withheld,--boiled water being substituted; some hours later barley water may be given, but no milk for at least twenty-four hours. where children have loss of appetite, it is well to give less cream, and the intervals between food should be increased. _sterilized (pasteurized) milk._--during epidemics of dysentery, diarrhoea, typhoid fever, scarlet fever, and diphtheria, as well as in those instances where it is suspected that the cow is not healthy, or where the milk has to be kept for considerable periods of time, it is well to sterilize it by heating. the most effective method of accomplishing this is by boiling the milk for an hour or so, but inasmuch as it is believed to be then not quite so wholesome as when less heat is employed, a process known as _pasteurization_ is frequently used; this consists in heating the milk for thirty minutes to from ° to °f.,--such temperatures killing all of the ordinary germs, but not altering the milk so completely as when it is boiled. _peptonized milk._--it now and then happens that children fail to thrive where all of the precautions heretofore referred to have been strictly adhered to, and under such circumstances good results are frequently secured by subjecting the milk to a process known as _peptonization_. this consists in the addition of a digestive ferment, obtained from the pancreas of lower animals, together with ordinary cooking-soda. in carrying out the process the milk, whether whole or modified, is placed in a clean bottle, and the peptonizing powder added after having been rubbed up with a teaspoonful of milk. the container is then placed in a pitcher of water at a temperature of °f., which is about as warm as the hand can bear comfortably, and is here left for from ten to twenty minutes if only partial peptonization is desired, or for a couple of hours should it be wished to complete the process. the peptonized milk may be prepared at each feeding, or the whole amount for the day may be made at one time in the morning; in the latter case, where it is desired to have the milk only partially peptonized, the ferment should be destroyed by boiling after it has been allowed to act for from ten to twenty minutes. _feeding after the first year._--as the infant is weaned other food should be gradually added; this should still consist largely of milk, to which some time later may be added gruels prepared from well-cooked oats or barley, beef-juice, or the white of an egg slightly cooked. the various broths may also be allowed. children relish very much all fruit-juices, and they may be given in moderation without harm, and even with benefit in many cases. as the child grows older, the various cereals should form a greater and greater proportion of its diet, but due care should be exercised in always seeing to it that they are thoroughly cooked; in order to be digestible for children such substances should be cooked at least three or four hours before eaten. _general hygiene of infant life._--in order for children to be healthy, the greatest regularity is necessary in their habits. they should arise at a certain hour in the morning and go to bed at a fixed time at night. their clothing should be loose, and not too tight fitting, and should at all times correspond to the state of the weather. nothing is more common, and nothing produces irritability, loss of sleep, and even serious general disturbances in infants, more frequently than too much clothing. it is generally customary to use from the time of birth and during the period of infancy a flannel band around the child's abdomen. just how this acts is not clear, but there seems good reason for the belief that in some unexplained way the practice has the effect of warding off intestinal disturbances, and is, therefore, to be recommended. napkins should be changed when soiled, and then should be immediately placed in water, in which they should remain until washed out; under no circumstances should they be left lying around the nursery. when the weather permits, the child should be kept as much out-of-doors as is possible. for the first few days of the infant's life, particularly if the weather be cool, it should, of course, be kept indoors, but even then free access of air should be allowed. there is no objection whatever to the infant sleeping out-of-doors--in fact, where this is feasible, it generally shows improvement as soon as the practice is commenced. when out-of-doors, it is of course necessary to see that the sun does not shine directly into the infant's face, and wetting should, of course, be avoided; also the hood of the carriage should be arranged to prevent strong winds from blowing on the child. the nursery should be well aired, a window being left up at night except during severe weather. _sleep._--nothing is more important for the proper development of a child than for it to have an abundance of sleep. during the first few months of its life it sleeps practically all of the time--the period becoming gradually lessened as it grows older. infants should be suffered to sleep just as much as is possible, it being not only unjustifiable but absolutely criminal to interfere with them in this particular in the slightest degree. not only is it necessary that infants have all the sleep that they desire, but it is true throughout childhood, a fact to which many foolish parents seem utterly oblivious. how often do we see a child scarcely more than an infant aroused in the morning and sent off to school, and how frequently do we hear misguided parents boast of their inflexible rules in enforcing such evil practices. truly man comes hard by the knowledge that nature is much wiser than he, and the vast majority never learn the fact at all. as soon as the child is able to crawl, it should be placed on a clean quilt or blanket on the floor, and allowed to move about to its heart's content. when it is able to walk, allow it to run about and play to its full capacity--as in such exercises consists the great school of its physical being, the school upon which will depend its strength and health in after life. allow the child to keep up his play as long as he has any inclination to do so, and never be so foolish as to confine him in the house when he wishes to be out under the blue heavens, for here only will it be possible for him or her to develop into a real man or woman. allow this to go on until the child of its own accord comes and asks to be taught other things, for not until then is its outside education nearing completion, and not until then is it possible for him to take interest in and learn things connected with books. no boy should ever be sent to school before he is twelve or fourteen years of age; girls, on account of their maturing earlier, may begin a couple of years sooner. the whole science and art of properly raising children consists in feeding them good clean food in proper amounts, in never allowing them to be awakened, and in permitting them to play in the open air to their hearts' content. _teething._--teething is a subject which has at all times interested both doctor and layman, and in its supposed relation to all kinds of disorders of infancy has undoubtedly exercised an influence over the popular imagination out of all proportion to its real importance. too often it has happened that this perfectly normal, and usually by no means serious, process, has been held responsible for grave diseases in children--diseases which in reality were the consequence of neglect and mismanagement in the far more serious matters of food, sleep, out-of-door exercises, and general hygiene. it cannot, however, be denied--particularly in respect to nervous children--that teething appears occasionally to induce unpleasant disturbances, such as fretfulness, broken sleep, digestive disorders, and occasionally fever; as a rule such symptoms persist only for a few days, if the infant be properly looked after. the treatment should consist in lancing the gums should they become much swollen, and the withholding of the usual amount of food, particularly where intestinal disturbances occur. the ages at which the teeth usually come are as follows: middle lower teeth to months. upper front teeth to months. remaining lower front teeth to months. front jaw teeth to months. stomach teeth (canine) to months. eye teeth (canine) to months. back jaw teeth to months. _bowel diseases._--digestive disturbances, accompanied by diarrhoea, are the bane of infancy, and are responsible for a very large part of the frightful mortality among babies. the subject, therefore, is one of tremendous importance, but is so complicated that the limits of this little volume will only permit its being touched upon. as already mentioned, indigestion accompanied by looseness of the bowels may be and often is the result of milk being used from diseased cows, or it may be the consequence of such carelessness in handling it that disease-producing bacteria are later allowed to contaminate it. it should also never be forgotten that where children are eating artificially prepared food improper mixing of the different components may result in serious disturbances, and we should, therefore, exercise the utmost care always in seeing to it that the food is prepared strictly according to the table which has already been given--not forgetting that in a certain number of instances we can go by no rule, and will have to experiment until we ascertain the proper proportion of the ingredients. after a diarrhoea begins we should at once reduce the quantity of fat in the milk that is being given to the infant, and if the trouble be at all severe it is best to take it off of all food for twenty-four hours, and substitute boiled water or barley-water. as soon as the trouble is checked we may then begin to feed cautiously with largely diluted milk, and, gradually increasing its strength, in the course of a few days return to the food that was being given before the disturbance occurred. a dose of calomel or castor oil in the beginning of diarrhoeal troubles often has a very salutary effect; the parent should not hesitate to administer this if a doctor is not at hand. in warm climates during the time of teething children very commonly develop chronic diarrhoeal conditions which often end fatally; wherever possible the parent should under such circumstances at once remove the little sufferer to a colder climate where recovery is generally rapid and complete. even the most careful nursing under the most competent physician is often fruitless in combating disorders of this character as long as the infant remains in a warm climate. _colic._--colic is always due to indigestion, and is the result of the food undergoing fermentative changes, with the production of gases. this goes on even under normal conditions to a certain extent, but when it is excessive the intestines become greatly distended, and pain of a severe or even agonizing character is produced. in the treatment of this condition warm applications should be made to the abdomen, and as quickly as possible an enema (injection), consisting of a few ounces of warm solution of salt water should be given; the salt should be in the proportion of a level teaspoonful to the quart of water. parents will find the little ear syringe, which may be purchased at any drug store, a most satisfactory instrument for giving enemas to infants, as they do not hold too much, and being soft, are incapable of tearing the delicate tissues of the child. it is of the utmost importance to remember that the salt solution should be tepid, yet not sufficiently hot to scald the infant. as the water when given in this way is expelled very quickly the enemas may be repeated any number of times desired. where these measures fail, a physician should be sent for at once, but in the meantime if it be evident that the infant is suffering very much, a small dose of paregoric may be given; it should not however be forgotten that opiates are exceedingly hurtful to nervous children, and that soothing syrups and other mixtures containing drugs of this class should be avoided. _constipation._--constipation among very young children generally passes off as the food becomes richer, but should it occur at a later time, the trouble may be more difficult to remedy. of first importance is having the bowels of the infant move at a certain time each day, which may be quickly accomplished in many little children by placing them upon a small chamber daily at a given hour; usually the baby very quickly learns what this procedure means, and in this way a regular habit is established which is of the utmost value to the child throughout its infancy, and every effort, therefore, should be made to bring it about as quickly as possible. the addition of malted milk or mellin's food may also have the effect of diminishing constipation;--the result being brought about by the maltose contained in these preparations. the same thing may be accomplished by substituting for a part of the milk sugar in the baby's food a similar quantity of maltose. milk of magnesia may be used in preparing the baby's food in the place of lime-water, with the result oftentimes of relieving a tendency to constipation. _croup._--by croup is meant a spasmodic condition which usually affects children at night, and is in no way to be confounded with that really dangerous disease, membranous croup, or diphtheria, to which so many children fall victims. spasmodic croup is a condition which has as its basis digestive disturbances, and is almost always relieved as soon as the stomach is emptied. vomiting may be brought about by making the child swallow a small quantity of mustard stirred up in water, or by the use of ipecac. such severe and extremely unpleasant remedies are rarely necessary, however, since the disease may be in almost all instances at once relieved by placing around the victim's throat a cloth wrung out of cold water, which may itself be covered by a dry bandage to prevent the bed from getting wet. children will usually go to sleep in a few minutes after the cold cloth is applied, and suffer no ill consequences as a result of its remaining around their throats throughout the night. where the croup is very severe the little sufferer's feet may be placed in hot water, in addition to the cold cloth around the neck--the combination practically always resulting in the rapid relief of the unpleasant symptoms. great care should be exercised in the diet of children who are subject to croup, as by intelligent supervision the tendency to this very annoying trouble may be in a short time entirely overcome. _nervousness._--children of neurotic parents, particularly where they are reared in cities, are exceedingly prone to nervousness in one form or another. the condition is undoubtedly often due to heredity, but may be induced in otherwise healthy children by unhygienic surroundings and improper food. infants exhibiting symptoms that indicate trouble of this kind should not be played with, and every care should be exercised to so direct their lives that the trouble may be gradually overcome. in all cases where nervousness persists an intelligent physician should be consulted. _vaccination._--the only safe method that we possess of preventing small-pox is by means of vaccination. its great value has been so thoroughly tested that the writer does not deem it necessary to go into a discussion as to its merits. a child should be vaccinated in at least three places during its early infancy,--there being no danger in doing the operation immediately after birth. persons ignorant of aseptic surgery should not do this operation, but should always call in the services of some person prepared to do the work in a cleanly manner. either the leg or the arm may be selected; and children should be revaccinated whenever small-pox breaks out in the community. _kissing babies to be avoided._--kissing infants in the mouth is a very bad practice, as in this way disease may be quite innocently conveyed to them. the public should be taught to understand that it is not infrequently the case that bacteria may be present in the mouths of individuals who are quite immune to their ill effects, and who are, therefore, perfectly well, but who may, by conveying them to others, particularly children, induce in them serious disease. when caressed in this way at all children should be kissed upon their necks or feet, and never in their mouths or on their hands. _juvenile contagious diseases._--children are peculiarly prone to a class of highly contagious diseases, the exact nature of which is not yet understood, and we possess therefore little knowledge as to the proper means of preventing their spread. practically all that is known about them is that they are conveyed by contact, or even by the air, particularly where a child suffering from one of them is placed in a confined place with another who is susceptible; these diseases likewise may be carried by means of clothing and other articles that have been in close contact with a child suffering with any of them. the lesson of importance to be learned, therefore, is that if we wish our children to escape maladies of this class we should not permit their indiscriminate association with others. as these diseases cease to be a serious menace after children have passed through their earlier years it does not at a later time matter so much as to whether they are exposed to them or not. as a general thing children develop these affections in from ten to fifteen days after having been exposed, though one of the most severe of them, scarlet fever, may make its appearance as early as twenty-four hours after it is contracted. these diseases are usually ushered in by a severe headache, pains in the head, back, and limbs, high fever, and oftentimes a chill. as soon as a child develops such symptoms the advice of a competent medical man should be at once sought, and the little sufferer should be at once completely isolated. in concluding, the writer would particularly exhort parents to obey to the letter the instructions of their physicians, and never under any circumstances to dose their helpless off-spring with patent or proprietary medicines, which contain no man knows what, and which unquestionably are often highly injurious, especially to children. chapter v proper eating--the secret of good health very slowly the world is awakening to the fact that no agencies play such an important part in the preservation of health as the consumption of reasonable quantities of well-cooked and properly selected food, and the habitual taking of wholesome drinks. on all sides the observant medical man sees constant and reckless disregard of the simplest and most fundamental laws governing this subject. nothing is more common than to hear of men in the prime of life being seized with what is called a "nervous breakdown,"--which generally means a digestive breakdown--to be followed by an era of misery for the unfortunate subject and his scarcely happier family. nervous and irritable, the slightest inconveniences are magnified into terrible calamities, he constantly fears death, and his sleepless nights become a saturnalia of gloomy thoughts and abject fears. of course, not everyone guilty of dietetic sins goes through such sad experiences, for the naturally strong frequently escape the consequences of their rashness, particularly where they live in the rural districts and take plenty of out-door exercise. let not such, however, flatter themselves that their disregard of hygienic laws will go unpunished. after indiscretions in eating they will all, at one time or another, have acute indigestion with diarrhoea; and how often does the previously well and hearty man after indiscretion in eating wake up with a dull headache, furred tongue, foul breath, and a general feeling of sluggishness and mental depression? is it his liver? our unscientific medical ancestors--at a loss to account for the state of affairs in any other way--answered in the affirmative, and, believing it was produced by a collection of bile in the liver, called the condition "biliousness." how absurd modern science has shown this assumption to be! we now know that the liver is rarely diseased, and that it furnishes its secretion, called bile, for the purpose of aiding digestion rather than hindering it, and that this substance is rarely, if ever, produced in excess. it is undigested, putrefying food in the intestinal tract that produces the trouble. under such circumstances one usually takes a dose of calomel, which, being perhaps the most satisfactory and perfect purgative that we possess, relieves the condition promptly by getting rid of the offending material; but the drug does not act on the liver. unfortunately ill results of quite a different and a much more serious character often follow in the wake of dietetic errors; in those who have a tendency to consumption, particularly where they overwork, this dread disease frequently makes its appearance as a consequence of bad eating and drinking. many, if not all, of the degenerative diseases that appear in the latter half of life are produced in this way, and nothing is more certain than that the peace, happiness and longevity of mankind could be incalculably increased by the simple observance of what is known concerning proper eating and drinking. we will now consider the very important subject of the quantity and character of foods which should be taken in health, with suggestions as to those most suitable for dyspeptics. _over-eating too prevalent._--the majority of us take much more food than is necessary, with the result that we suffer from indigestion. when we consume more than a reasonable amount of food habitually serious digestive disturbances are sure to result,--to be often followed at a later time by tuberculosis, morbid alterations in the blood-vessels, bright's disease, and other serious maladies of a chronic nature. professor chittenden, who is america's greatest physiological chemist, has demonstrated that in all probability previous workers along these lines have been excessive in their estimates as to the amount of food required. he showed that a man could live for a period of nine months on a daily ration which contained about one-third of the usual amount of proteids generally thought to be necessary, and at the same time the fats and carbohydrates were reduced to such a degree that the total number of heat units, or calories, liberated from the food scarcely exceeded in number one-half of the standard requirements. he also experimented on thirteen volunteers from the hospital corps of the united states army, to whom he daily fed rations of only , calories, and, notwithstanding that they engaged in physical work, all were found to be in better condition at the end of six months than they were at the beginning. these results strongly point to the conclusion that previous estimates as to the quantity of food required are erroneous, and that man can not only live, but may continue in strength and health on much smaller amounts. it is highly probable that this discrepancy may be accounted for, at least to a considerable extent, by the assumption that much of the food ordinarily taken is rejected by the system, and passes out as waste, while, when small quantities are eaten, it is for the most part absorbed. _mastication._--thorough chewing of the food is absolutely essential for proper digestion. while it is true that this, like all other good things in life, may be, and often is, carried to an unnecessary extreme, it is certainly true that we would be infinitely better off if we were to go to the extent in this direction of so called "fletcherism" rather than perform this most important function in an indifferent manner. this rule applies with especial force to food of a starchy nature,--bread, potatoes, oatmeal, rice, etc. in order to digest food of this character it must be very thoroughly cooked and when finally placed upon the table it should be of such consistence that it requires chewing before it can be swallowed. not only is this necessary from the standpoint of breaking up the larger particles into smaller ones, thus permitting the food to pass freely through the stomach and intestine, but it is of the greatest importance for it to be thoroughly soaked with the saliva during the process. it is thus of no advantage for starches to be served in a finely divided form--in fact it is directly the contrary, since under such circumstances it is almost always the case that such foods are swallowed without having been insalivated. what has been said concerning the mastication of starches applies with almost equal force to other foods. without exception their digestibility is much increased by thorough chewing. as the result of recent experiments carried out by means of the x-ray, it has been shown that particles of food of any considerable size will not pass from the stomach into the intestine; as often as an object of this kind attempts to force its way from the former into the latter the opening between the two closes, and as a consequence the food is retained in the stomach longer than it is in health--resulting in the course of time in catarrhal conditions of the organ just named, and an unnatural relaxation of its muscular walls. under such circumstances the patient quickly develops symptoms of indigestion, and if his habits be not corrected the trouble gradually grows worse until the sufferer becomes a chronic dyspeptic. _classes of nutritive substances._--all substances that are of any appreciable value in nutrition may be divided into those that are nitrogenous in character (albumins, legumins), the carbohydrates (starches and sugars) and compound ethers (fats). of all these the nitrogenous foods are the most important, since they contain the material from which the great bulk of the body is largely composed, and at the same time there is every evidence that in case of need they may be broken up into chemical substances that may take the place of any of the other kinds of foods; upon nitrogenous food, then, a man may live alone, while this cannot be done on other articles of diet. the fats, starches and sugars are very closely related to each other, and it is generally believed that they subserve much the same end in the economy; by undergoing chemical change they furnish energy (heat and muscular force) and are undoubtedly largely responsible for the formation of the fats of the body. while there is some evidence that under certain conditions alcohol may be a food, its value is certainly very small, and it is not of sufficient importance to be considered in this connection. the ideal diet then for a healthy man is a proper proportion of nitrogenous (albuminous) food, along with a reasonable portion of fats, starches and sugars. professors voight and atwater have calculated the following table, which fairly represents the amount of proteids, fats and carbohydrates that should compose the rations for twenty-four hours for the ordinary adult male. adult male of average weight. at rest. moderate labor. severe labor. proteids grammes grammes grammes. fats " " " carbohydrates " " " the tables that follow, which were arranged by hutchinson, give a very good idea of the generally accepted views as to the relative quantities of the different foods that are thought necessary for the average adult engaged in ordinary muscular work:-- fuel food materials. amount. albumins. fats. starches. value. . ozs. lbs. lbs. lbs. calories. beef, round st'k . . .... butter .... . .... potatoes . .... . bread . . . -- ---- ---- ---- ---- totals . . . . pork, salt .... . .... butter .... . .... beans . . . bread . . . -- ---- ---- ---- ---- totals . . . . beef, neck . . .... butter .... . .... milk, one pint . . . potatoes . .... . oatmeal . . . bread . . . sugar .... .... . -- ---- ---- ---- ---- totals . . . . beef, up. sh'lder . . .... ham . . .... eggs, two . . .... butter .... . .... milk, one pint . . . potatoes . .... . flour . . . sugar .... .... . -- ---- ---- ---- ---- totals . . . . sausage . . .... codfish . .... .... butter .... . .... milk, one pint . . . beans . .... . rice . .... . potatoes . .... . bread . . . sugar .... .... . -- ---- ---- ---- ---- totals . . . . beef . . .... mackerel, salt . . .... eggs, two . . .... butter - / .... . .... cheese . . .... milk, one pint . . . potatoes . .... . rice . .... . bread . . . sugar - / .... .... . -- ---- ---- ---- ---- totals . . . _calories defined._--it should be explained that the term "calorie" is one which has been adopted as a scientific expression for the fuel-value of substances undergoing oxidation, and in this connection refers to the heat-producing capacity of foods. the "calorie" is the amount of heat required to raise the temperature of one gramme of water °c. it has been estimated that starches, sugars and albumins liberate during combustion . calories per gramme, while fats produce . calories. it will be noted that in the tables just given the total number of calories is in each instance somewhere in the neighborhood of , , which is considered to be about the number of heat units required by the average man at moderate muscular work. the weight of the average woman being less than that of the adult male, a reduction of about per cent. from the foregoing figures would approximate the amount of food required by the former. chapter vi bread and its relations at all times, and among all peoples, bread has been recognized as one of the great staple articles of diet. although its commonly quoted designation, "the staff of life," would more appropriately belong to the albumins, there can be no question that breads of one kind or another are among the most wholesome and necessary of all food-substances. not alone is this true on account of the starch of which they are largely composed, but they contain more or less vegetable albumin; it is thus seen that bread is a mixture of the two most important food-stuffs, starch and albumin, but the quantity of the latter is so small that an individual would have to eat an enormous amount of the mixture to secure enough of this ingredient to meet the needs of the body. for practical purposes, then, we may regard bread as being starch. within recent years quacks have disseminated very widely throughout this country the error that foods are more digestible when raw. it was long ago demonstrated that pure albumins, of which eggs and milk are the nearest natural examples among foods, are assimilated somewhat better when eaten raw, but this applies to no other foods except sugars. any success that has followed the teachings just referred to undoubtedly rests purely on the fact that their followers are instructed to live largely on raw eggs and milk, and as the patient usually discovers in a short time that these two foods agree with him while other uncooked ones do not, he naturally eats them to the exclusion of the rest and where he takes a sufficient quantity increases in weight and strength. the idea that starches are more digestible when eaten raw could be easily refuted by any intelligent farm-boy who recalls one or more sad experiences from over-indulgence in raw sweet potatoes. what shall we look upon as bread? of course all such food-stuffs as are commonly included within this designation are to be accepted; such as wheat-bread, graham-bread, whole-wheat bread, biscuits, rolls, light bread, bakers' bread, waffles and batter-cakes, rye bread, corn bread, preparations of corn-starch, with which we should place those articles of diet so commonly used in the south, usually called grits, hominy, egg-bread, muffins, corn-meal cakes, potatoes, both sweet and irish, arrowroot and the so-called cereals or breakfast-foods, including oatmeal. now which of these is the most wholesome? this inquiry cannot be answered conclusively for the reason that the digestibility of this, as of other foods, depends largely on the individual. for the sake of clearness the various breads will now be considered in detail. _wheat-bread the best._--it may be confidently asserted that well-cooked and perfectly dry wheat-breads are to be regarded as being generally the most digestible of all bread-stuffs. this is not dependent on any inherent property in wheaten starch as a result of which it is acted upon more readily by the juices whose office it is to render it fit for absorption in the body, but is wholly due to the fact that breads of wheat-flour may be made very dry and light. as has been already explained, it is particularly necessary that starches should be thoroughly soaked in saliva, and this can only be accomplished when the bread is of such consistence that it must be chewed for a time, and so dry that it will readily absorb the salivary secretion. the writer, then, would advocate well cooked light-bread or bakers' bread, or toast made from either, as being the best of all food-stuffs of this character. the crusts of biscuit a day or so old are quite digestible, as are also waffles, if made with little grease and cooked thoroughly. the soft inner portion of biscuit and that of hot rolls, as well as batter-cakes, is decidedly unwholesome. graham-bread should not be constantly indulged in for the reason that it contains multitudes of sharp particles of the husk of the grain that cut the delicate mucous membrane of the stomach and intestines as it passes along, and if its use be long and continued, severe ill effects necessarily follow. in this connection attention should also be called to the common error that particles of husk are of advantage to breads of all sorts; the former consist chemically of exactly the same thing as sand, and are quite as indigestible, and this, in connection with what has just been said of their action on the delicate mucous membranes of the intestinal tract, should be quite enough to convince anyone that they are not only useless, but injurious. it is true that the irritation produced by the husk will oftentimes cause the bowels to act, but results of the same character may be induced by many other agencies, within themselves less harmful. _rye-bread._--there is no reason why rye-bread should not be prepared in quite as wholesome a way as is wheaten-bread, and this grain should undoubtedly rank as one of the best of the cereals. its use, however, is so limited in this country that it is scarcely necessary to go into a lengthy discussion as to its merits. it may be remarked that the ergot fungus frequently grows on this grain, and when ground up with it occasionally poisons the consumer where the quantity of the substance is large and the bread is eaten in considerable quantities. instances of this kind are not uncommon among the peasantry of europe, where a black bread made from rye is the staple article of diet. of course, when making food-preparations of rye, we should be careful to have the flour thoroughly winnowed, and to cook the bread until sufficiently dry to acquire a proper consistency for chewing. _corn-bread and corn food-products._--when made from perfectly sound grain, and if not allowed to undergo fermentative changes afterward, there can be no question that food-products of corn are entirely wholesome, and, from the standpoint of chemical composition, quite as nourishing as similar articles of diet prepared from other grains. it is, however, unfortunately true that we cannot, in the majority of instances, definitely assure ourselves that our corn-bread is made from grain that comes up to the above specification, nor can we be sure that the meal is fresh, or preserved at such a temperature as would forbid the growth of various germs. it has long been known that bad corn would kill horses, but notwithstanding this, we have accepted the view that no amount of deterioration in the grain could result harmfully to man. that this latter assumption is incorrect seems now in the highest degree probable. _pellagra._--it is known that a very curious and fatal disease called pellagra is prevalent to a considerable degree at the present time in the united states, and it is not going too far to say that all of those best capable of judging are of the opinion that the malady is the result of eating just such corn as we know kills horses. it is likewise true that the nutritive power of this grain could in no way be increased by allowing it to decay before consumption; indeed, the contrary must be the case, and, if it were in no manner actually harmful, our sense of the æsthetic and of what is proper to eat, should make us reject in this case, as with other foods, that which is unsightly to the eye and unpleasant to the taste. we should no more eat bad grain than a rotten apple, or putrefying meat. the increased prevalence of pellagra is exciting attention all over the united states, and is very generally assumed to be the result of lack of care in the harvesting and preservation of our corn. instead of being cut before it is ripe, and shocked in the field during the latter part of the summer, it should be allowed to ripen on the stalk, and after cold weather sets in gathered while dry, and preserved in well-covered and well-ventilated barns. every care should be taken to keep it dry while being shipped from one part of the country to another, and similar precaution should be observed with the various food-products made from it. if kept in a cold place, meal or grits made of good corn may be preserved in excellent condition for eating throughout the winter; but as soon as the warm weather begins they should be stored in the refrigerator, and should there remain during the summer; similar precaution should be taken with meal or other corn-products during the hot months. over a large area of the united states corn-bread is an article of daily diet with a great majority of the inhabitants, and its wholesomeness as compared with other breads becomes, therefore, an important question. unfortunately, corn-meal does not lend itself to the preparation of a dry bread having sufficient consistency to require chewing. it is true that the crusts of the bread made from this grain answer these requirements fairly well, and there is therefore no reason why this part of it should not be used to any extent, provided it be prepared from good meal. we should endeavor to cook thin pones of the bread rather than the thicker ones so common in the south. the objection that corn-bread can only be masticated with difficulty applies to the other preparations of this cereal, such as egg-bread, muffins, etc., and they are not, therefore, with the exception of the crusts, to be looked upon as being the best form of bread. corn-cakes, like all batter-bread, are to be mentioned only to be condemned. grits and hominy are soft and moist and cannot be properly chewed, and are, therefore, not to be recommended as good breads. corn-starch preparations are likewise entirely lacking in the elements required to make good bread, and should only be used occasionally and in small amounts. _disadvantages of potatoes._--irish potatoes are eaten almost as commonly in some portions of the united states as are corn-products in others, and therefore deserve the careful consideration of the hygienist. while it is not believed that, like the latter, potatoes give rise to any definite disease, it is unfortunately true that they are theoretically worse breads than those made from the grain just referred to. in whatever way cooked, they are moist and require no chewing, and as a consequence many persons with delicate digestions do not assimilate them properly. _arrowroot._--the preparations of arrowroot are considered digestible, though here again we find that such articles of diet are generally moist and of not proper consistence to be chewed, and they are, therefore, not as valuable as are breads made from wheaten flour. _rice._--rice is used by a large portion of the world's inhabitants. when cooked thoroughly and very dry, it is perhaps almost as good bread as is that made from wheat. the starch granules of the former, like those of arrowroot, are somewhat smaller than those of wheat. if it were possible to keep rice-flour in good condition, and if it could be made into light-bread, it is likely that it would be superior to wheaten flour, but this does not appear feasible. a peculiar and very fatal disease prevails in the east, known as "kak-ke" or "beri-beri," which is now generally regarded as being the result of eating decomposed rice. the writer has seen one or two examples of what he considers american beri-beri, but as our rice-eating population is small, it is not likely that this disease will ever become a serious problem in the united states. _cereals or breakfast-foods._--lastly we will consider the so-called breakfast-foods, which are neither more nor less than various preparations of the different varieties of starch. they are generally made from oats or corn-starch. they are nothing more than bread, and as some of them have been put through a sort of fermentation it is difficult to understand how they could be regarded as being quite as wholesome as the original products from which they were made. this, however, is not the principal objection to them. the real trouble lies in the fact that they are, in the majority of instances, served with cream and sugar. when we remember what has already been said about starches that are soft and cannot be chewed, and of the ill effects of sweets on persons who have any inclination towards dyspepsia, it will be seen that these foods are not to be regarded as being wholesome. the real reason that would appear to explain the coming into existence of these preparations is that they are mixed with cream and sugar, which appeals strongly to the "sweet-tooth" of the average person. they are nothing but bread, and very bad bread at that. the remarks made concerning breakfast-foods apply with equal force to oatmeal, which, as generally used, has the additional disadvantage of containing particles of husk. in concluding this discussion on starchy foods the writer desires particularly to call attention to a very common error in the way they are eaten. mention has already been made of the fact that fats after being melted are by no means so wholesome as in their natural state, and produce, when heated with starches, a very indigestible mixture. thus, theoretically, it is bad to use any great amount of lard, butter or other fat in the preparation of breads, and it is likewise undesirable to spread butter on heated breads, as is so often done just before eating biscuits, waffles and batter-cakes. the combination is certainly a seductive one, and pleasing to the taste of most persons, but this in no way invalidates the fact that the mixture is exceedingly indigestible. _pastries and cakes._--peculiarly unwholesome are pastries containing any considerable proportion of fat, and also most varieties of cake. with the exception possibly of hot batter-cakes served with an abundance of butter and syrup, cooks have so far produced no compound so heinous and totally depraved as pound-cake. fruit-cake also stands high up in the list of undesirable sweets. it certainly passes all understanding why cooks should continue to persecute the stomachs of a dependent world with such highly obnoxious concoctions; the only excuse that can be given for them is that the mixtures are palatable. where a housekeeper feels it necessary to prepare cake, she should select some receipt free from butter or other fat, such as angel-cake or sponge-cake, both of which when properly made are exceedingly good to the taste, and lack the undesirable quality of containing fats. explanation for the peculiarly unwholesome character of food containing melted grease lies probably in the fact that the grains of starch under such circumstances must be to a greater or less extent covered by a thin layer of the fatty substances, and as a consequence it is impossible for the saliva to penetrate to the starch and perform its normal digestive function. chapter vii meats, sugars and milk first in the list of foods the writer would place those nitrogenous substances commonly eaten that belong to the class of albumins. that these substances are in reality the most important of all food-stuffs there can be no sort of question, since they, of all things eaten by the human being, are alone absolutely essential for his well being and even his existence. they are the substances that almost exclusively go to make up the muscle and tendons. along with the lime-salts they enter largely into the composition of the bones and cartilages, brain, spinal cord and nerves. other foods are incapable of taking the place of the albumins, so that they are absolutely essential for normal life in the human being. the amount of albumin necessary for the normal adult has been variously estimated, the tendency at the present time being to place the quantity needed somewhat lower than was at one time done. it is probable that about two ounces of pure albumins is somewhere near the amount required in twenty-four hours by a normal adult. it is well, since we are so dependent on foods of this class, that we have two quite distinct sources from which they may be taken. the great bulk comes to us in the form of meats, including poultry, game, oysters and fish of various kinds, in addition to beef, mutton, and hog-meat in its several forms. of animal origin also we have eggs, which are among the most valuable of all foods of this class on account of their high digestibility. from the vegetable world we get albumins known as legumins, which differ somewhat from those obtained from animal sources, though taking their place in the economy in all essential particulars. unfortunately the legumins are usually so mixed with starches and other vegetable substances less digestible, that it is necessary to take a large bulk of foods of this latter class in order to secure anything like the requisite amount of the former. before taking up individually the various albuminous foods, the writer would again direct attention to the chapter on cooking, and would strongly urge upon the reader the proper methods of preparing nitrogenous foods therein stated. where the albumins are in a nearly pure state, as in milk and eggs, they are slightly more digestible when raw, but all meats should be cooked until only the faintest tinge of red remains if we wish to have them prepared in the most wholesome way for those with delicate digestions. meats are, as a rule, most wholesome when cooked "very done." it has long been the cry of sentimentalists that no living being should die in order that man might exist. unfortunately for such theories, the stern and unbending edict of nature has negatived views of this kind ages before the altruistic philosopher came on the scene, and we are daily constrained to bow to this mandate of one of the primal laws of existence. however much we might desire it otherwise, it has been written that "only in death is there life;" nor may any animal being disobey and continue to exist. as has been already explained, the human being cannot thrive on vegetable substances alone; from them he may get a certain amount of nitrogen in the form of legumin, but there is not enough to make up for the waste of this substance that constantly goes on in the body. theoretically it is of very little importance which of the meats are selected to supply our nitrogenous food, but it is unfortunately true that such foods vary much in digestibility, and it will therefore be necessary to consider them separately. _beef._--when tender and cooked to a proper degree, beef is considered one of our most wholesome of meats. like other foods of this kind, it should not be fried, but should be broiled or roasted, and a certain amount of fat may be eaten along with the lean portions without injury, and in many persons unquestionably with benefit. _mutton._--of all the coarser meats, mutton is unquestionably the most digestible, and when cooked in the same way as directed for beef is eminently wholesome. _hog-meats._--on account of the large portion of fat between the muscle-fibers, hog-meat, particularly when fresh, is not usually regarded as being digestible. some persons eat it with impunity, but for the vast majority it should be taken only in small quantities. it should not be fried. in the form of ham, hog meat is more wholesome than when fresh, but even in this condition many dyspeptics find much difficulty in digesting it. the best method of cooking it is to boil thoroughly. after being cooked in this way and then broiled, it is most appetizing, and is much more wholesome than when broiled without being previously cooked. as bacon, hog-meat enters largely into the dietary of a great portion of the laborers of this country, and there can be no doubt that on the whole it answers the purpose of a staple food admirably. it contains even more fat than nitrogenous substances, and may therefore be looked upon as a mixture of butter and meat. dyspeptics cannot eat it with impunity in many instances, though it agrees far better with them than does ham or the fresh meat. if it were generally eaten boiled it would provoke less trouble than when fried. at this point the writer would repeat his warning concerning the indigestible character of melted grease, of which the gravy from bacon is a striking example. when "cured" in a somewhat different way hog-meat as "breakfast-bacon" is very generally used throughout the civilized world, and is one of its most wholesome forms. this when broiled is both appetizing and wholesome, and should form a part of the daily dietary of everyone able to afford it. _poultry and game._--among the more delicate and most wholesome forms in which albumins are taken we find poultry and game well up toward the head of the list. meats of this character should be very thoroughly cooked by being either baked, smothered or broiled. _fish._--fish of almost all kinds are wholesome provided they be fresh and properly cooked. the culinary artist prepares of them most appetizing and nutritious dishes, and they are therefore properly to be recommended as among the best of the albuminous foods. _oysters and clams._--oysters and clams are usually considered somewhat apart from the generality of the foods of this character. when fresh they are wholesome and delicious when eaten raw, and may be cooked in a great variety of ways. the reader should be especially warned that fried oysters are not so wholesome as when they are prepared by other methods, for the reason that they are surrounded by a batter containing quantities of melted grease. _eggs._--among the most delicate, digestible, and nutritious of all foods we may place eggs. though somewhat more digestible when raw, they agree, as a rule, even with the most fastidious stomach, however cooked, even when hard-boiled. eggs lend themselves readily to the formation of many delicious dishes, such as omelets, soufflés, etc.; but unfortunately they do not contain nutriment in a very concentrated form, and where an adult is living on them alone it requires from one and a half to two dozen daily to furnish the necessary amount of food. _fats._--under the term "fats" are included all oily substances, such as butter, lard, olive and cotton-seed oils, and to a great extent the fat contained in meats. these substances are closely related to starches and sugars, and undoubtedly play a more or less similar rôle when taken into the body as food. from the standpoint of heat-producing capacity they more than double, weight for weight, meats and starches, and are, therefore, instinctively highly prized by dwellers in cold countries where much heat is necessary. in warmer countries the necessity for excessive heat-production in the body does not exist. while oily substances are certainly capable of adding to the cushion of fat commonly found beneath the skin in normal individuals, they are not looked upon as being to any extent tissue-builders, resembling in this particular the starches and sugars. when fats are to be eaten, care should be taken that they be as fresh as possible, or, if this is not feasible, they should be preserved in such a way as to prevent their becoming rancid--a condition which is the result of the formation of fatty acids, lending a peculiarly unpleasant odor and taste, and producing a decided decrease in food-value. this alteration may be largely prevented by keeping fats in a refrigerator at a low temperature, and may also be greatly retarded by the addition of salt. in this country butter is usually treated with a very considerable amount of salt, but in europe it is universally served fresh. within recent years facts have been established that show that americans use an excessive amount of this substance--possibly causing disease in some cases; and doubtless we would be better off if we were to follow the european practice. oily substances when in good condition are certainly of high value as foods, but should be taken more or less with an eye to the climate, and to the season of the year. when placed on cold bread and eaten along with it they are extremely palatable, and may be taken in reasonable amounts with decided benefit to the whole body. in temperate climates it is generally estimated that about three ounces is a desirable amount for the average adult. in this connection it may not be out of place to mention that the various preparations of cod-liver oil, advertised so freely in the lay press, in some instances actually do not contain a single particle of the substance that they are supposed to be principally composed of; and it may be further stated that there is no good reason to believe that bulk for bulk oils of this kind are in any way superior to those fats commonly eaten. the writer often recalls the saying of a very wise old physician of his acquaintance that "cod-liver oil is nearly as good as butter." _sugars._--this term includes the large number of different substances of a more or less sweetish taste that belong to the group of carbohydrates. they are closely related to the starches, and it is generally assumed that they play much the same part after being taken into the body. some of these are of animal and some of vegetable origin--but except the sugar found in milk, the only ones commonly consumed are those derived from cane, beets, and fruits; the sugar from the first two is known as cane sugar or dextrose, and that from the latter as grape sugar or glucose. like albumins they may be eaten without having been previously cooked, and are unique in that they undergo no chemical change whatever as a result of ordinary degrees of heat. while the consumption of sugars in all civilized nations is rapidly increasing, there can be no question that, irrespective of fruits, they are, of all foods, the most frequent causes of digestive disturbances. it is only within comparatively recent times that mankind has possessed means of separating sugars in any great bulk from the plants containing them, and as a consequence they have only entered prominently into our every-day diet for a relatively short period of time. before this, it is true, they were consumed to a greater or less extent in various fruits, but the quantity was insignificant as compared with the amount now universally eaten. as a result of this we are now confronted with a new dietetic problem. for ages the human stomach has been accustomed to deal with only small quantities of these substances, and developed accordingly a capacity to digest them proportionate to the amounts then eaten. now, however, we constantly call upon our digestive organs to deal with large quantities of such foods, and it is not strange that there has been more or less rebellion on their part. experiments have shown that a small amount of sugar assists in the normal chemical changes that go on in the body, and it is, therefore, obvious that nature intends us to take a certain quantity of it. moreover it is true that sugars while being burned in the body give off much energy--mainly manifested in muscular power; where then we are taking active physical exercise foods of this kind are peculiarly appropriate. it would, therefore, not be wise for us to leave this food entirely out of the dietetic list, but to use it only in small amounts--particularly where we lead sedentary lives. sugar and alcohol play a more or less similar rôle in the animal economy. it is well known that those who do not use alcohol are peculiarly prone to consume considerable quantities of sugar; and it is equally a matter of common observation that those who habitually take alcohol rarely eat sweets to any extent. when sugar is properly assimilated, as seems to be done most easily by children, it is an excellent food, but where sweets are over-eaten, and not properly digested, they give rise to a great accumulation of gas in the intestine, and produce in many persons a marked acidity of the stomach, frequently accompanied by severe insomnia. nothing so quickly relieves such sleeplessness, caused by a "sour stomach," as allowing ten or fifteen grains of ordinary cooking-soda to slowly dissolve in the mouth and swallowing the saliva rendered alkaline in this way. _milk._--milk may be looked upon as an ideal food, it being composed of water carrying in solution the three great natural foods--albumins in the form of casein, carbohydrates as milk-sugar or lactose, and fat. mixed in the proportion in which they here occur, they are most admirably adapted to the delicate digestive apparatus of the infant--the relative proportion of the different substances even gradually changing as the assimilative powers of the youthful organism increase; it is thus seen that milk itself is not of constant composition, even in the same animal, and that it alters in such a manner as to meet best the needs of the delicate being depending upon it for proper sustenance. it is also the case that the composition of milk varies in different animals--showing again how admirably nature exerts its powers in meeting desired ends. the lesson of practicable importance that we learn from this is that the milk of one of the lower animals is not in its natural state quite suited to the delicate stomach of the growing infant, and that if it be substituted for the mother's milk it must be more or less altered, depending upon the age of the child. it is particularly important that sweet milk be taken slowly, as otherwise large curds, difficult of digestion, form as soon as it gets into the stomach. chapter viii food-value of vegetables in recent times we hear much of vegetarianism, which has its advocates among many highly intelligent people, and which, as a consequence, has achieved a certain vogue throughout the civilized world. it is rarely the case, however, that those who affect to practice this cult in reality live exclusively on a vegetable diet. as a rule it will be found that they are milk-drinkers, and not infrequently add eggs to their dietary. it is, of course, absurd to regard as vegetarians those who simply avoid meat, since it is true that the nitrogenous substances contained in milk and eggs differ in no essential particular from similar substances found in flesh of all kinds. experiments on a somewhat extended scale have shown within recent years that young and vigorous individuals at least may live and thrive on a diet composed largely of vegetables; no one has yet shown that a strict vegetable diet is that best adapted to the average individual, and no competent authority on this subject at the present time advocates a diet purely of this kind. it is true that the vegetables ordinarily eaten contain all of the elements that are essential to the animal system, such as starch, sugar, fat and albumins. unfortunately, however, the amount of the last-named substance is usually so small in food-plants that the quantity that would have to be eaten by a normal individual taking active exercise would cost considerably more than if a reasonable proportion of animal food were included, and--which is of even greater importance--the digestive powers of the individual who attempted to live only on food of this character would be severely taxed, and, in the long run, probably seriously impaired. furthermore, vegetables and fruits contain substances, usually in great quantity, that are scarcely acted upon at all by the digestive juices. chief among the latter is cellulose, which, while forming the great bulk of the food of herbivorous animals, is scarcely suited to the weaker digestive capacity of the human being; practically none of it is converted to the uses of the body. it is thus seen that in the average man or woman a dietary consisting largely of vegetables would result in the presence in the intestines of a greater or less bulk of indigestible materials, which could subserve no good purpose other than that they would by their mechanical presence have a tendency to cause the bowels to act; as is the case with fruits, however, it is unfortunately true that this large residue of undigested food, in one way or another, often gives rise to considerable irritation of the mucous membrane of the intestine, and frequently produces dyspeptic disturbances, among which looseness of the bowels is common. this brings us to a consideration of the digestibility of vegetables in general, which is always the paramount consideration when dealing with the value of any substance to be used as a food. it has been before remarked that young and vigorous persons seem to thrive on a dietary largely of vegetable character, but the case is certainly quite different with older people, particularly where their digestive powers are impaired. in the latter we often find that severe intestinal disturbances follow even after moderate indulgence in vegetable foods--particularly where they are served with vinegar, or some other fruit acid. another peculiarity of foods of this kind that makes decidedly against their digestibility lies in the fact that, being soft and containing a large proportion of water, they are scarcely ever properly chewed, and as a consequence they are swallowed in comparatively large masses without having been adequately insalivated. vegetables may be roughly classified as legumes, roots and tubers, and green vegetables, and will now be considered briefly in the order named. _legumes,--beans, peas, lentils, and peanuts._--with the exception of the cereals, the legumes are the most valuable of all vegetable foods. their nutritious properties are mainly due to their relatively high percentage of nitrogenous material, though they also contain starch and fat. hence these vegetables contain the ingredients necessary to supply all the needs of the human economy; unfortunately, however, when eaten alone in sufficient bulk to furnish the nourishment required, they often--even in healthy individuals--give rise after a little time to dyspeptic disturbances. of beans, a large number of different varieties are in common use including string-beans (or snap-beans), lima-beans, kidney-beans, red beans, the frijole, and the soya bean. string-beans are exceedingly palatable, and are very much prized as an article of diet by the peoples of all countries. when gathered young and thoroughly cooked while still fresh they are exceedingly wholesome, and are very well assimilated, when properly chewed, by even those whose digestions are considerably impaired. the other beans named are generally eaten dry after having been removed from the pod in which they grow. when they are soaked in water until they become soft and then thoroughly cooked they make an excellent food, and, when not taken in too great quantities, are fairly digestible. when cooked with onions, parsley, and red pepper in proper proportions they make a very delicious dish. in japan the soya bean forms the basis for a kind of vegetable cheese which is eaten with rice, and furnishes the nitrogenous materials in which the latter is deficient. peas are wholesome when young and fresh and when properly cooked, and as they come on in the early spring when other fresh vegetables cannot be obtained, they furnish a most acceptable addition to the dietary. when old, after their skins become tough, they cease to be digestible, and should not be eaten except in the form of purees, during the preparation of which the hull is removed. lentils are scarcely eaten at all in america, but are much prized in some portions of the old world, as the basis of soups. peanuts belong to the group of legumes, though, unlike the others that serve as food, they grow beneath the surface of the ground. they are highly nutritious, but are, unfortunately, indigestible, owing largely to the high percentage of oil that they contain. the latter is extracted, and is sometimes sold as olive-oil; in a somewhat different form it is made into a sort of butter which is quite palatable. _roots, tubers, and yams._--sweet and irish potatoes, which constitute the most important members of this group, have already been discussed under the head of breads. of those that remain, some few, as beets and artichokes, may be regarded as related to those just referred to, while others, such as carrots, turnips, radishes, parsnips, etc., are generally reckoned among the succulent tubers on account of the large proportion of juice that they contain. irrespective of the beet, which furnishes a considerable portion of the sugar of commerce, none of them may be looked upon as foods of a very important character, as they contain only relatively small proportions of sugars, starches, and nitrogenous materials. beets, however, do contain a very high percentage of that which makes potatoes so popular,--about eighty-five per cent. of starches and sugars, with only a trifle of nitrogenous material. when young and tender they are often eaten as a salad, either alone or mixed with other vegetables, and are generally regarded as being wholesome and highly nutritious. they should not be eaten by dyspeptics when pickled, on account of the vinegar. artichokes are occasionally eaten, but are not nutritious, although they agree well with many persons. carrots, when young and fresh, are fairly digestible, but like other vegetables are exceedingly apt, particularly if old, to produce intestinal disturbances in dyspeptics. they are not very commonly eaten in the united states, but where selected with care we would profit by their more frequent use. they contain a small percentage of starches, with an insignificant proportion of vegetable albumin. turnips are exceedingly unwholesome, contain very little nourishment, and may be eaten with impunity only by persons in vigorous health. the same remarks apply to radishes, and to parsnips. _green vegetables._--vegetables of this class are of much more value from the standpoint of their agreeable taste, and the consequent stimulating effect upon the appetite, than from the nutritive materials that they contain. some of them are eaten cooked, while others are usually consumed in a raw state. they are all much less indigestible if eaten when quite young and fresh--drying seemingly having the effect of producing alterations in them that predispose to dyspeptic disturbances in those so inclined. spinach is one of the most digestible of the entire group, and is much eaten in all parts of the world. turnip-tops differ in no essential particular from spinach. they have a somewhat bitter taste, but when young and fresh are highly palatable, and if thoroughly cooked cause comparatively little intestinal trouble, but like spinach they contain practically no nourishment. the same may be said of the leaves of various other plants commonly served as greens, among them beet-tops, and dandelion-tops. cabbages, many different kinds of which are habitually eaten as food in civilized countries, have comparatively little nutritive value, and are, generally speaking, decidedly indigestible, although young and vigorous persons, particularly where they take abundant out-door exercise, find no difficulty in assimilating the inner portions of the fresh cabbage "head." as in the case with other vegetables, the soil and locality in which the cabbage is grown largely influences its taste, and to some extent its digestibility. it should never be given to infants. sauerkraut is a preparation of cabbage leaves produced by adding salt, and later crushing them with considerable pressure; after a time alterations occur of a fermentative character, and the product is generally regarded as more wholesome than fresh cabbage. cauliflower consists of masses of the somewhat modified flowers of a plant closely related to the cabbage, and is, when properly prepared, palatable, and perhaps somewhat more digestible than cabbage. cole, and brussels sprouts, are plants of the cabbage family, and are perhaps even more indigestible. _salad plants._--the leaves of the lettuce are usually eaten raw, most commonly being served as a salad in combination with oil and vinegar, or lemon juice. that the leaves possess, when treated in this way, a very palatable taste all will perhaps agree, but they cannot be said to be of any nutritive value, nor are the acids just referred to conducive to their digestibility. on account of their somewhat pungent taste, watercresses are used in many parts of the world as ingredients of salads, but they are, of all vegetables, the ones that are most liable to transmit disease to man, for in addition to the possibility of contracting in this way typhoid fever, dysentery, cholera, and the ordinary intestinal worms, the human being is apt to receive with them the eggs of the flukes, and the spores of the amoebæ that produce chronic tropical dysentery. as they are probably never grown under such conditions as to preclude the possibility of this danger, it would be the part of wisdom to absolutely refrain from their use. _onions, leeks, shallots, and garlic._--vegetables of this group are eaten either raw or cooked, and of all those consumed in the former state are least liable to transmit disease, owing to the fact that they are nearly always thoroughly peeled before being eaten. they have the advantage, furthermore, that they may be preserved for long periods of time in such a way as to be fit for food, and when properly cooked have a delicate flavor, and are quite wholesome although furnishing little food for the body. garlic is never eaten as a vegetable, but serves as the basis for many of the delicate sauces for which the french cooks are so justly celebrated. the tomato has been used as a food only within comparatively recent times, it having been formerly thought to be poisonous. like the onion it may be eaten either raw or cooked, and if taken in moderation does not, as a rule, produce any serious harm. when eaten in greater quantities, both on account of the acid that it contains and its relatively small proportion of assimilable nutriment, the tomato is exceedingly prone to cause intestinal disturbances, and should rather be regarded as a fruit than a vegetable. growing at some distance from the ground, it is rather less apt to convey diseases than the majority of vegetables eaten in a raw state. while celery is generally eaten raw, it furnishes a palatable dish when cooked in milk. it should not be eaten by dyspeptics or children, particularly if raw. similarly the cucumber has a well-merited reputation for producing dyspeptic disturbances. it is only eaten raw, is frequently served as a salad, and should be used only when very young and fresh, and eaten only by persons of sound digestion. okra is much prized in the southern states as the principal ingredient of a very palatable soup, but is not as a rule looked upon with favor by the uninitiated. it is also much eaten boiled and served with a little butter and pepper. when fresh and young it is fairly digestible, and furnishes a very agreeable addition to the dinner. in addition to those already referred to, there are a number of vegetables that are very popular either alone, or in combination as salads--particularly in the south; among them are green peppers, parsley, mint, capers, endive, and chicory. the remarks already made concerning green vegetables apply equally to these just mentioned, and it should here again be particularly insisted upon that salads containing acids are unwholesome for infants and children, and should be used sparingly even by those in health. none contains much nourishment. among easily digestible vegetables asparagus probably takes front rank, and in addition to this has the merit of being exceedingly agreeable to the taste. it possesses little nutritive value, but when young, fresh, and well cooked, it may be taken even by infants without harm. rhubarb, or "pie plant," is eaten stewed, and made into pie. it is said to be somewhat laxative, and is decidedly more wholesome than many others. the squash, when properly cooked is comparatively wholesome, but contains little nourishment, and is of no particular value as a food, and the pumpkin is not much better, although useful during the winter for making pies after the ordinary vegetables and fruits are gone. cranberries, when thoroughly cooked and separated from the hulls, form the basis of a delicious jelly that is widely eaten in the winter over all portions of the united states. like all sweets it is not entirely wholesome for dyspeptics or infants, but as it is usually eaten with meats and not in great quantities, it may be looked upon as being one of the most wholesome of all foods of this class. it does not seem to have such a tendency to produce sour stomach in many dyspeptics as is so frequently done by other foods containing vegetable acids. chapter ix danger in fruits and pickles it is an error shared almost universally by both medical men and the laity that fruits and raw foods are wholesome. everyone is familiar with the fact that fruits produce intestinal disturbances in children,--not only when they are very young, but after their digestive apparatus is fully developed. rather curiously, however, instead of ascribing the disturbances that follow to the real cause, we generally dismiss the matter with the assertion that "early fruits are unhealthy," or trace the resulting ill effects to some other equally imaginary factor. in reality the reason why diarrhoea and other intestinal troubles so often occur after eating fruits in the early spring is that the boy or girl after a winter's fast greedily devours enormous quantities of them when they first ripen, and disturbances follow in proportion to the amount and character of these substances taken. there can be no question that fruits, while extremely palatable, usually produce trouble in dyspeptics, and even in those who still possess unimpaired digestive organs ill effects quite constantly follow on the heels of the taking of food of this character. unfortunately, however, the great majority of dyspeptics have symptoms that in no way outwardly point toward digestive errors; as common examples, we might refer to the blackheads, pimples and small boils, so frequently observed on the faces of young boys and girls, or the rheumatic pains, and, at a later time, the "bright's disease," that occur in older people. when you tell such patients that their trouble is indigestion, they are often mildly indignant, and loudly protest that they can eat anything with impunity; that they never have heart-burn, feelings of heaviness after eating, pains in the abdomen, or other symptoms referable to the stomach and intestines. we are rather disposed to be proud of our digestive powers, just as we are of our bodily strength, and nothing is more common than for chronic dyspeptics to maintain that they have never had indigestion in their lives, and to resent any insinuation to the contrary. another popular error, almost universally accepted, is that fruits are highly nutritious; as a matter of fact they consist almost wholly of water, and of materials that are utterly indigestible. the latter substances pass through the alimentary tract, therefore, in much the same condition that they enter and serve no better purpose than to promote, somewhat, activity in the bowels. nevertheless the writer does not wish to be misunderstood as advocating total abstinence from such a palatable class of foods; no harm results in most people if they only take perfectly ripe and fresh fruits in moderation now and then; and these should be always eaten after meals rather than before. the fruits that contain comparatively little acid are, as a rule, more wholesome than those that are rich in substance of this kind. for example, perfectly fresh and ripe figs or peaches may be taken by most persons with impunity if they be eaten after meals, and at intervals of at least two or three days. acid fruits, particularly lemons, seem to be peculiarly unwholesome; apples are prone to cause trouble and can rarely be eaten without ill effects, however mellow and palatable they may be. it sometimes happens that persons take grape-fruit with less harm than others. closely akin to fruits in their deleterious action on the digestive apparatus are sours in any form whatever. women, especially, indulge freely and at irregular hours in foods containing much vinegar, lemon-juice, etc.,--usually in the form of pickles or salads. in healthy persons, in moderation, foods of this character perhaps produce no appreciable trouble, but nothing is more thoroughly established than that they act harmfully on the general run of dyspeptics, such as most of us are to a greater or less degree after thirty years of age. this leads to the remark that here, as in everything else, we must regard individual peculiarities--it being true that one person can eat without ill effects what may produce decided disturbances in others, or suffer from excess when moderation would entail no ill-effects. chapter x drinks--proper and harmful an immense amount of rubbish has been written during the last few decades concerning the supposed good effect of excessive water-drinking on the human economy. something like a quarter of a century ago a london physician by the name of haig brought forward and strenuously advocated the view that a large number of minor ailments were the result of the presence in the body of excessive quantities of uric acid; applying the well known fact that the substance just mentioned requires a large amount of water to dissolve it he conceived the idea that the proper remedy was to flood the body with enormous quantities of liquids, and thus, as it were, wash the offending substance out of the system. so plausible did he make this theory appear that it was accepted very largely by medical men, who in turn taught it to the general public. within recent times it has been fortunately shown that haig's theory was wholly chimerical, and that quantities of uric acid greatly in excess of the normal amount could collect in the body, or might be injected into the blood-vessels, without the least harm resulting; thus, at one blow, this widely accepted theory was annihilated, and there now remains no sort of reason for attempting to remove uric acid by excessive water-drinking, or by other means. it is fortunate that the uric-acid theory has been disproved, for the excessive use of water is not only unnecessary, but highly injurious to the digestive organs, particularly when the fluids are taken at or about meals. experience has shown that excessive stomach-acidity, which is the most common form of indigestion, is in a large degree dependent on the taking of liquids while eating, and that even in those who are healthy any more than small quantities cannot be looked upon as being wholesome. in dyspeptics liquids seem to act in a hurtful way in several different directions. for example, where persons constantly take liquids while eating the necessity of properly chewing the food is largely done away with; in addition to this the mere presence of water in the stomach seems to tend to the production of increased acidity, for it has often been observed by the writer that even where food was eaten dry indigestion would follow in many dyspeptics if they took water just before or immediately after eating. the only sensible advice that can be given in this connection is that persons should take no more liquids that they feel a desire for, and they should avoid taking them in any quantity about meal time. what has just been said concerning water applies equally well to milk. when taken alone it very frequently agrees with patients much better than does solid food, but when mixed with the latter is prone to produce indigestion, just as does water. fermented milk in the form of buttermilk is a very popular beverage in some parts of the world, but it may be well doubted as to whether it deserves the reputation for wholesomeness generally accorded it; being a liquid, and at the same time acid, it is peculiarly prone to increase acidity, and is not tolerated by persons who suffer with sour stomach. it should, however, be said that it, on the other hand, seems to agree particularly well with some people, and has been known when taken alone, at least temporarily, to relieve obstinate forms of indigestion. _coffee._--the most universal beverage taken at meal time in america is undoubtedly coffee. each morning countless thousands are cheered and stimulated by its invigorating properties to undertake their daily tasks, but, as is always the case after taking drugs that have such action the system has to pay the penalty in a reaction following later, during which the capacity for work is diminished. it is, however, true that the effect last referred to is not of such importance as to constitute in itself a serious objection to the use of coffee, but other ill results are rather prone to ensue that in many instances change the aspect of the question entirely. in a great many people, particularly after the first vigor of youth has passed, coffee produces anything but pleasant effects, and on some it seems to act as a downright poison. like all liquids taken at meal time, it predisposes to acid indigestion, particularly when it is sweetened. it is likewise true that when it contains any considerable quantity of cream the liability to dyspeptic disturbances following its use are particularly great--doubtless as a result of the considerable quantity of melted fats that it contains under such circumstances. from the foregoing it appears then that coffee without either cream or sugar is less unwholesome than when these substances are added to it, but even when it is taken in this way it causes decided symptoms of indigestion in many persons. the writer is not of the opinion that the habitual taking of coffee is to be commended, and would, therefore, not advise its constant use; it, however, must be admitted--as is the case with all other substances that cause indigestion--that in many people, and particularly in those who live out-of-doors and are actively engaged in physical occupations, the use of coffee seems to result in no harm. like other substances that cause indigestion in a concentrated form, coffee when largely diluted is less apt to produce disturbances of this kind; for example, a beverage consisting of two-thirds of hot skimmed milk and one-third coffee may be taken by many dyspeptics in reasonable amounts without any particular harm. parents should be warned against allowing growing children to drink coffee; it seriously interferes with the normal chemical changes going on in their bodies, and is almost certain to be followed in later life by nervous dyspepsia. _tea._--the stimulating principle of tea is chemically so nearly like that of coffee that they are generally considered as being one and the same. that they differ decidedly in their action on the stomach and the body generally there can, however, be no doubt. the stimulating action of tea comes on more slowly than that of coffee, and is correspondingly prolonged. in most persons it is not so apt to produce nervousness, nor is its action in preventing sleep so pronounced. on the stomach it also produces effects that are diametrically opposed to those induced by coffee, since, instead of stimulating, it seems actually to retard the secretion of acids. it is, therefore, probably true that we should look upon tea as a beverage with much less disfavor than we do coffee--though, of course, it should always be remembered that there may be, and unquestionably are, many exceptions to this judgment. probably no other daily article of food or drink is so commonly prepared in an improper manner as tea--which is all the more curious when we consider that perhaps none other that requires heat for its preparation is so easily made. it should be brewed by simply pouring boiling water upon the leaves, but the vessel containing the decoction should not be placed over the fire while the tea is being prepared. of even greater importance is the necessity of allowing the water to remain in contact with the leaves only a few moments--_never more than a minute if we wish the tea to be good._ the reason for the latter precaution lies in the fact that tea-leaves contain a considerable amount of tannic acid, and, as the longer the water and leaves remain together the more of this substance is extracted from the latter, it is not difficult to see that we should be careful to allow only a brief contact between the two; the presence of this acid is undesirable, not only on account of the fact that it gives to the decoction a bitter and unpleasant taste, but because it has a tendency to cause digestive disturbances. it is seemingly not generally known that there are many varieties of tea, and that some of them are so superior in flavor and bouquet to others that they might well be entirely different substances. the best of all (in the writer's opinion) are those that are composed largely of leaves grown in ceylon, usually mixed with india tea. if we will demand of our grocer a first-class ceylon tea we will find that a beverage may be made from it that will appeal quite as much to the palate as a good coffee. before dismissing this subject finally, some reference should be made to ice-tea. this beverage is exceedingly palatable when properly prepared, and under such circumstances by no means deserves the disfavor with which it is regarded by many. the latter circumstance is entirely due to two things; first, we find too frequently that it is the habit of house-keepers to pour boiling water on the leaves when the midday meal is cooked and to allow them to soak together until night, and second, the fact that lemon-juice is very commonly added to the tea before being drunk. the ice that the tea contains has little or nothing to do with the dyspeptic disturbances that frequently follow the drinking of cold tea. if we will leave out the lemon and pour off the water after it has been in contact with the tea leaves for something like a minute, it will be discovered that practically all of the ill effects usually ascribed to this palatable beverage have been done away with. _alcohol._--a discussion of beverages would not be complete without some mention of those containing alcohol. this at once brings us face to face with the bitter controversy on this subject that has been waged so long throughout the united states, and which can only be considered here from the standpoint of the effects of alcohol on the human economy, and to draw corresponding conclusions. that alcohol, even in very small quantities, reduces the general strength and capacity for work there can be no question, and in addition we find from experiments carefully conducted on the lower animals that the liability to infection by various disease-producing germs is greatly increased by the administration of even minute amounts of the drug. a man then who is a habitual user of alcoholic drinks not only thereby diminishes his capacity to labor effectually, but at the same time renders himself more liable to disease. no more striking example of this could be brought forward than the well established fact that persons who use alcohol are exceedingly prone to consumption--so true is this, indeed, that we might almost look upon the drug as being practically the cause of this disease in most instances. of course the bacillus of tuberculosis must be present in order for the malady to develop, but we find that the alcohol has prepared a soil for the growth of the germ which would not otherwise exist. this holds with equal force as regards other infectious diseases. again, it is true that maladies that result from bad digestion and improper assimilation are frequently produced by the habitual use of alcoholic liquors. gout and bright's disease are in the vast majority of cases the indirect off-spring of habitual drinking. it should be noted--and the distinction is of importance--that the affections of a grave character most frequently produced by the alcoholic habit do not ensue as a consequence of what could be rightly called intemperate taking of the drug,--its moderate use more commonly resulting in serious disease than when it is taken in great excess. the explanation of this probably lies, at least in part, in the fact that the majority of drunkards only take alcohol at greater or less intervals, and as a consequence the system has time to recuperate between sprees. the typical dipsomaniac goes weeks, months, and even years without drinking at all, but when he is seized by the desire for drink he throws everything else aside and spends days and weeks in a prolonged debauch; during this period he eats very little, and as a consequence largely avoids the grave dyspeptic disturbances that would otherwise inevitably result. alcoholics of this class acquire catarrhal conditions of their stomachs, and if seized with some acute disease, like pneumonia, during or just after a spree, quickly die in a large proportion of cases, but they do not develop gout or bright's disease as a rule, nor do they very commonly become consumptive, as is the case with those who take the drug in small quantities day by day. furthermore, it would appear that the grave disorders that so frequently follow the long-continued use of alcohol cannot be said to be the direct result of the use of the drug, but ensue as a consequence of the stimulating action of the alcohol on the appetite, leading to over-eating. under such circumstances indigestion follows from excessive over-feeding, and this is added to by the naturally irritating effect of the alcohol on the stomach. when this is continued through a series of years, the assimilating power of the organism gradually deteriorates, and we begin to meet with chronic dyspepsia, acute bright's disease, and cirrhosis of the liver. let no one then consider that he is not misusing alcohol for the reason that he only takes a drink before meals--it would be far better if he were to go on a moderate spree occasionally. in this connection mention should be made of the great evil of patent medicines containing, and in reality essentially consisting, of alcohol. a vast number of them are widely sold under the misleading statement that they relieve catarrh, cure diseases of the kidneys, and that they act as tonics and general invigorants of the entire system. masquerading under one guise or another they are sold to the unsuspecting public--prohibitionists for the most part--who fondly imagine that their glass of "bitters," "liver-regulator," or "safe cure for the kidneys," is entirely harmless. let all such be warned that with scarcely an exception patent medicines of this class are nothing more nor less than poor whisky containing some bitter to disguise the taste, and that they are in fact taking a drink when they use nostrums of this kind. the ultimate effect of this kind of drinking is to produce serious and grave diseases. this discussion of the effect of alcohol on the human body would not be complete without calling attention to the extraordinary fact that those peoples to whom we owe our modern civilization have from time immemorial, most of all others, consumed the greatest amount of alcohol. explain it as we may, the fact remains that the greatest achievements of the world were brought about by a society in which a very large proportion of its members were in the habit of more or less constantly taking alcoholic beverages. naturally, the query is forced upon us whether this drug may not have played some important part in the great results achieved. unfortunately, no one can answer one way or another, but our very ignorance should emphasize the importance of looking at the question from every side, and not jumping at conclusions before they are warranted by facts. it is true that most of our positive knowledge on this subject would condemn alcohol as being the greatest curse of the ages, but it may be that it has played a beneficent part in the affairs of mankind through devious paths impossible to trace. unquestionably a drug, the taking of which assists us in momentarily throwing our troubles aside, must be of a certain positive value to mankind. if only it possessed these good qualities with none of its bad ones! having considered very briefly the general effects of alcohol on the system a few remarks may be appropriately made concerning the several beverages commonly consumed in the united states for which it serves as a basis. _whisky._--under the term whisky will here be included all of those stronger alcoholic beverages that are the product of distillation. in addition to those commonly designated as such we may reckon brandy, gin, and rum, and at the same time those subtle combinations called mixed-drinks, for which they serve as a basis. it will, perhaps, startle the average reader when the statement is made that whisky and its near relatives just referred to, particularly when diluted by water, are by far the least harmful of all alcoholic drinks. their bad reputation lies in the fact that on account of their large percentage of alcohol they are usually preferred by drunkards, and that when consumed in excessive amounts by those unaccustomed to their use there often follow those frightful crimes with which these particular forms of alcohol are so odiously associated. the facts are, however, that when taken in moderation they are much less prone to produce indigestion than wines or malt liquors, and where one is determined to drink, they should unquestionably receive the preference. it should not be understood that the writer is in any way advocating their use, but the facts of experience compel him to state frankly that the least harmful of all alcoholic beverages is whisky, or its near relatives. _wines._--there are a large number of fermented juices of fruits that are known as wines. they are either sweet or acid in taste, and both are peculiarly prone to induce dyspepsia in persons with delicate stomachs. irrespective of their delicate flavor, which, in many instances, appeals strongly to the palate, the only virtue that they may be said to possess is that they contain alcohol in small amounts; this, however, is off-set entirely by their large percentage of sugars and acids, causing them to be much more unwholesome than plain whisky. _beers and malt liquors._--it is very fortunate that in those states of the american union that have recently enacted prohibition laws, beer and other malt liquors are now being widely sold under the plea that they are non-intoxicating and that they are in no way unwholesome. while it is true that the former claim is in a measure correct, it is a fact well understood by those who have given the matter study that they are perhaps the most unwholesome of all alcoholic beverages. those in the habit of using them are almost universally under the impression that they are harmless, and as the taste for them is easily cultivated, those who once acquire the habit are very apt to take them in greater or less quantities daily. as a result of this, chronic digestive disturbances are always sooner or later set up, and the victim in the course of time often acquires a gouty tendency, which is all the more dangerous for the reason that in america it scarcely ever manifests itself in acute joint inflammations. the patient gets into what has been called a "lithemic" state, which is but another name for gout, and sooner or later is exceedingly apt to develop a chronic form of bright's disease. it is greatly to be deplored that some of our professional national school-masters do not address themselves to this subject rather than to appealing to the worst passions of the ignorant in attacking the great institutions of our country, and in assailing the fundamental principles of our government that come down to us as a priceless heritage from the wise and patriotic statesmen who first brought our nation into life. in addition to the three great classes of alcoholic beverages already considered there are innumerable others, fortunately but little known to the general public, and prized only by connoisseurs in such matters. as we happily have no problem confronting us in any way similar to the absinthe-habit, so common in france, it is not deemed necessary here to do more than merely to refer to them. chapter xi importance of good cooking reference has already been made to certain misconceptions concerning cooking diligently circulated in recent years by various quacks. the victim is advised that he must take large quantities of raw eggs and milk, and at the same time is instructed to eat a number of other specially prepared articles furnished at a stiff price and certified as being raw by the "medical company" furnishing the "treatment." since it is quickly discovered by those who are entrapped by charlatans of this kind that the only raw foods that they can take with comfort and without disgust are milk and eggs, they naturally practically live on these alone, and as these foods are extremely digestible and nutritious, improvement in the patient's condition not uncommonly results. nevertheless, it is unquestionably true that the vast majority of foods are greatly improved in digestibility, and are rendered much more palatable by thorough cooking. after being properly cooked there develop in foods certain flavors and odors that are highly appetizing, and unquestionably aid in the subsequent digestion of the same. with but few exceptions, foods are so altered by heat that their proper mastication becomes much easier, and cooking, therefore, materially aids in reducing them to a state in which they are much more readily acted upon by the digestive juices. it should never be forgotten, also, that cooking is of the utmost importance from the standpoint of killing bacteria and animal parasites that may be present in food. if we were to adopt universally the habit of eating everything raw, the general mortality would certainly be considerably increased. _cooking of starchy foods._--nothing in the whole art and science of preparing food for the human being is of so much importance as the proper cooking of starches. as a result of the heat employed, certain chemical changes are induced in the starch-granules, as a consequence of which they are rendered digestible. it is of fundamental importance that at all times and under all circumstances the cooking of this class of foods should be as thorough as is possible, for when this is not done digestive disturbances are sure to follow, and much of the food is actually wasted. there are but few cardinal principles in the ordinary hygiene of life that are so commonly neglected as this, since it is the habit of a large proportion of the american people to consume three times a day masses of tenacious starch which has not been acted upon by heat sufficiently to render it digestible. of all the different methods of cooking starches, by far the most common, and, therefore, the most important, is the process called baking. while it is not possible in this volume to go into the subject with the thoroughness that it deserves, the principal points deserve some mention. they may be briefly stated as follows: ( ) the flour must be made into a dough in which are incorporated substances that produce a gas called carbon dioxide, which, forming in innumerable small bubbles throughout the mass, cause the whole to swell; when this is completed the bread is said to have "risen." of course the object of this is to produce a thorough breaking up of the sticky dough--with the result that when the bread is finally cooked it is light and fluffy, and can be readily masticated. ( ) after the process just described has been completed the bread should be thoroughly cooked, for reasons which have already been explained. ( ) after cooking has been accomplished the bread should be thoroughly dried, either by keeping it hot until this occurs, or, what is better, permitting it to remain warm for a time and then allowing the process to be completed in a natural way by putting the bread aside for several days. it is necessary for bread to be dried in order that it may be thoroughly soaked in saliva during the process of chewing. if the principles above enunciated be properly followed out, good wholesome bread will result. there are, of course, many details connected with the preparation of food known to expert cooks into which it will not be possible for us to go here, and for which the reader is referred to any good cook-book. some starchy foods such as rice and potatoes, do not lend themselves readily to the production of breads, and are consequently usually cooked in some other manner. it cannot be too strongly insisted upon that they should be rather _steamed_ than boiled,--the process being usually carried out by placing a small amount of water with them and allowing it to boil away; we should remember also that the principles just insisted upon in connection with making bread apply here with equal force--we should cook thoroughly and serve both as dry as is possible. _cooking of meats._--here again it is necessary to insist upon the necessity of thorough cooking. the error has long prevailed that raw meats are wholesome, but within recent years it has been clearly demonstrated that this old view is erroneous. the muscle-fibers that constitute the bulk of the nourishment of meats are separated from each other by a substance which cannot be acted upon by the juices of the stomach until it has been heated to a temperature which results in the cooking of the entire mass. it is true that the muscular substance proper may be digested without heat--resembling in this way the white of the egg, to which it is chemically closely related; by scraping meat with some dull instrument the muscle fibers may be separated in a more or less pure state--leaving the substance that requires heat in order to become digestible behind--and after having been removed in this way, of course, may be eaten in a raw or semi-cooked condition without ill effects. in preparing meat it is not absolutely essential that it be cooked until thoroughly "done"--a slight tinge of red being allowable. _healthful recipes._--in an appendix to this volume will be found a series of recipes for the preparation of common foods, for which the author is indebted to dr. mary e. lapham, of highlands, n. c. they will be found extremely practicable for making not only very palatable but thoroughly wholesome dishes; and are earnestly recommended to young housewives, who err through ignorance, as a rule, rather than because of carelessness or of lack of good materials. it has often been said that the road to a man's heart lies through his stomach. it would not be surprising to learn that this aphorism fell first from the lips of some wise woman who had observed that in a great number of cases unhappiness in home-life had resulted primarily from lack of home-comfort, and chiefly from unvaried, unappetizing meals and table-service. another point is well worth remembering, especially by young married women: a man whose home is pleasant and comfortable is likely to spend as much of his time there as he can--if it is otherwise, he will seek some place that has these desirable qualities, such as his club, or an arm-chair in some corner saloon. furthermore, a man who is not only abundantly, but _nicely_ fed, has far less desire for the stimulants which lead to drunkenness, than the man who is denied at home the properly cooked and seasonably varied food which his system craves. no better work in the "temperance cause" can be done than to make an attractive home. these are facts which many a young housewife needs to learn and keep in mind; and it is for her benefit that dr. lapham has prepared her simple but excellent cooking directions presented in the appendix. chapter xii seven avoidable diseases malaria fever. malaria, in its various manifestations, has ever constituted the principal obstacle to the civilization of all tropical and semi-tropical countries, and as a consequence vast tracts of the richest and fairest portions of the world have remained uncultivated and unredeemed from their primitive savage state. recent investigations have shown that this disease can be easily prevented if the matter is taken up intelligently. malaria is a disease produced by a parasite belonging to the very lowest order of animal life--the _plasmodium malaria_, which is conveyed from man to man by that genus of mosquitoes called the anopheles. the parasite attacks and destroys the red cells of the blood, and produces a poison that causes the symptoms characteristic of malaria. _course of the disease._--the most common and well-recognized symptoms of malaria are those that occur in that variety of the disease which is known as malarial or intermittent fever. in this type the patient--who may or may not have at intervals for some days noticed chilly sensations, a feeling of fullness in the head, and general bodily depression--is suddenly seized with a chill followed by a high fever and subsequent profuse perspiration; after these symptoms subdue, which generally requires several hours, the patient returns to a practically normal condition and feels, on the whole, well until the next attack occurs. these chills-and-fever paroxysms occur at various intervals depending upon the character of the parasite inducing them, the most common form being that which produces a chill every day. in some instances the malady comes on more insidiously, there being no marked chills but only periodical elevations of temperature. in the more chronic forms of the disease the unfortunate victim is frequently subjected for years to attacks of fever coming on at irregular intervals, the patient being more or less of an invalid throughout the course of the disease. in other instances the brain becomes affected, producing very alarming symptoms; and in quite a proportion of cases the malady ultimately terminates in chronic bright's disease. _treatment of the disease._--most fortunately, we have in quinine, when properly administered, a medicine that in practically all instances acts as a specific in this affection; but it should be used only on the advice and under the directions of a physician. in the more chronic forms of the disease, combinations of arsenic, with such tonics as nux vomica, iron, and small doses of some of the preparations of mercury, produce permanent cures where quinine has failed. it is of the utmost importance that attention be given to the treatment, as, so long as the patient remains with the parasites in his blood, so long is he a menace to his friends and neighbors. _mode of infection through mosquitoes._--the most brilliant triumph in modern medicine, and one of the most creditable achievements of human ingenuity, has been the absolute demonstration that malaria is carried from man to man by means of the anopheles mosquito, and that the disease can, in nature, be produced in absolutely no other way. this is not a theory, but it is a fact which has been demonstrated in its every detail beyond dispute, and we are now happily in a condition to reject our venerable notions concerning bad air, miasma, etc. before describing the method by which infection takes place, it is well to say a few words concerning the mosquito that acts as a carrier of the disease, which may be easily differentiated from other similar gnats. the malarial mosquito has a body which is placed parallel to and almost on the same plane with the front portions of the insect, and as a consequence, when at rest on walls or other objects, the back of the body sticks out almost or quite at right angles with the surface upon which it is resting. the back portion of the common mosquito forms an angle with the front part of its body, with the effect that both ends of the insect point toward the object upon which it rests. there are still other differences that clearly differentiate the malarial from the common mosquito, but the one given ordinarily serves to distinguish between them. the malarial mosquito is pre-eminently a house-gnat, being scarcely ever seen in the woods or open, but may be found--oftentimes in great numbers--in all malarial localities, lying quietly during the day in dark corners of rooms or stables. this mosquito practically never bites in the day, but will do so in a darkened room, if a person will remain perfectly quiet; their favorite time for feeding is in the early parts of the night and about daybreak--all of which accounts for the fact, long observed, that malarial fever is almost invariably contracted at night. the malarial mosquito bites and then goes back to some dark corner where it remains quiescent for forty-eight hours, at the end of which time it again descends to feed. contrary to the general opinion mosquitoes bite many times, and frequently remain alive for months--the malarial mosquito particularly living in cellars and attics oftentimes throughout the entire winter. if one of these mosquitoes bite a person with malaria, the parasites are sucked in along with the blood and pass into the stomach of the gnat, making their way ultimately into the body substance; here the parasites undergo a series of multiplications, a single one of them sometimes producing as many as ten thousand young malarial parasites. after the parasites have developed fully, which requires eight days in warm weather, they make their way to the venom-gland of the mosquito and there remain until it bites, when they are injected into the body of the individual attacked along with the poison. after getting into the human blood, each parasite attacks a red-blood cell, bores into it, and grows at the expense of the cell until it reaches maturity, at which time it divides up into from seven to twenty-five young parasites which are liberated and each in turn attacks a new cell. this process goes on until a sufficient number of parasites are produced in the individual to cause the symptoms of malaria, and the new subject of the disease thereafter becomes a source of danger to others in the vicinity through the intervention of still other malarial mosquitoes. _malaria avoidable._--from the foregoing it is seen that the proper way to avoid malaria is so to screen houses that mosquitoes cannot enter them. persons in malarial districts should not sit on open porches at night, and should be careful to sleep under properly constructed nets. if this be done, there is absolutely no danger of anyone ever contracting the disease. it will be well observed that these precautions are not necessary in the daytime, as the malarial mosquito rarely attempts to bite during this period. it should be remembered by those who have the disease that they are a constant source of danger to people living in the vicinity, and they should be doubly careful as long as the disease persists to avoid being bitten by mosquitoes at night. it is furthermore their duty to vigorously treat the disease until the parasites are no longer present in their bodies, at which time they cease to be a menace to others. many children have malaria without showing symptoms, and, if allowed to sleep without being properly covered with a net, are very apt to infect a large number of malarial mosquitoes; the blood of children in malarial localities should be examined from time to time, and if the parasites be found, the children should be given the proper remedies until a cure is effected. particular attention should also be directed to the fact that almost all negroes in malarial localities of the south harbor the parasites, though very few of them show symptoms of their attacks. it is, therefore, very important that they be treated properly, and their white neighbors should see to it, for their own safety, that they do not sleep in houses unprotected by nets. if the precautions herein detailed were properly carried out, for even a few months, malaria would practically cease to exist wherever this was done, and would not recur unless individuals from other places suffering from the disease were to come into the districts where the anopheles mosquito is present, and so give it to the gnats--to be by them recommunicated to humanity. tuberculosis. of all the enemies of mankind, tuberculosis, in its various forms, takes the first rank. of protean manifestations, occurring in almost every part of the body and producing diseases of the brain, of the nerves, of the bones, of the skin, and of all of the internal organs--pre-eminent is the terrible malady we call consumption, which is tuberculosis of the lungs. it has been estimated that one-seventh of all the people born into the world die as a result of this malady in some one of its various forms, and it is probable that one person out of every three dying between the ages of fifteen and sixty years, succumb to this disease. as a result of the labors of thousands of patient, self-sacrificing investigators--many of the most distinguished of whom have died of this disease while carrying on their work--the peculiarities of this affection are now fairly well understood, and if we were to apply the knowledge which we now possess in our attempts to free ourselves from its ravages, there is no question but that within a comparatively short period of time the disease would practically cease to exist. _character and course of the disease._--tuberculosis is produced by a minute vegetable parasite known as the _bacillus tuberculosis_, a germ which not only occurs in the human being, but is widely distributed among the lower animals. tuberculosis of the lungs (to restrict ourselves to this most important manifestation) generally comes on insidiously, there being usually no definite period from which the sufferer can date the onset of the malady. in the early stages there is usually loss of appetite and a pronounced feeling of weakness followed by a slight cough; the latter symptom frequently leads patients to erroneously believe that their trouble began with a bad cold, when as a matter of fact, the catarrhal trouble of the throat and bronchial tubes was originally produced by the germs of tuberculosis--there being no such thing as a cold changing into consumption. as the disease progresses the patient complains of fever and chills, these symptoms being oftentimes periodical, and lead to the belief that the trouble is malarial fever: this mistake is very common, and whenever such symptoms appear a good physician should be immediately consulted. the patient also suffers from exhausting night-sweats in many instances, though this is not invariable. a rapid loss of flesh is one of the earliest and most common symptoms. the symptoms above enumerated continue and grow worse, and in quite a proportion of the cases there is, in addition, spitting up blood, which in some instances may be so pronounced that it becomes a distinct hemorrhage. in the more rapid or "galloping" forms of the disease the patient frequently dies within a few weeks or a month or so, while in the less severe types the malady may persist for many years before death occurs. _treatment._--the treatment of tuberculosis by drugs has proven an entire failure, but a large number of persons afflicted with this disease will recover, if placed under proper hygienic conditions. the patient should be put on a porch or in a tent, whether it be winter or summer, and kept in bed at absolute rest as long as there is any fever, and should be fed in abundance with good, wholesome food. while this treatment appears simple it should always be carried out under the directions of a physician, as it is only possible for those having a thorough knowledge of the subject to give such directions as would lead to a rapid cure of the patient. _modes of infection._--hereditary tuberculosis, notwithstanding a popular idea to the contrary, is very rare, but there is no question that those persons in whose family tuberculosis exists are much more prone to contract the disease than others. in just what manner the germ of consumption gains entrance to the human body, we are more or less uncertain, but there are reasons for the belief that in many instances they pass in by means of the inhaled air; there is no doubt that in a small percentage of cases the bacillus gains entrance to the body through an abrasion of the skin or of some mucous membrane; finally the bacteria are often taken in with the foods that we eat, or by putting objects upon which the germs are present into the mouth, or eating with hands which have been contaminated and not washed. of the foods that contain the germs of consumption, milk is unquestionably the most common, as there can be no question that fully per cent. of our cows have this disease, and under such circumstances their milk is usually infected with the bacillus that produces the malady; meats, likewise, often contain germs of this disease, but, as they are usually cooked, no harm, as a rule, results. of quite as much importance as the introduction of the germ into the body is the resisting power of the individual at the time when this occurs, since the disease can make no progress unless the tissues have become susceptible through lowered resistance. all things then that have the effect of lowering the vitality of the body act as predisposing causes to consumption; such, for example, as _want of proper food_, _lack of sleep_, _improper clothing in cold and wet weather_, _and living in damp and improperly ventilated houses_; excesses, _particularly the taking of alcohol_, conduce to the development of the disease--long-continued inebriety being beyond doubt the cause that most frequently leads to consumption. it is a common error that alcoholic stimulants tend to ward off consumption, and it is absolutely certain that these substances not only do not act in a curative way in those who have already contracted the disease, but are positively detrimental. in order then to avoid consumption--and this is particularly of importance for those in whose family there is a predisposition to the disease--the individual should live soberly, should try at all times to obtain a reasonable amount of good food, should sleep a sufficient number of hours, and should be clothed properly, particularly in the winter. those who devote their time and energy to the performance of their work--being careful of course not to labor excessively--are much more apt to escape consumption than those who do otherwise. it is particularly of importance that those who have a tendency towards consumption should early learn, and throughout life practice, the habit of _breathing through the nose_: if this rule be followed a large percentage not only of the germs of consumption, but other bacteria as well, are filtered out during their passage through the nose and do not reach the lungs. cleanliness is also of much importance--a bath taken each morning in moderately cold water being conducive to health, not only as regards consumption but other diseases as well. it is of course necessary that dwelling houses should be kept thoroughly clean. _advice to diseased persons._--in all cases where a person observes in himself, or in those for whom he is responsible, the symptoms already detailed, it is his duty to at once consult an intelligent physician, and if it be found that tuberculosis is present, every precaution should be taken by the diseased individual to prevent the further spread of the malady. _in such a case the sputum that is constantly being coughed up contains myriads of the germs,_ and it is of the utmost importance in order to prevent other persons in the neighborhood from being infected that this _sputum be destroyed_. the patient should at all times carry about with him either a small receptacle into which the sputum can be expectorated, or a large cloth which would answer the same purpose, and in either case the sputum should be burned; if this be impracticable, it should be placed in some good antiseptic, such as a saturated solution of carbolic acid or a -to- , solution of corrosive sublimate in water. the patient's handkerchiefs should be thoroughly boiled, and his clothing should receive like treatment. every precaution should at all times be observed in order to prevent the sputum getting onto the furniture or floors, as, under such circumstances, it quickly dries and being broken up into small particles is carried by means of the air to other parts of the house. the patient should always remember that the quicker he is placed under proper treatment the more the chances of ultimate recovery; in the early stages almost all of the cases of this kind are curable, but later this is not often accomplished. typhoid fever. of all of the infectious diseases prevalent in the united states, typhoid fever is one of the most common and fatal. as a result of its ravages a vast amount of invalidism, suffering and financial loss is brought about each year, and a frightful mortality results. it has for some time been recognized that typhoid fever is among the most preventable of all diseases, and if our people would bestir themselves and carry out the comparatively simple rules that are necessary for its prevention, the scourge would, in a short time, practically cease to exist among us. _character and course of the disease._--typhoid fever, enteric fever, or abdominal typhus, is an infectious disease believed to be caused by a specific bacterial germ known as the _bacillus typhosus_. it develops, as a rule, quite slowly, the first symptoms being loss of appetite, headache, and a marked fatigue on slight exertion. these symptoms gradually grow worse, fever develops, and the patient oftentimes suffers with chilly sensations; the temperature gradually rises, and in the course of from a few days to a week reaches a height of degrees, degrees, degrees, or degrees f. in many cases no symptoms exist that indicate trouble with the bowels, but in the severe forms of the disease diarrhoea generally comes on during the first week and continues throughout the course of the disease. during the second week the symptoms above detailed continue, becoming often more severe, and there develops great nervousness and delirium. about this time there are frequently observed over the chest, abdomen and thighs, minute reddish spots resembling flea-bites; these spots last for a few days and then pass away and are followed by a fresh crop in other situations. during this period of the disease inflammation of the bronchial tubes frequently comes on, and now and then pneumonia develops. bleeding from the bowels is an occasional highly characteristic symptom of the second week. when the disease follows a normal course, the symptoms during the third week begin gradually to abate; the fever lessens, and the patient, though much emaciated, gradually returns to a normal condition. unfortunately, however, the disease does not always pursue this favorable course, for, in quite a proportion of instances, the symptoms increase in severity during the second or third week, the patient becomes profoundly prostrated, the delirium deepens, and death occurs. the hemorrhage from the bowels, in some instances, is so severe that death is produced even in comparatively early stages of the affection. in many instances, through indiscretion, usually as a result of eating solid food, patients who are apparently on the road to rapid recovery, relapse, and the disease repeats the course already detailed. it is of importance to remember that now and then so-called walking cases of typhoid fever occur, the disease in these instances being characterized by the fact that the symptoms are so slight that the sufferer does not feel it necessary to go to bed. however, in these mild cases, fatal hemorrhage from the bowels is as frequent as in the severer types, and as a consequence the patient should receive careful attention. moreover, it is of importance to remember that from this mild form of the affection the most malignant varieties of the disease may be contracted. the mortality in typhoid fever varies from five to twenty per cent., depending upon the character of the disease and the nature of the nursing and treatment that the patient receives. _modes of infection._--it is clear that typhoid fever is the result of the entrance into the body of some minute form of germ-life, whether this be the bacterium generally supposed to induce the disease or not. this contagion is beyond question a living something which multiplies with great rapidity under proper conditions, and, escaping from the bodies of those infected with the disease, in one way or another, reaches other individuals. it is beyond question true that the virus passes from the body of those infected by means of the urine and feces, and it is likely that the secretions from the mouth and nose frequently contain the germs that cause the fever. as the germs are certainly extraordinarily minute, a very small amount of any of these excretions might produce the disease in healthy individuals if it were to get into their bodies through water, milk, or any uncooked food, or if it were to find lodgment about the nose or mouth, or get upon the hands of other persons. it should also be remembered that the virus may easily get upon cooking-utensils, drinking-cups, bed-linen, and other articles with which we are constantly brought into close contact, and that the disease might be transmitted in this way. it is also true that the malady may be carried from place to place by insects, particularly flies; the latter may readily get enough infectious material upon their legs in various ways, and then, crawling over the food, leave the deadly poison deposited upon it. _treatment of typhoid fever._--as soon as the symptoms appear, a physician should be called and his directions faithfully and carefully followed out. nothing in this disease is of more importance than careful nursing, and it is absolutely necessary that the patient receive only liquid diet until the physician permits other food. wherever possible then, patients with typhoid fever should be completely isolated, since, if this is not done, other members of the family are almost sure to contract the malady--a result which almost everyone has seen who has had any experience with the disease. wherever possible patients should be sent to a hospital, but where this cannot be done they should be placed in an outhouse, if practicable, or in an isolated room, which should be thoroughly disinfected after the patient's recovery. no one should visit a typhoid-fever patient, except when compelled to do so, and we should be particularly careful to prevent children from coming in contact with them, as it has been shown that they contract the disease much more readily than grown people. it is also of importance that persons should not sit for any length of time in the sick room, and, above all, under no circumstances, should cooking and eating be done there. the room in which the patient is placed should be furnished only with those things absolutely necessary, and it is particularly desirable that carpets and curtains should be removed. it is well to wash the floor each day with some antiseptic solution. those persons who come in contact with typhoid fever should wear outer clothing which can be easily washed and boiled. after touching the patient, or any of his clothing, the hands should be at once thoroughly scrubbed in an antiseptic solution. of course, under no circumstances, should the nurse eat or drink from the same vessels that the patient does. none of the excretions from persons afflicted with typhoid fever should ever be emptied until thoroughly disinfected with creo-carboline or strong lime-water, and under no circumstances should these be poured out in the neighborhood of springs or wells. towels, handkerchiefs, and clothing that comes in contact with the patient should be thoroughly disinfected before being sent to the laundry. this is best accomplished by thorough boiling, but in cases where this can not be at once carried out, it is advisable to use some chemical antiseptic; of these, perhaps the best is creo-carboline, which may be employed in a - solution in water; where this solution is not obtainable, a -per-cent. solution of carbolic acid in water will answer. it should also be remembered that the water in which typhoid-fever patients are bathed necessarily becomes infected, and this should always be thoroughly disinfected before being emptied. these precautions should be carried out for some time after the patient has recovered, as it is well known that persons, under such circumstances, for some time frequently contain the poison in their evacuations. after the patient recovers, the room should be disinfected with formaldehyde gas obtained from the substance known as "formalin." this gas may now be obtained from the formalin without the use of heat in the following manner: when everything is ready, and the room properly sealed, thirteen ounces of permanganate of potash to each quart of formalin are placed in a large vessel, the room being closed immediately after the two substances are put together; it is important that the permanganate be placed in the vessel first. when this method is employed a quart of formalin should be used to each one thousand cubic feet of air-space in the room. as the gas, by this process, comes off with great rapidity, it is not necessary to keep the room closed more than about four hours. this method is to be advised for the reasons that it acts more quickly than the older one, and there is never danger of fire. in cases where houses are too open to permit of disinfection by means of gas, the sick chamber should be thoroughly washed with a solution of corrosive sublimate, carbolic acid or some other good disinfectant. hook-worm disease. it has been only recently recognized that a large percentage of the invalidism and a great number of the deaths yearly in the southern portion of the united states are caused by a very small intestinal parasite known as the _necator americanus_, or hook-worm. this parasite has unquestionably existed over the area just named since the advent of the negro--recent investigations having shown that the worm is in all probability of african origin. this hook-worm disease is probably the most common of all the serious diseases prevalent in the south, and as it is easily curable, and can be readily prevented, there is no matter which should be of greater interest to the people in the infected regions, especially those who live in villages or on farms. _character of the disease._--the animal parasite called hook-worm closely resembles, externally, the pin-worm which so often occurs in children. the female, which is larger than the male, measures somewhat more than half an inch in length, and has the thickness of a knitting-needle; the male is between a quarter and three-eighths of an inch in length as a rule. the parasite possesses around its mouth a row of minute plates somewhat resembling hooklets, by means of which it grasps hold of the mucous membrane of the intestine and bruises it sufficiently to cause the blood to flow; with this blood the parasite nourishes itself. at the same time the worm injects into the tissues a poison which has much to do with the symptoms that occur in the disease that it produces. these worms are usually present in great numbers, there being as a rule from to , of them, and as they unquestionably live at least eight or ten years, the unfortunate victim suffers for a long period of time as a result of their presence. while living in the intestines the females lay enormous numbers of eggs which pass out with the feces, and under suitable conditions of temperature and moisture there develops within each of them, within from two to three days, a minute snake-like embryo which bursts through the shell of the egg and passes into the neighboring earth. here the embryos live for considerable periods of time, and, ultimately, may infect other individuals, or those from whom the eggs were passed. there are at least two ways by which these embryos gain entrance into the human body. some do so by getting into drinking-water and being swallowed; but, extraordinarily, they most frequently penetrate through the skin. when this happens the parasite, in passing through the skin, produces the disease known as "ground-itch." the vast majority of the victims of this affection are children with whose skin the embryo comes in contact while they go barefooted during the summer months. _course of the disease._--having entered through the skin, the embryos of the hook-worm, moving by a circuitous route finally reach the intestines, and, grasping hold of the mucous membrane with their saw-like teeth, they begin to suck blood and grow until they reach the size of the adult worm in about a month or six weeks. depending upon the number which have gained entrance, and the susceptibility of the individual, there now begins to develop symptoms of profound anæmia; the skin of the child becomes very pale, and assumes a sort of yellowish hue, and in cases where there is a severe infection, the victim begins to suffer with shortness of breath and dropsy. when this occurs the patient sometimes dies, but more commonly death results from contracting some other disease, which, under ordinary conditions, would produce no serious results. one of the most unfortunate effects of this malady is that when children become infected they cease to grow, and frequently retain the appearance of early youth even after they have reached full maturity in years. these unfortunates are generally incorrectly regarded as dirt-eaters. the symptoms frequently last over a period of many years, as in the intestines of these victims the worms that originally infect them live certainly eight or ten years, and during this period it is beyond question true that additions to the original number are frequently received. _diagnosis and treatment._--there is no disease that can be diagnosticated with more ease and certainty; the eggs are present in the feces in great numbers, and by means of a microscope they can always be detected. in all cases where the disease is suspected, a half-teaspoonful of the feces of the person supposed to be infected should be placed in a bottle and sent to a competent microscopist for examination. this is done free of charge at the laboratories of most state boards of health in those parts of the country where the malady exists. whenever an individual shows the symptoms above detailed, an intelligent physician should at once be called. we have medicines that act as specifics, and the disease can always be cured in a very short period of time. _preventive measures._--of course the best method of preventing this disease is to administer to those already infected the proper medicines, and cause the expulsion from the intestines of the worms that lay the eggs. the indiscriminate scattering of the feces around the stables, so very common in many districts, should be absolutely forbidden. around the house where individuals have lived who have the disease every care should be taken to prevent contact with the earth in the neighborhood of places where the ground might have become infected. it would be advisable for children and others to wear shoes for at least a year after the last individual having the disease was cured; and as a precautionary measure it should be insisted upon that properly constructed privies or water-closets should be at every house, and that they should be used by everyone in whom there is a possibility that the disease exists. diphtheria and its treatment. loeffler's discovery in of the germ of diphtheria, and its relation to the disease of the same name, established the specific infectious nature of this malady, and demonstrated beyond a doubt that membranous croup is not ordinarily an independent affection, but is almost always simply diphtheria of the wind-pipe. the discovery of antitoxin, some time later, reduced the mortality of diphtheria from an average of % to % in ten years; its use has also shortened the course of the disease, and decreased greatly the frequency of the paralytic conditions that not uncommonly follow this malady. _character and course of diphtheria._--diphtheria is an affection caused by a bacterial microbe which produces a poison that acts locally upon the tissues invaded, and also, as a result of its introduction into the general circulation, brings about more or less profound effects on the entire system. the period of incubation is from two to ten days. the onset is generally characterized by a rise of temperature from °f. to °f., chilliness, headache, and pain in the back and limbs. albuminuria is common. the glands of the neck often become swollen. in mild attacks a slight sore throat is all that is complained of. in the majority of cases the disease attacks the throat and tonsils, and is characterized locally by the appearance of a membrane, which is usually gray or yellowish-white, elastic, and adheres tightly to the surface upon which it lies. at times, however, the membrane is soft and pliable, and is easily separated from the tissue; such cases are frequently diagnosticated as follicular tonsillitis. a bad cold is occasionally the only symptom of the disease. the diagnosis should always be confirmed by bacteriologic examination. in some instances the wind-pipe is primarily attacked, but when the disease affects this part of the throat it is generally a consequence of the extension of the membrane downward from the region of the tonsils. in the former case the diagnosis is somewhat difficult, as cultures taken from the throat may not show the presence of diphtheria bacilli, though material that is coughed up may contain myriads of the germs; in this phase of the disease interference with respiration is the symptom most to be feared. the mucous membrane of the nose, eyes, ears and generative organs, may be affected. wounds are also liable to become infected with this organism. in rare instances the membrane may extend down into the bronchial tubes and lungs, and has been found on post-mortem examination covering the inside of the stomach. as complications we may have broncho-pneumonia, acute bright's disease, inflammation of the internal structures of the ears, bleeding from the nose, inflammation of the valves of the heart, and sometimes paralysis of this organ, with death; the last named sequel of diphtheria comes on during convalescence, usually from two to four weeks after the subsidence of local symptoms, and is due to inflammation of the nerves that control the heart. much less commonly paralytic conditions of the palate, throat, eye muscles and the nerves of taste occur, and under rare conditions, paralysis of the lower extremities. paralysis of some kind follows in from ten per cent. to fifteen per cent. of the cases, and appears with equal frequency after the mildest as well as following the most severe cases. _mode of infection._--the germs of diphtheria may be carried in articles used by persons with the disease, or they may be communicated by direct contact. the micro-organism is found in the secretions from the mouth, throat, or nose, and in particles of detached membrane. bedding, utensils, etc., used in the room where a patient has diphtheria, are liable to carry the germs if taken from the sick-room, and consequently should be always properly disinfected before being removed. milk-bottles carried into the sick-room, or handled by persons caring for the patient, should never be returned to the dealer without being disinfected. cats, and less frequently dogs, may contract the disease and convey it to those with whom they come in contact. unrecognized mild cases are a frequent means of spreading the disease, as also is a too early release of patients after recovery. it is a much safer method of procedure to require at least two negative examinations before releasing a patient from quarantine, as during convalescence the germs may be entirely absent on one day and a few days later be quite abundant. the bacilli may remain in the throat from a few days to several years after the disease is apparently entirely well, and under such circumstances the persons carrying them become quite as great, if not a greater, menace to those with whom they came in contact as they were during the height of the disease. a thorough disinfection of the room and everything used about the sick person should be carried out after the patient is released. complete isolation should be observed during the illness, and as long as the bacilli remains in the throat. _treatment._--diphtheria antitoxin is the specific treatment of this malady, and should be given early in the disease. the chances of recovery decrease in proportion to the length of time existing between the onset of the affection and the time of administration of the drug. antitoxin may be repeated in six hours after the initial injection if improvement is not noticed, but ordinarily twenty-four hours should elapse between doses. it is well to remember that it is safer to give too much antitoxin than too little. the initial curative dose varies from , to , units, according to the age of the patient and the severity of the disease. when a case is seen late it is often advisable to begin with a large dose,--it being good practice under such circumstances to use at once as much as , units or even more. the average case requires from the beginning to the end of the treatment a total of from , to , units, but occasionally , or even , units may be necessary. there are very few risks in giving antitoxin. in a series of , cases treated with it only two deaths occurred sufficiently early after the injections to warrant the belief that this unhappy result was produced by the drug. it is worth remembering that asthmatic cases bear the administration of antitoxin very poorly; a marked and sometimes serious embarrassment of respiration, with cyanosis, unconsciousness, and general collapse may follow its use, but recovery is usual in such cases. a condition known as anaphylaxis or hypersensitiveness, which at present is being much studied, may sometimes occur in the human being. this hypersensitiveness is manifested by the extraordinary peculiarity that any number of doses of antitoxin may be given provided they are administered within a period of less than ten or twelve days. on the other hand a single minute dose may induce this state after the period named, and, as we never know whether a patient is going to develop it or not, it becomes a question as to the safety of giving a second injection after ten or twelve days have elapsed following the administration of the initial treatment. as it is true that this hypersensitiveness once established in animals may continue throughout life, it becomes a question as to whether or not it is quite safe to administer antitoxin to an individual who has had the drug given him at some prior time, and we are not as yet in a position to definitely determine the risks that are involved in such a procedure. there is no reason to doubt that this hypersensitiveness is much less marked in man than in the lower animals, and there can be no question that it much less commonly develops, but notwithstanding this it would be the part of prudence to avoid a second administration of the drug after the interval referred to in all instances where this seems possible. anaphylaxis is thus seen to bear an important relationship to what is commonly called the "immunizing treatment" to prevent diphtheria, which consists in giving a moderate dose of antitoxin to a person immediately after exposure to the disease. under such circumstances a degree of immunity is undoubtedly secured, but this passes off in the course of a few weeks, and the patient then becomes just as susceptible as he was before. should he now contract diphtheria, we would be confronted with the possibility that the treatment by means of antitoxin might possibly produce serious and even fatal results. occasionally rashes occur several days after the inoculation, but such disturbances are insignificant except for the immediate discomfort experienced. antitoxin concentrated by the gibson method has reduced to a considerable extent the number of cases in which rashes occur. treatment other than by antitoxin is symptomatic. where the disease occurs in the wind-pipe, it may be necessary to pass a tube into its upper opening to allow the patient to breathe, and in other instances the wind-pipe is itself opened from the outside in order to permit a sufficient amount of air to enter the lungs to maintain life. it is of the utmost importance that patients be kept in bed until all danger of complications has passed. death from heart-failure several weeks after the diphtheria in the throat is well, is not an uncommon result of the disease, and is especially prone to follow even the slightest exertion. patients under such circumstances have been known to die from raising themselves up in the bed. cerebrospinal meningitis. meningitis, or spotted fever, is one of the most terrible and fatal of all diseases, every case proving fatal in some local epidemics. although the cause of the disease has been known for a number of years, the exact method by which the germ that produces it spreads from man to man was until quite recently entirely unrecognized, and even now it cannot be said that the whole matter has been demonstrated. _character and course of the disease._--cerebrospinal meningitis is produced by a minute vegetable (bacterium), the _micrococcus intracellularis_. this germ does not appear to occur normally in any of the lower animals, nor has it been found in the outer world, and is therefore to be regarded as distinctly a human parasite. it is very fortunately a germ of low vitality, as it develops only at about blood heat, and when expelled from its normal dwelling-place in the human body it dies very quickly. the accompanying illustration shows how these bacteria appear under the microscope; the drawing was made from fluid taken from the spinal canal of a patient suffering from cerebrospinal meningitis. these germs get within the skull and spinal canal, and produce violent inflammation of the coverings of the brain and cord; these membranes are called "meninges," hence the name "cerebrospinal meningitis." within a short time after their entrance pus is produced, and the condition becomes practically one of abscess around the brain and spinal cord. in almost all cases the disease is preceded by a slight catarrhal condition of the nose and throat, the symptoms being those of an ordinary cold. the symptoms that point to the covering of the brain being attacked come on with great suddenness; there is usually a chill, followed by intense headache, vomiting, restlessness, with great dread of noises and bright light; in many cases reddish spots appear beneath the skin, and these are usually tender on pressure. in some cases the muscles of the neck become very stiff, and contract so that the head is drawn backward. the temperature is somewhat irregular, but is always above normal in the beginning, and sometimes goes very high; the pulse as a rule is normal, or but little accelerated. after the patient remains in this condition for a period varying from a few hours to several days, he generally becomes unconscious, and in a comparatively short time dies. in some cases the symptoms after starting off very violently quickly subside, and the patient makes a comparatively rapid recovery. in other instances the disease begins more mildly, the patient having more or less of the usual symptoms, but not so severely as is ordinarily the case; in such cases the patient may die, after lingering weeks or months; or may make a protracted recovery, frequently with partial paralytic conditions that permanently remain. unfortunately we possess no specific for this disease. recently there has come into vogue a treatment by a serum supposed to have antitoxic power against this disease, but its exact value is, as yet, by no means settled; it must be used early if any good is to be expected from it. in addition to the antitoxin all that can be done is to keep the patient quiet with anodynes, and to minister to his comfort in every way possible. ice applications to the head sometimes alleviate the intense headache. as the disease is practically an abscess around the brain and cord, perhaps the most rational treatment would be to open up the skull and let the pus drain away. _mode of infection._--as this disease is one that is due to a specific germ it is obvious that it cannot exist without the presence of this organism; the malady is therefore infectious, and must necessarily be to a certain extent contagious, notwithstanding the fact that it is generally thought not to be so. the reason that the affection has not been thought to be contagious may be explained by the following facts: recent investigation has shown that in many, if not all, instances of this disease, the germ may be found in the nose and throat, where, as has already been explained, it sets up a condition resembling an ordinary cold. in all probability the infection takes place in the nasal cavity first, and the germ ultimately finds its way to the coverings of the brain. now there is every reason to believe that in many, and probably in a great majority of instances, the germ goes no further than the mucous membrane of the nose, and the patient merely has as a consequence what he considers an ordinary cold. it is clear, however, that if another individual, who was very susceptible to this germ, should contract the disease from this person, he might have the meningeal form of it. in other words, it is probably true that the vast majority of people who are attacked by this organism simply get colds as a consequence, and only now and then does a person get meningitis as a result. this explains why the disease does not ordinarily appear contagious. the facts above stated are of much importance in combating the spread of this disease. people who are exposed to those having meningitis should be exceedingly careful not to get upon their persons any of the secretions that come from the patient, and during periods of epidemics those who observe a bad cold coming on should promptly consult their physicians, and do everything to prevent the development of all catarrhal conditions in their noses. during epidemics persons with colds should be very careful not to allow other people to become infected from them. as cold and wet are undoubtedly predisposing causes to colds it is well for everyone to shun such exposure during periods when meningitis is prevalent; debilitating influences, such as alcoholic excess and lack of sleep, should also be avoided. hydrophobia. this disease, as it occurs in man, is practically always conveyed by the bite of some animal, the dog being the usual offender. the poison is present in the saliva of the diseased animal and is transmitted through wounds made by its bite. as observed in the dog, there are two types of the disease,--one the "furious," the other the "paralytic." _in the furious type_ the animal first appears to be restless and somewhat excited. he seeks dark places and apparently prefers to be by himself. in this stage of the disease the dog's appetite is good and may be excessive; he responds to orders although his attention can be attracted only for a moment at a time. as the malady progresses the animal becomes more and more restless, and develops a desire to tear those things about him into pieces. there is described a peculiar bark at this stage of the disease; instead of ending as it ordinarily does, it is prolonged and terminates in a higher pitched note simulating a cry. this is supposed to be very characteristic at this stage of the affection. the appetite gradually diminishes, food is refused, and swallowing becomes difficult. as the symptoms gradually progress the dog shows signs of delirium and begins to wander. as a rule, he goes about with his tail hung, mouth wide open, and with a wild look in his eyes, biting as he goes, anything that happens to be directly in his path; seldom does he turn aside to disturb anything or anybody. in the later stages of the disease paralysis generally develops, beginning in the hind legs and soon involving the body. if the animal be now carefully observed it will be seen that he cannot swallow. there is no dread of water, as the name "hydrophobia" implies, and as is commonly thought, the animal often attempting to drink, but owing to the paralysis of the muscles of the throat this is impossible. inability then to swallow either water or solid food is one of the surest and most reliable signs of rabies. weakness becomes very marked, and the animal finally lies down in a stupor and dies. the entire course of this type may last from six to ten days; generally it is four or five. _the paralytic type_ of the disease occurs in fifteen or twenty per cent. of the cases. the onset is, as a rule, the same as that observed in the furious type. instead, however, of the dog beginning to wander, as previously mentioned, the animal becomes paralyzed, the paralysis first affecting the muscles of the jaw, later of the tongue. as is the case in the furious type of the disease, the animal loses the power to swallow both solids and liquids, but has no fear of water. the mouth remains wide open, the tongue protruding, and an abundant amount of thick saliva exudes. the animal remains quiet, does not attempt to bite any animal or individual. death occurs on the second or third day of the disease. _precautions._--when an individual is bitten by an animal either supposed or known to be rabid, the wound should be immediately cauterized with some caustic, preferably concentrated nitric acid. this should be applied without fear because it is safer to use too much than too little. in case this is not available any strong caustic may be used. punctured wounds should be laid open with a knife and the surfaces freely cauterized. it should not be forgotten that the slightest scratch from the tooth of a rabid animal may lead to the development of hydrophobia in man, and it therefore behooves all persons bitten by dogs to take every precaution possible. even though the animal at the time may appear to be healthy, some strong antiseptic should be applied to the wound, and the animal carefully watched until all possibility of his having the disease has passed. many persons have died from slight wounds inflicted by animals appearing at the time to be perfectly well. attention should also be directed to the fact that wounds where the teeth of the animal pass through the clothing are not so dangerous as those where no such protection intervenes. bites about the face and head are much more frequently followed by rabies than those inflicted on the extremities, and, of course, where wounds are deep the chances of infection are much greater; where injuries of the latter kind are inflicted it is practically out of the question to thoroughly cauterize them, and the patient should immediately receive the pasteur treatment. it is probable that if thorough cauterization be not done within five minutes that it cannot be relied on to prevent the development of the disease; where there is any doubt the only safety lies in the pasteur treatment. where a person is bitten by a dog supposed to be rabid the animal should be caught, if possible, and kept carefully isolated for at least ten days; should it appear well after the expiration of this period no fear need be felt as to the results of its bite, but if it should die the head should be cut off, packed in ice, and sent to some laboratory for examination. _under no condition should the animal be killed, as the best possible proof of the harmlessness of its bite would lie in its continuing to live._ _treatment._--since the epoch-making researches of pasteur, laboratories have been installed in various parts of the world for the purpose of making a vaccine by means of which it is possible, by gradual immunization, to prevent the development of hydrophobia in persons bitten by rabid dogs. this is done by a series of injections of a weak virus prepared according to the directions of pasteur. _it should always be remembered that no harm can come from the treatment whether the patient was bitten by a rabid dog or not, and that in all cases of doubt no hesitation should be felt in resorting to it._ chapter xiii hygiene of the sick room far too little attention is generally accorded to the proper care of the sick,--the prevailing opinion being that the royal road to recovery under the circumstances is opened up only through the taking of drugs, and that provided the appropriate ones be given in sufficient quantities recovery will result. no greater mistake is possible. as a matter of fact, there are very few diseases for which we have medicines that act in a specific manner, and far more is usually to be hoped for from good nursing. fortunately the general public is beginning to recognize the truth of the statements just made. it has only been a short time since the trained nurse was unknown except in the larger medical centres, but now her presence and beneficent influence is being felt from one end of the land to the other, and her importance is destined to increase with the onward march of time; she is undoubtedly the greatest advance that we have made in medicine during the last decade. where persons are ill they should always be attended by a trained nurse if possible, but if this is out of the question a few suggestions as to the sick room and its hygiene should certainly not be omitted from any book dealing with rural sanitation. _ventilation and warmth._--the sick room if possible should be located on the sunny side of the house, and should have fire in a fireplace if the weather be cold. it is of the utmost consequence that the room have windows and doors by means of which it can be at all times thoroughly ventilated. at all seasons of the year a room on the lowest floor of the house is more satisfactory, since it is warmer in the winter and cooler in the summer. the room should not be uncomfortably cold, though it is much better to have the temperature too low than to have the air stuffy. in most diseases ventilation is of supreme importance, and should be secured at any cost. where, however, it is compatible with thorough ventilation, a temperature of about °f. is generally considered most desirable. before a patient is moved into a room all superfluous furniture should be taken out, particularly carpets and hangings of all kinds. it is likewise of the utmost importance that all insects, particularly flies, be excluded by proper screening. the patient's bed should be narrow, and a mattress is much to be preferred to a feather bed. the mattress should be protected by a rubber sheet or newspaper pads; oil-cloth cracks and wrinkles too badly to be of service for this purpose. the rubber sheet should of course be kept under the sheet nearest the mattress. the cover should consist of a sheet which is long enough to fold back at the head over the other covering for some distance, and blankets should be used for warmth in preference to quilts. the bed should be kept scrupulously clean, and the linen and covering should be removed when soiled. the nurse should see to it that bread-crumbs do not remain in the bed. in removing soiled bed-clothes the following plan is the one usually adopted. the patient is moved to one side of the bed as near the edge as possible, and the sheet beneath him loosened at the head and the foot and on the opposite side; it is then rolled up toward the patient and pushed well up under him, leaving the side of the bed opposite to that upon which he is lying bare; upon this the new sheet is placed, which is then tucked under the edges of the mattress, and the patient rolls or is pulled back over on it. the soiled sheet is then removed and the edges of the fresh one pulled over the portions of the bed still uncovered, and secured in the usual way. _general precautions._--the room should also be kept scrupulously clean; all sweepings should be burned. soiled linen and all excretions from the patient should be promptly removed, and if the latter need not be preserved for the inspection of the physician, should be at once disinfected and properly disposed of. milk and other food should not be left in the sick room; and soiled glasses and dishes should be removed and washed at once in boiling water. persons who are ill should not be allowed to have company. there is nothing more important in connection with the looking after patients with infectious diseases than this precaution. the writer has often seen in the country districts patients with typhoid fever and other infectious diseases surrounded by the neighbors from miles around,--the entire company often eating and drinking in the room occupied by the afflicted person. the strain that results on the patient from a practice of this kind might well in many cases have fatal consequences, and there is no question whatever that many diseases, particularly typhoid fever, are scattered in this way from house to house and from one community to another. the diet should be given regularly and should consist strictly of only such things as are allowed by the physician. all medicines should be given absolutely according to directions, as otherwise having a doctor is worse than useless. all patients should have a daily bath, special attention being given to their hair, teeth, mouth and nails. in many cases it is necessary to wash the patient's mouth frequently with some antiseptic wash. this should only be done on the expressed instructions of the doctor. chapter xiv emergencies and accidents few things are of greater importance, and nothing is more neglected than instructing school-children how to act in emergencies. particularly is such knowledge of value in the country. in cities the need of understanding matters of this kind is not so great, since it is usually possible to secure at short notice some one capable of dealing with any situation that may arise. children very quickly grasp knowledge of this character, and opportunities frequently offer for an actual demonstration of the proper remedies in the case of accidents. when the instructor speaks of cuts and burns they at once understand what is meant. the most serious result of our neglect in this particular is that our children pass through life with the most meagre knowledge of the proper way in which to meet accidents of all sorts, for where they are not taught during their school days they, for the most part, remain ignorant of matters of this kind throughout their maturer years. it is much to be hoped--though this is somewhat of a digression--that the old unscientific and senseless system of teaching, which persists even in the present time to a considerable degree, may in the future give way to a more rational and practical plan of instruction--one that will deal with perceptible needs rather than abstractions. the most common emergencies will now be taken up and considered in detail. _drowning._--the subject of drowning is one of especial interest in rural districts, since it is here that accidents of this kind are most apt to occur, and skilled attention is most difficult to obtain. it is of the utmost importance to remember that people may be resuscitated after having been under the water for considerable periods of time, and we should, therefore, look upon no ordinary cases as hopeless until the proper restorative measures have failed. on removing the body from the water we should not waste time by attempting to drain the water from the victim's mouth, as the amount of this substance that enters the air-passages under such circumstances is so trifling that it may be entirely disregarded. the drowned person should be placed face down upon the ground with the head slightly turned to the left, and we should begin at once with artificial respiration. _artificial respiration._--this is accomplished by the operator kneeling between the separated legs of the patient and placing his hands on the small of his back, the thumbs nearly meeting at the middle of the spine, and the other fingers spread out over the lower portion of the chest; the operator then sways his body downward and forward slowly, counting three during the movement, then quickly swinging backward releasing the pressure on the patient's chest; again count three and repeat the original movement. the pressure should be brought to bear from twelve to fourteen times a minute, and the movement should be kept up until the patient begins to show evidences of being restored, or until it is quite evident that life is extinct. this system of artificial respiration was originated by professor schafer, as the head of a commission appointed by the british government, and is now universally regarded as being by far the most satisfactory of all such methods. in the accompanying figures are shown the positions assumed by the patient and operator while carrying on artificial respiration. it should be remembered that the victims of accidents of this kind suffer considerably from lowering of the temperature of the body as a consequence of the long exposure to water, and we should, therefore, also direct our attention toward bringing about an immediate reaction by means of warm blankets and hot bottles, and by vigorous rubbing of the patient's body. _danger from wounds._--wounds may be produced by a great variety of objects, but chiefly, of course, by cutting instruments. where they are caused by duller objects, producing more or less tearing and bruising of the tissues, they are more apt to be followed by infection with disease-producing germs than where smoothly cut, and consequently require greater care in treatment. germs sufficient to produce death may be introduced into the body by the most minute wound; it is for example well known that fatal consequences have resulted from the bites of various insects, and the writer has personally seen a case where a pin-prick was followed by lockjaw and death. such facts teach us that we should be careful in avoiding wounds of all kinds, and, that after they have been received, they deserve attention, however insignificant they may appear to be. wounds resulting from objects more or less covered with dirt are particularly dangerous, since under such circumstances the germs of lockjaw are apt to be introduced into the body, and fatal consequences not uncommonly ensue. it is astonishing how frequently the disease just referred to follows where a barefooted child sticks a dirty splinter or a rusty nail into its foot, and it cannot be too strongly urged that it is the duty of the parent in such instances to call in a competent physician at once. the reason that injuries of this kind are so apt to be followed by lockjaw is that the germ that produces the disease lives practically everywhere in the earth--being especially common in the rich soil of gardens and other highly fertilized earths; and the germs are so minute that thousands of them might be present on the point of a pin without being visible to the naked eye. the bacilli of lockjaw do not grow at all where exposed freely to the oxygen of the air, and as a consequence of this fact we rarely see the disease that they produce developing after slight superficial wounds; much more commonly the malady results from a wound made by some penetrating object, such as a splinter of wood, a nail, or a pin. the lesson that these facts teach is that where wounds are small and deep it is the part of wisdom to cut them open freely in order that they may be cleansed as far as is possible, and at the same time allow the air to obtain free access to their deepest portions; a wound of this kind should not be sewn up, but should be left open and allowed gradually to heal up. the reason why lockjaw so frequently follows wounds from the premature explosion of fireworks is that the paper used in fire crackers, etc., often contains the germs of the disease and is driven deeply into the tissues. in view of the very considerable mortality that yearly occurs among the children of this country it seems incomprehensible that our legislatures--which commonly exhibit such an uncontrollable desire to regulate their neighbors in every possible way--should not long ago have placed the ban on fireworks of all kinds. _treatment of wounds._--the treatment of wounds necessarily depends to a considerable extent on their character and general severity: there are certain practices, however, that apply in all cases, and should, therefore, be resorted to wherever injuries of this kind occur. where the wound is superficial the bleeding is as a rule trifling in character, and very quickly stops of its own accord. in other cases, particularly where deep, larger blood-vessels may be severed, and if they be of any considerable size, the hemorrhage will not cease until the subject becomes exceedingly weak, and in some instances the bleeding will go on until death results. where bleeding is profuse, it may generally be assumed that one of the larger vessels has been cut, and under such circumstances it should be compressed until skilled assistance arrives. there is a popular but very erroneous impression that arteries can only be stopped by tying; as a matter of fact any one possesses sufficient strength in the fingers to pinch them enough to stop the hemorrhage. if possible, the operator should get his finger down into the wound, after which he can quickly discover the exact point where pressure stops the bleeding. one who is unaccustomed to surgical practices would, of course, hesitate at doing this, but it cannot be too strongly urged that a procedure of this character produces little or no pain after the finger is first introduced, and that no one should be deterred by foolish squeamishness from immediately doing that which in many instances can only save the life of the victim. where arteries are evidently bleeding--which may be inferred from the spurting character of the hemorrhage--a tight bandage above the seat of the wound, if on one of the extremities, will often be followed by a cessation of the bleeding, and where only small vessels are cut, a bandage tightly applied over the wound itself may accomplish a similar result. under such circumstances the reader should be warned that it is not safe to leave a limb tightly bandaged in this way for any considerable length of time, as complete death of the part below may result. where then a ligature is placed above or over a wound, it should be loosened cautiously every twenty or thirty minutes, and should be left off for a time. if the wounded artery begins to bleed, one should resort to local pressure upon it with the finger for five or ten minutes, after which the bandage may again be applied. as soon as all bleeding has ceased, the wound should be thoroughly washed out by means of water that has been boiled and allowed to cool; the operation may be greatly assisted by using a rag or a piece of cotton that was boiled in the water. if there be grease or other dirt that does not readily come away soap may be freely used. after the wound has been thoroughly cleansed, some sort of antiseptic had better be applied. unquestionably the best of all of these is tincture of iodine, a small amount of which should be poured directly into the wound. a saturated solution of carbolic acid in water is also a fairly good disinfectant, and may be employed where the tincture of iodine cannot be obtained. a solution of corrosive sublimate in water--one part of the former to one thousand parts of the latter--is much used as an antiseptic by surgeons, but when placed directly in wounds has a tendency to cause much irritation, and is by no means so efficient as either of the disinfectants just referred to. in the country it is an old custom to use turpentine, or resins from several different species of pines; these are fairly efficient antiseptics, and should be employed where it is impossible to obtain those that are better. it should always be remembered that thorough washing out with boiled water and soap is in itself a procedure that will remove a considerable proportion of any germs that may have got into the wound, and that if carefully done, it is almost as efficient as the best antiseptic. after the wound has been thoroughly cleansed by water and antiseptics, it should then be bandaged with a cloth that has been previously boiled and dried, if no regular surgical dressing is at hand. every precaution should then be taken to prevent it being reopened. collodion is sometimes used over small wounds, and is quite efficient in that it forms a coating over any surface upon which it is placed that is impermeable to both air and water. small wounds that have been thoroughly cleansed and disinfected with tincture of iodine may be safely and satisfactorily closed by means of the substance just mentioned, but it should never be forgotten that the germ of lockjaw--which is the one, ordinarily, most to be dreaded in such injuries--lives and grows best in the absence of the oxygen of the air, and that a covering of collodion would materially assist in the development of this dreadful disease. in those instances where pus forms in wounds, they should be at once reopened and allowed to drain. it very often follows after cuts--particularly if they be not properly cleansed--that a scab forms on the outside, holding beneath a greater or less amount of pus. the presence of the latter can generally be inferred by a wound presenting a red and angry appearance around its edges, and from swelling and pain. as soon as such a condition is observed, the scab should be thoroughly soaked in water and removed, and it is then necessary that the wound be kept open and allowed to drain freely until it heals up from the bottom. a failure to observe precautions of this kind may result in blood-poisoning, and finally even in death. after a wound begins to suppurate it does little good to put antiseptics into it, as they cause considerable irritation, and under no circumstances do they put an end to the pus formation. open drainage of the wound, and keeping up the general health of the patient, are the only means that we possess of successfully combating conditions of this kind. inasmuch as we possess an antitoxin that unquestionably has the power of preventing lockjaw, if given sufficiently early, it is the part of wisdom to administer at once a sufficient dose of this substance to any child who has received a penetrating wound from some dirty object, or from the explosion of fire-crackers. statistics show that under such circumstances lockjaw may be prevented in almost all cases. if we wait until the disease develops, the antitoxin is of no value. _care of sprains._--the seriousness of sprains is very generally underestimated, and as a consequence many persons go through life with ankles that are abnormally weak, and even painful in bad weather, and in which there is a tendency to swell and become exceedingly troublesome after a slight wrench. in all true sprains there is more or less actual tearing of the ligaments that bind the joint together, and, if the injury be not properly treated and the joint thoroughly supported, complete recovery in many instances never takes place. as soon as a sprain occurs the injured joint should be immersed in water just as warm as can be borne, and hot water should be from time to time added in order to keep the temperature sufficiently high. the bath should be continued for several hours--the longer the better. thus the pain and swelling will be greatly reduced, and the tenderness which, in the beginning, is so excruciating, will largely disappear. the next step is to properly support the injured parts in order that unnecessary movement may be prevented, thus avoiding further tearing of the ligaments. this may be accomplished by means of various splints--the most popular being those made of plaster of paris, or silicate of sodium, either of which will require the services of a physician in order to have them properly applied. within recent years a treatment has come much into vogue, which is exceedingly satisfactory, and has the advantage that it does not require the service of an expert in order to have it properly carried out. this consists in the application of strips of adhesive plaster to the skin over the seat of the injury and for some distance both above and below the joint affected. ordinary sticking-plaster is not the best for this purpose, though in an emergency it might be used; much better is the so-called mole-skin plaster, which is much thicker, and does not require moistening before being applied. the plaster should be torn into strips about three-fourths of an inch wide and twelve to eighteen inches long. where the ankle is the seat of the trouble, a strip is firmly applied to the back of the foot, beginning just behind the toes, and is brought around the ankle and carried up on to the calf of the leg--thus partially winding the plaster around the leg. the first strip having been applied, another is put on in a similar way, the edges of the latter overlapping those of the former. this is continued until one side of the ankle is fairly well covered, after which we may begin operations on the opposite side, carrying the strips around the leg in such a way as to meet and overlap those first put on. this process is continued until the entire joint is completely covered with the plaster. it is of the utmost importance that the foot be put in a natural position before we begin to apply the plaster, as, otherwise, it will be left in a constrained and uncomfortable position, which will do away largely with the good effects of the splint. where carried out in the proper way it is in the highest degree astonishing to see how perfectly the joint is supported, with the effect that the use of the injured limb may be immediately resumed. the writer recalls having seen a young lady with a frightful sprain, who could not bear to touch her foot to the floor, improve to such an extent under the treatment as outlined that she was able to go to a ball and dance through the evening on the day the injury occurred. not only does the immediate resuming of the use of an injured limb, when treated in this way, appear not to be injurious, but the ultimate recovery seems actually hastened. after a day or so it is well to remove the plaster splint first applied and put on another, as the former has by this time usually ceased to fit the injured joint--owing to the diminution in the swelling. the splint may be changed three, four, or even five times, if deemed necessary, though two or three applications generally amply suffice. _this or some other splint should be kept on the injured joint for at least a month or six weeks, as otherwise complete recovery frequently fails to occur, with the permanent weakening of the joint as a consequence._ of course it is always desirable to have a physician apply the splints for a sprain where this is feasible, but with a little care it may be done by any intelligent person who will observe closely the directions given. the plaster should be put on moderately tight, but the utmost care must be exercised in not carrying this to an extreme, as in such cases serious results might ensue. in order that it may be determined as to whether or not the splint is too tight, it is advisable to watch the patient's toes for some hours after the plaster is put on, and should they be found to be very cold, and particularly should they begin to show a dusky discoloration, it is evidence that the strips are exerting too much pressure, and they should be at once removed. under such circumstances, in a half an hour or so, the splint could be reapplied with safety. the mole-skin plaster, which is used in making the splint just referred to, may be obtained in rolls of any width from all druggists; and as the plaster keeps practically indefinitely, it should be in the medicine-closet of everyone living at a distance from skilled medical aid. after a sprained ankle the patient should wear shoes that come well up above the injured joint, and they should be laced tightly until some time after all symptoms of trouble have disappeared; it would be on the safe side to wear shoes of this kind from six months to a year, depending upon the severity of the injury. _treating bruises._--bruises are not usually followed by serious consequences if properly treated. they result from injuries that tear the tissues beneath the skin to such a degree that hemorrhage from many minute blood-vessels occurs in the injured part. in the course of a few hours they often present a truly alarming appearance, being swollen and greatly discolored, but they are not as a rule followed by any permanent ill results. where bruises are slight no treatment of any kind is required, as in a short time the effused blood is absorbed, and the part returns to a normal condition. where more severe it is not a bad practice to cover them with flannels wrung out from hot water, the same being renewed from time to time, and the applications kept up for from six to twelve hours. usually at the end of this time the soreness and swelling will have considerably abated, and the injured tissues quickly return to a normal condition. _the reader should be warned that under no circumstances should the skin be opened, even though it may be quite obvious that there is a bluish mass of blood immediately beneath._ where this mistake is made, infection of the injured tissues with the germs that produce pus inevitably results, and as a consequence the patient suffers with a discharging wound for a considerable period of time. in rare cases germs get into the injured parts without the skin having been opened, and there results under such circumstances a condition which closely resembles that of an ordinary abscess. the probability that this undesirable complication has arisen is shown by the swelling becoming greater and more painful some days after the injury has occurred, and under such circumstances a good physician should be at once consulted, as it will be necessary to make an incision into the diseased area. _soothing burns._--one of the most common and painful of injuries are burns. small superficial burns require no particular treatment. where, however, they are of sufficient severity to merit attention, the simplest and best of all treatments is to immerse the diseased part in cold water, and here it should remain at least some hours, or until competent medical aid can be secured. medical treatment of injuries of this kind is not particularly satisfactory, though there are some drugs that may be used with more or less benefit. chief among them is picric acid, which may be applied by means of a cloth wrung out of a one per cent. solution of this substance in water. another treatment which has some merit, and which has long enjoyed a certain vogue among both medical men and the laity, is a combination of equal parts of lime-water with either olive or linseed oil; this is called carron oil and is applied in the same way as the picric acid solution. all three of the remedies referred to act largely by preventing the access of air to the burned surface, and they, therefore, may be replaced by any bland and non-poisonous substance which accomplishes like results. _accidents from heat and cold._--the climate of the united states is characterized by extreme variations--there being over almost its entire extent during the winter months a series of "cold waves," during which excessively low temperatures are often experienced,--particularly in the northern and western portions of the country. during the summer, on the other hand, we have almost everywhere periods during which the temperature goes very high--often accompanied by excessive atmospheric moisture. as a consequence of these extremes in temperature it could only be expected that we would often experience bad effects, so that serious illness, and even death, occasionally result. of the two extremes, excessive heat is much the more dangerous, and is by far more frequently followed by fatal results--particularly in crowded cities. fortunately for the dwellers in rural districts the precise conditions under which excessive heat is followed by serious consequences are not so frequently encountered as in the more populous centers, and as a result we find that serious ill effects from high temperatures are by no means so common in the former as in the latter. there are, however, two quite well defined and distinct morbid conditions that are the result of high temperatures, and inasmuch as they differ in their symptoms as well as in their treatment, it will be necessary to consider them separately. _sunstroke._--sunstroke is characterized by a rapid onset, the patient usually complaining of an uncomfortable sense of burning heat and a feeling of dizziness and depression. nausea, vomiting, and diarrhoea are common, frequently an intense headache, and sooner or later a muttering delirium. the patient's skin is dry and hot, the face is flushed, and the eyes suffused, and a thermometer will show a bodily temperature of from ° to ° or even °f. in fatal cases it is usually some hours before the patient dies, though sometimes he succumbs almost instantly. when attacked, the patient should at once be removed to some shady place, and should be held in a sitting posture against any suitable object that may be at hand. the clothing should be loosened at once, and every endeavor should be directed towards lowering the temperature of the victim. this is best done by pouring ice-water or the coolest water that can be secured freely over the entire body of the patient. this treatment should be continued until the temperature approaches the normal--the vigor of the measure employed gradually decreasing, as the patient shows signs of getting better. improvement is shown by a gradual return of consciousness. _heat-prostration._--like true sunstroke, heat-prostration comes on with an extreme suddenness. the patient becomes suddenly dizzy, and sinks to the ground in a state of collapse. the skin is pale and cool, the pulse limp and weak, and the thermometer shows the temperature to be somewhat below normal. the patient should be laid on the ground in a cool, shady place, and stimulants at once given. by far the most efficient of them is a hypodermic injection of morphine and atropine, to which strychnine in appropriate doses may be added. _guarding against sunstroke and heat-prostration._--excessive heat is the basis of both of these conditions, but there are many contributing causes which play a more or less important part in their production. notwithstanding the fact that they are regarded as being different, and that the treatment and symptoms of the two conditions vary widely, there can be no doubt that certain depressing influences, in every way similar, play an important part in their causation. foremost among such influences alcohol claims first place, and unquestionably not only predisposes to all diseases brought on by heat, but lends much greater gravity to an attack--the drunkard rarely recovering from true sunstroke, and frequently dying from the much less dangerous heat-prostration. it is said that the latter condition is particularly prone to occur after freely indulging in beer or other malt liquors. not only does alcohol predispose to these morbid states, but other influences that depress the general vitality are more or less apt to predispose to the production of both, such as loss of sleep, overwork, worry, excessive eating, and insufficient food. the danger is greater when there is excessive moisture in the air, so that at such times we should particularly avoid excesses of all kinds, and as far as possible, keep out of the direct rays of the sun. _frost-bite._--in the extreme northern and northwestern portions of the united states frost-bite is not uncommon in winter. the part attacked becomes suddenly bloodless, presenting much the appearance of the skin after death. the victim is usually not aware of the fact as at first there is no pain. as soon as a condition of this kind is observed,--and in cold countries persons are quick to inform the victim when they notice it,--the place should be vigorously rubbed with a piece of ice, or with a handful of snow, and this should be continued until the circulation again returns as evidenced by the parts becoming reddened. a rapid warming of the affected parts is not advisable, the result being not unlike that of a burn. _chilblains._--many persons suffer during the winter from chilblains--this being a state in which more or less pain and itching is produced in a part as the result of poor circulation. such a condition is usually the result of a combination of cold with the affected part being more or less compressed, and as a consequence, we find that troubles of this kind are more frequently in the feet--particularly where tight shoes are worn. the remedy for troubles of this character is to wear loose-fitting shoes, and to thoroughly protect the parts by appropriate woolen socks. it is particularly of importance to change the socks often, since as soon as they become moistened with perspiration a tendency to a recurrence of the trouble is very great. drugs are of no particular use in conditions of this kind. chilblains are more commonly suffered in europe than in america. one young american lady in paris acquired them one winter, and "knowing no better," as she told the writer, cured herself by "boiling the chilblains"--soaking her feet in the hottest water she could endure. the affliction did not return; and the novel recipe was delightedly followed by all the art-students of the neighborhood. _blisters._--small blisters on the feet are not uncommon as the result of wearing tight, or ill-fitting shoes. wherever possible, they should be quickly relieved from all compression, and should under no circumstances be opened. the treatment is very simple and quite efficient, provided it be instituted while the skin is still intact, and consists simply in placing over the affected area a small piece of mole-skin plaster, which should extend for a short distance out on the normal skin surrounding the blister; the same sort of plaster should here be used as was recommended for supporting sprained joints, and is an article so useful that it should be kept in every house. where blisters have ruptured, the better plan is to apply some antiseptic, like tincture of iodine, and after having allowed it to dry, stick on some plaster as already directed. if no antiseptic be at hand the plaster should be used any way, but it should be frequently removed in order to see that no suppuration is occurring beneath. small blisters, the result of burns, may be treated in a similar way with good results. _tooth-ache._--tooth-ache is a condition for which there is no excuse in the present state of knowledge. as soon as decay begins in a tooth it should receive the attention of a competent dentist, and where this is done a true tooth-ache never occurs. where one has been so neglectful as to permit the exposure of the nerve of a tooth, he can only be saved from much suffering by going at once to a dentist. in the meantime, various measures may be adopted to diminish the pain. a piece of cotton dipped in dilute carbolic acid and thrust into the cavity will almost immediately relieve the suffering for the time being. oil of cloves, or a mixture of this substance with chloroform, applied in a similar way will bring about a like result. the reader cannot be too often reminded of the fact that bad teeth not only cause much suffering, but likewise lead to many digestive disturbances, and as a consequence little could be of more importance to the health of the body than to see to it that they be kept in perfect order. where teeth are knocked out, they will often grow back and render good service for many years afterwards if replaced immediately in their sockets. _bites of animals._--wounds of this character, particularly those produced by dogs and cats, are not at all uncommon. where it is definitely known that the animal is not rabid, the treatment should be that of punctured wounds,--to the chapter on which the reader is referred for further information. where there is reason to suspect that the animal has hydrophobia, it should be, if possible, at once confined, and watched for developments. under no circumstances should it be killed. if the animal is rabid, it will be unable to eat or drink, and will die in the course of a few days; should it survive not the least fear need be felt as to it having had hydrophobia, as no instance is on record where the disease was followed by recovery. for further information on this subject, the reader is referred to the special article on hydrophobia (page ). _hiccough._--hiccough is a condition caused by a spasm of the diaphragm. all methods for the relief of this somewhat annoying condition are based upon the idea of having the patient hold his breath as long as is possible. the remedy is best applied by the sufferer holding his breath and leaning as far backward as is possible, and in the meanwhile distracting the attention by pointing the index finger of one hand towards the nose, and bringing the former toward the latter as slowly as is possible. sticking the tongue out and holding the breath at the same time will often relieve hiccough, or if the victim can be induced to sneeze the distressing symptom will at once cease. the _slow_ swallowing of a few sips of water will frequently put an end to the trouble. chapter xv what to do when poisoned the vast majority of cases of poisoning occur in children, and are, almost without exception, due to carelessness of their elders, and therefore preventable. as soon as it is recognized that anyone has swallowed a poison of any kind, a competent physician should be summoned with the utmost haste, and in the meantime much may be done, in most cases, to minimize the effects of the substance taken. the patient should at once be urged to drink as much water as is possible, in order that the poison may be diluted, and every effort should be made to induce vomiting; this may often be brought about as soon as the stomach is full of water, by tickling the throat with the finger, or with any other object that can be readily introduced through the mouth. as quickly as possible, some warm water should be secured, to a quart of which either a teaspoon of salt or mustard should be added, and the patient urged to drink until the stomach is thoroughly distended; following this, particularly where aided by tickling the throat, vomiting may be generally induced, with the effect, of course, of expelling a greater or less proportion of the poison from the stomach. if it be known that the poison is an _acid_, ordinary cooking soda should be added to the water that the patient drinks, as in this way all acid substances are at once neutralized. if the patient has taken an _alkaline_ poison, he should immediately be given diluted vinegar, or water into which the juice of lemons or oranges has been squeezed; such harmless acids neutralize poisonous alkaloids just as harmless alkalies antidote poisonous acids. _arsenic poisoning_ usually results from the accidental swallowing of rat-poison or some insecticide, as paris green, or else some sort of green dye, many of which contain salts of arsenic in some form. an emetic should be at once given, to be followed by the whites of several eggs dissolved in a small amount of water; sweet milk may also be administered with benefit. accidental poisoning by _phosphorus_, results usually from children eating the heads of matches, and it is rarely the case that enough of the substance is taken to produce serious results. the poison, however, is a deadly one if taken in sufficient quantity, and where it is found that substances containing it have been swallowed the most energetic measures should at once be resorted to. warm water containing mustard or some other emetic should at once be given, and this should be followed by whites of eggs and sweet milk. it is well also to try to get rid of any of the phosphorus that might remain in the stomach by giving the patient some saline purgative like epsom salts. where _carbolic acid_ has been taken, the fact can be readily determined by noting the characteristic smell of this substance on the patient's breath, and by observing that the mouth and throat present a more or less whitish appearance. the treatment to be of any avail, should be of the most energetic character. the patient should at once drink largely of water, and vomiting should be induced as quickly as possible. either milk or the white of an egg should then be given. ordinary quick-lime, or even plaster from the walls of the house, may be stirred up in water and administered to the sufferer, as both have a distinct value in antidoting the effects of this poison. burns of the skin with carbolic acid are rarely followed by serious consequences. as soon as the accident occurs the part should be thoroughly washed with water, and if at hand a little alcohol may be rubbed over the part; the affected tissues return to a normal condition in the course of a short time in the vast majority of cases. _strychnine poisoning_ is comparatively rare, except when this substance is given with suicidal or murderous intent. water should be given, immediately followed by an emetic. a mass of crystals of permanganate of potash as big as a pea may be administered in a glass of water, if this substance be at hand. after the poison has been absorbed nothing is usually of any avail if the amount was originally sufficient to produce death. one of the commonest forms of poisoning is from _opium_ in the form of morphine, paregoric or laudanum. when this happens the stomach should be washed out by water frequently, even where the drug was administered hypodermatically. this is best accomplished by causing vomiting by warm water to which a small amount of mustard has been added. the patient should be given strong coffee or tea at frequent intervals, and artificial respiration should be practiced. where it is possible to obtain it, permanganate of potash in a watery solution should be given, enough of the chemical being used to make the water a deep purple color; this may be frequently repeated, as the substance is not poisonous in ordinary doses, and destroys morphine and other alkaloids of opium very rapidly. _it should never be forgotten that infants and children are poisoned by comparatively very small doses of opium, and consequently nothing containing any derivative of this substance should be given them except on the advice of a competent doctor._ many soothing syrups advertised for the relief of the minor ailments of children contain opium, and there can be no doubt that many deaths have occurred as a consequence of taking such nostrums. _mushroom poisoning_ in this country is relatively rare, but there are quite a number of popular notions on this subject that are totally incorrect, chief among which is the idea that there is a difference between mushrooms and toad-stools, the former being generally regarded as edible, and the latter poisonous. as a matter of fact, those conversant with this subject make no distinction between the two, using the terms toad-stool and mushroom as interchangeable. it is likewise a common error to suppose that we possess any tests by which the poisonous toad-stools can be told from those that are wholesome. although a skilled student of the subject can almost at a glance determine which are poisonous and which are not, it is hazardous in the extreme to consume those selected by one who is inexperienced. as a matter of fact, for all practicable purposes, there is only one species that is generally eaten,--the _agaricus campestris_, or meadow mushroom. this grows for the most part in open fields, and in many parts of the world may be gathered in great number throughout the warmer seasons immediately following rains. this mushroom has also the great advantage that it is the only one of the edible species that can be cultivated. just as we have only one common mushroom that is ordinarily eaten, there is only one common species of these plants that is highly dangerous,--the _amanita phalloides_, which contains one of the most deadly poisons known--and one for which we possess no adequate antidote. this mushroom is very common, being frequently seen along the roadside, and at the edges of fields; it also grows in forests, and is occasionally encountered in treeless areas. it presents a rather attractive appearance, being rather large, and having a glistening white cap with a long stem, around which there may always be seen a distinct collar; on carefully removing the soil from around its roots, it will be seen that its stem is surrounded just below the surface of the earth by a sheath-like structure, the so-called "death-cup," which, together with the peculiarities already mentioned, clearly stamp this mushroom as being one of the most deadly of all known natural objects. in addition to the rather inviting appearance of this toad-stool, its flavor is agreeable, thus in every way insidiously inviting, it would seem, the unwary to their doom. less common than the species just considered is another closely related fungus known as the _amanita muscarius_, or fly-agaric; this handsome mushroom presents the same peculiarities of structure exhibited by the _amanita phalloides_, but differs from it in the fact that the tip of its cap is scaly, and is of a reddish-yellow color. the fly-agaric is quite as poisonous as its more common relative, and is equally to be shunned. the reader should be warned that even handling either of the fungi just considered may result in poisonous symptoms--probably as a consequence of multitudes of the tiny spores of the plants being carried into the nose and mouth by the air. some hours after eating the _amanitas_, the patient is taken with vomiting, diarrhoea, cramps, and extreme prostration; in children, convulsions may occur. most unfortunately evidences of this poisoning do not usually develop until some hours after eating it. as a consequence, a considerable amount of the poison has usually been absorbed into the body before the victim is aware that anything is wrong, and it, therefore, becomes impossible, as a rule, to greatly help matters by attempting to remove the offending material from the stomach by emetics. notwithstanding this it would be proper to administer warm water, into which a small amount of mustard had been stirred, in order to assist nature by washing out of the stomach whatever portions of the fungus might remain. when exhaustion begins to appear, it should be combated with doses of aromatic spirits of ammonia, and by the external application of heat. as it is believed that atropine possesses some antidotal powers to the poison of the _amanitas_, this substance should be injected hypodermatically in the usual dose as quickly as possible, and an experienced physician should be called at once. _ivy poisoning from touch._--one of the two species of _rhus_, is exceedingly common in all portions of the united states, producing a severe inflammation of the skin when handled, or even in some persons by merely being near the plants or in the smoke of a fire where they are burning. there are two varieties of the _rhus toxicodendron_, one being the shrub commonly called _poison oak_, and the other a climbing vine generally known by the name of poison ivy. the _rhus venenata_ grows in swampy localities all over the united states, and is known as poison-sumac, swamp dog-wood, poison-elder, and poison dog-wood. about twenty-four to forty-eight hours after the exposure, the skin begins to itch, and this is shortly followed by an inflammation accompanied by the formation of numerous small blisters, and still later by scaling. it should not be forgotten that the berries and other portions of these plants are poisonous when taken internally, giving rise under such circumstances to vertigo, faintness, dilation of the pupils, trembling, confusion of the senses, and, in some instances, convulsions. should it be discovered that anyone has been exposed to poisoning by these plants, the skin should be washed as quickly as is possible with alcohol, or some substance like whisky that contains it; where this cannot be obtained, hot water and soap should be liberally applied--the object, in either case, being the removal of as much of the poison as is possible. after the irritation of the skin has begun, the parts may be bathed in a one per cent. solution of carbolic acid, to be repeated every few hours, as the necessities of the case may demand. lead-water is also frequently used with benefit, lime-water also appears to be of use, but the various powders and salves sold in stores rarely help the patient much. the best thing after all is soap and water as hot as it can be borne; and ordinarily the itching and inflammation will disappear in four or five days, followed by scaling. venomous snakes and snake bites. much popular misapprehension exists on the subject of snakes, both as to the results of their bites and the appropriate treatment under such circumstances. it is not generally understood that a very large percentage of our american snakes are entirely harmless--the poisonous ones being decidedly more the exception than the rule. within the confines of the united states there exist only two families of venomous serpents. by far the most numerous are three genera of viperine snakes, including the rattlesnakes and moccasins; all of these have a pit-like depression between the nose and eyes, and hence are called _pit-vipers_. in the southern portion of our country there are two species of a colubrine genus closely related to the dreaded cobra of the east, one of them being called the coral-snake or harlequin snake, and the other, which occurs in the southwest, is known as the sonoran coral-snake. while there are three genera of vipers in america, two of them are so closely related, and present characteristics that are so similar that the ordinary observer would regard them as being identical, and inasmuch as the character of their poison seems in every way similar, for practical purposes it would seem desirable to include them under one head; in both genera, the species have rattles on the tips of their tails, the more common being the ordinary rattlesnakes (genus _crotalus_), of which there are twelve species in the united states, and the ground-rattlesnakes (genus _sistrurus_), of which there are two species. closely related to the rattlesnakes are the true moccasins, of which there are two species, one being the cotton-mouth or water-moccasin (_ancistrodon piscivorus_), and the other the highland moccasin, pilot-snake or copper-head, (_ancistrodon contortrix_). the two species of poisonous colubrine serpents already referred to are known respectively as the _elaps fulvius_, and the _elaps euryxanthus_, both of which occur in the southern portions of the united states. these snakes are fortunately of a very mild disposition, and rarely attempt to bite, even when handled. that their poison is exceedingly deadly is attested by the fact that out of eight instances where it was known that persons were bitten by them, six died, and they should, therefore, be looked upon as among the most deadly of north american serpents. mention should be made of the fact that there are at least six harmless reptiles that resemble the coral-snakes very closely, and as a consequence of the former being mistaken for the latter, the assertion has been frequently made by the ignorant that our elapine serpents are harmless. a short description of the really deadly reptiles encountered in this country that would enable even the novice to distinguish them from those that are harmless would seem not inappropriate here, for where a person is bitten by a snake it becomes at once a matter of vital importance to determine, if possible, its true character. most non-venomous serpents will viciously bite when cornered, and while they may produce slight wounds, with a small amount of bleeding, such injuries are entirely devoid of danger, and need occasion no fear on the part of the victim. there now follows a brief description of our venomous snakes, by means of which it will be easy for any one to distinguish them from their innocent relatives. _true rattlesnakes._--there are twelve species of these reptiles in the united states, all of which, with but two exceptions, live west of the mississippi. they vary very greatly in color, but the common eastern forms generally have alternate transverse yellow and brownish-black marks over their bodies. all possess rattles. the body of the snake is thick in proportion to its length, and the head, which is more or less diamond-shaped, is much larger than, and is quite distinct from the neck. the pupils of the eye are elliptical--a peculiarity which the pit-vipers alone possess of all the north american snakes. between the eye and nose there is a comparatively deep depression or pit which gives to this group of snakes their name. there are two large, exceedingly sharp fangs in the front of the mouth, in the position of a dog's canine teeth, that are folded up against the roof of the mouth when the snake is in repose;--being brought forward in a position for stabbing as the serpent strikes. the scales on the under surface of the body back of the anus do not divide along the middle line into two rows, as in harmless snakes. _ground rattlesnakes._--there are two species of the pygmy or ground-rattlesnakes. they attain to a length of only about twenty inches, and present the general characteristics of the true rattlesnakes, with the exception that the rattle is small, consisting of but one single button at the end of the tail. these serpents are exceedingly vicious, and usually bite without warning. contrary to the general opinion, however, the wounds they inflict are rarely, or never, followed by serious consequences in man. one species is southern. the other occurs from ohio to nebraska, where it is called massasauga. _cotton-mouth moccasin._--the largest specimens of the cotton-mouth moccasin attain to a length of about six feet. the full grown reptile is of a dingy brownish-black color, but the young are pinkish, with coppery bands running transversely across the body. with the exception that this reptile has no rattles, it answers in its general peculiarities to the description already given of its near relatives the rattlesnakes. the cotton-mouth moccasin is semi-aquatic, being found around the edges of streams and other bodies of water. _the copper-head, or highland moccasin._--this serpent is found from florida and illinois to southern massachusetts; also in parts of texas. the largest specimens have a length of about three feet. they resemble the cotton-mouth moccasin in their general peculiarities, being, however, somewhat lighter in color. the head has a coppery tinge, from which the snake gets its name, while the body is of a brownish color, with transverse y-shaped bands of reddish-brown. its favorite habitat is rocky hill-sides and the banks of mountain water-courses. _coral-snakes._--the two coral-snakes resemble each other very closely, and are long slender serpents, whose heads are quite small, and scarcely differentiated from their bodies. the pupils are round, and the head has no pits. they possess two short permanently erect fangs, which are by no means so well developed as those of the viperine reptiles--though perhaps capable of inflicting more deadly wounds than any of the latter,--with the possible exception of the diamond-back rattlesnake of the extreme southern portion of the country. their coloration is exceedingly beautiful, and when properly interpreted, entirely characteristic. from the head to the tail their skins exhibit alternate rings, or encircling bands of black, red and yellow--each band of the two former colors being bordered by yellow; _in other words there are as many yellow stripes as there are both black and red together._ stress is laid upon the characteristics just mentioned, for the reason that half a dozen species of harmless serpents that greatly resemble them may, without exception, be differentiated from the true coral-snakes by the fact that there are as many _black bands as both red and yellow_. where a snake has been killed, it is of course quite easy to determine whether or not it is venomous by a search for the fangs, which are never present in the non-poisonous reptiles. fortunately, the coral-snakes are only found in the extreme southern portion of the united states, live under ground for the most part, and are rarely encountered. _treatment of snake-bite._--as soon as a person has been bitten by a poisonous serpent, a tight bandage, or ligature of any kind, should be applied above the wound if the injury has been received on any of the extremities,--which is fortunately the case in the vast majority of instances. the part bitten should be at once exposed, and search made for the point of entrance of the fangs. it should be particularly noted as to whether there are one or two wounds, as it is true in about one-half of the cases that only one fang enters the flesh,--in which case, of course, the probabilities of serious consequences resulting are largely diminished. with a pocket-knife or other sharp instrument the wound should be enlarged, and, if possible, someone should be persuaded to suck the wound; this should not be done by one with decayed teeth, as under such circumstances the poison might be absorbed and produce unpleasant consequences. a doctor should be summoned as quickly as is possible, but it must be confessed that in the present state of knowledge, unless he should happen to possess--which he probably will not--some antitoxin for the particular snake doing the damage, his services will likely be of no great value. it has been asserted by some that very large doses of strychnine are directly antidotal to snake venom, but more recent experience does not tend to confirm this view; still there is no harm in making the trial, and if the services of someone capable of giving the injections can be secured, the treatment is certainly worth the trial. the immediate injection into the tissues around the wound of a one-per-cent. watery solution of chromic acid or potassium permanganate is thought to be of value by destroying the poison, but in order to be efficient it must be administered within a short time after the bite has been received. should the patient's condition become serious, and the breathing finally stop, artificial respiration may be resorted to. as soon as the remedies suggested have been tried, it is time for us to go back to the ligature, which cannot be suffered to remain around the limb indefinitely, as by cutting off the blood-supply it will sooner or later produce death of the tissues. from time to time we should slowly loosen the bandage, thus allowing a little of the poison to pass into the body, and at the same time permit the entrance of a small quantity of blood into the tissues of the limb beyond the ligature; the bandage should of course be tightened at the end of a half a minute, and it should be alternately loosened and tightened every half hour until the patient is considered to be out of danger. the reader cannot fail to have observed that nothing has been said concerning the use of alcohol in the treatment of snake-bite, and the matter is only here referred to for the purpose of condemning it as being unsound in theory and bad in practice. the idea that this drug is of value in snake bite doubtless originally arose from the fact that those bitten by poisonous serpents were depressed, and, as in the past alcohol was considered the best of all stimulants, it is not surprising that its use was generally considered to be essential. as we now know, however, that alcohol is a depressant rather than a stimulant, and as numerous experiments carried out on animals have clearly shown that it does harm in snake bite rather than good, there is every reason why we should cease to endanger the lives of those already poisoned by adding to the trouble by using this drug. there is but little doubt that many more persons have been killed by the alcoholic treatment for snake bites than have died from the effects of snake venom. inasmuch as there is a deep-rooted superstition among most people that alcohol is the panacea for snake bite--and such notions die hard--it may be well to say that all of the authenticated cases of this character that have occurred in this country have recently been collected, with the result that it was shown that only about one man in ten dies who is bitten by a venomous serpent, and it is, therefore, quite easy to understand why alcohol has maintained its reputation as being an antidote in such cases--the chances being nine to one in the victim's favor without any treatment whatever. as soon as the patient's needs are attended to, it is well to find if the snake that inflicted the wound was killed, and an examination of it should at once be made as by determining the size and character of the reptile an accurate forecast to the probable results may be made. in many instances it will be found that the snake was not venomous, it having made only a few scratches which are of no more consequence than the prick of a brier. if it be found that the serpent inflicting the wound belongs to one of the groups already referred to, the probabilities of a serious result will depend upon the size and character of the snake, and also to a considerable degree on whether one or both fangs entered the victim's body. a full grown diamond-back rattlesnake, which may attain the extreme length of eight feet, is perhaps the most dangerous of all the american poisonous reptiles, though a fully grown coral-snake may be regarded as almost, if not quite as, deadly. next to these a large sized cotton-mouth moccasin is perhaps most to be dreaded, to be followed, depending upon their size, by the other varieties of rattlesnakes, the copperheads, and finally the ground-rattler. the larger the serpent inflicting the wound the greater is the result to be dreaded; naturally it also follows that the larger the individual bitten the less the danger. appendix recipes for cooking common foods by dr. mary e. lapham preparation of meats _roast beef._--the problem of roasting beef is to have it sufficiently cooked in the center without hardening and over-cooking the outside. burned edges and a raw center testify to a lack of intelligence. the english way of baking beef is to allow nine minutes to the pound for a rib-roast and eight minutes for a sirloin. sprinkle pepper and salt over the meat and sprinkle with flour. pour a little boiling water into the pan and bake in an oven hot enough to crisp and brown peeled raw potatoes cooked in the same pan. do not forget to baste often. this method gives a rich flavor to the beef and the gravy, but the outside is apt to be cooked too hard while the inside is not enough cooked. too hot a fire tends to make meat tough and dry. the french have a safer way, especially for small roasts. the beef is cooked in a cool oven--so cool that a peeled, raw potato will cook tender without browning. allow about an hour and a quarter for a four-pound rib-roast. in this way the heat penetrates to the center without hardening the outside. when properly done the outside is very little more cooked than the inside, and the roast throughout is tender, rare, and juicy, with no hard-burned edges. this way of baking makes inferior beef more tender and juicy than the english way. it has the disadvantage of not leaving any gravy in the pan. when baked after the english method the fat fries out into the pan, and a delicious, rich, brown gravy may be made by adding flour and water. strain the juice through a fine sieve and allow to stand a few minutes so as to be able to skim or pour off all the grease. do not serve gravies with half an inch of pure grease on top. it does not require a scientific education nor a herculean effort to remove the grease. _pot roast._--if the beef is of an inferior quality, the best way to cook it is in a heavy iron kettle, preferably with a sloping bottom. sprinkle the meat with salt and pepper; place a little fat in the bottom of the kettle--enough to keep the meat from sticking--and allow the roast to brown slowly for half an hour. now put a pint of boiling water in the pot. cover very closely and let it simmer on the back of the stove for about four hours, adding small quantities of hot water as necessary, and turning often. when cooked take up the meat; skim the fat from the gravy and thicken with flour. _hamburg steaks._--another way of preparing inferior cuts of beef is to make hamburg steaks. chop the meat in fine pieces. season with salt, pepper and a little onion juice, and shape into thin cakes. put three or four slices of fat salt pork into a frying-pan, and when brown remove it and place the steaks in the fat. fry four minutes; turn, and fry three more, and serve on a hot platter. put a tablespoonful of flour into the fat and stir until brown. gradually add a cupful of water or preferably milk and boil three minutes; season well, pour over the meat, and serve immediately. _broiled beef._--broiling is the simplest, easiest, and most delicious method of cooking meats, but, as a rule, ignorance instinctively turns to the frying-pan, and broiling is unknown in many homes. this is partly due to not knowing how to manage the fire. it seems so much easier to fry on top of the stove than to plan beforehand an adequate preparation of the coals. it is necessary to have a bed of clear, hot coals with no smoke. have the steak cut three-quarters of an inch thick; place in a wire broiler; put over the coals and cover with a baking-pan. turn every minute or two until the meat is sufficiently cooked. when done, place on a hot platter, and season well with salt, pepper, and butter. serve immediately. it should take about ten minutes to cook a steak or thick mutton chop. _fried beef._--if beef must be fried, have a hot fire; heat a thick iron frying-pan and grease it just enough to keep the meat from sticking. have the meat three-quarters of an inch thick; place in the hot pan and turn as soon as it is well seared. turn often until done and then season well and serve at once. there should be no gravy in the pan; all the juices should be in the meat. _beef hash._--take equal parts of beef and cold potatoes, chopped moderately fine. chop a small onion and fry in plenty of butter until brown; add the meat and potatoes and just enough milk to keep from sticking. cook for half an hour, stirring frequently. serve with thin, dry toast or toasted crackers. poached eggs are a very nice addition. _veal._--veal, when properly cooked, is delicious and delicate. like pork it should be cooked slowly for a long time to develop its full flavor. unfortunately it is usually half-cooked, tough, and insipid. the housewife who can cook veal properly has a distinct advantage over her less fortunate neighbor. _leg roast of veal._--take out the bone and fill the space with stuffing made as follows: take one half-cupful of chopped fat pork, or unsmoked bacon, and fry with a finely chopped onion until delicately brown. add two cupfuls of bread crumbs; season with salt and pepper and moisten with a little milk. tie the veal closely; sprinkle with pepper and salt; rub thoroughly with flour and cover with buttered paper. into the baking-pan put a generous number of thin slices of unsmoked bacon, an onion and half a can of tomatoes. add just enough boiling water to steam the veal. cook gently in a moderate oven, allowing twenty-five minutes to the pound, and baste very frequently, turning the meat about every half-hour. when done, put it on a hot platter in the warming oven, and add enough water to make the requisite amount of gravy. thicken with browned flour, strain, and pour over the roast. _fried veal._--fried veal steak or cutlets are delicious, but very difficult to prepare properly. as a usual thing veal cutlets are either half raw, or cooked until dry and hard. when properly cooked veal should be spongy, soft, and velvety. the chops should be not quite a half inch thick. melt a little lard in a hot frying-pan; sprinkle some salt and pepper on the veal and fry quickly until brown on both sides. then cover tightly, and place on the back of the stove and steam until thoroughly tender. it requires from forty to forty-five minutes to fry veal. _broiled veal._--the veal should be cut thin, broiled quickly until brown, and seasoned with salt, pepper, and melted butter, to which a little chopped parsley and lemon juice have been added. serve on a hot platter and eat at once. if the veal is fat, tender and nicely broiled, it is almost as good as game. _veal stew or pot-pie._--cut the meat from a knuckle of veal into pieces not too small; put them into a pot with some small pieces of salt pork, and plenty of pepper and salt; pour over enough hot water to cover it well, and boil until the meat is thoroughly done. while the water is still boiling drop in, by the spoonful, a batter made as follows: two eggs well beaten, two and a half or three cupfuls of buttermilk, one even teaspoonful of soda, and flour enough to make a thick batter. cover the pot, and as soon as the batter is well cooked serve it. _veal stew._--this is an exceedingly nutritious, economical, and appetizing dish. cut the veal into small pieces about an inch square; add three or four thin slices of salt pork; one or two onions and potatoes cut up fine, and a little turnip, carrot, parsley and celery, if you have them. cover well with boiling water and cook over a brisk fire until the meat is tender and the water pretty well cooked away. this will require about an hour. cover the meat well with fresh milk; season to taste with pepper, salt, and a generous quantity of butter; let the mess simmer on the back of the stove about twenty minutes, and serve it in a hot covered dish. _jellied veal._--jellied veal gives the impression of an expensive preparation, and yet nothing is cheaper or simpler. put a knuckle of veal into a pot that can be tightly covered; season well with two or three slices of unsmoked bacon, the heart of an onion, salt, pepper and a little butter, adding just enough water to steam the meat thoroughly (replenishing it from time to time as needed), and cook over a slow fire until tender--probably about four hours. when done there should be about two teacupfuls of broth. prepare three cold hard-boiled eggs. cut the veal into pieces the size of a walnut. now choose a dish just large enough to hold the meat, the eggs and the broth. slice the eggs and place a few pieces on the bottom of the dish. now put in a layer of veal; then more egg and continue in this way until the veal is used. strain the broth over the veal and set it away in a cool place, preferably on ice, until quite firm. when about to serve it, loosen by slipping a knife, warmed in water, between the meat and the dish. garnish with parsley or lettuce, and serve with salad of any kind. _roast pork._--pork should be thoroughly cooked in a medium hot oven. for the leg or the shoulder allow twenty-five minutes to the pound. for the spareribs allow fifteen minutes. sprinkle the spareribs well with salt, pepper, sage, and a little chopped onion, or bake a few onions in the same dish. put a little water in the pan and add to it as it cooks away. the leg, the loin, and the shoulder may be stuffed with well-seasoned sage stuffing. to make this, cut a few strips of fat pork into small dice and fry over a slow fire. add a finely chopped onion and cook until brown. crumble as many slices of dry bread as you will need, and fry with the onion and pork over a slow fire until nicely browned. moisten a little with milk or cream, and fill the space left by removing the bones. sew tightly together and bake thoroughly. peeled, raw potatoes are very nice baked in the same dish with the pork. a medium sized potato will require a little over an hour to bake in a moderate oven. apple sauce, sauerkraut, or cabbage cooked with a little vinegar, are nice to serve with pork. _broiled pork._--very thin slices cut from a leg of pork, or the cutlets, or the chops, are extremely nice and delicate when broiled. they must be cut thin; the coals must be bright and hot; and the meat turned very often. serve on a hot platter. _fried pork._--for frying, pork should not be cut over a half an inch thick: cook slowly from forty minutes to an hour, with the pan closely covered, to keep in the steam. pork requires a long, slow process to develop its flavor and tenderness. nearly everyone cooks it too fast, and for too short a time. when thoroughly steamed and nicely seasoned with salt, pepper, sage and a little onion, well fed pork is as toothsome and dainty as turkey. make a brown gravy and pour over the meat. serve with apple sauce. _boiled pork._--take a leg of pork, or a shoulder, and remove the bones. tie closely together and let it cook slowly in a tightly covered pot for half an hour, adding a little fat if necessary to keep the meat from sticking. now sprinkle with salt, pepper and sage. put two whole onions in the pot, and just enough boiling water to thoroughly steam the meat. place it on the back of the stove and cook over a slow fire for four or five hours until thoroughly tender and velvety. when done put on a hot platter in the warming-oven. thicken the gravy with flour, adding a little water or milk if necessary, then let it boil for five minutes and strain. when properly cooked this is delicious cold, and almost as good for salad as chicken or turkey. if desired, peeled raw potatoes may be browned in the pot with the meat. these will take about an hour to cook. _curing ham and bacon._--to have good ham and bacon the meat must first be properly cured so that the lean part is pink, tender and soft to the touch, while the fat is clear and white. in many country homes the lean meat is about as tough, hard, and indigestible as sole leather. a good recipe for curing is as follows: for every gallon of water take two pounds of coarse salt and one-half ounce of soda. boil all together and skim well, and, while hot, pour over the meat. put in a cold dry place with a stone to keep the meat well below the water. after three weeks, hang the meat and let it dry for two or three days before smoking. _broiled ham._--nothing is more appetizing for supper than broiled ham, served with mashed potatoes, milk toast, or a poached egg on dry toast. cut the ham as thin as possible, and broil quickly over hot coals, turning constantly until the fat begins to shrivel. have everything else ready so that it can be eaten immediately. cold cabbage salad is nice with this. _boiled ham._--if quite salty, soak the ham twenty-four hours. put it in a large kettle with a generous supply of water, and allow twenty-five minutes to the pound for boiling. take the pot from the fire and let the meat remain in the water until nearly cold. sprinkle with pepper and rub thoroughly with brown sugar; put the ham and the fat from the liquor into a baking-pan and brown for about an hour in the oven. cut as thin as possible when serving. _frying ham._--cut the ham in the thinnest possible slices, with a large, sharp knife. have the frying-pan hot, and cook the meat just enough to give the fat a delicate brown, turning frequently. to cook ham too much is to make it tough, hard, dry, and indigestible. put the ham on a hot platter in the warming oven. add a cupful, or more, of fresh milk to the grease and thicken with flour. serve with boiled potatoes. instead of making a gravy, eggs may be fried in the fat. to do this nicely the fat must not be burned. the eggs should be dropped in one by one, allowing them plenty of room to spread out. cook slowly and with a spoon baste the yolks with the hot fat until they sear, being careful not to cook the egg too hard. these eggs are very nice served on thin, dry toast, or one may be placed on each slice of ham. _fried bacon._--cut the bacon into very thin slices, and cook in a hot frying-pan just long enough to turn the fat to a delicate brown. if cooked too long it is hard and indigestible, besides losing its delicacy of flavor. a very nice way to cook bacon, instead of frying it, is to roll the slices up into curls, skewer them with toothpicks, and place them in a baking-pan on the grate of a hot oven until they are slightly brown. serve on dry toast. they should be eaten at once. _broiled bacon._--bacon can be broiled like ham. a very nice way to serve it, especially for an invalid, is to toast it before the fire; split a hot biscuit and make a sandwich with the bacon. bacon toasted this way and eaten when very hot has a peculiarly appetizing flavor. _unsmoked bacon._--cut in thin slices; roll in flour or meal; dust lightly with pepper; fry over a moderately hot fire until delicately brown and crisp, and put on a warm platter in the warming closet. add sufficient fresh milk to the fat to make the requisite amount of gravy. season with a little salt and pepper, and thicken with flour. do not pour over the meat. serve in separate dish. _boiled mutton._--mutton should be cooked very much like beef,--just enough to leave a faint pink, but not enough to make it hard and develop a strong taste. for boiled mutton allow ten minutes to the pound. add a little rice to make the meat whiter and tenderer. cover with boiling water and cook rapidly for fifteen minutes; then place on the back of the stove where it will simmer nicely for two hours. young turnips, boiled with the mutton are a very nice addition. _mutton cutlets._--the chops should be thick. grease the bottom of a hot frying-pan just enough to keep the chops from sticking; place over a hot fire, and turn the meat constantly to keep it from burning until the center is a faint pink. season with salt, pepper, and melted butter to which a little lemon juice and parsley may be added. _roast mutton._--the french roast mutton in a slow oven in order that the heat may penetrate to the center without injuring the outside. allow twenty minutes to the pound, or, if a very large roast, twenty-five minutes may not be too much, providing the oven is not too hot. season with salt and pepper, and put a generous supply of boiling water in the pan. baste frequently, and turn the meat every half hour. place two or three peeled raw potatoes in the pan, and watch them; if they begin to brown, the oven is too hot. the potatoes should keep pace with the mutton, and when the latter is half done the former should be cooked to the same degree. _broiled mutton chops._--the chops should be cut an inch thick. trim off the fat and scrape the bones. roll in a little melted butter or oil, and broil over a hot fire, turning constantly until just pink within. have ready a mound of hot mashed potatoes and lay the chops around it. pour a little melted butter over them and serve with green peas. proper cooking of cereals. starchy foods in any form must be well cooked. gluey, slimy oatmeal, full of hard lumps of half-cooked grains, the whole forming a raw, horrid mass, is very different from the smooth, well cooked, easily digestible, oatmeal prepared by a good cook. rolled oats are more easily cooked than oatmeal, as they are already prepared. for four people, put a quarter of a teaspoonful of salt into four cups of _hot_ water and stir in slowly one cup of rolled oats, being careful not to allow lumps to form. cook for an hour in a double boiler. _hominy._--hominy is seldom well cooked. it is often lumpy and raw, and yet has a burned taste which comes from being cooked in too little water, while if too much is used it goes all to soup and can never be made good. salt a quart of boiling water, and very carefully stir into it a cup of hominy. stir often and add a little water from time to time if it gets too dry. cook until every grain is thoroughly done. _rice._--rice is rarely well prepared, the greatest trouble being to get each grain well cooked without making it mushy. when properly cooked each grain will be firm and distinct, and at the same time soft and tender. wash half a cupful of rice thoroughly, put it in a quart of boiling salted water, and let it boil for half an hour; then drain it thoroughly and steam it in a colander for an hour. _corn-bread._--corn-bread should be something like rice: every particle thoroughly cooked and soft, and yet not sticking together, so that the inside is dry and crumbly while the outside is crisp and nutty. the thinner corn-bread is baked the more perfectly it cooks. it should not be more than an inch thick and preferably less. a cannon-ball of raw meal, with only the thinnest of surfaces decently baked, is an insult to a man's intelligence as well as to his digestion. this is the way to prepare it properly. sift a teaspoonful of baking powder into a pint of corn meal. mix in a piece of butter the size of a walnut and add sweet milk until you get a dough that can be kneaded into a cake. bake in a hot oven until brown and well done. a little richer corn-bread is made by heating a pint of sweet milk and pouring it over a pint of corn-meal. melt a piece of butter the size of a walnut, beat two eggs, add a little salt, and mix well into the meal. put in a shallow dish, and bake about a half hour in a quick oven. _biscuits._--biscuits should be thin, crisp, delicately browned and free from flour. the inside of a biscuit should be flaky and dry. thick, soggy, heavy biscuits impose a severe task upon digestion. make the biscuits about two inches in diameter, and three-quarters of an inch thick. bake them brown on both the top and the bottom. it is much easier to make light, wholesome biscuits with baking-powder than with soda. buttermilk biscuits are very delicate and palatable, but not quite so certain to turn out well. if soda is not properly used you will have a yellow, evil-smelling compound, or else there will not be enough soda to make the biscuits rise, and they will be dangerously heavy. to make soda-biscuits sift one level teaspoonful of soda, one half-teaspoonful salt, and one quart of flour together three times so as to get the soda thoroughly well mixed in. now rub two tablespoons of lard into the flour and add enough buttermilk to make a soft dough. roll out into a sheet, cut into small thin biscuits and bake in a hot oven until well browned. baking-powder biscuits are made in the same way, by using two teaspoonfuls of baking-powder in place of the soda, and sweet milk instead of buttermilk. _yeast._--put three hops in a pot containing two quarts of cold water. place on the stove and see that it boils twenty minutes. have a pint of flour in a large bowl and mix into it a tablespoonful of sugar, one of salt and a teaspoonful of ginger. strain the water from the hops into this, stirring constantly. allow it to cool. when lukewarm put in a cup of yeast or a yeast-cake. _rolls._--at night take one half-cup of lukewarm water, one half-teaspoonful of salt, three-quarters of a cup of yeast, and enough flour to make a thin batter. in the morning add to this a pint of milk, a teaspoonful of sugar, a half-cup of butter and beat in flour until it is no longer sticky. set it in a warm place to rise and when well up knock back. repeat this process, and when it comes up the third time make it into rolls. let it rise once more and then bake it. methods with chicken. the simplest and easiest way to cook chicken is to fry it. a poorly fed chicken is better stewed. for baking and broiling the chicken must be fat. in whatever way the chicken is cooked there is danger of its being tough, dry, stringy, and tasteless. plain, artless, boiling results in insipidity. quick, superficial frying means tough stringy fibres; and a hot oven frequently dries the meat until it is not fit to eat. _fried chicken._--all housewives think they can fry chicken, but the results are vastly different, according to the way it is done. you may have a tender, rich, delicious morsel, or tough masses of meat, stringy, tasteless and almost impossible to chew. of course the condition of the chicken has a great deal to do with the results. a tender, well-fed chicken will fry far better and much more quickly than a thin, scrawny one. the thinner the chicken the greater the necessity for care in cooking it. it must be cooked slowly, over a moderate fire, in a tightly covered pan, until it is perfectly tender. melt a little fat in the frying-pan; flour, salt, and pepper the pieces of chicken and fry them in the fat until nicely browned on both sides. now cover closely and place on the back of the stove where the chicken will steam for half an hour. when tender take up on a hot platter and put in the warming oven. make a rich, brown gravy and pour over it. _boiled chicken._--chickens may be boiled whole or cut into pieces. to boil whole place a few pieces of unsmoked bacon in a stew-pan that is deep enough to hold the chicken and can be tightly covered. cook slowly for an hour without adding water, turning it often until it is evenly browned. now add a small onion, some raw peeled potatoes not larger than an egg, and a little boiling water. cook over a brisk fire for three-quarters of an hour. salt and pepper the chicken and put it and the potatoes in a baking-dish in a hot oven while making the gravy. a couple of hard-boiled eggs chopped very fine, and a little chopped parsley, improve the gravy. _baked chicken._--a properly baked chicken is tender, juicy, and has a rich flavor, while one improperly baked is tough, dry, stringy, and tasteless. to bake a chicken properly the oven must not be too hot; the chicken must be repeatedly basted, and cooked until it is tender, but not until all dried up. stuffing the chicken improves the flavor. to make the dressing, melt enough of any kind of wholesome fat in a hot frying-pan to keep the bread crumbs from sticking, and fry in it a large onion, chopped fine, until it is tender. place the dry bread-crumbs into the fat, and cook for half an hour over a slow fire, stirring often to keep from sticking, until the crumbs are slightly browned and well dried. season with salt, pepper and a little celery-salt, and moisten with just enough milk to make it stick together. always taste the dressing to see if it is properly seasoned. a well-fed chicken can be baked more rapidly than a thin one. if the chicken is thin add plenty of fat to the water in the baking-pan; cover closely and cook slowly and carefully until it is tender, turning very often; if it is fat and well-fed put plenty of wholesome grease in the baking-dish, and without covering it, cook in a hot oven, basting frequently. a young, fat chicken will bake in an hour. an older fowl may require two or three hours. it is a good plan to allow the chicken plenty of time and then, if done too soon, to cover it closely and keep it warm on the back of the stove. use just enough water while baking to keep the fat from sputtering. if the water is cooked out towards the end, and the chicken is thoroughly basted, the skin will take on a rich, thick glazing that is highly creditable to the skill of the cook. delicious gravy can be made of the fat by adding milk and thickening with flour. _smothered chicken._--use a frying-size chicken. split it down the back and rub with a little salt. put it in a pan with a slice of bacon and a pint of water. cover the pan closely and let it simmer on top of the stove from one to two hours, or until the chicken is thoroughly tender. when done sprinkle with flour and baste well. add a small tablespoon of butter, and put in the oven and cook until brown. _broiled chicken._--a young, tender, fat chicken is better broiled than any other way. it has a finer flavor; is tenderer, more juicy and more easily digested; in fact broiled chicken is one of the most delicious dishes that can be served. there is no earthly use, however, in trying to broil a chicken that is not fat and nice. if the chicken is a little too old to broil whole the breast will still be tender. flatten the chicken by pounding it. have a bed of clear, bright coals and a hot gridiron well greased to prevent sticking. cover with a baking-dish and turn often, allowing the bony side to stay down longer than the other side. from fifteen to twenty minutes should be enough, but it is always best to test with a fork by pulling the fibres apart to see that they are not raw. as soon as the raw look has disappeared the chicken is done. the least over-cooking injures the flavor. serve on a hot platter. pour over a little melted butter, seasoned with lemon juice and chopped parsley. to bake or boil a turkey proceed the same as for chicken, simply allowing more time. an eight-pound turkey will require three hours to roast. making good soups. _vegetable soups._--the simplest and most easily prepared soups are those made from peas, beans, tomatoes, asparagus, celery, carrots, onions, and potatoes. they require neither meat nor any previous preparation, but can be made and eaten at once. these soups are somewhat paradoxical because they are both cheap and rich; deliciously simple and simply delicious. take enough of any of these vegetables to furnish sufficient soup after they have been rubbed through a strainer and thinned with milk or cream. cook the vegetables thoroughly until perfectly soft, so that they can be easily rubbed through a coarse strainer. add enough milk to this purée to make it about the thickness of cream. season with salt, pepper, and a little celery-salt, and serve with bits of bread browned crisp in the oven. when the vegetables can be got fresh from the garden nothing is more delicious than these soups, and in winter, canned peas and dried beans make excellent substitutes. in making potato purée two onions boiled with the potatoes improve the flavor. potato soup without onion is tasteless; a little celery boiled in with the potatoes and onion, makes it still nicer. tomato soup is also better slightly flavored with onion and a little carrot. a little cold boiled rice, simmered for a half-hour in the soup after the milk has been added, is an excellent addition. these soups are also delicious when made rather thin with milk and then thickened by putting the well-beaten yolks of two eggs into the hot soup-tureen, and stirring vigorously while adding the soup; this last soup must be served at once, as it cannot stand after the eggs are added. _meat soups._--these soups should always be made the day before required in order to thoroughly remove the fat, which cannot be done until it hardens on the top of the soup. nothing is more disgusting than greasy soup. the foundation for an infinite variety of soups is made by boiling about a pound of meat in three pints of water. after the meat is cooked to pieces strain it out and keep the well-skimmed liquor, or "stock," as it is called, in a stone jar in a cool place. it should form a jelly, and in order to prepare a different soup for each day, it is only necessary to heat some of the jelly and flavor it differently. for instance: chop fine one small onion to each person and fry it in butter, or in some of the grease taken off the soup, until tender and slightly brown. pour over enough stock and let stand for half an hour. serve with a little grated cheese. cabbage soup is made in the same way except that it takes longer to cook the cabbage. instead of one vegetable several may be used. turnips, cabbage, onions, and carrots in about the same proportion, chopped fine and fried tender, without any water, and added to the soup, make what is known in france as julienne soup. eggs in several forms. _coddled eggs._--the most delicate way to cook an egg is to coddle it. put six into a vessel that will hold two quarts. fill with boiling water, cover closely, and let it stand in a warm place for ten minutes. if you desire them better cooked let them stay in the water longer. if you want to do but one egg, put it in a quart of boiling water, cover and let stand five minutes. _shirred eggs._--to shirr an egg break it into a saucer or any small dish that has been well greased. put into a hot oven and leave until glazed. season and serve at once. _scrambled eggs._--heat a teaspoonful of milk to each egg in a sauce-pan not more than a quarter of an inch deep and about the right size to hold the quantity of eggs desired. add a little salt, pepper, and butter. when hot put in the eggs, and as they lie on the bottom of the pan, scrape off with a spoon letting the raw part take the place of those portions already cooked, and continue this until a creamy custard is formed. be careful not to cook the eggs so long that this custard is changed to a hard mass. proper cooking of vegetables. the general tendency in cooking vegetables is to use altogether too much water so that they become soaked and tasteless. the ideal way to cook most vegetables is to use as little water as possible; just a little in the bottom of the pot so that the vegetables will not stick and burn, but steam through in their own juices until thoroughly tender and full of their own flavor. the fire should not be too hot; the pot should be tightly covered; a sufficient amount of butter must be added when the vegetable is about half done; and plenty of time given to allow it to simmer and steam until thoroughly flavored. onions, beans, carrots, and cabbage are most delicate when chopped fine, cooked until tender in a very little water, seasoned with salt, pepper, and butter, covered with milk, and allowed to stand on the back of the stove for twenty minutes until the flavor is thoroughly developed. _boiled potatoes._--potatoes should not be peeled before boiling, but should be thoroughly washed and rinsed. they should be put in an abundance of boiling water, well salted, and covered tightly. when tender pour off all the water, cover the pot with a towel and let it stand on the back of the stove for ten minutes. _baked potatoes._--if baked potatoes stand they lose their flavor. a baked potato, eaten as soon as done, is sweet, dry and mealy. allow them to stand even for ten minutes and the flavor is lost, and they become wet and tasteless. a pleasant change is to peel the potatoes before baking. these must be eaten as soon as they come from the oven or they lose their crispness. _beans._--nothing is more valuable for winter food than beans. they give as much strength as beefsteak and are far less expensive. soak them in plenty of water over night; add a generous piece of unsmoked bacon; let simmer on the back of the stove until they are tender and the water is well cooked away; cover with milk, and either let them stand on the back of the stove until the milk is thickened, or put them into a shallow baking-dish and bake until nearly dry. serve either hot or cold. some capital desserts. _apple pudding._--peel and slice enough apples to nearly fill your pudding-dish, sugar to taste, and grate over them a little nutmeg. also add a little water. now make a batter as follows: three quarters of a cup of sugar; a piece of butter the size of a small egg, one half-cup of milk, one egg, a pinch of salt, a teaspoonful of baking-powder, and one and one-eighth cups of flour. this is an extremely nice, wholesome pudding, which can be served with either cream or hard sauce. to make hard sauce take a half-cup of butter and cream it with a fork; add a cupful of sugar and beat until nicely mixed and creamy. flavor to taste and sprinkle a little nutmeg over it. _cottage pudding._--one cupful of sugar, one tablespoonful of butter, one half-cupful of milk, two eggs, one and one-half cupfuls of flour, and one teaspoonful of baking-powder. for the sauce, take three and a half cupfuls of boiling water and stir in it a cupful of sugar, and a tablespoonful of either flour or corn-starch rubbed smooth with a little cold water. cook well for two or three minutes; take the pan from the fire, add the butter and flavor as you prefer. _batter pudding boiled or baked._--one quart of milk, six eggs beaten separately, six tablespoonfuls of flour worked gradually into the yolks of the eggs, and a pinch of salt. bake or boil about three-quarters of an hour. serve with sauce. _cream of corn-starch._--one quart of milk, four eggs, one half-cupful sugar, four tablespoonfuls of corn-starch dissolved in a little milk. into a pint of the milk put the sugar, and place on the stove to heat. when very hot gradually stir in the corn-starch and beat well. have ready the whites of the eggs, and beat them into the milk; flavor as preferred. take the other pint of milk, the four yolks and four light tablespoonfuls of sugar, and place them over the fire, stirring constantly. this makes a nice custard. just before serving pour the custard over the pudding. _caramel custard._--one egg for each person; also one teaspoonful of milk for each person. put the yolks and milk together with a tablespoonful of sugar to each egg. have ready some caramel, and stir in enough to give a decided flavor. put this into cups or baking-dishes, and set in a pan of hot water on top of the stove for twenty minutes; then in the oven until the custard sets. serve cold. for the caramel, take two cupfuls of sugar (preferably brown) and put it in a frying-pan with a teaspoonful of water. cook until well burned. add a cup of water, and, when cold, put it in a bottle or fruit-jar. this quantity will last a long time. _brown betty pudding._--take a cupful of grated bread-crumbs, two cupfuls of finely chopped, tart apples, half a cupful of brown sugar, a teaspoonful of cinnamon, and one tablespoonful of butter. butter a deep pudding-dish, and put a layer of apples on the bottom; then sprinkle with sugar, cinnamon and bits of the butter. put in another layer of apples, and proceed as before until all the ingredients have been used. cover the dish and bake for three-quarters of an hour in a moderate oven; remove the cover now and brown the pudding. serve with sugar and cream. _rice pudding._--one cupful of boiled rice (better if still hot), three cupfuls of milk, three-quarters of a cup of sugar, a tablespoonful of corn-starch, and two eggs; add flavoring. dissolve the corn-starch with a little of the milk, and stir it into the rest of the milk; also add the yolks of the eggs and the sugar beaten together. put this over the fire and when hot add the rice. stir it carefully until it begins to thicken, then take it off and add the flavoring. put it into a pudding-dish and bake in the oven. the end index a accidents, . acid, carbolic, for _rhus_ poisoning, ; in wounds, ; poisoning by, ; of fruit, , ; picric, ; uric, . acrodinia, . _agaricus campestris_, . air, . air-space, . albumin, . albumins, , , , . alcohol and its effects, ; for _rhus_ poisoning, ; of no value in snake-poisoning, ; predisposes to consumption, ; predisposes to heat-prostration, . _amanita muscarius_, . _amanita phalloides_, . ammonia, aromatic spirits of, . anaphylaxis, . _ancistrodon contortrix_, . _ancistrodon piscivorus_, . animals, bites of, ; location of quarters, . _anopheles_, , , . antidotes for poisons, see under names of poisons. antiseptics, , . antitoxin, for diphtheria, , ; for lockjaw, . apples, . arrowroot, . arsenic, . arteries, . artichokes, . asparagus, . atropine, . b _bacillus tuberculosis_, . _bacillus typhosus_, . bacon, broiled, ; curing of, ; fried, ; importance of, , ; unsmoked, . baking, process of, . baths, for sick people, ; hot and cold, ; importance of, ; sea, . beans, bad, give lathyrismus, ; how to cook, ; value of, , . bed-bug, . bedmaking, . beef, broiled, ; fried, ; hamburg steak, ; hashed, ; pot-roast, ; roast, ; value of, . beer, . beets, , . beri-beri, . beverages, ; alcoholic, ; medicinal, ; "soft drinks," . biliousness, . biscuits, . bites of animals, flies, mosquitoes and snakes, see under several subjects. bleeding, how to stop, ; in consumption, ; in typhoid fever, . blisters, . blood-vessels, . bottle, for infants, . brandy, . bread, and its relations, ; baking of, ; corn-bread, , , ; diseases derived from decomposed, ; graham-bread, ; rye-bread, ; why wheat-bread is the best, . bricks, . bright's disease, , , , , , , , . broncho-pneumonia, . bruises, . brussels-sprouts, . burns, . buttermilk, . c cabbage, . cake, . calomel, . calories, . carbohydrates, . carron-oil, . carrots, . cat, conveys diphtheria, ; harbors tapeworms, . cauliflower, . caustic, . celery, . cellulose, . cereals, . charlatans, . chewing, . chicken, baked, ; boiled, ; broiled, ; fried, ; smothered, . chickory (salad), . chilblains, . child, diseases of, , ; exercise of, ; hygiene treatment of, ; ill-treatment of, ; instruction in cases of accident, ; sleep necessary to, ; syringe for, . chills-and-fever, see malaria. chocolate, . cholera, , , . chromic acid, . cisterns, . clams, . cleanliness, . clothing, . cocoa, . cod-liver oil, . coffee, , . cold, accidents arising from, . cole, . colic, cause of, ; treatment of, . collodion, . color, in clothing, . constipation, . cooking, , . copper-head, , . coral-snakes, , , . corn, . corn-starch, . corrosive sublimate, . cotton-mouth, , . cows, carry tapeworm, ; infected with tuberculosis, . _crotalus_, . croup, membranous, ; treatment of, . cucumber, . d dandelion, . "death-cup," . dextrose, . diarrhoea, reason for, ; treatment of, . diet, for the sick, ; vegetarian, . diphtheria, conveyance of, ; description and treatment, . dipsomaniac, . dirt-eaters, . diseases, avoidable, ; contagious, ; contraction of, ; digestive, . see also names of diseases. disinfectants, . dog, conveys diphtheria, ; dangers of, ; description of rabies in, ; harbors tapeworm, , . drinks, see beverages. drowning, . dry-closet system, . dysentery, , , , . dyspepsia, , . e earth, diseases contracted from, . eating, ; importance of, ; over-eating too prevalent, . eggs, coddled, ; in vegetarian diet, ; nitrogenous food, ; scrambled, ; shirred, ; value of, . _elaps euryxanthus_, . _elaps fulvius_, . emergencies, . emetics, - . endive, . ergot, . ergotism, . ethers, compound, . exercise, . f fabrics, . fats, , ; in vegetables, ; unwholesomeness of, ; value of, . fever, malaria, see malaria; scarlet, ; typhoid, contraction of, , , , , ; description and treatment, ; yellow, , , . figs, . filaria, . fireplace, . fish, decomposed, source of ptomaine poisoning, ; nitrogenous food, ; value of, . fly, conveyor of disease, , , ; sick-room, . fly-agaric, . flukes, . foods, , ; albuminous, ; amount necessary, ; breakfast-foods, ; diseases contracted from, ; in sick-room, ; mellin's food, ; nitrogenous, , ; nutritive substances in, ; raw, , ; starchy, , , ; tables, . formaldehyde gas, . frost-bite, . fruits, as food, ; dangers in, ; diseases contracted from, ; not nutritious, . furnace, . g game, . garlic, . gin, . glanders, . glucose, . gout, , . grape-fruit, . greens, . ground-itch, . h haig, a physician, . ham, boiled, ; broiled, ; curing of, ; fried, ; wholesomeness of, . headache, . health, . heat, accidents arising from, ; for house, ; in sick-room, . see also calories. heat-prostration, . hiccough, . hog, . hog-meats, . hominy, . hookworm, ; method of transmission, , ; description and treatment of disease, . horses, convey glanders, ; killed by bad corn, . house, materials for, ; sanitation of, . husks, . hydrophobia, from dog's bite, , ; description and treatment, . hygiene, , ; of infancy and childhood, ; of the person, ; of the sick-room, . hypersensitiveness, . i indigestion, . infants, hygiene and feeding of, ; weaning of, . iodine, as antiseptic, ; in blisters, . k kak-ke, , . kala-azar, . kissing, . l lathyrismus, . lead-water, . leeks, . legumes, . legumins, , . lemons, . lentils, , . lettuce, . ligature, , . lime-water, , . liquids, . liquors, malt, . liver, ; cirrhosis of the, . lockjaw, ; antitoxin for, . loeffler, discovered diphtheria germ, . m malaria, conveyed by mosquito, , , ; description and treatment, . maltose, . massasauga, . mastication, . meat, cooking of, ; nitrogenous food, ; source of ptomaine poisoning, ; value of, . medicine, ; patent, , . meninges, . meningitis, cerebrospinal, . _micrococcus intracellulais_, . milk, an ideal food, ; apt to promote indigestion, ; as a drink, - ; in vegetarian diet, ; infected with tuberculosis, ; malted, ; modified cow's, ; mother's, ; peptonized, ; sterilized (pasteurized), ; table for calculating proportions of milk to be fed, . mint, . moccasin (snake), , , , . mosquito, , , , . mouse, . mushrooms, . mutton, boiled, ; chops, ; cutlets, ; roast ; value of, . n _necator americanus_, . nervousness, . nipple, . nose, . nursing, . o oatmeal, , . okra, . opiates, . opium, . oysters, , . p pains, rheumatic, . paris green, . parsley, . parsnips, . pasteur, . pastries, . peaches, . peanuts, , . peas, , . pellagra, , . peppers, green, . phosphorus, . pickles, . pieplant, . pilot-snake, . pit-vipers, , . plague, bubonic, . _plasmodium malaria_, . plaster, for blisters, ; for sprains, . poison-dogwood, . poison-elder, . poison-ivy, . poison-oak, . poisons, acid and alkaline, ; ptomaine, ; treatment of poison cases, with antidotes, . poison-sumac, . pork, boiled, ; broiled, ; fried, ; roast, . potassium permanganate, , , . potatoes, , ; baked, ; boiled, ; cooking of, ; disadvantages of, . poultry, . privies, , , . ptomaines, poisoning by, . puddings, apple, ; batter, ; brown betty, ; caramel custard, ; cottage, ; cream of corn-starch, ; rice, . pumpkin, . pus, . q quacks, medical, , . quinine, . r rabies, see hydrophobia. radishes, . rat, . rat-poison, . rattlesnake, , , ; ground-rattlers, , . recipes, . resins, . respiration, artificial, . rest, need of, . rhubarb, . _rhus_, poisoning by, . _rhus toxicodendron_, . _rhus venenata_, . rice, boiled, ; cooking of, ; value of, . rochdale, system of, . rolls, . rum, . s salad plants, . saliva, . sanitation, . sauerkraut, . scab, . schafer, prof., system of artificial respiration, . screens, , , . sewage, disposal of, . shallots, . sheet, rubber, . sick-room, . _sistrurus_, . sleep, , . sleeping-sickness, . snake, harlequin, . snake-bites, . snakes, columbine, , ; elapine, ; non-venomous, ; venomous, ; viperine, . soups, meat, ; vegetable, . sours, . spinach, . splints, . sprains, . sputum, . squash, . starches, , ; changes in, ; in cooking, ; in vegetables, ; raw, . steam, . stove, . streams, . strychnine, as antidote, ; poisoning by, . sugar, consumption of, ; from beets, ; in vegetables, ; kinds of, ; raw, . sunstroke, . swamp-dogwood, . syringe, . syrups, ; soothing, . t tapeworm, , , . tea, , . teeth, care of, , ; teething of infants, ; tooth-ache, . toadstool, see mushroom. tobacco, . tomato, . tonsillitis, follicular, . tooth-ache, . treatment, immunizing, ; pasteur, . tricina, . tuberculosis, , , ; description and treatment, . tubers, . turnips, , , . v vaccination, . veal, boiled, ; fried, ; jellied, ; roast, ; stew or pot-pie, . vegetables, cooking of, ; digestibility of, , ; diseases contracted from, . ventilation, , . vinegar, , , . vipers, . see also pit-vipers. vomiting, , . w waffles, . wall-paper, . water, as a drink, , ; dangers of, ; diseases contracted from, ; for heating, ; for poisons, ; for wounds, . water-supply, . wells, . whisky, . wines, . work, . worms, . wounds, . y yams, . yeast, . transcriber's note: a few typographical errors have been corrected: they are listed at the end of the text. * * * * * page numbers enclosed by curly braces (example: { }) have been incorporated to facilitate the use of the table of contents. * * * * * epidemics examined and explained: or, living germs proved by analogy to be a source of disease. by john grove, m.r.c.s.l. author of "sulphur as a remedy in epidemic cholera." london: james ridgway, piccadilly. mdcccl. * * * * * "the tendencies of the mind, the turn of thought of whole ages, have frequently depended on prevailing diseases; for nothing exercises a more potent influence over man, either in disposing him to calmness and submission, or in kindling in him the wildest passions, than the proximity of inevitable and universal danger."--_hecker's epidemics of the middle ages._ "the grand field of investigation lies immediately before us; we are trampling every hour upon things which to the ignorant seem nothing but dirt, but to the curious are precious as gold."--_sewell on the cultivation of the intellect._ * * * * * to benjamin guy babington, f.r.s., m.d., physician to guy's hospital, and president of the epidemiological society, etc. etc. these pages are, by his kind permission, respectfully dedicated, by his obliged and faithful servant, the author. * * * * * {v} preface. the following pages have been written with a view to render some aid in establishing a sound and firm basis for future research, on that absorbing topic, the causes and nature of epidemic diseases. the amount of information already published on fevers, on the exanthemata, and on the plague, is truly astonishing, and the more so when it is considered, that at present no rational account or explanation is given of the causes of these affections. it appears to me but reasonable to suppose that as every thing on this earth has been created on a wise and unerring principle, epidemic and infectious diseases are only indicative of some serious errors in our social arrangements and habits. the dangers and misery brought upon us by disease, may, as shewn by dr. spurzheim and mr. combe, be warnings against the infringement of the natural laws. indeed, what is more rational than to suppose that the seeds of disease are coeval with the fall of man. his first disobedience {vi} brought death:--that his subsequent errors should hasten its approaches is not to be marvelled at. the undetected murderer, though he may escape the punishment human justice would inflict upon him for his delinquency, suffers a penalty in the tortures of conscience, infinitely more horrifying than the most ignominious death. the law of nature is triumphant. no less certain, though after a different manner, are the consequences of minor forms of disobedience. it is so ordained, that certain diseases shall arise, under peculiar conditions, which may have been brought about by a train of causes, easily imagined, and difficult to be explained, but all having their origin in the vices and errors of man in his moral and social relations. if man neglects the cultivation of the ground; with rank vegetation, the germs of fever will invisibly grow and multiply; if he harbours that which is rotten and corrupt, he is himself consumed by those agents destined to remove the rottenness and corruption; it is a part of the law of nature that there should be active and energetic agents for this purpose. the seeds of disease, like the seeds of plants, may be shewn to have {vii} their indigenous localities; like them they may be spread and multiplied; like them they may lie dormant, and after awhile spring as it were into active existence; like them, when the soil and other conditions favour, they are ever ready to make their appearance. and this is the law, the germs of all disease exist, and have existed. despise the dictates of nature, be careless of yourself and those around you, neglect to use the means which a noble intelligence has placed at your command, and above all, transgress the laws of god, then will disease pursue and attend you, as the conscience of the murderer pursues and attends him until he is finally cut off. his wants and necessities, his sufferings and privations, are the basis of the intellectual progress of man. the wonders of omnipotence are revealed through the whirlwind, the storm, the pestilence, and the famine. the constructive and perceptive faculties of man have been developed by the necessity of protecting himself from injury by winds and rains; his intellectual faculties have been cultivated, by the sufferings of disease having led him to the study of {viii} organization and life, to discover the cause,--and to chemistry, and other sciences for the cure of his ailments. famine and distress have aroused his emotions, and softened down his asperities, so that what appears at first to be the infliction of a curse without pity, is in reality a judgment with mercy. it occurred to me, that on the formation of the epidemiological society, the first question for consideration should be, what is the nature of those agents, which induce epidemic diseases? are they composed of animate or inanimate matter? in other words, do the manifestations of these diseases exhibit the operations of living or of chemical forces. having, in my study, dwelt on the subject with an earnest desire to find the truth, i put the suggestion, with my ideas, before the public to reject or receive them. if they be rejected, i can but think a full discussion of the enquiry will lead to the most important results. if they be received with favour, i doubt not others, with more ability, will take up the strain and resolve the discords into harmony. j. g. _wandsworth, september, ._ {ix} contents. page introduction chapter i. is it probable that epidemic, endemic, and infectious diseases, depend upon vital germs for their manifestations? chapter ii. the number and value of facts to support the proposition. section i.--on reproduction section ii.--historical notice of epidemic diseases section iii.--the dispersion of plants and diseases section iv.--the relation between epidemic and endemic diseases chapter iii. the reasonableness of the application of the facts to the inference. section i.--the chemical theory of epidemics untenable section ii.--the animalcular theory of epidemics untenable section iii.--sketch of the physiology and pathology of plants and animals chapter iv. results in proof of the tenableness of the proposition. section i.--observations on some of the laws of epidemic diseases section ii.--what is the nature of those poisons which most resemble the morbid poisons in their effects on the body? section iii.--what results do we obtain from the effects of remedial agents, in proof of the hypothesis? conclusion * * * * * { } introduction. it is one thing for a man to convince himself, but a very different thing to be able to convince others. i am not now speaking of a conviction arising from the impression made by a few startling facts, nor of one forced on the mind by early prejudices, or by the dogmas of the schools, but of a conviction arising from careful enquiry. in the course of that enquiry, the collector of facts, sees their relations to the idea in his mind, in a multiplicity of ways, from their remaining, each, as one succeeds the other, an appreciable time on the sensorium, and undergoing a certain process of comparison and relation, with all other facts and ideas which have been previously stored up. as the materials for an edifice which have been shaped and prepared in accordance with the completion of the design, so do the facts and ideas which are accumulated { } in the mind, become shaped and prepared for the elimination of a truth. the ultimate design of the architect can no more be conceived by the examination of the framework of a window, or the capital of a column, than the whole truth of a proposition by the examination of separate facts; the whole must be conceived and all the relations of all the parts thoroughly understood, before the architect can be comprehended or the harmony of his design appreciated. the process of thought in the minds of the architect, and in the framer of a proposition, is never exactly the same as in those who contemplate and examine their completed works. much may be done, however, by both to aid others in comprehending them. the more accurately they keep in view the course their minds have taken, the more readily will their descriptions be understood. to simplify the elements of our knowledge is to give others a ready access to our thoughts. to arrange the course of our ideas in harmony with the elements of our knowledge should be the end of all writing, as it is the only means of multiplying knowledge. { } it is not the mere accumulation of facts which constitutes science, any more than a collection of building materials constitutes a house, it is the arrangement and adaptation of the means to the end by which the house becomes built and science cultivated. these reflections have been suggested by the circumstance that for the last years and upwards, pestilences have at certain intervals done their work of destruction, and opened the springs of misery to untold millions, and yet i see not that we are much further advanced as to the knowledge of the cause of these inflictions than the jews in the time of moses. in the levitical law, as i shall have occasion more particularly to shew hereafter, were directions specially given in reference to the plague of leprosy; what means should be adopted for the cure of the disease, and for preventing its extension, and moreover pointing very significantly to certain facts having connexion with the cause of the affection. since that time historians generally, and medical writers in particular, have diligently recorded their observations and accumulated facts, on the various desolating plagues which { } have afflicted mankind. some of these men have grappled with the whole subject, and endeavoured to shew the presumed relation of the supposed causes in all their intricacies, but it is hardly necessary to say that all have signally failed in their attempts to furnish us with any practical information. satisfied in my own mind that the whole subject is beyond the labour of one man, and impressed with the belief that the basis of the enquiry is in anything but a satisfactory state, i have applied myself entirely to the study of the groundwork only, as the primary proceeding for a solid superstructure. the days are past, when imaginary spirits, ethers, and astronomical phenomena, were believed to have any essential influence over our destinies in a physical point of view; we have therefore to deal with _matter_ in some form or other. the question, therefore, which i have proposed for enquiry, is, whether the matter which causes epidemic and endemic diseases, exhibits the properties of inorganic or organized matter. the properties and qualities of organized { } bodies, as well as those of inorganic matter, need but be stated, and in some instances we may picture to ourselves the object, without having seen it, and not be very far from a true conception. but for this purpose a clear and definite idea must be previously formed, and have taken possession of the mind, of the great general divisions of objects in the material world. having made these preliminary remarks, i have suggested a certain mode of procedure in making enquiries of this kind, not perhaps in strict accordance with logical systems, but on the principle of nature's operations in our own minds, which appears to me, when reduced to a systematic and simple form, to be sufficiently clear and strict for synthetical application, and so concise as to be usefully and practicably applied. in endeavouring to establish a theory for the explanation of extraordinary phenomena, there are certain rules which should guide us in the thorny and treacherous path of speculation. but these rules readily flow from the train of thought, and if we examine our own minds during their operations, we { } shall find that the following is the course of our instinctive reflections. it is a course we adopt as the test of theories when formed, and is a guide in all cases for their construction. we first commence with an idea, which exists in our minds in the form of a proposition: then the following rules naturally suggest themselves:-- . the probability of the value of our proposition from inference. . the number and value of facts to support the proposition. . the reasonableness of the application of the facts to the inference. . what amount of information in the form of results can be produced in proof of the tenableness of the proposition.[ ] in illustration of the value of these rules the history of dr. jenner's discovery affords an appropriate example. to use the words of dr. gregory, "he appears very early in { } life to have had his attention fixed by a popular notion among the peasantry of gloucestershire, of the existence of an affection in the cow, supposed to afford security against the small pox; but he was not successful in convincing his professional brethren of the importance of the _idea_." the popular notion of the peasantry originated the idea in jenner's mind, and it became fixed there as a proposition. . he commenced his enquiry by observing that the hands of milkers on the dairy farms were subject to an eruption, and he _inferred_ that the notion of the peasantry bore the stamp of probability, which strengthened the idea in his mind and gave force to the proposition. . his next step was to accumulate facts; he found on enquiry that the persons engaged on these farms in milking, possessed an immunity from small pox to an extent sufficient to strengthen the value of his proposition. . the reasonableness of the application of the facts to the inference is clear from the coincidence that the eruption on the hands of the dairy people bore a striking { } resemblance to the small pox, and as this disease does not usually occur twice in the same individual, the inference was most reasonable that this eruption protected the people from small pox. . we have but to take the almost universal adoption of vaccination, and its acknowledged prophylactic powers against the propagation of small pox to shew the application of our fourth rule.[ ] between the conception of the idea and the accomplishment of jenner's designs, vaccination seems to have undergone an incubation of nearly twenty years. during that period, with an energy and perseverance only to be obtained by confidence, did this great man brood over and elaborate his idea; and well might the th day of may, { } , be styled the birth day of vaccination, for on that day was a child first inoculated from the hands of a milker. in adopting the above method i have endeavoured to bear in mind m. quetelet's observations on the requirements necessary for medical authorship; he says, "all reasonable men will, i think, agree on this point, that we must inform ourselves by observation, collect well-recorded facts, render them rigorously comparable, before seeking to discuss them with a view of declaring their relations, and methodically proceeding to the appreciation of causes." * * * * * { } { } chapter i. is it probable that epidemic, endemic, and infectious diseases, depend upon vital germs for their manifestations? it is, i believe, almost universally considered that epidemic, endemic, and infectious diseases, originate from some imaginary poisons of a specific nature, each disease having its own peculiar poison. that this conception should have taken possession of the minds of men, is most natural from the symptoms which characterize these diseases, but when we come to enquire into the nature of these agents, or supposed poisons, we are at once struck with the idea that they exhibit one peculiarity which separates them in a marked manner, from those poisons with which we are familiar; for the poisons of small pox, measles, scarlet fever, hooping cough, fever, &c. possess the power of multiplication, or spontaneous increase, a property which attaches only to the organic kingdom, and is never known in the inorganic kingdom. the source of most of the poisons is to be found among mineral or vegetable products. a mineral in combination with an acid or oxygen may become a poison, and { } nitrogen in various combinations with oxygen, hydrogen, and carbon, or with carbon alone, may become a poison; these combinations are, however, in most instances the products of vegetable life, others again are obtained from the animal kingdom, such as the poison of the serpent, &c. but in all of these instances, there is not one in which the power of self-multiplication is to be found. we are, therefore, constrained to admit that this feature, which distinguishes poisons, is one well worthy attentive consideration. the varieties of poisons may be classified into those which act topically as escharotic poisons, those which act chemically on the blood, and those whose effects are manifested in inducing a speedy annihilation of organic or vital action, as in the case of hydrocyanic acid, which is supposed specifically to affect the nervous centres from which originate the vital manifestations. it is rather remarkable that the vital poisons (as i will call them for distinction), seem to have their appropriate locality in the blood, they do not primarily affect one organ more than another, all the effects we witness resulting from them are to be traced progressively from the blood to other parts of the body. when a person is inoculated with small pox, a very minute portion (indeed it is impossible to say how minute it may be) is sufficient, when absorbed, to excite a certain train of symptoms, all due to absorption of the materies of the disease, and the process by which { } that materies arrives at maturity, is that known in the vegetable world as the fructification; this process of fructification is a process of development and increase. i here may repeat that among all the poisons known, constituted as they are of various combinations of elementary matter, they are without exception destitute of the power of development or increase. now, it is pretty accurately known what amount of these poisons is necessary to produce their effects on the living body; we can say how many drops are sufficient of hydrocyanic acid of scheeles strength, to destroy a man instantaneously. again, how many grains of arsenious acid are sufficient to induce such an inflammatory condition of the stomach and intestine as will end in death, and how many grains of morphia, will bring about a fatal coma,--but who shall say the amount of the vital poisons necessary to produce their results? it far exceeds the limit of conjecture, to what extent the dilution of miasmatic or contagious matter may be carried, and the poison yet be capable of committing in a short time the most frightful ravages. we may fairly then infer, that if a quantity of matter inappreciable in amount be sufficient to exhibit the characters of growth and increase, that it is endowed with the properties of vitality. that the poisons of scarlet fever, of measles, and of small-pox have this power of growth and increase, is as much a matter of universal belief as that "the sun { } will rise and set to-morrow, and that all living beings will die." this power of individual increase, or reproduction, is the very summit of vital manifestation; indeed coleridge, in his theory of life, (in which he says, "i define life as the _principle of individuation_, or the power which unites a given _all_ into a whole that is presupposed by all its parts,") places reproduction in the first rank, and expresses his hypothesis thus: "the constituent forces of life in the human living body are, first, the power of length or reproduction; nd, the power of surface, or irritability; rd, the power of depth, or sensibility--life itself is neither of these separately, but the copula of all three." extensive research is not required to shew that many thinking men believe in the existence of living organic beings, as the elements of contagious and epidemic diseases; the idea indeed seems to flow spontaneously in that direction. whenever thought, and enduring contemplation, have been concentrated on the subject, the result appears to have been the same, a firm conviction in each individual mind that a vital force must be in operation; or as schlegel would define it, "a living reproductive power, capable of and designed to develope and propagate itself."--"its maker originally fixed and assigned to it the end towards which all its efforts were ultimately to be directed." referring further to beings having the property of reproduction and propagation, he says, (using { } the word nature here evidently as the vital principle for want of a better term,) "nature indeed is not free like man, but still is not a piece of dead clockwork. _there is life in it._"--"thus we know that even plants sleep, and that they too as much as animals, though after a different sort, have a true impregnation and propagation." when schlegel wrote this, how little could he have imagined the intricacy of this proceeding among the lower forms of vegetation. it has been shewn by suminski, and verified by many others, that the mode of impregnation, and the period at which it occurs in the ferns, do not at all correspond to the general notion on this subject. he has discovered in the early development of the frond of ferns certain cells, which he denominates antheridia, or sperm cells; these contain in their cavity a number of subordinate cells, each containing a spermatazoon. at a certain period of the progress of the frond, the parent cells become ruptured and liberate the spermatoza, these move about in a mucilaginous fluid, which bedews the inferior surface of the frond, and become the means of impregnating the germ cells, or pistillidia, with which they readily come in contact. thus the process of impregnation in these plants occurs during the germination, or what corresponds to the period of germination in the seeds of exogenous and endogenous plants. i have referred to the discovery of suminski in { } this place to recal to the mind the great and incomprehensible wonders of creation, for who could conceive it possible or feasible that even for the impregnation of an inferior vegetable, animal life should form an indispensable and essential appurtenant of the process. truly may we say with coleridge, of plants and insects, "so reciprocally inter-dependent and necessary are they to each other, that we can almost as little think of vegetation without insects, as of insects without vegetation." i will make but two more quotations on the supposed vital character of the germs of disease. "that the air and atmosphere of our globe is in the highest degree full of life, i may, i think, take here for granted, and generally admitted. it is, however, of a mixed kind and quality, combining the refreshing breath of spring with the parching simooms of the desert, and where the healthy odours fluctuate in chaotic struggle with the most deadly vapours. what else in general _is the wide-spread and spreading pestilence_, but a living propagation of foulness, corruption, and death? are not many poisons, _especially animal poisons, in a true sense, living forces_?"--schlegel.[ ] it were useless to multiply quotations to shew { } that the opinions here entertained are matters of general belief among thinking men.[ ] i will at once then conclude with an observation of dr. c. j. b. williams: he puts the question, "does the matter of contagion consist of vegetable seeds? are infectious diseases the results of the operations and invasions of living parasites, disturbing in sundry ways the structures and functions of the body, each after its own kind, until the vital powers either fail or succeed in expelling the invading tribes from the system?" and this expression, the seeds, is an universal expression, it is a "household word" in connexion with disease. that it has obtained this position in the popular vocabulary is alone a proof of the applicability of the term to the thing intended to be { } signified. popular notions, as we have seen in the case of jenner's discovery, are not to be unheeded. an instance occurs to me, it was a popular belief, that in acne punctata, the matter of a sebaceous follicle, was itself, when pressed out, a worm, the dark portion which results from the accumulation of dust upon the matter at the mouth of the follicle was supposed to be the head of the maggot, as it was called; subsequent observation, however, has proved that though this matter is not a worm, it contains an animal within its substance, the acarus folliculorum. the popular notions found among savage tribes as to the efficacy of certain remedies in the cure of disease have been the means of furnishing us with some of our most valuable medicines, indeed it is almost impossible to say whether originally man did not derive his remedies from the herbs and trees by an instinctive faculty impelling him, as it does the animals when in a state of liberty and with freedom of range, to seek certain plants as they avoid others. it is well known that animals when indisposed will find out some spot as if almost led to it by a visionary guide where the "healing plant" is to be discovered. i am told that sheep have this faculty, and that they will, when affected with the rot, feed upon some plant when they can discover it, which eradicates the disease. almost every one is familiar with the fact that cats and dogs will crop herbage and eat it; i have { } seen them frequently leave the house and proceed to the grass in the most business-like manner, partake of some quantity, and quietly return. a close observer of diseased animals might obtain some useful information by noticing the plants cropped by them while in that condition. the observations should be made in a variety of districts in consequence of the uncertain distribution of some even of the most commonly scattered plants; in one year they may be abundant, but in another they may be almost entirely absent from the same spot.[ ] were it only on the fact of reproduction, i would be contented to take my stand that the force of life is the indwelling power of pestilential matter. reproduction is a law of nature, and the law of nature is the law of god. and where do we find he prevaricates with us? the more we study his laws the more harmony and perfection we find; what is seeming confusion in the ignorance of to-day, is order in the knowledge of to-morrow. if any one ignorant of the law which regulates the diffusion of gases were { } told that a heavier gas would ascend contrary to its specific gravity through the septum in a vessel containing a lighter gas above the heavier, he would naturally doubt your assertion, and say, "that is contrary to the law of gravity;" but explain to him the principle by which this comes about, and the objects of the law; the order and beauty of the design become manifest. but this is no equivocation, it is evidence there, that subordinate laws exist and nothing more. it has never been found that men have gathered "grapes of thorns and figs of thistles," nor has it ever been discovered that inanimate matter multiplies itself. the seed of disease "is within itself," multiplying and propagating itself; whether it formed a part of creation at the beginning or not, is rather a question to be solved by divines than physicians. when we know, however, the latency of seeds and even of entire plants, and that they may be dried and remain so for years yet being brought again into conditions adapted to their active existence, they, as it were, revive from their sleep, and renew again their reproductive properties: can we wonder if, in the great scheme of nature, existences new to mankind should make their appearance? when the new zealander saw the surface of his ground producing to him unknown plants, and the skins of his children generating peculiar eruptions, and each propagating its kind, would he look, think you, to the wood or the stones, the air or the water,--for the solution of the { } mystery? no, he would naturally say these people brought the _seeds_ with them. from the property of reproduction possessed by these forms of matter, we infer the value of the proposition. * * * * * { } chapter ii. the number and value of facts to support the proposition. -------- section i. on reproduction. it is inferred that the proposition, "_the matter which operates in the production of epidemic, endemic, and infectious diseases, possesses the property of vitality_," we proceed now to the enumeration of those facts which further elucidate this subject. the facts must necessarily be such as illustrate the identity of properties in the imaginary germs, that are known to exist in demonstrable germs: we take therefore the law of reproduction to be to life, what the law of attraction is to gravitation.[ ] { } but further; do those matters which engender disease furnish to our minds the properties inseparable from life in the abstract? though the faculty of reproduction is essentially an evidence that the thing which reproduces its kind must be a living body, yet it is only a property or power of living beings and is not itself life, it therefore is necessary to establish the fact that the _materies morbi_ not only has the power of reproduction, but also those properties which in the abstract will prove as far as demonstration can go, that it has the essential properties common to all living bodies. i must again quote from coleridge, he says: "by life i every where mean the true idea of life, or that most general form under which life manifests itself to us, which includes all its other forms. this i have stated to be the _tendency to individuation_ and the degrees or intensities of life, to consist in the progressive realization of this tendency. the { } power which is acknowledged to exist wherever the realization is found, must subsist wherever the tendency is manifested. the power which comes forth and stirs abroad in the bird, must be latent in the egg." the tendency to individuation cannot be more strongly marked than in the simple experiment of vaccination: we insert a small particle of the so-called vaccine lymph under the skin, and by this means we multiply to an enormous extent, the power which, in the first instance, we had in the form of minute corpuscles in a dry and apparently inert state; nevertheless, though in this condition there must have existed the tendency to individuation or multiplication of individual existence, and the germs are here to their active existence, as seen in the development of the vaccine vesicle, what the egg is to the bird,[ ] as described above; we may, therefore, say that the power which exhibits itself in the production of a vaccine vesicle, must have been latent in the dried matter. it is the opinion of muller that the entire vital principle of the egg { } resides in the germinal disk alone, and since _the external influences which act on the germs_ of the most different organic beings are the same, we must regard the simple germinal disk, consisting of granular amorphous matter, as the potential whole of the future animal, endowed with the essential and specific force or principle of the future being, and capable of increasing the very small amount of this specific force and matter, which it already possesses, by the assimilation of new matter. after speaking of inanimate objects, dr. carpenter says; "and what compared with the permanence of these is the duration of any structure subject to the conditions of _vitality_? _to be born_, to grow, to arrive at maturity, to decline, to die, to decay, is the sum of the history of every being that lives; from man, in the pomp of royalty, or the pride of philosophy, to the gay and thoughtless insect that glitters for a few hours in the sunbeam and is seen no more; from the stately oak, the monarch of the forest through successive centuries, to the humble fungus which shoots forth and withers in a day." to be born, signifies the faculty of reproduction existing or having existed in an antecedent being to that one born, and also that itself possesses equally a like power. to be born, is the first expression which must be used in speaking of the faculties or properties of living beings as independent existences, the annual formation of buds, trees, and shrubs, is a multiplication of the species; the coral { } and various budding polypes increase by this process, indeed what is the seed of a plant, or the egg of a bird, or the ovum of mammalia, but cast off buds; in all, the new being was originally a portion of its parent, and if we examine the ovary of the vegetable, the bird, or the mammal, can we find any expression more fitting to designate the process than that of budding. to be born then, is the evidence of an act of one living being, and the commencement of a series of vital phenomena in another, but all these are subsequent to reproduction, and constitute another chain of vital acts, all tending to a similar result, the multiplication of the species.[ ] now, whether we apply the philosophical language of coleridge, or the language of observation of muller, in confirmation of the doctrine here inculcated, we arrive at the same point. do we not witness in the newly formed vaccine vesicle, an increase of the specific force and principle? we certainly have acquired by the process of vaccination a manifold multiplication of power, and is there not also assimilation of new matter in { } which this power resides? and does not every particle of this new matter contain within itself the same force and principle, as existed in that which generated it? "we revert again to potentiated length in the power of magnetism (reproduction); to surface in the power of electricity, and to the synthesis of both or potentiated depth in constructive, that is chemical affinity."[ ] some may be at a loss to conceive, at first, how irritability may be considered a property of all vegetable matter; that it does exist in some vegetables is certain, but that it does exist in all living beings is equally certain;[ ] the term, however, which would appear more appropriate when that irritability does not exhibit itself in an appreciable form, is _impressibility_. irritability, as commonly understood, is seen in its highest condition in muscular tissue; but "the irritable power and an analogon of voluntary motion first dawn on us in the vegetable world in the stamina and anthers at the period of { } impregnation."--"the insect world is the exponent of irritability, as the vegetable is of reproduction." the property of irritability attains its acme in man, the most highly organized of all beings; and its gradations pass downwards through the whole scale of animate creation; not so reproduction, for this faculty observes the very opposite direction, for in plants a single impregnation is sufficient for the evolution of myriads of detached lives. reproduction is a fact, it is an essential property of life, and is a reality to us from observation; but irritability is not so tangible and demonstrable a property. we nevertheless may assume its universality, from the circumstance that we lose sight of it by imperceptible degrees; the irritability of the sensitive plant is as much irritability as that of the highly organized muscle; but because the faculty evades our perception, "in tapering by degrees, becoming beautifully less," we have no reason for pronouncing its total extinction at any one point of the vegetable kingdom,[ ] any more than we should have { } in saying that we see the end of the earth, when describing the extent of our vision as we stand on the sea shore. the extreme limit of our vision is the tangent of the circle in reference to our visual organs; but how many tangential points there may be beyond, it is impossible to say without knowing the dimensions of the circle. i think we are now in a condition to assume, as far as abstraction will conduct us without proceeding to an extreme length, that the _materies morbi_, or, as i will now call them for the sake of clearer distinction, _semina morbi_, possess those properties which in the abstract are common to all living beings. another argument strikes me as capable of adding further strength to the proposition. we need but be told that a small piece of iron was placed in a certain position with regard to another piece of iron, and that the smaller piece moved through a given space and became attached to the larger, to infer that magnetic force was in operation. supposing this magnet then to be folded in paper, and that it { } be promiscuously placed near a compass, the deflection of the needle would indicate that some object in the vicinity was the cause of the deflection; we may farther try what positions the needle takes by varying the position of the packet, and thus point out which is the north and which the south pole of the screw of paper. if we may consider attraction then to be to gravitation what reproduction is to life, we do not err in saying in the one instance that there is a living being, and in the other there is a magnet. the nebular theory, from which some astronomers made the foundation of many speculations, came with so much interest to our minds that the fascination could not be resisted. it was most delightful to revel in the imagination that we possessed a key to the mode of formation of the starry hosts, and when speculation had taken its extreme limits in the "vestiges of the natural history of creation," and the nebulæ had served as the ground work of a gigantic scheme, lord ross's monster telescope swept the heavens of its cobwebs. we can imagine this great promoter of science saying to us, gentlemen, the clouds which have obscured you, are composed of myriads of stars, and comprise systems as vast and as luminous as our own, had you but power of vision to discern them. a new light thus appeared to philosophers, and though no great practical results may flow from the discovery, it is instructive from the fact that the imperfectly aided or unaided vision, should not limit legitimate { } inference. the nebulæ before lord ross's discovery were to the astronomer what the materies of epidemic and infectious disease are to medical men. in the absence however of a giant microscope to reveal such great truths, we may yet dimly shadow them by the light of our reason. it was predicted in that minute vegetable germs, in all probability all of the same type, were the agents producing epidemic and infectious disease. in , mr. oke spooner says,[ ] "on examining the matter of small { } pox and cow pox in every stage, he finds its essential character to consist of a number of minute cells not exceeding the , th part of an inch in diameter: being about one-fourth smaller than the globules of the blood, containing within their circumference many still more minute nuclei, and presenting beyond their circumference bud-like cells of the same size and character as those contained within the circle." should these observations made by mr. spooner turn out to be correct, they will but fulfil my anticipations. then again shall we see the same application of imperfect vision to the limitation or temporary obstruction of solid and determinate knowledge. we may reasonably expect that these bodies, discovered by mr. spooner, should be the elementary matters of disease. their existence was predicted from the probability that living matter must be the agent; moreover, that this matter when discovered { } would be cellular, most probably resembling the yeast plant as described by mr. spooner. it was predicted that a planet would be discovered in a certain position in the heavens, because the perturbations of a comet indicated an attracting body in the path of the eccentric wanderer; the prediction and the fulfilment were almost simultaneous. * * * * * { } section ii. historical notice of epidemic diseases. the earliest notices we have of pestilences are contained in holy writ. the plagues which smote the egyptians in the time of moses are not unworthy some comment here. of those ten plagues, four out of the number were due to the miraculous appearance of myriads of the lower animal tribes, in three instances of insects,[ ] viz. lice, flies, and locusts; in the fourth, when aaron stretched forth his hand with his rod over the streams, over the rivers, and the ponds, frogs came up and covered the land of egypt. in these instances living beings are made the instruments in god's hand for the punishment of the wicked. these plagues include the second, third, fourth, and eighth. the first plague is mentioned as a conversion of the waters into blood. now if we may take this expression as being literal, there is no reason to suppose that this blood differed in any respect from ordinary sanguineous liquid; we therefore may assume, as the blood is every where in scripture spoken of as the _life_, that this fluid was endowed with vital properties. { } the fifth plague is described as a murrain among beasts; and the sixth, as exhibiting itself as "a boil breaking forth with blains, upon man and upon beast."[ ] now these affections bear a resemblance to the diseases known to us at the present day through authentic records. the black death of the th century affords in its history but too awful a picture of the horrors of such pestilences. in the tenth plague, the smiting of the first-born, we are not told by what means it was brought about; but we have something even here to lead us to conjecture. in the second visitation of the black death, there were destroyed a great many children whom it had formerly spared, and but few women. the seventh plague of hail is within our conception; as is also that of darkness, the ninth plague. it is not a little remarkable that of the ten plagues, seven of them depended upon agents intelligible to our comprehension; we can conceive of { } the invasion of a country by myriads of loathsome insects and reptiles, and can imagine the wrath of an offended deity directing the force of a supernatural storm of hail upon a disobedient people; and we can conjecture, though faintly, the consternation of human nature on being subjected to a total darkness of three days' duration, when we consider _that_ darkness has been described, as "a darkness that might be felt." from this abstract we discover that the three plagues whose causes we cannot understand, or rather upon which no light has been thrown by scripture, bear analogies to those which we recognise, in the writings of modern authors, as fearful pestilences. it is now our province to reflect on the causes supposed to be in operation in the three instances, which become naturally separated from the rest. we are told that a murrain appeared among the cattle, without any preliminary step. when the blains broke out upon man and beast, moses had been previously directed by the almighty to take handfuls of the ashes of the furnace, and sprinkle them towards the heaven in the sight of pharaoh. "_and it shall become small dust in all the land of egypt_, and shall be a boil breaking forth with blains upon man and upon beast, throughout all the land of egypt." another coincidence, in connexion with subsequent pestilences, arrests the attention, on the subject of the mysterious appearance on these occasions of { } matter resembling dust being prevalent about the houses, and on the clothes of the people. clouds also, and showers of dust-like particles, were not of infrequent occurrence. indeed, in the summer of , during the progress of the cholera, several phenomena of a similar nature were observed and authenticated; i myself can bear testimony to one instance of the kind. it was observed by many persons in my neighbourhood after the passage of an ominous and lurid cloud, that as they walked their clothes became covered with a singular dust-like matter of very peculiar appearance. that this phenomenon was not destitute of significance may be gathered from the fact, that on the night of that day several severe cases of cholera occurred, though our village had been comparatively free for ten days. hecker, in writing on the black death says, the german accounts expressly speak of a "thick stinking mist which advanced from the east,[ ] and { } spread itself over italy; there could be no deception in so palpable a phenomenon." it is not unworthy of mention, that in the east successive invasions of locusts "which had never perhaps darkened the sun in thicker swarms," preceded the great outbreak of this disease, for they left famine in their train. from to in germany and france, during the prevalence of the sweating sickness, spots of different colours made their appearance, "principally red, but also white, yellow, grey, and black, often in a very short time, on the roofs of houses, on clothes, on the veils and neckerchiefs of women, &c." blood rain is also mentioned as having occurred at this time, which consisted of the aggregation of minute particles of red matter. in the seven plagues, miraculous operations of the deity consisted in the unusual manifestation of phenomena, but which in their effects are recognizable as of clear and definite import. the miracles here are,--in the _mode_ of producing the swarms of frogs, locusts, &c. but they are manifest and unmistakeable _causes_ of plague and famine; in the other three, on the contrary, we witness only the effects, the causes are hidden from us; we may, therefore, as in current events, legitimately investigate the subject, and what better course can be adopted than that which classifies the traditionary past with all subsequent history. presuming such a method of research to be admitted, i have assumed that as { } the _causes_ of the seven plagues have been distinctly given, the others, though only mentioned in their effects, were due to causes of a nature in some way to be compared with their concomitants, that is to say, if a special intervention of the deity brought about a miraculous appearance of frogs, lice, &c. there is but little reason to doubt that some other agent was miraculously multiplied and concentrated to induce the murrain, engender the blain, and smite the first-born: as if to lead us into this enquiry, on the visitation of the blain in man and beast, the bible history tells us that moses threw ashes of the furnace, which became a dust throughout all the land of egypt; we cannot imagine that this simply as ashes could have caused the blain, we may conclude that by some special miracle, either the ashes were converted into a specific form of matter capable of inducing the effects recorded, or that an independent septic matter was generated for the purpose. if the latter, the act of throwing the ashes of the furnace into the air may have been intended to signify that the extremely minute division of the particles when thus cast into space, typified the inscrutable and hidden nature of the matter endowed with such marvellous properties.[ ] { } further on in the book of leviticus are passages which i cannot forbear transcribing, for they point out to us most indubitably a line of enquiry in reference to diseases of a contagious nature. "the garment also that the plague of leprosy is in, whether it be a woollen garment, or a linen garment, whether it be in the warp or woof, of linen or of woollen, whether in a skin, or in any thing made of skin, and if the plague be greenish or reddish in the garment ... it is a plague of leprosy, and shall be shewed unto the priest, and the priest shall look upon the plague and shut up it that hath the plague seven days; and he shall look on the plague on the seventh day; if the plague be spread in the garment, either in the warp, &c. ... the plague is a fretting leprosy, it is unclean. he shall therefore burn that garment ... wherein the plague is, for it is a fretting leprosy; it shall be burnt in the fire. and if the priest shall look, and behold, the plague be not spread in the garment ... then the priest shall command that they wash the thing wherein the plague is, and he shall shut it up seven days more: and the priest shall look on the plague, after that it is washed: and behold if the plague have _not_ changed his colour, and the plague be not spread, it is unclean; thou { } shalt burn it in the fire; it is fret inward; whether it be bare within or without. and if the priest look and behold the plague be somewhat dark after the washing of it, then he shall rend it out of the garment ... and if it appear still in the garment either in the warp or the woof ... it is a spreading plague: thou shalt burn that wherein the plague is with fire. and the garment ... which thou shalt wash, if the plague be departed from them, then it shall be washed the second time and shall be clean."--chap. xiii. - . again in deuteronomy. the curse for disobedience: "the lord shall make the pestilence cleave to thee until he have consumed thee from off the land.--the lord shall smite thee with a consumption, and with a fever, and with an inflammation, and with an extreme burning, and with the drought, and with blasting, and with _mildew_, and they shall pursue thee until thou perish.--the lord shall make the rain of thy land _powder_ and _dust_: from heaven shall it come down upon thee until thou be destroyed." it may be said, and i doubt not will be said, all this is unnecessarily dragging the sacred volume into an enquiry totally foreign to its general tenor; on the contrary, however, i maintain by that book we are to learn the ways of god to man, and further, that no study can impress mankind with so awful, so terrific an idea of his responsible position, as that which leads him into the investigation of the causes { } by which the almighty, doubtless in his wisdom, has thought fit at various epochs of this world's history, to place man face to face with pestilence, famine and sudden death. there is no man would less willingly than myself introduce profanely the revelations of scripture. the observations here made are not, therefore, intended for light or heedless controversy; if they have a significance of any import, let them be alluded to in the same spirit with which they have been quoted; if they convey nothing for approval to the reader, let silence rest upon them. to those who would fain disregard my request, let me recall to their minds the veneration which from childhood i trust we have always felt on hearing or seeing those two words--holy bible. it is yet to be determined, whether the greenish or reddish appearance of the garment spoken of, as being contaminated with the plague of the leprosy had any specific relation to the disease itself. the priest orders that the garment shall be shut up seven days, and on the seventh day, if the plague be increased, by which, of course, is meant if the greenish or reddish colour have increased, and from which we may gather that a power of spontaneous increase was possessed by the matter, such a result indicated a fretting leprosy, and the garment was to be burnt. again, though there may have been no increase, but a persistence of the coloured matter after shutting up and washing the garment, it is to { } be burnt, for it is fret inward, signifying, that the germs of the affection are still there, and may soon increase. other rules follow in reference to the plague of leprosy, and the mode of deciding whether an article be unclean or clean is definitely laid down, but our purpose is served in mentioning the above, to shew that in the time of moses the spontaneous increase of certain minute multiplying germs was supposed to have a close connexion with disease. it is equally clear, that the priests were aware by the order given them, that if the ordinary modes of purifying articles of clothing failed in their effect, the safest and surest method of destroying infectious matter was to resort to the practice of consuming by fire all materials capable of propagating an infectious malady. the facts above noticed, accurately correspond to what we now know as applicable to the matter of infectious and contagious maladies. it is a rule, i believe universally adopted throughout the poor-houses of this country, to put the clothes of all persons about to become residents in these establishments, into ovens, where they are submitted to a temperature incompatible with the existence of either animal or vegetable life. by this means all living matters are destroyed, but the fabrics and inorganic matters retain their properties intact. this simple proceeding, i am credibly informed, is an effectual preventive of contamination by articles of clothing, a desideratum of no small importance, when it is { } remembered that the diseases among the poor owe much of their inveteracy to the accumulation of effete organic matters about their persons and clothes. a few more observations are called for on the quotation from deuteronomy, in which allusion is made to living matter being an agent in the production of disease. in the curse upon the children of israel for disobedience, we read that they are to be smitten with mildew. no further information, however, is vouchsafed to us, nevertheless, we can conceive the wretched condition of those on whom the curse might fall. again, we find in a continuation of this curse that the almighty uses means such as he adopted in the sixth plague of the egyptians. the ashes of the furnace became a small dust in all the land of egypt, breaking forth with blains upon man and beast. in the curse of the israelites the words are: "the lord shall make the rain of thy land _powder and dust_: from heaven shall it come down upon thee until thou be destroyed." it might be conjectured that the absence of rain would be sufficient to account for the extinction of the people on whom the curse was pronounced, by the famine and drought necessarily attendant upon the loss of moisture. but this does not appear to be the meaning of the passage, for the powder and dust are mentioned as the agents of destruction; besides, in the continuation of the curse, the locust is to destroy the grain, the worm the grapes, and { } the olive is to shed his fruit; we may thus take for granted that drought and famine are not to be caused by the showering of powder and dust, it must consequently be supposed that the effects of the dust in the instance of the egyptians are to be compared and classified with those of the dust which smote the israelites. as far then as sacred history conducts us in the enquiry, concerning the causes of pestilences, we gain encouragement in the belief that living germs are the active agents, for in the case of the leprosy, we have evidence of reproduction in connexion with infection, which, if our line of argument be tenable, amounts to demonstration; then, in the other instances of the plagues, by boils and blains, they distinctly bear comparison with the accounts given by profane writers, of the visitations of pestilences on the earth, subsequently to those mentioned in scripture history. this leads now to the consideration of recorded facts observed and noted during the various epidemics in the early and subsequent periods of man's history, as given by those on whom reliance may be fairly placed. setting aside the uncertain information contained in the writings of the chinese,[ ] a people whose { } progress in the science and practice of medicine has nothing to commend it (even as it is at the present day) to the notice either of the physician or the historian, unless it be to the latter as a mark of peculiarity both in a social and political point of view,--passing also over the egyptians, the arabians, and the greeks,--and even hippocrates himself, we are driven to the romans for any authentic or precise notice of epidemic affections. it has been attributed to hippocrates that he predicted the appearance of the plague at athens, { } and that when it was introduced into greece he dispelled it, "by purifying the air with fires into which were thrown sweet-scented herbs and flowers along with other perfumes."[ ] but little advantage can be derived from enquiries concerning the first appearance of any disease, for the probability of discovering the primary cause is certainly a { } hopeless case, if attempted by means of the writings of ancient authors, when it is recollected that with all the science and learning of the ancient egyptians, the use of optical instruments was not comprised among the paraphernalia of their arts. the knowledge that was limited to the powers of natural vision, where the foundation of knowledge is based upon facts obtained through the aid of that penetrator of nature's secrets, the microscope, offers no advantages to the student of the present day. to say that a disease commenced in the east and travelled westward, and at length found a habitation and a name in every part of the globe, is no more than to say that disease is coeval with the fall of man. the cause is as much hidden in the region of its birth, as in that where it sojourns for a time. the cause of the sweating sickness was as much a mystery in england as in all the other nations of europe, which were visited by its devastating power. and these observations apply with as much force to one disease as another; for even our indigenous ague, originating in some places so limited that the shadow of a passing cloud may mark the boundary of its dwelling place, as inscrutably evades our vigilance, with all the appliances that art can bring to our assistance, in endeavouring to evoke its extraordinary properties under the cognizance of our senses. if we weigh the air which carries the poison, or analyze it by the most delicate chemical tests, or { } take the weight of the atmosphere which is charged with it, or if we take the blood which carries the germs of the disease to the tissues of the body, and submit them after the work of destruction is accomplished, to the most rigid inspection, we can but exclaim, "these are thy marvellous works!" and confess our total inability to fathom the unbounded. if then no practical advantage can accrue from investigating the writings of the ancients on these subjects, beyond comparing their historical statements with those of more recent date, our purpose will be served by occasionally embodying any remarkable observations of the former with those of the latter. in proceeding with this course it were better to confine our minds chiefly to two diseases which appear from history to have been known from the earliest periods, these are the plague and the small pox, mentioning other diseases only _en route_. passing then, to the sixth century of the christian era for the first distinct and connected account of the plague, it appears from a host of testimony, that the history of this disease, as given by procopius, well merits our attention. drs. friend and hamilton, in their histories of medicine, and gibbon, in his history of rome, are equally warm in their praise of procopius: the latter says, he "emulated the skill and diligence of thucydides in the { } description of the plague at athens." the account given by procopius of this disease, does not differ materially from that given by subsequent eye-witnesses of similar pestilences. its point of origin is clearly marked, and its mode of dispersion in all directions distinctly traced from "the neighbourhood of pelusium, between the serbonian bog and the eastern channel of the nile." it commenced in the year . it raged in constantinople in the following year, and it was in this city that our historian gathered the materials which are handed down to us. when, however, we anxiously look for any explanation as to the cause of the malady, we are told that it must have been a direct visitation from heaven, in consequence of the eccentric characters exhibited in its wide-spreading influence, in not yielding to the scrutiny nor bending to the laws known to prevail, and to regulate the course of other diseases: neither country nor clime, age nor sex, the strong and healthy, nor the weakly and previously diseased, could be said to be free from its indiscriminate destruction. but some phenomena preceding the outbreak of the pestilence are observed as coincidences by all authors. gibbon thus writes: "i shall conclude this chapter with the comets, the earthquakes, and the plague which astonished or afflicted the age of justinian." from the accounts given by this author, earthquakes for some years had been threatening and destroying many portions of the globe, { } that in the ruins of cities and in the chasms of the earth, great was the sacrifice of human life. constantinople, which suffered so severely from the plague is said to have been shaken for forty days. these great disturbances of the globe have been always looked upon as indicating other and important influences of a secret or hidden nature; these impressions on the minds of the people are traceable throughout the histories of all epidemics, and have been sufficiently distinct among the people of our own time, preceding and during the period of infliction. from this short notice of the plague of , i pass to the ninth century, when rhazes, the arabian physician, endeavoured to enlighten the world on the subject of small pox.[ ] in quoting his opinions, i am not to be understood as subscribing to them, but merely endeavouring to point out some peculiar and interesting observations. first, then, rhazes attributes the disease to a condition of the blood, which he thus describes, to shew how it happens that in infancy and childhood the disease is most prevalent, and that old age is { } least liable to the affection.[ ] "the blood of infants and children may be compared to _must_, in which the coction leading to perfect ripeness has not yet begun, nor the movement towards fermentation taken place; the blood of young men may be compared to must which has already fermented and made a hissing noise, and has thrown out abundant vapours and its superfluous parts, like wine which is now still and quiet, and arrived at its full strength, and as to the blood of old men, it may be compared to wine which has now lost its strength, and is beginning to grow vapid and sour." "now the small pox arises when the blood putrifies and ferments, so that the superfluous vapours are thrown out of it, and it is changed from the blood of infants which is like must, into the blood of young men which is like wine perfectly ripened: and the small pox itself may be compared to the fermentation and the hissing noise which take place at that time." but the cause of the disease is simply alluded to by this author, as depending upon "occult dispositions in the air," and as he speaks here of measles with the small pox he goes on to say--"which necessarily cause these diseases and predispose bodies to them." this notion of rhazes that there is some peculiar condition of the blood which favours a process resembling fermentation is not without interest. the circumstance that individuals are not { } usually liable to a second attack of the disease, no doubt directed the attention of this physician to compare the process of fermentation with disease of such a nature, seeing that when the whole of the saccharine matter was converted into spirit, the hissing noise, as he calls it, or the disengagement of carbonic acid gas would cease, and the capacity for fermentation be entirely gone. so that the occult conditions of the air, their power of inducing a disease, and multiplying the matter capable of engendering a similar affection, stood in the mind of rhazes as analogous if not identical phenomena. we pass now without further comment to the epidemics of the middle ages; and here the work of the philosophical hecker leaves us little else to desire in the way of information, as far as it is obtainable from published records. from the manner in which he has grouped the facts which presented themselves to his mind in the course of a most laborious research, he has saved the student of this subject much toil in acquiring matter for reflection; he has here but to read and digest. i know not how to select from this invaluable work the most striking passages, to strengthen and support my hypothesis, for not a page is destitute of facts corroborative of the doctrine that vital germs are the material agents of pestilential disorders. the opening paragraph to the black death is a most cogent illustration of the assertion; it is, as it were, the theme of the work. "that { } omnipotence, which has called the world with all _its living creatures into one animated being_, especially reveals himself in the desolation of great pestilences. the powers of creation come into violent collision; the sultry dryness of the atmosphere; the subterranean thunders; the mist of overflowing waters are the harbingers of destruction. nature is not satisfied with the ordinary alternations of life and death, and the destroying angel waves over man and beast his flaming sword." i must here apologise for large transcripts from hecker's work, for neither could i command the amount of knowledge there displayed, nor use such appropriate language as the learned translator has employed. it is not doubted that the black death was an oriental plague, only of more than usual severity, and wider spread influence of the infectious nature of this disease, and the active properties of the matter producing it. hecker says, "articles of this kind--bedding and clothes--removed from the access of air, not only retain the matter of contagion for an indefinite period, _but also increase its activity, and engender it like a living being_, frightful ill consequences followed for many years after the first fury of the pestilence was past."[ ] { } as extraordinary atmospheric and telluric phenomena preceded the plague in the time of justinian, so do we find similar instances recorded as the precursor of a similar visitation years later. i am concerned more with those circumstances which refer more especially to my subject, _viz._ the development of organic matter, and the peculiar odours of the atmosphere, the latter being evidence of some foreign and unusual production in our respiratory media. "on the island of cyprus, before the earthquake, a pestiferous wind spread so poisonous an odour, that many being overpowered by it, fell down suddenly and expired in dreadful agonies. a thick stinking mist advanced from the east, and spread itself over italy." { } it is probable that the atmosphere contained foreign and sensibly perceptible admixtures to a great extent, which, at least in the lower regions, could not be decomposed or rendered ineffective by separation. in an unexampled earthquake shook greece, italy, and the neighbouring countries. during this earthquake the wine in the casks became turbid, a proof that changes causing a decomposition of the atmosphere had taken place. "the insect tribe was wonderfully called into life, as if animated beings were destined to complete the destruction which astral and telluric powers had began." "the corruption of the atmosphere came from the east, but the disease itself came not upon the wings of the wind, but was only excited and increased by the atmosphere where it had previously existed." "the most powerful of all the springs of the disease was contagion; for in the most distant countries, which had scarcely yet heard the echo of the first concussion, the people fell a sacrifice to organic poison, the untimely offspring of vital energies thrown into violent commotion." "after the cessation of the black plague, a greater fecundity in women was every where remarkable, a grand phenomena, which from its occurrence after every destructive pestilence, proves to conviction the prevalence of a higher power in the direction of general organic life." { } in the article contagion, of the essay, sweating sickness: "most fevers which are produced by general causes, propagate themselves for a time spontaneously." "the exhalations of the affected become the germs of a similar decomposition in those bodies which receive them, and produce in these a like attack upon the internal organs, _and thus a merely morbid phenomenon of life, shows that it possesses the fundamental property of all life, that of propagating itself in an appropriate soil. on this point there is no doubt, the phenomena which prove it have been observed from time immemorial, in an endless variety of circumstances, but always with a uniform manifestation of a fundamental law._" mead, in his essay on the plague, makes many observations of great interest and worthy a physician of eminence; and where, in recent times, shall we look for any more definite information concerning the causes of pestilences? it is not a little singular that at the time this book was published, it was read with such avidity that it went through seven editions in one year.[ ] from this circumstance we may gather that the public generally took a lively and proper interest in a subject that was not only of domestic, but national importance. whether this interest was stimulated by the fact that the work was written expressly by order of the { } government, it is now impossible to say, at any rate much credit is due to the lords of the regency for having placed so important a duty upon one so thoroughly and in every way so duly qualified for the task as dr. mead. it had been well if some of the advice given at that time, as means of protection against the plague, had been applied and put in force during the late visitation of epidemic cholera, for, however the minds of some may be convinced of the non-contagiousness of cholera, there are many who hold a different opinion, and all will acknowledge, that if not strictly a contagious affection, it is clearly proved to be capable of being carried from place to place, or to use dr. copland's words, it is "a portable disease." but this is not the place to discuss the subject of contagion, allusion will be made to it hereafter. to return, mead's expressions are singularly illustrative of the vital power possessed by the germs of disease; he says, "there are instances of the distemper's being stopt by the winter cold, and yet the seeds of it not destroyed, but only kept unactive, _till the warmth of the following spring has given them new life and force_. his confession as to the hidden cause of the disease, is worthy transcribing: "we are acquainted too little with the laws, by which the small parts of matter act upon each other, to be able precisely to determine the qualities requisite to change animal juices into such acrimonious humours, or to explain { } how all the distinguishing symptoms attending the disease are produced."[ ] on the spread of the plague is the following:--"the plague is a _real poison_, which being bred in the southern parts of the world, maintains itself there by circulating from infected persons to goods, that when the constitution of the air happens to favour infection, it rages with great violence." contagious matter is lodged in goods of a loose and soft texture, which being packed up, and carried into other countries, let out, when opened, the imprisoned seeds of contagion, and produce the disease whenever the air is disposed to give them force, "otherwise they may be dispersed without any considerable ill effects." gibbon thus speaks of the above quoted work: "i have read with pleasure mead's short but elegant treatise concerning pestilential disorders;" many also might read it at the present day with infinite advantage. mead most satisfactorily combats the opinions of the french physicians who maintained the non-contagiousness of the plague. experience proves beyond doubt, that certain conditions of atmosphere, of { } which we are ignorant, favour the growth and increase of pestilences as they do of all vegetation. dr. bancroft was of opinion that specific contagions are each and severally creatures of divine wisdom, as distinctly and designedly exerted for their production, as it was to create the several species of animals and vegetables around us. the indigenous fever of ireland, which has several times shewn itself in an epidemic form, appears to have been as fatal, as the plague in the south of europe. its devastations have generally been associated or preceded by famine and general distress. dr. harty, writing in , says that thrice within the last eighty years has the same fever appeared in its epidemic character. in the year ireland lost , of her inhabitants from this cause. it is a maculated typhus, and considered to be a special product of the emerald isle. it has been shewn that fever began to exceed its ordinary rate in those places first where famine and want of employment were most severely felt,[ ] and that in such places and under such circumstances, it was most prevalent and fatal. the physicians generally believed it to have been spontaneously produced and not to have been imported. in the last famine fever of ireland, liverpool and several other places suffered severely from the { } importation of their channel neighbours with the disease in some instances, and the infection in others about their persons. hitherto these have to all appearance been the limits of the affection; we know not, however, how soon the time may come when the invisible bonds which have thus chained the disease to certain localities may be severed, and spreading itself like other pestilences in an aggravated form, attack this country as a last and crowning act of retributive justice. at present it has but cost us money and regrets, but if the history of pestilences is to be heeded, there are many tokens which seem to indicate that a few slight concurrent circumstances only are wanting, to bring the full force of this disease upon us; then will there be a sacrifice of life. edinburgh and other towns of scotland have had some visitations already, ourselves but slightly, but let our labouring population suffer to any large extent for want of work, and we shall inevitably be the sufferers from that fever which in consequence of general destitution is now always more or less prevalent in ireland. the sweating sickness prevailed in england alone at first, but at length sought foreign victims. the cholera is an exotic disease, as well as the plague, but they occasionally have visited our shores, and their seeds remain among us. the small pox is now even not known in some parts of the world, but when once it is established, who can predict the period of its first appearance in an { } epidemic form. the history of the disease informs us that in all the countries where it has been introduced, sooner or later an epidemic has seized the inhabitants. a disease previously unknown in india appeared at rangoon in the year , which obtained the name of scarlatina rheumatica. four years afterwards it attacked the southern states of north america, and though the disease was so impartial as scarcely to spare a single individual of any town to which it extended its influence, it was not accompanied with that mortality which has usually been the characteristic of wide spread epidemics. there is one peculiar feature of all epidemics which may be here mentioned as indicative of some definite, though at present unaccountable cause, operating in the sudden suppression of the disease after a certain period of duration. this distinctive character may almost be considered as a law in reference to these affections; if we take three distinct diseases, the plague, the irish fever and the cholera, we find the rule apply to all. of the latter disease we have so recently been witnesses, that i need not quote authorities on this point concerning it. in dr. patrick russell's work on the plague at aleppo i find the following remarkable passage. after alluding to the great increase of pestilential effluvia that there must be towards the close of an epidemic, compared with the amount at the onset of the disease, and expressing his { } astonishment that so many escape infection, he says: "the fact, however unaccountable, is unquestionably certain; the distemper seems to be extinguished by some cause or causes equally unknown, as those which concurred to render it more or less epidemical in its advance and at its height." he then mentions that in europe the sudden cessation may be partly attributable to the measures adopted for preventing its extension; but "at aleppo, where the disease is left to run its natural course, and few or no means of purification are employed, it pursues nearly the same progress in different years; it declines and revives in certain seasons, and at length, without the interference of human aid, ceases entirely." the expressions of dr. harty on this subject, in connexion with the irish fever, would apply as well to all other epidemics: "it is a fact, that though every diversity of management was resorted to for effecting the suppression of the disease, yet, nevertheless, there was an almost simultaneous and apparently spontaneous decline of the epidemic in the various and most remote parts of ireland. it is not an easy matter to offer a satisfactory explanation of this circumstance, _some general cause must_ no doubt have influenced the subsidence of the disease, yet that cause could not be atmospheric, inasmuch as the decline, though it might be said to be simultaneous, was not sufficiently so to admit of that explanation." * * * * * { } section iii. the dispersion of plants and diseases. the dispersion of diseases and the dispersion of plants, exhibit analogies which might be little expected, on a superficial view of the enquiry. we are led to believe, that the earth as a whole, was not covered with vegetation in a day, the geological history of this planet is one of development, and though at first sight this expression of opinion may appear to savour of doubt in the mosaic record, a more extended acquaintance with the subject, favours rather and confirms scripture history. as the peopling of the earth has been a gradual process with the animal creation, so has it been also with the vegetable kingdom. we see at the present day, that plants by various means of transit from place to place, multiply themselves on new soils and in new climes, the same with animals. by other means we observe, or can trace, the extinction from various localities and countries, of members of both the animal and vegetable kingdom. we learn that originally this planet had a temperature much higher than at present, and that the variation of temperature between the equator and the poles, which we now witness, did not obtain in the earlier condition of the globe. we are given to understand, and not without considerable proof, { } if not demonstration, that the earth was a vast bog, in which rank vegetation grew, and in which the ichthyosauri and plesiosauri, must have floundered about as unwieldy and loathsome bodies. we can readily conceive a condition of atmosphere at this time to have been loaded with pestiferous vapours of an organized nature; it is entirely in accordance with all we know, that it should have been so. allied forms of plants to those now in existence, are found in the form of fossils, by which comparisons are made, but how the transition into the present flora took place, or at what period, it is impossible to say. that these plants should have been entirely destroyed during the revolutions of the earth by earthquakes, and their consequences; the collection of waters into the vacuities formed, and their draining off from other places by elevations of the land, is not to be dwelt on without astonishment; then again the ultimate changes of temperature on the surface of the earth, may have been another element in the history of their extinction. but if we may be allowed to imagine that there were organic germs floating in the vapours of the atmosphere, these would hardly be subject to the same influences as those which depended solely on their fixation to the soil for subsistence. the atmosphere, their native element, being influenced by the commotions from below, would be agitated; vortiginous currents would be established, hurricanes would sweep over the stagnant pool and reeking morass, { } and the higher regions of the air might have thus given protection to these subtle germs, while almost a total extinction of the elegant ferns, the stately palm, and the towering cane was in course of procedure. then when the strife of the earth and elements had subsided, these would descend with the gentle breezes, and again find in various spots a local habitation-- "where blue mists, through the unmoving atmosphere, scatter the seeds of pestilence _and feed unnatural vegetation_." in the new era, when the earth took its present physiognomy, who shall say whether much of the pestiferous matter may not have been enclosed and condensed in the bowels of the earth, and when it is remembered, that earthquakes and convulsions of nature,[ ] have invariably preceded the outbreak of { } any great pestilences, that stinking mists, coming from some unknown regions, and unusual vegetations have made their appearance in concert at these times, what i ask is more natural than to imagine, that they have been let loose during the general convulsion? it may be asked, what is to be said about that revolution of the earth, when the great deluge spread over the whole face of the globe? it can only be replied, that this is a part of the scheme of cosmogony into which we are not called upon to enter. there are yet strenuous supporters of the partial as well as total submersion of this planet, but whether it be true that the vast torrents which appear to have swept the surface uniformly in a southern direction, were of a date coeval with the deluge, and constituted an essential portion of the phenomena, of which one was, that "the fountains of the great deep were broken up," or whether they were anterior to this catastrophe, will not at all interfere with the conjecture of a very early formation and propagation of the germs of pestilential diseases, for the commotions of a deluge were less likely to interfere with the vapours of the atmosphere, than extensive volcanic and electric disturbances. moreover, it is rather in favour of this theory, that the { } regions where the temperature and exhalations most nearly resemble those of the former condition of the earth, are those in which pestilential disorders most frequently arise, and where their virulence has always been most strongly marked. after the various commotions which left the globe, with its present physiognomy of mountains, plains, valleys, rivers, lakes, and oceans; a new flora and fauna appeared to adorn and animate the scene of man's existence. plants and animals were created apparently in adaptation to the numerous climes, which the seasons in the various latitudes or the elevations of the soil, were prepared to render fruitful and useful each in its own sphere. besides this, the plants of the same latitude, in some instances, differ materially from each other; in this case it seems that the soil has much to do with this peculiarity, for it is certain that the soil and the contiguous atmosphere, have a close and intimate relation; the drought of the desert depends upon the sand, as humid atmosphere is connected with the morass. to illustrate the tendency which vegetation shews in appropriating one locality more than another, i may quote the following: "some of the volcanic masses of the Ã�olian or lipari islands, that have existed beyond the reach of history, are still without a blade of verdure; while others in various parts, of little more than two hundred years date, bear spontaneous vegetation, and the same is seen on two lavas of etna near each other, for the one { } of is still black and arid, while that of , is covered with oaks, fruit trees, and vines." in comparing the diffusion of plants, and the diffusion of diseases, the different modes by which this generally has been effected may be considered under heads, that the comparison may be more readily traced. _first_, seeds are diffused by the atmosphere, either by the prevalence of certain currents, which are produced by known laws, in which case, no difficulty occurs in the explanations; or in a more imperceptible manner, as by those more uncertain atmospheric currents of a partial nature, which, though they seem to have laws governing them, are not yet understood. _second_, seeds are transported by water across oceans, &c. when they can be floated on any material by which they are preserved, as by wrecks and masses of wood, which have been washed down the rivers. _third_, they are conveyed by man to all parts of the globe. _fourth_, a period of latency is observed to apply to them, that is, they require certain essential conditions before germination occurs; so that even in some localities, a plant may not have been known to exist in a particular neighbourhood, but by a train of circumstances, it may make its appearance, and again be a centre of development. st. i shall not here wander into the speculation, { } whether plants had originally one birth-place, as a centre from which they spread by various agencies, as supposed by linnæus, nor into any enquiry beyond those facts, which may fairly come within our own comprehension, and within our own means of demonstration. many seeds are provided with means adapting them for floating in the atmosphere, these are by pappi, or winglets and hairs, but it cannot be doubted that the agency of atmospheric currents, is productive of considerable effects in the dispersion of lighter seeds, such as those of mosses, fungi, and lichens--lichens have been discovered in brittany, which are peculiar to jamaica, and monsieur de candolle concludes, that their seeds had been carried thence by the south-westerly winds, which prevail during a great part of the year on this portion of the french coast. but humboldt's testimony on the subject of winds is most satisfactory, for he says, "small singing birds, and even butterflies, are found at sea, at great distances from the coast (as i have several times had opportunities of observing in the pacific), being carried there by the force of the wind, when storms come off the land." it is generally believed, from abundance of proofs, that the trade winds, and other continuous currents, are means by which plants are conveyed from one country to another.[ ] { } as to the partial currents, humboldt further says, "the heated crust of the earth occasions an ascending vertical current of air by which light bodies are borne upwards. m. boussingault, and don mariano de rivero, in ascending the summit of the silla, one of the gneiss mountains of caraccas, saw in the middle of the day, about noon, whitish shining bodies rise from the valley to the summit of the mountain, feet high, and then sink down towards the neighbouring sea coast. these movements continued uninterruptedly for the space of an hour. the whitish shining bodies proved to be small agglomerations of straws, or blades of grass, which were recognized by professor kunth, for a species of vilfa, a genus, which together with agrostis, is very abundant in the provinces of caraccas and cumana." on the plague of locusts we read, that "the lord brought an east wind upon the land, all that day and all that night, and when it was morning the east wind brought the locusts." on the black death we read, "there were many locusts which had been blown into the sea by a hurricane, and a dense and awful fog was seen in the heavens, rising in the east, and descending upon italy." of the plague of , gibbon says, "the winds might diffuse that subtle venom, but unless the atmosphere be previously disposed for its reception, the plague would soon expire in the cold or { } temperate regions of the north. the disease alternately languished and revived, but it was not till a calamitous period of fifty-two years, that mankind recovered their health, or the air resumed its pure and salubrious quality." in the history of the sweating sickness, of which there were five distinct visitations, we find ample allusions to the atmosphere, and the mode in which the disease was conveyed by this medium. i quote again from hecker: "it seemed that _the banks of the severn_ were the _focus of the malady_, and that from hence, a true impestation of the atmosphere, was diffused in every direction. whithersoever the winds wafted the stinking mists, the inhabitants became infested with the sweating sickness. _these poisonous clouds of mists were observed moving from place to place_, with the disease in their train, affecting one town after another, and morning and evening spreading their nauseating insufferable stench. at greater distances, these clouds being dispersed by the wind, became gradually attenuated yet their dispersion set no bounds to the pestilence, and it was as if they had imparted to the lower strata of the atmosphere, _a kind of ferment which went on engendering itself even without the presence of the thick misty vapour_, and being received into men's lungs, produced the frightful disease everywhere."[ ] { } mr. k. b. martin, harbour-master of ramsgate, in a communication to lord carlisle on the cholera of last autumn, says, "at midnight of the st august ( ), the samson (steam-tug) proceeded to the goodwin sands, where the crew were employed under the trinity agent, assisting in work carried on there by that corporation. while there, at a.m. st september, _a hot humid haze, with a bog-like smell_, passed over them; and the greater number of the men there employed instantly felt a nausea. they were in two parties. one man at work on the sand was obliged to be carried to the boat; and before they reached the steam vessel at anchor, the cramps and spasm had supervened upon the vomitings; but here they found two of the party on board similarly affected. here then is a very marked case without any known predisposing local cause. doubtless it was atmospheric, and in the hot blast of pestilence which passed over them." many more instances might be quoted, to shew that the germs of disease, as well as of plants, are borne on the wings of the wind from place to place { } in one country, and from one country to another, the distance being no obstacle, however great that may be.[ ] "dust and sands," says sharon turner, "heavier than many seeds, are borne by the winds and clouds for several hundred miles across the atmosphere, falling on the earth and seas as they pass along." "the clouds not only bring us occasionally meteoric stones, hail, and _epidemics_, but also vegetable seeds."[ ] nd. the transportation of seeds of plants by water requires very little notice; every one is familiar with the mode in which coral islands, which gradually rise out of the sea, become covered with vegetation. "if new lands are formed, the organic forces are ever ready to cover the naked rock with life.--lichens form the first covering of the barren { } rocks, where afterwards lofty forest trees wave their airy summits. the successive growth of mosses, grasses, herbaceous plants and shrubs or bushes, occupies the intervening period of long but undetermined duration." the following may be cited as an instance of the transportation of disease by water. "cyprus lost almost all its inhabitants, and ships without crews were often seen in the mediterranean, or afterwards in the north sea, driving about, _and spreading the plague wherever they went on shore_."[ ] it requires no argument to enforce the conviction that cottons, woollens, furs, skins, &c. will retain the matter of infection for almost an indefinite period; instances of the kind have been already given; it is therefore easy to understand that portions of wrecks and ship's goods would be a frequent though unsuspected source of infection. dr. halley mentions a case, in which a bale of cotton was put on shore at bermuda by stealth; it lay above a month without prejudice, where it was hid, but when opened and distributed among the inhabitants, it produced such a contagion that the living scarce sufficed to bury the dead. dr. walker found seeds dropt accidentally into the sea in the west indies cast ashore on the hebrides. he says, "the sea and rivers waft more seed than sails." the waters of many rivers induce diarrhoea and dysentery.[ ] well water also in many { } places has a similar effect, especially if any surface drainage happens to find its way into the well. rd. the part performed by man himself in the communication of disease to his fellow creatures, is perhaps the most fruitful source of the extensive spread of epidemic and contagious diseases. in the time of moses, restrictions were laid on those who had the plague of the leprosy to avoid contagion; the dictum for one so affected was, "he shall dwell alone; without the camp shall his habitation be."[ ] all the ancient authors believed in the { } infectious nature of pestilential fevers, and some other diseases; but, according. to mr. adams, they held that no specific virus was the cause, and merely a contamination of the surrounding air by effluvia from the sick. thucydides, hippocrates, procopius, galen, plutarch, all recognized the property of communicability from one individual to another of the plague; and hecker, on the epidemics of the middle ages, abounds with instances in support of contagion. as regards small-pox and measles, rhazes observes particularly the connection that exists between the condition of the air and the severity or mildness of these diseases, remarking that small-pox seldom happens to old men, except in pestilential, putrid, and malignant constitutions of the air in which this disease is usually prevalent. the history of the introduction of scarlet fever, hooping cough, lues, and other diseases into the various countries of the globe, is sufficiently convincing that men carry about with them the seeds of disease; that while these attach themselves to the persons and clothing of those who introduce them into new climes, and flourish independently of cultivation, yet the exotics which they foster with so much care, often disappoint their most sanguine expectations; and these "languishing in our { } hothouses can give but a very faint idea of the majestic vegetation of the tropical zone." art in this procedure fails to accomplish here, what nature but too sadly, under some circumstances, effects most readily. the germs of some diseases though of an exotic character, under congenial influences of various kinds, appear to flourish with native vigour: is it not so, also, with some forms of vegetation? the aloe, a native of mexico, which lives, but does not thrive well, or reproduce under ordinary circumstances in this country, will occasionally send forth a most luxuriant blossom;[ ] so rare is this, that some say it occurs every or years, but no law seems to be established on this point, any more than the statement that we may expect pestilential diseases at certain intervals. but that there are intervals of _uncertain_ duration when the aloe will blossom, when the grapes will ripen, and a general productiveness of exotics will occur, is as certain as that seasons will occur when contagion will be rife, and a most unusual multiplication of disease prevail. this is not an imaginary or speculative notion,--all observers of seasons and diseases within the last twenty years, may fully verify the statement. in , a large vine, the black hambro-grape, { } ripened its fruit out of doors, and was as fine as any green-house production; but during nine years that the vine has been under my inspection, this was the only time i have witnessed such a result. we are apt to attribute an abundant or scarce fruit season to temperature alone, but this is an error--for we have before remarked, that though certain lands may be in the same degree of latitude, the plants which thrive well on one land, will not do so on the other: in fine, that where reason and analogy would lead one to expect a particular form of vegetation, a totally different flora is presented to the view. these facts are indeed suggestive of new and important deductions. is it yet explained why the town of birmingham should be free from cholera? there is a large manufacturing population, a great number of poor, the usual overcrowding of individuals in small chambers, a considerable amount of destitution and depravity; irregular habits of living, and unwholesome diet, and doubtless many parts of the town, which on investigation would have yielded all the elements usually considered necessary for the localization of the disease: but no--here was some repelling cause, some opposing agent to the generation and propagation of the pestilential seeds. there are no known laws by which inorganic matter could be supposed to observe such a selection, or such an antagonism. electricity, magnetism, ozone, gases, exhibit no such elective properties that here they will destroy, and { } there they will spare; that they can almost depopulate small villages, and scarcely find a victim in birmingham and bath. but if we suppose a living, and multiplying matter as the cause of disease, many local causes may conspire to arrest the development of the germs, or perhaps, even utterly destroy them. th. as to the time of latency, facts crowd upon us indefinitely, as elements of comparison between vegetation generally, and disease in its early stages and history. the seeds of plants are extraordinarily tenacious of life. what a mysterious arrangement of the ultimate particles of matter must there be, by which the vital force remains apparently inactive for many years, and yet when the conditions arise favourable to its manifestation, as it were by an extraordinary fiat, life appears. previous to the year , no broom grew in the king's park, at stirling; but in that year a camp was formed there, and the surface of the ground consequently was broken in many places. wherever it was broken, broom sprang up. the plant was subsequently destroyed; but in a similar growth appeared after the ground had been again broken for a like purpose. some time afterwards the park was ploughed up, and the broom became generally spread over it. "in several places in the neighbourhood of edinburgh," says professor graham, "the breaking of the surface produces an abundant crop of fumaria parviflora, { } although the same plant had never before been observed in the neighbourhood. it is impossible to say the lapse of time since these were buried, before they were again excited to the performance of all their vital functions." dr. graham also gives another proof of the vital force existing in seeds. "to the westward of stirling there is a large peat bog, a great part of which has been flooded away by raising water from the river teith, and discharging it into the forth,--the under soil of clay being then cultivated. the clergyman of the parish standing by while the workmen were forming a ditch in this clay, which had been covered with fourteen feet of peat earth, saw some seeds in the clay which was thrown out of the ditch; he took some of them up and sowed them: they germinated and produced a crop of chrysanthemum septum. what a period of years must have elapsed while the seeds were getting their covering of clay, and while this clay became buried under fourteen feet of peat earth!"[ ] { } what limit can there be to the dispersion of seeds when their vital properties may remain so long unimpaired? the seeds of which we have been speaking were, no doubt many of them, washed away with the waters of the teith, and carried by the stream into the forth; and who shall then mark their destination; for we have seen that by such means the most distant lands are supplied with vegetation; for whence come the plants which cover the coral islands, unless by the air and the water, and that both contribute, has been incontestably proved. dr. lindley states that melon seeds have been known to grow when forty-one years old; maize thirty years, rye forty years, the sensitive plant sixty years, kidney-beans a hundred years. but seeds in general have an indefinite period, apparently, at which they can retain their power of germination; for many of the seeds which had been kept in the herbarium of tournefort for more than a century, were found to have preserved their fertility. it has now to be shewn that the germs of disease also retain their vital powers in a state of dormancy during a lengthened period. { } mead has very judiciously observed, "to breed a distemper, and to give force to it when bred, are two different things." he further remarks, that the seeds of the plague may confine themselves to a house or two during a hard frosty winter, and be preserved, and again put forth their malignant quality as soon as the warmth of the spring gives them force. it is certainly very remarkable that the plague of london, which commenced at the latter end of the year , should "lie asleep," as mead says, from christmas to the middle of february, and then break out in the same parish. it has been also known that an infected bed laid by for seven years had done infinite mischief on being again brought into use. indeed, it is quite uncertain for how long a period woollen, fur, linen, cotton, and other articles may retain infectious matter in a dormant state. it has been supposed by some that in closely packed bed and body clothes a multiplication of the germs may and does take place, nor do i see any reason why this should not be the case, for these articles contain within their structure the effluvia of the animal body, and they may possibly there find sufficient nutriment for their development. nees von esenbeck believed that some of the minute cryptogamia were re-produced in the air, we are not therefore exceeding philosophical conjecture when we imagine a basis and substratum, though an unusual one, for the germs of vegetation. exclusion from air and light, { } however, as would be the case in packed-up clothes, would _a priori_ give a better colour to the conjecture, as these are the usual conditions necessary for the growth of seeds. small pox and cow pox matter, which are now proved to be the same virus, the former modified by having been through a process of growth and maturation in the cow, are both remarkable for exhibiting their active properties after having lain dormant for a considerable time. and each, though so closely allied, retaining its specific properties. this peculiarity in the history of small pox virus suggests a comparison with some phenomena of vegetation, _viz._ that of grafting or budding. the lower cryptogamia in their fructifications resemble rather multiplication by buds than by seeds. m. moyen's idea is that every spore or little globule, independently of its neighbouring one, lives, absorbs, assimilates, grows, and re-produces on its own account; this is certainly the characteristic of the torula and the uredo, and doubtless is so of many other of the cryptogamia, the protococcus nivalis is another instance. other modes of cultivation produce also great varieties of results of an unexpected kind. would any one, says dr. walker, imagine that cabbage, cauliflower, savoy, kale, brocoli, and turnip-rooted cabbage, were the same species? yet nothing is more certain than that they are only varieties produced by the cultivation of the brassica oleracea, { } a plant which grows wild on the sea-shores of europe. these varieties in vegetables have now become permanent, and though it is supposed that each is liable to return to its original condition, i am not yet certain that such is the tendency. a deterioration is not unlikely to ensue in the course of time, because the propagation by seeds must necessarily very much approach the system of intermarriage, on which mr. walker has so ably written and clearly shewn that as a result we may invariably expect a deterioration of the species. dr. darwin has also poetically described what his experience taught him. "so grafted trees with shadowy summits rise, spread their fair blossoms and perfume the skies, _till canker taints the vegetable blood_, mines round the bark and feeds upon the wood; so years successive from perennial roots, the wire or bulb with lessened vigour shoots, till curled leaves or barren flowers betray a waning lineage verging to decay; or till amended by connubial powers, rise seedling progenies from sexual flowers." the minute nature of the germs of disease preclude all possibility of their being submitted, as far as we know at present, to the inspection of the physiologist, but we may infer many facts from results. in the same way, though with humbler { } ideas, as cuvier could build up an animal from a single bone, can we by a combination of facts infer the existence of living beings and conjecture their forms. "the re-production or generation of living organized bodies is the great criterion or characteristic which distinguishes animation from mechanism." we find the virus of small pox, according to mr. ceely's experiments, developing itself as a constitutional disease upon the cow, and becoming modified into a form known as the cow pox; this resembles the process of cultivation by which a species is converted into a variety, this variety remains for a certain time persistent; the time is not yet known, but it is known that by degrees, as stated above, a deterioration occurs, and fertility becomes impaired, "a waning lineage verging to decay," and this has been observed as a feature in the result of vaccination. i believe dr. gregory was one of the first to notice this fact, and deemed it necessary to obtain fresh lymph from the cow; this has been done, and it is not improbable, if the analogy we have drawn be correct, that the slowly spreading scepticism regarding vaccination may be arrested in its progress. if we can explain the deterioration of cow pox virus on this principle we have a hold at once upon the public, and can assure them that the efficacy of the proceeding is as certain as in the time of jenner. the people, i contend, have a right to demand of us the reason why vaccination is not so efficacious as formerly, and i { } affirm as unhesitatingly that we are bound to give the subject our most earnest attention.[ ] now concerning the re-production of cow pox matter, and assuming it to resemble that of the lower cryptogamia, we can easily understand how degeneration in a course of years should ensue, for we find that though the small pox is a constitutional disease, that produced by vaccine lymph is a local affection, so that it bears the relation that grafting does to vegetation, and it is not improbable that such a modification takes place in the germs by passing through or becoming generated in the blood of the cow, that they entirely lose their original and characteristic form of reproduction: the seeds of the disease were originally capable of vegetating, if i may be allowed to use the term, by diffusion through the atmosphere; they now, however, have lost that property, and require to be grafted to exhibit any manifestation of vitality. how often will the seeds of a cultivated fruit grow? if you bud it upon another plant, you obtain a being exactly like the parent, but this, as we have seen, deteriorates in a course of years, we have also seen that the virus deteriorates; but not to stretch this point to an unseemly length, i cannot avoid expressing my conviction, that these are elements of comparison, possessing an interest and a practical utility of no small value. { } i have before said, that the reproduction in the cryptogamia, rather resembles budding than seeding. if we observe the torula, or take the process of all formation, generally it will be found to accord more exactly with the budding than the seeding process, and this peculiarity is not confined to vegetation, it is also a marked feature in the reproduction of infusoria, sponges, polypes, &c. "new buds surround the microscopic plant." the reproduction of plants and animals appears to be of two kinds, solitary and sexual; the former occurs in the formation of the buds of trees, and the bulbs of tulips. the microscopic productions of spontaneous vitality propagate by solitary generation only. we have but reached the threshold of this vast and interesting subject, the experiments which suggest themselves to the mind while reflecting upon it, would alone occupy a whole life of leisure, and i can but feel how forcibly mr. sewell's words apply to us: "the grand field of investigation lies immediately before us, we are trampling every hour upon things which to the ignorant seem nothing but dirt, but to the curious are precious as gold." it is difficult, perhaps, to bring many instances, in which the germs of disease have lain dormant for a lengthened period, because many may take exception to them, from the fact, that sporadic cases of { } most epidemic and infectious diseases, are rarely absent from any country in which those diseases have become indigenous, and these cases may be said to be the foci whence originates the epidemic constitution of the air; this, however, would not invalidate the supposition, because one of two inferences must be drawn, either that the germs of disease always exist in a dormant state, requiring circumstances and conditions only for their development, or that the germs are imported from some distant locality, where the disease has occurred, and finding a nidus there, grow and multiply.[ ] whichever notion we take, however, matters very little to the fact of the dormancy of the germs, for in both, a certain period elapses between their transmission and their propagation. it may fairly be presumed, that sometimes one method may apply { } and sometimes the other, perhaps both during general epidemic conditions of the atmosphere. the oidium vitis attacked the vines partially last year, and i believe generally spared other forms of vegetation; but this year in my vicinity, cucumbers, melons, and vegetable marrows, are all suffering more or less under the disease.[ ] how shall we say, whether are the seeds of last year the cause of the general diffusion at the present time, or were there a sufficient number of old and dormant seeds, universally diffused, and only waiting opportunities for multiplying themselves? we are here on the horns of a dilemma; and spontaneous generation, from which one naturally shrinks, can alone extricate us, if we do not admit diffusion and dormancy. i think i may, without undue assumption, affirm that a period of latency of indefinite duration, applies as cogently to the germs of disease as to those of plants. there is yet one other point in connection with this subject, and that is the apparent extinction of some diseases, at any rate their non-appearance in certain localities, which had been at one time congenial to them, and in which they flourished. we have seen, in illustrating the dormancy of seeds, that the broom must have been a common plant at { } some considerable period back, in the king's park at stirling, or on that site. then again, the appearance of fumaria parviflora in the vicinity of edinburgh, in several places where the ground is broken, is sufficiently convincing that this plant must once have been a common form of vegetation there; and as it had never before been observed in the neighbourhood, there must have been a combination of peculiar circumstances capable of rendering germination impossible, otherwise a continued multiplication, as in other forms of vegetation, would have followed of necessity. but besides these instances, how many are passing under our own eyes of the disappearance of plants under the influence of cultivation, and the generation of the noxious fumes arising from different and innumerable manufactories. in the vicinity of large cities and manufacturing towns, how rarely do we see healthy vegetation; shrubs and animals drag on a sickly and almost unprolific existence, and their term of natural life is much shortened. and if we compare diseases with this peculiar feature of vegetation, how very close do we find the analogies. the sweating sickness which appeared in the latter part of the fifteenth century, and at certain intervals multiplied and extended itself at first only in this country, but ultimately more or less over the continent of europe, has { } never since the year shewn any symptom of productiveness, indeed for all we know the disease may be extinct; on the other hand, it is impossible to say whether or not circumstances may arise, under which it may commence again, to put forth its energies and again desolate the land.[ ] since , the bubo-plague has not found a congenial soil in this country, or if the seeds be here, which is more than probable, the necessary conditions to excite them to activity do not exist. it cannot be imagined that with all the merchandize which comes into this country from the mediterranean, but that an abundance of the germs of the disease are annually brought into our ports, and disseminated throughout the land. the law by which we have seen that they possess a power of vitality and reproduction, holds now as it did in former times;--the properties of matter never alter, but the conditions under which they exist may be so modified, as to influence their properties, and the usual course of their operations. it is therefore to { } an alteration or modification of conditions that we are to look for the exemption, during the last two centuries, from an invasion of the plague. to say what those conditions may be in their totality is difficult, perhaps impossible. we may generalize on the subject, and imagine the reason discovered, but all those causes which were said to have conspired to favour the spread and contamination with plague, were as distinctly specified and attributed, as the cause of our late infliction with epidemic cholera. why then did we have the cholera and not the plague? to what particular element was it--in the mode of living, of destitution, of filth and want of drainage--can it be ascribed that we suffer under one disease, and not under the other? we have made some few observations and comparisons on the mode of dispersion of plants and diseases,--but there is yet one more point which invites notice. not only do seasons vary in their effects on vegetation in a remarkable and unexplained manner, but there are many localities to which some special form of vegetation attaches, and which appear to have a power of exclusion of other forms; and as yet i have not been able to trace the connexion, nor can i discover it in the writings of botanists and travellers, who would be most likely to have sought an explanation of so interesting and curious a fact. dr. prichard has on this subject some very apposite illustrations. "still further southward, the austral temperated zone completely { } changes the physiognomy of vegetation, and the isle of norfolk has, in common with new holland, the auracania found also in the harbour of balade, and with new zealand, the phormium tenax. it is however remarkable, that this vast island, composed of two lands, separated by a channel, though so near new holland, and lying under the same latitude, differs from it so completely, that they display no resemblance in their vegetation. yet new zealand, so rich in genera peculiar to its soil, and little known, has some indian plants: such as pepper, the olea, and a reniform fern, which is said to exist in the isle of maurice." i must quote one more passage from dr. prichard's excellent work. "we have one instance of an island at no great distance from a continent, having a peculiar vegetation. mr. r. brown has remarked, that there is not even a single indigenous species characterising the vegetation of st. helena, that has been found either on the banks of the congo, or on any other part of the western coast of africa. does the diversity of marine and atmospheric currents more completely separate this island from the continent, than its situation would imply; or are the nature of soil and other local circumstances, the cause of so marked a diversity? the last supposition seems the most probable; because not only the species of plants, but likewise the genera in st. helena, are different from those of the african coast." { } we are not without instances of diseases, observing this peculiarity which attaches to plants; but their specific characters have hardly been sufficiently considered in reference to climate and situation, together with diet and local influences, to afford us accurate data for comparison. it has, however, been remarked, in every country where epidemics have prevailed, that some districts or tracts of country, though supposed to possess all the qualities favourable to the development of the diseases, have nevertheless been entirely or nearly free from them. the following passage on the course of the cholera gives an example of this peculiarity. "whenever the malady deviated, so to speak, from its normal direction, and passed towards the west, it seemed incapable of propagating itself; and _died away spontaneously, even in places which appeared to be well fitted for its reception_.--the rich fertile and densely peopled countries to the right of the dneiper, enjoyed an equal freedom from attack, which can only be explained by the fact that they were situated _beyond the line of the disease_." with this i close the subject of the diffusion of plants and diseases, though it would require a volume of itself, to record all that has been noticed. i have endeavoured to select such instances as shall mark distinctly the features which point to comparison without overloading the enquiry. * * * * * { } section iv. the relation between epidemic and endemic diseases. epidemic diseases, which multiply their germs in any climate, and under apparently the most varying conditions of temperature and hygrometric and electrical states of atmosphere, offer many points of contrast with endemic affections, and many of relationship. the latter are traceable to a certain extent, to geological and geographical positions of the localities where they are observed to prevail, in combination with atmospheric vicissitudes and peculiarities, as well as to extent of cultivation of the soil: it has been remarked that the sickly island (as it is called) of st. lucia has certain salubrious parts, but these are where sulphur abounds; this geological peculiarity has been deemed sufficient to account for the absence of endemic affections in these parts, and with much force of reason; for in the neighbourhoods where sulphur or sulphurous acid, a compound of sulphur, is an element prevalent in the soil or atmosphere, vegetation and the ague disappear together. now ague, and other endemic fevers, doubtless originate from some allied, if not identical cause; for the localities in which they appear have so many { } features in common, that we are constrained to acknowledge that endemic fevers have some relations and analogies, though not yet unravelled. geographical situation, together with certain vegetation, particularly of grounds which grow rice, is one remarkable for the production of endemic affections. but the soil which generates or gives force to the contaminating matter, is not alone the part where human beings feel its influence most severely. a low marshy ground, prolific of malaria, may be comparatively free; while some neighbouring elevated land, to which prevailing currents of air waft the volatile elements of disease, may be desolated by their virulent and concentrated action. "malaria may be conveyed a considerable distance from its source, _and be condensed_ in the exhaled vapour, when attracted by hills or acclivities in the vicinity, and when there are no high trees or woods to confine it, or to intercept it in its passage." the inhabitants of the city of abydos were at one time subject to disease, arising from malaria, generated in some neighbouring marshes; by draining these marshes, which suspended the growth of rank vegetation, the city became healthy. rome is in like manner even now subject to fevers, having a similar origin. sir james clark says, "among the more prevalent diseases of rome, malaria fevers are the most remarkable, and claim our first notice." he considers the fevers to be of exactly the same nature as those of lincolnshire { } and essex in this country, of holland, and certain districts over the greater part of the globe. to the climate, the season, or the concentration of the cause of these fevers, he attributes their varieties. it is the same disease, he says, whether from the swamps of walcheren, or the pestilential shores of africa. from july to october the inhabitants of rome are most subject to these affections. sir james clark further says: "it may be stated as a general rule, that houses in confined shaded situations, with damp courts or gardens, or standing water close to them, are unhealthy in every climate and season; but especially in a country subject to intermittent fevers, and during summer and autumn. the exemption of the central parts of a large town from these fevers, is explained by the dryness of the atmosphere, and by the comparative equality of temperature which prevails there." in this respect there is a marked difference between an epidemic and an endemic affection; for when an epidemic disease attacks a city or town we do not discover that the central parts are more exempt than others; indeed, it is rather the contrary; for the most crowded parts of towns and cities are those, if not exactly in the centre, which would be comprised in a space nearer to the centre than the circumference; and it has been in those parts generally where the epidemic influences seem to have exercised the most potent sway. one would more naturally suppose, that a city surrounded by { } paludal miasm, and not itself being capable of generating the poison, should be more affected at the circumference, from the simple fact that the paludal germs, which rise in the air, are suspended in the fogs and dews of the atmosphere. these, unless widely dispersed by the winds, would remain within a comparatively confined space; and those situations nearest to them would be most subject to their influence. besides, it has been shewn, that a small wood or hill, or even a wall, has been sufficient to cut off or obstruct the paludal miasm. without enumerating all the known endemic diseases, two or three may be alluded to for our present purpose; viz. that of shewing that endemic and epidemic diseases have a similar origin.[ ] it is well known that under certain favouring conditions an endemic may become a malignant and pestilential disease; that yellow fever, which is always endemic in the west, cholera in the east, and the plague in the south of europe and north of africa, every few years takes on an epidemic form, and desolates considerable tracts of country.[ ] the pestilence which raged in the summer and autumn of in spain, commenced at malaga, and remained for a considerable time confined to its { } boundaries, in consequence of the measures of precaution that were used, in preventing all communication between the inhabitants of the infected city and those living in the surrounding country. it was only in consequence of persons escaping through the cordon, and passing into the interior of the country, that the disease spread, and extended its ravages to distant places. it appears to be quite clear, that this disease may properly be considered in the first instance of endemic origin; but the tendencies, atmospheric and otherwise, were such as to favour its multiplication in other districts than that in which it first came into active existence. from this we may infer, that the seeds of the disease were dormant, and only became roused into vital activity by fortuitous circumstances. dr. rush states, that the endemic disorders of pennsylvania were converted, by clearing the soil, to bilious and malignant remittents, and to destructive epidemics. dr. copland says, it has been observed, especially in warm climates, and in hot seasons in temperate countries, that when the air has been long undisturbed by high winds and thunder-storms, and at the same time hot and moist, endemic diseases have assumed a very severe and even epidemic character. dr. robertson also confirms this view. "endemic diseases, in cases of neglect and preposterous management, are found to become more malignant even in the most temperate climates; and to { } generate a matter in their course, capable of producing a particular disease in any circumstances. _indeed the origin of every_ contagious fever unattended with eruptions, with the exception of plague, must commence in this way." why dr. robertson should except eruptive fevers and plague i cannot understand, for they must have had a commencement; and their many points of similarity indicate, if not an identical, an analogous source to other endemic fevers. it will doubtless be generally acknowledged that endemic and epidemic diseases depend upon some unknown agents, having their source in malarious districts, and being capable of assuming either a contagious or non-contagious character, according to circumstances. if, therefore, we find that under any conditions an endemic affection becomes capable of being propagated by contagion, the same law will hold with regard to it as to the plague; that the power of reproduction in this matter is evidence of life, according to the doctrine laid down in the earlier part of this work. but whether or not infection be admitted, a matter generated in a malarious district, if confined in its effects to that district alone, would not necessarily imply an inorganic nature of the poison; for it is difficult to understand how inorganic poison, prevailing generally over a certain tract of country, could select particular individuals for its victims. if chloroform, chlorine, carbonic acid, sulphuretted hydrogen, or even spores of poisonous fungi, (as { } supposed by mitchell, which, as he regards their effects, would act in a similar manner to inorganic compounds) were the agents, all persons would suffer more or less, and the majority be similarly affected. we do not find that uniformity of symptoms, which attend upon the exhibition of poisons in the ordinary acceptation of the term, poisoning. this subject shall be more particularly considered, when treating of the influence of organic germs on animals and plants. the history of the eclair steamer is particularly interesting, as shewing the extraordinary tenacity with which the germs of disease attach themselves to vessels, which we may call floating houses. the crew of the eclair contracted yellow fever on the coast of africa, and a number of them died. the remainder, sick and well, landed at bona vista, one of the cape de verde islands, and the vessel underwent a process of washing, whitewashing, and fumigating. nevertheless, on the return of the ship's company, the disease broke out again with equal intensity, and the vessel was ordered home. sixty-five out of officers and men, who composed the crew, died of the disease before reaching portsmouth, and twenty-three were sick at the time of arrival. eight days after the eclair left bona vista, a portuguese soldier who had mixed with her crew died in the fort which had been occupied by them. other soldiers then fell sick, and the fort was abandoned. the fever still spread. from the th september, when the first soldier { } was attacked, to the first week in december, the fever continued to rage, and at that period it had found its way into almost all the country villages. the fever was believed to be the genuine black vomit fever; it proved contagious almost without exception to the nurses of the sick. this is an abstract of mr. rendell's letter to lord aberdeen, mr. rendell being british consul at bona vista. now at the time the fever broke out in the island the weather was extraordinarily hot, and much rain had fallen, and the town itself was badly drained and in a filthy state; can it be imagined then that the seeds of a disease liable to assume a pestilential character should lie dormant or be annihilated under circumstances the most favourable for their development, especially when we know that endemic diseases may assume a malignant character? this is just one of many cases which confirm our opinion in this respect, that plants and diseases are not long in making their appearance where the soil and atmosphere are congenial. the tenacity with which the disease attached itself to the eclair is sufficiently explained in the absence of due ventilation; in fact, that in the first instance there was no ventilation at all in the hold of the ship. this also the more readily affords a clue to the disaster through all its stages, first in the contraction of the disease as an endemical affection in the vessel; secondly, in the multiplication of the { } germs in the damp ill-ventilated hold, in a warm climate; and thirdly, the persistence and entire localization of the disease to the vessel when it arrived in the climate of the british shores; while, fourth and lastly, in the unusually hot and damp island of bona vista, the seeds of the disease were sown, and, as we might expect, multiplied indefinitely. the consecutive attacks of the crew of the eclair shew that here a noxious gas or a vaporized inorganic poison could not have been the cause of the disease, for as i have before said, in this case the attacks should have been simultaneous; we find, on the contrary, that as the depressing effects of the melancholy condition of the crew was almost hourly undermining the health of the stoutest of them they as surely became the victims. the kroomen, or natives on board the ship had not suffered, shewing that they were inured to the miasm, or were destitute of that condition of blood which would be favourable to a propagation of the materies of the disease. the eclair we learn had left bona vista eight days when the first victim breathed his last; this would give perhaps three or four days for the incubation of the disease in the patient, or supposing he had not contracted the germs of the disease before the crew of the eclair left the fort, some local favouring conditions were the means of keeping the germs in a fertilizing state, for it is clear from this spot the infection spread as from a centre or focus. { } such instances as these might be multiplied to extend the length of the enquiry, but, i think, to little advantage. the chief facts to be gathered are that an endemic affection became epidemic and pestilential, contrary to its usual mode, for the portuguese official physician, on being consulted by the governor of the island as to the safety of landing the contaminated crew, said, "no danger at all; i have often brought sick men on shore coming in vessels from the african coast, and i never knew any ill effects to arise." putting the most reasonable construction on this emphatic and straightforward language, we may presume that ordinary, remittent, and yellow fever had been commonly imported into the island, for it is not to be supposed but that both forms of disease must have existed among those sick men who had "_often been landed_," under the sanction of the portuguese physician. to take another instance; intermittent fever or ague, is a disease known among almost all nations of the world, but it usually occurs in the endemic form only. it is universally supposed to depend entirely upon marsh effluvia, and we are accustomed to consider it as attaching only to low lying countries;[ ] but this is not always the case, for disease in { } this respect, like vegetation, may be found in various latitudes, to accommodate itself at varying altitudes, to the temperature and climatic relations, so as to appear indigenous. but though our prejudices are in favour of a simple miasmatic source of ague, as its sole cause, there are some who believe in its infectious nature. m. sigaud, in his work on the climate and diseases of brazil, speaks of epidemics of _grave intermittent fever_, and dr. copland says, that the epidemic prevalence of ague is a better established fact than its infection, and has been admitted by most writers.[ ] we have, therefore, but to go one step further to arrive at infection, after having found that an endemic disease under peculiar circumstances, though but rarely, becomes { } epidemic. the number of persons attacked by ague in a malarious district, in proportion to the population, is not so great as might be expected, considering that they are always subject by night and day, more or less, to respire the air containing the germs of intermittent fever; we might, therefore, deny the paludal source of the affection, as reasonably as deny infection, if we found that occasionally, persons, though subject to all the usual influences, yet escaped all injurious consequences. there are grades and varieties of infectious diseases, from the most inveterate to the most mild and doubtful; but that all, without exception, which can in any way be traced to a specific generating and organic cause, may assume an exalted infectious character, and that the most inveterate, on the contrary, may more resemble the mild and doubtfully infectious forms, is a conviction that must be forced on all who pursue this enquiry with unbiassed interest. * * * * * { } chapter iii. the reasonableness of the application of the facts to the inference. -------- section i. the chemical theory of epidemics untenable. it has been inferred that the germs of disease possess the property of vitality, and a number of facts have been adduced to support the proposition that vitality is the indwelling force by which the matter generating epidemic and endemic disease exercises its influence over man and animals. the reasonableness of the application of these facts to the end in view has now to be considered. chemistry cannot account for epidemics. our first subject of reflection points to the chemical discoveries of the last few years, and particularly to those of the great german chemist liebig. we find in the first paragraph of his organic chemistry applied to physiology and pathology, the following words: "in the animal ovum, as well as in the seed of the plant, we recognize a certain remarkable force, _the source of growth_ or increase in the mass, _and of reproduction_ or of supply of the matter consumed; a force in a state of rest. by the action of external influences, by impregnation, by the presence of air and moisture, the condition { } of static equilibrium is disturbed. this force is called the _vital force_, _vis vitæ_, or vitality." the doctrine of liebig, that the vital force manifests itself in two conditions, or rather, that it is known to be in two different states, that of static equilibrium as in the seed, and in a dynamic state, as in that of growth and reproduction, is perfectly applicable to the germs of disease; the static equilibrium is referrible to the matter of vaccine lymph when dried and preserved for use, and the dynamic forces of the matter are known to be in operation during its reproduction and growth in the system of the vaccinated child. then as to reproduction of matter by any chemical process, our author can furnish us with no examples, for even in his explanation of the causes of disease he is quite silent on this point, merely acknowledging that diseased products must be either rendered "harmless, destroyed, or expelled from the body." he further says, that "in all diseases where the formation of contagious matter and of exanthemata is accompanied by fever, two diseased conditions simultaneously exist, and two processes are simultaneously completed," and that it is by means of the blood as a carrier of oxygen that neutralization or equilibrium is established. liebig thus admits that an agent exists in the blood, capable of deteriorating it at the expense of the oxygen, which he maintains is contained in the red globules; he further acknowledges that two processes of diseased { } action are going on at the same time, and though he does not explain them, i imagine him to mean that new contagious matter is generated and eliminated from the blood, and that at the same time, there is that condition of body which he would call simply a diseased state, and characterizes it thus: "disease occurs when the sum of vital force which tends to neutralize all causes of disturbance, (in other words, when the resistance offered by the vital force) is weaker than the acting cause of the disturbance." if i rightly apprehend his notions, they perfectly harmonize with my ideas, to a certain extent, on the subject. they accord, at any rate, most completely with the theory attempted to be established, and fully confirm the reasonableness of the application of the facts recorded to the inference drawn from other sources. the difference only rests on the question whether vitalized or non-vitalized matter is the _fons et origo mali_. how is the production of new matter, resembling that originally causing the disease, to be explained by any known hypothesis, except on the assumption of living organized matter? though liebig and mulder both deny the fact, that the torula cerevisiæ is the sole agent in the process of fermentation: they both equally fail in shewing upon what it does depend, and their difficulty rests entirely on their incapacity to explain the uniform reproductive properties of the matter engaged in this, as well as in all other allied operations. liebig's statement { } however on this matter requires notice--he says, "that _putrifying_ blood, white of egg, flesh and cheese, produce the same effects in a solution of sugar, as yeast or ferment. the explanation is simply this; that ferment or yeast is nothing but vegetable fibrine, albumen or caseine, in a state of decomposition." this state of decomposition, however, involves a much more complex proceeding, than simply a reduction of matter into its elementary forms of gases, earths, and minerals; for we nowhere find decomposition of this kind going on without the development of some organized bodies, either animal or vegetable: and since we have seen that the spores of the cryptogami are always in existence in the atmosphere, and making their appearance under favouring conditions, and especially when we find that fermentation is invariably accompanied, and i may safely say, preceded by the deposition in the fluid of the sporules of the torula, we can hardly believe that they are any other than the sole agents of the process. i have now a considerable quantity of the torula obtained from the urine of a diabetic patient, in which they appeared, as it were, spontaneously. after the urine had been allowed access to the air for a certain time, and the whole of the saccharine matter was converted into new compounds, reproduction of the torula ceased;--and those which remained when the process was completed, still continue as organic cells, deposited { } in the bottle in an inert state, but ready, on the addition of fresh sugar, as has been proved, to resume an active existence. these germs, it is now well known, may be dried into powder, so as to be blown away like dust without any, or but little, detriment to their vital energies; and there is now no doubt that they exist in this condition in the air, as do the spores of mucor, aspergillus, oidium, agaricus, and all other fungi. mulder, however, does allow some properties to the yeast vesicle; he says, "a variety of strange ideas have been entertained respecting the nature of yeast; recent experiments have convinced me that it undoubtedly is a cellular plant consisting of isolated cells. they resemble the composition of cellulose in some respects, but differ from it in many." "these vesicles, consisting of a substance resembling that of cells, do not contribute in the least to the fermentation, but are exosmotically penetrated during fermentation by the protein compound." these chemists seem to have an instinctive horror of allowing any active properties to the yeast vesicle, that is as far as the conversion of sugar into carbonic acid and alcohol is concerned in the act of fermentation. dr. carpenter, as if desiring to conciliate the chemical and physiological disputants, considers that the truth is to be found in the mean of the two extremes,--that is, that the process of fermentation is neither entirely dependent on chemical laws, nor on those laws which preside { } over the growth of reproductive matter, but is a process in which both perform certain offices, each depending on the other to produce the combined result; he thus approaches more nearly to the theory of mulder, than that of liebig. but to revert to mulder, he speaks of the torula cells being "exosmotically penetrated during the process of fermentation by the protein compound." now the torula is acknowledged to be one of the fungals, and the chemical constituents of the fungi approach very nearly that of animal tissues. they contain a peculiar principle, residing in and obtainable from them, termed fungin, which is as highly azotised as animal fibre. the protein compound alluded to, mulder says, is not gluten, because insoluble in boiling alcohol, and not albumen, because it is very readily dissolved in acetic acid, and he regards it as a superoxide of protein. this superoxide of protein can only have been produced by a vital action in the cells of the torula, and as the fungi consume oxygen, and give out carbonic acid, we clearly have all the elementary conditions for their growth in almost all decomposing animal and vegetable matters. it is the nature of the fungi to live on organized matter, but always when it has a tendency to decay; it is for this reason they have been called "scavengers." again, we can understand why some animalized or nitrogenous matter should be necessary for fermentation, otherwise fungi could not grow, nitrogen being an essential constituent of { } their structure, and further fermentation does not commence without the presence of oxygen, and like as in animals, this gas supports their existence. the conversion of sugar into alcohol is represented by the following formula:-- result. sugar. alcohol. carbonic acid. hydrogen oxygen carbon if therefore the process were merely of a chemical nature, where is the necessity for atmospheric oxygen to accomplish the end? it is quite certain that fermentation cannot go on without its presence. let us compare the action of ferment or yeast in a dried state to the action of albumen, which liebig says is sufficient when decomposing to set up fermentation. "the white of eggs when added to saccharine liquors requires a period of three weeks, with a temperature of ° f. before it will excite fermentation."[ ] but any saccharine liquor on exposure to the air, though entirely destitute of albumen or gluten, will ferment, and the torula may be found in it. i have found the torula in a great variety of syrups which have spontaneously undergone fermentation. i have also discovered that the development of the cells is delayed or accelerated by the nature of the ingredient used in flavouring { } the syrups, with other peculiarities which need not here be mentioned. but the conversion of starch into sugar by means of gluten requires some notice, as by some persons it is associated in their minds with the organic process of fermentation.[ ] mulder ascribes the latter in the first instance to the action of heat, evidently believing that the pseudo-catalytic operation of gluten upon starch is the type of all such actions, and regarding them all as simply chemical, but we here distinguish a wide difference; in the latter instance the gluten is decomposed, and rendered unfit for a repetition of the chemical phenomenon, and if it is desired to renew the action fresh gluten must be obtained, and a certain temperature kept up, otherwise the experiment fails. how different is fermentation: in the ordinary temperature of the atmosphere the yeast vesicle will multiply, no incremental or unnatural addition of heat is requisite, and it is one of the commonest and most natural instances of vegeto-chemistry: the grape cannot shed its juice, nor the sugar cane its sap without admitting these germs, which, under certain { } conditions multiply themselves and convert the saccharine elements into new compounds. the method by which the conversion of starch into sugar is accomplished is thus described by dr. ure. he says that if starch one part be boiled with twelve parts of water and left to itself, water merely being stirred in it as it evaporates, at the end of a month or two in summer weather it is changed into sugar and gum, bearing certain proportions to the amount of starch used. but "if we boil two parts of potato starch into a paste, with twenty parts of water, mix this paste with one part of the gluten of wheat flour, and set the mixture for eight hours in a temperature of from ° to ° f. the mixture soon loses its pasty character, and becomes by degrees limpid, transparent, and sweet, passing at the same time first into gum and then into sugar."--"the residue has lost the faculty of acting upon fresh portions of starch." four points of contrast present themselves for notice as elements of comparison with true fermentation. st. the starch solution has to be boiled, so that heat, by which it is to be supposed that the starch globule is ruptured, seems to be an essential portion of the chemical change, and even this may in fact alone be sufficient in such a case to produce some elementary change in the starch, and may prepare it for the subsequent catalytic action of some related organic, though not vital material.[ ] { } nd. not only a summer heat is necessary, but a period of one or two months time must elapse before the starch with the water simply becomes converted into sugar, and if artificial heat is to be used to hasten the operation, a temperature from ° to ° f. must be resorted to in order to obtain the desired result. rd. when even this is accomplished there is no reproduction of the fermenting matter, and artificial and chemical means must again be applied to repeat the experiment. th. the conversion of starch into sugar can be accomplished without the presence of gluten at all, by the aid only of temperature and time. it seems to me, therefore, to be entirely unnecessary to occupy more space in the elaboration of a proof of the doctrine that the germs of the torula are the sole agents in the conversion of saccharine fluids into alcohol and carbonic acid. by another chemical process starch can be converted into sugar, but i am not aware that hitherto any method has been discovered by which sugar can be converted into alcohol except by the process of fermentation proper. i have been thus particular in commenting on this subject, as it bears, in an especial manner, on the question under consideration. { } the physiologist cannot afford to lose this process from the category of chemico-vital, or biochemical manifestations.[ ] the philosophy of the age has a tendency to make every thing chemical; it is true that the divinity is as much seen in the laws which govern the elementary particles of matter, as in those laws which preside over the transmutation and sustentation of those elementary and inorganic particles, when compounded in the tissues which are engaged in the formation of living beings. the laws by which acids and alkalies neutralize each other, and the affinities single, double and elective, which the particles of matter exhibit, together with the influences of light, heat, and electricity upon almost every condition of matter, are as truly wonderful as the creative power. man may, in many instances, imitate the processes of nature, he can render iron magnetic, and form alkaloids, but the { } laws which govern the particles of matter are still the secret of the whole proceedings. we do but interpret the language of nature in discovery, the book is ever open before us, and every atom of the world is a word and a theme, capable of occupying the short span of sublunary existence allotted to man. we have read of "sermons in stones," but a book has been written on a "pebble."[ ] to return, as we every where in nature find a gradual transition in the forms, arrangements and properties of matter, so we may expect to find a link between the inorganic and vital chemistry of nature. the fungi, by which we contend this transition appears to be accomplished, are also a link in chemical composition, between the animal and vegetable kingdom, and not only in that, but in their subsisting upon matter which has been organized, they are deoxidizers and reducers, as the vegetable kingdom in its highest function is a compounder. to their functions and offices in the great scheme of creation, we may fairly apply ourselves with a sure and certain result of the most interesting discovery. is it no hint that wherever decaying organic matter is found, there do we find fungi? is it no hint that they are found in all parts of the world? that even in snow the germs of fungi will grow and multiply to such an extent, according to capt. ross, that the protococcus was seen { } by him, clothing the sides of the mountains at baffin's bay, rising, according to his report, to the height of several _hundred feet_, and extending to the distance of _eight miles_? even stones contain in their interior, or interspaces of their structure, the germs of fungi. a species of tufa is found in the vicinity of naples of a porous texture, which, when moistened and shaded, produces vast mushrooms, four or five inches high, and eight or ten inches broad.[ ] this author further says: "in the maremma, where the volcanic tufa is the basis of the soil the surface is intermixed with the animal remains of departed empires, and the ordure of cattle, is covered with grasses of old pasturages, and is wet with heavy dews. everything, therefore, conspires there to a fungiferous end." they are found growing in and upon both vegetables and animals. nees von esenbeck imagined, that minute forms multiplied themselves in the atmosphere; and really, when we consider the amount of effluvia composed of the atoms cast off from the bodies of living or decaying organic matters, which are incessantly passing into the atmosphere, the conjecture is not an unreasonable one. the minuteness of those, which we know are always found growing on decomposing bodies, does not preclude the possibility, nay, further favours { } the probability, that others infinitely more minute,[ ] may be destined to remove the more subtle and vaporous particles which escape into the air. we can, therefore, i think, conclude, that the lower tribes of vegetation, may consistently be regarded as capable of existing in almost any condition, and almost under any circumstances, they may be made to grow in plants by inoculation, as shewn by de candolle, and dr. hassall. if the stem of wheat also is inoculated with vibriones, they will make their appearance in the grain.[ ] if the seed contain them and have not lost its germinating properties, these worms will be found again in the grain. if the grain containing them be dried for years, and moistened again with water, these animalcules, according to bauer and steinbach, will present all the phenomena of life. this experiment i have witnessed, and can confirm the statement. these animalcules in the diseased grain, have under the microscope the appearance of an immense { } number of eels crowded together in a small space, and presenting a movement more, perhaps, vermicular than any other, and it is continued for a considerable time. now if these animalcules, or their ova, can be proved to pass with the sap to the seed, there can be no difficulty in comprehending how germs, considerably more minute and of a vegetable nature, should be found subject to the same peculiar mode of obtaining an entrance into animals and vegetables for sustenance. "it is usually imagined," says dr. carpenter, "that the germs liberated by one plant are taken up by the roots of others, and being carried along the current of the sap, are deposited and developed, where vegetation is most active." the chemical theory of disease would be better sustained by a comparison of "the artificial formation of alkaloids," and the phenomena of transformation of blood into the tissues of animals, and their degeneration into effete matters, and of sap into the tissues of plants and their degenerations. professor kopp of strasburg, says, "in a chemical point of view, the alkaloids are remarkable for their composition, for their special properties, both physical and chemical, and for the interesting reactions to which many of them give rise, when exposed to the influence of different reagents. considered medically, the organic bases are distinguished by their energetic properties. they { } constitute at the same time, the most violent and sudden poisons, and the most valuable and heroic remedies." upon this very intricate and interesting part of chemical philosophy, it is rather dangerous to enter without a thorough and practical knowledge of the subject. this, however, falls to the lot of few men. we, who are engaged in the study of disease, and of the best methods of cure, are obliged to take the investigations of the analytical chemist, and examine them for ourselves in the intervals of leisure allowed us during the active exercise of our calling. though with less advantages for the study of these transcendental relations of organic and inorganic matter, we are not, nevertheless, precluded from forming our opinions on their practical bearings to the phenomena and treatment of disease. that there is a matter of a poisonous nature concerned in the production of endemic and epidemic affections, cannot be doubted by any one; i believe indeed, that the chemical theorists admit this, at all events liebig does, for he says, "the morbid poison changes in the blood are fermentative, just such as occur in beer making." if we start, then, with the consideration that poisons, in a chemical point of view, are the objects of our research; the obvious course to take is to enquire what is the source of poisons generally, and what their effects on the animal economy? the mineral poisons are entirely excluded from the enquiry by their { } inaptitude for diffusion, and their uniform effects upon all persons, differing only in degree in their operation. the same objections apply to gaseous poisons, except that to them the property of diffusion would be admitted.[ ] we come then to the alkaloids, which constitute, as kopp says, the most violent and sudden poisons. for the production of alkaloids by artificial means, organic products of some kind are required. artificial heat, powerful chemical agents or length of time, are, as far as information at present extends, the indispensable requirements to induce these peculiar changes in matter. the only instance i can find, in which elementary matters can by artificial means be combined, so as to resemble the products of nature, is that of the conversion of carbon and nitrogen into cyanogen. but the process by which this is accomplished, leads rather to doubt whether it be really and simply by a combination of _elementary_ carbon and nitrogen. i extract the following from the annual report of the progress of chemistry, for . "h. delbruck has performed some experiments on the important subject of the formation of cyanogen. he confirms the statements of desfosses and fownes, inasmuch as a _weak but distinct_ formation of cyanogen was observed on igniting { } _sugar-charcoal_[ ] with carbonate of potassa in an atmosphere of nitrogen." the use of sugar-charcoal, may be perhaps an explanation of the weak formation of cyanogen, for in these numerous and successive chemical changes of matter, it is impossible to say how many sources of error may arise. the constant contradictions of each other, and the opposite statements made by chemists, of equal eminence, leave us in a wilderness of doubt, from which we are not likely to be freed, until definite laws shall be discovered to act as a guide in the comprehension of the higher branches of chemical philosophy. but supposing that the generation of alkaloids could take place in the body, or some analogous poisonous matter, we have yet to imagine a whole host of peculiar and essential conditions to effect this change, besides an atmospheric agent or agents to set in motion those compositions and decompositions, capable of bringing out these new products from the elements of blood. we are aware that in the blood, carbon and nitrogen are sufficiently abundant as well as saline compounds, to generate cyanides, and, with hydrogen also there in plenty, hydrocyanates, and thus from them many other poisonous products, but how is all this to be effected? and even if effected, it is yet a question if such compounds can in any way simulate the attacks of epidemic disease. we have { } already shewn that the amount of most poisons necessary to destroy an individual, can be pretty clearly estimated, and their _modus operandi_ is tolerably well understood. again, the most essential part, in which all chemical theory fails, is an explanation of the reproduction of contagious matter. the catalytic process, by which decompositions are said to be effected, and in which liebig includes the various fermentations, is one of those chemical relations of matter to matter, considered by some as the probable cause of infection. mr. simon, in a late lecture, has said, "i consider the phenomena of infective diseases, to be essentially chemical, and i look to chemistry to enlighten the darkness of their pathology. qualitative modifications, affecting the molecules of matter as to their modes of action and reaction, are such as form the subject of chemical science; and those humoral changes which arise as the result of infection clearly fall within the terms of its definitions." further on he adds: "the phenomena of infected diseases appears then, in many respects, to be sui generis. certainly they are chemical. _probably_ they belong to that _class_ of chemical actions called _catalytic_."[ ] { } it is not improbable that something resembling a catalytic action may take place in the blood in those diseases of endemic and epidemic origin, but that it can be by a chemical process alone is contrary to all experience of catalytic operations, for except in the instance of fermentation proper, there is no multiplication of the fermentative matter. the action of the matter of contagion seems to stand on the confines between electro-chemical and bio-chemical manifestations, and so long as no chemical explanation can be given for the multiplication of the matter of infection, the most rational course to adopt is to assume that life under some unknown form is, as we every where find it, the sole reproductive agent. * * * * * { } section ii. the animalcular theory of epidemics untenable. the animalcular theory of disease, after remaining almost unnoticed for nearly two centuries, has been again revived under the auspices of dr. holland in this country, and henle of berlin. and though not entirely buried in obscurity, this theory had completely failed to modify the practice of physicians in the treatment of those diseases which were supposed to owe their existence to these invisible atoms of created being. the resuscitated notions and all their amplifications, to which the advance of science has contributed so much, are threatened with a like fate, an absence of all practical results. though i would not attempt to deny the possibility, nay, even the probability, that insect life may yet be discovered as the cause of some diseases,[ ] still { } there are many and cogent reasons against both, and which are at variance with facts and observations. where insect life has been found associated with disease, it more especially appears as a consequence than as a cause. disease, in its most enlarged sense, is a conversion of one form of matter into another; it is a transformation of healthy blood and tissue into new and abnormal products. where insects in all their variety of forms are discovered, their voracious propensities are their chief characteristics, they are the consumers of matter after its partial disintegration, if animal matter be their food, unless they be carnivorous and predacious, or if herbivorous they usually feed upon the tender shoots of plants. thus far we are certain of the manner in which insects destroy living matter; it is a process the unassisted eye may every where witness, and which experience has amply attested. to take, however, the animalcular world as it presents itself to us under the microscope, and as the intermediate step between the manifest and the hidden for a fairer and more direct method of reaching the truth, what do we observe to be the ruling law of infusory instinct? they live to feed; the term polygastrica sufficiently implies their natural tendency to consume. the simplest form of animalcular life, seen in the genera of monads, still preserves the animal character by possessing a stomach or stomachs in which the food is received, to be digested for the nourishment of the { } system; and even some of these minute objects which vary in size from one _two-thousandth_, to one _three-thousandth_ of a line in diameter, are said to be carnivorous and predacious. upon this fact alone, i would place the improbability of insects being the cause of epidemic disease. each insect doubtless has its own peculiar food, and whether it be a vegetable or animal feeder, it consumes the matter already organized for conversion into its own tissue, and the only change which could be affected by them in the blood, would necessarily be that of appropriation of some one of the constituents as an element of food; when that food is digested, (taking digestion generally as an identical process,) the excrementitious matter is composed of secretions and disorganized matter, mixed together as an _effete_ product, and destined then for reorganization by the vegetable kingdom. now all animals, whether they be large or small, live on organized matter,--they convert that matter into an inorganic form, and i cannot help imagining that if epidemic diseases and fevers depended upon animalcular growth and development in the blood or tissues of the body, the excretions or secretions from them would have yielded some information to the searching enquiries of the chemist, supposing that these excretions and secretions were capable of reaching to a sufficient amount in quantity, to bring about those fatal effects of poisoning, we witness in cholera and other epidemic affections. insects, i { } believe are poisonous only by their secretions, and though they are known to multiply with exceeding rapidity, i can hardly imagine that by their development, however rapid, they could produce such a change in the human body, as to bring about the speedy dissolution, and generally gangrenous appearance, that has invariably been observed in those suddenly dying under the influence of epidemic poisons. the vibriones, whose destructive effects on wheat are so well known, are a genus of animalcules, which at first would seem to favour the animalcular theory in a remarkable manner; for on examining them, they do not appear to possess any other structure than a gelatinous absorbing mass, in this respect resembling a vegetable. but ehrenberg's scrutiny corrected the error of de blanville, and shewed, that they were far from being agastria, or stomachless animals. the rev. william kirby says, "ehrenberg has studied the vibriones in almost every climate, and has discovered, by keeping them in coloured waters, that they are not the simple animals that lamarck and others supposed, and that almost all have a mouth and digestive organs, and that numbers of them have many stomachs." all the discoveries indeed which have been made on the minuter forms of animal life, have tended to confirm the doctrine that the stomach is the exponent organ of an animal; that is, in all animals there exists, in a variety of modified conditions, a receptacle for food. some of the { } animalcules, however, are still supposed to exist by absorption, as the vinegar eel, _vibrio anguilla_,[ ] but when we find that the law is, generally speaking, that the receptacles of food become multiplied in number in these minute beings, and the vibriones which were supposed to be stomachless, have been proved to emulate their associates in the number of these organs; it would be more reasonable to conclude that our imperfect vision is the barrier to their detection, rather than to suppose that they do not exist. besides, when we are told on undoubted authority that some of the animals of this class, have as many as _forty or fifty_ stomachs; the least we can do, is to allow that all of them possess, at least one digestive organ, though we may not be able to detect it.[ ] so far then for the consideration of animalcular structure: let us now more particularly enquire into their destructive habits, and their functions, inasmuch { } as they may be supposed capable of engendering epidemic diseases and fever. the truly carnivorous animalcules, or those truly herbivorous in their instincts, we may presume to be beyond the limits of our enquiry. we have rather to do with those which take an intermediate position, namely, those which feed upon matter undergoing decomposition, or upon fluids containing organic matters in solution, or suspension. if we take entozoa generally, they may be considered as most conveniently to be placed in this intermediate class; and here we find still the digestive apparatus, and more than this,--for upon the modifications of the organs appropriated to digestion is their classification founded. "rudolphi divided the entozoa into sterelmintha, or those in which the nutrient tubes without anal outlet are simply excavated in the general parenchyma, and into the coelelmintha, in which an intestinal canal with proper parietes floats in a distinct abdominal cavity, and has a separate outlet for the excrements."[ ] how do these animals obtain their sustenance, and what changes can they produce upon the vital fluid of the body? analogy is here our only guide. if the trichina spiralis is examined, it is found to be enclosed in a cyst containing fluid; and this is, { } doubtless, the source of its nutriment, and contains in solution the elements for its nutrition; but in this instance there is no selection, and there can be no locomotion to an extent sufficient to imply searching for food, as the animalcule in its natural state, when taken from the human muscle, is found coiled upon itself, making about two and a half turns. the fluid of the cyst is thus in all likelihood prepared by endosmosis, for the immediate and appropriate nutrition of the parasite. the cyst is thus the part which performs the diseased process, the containing animalcule is merely the consumer of what is prepared for it by the cyst. and this would seem to be the rule with all parasites, of the encysted kind. we have alluded to the vibriones which are found in the fluids of living bodies, and the trichina which is found in the solid muscle; we have now to refer to those which infest the cavities. it was, i believe, ehrenberg, who shewed that the tartar which accumulates on the teeth is composed of the debris of minute animalcules; in fact, that it consists of calcareous matter, having once formed a portion of the structure of their bodies, the ubiquity of these creatures is therefore as much and clearly established as the lower forms of vegetation. the intestinal worms, of which perhaps the tænia is the most curious and important to be noticed, are from the locality in which they are found, chiefly injurious by the irritation they set up, and by appropriating { } to themselves the nutrient juices elaborated in the process of animal digestion, thus depriving the individuals they infest of that which was destined for their own nourishment. in this, as in all associated instances, the character by which these parasitic animals are marked is their consuming propensity. there is, however, one more observation to make upon parasitic growths; but the question is yet unsettled in what kingdom of nature is the acephalocyst, or hydatid, to be placed. mr. owen says, "as the best observers agree in stating, that the acephalocyst is impassive under the application of stimuli of any kind, and manifests no contractile power, either partial or general, save such as results from elasticity, in short, neither feels nor moves, it cannot, as the animal kingdom is at present characterized, be referred to that division of organic nature." we thus arrive at the simple cell, and the multiplication of living beings by cell buds; it is the point at which the confines of the animal kingdom are reached, and at which we are driven to speculation. the hydatid lives like a plant, by imbibition; and procreates, like a plant, by budding, either endogenously or exogenously, as regards the original or parent cell.[ ] { } this condition of being, suggested the notion of protozoa, or first animals, in the same way that the purely cellular plants, that is, each individual, consisting of a single cell, gave the idea of protophyta, or first plants. mr. kirby thus expresses himself on this subject: "the first plants, and the first animals, are scarcely more than animated molecules, and appear analogues of each other; and those above them in each kingdom represent jointed fibrils." admitting, then, that animals as well as plants exist in the form of simple cells, and that their multiplication proceeds apparently upon the same principle in each, it is nevertheless abundantly manifest, that the cellular form of perfect individuals is infinitely more numerous in the vegetable than in the animal kingdom. { } from the mosses downwards to the fungi, the whole structure of the plants consists of an aggregation of cells, more or less in number and complicate arrangement, until, through a variety of gradations, we reach the single cell as a perfect individual. it is rather remarkable, that the lower forms of vegetables and animals seem to derive their nutriment from matter of a similar kind; and though the office of plants is as a rule, to convert inorganic into organized matter, it appears that some of the fungi may live as animals do on organic matter when in a state of solution. this, however, is uncertain; for we do not know what are the first signs of decomposition in organized bodies, and for aught we can tell, it may be perpetually going on; so far as the disengagement of carbon from the system is concerned, this is certain; but whether the nitrogenous compounds also are subject to a resolution into their elements in the living body, is another question, and not so easy of solution. the partially decomposed elements of animal structures are, however, particularly adapted for the nutrition of the lower forms of vegetation; it is, indeed, from the decaying organic matters that the fungi derive, it may be said, their entire food. * * * * * { } section iii. sketch of the physiology and pathology of plants and animals. animals and plants depend for their existence upon a nutritive fluid, which permeates their structure; it is the element from which all their secretions are formed, and their organs are nourished. the food of animals is composed of previously organized matters, and is conveyed into a reservoir called a stomach, where it undergoes a process of solution, previously to entering the circulation. at this period, the animal and the plant again present points of resemblance, the lymphatics or absorbent vessels take up the products of digestion, and convey them to the blood-vessels, where mingling with the current of the blood, they are conveyed to the lungs, there to undergo a process of oxygenation before they become fitted for the renovation of the tissues of the body. such is the nature of the food of man, that it contains all the elements necessary and adapted for transformation into bone, muscle, brain, and parenchyma, as well as the other tissues of the body; besides other elementary matters, which, though they form a very insignificant portion of { } animal textures, from their constant presence in the vital fluid, evidently perform some important offices in the general economy of life; they are partly, perhaps, occupied in forming constituents of secretions. plants do not require a stomach,--the humus or soil to which they are fixed is the laboratory, where the nutritive matter is prepared in a state fit for absorption by the spongioles of their roots, and these correspond to the lymphatics of animals; after being taken up by the spongioles, this new fluid mingles with the sap, and passes to the leaves or breathing apparatus of plants, where carbonic acid gas combines with the crude vital liquid, and converts it into a condition fit for all the offices to be performed by the plant: viz. the growth of tissues, and the elaboration of secretions. the tissues, however, of plants, though more simple in their nature, present a much more varied character than those of animals, when the different species are compared. the bones of animals which give them their form, are invariably constituted of phosphate and carbonate of lime, deposited in a matrix of gluten; muscle, nerve, brain, tendons, and ligaments, have nearly, if not completely, an identical composition throughout the whole range of the animal kingdom: their secretions, however, vary much more considerably, as also do the secretions of vegetables. but vegetable tissue may contain, as in the stems of { } grasses, a considerable amount of silex, and some notable quantity of sulphur, and so essential to their existence is the former element, that they cannot live without its presence in the soil, and also with it an alkali, to render it soluble. a large amount of soda, is an invariable attendant upon the structure of marine plants, as potash is of those growing on the land. thus, whether we regard the health of animals, or vegetables, we discover, that besides the matters which are absolutely indispensable for the nutriment of the tissues which undergo rapid transformation, those of a more permanent and durable nature require in an almost insensible degree, a restitution of elements; and though not apparently absolutely necessary to preserve vitality in the being, yet have so marked an influence over it, as to indicate an extensive bearing of each individual part, on the whole associated entity. the elementary tissues of both kingdoms have been traced, in whatever form they may be found, to a cellular origin. the minutest vegetable germ, is a cell containing a granular matter within it, and even man himself, in his embryonic state, may be represented as an insignificant point in the realms of space; and might be placed side by side with the smallest particle of living matter, without suffering by the comparison. the laws by which the development of these elementary cells is regulated, so that each advances { } to its limit, and fulfils its destination, is one of those inscrutable and overwhelming mysteries of nature, which leads the admirer of creation on and on into the abyss of the future, and fills his soul with aspirations for that time, when the veil of ignorance shall be withdrawn. but this is not my subject. the organization of the two animated kingdoms, is then regulated by definite laws, and all matter, whether acting upon them as agents of nutrition or destruction, are equally under their dominion; to investigate and to endeavour to fathom some of these laws, is the aim i have in view. the sap is to the plant, what the blood is to the animal,--the elements of nutrition and secretion are contained in it, and whatever interferes with its normal constitution by subtracting from, or adding to it, deteriorates its qualities, and retards or accelerates the functions of the individual. excess or deficiency of the natural elements may also be a source of disturbance; if carbonic acid be too abundantly liberated in the soil, as dr. lindley expresses it, "plants become gorged;" and if, on the other hand, the elimination be too slow, they become starved. it has been also shewn, that plants though they give out oxygen from their leaves, do not throw it off as animals do carbonic acid from their lungs; but that this arises as a result of digestion, and the fixation of carbon in the system, and that they really respire oxygen as { } animals do, and give off carbonic acid, both by day and night. that light is the stimulant of the digestive functions, and that, therefore, during the day, the amount of oxygen thrown off, far exceeds the amount of carbonic acid liberated during the same period. the great and important distinction between animals and plants is, that the former possess a nervous system, by which they are subject to a very extended series of psychological relations; it is in these chiefly, if not entirely, that we are to look for the distinctive and well-marked differences of diseased action. in animals there are special media of communication between the sources of dynamic power, and the parts upon which the force is exercised: and again, a return communication exists, which conveys impressions to the source of power, and to use a simple comparison, a system of telegraphing is in incessant and watchful operation. this force is influenced and modified in its action, when exercised in the regulation of nutrition, growth, and reproduction of tissues, by the passions and emotions of the mind. all the secretions and functions of the body are more or less susceptible of being accelerated, retarded or modified by the psychical relations of mind and matter. though we are apt to imagine that in man alone, these phenomena obtain much importance--there can be but little doubt, that wherever a { } nervous system exists, whether in the form of aggregated or diffused ganglia, the interdependence of force and organization, each upon the other, bears a certain and definite physiological comparison; the more aggregated the ganglia, the more close, intimate, and extensive the psychical connexions, and the gradations pass downwards, until they appear to be lost on the confines of the vegetable kingdom. the diseases of plants and animals deserve a more careful comparison than, i think, has hitherto been bestowed upon them.[ ] if the study of physiology, or an enquiry into the laws which regulate the functions of living beings in a state of health, has been materially aided by the intimate knowledge of vegetable physiology, which, from the simple structure of plants, so favours the experiments of the student, there is every reason to suppose that vegetable pathology may also lead us to an equally important and useful result. it is quite certain, that if a healthy seed, or leaf-bud, be placed in such a situation, that, according to the laws known, it will in all likelihood germinate, if all the elements for its sustenance exist in the soil, and the temperature and hygrometric { } condition of the atmosphere are adapted to it, a healthy plant will be the result. light, heat, moisture, and soil are therefore to be considered as the agents required to exist in a certain balance, or proportion, in reference to the health or power of vitality of the plant. within a certain amount of variation, health may persist in virtue of the power of selection, which appertains to the spongioles of the root in absorbing nutriment; and also as regards light, from the tendency which most plants have to accommodate themselves to any deficiency of this element, by presenting their leafy expansion in that direction where the most of its influence may be obtained. but beyond a certain limit an unhealthy condition sets in. if the soil contain not the inorganic elements, which are absolutely indispensable for the tissues of the plant, or even if they be there and not in a state to be absorbed, a dwindling and degeneration ensue; if light be deficient in quantity, pallor, feebleness, and elongation of tissue follow, with more fluidity and general softness of texture. these conditions of plants have their analogues in the ill-fed and ill-nourished children in some of our manufacturing districts; they are stunted and diseased. transport a healthy country lad, with the bloom of health on his cheek, from his native hills and valleys, or woods and fields, to the stool behind a desk for eight hours a day, in a narrow street in any city, where the rays of the sun rarely penetrate, it will not be long before { } the skin of the animal and the cuticle of the plant may be submitted for comparison, when both will testify to the importance of the solar rays, as an indispensable agent in supporting the normal processes of organic life. so far common observation is competent to a solution of the facts; but beyond this we come to the enquiry, what resemblances are there in the early conditions of plants and animals. each originates from nucleated cells, endowed by the all-seeing power with a blind impulse of progressive development; the most simple cell of a vegetable multiplies itself by a generation of new cells within it, when the parent dies, and liberates the offspring. here progression is simply multiplication; it is, as it were, progression in length only. the original cell, however, of animals, which is styled the germinal vesicle, extends or becomes developed into dissimilar parts; and whatever may be the variety, all alike proceed from the original germ cell, and the _tout ensemble_ of parts constitutes the one and indivisible whole; in this instance there is addition besides multiplication, tissues and organs are added in all variety, until the maximum of organic development is attained in the wonderful being, man. yet how many points of resemblance are there between the vegetable cell and the fully developed human being, in a physiological and pathological point of view. there must be nourishment to sustain both; both require a certain amount of light { } and heat for their growth and increase, and are dependent upon various unknown causes for active and healthy existence; and when a certain time has expired, all alike return to a condition, in which the particles composing them are subject only to the dominion of the laws which preside over inorganic matter. but during the existence of plants and animals, we discover other features of comparison; plants, as well as animals, are liable to disease; they are subject to functional and organic affections. the former, among plants, are usually traceable to atmospheric vicissitudes or irregularities, changes of situation, &c.; and in man to irregularities of diet, and mental and bodily excesses, as well as to atmospheric vicissitudes.[ ] the organic diseases of plants and animals depend upon a repetition, or continuance, of functional derangement. as a consequence of this, the nutrition and reproduction of tissues lose their normal and definite character, wherefrom an indefinite and abnormal result is obtained. there is a limit to abnormal productions, and they are apparently { } subject to laws, though not yet understood. in animals, they may be either excessive development of natural tissue in natural localities, as obesity and fatty tumours; they may be natural products in unnatural situations, as fatty degenerations of muscular tissue; or altogether new and unnatural products, as tubercle and cancer. in plants, from their greater simplicity of structure, organic affections are perhaps entirely limited to the two first forms of animal organic disease; viz. to undue development of tissue in natural situations, and to the formation of natural tissue in parts of a plant where they are not usually found in a state of nature. the variety of excrescences seen on the stems, branches, and twigs of plants, may be given as instances of the former; and the conversion of stamina into petals, as in double flowers, as an instance of the latter. we derive our sustenance from vegetables, and they from us; they produce for us the soothing opiate and the deadly strychnia; we for them the animating ammonia, and the distortions and sterility of excessive culture; we engender in them, by the latter, debility, disease, and death; and in our turn we become their prey. all this indeed is but a cycle of events, that requires no learned mind to fathom, and to comprehend; it is a matter of every day occurrence, and, though perhaps not entirely unheeded, is not dwelt upon in the fulness of its bearings and importance. { } let us now consider the diseases of plants, as a study progressive to those of man; and as their physiology has so extensively served us, we may possibly also find in their pathology much material for instruction; not that it will be attempted to shew that the same diseases affect both kingdoms, but that diseases, though dissimilar in effects, may have similar sources. unfortunately, there are not many men in this country, who need go further than their own gardens to find abundance of disease among their fruit trees and vegetables. the vine, the apple and the potato, common to most gardens, will furnish specimens. it is an error of a serious kind to suppose, that the parasites which infest plants are not essentially the cause, or, perhaps, more properly speaking, the elements of disease. i confine myself here to disease of parasitic origin, as that is the subject of which i am chiefly treating. that parasitic growths are the elements of disease in some instances, is now beyond dispute. the experiments of mr. hassall, detailed in part ii. of the transactions of the microscopical society of london, are most conclusive; and they are of that simple nature, that any one may convince himself of their accuracy, by a repetition of them from the directions there laid down. he says, the decay is communicable at will "to any fruits of the apple and peach kind, no matter { } how strong their vital energies may be, by the simple act of inoculation of the sound fruit with a portion of decayed matter, containing filaments of the fungi. we may use with success the sporules of such fungi; but in this case the decomposition does not set in so quickly; in the one case, the smaller filaments of the fungi have advanced several stages in their growth; while in the other, the sporules have yet to pass through the several stages of their development." mr. hassan, however, seems to speak doubtfully as to the mode in which the disease becomes naturally introduced;[ ] how the spores enter the fruit, "is not very clear--though probably, it is by insinuating themselves between the cells of which the cuticle is composed, or perhaps by means of the stomata, where they are present. i may here state that the experiments were made on fruit, while living, and attached to the tree." but why should there be a doubt as to the parts by which the sporules of minute fungi enter the plant, when it is clear, that not only can they enter { } by the spongioles, but by the stomata of the leaves, and mingle with the sap. it is true, that they make their appearance and grow upon the leaves and the fruit; but these are the situations most adapted for their fructification. i have seen the spores of the fungi which attack the cucumber and vegetable-marrow, in the cells of the hairs, and even their filamentous prolongations; these appropriate the fluids conveyed to the cells of the hair, rupture them, and at length fructify. on referring to dr. lindley's medical and economic botany, i find that many fungi are the active elements of disease, and in a manner which renders it highly improbable that they are so in any other way, than by obtaining an entrance to the sap of the plants. of the microscopic fungus which destroys wheat, the uredo caries of de candolle, we find the habitat to be within the ovary of the corn, and that , , may be contained in a grain of wheat,--now this and another fungus, the lanosa nivalis, are said to destroy whole crops of corn: we cannot imagine that such an extensive affection, can have any other source than by means of the spores through the sap, seeing that bruising of the surface, or rupture of the cuticle of the apple, a comparatively soft fruit is necessary to produce the disease artificially in them; besides, a grain of corn containing vibriones, when grown and having fruited, the new fruit also contains them--now here, as this is i believe almost invariably the { } case, either they or their ova must be carried with the sap to the new germs. it is rather a remarkable fact, that these entophytes appropriate the nutriment destined for the plant in which they grow, they are consequently the means in many instances of its entire destruction, though only partially so in others. there are many fungi which have this tendency. the puccinia gramienis, "preys upon the juices of plants, and prevents the grain from swelling." the Ã�cidium urticæ, common on nettles, deprives the plant on which it grows, of the organizable matter, intended for its own nutrition. the erysiphe communis, overruns and destroys peas. the botrytis infestans, "attacks the leaves and stems of potatoes." the oidium abortifaciens, attacks the ovaries of grasses--and the oidium tuckeri, "a formidable parasite, destroys the functions of the skin, of the parts it attacks." the latter has been most injurious to the vines, during the last two years. i have known instances in which the vines have been cut down, and every means taken to rid the houses of the disease; but this year, it has made its appearance, with all its former virulence, in the new shoots. this, however, is sufficient to shew that plants are liable to disease, depending upon parasitic growths, which affect their vital powers, and deprive them of their natural nutritive fluids. but somewhat similar diseases belong also to { } warm climates; in a letter from cuba, dated dec. ,--mr. bastian writes, "_a plague_ has appeared among the orange trees--a mildew attacking the leaves and the blossoms, which finally dry up. it most frequently kills the trees. none of the orange family are exempt; lemons, limes, and their varieties, with the shaddock and forbidden fruit, have all suffered." this disease has continued without intermission, till the present year,--when the same gentleman writes, feb. th, : "the evil exists, although in a diminished degree, so much so, as to have allowed the trees to produce me , oranges again. in old times, the same plantations produced me , ." the west india sugar-canes are also liable to a disease, which the rev. mr. griffiths, in his natural history of the island of barbadoes, speaks of, in the following manner: "this, among diseases peculiar to canes, as among those which happen to men, too justly claims the horrible precedence." this disease is called the yellow blast. it is difficult to distinguish the blast in its infancy, from the effect of dry weather. there are often seen on such sickly canes, many small protuberant knobs, of a soft downy substance. it is likewise observable, that such blades will be full of brownish decaying spots. the disease is very destructive to the canes. it is observed, that the blast usually appears successively in the same fields, and often in the very same spot of land. { } this blast is often found far from "infected places," and the infection always spreads faster to the leeward, or with the wind. "_it is remarkable if canes_ have been once infected with the blast, although they afterwards to all appearance, seem to recover; yet the juice of such canes will neither afford so much sugar, nor so good of its kind, as if obtained from canes which were never infected." i may here allude to the circumstance, that in the island of cuba, the destructive mildew is commonly called, _la pesta_. it were needless to multiply instances of other endemic and epidemic diseases of vegetables; they are well known by practical observers to be very numerous, and i believe, in most instances, depending upon fungoid growths. the destruction of vegetables by insects, is of a very different nature to that produced by the fungi; it would be as unreasonable to consider the consumption of corn and herbage by locusts, as a disease of vegetation, as the massacre and devouring of human beings by cannibals, a disease of the human body. it is true that insects are exceedingly destructive to plants, but as far as i am able to obtain information, they appear to be so chiefly by their voracious propensities; they consume the structure of the plant in its entity, and do not primarily interfere with its vitality. the instance of the vibriones, before-mentioned, seems at first to be an exception { } to the rule, but this is rather apparent, than real; and it may be made to apply more as a confirmation, than an obstacle to the vegetable theory: for if we may fairly compare the diseases of animals with those of plants, the existence of entozoa in the latter, would be considered an essential point to be substantiated. having now considered the question as to the infeasibility of supposing that chemical fermentation is the basis upon which a theory of diseases can be sustained, and having shewn that life is inseparable from infection, and miasmatic generation;--having explained the phenomena of the dispersion of diseases by comparison with the dispersion of plants, and finally, having demonstrated that the physiology and pathology of plants bear so close a relation to each other, and that their epidemic affections depend upon minute organic germs, i submit to the judgment of my readers, whether there is not much reasonableness in the application of the facts to the inference--that living germs are the cause of epidemic disease in man and animals. * * * * * { } chapter iv. results in proof of the tenableness of the proposition. -------- section i. observations on some of the laws of epidemic diseases. the results obtained by comparing certain facts connected with epidemic affections of animals, with analogous affections in plants, afford, from the few instances i shall here notice, a very strong presumption, that analogous causes operate in the production of these affections. i have already quoted from hecker, to shew that previously to, and during the epidemics of the middle ages, the minuter forms of animal and vegetable life appeared to be called into existence, much more abundantly than usual; that famines prevailed in consequence of failure of cereal crops, no doubt depending then, as now, upon the various forms of fungiferous growth. i cannot refrain quoting here, a passage or two from our old friend virgil; for he confirms not only the fact of peculiar showers in { } connexion with diseases, but he also refers to the rust of corn, thus: . "mox et frumentis labor additus; ut mala culmos esset rubigo ... ... intereunt segetes." _georg. ._ then: . "quid tempestates autumni et sidera dicam? . . . . . . . "sæpe etiam[ ] immensum coelo venit agmen aquarum et foedam glomerant tempestatem imbribus atris collectæ ex alto nubes." _georg. ._ the occurrence of black showers in this country has been observed during the present year, and i understand that in the fenny countries of the east, the corn has suffered much from the uredo. i am not mentioning the circumstances as cause and effect, but merely to call attention to the fact, that unusual phenomena of this kind have been generally associated with disease of the animal and vegetable tribes. the same causes also predispose plants as well as animals, to epidemic attacks of disease. the repeated observations in the public journals on the subject of ventilation, drainage, and over-crowding, render all notice from me needless, to shew that these, though they do not produce the diseases { } treated of, yet that under the influence of bad air, bad drainage, and over-crowding, epidemics are fostered and spread. lastly, says the count philippo ré, "i would remark that if _bad cultivation, and especially bad drainage, does not produce bunt or smut, it is certain that those fields, the worst treated in these respects, suffer the most from these diseases_." it has been remarked by many observers, that a greater fecundity has attended upon pestilences, and this has been proved by comparison, that the births in proportion have far exceeded the ordinary limit.[ ] in juxtaposition with this observation, i will place the following, not as a proof, but as a remark made quite independently of the subject of which i am treating. "from the first the diseased ears are larger than the healthy ones, and are sooner matured. what appears singular, but which i have not, perhaps, sufficiently verified, is _that the seeds are more abundant than in a sound ear_." { } now these are facts which require amplification, and if these two alone should be shewn upon an extensive field of observation, to apply not only to corn, but to other members of the vegetable kingdom, as i doubt not will be the case, though i am not fully prepared to prove it, it would be difficult to dissociate the fertility of the two living kingdoms from the operations of one and the same, or an analogous law. the epidemic diseases of plants are both infectious and contagious, at times they are observed to be endemic only, and then depending particularly upon some local causes. this is a law of diseases which applies equally to those of men and animals. in connexion with this law is another, which, as far as i am aware, has not hitherto been noticed in connexion with plants. the potato disease, which excited so much interest and created so much anxiety for the poorer classes of society, led the government of this country to employ the most learned men to investigate the subject, in the hope of propounding some reasons which should explain the cause of the calamity, and thereby deduce a method of eradicating the evil, or, in other words, discover a cure for the disease. many were the opinions as to the cause of the distemper, which it were useless here to recount, but a method was suggested, to which most people, i believe, looked forward with great anticipations, and this was to obtain native seed, and to sow it on virgin soil. was the end accomplished? no. { } for though the seed was sown, and the plants grew, the disease still appeared among the newly imported individuals, to as great an extent, as among the native or domesticated plants. as a parallel to this, it may be stated, that, as regards either endemic or epidemic disease, those persons newly arrived, either in a district or country where these prevail, are even more liable to them than the residents.[ ] again, i have learned, that where the potato disease has been so bad as to render the crop almost valueless, the best plan to be adopted is, to allow the plants to remain in the earth, and thus leave such as retain their germinating powers to come up spontaneously the following year. i certainly saw one large field treated in this way, yield a crop almost without disease. { } the seasoning, in this instance, seems to bear a comparison with the seasoning of animals and man, under a variety of diseases, which for a time renders them insusceptible of another attack. it therefore does not appear so improbable, that these affections may be regarded, as unger, the german botanist supposed, the exanthemata, or eruptive fevers of vegetables. another feature seems to associate the epidemics of plants and animals, in a manner suggestive of analogous causes operating in both instances. the lungs of animals and the leaves of vegetables, are their respiratory organs, by means of which, the blood in the one case and the sap in the other, derive gas from the air, and impart gas to it, each taking what is thrown off by the other. now the epidemics among vegetables, have a remarkable tendency to exhibit their effects primarily on the leaves, and particularly on those parts which are appropriated to the function of respiration. it is from the stomates that many of the fungi commence to germinate, and their fructification may be seen sprouting from the opening composed of a chink, surrounded by a peculiar arrangement of cells, which constitute the breathing apparatus of their victim. in the earlier epidemics, of which we read, one of the most remarkable circumstances, was the extraordinary influence the poisonous matter appeared to { } exercise over the lungs,[ ] and they again, were the means of propagating the disease, and spreading the contagious particles through the atmosphere, for we read: "thus did the plague rage in avignon for six or eight weeks, and the pestilential breath of the sick, who expectorated blood, caused a terrible contagion far and near, for even the vicinity of those who had fallen ill of plague was certain death; so that parents abandoned their infected children, and all the ties of kindred were dissolved."[ ] "the like was seen in egypt. here also inflammation of the lungs was predominant." "here too the _breath_ of the sick spread a deadly contagion." it is more than probable that all infectious matter obtains an entrance to the system through the lungs. inspiring the air containing the pestilential semina is, indeed, the only plausible explanation of infection; for though the skin is indubitably an absorbing { } surface, and capable of taking up and conveying to the blood any noxious matter applied to it, yet it is far more probable that the lungs would effect this process with greater rapidity. then the stomach, the only other absorbing surface to which extraneous matter can be applied, is not likely to be the part where the elements of disease would obtain an entrance to the system, for many facts prove, that infectious matter may be swallowed without any injurious consequences, unless in a very concentrated state. instances are not easily found of diseased matter having been swallowed, except where diseased vegetables have formed under some combination of circumstances, a portion of diet.[ ] many facts are on record which prove the powerful effect of diseased grain when made into bread, and taken for any length time as a principal article of food. the history of ergot of rye is too fresh in the memory of most people to require more than an allusion here. the stomach had no power over the secale, its poisonous properties were retained, after having been submitted to the digestive process, as was evidenced by the abortions and gangrenes it occasioned. but diseased wheat is also capable of inducing { } gangrene, and it is more than probable, that many diseases might be traced to the use of infected grain of various kinds. an interesting account of a family who lived at wattisham, near stowmarket, in suffolk, and all of whom suffered more or less from living on bread made of smutty wheat, may be found in the philosophical transactions. the mother of this family and five of the children, consisting of three girls and two boys, all suffered from gangrene of the extremities; the father lost the nails from his hands, and had ulceration of two of his fingers.[ ] dr. woollaston wrote thus in a letter on this case: "the corn with which they made their bread was certainly very bad: it was wheat that had been cut in a rainy season, and had lain on the ground till many of the grains were black and totally decayed, but many other poor families in the same village made use of the same corn without receiving any injury from it. one man lost the use of his arm for some time, and still imagines himself that he was afflicted with the same disorder as downing's family." it is not unlikely this was the case, for numbness and loss of power was one of the well marked characters of the disease. what other afflictions may be due to diseased vegetation and adulterated articles of food, and what loss of life may accrue from cheap and adulterated { } drugs and chemicals is hardly yet dreamt of.[ ] the systematic practice of adulteration of almost every article of diet which comes to table has become a serious question for the legislature to consider. take only the article of milk, upon which the young children of large towns and cities, make their chief meals, with the addition of bread. how much milk comes into london from the country, how much is obtained from stall and grain-fed cows in the metropolis, and how much is said to be consumed, would be an interesting calculation. it is pretty well known that a mixture is sold by which a retailer of milk may increase his supply by one-third or one-half. it was discovered in paris that the brains of animals, when prepared in a particular manner, formed, when mixed with a certain proportion of milk and water, a very fine and deceptive cream; in that city this system was carried on to a considerable extent. i could not help alluding to these facts while speaking of diseased grain, for who shall say to what extent a miller in a large way of business, may be able to "work in," as it is called, a considerable amount of smutty corn in the manufacture of flour? now, as diseased grain is known { } to induce abortion, it is impossible to tell how small a portion may in some cases produce the effect; we may therefore say with thomas of malmesbury, "there is no action of man in this life which is not the beginning of so long a chain of consequences, as that no human providence is high enough to give us a prospect to the end."[ ] to return,--associated with these observations are other facts of considerable weight. before and during pestilences, abortions are more frequent than in ordinary times; infectious and contagious diseases induce abortion; besides this, and independently of disease, conditions of the atmosphere have been known to exist when abortion has been an epidemic affection; of this dr. copland says, "to certain states of the atmosphere only can be attributed those frequent abortions sometimes observed which have even assumed an epidemic form, and of which hippocrates, fischer, tessier, desormeaux, and others have made mention." with this reference i will close the subject of comparison between the affections of the breathing apparatus in animals and plants, merely alluding to the probability that under some conditions of atmosphere, independently of heat, &c. vegetables without any other assignable cause will become abortive. * * * * * { } section ii. what is the nature of those poisons which most resemble the morbid poisons in their effects on the body? in the early part of this book, i considered the nature of poisons generally, and had occasion to remark upon the characters which separated poisons into two distinct classes. st, those which have the power of self multiplication; and nd, those destitute of this property. of the first we have seen that the poisons of epidemic diseases multiply both in and out of the body. the poisons of infectious diseases, not usually epidemic, do the same. those of endemic affections, such as ague and some fevers, usually become multiplied out of the body only, but under some circumstances, and peculiar atmospheric conditions, they may be also multiplied within the body. the amount of these poisons necessary to produce their specific effects, may be inappreciable. of the second class, there are two kinds, those derived from the organic kingdom and those derived from the inorganic kingdom. of these, the amount necessary to produce their specific effects is appreciable and pretty well known. but among those poisons, consisting of organic { } products, there is one which seems to hold an intermediate place. this is derived from one of the fungals, and as it takes this remarkable position as a link of connexion between the two classes of poisons, i may be excused quoting a passage of some length upon this agent, from dr. lindley's vegetable kingdom. "one of the most poisonous of our fungi, is the amanita muscaria, so called from its power of killing flies, when steeped in milk. even this is eaten in kamchatka, with no other than intoxicating effects, according to the following account by langsdorf, as translated by greville. this variety of amanita muscaria, is used by the inhabitants of the north-eastern parts of asia in the same manner as wine, brandy, arrack, opium, &c. is by other nations."--"the most singular effect of the amanita is the influence it possesses over the urine. it is said, that from time immemorial, the inhabitants have known that the fungus imparts an intoxicating quality to that secretion, which _continues for a considerable time after taking it_. for instance, a man moderately intoxicated to-day, will by the next morning have slept himself sober, but (as is the custom) by taking a teacup of his urine, he will be _more powerfully intoxicated_ than he was the preceding day. it is, therefore, not uncommon for confirmed drunkards to preserve their urine, as a precious liquor against a scarcity of the fungus. the intoxicating property of the urine _is capable of_ { } _being propagated_; for every one who partakes of it has his urine similarly affected. thus with a very few amanitæ, a party of drunkards may keep up their debauch for a week." this property of the amanita, at once places it in a separate category from all other organic poisons, it has yet to be shewn upon what this intoxicating fungus depends for its activity. whether some secretion is formed in the tissue of the plant, or whether some new arrangement of the particles of matter or modification of the sporules, is brought about by entering the system, it is impossible to say. langsdorf states that the small deep-coloured specimens of amanita, and thickly covered with warts, are said to be more powerful than those of a larger size and paler colour. as the effect is not produced until from one to two hours after swallowing the bolus, and as a pleasant intoxication may be obtained by this agent for a whole day, and from one dose only, there is a defined line between this and the ordinary narcotics and stimulants in common use. that the digestive powers of the stomach have no influence over the intoxicating properties of the plant, is manifested in the fact, that the active principle passes into the urine, not only not deteriorated but apparently increased, for, as we have seen, a teacup of the urine from a man, intoxicated by taking the amanita into his stomach, will cause him to be more powerfully intoxicated than by the { } original dose. we have, therefore, but two conjectures left for consideration, either the original intoxicating principle is excreted from the system in a condensed form, in which case its indestructibility by digestion, makes it approach the ordinary organic poisons, or there must be an increase of the toxic agent, in which case we must suppose a reproductive process having taken place in the system. "there is," says dr. mitchell, "in the wild regions of our western country, a disease called the _milk sickness_, the _trembles_, the _tires_, the _slows_, the _stiff-joints_, the _puking fever_, _&c._" the animals affected with this disease, "stray irregularly, apparently without motive;" they lose their power of attention, and finally tremble, stagger, and die. "when other animals--men, dogs, cats, poultry, crows, buzzards, and hogs, drink the milk or eat the flesh of a diseased cow, they suffer in a somewhat similar manner." this disease is attributed by dr. mitchell to the animals having grazed on pasture contaminated with mildew, and the resemblance to the effects of the amanita, together with the persistence of the specific principle within the fluids and tissues of the body, render it more than probable that to some fungoid growth, is due the peculiar toxic effects here noticed. further: "the animals made sick by the beef of the first one, have been in their turn the cause of a like affection in others; so that three or four have thus fallen victims successively." de graaf states, that butter { } made from the milk of diseased cows, though heated until it caught fire, did not lose its deleterious properties. the urine of diseased animals, collected and reduced by evaporation, produced the characteristic symptoms. all these facts point to some peculiarity in the properties of matter not yet investigated or at least not explained. if we may assume that reproduction is here an element of the persistence and apparent multiplication of active matter, i know only of one instance to compare with it. a gentleman about to deliver a lecture on the properties of arsenic, and its history generally, made two solutions of a given quantity of arsenious acid, in the following manner. he took a certain amount of distilled water, and the same of filtered thames water, and made his solutions of arsenic by separate boilings, he then as soon as possible placed the liquids in identical bottles, carefully prepared for their reception. in the one which contained the arsenic boiled in river water, the hygrocrocis is now growing, while that boiled in distilled water remains perfectly limpid and free from any vegetable production. there can scarcely be a doubt, that the filtration of river water was not sufficiently purifying to remove the minute spores of some lower forms of vegetation, which not only live in arsenic but have resisted the temperature employed in boiling an arsenical solution to saturation. as to the first class, or truly reproductive and { } morbid poisons, the most heterogenous ideas have from all time existed. i have introduced the notice of the above poisons, viz. the amanita, and that which engenders the milk sickness, to compare the results of the morbid poisons on the human body with them, and also to associate them with the effects of diseased grain. from the amanita and that other fungoid matter which is said to produce the milk sickness, there appears to be a purely toxic action on the system, but in the instance of diseased grain, a blood disease, ending in gangrene, or a specific and peculiar action of the generative organs is the consequence, and where the latter occurs, the poison usually expends itself on these parts, either by inducing abortion, or augmenting the catamenial secretion. now, the morbid poisons, if studied only in their results, shew that there is a combination of these two actions. there is usually, in the first place, a toxic or poisonous action, and secondly, a deteriorating or decomposing action on the blood, by which there is a tendency to low or asthenic inflammation and gangrene. it matters not what form of fever we take as an illustration, whether intermittent, pestilential, or exanthematous, either will serve the purpose of shewing how completely the effects of vegetable organic poisons resemble those which for the sake of distinction (i suppose) have been denominated morbid poisons. take an attack from the paludal poison. it is { } usually ushered in with head-ache, weariness, pains in the limbs, and thirst, with other symptoms; all these are indicative of a poisonous agent in the blood: then come the full phenomena of the disease at a longer or shorter interval, and tending ultimately to destroy some organ of the body. the mind suffers during the course of the attack, and delirium occasionally happens. in severe cases of this disease, which were more frequent formerly than now, coma, delirium, and frenzy were observed at the commencement of the attack, and a tendency to rapid disorganization of one or several of the viscera. if we take the effects of poison of erysipelas, of scarlet fever, or plague, in each we find at the onset more or less general derangement of the system, usually with cerebral disturbance and disordered action of all the dynamic forces of the body, which clearly indicate the action of a poison; then, unless some favourable symptoms arise, the blood exhibits a steady advance towards disorganization, and sphacelation of one or more tissues or parts of the body ensues. in erysipelas the force of the diseased action is expended on the skin, and subcutaneous cellular tissue; in scarlet fever the fauces ulcerate, and slough and the parotids suppurate; in the plague there is a general tendency to putrefaction, and the formation of glandular abscesses with sphacelas. without going any further into this matter, for my present intention is merely to draw { } notice to certain facts, let me now ask, whether or not, do the poisons of the ergot, the uredo, and the amanita, exhibit more analogy in their action on the nervous system, the blood and the tissues, than any other poisonous agents with which we are acquainted? if the whole range of the lower fungi could be examined in reference to their operation on the blood, as decomposers of organic compounds,--if experiments could be made, by which the properties of fungoid matter could be detected, i would venture to say the whole of the phenomena of these diseases could be readily comprehended and their intricacies unravelled. we know that the fungi are poisonous, that at times and seasons, and under variations of climate, they vary in their effects, and perhaps lose altogether these properties. we know that the fungi produce gangrene of the tissues, and disorganization of the blood; we know that their spores pervade the atmosphere, and are ready, under favouring conditions, to increase and multiply; we know that they are ubiquitous, and that those conditions most favourable to their development, are exactly such as are proved to foster and engender disease, and above all, they have been proved to be the elements of some diseases in man, in animals, and in plants. can as much be said of any other known agents, animate or inanimate, comprised in our category? it has been said, we do not see after death,--the { } interlacing mycilium, or the sprouting pileus; therefore the fungi are not the agents of disease--it has been said that carbonic acid and alcohol are not found as products of diseased action--consequently disease is not a fermentative process. "in all cases," says liebig, "where the strictest investigation has failed to demonstrate the presence of organic beings in the contagion of a miasm, or contagious disease, the hypothesis that such beings have cooperated, or do cooperate in the morbid process, must be rejected as totally void of foundation and support." much as i admire the genius of this great man, it is difficult to refrain from remarking, that i doubt if any of his great discoveries would have been made, if, in the first instance, hypotheses had not formed the basis of all his researches. it has been said, "that casual conjunctions in chemistry, gave us most of our valuable discoveries:" and it is from casual conjunctions that hypotheses are usually formed, the working out proves either their fallacy or their truth, but to say that an hypothesis has no foundation, until demonstrated to be true, is rather knocking down argument. and who, let me ask, has been more prolific of hypotheses than our continental neighbour? yet he, according to his mode of reasoning, would sweep away all such words from the vocabularies of philosophers. what foundation has the chemical hypothesis of disease, when it fails to explain the most important element { } of contagious and infectious diseases: viz. the reproductive property of their germs? it is perhaps necessary to say something in explanation of the sudden deaths arising from morbid poisons. they may occur from two causes. one being the result of a concentrated amount of poison germs being inhaled into the lungs, and acting as an ordinary toxic agent; and the other, which i put only hypothetically, the consequence of the rapid evolution of gas in the vessels arising from a sudden decomposition of blood, as it passes through the lungs. the only authority i have for this supposition, is the fact that the blood after death, from pestilential affections, is found to be far advanced towards decomposition; that in paris last year, two patients were bled while suffering from cholera, and with the small quantity of blood which flowed, bubbles of air also escaped:[ ] and besides this, it was demonstrated by mr. herapath, that ammonia was given off from cholera patients, both by the lungs and skin. these facts, though they are not conclusive, nevertheless render it probable that such an explanation is not entirely out of reason--especially too, when we know how fatal are the effects of uncombined air, when it enters the vessels near to the heart. * * * * * { } section iii. what results do we obtain from the effects of remedial agents, in proof of the hypothesis? i have here used the word hypothesis, because, having so far advanced in the enquiry, i trust sufficient has been said to render the term applicable. under the term remedial agents, i shall include all those causes, whether natural or artificial, which tend to neutralize or destroy the germs of infection, or miasmatic poison, whether this be effected out of or within the body. first, then, let us consider the results of drainage and cultivation in removing the causes of endemic disease. one well authenticated case is as good as a thousand. i will take one, which, from its source, will be received as unexceptionable; and from its association with a very learned and amusing book, will be accepted as an agreeable reminder of the many pleasant hours spent in the perusal of the poet southey's "doctor." "doncaster is built upon a peninsula, or ridge of land, about a mile across, having a gentle slope from east to west, and bounded on the west by the river; this ridge is composed of three strata; to wit, of the alluvial soil deposited by the river in former { } ages, and of limestone on the north and west; and of sandstone to the south and east. to the south of this neck of land, lies a tract called potteric carr, which is much below the level of the river, and was a morass, or range of fens when our doctor first took up his abode in doncaster. this tract extends about four miles in length, and nearly three in breadth, and the security which it afforded against an attack on that side, while the river protected the peninsula by its semicircular bend on the other, was evidently one reason why the romans fixed upon the site of doncaster for a station. in brockett's glossary of north country words, carr is interpreted to mean 'flat marshy land,' 'a pool or lake;' but the etymology of the word is yet to be discovered. "these fens were drained and enclosed pursuant to an act of parliament, which was obtained for that purpose in the year . three principal drains were then cut, fourteen feet wide, and about four miles long, into which the water was conducted from every part of the carr southward, to the little river torne, at rossington bridge, whence it flows into the trent. before these drainings, the ground was liable to frequent inundations; and about the centre there was a decoy for wild ducks; there is still a deep water there of considerable extent, in which very large pike and eels are found. the soil, which was so boggy at first that horses were lost in attempting to drink at the drains, has been brought { } into good cultivation, (as all such ground may be) to the great improvement of the district; for till this improvement was effected, _intermittent fevers and sore throats were prevalent there, and they have ceased from the time the land was drained_. the most unhealthy season now, is the spring, when cold winds, from the north and north-east, usually prevail during some six weeks; at other times doncaster is considered to be a healthy place. it has been observed that when endemic(?) diseases arrive there, they uniformly come from the south; and that the state of the weather may be foretold from a knowledge of what it has been at a given time in london, making an allowance of about three days, for the chance of winds. here, as in all places which lie upon a great and frequented road, the transmission of disease has been greatly facilitated by the increase of travelling." i feel certain of being excused for transcribing this long passage from southey. it would have been impossible to convey its whole meaning without giving it entire. the continuation of the chapter is no less instructive and applicable to our subject, though more particularly so to an extension of the enquiry. the sore throats and intermittents, from which doncaster has been freed, by the drainage of potteric carr, informs us at once that decomposing matter is the material by which the poison of fever is vivified and sustained, the wet and boggy state of the soil is just the condition, when no drainage exists, to bring into activity the germs of { } disease, which otherwise would lie latent. so satisfied and acquainted are we with the elements necessary for the production of fever, that we might as certainly bring about an endemic intermittent by forming an artificial bog, as we could be sure of growing mushrooms by making a bed in the manner laid down by gardeners for this purpose. dr. lindley also says, "the _polyporus fomentarius_ has been artificially produced in germany, but merely by placing wood in a favourable situation, and keeping it well moistened. five or six crops were obtained in the year." let warmth, moisture, darkness, and decaying matter be given, and inanimate disintegrated particles will soon be converted into definite forms and combinations instinct with life. it is by the unseen forms of living beings, that the atmosphere is preserved from becoming charged with deadly gases; they take the first rank in the great scheme of animated beings, the plant first, and then the animal. "let the earth bring forth grass." "let there be lights in the firmament." "let the waters bring forth the moving creature, and fowl that may fly," and "let the earth bring forth the cattle, the creeping thing, and the beast." this is the order of creation, of living things, and the earth was prepared by vegetation for the animal world. the work of conversion is accomplished by vegetation; and this is consumed for the construction of higher organizations. the laws which govern and control the universe, { } are as definite and as wonderful among invisible atoms, as those which regulate the enormous masses floating in space; and the time will come when the advancing intellect of man will measure and weigh the morbid poisons, as he measures and weighs the stars. why should the laws of epidemics be less understood, than the laws which govern the course of comets? the aspirations of man have led him to penetrate the heavens, which charm and inspire him; he studies rather the more violent disturbing elements of nature, the thunder-cloud and the fire of heaven, than the silent pestilence which steals over the earth. i cannot conceive it possible that the intellects, which are occupied in procuring means for the majesty of this empire to issue her mandates with the velocity of a spirit to the nethermost parts of the earth, should be incapable of solving so deeply interesting a mystery as the causes and nature of pestilential diseases. it would seem that man prefers to issue a mandate of destruction many thousand miles distant, than to disarm the pestilence at his door. it is barely a century since galvani observed the twitchings in the muscles of a frog's leg, and the battery, still named after him, has already become an agent of instantaneous communication between places many miles distant. but how many centuries have passed away, each one succeeding the other, with its millions of victims to epidemics? and where are the remedies for the evils? drainage and cleanliness, with all their advantages, were better understood and more fully carried out by the ancient { } romans than by ourselves; there are monuments, though crumbling to decay, to tell us of the vast enterprise of these people and of the value they set upon a healthy and vigorous constitution, and how well they understood the means of warding of disease. cultivation and drainage are now fully understood to be the basis by which a healthy condition of air is to be obtained, next to that, cleanliness and ventilation; if either be neglected a sickly, mouldy, and unwholesome contamination of atmosphere ensues; the odour of a bog is proverbially mouldy, and so is that of an ill-ventilated house or cellar; dryness, or the fresh pleasant scent of clean water, are the antagonists of these; the aromatic odours of vegetation are opponents of putrefaction, and consequently of the development of the lower forms of life. all empyreumatic matters prevent mouldiness and decomposition; and odours arrest and prevent the growth of mouldiness. the oil of birch, with which the russia leather is impregnated, and which gives it so pleasant an odour, effectually prevents mouldiness, and consequently decay. lindley says, "it is a most remarkable circumstance, and one which _deserves particular enquiry_, that the growth of the _minute fungi_, which constitute what is called mouldiness, is _effectually prevented_ by any kind of perfume."[ ] cedar has { } been used, from time immemorial, for a like purpose; and i doubt not the recommendation of virgil, before quoted, in reference to the burning of cedar, was founded on some practical utility of this kind, though its _modus operandi_ was unknown to him. allied to these is a curious circumstance, and worthy attention. i copy the following from an old work on pestilences. "it is remarkable that when the plague raged in london, bucklersbury, which stood in the very heart of the city, was free from that distemper; the reason given for it is, that it was chiefly inhabited by druggists and apothecaries, the scent of whose drugs kept away the infection, which were so unnatural to the pestilential insects, that they were killed or driven away by the strong smell of some sorts of them." "the smell of _rue_, and the smoke of tobacco, were prescribed as remedies against the infection; but especially tar and pitch barrels, which it was imagined preserved limehouse, and some of the dock-yards from infection."[ ] pitch and tar dealers are everywhere spoken of as being remarkably exempt from infectious diseases. cold infusion of tar was used in our colonies as a prophylactic against the small pox. bishop { } berkeley was induced to try it when this disease raged in his neighbourhood. the trial fully answered expectation--for all those who took tar-water, either escaped the disease, or had it very slightly. tan yards and places in the immediate vicinity, are said to be free from pestilences. the tanners of bermondsey are said to have escaped the plague of london, and one person only died in gutter lane, where was a tan yard. the tanners of rome are also stated to have been free from plague. dr. mclean refers to the exemption of tanners at cairo. _tannin is prejudicial to most vegetables_,--but dr. lindley says it is not always so to fungi. "a species of rhizomorpha is often developed in tan pits." i should imagine that neither plants nor insects would be found very abundantly, where tannin prevails; yet we find that the gall-nut is formed for the protection of an insect from injury by weather, and as a temporary means of sustenance. the custom of fumigating with odoriferous substances, does not therefore appear upon this view of the matter to be destitute of importance; indeed, the universal practice stamps it at once, as an efficacious remedy for the purposes of disinfection. the introduction of chlorine fumigation, seems to have superseded, in a great measure, the use of fragrant herbs and woods; and it is questionable whether the substitution be altogether desirable or { } advantageous. many scents may be agreeably and usefully employed, with much less chance of annoyance to the patient, and considerably less injury to articles of furniture, &c. the fumigations of sulphurous acid and chlorine are, perhaps, more adapted as disinfectants in uninhabited apartments;--their power to destroy vegetation, is well known. they have been used, chiefly, with the idea of neutralizing gaseous exhalations, particularly chlorine, as it tends to combine with hydrogen, to form hydrochloric acid, and then to unite with ammoniacal matters, forming hydrochlorate of ammonia. this, supposing noxious or pestilential effluvia consisted of the ammoniacal exudations variously combined, was an exceedingly efficacious method of rendering them inert; but as we feel convinced that no ammoniacal compound could possibly be the cause of infection, we must look to the influence these gases possess over other forms of matter, and as they are so destructive, even in minute quantities, to vegetable existence, it is possible that their beneficial effects may be due to this property. the immediate neighbourhood of gas works is prejudicial to vegetation, i imagine, from the amount of sulphurous vapours, and to this has been attributed the exemption of persons employed in these works. many other instances might be cited of a similar nature. i have now to speak of medicinal agents, and here comes a considerable difficulty. { } if we might believe all that has been written on the sure and certain remedies for the "ills that man is heir to," we should be led to acknowledge that both nature and art were prodigal in antidotes and specifics. the all-bountiful hand of nature, i do not doubt, has at the same time scattered the seeds of good and of evil. the fertilizing showers fall to irrigate the soil, and produce food and nourishment to man; here and there is the reeking morass "feeding unnatural vegetation," and if man takes up his abode in its vicinity, the rains which made it unhealthy, have also made it highly fertile; by labour and cultivation he may convert the mephitic bog into a waving corn-field, and the seeds of life and sustenance be made to supplant the seeds of death and corruption. it is generally believed, that where there are particular and specific diseases, there also may be found appropriate and specific remedies; the discoveries of chemistry, it is not improbable, may in some respects have retarded the progress of natural medicine. in the early ages of the world, the "healing plant" must have formed the staple of medical commerce, for though tubal cain[ ] has been considered as the first surgical instrument maker, because he was the first artificer in brass and iron, we have not discovered that chemical compounds entered into the composition of physic, till very { } many years after his time. to the alchemists we owe the science of chemistry, and much of the physic of the present day may be traced to them. the multiplicity of ingredients which at one time entered into the composition of one dose of physic could only be spoken of under the title of "legion." who shall specify the active and curative ingredient (if there be one), when from five to a hundred may have been exhibited at the same time? it has been the pride of our physicians, that the pharmacopoeia has been simplified; it has not reached its most simple form yet. that many simple plants have specific and wonderful power over disease, is an indubitable fact, but i firmly believe that the laudable, though mistaken efforts of physicians to improve their effect by various combinations, have been the means of throwing many valuable medicines into oblivion; i must also add, that cheap physic and adulterations have had no small share too in the banishment of much valuable physic from ordinary practice. it has been believed, and i think with much reason, that a thorough search into the qualities of plants, would shew that "they are capable of affording not only great relief, but also effectual and specific remedies." "that they are not already found, is rather an argument that we have not been sufficiently inquisitive, than that there are no such plants endued with these virtues." of the result obtained by medical treatment, in cases of epidemic or infectious disease, it is most { } difficult to speak, but as my province here is only to shew that living germs are the morbific agents, i have but to refer to such remedies as have been most extolled in controlling these affections. the disinfectants have already been mentioned in a cursory manner. an enumeration only of simple medicines used during the late epidemic, shall conclude this work, as the treatment in former times could not by any possibility furnish satisfactory information. aromatics and fragrant stimulants have in all times taken the foremost rank with acids, such as vinegar, lime and lemon juice. mr. guthrie's adoption of lemon juice in preference to bark, which he said made him worse while suffering from an attack of fever, during the peninsular campaign, and his speedy recovery from the disease, though not from its effects, shews, when many others can bear equal testimony to its value, that such a remedy though simple is not to be despised. but to the late epidemic. dr. stevens' saline treatment, appears, on the whole, to have been the most successful. common salt was used both medically and dietetically, and formed the greatest bulk of the medicine employed. chlorate of potash and carbonate of soda were added to the medicine. the nitro-hydrochloric acid was used with success at st. thomas's hospital. dr. copland used chlorate of potash, bicarb. soda, hydrochloric, ether, and camphor water. dr. ayre's calomel treatment had as many, if { } not more, opponents than advocates. phosphorus had several advocates. creasote and camphor were lauded by some. the beneficial operation of all these remedies might be explained on the theory here supposed, that living germs are the cause of epidemic disease, but the specific action of any one remedy has not yet had sufficient attention or trial to enable me to make any deductions of a satisfactory or conclusive nature. in the uncertainty which generally prevailed as to the best method of treating cholera patients, i was induced (for reasons stated in a pamphlet published last year) to try the efficacy of sulphur, which had been extolled as a specific. in its effects i was not disappointed; but as the results are already before the public, i need not do more than refer to it among other remedies. i did not contemplate even alluding to this subject, as it would extend far beyond my intended limits. this portion of the enquiry would be more properly carried out by keeping records of cases, treated in accordance with the view attempted to be established, and i have not the slightest hesitation in saying, that the most ample success would ultimately attend a well directed practice, based upon the principles inculcated in these pages. * * * * * { } conclusion. in making the foregoing sketch, i have attempted to put together some ideas on a subject, which has for the last few years been a theme for meditation in leisure hours, viz. what are the causes of epidemic, endemic, and infectious diseases? the occurrence of epidemic cholera last year in this country, awakened a spirit of enquiry. where there is unrest, whatever may be the cause, there also is disquiet and discontent. when the oracles of the age were consulted in the emergency, the discordant answers perplexed and confused the anxious searcher after truth. in the spring of last year, when the enemy was approaching, unseen and unheard, and the thousands of unconscious victims, who are now lying in their graves, were faithfully trusting and fully relying on the heads of our profession, and the resources of our art, what was the state of our defences, and what the nature or character of our resistance? one considerable body of men would discharge from a little tube of glass, a host of almost invisible globular atoms of sugar, said to be as potent and inscrutably operative as the unseen enemy. these infinitesimal practitioners assured the people that they "_had powerful means of subduing the disease_," { } but even they differed among themselves, though they carried out to the fullest extent the doctrine of their leader, _similia similibus_, which we may suppose to refer in this case to the minuteness of the opposing armamenta. without, however, agreeing with this school, i may quote a passage from dr. curie, which is, alas! too true: "we have shewn, as they must (allopathists), and many of them do acknowledge, that they have no fixed basis, no natural law upon which their treatment rests." who can deny the force of this observation? sheltered by a principle, it matters not how fallacious, a man is placed as behind a barrier. if with any reason it could be shewn that the infinitesimal doses, could by no possibility effect a cure in cholera; if it could be demonstrated by any line of argument, that a poison, a living poison, circulates with the blood, or lodges in the tissues, the homæopathist must fall; his "electricity and mineral magnetism," and "_powerful concentration of life power towards the digestive canal_," will stand for what they are worth. that minute doses of medicine can exert an active influence over the body is not to be denied, but these must consist of powerful drugs, as arnica, aconite, and nux vomica, with others, and it is more than probable, that of such medicines, an inconceivably small amount may produce a specific effect upon some portion of the organic nervous system. how is it that a dose of nitre or digitalis, "can { } convert cheerfulness into low spirits," or a grain of red sulphuret of antimony, "excite warmth and lively spirits?"[ ] why should indigo dyers become melancholy, and scarlet dyers choleric?[ ] we do not know. but there is one thing we most certainly do know, that a poison may be disarmed by an antidote, and the amount of the latter must be in proportion to that of the former, and as epidemic and contagious diseases do most unquestionably depend upon poisons of a specific nature, and of great amount and activity, an infinitesimal remedy, however it may claim to direct and control the organic forces, under slight and ordinary disturbances, can be no more effectual in destroying the poison of fever, or small pox, than in neutralizing arsenic or prussic acid. the uncertainty which generally prevails as to the treatment of epidemic diseases, fevers, &c. induced me to put together the notions which are contained in these pages, in the hope of leading to some definite ideas of the causes of these affections, and consequently to a more uniform and scientific mode of treating them. i have endeavoured to shew that reproduction is a phenomenon inseparable from morbific matter, and that in all probability the vegetable kingdom is the source of the germs. { } the train of argument adopted is such as appeared to me most natural for such an enquiry, and it rests now only with those who are capable of deciding whether such a course, though (i am sensibly aware) not without many faults in conception and execution, is calculated to advance the science of medicine and the interests of mankind. the real tree of knowledge, possesses in the spongioles of its roots, an elective property, by which truth alone can enter; nourished and sustained by this, it sends a fragrant incense and breathing odour on high, and dispels the mists of ignorance and superstition. in natural causes and reasonable deductions we must seek for instruction and solid information, for in over-straining either nature or art, deformity and error must inevitably be the result. the end. norman and skeen, printers, maiden lane, covent garden. * * * * * notes [ ] "it matters little how vague and false hypotheses may appear at first: experiment will gradually reduce and correct them, and all that is required, is industry to elaborate the proof, and impartiality to secure it from distortion."--_sewell_ "on the cultivation of the intellect." [ ] it is stated by mr. crosse, of norwich, that vaccination was adopted in denmark, and made compulsory in . after the year small pox no longer existed there, and was a thing totally unknown; whereas during the twelve years preceding the introduction of the preventive disease, , persons died of the small pox in copenhagen alone.--_dr. watson's lectures._ dr. blick, an intelligent danish physician, corroborated the above statement to dr. watson himself in the year . [ ] philosophy of life, lecture , translated by the rev. a. j. w. morrison, m.a. [ ] the following i quote from dr. fuller on small pox and measles:-- "to this purpose some (and particularly kircherus) are of opinion that animalcules have been the causes of malignant and pestilential fevers in epidemic times, which differ in essence and symptoms, according to the nature and venoms of those creatures. "thus the atmosphere and air is filled both from above and beneath with innumerable millions of millions of species or corpuscles, aporrhoeas, steams, vapours, fumes, dust, little insects, &c. all which make it such a wonderful chaotic compost of things that contains the _seeds_ of good and evil to man as surpasseth the understanding (as i suppose) of even the highest order of archangels." [ ] i learn from an undoubted authority that the cow when "slack of health" eats with avidity the "field parsley;" the sheep under similar circumstances seeks the ivy, and the goat the plantain. from an equally good source i have the following: that rabbits and hares, when they are what is commonly called _pot-gutted_, seek the green broom, though at a distance of _twenty miles_. [ ] "my settled opinion is, that in regard every effect is necessarily such as its cause; it must needs be that every sort of venomous fevers is produced by its proper and peculiar species of virus. "and that the manner and symptoms of every such fever is not so much from the particular constitution of the sick; as from the different nature and genius of their specific venom which caused them. "and i conceive that venomous febrile matters differ not in degree of intenseness only, but in essence and _toto genere_ also; and that venomous fevers are for the most part contagious."--_thomas fuller, m. d. ._ "another important class of organic poisons are those which when introduced in almost inappreciable quantities into the system, seem to increase in quantity; and which when communicated in the same inappreciable quantity from the individual poisoned to one who is healthy, excite the same series of febrile phenomena and local inflammation, and the same increase in the quantity of the poisonous agent."--_med. chir. review._ "this unseen influence working in the body, presents very striking analogies to the modes of operation of different poisons."--_dr. ormerod on continued fever._ [ ] i am aware that the vesicle does not here strictly bear the relation to the original germ, supposing one active particle alone to be sufficient for its production, that the egg does to the bird, for in the former case multitudes of active particles may have been generated from one. i have, therefore, merely used this expression to signify an aggregation of vital forces, such as may be imagined to exist in the bird. [ ] "at an early period the form of the ovisacs is usually elliptical, and their size extremely minute,--their long diameter measuring in the ox no more than / of an inch, so that a cubic inch would contain nearly two hundred millions of them. they are _at this time_ quite distinct from the _stroma_ of the ovarium; this forms a cavity in which they are loosely embedded." [ ] coleridge, p. . [ ] "all vegetables," says sharon turner, "from that pettiness which escapes our natural sight, to that magnitude which we feel to be gigantic, have these properties in common with all animals--organization; an interior power of progressive growth, a principle of life, with many phenomena that resemble irritability, excitability, and susceptibility, and a self-reproductive and multiplying faculty."--_sharon turner's sacred history._ [ ] "plants highly sensitive to light are those of the leguminous, or pea kind. they always close up in the evening and clasp their two upper surfaces together, presenting only their backs to the air. plants of pinnated leaves, as the tansy, are more sensible than these to the effects of light. they fold up when light is too strong, as in robinia; it produces the same effect as want of light. its leaves close up, apparently, because they are receiving too much. so they do if a hot iron be brought near them. they contract as if to avoid the heat. sensitive plants, and those of the oxalis lent. are so sensitive that the least motion, even a breath of air, will make them close."--_sir j. smith._ "the vitality of plants seems to depend upon the existence of an irritability, which although far inferior to that of animals, is nevertheless of an analogous character."--_lindley's introduction to botany._ [ ] provincial medical and surgical journal. july th, . no. xiv. p. . "practical observations on the vaccination question." by e. oke spooner, m. r. c. s., blandford. "if we examine the cow pox and the small pox microscopically, as i have done very carefully in every stage, we find that the essential character consists of a number of minute cells, not exceeding the , th part of an inch in diameter, being about one-fourth smaller than the globules of the blood, containing _within their circumference many still more minute nuclei, and presenting_ beyond their circumference bud-like cells of the same size and character as those contained within the circle. they exactly resemble in everything except the size, the globules of the yeast plant, the torula cerevesiæ. now if we examine more circumstantially the analogies of what i would call the torula variolæ with the torula cerevesiæ, we observe the following corresponding facts. "what do we accomplish by inoculation as it is called? simply this. we take on the top of a lancet, or an ivory point, a few of these minute cells or germs, and we put them _in their appropriate nidus_, the subcuticular tissue, where, after a few days if they find their appropriate nutrient elements, they grow and multiply." simon, chemistry of man, vol. i. p. . "macgregor ascertained that the air expired by persons ill of confluent small pox, contained as much as _eight_ per cent of carbonic acid, and in proportion as health was restored the percentage was diminished to its natural standard." carbonic acid is also produced during the process of fermentation and germination. [ ] see history of the jews, p. . [ ] it is said by whewell, that the murrain is supposed to have fallen only on the animals which were in the open pasture.--_history of the jews._ "j. s. michael leger, published at vienna, in , a treatise concerning the mildew as the principal cause of the epidemic disease among cattle. the mildew is that which _burns_ and _dries_ the grass and leaves. it is observed early in the morning, particularly after _thunder-storms_. its poisonous quality, which does not last above twenty-four hours, never operates but when it is swallowed immediately after its falling."--_mitchell on fevers._ [ ] "the prevalence of the south-east wind was observed to be particularly favourable to the increase of both cholera and influenza: and i cannot but think that this had some connexion with the general tendency exhibited by the former to spread from east to west. has the morbific property of this wind aught to do with the haziness of the air when it prevails--a haziness seen in the country remote from smoke, and quite distinct from fog? what is this haze? in the west of england a hazy day in spring is called a _blight_."--_dr. williams' principles of medicine._ [ ] we are to understand also that some peculiar operation took place of a nature difficult to comprehend, which seems also to typify reproduction, for the handfuls of ashes which moses threw into the air _became a dust in all the land of egypt_, thus signifying an enormous reproduction of atomic matter. [ ] the chinese affect to trace the origin of small pox back to a period of at least years, or years beyond the era of the trojan war, , a. c. the chinese pretend to discriminate no less than different species of small pox. "they also pretend to discover whether a person has died by violence or from natural causes, not only after the body has been some time interred and decomposition of the softer parts has commenced, but even after the total disappearance of the soft parts, and when the dry skeleton alone is left."--for the process, see _hamilton's history of medicine_, vol. i. p. . to give some notion of the state of medical science among the chinese, i may quote the following: "the theory of the circulation of the blood, du halde affirms, was known by the chinese about years after the deluge; be this assertion veracious or not, no correct knowledge up to the present day, do the nation possess of the circulating system of the human frame."--_china and the chinese, henry charles sirr, m. a._ according to their anatomy, the trachea extends from the larynx through the lungs to the heart, whilst the oesophagus goes over them to the stomach. [ ] "and aaron took as moses commanded, and ran into the midst of the congregation: and behold the plague was begun among the people; and he put on incense and made an atonement for the people. and he stood between the dead and the living, and the plague was stayed."--_numbers._ the practice of burning scented herbs has been observed in all times during an invasion of the plague, as a means of protection. also wearing perfumes and aromatic preparations has been recommended. whether they have any counteracting influence, it is impossible to say. virgil in the third georgic speaks of a murrain among cattle. he says, if any wore a vestment made of wool from an infected sheep, fiery blains and filthy sweat overspread his body, and ere long a pestilential fire preyed upon his infected limbs. in his directions for preserving the health of flocks he says-- "disce et odoratam stabulis accendere cedrum." the motive for burning the fragrant cedar is not mentioned; we cannot doubt but it was a good one, and having some great practical utility, from the following line-- "galbaneoque agitare graves nidore chelydros." [ ] the earliest mention of this complaint upon which reliance can be placed, is an ancient arabic ms. preserved in the public library at leyden. "this year, in fine, the small pox and measles made their first appearance in arabia." the year alluded to being that of the birth of mahomet, or the year of the christian æra.--_hamilton's history of medicine_, vol. i. p. . [ ] dr. w. a. greenhill's translation. [ ] the black assize at oxford, , is an instance in which a pestilential vapour suddenly appeared in the court, "whereby the judge, several noblemen, and more than others, died within three days." "of an unaccountable vapour suddenly coming, i have this relation from richard humphrey, my neighbour, and a man of veracity, that on wednesday, april , , as he and one walter, were travelling a-foot from canterbury; when they came to rainham, they were assaulted with such a strong loathsome stink, as he thought was like the stench from a corrupted human corpse. they were so offended at it, as thinking it was from carrion in that town, that they would not stay there to rest and refresh themselves, but travelled on for about two hours, mostly in the stench, but sometimes out of it, till they came to the hill that leads down to chatham: and there they went clear out of it and smelt it no more."--_dr. fuller_. it appears that these persons did not fall sick of any disease, but the fact of itself is remarkable enough. [ ] hamilton's history of medicine. [ ] it has been said, that "an induction once carefully drawn, is as perfect from a single instance as it is from ten thousand, and that it is only an uncultivated mind which requires a load and accumulation of knowledge to assist his thoughts."--_sewell_ "on the cultivation of the intellect." [ ] see dr. alison's pamphlet on the fever in edinburgh. [ ] earthquakes have in all times been considered to have some connexion with pestilences. "a most grievous pestilence broke out in seleucia, which from thence to parthia, greece, and italy, spread itself through a great part of the world, from the opening of an ancient vault in the temple of apollo, and that it raged with so much fury as to sweep away a third part of the inhabitants of those countries it visited."--_dr. quincy, on the causes of pestilential disease._ "upon an earthquake the earth sends forth noisome vapours which infect the air; so it was observed to be at hull in yorkshire, by the rev. mr. banks, of that place, after a small earthquake there in , it was a most sickly time for a considerable while afterwards, and the greatest mortality that had been known for fifteen years."--_anonymous_, . [ ] see sharon turner's sacred history, text and notes, vol. i. p. & . [ ] "each seed includes a plant; that plant, again, has other seeds, which other plants contain, those other plants have all their seeds; and those more plants, again, successively enclose. thus ev'ry single berry that we find, has really in itself whole forests of its kind. empire and wealth one acorn may dispense, by fleets to sail a thousand ages hence; each myrtle-seed includes a thousand groves, where future bards may warble forth their loves." [ ] "on june th, , a man and his son, a lad aged years, left noss to fish, and when five miles out at sea, no vessel being in sight, they both simultaneously became aware of a hot _offensive_ stream of air passing over them. it was so decided, that the crab pots were examined to discover if it were from them, but it did not, and five minutes after the father's attention was directed to the boy, who was vomiting and purging."--_dr. roe on the cholera at plymouth, med. gaz. aug. th, ._ [ ] linnæus remarked that erigeron canadense was introduced into gardens near paris from north america. the seeds had been carried by the wind, and this plant was in the course of a century spread over all france, italy, sicily and belgium. [ ] hecker. [ ] this is found most generally to be the case where rivers flow through uncultivated tracts of country. the californian emigrants suffer much from diarrhoea and dysentery, if they drink of the river and certain well waters of that gold district. [ ] "purification from leprosy. as this fearful disease was contagious and hereditary to the third and fourth generation, the separation of lepers from the camp and congregation, and the destruction of infected houses and clothes, was of the utmost importance to the preservation of public health. "leprosy was of three kinds: st, leprosy in man. nd, leprosy in houses. rd, leprosy in clothes. "contagious or malignant leprosy was of two kinds, viz. " st. the white leprosy, or bright berat, which was the most serious and obstinate form which leprosy assumes. it exhibited itself as a bright white and spreading scale, on an elevated base; turning the hair white in patches, which were continually spreading. " nd. the black leprosy, or dusky berat, which was less serious than the foregoing. it did not change the colour of the hair, nor was there any depression in the dusky spot; but the patches were perpetually spreading, as in the white leprosy."--_analysis and summary of old testament history._ _oxford._ [ ] the mexican aloe blows when nine years old, and then dies. at least this is its usual course in the island of cuba. [ ] "ground that has not been disturbed for some hundred years, on being ploughed, has frequently surprised the cultivator by the appearance of plants which he never sowed, and often which were then unknown to the country. the principle has been ascertained to be capable of existing in this latent state for above years, unextinguished, and springing again into active vegetation, as soon as planted in a congenial soil. "in boring for water near kingston on thames, some earth was brought up from a depth of feet, and though carefully covered with a hand-glass to prevent the possibility of other seeds being deposited on it, was yet in a short time covered with vegetation. "turner says, from the depth, these seeds must have been of the diluvian age."--_jesse's gleanings._ [ ] hamilton's history of medicine, vol. ii. p. , note. [ ] "what i wish you to remark is this, that while almost all men are prone to take the disorder, large portions of the world have remained for centuries entirely exempt from it, until at length it was imported, and that then it infallibly diffused and established itself in those parts."--_dr. watson on the principles and practice of physic._ dr. r. williams says, "the seeds of intermittent fever lay dormant for months, it was not at all uncommon for cases of intermittent fever to be brought into the hospital eight or ten months after the patients had subjected themselves to the influence of paludal or marsh effluvia." [ ] i have observed in the hot-houses, that many of the exotic plants, which are in company with the diseased vines, have been attacked, while others again have been entirely free. [ ] by causes of the greatest variety plants may become extinct for a time. it is not very easy to trace them, but one fact may be mentioned in proof of the statement. dr. prichard states that vast forests are destroyed either for the purpose of tillage or accidentally by conflagrations. "the same trees do not reappear in the same spots, but they have successors, which seem regularly to take their place. thus the pine forests of north america when burnt, afford room to forests of oak trees." [ ] hecker says of chalin de vinario, that "he asserted boldly and with truth, that _all epidemic diseases might become contagious, and all fevers epidemic_,--which attentive observers of all subsequent ages have confirmed." p. . [ ] in , the thirty-first year of henry the eighth, was great death of burning agues and flixes; and such a drought that welles and small rivers were dryed up, and many cattle dyed for lacke of water; the salt water flowed above london bridge.--_stowe._ in , the fourth of mary, and the third of philip, about this time began the burning fevers, quarterne agues, and other strange diseases, whereof died many.--_stowe._ the next winter, , the quarterne agues continued in like manner, or more vehemently than they had done the last yere.--_stowe._ [ ] every writer on the climate of egypt has remarked, that the endemic fever which is so frequent, originating on the coast, particularly about alexandria, becomes occasionally so virulent, that it cannot be distinguished from the _true plague._--_robertson on the atmosphere_, vol. . p. . "endemial fevers of every situation become occasionally so aggravated, that they cannot be distinguished from such as originate from contagion; and in every unusual virulence of this endemic fever, it is probable that it may be propagated afterwards by contagion as every epidemic." _ibid._ p. . [ ] dr. ure. [ ] "the metamorphosis of starch into sugar depends simply, as is proved by analysis, on the addition of the elements of water. all the carbon of the starch is found in the sugar; none of its elements have been separated, and except the elements of water, no foreign element has been added to it in this transformation."--_liebig_, _organic chemistry_, p. . [ ] as regards starch there appears to be some peculiar faculty regarding it. it is converted into sugar during the ripening of fruit, and it is just possible that being as it is of a cellular nature, the property of vitality may attach to it until it has, by being converted into sugar, fulfilled its destination. [ ] though i do not consider that the fermentation process is a fac-simile of diseased action, yet i think its phenomena generally afford an apt illustration of the changes which may be effected by living germs. many able chemists still maintain the entire dependence of fermentation upon the torula: "m. blondeau propounds the view that _every kind_ of fermentation is _caused_ by the development of fungi." the varieties of opinions found in the literature of this subject, forms a curious specimen of scientific enquiry, and is sufficient alone to convince us of its vast importance and extensive relations. [ ] by dr. mantell. [ ] mitchell on fevers. [ ] we wonder, and ask ourselves: "what does small mean in nature?"--_schleiden's lectures on botany._ [ ] speaking of the bunt in wheat: "it appears certainly to be contagious, from numerous experiments, which shew that the contagious principle lasts a long time. i have tried it myself; some, however, doubt it, but it cannot be denied, that seed sown, infected with bunt, produces plants similarly affected; every one who has had the slightest experience must be convinced of it."--_essay on the diseases of plants._ _count ré._ [ ] we have already spoken of the effects of these poisons, and have stated that the amount of each poison capable of destroying the body is pretty accurately known. [ ] the italics are my own. [ ] gmelin says: "but the mode of action in these transformations, sometimes admits of other explanations; and when this is not the case, our conception of it is by no means sufficiently clear to justify the positive assumption of this, so called contact-action or catalytic force, which, after all, merely states the fact without explaining it"--_gmelin's hand-book of chemistry_, vol. i. p. . [ ] the history and symptoms of some epidemic diseases, such as cholera and influenza, are not inconsistent with the hypothesis that they are caused by the sudden development of animalcules from ova in the blood. but there is a total want of direct observation in support of this hypothesis.--_dr. williams' principles of medicine._ [ ] since writing the above, i have referred for information on this subject, and find, that the anguillula aceti exhibits sexual distinctions; and that the ovaries of the females are situated on each side of the alimentary canal.--_cyclo. anat. and phys. art. entozoa._ [ ] speaking of the examination of the infusory animalcules--mr. kirby says: "but to us the wondrous spectacle is seen, and known only in part; for those that still escape all our methods of assisting sight, and remain members of the invisible world, may probably _far exceed those that we know_."--_bridgewater treatise_, vol. i. p. . [ ] mr. owen has added another class, as the first, called protelmintha, which comprises the cercariadæ and vibrionidæ. [ ] "it is probable that in the waters of our globe an infinity of animal and vegetable molecules are suspended, that are too minute to form the food of even the lowest and minute animals of the visible creation: and therefore an infinite host of invisibles was necessary to remove them as nuisances."--_bridgewater treatise_, vol. i. p. . "when creative wisdom covered the earth with plants, and peopled it with animals, he laid the foundations of the vegetable and animal kingdoms with such as were most easily convertible into nutriment for the tribes immediately above them. the first plants, and the first animals, are scarcely more than animated molecules,* and appear analogues of each other; and those above them in each kingdom represent jointed fibrils."+--_bridgewater treatise_, vol. i. p. . * globulina and monus. + oscillatoria and vibrio. [ ] "a treatise which should present a systematic arrangement of all the diseases of plants, giving in detail the exact history of each, and adding the means of preventing and curing them, would certainly be of the greatest utility to agriculture." --_essay on the diseases of plants, count philippo ré, translated into gardener's chron._ [ ] "plenck published a treatise on vegetable pathology, in which he divided diseases into eight classes: . external injuries; . flux of juices; . debility; . cachexies; . putrefactions; . excrescences; . monstrosities; and . sterility. and he concludes with an enumeration of the animals which injure plants."--_essay on the diseases of plants, gardener's chronicle._ [ ] the bunt. "this disease appears at the moment of the germination of the plant. the affected individuals are of a dark green, and the stem is discoloured. as the ears are issuing from the sheaths, their stalks are of a dark green, but very slender. when the ear has fully grown out, its dull, dirty colour, causes it to be immediately distinguished from the healthy ones, and it soon turns white."--_essay on the diseases of plants._ [ ] _vidi_ understood. [ ] "at the close of the year ," says dr. hodges, "even women, before deemed barren, were said to prove prolific." "after the cessation of the black plague, a greater fecundity in women was every where remarkable--a grand phenomenon, which from its occurrence after every destructive pestilence proves to conviction, if any occurrence can do so, the prevalence of a higher power in the direction of general organic life. marriages were almost without exception prolific; and double and treble births were more frequent than at other times."--_hecker_, p. . [ ] it is stated that on the decline of the plague, , those who returned early to london, or new comers, were certain to be attacked. in proof of this the st week of november, the deaths increased , and "physicians reported that above fell sick that week, mostly new comers." see also dr. copland's dict. pract. med. epidemic and endemic diseases. "the hardy mountaineer is a surer victim of paludal fever, whether he visits the low countries of the tropics, or the marshes of a more temperate climate, than the feebler native of those countries."--_dr. r. williams on morbid poisons._ [ ] "substances presented to the gastro-intestinal surfaces, are mixed up with various secretions, mucus, saliva, gastric juice, bile, pancreatic liquor, and special exudations from the peculiar glands of each successive section, while aerial poisons, unmixed and unfettered, are applied at once to a surface on which, behind scarcely a shadow of a film, circulates the blood prepared, by the habitual action of the respiratory function, to absorb almost every vapour, and every odour, which may not be too irritating to pass the gates of the _glottis_."--_mitchell on fevers._ [ ] hecker on the "black death." [ ] the stomach in some cases is no doubt the medium by which some diseases are contracted. it is well known, that in many places the water induces diarrhoea, the permanent residents, however, may not suffer, but all new comers are more or less affected by drinking it. [ ] "similar effects have been experienced from the use of mouldy provisions."--_dr. lindley's vegetable kingdom._ [ ] "untold numbers die of the diseases produced by scanty and _unwholesome food_."--_southey._ a large, nay, a most extensive adulteration of flour with plaster of paris was detected not many years since. the flour was supplied by a contractor for the manufacture of biscuits for the navy. [ ] see southey's doctor, vol. ii. interchapter vi. p. , for an illustration of this subject. [ ] both these patients died. [ ] "a good part of the clove trees which grew so plentifully in the island of ternate, being felled at the solicitation of the dutch, in order to heighten the price of that fruit, such a change ensued in the air, _as shewed the salutary effect of the effluvia of clove trees and their blossoms; the whole island, soon after they were cut down, becoming exceeding sickly_." [ ] the observation is originally taken from the city remembrancer, . [ ] see hamilton's history of medicine, vol. i. p. . [ ] feuchtersleben's medical psychology, p. , . [ ] ibid. p. . * * * * * changes made against printed original. page . "the idea of protophyta, or first plants": 'prolophyta' in original. page . "an extensive bearing of each individual part": 'indivdual' in original. as a matter of course by annie payson call author of "power through repose," "the freedom of life," "nerves and common sense," etc. preface. the aim of this book is to assist towards the removal of nervous irritants, which are not only the cause of much physical disease, but materially interfere with the best possibilities of usefulness and pleasure in everyday life. contents. i. introduction ii. physical care iii. amusements iv. brain impressions v. the triviality of trivialities vi. moods vii. tolerance viii. sympathy ix. others x. one's self xi. children xii. illness xiii. sentiment versus sentimentality xiv. problems xv. summary as a matter of course. i. introduction. in climbing a mountain, if we know the path and take it as a matter of course, we are free to enjoy the beauties of the surrounding country. if in the same journey we set a stone in the way and recognize our ability to step over it, we do so at once, and save ourselves from tripping or from useless waste of time and thought as to how we might best go round it. there are stones upon stones in every-day life which might be stepped over with perfect ease, but which, curiously enough, are considered from all sides and then tripped upon; and the result is a stubbing of the moral toes, and a consequent irritation of the nervous system. or, if semi-occasionally one of these stones is stepped over as a matter of course, the danger is that attention is immediately called to the action by admiring friends, or by the person himself, in a way so to tickle the nervous system that it amounts to an irritation, and causes him to trip over the next stone, and finally tumble on his nose. then, if he is not wise enough to pick himself up and walk on with the renewed ability of stepping over future stones, he remains on his nose far longer than is either necessary or advisable. these various stones in the way do more towards keeping a nervous system in a chronic state of irritation than is imagined. they are what might perhaps be called the outside elements of life. these once normally faced, cease to exist as impediments, dwindle away, and finally disappear altogether. thus we are enabled to get nearer the kernel, and have a growing realization of life itself. civilization may give a man new freedom, a freedom beyond any power of description or conception, except to those who achieve it, or it may so bind him body and soul that in moments when he recognizes his nervous contractions he would willingly sell his hope of immortality to be a wild horse or tiger for the rest of his days. these stones in the way are the result of a perversion of civilization, and the cause of much contraction and unnecessary suffering. there is the physical stone. if the health of the body were attended to as a matter of course, as its cleanliness is attended to by those of us who are more civilized, how much easier life might be! indeed, the various trippings on, and endeavors to encircle, this physical stone, raise many phantom stones, and the severity of the fall is just as great when one trips over a stone that is not there. don quixote was quite exhausted when he had been fighting the windmills. one recognizes over and over the truth spoken by the little girl who, when reprimanded by her father for being fretful, said: "it isn't me, papa, it's that banana." there is also the over-serious stone; and this, so far from being stepped over or any effort made to encircle it, is often raised to the undue dignity of a throne, and not rested upon. it seems to produce an inability for any sort of recreation, and a scorn of the necessity or the pleasure of being amused. every one will admit that recreation is one swing of life's pendulum; and in proportion to the swing in that direction will be the strength of the swing in the other direction, and vice versa. one kind of stone which is not the least among the self-made impediments is the microscopic faculty which most of us possess for increasing small, inoffensive pebbles to good-sized rocks. a quiet insistence on seeing these pebbles in their natural size would reduce them shortly to a pile of sand which might be easily smoothed to a level, and add to the comfort of the path. moods are stones which not only may be stepped over, but kicked right out of the path with a good bold stroke. and the stones of intolerance may be replaced by an open sympathy,--an ability to take the other's point of view,--which will bring flowers in the path instead. in dealing with ourselves and others there are stones innumerable, if one chooses to regard them, and a steadily decreasing number as one steps over and ignores. in our relations with illness and poverty, so-called, the ghosts of stones multiply themselves as the illness or the poverty is allowed to be a limit rather than a guide. and there is nothing that exorcises all such ghosts more truly than a free and open intercourse with little children. if we take this business of slipping over our various nerve-stones as a matter of course, and not as a matter of sentiment, we get a powerful result just as surely as we get powerful results in obedience to any other practical laws. in bygone generations men used to fight and kill one another for the most trivial cause. as civilization increased, self-control was magnified into a virtue, and the man who governed himself and allowed his neighbor to escape unslain was regarded as a hero. subsequently, general slashing was found to be incompatible with a well-ordered community, and forbearance in killing or scratching or any other unseemly manner of attacking an enemy was taken as a matter of course. nowadays we do not know how often this old desire to kill is repressed, a brain-impression of hatred thereby intensified, and a nervous irritation caused which has its effect upon the entire disposition. it would hardly be feasible to return to the killing to save the irritation that follows repression; civilization has taken us too far for that. but civilization does not necessarily mean repression. there are many refinements of barbarity in our civilization which might be dropped now, as the coarser expressions of such states were dropped by our ancestors to enable them to reach the present stage of knives and forks and napkins. and inasmuch as we are farther on the way towards a true civilization, our progress should be more rapid than that of our barbaric grandfathers. an increasingly accelerated progress has proved possible in scientific research and discovery; why not, then, in our practical dealings with ourselves and one another? does it not seem likely that the various forms of nervous irritation, excitement, or disease may result as much from the repressed savage within us as from the complexity of civilization? the remedy is, not to let the savage have his own way; with many of us, indeed, this would be difficult, because of the generations of repression behind us. it is to cast his skin, so to speak, and rise to another order of living. certainly repression is only apparent progress. no good physician would allow it in bodily disease, and, on careful observation, the law seems to hold good in other phases of life. there must be a practical way by which these stones, these survivals of barbaric times, may be stepped over and made finally to disappear. the first necessity is to take the practical way, and not the sentimental. thus true sentiment is found, not lost. the second is to follow daily, even hourly, the process of stepping over until it comes to be indeed a matter of course. so, little by little, shall we emerge from this mass of abnormal nervous irritation into what is more truly life itself. ii. physical care. rest, fresh air, exercise, and nourishment, enough of each in proportion to the work done, are the material essentials to a healthy physique. indeed, so simple is the whole process of physical care, it would seem absurd to write about it at all. the only excuse for such writing is the constant disobedience to natural laws which has resulted from the useless complexity of our civilization. there is a current of physical order which, if one once gets into it, gives an instinct as to what to do and what to leave undone, as true as the instinct which leads a man to wash his hands when they need it, and to wash them often enough so that they never remain soiled for any length of time, simply because that state is uncomfortable to their owner. soap and water are not unpleasant to most of us in their process of cleansing; we have to deny ourselves nothing through their use. to keep the digestion in order, it is often necessary to deny ourselves certain sensations of the palate which are pleasant at the time. so by a gradual process of not denying we are swung out of the instinctive nourishment-current, and life is complicated for us either by an amount of thought as to what we should or should not eat, or by irritations which arise from having eaten the wrong food. it is not uncommon to find a mind taken up for some hours in wondering whether that last piece of cake will digest. we can easily see how from this there might be developed a nervous sensitiveness about eating which would prevent the individual from eating even the food that is nourishing. this last is a not unusual form of dyspepsia,--a dyspepsia which keeps itself alive on the patient's want of nourishment. fortunately the process of getting back into the true food-current is not difficult if one will adopt it the trouble is in making the bold plunge. if anything is eaten that is afterwards deemed to have been imprudent, let it disagree. take the full consequences and bear them like a man, with whatever remedies are found to lighten the painful result. having made sure through bitter experience that a particular food disagrees, simply do not take it again, and think nothing about it. it does not exist for you. a nervous resistance to any sort of indigestion prolongs the attack and leaves, a brain-impression which not only makes the same trouble more liable to recur, but increases the temptation to eat forbidden fruit. of course this is always preceded by a full persuasion that the food is not likely to disagree with us now simply because it did before. and to some extent, this is true. food that will bring pain and suffering when taken by a tired stomach, may prove entirely nourishing when the stomach is rested and ready for it. in that case, the owner of the stomach has learned once for all never to give his digestive apparatus work to do when it is tired. send a warm drink as a messenger to say that food is coming later, give yourself a little rest, and then eat your dinner. the fundamental laws of health in eating are very simple; their variations for individual needs must be discovered by each for himself. "but," it may be objected, "why make all this fuss, why take so much thought about what i eat or what i do not eat?" the special thought is simply to be taken at first to get into the normal habit, and as a means of forgetting our digestion just as we forget the washing of our hands until we are reminded by some discomfort; whereupon we wash them and forget again. nature will not allow us to forget. when we are not obeying her laws, she is constantly irritating us in one way or another. it is when we obey, and obey as a matter of course, that she shows herself to be a tender mother, and helps us to a real companionship with her. nothing is more amusing, nothing could appeal more to mother nature's sense of humor, than the various devices for exercise which give us a complicated self-consciousness rather than a natural development of our physical powers. certain simple exercises are most useful, and if the weather is so inclement that they cannot be taken in the open air, it is good to have a well-ventilated hall. exercise with others, too, is stimulating, and more invigorating when there is air enough and to spare. but there is nothing that shows the subjective, self-conscious state of this generation more than the subjective form which exercise takes. instead of games and play or a good vigorous walk in the country, there are endless varieties of physical culture, most of it good and helpful if taken as a means to an end, but almost useless as it is taken as an end in itself; for it draws the attention to one's self and one's own muscles in a way to make the owner serve the muscle instead of the muscle being made to serve the owner. the more physical exercise can be simplified and made objective, the more it serves its end. to climb a high mountain is admirable exercise, for we have the summit as an end, and the work of climbing is steadily objective, while we get the delicious effect of a freer circulation and all that it means. there might be similar exercises in gymnasiums, and there are, indeed, many exercises where some objective achievement is the end, and the training of a muscle follows as a matter of course. there is the exercise-instinct; we all have it the more perfectly as we obey it. if we have suffered from a series of disobediences, it is a comparatively easy process to work back into obedience. the fresh-air-instinct is abnormally developed with some of us, but only with some. the popular fear of draughts is one cause of its loss. the fear of a draught will cause a contraction, the contraction will interfere with the circulation, and a cold is the natural result. the effect of vitiated air is well known. the necessity, not only for breathing fresh air when we are quiet, but for exercising in the open, grows upon us as we see the result. to feel the need is to take the remedy, as a matter of course. the rest-instinct is most generally disobeyed, most widely needed, and obedience to it would bring the most effective results. a restful state of mind and body prepares one for the best effects from exercise, fresh air, and nourishment. this instinct is the more disobeyed because with the need for rest there seems to come an inability to take it, so that not only is every impediment magnified, but imaginary impediments are erected, and only a decided and insistent use of the will in dropping everything that interferes, whether real or imaginary, will bring a whiff of a breeze from the true rest-current. rest is not always silence, but silence is always rest; and a real silence of the mind is known by very few. having gained that, or even approached it, we are taken by the rest-wind itself, and it is strong enough to bear our full weight as it swings us along to renewed life and new strength for work to come. the secret is to turn to silence at the first hint from nature; and sleep should be the very essence of silence itself. all this would be very well if we were free to take the right amount of rest, fresh air, exercise, and nourishment; but many of us are not. it will not be difficult for any one to call to mind half a dozen persons who impede the good which might result from the use of these four necessities simply by complaining that they cannot have their full share of either. indeed, some of us may find in ourselves various stones of this sort stopping the way. to take what we can and be thankful, not only enables us to gain more from every source of health, but opens the way for us to see clearly how to get more. this complaint, however, is less of an impediment than the whining and fussing which come from those who are free to take all four in abundance, and who have the necessity of their own especial physical health so much at heart that there is room to think of little else. these people crowd into the various schools of physical culture by the hundred, pervade the rest-cures, and are ready for any new physiological fad which may arise, with no result but more physical culture, more rest-cure, and more fads. nay, there is sometimes one other result,--disease. that gives them something tangible to work for or to work about. but all their eating and breathing and exercising and resting does not bring lasting vigorous health, simply because they work at it as an end, of which self is the centre and circumference. the sooner our health-instinct is developed, and then taken as a matter of course, the sooner can the body become a perfect servant, to be treated with true courtesy, and then forgotten. here is an instinct of our barbarous ancestry which may be kept and refined through all future phases of civilization. this instinct is natural, and the obedience to it enables us to gain more rapidly in other, higher instincts which, if our ancestors had at all, were so embryonic as not to have attained expression. nourishment, fresh air, exercise, rest,--so far as these are not taken simply and in obedience to the natural instinct, there arise physical stones in the way, stones that form themselves into an apparently insurmountable wall. there is a stile over that wall, however, if we will but open our eyes to see it. this stile, carefully climbed, will enable us to step over the few stones on the other side, and follow the physical path quite clearly. iii. amusements. the ability to be easily and heartily amused brings a wholesome reaction from intense thought or hard work of any kind which does more towards keeping the nervous system in a normal state than almost anything else of an external kind. as a frenchman very aptly said: "this is all very well, all this study and care to relieve one's nerves; but would it not be much simpler and more effective to go and amuse one's self?" the same frenchman could not realize that in many countries amusement is almost a lost art. fortunately, it is not entirely lost; and the sooner it is regained, the nearer we shall be to health and happiness. one of the chief impediments in the way of hearty amusement is over-seriousness. there should be two words for "serious," as there are literally two meanings. there is a certain intense form of taking the care and responsibility of one's own individual interests, or the interests of others which are selfishly made one's own, which leads to a surface-seriousness that is not only a chronic irritation of the nervous system, but a constant distress to those who come under this serious care. this is taking life _au grand serieux_. the superficiality of this attitude is striking, and would be surprising could the sufferer from such seriousness once see himself (or more often it is herself) in a clear light. it is quite common to call such a person over-serious, when in reality he is not serious enough. he or she is laboring under a sham seriousness, as an actor might who had such a part to play and merged himself in the character. these people are simply exaggerating their own importance to life, instead of recognizing life's importance to them. an example of this is the heroine of mrs. ward's "robert elsmere," who refused to marry because the family could not get on without her; and when finally she consented, the family lived more happily and comfortably than when she considered herself their leader. if this woman's seriousness, which blinded her judgment, had been real instead of sham, the state of the case would have been quite clear to her; but then, indeed, there would have been no case at all. when seriousness is real, it is never intrusive and can never be overdone. it is simply a quiet, steady obedience to recognized laws followed as a matter of course, which must lead to a clearer appreciation of such laws, and of our own freedom in obeying them. whereas with a sham seriousness we dwell upon the importance of our own relation to the law, and our own responsibility in forcing others to obey. with the real, it is the law first, and then my obedience. with the sham, it is myself first, and then the laws; and often a strained obedience to laws of my own making. this sham seriousness, which is peculiarly a new england trait, but may also be found in many other parts of the world, is often the perversion of a strong, fine nature. it places many stones in the way, most of them phantoms, which, once stepped over and then ignored, brings to light a nature nobly expansive, and a source of joy to all who come in contact with it. but so long as the "seriousness" lasts, it is quite incompatible with any form of real amusement. for the very essence of amusement is the child-spirit. the child throws himself heartily and spontaneously into the game, or whatever it may be, and forgets that there is anything else in the world, for the time being. children have nothing else to remember. we have the advantage of them there, in the pleasure of forgetting and in the renewed strength with which we can return to our work or care, in consequence. any one who cannot play children's games with children, and with the same enjoyment that children have, does not know the spirit of amusement. for this same spirit must be taken into all forms of amusement, especially those that are beyond the childish mind, to bring the delicious reaction which nature is ever ready to bestow. this is almost a self-evident truth; and yet so confirmed is man in his sham maturity that it is quite common to see one look with contempt, and a sense of superiority which is ludicrous, upon another who is enjoying a child's game like a child. the trouble is that many of us are so contracted in and oppressed by our own self-consciousness that open spontaneity is out of the question and even inconceivable. the sooner we shake it off, the better. when the great philosopher said, "except ye become as little children," he must have meant it all the way through in spirit, if not in the letter. it certainly is the common-sense view, whichever way we look at it, and proves as practical as walking upon one's feet. with the spontaneity grows the ability to be amused, and with that ability comes new power for better and really serious work. to endeavor with all your might to win, and then if you fail, not to care, relieves a game of an immense amount of unnecessary nervous strain. a spirit of rivalry has so taken hold of us and become such a large stone in the way, that it takes wellnigh a reversal of all our ideas to realize that this same spirit is quite compatible with a good healthy willingness that the other man should win--if he can. not from the goody-goody motive of wishing your neighbor to beat,--no neighbor would thank you for playing with him in that spirit,--but from a feeling that you have gone in to beat, you have done your best, as far as you could see, and where you have not, you have learned to do better. the fact of beating is not of paramount importance. every man should have his chance, and, from your opponent's point of view, provided you were as severe on him as you knew how to be at the time, it is well that he won. you will see that it does not happen again. curious it is that the very men or women who would scorn to play a child's game in a childlike spirit, will show the best known form of childish fretfulness and sheer naughtiness in their way of taking a game which is considered to be more on a level with the adult mind, and so rasp their nerves and the nerves of their opponents that recreation is simply out of the question. whilst one should certainly have the ability to enjoy a child's game with a child and like a child, that not only does not exclude the preference which many, perhaps most of us may have for more mature games, it gives the power to play those games with a freedom and ease which help to preserve a healthy nervous system. if, however, amusement is taken for the sole purpose of preserving a normal nervous system, or for returning to health, it loses its zest just in proportion. if, as is often the case, one must force one's self to it at first, the love of the fun will gradually come as one ignores the first necessity of forcing; and the interest will come sooner if a form of amusement is taken quite opposite to the daily work, a form which will bring new faculties and muscles into action. there is, of course, nothing that results in a more unpleasant state of ennui than an excess of amusement. after a certain amount of careless enjoyment, life comes to a deadly stupid standstill, or the forms of amusement grow lower. in either case the effect upon the nervous system is worse even than over-work. the variety in sources of amusement is endless, and the ability to get amusement out of almost anything is delightful, as long as it is well balanced. after all, our amusement depends upon the way in which we take our work, and our work, again, depends upon the amusement; they play back and forth into one another's hands. the man or the woman who cannot get the holiday spirit, who cannot enjoy pure fun for the sake of fun, who cannot be at one with a little child, not only is missing much in life that is clear happiness, but is draining his nervous system, and losing his better power for work accordingly. this anti-amusement stone once removed, the path before us is entirely new and refreshing. the power to be amused runs in nations. but each individual is in himself a nation, and can govern himself as such; and if he has any desire for the prosperity of his own kingdom, let him order a public holiday at regular intervals, and see that the people enjoy it. iv. brain impressions. the mere idea of a brain clear from false impressions gives a sense of freedom which is refreshing. in a comic journal, some years ago, there was a picture of a man in a most self-important attitude, with two common mortals in the background gazing at him. "what makes him stand like that?" said one. "because," answered the other, "that is his own idea of himself." the truth suggested in that picture strikes one aghast; for in looking about us we see constant examples of attitudinizing in one's own idea of one's self. there is sometimes a feeling of fright as to whether i am not quite as abnormal in my idea of myself as are those about me. if one could only get the relief of acknowledging ignorance of one's self, light would be welcome, however given. in seeing the truth of an unkind criticism one could forget to resent the spirit; and what an amount of nerve-friction might be saved! imagine the surprise of a man who, in return for a volley of abuse, should receive thanks for light thrown upon a false attitude. whatever we are enabled to see, relieves us of one mistaken brain-impression, which we can replace by something more agreeable. and if, in the excitement of feeling, the mistake was exaggerated, what is that to us? all we wanted was to see it in quality. as to degree, that lessens in proportion as the quality is bettered. fortunately, in living our own idea of ourselves, it is only ourselves we deceive, with possible exceptions in the case of friends who are so used to us, or so over-fond of us, as to lose the perspective. there is the idea of humility,--an obstinate belief that we know we are nothing at all, and deserve no credit; which, literally translated, means we know we are everything, and deserve every credit. there is the idea, too, of immense dignity, of freedom from all self-seeking and from all vanity. but it is idle to attempt to catalogue these various forms of private theatricals; they are constantly to be seen about us. it is with surprise unbounded that one hears another calmly assert that he is so-and-so or so-and-so, and in his next action, or next hundred actions, sees that same assertion entirely contradicted. daily familiarity with the manifestations of mistaken brain-impressions does not lessen one's surprise at this curious personal contradiction; it gives one an increasing desire to look to one's self, and see how far these private theatricals extend in one's own case, and to throw off the disguise, as far as it is seen, with a full acknowledgment that there may be--probably is--an abundance more of which to rid one's self in future. there are many ways in which true openness in life, one with another, would be of immense service; and not the least of these is the ability gained to erase false brain-impressions. the self-condemnatory brain-impression is quite as pernicious as its opposite. singularly enough, it goes with it. one often finds inordinate self-esteem combined with the most abject condemnation of self. one can be played against the other as a counter-irritant; but this only as a process of rousing, for the irritation of either brings equal misery. i am not even sure that as a rousing process it is ever really useful. to be clear of a mistaken brain-impression, a man must recognize it himself; and this recognition can never be brought about by an unasked attempt of help from another. it is often cleared by help asked and given; and perhaps more often by help which is quite involuntary and unconscious. one of the greatest points in friendly diplomacy is to be open and absolutely frank so far as we are asked, but never to go beyond. at least, in the experience of many, that leads more surely to the point where no diplomacy is needed, which is certainly the point to be aimed at in friendship. it is trying to see a friend living his own idea of himself, and to be obliged to wait until he has discovered that he is only playing a part. but this very waiting may be of immense assistance in reducing our own moral attitudinizing. how often do we hear others or find ourselves complaining of a fault over and over again! "i know that is a fault of mine, and has been for years. i wish i could get over it." "i know that is a fault of mine,"--one brain-impression; "it has been for years,"--a dozen or more brain-impressions, according to the number of years; until we have drilled the impression of that fault in, by emphasizing it over and over, to an extent which daily increases the difficulty of dropping it. so, if we have the habit of unpunctuality, and emphasize it by deploring it, it keeps us always behind time. if we are sharp-tongued, and dwell with remorse on something said in the past, it increases the tendency in the future. the slavery to nerve habit is a well-known physiological fact; but nerve habit may be strengthened negatively as well as positively. when this is more widely recognized, and the negative practice avoided, much will have been done towards freeing us from our subservience to mistaken brain-impressions. let us take an instance: unpunctuality-for example, as that is a common form of repetition. if we really want to rid ourselves of the habit, suppose every time we are late we cease to deplore it; make a vivid mental picture of ourselves as being on time at the next appointment; then, with the how and the when clearly impressed upon our minds, there should be an absolute refusal to imagine ourselves anything but early. surely that would be quite as effective as a constant repetition of the regret we feel at being late, whether this is repeated aloud to others, or only in our own minds. as we place the two processes side by side, the latter certainly has the advantage, and might be tried, until a better is found. of course we must beware of getting an impression of promptness which has no ground in reality. it is quite possible for an individual to be habitually and exasperatingly late, with all the air and innocence of unusual punctuality. it would strike us as absurd to see a man painting a house the color he did not like, and go on painting it the same color, to show others and himself that which he detested. is it not equally absurd for any of us, through the constant expression of regret for a fault, to impress the tendency to it more and more upon the brain? it is intensely sad when the consciousness of evil once committed has so impressed a man with a sense of guilt as to make him steadily undervalue himself and his own powers. here is a case where one's own idea of one's self is seventy-five per cent below par; and a gentle and consistent encouragement in raising that idea is most necessary before par is reached. and par, as i understand it, is simple freedom from any fixed idea of one's self, either good or bad. if fixed impressions of one's self are stones in the way, the same certainly holds good with fixed impressions of others. unpleasant brain-impressions of others are great weights, and greater impediments in the way of clearing our own brains. suppose so-and-so had such a fault yesterday; it does not follow that he has not rid himself of at least part of it to-day. why should we hold the brain-impression of his mistake, so that every time we look at him we make it stronger? he is not the gainer thereby, and we certainly are the losers. repeated brain-impressions of another's faults prevent our discerning his virtues. we are constantly attributing to him disagreeable motives, which arise solely from our idea of him, and of which he is quite innocent. not only so, but our mistaken impressions increase his difficulty in rising to the best of himself. for any one whose temperament is in the least sensitive is oppressed by what he feels to be another's idea of him, until he learns to clear himself of that as well as of other brain-impressions. it is not uncommon to hear one go over and over a supposed injury, or even small annoyances from others, with the reiterated assertion that he fervently desires to forget such injury or annoyances. this fervent desire to forgive and forget expresses itself by a repeated brain-impression of that which is to be forgiven; and if this is so often repeated in words, how many times more must it be repeated mentally! thus, the brain-impression is increased until at last forgetting seems out of the question. and forgiving is impossible unless one can at the same time so entirely forget the ill-feeling roused as to place it beyond recall. surely, if we realized the force and influence of unpleasant brain-impressions, it would be a simple matter to relax and let them escape, to be replaced by others that are only pleasant it cannot be that we enjoy the discomfort of the disagreeable impressions. and yet, so curiously perverted is human nature that we often hear a revolting story told with the preface, "oh, i can't bear to think of it!" and the whole story is given, with a careful attention to detail which is quite unnecessary, even if there were any reason for telling the story at all, and generally concluded with a repetition of the prefatory exclamation. how many pathetic sights are told of, to no end but the repetition of an unpleasant brain-impression. how many past experiences, past illnesses, are gone over and over, which serve the same worse than useless purpose,--that of repeating and emphasizing the brain-impression. a little pain is made a big one by persistent dwelling upon it; what might have been a short pain is sometimes lengthened for a lifetime. similarly, an old pain is brought back by recalling a brain-impression. the law of association is well known. we all know how familiar places and happenings will recall old feelings; we can realize this at any time by mentally reviving the association. by dwelling on the pain we had yesterday we are encouraging it to return to-morrow. by emphasizing the impression of an annoyance of to-day we are making it possible to suffer beyond expression from annoyances to come; and the annoyances, the pains, the disagreeable feelings will find their old brain-grooves with remarkable rapidity when given the ghost of a chance. i have known more than one case where a woman kept herself ill by the constant repetition, to others and to herself, of a nervous shock. a woman who had once been frightened by burglars refused to sleep for fear of being awakened by more burglars, thus increasing her impression of fear; and of course, if she slept at all, she was liable at any time to wake with a nervous start. the process of working herself into nervous prostration through this constant, useless repetition was not slow. the fixed impressions of preconceived ideas in any direction are strangely in the way of real freedom. it is difficult to catch new harmonies with old ones ringing in our ears; still more difficult when we persist in listening at the same time to discords. the experience of arguing with another whose preconceived idea is so firmly fixed that the argument is nothing but a series of circles, might be funny if it were not sad; and it often is funny, in spite of the sadness. suppose we should insist upon retaining an unpleasant brain-impression, only when and so long as it seemed necessary in order to bring a remedy. that accomplished, suppose we dropped it on the instant. suppose, further, that we should continue this process, and never allow ourselves to repeat a disagreeable brain-impression aloud or mentally. imagine the result. nature abhors a vacuum; something must come in place of the unpleasantness; therefore way is made for feelings more comfortable to one's self and to others. bad feelings cause contraction, good ones expansion. relax the muscular contraction; take a long, free breath of fresh air, and expansion follows as a matter of course. drop the brain-contraction, take a good inhalation of whatever pleasant feeling is nearest, and the expansion is a necessary consequence. as we expand mentally, disagreeable brain-impressions, that in former contracted states were eclipsed by greater ones, will be keenly felt, and dropped at once, for the mere relief thus obtained. the healthier the brain, the more sensitive it is to false impressions, and the more easily are they dropped. one word by way of warning. we never can rid ourselves of an uncomfortable brain-impression by saying, "i will try to think something pleasant of that disagreeable man." the temptation, too, is very common to say to ourselves clearly, "i will try to think something pleasant," and then leave "of that disagreeable man" a subtle feeling in the background. the feeling in the background, however unconscious we may be of it, is a strong brain-impression,--all the stronger because we fail to recognize it,--and the result of our "something pleasant" is an insidious complacency at our own magnanimous disposition. thus we get the disagreeable brain-impression of another, backed up by our agreeable brain-impression of ourselves, both mistaken. unless we keep a sharp look-out, we may here get into a snarl from which extrication is slow work. neither is it possible to counteract an unpleasant brain-impression by something pleasant but false. we must call a spade a spade, but not consider it a component part of the man who handles it, nor yet associate the man with the spade, or the spade with the man. when we drop it, so long as we drop it for what it is worth, which is nothing in the case of the spade in question, we have dropped it entirely. if we try to improve our brain-impression by insisting that a spade is something better and pleasanter, we are transforming a disagreeable impression to a mongrel state which again brings anything but a happy result. simply to refuse all unpleasant brain-impressions, with no effort or desire to recast them into something that they are not, seems to be the only clear process to freedom. not only so, but whatever there might have been pleasant in what seemed entirely unpleasant can more truly return as we drop the unpleasantness completely. it is a good thing that most of us can approach the freedom of such a change in imagination before we reach it in reality. so we can learn more rapidly not to hamper ourselves or others by retaining disagreeable brain-impressions of the present, or by recalling others of the past. v. the triviality of trivialities. life is clearer, happier, and easier for us as things assume their true proportions. i might better say, as they come nearer in appearance to their true proportions; for it seems doubtful whether any one ever reaches the place in this world where the sense of proportion is absolutely normal. some come much nearer than others; and part of the interest of living is the growing realization of better proportion, and the relief from the abnormal state in which circumstances seem quite out of proportion in their relation to one another. imagine a landscape-painter who made his cows as large as the houses, his blades of grass waving above the tops of the trees, and all things similarly disproportionate. or, worse, imagine a disease of the retina which caused a like curious change in the landscape itself wherein a mountain appeared to be a mole-hill, and a mole-hill a mountain. it seems absurd to think of. and, yet, is not the want of a true sense of proportion in the circumstances and relations of life quite as extreme with many of us? it is well that our physical sense remains intact. if we lost that too, there would seem to be but little hope indeed. now, almost the only thing needed for a rapid approach to a more normal mental sense of proportion is a keener recognition of the want. but this want must be found first in ourselves, not in others. there is the inclination to regard our own life as bigger and more important than the life of any one about us; or the reverse attitude of bewailing its lack of importance, which is quite the same. in either case our own life is dwelt upon first. then there is the immediate family, after that our own especial friends,--all assuming a gigantic size which puts quite out of the question an occasional bird's-eye view of the world in general. even objects which might be in the middle distance of a less extended view are quite screened by the exaggerated size of those which seem to concern us most immediately. one's own life is important; one's own family and friends are important, very, when taken in their true proportion. one should surely be able to look upon one's own brothers and sisters as if they were the brothers and sisters of another, and to regard the brothers and sisters of another as one's own. singularly, too, real appreciation of and sympathy with one's own grows with this broader sense of relationship. in no way is this sense shown more clearly than by a mother who has the breadth and the strength to look upon her own children as if they belonged to some one else, and upon the children of others as if they belonged to her. but the triviality of magnifying one's own out of all proportion has not yet been recognized by many. so every trivial happening in our own lives or the lives of those connected with us is exaggerated, and we keep ourselves and others in a chronic state of contraction accordingly. think of the many trifles which, by being magnified and kept in the foreground, obstruct the way to all possible sight or appreciation of things that really hold a more important place. the cook, the waitress, various other annoyances of housekeeping; a gown that does not suit, the annoyances of travel, whether we said the right thing to so-and-so, whether so-and-so likes us or does not like us,--indeed, there is an immense army of trivial imps, and the breadth of capacity for entertaining these imps is so large in some of us as to be truly encouraging; for if the domain were once deserted by the imps, there remains the breadth, which must have the same capacity for holding something better. unfortunately, a long occupancy by these miserable little offenders means eventually the saddest sort of contraction. what a picture for a new gulliver!--a human being overwhelmed by the imps of triviality, and bound fast to the ground by manifold windings of their cobweb-sized thread. this exaggeration of trifles is one form of nervous disease. it would be exceedingly interesting and profitable to study the various phases of nervous disease as exaggerated expressions of perverted character. they can be traced directly and easily in many cases. if a woman fusses about trivialities, she fusses more when she is tired. the more fatigue, the more fussing; and with a persistent tendency to fatigue and fussing it does not take long to work up or down to nervous prostration. from this form of nervous excitement one never really recovers, except by a hearty acknowledgment of the trivialities as trivialities, when, with growing health, there is a growing sense of true proportion. i have seen a woman spend more attention, time, and nerve-power on emphasizing the fact that her hands were all stained from the dye on her dress than a normal woman would take for a good hour's work. as she grew better, this emphasizing of trivialities decreased, but, of course, might have returned with any over-fatigue, unless it had been recognized, taken at its worth, and simply dropped. any one can think of example after example in his own individual experience, when he has suffered unnecessary tortures through the regarding of trifling things, either by himself or by some one near him. with many, the first instance will probably be to insist, with emphasis and some feeling, that they are _not_ trivialities. trivialities have their importance _when given their true proportion_. the size of a triviality is often exaggerated as much by neglect as by an undue amount of attention. when we do what we can to amend an annoyance, and then think no more about it until there appears something further to do, the saving of nervous force is very great. yet, so successful have these imps of triviality come to be in their rule of human nature that the trivialities of the past are oftentimes dwelt upon with as much earnestness as if they belonged to the present. the past itself is a triviality, except in its results. yet what an immense screen it is sometimes to any clear understanding or appreciation of the present! how many of us have listened over and over to the same tale of past annoyances, until we wonder how it can be possible that the constant repetition is not recognized by the narrator! how many of us have been over and over in our minds past troubles, little and big, so that we have no right whatever to feel impatient when listening to such repetitions by others! here again we have, in nervous disease, the extreme of a common trait in humanity. with increased nervous fatigue there is always an increase of the tendency to repetition. best drop it before it gets to the fatigue stage, if possible. then again there are the common things of life, such as dressing and undressing, and the numberless every-day duties. it is possible to distort them to perfect monstrosities by the manner of dwelling upon them. taken as a matter of course, they are the very triviality of trivialities, and assume their place without second thought. when life seems to get into such a snarl that we despair of disentangling it, a long journey and change of human surroundings enable us to take a distant view, which not uncommonly shows the tangle to be no tangle at all. although we cannot always go upon a material journey, we can change the mental perspective, and it is this adjustment of the focus which brings our perspective into truer proportions. having once found what appears to be the true focus, let us be true to it. the temptations to lose one's focus are many, and sometimes severe. when temporarily thrown off our balance, the best help is to return at once, without dwelling on the fact that we have lost the focus longer than is necessary to find it again. after that, our focus is better adjusted and the range steadily expanded. it is impossible for us to widen the range by thinking about it; holding the best focus we know in our daily experience does that thus the proportions arrange themselves; we cannot arrange the proportions. or, what is more nearly the truth, the proportions are in reality true, to begin with. as with the imaginary eye-disease, which transformed the relative sizes of the component parts of a landscape, the fault is in the eye, not in the landscape; so, when the circumstances of life are quite in the wrong proportion to one another, in our own minds, the trouble is in the mental sight, not in the circumstances. there are many ways of getting a better focus, and ridding one's self of trivial annoyances. one is, to be quiet; get at a good mental distance. be sure that you have a clear view, and then hold it. always keep your distance; never return to the old stand-point if you can manage to keep away. we may be thankful if trivialities annoy us as trivialities. it is with those who have the constant habit of dwelling on them without feeling the discomfort that a return to freedom seems impossible. as one comes to realize, even in a slight degree, the triviality of trivialities, and then forget them entirely in a better idea of true proportion, the sense of freedom gained is well worth working for. it certainly brings the possibility of a normal nervous system much nearer. vi. moods. relief from the mastery of an evil mood is like fresh air after having been several hours in a close room. if one should go to work deliberately to break up another's nervous system, and if one were perfectly free in methods of procedure, the best way would be to throw upon the victim in rapid sequence a long series of the most extreme moods. the disastrous result could be hastened by insisting that each mood should be resisted as it manifested itself, for then there would be the double strain,--the strain of the mood, and the strain of resistance. it is better to let a mood have its way than to suppress it. the story of the man who suffered from varicose veins and was cured by the waters of lourdes, only to die a little later from an affection of the heart which arose from the suppression of the former disease, is a good illustration of the effect of mood-suppression. in the case cited, death followed at once; but death from repeated impressions of moods resisted is long drawn out, and the suffering intense, both for the patient and for his friends. the only way to drop a mood is to look it in the face and call it by its right name; then by persistent ignoring, sometimes in one way, sometimes in another, finally drop it altogether. it takes a looser hold next time, and eventually slides off entirely. to be sure, over-fatigue, an attack of indigestion, or some unexpected contact with the same phase in another, may bring back the ghost of former moods. these ghosts may even materialize, unless the practice of ignoring is at once referred to; but they can ultimately be routed completely. a great help in gaining freedom from moods is to realize clearly their superficiality. moods are deadly, desperately serious things when taken seriously and indulged in to the full extent of their power. they are like a tiny spot directly in front of the eye. we see that, and that only. it blurs and shuts out everything else. we groan and suffer and are unhappy and wretched, still persistently keeping our eye on the spot, until finally we forget that there is anything else in the world. in mind and body we are impressed by that and that alone. thus the difficulty of moving off a little distance is greatly increased, and liberation is impossible until we do move away, and, by a change of perspective, see the spot for what it really is. let any one who is ruled by moods, in a moment when he is absolutely free from them, take a good look at all past moody states, and he will see that they come from nothing, go to nothing, and, are nothing. indeed, that has been and is often done by the moody person, with at the same time an unhappy realization that when the moods are on him, they are as real as they are unreal when he is free. to treat a mood as a good joke when you are in its clutches, is simply out of the question. but to say, "this now is a mood. come on, do your worst; i can stand it as long as you can," takes away all nerve-resistance, until the thing has nothing to clutch, and dissolves for want of nourishment. if it proves too much for one at times, and breaks out in a bad expression of some sort, a quick acknowledgment that you are under the spell of a bad mood, and a further invitation to come on if it wants to, will loosen the hold again. if the mood is a melancholy one, speak as little as possible under its influence; go on and do whatever there is to be done, not resisting it in any way, but keep busy. this non-resistance can, perhaps, be better illustrated by taking, instead of a mood, a person who teases. it is well known that the more we are annoyed, the more our opponent teases; and that the surest and quickest way of freeing ourselves is not to be teased. we can ignore the teaser externally with an internal irritation which he sees as clearly as if we expressed it. we can laugh in such a way that every sound of our own voice proclaims the annoyance we are trying to hide. it is when we take his words for what they are worth, and go with him, that the wind is taken out of his sails, and he stops because there is no fun in it. the experience with a mood is quite parallel, though rather more difficult at first, for there is no enemy like the enemies in one's self, no teasing like the teasing from one's self. it takes a little longer, a little heartier and more persistent process of non-resistance to cure the teasing from one's own nature. but the process is just as certain, and the freedom greater in result. why is it not clear to us that to set our teeth, clench our hands, or hold any form of extreme tension and mistaken control, doubles, trebles, quadruples the impression of the feeling controlled, and increases by many degrees its power for attacking us another time? persistent control of this kind gives a certain sort of strength. it might be called sham strength, for it takes it out of one in other ways. but the control that comes from non-resistance brings a natural strength, which not only steadily increases, but spreads on all sides, as the growth of a tree is even in its development. "if a man takes your cloak, give him your coat also; if one compel you to go a mile, go with him twain." "love your enemies, do good to them that hurt you, and pray for them that despitefully use you." why have we been so long in realizing the practical, i might say the physiological, truth of this great philosophy? possibly because in forgiving our enemies we have been so impressed with the idea that it was our enemies we were forgiving. if we realized that following this philosophy would bring us real freedom, it would be followed steadily as a matter of course, and with no more sense that we deserved credit for doing a good thing than a man might have in walking out of prison when his jailer opened the door. so it is with our enemies the moods. i have written heretofore of bad moods only. but there are moods and moods. in a degree, certainly, one should respect one's moods. those who are subject to bad moods are equally subject to good ones, and the superficiality of the happier modes is just as much to be recognized as that of the wretched ones. in fact, in recognizing the shallowness of our happy moods, we are storing ammunition for a healthy openness and freedom from the opposite forms. with the full realization that a mood is a mood, we can respect it, and so gradually reach a truer evenness of life. moods are phases that we are all subject to whilst in the process of finding our balance; the more sensitive and finer the temperament, the more moods. the rhythm of moods is most interesting, and there is a spice about the change which we need to give relish to these first steps towards the art of living. it is when their seriousness is exaggerated that they lose their power for good and make slaves of us. the seriousness may be equally exaggerated in succumbing to them and in resisting them. in either case they are our masters, and not our slaves. they are steady consumers of the nervous system in their ups and downs when they master us; and of course retain no jot of that fascination which is a good part of their very shallowness, and brings new life as we take them as a matter of course. then we are swung in their rhythm, never once losing sight of the point that it is the mood that is to serve us, and not we the mood. as we gain freedom from our own moods, we are enabled to respect those of others and give up any endeavor to force a friend out of his moods, or even to lead him out, unless he shows a desire to be led. nor do we rejoice fully in the extreme of his happy moods, knowing the certain reaction. respect for the moods of others is necessary to a perfect freedom from our own. in one sense no man is alone in the world; in another sense every man is alone; and with moods especially, a man must be left to work out his own salvation, unless he asks for help. so, as he understands his moods, and frees himself from their mastery, he will find that moods are in reality one of nature's gifts, a sort of melody which strengthens the harmony of life and gives it fuller tone. freedom from moods does not mean the loss of them, any more than non-resistance means allowing them to master you. it is non-resistance, with the full recognition of what they are, that clears the way. vii. tolerance. when we are tolerant as a matter of course, the nervous system is relieved of almost the worst form of persistent irritation it could have. the freedom of tolerance can only be appreciated by those who have known the suffering of intolerance and gained relief. a certain perspective is necessary to a recognition of the full absurdity of intolerance. one of the greatest absurdities of it is evident when we are annoyed and caused intense suffering by our intolerance of others, and, as a consequence, blame others for the fatigue or illness which follows. however mistaken or blind other people may be in their habits or their ideas, it is entirely our fault if we are annoyed by them. the slightest blame given to another in such a case, on account of our suffering, is quite out of place. our intolerance is often unconscious. it is disguised under one form of annoyance or another, but when looked full in the face, it can only be recognized as intolerance. of course, the most severe form is when the belief, the action, or habit of another interferes directly with our own selfish aims. that brings the double annoyance of being thwarted and of rousing more selfish antagonism. where our selfish desires are directly interfered with, or even where an action which we know to be entirely right is prevented, intolerance only makes matters worse. if expressed, it probably rouses bitter feelings in another. whether we express it openly or not, it keeps us in a state of nervous irritation which is often most painful in its results. such irritation, if not extreme in its effect, is strong enough to keep any amount of pure enjoyment out of life. there may be some one who rouses our intolerant feelings, and who may have many good points which might give us real pleasure and profit; but they all go for nothing before our blind, restless intolerance. it is often the case that this imaginary enemy is found to be a friend and ally in reality, if we once drop the wretched state of intolerance long enough to see him clearly. yet the promptest answer to such an assertion will probably be, "that may be so in some cases, but not with the man or woman who rouses my intolerance." it is a powerful temptation, this one of intolerance, and takes hold of strong natures; it frequently rouses tremendous tempests before it can be recognized and ignored. and with the tempest comes an obstinate refusal to call it by its right name, and a resentment towards others for rousing in us what should not have been there to be roused. so long as a tendency to anything evil is in us, it is a good thing to have it roused, recognized, and shaken off; and we might as reasonably blame a rock, over which we stumble, for the bruises received, as blame the person who rouses our intolerance for the suffering we endure. this intolerance, which is so useless, seems strangely absurd when it is roused through some interference with our own plans; but it is stranger when we are rampant against a belief which does not in any way interfere with us. this last form is more prevalent in antagonistic religious beliefs than in anything else. the excuse given would be an earnest desire for the salvation of our opponent. but who ever saved a soul through an ungracious intolerance of that soul's chosen way of believing or living? the danger of loss would seem to be all on the other side. one's sense of humor is touched, in spite of one's self, to hear a war of words and feeling between two christians whose belief is supposed to be founded on the axiom, "judge not, that ye be not judged." without this intolerance, argument is interesting, and often profitable. with it, the disputants gain each a more obstinate belief in his own doctrines; and the excitement is steadily destructive to the best health of the nervous system. again, there is the intolerance felt from various little ways and habits of others,--habits which are comparatively nothing in themselves, but which are monstrous in their effect upon a person who is intolerant of them. one might almost think we enjoyed irritated nerves, so persistently do we dwell upon the personal peculiarities of others. indeed, there is no better example of biting off one's own nose than the habit of intolerance. it might more truly be called the habit of irritating one's own nervous system. having recognized intolerance as intolerance, having estimated it at its true worth, the next question is, how to get rid of it. the habit has, not infrequently, made such a strong brain-impression that, in spite of an earnest desire to shake it off, it persistently clings. of course, the soil about the obnoxious growth is loosened the moment we recognize its true quality. that is a beginning, and the rest is easier than might be imagined by those who have not tried it. intolerance is an unwillingness that others should live in their own way, believe as they prefer to, hold personal habits which they enjoy or are unconscious of, or interfere in any degree with our ways, beliefs, or habits. that very sense of unwillingness causes a contraction of the nerves which is wasteful and disagreeable. the feeling rouses the contraction, the contraction more feeling; and so the intolerance is increased in cause and in effect. the immediate effect of being willing, on the contrary, is, of course, the relaxation of such contraction, and a healthy expansion of the nerves. try the experiment on some small pet form of intolerance. try to realize what it is to feel quite willing. say over and over to yourself that you are quite willing so-and-so should make that curious noise with his mouth. do not hesitate at the simplicity of saying the words to yourself; that brings a much quicker effect at first. by and by we get accustomed to the sensation of willingness, and can recall it with less repetition of words, or without words at all. when the feeling of nervous annoyance is roused by the other, counteract it on the instant by repeating silently: "i am quite willing you should do that,--do it again." the man or woman, whoever he or she may be, is quite certain to oblige you! there will be any number of opportunities to be willing, until by and by the willingness is a matter of course, and it would not be surprising if the habit passed entirely unnoticed, as far as you are concerned. this experiment tried successfully on small things can be carried to greater. if steadily persisted in, a good fifty per cent of wasted nervous force can be saved for better things; and this saving of nervous force is the least gain which comes from a thorough riddance of every form of intolerance. "but," it will be objected, "how can i say i am willing when i am not?" surely you can see no good from the irritation of unwillingness; there can be no real gain from it, and there is every reason for giving it up. a clear realization of the necessity for willingness, both for our own comfort and for that of others, helps us to its repetition in words. the words said with sincere purpose, help us to the feeling, and so we come steadily into clearer light. our very willingness that a friend should go the wrong way, if he chooses, gives us new power to help him towards the right. if we are moved by intolerance, that is selfishness; with it will come the desire to force our friend into the way which we consider right. such forcing, if even apparently successful, invariably produces a reaction on the friend's part, and disappointment and chagrin on our own. the fact that most great reformers were and are actuated by the very spirit of intolerance, makes that scorning of the ways of others seem to us essential as the root of all great reform. amidst the necessity for and strength in the reform, the petty spirit of intolerance intrudes unnoticed. but if any one wants to see it in full-fledged power, let him study the family of a reformer who have inherited the intolerance of his nature without the work to which it was applied. this intolerant spirit is not indispensable to great reforms; but it sometimes goes with them, and is made use of, as intense selfishness may often be used, for higher ends. the ends might have been accomplished more rapidly and more effectually with less selfish instruments. but man must be left free, and if he will not offer himself as an open channel to his highest impulses, he is used to the best advantage possible without them. there is no finer type of a great reformer than jesus christ; in his life there was no shadow of intolerance. from first to last, he showed willingness in spirit and in action. in upbraiding the scribes and pharisees he evinced no feeling of antagonism; he merely stated the facts. the same firm calm truth of assertion, carried out in action, characterized his expulsion of the money-changers from the temple. when he was arrested, and throughout his trial and execution, it was his accusers who showed the intolerance; they sent out with swords and staves to take him, with a show of antagonism which failed to affect him in the slightest degree. who cannot see that, with the irritated feeling of intolerance, we put ourselves on the plane of the very habit or action we are so vigorously condemning? we are inviting greater mistakes on our part. for often the rouser of our selfish antagonism is quite blind to his deficiencies, and unless he is broader in his way than we are in ours, any show of intolerance simply blinds him the more. intolerance, through its indulgence, has come to assume a monstrous form. it interferes with all pleasure in life; it makes clear, open intercourse with others impossible; it interferes with any form of use into which it is permitted to intrude. in its indulgence it is a monstrosity,--in itself it is mean, petty, and absurd. let us then work with all possible rapidity to relax from contractions of unwillingness, and become tolerant as a matter of course. whatever is the plan of creation, we cannot improve it through any antagonistic feeling of our own against creatures or circumstances. through a quiet, gentle tolerance we leave ourselves free to be carried by the laws. truth is greater than we are, and if we can be the means of righting any wrong, it is by giving up the presumption that we can carry truth, and by standing free and ready to let truth carry us. the same willingness that is practised in relation to persons will be found equally effective in relation to the circumstances of life, from the losing of a train to matters far greater and more important. there is as much intolerance to be dropped in our relations to various happenings as in our relations to persons; and the relief to our nerves is just as great, perhaps even greater. it seems to be clear that heretofore we have not realized either the relief or the strength of an entire willingness that people and things should progress in their own way. how can we ever gain freedom whilst we are entangled in the contractions of intolerance? freedom and a healthy nervous system are synonymous; we cannot have one without the other. viii. sympathy. sympathy, in its best sense, is the ability to take another's point of view. not to mourn because he mourns; not to feel injured because he feels injured. there are times when we cannot agree with a friend in the necessity for mourning or feeling injured; but we can understand the cause of his disturbance, and see clearly that his suffering is quite reasonable, _from his own point of view_. one cannot blame a man for being color-blind; but by thoroughly understanding and sympathizing with the fact that red _must_ be green as he sees it, one can help him to bring his mental retina to a more normal state, until every color is taken at its proper value. this broader sort of sympathy enables us to serve others much more truly. if we feel at one with a man who is suffering from a supposed injury which may be entirely his own fault, we are doing all in our power to confirm him in his mistake, and his impression of martyrdom is increased and protracted in proportion. but if, with a genuine comprehension of his point of view, however unreal it may be in itself, we do our best to see his trouble in an unprejudiced light, that is sympathy indeed; for our real sympathy is with the man himself, cleared from his selfish fog. what is called our sympathy with his point of view is more a matter of understanding. the sympathy which takes the man for all in all, and includes the comprehension of his prejudices, will enable us to hold our tongues with regard to his prejudiced view until he sees for himself or comes to us for advice. it is interesting to notice how this sympathy with another enables us to understand and forgive one from whom we have received an injury. his point of view taken, his animosity against us seems to follow as a matter of course; then no time or force need be wasted on resentment. again, you cannot blame a man for being blind, even though his blindness may be absolutely and entirely selfish, and you the sufferer in consequence. it often follows that the endeavor to get a clear understanding of another's view brings to notice many mistaken ideas of our own, and thus enables us to gain a better standpoint it certainly helps us to enduring patience; whereas a positive refusal to regard the prejudices of another is rasping to our own nerves, and helps to fix him in whatever contraction may have possessed him. there can be no doubt that this open sympathy is one of the better phases of our human intercourse most to be desired. it requires a clear head and a warm heart to understand the prejudices of a friend or an enemy, and to sympathize with his capabilities enough to help him to clearer mental vision. often, to be sure, there are two points of view, both equally true. but they generally converge into one, and that one is more easily found through not disputing our own with another's. through sympathy with him we are enabled to see the right on both sides, and reach the central point. it is singular that it takes us so long to recognize this breadth of sympathy and practise it. its practice would relieve us of an immense amount of unnecessary nerve-strain. but the nerve-relief is the mere beginning of gain to come. it steadily opens a clearer knowledge and a heartier appreciation of human nature. we see in individuals traits of character, good and bad, that we never could have recognized whilst blinded by our own personal prejudices. by becoming alive to various little sensitive spots in others, we are enabled to avoid them, and save an endless amount of petty suffering which might increase to suffering that was really severe. one good illustration of this want of sympathy, in a small way, is the waiting-room of a well-known nerve-doctor. the room is in such a state of confusion, it is such a mixture of colors and forms, that it would be fatiguing even for a person in tolerable health to stay there for an hour. yet the doctor keeps his sensitive, nervously excited patients sitting in this heterogeneous mass of discordant objects hour after hour. surely it is no psychological subtlety of insight that gives a man of this type his name and fame: it must be the feeding and resting process alone; for a man of sensitive sympathy would study to save his patients by taking their point of view, as well as to bring them to a better physical state through nourishment and rest. the ability to take a nervous sufferer's point of view is greatly needed. there can be no doubt that with that effort on the part of friends and relatives, many cases of severe nervous prostration might be saved, certainly much nervous suffering could be prevented. a woman who is suffering from a nervous conscience writes a note which shows that she is worrying over this or that supposed mistake, or as to what your attitude is towards her. a prompt, kind, and direct answer will save her at once from further nervous suffering of that sort. to keep an anxious person, whether he be sick or well, watching the mails, is a want of sympathy which is also shown in many other ways, unimportant, perhaps, to us, but important if we are broad enough to take the other's point of view. there are many foolish little troubles from which men and women suffer that come only from tired nerves. a wise patience with such anxieties will help greatly towards removing their cause. a wise patience is not indulgence. an elaborate nervous letter of great length is better answered by a short but very kind note. the sympathy which enables us to understand the point of view of tired nerves gives us the power to be lovingly brief in our response to them, and at the same time more satisfying than if we responded at length. most of us take human nature as a great whole, and judge individuals from our idea in general. or, worse, we judge it all from our own personal prejudices. there is a grossness about this which we wonder at not having seen before, when we compare the finer sensitiveness which is surely developed by the steady effort to understand another's point of view. we know a whole more perfectly as a whole if we have a distinct knowledge of the component parts. we can only understand human nature en masse through a daily clearer knowledge of and sympathy with its individuals. every one of us knows the happiness of having at least one friend whom he is perfectly sure will neither undervalue him nor give him undeserved praise, and whose friendship and help he can count upon, no matter how great a wrong he has done, as securely as he could count upon his loving thought and attention in physical illness. surely it is possible for each of us to approach such friendship in our feeling and attitude towards every one who comes in touch with us. it is comparatively easy to think of this open sympathy, or even practise it in big ways; it is in the little matters of everyday life that the difficulty arises. of course the big ways count for less if they come through a brain clogged with little prejudices, although to some extent one must help the other. it cannot be that a man has a real open sympathy who limits it to his own family and friends; indeed, the very limit would make the open sympathy impossible. one is just as far from a clear comprehension of human nature when he limits himself by his prejudices for his immediate relatives as when he makes himself alone the boundary. once having gained even the beginning of this broader sympathy with others, there follows the pleasure of freedom from antagonisms, keener delight in understanding others, individually and collectively, and greater ability to serve others; and all these must give an impetus which takes us steadily on to greater freedom, to clearer understanding, and to more power to serve and to be served. others have many experiences which we have never even touched upon. in that case, our ability to understand is necessarily limited. the only thing to do is to acknowledge that we cannot see the point of view, that we have no experience to start from, and to wait with an open mind until we are able to understand. curiously enough, it is precisely these persons of limited experience who are most prone to prejudice. i have heard a man assert with emphasis that it was every one's _duty_ to be happy, who had apparently not a single thing in life to interfere with his own happiness. the duty may be clear enough, but he certainly was not in a position to recognize its difficulty. and just in proportion with his inability to take another's point of view in such difficulty did he miss his power to lead others to this agreeable duty. there are, of course, innumerable things, little and big, which we shall be enabled to give to others and to receive from others as the true sympathy grows. the common-sense of it all appeals to us forcibly. who wants to carry about a mass of personal prejudices when he can replace them by the warm, healthy feeling of sympathetic friendship? who wants his nerves to be steadily irritated by various forms of intolerance when, by understanding the other's point of view, he can replace these by better forms of patience? this lower relief is little compared with the higher power gained, but it is the first step up, and the steps beyond go ever upward. human nature is worth knowing and worth loving, and it can never be known or loved without open sympathy. why, we ourselves are human nature! many of us would be glad to give sympathy to others, especially in little ways, but we do not know how to go to work about it; we seem always to be doing the wrong thing, when our desire is to do the right. this comes, of course, from the same inability to take the other's point of view; and the ability is gained as we are quiet and watch for it. practice, here as in everything else, is what helps. and the object is well worth working for. ix. others. how to live at peace with others is a problem which, if practically solved, would relieve the nervous system of a great weight, and give to living a lightness and ease that might for a time seem weirdly unnatural. it would certainly decrease the income of the nerve-specialists to the extent of depriving those gentlemen of many luxuries they now enjoy. peace does not mean an outside civility with an inside dislike or annoyance. in that case, the repressed antagonism not only increases the brain-impression and wears upon the nervous system, but it is sure to manifest itself some time, in one form or another; and the longer it is repressed, the worse will be the effect. it may be a volcanic eruption that is produced after long repression, which simmers down to a chronic interior grumble; or it may be that the repression has caused such steadily increasing contraction that an eruption is impossible. in this case, life grows heavier and heavier, burdened with the shackles of one's own dislikes. if we can only recognize two truths in our relations with others, and let these truths become to us a matter of course, the worst difficulties are removed. indeed, with these two simple bits of rationality well in hand, we may safely expect to walk amicably side by side with our dearest foe. the first is, that dislike, nine times out often, is simply a "cutaneous disorder." that is, it is merely an irritation excited by the friction of one nervous system upon another. the tiny tempests in the tiny teapots which are caused by this nervous friction, the great weight attached to the most trivial matters of dispute, would touch one's sense of humor keenly if it were not that in so many cases these tiny tempests develop into real hurricanes. take, for example, two dear and intimate friends who have lived happily together for years. neither has a disposition which is perfect; but that fact has never interfered with their friendship. both get over-tired. words are spoken which sound intensely disagreeable, even cruel. they really express nothing in the world but tired nerves. they are received and misinterpreted by tired nerves on the other side. so these two sets of nerves act and react upon one another, and from nothing at all is evolved an ill-feeling which, if allowed to grow, separates the friends. each is fully persuaded that his cutaneous trouble has profound depth. by a persistent refusal of all healing salves it sometimes sinks in until the disease becomes really deep seated. all this is so unnecessary. through the same mistake many of us carry minor dislikes which, on account of their number and their very pettiness, are wearing upon the nerves, and keep us from our best in whatever direction we may be working. the remedy for all these seems very clear when once we find it. recognize the shallow-ness of the disorder, acknowledge that it is a mere matter of nerves, and avoid the friction. keep your distance. it is perfectly possible and very comfortable to keep your distance from the irritating peculiarities of another, while having daily and familiar relations with him or her. the difficulty is in getting to a distance when we have allowed ourselves to be over-near; but that, too, can be accomplished with patience. and by keeping a nervous distance, so to speak, we are not only relieved from irritation, but we find a much more delightful friendship; we see and enjoy the qualities in another which the petty irritations had entirely obscured from our view. if we do not allow ourselves to be touched by the personal peculiarities, we get nearer the individual himself. to give a simple example which would perhaps seem absurd if it had not been proved true so many times: a man was so annoyed by his friend's state of nervous excitability that in taking a regular morning walk with him, which he might have enjoyed heartily, he always returned fagged out he tried whilst walking beside his friend to put himself in imagination on the other side of the street the nervous irritation lessened, and finally ceased; the walk was delightful, and the friend--never suspected! a japanese crowd is so well-bred that no one person touches another; one need never jostle, but, with an occasional "i beg your pardon," can circulate with perfect ease. in such a crowd there can be no irritation. there is a certain good-breeding which leads us to avoid friction with another's nervous system. it must, however, be an avoidance inside as well as outside. the subterfuge of holding one's tongue never works in the end. there is a subtle communication from one nervous system to another which is more insinuating than any verbal intercourse. those nearest us, and whom we really love best, are often the very persons by whom we are most annoyed. as we learn to keep a courteous distance from their personal peculiarities our love grows stronger and more real; and an open frankness in our relation is more nearly possible. strangely enough, too, the personal peculiarities sometimes disappear. it is possible, and quite as necessary, to treat one's own nervous system with this distant courtesy. this brings us to the second simple truth. in nine cases out of ten the cause of this nervous irritation is in ourselves. if a man loses his temper and rouses us to a return attack, how can we blame him? are we not quite as bad in hitting back? to be sure, he began it. but did he? how do we know what roused him? then, too, he might have poured volleys of abuse upon us, and not provoked an angry retort, if the temper had not been latent within us, to begin with. so it is with minor matters. in direct proportion to our freedom from others is our power for appreciating their good points; just in proportion to our slavery to their tricks and their habits are we blinded to their good points and open to increased irritation from their bad ones. it is curious that it should work that way, but it does. if there is nothing in us to be roused, we are all free; if we are not free, it is because there is something in us akin to that which rouses us. this is hard to acknowledge. but it puts our attitude to others on a good clean basis, and brings us into reality and out of private theatricals; not to mention a clearing of the nervous system which gives us new power. there is one trouble in dealing with people which does not affect all of us, but which causes enough pain and suffering to those who are under its influence to make up for the immunity of the rest. that is, the strong feeling that many of us have that it is our duty to reform those about us whose life and ways are not according to our ideas of right. no one ever forced another to reform, against that other's will. it may have appeared so; but there is sure to be a reaction sooner or later. the number of nervous systems, however, that have been overwrought by this effort to turn others to better ways, is sad indeed. and in many instances the owners of these nervous systems will pose to themselves as martyrs; and they are quite sincere in such posing. they are living their own impressions of themselves, and wearing themselves out in consequence. if they really wanted right for the sake of right, they would do all in their power without intruding, would recognize the other as a free agent, and wait. but they want right because it is their way; consequently they are crushed by useless anxiety, and suffer superfluously. this is true of those who feel themselves under the necessity of reforming all who come in touch with them. it is more sadly true of those whose near friends seem steadily to be working out their own destruction. to stand aside and be patient in this last case requires strength indeed. but such patience clears one's mind to see, and gives power to act when action can prove effective. indeed, as the ability to leave others free grows in us, our power really to serve increases. the relief to the nervous system of dropping mistaken responsibility cannot be computed. for it is by means of the nervous system that we deal with others; it is the medium of our expression and of our impression. and as it is cleared of its false contractions, does it not seem probable that we might be opened to an exquisite delight in companionship that we never knew before, and that our appreciation of human nature would increase indefinitely? suppose when we find another whose ways are quite different from ours, we immediately contract, and draw away with the feeling that there is nothing in him for us. or suppose, instead, that we look into his ways with real interest in having found a new phase of human nature. which would be the more broadening process on the whole, or the more delightful? frequently the contraction takes more time and attention than would an effort to understand the strange ways. we are almost always sure to find something in others to which we can respond, and which awakens a new power in us, if only a new power of sympathy. to sum it all up, the best way to deal with others seems to be to avoid nervous friction of any sort, inside or out; to harbor no ill-will towards another for selfishness roused in one's self; to be urged by no presumptive sense of responsibility; and to remember that we are all in the same world and under the same laws. a loving sympathy with human nature in general, leads us first to obey the laws ourselves, and gives us a fellow-feeling with individuals which means new strength on both sides. to take this as a matter of course does not seem impossible. it is simply casting the skin of the savage and rising to another plane, where there will doubtless be new problems better worth attention. x. one's self. to be truly at peace with one's self means rest indeed. there is a quiet complacency, though, which passes for peace, and is like the remarkably clear red-and-white complexion which indicates disease. it will be noticed that the sufferers from this complacent spirit of so-called peace shrink from openness of any sort, from others or to others. they will put a disagreeable feeling out of sight with a rapidity which would seem to come from sheer fright lest they should see and acknowledge themselves in their true guise. or they will acknowledge it to a certain extent, with a pleasure in their own humility which increases the complacency in proportion. this peace is not to be desired. with those who enjoy it, a true knowledge of or friendship with others is as much out of the question as a knowledge of themselves. and when it is broken or interfered with in any way, the pain is as intense and real as the peace was false. the first step towards amicable relations with ourselves is to acknowledge that we are living with a stranger. then it sometimes happens that through being annoyed by some one else we are enabled to recognize similar disagreeable tendencies in ourselves of which we were totally ignorant before. as honest dealing with others always pays best in the end, so it is in all relations with one's self. there are many times when to be quite open with a friend we must wait to be asked. with ourselves no such courtesy is needed. we can speak out and done with it, and the franker we are, the sooner we are free. for, unlike other companions, we can enjoy ourselves best when we are conspicuous only by our own absence! it is this constant persistence in clinging to ourselves that is most in the way; it increases that crown of nervous troubles, self-consciousness, and makes it quite impossible that we should ever really know ourselves. if by all this, we are not ineffable bores to ourselves, we certainly become so to other people. it is surprising, when once we come to recognize it, how we are in an almost chronic state of posing to ourselves. fortunately, a clear recognition of the fact is most effectual in stopping the poses. but they must be recognized, pose by pose, individually and separately stopped, _and then ignored_, if we want to free ourselves from ourselves entirely. the interior posing-habit makes one a slave to brain-impressions which puts all freedom out of the question. to cease from such posing opens one of the most interesting gates to natural life. we wonder how we could have obscured the outside view for so long. to find that we cannot, or do not, let ourselves alone for an hour in the day seems the more surprising when we remember that there is so much to enjoy outside. egotism is immensely magnified in nervous disorders; but that it is the positive cause of much nervous trouble has not been generally admitted. let any one of us take a good look at the amount of attention given by ourselves to ourselves. then acknowledge, without flinching, what amount of that attention is unnecessary; and it will clear the air delightfully, for a moment at any rate. the tendency to refer everything, in some way or another, to one's self; the touchiness and suspicion aroused by nothing but petty jealousy as to one's own place; the imagined slights from others; the want of consideration given us,--all these and many more senseless irritations are in this over-attention to self. the worries about our own moral state take up so great a place with many of us as to leave no room for any other thought. indeed, it is not uncommon to see a woman worrying so over her faults that she has no time to correct them. self-condemnation is as great a vanity as its opposite. either in one way or another there is the steady temptation to attend to one's self, and along with it an irritation of the nerves which keeps us from any sense of real freedom. with most of us there is no great depth to the self-disease if it is only stopped in time. when once we are well started in the wholesome practice of getting rid of ourselves, the process is rapid. a thorough freedom from self once gained, we find ourselves quite companionable, which, though paradoxical, is without doubt a truth. "that freedom of the soul," writes fenelon, "which looks straight onward in its path, losing no time to reason upon its steps, to study them, or to dwell upon those already taken, is true simplicity." we recognize a mistake, correct it, go on and forget. if it appears again, correct it again. irritation at the second or at any number of reappearances only increases the brain-impression of the mistake, and makes the tendency to future error greater. if opportunity arises to do a good action, take advantage of it, and silently decline the disadvantage of having your attention riveted to it by the praise of others. a man who is constantly analyzing his physical state is called a hypochondriac. what shall we call the man who is constantly analyzing his moral state? as the hypochondriac loses all sense of health in holding the impression of disease, so the other gradually loses the sense of wholesome relation to himself and to others. if a man obeyed the laws of health as a matter of course, and turned back every time nature convicted him of disobedience, he would never feel the need of self-analysis so far as his physical state was concerned. just so far as a man obeys higher laws as a matter of course, and uses every mistake to enable him to know the laws better, is morbid introspection out of the question with him. "man, know thyself!" but, being sure of the desire to know thyself, do not be impatient at slow progress; pay little attention to the process, and forget thyself, except when remembering is necessary to a better forgetting. to live at real peace with ourselves, we must surely let every little evil imp of selfishness show himself, and not have any skulking around corners. recognize him for his full worthless-ness, call him by his right name, and move off. having called him by his right name, our severity with ourselves for harboring him is unnecessary. to be gentle with ourselves is quite as important as to be gentle with others. great nervous suffering is caused by this over-severity to one's self, and freedom is never accomplished by that means. many of us are not severe enough, but very many are too severe. one mistake is quite as bad as the other, and as disastrous in its effects. if we would regard our own state less, or careless whether we were happy or unhappy, our freedom from self would be gained more rapidly. as a man intensely interested in some special work does not notice the weather, so we, if we once get hold of the immense interest there may be in living, are not moved to any depth by changes in the clouds of our personal state. we take our moods as a matter of course, and look beyond to interests that are greater. self may be a great burden if we allow it. it is only a clear window through which we see and are seen, if we are free. and the repose of such freedom must be beyond our conception until we have found it. to be absolutely certain that we know ourselves at any time is one great impediment to reaching such rest. every bit of self-knowledge gained makes us more doubtful as to knowledge to come. it would surprise most of us to see how really unimportant we are. as a part of the universe, our importance increases just in proportion to the laws that work through us; but this self-importance is lost to us entirely in our greater recognition of the laws. as we gain in the sensitive recognition of universal laws, every petty bit of self-contraction disappears as darkness before the rising of the sun. xi. children. work for the better progress of the human race is most effective when it is done through the children; for children are future generations. the freedom in mature life gained by a training that would enable the child to avoid nervous irritants is, of course, greatly in advance of most individual freedom to-day. this real freedom is the spirit of the kindergarten; but frobel's method, as practised to-day, does not attack and put to rout all those various nervous irritants which are the enemies of our civilization. to be sure, the teaching of his philosophy develops such a nature that much pettiness is thrown off without even being noticed as a snare; and frobel helps one to recognize all pettiness more rapidly. there are, however, many forms of nervous irritation which one is not warned against in the kindergarten, and the absence of which, if the child is taught as a matter of course to avoid them, will give him a freedom that his elders and betters (?) lack. the essential fact of this training is that it is only truly effectual when coming from example rather than precept. a child is exquisitely sensitive to the shortcomings of others, and very keen, as well as correct, in his criticism, whether expressed or unexpressed. in so far as a man consents to be taught by children, does he not only remain young, but he frees himself from the habit of impeding his own progress. this is a great impediment, this unwillingness to be taught by those whom we consider more ignorant than ourselves because they have not been in the world so long. did no one ever take into account the possibility of our eyes being blinded just because they had been exposed to the dust longer? certainly one possible way of clearing this dust and avoiding it is to learn from observing those who have had less of it to contend with. indeed, one might go so far as to say that no training of any child could be effectual to a lasting degree unless the education was mutual. when frobel says, "come, let us live with our children," he does not mean, come, let us stoop to our children; he means, let us be at one with them. surely a more perfect harmony in these two great phases of human nature--the child and the man--would be greatly to the advantage of the latter. yet, to begin at the beginning, who ever feels the necessity of treating a baby with respect? how quickly the baby would resent intrusive attentions, if it knew how. indeed, i have seen a baby not a year old resent being transferred from one person to another, with an expression of the face that was most eloquent. women seem so full of their sense of possession of a baby that this eloquence is not even observed, and the poor child's nervous irritants begin at a very early age. there is so much to be gained by keeping at a respectful nervous distance from a baby, that one has only to be quiet enough to perceive the new pleasure once, to lose the temptation to interfere; and imagine the relief to the baby! it is, after all, the sense of possession that makes the trouble; and this sense is so strong that there are babies, all the way from twenty to forty, whose individuality is intruded upon so grossly that they have never known what freedom is; and when they venture to struggle for it, their suffering is intense. this is a steadily increasing nervous contraction, both in the case of the possessed and the possessor, and perfect nervous health is not possible on either side. to begin by respecting the individuality of the baby would put this last abnormal attitude of parent and child out of the question. curiously enough, there is in some of the worst phases of this parent-child contraction an external appearance of freedom which only enhances the internal slavery. when a man, who has never known what it was in reality to give up a strong will, prides himself upon the freedom he gives to his child, he is entangling himself in the meshes of self-deception, and either depriving another of his own, or ripening him for a good hearty hatred which may at any time mean volcanoes and earthquakes to both. this forcible resentment of and resistance to the strong will of another is a cause of great nervous suffering, the greater as the expression of such feeling is repressed. severe illness may easily be the result. to train a child to gain freedom from the various nervous irritants, one must not only be gaining the same freedom one's self, but must practise meeting the child in the way he is counselled to meet others. one must refuse to be in any way a nervous irritant to the child. in that case quite as much instruction is received as given. a child, too, is doubly sensitive; he not only feels the intrusion on his own individuality, but the irritable or self-willed attitude of another in expressing such intrusion. similarly, in keeping a respectful distance, a teacher grows sensitive to the child, and again the help is mutual, with sometimes a balance in favor of the child. this mistaken, parent-child attitude is often the cause of severe nervous suffering in those whose only relation is that of friendship, when one mind is stronger than the other. sometimes there is not any real superior strength on the one side; it is simply by the greater gross-ness of the will that the other is overcome. this very grossness blinds one completely to the individuality of a finer strength; the finer individual succumbs because he cannot compete with crowbars, and the parent-child contraction is the disastrous result. to preserve for a child a normal nervous system, one must guide but not limit him. it is a sad sight to see a mother impressing upon a little brain that its owner is a naughty, naughty boy, especially when such impression is increased by the irritability of the mother. one hardly dares to think how many more grooves are made in a child's brain which simply give him contractions to take into mature life with him; how many trivial happenings are made to assume a monstrous form through being misrepresented. it is worth while to think of such dangers, such warping influences, only long enough to avoid them. a child's imagination is so exquisitely alive, his whole little being is so responsive, that the guidance which can be given him through happy brain-impressions is eminently practicable. to test this responsiveness, and feel it more keenly, just tell a child a dramatic story, and watch his face respond; or even recite a mother-goose rhyme with all the expression at your command. the little face changes in rapid succession, as one event after another is related, in a way to put a modern actor to shame. if the response is so quick on the outside, it must be at least equally active within. one might as well try to make a white rose red by rouging its petals as to mould a child according to one's own idea of what he should be; and as the beauty and delicacy of the rose would be spoiled by the application of the pigment, so is the baby's nervous system twisted and contracted by the limiting force of a grosser will. water the rose, put it in the sun, keep the insect enemies away, and then enjoy it for itself. give the child everything that is consistent with its best growth, but neither force the growth nor limit it; and stand far enough off to see the individuality, to enjoy it and profit by it. use the child's imagination to calm and strengthen it; give it happy channels for its activity; guide it physically to the rhythm of fresh air, nourishment, and rest; then do not interfere. if the man never turns to thank you for such guidance, because it all came as a matter of course, a wholesome, powerful nervous system will speak thanks daily with more eloquence than any words could ever express. xii. illness. as far as we make circumstances guides and not limitations, they serve us. otherwise, we serve them, and suffer accordingly. just in proportion, too, to our allowing circumstances to be limits do we resist them. such resistance is a nervous strain which disables us physically, and of course puts us more in the clutches of what appears to be our misfortune. the moment we begin to regard every circumstance as an opportunity, the tables are turned on fate, and we have the upper hand of her. when we come to think of it, how much common-sense there is in making the best of every "opportunity," and what a lack of sense in chafing at that which we choose to call our limitations! the former way is sure to bring a good result of some sort, be it ever so small; the latter wears upon our nerves, blinds our mental vision, and certainly does not cultivate the spirit of freedom in us. how absurd it would seem if a wounded man were to expose his wound to unnecessary friction, and then complain that it did not heal! yet that is what many of us have done at one time or another, when prevented by illness from carrying out our plans in life just as we had arranged. it matters not whether those plans were for ourselves or for others; chafing and fretting at their interruption is just as absurd and quite as sure to delay our recovery. "i know," with tears in our eyes, "i ought not to complain, but it is so hard," to which common-sense may truly answer: "if it is hard, you want to get well, don't you? then why do you not take every means to get well, instead of indulging first in the very process that will most tend to keep you ill?" besides this, there is a dogged resistance which remains silent, refuses to complain aloud, and yet holds a state of rigidity that is even worse than the external expression. there are many individual ways of resisting. each of us knows his own, and knows, too, the futility of it; we do not need to multiply examples. the patients who resist recovery are quite as numerous as those who keep themselves ill by resisting illness. a person of this sort seems to be fascinated by his own body and its disorders. so far from resisting illness, he may be said to be indulging in it he will talk about himself and his physical state for hours. he will locate each separate disease in a way to surprise the listener by his knowledge of his own anatomy. not infrequently he will preface a long account of himself by informing you that he has a hearty detestation of talking about himself, and never could understand why people wanted to talk of their diseases. then in minute detail he will reveal to you his brain-impression of his own case, and look for sympathetic response. these people might recover a hundred times over, and they would never know it, so occupied are they in living their own idea of themselves and in resisting nature. when nature has knocked us down because of disobedience to her laws, we resist her if we attempt at once to rise, or complain of the punishment. when the dear lady would hasten our recovery to the best of her ability, we resist her if we delay progress by dwelling on the punishment or chafing at its necessity. nature always tends towards health. it is to prevent further ill-health that she allows us to suffer for our disobedience to her laws. it is to lead us back to health that she is giving the best of her powers, having dealt the deserved punishment. the truest help we can give nature is not to think of our bodies, well or ill, more than is necessary for their best health. i knew a woman who was, to all appearances, remarkably well; in fact, her health was her profession. she was supposed to be a priestess of health. she talked about and dwelt upon the health of her body until one would have thought there was nothing in the world worth thinking of but a body. she displayed her fine points in the way of health, and enjoyed being questioned with regard to them. this woman was taken ill. she exhibited the same interest, the same pleasure, in talking over and dwelling upon her various forms of illness; in fact, more. she counted her diseases. i am not aware that she ever counted her strong points of health. this illustration is perhaps clear enough to give a new sense of the necessity for forgetting our bodies. when ill use every necessary remedy; do all that is best to bring renewed health. having made sure you are doing all you can, forget; don't follow the process. when, as is often the case, pain or other suffering puts forgetting out of the question, use no unnecessary resistance, and forget as soon as the pain is past don't strengthen the impression by talking about it or telling it over to no purpose. better forego a little sympathy, and forget the pain sooner. it is with our nerves that we resist when nature has punished us. it is nervous strain that we put into a useless attention to and repetition of the details of our illness. nature wants all this nerve-force to get us well the faster; we can save it for her by not resisting and by a healthy forgetting. by taking an illness as comfortably as possible, and turning our attention to something pleasant outside of ourselves, recovery is made more rapidly. many illnesses are accompanied by more or less nervous strain, and its natural control will assist nature and enable medicines to work more quickly. the slowest process of recovery, and that which most needs the relief of a wholesome non-resistance, is when the illness is the result entirely of over-worked nerves. nature allows herself to be tried to the utmost before she permits nervous prostration. she insists upon being paid in full, principal and interest, before she heals such illness. so severe is she in this case that a patient may appear in every way physically well and strong weeks, nay, months, before he really is so. it was the nerves that broke down last, and the nerves are the last to be restored. it is, however, wonderful to see how much more rapid and certain recovery is if the patient will only separate himself from his nervous system, and refuse all useless strain. here are some simple directions which may help nervous patients, if considered in regular order. they can hardly be read too often if the man or woman is in for a long siege; and if simply and steadily obeyed, they will shorten the siege by many days, nay, by many weeks or months, in some cases. remember that nature tends towards health. all you want is nourishment, fresh air, exercise, rest, and patience. all your worries and anxieties now are tired nerves. when a worry appears, drop it. if it appears again, drop it again. and so continue to drop it if it appears fifty or a hundred times a day or more. if you feel like crying, cry; but know that it is the tired nerves that are crying, and don't wonder why you are so foolish,--don't feel ashamed of yourself. if you cannot sleep, don't care. get all the rest you can without sleeping. that will bring sleep when it is ready to come, or you are ready to have it. don't wonder whether you are going to sleep or not. go to bed to rest, and let sleep come when it pleases. think about everything in nature. follow the growing of the trees and flowers. remember all the beauties in nature you have ever seen. say mother-goose rhymes over and over, trying how many you can remember. read bright stories for children, and quiet novels, especially jane austen's. sometimes it helps to work on arithmetic. keep aloof from emotions. think of other people. never think of yourself. bear in mind that nerves always get well in waves; and if you thought yourself so much better,--almost well, indeed,--and then have a bad time of suffering, don't wonder why it is, or what could have brought it on. know that it is part of the recovery-process; take it as easily as you can, and then ignore it. don't try to do any number of things to get yourself well; don't change doctors any number of times, or take countless medicines. every doctor knows he cannot hurry your recovery, whatever he may say, and you only retard it by being over-anxious to get strong. drop every bit of unnecessary muscular tension. when you walk, feel your feet heavy, as if your shoes were full of lead, and think in your feet. be as much like a child as possible. play with children as one of them, and think with them when you can. as you begin to recover, find something every day to do for others. best let it be in the way of house-work, or gardening, or something to do with your hands. take care of yourself every day as a matter of course, as you would dress or undress; and be sure that health is coming. say over and over to yourself: nourishment, fresh air, exercise, rest, patience. when you are well, and resume your former life, if old associations recall the unhappy nervous feelings, know that it is only the associations; pay no attention to the suffering, and work right on. only be careful to take life very quietly until you are quite used to being well again. an illness that is merely nervous is an immense opportunity, if one will only realize it as such. it not only makes one more genuinely appreciative of the best health, and the way to keep it, it opens the sympathies and gives a feeling for one's fellow-creatures which, having once found, we cannot prize too highly. it would seem hard to believe that all must suffer to find a delicate sympathy; it can hardly be so. to be always strong, and at the same time full of warm sympathy, is possible, with more thought. when illness or adverse circumstances bring it, the gate has been opened for us. if illness is taken as an opportunity to better health, not to more illness, our mental attitude will put complaint out of the question; and as the practice spreads it will as surely decrease the tendency to illness in others as it will shorten its duration in ourselves. xiii. sentiment _versus_ sentimentality. freedom from sentimentality opens the way for true sentiment. an immense amount of time, thought, and nervous force is wasted in sentimentalizing about "being good." with many, the amount of talk about their evils and their desire to overcome them is a thermometer which indicates about five times that amount of thought neither the talk nor the thought is of assistance in leading to any greater strength or to a more useful life; because the talk is all talk, and the essence of both talk and thought is a selfish, morbid pleasure in dwelling upon one's self. i remember the remark of a young girl who had been several times to prayer-meeting where she heard the same woman say every time that she "longed for the true spirit of religion in her life." with all simplicity, this child said: "if she longs for it, why doesn't she work and find it, instead of coming every week and telling us that she longs?" in all probability the woman returned from every prayer-meeting with the full conviction that, having told her aspirations, she had reached the height desired, and was worthy of all praise. prayer-meetings in the old, orthodox sense are not so numerous as they were fifty years ago; but the same morbid love of telling one's own experiences and expressing in words one's own desires for a better life is as common as ever. many who would express horror at these public forms of sentimentalizing do not hesitate to indulge in it privately to any extent. nor do they realize for a moment that it is the same morbid spirit that moves them. it might not be so pernicious a practice if it were not so steadily weakening. if one has a spark of real desire for better ways of living, sentimentalizing about it is a sure extinguisher if practised for any length of time. a woman will sometimes pour forth an amount of gush about wishing to be better, broader, nobler, stronger, in a manner that would lead you, for a moment, perhaps, to believe in her sincerity. but when, in the next hour, you see her neglecting little duties that a woman who was really broad, strong, and noble would attend to as a matter of course, and not give a second thought to; when you see that although she must realize that attention to these smaller duties should come first, to open the way to her higher aspirations, she continues to neglect them and continues to aspire,--you are surely right in concluding that she is using up her nervous system in sentimentalizing about a better life; and by that means is doing all in her power to hinder the achievement of it. it is curious and very sad to see what might be a really strong nature weakening itself steadily with this philosophy and water. of course it reaches a maudlin state if it continues. his satanic majesty must offer this dose, sweetened with the sugar of self-love, with intense satisfaction. and if we may personify that gentleman for the sake of illustration, what a fine sarcastic smile must dwell upon his countenance as he sees it swallowed and enjoyed, and knows that he did not even have to waste spice as an ingredient! the sugar would have drowned the taste of any spice he could supply. there is not even the appearance of strength in sentimentalizing. besides the sentimentalizing about ourselves in our desire to live a better life, there is the same morbid practice in our love for others; and this is quite as weakening. it contains, of course, no jot of real affection. what wholesome love there is lives in spite of the sentimentalizing, and fortunately is sometimes strong enough on one side or the other to crowd it out and finally exterminate it. it is curious to notice how often this sham sentiment for others is merely a matter of nerves. as an instance we can take an example, which is quite true, of a woman who fancied herself desperately fond of another, when, much to her surprise, an acute attack of toothache and dentist-fright put the "affection" quite out of her head. in this case the "love" was a nervous irritant, and the toothache a counter-irritant. of course the sooner such superficial feeling is recognized and shaken off, the nearer we are to real sentiment. "but," some one will say, "how are we to know what is real and what is not? i would much rather live my life and get more or less unreality than have this everlasting analyzing." there need be no abnormal analyzing; that is as morbid as the other state. indulge to your heart's content in whatever seems to you real, in what you believe to be wholesome sentiment. but be ready to recognize it as sham at the first hint you get to that effect, and to drop it accordingly. a perfectly healthy body will shed germs of disease without ever feeling their presence. so a perfectly healthy mind will shed the germs of sentimentality. few of us are so healthy in mind but that we have to recognize a germ or two and apply a disinfectant before we can reach the freedom that will enable us to shed the germs unconsciously. a good disinfectant is, to refuse to talk of our own feelings or desires or affections, unless for some end which we know may help us to more light and better strength. talking, however, is mild in its weakening effect compared with thinking. it is better to dribble sham sentiment in words over and over than to think it, and repress the desire to talk. the only clear way is to drop it from our minds the moment it appears; to let go of it as we would loosen our fingers and drop something disagreeable from our hands. a good amount of exercise and fresh air helps one out of sentimentalizing. this morbid mental habit is often the result of a body ill in some way or another. frequently it is simply the effect of tired nerves. we help others and ourselves out of it more rapidly by not mentioning the sentimentalizing habit, but by taking some immediate means towards rest, fresh air, vigorous exercise, and better nourishment. mistakes are often made and ourselves or others kept an unnecessary length of time in mental suffering because we fail to attribute a morbid mental state to its physical cause. we blame ourselves or others for behavior that we call wicked or silly, and increase the suffering, when all that is required is a little thoughtful care of the body to cause the silly wickedness to disappear entirely. we are supposed to be indulging in sickly sentiment when we are really suffering from sickly nerves. an open sympathy will detect this mistake very soon, and save intense suffering by an early remedy. sentiment is as strengthening as sentimentality is weakening. it is as strong, as clear, and as fine in flavor as the other is sickly sweet. no one who has tasted the wholesome vigor of the one could ever care again for the weakening sweetness of the other, however much he might have to suffer in getting rid of it. true sentiment seeks us; we do not seek it. it not only seeks us, it possesses us, and runs in our blood like the new life which comes from fresh air on top of a mountain. with that true sentiment we can feel a desire to know better things and to live them. we can feel a hearty love for others; and a love that is, in its essence, the strongest of all human loves. we can give and receive a healthy sympathy which we could never have known otherwise. we can enjoy talking about ourselves and about "being good," because every word we say will be spontaneous and direct, with more thought of law than of self. this true sentiment seeks and finds us as we recognize the sham and shake it off, and as we refuse to dwell upon our actions and thoughts in the past or to look back at all except when it is a necessity to gain a better result. we are like orpheus, and true sentiment is our eurydice with her touch on our shoulder; the spirits that follow are the sham-sentiments, the temptations to look back and pose. the music of our lyre is the love and thought we bring to our every-day life. let us keep steadily on with the music, and lead our eurydice right through hades until we have her safely over the lethe, and we know sentimentality only as a name. xiv. problems. there are very few persons who have not i had the experience of giving up a problem in mathematics late in the evening, and waking in the morning with the solution clear in their minds. that has been the experience of many, too, in real-life problems. if it were more common, a great amount of nervous strain might be saved. there are big problems and little, real and imaginary; and some that are merely tired nerves. in problems, the useless nervous element often plays a large part. if the "problems" were dropped out of mind with sufferers from nervous prostration, their progress towards renewed health might be just twice as rapid. if they were met normally, many nervous men and women might be entirely saved from even a bowing acquaintance with nervous prostration. it is not a difficult matter, that of meeting a problem normally,--simply let it solve itself. in nine cases out of ten, if we leave it alone and live as if it were not, it will solve itself. it is at first a matter of continual surprise to see how surely this self-solution is the result of a wholesome ignoring both of little problems and big ones. in the tenth case, where the problem must be faced at once, to face it and decide to the best of our ability is, of course, the only thing to do. but having decided, be sure that it ceases to be a problem. if we have made a mistake, it is simply a circumstance to guide us for similar problems to come. all this is obvious; we know it, and have probably said it to ourselves dozens of times. if we are sufferers from nervous problems, we may have said it dozens upon dozens of times. the trouble is that we have said it and not acted upon it. when a problem will persist in worrying us, in pulling and dragging upon our nerves, an invitation to continue the worrying until it has worked itself out is a great help towards its solution or disappearance. i remember once hearing a bright woman say that when there was anything difficult to decide in her life she stepped aside and let the opposing elements fight it out within her. presumably she herself threw in a little help on one side or the other which really decided the battle. but the help was given from a clear standpoint, not from a brain entirely befogged in the thick of the fight. whatever form problems may take, however important they may seem, when they attack tired nerves they must be let alone. a good way is to go out into the open air and so identify one's self with nature that one is drawn away in spite of one's self. a big wind will sometimes blow a brain clear of nervous problems in a very little while if we let it have its will. another way out is to interest one's self in some game or other amusement, or to get a healthy interest in other people's affairs, and help where we can. each individual can find his own favorite escape. of course we should never shirk a problem that must be decided, but let us always wait a reasonable time for it to decide itself first. the solving that is done for us is invariably better and clearer than any we could do for ourselves. it will be curious, too, to see how many apparently serious problems, relieved of the importance given them by a strained nervous system, are recognized to be nothing at all. they fairly dissolve themselves and disappear. xv. summary. the line has not been clearly drawn, either in general or by individuals, between true civilization and the various perversions of the civilizing process. this is mainly because we do not fairly face the fact that the process of civilization is entirely according to nature, and that the perversions which purport to be a direct outcome of civilization are, in point of fact, contradictions or artificialities which are simply a going-over into barbarism, just as too far east is west. if you suggest "nature" in habits and customs to most men nowadays, they at once interpret you to mean "beastly," although they would never use the word. it is natural to a beast to be beastly: he could not be anything else; and the true order of his life as a beast is to be respected. it is natural to a man to govern himself, as he possesses the power of distinguishing and choosing, with all the senses and passions much keener, and in their possibilities many degrees finer, than the beasts, he has this governing power, which makes his whole nervous system his servant just in so far as through this servant he loyally obeys his own natural laws. a man in building a bridge could never complain when he recognized that it was his obedience to the laws of mechanics which enabled him to build the bridge, and that he never could have arbitrarily arranged laws that would make the bridge stand. in the same way, one who has come to even a slight recognition of the laws that enable him to be naturally civilized and not barbarously so, steadily gains, not only a realization of the absolute futility of resisting the laws, but a growing respect and affection for them. it is this sham civilization, this selfish refinement of barbarous propensities, this clashing of nervous systems instead of the clashing of weapons, which has been largely, if not entirely, the cause of such a variety and extent of nervous trouble throughout the so-called civilized world. it is not confined to nervous prostration; if there is a defective spot organically, an inherited tendency to weakness, the nervous irritation is almost certain to concentrate upon it instead of developing into a general nervous break-down. with regard to a cure for all this, no superficial remedy, such as resting and feeding, is going to prove of lasting benefit; any more than a healing salve will suffice to do away with a blood disease which manifests itself by sores on the surface of the skin. no physician would for a moment inveigle himself into the belief that the use of external means alone would cure a skin disease that was caused by some internal disorder. such skin irritation may be easily cured by the right remedy, whereas an external salve would only be a means of repression, and would result in much greater trouble subsequently. imagine a man superficially cured of an illness, and then exposed while yet barely convalescent to influences which produce a relapse. that is what is done in many cases when a patient is rested, and fattened like a prize pig, and then sent home into all the old conditions, with nothing to help him to elude them but a well-fed, well-rested body. that, undeniably, means a great deal for a short period; but the old conditions discover the scars of old wounds, and the process of reopening is merely a matter of time. from all sides complaints are heard of the disastrous results of civilization; while with even a slight recognition of the fact that the trouble was caused by the rudiments of barbarism, and that the higher civilization is the life which is most truly natural, remedies for our nervous disorders would be more easily found. it is the perversions of the natural process of civilization that do the harm; just as with so-called domesticated flowers there arise coarse abnormal growths, and even diseases, which the wholesome, delicate organism of a wild flower makes impossible. the trouble is that we do not know our own best powers at all; the way is stopped so effectually by this persistent nervous irritation. with all its superficiality, it is enough to impede the way to the clear, nervous strength which is certainly our inheritance. after all, what has been said in the foregoing chapters is simply illustrative of a prevalent mental skin-disorder. if the whole world were suffering from a physical cutaneous irritation, the minds of individuals would be so concentrated on their sensations that no one could know of various wonderful powers in his own body which are now taken as a matter of course. there would be self-consciousness in every physical action, because it must come through, and in spite of, external irritation. just in so far as each individual one of us found and used the right remedy for our skin-trouble should we be free to discover physical powers that were unknown to our fellow-sufferers, and free to help them to a similar remedy when they were willing to be helped. this mental skin-disorder is far more irritating and more destructive, and not only leads to, but actually is, in all its forms, a sort of self-consciousness through which we work with real difficulty. to discover its shallowness and the simplicity of its cure is a boon we can hardly realize until, by steady application, we have found the relief. the discovery and cure do not lead to a millennium any more than the cure of any skin disease guarantees permanent health. for deeper personal troubles there are other remedies. each will recognize and find his own; but freedom, through and through, can never be found, or even looked for clearly, while the irritation from the skin disease is withdrawing our attention. "but, friends, truth is within ourselves: it takes no rise from outward things; whatever you may believe, there is an inmost centre in us all where truth abides in fulness; and around, wall upon wall, the gross flesh hems it in, this perfect clear perception which is truth. a baffling and perverting carnal mesh blinds it, and makes all error; and to know rather consists in opening out a way whence the imprisoned splendor may escape, than in effecting entry for a light supposed to be without." browning's "baffling and perverting carnal mesh" might be truly interpreted as a nervous tangle which is nothing at all except as we make it with our own perverted sight. to help us to move a little distance from the phantom tangle, that it may disappear before our eyes, has been the aim of this book. so by curing our mental skin-disease as a matter of course, and then forgetting that it ever existed, we may come to real life. this no one can find for another, but each has within himself the way. the end. discourses on a sober and temperate life. by lewis cornaro, a noble venetian. wherein is demonstrated, by his own example, the method of preserving health to extreme old age. translated from the italian original. a new edition, corrected. london: printed for benjamin white, at horace's head, in fleet-street. m.dcc.lxxix. preface the author of the following discourses, lewis cornaro, was descended from one of the most illustrious families in venice, but by the ill conduct of some of his relations, had the misfortune to be deprived of the dignity of a nobleman, and excluded from all honours and public employments in the state. chagrined at this unmerited disgrace, he retired to padua, and married a lady of the family of spiltemberg, whose name was veronica. being in possession of a good estate, he was very desirous of having children; and after a long expectation of this happiness, his wife was delivered of a daughter, to whom he gave the name of clara. this was his only child, who afterwards was married to john, the son of fantini cornaro, of a rich family in cyprus, while that island belonged to the republic of venice. though he was far advanced in life when his daughter clara came into the world, yet he lived to see her very old, and the mother of eight sons and three daughters. he was a man of sound understanding, determined courage and resolution. in his younger days, he had contracted infirmities by intemperance, and by indulging his too great propensity to anger; but when he perceived the ill consequence of his irregularities, he had command enough of himself to subdue his passion and inordinate appetites. by means of great sobriety, and a strict regimen in his diet, he recovered his health and vigour, which he preserved to an extreme old age. at a very advanced stage of life he wrote the following discourses, wherein he acquaints us with the irregularity of his youth, his reformation of manners, and the hopes he entertained of living a long time. nor was he mistaken in his expectation, for he resigned his last breath without any agony, sitting in an elbow chair, being above an hundred years old. this happened at padua, the th of april, . his lady, almost as old as himself, survived him but a short time, and died an early death. they were both interred in st. anthony's church, without pomp, pursuant to their testamentary directions. these discourses, though written in cornaro's old age, were penned at different times, and published separately: the first, which he wrote at the age of eighty-three, is intitled, a treatise on a sober life, in which he declares war against every kind of intemperance; and his vigorous old age speaks in favour of his precepts. the second treatise he composed at the age of eighty-six: it contains farther encomiums on sobriety, and points out the means of mending a bad constitution. he says, that he came into the world with a choleric disposition, but that his temperate way of life had enabled him to subdue it. the third, which he wrote at the age of ninety-one, is intitled, an earnest exhortation to a sober life; here he uses the strongest arguments to persuade mankind to embrace a temperate life, as the means of attaining a healthy and vigorous old age. the fourth and last, is a letter to barbaro, patriarch of aquileia, written at the age of ninety-five; it contains a lively description of the healthy, vigour, and perfect use of all his faculties, which he had the happiness of enjoying at that advanced period of life. this useful work was translated some years ago into english, under the title of _sure and certain methods of attaining a long and healthy life_. the translator seems rather to have made use of a french version than of the italian original; he has likewise omitted several passages of the italian, and the whole is rather a paraphrase than a translation. this has induced us to give the public an exact and faithful version of that excellent performance, from the venice edition in vo, in the year [ ]: and as a proof of the merit and authenticity of the work, we beg leave to quote mr. addison's recommendation of it, spectator, vol. iii, no . "the most remarkable instance of the efficacy of temperance, towards the procuring long life, is what we meet with in a little book published by _lewis cornaro,_ the _venetian;_ which i rather mention, because it is of undoubted credit, as the late _venetian_ ambassador, who was of the same family, attested more than once in conversation, when he resided in _england_. _cornaro,_ who was the author of the little treatise i am mentioning, was of an infirm constitution, till about forty, when, by obstinately persisting in an exact course of temperance, he recovered a perfect state of health; insomuch that at fourscore he published his book, which has been translated into _english_ under the title of, _sure and certain methods of attaining a long and healthy life_. he lived to give a third or fourth edition of it, and after having passed his hundredth year, died without pain or agony, and like one who falls asleep. the treatise i mention has been taken notice of by several eminent authors, and is written with such spirit of chearfulness, religion, and good sense, as are the natural concomitants of temperance and sobriety. the mixture of the old man in it, is rather a recommendation than a discredit to it." [ ] the first edition was published by the author at padua, in to, a.d. . a treatise on a sober life it is a thing past all doubt, that custom, by time, becomes a second nature, forcing men to use that, whether good or bad, to which they have been habituated: nay, we see habit, in many things, get the better of reason. this is so undeniably true, that virtuous men, by conversing with the wicked, very often fall into the same vicious course of life. the contrary, likewise, we see sometimes happen; viz. that, as good morals easily change to bad, so bad morals change again to good. for instance: let a wicked man, who was once virtuous, keep company with a virtuous man, and he will again become virtuous; and this alteration can be attributed to nothing but the force of habit, which is, indeed, very great. seeing many examples of this; and besides, considering that, in consequence of this great force of habit, three bad customs have got footing in italy within a few years, even within my own memory; the first flattery and ceremoniousness: the second lutheranism [ ], which some have most preposterously embraced; the third intemperance; and that these three vices, like so many cruel monsters, leagued, as indeed they are, against mankind, have gradually prevailed so far, as to rob civil life of its sincerity, the soul of its piety, and the body of its health; i have resolved to treat of the last of these vices, and prove that it is an abuse, in order to extirpate it, if possible. as to the second, lutheranism, and the first, flattery, i am certain, that some great genius or another will soon undertake the task of exposing their deformity, and effectually suppressing them. therefore, i firmly hope, that, before i die, i shall see these three abuses conquered and driven out of italy; and this country of course restored to its former laudable and virtuous customs. [ ] the author writes with the prejudice of a zealous roman catholic against the doctrine of the reformation, which he here distinguishes by the name of lutheranism. this was owing to the artifices of the romish clergy in those days, by whom the reformed religion was misinterpreted, as introductive of licentiousness and debauchery. to come then to that abuse, of which i am proposed to speak, namely, intemperance; i say, that it is a great pity it should have prevailed so much, as entirely to banish sobriety. though all are agreed, that intemperance is the offspring of gluttony, and sober living of abstemiousness; the former, nevertheless, is considered a virtue and a mark of distinction, and the latter, as dishonourable and the badge of avarice. such mistaken notions are entirely owing to the power of custom, established by our senses and irregular appetites; these have blinded and besotted men to such a degree, that, leaving the paths of virtue, they have followed those of vice, which lead them before their time to an old age, burthened with strange and mortal infirmities, so as to render them quite decrepid before forty, contrary to the effects of sobriety, which, before it was banished by this destructive intemperance, used to keep men sound and hearty to the age of eighty and upwards. o wretched and unhappy italy! do you not see, that intemperance murders every year more of your subjects, than you could lose by the most cruel plague, or by fire and sword in many battles? those truly shameful feasts, no so much in fashion, and so intolerably profuse, that no tables are large enough to hold the dishes, which renders it necessary to heap them one upon another; those feasts, i say, are so many battles; and how is it possible to support nature by such a variety of contrary and unwholesome foods? put a stop to this abuse, for god's sake, for there is not, i am certain of it, a vice more abominable than this in the eyes of the divine majesty. drive away this new kind of death, and you have banished the plague, which, though it formerly used to make such havock, now does little or no mischief, owing to the laudable practice of attending more to the goodness of the provisions brought to our markets. there are means still left to banish intemperance, and such means too, that every man may have recourse to them without any assistance. nothing more is requisite for this purpose, than to live up to the simplicity dictated by nature, which teaches us to be content with little, to pursue the medium of holy abstemiousness and divine reason, and to accustom ourselves to eat no more than is absolutely necessary to support life; considering, that what exceeds this, is disease and death, and merely gives the palate satisfaction, which, though but momentary, brings on the body a long and lasting train of disagreeable sensations and diseases, and at length destroys it along with the soul. how many friends of mine, men of the finest understanding and most amiable disposition, have i seen carried off by this plague in the flower of their youth? who, where they now living, would be an ornament to the public, whose company i should enjoy with as much pleasure, as i now feel concern at their loss. in order, therefore, to put a stop to so great an evil, i have resolved by this short discourse to demonstrate, that intemperance is an abuse which may be easily removed, and that the good old sober living may be substituted in its stead; and this i undertake more readily, as many young men of the best understanding, knowing that it is a vice, have requested it of me, moved thereto by seeing their fathers drop off in the flower of their youth, and me so sound and hearty at the age of eighty-one. they expressed a desire to reach the same term, nature not forbidding us to wish for longevity; and old-age being, in fact, that time of life in which prudence can be best exercised, and the fruits of all the other virtues enjoyed with less opposition, the passions being then so subdued, that man gives himself up entirely to reason. they beseeched me to let them know the method pursued by me to attain it; and then finding them intent on so laudable a pursuit, i have resolved to treat of that method, in order to be of service not only to them, but to all those who may be willing to peruse this discourse. i shall, therefore, give my reasons for renouncing intemperance, and betaking myself to a sober course of life; declare freely the method pursued by me for that purpose; and then set forth the effects of so good an habit upon me; whence it may be clearly gathered, how easy it is to remove the abuse of intemperance. i shall conclude, by shewing how many conveniencies and blessings are the consequences of a sober life. i say then, that the heavy train of infirmities, which had not only invaded, but even made great inroads in my constitution, were my motives for renouncing intemperance, to which i had been greatly addicted; so that, in consequence of it, and the badness of my constitution, my stomach being exceedingly cold and moist, i was fallen into different kinds of disorders, such as pains in my stomach, and often stitches, and spices of the gout; attended by, what was still worse, an almost continual slow fever, a stomach generally out of order, and a perpetual thirst. from these natural and acquired disorders the best delivery i had to hope for, was death, to put an end to the pains and miseries of life; a period very remote in the regular course of nature, though i had hastened it by my irregular manner of living. finding myself, therefore, in such unhappy circumstances between my thirty-fifth and fortieth year, every thing that could be thought of having been tried to no purpose to relieve me, the physicians gave me to understand, that there was but one method left to get the better of my complaints, provided i would resolve to use it, and patiently persevere in it. this was a sober and regular life, which the assured me would be still of the greatest service to me, and would be as powerful in its effects, as the intemperance and irregular one had been, in reducing me to the present low condition: and that i might be fully satisfied of its salutary effects, for though by my irregularities i was become infirm, i was not reduced so low, but that a temperate life, the opposite in every respect to an intemperate one, might still entirely recover me. and besides, it in fact appears, such a regular life, whilst observed, preserves men of a bad constitution, and far gone in years, just as a contrary course has the power to destroy those of the best constitution, and in their prime; for this plain reason, that different modes of life are attended by different effects; art following, even herein, the steps of nature, with equal power to correct natural vices and imperfections. this is obvious in husbandry and the like. they added, that if i did not immediately have recourse to such a regimen, i could receive no benefit from it in a few months, and that in a few more i must resign myself to death. these solid and convincing arguments made such an impression on me, that, mortified as i was besides, by the thoughts of dying in the prime of life, and at the same time perpetually tormented by various diseases, i immediately concluded, that the foregoing contrary effects could not be produced but by contrary modes of living; and, therefore, full of hopes, resolved, in order to avoid at once both death and disease, to betake myself to a regular course of life. having, upon this, enquired of them what rules i should follow, they told me, that i must not use any food, solid or liquid, but such as, being generally prescribed to sick persons, is, for that reason, called diet, and both very sparingly. these directions, to say the truth, they had before given me; but it was at a time of life when, impatient of such restraint, and finding myself satiated, as it were, with such food, i could not put up with it, and therefore eat freely of every thing i liked best; and likewise, feeling myself in a manner parched up by the heat of my disease, made no scruple of drinking, and in large quantities, the wines that best pleased my palate. this indeed, like all other patients, i kept a secret from my physicians. but, when i had once resolved to live sparingly, and according to the dictates of reason, seeing that is was no difficult matter, nay, that it was my duty as a man so to do, i entered with so much resolution upon this new course of life, that nothing has been since able to divert me from it. the consequence was, that in a few days i began to perceive, that such a course agreed with me very well; and by pursuing it, in less than a year, i found myself (some persons, perhaps, will not believe it) entirely freed from all my complaints. having thus recovered my health, i began seriously to consider the power of temperance, and say to myself, that if this virtue had efficacy enough to subdue such grievous disorders as mine, it must have still greater to preserve me in health, to help my bad constitution, and comfort my very weak stomach. i therefore applied myself diligently to discover what kinds of food suited me best. but, first, i resolved to try, whether those, which pleased my palate, agreed or disagreed with my stomach, in order to judge for myself of the truth of that proverb, which i once held true, and is universally held as such in the highest degree, insomuch that epicures, who give a loose to their appetites, lay it down as a fundamental maxim. this proverb is, that whatever pleases the palate, must agree with the stomach, and nourish the body; or whatever is palatable must be equally wholesome and nourishing. the issue was, that i found it to be false: for, though rough and very cold wines, as likewise melons and other fruits, sallad, fish and pork, tarts, garden-stuff, pastry, and the like, were very pleasing to my palate, the disagreed with me notwithstanding. having convinced myself, that the proverb in question was false, i look'd upon it as such; and, taught by experience, i gave over the use of such meats and wines, and likewise of ice; chose wine suited to my stomach, drinking of it but the quantity i knew i could digest. i did the same by my meat, as well in regard to quantity as to quality, accustoming myself never to cloy my stomach with eating or drinking; but constantly rise from table with a disposition to eat and drink still more. in this i conformed to the proverb, which says, that a man, to consult his health, must check his appetite. having in this manner, and for these reasons, conquered intemperance and irregularity, i betook myself intirely to a temperate and regular life: which effected in me the alteration already mentioned, that is, in less than a year it rid me of all those disorders, which had taken so deep a root in me; nay, as i have already observed, had made such a progress, as to be in a manner incurable. it had likewise this other good effect, that i no longer experienced those annual fits of sickness, with which i used to be afflicted, while i followed a different, that is a sensual, course of life; for then i used to be attacked every year with a strange kind of fever, which sometimes brought me to death's door. from this disease, then, i also freed myself, and became exceeding healthy, as i have continued from that time forward to this very day; and for no other reason than that i never trespassed against regularity, which by its infinite efficacy has been the cause, that the meat i constantly eat, and the wine i constantly drink, being such as agreed with my constitution, and taken in proper quantities, imparted all their virtue to my body, and then left it without difficulty, and without engendering in it any bad humours. in consequence therfore of my taking such methods, i have always enjoyed, and (god be praised) actually enjoy, the best of healths. it is true, indeed, that, besides the two forgoing most important rules relative to eating and drinking, which i have ever been very scrupulous to observe; that is, not to take of any thing, but as much as my stomach can easily digest, and to use those things only, which agree with me; i have carefully avoided heat, cold, and extraordinary fatigue, interruption of my usual hours of rest, excessive venery, making any stay in bad air, and exposing myself to the wind and sun; for these, too, are great disorders. but then, fortunately, there is no great difficulty in avoiding them, the love of life and health having more sway over men of understanding, than any satisfaction they could find in doing what must be extremely hurtful to their constitution. i have likewise done all that lay in my power to avoid those evils, which we do not find so easy to remove; these are melancholy, hatred, and other violent passions, which appear to have the greatest influence over our bodies. however, i have not been able to guard so well against either one or the other kind of these disorders, as not to suffer myself now and then to be hurried away by many, not to say, all of them; but i have reaped the benefit of knowing by experience that these passions have, in the main, no great influence over bodies governed by the two foregoing rules of eating and drinking, and therefore can do them but very little harm; so that it may with great truth be affirmed, that whoever observes these two capital rules, is liable to very little inconveniency from any other excesses. this, galen, who was an eminent physician, observed before me. he affirms, that so long as he followed these rules relative to eating and drinking, he suffered but little from other disorders, so little, that they never gave him above a day's uneasiness. that what he says is true, i am a living witness, and so are many others, who know me, and have seen, how often i have been exposed to heats and colds, and such other disagreeable changes of weather; and have, likewise, seen me (owing to various misfortunes, which have more than once befallen me) greatly disturbed my mind. for they can not only say of me, that such disturbance of mind has done me very little harm, but they can aver of many others, who did not lead a sober and regular life, that it proved very prejudicial to them, amongst whom was a brother of my own, and others of my family, who trusting to the goodness of their constitution, did not follow my way of living. the consequence hereof was a great misfortune to them, the perturbations of the mind having thereby acquired an extraordinary influence over their bodies. such, in a word, was their grief and dejection at seeing me involved in expensive law-suits, commenced against my by great and powerful men, that, fearing i should be cast, they were seized with that melancholy humour, with which intemperate bodies always abound; and these humours had such an influence over them, and increased to such a degree, as to carry them off before their time; whereas i suffered nothing on the occasion, as i had in me no superfluous humours of that kind. nay, in order to keep up my spirits, i brought myself to think, that god had raised up these suits against me, in order to make me more sensible of my strength of body and mind; and that i should get the better of them with honour and advantage, as it, in fact, came to pass: for, at last, i obtained a decree exceeding favourable to my fortune and my character, which, though it gave me the highest pleasure, had not the power to do me any harm in other respects. thus it is plain, that neither melancholy nor any other affection of the mind can hurt bodies governed with temperance and regularity. but i must go a step further, and say, that even misfortunes themselves can do but very little mischief, or cause but very little pain, to such bodies; and that this is true, i have myself experienced at the age of seventy. i happened, as is often the case, to be in a coach, which going at a pretty smart rate, was overset, and in that condition drawn a considerable way by the horses, before means could be found to stop them; whence i received so many shocks and bruises, that i was taken out with my head and all the rest of my body terribly battered, and a dislocated leg and arm. when i was brought home, the family immediately sent for the physicians, who, on their arrival, seeing me in so bad a plight, concluded, that within three days i should die; nevertheless, they would try what good two things would do me; one was to bleed me, the other to purge me; and thereby prevent my humours altering, as they every moment expected, to such a degree, as to ferment greatly, and bring on a high fever. but i, on the contrary, who knew, that the sober life i had led for many years past, had so well united, harmonized, and disposed my humours, as not to leave it in their power to ferment to such a degree, refused to be either bled, or purged. i just caused my leg and arm to be set, an suffered myself to be rubbed with some oils, which they said were proper on the occasion. thus, without using any other kind of remedy, i recovered, as i thought i should, without feeling the least alteration in myself, or any other bad effects from the accident; a thing, which appeared miraculous even in the eyes of the physicians. hence we are to infer, that whoever leads a sober and regular life, and commits no excess in his diet, can suffer but very little from disorders of any other kind, or external accidents. on the contrary, i conclude, especially from the late trial i have had, that excesses in eating and drinking are fatal. of this i convinced myself four years ago, when by the advice of my physicians, the instigation of my friends, and the importunity of my own family, i consented to such an excess, which, as it will appear hereafter, was attended with far worse consequences, than could naturally be expected. this excess consisted in increasing the quantity of food i generally made use of; which increase alone brought me to a most cruel fit of sickness. and as it is a case so much in point to the subject in hand, and the knowledge of it may be useful to some of my readers, i shall take the trouble to relate it. i say, then, that my dearest friends and relations, actuated by the warm and laudable affection and regard they have for me, seeing how little i eat, represented to me, in conjunction with my physicians, that the sustenance i took could not be sufficient to support one so far advanced in years, when it was become necessary not only to preserve nature, but to increase its vigour. that, as this could not be done without food, it was absolutely incumbent upon me to eat a little more plentifully. i, on the other hand, produced my reasons for not complying with their desires. these were, that nature is content with little, and that with this little i had preserved myself so many years; and that, to me, the habit of it was become a second nature; and that it was more agreeable to reason, that, as i advanced in years and lost my strength, i should rather lessen than increase the quantity of my food: farther, that it was but natural to think, that the powers of the stomach grew weaker from day to day; on which account i could see no reason to make such an addition. to corroborate my arguments, i alleged that those two natural and very true proverbs; one, that he, who has a mind to eat a great deal, must eat but little; which is said for no other reason than this, that eating little makes a man live very long, and living very long he must eat a great deal. the other proverb was, that what we leave after making a hearty meal, does us more good than what we have eat. but neither these proverbs, nor any other arguments i could think of, were able to prevent their teazing me more than ever. wherefore, not to appear obstinate, or affect to know more than the physicians themselves; but, above all, to please my family, who very earnestly desired it, from a persuasion that such an addition to my usual allowance would preserve my strength, i consented to increase the quantity of food, but with two ounces only. so that, as before, what with bread, meat, the yolk of an egg, and soup, i eat as much, as weighed in all twelve ounces, neither more nor less, i now increased it to fourteen; and as before i drank but fourteen ounces of wine, i now increased it to sixteen. this increase and irregularity, had, in eight days time, such an effect upon me, that, from being chearful and brisk, i began to be peevish and melancholy, so that nothing could please me; and was constantly so strangely disposed, that i neither knew what to say to others, nor what to do with myself. on the twelfth day, i was attacked with a most violent pain in my side, which held me twenty-two hours, and was succeeded by a terrible fever, which continued thirty-five days and as many nights, without giving me a moment's respite; though, to say the truth, it began to abate gradually on the fifteenth. but notwithstanding such abatement, i could not, during the whole time, sleep half a quarter of an hour together, insomuch that every one looked upon me as a dead man. but, god be praised, i recovered merely by my former regular course of life, though then in my seventy-eighth year, and in the coldest season of a very cold year, and reduced to a mere skeleton; and i am positive that it was the great regularity i had observed for so many years, and that only, which rescued me from the jaws of death. in all that time i never knew what sickness was, unless i may call by that same name some slight indispositions of a day or two's continuance; the regular life i had led, as i have already taken notice, for so many years, not having permitted any superfluous or bad humours to breed in me; or if they did, to acquire such strength and malignity, a they generally acquire in the superannuated bodies of those, who live without rule. and as there was not any old malignity in my humours (which is the thing that kills people) but only that, which my new irregularity had occasioned, this fit of sickness, though exceeding violent, had not the strength to destroy me. this it was, and nothing else, that saved my life; whence may be gathered, how great is the power and efficacy of regularity; and how great, likewise, is that of irregularity, which in a few days could bring on me so terrible a fit of sickness, just as regularity had preserved me in health for so many years. and it appears to me a no weak argument, that, since the world, consisting of the four elements, is upheld by order; and our life, as to the body, is no other than a harmonious combination of the same four elements, so it should be preserved and maintained by the very same order; and, on the other hand, it must be worn out by sickness, or destroyed by death, which are produced by the contrary effects. by order the arts are more easily learned; by order armies are rendered victorious; by order, in a word, families, cities, and even states are maintained. hence i concluded, that orderly living is no other than a most certain cause and foundation of health and long life; nay i cannot help saying, that it is the only and true medicine; and whoever weighs the matter well, must also conclude, that this is really the case. hence it is, that when a physician comes to visit a patient, the first thing he prescribes, is to live regularly. in like manner, when a physician takes leave of a patient, on his being recovered, he advises him, as he tenders his health, to lead a regular life. and it is not to be doubted, that, were a patient so recovered to live in that manner, he could never be sick again, as it removes every cause of illness; and so, for the future, would never want either physician or physic. nay, by attending duly to what i have said, he would become his own physician, and, indeed, the best he could have; since, in fact, no many can be a perfect physician to any one but himself. the reason of which is, that any man may, by repeated trials, acquire a perfect knowledge of his own constitution, and the most hidden qualities of his body; and what wine and food agree with his stomach. now, it is so far from being an easy matter to know these things perfectly of another, that we cannot without much trouble discover them in ourselves, since a great deal of time and repeated trials are requisite for the purpose. these trials are, indeed, (if i may say it) more than necessary, as there is a greater variety in the natures and constitutions of different men, than in their persons. who could believe, that old wine, wine that had passed its first year, should disagree with my stomach, and new wine agree with it? and that pepper, which is looked upon as a warm spice, should not have a warm effect upon me, insomuch that i find myself more warmed and comforted by cinnamon? where is the physician, that could have informed me of these two latent qualities, since i myself, even by a long course of observation, could scarce discover them? from all these reasons it follows, that it is impossible to be a perfect physician to another. since, therefore, a man cannot have a better physician than himself, nor any physic better than a regular life, a regular life he ought to embrace. i do not, however, mean, that, for the knowledge and cure of such disorders, as often befall those who do not live regularly, there is no occasion for a physician, and that his assistance ought to be slighted. for, if we are apt to receive such great comfort from friends, who come to visit us in our illness, though they do no more than testify their concern for us, and bid us be of good cheer; how much more regard ought we to have for the physician, who is a friend that comes to see us in order to relieve us, and promises us a cure? but for the bare purpose of keeping ourselves in good health, i am of the opinion, that we should consider as a physician this regular life, which, as we have seen, is our natural and proper physic, since it preserves men, even those of a bad constitution, in health; makes them live sound and hearty to the age of one hundred and upwards; and prevents their dying of sickness, or through a corruption of their humours, but merely by a dissolution of their radical moisture, when quite exhausted; all which effects several wise men have attributed to potable gold, and the elixir, sought for by many, but discovered by few. however to confess the truth, men, for the most part, are very sensual and intemperate, and love to satisfy their appetites, and to commit every excess; therefore, seeing that they cannot avoid being greatly injured by such excess, as often as they are guilty of it, they, by way of apologizing for their conduct, say, that it is better to live ten years less, and enjoy themselves; not considering, of what importance are ten years more of life, especially a healthy life, and at a maturer age; when men become sensible of their progress in knowledge and virtue, which cannot attain to any degree of perfection before this period of life. not to speak, at present, of many other advantages, i shall barely mention that in regard to letters and the sciences; far the greatest number of the best and most celebrated books extant, were written during that period of life, and those ten years, which some make it their business to undervalue, in order to give a loose to their appetites. be that as it will, i would not act like them. i rather coveted to live these ten years, and, had i not done so, i should never have finished those tracts, which i have composed in consequence of my having been sound and hearty these ten years past; and which i have the pleasure to think will be of service to others. these sensualists add, that a regular life is such as no man can lead. to this i answer, galen, who was so great a physician, led such a life, and chose it as the best physic. the same did plato, cicero, isocrates, and many other great men of former times; whom, not to tire the reader, i shall forbear naming: and, in our own days, pope paul farnese led it, and cardinal bembo; and it was for that reason they lived so long; likewise our two doges, lando and donato; besides many others of meaner condition, and those who live not only in cities, but also in different parts of the country, who all found great benefit by conforming to this regularity. therefore, since many have led this life, and many actually lead it, it is not such a life but that every one may conform to it; and the more so, as no great difficulty attends it; nothing, indeed, being requisite but to begin in good earnest, as the above-mentioned cicero affirms, and all those who now live in this manner. plato, you will say, though he himself lived very regularly, affirms, notwithstanding, that, in republics, men cannot do so, being often obligated to expose themselves to heat, cold, and several other kinds of hardship, and other things, which are all so many disorders, and incompatable with a regular life. i answer, as i have already observed, that these are not disorders attended with any bad consequence, or which affect either health or life, when the man, who undergoes them, observes the rules of sobriety, and commits no excess in the two points concerning diet, which a republican may very well avoid, nay it is requisite he should avoid; because, by so doing, he may be sure either to escape those disorders, which, otherwise, it would be no easy matter for him to escape while exposed to these hardships; or, in case he could not escape them, he may more easily and speedily prevent their bad effects. here it may be objected, and some actually object, that he, who leads a regular life, having constantly, when well, made use of food fit for the sick, and in small quantities, has no resource left in case of illness. to this i might, in the first place, answer, that nature, desirous to preserve man in good health as long as possible, informs him, herself, how he is to act in time of illness; for she immediately deprives him, when sick, of his appetite, in order that he may eat but little; because nature (as i have said already) is satisfied with little; wherefore, it is requisite, that a man, when sick, whether he has been a regular or irregular liver, should use no meats, but such as are suited to his disorder; and of these even in a much smaller quantity than he was wont to do, when in health. for were he to eat as much as he used to do, he would die by it; because it would be only adding to the burden, with which nature was already oppressed, by giving her a greater quantity of food, than she can in such circumstances support; and this, i imagine, would be a sufficient caution to any sick person. but, independent of all this, i might answer some others, and still better, that whoever leads a regular life, cannot be sick; or, at least, but seldom, and for a short time; because, by living regularly, he extirpates every seed of sickness; and thus, by removing the cause, prevents the effect; so that he, who pursues a regular course of life, need not be apprehensive of illness, as he need not be afraid of the effect, who has guarded against the cause. since it therefore appears that a regular life is so profitable and virtuous, so lovely and so holy, it ought to be universally followed and embraced; and more so, as it does not clash with the means or duties of any station, but is easy to all; because, to lead it, a man need not tie himself down to eat so little as i do, or not to eat fruit, fish, and other things of that kind, from which i abstain, who eat little, because it is sufficient for my puny and weak stomach; and fruit, fish, and other things of that kind, disagree with me, which is my reason for not touching them. those, however, with whom such things agree, may, and ought to eat of them; since they are not by any means forbid the use use of such sustinance. but, then, both they, and all others, are forbid to eat a greater quantity of any kind of food, even of that which agrees with them, than what their stomachs can easily digest; the same is to be understood of drink. hence it is that those, with whom nothing disagrees, are not bound to observe any rule but that relating to the quantity, and not to the quality, of their food; a rule which they may, without the least difficulty in the world, comply with. let nobody tell me, that there are numbers, who, though they live most irregularly, live in health and spirits, to those remote periods of life, attained by the most sober; for, this argument being grounded on a case full of uncertainty and hazard, and which, besides, so seldom occurs, as to look more like a miracle than the work of nature, men should not suffer themselves to be thereby persuaded to live irregularly, nature having been too liberal to those, who did so without suffering by it; a favour, which very few have any right to expect. whoever, trusting to his youth, or the strength of his constitution, or the goodness of his stomach, slights these observations, must expect to suffer greatly by so doing, and live in constant danger of disease and death. i therefore affirm, that an old man, even of a bad constitution, who leads a regular and sober life, is surer of a long one, than a young man of the best constitution, who leads a disorderly life. it is not to be doubted, however, that a man blessed with a good constitution may, by living temperately, expect to live longer than one, whose constitution is not so good; and that god and nature can dispose matters so, that a man shall bring into the world with him so sound a constitution, as to live long and healthy, without observing such strick rules; and then die in a very advanced age through a mere dissolution of his elementary parts; as was the case, in venice, of the procurator thomas contarini; and in padua, of the cavalier antonio capo di vacca. but it is not one man in a hundred thousand, that so much can be said of. if others have a mind to live long and healthy, and die without sickness of body or mind, but by mere dissolution, they must submit to live regularly, since the cannot otherwise expect to enjoy the fruits of such a life, which are almost infinite in number, and each of them, in particular, of infinite value. for, as such regularity keeps the humours of the body cleansed and purified; it suffers no vapors to ascend from the stomach to the head; hence the brain of him, who lives in that manner, enjoys such a constant serenity, that he is always perfectly master of himself. he, therefore, easily soars above the low and groveling concerns of this life, to the exalted and beautiful contemplation of heavenly things, to his exceeding great comfort and satisfaction; because he, by this means, comes to consider, know, and understand that, which otherwise he would never have considered, known, or understood; that is, how great is the power, wisdom, and goodness of the deity. he then descends into nature, and acknowledges her for the daughter of god; and sees, and even feels with his hands, that, which in any other age, or with a perception less clear, he could never have seen or felt. he then truly discerns the brutality of that vice into which they fall, who know not how to subdue their passions, and those three importunate lusts, which, one would imagine, came all together into the world with us, in order to keep us in perpetual anxiety and disturbance. these are, the lust of the flesh, the lust of honours, and the lust of riches; which are apt to increase with years in such old persons as do not lead a regular life; because, in their passage through the stage of manhood, they did not, as they ought, renounce sensuality and their passions; and take up with sobriety and reason; virtues which men of a regular life, did not neglect when they passed through the above-mentioned stage. for, knowing such passions are such lusts to be inconsistent with reason, by which they are entirely governed; they, at once, broke loose from all temptations to vice; and, instead of being slaves to their inordinate appetites, they applied themselves to virtue and good works; and by these means, they altered their conduct, and became men of good and sober lives. when, therefore, in process of time, they see themselves brought by a long series of years to their dissolution, conscious that, through the singular mercy of god, they had so sincerely relinquished the paths of vice, as never afterwards to enter them; and moreover hoping, through the merits of our saviour jesus christ, to die in his favour, they do not suffer themselves to be cast down at the thoughts of death, knowing that they must die. this is particularly the case, when, loaded with honour, and sated with life, they see themselves arrived at that age, which not one in many thousands of those, who live otherwise, ever attains. they have still the greater reason not to be dejected at the thoughts of death, as it does not attack them violently and by surprize, with a bitter and painful turn of their humours, with feverish sensations, and sharp pains, but steals upon them insensibly and with the greatest ease and gentleness; such an end, proceeding intirely from an exhaustion of the radical moisture, which decays by degrees like the oil of a lamp; so that they pass gently, without any sickness, from this terrestrial and mortal to a celestial and eternal life. o holy and truly happy regularity! how holy and happy should men, in fact, deem thee, since the opposite habit is the cause of such guilt and misery, as evidently appears to those who consider the opposite effects of both! so that men should know thee by thy voice alone, and thy lovely name; for what a glorious name, what a noble thing, is an orderly and sober life! as, on the contrary, the bare mention of disorder and intemperance is offensive to our ears. nay, there is the same difference between the mentioning these two things, as between the uttering of the words angel and devil. thus i have assigned my reasons for abandoning intemperance, and betaking myself intirely to a sober life; with the method i pursued in doing so, and what was the consequence of it; and, finally, the advantages an blessings, which a sober life confers upon those who embrace it. some sensual, inconsiderate persons affirm, that a long life is no blessing; and that the state of a man, who has passed his seventy-fifth year, cannot really be called life, but death: but this is a great mistake, as i shall fully prove; and it is my sincere wish, that all men would endeavour to attain my old age, in order that they too may enjoy that period of life, which of all others is the most desirable. i will therefore give an account of my recreations, and the relish which i find at this stage of life, in order to convince the public (which may likewise be done by all those who know me) that the state i have now attained to is by no means death, but real life; such a life, as by many is deemed happy, since it abounds with all the felicity that can be enjoyed in this world. and this testimony they will give, in the first place, because they see, and not without the greatest amazement, the good state of health and spirits i enjoy; how i mount my horse without any assistance, or advantage of situation; and how i not only ascend a single flight of stairs, but climb up an hill from bottom to top, afoot, and with the greatest of ease and unconcern; then how gay, pleasant, and good-humoured i am; how free from every perturbation of mind, and every disagreeable thought; in lieu of which, joy and peace have so firmly fixed their residence in my bosom, as never to depart from it. moreover, they know in what manner i pass my time, so as not to find life a burden; seeing i can contrive to spend every hour of it with the greatest delight and pleasure, having frequent opportunities of conversing with many honourable gentlemen, men valuable for their good sense and manners, their acquaintance with letters, and every other good quality. then, when i cannot enjoy their conversation, i betake myself to the reading of some good book. when i have read as much as i like, i write; endeavouring, in this as in everything else, to be of service to others, to the utmost of my power. and all these things i do with the greatest ease to myself, at their proper seasons, and in my own house; which, besides being situated in the most beautiful quarter of this noble and learned city of padua, is, in itself, really convenient and handsome, such, in a word, as it is no longer the fashion to build; for, in one part of it, i can shelter myself from extreme heat; and, in the other, from extreme cold, having contrived the apartments according to the rules of architecture, which teach us what is to be observed in practice. besides this house, i have my several gardens, supplied with running waters; and in which i always find something to do, that amuses me. i have another way of diverting myself, which is going every april and may; and, likewise, every september and october, for some days, to enjoy an eminence belonging to me in the euganean mountains, and in the most beautiful part of them, adorned with fountains and gardens; and, above all, a convenient and handsome lodge; in which place i likewise now and then make one in some hunting party suitable to my taste and age. then i enjoy for as many days my villa in the plain, which is laid out in regular streets, all terminating in a large square, in the middle of which stands a church, suited to the condition of the place. this villa is divided by a wide and rapid branch of the river brenta, on both sides of which there is a considerable extent of country, consisting intirely of fertile and well-cultivated fields. besides, this district is now, god be praised, exceedingly well inhabited, which it was not at first, but rather the reverse; for it was marshy; and the air so unwholesome, as to make it a residence fitter for snakes than men. but, on my draining off the waters, the air mended, and people resorted to it so fast, and increased to such a degree, that it soon acquired the perfection in which it now appears: hence, i may say with truth, that i have offered this place, an alter and a temple to god, with souls to adore him: these are things which afford me infinite pleasure, comfort, and satisfaction, as often as i go to see and enjoy them. at the same seasons every year, i revisit some of the neighbouring cities, and enjoy such of my friends as live there, taking the greatest pleasure in their company and conversation; and by their means i also enjoy the conversation of other men of parts, who live in the same places; such as architects, painters, sculptors, musicians, and husbandmen, with whom this age certainly abounds. i visit their new works; i revisit their former ones; and i always learn something, which gives me satisfaction. i see palaces, gardens, antiquities; and with these, the squares and other public places, the churches, the fortifications, leaving nothing unobserved, from whence i may reap either entertainment or instruction. but what delights me most, is, in my journies backwards and forwards, to contemplate the situation and other beauties of the places i pass through; some in the plain, others on hills, adjoining to rivers or fountains; with a great many fine houses and gardens. nor are my recreations rendered less agreeable and entertaining by my not feeling well, or not hearing readily every thing that is said to me; or by any other of my faculties not being perfect; for they are all, thank god, in the highest perfection; particularly my palate, which now relishes better the simple fare i eat, wherever i happen to be, than it formerly did with the most delicate dishes, when i led an irregular life. nor does the change of beds give me any uneasiness, so that i sleep every where soundly and quietly, without experiencing the least disturbance; and all my dreams are pleasant and delightful. it is likewise with the greatest pleasure and satisfaction i behold the success of an undertaking so important to this state, i mean that of draining and improving so many uncultivated pieces of ground, an undertaking begun within my memory; and which i never thought i should live to see compleated; knowing how slow republics are apt to proceed in enterprises of great importance. nevertheless, i have lived to see it; and was even in person, in the marshy places, along with those appointed to superintend the draining of them, for two months together, during the greatest heats of summer, without ever finding myself the worse for the fatigues of inconveniences i suffered; of so much efficacy is that orderly life, which i every where constantly lead. what is more, i am in the greatest hopes, or rather sure, to see the beginning and completion of another undertaking of no less importance, which is that of preserving our estuary or port, that last and wonderful bulwark of my dear country, the preservation of which (it is not to flatter my vanity to say it, but merely to do justice to the truth) has been more than once recommended by me to this republic, by word of mouth, and in writings which cost me many nights study. and to this dear country of mine, as i am bound by the laws of nature to do every thing, from which it may reap any benefit, so i most ardently wish perpetual duration, and a long succession of every kind of prosperity. such are my genuine and no trifling satisfactions; such are the recreations and diversions of my old age, which is so much the more to be valued than the old age, or even youth, of other men, because being freed, by god's grace, from the perturbations of the mind, and the infirmities of the body, it no longer experiences any of those contrary emotions, which torment a number of young men, and many old ones destitute of strength and health, and every other blessing. and if it be lawful to compare little matters, and such as are esteemed trifling, to affairs of importance, i will further venture to say, that such are the effects of this sober life, that at my present age of eighty-three, i have been able to write a very entertaining comedy, abounding with innocent mirth and pleasant jests. this species of composition is generally the child and offspring of youth, as tragedy is that of old age; the former being by its facetious and sprightly turn suited to the bloom of life, and the latter by its gravity adapted to riper years. now, if that good old man [sophocles], a grecian by birth, and a poet, was so much extolled for having written a tragedy at the age of seventy-three, and, on that account alone, reputed of sound memory and understanding, though tragedy be a grave and melancholy poem; why should i be deemed less happy, and to have a smaller share of memory and understanding, who have, at an age, ten years more advanced than his, written a comedy, which, as every one knows, is a merry and pleasant kind of composition? and, indeed, if i may be allowed to be an impartial judge in my own cause, i cannot help thinking, that i am now of sounder memory and understanding, and heartier, than hew was when ten years younger. and, that no comfort might be wanting to the fulness of my years, whereby my great age may be rendered less irksome, or rather the number of my enjoyments increased, i have the additional comfort of seeing a kind of immortality in a succession of descendants. for, as often as i return home, i find there, before me, not one or two, but eleven grandchildren, the oldest of them eighteen, and the youngest two; all the offspring of one father and one mother; all blessed with the best health; and, by what as yet appears, fond of learning, and of good parts and morals. some of the youngest i always play with; and, indeed, children from three to five are only fit for play. those above that age i make companions of; and, as nature has bestowed very fine voices upon them, i amuse myself, besides, with seeing and hearing them sing, and play on various instruments. nay, i sing myself, as i have a better voice now, and a clearer and louder pipe, than at any other period of life. such are the recreations of my old age. whence it appears, that the life i lead is chearful, and not gloomy, as some persons pretend, who know no better; to whom, in order that it may appear what value i set on every other kind of life, i must declare, that i would not exchange my manner of living or my grey hairs with any of those young men, even of the best constitution, who give way to their appetites; knowing, as i do, that such are daily, nay hourly, subject, as i have observed, to a thousand kind of ailments and deaths. this is, in fact, so obvious, as to require no proof. nay, i remember perfectly well, how i used to behave at that time of life. i know how inconsiderately that age is apt to act, and how foolhardy young men, hurried on by the heat of their blood, are wont to be; how apt they are to presume too much on their own strength in all their actions; and how sanguine they are in their expectations; as well on account of the little experience they have had for the the time past, as by reason of the power they enjoy in their own imaginations over the time to come. hence they expose themselves rashly to every kind of danger; and, banishing reason, and bowing their necks to the yoke of concupiscence, endeavour to gratify all their appetites, not minding, fools as they are, that they thereby hasten, as i have several times observed, the approach of what they would most willingly avoid, i mean sickness, and death. of these two evils, one is troublesome and painful, the other, above all things, dreadful and insupportable; insupportable to every man, who has given himself up to his sensual appetites, and to young men in particular, to whom it appears a hardship to die an early death; dreadful to those, who reflect on the errors, to which this mortal life is subject, and on the vengeance, which the justice of god is wont to take on sinners, by condemning them to everlasting punishment. on the other hand, i, in my old age (praise to the almighty) am exempt from both these apprehensions; from the one, because i am sure and certain, that i cannot fall sick, having removed all the causes of illness by my divine medicine; from the other, that of death, because from so many years experience i have learned to obey reason; whence i not only think it a great piece of folly to fear that, which cannot be avoided, but likewise firmly expect some consolation, from the grace of jesus christ, when i shall arrive at that period. besides, though i am sensible that i must, like others, reach that term, it is yet at so great a distance, that i cannot discern it, because i know i shall not die except by mere dissolution, having already, by my regular course of life, shut up all the other avenues of death, and thereby prevented the humours of my body from making any other war upon me, than that which i must expect from the elements employed in the composition of this mortal frame. i am not so simple as not to know, that, as i was born, so i must die. but that is a desirable death, which nature brings on us by way of dissolution. for nature, having herself formed the union between our body and soul, knows best in what manner it may be most easily dissolved, and grants us a longer day to do it, than we could expect from sickness, which is violent. this is the death, which, without speaking like a poet, i may call, not death, but life. nor can it be otherwise. such a death does not overtake one till after a very long course of years, and in consequence of an extreme weakness; it being only by slow degrees, that men grow too feeble to walk, and unable to reason, becoming blind, and deaf, decrepid, and full of every other kind of infirmity. now i (by god's blessing) may be quite sure that i am at a very great distance from such a period. nay, i have reason to think, that my soul, having so agreeable a dwelling in my body, as not to meet with any thing in it but peace, love, and harmony, not only between its humours, but between my reason and my senses, is exceedingly content and well pleased with her present situation: and of course, that a great length of time and many years must be requisite to dislodge her. whence it must be concluded for certain, that i have still a series of years to live in health and spirits, and enjoy this beautiful world, which is, indeed, beautiful to those, who know how to make it so, as i have done, and likewise expect to be able to do, with god's assistance, in the next; and all by the means of virtue, and that divine regularity of life, which i have adopted, concluding an alliance with my reason, and declaring war against my sensual appetites; a thing which every man may do, who desired to live as he ought. now, if this sober life be so happy; if its name be so desirable and delightful; if the possession of the blessings which attend it, be so stable and permanent, all i have still left to do, is to beseech (since i cannot compass my desires by the powers of oratory) every man of a liberal disposition, and sound understanding, to embrace with open arms this most valuable treasure of a long and healthy life; a treasure, which as it exceeds all the other riches and blessings of this world, so it deserves above all things to be cherished, sought after, and carefully preserved. this is that divine sobriety, agreeable to the deity, the friend of nature, the daughter of reason, the sister of all the virtues, the companion of temperate living, modest, courteous, content with little, regular, and perfect mistress of all her operations. from her, as from their proper root, spring life, health, chearfulness, industry, learning, and all those actions and employments worth of noble and generous minds. the laws of god and man are all in her favour. repletion, excess, intemperance, superfluous humours, diseases, fevers, pains, and the dangers of death, vanish, in her presence, like clouds before the sun. her comeliness ravishes every well-disposed mind. her influence is so sure, as to promise to all a very long and agreeable existence; the facility of acquiring her is such, as ought to induce every one to look for her, and share in her victories. and, lastly, she promises to be a mild and agreeable guardian of life; as well of the rich as of the poor; of the male as of the female sex; the old as of the young; being that, which teaches the rich modesty; the poor frugality; men, continence; women, chastity; the old, how to ward off the attacks of death; and bestows on youth firmer and securer hopes of life. sobriety renders the senses clear, the body light, the understanding lively, the soul brisk, the memory tenacious, our motions free, and all our actions regular and easy. by means of sobriety, the soul delivered, as it were, of her earthly burthen, experiences a great deal of her natural liberty: the spirits circulate gently through the arteries; the blood runs freely through the veins; the heat of the body, kept mild and temperate, has mild and temperate effects: and, lastly, our faculties, being under a perfect regulation, preserves a pleasing and agreeable harmony. o most innocent and holy sobriety, the sole refreshment of nature, the nursing mother of human life, the true physic of soul as well as of body. how ought men to praise thee, and thank thee for thy princely gifts! since thou bestowest on them the means of preserving this blessing, i mean life and health, than which it has not pleased god we should enjoy a greater on this side of the grave, life and existence being a thing so naturally coveted, and willingly preserved, by every living creature. but, as i do not intend to write a panegyric on this rare and excellent virtue, i shall put an end to this discourse, lest i should be guilty of excess, in dwelling so long on so pleasing a subject. yet as numberless things may still be said of it, i leave off, with an intention of setting forth the rest of its praises at a more convenient opportunity. a compendium of a sober life my treatise on a sober life has begun to answer my desire, in being of service to many persons born with a weak constitution, who every time they committed the least excess, found themselves greatly indisposed, a thing which it must be allowed does not happen to robust people: several of these persons of weak constitutions, on seeing the foregoing treatise, have betaken themselves to a regular course of life, convinced by experience of its utility. in like manner, i should be glad to be of service to those, who are born with a good constitution, and presuming upon it, lead a disorderly life; whence it comes to pass, that, on their attaining the age of sixty or thereabouts, they are attacked with various pains and diseases; some with the gout, some with pains in the side, and others with pains in the stomach, and the like, to which they would not be subject, were they to embrace a sober life; and as most of them die before they attain their eightieth year, they would live to a hundred, the time allowed to man by god and nature. and, it is but reasonable to believe, that the intention of this our mother is, that we should all attain that term, in order that we might all taste the sweets of every state of life. but, as our birth is subject to the revolution of the heavens, these have great influence over it, especially in rendering our constitutions robust or infirm; a thing, which nature cannot ward against; for, if she could, we should all bring a good constitution with us into the world. but then she hopes, that man, being endowed with reason and understanding, may of himself compensate, by dint of art, the want of that, which the heavens have denied him; and, by means of a sober life, contrive to mend his infirm constitution, live to a great age, and always enjoy good health. for man, it is not to be doubted, may by art exempt himself in part from the influence of the heavens; it being common opinion, that the heavens give an inclination, but do not impel us; for which reason the learned say, that a wise man rules the stars. i was born with a very choleric disposition, insomuch that there was no living with me; but i took notice of it, and considered, that a person swayed by his passion, must at certain times be no better than a madman; i mean at those times, when he suffers his passions to predominate, because he then renounces his reason and understanding. i, therefore, resolved to make my choleric disposition give way to reason; so that now, though born choleric, i never suffer anger intirely to overcome me. the man, who is naturally of a bad constitution, may, in like manner, by dint of reason, and a sober life, live to a great age and in good health, as i have done, who had naturally the worst, so that it was impossible i should live above forty years, whereas i now find myself sound and hearty at the age of eighty-six; and were it not for the long and violent fits of illness which i experienced in my youth to such a degree, that the physicians gave me over, and which robbed me of my radical moisture, a loss absolutely irreparable, i might expect to attain the abovementioned term of one hundred. but i know for good reasons that it is impossible; and, therefore, do not think of it. it is enough for me, that i have lived forty-six years beyond the term i had a right to expect; and that, during this so long a respite, all my senses have continued perfect; and even my teeth, my voice, my memory, and my strength. but what is still more, my brain is more itself now than it ever was; nor do any of these powers abate as i advance in years; and this because, as i grow older, i lessen the quantity of my solid food. this retrenchment is necessary, nor can it be avoided, since it is impossible for a man to live for ever; and, as he draws near his end, he is reduced so low as to be no longer able to take any nourishment, unless it be to swallow, and that too with difficulty, the yolk of an egg in the four and twenty hours, and thus end by mere dissolution, without any pain or sickness, as i expect will be my case. this is a blessing of great importance; yet may be expected by all those, who shall lead a sober life, of whatever degree or condition, whether high, or middling, or low; for we are all of the same species, and composed of the same four elements. and, since a long and healthy life ought to be greatly coveted by every man, as i shall presently shew, i conclude, that every man is bound in duty to exert himself to obtain longevity, and that he cannot promise himself such a blessing without temperance and sobriety. some allege, that many, without leading such a life, have lived to an hundred, and that in constant health, though they eat a great deal, and used indiscriminately every kinds of viands and wine; and, therefore, flatter themselves, that they shall be equally fortunate. but in this they are guilty of two mistakes; the first is, that it is not one in an hundred thousand that ever attains that happiness; the other mistake is, that such, in the end, most assuredly contract some illness, which carries them off: nor can they ever be sure of ending their days otherwise: so that the safest way to obtain a long and healthy life is, at least after forty, to embrace sobriety. this is no such difficult affair, since history informs us of so many who in former times lived with the greatest temperance; and i know that the present age furnishes us with many such instances, reckoning myself one of the number: we are all human beings, and endowed with reason, consequently we are masters of our actions. this sobriety is reduced to two things, quality and quantity. the first, namely quality, consists in nothing, but not eating food, or drinking wines, prejudicial to the stomach. the second, which is quantity, consists in not eating or drinking more than the stomach can easily digest; which quantity and quality every man should be a perfect judge of by the time he is forty, or fifty, or sixty; and, whoever observes these two rules, may be said to live a regular and sober life. this is of so much virtue and efficacy, that the humours of such a man's body become most homogeneous, harmonious, and perfect; and, when thus improved, are no longer liable to be corrupted or disturbed by any other disorders whatsoever, such as suffering excessive heat or cold, too much fatigue, want of natural rest, and the like, unless in the last degree of excess. wherefore, since the humours of persons, who observe these two rules relative to eating and drinking, cannot possibly be corrupted, and engender acute diseases, the sources of an untimely death, every man is bound to comply with them: for whoever acts otherwise, living a disorderly instead of a regular life, is constantly exposed to disease and mortality, as well in consequence of such disorders, as of others without number, each of which is capable of producing the same destructive effect. it is, indeed, true, that even those, who observe the two rules relating to diet, the observance of which constitutes a sober life, may, by committing any one of the other irregularities, find himself the worse for it, for a day or two; but not so as to breed a fever. he may, likewise, be affected by the revolutions of the heavens; but neither the heavens, nor those irregularities, are capable of corrupting the humours of a temperate person; and it is but reasonable and natural it should be so, as the two irregularities of diet are interior, and the others exterior. but as there are some persons, stricken in years, who are, notwithstanding, very gluttonous, and alledge that neither the quantity or quality of their diet makes any impression upon them, and therefore eat a great deal, and of every thing without distinction, and indulge themselves equally in point of drinking, because they do not know in what part of their bodies their stomachs are situated; such, no doubt, are beyond all measure sensual, and slaves to gluttony. to these i answer, that what they say is impossible in the nature of things, because it is impossible that every man, who comes into the world, should not bring with him a hot, a cold, or a temperate constitution; and that hot foods should agree with hot constitutions, cold with cold ones, and things that are not of a temperate nature, with temperate ones, is likewise impossible in nature. after all, these epicures must allow, that they are now and then out of order; and that they cure themselves by taking evacuating medicines and observing a strict diet. whence it appears, that their being out of order is owing to their eating too much, and of things disagreeing with their stomachs. there are other old gluttons, who say, that it is necessary they should eat and drink a great deal, to keep up their natural heat, which is constantly diminishing, as they advance in years; and that it is, therefore, necessary to eat heartily, and of such things as please their palate, be they hot, cold, or temperate; and that, were they to lead a sober life, it would be a short one. to these i answer, that our kind mother, nature, in order that old men may live still to a greater age, has contrived matters so, that they should be able to subsist on little, as i do; for, large quantities of food cannot be digested by old and feeble stomachs. nor should such persons be afraid of shortening their days by eating too little, since when they happen to be indisposed, they recover by lessening the quantity of their food; for it is a trifle they eat, when confined to a regimen, by observing which they get rid of their disorder. now, if by reducing themselves to a very small quantity of food, they recover from the jaws of death, how can they doubt but that with an increase of diet, still consistent however with sobriety, they will be able to support nature when in perfect health? others say, that it is better for a man to suffer every year three or four returns of his usual disorders, such as the gout, pain in the side, and the like, than be tormented the whole year by not indulging his appetite, and eating every thing his palate likes best; since, by a good regimen alone, he is sure to get the better of such attacks. to this i answer, that our natural heat growing less and less, as we advance in years, no regimen can retain virtue sufficient to conquer the malignity, with which disorders of repletion are ever attended; so that he must die, at last, of these periodical disorders, because they abridge life, as health prolongs it. others pretend, that it is much better to live ten years less, than not indulge one's appetite. to this i answer, that longevity ought to be highly valued by men of parts; as to others, it is no great matter if it is not duly prized by them, since they are a disgrace to mankind, so that their death is rather of service to the public. but it is a great misfortune, that men of bright parts should be cut off in that manner, since he, who is already a cardinal, might, perhaps, by living to eighty, attain the papal crown; and in the state, many, by living some years extraordinary, may acquire the ducal dignity; and so in regard to letters, by which a man may rise so as to be considered as a god upon earth; and the like in every other profession. there are others, who, though their stomachs become weaker and weaker with respect to digestion, as they advance in years, cannot, however, be brought to retrench the quantity of their food, nay they rather increase it. and, because they find themselves unable to digest the great quantity of food, with which they must load their stomachs, by eating twice in the four and twenty hours, they make a resolution to eat but once, that the long interval between one meal and the other may enable them to eat at one sitting as much as they used to do in two: thus they eat till their stomachs, overburthened with much food, pall, and sicken, and change the superfluous food into bad humours, which kill a man before his time. i never knew any person, who led that kind of life, live to be very old. all these old men i have been speaking of would live long, if, as they advanced in years, they lessened the quantity of their food, and eat oftener, but little at a time; for old stomachs cannot digest large quantities of food; old men changing, in that respect, to children, who eat several times in the four and twenty hours. others say, that temperance may, indeed, keep a man in health, but that it cannot prolong his life. to this i answer, that experience proves the contrary; and that i myself am a living instance of it. it cannot be said, that sobriety is apt to shorten one's days, as sickness does; and that the latter abbreviates life, is most certain. moreover, a constant succession of good health is preferable to frequent sickness, as the radical moisture is thereby preserved. hence it may be fairly concluded, that holy sobriety is the true parent of health and longevity. o thrice holy sobriety, so useful to man, by the services thou renderest him! thou prolongest his days, by which means he greatly improves his understanding, and by such improvement he avoids the bitter fruits of sensuality, which are an enemy to reason, man's peculiar privilege: those bitter fruits are the passions and perturbations of the mind. thou, moreover, freest him from the dreadful thoughts of death. how greatly is thy faithful disciple indebted to thee, since by thy assistance he enjoys this beautiful expanse of the visible world, which is really beautiful to such as know how to view it with the philosophic eye, as thou has enabled me to do. nor could i, at any other time of life, even when i was young, but altogether debauched by an irregular life, perceive its beauties, though i spared no pains or expence to enjoy every season of life. but i found that all the pleasures of that age had their alloy; so that i never knew, till i grew old, that the world was beautiful. o truly happy life, which, over and above all these favours conferred on thine old man, hast so improved and perfected his stomach, that he has now a better relish for his dry bread, than he had formerly and in his youth, for the most exquisite dainties: and all this he has compassed by acting rationally, knowing, that bread is, above all things, man's proper food, when seasoned by a good appetite; and, whilst a man leads a sober life, he may be sure of never wanting that natural sauce; because, by always eating little, the stomach, not being much burthened, need not wait long to have an appetite. it is for this reason, that dry bread relishes so well with me; and i know it from experience, and can with truth affirm, i find such sweetness in it, that i should be afraid of sinning against temperance, were it not for my being convinced of the absolute necessity of eating it, and that we cannot make use of a more natural food. and thou, kind parent nature, who actest so lovingly by thy aged offspring, in order to prolong his days, hast contrived matters so in his favour, that he can live upon very little; and, in order to add to the favour, and do him still greater service, hast made him sensible, that, as in his youth he used to eat twice a day, when he arrived at old age, he ought to divide that food, of which he was accustomed before to make but two meals, into four; because, thus divided, it will be more easily digested; and, as in his youth he made but two meals in the day, he should, in his old age, make four, provided however he lessens the quantity, as his years increase. and this is what i do, agreeably to my own experience; and, therefore, my spirits, not oppressed by much food, but barely kept up, are always brisk; especially after eating, so that i am accustomed then to sing a song, and afterwards to write. nor do i ever find myself the worse for writing immediately after meals; nor is my understanding ever clearer; nor am i apt to be drowsy; the food i take being too small a quantity to send up any fumes to the brain. o, how advantageous it is to an old man to eat but little! accordingly, i, who know it, eat but just enough to keep body and soul together; and the things i eat are as follow. first, bread, panado, some broth with an egg in it, or such other good kinds of soup or spoon-meat. of flesh meat, i eat veal, kid, and mutton. i eat poultry of every kind. i eat partridges, and other birds, such as thrushes. i likewise eat fish; for instance, the goldney and the like, amongst sea fish; and the pike, and such like, amongst the fresh-water fish. all these things are fit for an old man; and, therefore, he ought to be content with them, and, considering their number and variety, not hanker after others. such old men, as are too poor to allow themselves provisions of this kind, may do very well with bread, panado, and eggs; things, which no poor man can want, unless it be common beggars, and, as we call them, vagabonds, about whom we are not bound to make ourselves uneasy, since they have brought themselves to that pass by their indolence; and had better be dead than alive; for they are a disgrace to human nature. but, though a poor man should eat nothing but bread, panado, and eggs, there is no necessity for his eating more than his stomach can digest. and, whoever does not trespass in point of either quantity or quality, cannot die but by mere dissolution. o, what a difference there is between a regular and an irregular life! one gives longevity and health, the other produces diseases and untimely deaths. o unhappy, wretched life, my sworn enemy, who art good for nothing but to murder those, who follow thee! how many of my dearest relations and friends hast thou robbed me of, in consequence of their not giving credit to me; relations and friends, whom i should now enjoy. but thou hast not been able to destroy me, according to thy wicked intent and purpose. i am still alive in spite of thee, and have attained to such an age, as to see around me eleven grandchildren, all of fine understanding, and amiable disposition; all given to learning and virtue; all beautiful in their persons and lovely in their manners; whom, had i obeyed thy dictates, i should never have beheld. nor should i enjoy those beautiful and convenient apartments which i have built from the ground, with such a variety of gardens, as required no small time to attain their present degree of perfection. no! thy nature is to destroy those who follow thee, before they can see their houses or gardens so much as finished; whereas, i, to thy no small confusion, have already enjoyed mine for a great number of years. but, since thou art so pestilential a vice, as to poison and destroy the whole world; and i am determined to use my utmost endeavours to extirpate thee, at least in part; i have resolved to counteract thee so, that my eleven grandchildren shall take pattern after me; and thereby expose thee, for what thou really art, a most wicked, desperate, and mortal enemy of the children of men. i, really, cannot help admiring, that men of fine parts, and such there are, who have attained a superior rank in letters or any other profession, should not betake themselves to a regular life, when they are arrived at the age of fifty or sixty; or as soon as they find themselves attacked by any of the foregoing disorders, of which they might easily recover; whereas, by being permitted to get a head, they become incurable. as to young men, i am no way surprised by them, since, the passions being strong at that age, they are of course the more easily overpowered by their baleful influence. but after fifty, our lives should, in every thing, be governed by reason, which teaches us, that the consequences of gratifying our palate and our appetite are disease and death. were this pleasure of the palate lasting, it would be some excuse; but it is so momentary, that there is scarce any distinguishing between the beginning and the end of it; whereas the diseases it produces are very durable. but it must be a great contentment to a man of sober life, to be able to reflect that, in the manner he lives, he is sure, that what he eats, will keep him in good health, and be productive of no disease or infirmity. now i was willing to make this short addition to my treatise, founded on new reasons; few persons caring to peruse long-winded discourses; whereas short tracts have a chance of being read by many; and i wish that many may see this addition, to the end that its utility may be more extensive. an earnest exhortation; wherein the author uses the strongest arguments to persuade all men to embrace a regular and sober life, in order to attain old age, in which they may enjoy all the favours and blessings, that god, in his goodness, vouchsafes to bestow upon mortals. not to be wanting to my duty, that duty incumbent upon every man; and not to lose at the same time the satisfaction i feel in being useful to others, i have resolved to take up my pen, and inform those, who, for want of conversing with me, are strangers to what those know and see, with whom i have the pleasure of being acquainted. but, as certain things may appear, to some persons, scarce credible, nay impossible, though actually fact, i shall not fail to relate them for the benefit of the public. wherefore, i say, being (god be praised) arrived at my ninety-fifth year, and still finding myself sound and hearty, content and chearful, i never cease thanking the divine majesty for so great a blessing; considering the usual fate of other old men. these scarce attain the age of seventy, without losing their health and spirits; growing melancholy and peevish; and continually haunted by the thoughts of death; apprehending their last hour from one day to another, so that it is impossible to drive such thoughts out of their mind; whereas such things give me not the least uneasiness; for, indeed, i cannot, at all, make them the object of my attention, as i shall hereafter more plainly relate. i shall, besides, demonstrate the certainty i have of living to an hundred. but, to render this dissertation more methodical, i shall begin by considering man at his birth; and from thence accompany him through every stage of life to his grave. i, therefore, say, that some come into the world with the stamina of life so weak, that they live but a few days, or months, or years; and it cannot be clearly known, to what such shortness of life is owing; whether to some defect in the father or the mother, in begetting them; or to the revolutions of the heavens; or to the defect of nature, subject, as she is, to the celestial influence. for, i could never bring myself to believe, that nature, common parent of all, should be partial to any of her children. therefore, as we cannot assign causes, we must be content with reasoning from the effects, such as they daily appear to our view. others are born sound, indeed, and full of spirits; but, notwithstanding, with a poor weakly constitution; and of these some live to the age of ten; others to twenty; others to thirty or forty; yet they do not live to extreme old age. others, again, bring into the world a perfect constitution, and live to old age; but it is generally, as i have already said, an old age full of sickness and sorrow; for which they are to thank themselves; because they most unreasonably presume on the goodness of their constitution; and cannot by any means be brought to depart, when brought to depart, when grown old, from the mode of life they pursued in their younger days; as if they still retained all their primitive vigour. nay, they intend to live as irregularly when past the meridian of life, as they did all the time of their youth; thinking they shall never grow old, nor their constitution ever be impaired. neither do they consider, that their stomach has lost its natural heat; and that they should, on that account, pay a greater regard to the quality of what they eat, and what wines they drink; and likewise to the quantity of each, which they ought to lessen; whereas, on the contrary, they are for increasing it; saying, that, as we lose our health and vigour by growing old, we should endeavour to repair the loss by increasing the quantity of our food, since it is by sustenance that man is preserved. in this, nevertheless, they are greatly mistaken, since, as the natural heat lessens as a man grows in years, he should diminish the quantity of his meat and drink; nature, especially at that period, being content with little. nay, though they have all the reason to believe this to be the case, they are so obstinate as to think otherwise, and still follow their usual disorderly life. but were they to relinquish it in due time, and betake themselves to a regular and sober course, they would not grow infirm in their old age, but would continue, as i am, strong and hearty, considering how good and perfect a constitution it has pleased the almighty to bestow upon them; and would live to the age of one hundred and twenty. this has been the case of others, who, as we read in many authors, have lived a sober life, and, of course, were born with this perfect constitution; and had it been my lot to enjoy such a constitution, i should make no doubt of attaining the same age. but, as i was born with feeble stamina, i am afraid i shall not outlive an hundred. were others, too, who are also born with an infirm constitution, to betake themselves to a regular life, as i have done, they would attain the age of one hundred and upwards, as will be my case. and this certainty of being able to live a great age is, in my opinion, a great advantage, and highly to be valued; none being sure to live even a single hour, except such as adhere to the rules of temperance. this security of life is built on good and true natural reasons, which can never fail; it being impossible in the nature of things, that he, who leads a sober and regular life, should breed any sickness, or die of an unnatural death, before the time, at which it is absolutely impossible he should live. but sooner he cannot die, as a sober life has the virtue to remove all the usual causes of sickness, and sickness cannot happen without a cause; which cause being removed, sickness is, likewise, removed; and sickness being removed, an untimely and violent death must be prevented. and there is no doubt, that temperance has the virtue and efficacy to remove such causes; for since health and sickness, life and death, depend on the good or bad quality of the humours, temperance corrects their vicious tendencies, and renders them perfect, being possessed of the natural power of making them unite and hold together, so as to render them inseperable, and incapable of alteration and fermenting; circumstances, which engender cruel fevers, and end in death. it is true, indeed, and it would be a folly to deny it, that, let our humours be originally ever so good, time, which consumes every thing, cannot fail to consume and exhaust them; and that man, as soon as that happens, must die of a natural death; but yet without sickness, as will be my case, who shall die at my appointed time, when these humours shall be consumed, which they are not at present. nay, they are still perfect; nor is it possible they should be otherwise in my present condition, when i find myself hearty and content, eating with a good appetite, and sleeping soundly. moreover, all my faculties are as good as ever, and in the highest perfection; my understanding clearer and brighter than ever; my judgment sound; my memory tenacious; my spirits good; and my voice, the first thing which is apt to fail in others, grown so strong and sonorous, that i cannot help chanting out loud my prayers morning and night, instead of whispering and muttering them to myself, as was formerly my custom. and these are all so many true and sure signs and tokens, that my humours are good, and cannot waste but with time, as all those, who converse with me, conclude. o, how glorious this life of mine is like to be, replete with all the felicities which man can enjoy on this side of the grave; and even exempt from that sensual brutality which age has enabled my better reason to banish; because where reason resides, there is no room for sensuality, nor for its bitter fruits, the passions, and perturbations of the mind, with a train of disagreeable apprehensions. nor yet can the thoughts of death find room in my mind, as i have no sensuality to nourish such thoughts. neither can the death of grandchildren and other relations and friends make any impression on me, but for a moment or two; and then it is over. sill less am i liable to be cast down by losses in point of fortune (as many have seen to their no small surprise.) and this is a happiness not to be expected by any but such as attain old age by sobriety, and not in consequence of a strong constitution; and such may moreover expect to spend their days happily, as i do mine, in a perpetual round of amusement and pleasure. and how is it possible a man should not enjoy himself, who meets with no crosses or disappointments in his old age, such as youth is constantly plagued with, and from which, i shall presently shew, i have the happiness of being exempt? the first of these is to do service to my country. o! what a glorious amusement, in which i find infinite delight, as i thereby shew her the means of improving her important estuary or harbour beyond the possibility of its filling for thousands of years to come; so as to secure to venice her surprising and miraculous title of a maiden city, as she really is; and the only one in the whole world: she will, moreover, thereby, add to the lustre of her great and excellent surname of queen of the sea: such is my amusement; and nothing is wanting to make it complete. another amusement of mine, is that of shewing this maid and queen, in what manner she may abound with provisions, by improving large tracts of land, as well marshes, as barren sands, to great profit. a third amusement, and an amusement too, without any alloy, is the shewing how venice, though already so strong as to be in a manner impregnable, may be rendered still stronger; and, though extremely beautiful, may still increase in beauty; though rich, may acquire more wealth, and may be made to enjoy better air, though her air is excellent. these three amusements, all arising from the idea of public utility, i enjoy in the highest degree. and who can say, that they admit of any alloy, as in fact they do not? another comfort i enjoy, is, that having lost a considerable part of my income, of which my grandchildren had been unfortunately robbed, i by mere dint of thought, which never sleeps, and without any fatigue of body, and very little of mind, have found a true and infallable method of repairing such loss more than double, by the means of that most commendable of arts, agriculture. another comfort i still enjoy is to think, that my treatise on temperance, which i wrote in order to be useful to others, is really so, as many assure me by word of mouth, mentioning that it has proved extremely useful to them, as it in fact appears to have been, whilst others inform me by letter, that, under god, they are indebted to me for life. still another comfort i enjoy, is that of being able to write with my own hand; for, i write enough to be of service to others, both on architecture, and agriculture. i, likewise, enjoy another satisfaction, which is that of conversing with men of bright parts and superior understanding, from whom, even at this advanced period of life, i learn something. what a comfort is this, that, old as i am, i should be able, without the least fatigue, to study the most important, sublime, and difficult subjects! i must farther add, though it may appear impossible to some, and may be so in some measure, that at this age i enjoy, at once, two lives; one terrestrial, which i possess in fact; the other celestial, which i possess in thought; and this thought is equal to actual enjoyment, when founded upon things we are sure to attain, as i ams sure to attain that celestial life, through the infinite goodness and mercy of god. thus, i enjoy this terrestrial life, in consequence of my sobriety and temperance, virtues so agreeable to the deity; and i enjoy, by the grace of the same divine majesty, the celestial, which he makes me anticipate in thought; a thought so lovely, as to fix me entirely on this object, the enjoyment of which i hold and affirm to be of the utmost certainty. and i hold that dying, in the manner i expect, is not really death, but a passage of the soul from this earthly life to a celestial, immortal, and infinitely perfect existence. neither can it be otherwise: and this thought is so superlatively sublime, that it can no longer stoop to low and worldly objects, such as the death of this body, being intirely taken up with the happiness of living a celestial and divine life; whence it is, that i enjoy two lives. nor can the terminating of so high a gratification, which i enjoy in this life, give me any concern; it rather affords me infinite pleasure, as it will be only to make room for another, glorious and immortal life. now, it is possible, that any one should grow tired of so great a comfort and blessing, as this which i really enjoy; and which every on else might enjoy by leading the life i have led? an example which every one has it in his power to follow; for i am but a mere man, and no saint; a servant of god, to whom so regular a life is extremely agreeable. and, whereas many embrace a spiritual and contemplative life, which is holy and commendable, the chief employment of those who lead it being to celebrate the praises of god; o, that the would likewise, betake themselves intirely to a regular and sober life! how much more agreeable would they render themselves in the sight of god! what a much greater honour and ornament would the be to the world! they would then be considered as saints, indeed, upon earth, as those primitive christians were led, who joined sobriety to so recluse a life. by living, like them, to the age of one hundred and twenty, they might, like them, expect, by the power of god, to work numberless miracles; and they would, besides, enjoy constant health and spirits, and be always happy within themselves; whereas they are now, for the most part, infirm, melancholy, and dissatisfied. now, as some of these people think, that these are trials sent them by god almighty, with a view of promoting their salvation, that they may do penance, in this life, for their past errors, i cannot help saying, that, in my opinion, they are greatly mistaken. for i can by no means believe, that it is agreeable to the deity, that man, his favourite creature, should live infirm, melancholy, and dissatisfied, but rather enjoy good health and spirits, and be always content within himself. in this manner did the holy fathers live, and by such conduct did they daily render themselves more acceptable to the divine majesty, so as to work the great and surprising miracles we read in history. how beautiful, how glorious a scene should we then behold! far more beautiful than in those antient times, because we now abound with so many religious orders and monasteries, which did not then exist; and were the members of these communities to lead a temperate life, we should then behold such a number of venerable old men, as would create surprise. nor would they trespass against their rules; they would rather improve upon them; since every religious community allows its subjects bread, wine, and sometimes eggs (some of them allow meat) besides soups made with vegetables, sallets, fruit, and cakes, things which often disagree with them, and even shorten their lives. but, as they are allowed such things by their rules, they freely make use of them; thinking, perhaps, that it would be wrong to abstain from them, whereas it would not. it would rather be commendable, if, after the age of thirty, they abstained from such food, confined themselves to bread, wine, broths and eggs: for this is the true method of preserving men of a bad constitution; and it is a life of more indulgence than that led by the holy fathers of the desart, who subsisted intirely on wild fruits and roots, and drank nothing but pure water; and, nevertheless, lived, as i have already mentioned, in good health and spirits, and always happy within themselves. were those of our days to do the same, they would, like them, find the road to heaven much easier; for it is always open to every faithful christian, as our saviour jesus christ left it, when he came down upon earth to shed his precious blood, in order to deliver us from the tyrannical servitude of the devil; and all through his immense goodness. so that, to make an end of this discourse, i say, that since length of days abounds with so many favours and blessings, and i happen to be one of those who are arrived at that state, i cannot (as i would not willingly want charity) but give testimony in favour of it, and solemnly assure all mankind, that i really enjoy a great deal more than what i now mention; and that i have no other reason for writing, but that of demonstrating the great advantages which arise from longevity, to the end that their own conviction may induce them to observe those excellent rules of temperance and sobriety. and therefore i never cease to raise my voice, crying out to you, my friends: may your days be long, that you may be the better servants to the almighty! letter from signor lewis cornaro, to the right reverend barbaro, patriarch elect of aquileia. the human understanding must certainly have something of the divine in its constitution and frame. how divine the invention of conversing with an absent friend by the help of writing! how divinely it is contrived by nature, that men, though at a great distance, should see one another with the intellectual eye, as i now see your lordship! by means of this contrivance, i shall endeavour to entertain you with with matters of the greatest moment. it is true, that i shall speak of nothing but what i have already mentioned; but it was not at the age of ninety-one, to which i have now attained; a thing i cannot help taking notice of, because as i advance in years, the sounder and heartier i grow, to the amazement of all the world. i, who can account for it, am bound to shew, that a many may enjoy a terrestrial paradise after eighty; which i enjoy; but it is not to be obtained except by temperance and sobriety, virtues so acceptable to the almighty, because they are enemies to sensuality, and friends to reason. now, my lord, to begin, i must tell you, that, within these few days past, i have been visited by many of the learned doctors of this university, as well physicians and philosophers, who were well acquainted with my age, my life, and manners; knowing how stout, hearty, and gay i was; and in what perfection all my faculties still continued; likewise my memory, spirits, and understanding; and even my voice and teeth. they knew, besides, that i constantly employed eight hours every day in writing treatises, with my own hand, on subjects useful to mankind, and spent many hours in walking and singing. o, my lord, how melodious my voice is grown! were you to hear me chant my prayers; and that to my lyre, after the example of david, i am certain it would give you great pleasure, my voice is so musical. now, when they told me that they had been already acquainted with all these particulars, they added, that it was, indeed, next to a miracle, how i could write so much, and upon subjects that required both judgement and spirit. and, indeed, my lord, it is incredible, what satisfaction and pleasure i have in these compositions. but, as i write to be useful, your lordship may easily conceive what pleasure i enjoy. they concluded by telling me, that i ought not to be looked upon as a person advanced in years, since all my occupations were those of a young man; and, by no means, like those of other aged persons, who, when they have reached eighty, are reckoned decrepid. such, moreover, are subject, some to the gout, some to the sciatica, and some to other complaints, to be relieved from which they must undergo such a number of painful operations, as cannot but render life extremely disagreeable. and, if, by chance, one of them happens to escape a long illness, his faculties are impaired, and he cannot see or hear so well; or else fails in some or other of the corporeal faculties, he cannot walk, or his hands shake; and, supposing him exempt from these bodily infirmities, his memory, his spirits, or his understanding fail him; he is not chearful, pleasant, and happy within himself, as i am. besides all these blessings, i mentioned another, which i enjoyed; and so great a blessing, that they were all amazed at it, since it is altogether beside the usual course of nature. this blessing is, that i had already lived fifty years, in spite of a most powerful and mortal enemy, which i can by no means conquer, because it is natural, or an occult quality implanted in my body by nature; and this is, that every year, from the beginning of july till the end of august, i cannot drink any wine of whatever kind or country; for, besides being during these two months quite disgustful to my palate, it disagrees with my stomach. thus losing my milk, for wine is, indeed, the milk of old age; and having nothing to drink, for no change or preparation of waters can have the virtue of wine, nor of course do me any good; having nothing, i say, to drink, and my stomach being therefore disordered, i can eat but very little; and this spare diet, with the want of wine, reduces me, by the middle of august, extremely low; nor is the strongest capon broth, or any other remedy, of service to me; so that i am ready, through mere weakness, to sink into the grave. hence they inferred, that were not the new wine, for i always take care to have some ready by the beginning of september, to come in so soon, i should be a dead man. but what surprized them still more was, that this new wine should have power sufficient to restore me, in two or three days, to that degree of health and strength, of which the old wine had robbed me; a fact, they themselves have been eye-witnesses of, within these few days; and which a man must see to believe it; insomuch that they could not help crying out; "many of us, who are physicians, have visited him annually for several years past; and ten years ago, judged it impossible for him to live a year or two longer, considering what a mortal enemy he carried about him, and his advanced age; yet we do not find him so weak at present as he used to be." this singularity, and the many other blessings they see me enjoy, obliged them to confess, that the joining of such a number of favours was, with regard to me, a special grace conferred on me, at my birth, by nature, or by the stars; and to prove this to be a good conclusion, which it really is not (because not grounded on strong and sufficient reasons, but merely on their own opinions) they found themselves under a necessity to display their eloquence, and to say a great many fine things. certain it is, my lord, that eloquence, in men of bright parts, has great power; so great, as to induce people to believe things which have neither actual nor possible existence. i had, however, great pleasure and satisfaction in hearing them; for, it must, no doubt, be a high entertainment to hear such men talk in that manner. another satisfaction, without the least mixture of alloy, i at the same time enjoyed, was to think, that age and experience are sufficient to make a man learned, who without them would know nothing; nor is it surprizing they should, since length of days is the foundation of true knowledge. accordingly, it was by means of it alone i discovered their conclusion to be false. thus, you see, my lord, how apt men are to deceive themselves in their judgement of things, when such judgement is not built upon a solid foundation. and, therefore, to undeceive them, and set them right, i made answer, that their conclusion was false, as i should actually convince them by proving, that the happiness i enjoyed was not confined to me, but common to all mankind, and that every man might equally enjoy it; since i was but a mere mortal, composed, like all others, of the four elements; and endued, besides existence and life, with rational and intellectual faculties, which are common to all men. for it has pleased the almighty to bestow on his favourite creature man these extraordinary blessings and favours above other animals, which enjoy only the sensible perceptions; in order such blessings and favours my be the means of keeping him long in good health; so that length of days is a universal favour granted by the deity, and not by nature and the stars. but man being in his youthful days more of the sensual, than of the rational animal, is apt to yield to sensual impressions; and, when he afterwards arrives at the age of forty or fifty, he ought to consider, that he has attained the noon of life, by the vigour of his youth, and a good tone of stomach; natural blessings, which favoured him in ascending the hill; but that he must now think of going down, and approaching the grave, with a heavy weight of years on his back; and that old age is the reverse of youth, as much as order is the reverse of disorder. hence it is requisite he should alter his mode of life in regard to the articles of eating and drinking, on which health and longevity depend. and as the first part of his life was sensual and irregular, the second should be the reverse; since nothing can subsist without order, especially the life of man, irregularity being without all doubt prejudicial, and regularity advantageous to the human species. besides, it is impossible in the nature of things, that the man, who is bent on indulging his palate and his appetite, should not be guilty of irregularity. hence it was that to avoid this vice, as soon as i found myself arrived at maturer years, i embraced a regular and sober life. it is, no doubt, true, that i found some difficulty in compassing it; but, in order to conquer this difficulty, i beseeched the almighty to grant me the virtue of sobriety; well knowing, that he would graciously hear my prayer. then, considering, that when a man is about to undertake any thing of importance, which he knows he can compass, though not without difficulty, he may make it much easier to himself by being steady in his purpose; i pursued the same course. i endeavoured gradually to relinquish a disorderly life, and to accustom myself insensibly to the rules of temperance: and thus it came to pass that a sober and regular life no longer proved uneasy or disagreeable; though, on account of the weakness of my constitution, i tied myself down to such strict rules in regard to the quantity and quality of what i eat and drink. but others, who happen to be blessed with a stronger temperament, may eat many other kinds of food, and in greater quantities; and so of wines; whereas, though their lives may still be sober, they will not be so confined as mine, but much more free. now, on hearing these arguments, and examining the reasons on which they were founded, they all agreed that i had advanced nothing but what was true. indeed the youngest of them said, that though he could not but allow the favour of advantages, i had been speaking of, to be common to all mankind, yet i enjoyed the special grace of being able to relinquish with ease one kind of life, and embrace another; a think which he knew by experience to be feasible; but as difficult to him as it had proved easy to me. to this i replied, that, being a mortal like himself, i likewise found it a difficult task; but it did not become a person to shrink from a glorious but practicable undertaking, on account of the difficulties attending it, because in proportion to these difficulties, is the honour he acquires by it in the eye of man, and the merit in the sight of god. our beneficent creator is desirous, that, as he originally favoured human nature with longevity, we should all enjoy full advantage of his intentions; knowing, that, when a man has passed eighty, he is intirely exempt from the bitter fruits of sensual enjoyments, and is intirely governed by the dictates of reason. vice and immorality must then leave him; hence god is willing he should live to a full maturity of years; and has ordained that whoever reaches his natural term, should end his days without sickness by mere dissolution, the natural way of quitting this mortal life to enter upon immortality, as will be my case. for i am sure to die chanting my prayers; nor do the dreadful thoughts of death give me the least uneasiness, though, considering my great age, it cannot be far distant, knowing, as i do, that i was born to die, and reflecting that such numbers have departed my life without reaching my age. nor does that other thought, inseperable from the former, namely the fear of those torments, to which wicked men are hereafter liable, give me any uneasiness; because i am a good christian, and bound to believe, that i shall be saved by the virtue of the most sacred blood of christ, which he has vouchsafed to shed, in order to free us from those torments. how beautiful is the life i lead! how happy my end! to this, the young gentleman, my antagonist, had nothing to reply, but that he was resolved to embrace a sober life, in order to follow my example; and that he had taken another, more important, resolution, which was, that, as he had been always very desirous to live to be old, so he was now equally impatient to reach that period, the sooner to enjoy the felicity of old age. the great desire i had, my lord, to converse with you at this distance, has forced me to be prolix, and still obliges me to proceed; though not much farther. there are many sensualists, my lord, who say, that i have thrown away my time and trouble in writing a treatise on temperance, and other discourses on the same subject, to induce men to lead a regular life; alledging, that it is impossible to conform to it, so that my treatise must answer as little purpose as that of plato on government, who took a great deal of pains to recommend a thing impracticable; whence they inferred, that as his treatise was of no use, mine will share the same fate. now this surprises me the more, as they may see by my treatise, that i had led a sober life for many years before i had composed it; and that i should never have composed it, had i not previously been convinced, that it was such a life as a man might lead; and being a virtuous life, would be of great service to him; so that i thought myself under an obligation to represent it in a true light. i have the satisfaction now to hear, that numbers, on seeing my treatise, have embraced such a life; and i have read, that many, in times past, have actually led it; so that the objection, to which plato's treatise on government is liable, can be of no force against mine. but such sensualists, enemies to reason, and slaves to their passions, ought to think themselves well off, if, whilst they study to indulge their palate and their appetite, they do not contract long and painful diseases, and are not, many of them, overtaken by an untimely death. finis dailey, david garcia, and the online distributed proofreading team maintaining health (formerly health and efficiency) by r. l. alsaker, m. d. author of "eating for health and efficiency" _"when you arise in the morning, think what a precious privilege it is to live, to breathe, to think, to enjoy, to love."_ --marcus aurelius. _"nature cures"_ --hippocrates to isaac t. cook whose criticisms, assistance and encouragement have lightened the labor and added to the pleasure of producing this volume. chapter contents i preliminary considerations humanity, health and healers ii mental attitude correct and incorrect--results iii food general consideration iv overeating v daily food intake vi what to eat vii when to eat viii how to eat ix classification of foods x flesh foods composition--utility--preparation--combinations xi nuts composition--utility--preparation--combinations xii legumes composition--utility--preparation--combinations xiii succulent vegetables composition--utility--preparation--combinations--salads xiv cereal foods composition--utility--preparation--combinations xv tubers composition--utility--preparation--combinations xvi fruits composition--utility--preparation--combinations--salads xvii oils and fats xviii milk and other dairy products composition--utility--preparation--combinations xix menus food combination in general xx drink water--tea--coffee--alcohol--enslaving drugs xxi care of the skin baths--friction--clothing xxii exercise xxiii breathing and ventilation xxiv sleep xxv fasting our most important remedy--symptoms--when and how to fast--cases xxvi attitude of parent toward child xxvii children prenatal care--infancy--childhood--mental training xxviii duration of life advanced years--living to old age in health and comfort xxix evolving into health how it is often done--a case xxx retrospect a summing-up of the subject chapter i. preliminary considerations. writings on hygiene and health have been accessible for centuries, but never before have books and magazines on these subjects been as numerous as they are today. most of the information is so general, vague and indefinite that only a few have the time and patience to read the thousands of pages necessary to learn what to do to keep well. the truth is to be found in the archives of medicine, in writings covering a period of over thirty centuries, but it is rather difficult to find the grains of truth. health is the most valuable of all possessions, for with health one can attain anything else within reason. a few of the great people of the world have been sickly, but it takes men and women sound in body and mind to do the important work. healthy men and women are a nation's most valuable asset. it is natural to be healthy, but we have wandered so far astray that disease is the rule and good health the exception. of course, most people are well enough to attend to their work, but nearly all are suffering from some ill, mental or physical, acute or chronic, which deprives them of a part of their power. the average individual is of less value to himself, to his family and to society than he could be. his bad habits, of which he is often not aware, have brought weakness and disease upon him. these conditions prevent him from doing his best mentally and physically. this abnormal condition has a bad effect upon his descendants, who may not be born with any special defects, but they have less resistance at birth than is their due, and consequently fall prey to disease very easily. this state of impaired resistance has been passed on from generation to generation, and we of today are passing it on as a heritage to our children. about , babies under the age of one year die annually in the united states. the average lifetime is only a little more than forty years. it should be at least one hundred years. this is a very conservative statement, for many live to be considerably older, and it is within the power of each individual to prolong his life beyond what is now considered old age. under favorable conditions people should live in comfort and health to the age of one hundred years or more, useful and in full possession of their faculties. barring accidents, which should be less numerous when people fully realize that unreasonable haste and speed are wasteful and that life is more valuable than accumulated wealth, human life could and should be a certainty. there should be no sudden deaths resulting from the popular diseases of today. in fact, pneumonia, typhoid fever, tuberculosis, cancer and various other ills that are fatal to the vast majority of the race, should and could be abolished. this may sound idealistic, but though such results are not probable in the near future, they are possible. all civilized nations of which we have record, except the chinese, have decayed after growing and flourishing a few centuries, usually about a thousand years or less. many reasons are given for the decline and fall of nations. rome especially furnishes food for much thought. however, look into the history of each known nation that has risen to prominence, glory and power, and you will find that so long as they kept in close contact with the soil they flourished. with the advance of civilization the peoples change their mode of life from simplicity to luxuriousness and complexity. thus individuals decay and in the end there is enough individual decay to result in national degeneration. when this process has advanced far enough these people are unable to hold their own. in the severe competition of nations the strain is too great and they perish. there is a point of refinement beyond which people can not go and survive. from luxury nations are plunged into hardship. then their renewed contact with the soil gradually causes their regeneration, if they have enough vitality left to rise again. such is the history of the italians. many others, like the once great egyptians, whose civilization was very far advanced and who became so dissolute that a virtuous woman was a curiosity, have been unable to recover, even after a lapse of many centuries. the degenerated nations are like diseased individuals: some have gone so far on the road to ruin that they are doomed to die. others can slowly regain their health by mending their ways. nations, like individuals, generally do better in moderate circumstances than in opulence. nearly all can stand poverty, but only the exceptional individual or nation can bear up under riches. nature demands of us that we exercise both body and mind. civilization is not inimical to health and long life. in fact, the contrary is true, for as the people advance they learn to master the forces of nature and with these forces under control they are able to lead better, healthier lives, but if they become too soft and luxurious there is decay of moral and physical fibre, and in the end the nation must fall, for its individual units are unworthy of survival in a world which requires an admixture of brain and brawn. civilization is favorable to long life so long as the people are moderate and live simply, but when it degenerates to sensuous softness, individual and racial deterioration ensue. among savages the infant mortality is very great, but such ills as cancer, tuberculosis, smallpox and bright's disease are rare. these are luxuries which are generally introduced with civilization. close housing, too generous supply of food, too little exercise and alcohol are some of the fatal blessings which civilized man introduces among savages. a part of the price we must pay for being civilized is the exercise of considerable self-control and self-denial, otherwise we must suffer. the state of the individual health is not satisfactory. there is too much illness, too much suffering and too many premature deaths. it is estimated that in our country about three millions of people are ill each day, on the average. the monetary loss is tremendous and the anguish and suffering are beyond estimate. the race is losing every year a vast army of individuals who are in their productive prime. when a part of a great city is destroyed men give careful consideration to the material loss and plan to prevent a recurrence. but that is nothing compared to the loss we suffer from the annual death of a host of experienced men and women. destroyed business blocks can be replaced, but it is impossible to replace men and women. we look upon this unnecessary waste of life complacently because we are used to it and consequently think that it is natural. it is neither necessary nor natural. if we would read and heed nature's writings it would cease. then people would live until their time came to fade away peacefully and beautifully, as do the golden leaves of autumn or the blades of grass. many dread old age because they think of it in connection with decrepitude, helplessness and the childish querulousness popularly associated with advancing years. this is not a natural old age; it is disease. natural old age is sweet, tolerant and cheerful. there are few things in life more precious than the memory of parents and grandparents grown old gracefully, after having weathered the storms of appetites and passions, the mind firmly enthroned and filled with the calm toleration and wisdom that come with the passing years of a well spent life. a busy mind in a healthy body does not degenerate. the brain, though apparently unstable, is one of the most stable parts of the body. we should desire and acquire health because when healthy we are at our maximum efficiency. we are able to enjoy life. we have greater capacity for getting and giving. we live more fully. being normal, we are in harmony with ourselves and with our associates. we are of greater value all around. we are better citizens. every individual owes something to the race. it is our duty to contribute our part so that the result of our lives is not a tendency toward degeneration, but toward upbuilding, of the race. the part played by each individual is small, but the aggregate is great. if our children are better born and better brought up than we were, and there is generally room for improvement, we have at least helped. health is within the grasp of all who are not afflicted with organic disease, and the vast majority have no organic ills. all that is necessary is to lead natural lives and learn how to use the mind properly. those who are not in sympathy with the views on racial duty can enhance their personal worth through better living without giving the race any thought. every individual who leads a natural life and thinks to advantage helps to bring about better public health. the national health is the aggregate of individual health and is improved as the individuals evolve into better health. national or racial improvement come through evolution, not through revolution. the improvement is due to small contributions from many sources. the greatest power for human uplift is knowledge. reformers often believe that they can improve the world by legislation. lasting reform comes through education. if the laws are very repressive the reaction is both great and unpleasant. it takes about six months to learn stenography. it requires a long apprenticeship to become a first-class blacksmith or horseshoer. to obtain the rudiments of a physician's art it is necessary to spend four to six years in college. to learn a language takes an apt pupil at least a year. a lawyer must study from two to four years to become a novice. a businessman must work many years before he is an expert in his line. not one of these attainments is worth as much as good health, yet an individual of average intelligence can obtain enough knowledge about right living during his spare time in from two to six months to assure him of good health, if he lives as well as he knows how. is it worth while? it certainly is, for it is one of the essentials of life. health will increase one's earning capacity and productivity and more than double both the pleasure and the duration of life. disease is a very expensive luxury. health is one of the cheapest, though one of the rarest, things on earth. there is no royal road to health. if there is any law of health it is this: only those will retain it permanently who are deserving of it. many prefer to live in that state of uncertainty, which may be called tolerable health, a state in which they do not suffer, yet are not quite well. in this condition they have their little ups and downs and occasionally a serious illness, which too often proves fatal. even such people ought to acquire health knowledge, for the time may come when they will desire to enjoy life to the fullest, which they can do only when they have health. those who have this knowledge are often able to help themselves quickly and effectively when no one else can. i am acquainted with many who have been educated out of disease into health. many of them are indiscreet, but they have learned to know the signs of approaching trouble and they ease up before anything serious overtakes them. in this way they save themselves and their families from much suffering, much anxiety and much expense. every adult should know enough to remain well. every one should know the signs of approaching illness and how to abort it. the mental comfort and ease that come from the possession of such knowledge are priceless. everything that is worth while must be paid for in some way and the price of continued good health is some basic knowledge and self-control. there are no hardships connected with rational living. it means to live moderately and somewhat more simply than is customary. simplicity reduces the amount of work and friction and adds to the enjoyment of life. the cheerfulness, the buoyancy and the tingling with the joy of life that come to those who have perfect health more than compensate for the pet bad habits which must be given up. many of the popular teachings regarding disease and its prevention are false. the germ theory is a delusion. the fact will some day be generally recognized, as it is today by a few, that the so-called pathogenic bacteria or germs have no power to injure a healthy body, that there is bodily degeneration first and then the system becomes a favorable culture medium for germs: in other words, disease comes first and the pathogenic bacteria multiply afterwards. this view may seem very ridiculous to the majority, for it is a strong tenet of popular medical belief today that micro-organisms are the cause of most diseases. to most people, medical and lay, the various diseases stand out clear and individual. typhoid fever is one disease. pneumonia is an entirely different one. surely this is so, they say, for is not typhoid fever due to the bacillus typhosus and pneumonia to the pneumococcus? but it is not so. outside of mechanical injuries there is but one disease, and the various conditions that we dignify with individual names are but manifestations of this disease. the parent disease is filthiness, and its manifestations vary according to circumstances and individuals. this filthiness is not of the skin, but of the interior of the body. the blood stream becomes unclean, principally because of indigestion and constipation, which are chiefly due to improper eating habits. some of the contributory causes are wrong thinking, too little exercise, lack of fresh air, and ingestion of sedatives and stimulants which upset the assimilative and excretory functions of the body. in all cases the blood is unclean. the patient is suffering from autointoxication or autotoxemia. if this is true, it would follow that the treatment of all diseases is about the same. for instance, it would be necessary to give about the same treatment for eczema as for pneumonia. basically, that is exactly what has to be done to obtain the best results, though the variation in location and manifestation requires that special relief measures, of lesser importance, be used in special cases, to get the quickest and best results. in both eczema and pneumonia the essential thing is to get the body clean. the practice of medicine is not a science. we have drugs that are reputed to be excellent healers, yet these very drugs sometimes produce death within a few hours of being taken. the practice of medicine is an art, and the outcome in various cases depends more on the personality of the artist than on the drugs he gives, for roughly speaking, all medicines are either sedative or stimulant, and if the dosage is kept below the danger line, the patient generally recovers. it seems to make very little difference whether the medicine is given in the tiny homeopathic doses, so small that they have only a suggestive effect, or if they are given in doses several hundred times as large by allopaths and eclectics. it is true that we have drugs with which we can diminish or increase the number of heart beats per minute, dilate or contract the pupils of the eye, check or stimulate the secretion of mucus, sedate or irritate the nervous system, etc., but all that is accomplished is temporary stimulation or sedation, and such juggling does not cure. the practice of medicine is today what it has been in the past, largely experiment and guess-work. on the other hand, natural healers who have drunk deep of the cup of knowledge need not guess. they know that withholding of food and cleaning out the alimentary tract will reduce a fever. they know that the same measures will clean up foul wounds and stop the discharge of pus in a short time. they know that the same measures in connection with hot baths will terminate headaches and remove pain. they further know that if the patient will take the proper care of himself after the acute manifestations have disappeared there will be no more disease. after a little experience, an intelligent natural healer can tell his patients, in the majority of cases, what to expect if instructions are followed. he can say positively that there will be no relapses and no complications. how different is this from the unsatisfactory practice of conventional medicine! however, most physicians refuse to accept the valuable teachings which are offered to them freely, and one of the reasons is that the natural healers do not present their knowledge in scientific form. the knowledge is scientific but it is simple. such objection does not come with good grace from a profession practicing an art. life is but a tiny part science, mixed with much art. the true scientist in the healing art is he who can take an invalid and by the use of the means at his command bring him back to health, not in an accidental manner, but in such a knowing way that he can predict the outcome. in serious cases the natural healer of intelligence and experience can do this twenty times where the man who relies on drugs does it once. the physicians who prescribe drugs are ever on the look-out for complications and relapses, and they have many of them. the natural healers know that under proper treatment neither complications nor relapses can occur, unless the disease has already advanced so far that the vital powers are exhausted before treatment is begun, and this is generally not the case. in this book many of the medical fallacies of today, both professional and lay, will be touched upon in a kindly spirit of helpfulness and ideas that contain more truth will be offered in their place. the truth is the best knowledge we have today, according to our understanding. it is not fixed, for it may be replaced by something better tomorrow. however, one fundamental truth regarding health will never change, namely, that it is necessary to conform to the laws of nature, or in other words, the laws of our being, in order to retain it. no one can cover the field of health completely, for though it is very simple, it is as big as life. the most helpful parts of this book will be those which point the way for each individual to understand his relation to what we call nature, and hence help to enable him to gain a better understanding of himself. by natural living is not meant the discarding of the graces of civilization and roaming about in adamic costume, living on the foods as they are found in forest and field, without preparation. what is meant is the adjustment of each person to his environment, or the environment to the person, until harmony or balance is established, which means health. one of the most difficult things about teaching health is that it is so very simple. people look for something mysterious. when told that good old mother nature is the only healer, they are incredulous, for they have been taught that doctors cure. when informed that they do not need medicine and that outside treatment is unnecessary, they find it difficult to believe, for disease has always called for treatment of some kind in the hands of the medical profession. when further told that they have to help themselves by living so that they will not put any obstacles in the way of normal functioning of their bodies, they think that the physician who thinks and talks that way must be a crank, and many seek help where they are told that they can obtain health from pills, powders and potions or from various inoculations and injections. to live in health is so simple that any intelligent person can master the art and furthermore regain lost health in the average case, without any help from professional healers. there is plenty knowledge and all that is needed is a discriminating mind to find the truth and then exercise enough will power to live it. if a good healer is at hand, it is cheaper to pay his fee for personal advice than to try to evolve into health without aid, but if it is a burden to pay the price, get the knowledge and practice it and health will return in most cases. the vast majority of people suffering from chronic ills which are considered incurable can get well by living properly. the more capable and frank the healer is, the less treatment will be administered. minute examinations and frequent treatment serve to make the patient believe that he is getting a great deal for his money. advice is what the healer has to sell, and if it is correct, it is precious. the patient should not object to paying a reasonable fee, for what he learns is good for life. people gladly pay for prescriptions or drugs. the latter are injurious if taken in sufficient quantity to have great effect. so why object to paying for health education, which is more valuable than all the drugs in the world? because of their attitude on this subject, the people force many a doctor to use drugs, who would gladly practice in a more reasonable way if it would bring the necessities of life to him and his family. the public has to enlighten itself before it will get good health advice. the medical men will continue in the future, as they have done in the past, to furnish the kind of service that is popular. a good natural healer teaches his patients to get along without him and other doctors. a doctor of the conventional school teaches his patrons to depend upon him. the former is consequently deserving of far greater reward than the latter. the law of compensation may apply elsewhere, thinks the patient, but surely it is nonsense to teach that it applies in matters of health, for does not everybody know that most of our diseases are due to causes over which we have no control? that the chief cause is germs and that we can not control the air well enough to prevent one of these horrible monsters (about / , of an inch long) from settling in the body and multiplying, at last producing disease and maybe death? this is untrue, but it is a very comforting theory, for it removes the element of personal responsibility. people do not like to be told that if they are ill it is their own fault, that they are only reaping as they have sowed, yet such is the truth. patients often dislike to give up one or more of their bad habits. "mr. blank has done this very thing for sixty or seventy years and now at the age of eighty or ninety he is strong and active," they reply to warnings. this is sophistry, for although an individual occasionally lives to old age in spite of broken health laws, the average person who attempts it perishes young. those who do not conform to the rules are not allowed to sit in the game to the end. another false feeling, or rather hope, deeply implanted in the human breast is: "perhaps others can not do this, but i can. i have done it before and can do it again; it will not hurt me for i am strong and possessed of a good constitution." the wish is father to the thought, which is not founded on facts. the most common and the most destructive form of dishonesty is self-deception. those who are honest with themselves find it easy to deal fairly and squarely with others. the doctors of the dominant school are very distrustful of the natural healers, in spite of the fact that the latter obtain the best results. many of the conditions which the regular physicians treat without satisfactory results, the natural healers are able to remove in a few months. when members of the dominant school of medicine find men leading patients suffering from various skin diseases, bright's disease, chronic digestive troubles, rheumatism and other ills which they themselves make little or no impression upon back to health, they are unwilling to believe that such results can be accomplished by means of hygiene and proper feeding. they think there is some fakery about it, for their professors, books and experience have taught them otherwise. they consider the views of the natural healer unworthy of serious attention and often call him a quack, which epithet closes the discussion. they are ethical and do not wish to be mired by contact with quacks. the distrust of medical men for healers of the natural school is not hard to explain. many of the natural healers are men of education and experience, but others lack both, and no matter how good the latter may be at heart, they make very serious blunders. for instance: they get out circulars, listing all prominent diseases known, stating that they cure them. they either are so enthusiastic that they are carried away or they are so ignorant that they do not know that there is a stage of degeneration which will not allow of regeneration, and that when such a stage is reached in any chronic disease the end is death. another handicap is that intelligent natural healers have such excellent success that they lose their heads. they educate patients by the hundred into health who have been given up as incurable by the conventional physicians. in their success they forget that modesty is very becoming to the successful and begin to boast. this hurts the cause. let the natural healer ever remember that he does not cure, that he is but the interpreter and that nature is the restorer of health. the natural healers must be more careful about their statements if they would have the respect of intelligent people, and they must labor diligently to be well informed. for their own good regular physicians will have to be more open-minded, and recognize the fact that it is not necessary to have a m. d. degree to accept the truth regarding healing. medical men are losing their hold on the public largely because they have cultivated the class spirit. it is a well known fact among natural healers that most cases of bright's disease are curable, even after they have become chronic. however, a physician who voices this truth will probably be classed among irresponsible dreamers by other doctors. antagonism of this kind breeds extremists and is therefore harmful to the public, which pays for all the mistakes made. it is very easy to lose one's mental balance and to begin to play on a harp with but one string. we have a large army of christian scientists. if it were not for the way in which physicians of the past mistreated the body and neglected the mind, this sect would not exist. the doctors, with their awful doses of nauseous and destructive drugs, went to one extreme. the reaction was the formation of a sect that has gone to the other extreme. the christian scientists are incomprehensible in spots to us mortals who believe in a body as well as a mind, but they have a cheerful and helpful philosophy which brings enjoyment on earth and they have done an immense amount of good by teaching people to cease thinking and talking so much about themselves and their ills. among other demonstrations, they have shown the uselessness of drugs. of late so many varieties of drugless healers have sprung into existence that it is difficult to remember even their names. there are many pathies. these have a tendency to take one part of the human being, or one procedure of treatment, and to play this up to the elimination of all the rest. some do everything with the mind. others pay no attention to the mind. bathing, massage, manipulating the spine, washing out the colon, baths in mud, sunshine or water, suggestion and many other things are separately given credit for being cure-alls. many of these are excellent as a part of regenerative treatment, but they are not sufficient of themselves to give permanent results. most healers have too narrow vision. people come to them because they have faith. the faith alone will produce temporary improvement, but as soon as the interest is gone and the procedure grows old the patient becomes worse again unless the treatment possesses genuine merit. osteopathy is most excellent, as a part of a healing system, but it is not sufficient. the osteopaths find their patients relapsing over and over again, or taking some other disease. however, they are learning, in increasing numbers, that if they would keep their patrons well, they have to give them education along the line of hygiene and dietetics, with a little mental training thrown in. many chiropractors are learning the same thing. in some chiropractic schools there are professors wise enough to teach their students to be broad-minded. the true natural healer makes use of air, water, food, exercise, mental training--in fact, all the means nature has put at his disposal. he realizes that the best treatment is education of the patient. in many cases a cure can be greatly hastened by proper local treatment. it is unfortunate that the nature healers are so divided and that many operate upon such a narrow basis. if the vast majority of them were well informed, broad enough to make use of all helpful natural means, and were designated by the same name, it would not take them long to gain more public confidence and respect than they now possess. so long as the nature healers segregate themselves and allow themselves to be narrow, so long will they have to struggle at a disadvantage against the more united wielders of scalpels and prescribers of drugs. the question of choosing a health guide is sometimes perplexing. the patient should select one in whom he has confidence, for confidence is a great aid in restoring health. it often happens that there is no one in the town in whom the patient has confidence, for many communities have no competent natural healers. then the question is whether or not to seek advice by correspondence. in acute diseases this is generally a bad plan, for the family often lacks the poise and equanimity necessary to carry out directions. in chronic cases it is usually all right. here all that is required is correct knowledge put into practice and errors are not as dangerous as in acute diseases. curable cases will get well by following the advice given by correspondence. a medical man who educates people by correspondence is considered unethical and is severely censured by the ethical brethren. to prescribe medicine by mail is without doubt reprehensible, but to educate people into health is a work of merit, whether it is done face to face or by correspondence. it is advantageous to meet the physician, talk things over and be examined, but it is not necessary. i know of some cases of acute disease treated satisfactorily by letter and telegram, but the patients' families were in sympathy with natural methods, of which they had a fair knowledge, and they had unlimited confidence in the healer. i am personally acquainted with many people who have been educated out of chronic disease and into health by correspondence, after the local physicians had vainly exhausted all their skill. it is simply a matter of applied knowledge and it works just as well in curable cases if given by telephone, telegraph or letter as if imparted by word of mouth. however, it seems to me that it is most satisfactory for all concerned when the healer and the sufferer can meet. my words are not inspired by any ill feeling toward the members of the medical profession. i have found medical men to measure well up in every way. they are better educated than the average and they are as kind and considerate as are other men. as men we can expect no more of them under present conditions, but because they are better equipped than the average, we have a right to ask for an improvement in their practice, even if they have inherited a great many handicaps from their predecessors and it is not easy to throw off the past, which acts as a dead weight ever tending to check progress. the tendency of the times is for fuller, freer and more sincere service in every line, for evolving out of the useless into the greatest helpfulness. it is not asking too much when we demand of the doctors that they rid themselves of the injurious drug superstition and become health teachers, that instead of being in the rear they come to the front and make progress easier. what i say about drugs is founded on intimate observation. i was educated medically in two of the colleges where medication is strongly advocated and well taught, and am a regular m. d. i have watched people who were treated by means of drugs and the biologic products, such as serums, vaccines and bacterines, which are now so popular, and i have watched many who have been treated by natural methods. anyone with my experience and capable of thinking would come to the conclusions given in this book, that it is a mistake to administer drugs and serums and that the natural methods give results so much superior to the conventional methods that there is no comparison. others who have discarded drugs know from experience that this is true. the physicians who are on intimate terms with nature will neither desire nor require drugs. sound advice, that is, teaching, is the most valuable service a physician can render. right living and right thinking always result in health if no serious organic degeneration has taken place. if the public could only be made to realize that they need a great deal of knowledge and very little treatment, and that knowledge is very valuable and treatment often worthless the day would soon dawn when health matters will be placed on a sound, natural basis. surgery is occasionally necessary, but today from ten to twenty operations are performed where but one is needed. "there is nothing new beneath the sun," is a popular quotation. it seems to hold true in the healing art, for the best modern practice was the best ancient practice. naturally, people like to make new discoveries and get credit therefore. our valuable new discoveries in healing are very ancient. though much that appears in these pages may seem strange and new to many, i claim no originality. my aim is to present workable, helpful facts in such a way that any person of average intelligence and will power can apply them, and to get the essentials of health within such a compass that no unreasonable amount of time need be employed in finding them. according to late discoveries, the ancient egyptians were more advanced in the art of living than any other people on earth, including the moderns. they taught that overeating is the chief causative factor of disease, and so it is. they taught cleanliness, the priests going to the extreme of shaving the entire body daily. it would naturally follow that they prescribed moderation in eating, which leads to internal cleanliness. cleanliness of body, in conjunction with cleanliness of mind, will put disease to rout. the ancient greek writers commented on the good state of health among the egyptians, and modern medical writers marvel that they made so little use of drugs. evidently they found drugs of little value, for they were taught hygienic living. the admirable health laws laid down by moses were derived from egyptian sources. the ancient nations were as much influenced by the egyptians as we are today by the greeks who lived before the christian era. the greeks built combination temples and sanitaria, to which the afflicted resorted. the priests were in charge and these ancient heathens were great rogues. by fooling the people they got big fees out of them. their oracular sayings and miracles were adroitly presented. they did not teach that overeating is the chief cause of disease, for this did not suit the mystic times. the people liked oracular prescriptions, and they got them. the law of supply and demand worked as well then as it does now. the heathen priests waxed fat and the medical art degenerated. about five centuries b. c., pythagoras taught that health can be preserved by means of proper diet, exercise and the right use of the mind. he also taught many other truths and some fallacies. in spite of much superstition mixed with his philosophy, it was too pure for the times and he perished. hippocrates, born about years b. c., is one of the bright lights of the medical world. he was so far ahead of his time that he still lives. he was the founder of medical art as we know it. he used many drugs, but he also relied on natural means. he was the first medical man on record to pay serious attention to dietetics. the following quotations will show how well his mind grasped the essentials of the healing art: "old persons need less fuel (food) than the young." "in winter abundant nourishment is wholesome; in summer a more frugal diet." "follow nature." "complete abstinence often acts very well, if the strength of the patient can in any way maintain it." in acute disease he withheld nourishment at first and then he prescribed a liquid diet. he also made use of the "milk cure," which is considered modern, in conjunction with baths and exercise; this is very efficacious in some chronic diseases. he further spoke the oft-forgotten truth that physicians do not heal. "natural powers are the healers of disease." "nature suffices for everything under all conditions." the next great physician was galen, who lived in the second and third centuries of our era. he added greatly to medical knowledge, made extensive use of dietetics, and then in a self-satisfied manner informed his readers that they need look no further for enlightenment, for he had given them all that was of any value. perhaps he meant this as a joke, but those who followed him took it seriously, with the result that medical advance stopped for several centuries. the physicians of the dark ages had some light, as evidenced by this popular quotation taken from a poem that the faculty of the medical college of salerno gave to robert, son of william the conqueror, in the year : "salerno's school in conclave high unites to counsel england's king and thus indites: if thou to health and vigor wouldst attain, shun mighty cares, all anger deem profane; from heavy suppers and much wine abstain; nor trivial count it after pompous fare to rise from table and to take the air. shun idle noonday slumbers, nor delay the urgent calls of nature to obey. these rules if thou wilt follow to the end, thy life to greater length thou may'st extend." during recent times but two important discoveries have been made concerning matters of health: first, the advantage of cleanliness; second, the approximate chemical composition of various foods. all the other important new discoveries are old. cleanliness, moderation in all things, right thinking and a realization of the fact that nature cures are some of the most important stones upon which to build a healing practice. the most important single therapeutic factor is to abstain from food during pain and active disease processes. cleanliness of mind and body has been taught for thousands of years, yet cleanliness of body is a new discovery, for which we are greatly indebted to the great bacteriologist, pasteur. it has been found that germs thrive best in filth; this has been taught so thoroughly that the public is somewhat afraid of the germs and as a measure of self-protection they are cleaning up. of old, cleanliness meant a clean skin, but this is the least important part. it is far more necessary to have a clean alimentary tract and clean blood, with a resultant sweet, healthy body, and this is what cleanliness is beginning to mean. internal cleanliness necessitates moderation, for an overworked alimentary tract becomes foul and some of the poisons are taken into the blood. asepsis and antisepsis simply mean cleanliness. the benefits of moderation have been known for thousands of years. louis cornaro, who died in , wrote a delightful book on the subject. people know that it is necessary to be moderate, but they do not seem to realize the meaning of moderation nor is its value well enough implanted in the human mind to produce satisfactory results. right thinking seemed as important to the thinkers of old as it does to the new thought people today. "as a man thinketh in his heart, so is he." for the better knowledge of the composition of food we have to thank the chemists. laymen are referred to frequently in this book because their work has been so helpful and important. herbert spencer and alfred russel wallace had very clear conceptions regarding health. see their opinions regarding vaccination. there is no difference in the mental processes of physicians and laymen. anyone can know about health, though it takes considerable experience and observation to get acquainted with the less important subject of disease. one indictment against medical men is that they have dwelled almost entirely on disease and paid no attention to health. a group of modern men deserve great credit for popularizing health knowledge, which generally results in the loss of professional standing of the teacher. r. h. trall, m. d., insisted that drugs are useless and harmful, that the only rational and safe way of healing ordinary ills is to use nature's means. "strictly speaking, fever and food are antagonistic ideas," he wrote. in his hydropathic encyclopedia, copyrighted in , he puts great stress on natural remedies, such as food and water. he met with much opposition, but he has left a deep impression on the minds of men who are now having some influence in shaping public opinion on health and healing. dr. charles page of boston has been writing in advocacy of natural healing for over thirty years. he also has emphasized the harmfulness of drugs, the necessity of withholding food from fever patients, and simple living, remaining in touch with nature. another important point which the doctor has been trying to impress upon the public is that it is necessary to retain the natural salts of the foods, instead of ruining them or throwing them away, as is generally done, especially in the preparation of vegetables and many cereal products. dr. edward hooker dewey began to present his ideas to the public a few years after the civil war. his little book entitled "the no-breakfast plan and the fasting cure," has had a great influence among rational healers. the doctor emphasized the importance of going without food in acute diseases so that no one who has read the book can forget it. he pointed out some of the errors of conventional healing as they had never been shown before, and i believe he was the first one to give the correct rules to guide people in the consumption of food. for fourteen years dr. j. h. tilden of denver has been a voluminous writer on health. he teaches that the law of compensation applies to health; that all disease is one and the same fundamentally; that "autotoxemia is the fundamental basic cause of all diseases." like all others who have investigated the subject impartially he believes that one of the most important factors of health is correct feeding. he allows all foods, in compatible combinations. of course, he gives no drugs. dr. harry brook of los angeles is unique among the health educators of today. he is a brainy journalist with a good stock of fundamental health knowledge and is endowed with the ability to place his convictions before the public in a striking manner. he has been carrying on his educational work for many years. elbert hubbard has also had a great deal of influence on the thought of today. at intervals he publishes an article on health which gets wide distribution. he has the faculty of making people think, and those who allow themselves to think independently generally evolve into serviceable knowledge. bernarr macfadden has a large following. he is a strong advocate of physical culture and favors vegetarianism and other changes from conventional life. he educates his readers away from drugs. he has written much that is helpful and his influence is widely felt. like all others who have struggled against the fetters of convention, he has aroused much opposition. there are a few good health magazines, and there are many people living who deserve credit for their labor to improve the mental and physical condition of humanity. some of these will be mentioned and quoted. some of the teachers have dwelled upon but one idea and some have advocated fallacies, but there is good to be found in all of them. no knowledge assays one hundred per cent. pure. no helpful healing knowledge should be kept away from the public; it should be as free as possible. the public, when it understands, willingly pays a fair price for it, which is all that should be asked. to take advantage of the sick and helpless is contemptible. the old-time idea, still prevalent, that medical knowledge is for the doctor only is a mistake. the best patients are the intelligent ones. the office of the physician should be to educate his clients; his best knowledge and his best qualities will be developed in dealing honestly with intelligent people. the practice of medical secrecy began in ancient times when the healers and the priests believed in fooling the public. unfortunately, this professional attitude still survives. no one who has not practiced the healing art can know how tempted a doctor is to fake and humbug a little to retain and gain patronage. emerson wrote: "he is the rich man who can avail himself of other men's faculties. he is the richest man who knows how to draw a benefit from the labors of the greatest number of men--of men in distant countries and past times." those who wish to be healthy and efficient are compelled to advance by taking advantage of other men's faculties. he who attempts to learn all by experience does not live long enough to travel far. everyone should try to get a knowledge of the few most fundamental facts of nature governing life. then it would not be so easy to go astray. health literature should be read with an open mind. read in conjunction with your knowledge of the laws of nature, and then it will be seen that health and disease are according to law, and that by eliminating the mistakes disease will disappear. all disease is one. it is the manifestation of disobeyed natural law, and whether the mistakes are made knowingly or ignorantly matters but little so far as the results are concerned. it is generally considered a disgrace to be imprisoned for transgressing man-made law, which is faulty and complex. how about being in the fetters of disease for disregarding nature's law, which is just and simple? it is my aim to use as simple language as possible. if physicians read these pages, they will understand them without technicalities, and so will laymen. this book contains much knowledge that physicians should have, knowledge that will help them when that which they have acquired from conventional sources fails, but in many respects it is so opposed to popular customs and beliefs that many physicians will doubtless condemn it on first reading. doctors are taught otherwise at medical colleges, and most of them have such high regard for authority that it is very difficult for them to see matters in a different light. i appeal to both laymen and healers with open minds. these rambling thoughts will serve to show the reader whether it is worth while to go any further. the following chapters are devoted to an exposition of a workable knowledge of how to retain health, and how to regain lost health in ordinary cases. they will teach how to get dependable health, how to remain well in spite of climatic conditions, bacteria and other factors that are given as causes of disease, and how to more than double the ordinary span of life. good health and long life result in better work, increased earning capacity and efficiency of body and mind, greater understanding, and more enjoyment of life. it gives time to cultivate wisdom. chapter ii. mental attitude. on mental questions there is a wide divergence of opinion. at one extreme some say that all is mind, at the other, that life is entirely physical, that the mind is but a refined part of the body. most of us recognize both body and mind, and realize that life has a physical basis. if some are pleased to be known as mental phenomena, no harm is done. all desire to make a success of life. what would be a success for one would be a failure for another. it all depends on the point of view. broadly speaking, all are successful who are helpful, whether it be in furnishing pleasure or necessities to others. the humble may be as successful as the great, yes even more so. wealth and success are not synonymous, as many think. among the failures must be counted many of the wealthy. financial success is not real success unless it has been gained in return for valuable service. the men of initiative deserve greater rewards than the plodders and these rewards are cheerfully given. a little genuine love and affection can bring more beauty and happiness into life than wealth, and neither can be bought with money. the best and most satisfying form of success comes to him who helps himself by helping others. "it is more blessed to give than to receive," has passed into common currency; but the more we give the more we receive. he who loves attracts love. he who hates is repaid in kind. "he who lives by the sword shall perish by the sword." the enjoyment of the fruits of one's labor is a part of success. some make a fetish of success and thus lose out. others are so ambitious that in their striving they forget to live. a little ambition is good; too much sows the seed of struggle, strife and discontent and defeats its own ends. those who do evil because the end justifies the means have already buried some of the best that is in them. to enjoy life, health of body and mind is necessary. the mind can not come to full fruitage without a good body. those who strive so hard to reach a certain goal that they neglect the physical become wrecks and after a few years of discomfort and disease are consigned to premature graves. through proper living and thinking the body and mind are built up, not only enough to meet ordinary demands upon them, but extraordinary ones. in other words, it is within our power to have a large margin, balance or reserve of physical and mental force. to make the meaning clearer let us illustrate financially: prudent people lay aside a few dollars from time to time, in a savings bank, for instance. all goes well and the savings grow. at last there are one thousand dollars. now an emergency arises, and if the saver can not furnish nine hundred dollars he will lose his home. in this case he must either borrow or use his reserve, so he takes nine hundred dollars from the savings bank and keeps his home. the improvident man loses his home under similar circumstances, for his credit is not good and he has no balance to draw upon. and it is the same with physical and mental powers, except that we can not borrow these, no matter how much good will or credit we may have. he who lives well is accumulating a reserve. he has a wide margin. if trouble comes he can draw upon his reserve energy or surplus resistance and bridge it over. he may be tired out, but he escapes with body and mind intact. the imprudent liver generally has such a narrow margin that any extraordinary demand made upon him breaks him down. it is very common for men to die after a financial failure. disease, insanity and death often follow family trouble or the loss of a dear one. the reason is that such people live up to their limit every day. they have no margin to work on. they either overdo or underdo and fail to become balanced. then a little physical or mental exertion beyond the ordinary often means a breakage or extinction. equanimity and moderation will help to build up the reserve and give the resistance that is necessary to cope successfully with the unforeseen difficulties that we sometimes have to surmount. the physical state depends largely on the mental state and vice versa. body and mind react upon each other. bad blood does not only cause abnormal functioning of such organs as the heart, liver, kidneys and lungs, but it interferes with the normal functioning of the brain. it diminishes the mental output and causes a deterioration of the quality. an engorged liver makes a man cranky. indigestion causes pessimism. physical pain is so disturbing that the sufferer thinks mostly of himself and is unable to perform his work well. we never do our best when self-conscious. if there is severe pain the mind can perform no useful labor. on the other hand, anger stops digestion and poisons the secretions of the body. worry does the same. it takes the mind from constructive thoughts and deeds and centers it upon ourselves. an effective mind must be tranquil, otherwise it upsets the body and fails to give proper direction to our activities. for a real life success we need a proper perspective. we need to be balanced, poised, adjusted. most of us are too circumscribed mentally. we live so much by and for ourselves that we consider ourselves, individually, of greater importance than the facts warrant. others do not agree with us on this point, and this is a source of disturbance. i am personally acquainted with two surgeons and several physicians who think they are the greatest in the world, and one considers himself the best physician of all time. the rest of the world does not appraise them so highly, and some of these professional men are very much annoyed because of this lack of appreciation. selfishness and self-esteem to a certain point are virtues. beyond that point they become vices. certainly we should think well of ourselves, and then act so that this good opinion is merited. self-interest and selfishness are the main-springs of progress. most of us need some inducement to do good work. it is well that it is so. the ones who deserve the great rewards generally get them, whether they are mental or physical. to obtain a proper perspective of ourselves we must learn to think independently and honestly. it is too common to be conventionally honest, but dishonest with ourselves. it is too common to pass unnoticed in ourselves the faults we condemn in others. we should be lenient in our judgment because often the mistakes that others make would have been ours had we but had the opportunity to make them. as physical ills are principally caused by bad physical habits, so are mental ills and inefficiency chiefly due to various bad mental habits, which are allowed to fasten themselves upon us. these will be briefly discussed so as to focus attention upon them, for the first thing necessary for the correction of a bad habit is to recognize its presence. it is as important to think right as it is to give the body proper care. a good body with a mind working in the wrong direction is of no use. if we allow our minds to be disturbed and distressed by every little unfavorable happening, we shall never have enough tranquility to think well. the proper time to quit our bad habits is now. why wait until the first of the month or the first of the year? every day that we harbor a bad habit it grows greater and strikes deeper and stronger roots. a child one year old can often be broken of a bad habit in a week; a child of three, within a month; a child of six, within a few months; but let the habit grow until the age of twenty, and it may take a year or more to break the bonds. let it continue until the age of thirty, and the victim will say, "i can quit any time," but the chances are that the habit will remain for life. after the individual is fifty or sixty years old, he is rarely capable of changing. if he is the victim of a very bad habit, it has generally so sapped his strength of body and mind that he is unable to break away. the right time to stop bad habits is now. some people have many pet bad habits. it is often the best policy to attack them one at a time. those who try to conquer all at once often fail. they backslide, lose self-confidence, become discouraged, tell themselves that it is no use, for it can not be done. begin with the habit that is least formidable. after this is conquered, overcome another one, and in time most of the bad habits will be subdued. the first conquest builds confidence, and with confidence and determination it is possible to gain self-mastery in time. the greatest evil about bad habits is that they conquer us. they become masters, we slaves. let us be free. "he who conquers himself is greater than he who taketh a city." the mind grows strong by overcoming obstacles, as the body gains in strength through work and exercise. giving up bad habits is very disagreeable at first. those who have conquered the prevalent habit of overeating know that they have been in a fight. the smokers who quit suffer. those who break away from liquor have a much greater struggle. those who attempt to overcome drug addictions suffer the tortures of the damned. those who overcome their bad mental habits have a hard time of it at first, but though it is difficult it is possible. it is no easy matter to curb a fiery disposition or to quit worrying. it requires time, persistence and perseverance. fretting, envy, spite, jealousy and hatred are tenacious tenants of the mind they occupy. these harmful emotions are enemies which sap our strength and we must thrust them from our lives if we would live well. this is not all narrow selfishness, for when we have gained mental calm for ourselves we are in position to impart peace of mind to others and to be more useful than previously. a calm mind is not a stagnant one. it is a mind that is in the best possible condition to work, to think clearly and effectively. _self-pity_ is a very common mental ill. those who suffer much from this affliction usually have very good imagination. they think they are slighted and abused. they know that they do not get their dues. they envy others and are sure that others prosper at their expense. they minimize their blessings and magnify their misfortunes. this state of mind leads to spite and malice. these people become very nervous and irritable and are a nuisance, not only to themselves, but to those who are unfortunate enough to have to associate with them. _self-consciousness_ and _self-centeredness_ are twin evils. the sufferers lack perspective. they magnify their own importance. they believe they are the targets of many other minds and eyes. the youth refuses to take a dip in the ocean because he knows that the rest of the people on the beach are watching his spindle shanks or perhaps the bathing suit would reveal his narrow, undeveloped chest. the young man is afraid to go onto the dance floor because everybody is sure to see his ungainly gyrations. he stammers and stutters when he speaks because others are paying particular attention to his words, when in truth he is attracting little or no attention. whether working or playing, those whose good opinions are worth having are too busy to spend much time in finding fault with others and discovering flaws that do not concern them. more enjoyment is to be had in looking at fine physiques and graceful movements than in watching the less favored. we always do our best when we are natural. when we become self-conscious we become artificial and awkward. we can not even breathe properly. those who are ever thinking about themselves fail to do things well enough to hold sustained attention, even if they are able to gain it for a while. those who do their work well will in time gain the attention and appreciation they require. no one can long occupy a high place in the public heart without adding to the profit or pleasure of the world. here is a good line of thought for those who are too self-centered and self-important: "there are millions of solar systems in the universe, some of them much greater than ours. there are uncounted planets in space, beside some of which our little earth is a mere toy. some of these planets are doubtless inhabited. even on this small earth there are over a billion people. i am one in a number so great that my mind can not grasp such a multitude. countless billions have gone before and they got along very well before i was born. countless billions will live and die after i have passed on, and if they hear of me it will probably be by accident. and so it will be for ages and ages, so extensive that my brain can not grasp the stretch of time, which is without beginning and without end. how much do i, individually, amount to?" and an honest answer _must_ be, "personally i am of very small importance." an individual can not live of himself, for himself and by himself. only as he adds his efforts to those of others does his work count. when we realize that we are but atoms in this vast universe, we get down to a business basis. then it is easy to get adjusted. in order to count at all we must be in harmony with some of the rest of the atoms and when we discover this we are in a mental state to be of some real use. building for individual glory is vanity. sometimes an individual builds so well that he is picked out for special attention and honor, but this is comparatively seldom. as a rule, we can only help a little in shaping the ends of the race by adding our mite, as privates in the ranks. the time we spend in nursing our conceit is wasted. this does not mean that we are worms in the dust. a human being is a paradox. he is so little, yet he has great possibilities. our bodies are kept close to the earth, but our minds can be free and unfettered, soaring through time and space, exploring innumerable worlds of thought. but it will not do to be too self-centered or consider one's self of too great importance, for this lessens one's chances of meriting the esteem of others. the well balanced man is not greatly affected by too great praise or excessive censure, for he realizes that though the public may be hasty and unjust at times, in the end it renders a fairly just verdict. _fear_ is one of the harmful negative or depressing emotions. fear, like all other depressing emotions, poisons the body. this is not said in a figurative sense. it is an actual scientific fact; it has been demonstrated chemically. were it not for the fact that the lungs, skin, kidneys and the bowels are constantly removing poisons from the body, an acute attack of fear would prove fatal. fear or fright is largely a habit. the parents are often responsible for this affliction. it is far too common for them to scare their children. they people the darkness with all kinds of danger and with horrible shapes, and the children, with their vivid imaginations, magnify these. children should be taught to meet all conditions in life courageously and fear should not be instilled into their minds. there is a great deal of difference between fear and the caution which all must learn or perish early. the caution that is implanted in the human breast is our heritage from the ages and works for our preservation. it was necessary during the infancy of the race when man had to struggle with the animals for supremacy. beyond this point fear is a health-destroyer. there are people who cultivate fear until they imagine they are ever in danger. they fear that they may lose their health, their mind, their good name. some are afraid of many things. others have one pet fear. today the fear of the unseen is strong in the public mind. i refer to the fear of germs, those tiny plants which are so small that the unaided eye can not see them. children are shown moving pictures of these tiny beings, enormously enlarged and very formidable in appearance. they are told to beware, for these germs are in our food, in our drink, on the earth, in the air, in fact everywhere that man lives. it is very harmful to scare the young thus, for it inhibits physical action and stunts the mind. how much better it would be to teach the children these truths about the germs: "yes, there are germs in our foods and beverages. they are on the earth, in the water and in the air. they are necessary for our existence. if we take good care of our bodies and direct our minds in proper channels, these germs will not, in fact, can not harm us. if we do not take care of ourselves, but allow our bodies to fill with debris, the germs try to clean this away; they multiply and grow into great armies while doing it, for they thrive on waste. it is our fault, not the fault of the germs, that we allow our bodies to degenerate. the germs are our good friends and if we treat ourselves properly they will do all they can to help keep the water, the earth and the air in fit condition for our use." such teachings have the advantage of being true. they are helpful and healthful. the popular teachings are disease-producing. the mental depression and bodily inhibition caused by fear are injurious. those who fear a certain kind of disease often bring this ill upon themselves, so powerful is suggestion. the fear is more dangerous than the thing feared. in fear there is loss of both physical and mental power. not only the voluntary muscles become impotent, but the involuntary ones lose in effectiveness. digestion is partly or wholly suspended. "scared stiff" is a popular and truthful expression. the bodily rhythm is lost, the breathing becomes jerky and the heart beats out of tune. keep fear out of the lives of babes. if children are taught the truth, there will be little fear in adult minds. children should not be taught prayers in which there is an element of fear. it is much better to bring children up to love other people and god than to fear. those who have cultivated fear should try suggestion. positive suggestion is always best. let them analyze matters thus: "i have feared daily and nightly. nothing has happened. i have brought much unnecessary discomfort upon myself. there is nothing to fear and i shall be brave hereafter." those who fear god have a low conception of him. let them remember the beautiful saying that "god is love." through repeating them often enough, such positive suggestions sink so deeply into the mind that they replace doubts and fears. about years ago pythagoras wrote: "hate and fear breed a poison in the blood, which, if continued, affect eyes, ears, nose and the organs of digestion. therefore, it is not wise to hear and remember the unkind things that others may say of us." pythagoras was an ancient philosopher, but his words express modern scientific truths. _worry_: worrying is perhaps the most common and the worst of our mental sins. worry is like a cancer: it eats in and in. it is destructive of both body and mind. it is due largely to lack of self-control and is a symptom of cowardice. much worry is also indicative of great selfishness, which most of those afflicted will deny. those who worry much are always in poor health, which grows progressively worse. the form of indigestion accompanied by great acidity and gas formation is a prolific source of worry, as well as of other mental and physical troubles. the acidity irritates the nervous system and the irritation in time causes mental depression. confirmed worriers will worry about the weather, the past, the present, the future, about work and about play, about food, clothing and drink, about those who are present and those who are absent. nothing escapes them and they bring sadness and woe in their wake. worrying is slow suicide. elbert hubbard says that our most serious troubles are those that never happen. worrying is a very futile employment, for it never does any good, and it reacts evilly upon the one who indulges in it, and those with whom he associates. it is a waste of time and energy. the energy thus used could be directed into useful channels. let those who are afflicted with this bad and annoying habit get into good physical condition. then many of the worries will take wing. if they persist, it would be well to face the matter frankly and honestly, setting down the advantages of worrying on one side and the disadvantages on the other. then take into consideration that not one thing in a thousand worried about happens, and if something disagreeable does occur, worrying can not prevent it. besides a disagreeable happening now and then will not cause half of the discomfort and trouble that a disturbed mind does. "and this too shall pass away," is an ancient saying which it would be well to remember in conjunction with, "and this will probably never happen." _anger_ is a form of temporary insanity. it is an emotion that is unbecoming in strong men, for it is a sign of weakness, and the women who indulge in it frequently can not long keep the respect of others. those who become angry lay themselves open to wounds of all kinds, for they partly lose their mental and physical faculties temporarily. an angry man is easily vanquished in any contest where ready wit is necessary. as the saying is, he makes a fool of himself. to be high strung and quick to lose one's temper may sound fine in romantic rubbish, but in real life it is folly, for much more can be accomplished by being calm. like hatred, anger produces poisons in the system. an angry mother's milk has been known to kill the nursing child. a fit of anger is so serious that the evil effects can be felt for several days, and those who indulge in daily or even weekly loss of temper can not enjoy the best of health, for the anger produces enough toxins to poison all the fluids of the body. fortunately, anger is one of the emotions that can be conquered in a reasonable time, if there is a real desire to do so. it should not take an adult more than one or two years to get himself under control. during anger there is a tensing of various muscles, those of the face and hands for instance. if this tensing is not allowed the anger will not last long. if there is a tendency to become angry, relax and the mind will ease up. a perfectly relaxed individual can not harbor anger, for this emotion requires tensing of body and mind. a determination to control the temper and a whole-hearted apology after each display of anger will prove very effective in reducing the frequency and force of the attacks. mental suggestion is not as powerful as some say, but it is such a great force for good or evil, depending on its use, that those who are wise will not neglect it as a means of self-conquest. people who are easily offended and "stand on their dignity," have a very poor footing. those who find it necessary to inform others that they are ladies or gentlemen, are very apt to be prejudiced in their own favor. gentlefolks do not need to advertise, nor do they do so. others recognize their worth intuitively. _fretting_ is anger on a small scale. it is a habit that is easily formed. the fretter and those about him are made uncomfortable. those who respect themselves and others do not indulge. _hatred_ is one of the most harmful and poisonous of emotions. fortunately, violent hatred can last but a short time, otherwise it would prove fatal. some are chronic haters. he who hates harms himself. the thoughts weave themselves into one's personality and form the character. _jealousy_ is one of the most disagreeable of emotions. the jealous person insists on suffering. a jealous woman can convert a home into an inferno. jealousy is sure to kill love in time. the jealous individual often excuses himself on the ground that he loves. that is not true. there is more fear than love at the base of jealousy. jealous people are selfish and too indolent mentally to give their thoughts a positive direction. those who are violently jealous are suffering from mental aberration. the jealous person loses, for he drives away the object of his affection. there are many jealous men, but women suffer most. bad health and idleness are two prolific causes of jealousy. it has probably broken up more homes than any other one thing. it is blighting to all it touches. men and women may feel flattered for a time by producing jealousy, but it is a satisfaction of very short duration. they soon grow weary of the questions, doubts and reproaches. those who are sensible enough to give freely to others the liberty they crave for themselves do not suffer much from this emotion. it would help greatly if man and wife would look upon the marriage relation more as a partnership and less as a form of bondage. one of the partners can not force the other one to be "good." people do the best by others when full confidence is given, and even if the confidence should be misplaced, it would be better than to suffer from this corroding emotion at all times. it is not an easy task to overcome jealousy, but it can be done within a reasonable time if there is a real desire. first get physical health. then get busy with interesting, useful work. get something worth while to occupy the mind and the hands. determine to be master of yourself and not a slave to what is often but figments of the imagination. unfortunately, jealousy so dwarfs the judgment at times that the sufferers seek only to rule or ruin. love and hate are so closely akin that it is hard to find the dividing line. _sorrow_: some dedicate their lives to a sorrow. they make martyrs of themselves. they have suffered a loss and they dwell upon it during all of their waking hours. it may be that it was a very ordinary or worthless husband or child. after death the poor real is converted into a glorious ideal. with the passing years the virtues of the departed grow. all the love and tenderness are lavished upon the dead and the living are neglected. it is generally women who suffer from this peculiar form of mild insanity, but men are not exempt. it is natural to feel the loss of a dear one, but so long as we are mortal we must accept these things as matters of course. related to this form of sorrow is the regretting or brooding over past actions, especially in connection with the dead. perhaps something that should have been done was neglected, or something was done that should have been left undone. over this the sufferer broods by the hour, leading to a form of sad resignation that is rather irritating to normal people. for such people a change of interest and a change of scene will often prove very beneficial. _envy_ and _spite_ are closely akin to jealousy and anger. they have the same effect in lesser degree. _vacillation of mind_ is a common fault. many small questions have to be settled and a few important ones. some are in the habit of deferring their decisions from time to time, or making and revoking their decisions. then they decide over again, after which there is another revocation. this is repeated until it is absolutely necessary to make a final decision. by this time the mind is so muddled that the chances are that the last decision will be inferior to the first one. no one who leads an active life can be right all the time. he who is right six times out of ten does pretty well, and he who can make a correct decision three times out of four can command a fine salary as an executive or build up a flourishing business of his own, if his mind is active. the doubt and uncertainty which result from unsettled questions, which should be promptly decided, are more harmful than an occasional error. the untroubled mind works most quickly and truly. related to this in minor key is the doubtful condition of mind where the individual has to do things several times before he is sure they are properly done. for instance, there is the man who must try the office door several times to be sure that it is locked and after being satisfied on this point he is obliged to unlock it and investigate the condition of the safe door. then it is necessary to attend to the office door two or three times again. this kind of doubtfulness takes many forms. it does no special harm except that it leads to much waste of time. such people should teach themselves concentration, thinking about one thing only at a time, until they learn that when a thing is done it is properly done. _judging_: many insist on passing judgment on everything and everybody that come to their notice. every individual has to be placed with the sheep or the goats. this is a great waste of time. each one of us can know so little about the majority of individuals we meet and of the vast volume of knowledge that is to be had that if we try to judge everyone and everything, our opinions become worthless. wise people are never afraid to say, "i don't know." if it is necessary to judge, let there be kindness. _volunteering advice_: this is another annoying habit. it is very well to give advice if it is desired and asked for, otherwise it is a waste of time. take a person with a cold, for example: if he meets twenty people he may be told of fifteen different cures for it, ranging from goose grease on a red rag to suggestive therapeutics. if he were to act upon all the advice received there would probably be a funeral. it is best to be sparing with advice. those who have any that is worth while will be asked for it and paid for their trouble. free advice is generally worth what it costs. _cranks_: many allow themselves to get into a mental rut with their thoughts running almost entirely to one subject. this is a mild form of insanity, for normal people have many interests. these people are the cranks. they can talk volumes about their favorite topic, often of no importance. it may be some peculiar religion or ethics; or that bacon wrote the plays of shakespeare; or some health fad, or almost any subject. of all the cranks the diet crank is one of the most annoying, for he has three good opportunities to air his views each day. with the best meaning in the world he does more harm to the cause of food reform than do the advocates of living in the good old way, eating, drinking and being merry and dying young. when people become possessed of too much zeal and enthusiasm regarding a subject, they are sure that their knowledge is the truth and they insist upon trying to enforce their way upon others, resent having their old habits interfered with forcibly. those who are too persistent and insistent produce antagonism and prejudice in the minds of others, and then it is almost impossible to impart the truth to them, for they will neither see nor hear. to be able to influence others for better is a grand and glorious thing, but it is well to remember that we can not force knowledge which is contrary to popular thought upon others suddenly. those who change a well rooted opinion generally do so gradually. when they first hear the truth, they say it is ridiculous. after a while they think there may be something in it. at last they see its superiority over their former opinions and accept it. it requires infinite patience on the part of the educators to impart unpopular knowledge to other adults, no matter how much truth it contains. the truth about physical well-being is so simple and so self-evident that it is exceptionally hard to get an unprejudiced audience. from the time when the ancient heathen priests were the healers until today the impression has been that health and healing are beyond the understanding of the common mind, and therefore people are willing to be mystified. the mysterious has such a strong appeal in this world of uncertainties that it is more attractive than the simple truth. mystery simply demands faith. the truth compels thinking and thoughts are often painful. by all means, avoid being overinsistent in trying to impart health knowledge to others. all who have a little knowledge of the fundamentals of health and growth know that useful men and women are going into degeneration and premature death constantly, because of violated health laws. if these people on the brink, who can yet be saved by natural means, are told how it can be done, they generally either refuse to believe it, or they have led such self-indulgent lives that it is beyond their power to change. the knowledge often comes too late. those who are anxious to do good in the spreading of health knowledge among their friends can serve best by getting health themselves. if a physical wreck evolves into good health there will be considerable comment and inquiry. this is the opportunity to tell what nature will do and inform others where to obtain a good interpretation of nature's workings. a little practicing is worth more than a great deal of preaching. the truth is the truth, no matter what the source, but it is more effective if it comes from one who lives it. i have gone into the subject of health cranks so deeply because there are so many of them. they get a little knowledge and then they believe they are masters of the subject. the right attitude toward proper living, and especially toward proper eating is: "i shall try to conduct myself so as to be healthy and efficient. if others desire my help, i shall try to indicate the way to them. right living is no sign of superior goodness or merit, being a matter of higher selfishness, so i deserve no credit for it. although health is very important, i shall refrain from attempting to force my will on others." after conquering ourselves it is time to begin making foreign conquests, but by that time the realization comes that in the end it is best to leave others free to work out their own salvation. the desire is strong to mould others according to our pattern, but those who size themselves up honestly soon come to the conclusion that they are so imperfect that perchance some other pattern is fully as good. _postponing happiness_: one peculiar state of mind is to refuse to be happy at present. the romantic girl and boy think they can not be happy until they are married. after marriage they find that they have to gain a certain amount of wealth before happiness comes. then they have to postpone it for social position. they continue postponing happiness from time to time and the result is that they never attain it. happiness is not a great entity that bursts upon us, transforming us into radiant beings. it is a comfortable feeling that brings peace and places us in harmony with our surroundings. it can best be gained by doing well each day the work that is to be done, cheerfully giving in return for what is received. happiness is largely a habit. it is as easy to be bright and cheerful as it is to be sad and doleful, and much more comfortable. if we look for the best we will find beauty even in the most unpromising places. if we are looking for tears and woe, we can easily find them. we can get along without happiness, but it adds so much color and beauty to life, it makes us so much better, it helps us so much to be useful that it is folly to do without it. it is not gained by narrow selfishness. those who forget themselves most and are kind and considerate find it. by giving it to others we get it for ourselves. ecstasy and rapture are emotions of short duration. they are so exhilarating that they soon wear out. we all have our little troubles and annoyances. these we should accept as inevitable, and neither think nor talk much about them. they help to wear away the rough edges. we are stupid at times and so are others and then mistakes are made. these should also be accepted as inevitable, and we should not be more annoyed by those that others make than by our own. those who go into a rage when their subordinates err waste much time and energy, erring gravely themselves. it is not necessary to notice every unimportant detail that is not pleasing. fault-finding, carping and nagging destroy harmony. disagreements about trifles often lead to broken friendship and enmity. most quarrels are about trifles. if mistakes are made, learn the lesson they teach and then forget about them. all live, active beings make mistakes. sometimes we make serious ones and afterwards regrets come, but these must soon be thrust aside. brooding has put many into the insane asylums. _introspection_: it is not well to allow the mind to dwell upon one's self very much. give yourself enough thought to guide yourself through life, and then for the rest apply the mind to work and play. many of those who are too self-centered end up in believing they are something or somebody else and then they are shut away from the public. introspection is a very useless employment. individually we are so small, and the mind has such great possibilities, that if we center it upon our tiny physical being, things become unbalanced and the mind ceases to work to good advantage. it is useless to go deeply into self-analysis, for we are very poor judges of ourselves. one of my neighbors delved so deeply into his heart and tried so hard to find out if he was fit to dwell in heaven that he lost his mind and had to be confined for a long time. he allowed his vision to narrow down to one subject. there are many subjects that lead to insanity if they are allowed exclusive possession of the mind. after we have given ourselves proper care, we should think no more about ourselves. the best way is to get busy in work and play and forget ourselves. it is much better to love others than to center our love upon ourselves. if we conduct ourselves well we shall have all the love from others that we need. if there is a tendency to be introspective, cure it by becoming active mentally and physically. those who have acquired the bad habit of thinking and talking ill of others should break themselves of it. first cease talking ill. then begin to look for the good points and mention them. by and by the thoughts will be good. those who lack a virtue can often cultivate it by assuming it. one of the most helpful things is a sense of humor. laughter brings about relaxation and relaxation gives ease of body and mind. he who can see his own weaknesses and smile at them is surely safe and sane. if the mind is too austere, cultivate a sense of humor. train yourself to appreciate the ridiculous appearance you make and instead of being chagrined, smile. when others laugh at you, join them. whatever the mental ill may be, one-half of its cure will be brought about by getting physical health. be charitable, tolerant and kind, and the good things in life will come to you. be slow to judge and slower still to condemn others. those who give love attract it. hypatia said: "express beauty in your lives and beauty flows to you and through you. to love means to be loved, and to put hate behind is the sum of all loving that is of any avail." the best "new thought" is the best old thought. if we only would put some of the beautiful knowledge into common use, what an agreeable dwelling place this world would be. marcus aurelius gave us this pearl of wisdom: "when you arise in the morning, think what a precious privilege it is to live, to breathe, to think, to enjoy, to love! god's spirit is close to us when we love. therefore it is better not to resent, not to hate, not to fear. equanimity and moderation are the secrets of power and peace." chapter iii. food. the human body is so wonderfully made that as yet we have only a poor understanding of it, but we are learning a little each decade, and perhaps in time we shall have a fair knowledge both of the body and of the mind. body and mind can not be considered as two separate entities, for neither one is of any use without the other. the body is not a machine. those who look upon it as such make the mistake of feeding it as they would an engine, thinking that it takes so much fuel to keep going. the human organism is perhaps never quite alike on any two consecutive days, for the body changes with our thoughts, actions and environment, and the conditions never quite repeat themselves and therefore we have to readjust ourselves. the most important single item for gaining and retaining physical health is proper feeding, yet the medical men of this country pay so little attention to this subject that in some of our best equipped medical colleges dietetics are not taught. a total of from sixteen to thirty hours is considered sufficient to fit the future physicians to guide their patients in the selection, combination and preparation of food. dietetics should be the principal subject of study. it should be approached both from the scientific and from the empirical side. it is not a rigid subject, but one which can be treated in a very elastic way. the scientific part is important, but the practical part, which is the art, is vastly more important. a part of the art of feeding and fasting is scientific, for we get the same results every time, under given conditions. when we consider the fact that the body is made up of various tissues, such as connective tissue, blood, nerves and muscles; that these in turn are made up of billions of cells, as are the various glandular organs and membranes; that these cells are constantly bathed in blood and lymph, from which they select the food they need and throw the refuse away, we must marvel that an organism so complex is so resistant, stable and strong. all articles of good quality are made by first-class workmen from fine materials. however, many people fail to realize that in order to have quality bodies they must take quality food, properly cooked or prepared, in the right proportions and combinations. if we feed the body properly, nature is kind enough to do good constructive work without any thought on our part. you will find no rigid rules in these talks on diet, but you will find information that will enable you to select foods that will agree with you. people may well disagree on what to eat, for there are so many foods that a person could do without nine-tenths of them and still be well nourished. in fact, we consume too great a variety of food for our physical well-being. great variety leads to overeating. a healthy human body is composed of the following compounds, in about the proportions given: water, to per cent. mineral matter, to per cent. protein, to per cent. carbohydrates, per cent. fat, per cent. this is perhaps excessive. these substances are very complex and well distributed throughout the body. they are composed of about sixteen or seventeen elements, but a pure element is very rarely found in the body, unless it be a foreign substance, such as mercury or lead. about per cent of the body is oxygen, which is also the most abundant element of the earth. then in order of their weight come carbon, hydrogen, nitrogen, calcium, phosphorus, sulphur, sodium, chlorine, fluorine, potassium, iron, magnesium and silicon. because it will be helpful in giving a better idea of the necessity for proper feeding, i shall devote a few words to each of these elements. _oxygen_ is a colorless, tasteless, odorless gas, forming a large part of the atmospheric air, of water, of the earth's crust and of our foods. it is absolutely essential to life, for without oxygen there can be no combustion in the animal tissues, and without combustion there can be no life. the union of oxygen with fats, carbohydrates and proteins in the body results in slow combustion, which produces heat and energy. our chief supply of oxygen comes directly from the air, but this is supplemented by the intake in food and water. _carbon_ is the chief producer of energy within the body, being the principal constituent of starches, sugars and fats. it is what we rely on for internal heat, as well as for heating our dwellings, for the essential part of coal is carbon. the carbonaceous substances are needed in greater quantity than any other, but if they are taken pure, they cause starvation more quickly than if no food were eaten. this has been proved through experiments in feeding nothing but refined sugar, which is practically pure carbon. salts and nitrogenous foods are essential to life. _hydrogen_ is a very light gas, without odor, taste or color. it is a necessary constituent of all growing, living things. it is plentifully supplied in water. all acids contain hydrogen and so does the protoplasm of the body. _nitrogen_ is also a colorless, tasteless, odorless gas. it is an essential constituent of the body, being present in all compounds of protein. it is abundant in the atmospheric air, from which it is taken by plants. we get our supply either directly from vegetable foods or from animal products, such as milk, eggs and meat. _calcium_ is needed principally for the bones and for the teeth, but it is also necessary in the blood, where it assists in coagulation. we get sufficient calcium salts in fruits, grains and vegetables, provided they are properly prepared. the conventional preparation of the food often results in the loss of the various salts, which causes tissue degeneration. if the supply of calcium in the food is too small, the bones and the teeth suffer, for the blood removes the calcium from these structures. growing children need more calcium proportionately than do adults. this is without doubt the reason pregnant women suffer so much from softening of the teeth. they are fed on foods robbed of their calcium, such as white bread and vegetables that have been drained. _phosphorus_ in some forms is a poison whether taken in solid compounds or inhaled in fumes, producing phossy jaw. in other forms it is indispensable for bodily development. the compounds of phosphorus are present in fats, bones and protein. in natural foods they are abundantly present, but when these foods are unduly refined, or are soaked in water which is thrown away, much of the phosphorus is lost. we get phosphorus from milk, eggs, cereals, legumes and other foods. of course, there is phosphorus in fish, but those who eat sea food to make themselves brainy will probably be disappointed. phosphates are necessary for brain development, but those who eat natural foods never need to go to the trouble of taking special foods for the brain. if the rest of the body is well nourished, the brain will have sufficient food, and if the body is poorly nourished the brain will suffer. _sulphur_ is present in protein and we get a sufficient supply from milk, meat and legumes. the element sulphur is quite inert and harmless, but some of its acids and salts are very poisonous. sulphur dioxide is freely used in the process of drying fruits, as a bleacher. in this form it is poisonous, and for that reason it would be well to avoid bleached dried fruits. we need some sulphur, but not in the form of sulphur dioxide or concentrated sulphurous acid, both of which are used in the manufacture of food. _sodium_, in its elementary state, which is not found in nature, is a white, silvery metal. it is found in great abundance in the succulent vegetables, and is present in practically all foods. as sodium chloride, or common table salt, it is taken in great quantities by most people. those who have no salt get along well without it, which shows that it is not needed in large amounts. if but a little is added to the food, it does no perceptible harm, but when sprinkled on everything that is eaten, from watermelons to meat, it is without doubt harmful. by soaking foods, they are deprived of much of their soda: the two sodium salts that are very abundant are sodium chloride, or common salt, and sodium carbonate, generally called soda. _chlorine_ is ordinarily combined in our foods with sodium or potash, forming the chlorides. it is essential to life. he who gets enough sodium also gets enough chlorine. in its elementary form it is an irritating gas, used for bleaching purposes. _fluorine_ is present in small quantities in the body, appearing as fluorides in the bones and teeth. it is supplied by the various foods. in its elementary form it is a poisonous gas. _potassium_ is found in the body in very small quantities, but it is very important. it is mostly in the form of potassium phosphate in the muscles and in the blood. it is necessary for muscular activity. it is found in most foods in greater abundance than is sodium, which indicates that it plays an important part in development. like sodium, it is easily dissolved out of foods which are soaked in water, and this is one of the reasons that vegetables should not be soaked and the water thrown away. it is very peculiar in its metallic state, being a silvery metal, very light in weight, which burns when thrown upon water. that is, it decomposes both itself and the water with the liberation of so much heat that it fires the escaping hydrogen, which burns with a violet flame. pure potassium is not found in nature. _iron_ is found in very small quantities in the human body, but it is absolutely essential to life. animals deprived of iron die in a few weeks, and people will do the same under similar circumstances. iron is obtained principally from fruits and vegetables, but it is also present in other foods. man can not make use of inorganic iron. he has to get his supply from the vegetable and animal kingdoms. the giving of inorganic iron is folly and helps to ruin the teeth and the stomach of the one who takes it. in the form of hemoglobin this element is the chief agent in carrying oxygen from the lungs to the tissues of the body. in the manufacture of foods, much of the iron is lost. for instance, whole wheat flour contains about ten times as much iron as does the white flour. too little iron causes, among other ills, anemia, and if the iron is very low, chlorosis or the green sickness may ensue. _magnesium_ is found principally as phosphate in the bones. it is present both in animal and vegetable foods. its function in the body is not well understood, but it appears to assist the phosphorus. _silicon_ is found in traces in the human body. it is supplied in small quantities in nearly all of our foods, and therefore we must take it for granted that it is necessary, although we are in the dark as to its uses. it is very abundant in various rocks. the cereals are especially rich in silicon. in wheat it is found in the bran and is removed from the white flour. the elements mentioned are the most important in the body, though others are found in traces. we do not find the elements present as elements, but in the form of very complex compounds. under our present conditions of living, we generally partake of too much carbonaceous and nitrogenous food, and get too little of the salts, except sodium chloride, which is taken in too great quantity. salt, to most people, means but one thing, sodium chloride or table salt. however, there are thousands of salts, and when salts are mentioned in this book, all those necessary for the processes of life are meant, whether they be compounds of fluorine, sulphur, phosphorus, calcium, iron or magnesium or other metals and minerals. salts are not usually classified as foods, but they are essential to life. supply the body with all the protein, sugar, starch and fat that it requires, but withhold the salts, and it is but a question of a few weeks before life ceases. this is why it is so important to improve our methods of cooking. a potato that is peeled, soaked in cold water and boiled, may lose as much as one-half of its salts, according to one of the bulletins sent out by the u. s. department of agriculture. other vegetables not only lose their salts by such treatment, but as high as per cent of their nutritive value. the lesson we should learn from this is that ordinarily if it is necessary to soak foods, such as beans, they should be cooked in the water in which they have been soaked. furthermore, where possible, as it is with nearly all succulent vegetables, we should take the fluid in which the vegetables have been cooked as a part of the meal. if the vegetables are properly cooked, there will not be much fluid to take. to pour away the water in which vegetables have been cooked means that perhaps one-third of the food value and one-third to one-half of the valuable salts are lost. why continue impoverishing foods in this way? dr. charles page deserves much credit for calling our attention to this fact when most healers neither thought nor talked about it. now all up-to-date healers with a knowledge of dietetics realize how important it is to give good food. for those who wish more detailed information on the composition of the salts, i insert a table which was compiled by otto carque and published in "brain and brawn," february, . those who wish still more detailed knowledge can find it in volumes on food analysis and in some government reports. mineral matter in parts of water-free food products. ========================================================================== p p m h o a o c t c g s s s h a s a n p u i l s o l e h l l o s d c s i o p i r i i i i r r h c i u u u u o u u o n m m m m n s r n e total| | | | | | | | | salts| k o |na o | cao | mgo |fe o |p o | so |sio | cl -------------------------------------------------------------------------- human milk . | . | . | . | . | . | . | . | . | . cow's milk . | . | . | . | . | . | . | . | . | . meat (avge) . | . | . | . | . | . | . | . | . | . eggs . | . | . | . | . | . | . | . | . | . seafish . | . | . | . | . | ....| . | ....| ....| . cottage cheese . | . | . | . | . | . | . | . | ....| . | | | | | | | | | apples . | . | . | . | . | . | . | . | . | .... strawberries . | . | . | . | ....| . | . | . | . | . gooseberries . | . | . | . | . | . | . | . | . | . prunes . | . | . | . | . | . | . | . | . | . peaches . | . | . | . | . | . | . | . | . | .... cherries . | . | . | . | . | . | . | . | . | . grapes . | . | . | . | . | . | . | . | . | . figs . | . | . | . | . | . | . | . | . | . olives . | . | . | . | . | . | . | . | . | . apricots . | . | . | . | . | . | . | . | . | .... pears . | . | . | . | . | . | . | . | . | .... watermelons . | . | . | . | . | . | . | . | . | . bananas . | . | . | . | . | . | . | . | ....| . oranges . | . | . | . | . | . | . | . | . | . | | | | | | | | | spinach . | . | . | . | . | . | . | . | . | . onions . | . | . | . | . | . | . | . | . | . carrots . | . | . | . | . | . | . | . | . | . asparagus . | . | . | . | . | . | . | . | . | . radishes . | . | . | . | . | . | . | . | . | . cauliflower . | . | . | . | . | . | . | . | . | . cucumbers . | . | . | . | . | . | . | . | . | . lettuce . | . | . | . | . | . | . | . | . | . potatoes . | . | . | . | . | . | . | . | . | . cabbage . | . | . | . | . | . | . | . | . | . tomatoes . | . | . | . | . | . | . | . | . | . red beets . | . | . | . | . | . | . | . | . | . celery . | . | . | . | . | . | . | . | . | . | | | | | | | | | walnuts . | . | . | . | . | . | . | . | . | . almonds . | . | . | . | . | . | . | . | . | . cocoanuts . | . | . | . | . | ....| . | . | . | . | | | | | | | | | lentils . | . | . | . | . | . | . | ....| ....| . peas . | . | . | . | . | . | . | . | . | . beans . | . | . | . | . | . | . | . | . | . peanuts . | . | . | . | . | . | . | . | . | . | | | | | | | | | whole wheat . | . | . | . | . | . | . | . | . | . white flour . | . | . | . | . | . | . | ....| ....| .... rye . | . | . | . | . | . | . | . | . | . barley . | . | . | . | . | . | . | . | . | .... oats . | . | . | . | . | . | . | . | . | . corn . | . | . | . | . | . | . | . | . | . whole rice . | . | . | . | . | . | . | . | . | . rice, polished . | . | . | . | . | . | . | . | . | . -------------------------------------------------------------------------- please remember that most of the salts must be worked into organic form for us by vegetation, and that we are able to take but few elements that have not been thus elaborated. we need a moderate amount of food to maintain the body in health, but we should be careful not to overindulge. perhaps the most injurious errors are made by people who eat because they wish to gain in weight. they consider themselves below weight and they try to force a gain by overeating. this is a serious mistake and leads to much suffering. there is no weight that can be called ideal for all people. to get a basis, i copy a table from the literature of an insurance company. this is for people twenty years old: height weight -- ........ ........ ........ ........ ........ ........ ........ ........ ........ ........ ........ ........ -- ........ ........ ........ ........ if the weight is much above this, it is a sure sign that the individual is building disease. it may be bright's disease, fatty heart, arteriosclerosis, cancer or any other ill. the muscles can not be increased in size very much by eating and there is a limit to the amount of fluid that can be stored away. stout people generally carry about a great amount of fat. excess of fat is a burden. it replaces other tissues and weakens the muscles. it overcrowds the abdominal and thoracic cavities, thus making the breath short and the working of the heart more difficult, also producing a tendency to prolapsus of the various abdominal organs. people make the mistake of thinking that stoutness indicates health. it indicates disease. going into weight is going into degeneration. women like to be plump for various reasons, some of which are not the most creditable to either men or women. fat people are not good looking. there is not a statue in the world sculptured on corpulent lines that is considered beautiful. it is natural for some people to be slender and for others to be rather plump, but fatness is abnormal. rolling double chins and protruding abdomens are signs of self-abuse in eating and drinking. as a rule women are at their right weight at twenty and men at twenty-two or twenty-three. this weight they should retain. if twenty or thirty pounds are added to it life will be materially shortened. perfect health is impossible for obese people, but it is within the reach of lean ones. in getting well, it is often necessary to become quite slender, but after the system has cleansed itself, it gains in weight again. it may take from several months to several years to obtain a normal weight after the ravages of disease. a healthy body is self-regulating and will be as heavy as it ought to be. those who eat too much in order to gain weight sometimes wreck their digestive and assimilative powers to such an extent that they lose a great deal of weight, and the more they eat the more they lose. then it is necessary to reduce the food intake until digestion and assimilation catch up with supply. then if the eating is right the individual goes to the proper weight and retains it. the slender people are in the safest physical condition. the vast amount of statistics gathered by the life insurance companies bears this out. remember that fat is a low grade tissue, which sometimes crowds out high grade tissue, that an excess indicates degeneration and that obesity is a disease. all fat people eat too much, even though they consider themselves small eaters. they should regulate their eating and drinking so that they will return to a normal weight. this is the only safe way to reduce. pay no attention to underweight. eat what the body requires and is able to digest and assimilate, without causing any inconvenience. the organism will take care of the rest. to attempt to force weight onto a body at the expense of discomfort, disease, reduced efficiency and premature death shows poor judgment. losing weight does not matter at all if there is no discomfort or disease. it is all right to be a little lighter during summer than in winter. in discussing food and its use, two words are frequently employed, digestion and fermentation. strictly speaking, digestion is largely a process of fermentation, consisting of the breaking down of complex substances into simple ones, by means of ferments. however, in the popular mind digestion and fermentation are not synonymous, and will not be so considered in this book. to make my meaning clear, in this book the words will have the following meaning: digestion--the normal breaking down of food and formation into substances that can be used by the blood for building, repairing and producing heat and energy. fermentation--the abnormal breaking down of food in the digestive tract, producing discomfort and health impaired. this process manifests in various ways, such as the production of much gas in the digestive tract or hyperacidity of the body. we will consider digestion as a process conducive to health, but fermentation, as one that leads to disease, being an early stage of digestive derangement. chapter iv. overeating. all agree that excessive indulgence in alcoholics is harmful physically, mentally and morally. we condemn the too free use of tea and coffee and nearly all other excesses. however, intemperate eating is considered respectable. a large part of our social life consists in partaking of too much food. medical text-books say that we must eat great quantities of food to maintain strength and health. humanity views the subject of eating from the wrong angle, and it will perhaps be many years before the majority gets the right point of view. we should eat to live, but most of us eat to die. benjamin franklin said that we dig our graves with our teeth. men and women band themselves into societies and associations for the purpose of decreasing or doing away with the use of tobacco and alcoholic drinks. they advocate temperance and even abstinence in the use of those things which do not appeal to their own senses; but most of them are far from temperate in their eating. they have very keen vision when searching for weaknesses and faults in others, but are quite near-sighted regarding their own. is excessive indulgence in liquor any worse than overeating? not according to nature's answer. the inebriate deteriorates and so does the glutton. both cause race deterioration. gluttony is more common than inebriety and is responsible for more ills. gluttony is often the cause of the tea, coffee, alcohol and drug habits. overeating often causes so much irritation that food does not satisfy the cravings, and then drugs are used. improper eating, chiefly overeating, causes most of the ills to which man is heir. if people would learn to be moderate in all things disease and early death would be very rare. it is quite important to combine foods properly, but the worst combinations of food eaten in moderation are harmless, as compared to the damage done by overeating of the best foods. overeating is with us from the cradle to the grave. it shortens our days and fills them with woe. there is a hoary belief that a pregnant woman must eat for two. the mothers have generally obeyed this dictum. the result is that women suffer greatly during pregnancy and at childbirth. the morning sickness, the aching back, the headache, the swollen legs and all of the discomforts and diseases from which civilized woman suffers during this period are mostly due to improper eating. pregnancy and childbirth are physiologic and are devoid of any great amount of discomfort, pain or danger when women lead normal lives. the overeating affects both mother and child. the mothers are often injured or lose their lives during childbirth. sometimes labor is so protracted that the child dies and at other times the baby is so large that it can not be born naturally. the mother's suffering is frequently very great. in fact, it is at times so great that it is like a threatening storm cloud to many women, and some of them refuse to become mothers for this reason. babies born of normal mothers, who have lived moderately on a non-stimulating diet during gestation, are small. they rarely weigh more than six pounds. their bones are flexible. the skull can easily be moulded because the bones are very cartilaginous. the result is that childbirth is rapid and practically devoid of pain. however, there are very few normal mothers, and consequently normal babies are also rare. a heavy baby is never healthy. its growth has been forced by excessive maternal feeding. it is no hardier than other growing things which result from hot-house methods. such babies show early signs of catarrhal afflictions, indigestion or skin disease. their bodies are filled with poisons before they are born. mothers who overeat invariably overfeed their babies. and why should they do otherwise? family, friends and physicians give the same advice: the mother must eat much to be able to feed the child, and the child must be fed frequently in order to grow. it sounds very plausible, but it does not work well in practice. why are babies cross? why do they soon show catarrhal symptoms? why do they vomit so much? why are they so subject to stomach and intestinal disorders? why do they have skin eruptions? because they are overfed. the diseases of babies are almost entirely of digestive origin, and in nearly every instance overfeeding is the cause. statistics show that about one-fifth of the babies born die before they are one year old. in nearly every instance the parents are to blame. one's intentions may be good, but good intentions coupled with wrong actions are deadly to infants. oscar wilde wrote, "we kill the thing we love." parental love too often takes the form of indulging them and so it happens that hundreds of thousands of little ones are placed in their coffins annually through love. each year about , babies under one year of age perish in the united states, according to estimates based on census figures. outside of accidental deaths, which are but a small per cent., the mortality should be practically nil. it is natural for children to be well, and healthy children do not die. if an army of about , of our men and women were to perish in a spectacular manner each year it would cause such sorrow and indignation that a remedy would soon be found. but we are so accustomed to the procession of little caskets to the grave that it hardly arouses comment. it costs too much in every way to produce life to waste it so lavishly. why do little children suffer so much from eruptive diseases, whooping cough, tonsilitis, adenoids, diphtheria and numerous other diseases? because they are overfed. the younger the child the greater is the per cent. of disease due to wrong feeding. in adult life overeating and eating improperly otherwise are still the principal causes of disease. but during adult life the causation of disease is more complex than in childhood, for the senses have been more fully developed and instead of confining our physical sins to overeating we fall prey to the abuse of various appetites and passions. vigorous adults are often the victims of pneumonia, typhoid fever and tuberculosis. overeating is chiefly to blame, not the bacteria which are given as the principal cause. rheumatism, kidney disease and diseases that manifest in hardening of the various tissues, all being forms of degeneration, are quite common. again, the principal cause is overeating. there are a great number of people who live many years without any special disease, but who are always on the brink of being ill. they are full-blooded and too corpulent. although they are often considered successful, they are never fully efficient either physically or mentally. they do not know what good health is, but they are so accustomed to their state of toleration that they consider themselves healthy. they are rather proud of their stoutness and their friends mistake their precarious condition for health. these people often die suddenly, and friends and acquaintances are very much surprised. no healthy man dies suddenly and unexpectedly except by accident. instead of growing old gracefully, in possession of our senses and faculties, we die prematurely or go into physical and mental decay. bleary eyes, pettiness, childishness and lost mental faculties are no part of nature's plan for advanced years. those manifestations result from man's improvement on nature! from birth to death we are victims of this terrible ogre of overeating. it deprives us of friends and relatives. it takes away our strength and health. it makes us mentally inefficient and cowardly. at last it deprives us of life when our work is not half done and our days should not be half run. how is it possible, you may ask, that this is true? of course, overeating is not the only cause, but it is the overwhelming one. it is the basic cause. aided by other bad habits it conquers us. we are what we are because of our parentage, plus what we eat, drink, breathe and think, and the eating largely influences the other factors of life. cholera infantum causes the death of many babies. it never occurs in babies who are fed moderately on natural, clean food, not to exceed three or four times a day. the child is cross. the mother thinks that it is cross because it is hungry and accordingly feeds. the real cause of the irritability is the overfeeding that has already taken place. the baby has had so much milk that it is unable to digest all of it. a part of the milk spoils in the digestive tract. this fermented material is partly absorbed and irritates the whole system. a part of it remains in the alimentary tract where it acts as a direct local irritant to the intestines. when these are irritated, the blood-vessels begin to pour out their serum to soothe the bowels and the result is diarrhea. the sick child is fed often. digestive power is practically absent. the additional food given ferments and more serum has to be thrown out to protect the intestinal walls. soon there is a well established case of cholera infantum. if only enough food had been given to satisfy bodily requirements, none of the milk would have spoiled in the alimentary tract. if all feeding had been stopped as soon as the child became irritable and pinched looking about the mouth and nose, and all the water desired had been given and the child kept warm, there would have been no serious disease. in these cases, the less food given the quicker the recoveries and the fewer the fatalities. another common disease of childhood is adenoids. to talk of these maladies as diseases is rather misleading, for they are merely symptoms of perverted nutrition, but we are compelled to make the best of our medical language. adenoids are due to indigestion. the indigestion is due to overeating. this is how it comes about: a child eats more than can be digested, generally bolting the food, which is often of a mushy character. the excessive amount of food can not be digested, and as the intestines and the stomach are moist and have a temperature of degrees fahrenheit, fermentation soon takes place. some of the results of fermentation in the alimentary tract are acids, gases and bacterial poisons. these deleterious substances are absorbed into the blood stream and go to all parts of the body, acting as irritants. we do not know why they cause adenoids in one child and catarrh in another. it is easy enough to say that children are predisposed that way, which is no information at all. it seems that all of us have some weak point, and here disease has a tendency to localize. what part the sympathetic nervous system plays, we do not know. glandular tissue is rather unstable and therefore it becomes diseased easily and adenoids are therefore quite frequent. a coated tongue, or an irritated tongue, both due to indigestion, is a concomitant of adenoids. such diseases do not merely happen. there are good reasons for their appearance. they are not reflections on the child, but they are on the parents who should have the right knowledge and should take time and pains enough to educate and train the child into health. tuberculosis is one of the results of ruined nutrition. first there is overeating. this causes indigestion. the irritating products of food fermenting in the alimentary tract are taken up by the blood. the blood goes to the lungs where it irritates the delicate mucous membrane. in self-protection it begins to secrete an excess of mucus and if the irritation is great enough, pus. the various bacteria are incidental. the tubercular bacillus is never able to gain a foothold in healthy lungs, but after degeneration of lung-tissue has taken place the lungs furnish a splendid home for this bacillus. the tubercular bacillus is a scavenger and therefore does not thrive in healthy bodies. it is the result of disease, not the cause. tubercular subjects never have healthy digestive organs. unfortunately, nearly all of them are persuaded to eat many times more food than they can digest, and thus they have no opportunity to recover, for the overfeeding ruins the digestive and assimilative powers beyond recuperative ability. a large per cent. of the human race perish miserably from this disease, which results principally from the ingestion of too much food. the liberal use of such devitalized foods as sterilized milk, refined sugar and finely bolted wheat flour is doubtless a great factor in so reducing bodily resistance that the system falls an easy prey to disease. too little breathing and poor, devitalized air are also important factors. there are many causes of rheumatism, but overeating is the chief and it is very doubtful if a case of rheumatism can develop without this main cause. exposure is often given as the cause, but a healthy man with a clean body does not become rheumatic. rheumatism is due to internal filth. a filthy alimentary tract makes filthy blood. some say that the poison in rheumatism is uric acid, and perhaps it is, but there are no uric acid deposits in the body of a prudent eater. the elimination in this disease is imperfect. the skin, the kidneys, the bowels and the lungs do not throw out the debris as they should. perhaps only one or two of these organs are acting inadequately. the debris is stored up in the system. why do the organs of elimination fail to act? because so much work is thrust upon them that they grow weary and worn; also, a part of the material furnished them is the product of decay in the alimentary tract, and they can not thrive on poor material. too much food is eaten. an excess of nutritive material, poorly digested, is absorbed. and so we come back to the principal cause, overeating. when the eliminative organs fail to perform their function, the waste is deposited in those parts of the body which are weakened. the irritation from these foreign substances causes inflammation and the result is pain. the extent to which this depositing of material will go is well illustrated in some cases of multiple articular rheumatism, or arthritis deformans, where the deposits are so great that many of the joints become fixed (anchylosed). we could review all the diseases, and nearly every time we would come back to disturbed nutrition as the principal factor, and this is true of not only physical ills, but the mental ones as well. various foods do not combine well, still if they are eaten in moderation they do but little harm. if we overeat, the evil results are bound to manifest, no matter how good the food, though it sometimes takes years before they are perceptible. the effects are cumulative. each day there is a little fermentation with absorption of the poisonous products. each day the body degenerates a little. the time always comes when the body can continue its work no longer, and then the individual must choose between reform on one hand and suffering or death on the other. it is very difficult to convince people that they eat too much. indeed, the average person is a small eater, in his own estimation. we have been educated into consuming such vast quantities of food that we hardly know what moderation is. in the past, physiologists and observers have watched the amount of food that people could coax down and this they have called the normal amount of food. this is far from the truth. the average american eats at least two times as much as he can digest, assimilate and use to advantage. many eat three and four times too much. however, nature is very tolerant for a while. most of us start out with a fair amount of resistance and are thus enabled to live to the age of forty or fifty in spite of abuses. if we could only dispense with our excesses, we could double or treble our life span, live better, get more enjoyment out of life and give the world more and better work than we can under present conditions. there is much talk of food shortage. the amount of food consumed and wasted annually in the united states is enough to feed , , people. even with our present knowledge we can easily produce twice as much per acre as we are averaging, and we are tilling only about one-fourth of the land that could be made productive. if we use our brains there is little danger of starving. what is needed now is not more food, but intelligent distribution and consumption of what we produce. we hear of cases of undernourishment. this doubtless occurs at times in the congested parts of great centers of populations. but there are not so many cases suffering from want of the proper quantity of food as from want of quality of food. bread of finely bolted white flour is starvation food, no matter how great the quantity, unless other food rich in organic salts is also eaten. the overeating habit is so common and comes on so insidiously that the sufferers do not realize that they are eating to excess. the resultant discomforts are blamed on other things. babies are fed every two hours or oftener. they should be fed but three or at most four times a day, and never at night. when able to eat solid foods they get three meals a day and generally two or more lunches. some children seem to be lunching at all times. they have fruit or bread and butter with jelly or jam in the hand almost all the time. they are encouraged to eat much and often to produce growth and strength. this kind of feeding often does produce large children, heavy in weight, but they are not healthy. sad to relate, the excess causes disease and death. such frequent feeding allows the digestive organs no rest. the overwork imposed upon them and the fermentation cause irritation. this irritation manifests in a constant and almost irresistible desire for food, as does the consumption of much alcohol cause a desire for more alcohol, as the use of morphine or cocaine produces a dominating and ruinous appetite for more of these drugs. these appetites grow by what they feed upon. man ceases to be master and becomes the abject slave of his abnormal cravings. slaves of alcohol and the various habit-forming drugs generally lack the strength of body and mind to assert themselves and to regain mastery of themselves. coffee and tea have their victims, though they are generally not very firmly enslaved. no one realizes how he is bound by his cravings for an excessive amount of food until he tries to break the bonds. such people may eat moderately for days, perhaps for weeks, and then the old appetite reasserts itself in all its strength and unless the sufferer has a very strong will a food debauch follows. i have seen men go from one restaurant to another, consuming enormous quantities of food to efface the awful craving, just as men go from one saloon to another to satisfy their desire for alcohol. the gluttons often look with the greatest contempt upon the slaves of liquor. but what is the difference? no matter what appetite, what habit, what passion has gained the mastery, we are slaves. the important thing is to keep out of slavery, or break the bonds and regain freedom. those who eat to excess often eat more than three times a day. they take a little candy now, a little fruit then, or they go to the drug store for a glass of malted milk or buttermilk, which they call drinks, or they take a dish of ice cream. the housewife nibbles at cake or bread. if a person is in fair health and wishes to evolve into self-mastery and good health, he should make up his mind never to eat more than three times a day. nothing but plain water should enter his mouth except at meal times. next he should limit the number of articles eaten at a meal. the breakfast and lunch should each consist of no more than two or three varieties of food. the dinner should not exceed five or six varieties, and if that many are eaten, they should be compatible. less would be better. the less variety we have, the better the food digests. also, eating ten or twelve or more kinds of food, as many people do, always leads to overeating. a little of this added to a little of that soon makes a too great total. it is easy to eat all one should of a certain article of food and feel satisfied, and then change off to something else and before one is through one has eaten three or four times as much as necessary. if the meal is to consist of starch there is no great objection to a small amount of bread, potatoes, rice, macaroni and chestnuts. however, a normal person does not need to coax food down by using great variety. those who mix their foods this way invariably overeat. besides, the various starches require different periods for digestion. rice is more easily disposed of than bread. each new item stimulates the desire for more food. it is best, when having potatoes, to have no other starchy food in that meal; or when bread is eaten, to have no potatoes or other starchy food. the habit of eating meat, potatoes and bread in the same meal is very common and causes much disease. next the searcher for health should teach himself to eat foods that are natural, cooked simply, and with a minimum amount of seasoning and dressing. the various spices and sauces irritate the digestive organs and create a craving for an excessive amount of food. the food should be changed as little as possible because such denatured foods as white flour, polished rice, pasteurized milk, and many of the canned fruits and vegetables are so lacking in the natural salts that they do not satisfy one's desire for organic salts. overeating results. preserves, jellies and jams are open to the same objection. they cause an abnormal desire for food. therefore, they should be used seldom and very sparingly. so long as apples, oranges, figs, dates, raisins, sweet prunes and various other fruits can be had, there is no excuse for the consumption of great quantities of the heavily sugared concoctions which are now so popular. simplicity and naturalness are great aids in breaking away from food slavery. they are discussed more fully elsewhere. in the next chapter will be found hints on the solution of the normal amount of food to be eaten. chapter v. daily food intake. it is generally believed that the more we eat the better. physicians say that it is necessary to eat heartily when well to retain health and strength. when ill it is necessary to consume much food to regain lost health and strength. "eat all you can of nourishing food," is a common free prescription, and it sounds very reasonable. the physicians of today are not to blame for this belief in overeating, for they were taught thus at college, and very few men in any line do original thinking. it has been a racial belief for centuries and no one now living is responsible. when a physician advocates what he honestly believes he is doing his best, "and angels can do no more." when a child loses its appetite, the parents worry, for they think that it is very harmful for young people to go without food for a few meals. a lost appetite is nature's signal to quit eating, and it should always be heeded. if it is, it will prevent much disease and suffering and will save many lives. the present-day mode of preparing food leads to overeating. the sense of taste is ruined by the stimulants put into the food. dishes are so numerous and so temptingly made that more is eaten than can be digested and assimilated. refined sugar, salt, the various spices, pickles, sauces and preserves all lead to overeating because of stimulation. the same is true of alcohol taken immediately before meals. if we only give nature a chance, and are perfectly frank and honest with ourselves, she will guard us against the overconsumption of food. those who eat but few varieties of plain food at a meal are not sorely tempted to overeat. but when one savory dish is served after another it takes much will power to be moderate. people generally have had more than sufficient before the last course is served. however, the various dishes have different flavors and for this reason the palate is overwhelmed and accepts more food than is good for us. men who like to call their work scientific, figure on the amount of food we need to furnish a certain number of heat units--calories. heat, of course, is a form of energy. basing the body's food requirements on heat units expended does not solve the problem. the more food that is ingested, the more heat units must be manufactured, and often so much food is taken that the body is compelled to go into the heating business. then we have fevers. a large part of the heat is given off by the skin. those who overeat are compelled to do a great deal of radiating. this excessive amount of fuel taken into the system in the form of food, wears out the body. as figured by the experts, it gives a result of food need that is at least twice as great as necessary. experience is the only correct guide to food requirements, and each individual has to settle the matter for himself. the human body is not exactly a chemical laboratory, nor is it an engine which can be fed so much fuel with the resultant production of such and such an amount of heat and energy. some bodies are more efficient than others. it is among human beings as among the lower animals, some require more food than others. we need enough food to repair the waste, to perform our work and to furnish heat. every muscle contraction uses up a little energy. every breath deprives us of heat and carries away carbon dioxide, the latter being formed by oxidation of tissues in the body. every minute we lose heat by radiation from the skin. every thought requires a small amount of food. if we worry, the leak of nervous energy is tremendous, but at the same time we put ourselves in position where we are unable to replenish our stock, for worry ruins digestion. all this expenditure of energy and loss of heat must be made up for by the food intake. only a small amount of surplus food can be stored in the body. some fat can be stored as fat. some starch and sugar can be put aside as either glycogen--animal sugar--or be changed into fat. this storing of excess food is very limited, except in cases of obesity, which is a disease. overeating invariably causes disease. it may take two or three years, yes even twenty or thirty years, before the overeating results in serious illness, but the results are certain, and in the meanwhile the individual is never up to par. he can use neither body nor mind to the best advantage. to emphasize and illustrate these remarks, i shall copy a few diet lists, which their authors consider reasonable and correct for the average person for one day, and i shall give my comments. the first is taken from kirke's physiology, which has been used extensively as a text-book in medical colleges: grams lean uncooked meat, " bread, " butter, " cheese, " potatoes, " carrots. an ounce contains . grams; a pound, grams. it is easy to figure these quantities of food in ounces or pounds, which give a better idea to the average person. it is self-evident that this is too much food. over twelve ounces of lean, uncooked meat, over twenty-one ounces of bread, almost one-half of a pound each of potatoes and carrots, about an ounce of cheese and over three ounces of butter make enough food for two days, even for a big eater. he who tries to live up to a diet of this kind is sure to suffer disease and early death. the average loaf of bread weighs about fourteen ounces. here we are told to devour one-half of a pound of carrots (for which other vegetables such as turnips, parsnips, beets or cabbage may be substituted), one-half of a pound of potatoes, three-fourths of a pound of lean raw meat, which loses some weight in cooking, a loaf and one-half of bread, besides butter and cheese. the vast majority of people can not eat more than one-third of this amount and retain efficiency and health, but many eat even more. the next table is taken from dr. i. burney yeo's book on diet, and is given as the food required daily by a "well nourished worker": . grams meat, . " white of egg, . " bread, . " milk, . " beer, . " suet, . " butter, . " starch, . " sugar, . " salt. this worker is too well fed. often those who are so well fed are poorly nourished, for the excessive amount of food ruins the nutrition, after which the food is poorly digested and assimilated. this worker eats so much that he will be compelled to do manual labor all his days, for such feeding prevents effective thinking. the following daily average diet is taken from the book, "diet and dietetics," by a. gauthier, a well known authority on the subject of the nutritive needs of the body. mr. gauthier averaged the daily food intake of the inhabitants of paris for the ten years from to , inclusive. he takes it for granted that this is the average daily food requirement for a person: . grams bread and cakes, . " boned meat, . " eggs (weighed with shell), . " cheese (dry or cream), . " butter, oil, etc., . " fresh fruit, . " green vegetables, . " dried vegetables, . " potatoes, rice, . " sugar, . " salt, . c. c. milk, . c. c. of various alcoholics, containing . c. c. of pure alcohol. so long as the parisians consume such quantities of food they will continue to suffer and die before they reach one-half of the age that should be theirs. the french eat no more than do other people, in fact, they seem moderate in their food intake as compared with some of the germans, english and americans, but they eat too much for their physical and mental good. the lists given above are from sources that command the respect of the medical profession. they are the orthodox and popular opinions. it would be an easy matter to give many more tables, but they agree so closely that it would be a waste of time and space. quantitative tables from vegetarian sources are not so common. the vegetarians say that meat eating is wrong, being contrary to nature. whether they are right or wrong, they make the same mistakes that the orthodox prescribers do, that is, they advocate overeating. medical textbooks prescribe a too abundant supply of starch and meat in particular. the vegetarians prescribe a superabundance of starch. read the magazines advocating vegetarianism and note their menus, giving numerous cereals, tubers, peas, beans, lentils, as well as other vegetables, for the same meal. it is as easy to overeat of nuts and protein in leguminous vegetables as it is to overeat of meat. starch poisoning is as bad as meat poisoning and the results are equally fatal. the following are suggestions offered by a fruitarian. they give the food intake for two days: grams shelled peanuts, raw, " apples, " unfermented whole wheat bread. grams shelled filberts, " raisins, " bananas. in the first day's menu it will be noted that over two pounds of apples and over one pound of whole wheat bread are recommended, also over four ounces of raw peanuts. the writer says that this food should preferably be taken in two meals. there are very few people with enough digestive and assimilative power to care for more than one-half of a pound of whole wheat bread twice a day, especially when taken with raw peanuts, which are rather hard to digest. the trouble is made worse by the addition of more than one pound of apples to each meal, for when apples in large quantities are eaten with liberal amounts of starch, the tendency for the food to ferment is so strong that only a very few escape. gas is produced in great quantities, which is both unnatural and unpleasant. neither stomach nor bowels manufacture any perceptible amount of gas if they are in good condition and a moderate amount of food is taken. whole wheat bread digests easily enough when eaten in moderation, but it is very difficult to digest when as much as eight ounces are taken at a meal. one can accustom the body to accept this amount of food, but it is never required under ordinary conditions and the results in the long run are bad. the food prescribed for the second day is more easily digested, but it is too much. raisins are a splendid force food, but no ordinary individual needs a pound of raisins in one day, in addition to about one and three-fourths pounds of bananas, which are also a force food and are about as nourishing as the same amount of irish potatoes. in all my reading it has not been my good fortune to find a diet table for healthy people, giving moderate quantities of food. diet lists seem scientific, so they appeal to the mind that has not learned to think of the subject from the correct point of view. quantitative diet tables are worthless, for one person may need more than another. some are short and some are tall. some are naturally slender and others of stocky build. there is as much difference in people's food needs as there is in their appearance. to try to fit the same quantity and even kind of food to all is as senseless as it would be to dress all in garments of identical size and cut. if we eat in moderation it does not make much difference what we eat, provided our diet contains either raw fruits or raw vegetables enough to furnish the various mineral salts and the food is fairly well prepared. there are combinations that are not ideal, but they do very little harm if there is no overeating. people who are moderate in their eating generally relish simple foods. unfortunately, there is but little moderation in eating. from childhood on the suggestion that it is necessary to eat liberally is ever before us. medical men, grandparents, parents and neighbors think and talk alike. if the parents believe in moderation, the neighbors kindly give lunches to the children. it is really difficult to raise children right, especially in towns and cities. after such training we learn to believe in overeating and we pass the belief on to the next generation, as it has in the past been handed down from generation to generation. finally we die, many of us martyrs to overconsumption of food. ask any healer of intelligence who has thrown off the blinders put on at college and who has allowed himself to think without fear, and he will tell you that at least nine-tenths of our ills come from improper eating habits. it is not difficult to make up menus of compatible foods. no one knows how much another should eat, and he who prepares quantitative diet tables for the multitude must fail. however, every individual of ordinary intelligence can quickly learn his own food requirements and the key thereto is given by nature. it is not well to think of one's self much or often. it is not well to be introspective, but everyone should get acquainted with himself, learning to know himself well enough to treat himself with due consideration. we are taught kindness to others. we need to be taught kindness to ourselves. the average person ought to be able to learn his normal food requirements within three or four months, and a shorter time will often suffice. the following observations will prove helpful to the careful reader: food should have a pleasant taste while it is being eaten, but should not taste afterwards. if it does it is a sign of indigestion following overeating, or else it indicates improper combinations or very poor cooking. perhaps food was taken when there was no desire for it, which is always a mistake. perhaps too many foods were combined in the meal. or it may be that there was not enough mouth preparation. it is generally due to overeating. cabbage, onions, cucumbers and various other foods which often repeat, will not do so when properly prepared and eaten in moderation, if other conditions are right. eructation of gas and gas in the bowels are indications of overeating. more food is taken than can be digested. a part of it ferments and gas is a product of fermentation. a very small amount of gas in the alimentary tract is natural, but when there is belching or rumbling of gas in the intestines it is a sign of indigestion, which may be so mild that the individual is not aware of it, or it may be so bad that he can think of little else. when there is formation of much gas it is always necessary to reduce the food intake, and to give special attention to the mastication of all starch-containing aliments. also, if starches and sour fruits have been combined habitually, this combination should be given up. starch digests in an alkaline medium, and if it is taken with much acid by those whose digestive powers are weak, the result is fermentation instead of digestion. people should never eat enough to experience a feeling of languor. they should quit eating before they feel full. if there is a desire to sleep after meals, too much food has been ingested. when drowsiness possesses us after meals we have eaten so much that the digestive organs require so much blood that there is not enough left for the brain. this is a hint that if we have work or study that requires exceptional clearness of mind, we should eat very moderately or not at all immediately before. the digestive organs appropriate the needed amount of blood and the brain refuses to do its best when deprived of its normal supply of oxygen and nourishment. serpents, some beasts of prey and savages devour such large quantities of food at times that they go into a stupor. there is no excuse for our patterning after them now that a supply of food is easily obtained at all times. a bad taste in the mouth is usually a sign of overeating. it comes from the decomposition following a too liberal food intake. if water has a bad taste in the morning or at any other time, it indicates overeating. it may be due to a filthy mouth or the use of alcohol. heartburn is also due to overeating, and so is hiccough; both come from fermentation of food in the alimentary tract. a heavily coated tongue in the morning indicates excessive food intake. if the tongue is what is known as a dirty gray color it shows that the owner has been overeating for years. the normal mucous membrane is clean and pink. the mucous membrane of the mouth, stomach and the first part of the bowels should not be compelled to act as an organ of excretion, for the normal function is secretory and absorptive. however, when so much food is eaten that the skin, lungs, kidneys and lower bowel can not throw off all the waste and excess, the mucous membrane in the upper part of the alimentary tract must assist. the result is a coated tongue, but the tongue is in no worse condition than the mucous membrane of the stomach. a coated tongue indicates overcrowded nutrition and is nature's request to reduce the food intake. how much? enough to clean the tongue. if the coating is chronic it may take several months before the tongue becomes clean. a muddy skin, perhaps pimply, is another sign of overeating. it shows that the food intake is so great that the body tries to eliminate too many of the solids through the skin, which becomes irritated from this cause and the too acid state of the system and then there is inflammation. many forms of eczema and a great many other skin diseases are caused by stomach disorders and an overcrowded nutrition. there is a limit to the skin's excretory ability, and when this is exceeded skin diseases ensue. some of the so-called incurable skin diseases get well in a short time on a proper diet without any local treatment. dull eyes and a greenish tinge of the whites of the eyes point toward digestive disturbances due to an oversupply of food. the green color comes from bile thrown into the blood when the liver is overworked. the liver is never overtaxed unless the consumption of food is excessive. another very common sign of too generous feeding is catarrh, and it does not matter where the catarrh is located. it is true that there are other causes of catarrh, in fact, anything that irritates the mucous membrane any length of time will cause it, but an overcrowded nutrition causes the ordinary cases. it is the same old story: the mucous membrane is forced to take on the function of eliminating superfluous matter, which has been taken into the system in the form of food. many people dedicate their lives to the act of turning a superabundance of food into waste, and as a result they overwork their bodies so that they are never well physically and seldom efficient mentally. many people, especially women, say that if they miss a meal or get it later than usual, they suffer from headache. this indicates that the feeding is wrong, generally too generous and often too stimulating. a normal person can miss a dozen meals without a sign of a headache. to repeat: no one can tell how much another should eat, but everyone can learn for himself what the proper amount of food is. enough is given above to help solve the problem. the interpretations presented are not the popular ones, but they are true for they give good results when acted upon. if bad results follow a meal there has been overeating, either at the last meal or previously. undermasticating usually accompanies overeating and causes further trouble. those who masticate thoroughly are generally quite moderate in their food intake. many say that they eat so much because they enjoy their food so. he who eats too rapidly or in excess does not know what true enjoyment of food is. excessive eating causes food poisoning, and food poisoning blunts all the special senses. to have normal smell, taste, hearing and vision one must be clean through and through, and those who are surfeited with food are not clean internally. the average individual does not know the natural taste of most foods. he seasons them so highly that the normal taste is hidden or destroyed. those who wish to know the exquisite flavor of such common foods as onions, carrots, cabbage, apples and oranges must eat them without seasoning or dressing for a while. to get real enjoyment from food it is necessary to eat slowly and in moderation. i know both from personal experience and from the experience of others that seasoning is not necessary. instead of giving the foods better flavor, they taste inferior. a little salt will harm no one, but the constant use of much seasoning leads to irritation of the digestive organs and to overeating. salt taken in excess also helps to bring on premature aging. it is splendid for pickling and preserving, but health and life in abundance are the only preservatives needed for the body. refined sugar should be classed among the condiments. people who live normally lose the desire for it. grapefruit, for instance, tastes better when eaten plain than when sugar is added. people who sleep seven or eight hours and wake up feeling unrefreshed are suffering from the ingestion of too much food. a food poisoned individual can not be properly rested. to get sweet sleep and feel restored it is necessary to have clean blood and a sweet alimentary tract. much has been said about overeating. once in a while a person will habitually undereat, but such cases are exceedingly rare. to undereat is foolish. at all times we must use good sense. it is a subject upon which no fixed rules can be promulgated. be guided by the feelings, for perfect health is impossible to those who lack balance. those who think they need scientific direction may take one of the orthodox diet tables. if it contains alcoholics, remove them from the list. then partake of about one-third of the starch recommended, and about one-third of the protein. use more fresh fruit and fresh vegetables than listed. instead of eating bread made from white flour, use whole wheat bread. do not try to eat everything given on the scientific diet list each day. for instance, rice, potatoes and bread are given in many of these tables. select one of these starches one day, another the next day, etc. if one-third of the amount recommended is too much, and it sometimes is, reduce still further. please bear in mind that the orthodox way, the so-called scientific way, has been tried over a long period of time and it has given very poor results. moderation has always given good results and always will. chapter vi. what to eat. it is very important to eat the right kind of food, but it is even more important to be balanced and use common sense. those who are moderate in their habits and cheerful can eat almost anything with good results. of course, people who live almost entirely on such denatured foods as polished rice, finely bolted wheat flour products, sterilized milk and meat spoiled in the cooking, refined sugar and potatoes deprived of most of their salts through being soaked and cooked will suffer. there are many different diet systems, and some of them are very good. if their advocates say that their way is the only way, they are wrong. many try to force their ideas upon others. they find their happiness in making others miserable. they are afflicted with the proselyting zeal that makes fools of people. this is the wrong way to solve the food problem. let each individual choose his own way and allow those who differ to continue in the old way. many have changed their dietary habits to their own great benefit. after this they become so enthused and anxious for others to do likewise that they wear themselves and others out exhorting them to share in the new discovery. this does no good, but it often does harm, for it leads the zealot to think too much of and about himself, and it annoys others. many are like my friend who lunched daily on zwieback and raw carrots. "i think everybody ought to eat some raw carrots every day; don't you?" she said. we can not mold everybody to our liking, and we should not try. if we conquer ourselves, we have about all we can do. if we succeed in this great work, we will evolve enough tolerance to be willing to allow others to shape their own ends. to volunteer undesired information does no good, for it creates opposition in the mind of the hearers. if the information is sought, the chances are that it may in time do good. it is well enough to indicate how and where better knowledge may be obtained. we should at all times attempt to conserve our energy and use it only when and where it is helpful. such conduct leads to peace of mind, effectiveness, happiness and health. the tendency to become too enthusiastic about a dietary regime that has brought personal benefit is to be avoided, for it brings unnecessary odium upon the important subject of food reform. people do not like to change old habits, even if the change would be for the better, and when an enthusiast tries to force the change his actions are resented. he makes no real converts, but as pay for his efforts he gains the reputation of being a crank. those who wish to be helpful in an educational way should be patient. the race has been in the making for ages. its good habits, as well as its bad ones, have been acquired gradually. if we ever get rid of our bad habits it will be through gradual evolution, not through a hasty revolution. we need a change in dietary habits, but those who become food cranks, insisting that others be as they, retard this movement. only a few will change physical and mental habits suddenly. if those who know are content to show the benefits more in results than in words, their influence for good will be great. what shall we eat? how are we to know the truth among so many conflicting ideas? we can know the truth because it leads to health. error leads to suffering, degeneration and premature death. as the homely saying goes, "the proof of the pudding is in the eating." let us look into some of the diet theories before the public and give them thoughtful consideration. the late dr. j. h. salisbury advocated the use of water to drink and meat to eat, and nothing else. the water was to be taken warm and in copious quantities, but not at or near meal time. the meat, preferably beef, was to be scraped or minced, made into cakes and cooked in a very warm skillet until the cakes turned gray within. these meat cakes were to be eaten three times a day, seasoned with salt and a little pepper. the doctor had a very successful practice, which is attested by many who were benefited when ordinary medical skill failed. his diet was not well balanced. in meats there is a lack of the cell salts and force food. especially are the cell salts lacking when the flesh is drained of its blood. the animals of prey drink the blood and crunch many of the bones of their victims, thus getting nearly all the salts. but in spite of his giving such an unbalanced diet, the doctor had a satisfactory practice and good success. why? because his patients had to quit using narcotics and stimulants and they were compelled to consume such simple food that they ceased overeating. it is a well known fact that a mono-diet forces moderation, for there is no desire to overeat, as there is when living on a very varied diet. another fact that the salisbury plan brings to mind is that starch and sugar are not necessary for the feeding of adults, although they are convenient and cheap foods and ordinarily consumed in large quantities. the fat in the meat takes the place of the starch and sugar. atomically, starch, sugar and fat are almost identical, and they can be substituted one for the other. nature makes broad provisions. dr. salisbury's career also serves to remind us that a mixed diet is not necessary for the physical welfare of those who eat to live. vegetarians dwell upon the toxicity of meat. but dr. salisbury fed his patients on nothing but meat and water, and the percentage of recoveries in chronic diseases was considered remarkable. meat is very easy to digest and when prepared in the simple manner prescribed by the doctor and eaten by itself it will agree with nearly everybody. but when eaten with soup, bread, potatoes, vegetables, cooked and raw, fish, pudding, fruit, coffee, crackers and cheese, there will be overeating followed by indigestion and its consequent train of ills. however, it is not fair to blame the meat entirely, for the whole mixture goes into decomposition and poisons the body. the cures resulting from dr. salisbury's plan also help to disprove the much heralded theory of dr. haig, that uric acid from meat eating is the cause of rheumatism. overeating of meat is often a contributory cause. we are told that the rheumatics who followed dr. salisbury's plan got well. they regained physical tone. they lost their gout and rheumatism. they parted company with their pimples and blotches. all of which would indicate that the blood became clean. the chief lesson derived from dr. salisbury's plan and experience is the helpfulness of simple living and moderation. an exclusive diet of meat is not well balanced. energy produced from flesh food is too expensive. the good results came from substituting habits of simplicity and moderation for the habit of overeating of too great variety of food. the same results may be obtained by putting a patient on bread and milk. dr. salisbury's patients had unsatisfied longings, doubtless for various tissue salts. the addition of fresh raw fruits or vegetables would improve his diet, for apples, peaches, pears, lettuce, celery and cabbage are rich in the salts in which meats are deficient. dr. emmet densmore recommended omitting the starches entirely, that is, to avoid such foods as cereals, tubers and legumes. he believed that it is best to live on fruits and nuts. he recommended the sweet fruits--figs, dates, raisins, prunes--instead of the starchy foods. the doctor did much good, as everyone does who gets his patients to simplify. he also had good results before discovering that starch is a harmful food, when he fed his patients bread and milk. starch must be converted into sugar before it can be used by the body. the sugar is what is known as dextrose, not the refined sugar of commerce. the sweet fruits contain this sugar in the form of fruit sugar, which needs but little preparation to be absorbed by the blood. dr. densmore reasons thus: only birds are furnished with mills (gizzards); hence the grains are fit food for them only. other starches should be avoided because they are difficult to digest, the doctor wrote. raw starches are difficult to digest, but when they are properly cooked they are digested in a reasonable time without overburdening the system, provided they are well masticated and the amount eaten is not too great and the combining is correct. rice, which contains much starch, digests in a short time. we can do very nicely without starch. we can also thrive on it if we do not abuse it. the two chief starch-bearing staples, rice and wheat, contain considerable protein and salts in their natural state. in fact, the natural wheat will sustain life for a long time. man has improved on nature by polishing the rice and making finely bolted, bleached wheat flour, deprived of nearly all the salts in the wheat berry. the result is that both of them have become very poor foods. the more we eat of these refined products the worse off we are, unless we partake freely of other foods rich in mineral salts. not long ago a lady died in england who was a prominent advocate of a "brainy diet." her brainy diet consisted largely of excessive quantities of meat, pork being a favorite. she died comparatively young, her friends say from overwork. such a diet doubtless had a large part in wearing her out. to overeat of meat is dangerous. a gentleman is now advocating a diet of nothing but cocoanuts. this is a fad, for they are not a balanced food. he has published a book on the subject. perhaps his advocacy is influenced by his interest in the sale of cocoanuts. the vegetarians condemn the use of meat. some of them are called fruitarians. it is very difficult to decide who are the most representative of them. some advocate the use of nothing but fruit and nuts. others add cereals to this. others use vegetables in addition. some even allow the use of dairy products and eggs, that is, all foods except flesh. they say that meat is an unnatural food for man and condemn its use on moral grounds. it is difficult to decide what is natural, for we find that man is very adaptable, being able to live on fruits in the tropics and almost exclusively on flesh food, largely fat, in the arctic regions. in nature the strong live on the weak and the intelligent on the dull. there is no sentiment in nature. in her domain might, physical or mental, makes right. sentiments of right and justice are not highly developed except among human beings, and even there they are so weakly implanted that it takes but little provocation for civilized man to bare his teeth in a wolfish snarl. with some vegetarianism is largely a matter of esthetics, ethics and morality. morality is based on expediency, so it really is a question whether meat is an advantageous food or not. another vegetarian argument is that man's anatomy proves that he was not intended by nature to eat meat. good arguments have been used on both sides, but they are not very convincing nor are they conclusive. it is hard to draw any lines fairly. another objection to meat is that it is unclean and full of poisons, that these poisons produce various diseases, such as cancer. we are also informed that refined sugar causes cancer, and the belief in tomatoes as a causative factor is not dead. cancer is without doubt caused principally by dietary indiscretions but it is impossible to single out any one food. no matter what foods we eat, we are compelled to be careful or they will be unclean. those who wish clean meat can obtain it. the amount of poison or waste in a proper portion of meat is so small that we need give it no thought. those who eat in moderation can take meat once a day during cold weather and enjoy splendid health. during warm weather it should be eaten more seldom. on the other hand, meat is not necessary. we need a certain amount of protein, which we can obtain from nuts, eggs, milk, cheese, peanuts, peas, beans, lentils, cereals and from other food in smaller amounts. the amount of protein needed is small--about one-fifth of what the physiologists used to recommend. those who think meat eating is wrong should not partake of it. they can get along very well without it. we are consuming entirely too much meat in america. the organism can stand it if the life is active in the fresh air, but it will not do for people who are housed. much meat eating causes physical degeneration. the body loses tone. experiments have shown that vegetarians have more resistance and endurance than the meat eaters, but the meat eaters get so much stimulation from their food that they can speed up in spurts. the excretions of meat eaters are more poisonous than those of vegetarians. eggs produced by hens fed largely on meat scraps do not keep as well as those laid by hens feeding more on grains. in short, meat eating leads to instability or degeneration, if carried to excess. young children should have none of it and it would be a very easy matter for the rising generation to develop without using meat, and i believe this would be better than our present plan of eating. however, let us give flesh food the credit due it. when meat eaters are debilitated no other food seems to act as kindly as meat, given with fruits or vegetables. when properly prepared and taken in moderation meat digests easily and is quite completely assimilated. many make the mistake of living too exclusively on starch and taking it in excess. the result is fermentation and an acid state of the alimentary tract. dr. daniel s. sager says that, "about all that we have to fear in eating is excessive use of proteids." experience and observation do not bear out this statement, for it is as easy to find people injured by starch as by protein. one form of poisoning is as bad as the other. the doctor also warns against nearly all the succulent vegetables, saying that on account of the indigestible fibre, most of them are unfit for human consumption. dr. e. h. dewey condemned the apple as a disease-producer, and inferentially, other fruits. dr. charles e. page objects to the use of milk by adults, on the ground that it is fit food only for the calves for whom nature intended it. many writers have repeated this opinion. most of the regular physicians have a very vague idea of dietetics and proper feeding. when asked what to eat they commonly say, "eat plenty nourishing food of the kinds that agree with you." they do not point out the fundamentals to their patients. sometimes they advise avoiding combinations of milk and fruits. sometimes they say that all starches should be avoided and in the next breath prescribe toast, one of the starchiest of foods. at times they proscribe pork and pickles but they are seldom able to give a good diet prescription. what people need is a fair knowledge of what to do and the don'ts will take care of themselves. all foods have been condemned as unfit for human consumption by people who should know. however, those who look at these matters with open eyes and open minds will come to the conclusion that man is a very adaptable animal; that if necessary he can get along without almost all foods, being able to subsist on a very small variety; that he can live for a long period on animal food entirely; that he can live all his life without tasting flesh; that he can live on a mixed diet; that he can adopt a great many plans of eating and live in health and comfort on nearly all of them, provided he does not deprive himself of the natural salts and gets some protein; and finally and most important, that moderation is the chief factor in keeping well, for the best foods produce disease in time if taken in excess. those who object to flesh, dairy products, cereals, tubers, legumes, refined sugars, fruits or vegetables, should do without the class which they find objectionable, for it is easy to substitute from other classes. eggs, milk or legumes may be taken in place of flesh foods. the salts contained in fruits may be obtained from vegetables. the starch, which is the chief ingredient of cereals, is easily obtained from tubers and legumes; fats and sugars will take its place. commercial sugar is not a necessity. the force and heat derived from it can be obtained from starches and fats. outside of milk in infancy, there is not a single indispensable food. some people have peculiarities which prevent them from eating certain foods, such as pork, eggs, milk and strawberries, but with these exceptions a healthy person can eat any food he pleases, provided he is moderate. we eat too much flesh, sugar and starch and we suffer for it. this does not prove that these foods are harmful, but that overeating is. sometimes the food question becomes a very trying one in the home. one individual has learned the fact that good results are obtained by using good sense and judgment in combining and consuming food, and he tries to force others to do as he does. this is unfortunate, for most people object to such actions, and though the intention is good, it accomplishes nothing, but prejudices others against sensible living. the best way is to do right yourself and let others sin against themselves and suffer until they are weary. then, seeing how you got out of your trouble, perhaps they will come to you and accept what you have to offer. the attempt to force people to be good or to be healthy is merely wasted effort. the chapter devoted to menus gives definite information regarding the proper manner in which to combine foods and arrange meals. such information is also given in treating of the different classes of food. chapter vii. when to eat. three meals a day is the common plan. this is a matter of habit. three meals a day are sufficient and should not be exceeded by man, woman or child. lunching or "piecing" should never be indulged in. children who are fed on plain, nutritious foods that contain the necessary food elements do not need lunches. lunching is also a matter of habit, and we can safely say that it is a bad habit. if three meals a day are taken, two should be light. he who wishes to work efficiently can not eat three hearty meals a day. if it is brain work, the digestive organs will take so much of the blood supply that an insufficient amount of blood will be left to nourish the brain. the worker feels the lack of energy. he is not inclined to do thorough work, that is, to go to the root of matters, and he therefore does indifferent work. one rule to which there is no exception is that the brain can not do its best when the digestive organs are working hard. if there is a piece of work to be done or a problem to be solved that requires all of one's powers it is best to tackle it with an empty stomach, or after a very light meal. if the work is physical, it is not necessary to draw the line so fine. but it is well to remember that hard physical work prevents digestion. all experiments prove this. so if the labor is very trying, the eating should be light. those who eat much because they work hard will soon wear themselves out, for hard work retards digestion, and with weakened digestion the more that is eaten, the less nourishment is extracted from it. those who labor hard should take a light breakfast and the same kind of a noon meal. after the day's work is done, take a hearty meal. those who perform hard physical labor, as well as those who work chiefly with their brains, should relax a while after the noon meal. a nap lasting ten to twenty minutes is very beneficial, but not necessary if relaxation is taken. during sleep the activities of the body slow down. most people who take a heavy meal and retire immediately thereafter feel uncomfortable when they wake in the morning. the reason is that the food did not digest well. it is always well to remain up at least two hours after eating a hearty meal. most people would be better off if they took but two meals a day. those who have sedentary occupations need less fuel than manual laborers, and could get along very well on two meals a day. however, if moderation is practiced, no harm will come from eating three times a day. in olden times many people lived on one meal a day. some do so today and get along very well. it is easy to get plenty of nourishment from one meal, and it has the advantage of not taking so much time. most of us spend too much time preparing for meals and eating. once when it was rather inconvenient to get more meals, i lived for ten months on one meal a day. i enjoyed my food very much and was well nourished. for twelve years i have lived on two meals a day, one of them often consisting of nothing but some juicy fruit. many others do likewise, not because they are prejudiced against three meals per day, but they find the two meal plan more convenient and very satisfactory. meat, potatoes and bread, with other foods, three times a day is a common combination. no ordinary mortal can live in health on such a diet. such feeding results in discomfort and disease, and unless it is changed, in premature aging and death. the body needs only a certain amount of material. sufficient can be taken in two meals. if three meals is the custom less food at a meal should be eaten. however, the general rule is that those who eat three meals per day eat fully as large ones as those who take only two. as a rule, the meal times should be regular. we need a certain amount of nourishment, and it is well to take it regularly. this reduces friction, and is conducive to health, for the body is easily taught to fall into habits of regularity and works best when these are observed. there should be a period of at least four and one-half to five hours between meals. it takes that long for the body to get a meal out of the way. stomach digestion is but the beginning of the process, and this alone requires from two to five hours. on the two-meal plan it makes very little difference whether the breakfast or the lunch is omitted. after going without breakfast for a week or two, one does not miss it. miss the meal that it is the most troublesome to get. dr. dewey revived interest in the no-breakfast plan in this country. he considered it very beneficial. the doctor did not give credit where credit is due, for he insisted on going without breakfast. omitting lunch or dinner accomplishes the same thing. he got his beneficial results from reducing the number of meals, and consequently the amount of food taken, but it is immaterial which meal is omitted. heavy breakfasts are very common in england and in our country. on the european continent they do not eat so much for breakfast, a cup of coffee and one roll being a favorite morning meal there. to eat nothing in the morning is better than to take coffee and rolls. to eat enough to steal one's brain away is a poor way to begin the day. much better work could be done on some fruit or a glass of milk, or some cereal and butter than on eggs, steak potatoes, hot bread and coffee, which is not an uncommon breakfast. when we consider the best time to eat, we come back to our old friend, moderation, and find that it is the best solution of the question, for if the meals are moderate we may with benefit take three meals a day, but no more, for there is not time enough during the day to digest more than three meals. however, it is not necessary to eat three times a day. chapter viii. how to eat. it seems that all of us ought to know how to eat, for we have much practice; yet the individuals who know the true principles of nourishing the body are comparatively few. very few healers are able to give full and explicit directions on this important subject. some can give partial instructions, but we need a full working knowledge. in one period of our racial history there were times when it was difficult to obtain food, as it is now among some savage people. then it was without doubt customary to gorge, as it is among some savages now when they get a plenteous supply of food, especially of flesh food. even among so-called civilized people, the distribution of food is so uneven that some are in want somewhere, nearly all the time. in parts of russia, we are informed, the peasants go into a state of semi-hibernation during part of the winter, living on very small quantities of inferior food. with rapid transportation and the extensive use of power-propelled machinery, famine should be unheard of in civilized countries. in our land there is a sufficient quantity of food and people seldom suffer because they have not enough, but considerable suffering is due to excessive intake and to poor quality of food. weight for weight, white bread is not as valuable as whole wheat bread, though it contains as much starch. measure for measure, boiled milk is inferior as a food to untreated milk, either fresh or clabbered. such facts make it necessary for us to know how to eat. the correct principles of taking nourishment to the best advantage have been fairly well known for a long time, and perhaps they have been fully discussed years ago by some author, but so far as i know dr. e. h. dewey is the first one who grouped them and gave them the prominence they deserve. he employed many pages in explaining clearly and forcibly these principles, which can be briefly stated as follows: first, be guided by the appetite in eating. eat only when there is hunger. second, during acute illness fast, that is, live on water. third, be moderate in eating. fourth, masticate your food thoroughly. dr. j. h. tilden teaches his patients the same in these words: "never eat when you feel badly. "never eat when you have no desire. "do not overeat. "thoroughly masticate and insalivate all your food." because these true dietetic principles are so important, probably being the most valuable information given in this book, let us give them enough consideration to fix them in the mind. they should be a part of every child's education. they should be so thoroughly learned that they become second nature, for if they are observed disease is practically impossible. accidents may happen, but no serious disease can develop and certainly none of a chronic nature if these rules are observed, provided the individual gives himself half a chance in other ways. when the eating is correct, it is difficult to fall into bad habits mentally. correct eating is a powerful aid to health. health tends to produce proper thinking, which in turn leads the individual to proper acting. _first, eat only when there is hunger_: hunger is of two kinds, normal and abnormal. the real or normal hunger was given us by nature to make us active enough to get food. if it were not for hunger, there would be no special incentive for the young to partake of nourishment and consequently many would die comfortably of starvation, perhaps enough to endanger the life of the race. normal hunger asks for food, but no special kind of food. it is satisfied with anything that is clean and nourishing. it is strong enough to make a decided demand for food, but if there is no food to be had it will be satisfied for the time being with a glass of water and will cause no great inconvenience. abnormal hunger is entirely different. it is a very insistent craving and if it is not satisfied it produces bodily discomfort, perhaps headache. the gnawing remains and gives the victim no rest. very often it must be pampered. it calls for beefsteak, or toast and tea, or sweets, or some other special food. if not satisfied the results may be nervousness, weakness or headache or some other disagreeable symptom. when missing a meal or two brings discomfort, it is always a sign of a degenerating or degenerated body. a healthy person can go a day without food without any inconvenience. he feels a keen desire for food at meal times, but as soon as he has made up his mind that he is unable to get it or that he is not going to take any the hunger leaves. normal hunger is a servant. abnormal hunger is a hard master. a person in good condition does not get weak from missing a few meals. one in poor physical condition does, although this is more apparent than real. in the abnormal person a part of the food is used as nourishment, but on account of the poor working of the digestive organs, a part decomposes and this acts as an irritant or a stimulant. the greater the irritation the more food is demanded. the temporary stimulation is followed by depression and then the sufferer is wretched. this depression is relieved by more food. please note that it is relieved, not cured. the relief is only temporary. all food stimulates, but only slightly. it is when the food decomposes that it becomes stimulating enough to cause trouble. it is well to remember that considerable alcoholic fermentation can take place in an abused alimentary tract. the stimulation obtained from too much food is very much like the stimulation derived from alcohol, tobacco or morphine. at first there is a feeling of well-being, which is followed by a miserable feeling of depression that demands food, alcohol, tobacco or morphine for relief, as the case may be, and no matter which habit is obtaining mastery, to indulge it is courting disaster. when a habit begins to assert itself strongly, break it, for later on it will be very difficult, so difficult that most people lack the will power to overcome it. if there is abnormal hunger, reduce the food intake. instead of eating five or six times a day, reduce the meals to two or three. it is quite common for such people to take lunches, which may consist of candies, ice cream, cakes, milk or buttermilk and various other things which most people do not look upon as real food. take two or three meals a day, and let a large part of them be fresh vegetables and fresh fruits. eat in moderation and the troublesome abnormal hunger will soon leave. by indulging it you increase it. many people get into trouble because they believe that they have to have protein, starch and fat at every meal. this is not necessary, for the blood takes up enough nourishment to last for quite a while. a supply of the various food elements once a day is sufficient, which means that protein needs be taken but once a day, starch once a day and fat once a day. starch and fat serve the same purpose and one can be replaced by the other. cultivate a normal hunger, then fix two or three periods in which to take nourishment, and partake of nothing but water outside of these periods. if there is no desire for food when meal time comes, eat nothing, but drink all the water desired and wait until next meal time. _second, during acute illness fast_: this is so obviously correct that we should expect every normal individual to be guided by it. even the lower animals know this and act accordingly. according to this rule we should go without food when ill, but to do so is contrary to the teachings of medical men. they teach that when people are ill there is much waste, which is true, and that for this reason it is necessary to partake of a generous amount of nourishing food, so they give milk, broth, meat, toast and other foods, together with stimulants. feeding during illness would be all right if the body could take care of the food, which it can not. in all severe diseases digestion is almost or quite at a standstill and the food given under the circumstances decomposes in the alimentary tract and furnishes additional poison for the system to excrete. food under the circumstances is a detriment and a burden to the body. in fevers, the temperature goes up after feeding. this shows that more poison has entered the blood. in fevers little or none of the digestive fluids is secreted, but the alimentary tract is so warm that the food decomposes quickly. feeding during acute attacks of disease is one of the most serious and fatal of errors. there is an aversion to food, which is nature's request that none be taken. when an animal becomes seriously ill, it wants to fast, and does so unless man interferes. here we could with advantage do as the animals do. nature made no mistake when she took hunger away in acute diseases, and if we disregard her desires, we invariably suffer for it. we should make it a rule to take no food, either liquid or solid, during acute disease. those who have had no opportunity to watch the rapidity with which people recover from serious illness may take the ground that sick people would starve to death if they were to be treated thus, for some of these acute diseases last a long time. typhoid fever, for instance, occasionally lasts two or three months. it never lasts that long when treated by natural means, and it is very mild, as a rule. the fever will be gone in from seven to fourteen days in the vast majority of cases, and then feeding can be resumed. chronic disease is often due to neglected acute disease, at other times to the building of abnormality through errors of life which have not resulted in acute troubles. while acquiring chronic disease, the individual may be fairly comfortable, but he is never up to par. most chronic diseases can be cured quickly by taking a fast, but usually it is not necessary to take a complete fast. the desire for food is not generally absent and there is usually fair power to digest. one of the most satisfactory methods, if not the most satisfactory one, of treating chronic disease is to reduce the food intake, and instead of giving so much of the concentrated staples, feed more of the succulent vegetables and the fresh fruits, cooked and raw, using but small quantities of flesh, bread, potatoes and sugar. this gives the body a chance to throw off impurities. there are always many impurities in a deranged body. _third, be moderate in your eating_: this is often very difficult, for most people do not know what moderation is. in infancy the too frequent feeding and the overfeeding begin. the common belief that infants must be fed every two hours, or oftener, is acted upon. the result is that the child soon loses its normal hunger, which is replaced by abnormal hunger. when food is long withheld it begins to fret. the mother again feeds and there is peace for an hour or so. when mothers learn to feed their children three times a day and no more there will be a great decrease in infant ills and a falling off in the infant mortality. the healthiest children i have seen are fed but three times a day. they become used to it and expect no more. another thing that makes it difficult to be moderate is impoverishing the food through refinement and poor cooking. these processes take away a great part of the mineral salts which are present in foods in organic form. these salts can not be replaced by table salt, for sodium chloride is but one of many salts that the body needs and an excess of table salt does not make up for a deficiency in the others. children fed on refined, impoverished foods are not satisfied with a reasonable amount. there is something lacking and this makes itself known in cravings, which demand more food than is needed to nourish. i have noticed many times that children are satisfied with less of whole wheat bread than of white bread, and that the brown unpolished rice satisfies them more quickly and completely than the polished rice. in other words, depriving the foods of their salts is one of the factors that leads to overeating. simplicity is a great aid to moderation. it is also necessary to exercise the conservative measure, self-control. some writers suggest to eat all that is desired and then fast at various intervals to overcome the effects of overeating. in other words, they advise to eat enough to become diseased and then fast to cure the trouble. this is better than to continue the eating when the evil results of an excessive food intake make themselves known, but it does not bring the best results. such people have their spells of sickness, which are unnecessary. if they stop eating as soon as the disease makes itself known, it does not last long. by exercising self-control sickness will be warded off. by using will power daily it grows stronger and those who force themselves to be moderate at first, are in time rewarded by having moderation become second nature. people should always stop eating before they are full. those who eat until they are uncomfortable are gluttons. they should be classed with drunkards and drug addicts. if discomfort follows a meal it is a sign of overeating. it would be well to read this in connection with the chapter that treats of overeating. _fourth, thoroughly masticate all food_: horace fletcher has written a very enthusiastic book on this subject. enthusiasm is apt to lead one astray, and even if thorough mastication will not do all that mr. fletcher believed, it is very important, and we owe mr. fletcher thanks for calling our attention to the subject forcibly. thorough mastication partially checks overeating. our foods have to be finely divided and subdivided or they can not be thoroughly acted upon by the digestive juices. the stomach is well muscled and churns the food about, helping to comminute it, but it can not take the place of the teeth. all foods should be thoroughly masticated. while the mastication is going on the saliva becomes mixed with the food. in the saliva is the ptyalin, which begins to digest the starch. starch that is well masticated is not so liable to ferment as that which gets scant attention in the mouth. starches and nuts need the most thorough mastication. if thorough mastication were the rule, meat gluttons would be fewer, for when flesh is well chewed large quantities cause nausea. milk digests best when it is rolled around in the mouth long enough to be mixed with saliva. to treat milk as a drink is a mistake, for it is a very nourishing food. all kinds of nuts must be well masticated. if they are not they can not be well digested, for the digestive organs are unable to break down big pieces of the hard nut meats. the succulent vegetables contain considerable starch. if mastication is slighted they often ferment enough to produce considerable gas. fruits are generally eaten too rapidly, and therefore often produce bad results. even green fruits can be eaten with impunity if they are very thoroughly masticated. those who are fond enough of liquors to take an excess should sip their alcoholic beverages very slowly, tasting every drop before swallowing. this would decrease their consumption of liquor greatly. even water should not be gulped down. it should be taken rather slowly, especially on hot days. during hot weather many drink too much water. this tendency can usually be overcome by avoiding iced water and by drinking slowly. these four rules should be a part of your vital knowledge. if you forget everything else in this book, please remember them and try to put them into practice: _eat only when hungry. during acute illness fast. be moderate in your eating. thoroughly masticate all food._ chapter ix. classification of foods. food is anything which, when taken into the body under proper conditions, is broken down and taken into the blood and utilized for building, repairing or the production of heat or energy. there are various forms of foods, which can be divided into two classes: first, nitrogenous foods or proteins. second, carbonaceous, foods, under which caption come the sugars, starches and fats. salts and water are not usually classified as foods, though they should be, for life is impossible without either. the chief proteins are: first, the albuminoids, which are represented by the albumin in eggs, the casein in milk and cheese, the myosin of muscle and the gluten of wheat. second, the gelatinoids, which are represented by the ossein of bones, which can be made into glue, and the collogen of tendons. third, nitrogen extractives, which are the chief ingredients in beef tea. they are easily removed from flesh by soaking it while raw in cold water. they are rich in flavor and are stimulating. they have absolutely no food value. beef tea, and other related extracts, are not foods. they are stimulants. in truth they are of no value, and those who purchase such preparations pay a high price and get nothing in return. the sugars and starches are grouped under the name of carbohydrates, which means that they are a combination of water and carbon. there are various forms of sugar. about per cent of milk is milk sugar, which agrees better with the young than any other kind of sugar. it is not so soluble in water as the refined cane sugar, and therefore not so sweet, but it is fully as nourishing. honey is a mixture of various kinds of sugars. cane sugar is taken principally from sugar beets and sugar cane. there is no chemical difference between the products of canes and beets. sugars can not be utilized by the blood until it has changed them into other forms of sugar. the use of sugar is rapidly increasing. several centuries ago it was used as a drug. it was doubtless as effective as a curing agent as our drugs are today. until within the last sixty or seventy years it has not been used as a staple food. now it is one of our chief foods. not so very long ago but ten pounds of sugar per capita were used annually, but now we are consuming about ninety pounds each annually, that is, about four ounces per day. many people look upon sugar as a flavoring, which it is in a measure, but it is also one of our most concentrated foods. that this great consumption of sugar is harmful there is no doubt. physicians who practiced when the use of sugar was increasing very rapidly called attention to the increasing decay of teeth. sugar, as it appears upon the table is an unsatisfied compound. it does not appear in concentrated form in nature, but mixed with vegetable and mineral matters, and when the pure sugar is put into solution it seeks these matters. it is especially hungry for calcium and will therefore rob the bones, the teeth and the blood of this important salt, if it can not be had otherwise. the most noticeable effect is the decay of the teeth. i have read considerable literature of late blaming sugar for producing many diseases, among them tuberculosis and cancer. improper feeding is the chief cause of these diseases, but to blame sugar for all ills of that kind is far from arriving at the truth. cancer and tuberculosis killed vast numbers of people before sugar was used as a staple. if we wish to get at the root of any trouble, it is necessary for us to bury our prejudices and be broad minded. people who eat much sugar should also partake liberally of fresh raw fruits and vegetables, in order to supply the salts in which sugar is deficient. lump sugar is practically pure, and therefore a poorer article of diet than any other form of sugar, for man can not live on carbon without salts. grape sugar and fruit sugar are the same chemically. another name for them is dextrose, and in the form of dextrose sugar is ready to be taken up by the blood. children like sweets, but it is just as easy to give them the sweet fruits, such as good figs, dates and raisins, as it is to give them commercial sugar and candy, and it is much better for their health. children who get used to the sweet fruits do not care very much for candies. the sugar in these fruits is not concentrated enough to be an irritant and it contains the salts needed by the body. hence it does not rob the body of any of its necessary constituents. because the fruit sugar, taken in fruit form, is not so concentrated and irritating as the common sugar, the child is satisfied with less. sugar is an irritant of the mucous membrane and therefore stimulates the appetite. this is true only when it is taken in excess in its artificial form, and it does not matter whether it is sugar, jelly or jam. for this reason jellies and jams should be used sparingly, because it is not necessary to stimulate the appetite. those who resort to stimulation overeat. when much sugar is taken, it not only irritates the stomach, but it even inflames this organ. sugar is a preservative, and like all other preservatives it delays digestion, if taken in great quantities, and four ounces per day make a great quantity. the digestive organs rebel if they are given as much of sugar as they will tolerate of starch. when taken in excess sugar ferments easily, producing much gas, which is followed by serious results. sugar is changed into forms less sweet by acids and heat. the ferment invertin also acts upon sugars. sugar is a valuable food, but we are abusing it, and therefore it is doing us physical harm. the quantity should be reduced, and families who are using four ounces per person per day, as statistics indicate that most are doing, should reduce the intake to about one-third of this amount. it would be well to take as much of the sugar as possible in the form of sweet fruits. it is a fact that sugar is easy to digest and that one can soon get energy from it, but feeding is not merely a question of giving digestible aliments, but a question of using foods that are beneficial in the long run. the moderate use of this food is all right, but excess is always bad. starches need more change than sugars before they can be absorbed by the blood, but they give better results. chemically there is but small difference between starch and sugar. the starch must be changed into dextrose, a form of sugar, before it can be utilized by the body. the human body contains a small amount of a substance called glycogen, which is an animal starch or sugar. this glycogen is burned. sugar is a force food. it combines with oxygen and gives heat and energy. the waste product is carbonic acid gas, which is carried by the blood to the lungs and then exhaled. honey and maple sugar are good foods, but overconsumption is harmful. sugar eating is largely a habit. because the sugar has so much of the life and so many of the necessary salts removed in its refinement it is a good food only when taken in small quantities. nature demands of us that we do not get too refined in our habits, for excessive refinement is followed by decay. it is easy to overcome the tendency to overeat of sugar. some spoil the most delicious watermelon by heaping sugar or salt, or both, upon it. in this way the flavor is lost. there is not a raw fruit on the market which is as finely flavored after it has been sugared as it was before. true, those who have ruined their sense of taste object to the tartness and natural acidity of various foods, but they are not judges and can not be until they have regained a normal taste, which can only be done by living on natural foods for a while. fats are obtained most plentifully from nuts, legumes, dairy products and animal foods. they are the most concentrated of all foods, yielding over twice the amount of heat or energy that we can obtain from the same weight of pure sugar, starch or protein. many who think they are moderate eaters consume enough butter to put them in the glutton class. salts are present in all natural foods of which we partake. water is indispensable, for the body has to have fluids in order to perform its functions. foods are burned in the body. they are valuable in proportion to the completeness with which they are digested and assimilated and the ease with which this process is accomplished. it takes energy to digest food and if the food is very indigestible it takes too much energy. the following remarks on digestibility are according to the best knowledge we have on the subject: as a general rule, the protein of meat and fish is more completely and more quickly digested than the protein in vegetable foods. the reason is that the vegetable protein is found in cells which are protected by the indigestible cellulose which covers each cell. this covering is not always broken and then the digestive juices are practically powerless. the legumes, which are rich in protein, are comparatively hard to digest. if properly prepared and eaten, they give little or no trouble, but they are generally cooked soft and the mastication is slighted. the result is fermentation. beans, peas and lentils should be very well chewed, and eaten in moderation, for they are rich both in starch and protein. nuts are as a rule not as completely digested as meats and animal fats, and the principal reason is that they are eaten too rapidly and masticated too little. nuts properly masticated, taken in correct combinations and amounts agree very well. it is not necessary, as many believe, to salt them in order to prevent indigestion. in the following pages will be found a number of diet tables, giving compositions and fuel values of various foods which have been grouped for the sake of convenience, for the foods in each group are quite similar. these tables are not complete, for to list every food would take too much space. i have simply selected a representative list from the various classes of foods. under flesh are given fish, meats and eggs. under succulent vegetables are given both root and top vegetables, because of their similarity. nuts, cereals, legumes, tubers and fruits are each grouped because it is easy to gain an understanding of them in this way. milk is given a rather long chapter of its own because of its great importance in the morning of life. allow me to repeat that it is impossible to figure out the calories in a given amount of food and then give enough food to furnish so many calories and thus obtain good results. i have already given the key to the amount of food to eat, and it is the only kind of key that works well. however, it is very helpful to have a knowledge of food values. the calorie is the unit of heat, and heat is convertible into energy. a calorie is the heat required to raise the temperature of one kilogram of water one degree c. to translate into common terms, it is the heat required to raise one pound of water four degrees f. one pound of protein produces , calories. one pound of sugar produces , calories. one pound of starch produces , calories. one pound of oil or fat produces , calories. for the scientific facts regarding foods i have consulted various works, especially the following: diet and dietetics, by gauthier; foods, by tibbles; food inspection and analyses, by leach; foods and their adulteration, by wiley; commercial organic analysis, by allan. however, i am most indebted to the numerous bulletins issued by the u. s. department of agriculture. all who make a study of foods and their value owe a great debt to w. o. atwater and chas. d. wood, who have worked so long and faithfully to increase our knowledge regarding foods. as we consider the various groups of foods, directions are given for the best way of cooking, but no fancy cooking is considered. those who wish fancy, indigestible dishes should consult the popular cook books. the women have it in their power to raise the health standard fifty to one hundred per cent by cooking for health instead of catering to spoiled palates, and by learning to combine foods more sensibly than they have in the past. the art of cooking has made its appeal almost entirely to the palate. this art is not on as high level as the science of cooking, which gives foods that build healthy bodies. the right way of cooking is simpler, quicker and easier than the conventional method, and gives food that is superior in flavor. after the normal taste has been ruined, it takes a few months to acquire a natural taste again so that good foods will be enjoyed. chapter x. flesh foods. ==================================================================== pro- carbohy- calories water tein fat drates ash per lb. -------------------------------------------------------------------- beef, average . . . .... . .... veal, lean . . . .... . .... mutton, average . . . .... . .... pork, average fat . . . .... . .... pork, average lean . . . .... . .... rabbit . . . .... . .... chicken, fat . . . .... . .... turkey . . . .... . .... goose . . . .... . .... pigeon . . . .... . .... duck, wild . . . .... . .... black bass . . . .... . sea bass . . . .... . cod, steaks . . . .... . halibut, steaks . . . .... . herring . . . .... . .... mackerel . . . .... . perch, white . . . .... . pickerel . . . .... . salmon . . . .... . salmon trout . . . .... . shad . . . .... . sturgeon . . . .... . trout, brook . . . .... . clams, long . . . . . clams, round . . . . . lobster . . . . . oyster in shell . . . . . -------------------------------------------------------------------- the food value of meat depends on the amount of fat and protein it contains. lean meat may contain less than four hundred calories per pound, while very fat meat may contain more than one thousand five hundred calories. these foods are eaten because they are rich in protein. protein is the great builder and repairer of the body. it forms the framework for both bone and muscle. we can get along very well without starch or sugar or fat, but it is absolutely necessary to have proteid foods. they are the only ones that contain nitrogen, which is essential to animal life. nitrogenous foods are used not only to build and repair, but in the end they are burned, supplying as much heat as the same weight of sugar or starch. proteid foods are generally taken to excess. to most people they are very palatable, and they are generally prepared in a manner that renders rapid eating easy. besides, meats contain flavoring and stimulating principles, called extractives, which increase the desire for them. the consequence is that those who eat meat often have a tendency to eat too much. excessive meat eating often leads to consumption of large quantities of liquor. stimulants crave company. as will be noted, most fish and meat contain about per cent. of protein, while about per cent. is water. the fatter the meat, the less water it contains, and the more fuel value it has. the leaner the meat, the more watery the animal, and the more easily is the flesh digested. beef is fatter than veal and harder to digest. also, the flesh of old animals is more highly flavored than that of the young ones, because it contains more salts. for this reason people who have a tendency to the formation of foreign deposits, as is the case with those who have rheumatism and gout or hardening of the arteries, should take the flesh of young animals when it is obtainable. in the past we have been taught to partake of excessive amounts of protein. the prescribed amount for the average adult has been about five ounces. if we were to obtain all the protein from meat, this would necessitate eating about twenty-five ounces of meat daily. however, inasmuch as there is considerable protein in the cereals and milk, and a little in most fruits and vegetables, a pound of meat would probably suffice under the old plan. a few physicians have known that such an intake of protein is excessive, and now the physiologists are learning the same. it has lately been determined experimentally that the body needs only about an ounce of protein daily, which will be supplied by about five ounces of flesh. three or four ounces of flesh daily make a liberal allowance, for it is supplemented by protein in other foods. workers eat large quantities of flesh because they think they need a great deal. the fact is that very little more protein is needed by those who do hard physical labor than by brain workers. the extra energy needed calls for more carbohydrates, not for protein. when the organism is supplied with sugar, starch and fat, or one of these, the protein of the body is saved, only a very small amount being used to replace the waste through wear and tear. though protein can be burned in the body, it is not an economical fuel, either from a physiological or financial standpoint. the energy obtained from flesh costs much more than the same amount of energy obtained from carbonaceous foods. ten acres of ground well cultivated can raise enough cereals and vegetables to support a number of people, but if this amount of land is used for raising animals, it will support but a few. the protein obtained from peas, beans and lentils is cheap, but these foods do not appeal to the popular palate as much as flesh. meat immediately after being killed is soft. after a while it goes into a state of rigidity known as rigor mortis. then it begins to soften again. this third stage is really a form of decay, called ripening. it is believed that the lactic acid formed is one of the principal agents producing this softening. some people enjoy their meats, especially that of fowls and game, ripe enough to deserve the name of rotten. the ripening produces many chemical changes in the meat, which give the flesh more flavor. consequently those who indulge are very apt to overeat. it is a fact that those who eat much flesh go into degeneration more quickly than those who are moderate flesh eaters and depend largely on the vegetable kingdom for food. if an excess of good meat causes degeneration, there is no reason to doubt that partaking of overripe foods is even worse. all meat contains waste. if the flesh comes from healthy animals and is eaten in moderation this waste is so small that it will cause no inconvenience, for a healthy body is able to take care of it. if too much is eaten, the results are serious. overeating of flesh is followed by excessive production of urea and uric acid products. some of these may be deposited in various parts of the body, while the urea is mostly excreted by the kidneys. the kidneys do not thrive under overwork any more than other organs. the vast majority of cases of diabetes and bright's disease are caused by overworking the digestive organs. too much food is absorbed into the blood and the excretory organs have to work overtime to get rid of the excess. meats are easily spoiled. they should be kept in a cold place and not very long. fresh meat and fish are more easily digested than those which are salted, or preserved in any other way. pickled meats should be used rarely the same is true of fish. ptomaines, or animal poisons, form easily in flesh foods. these are very dangerous, and it is not safe to eat tainted flesh, even after it is cooked. fish decomposes quickly and fish poisoning is probably even more severe than meat poisoning. fish should be killed immediately after it is caught, for experiments have shown that the flesh of fish kept captive after the manner of fishers degenerates very rapidly. fish should be eaten while fresh. even when the best precautions have been taken, it is somewhat risky to partake of fish that has been shipped from afar. flesh foods are more easily and completely digested than the protein derived from the vegetable kingdom. from the table it will be noted that some fish is fat and some is lean. the ones containing more than per cent of fat should be considered fat fish. these are somewhat harder to digest than the lean ones, but they are more nutritious. shell fish is generally low in food value and if taken as nourishment is very expensive. however, most people eat this food for its flavor. cooking. cooking is an art that should be learned according to correct principles. every physician should be a good cook. he should be able to go into the kitchen and show the housewife how to prepare foods properly. medical men who are well versed in food preparation and able to make good food prescriptions have no need of drugs. the flesh of animals is composed of fibres. these fibres are surrounded by connective tissue which is tough. the cooking softens and breaks down these tissues, thus rendering it easier for the digestive juices to penetrate and dissolve them. that is, proper cooking does this. poor cooking generally renders the meats indigestible. the simpler the cooking, the more digestible will be the food. flavors are developed in the process, but these are hidden if the meats are highly seasoned. _boiling_: when meats are boiled they lose muscle sugar, flavoring extracts, organic acids, gelatin, mineral matters and soluble albumin. that is, they lose both flavor and nourishment. therefore the liquid in which they are cooked should be used. the proper way to boil meat is to plunge it into plain boiling water. allow the water to boil hard for ten or fifteen minutes. this coagulates the outer part of the piece of meat. then lower the temperature of the water to about degrees f. and cook until it suits the taste. if it is allowed to boil at a high temperature a long time, it becomes tough, for the albumin will coagulate throughout. salt extracts the water from meat. therefore none of it should be used in boiling. the meat should be cooked in plain water with no addition. no vegetables and no cereals are to be added. all meats contain some fat, and this comes into the water and acts upon the vegetables and starches, making them indigestible. season the meat after it is cooked, or better still, let everyone season it to suit the taste after serving. meats that are to be boiled should never be soaked, for the cold water dissolves out some of the salts and some of the flavoring extracts, as well as a part of the nutritive substances. it is better to simply wash the meat if it does not look fresh and clean enough to appeal to the eye, which it always should be. _stewing_: if meat is to be stewed, cut into small pieces and stew or simmer at a temperature of about degrees f. until it is tender. it is to be stewed in plain water. if a meat and vegetable stew is desired, stew the vegetables in one dish, and the meat in another. when both are done, mix. by cooking thus a stew is made that will not "repeat" if it is properly eaten. foods should taste while being eaten, not afterwards. _broths_: if a broth is desired, select lean meat. either grind it or chop it up fine. there is no objection to soaking the meat in cold water, provided this water is used in making the broth. use no seasoning. let it stew or simmer at about degrees f. until the strength of the meat is largely in the water. when the broth is done, set it aside to cool. then skim off all the fat and warm it up and use. one pound of lean meat will produce a quart of quite strong broth. _broiling_: cut the meat into desired thickness. place near intense fire, turning occasionally, until done. be careful not to burn the flesh. an ordinary steak should be broiled in about ten minutes. of course, the time depends on the thickness of the cut and whether it is desired rare, medium or well done, and in this let the individual suit himself, for he will digest the meat best the way he enjoys it most. beefsteak smothered in onions is a favorite dish. it is not a good way to prepare either the onions or the steak. a better way is to broil both the steak and the onions, or broil the steak, cut the onions in slices about one-half to three-fourths of an inch thick, add a little water and bake them. beefsteak and onions prepared in this way are both palatable and easy to digest. _roasting_ is just like broiling, that is, cooking a piece of meat before an open fire. here we use a larger piece of meat and it therefore takes longer. of old roasting was quite common, but now we seldom roast meat in this country. _baking_: here we place the meat in an enclosed oven. most of our so-called roast meats are baked. the oven for the first ten or fifteen minutes should be very hot, about degrees f. this heat seals the outside of the meat up quite well. then let the heat be reduced to about degrees f. if it is kept at a high temperature it will produce a tough piece of meat. the time the meat should be in the oven depends upon the size of the piece of meat and how well done it is desired. while baking, some of the juices and a part of the fat escape. about every fifteen minutes, baste the meat with its own juice. a few minutes before the meat is to be removed from the oven it may be sprinkled with a small amount of salt, and so may broiled and roasted meats a little while before they are done. however, many prefer to season their own foods or eat them without seasoning and they should be allowed to do so. _steaming_: this is an excellent way of cooking. none of the food value is lost. put the meat in the steamer and allow it to remain until done. the cheapest and toughest cuts of meat, which are fully as good as the more expensive ones and often better flavored, can be rendered very tender by steaming. tough birds can be treated in the same way. an excellent way to cook an old hen or an old turkey is to steam until tender and then put into a hot oven for a few minutes to brown. some birds are so tough that they can not be made eatable by either boiling or baking, but steaming makes them tender. it is best to avoid starchy dressings, in fact dressings of all kinds. a well cooked bird needs none, and dressing does not save a poorly cooked one. most dressings are very difficult to digest. _fireless cooking_: every household should have either a good steamer or a fireless cooker. both are savers of time and fuel and food. they emancipate the women. those who have fireless cookers and plan their meals properly do not need to spend much time in the kitchen. place the meat in the fireless cooker, following the directions which accompany it. however, if they tell you to season the meat, omit this part. _smothering_ is a modification of baking. any kind of meat may be smothered, but it is especially fine for chickens. take a young bird, separate it into joints, place into a pan, add a pint of boiling water. if chicken is lean put in a little butter, but if fat use no butter. cover the pan tightly and place in oven and let it bake. a chicken weighing two and one-half pounds when dressed will require baking for one hour and fifteen minutes. keep the cover on the baking pan until the chicken is done, not raising it even once. gravy will be found in the pan. pressed chicken is very good. get a hen about a year old. place it into steamer or fireless cooker until so tender that the flesh readily falls from the bones. remove the bones, but keep the skin with the meat. chop it up. place in dish or jar, salting very lightly. over the chopped-up meat place a plate and on this a weight, and allow it to press over night. then it is ready to slice and serve. this is very convenient for outings. fish should preferably be baked or broiled. it may also be boiled, but it boils to pieces rather easily and loses a part of its food value. it must be handled with great care. no seasoning is to be used. when served a little salt and drawn butter or oil may be added as dressing. _frying_ is an objectionable method of cooking. it is generally held, and with good reason, that when grease at a high temperature is forced into flesh, it becomes very indigestible. in fact the crust formed on the outside of the flesh can not be digested. it is folly to prepare food so that it proves injurious. however, there is a way of using the frying pan so that practically no harm is done. grease the pan very lightly, just enough to prevent the flesh from sticking. make the pan very hot and place the meat in it. turn the meat frequently. fries (young chickens) may be cooked in this way with good results. the same is true of steaks and chops. avoid greasy cooking. it is an abomination that helps to kill thousands of people annually. _paper bag cooking_ is all right if it is convenient. those who have good steamers or fireless cookers will not find it of special advantage. brown flour gravies are not fit to eat. if there is any gravy serve it as it comes from the pan without mixing it with flour or other starches. it may be put over the meat or used as dressing for the vegetables. milk gravies are also to be avoided. use only the natural gravies. oysters may be eaten raw or stewed. stew the oysters in a little water. heat the milk and mix. eat with cooked succulent vegetables and with raw salad vegetables. it is best to leave the crackers out. the oysters themselves contain very little nourishment, but when made into a milk stew the result is very nutritious. eggs should be fresh. some bakers buy spoiled eggs and use them for their fancy cakes and cookies. this is a very objectionable practice and may be one of the reasons that bakers' cookies never taste like those "mother used to make." eggs take the place of fish, meat or nuts, for they are rich in protein. they may be taken raw, rare or well done. eggs may be boiled, poached, steamed or baked. soft boiled eggs require about three and one-half minutes. hard boiled ones require from fifteen to twenty minutes. the albumin of an egg boiled six or seven minutes is tough. when boiled longer it becomes mellow. eggs may be made into omelettes or scrambled, but the pan should be lightly greased and quite hot so that the cooking will be quickly done. eggs are variously treated for an omelette. some cooks add nothing but water and this makes a delicate dish. others use milk, cream or butter, and beat. bacon is a relish and may be taken occasionally with any other food. it should be well done, fried or broiled until quite crisp. this is one place where frying is not objectionable. pork should rarely be used. it is too fat and rich and requires too long to digest. when eaten it should be taken in the simplest of combinations, such as pork and succulent vegetables or juicy fruits, either cooked or raw, and nothing else. flesh may be eaten more freely in winter than in summer. meat especially should be eaten very sparingly during hot weather, for it is too stimulating and heating. nuts, eggs and fish are then better forms in which to take protein. combinations. flesh foods combine best with the succulent vegetables and the salad vegetables or with juicy fruits. it is more usual to take vegetables with flesh than to take fruit, but those who prefer fruit may take it with equally as good results. both fruits and vegetables are rich in tissue salts, in which flesh foods are rather deficient. the succulent vegetables contain some starch and the juicy fruits some sugar, but not enough to do any harm. they both act as fillers. flesh is quite concentrated and it is customary to take it with other concentrated foods, such as bread and potatoes. as a result too much food is ingested. it would be a splendid rule to make to avoid bread and potatoes when flesh food is taken, but if this seems too rigid, make it a rule never to eat all three at the same meal. it is best to eat the flesh foods without bread or potatoes, but if starch is desired, take only one kind at a time. most people crave a certain amount of food as filler, and they have fallen into the habit of using bread and potatoes for this purpose. this is a mistake. use the juicy fruits and the succulent vegetables for filling purposes and thus get sufficient salts and avoid the many ills that come from eating great quantities of concentrated foods. when possible, have a raw salad vegetable or two with the meat or fish meal. eat only one concentrated albuminous food at a meal. if you have meat, take no fish, eggs, nuts or cheese. chapter xi. nuts. ==================================================================== pro- carbohy- calories water tein fat drates ash per lb. -------------------------------------------------------------------- acorns . . . . . almonds . . . . . brazil nuts . . . . . filberts . . . . . hickory nuts . . . . . pecans . . . . . english walnuts . . . . . chestnuts, dried . . . . . butternuts . . . . . cocoanuts . . . . . pistachio nuts . . . . . peanuts, roasted . . . . . -------------------------------------------------------------------- nuts vary a great deal in composition. they are generally the seeds of trees, enclosed in shells, but other substances are also called nuts. the representative nuts are rich in fat and protein, containing some carbohydrate (sugar or starch.) a few nuts, such as the acorn, cocoanut and chestnut, are very rich in starch, and these should be classified as starchy foods. very few foods contain as high per cent of starch as the dry chestnut. in southern europe chestnuts are made into flour, and this is made into bread or cakes. an inferior bread is also made of acorn flour. chestnuts may be boiled or roasted. they are very nutritious. the more representative nuts are pecans, filberts, brazil nuts and walnuts. these may be used in place of flesh foods, for they furnish both protein and fats. if the kernel is surrounded by a tough membrane, as is the case in walnuts and almonds, it should be blanched, which consists in putting the kernel in very hot water for a little while and then removing this membrane. the pecan, though it does not contain very much protein, is one of the best nuts, one which can be eaten often without producing dislike. nuts have the reputation of being hard to digest. if they are not well masticated they are very hard to digest indeed, but when they are well masticated they digest almost as completely as do flesh foods and they produce no digestive troubles. one reason that nuts have obtained a bad reputation is that they are often eaten at the end of a heavy meal, when perhaps two or three times too much food has already been ingested. the result is indigestion and the sufferer swears off on nuts. if he had sense enough to reduce his intake of bread, potatoes, meat, pudding and coffee, the benefit would be very great. the tendency is for the sufferer from indigestion to pick out a certain food and blame all the trouble on that, when in truth the combinations and the quantity of food are to blame. some vegetarians make nuts one of their principal foods. we can easily get along without flesh, for we can obtain all the protein needed from milk, eggs, nuts and legumes. however, people who are used to flesh are able to digest it when they can take hardly anything else. the foods which we prefer are taken largely because we have become accustomed to them and have formed a liking for them, not because they are the very best from which to select. cooking. _nut butter_: take the nut meats, clean away all the skins and grind fine in a nut mill. then form into a pasty substance with or without the addition of oil or water, to suit the individual taste. most nut butters are very agreeable in flavor. sometimes the nuts are roasted and sometimes they are not. almond butter is very good. the nut butters soon spoil if left exposed to the air, for the oils they contain turn rancid. peanut butter can be made by taking clean kernels of freshly roasted peanuts and grinding fine. some are very fond of this butter. cocoanut and cocoa butters are not made in this way. they are purified fats, the former from cocoanuts, the latter from the cocoa bean. _nut milk_: take nut butter and mix with water until it is of the desired consistency. cocoanuts contain a sweet liquid which is called cocoanut milk. however, the artificial cocoanut milk is made by pouring a pint of boiling water over the flesh of a freshly grated cocoanut. let it stand until cold and strain. if it is allowed to stand some hours the fat will rise to the top and form cream. this milk is used by some who object to the use of animal products. various meals are made from nuts and made into food for the sick. this does no harm, nor does it do any special good. these meals contain more or less starch and the action of starches is much the same, no matter what the source. please remember that there are no health foods. combinations. nuts are especially fine in combination with fruits. fresh pecan meats and mild apples make a meal fit for the gods. nuts may be used in any combination in which flesh is used, that is, they take the place of flesh foods. the starchy nuts take the place of starchy foods. a good meal is made of a fruit salad, consisting of two or three kinds of fresh fruits and nuts. nuts or nut butter with toast also make a good meal. nuts have such fine flavor that cooks should think twice before spoiling them. it is very difficult to use them in cookery and get a product that is as finely flavored as the original nuts. the vegetarians use them in compounding what they call roasts, cutlets, steaks, etc. my experience with these imitation products has not been of the best, for though my digestive organs are strong, they do not take kindly to these mixtures. some of my friends report the same results, in spite of thorough mastication and moderation. these imitation roasts and cutlets usually contain much starch and there is no reason to believe that it is better to cook nut oils into starchy foods than it is to use any other form of fat for this purpose. those who like starch and nuts can make a splendid meal of nut meats and whole wheat biscuits or zwieback. in eating nuts, always remember that the mastication must be thorough. it takes grinding to break up the solid nut meats and the stomach and bowels have no teeth. those who can not chew well should use the nuts in the form of butter. ordinarily two ounces of nut meats, or less, are sufficient for a meal. at present prices, nuts are not expensive, as compared with meat. meat is mostly water. lean meat produces from five to seven hundred calories to the pound. nut meats produce from twenty-seven to thirty-three hundred calories per pound. in other words, a pound of nut meats has the same fuel value as about five pounds of lean meat, but not as great protein value. those who are not used to nuts have a tendency to overeat, but this is largely overcome as soon as people become accustomed to them. chapter xii. legumes. ==================================================================== pro- carbohy- calories water tein fat drates ash per lb. -------------------------------------------------------------------- _fresh legumes_: string beans ......... . . . . . shelled limas ........ . . . . . shelled peas ......... . . . . . _dried legumes_: lima beans ........... . . . . . navy beans ........... . . . . . lentils .............. . . . . . dried peas ........... . . . . . soy beans ............ . . . . . peanuts .............. . . . . . --------------------------------------------------------------------- analyses of all foods are approximate. the food value varies with the conditions under which the foods are grown and is not always even approximately the same. the fresh young legumes may be classed with the succulent vegetables. the matured, dried legumes are to be classed both as starchy and proteid foods. they are very easily raised and consequently cheap. they are the cheapest source of protein that we have. peas and beans are very important foods in europe. in this country we consume enormous quantities of beans. in mexico they use a great deal of frijoles, the poor people having this bean at nearly every meal. in china they make the soy beans into various dishes. the lentil is much used in europe and is gaining favor here, as it should, for it is splendid food, with a flavor of its own. peanuts, which are really not nuts, but leguminous plants growing their seeds under the ground, are used extensively as food for man and beast. these foods are much alike in composition, the soy bean being exceptionally rich in protein. these foods have the undeserved reputation of being indigestible and of producing flatulence. they are a little more difficult to digest than some other foods, but they cause no trouble if they are taken in simple combinations and in moderation, provided they have been properly prepared. it is necessary to masticate these foods very well, and avoid overeating. they are generally so soft that they are swallowed without proper mouth preparation. the result is that too much is taken of these rich foods, after which there is indigestion accompanied by gas production. one rather peculiar food belonging to the legumes is the locust bean or st. john's bread, which we can sometimes obtain at the candy stores. it grows near the mediterranean and is used in places for cattle feed. it is so sweet that it is eaten as a confection. its name is due to the fact that they say st. john lived on this bean and wild honey. if he did he must have had a sweet tooth. others say that the saint really devoured grasshoppers. it is not easy to decide, but i prefer to believe that he was a vegetarian. cooking. the fresh young legumes are to be considered in the same class as succulent vegetables, which are dealt with in the next chapter. ripe peas, beans and lentils may be cooked alike. in cooking ripe legumes, try to get as soft water as possible. hard water contains salts of lime and magnesia and these prevent the softening of the legumes. _bean soup_: clean the beans and wash them. let them soak over night. cook them in the same water in which they have been soaked, until tender. they are to be cooked in plain water without any seasoning and with the addition of neither fats, starches nor other vegetables. when the beans are done, meat stock and other vegetables may be added, if desired. pea soup is made in the same way. the reason for not draining away the water in which the beans are soaked is that it takes up some of the valuable salts, the phosphates for instance. the addition of seasoning or fat while they are cooking makes the beans indigestible. _baked beans_: clean and wash well. soak them over night. let them boil about three and one-half to four hours, using the water in which they were soaked. then put them into the oven to bake. they are to be cooked plain and no fat or seasoning is to be added while they are baking. after they are done you may add some form of fatty dressing, such as bacon, which has been stewed in a separate dish, or you may dress them with butter and salt when they are served. cooked this way they digest much more easily than when cooked in the ordinary way with tomatoes and grease. some prefer to add either sugar or molasses to the beans when they are put into the oven. avoid too much sweetening. lentils may be baked in the same way. _boiled beans_: the same as bean soup, except that less water is used. dressing may be the same as for baked beans. lentils and peas may be treated in the same way. beans and corn may be cooked together. combinations. the legumes are so very rich that they should be eaten in very simple combinations. it is best to take them with some of the raw salad vegetables and nothing else, or with the raw salad vegetables and one of the stewed succulent vegetables. the legumes contain all the protein and all the force food the body needs, so it is useless to add meat, bread and potatoes. tomatoes and other acid foods should not be used in the same meal, yet beans and tomatoes or beans and catsup are very common combinations. a plate of bean soup makes a good lunch. bean soup or baked or boiled beans with succulent vegetables, raw and cooked, give all the nourishment needed in a dinner. pea and bean flours can be purchased on the market. these flours can not be made into dough, but they may be used for thickening. they contain more protein than ordinary flour. both peas and beans may be roasted, but they are rather difficult to masticate. roasted peas have a fine flavor. roasted peanuts are a nutritious food, and may be taken in place of peas or beans. more legumes and less flesh foods will help to reduce the cost of living. taken in moderation and well masticated, the legumes are excellent foods. chapter xiii. succulent vegetables. ==================================================================== pro- carbohy- calories water tein fat drates ash per lb. -------------------------------------------------------------------- asparagus........ . . . . . ..... beet............. . . . . . cabbage.......... . . . . . ..... carrot........... . . . . . cauliflower...... . . . . . ..... cucumber......... . . . . . egg plant........ . . . . . ..... pumpkin.......... . . . . . ..... lettuce.......... . . . . . okra............. . . . . . ..... onion............ . . . . . parsnip.......... . . . . . radish........... . . . . . squash........... . . . . . tomato........... . . . . . spinach.......... . . . . . ..... kohlrabi......... . . . . . ..... -------------------------------------------------------------------- lima beans and shelled peas are generally included in this list, though the young lima beans contain about per cent. starch. look at the cabbage analysis for kale and brussels sprouts. they are much alike. most of the vegetables contain from one-half of one per cent. to two per cent. of indigestible fibre, which is not listed above. this is but a partial list of the succulent vegetables. in addition may be mentioned artichokes of the green or cone variety, chard, string beans, celery, corn on the cob, turnips, turnip tops, lotus, endive, dandelion and garlic. these vegetables produce but little energy, for most of them are not rich in protein, fat and carbohydrates, but they have considerable salts, which are given in the tables as ash. their juices help to keep the blood alkaline, and it would be well for people to get into the habit of eating these foods, not only cooked, but some of them raw. the salts are very easily disturbed and in cooking they are somewhat changed. the best salts we get when we consume natural foods, such as raw fruits and raw vegetables and milk. another function of the succulent vegetables is to take up space in the stomach. many like to eat until they feel comfortably full, but if they indulge in concentrated foods to this extent they overeat. the succulent vegetables have the merit of taking up much space without furnishing very much nourishment and they should, therefore, be used as space-fillers. however, they contain enough nourishment to be well worth eating, and most of them are excellent in flavor. this flavor is not appreciated by those who eat much meat and drink much alcohol. the liberal use of these cooked vegetables has a tendency to prevent constipation, and some of them are called laxative foods, such as stewed onions and spinach. preparation. these vegetables may be either steamed or prepared in a fireless cooker. the usual way is to cook them in water. clean the vegetables. then put them on to cook in enough water to keep from burning, but use no seasoning. when the vegetables are tender there should be only a little fluid left and those who eat of the vegetables should take their share of this fluid, for it may contain as high as one-half to two-thirds of the salts. when served, let each one season to taste. avoid the use of vinegar and all other products of fermentation as much as possible. lemon juice will furnish all the acid needed for dressing. the vegetables may be dressed with salt, or salt and butter, or salt and olive oil, and at times with cream, or with the natural gravy from meats, but avoid the use of flour and milk dressings, usually called cream gravy. these vegetables may also be eaten without any dressing. the water is drained off from corn on the cob, asparagus, artichokes and unpeeled beets. vegetables should not be soaked in water, for they lose a part of their value if this is done. cucumbers may be soaked in water to remove a part of the rank flavor, before being peeled. _spinach_ is prepared as follows: wash thoroughly. put about two tablespoonfuls of water in the bottom of the kettle. put over the fire and let the spinach wilt. its juice will then begin to pour out and the spinach will cook in its own juice. let it cook slowly until tender. serve the spinach with its proportion of the juice. at first this will taste rather strong, but after a while a person will not want the dry, tasteless mess that is drained, usually served in hotels and restaurants. if some of the roots are left on the spinach, it tastes milder. the roots contain sugar. some of these vegetables, such as summer squash, onions and parsnips may be baked. onions are very good sliced and broiled, but they should never be fried. beets are good baked, and especially is this true of sugar beets. radishes are very delicate and delicious when peeled and boiled, but their preparation is tedious. egg plant is to be stewed, but not fried. as usually served, dipped in egg, rolled in crumbs and fried it is very indigestible. beet greens are excellent. they are best if the beets are pulled very young and both the roots and the leaves are used. turnip tops, dandelion, mustard and swiss chard are other greens that are good. all of them are prepared like spinach, except that more water is necessary. however, do not use much water. those who say that the various vegetables are unfit to eat and act accordingly are missing some good food. the vegetables all contain crude fibre, but they hurt the stomach and intestinal walls no more than they hurt the mucous membrane of the tongue. they furnish some bulk for the intestines to act upon, which is good and proper. all animals need some bulky food, otherwise they become constipated. tomatoes are best raw. if they are stewed they are to be cooked plain. adding crackers and bread crumbs is a mistake. they taste all right without sugar, but a little may be used as dressing. _vegetable soup_: take equal parts of about four vegetables, any that you like. slice and cook in plain water until tender. when done add enough water or hot milk to make it of the right consistency. season to taste. one of the constituents may be starchy, such as potatoes, barley or rice, but the rest should be succulent vegetables. combinations. the succulent vegetables may be combined with all other foods. they go well with flesh or milk or nuts or starchy foods. with flesh or nuts they make a very satisfying meal. they may be taken with fruit. the tomato grows as a vegetable, but for practical purposes it is a fruit. the tomato combines well with protein, but not so well with the starchy foods. salad vegetables. if possible, salads should be made entirely of raw vegetables and raw fruits. the chief salad vegetables are celery, lettuce, tomatoes, cucumbers, cabbage, onions and garlic, the two last mentioned being used for flavoring. dr. tilden, who has done much to popularize raw vegetable salads, has a favorite, which he calls by his own name. it is equal parts of lettuce, tomatoes and cucumbers, with a small piece of onion. chop up coarse and dress with salt and olive oil and lemon juice. this is all right for those who like it, but many do not care for such a complex salad with such dressing. some of the combination salads that are served are wonderful mixtures, containing as many as seven or eight vegetables and a complex dressing. raw onions are too irritating to use in large quantities, and the same is true of garlic. the best salads contain but two or three ingredients. take any two of the vegetables mentioned, such as lettuce and tomatoes; lettuce and cucumbers; cabbage and celery; celery and tomatoes, or eat simply one of these green vegetables raw. it is a good thing to eat some of those salad vegetables daily. if your digestion is excellent, you may occasionally take raw carrots or turnips, and a few raw spinach leaves are tasty for a change. never mind if people tease you about eating grass, for it helps you to keep well. dress the raw vegetables as your taste allows. most people want some salt, or salt and lemon juice, or a little sugar, or cream, or salt and olive oil, or salt, olive oil and lemon juice, or mayonnaise on their salad vegetables. some eat them without any dressing and the flavor is excellent. tasty salad can be made of fruit and vegetables, using no dressing, but strewing some nuts over the dish. on warm days, such a salad makes a satisfactory lunch. it is all right to make a fruit and vegetable salad. instead of using tomatoes, take strawberries, apples, grapes, or any other acid fruit. these fruits may be combined with cabbage, lettuce, celery or cucumbers. do not mix too many foods in a meal, for to do so is indicative of poor taste. those with refined palates like simple meals, and there is no reason for making salads so complex, when simplicity is a requirement for building health. however, a complex salad made of raw vegetables and raw juicy fruits does not play so much havoc as a mixture of concentrated foods. lettuce and celery are the most satisfactory salad vegetables to mix with fruits. people who eat raw fruits do not need to eat the raw salad vegetables, for fruits and vegetables supply the same salts. those who avoid both raw fruits and raw vegetables are not treating their bodies fairly. the vegetable salads are most satisfactory when taken in combination with flesh, nuts or eggs, together with cooked succulent vegetables. they may be eaten with starchy foods, but then they should contain little or no acid. chapter xiv. cereal foods. ==================================================================== carbohy- water protein fat drates ash -------------------------------------------------------------------- barley. . . . . . buckwheat. . . . . . corn. . . . . . kafir corn. . . . . . oats. . . . . . rice. . . . . . rye. . . . . . wheat, spring. . . . . . wheat, winter. . . . . . first patent flour. . . . . . whole wheat flour. . . . . . graham flour. . . . . . bread, ordinary white. . . . . . bread, whole wheat. . . . . . bread, graham. . . . . . -------------------------------------------------------------------- the cereal foods are important because of their wide distribution and the ease with which they can be prepared and utilized as food. they are very productive and need but little care and hence are a cheap food. the body can digest and absorb sugar and starch more completely than any other kind of food. all civilized people have a favorite cereal. the chinese and japanese use rice very extensively, and this grain is growing in favor with us. white people generally prefer wheat, which is an excellent grain that has been used by man for thousands of years. it has been found in ancient egyptian tombs, and it is so retentive of life that it has started to grow after lying dormant for several thousand years. truly it is a worthy food for man. the table of cereals should be carefully studied. it will be seen that the grains contain much starch, a little fat, and considerable protein. they also carry sufficient of salts, but only a small amount of water. please note further that patent flour loses nearly all of its salts. patent flour is the product that is left after all the bran and practically all of the germ have been removed from the wheat. whole wheat flour, or entire wheat flour, is the name given to the flour that has had a great part of the outer covering of the wheat kernel removed. it is a misnomer. graham flour, named after dr. graham, is the product of the whole wheat kernel, and it will be noted that it is richer in salts and protein than the white flour and the whole wheat flour. the whole wheat flour and graham flour we find on the market are often the result of blending, which is also true of the patent flour. as we would expect, the various breads are rich or poor in salts according to the flours from which they are made. all the cereals are good foods, but inasmuch as wheat and rice are used most extensively, they will receive more attention than the rest. wheat is perhaps the best and most balanced of all our cereals. the whole wheat with the addition of a little milk is sufficient to support life indefinitely. it is one of the foods of which people never seem to tire. tiring of food is often an indication of excess. it is with food as with amusement, if we get too much we become blase. those who eat in moderation are content with simple foods, but those who eat too much want a great variety, as a rule. there are beef gluttons, who are satisfied with their flesh and liquor, but this is because the meats are so stimulating. inasmuch as we use so much wheat, it is important that we use it properly. today people want refined foods, and in refining they spoil many of our best food products. sugar is too refined for health, rice suffers through refinement, and so does wheat. the wheat kernel contains all the elements needed to support life. in making fine white flour of it, at least three-fourths of the essential salts are removed. this robs the wheat of a large part of its life-imparting elements, and makes of it starvation food. if much white bread is consumed it is necessary to supplement it by taking large quantities of fresh fruits and vegetables, not necessarily in the same meal, in order to get the salts that have been removed in the process of milling. the salts are found principally in the coats of the wheat, and in removing these coats and the germ, not only the salts, but considerable protein is lost. in other words, we remove most of the essential salts and a considerable part of the building material of the wheat, and then we eat the inferior product. the finer and whiter the flour, the poorer it is. white flour has a very high starch content. the products made from it are quite tasteless and lacking in flavor, unless flavoring is added. those who are used to whole wheat products find the white bread flat. it is possible to consume large quantities of white bread, and yet not be satisfied. there is something lacking. whole wheat bread is more satisfying and therefore the danger of overeating of it is not so great. the advocates of white flour say that the bran is too irritating for the bowels and for this reason it should be rejected. there is no danger in eating the entire kernel, after it is ground up. the particles of bran are so fine that they do no harm. the intestines were evidently intended for a little roughage, and it might as well come partly from wheat as from other sources. the gentle stimulation produced by the bran helps to keep the intestines active. it is noticeable that consumption of very refined foods leads to constipation. bran bread and bran biscuits are prescribed for constipation. this is just as bad as removing the bran entirely. man has never been able to improve on the composition of the wheat berry. when an excess of bran is eaten, it causes too great irritation and in the end the individual is worse off than before. the after effect of irritation is always depression and sluggishness. recent experiments seem to show that it is not the coarseness of the bran that causes activity of the bowels, but that some of the contained salts are laxative, for the same results have been obtained by soaking the bran in water and drinking the liquid. the products of refined flour are more completely and easily digested than the whole wheat products. however, by eating in moderation and masticating well every normal person is able to take good care of whole wheat products, and the benefit of using the entire grain is so great that we should hesitate about continuing the use of the refined flours and white breads. in the french army it has been found that when the soldiers are fed on refined flour products they are not so well nourished as when they have whole wheat products, and that they must have more of other foods to supplement the impoverished breadstuffs. it is difficult to get people to realize how important it is to give the tissue salts with the foods. salts are absolutely essential to vital activity, and a lack of salts always results in mental and physical depression and even in disease. no matter what adults are given, children should not be fed on white flour products. they need all the salts in the wheat. depriving them of salts retards their development and results in decaying teeth and poor bone formation, among other things. they do not feel satisfied with their white flour foods. therefore they overeat and get indigestion, catarrh, adenoids and various other ills. it is not difficult for people with observing eyes to note the difference in satisfaction of children after they get impoverished foods and the natural foods. anemia is very common among children, especially among the girls. the chief reason is impoverished foods. salts can be used by the animal organism only after they have been elaborated by the vegetable kingdom. to remove all the iron from wheat and then give inorganic iron, which can not be assimilated, in its stead, is the height of folly. by all means, use less of the white flour and more of the entire wheat flour. if the white flour habit can not be given up, take enough raw fruit and vegetables to make up for the loss of salts in milling. when rice is properly prepared it digests very easily. it is a little poor in protein, but this can be remedied by taking some milk in the same meal. the rice we ordinarily get is inferior to the natural product. first they remove the bran. then the flour is taken off. then it is coated with a mixture of glucose and talcum and polished. all this trouble is taken to make it appeal to the eye. this impoverished rice is lacking in salts. it will not support people in health. in the countries where polished rice is fed in great quantities, they suffer a great deal from degenerative diseases. one of these is beri-beri, in which there are muscular weakness and degeneration, indigestion, disturbances of the heart and often times anasarca. when people suffering from this disease are given those parts of the rice grain lost in making polished rice, they recover. this is proof enough that the cause of the disease is the impoverished food. the rice that should be used is brown and unpolished. when it is cooked it looks quite white. it is very satisfying. rye is extensively used in some lands. the bread is very good. oats are largely devoured in scotland. corn bread is a favorite food in the southern part of our country. the negroes are fond of corn and pork with molasses, which is far from an ideal combination in warm climates. preparations. wheat makes the best bread because it contains gluten. among proteins gluten is unique, because it is so elastic and after it has stretched it has a tendency to retain its place. this is what makes bread so porous. there are various meals or flours that can not be made into bread, or even dough, because they lack compounds which will act as frame work. bread can be made in many ways. the chief question for the housewife to decide is whether to make the bread from entire wheat flour or from patent flour. they are so different in value that a decision should not be difficult. it is also necessary to decide whether to use yeast bread or some other kind. yeast bread is made essentially from flour, water and yeast in the presence of heat. there are so many ways of making bread of this kind that a recipe is not necessary. the amount of salt to be added depends upon individual taste. some like to set their yeast working in part potato, part flour. others use milk instead of water. some add shortening. and nearly all women believe that their own bread is the best. yeast is made up of myriads of little plants or fungi, which thrive on the sugary part of the flour. they convert this into alcohol and carbonic acid gas. the alcohol is practically all gone before the bread is brought to the table. the gas raises the bread, assisted by the expansion of the water in the dough when it is placed in a hot oven. the yeast consumes a great deal of the nutritive part of the flour. this may amount to from to per cent. of the food value, and i have read that sometimes it is as high as per cent. liebig said that the fermentation destroyed enough food material daily in germany to supply , people with bread. however, yeast bread is very agreeable to the taste and therefore is probably worth more than the unfermented product. one objection to yeast bread is that all the yeast is not killed in baking, and the alcoholic fermentation may start again in the stomach. if the bread is turned into zwieback this is remedied. fresh bread is not fit to eat, for it is very rarely properly masticated and if it is merely moistened and converted into a soggy mass in the mouth it is hard to digest. unleavened bread is made by making the flour into a paste, rolling out thin and baking well. any kind of flour may be used. this is the passover bread of the jews. dr. graham's bread was made by mixing graham flour with water, without any leavening, mixing the dough thoroughly, putting this aside several hours and baking. macaroni and spaghetti are made by mixing durum wheat flour with water, without any leavening. with the addition of eggs we get commercial noodles. the paste is moulded as desired. all bread stuffs should be well baked.. the baking turns part of the starch into dextrine, which is easy to digest. biscuits should be placed into a hot oven, but bread should be put into an oven moderately heated, otherwise the crust forms too quickly. whenever a light product is desired, whether it is bread, biscuit or cake, sift the flour over and over again to get it well impregnated with air. the more air it contains the more porous will be the finished product. five or six siftings will suffice. unleavened breads of excellent flavor can be made by using either cream or butter as shortening, rolling the bread very thin, like crackers, and baking thoroughly. shredded wheat biscuits, puffed wheat and puffed rice, flaked wheat and flaked corn are some of the good foods we can purchase ready made. most of them should be placed in a warm oven long enough to crisp. masticate thoroughly and take them with either butter or milk, or both. it is best to take the milk either before or after eating the cereal. sugar should not be added to these foods. those who are not hungry enough to eat them without sugar should fast until normal hunger returns. _baking powder bread_ is very good. the essentials are well sifted flour, liquid, good baking powder, quick mixing and a hot oven. the following recipe, recommended by dr. tilden, is good: to a quart of very best flour, which has been sifted two or three times, add a little salt and a heaping teaspoonful of baking powder. sift again three times. then add one or two tablespoonfuls of soft butter. mix rapidly into a rather stiff dough with unskimmed milk. the dough should be rolled thin, and cut into small biscuits or strips. put into a pan and bake in a hot oven until there is a crisp crust on bottom and top, which will take about twenty minutes. the more thoroughly and quickly the dough is mixed, the better the result. these biscuits or bread sticks are good, always best when made rather thin, not to exceed an inch in thickness after being baked. when an attempt is made to bake in the form of a fairly thick loaf it is generally a failure. use the proportions of white and whole wheat flours desired. if more butter or some cream is added and it is rolled out thin, it serves very well for the bread part of shortcake. _toast_: slice any kind of bread fairly thin, preferably stale bread. place the slices into a moderately hot oven and let them remain there until they are crisp through and through. the scorched bread that is generally served as toast is no better than untoasted bread. _whole wheat muffins_: one cup whole wheat flour; one cup white flour; one-fourth cup sugar; one teaspoonful salt; one cup milk; one egg; two tablespoonfuls melted butter; four teaspoonfuls baking powder. mix dry ingredients; add milk gradually, then eggs and melted butter. put into gem pans and bake in hot oven for twenty-five minutes. _ginger bread_: one cup molasses; one and three-fourths teaspoons soda; one-half cup sour milk; two cups flour; one-half teaspoon salt; one-third cup butter; two eggs; two teaspoonfuls ginger. put butter and molasses in sauce pan and heat until boiling point is reached. remove from fire, add soda and beat vigorously. then add milk, egg well beaten, and remaining ingredients mixed and sifted. bake twenty-five minutes in buttered, shallow pan in moderate oven. _custard_: three cups milk; three eggs; one-half cup sugar; one-half teaspoonful vanilla; pinch of salt. beat eggs, add sugar and salt; then add scalded milk and vanilla; mix well. pour into cups, place them in a pan of hot water in oven and bake twenty to twenty-five minutes. serve cold. custard may also be cooked in double boiler or baked in a large pan. this is not a cereal dish, but the next one is. _rice custard_: to well cooked rice add a few raisins and a small amount of sugar. the raisins can be cooked with the rice or separately. place the rice and raisins in a baking dish, pour over an equal amount of raw custard and bake as directed for custard. bake in either individual cups or pan. when done the layer of custard is on top and the rice and raisins on the bottom. _macaroni and cheese_: three-fourths cup macaroni broken in pieces; two quarts boiling water; one-half table-spoonful salt. cook macaroni in salted water twenty minutes, or longer if necessary to make it tender; drain. put layer of macaroni in buttered baking dish; sprinkle with cheese, and repeat, making the last or top layer of cheese. pour in milk to almost cover. put into oven and bake until the top layer of cheese is brown. _corn bread_: two cups corn meal; one-half cup wheat flour; one tablespoonful sugar; one-half teaspoonful salt; two teaspoonfuls baking powder; two eggs; one and three-fourths cups milk. sift corn meal, flour, baking powder, salt and sugar together four or five times; add eggs and milk; stir well, pour into a hot buttered pan; smooth the top with a little melted butter to crisp the crust. bake a good brown in hot oven. another recipe for corn bread is: to one cup of wheat flour, add two cups of corn flour; two eggs; one heaping teaspoonful butter or cottolene; one heaping teaspoonful baking powder; one pinch soda, a scant fourth teaspoonful; one-half teaspoonful salt. prepare and make into batter with milk and bake as directed in first recipe. _corn mush_: cook corn meal in plain water until it is done. it may be cooked over the fire, in a fireless cooker or in a double boiler. serve with rich milk; add a little salt if desired. _oatmeal_: put into a double boiler and let it cook until it is very tender. it can also be cooked in a fireless cooker over night. it requires several hours cooking before it is fit to eat. all foods of this nature should be thoroughly cooked, and they may all be made into porridge, which is better. the objection to all mushy foods is that they are hardly ever properly masticated. the result is that they ferment in the alimentary tract, especially when they are eaten with sugar, as they generally are. it is best to take the mushy foods with milk and a little salt or with butter. eaten in this way there is not such tendency to overeat as when sugar is used. children especially eat more of these foods than is good for them if they are allowed to take them with sweets. porridge is more diluted than the mushes and hence the danger of overeating is not so great. _boiled rice_: the best way to cook it is in a double boiler or a fireless cooker. every grain should be tender. cook it in plan water. it is not necessary to stir, but if the rice becomes dry add some more water. if rice and milk are desired, warm the milk and add when the rice is done. serve like oatmeal. putting sugar on cereals is nonsense. they are very rich in starch and sugar is about the same as starch. sugar stimulates the appetite, and consequently people who use it on cereals overeat of this concentrated food. _rice and raisins_: this is prepared the same as boiled rice, except that raisins are added to the rice and water when first put on to cook. with milk this makes a good breakfast or lunch. combinations. starches of the cereal order may be eaten in combination with fats, such as cream, butter, olive oil and other vegetable oils. they combine well with all the dairy products, such as milk and cheese. starches combine well with nuts. take a piece of whole wheat zwieback and some pecans, chew both the bread and the nuts well and you will find this an excellent meal. there is nothing incompatible about eating cereals with flesh, but it generally leads to trouble, for people eat enough meat for a meal, and then they eat enough starch for a full meal. this overeating is injurious. besides, starch digestion and meat digestion are different and carried on in different parts of the alimentary tract, so it is best to eat starchy foods and meats at different meals. those who eat in moderation may eat starch and flesh in the same meal without getting into trouble. in winter it is all right to take starch with the sweet fruits. it is best to avoid mixing acid fruits and cereals. even healthy people find that a breakfast of oranges and bread does not agree as well as one of milk and bread. the saliva, which contains ptyalin, is secreted in the mouth. the ptyalin starts starch digestion, but it does not work in the presence of acid. eating acid fruits makes the mouth acid temporarily, and consequently the starch does not receive the benefit it should from mouth digestion. the result is an increased liability to fermentation in the alimentary tract. to get the best results it is absolutely necessary to masticate all starchy foods well. if this is not done it is merely a question of time until there is indigestion, generally accompanied by much acidity and gas production. this condition is a builder of many ills. recipes for pies and cakes are not given in this book. the less these compounds are used the better. they are very popular and can be made according to directions in conventional cook books. pies should be made with thin crusts, which should be baked crisp both on bottom and top. the best cakes are the plain ones. when desserts are eaten, less should be taken of other foods. most people make the mistake of eating more than enough of staple foods and then they add insult to injury by partaking of dessert. chapter xv. tubers. ==================================================================== pro- carbohy- calories water tein fat drates ash per lb. -------------------------------------------------------------------- potato............ . . . . . sweet potato...... . . . . . jerusalem artichoke. . . . . . the two tubers that are of chief interest are the irish potato and the sweet potato. the former is easily and cheaply grown on vast areas of land and therefore forms a large part of the food of many people. properly prepared it is easily digested and very nourishing. the sweet potato is a richer food than the irish potato, but on account of its high sugar contents people soon weary of it. the southern negroes are very fond of this food. like all other starches, potatoes must be thoroughly masticated, or they will disagree in time. potatoes are of such consistency that they are easily bolted without proper mouth preparation. in time the digestive organs object. a new tuber is receiving considerable attention. it is the dasheen. it is said to be of very agreeable flavor, mealy after cooking, and produces tops that can be used in the same manner as asparagus. the dasheen requires a rather warm climate for its growth. preparation. _baking_: all the tubers may be baked. clean and place in the oven; bake until tender. a medium sized potato will bake in about an hour. if the potatoes are soggy after being baked they are not well flavored. to remedy this, run a fork into them after they have been in the oven for a while; this allows some of the steam to escape and the potatoes become mealy. when a fork can easily be run into the potato, it is well enough done. if the potatoes are well cleaned, there is no objection to eating a part of the jacket after they are baked. the finest flavoring is right under the jacket. this part contains a large portion of the salts. _boiling_: all tubers may be boiled. it is best to keep the jacket on, otherwise a great deal of both the salts and the nourishment is lost. if the potatoes boiled in the jacket seem too highly flavored, cut off one of the ends before placing them in the water. it takes about thirty or forty minutes to boil a medium sized irish potato. test with a fork, the same as baked potato, to find if done. potatoes should never be peeled and soaked. if they are to be boiled without the jacket, they should be cooked immediately after being peeled. steamed potatoes are good. there is no objection to mashing potatoes and adding milk, cream or butter, provided they are thoroughly masticated when eaten. if the potatoes are mashed, this should be so thoroughly done that not a lump is to be found. potatoes cooked in grease are an abomination. the grease ruins a part of the potato and makes the rest more difficult to digest. potato chips, french fried potatoes and german fried potatoes are too hard to digest for people who live mostly indoors. they should be used very seldom. combinations. potatoes are best eaten in combinations such as given for cereals. they are commonly taken with meat and bread. this combination is one of the causes of overeating. occasionally they may be eaten with flesh, but this should not be a habit. take them as the main part of the meal. baked potatoes and butter with a glass of milk make a very satisfying meal. a good dinner can be made of potatoes with cooked succulent vegetables and one or two of the raw salad vegetables, with the usual dressings. it is best not to eat potatoes and acid fruits in the same meal. in selecting food it is well to remember that as a general rule but one heavy, concentrated food should be eaten at a meal, for when two, three or even four concentrated foods are partaken of, the appetite is so tempted and stimulated by each new dish that before one is aware of it an excessive amount of food has been ingested. chapter xvi. fruits. ==================================================================== pro- etherial carbohy- calories water tein extracts drates ash per lb. -------------------------------------------------------------------- apples........... . . . . . bananas.......... . . . . . figs, fresh...... . . ... . . lemons........... . . . . . muskmelons....... . . ... . . oranges.......... . . . . . peaches.......... . . . . . pears............ . . . . . ... persimmons....... . . . . . rhubarb, stalk... . . . . . strawberries..... . . . . . watermelon....... . . . . . _dried fruits_: apples........... . . . . . apricots......... . . . . . citrons.......... . . . . . dates............ . . . . . figs............. . . . . . prunes........... . . ... . . raisins.......... . . . . . currants......... . . . . . -------------------------------------------------------------------- apricots, avocados, blackberries, cherries, cranberries, currants, gooseberries, grapes, huckleberries, mulberries, nectarines, olives, pineapples, plums, raspberries and whortleberries are some of the other juicy fruits. they are much like the apple in composition, containing much water and generally from to per cent of carbohydrates (sugar). olives and avocados are rich in oil. you may classify rhubarb, watermelons and muskmelons as vegetables, if you wish. on the table they seem more like fruit, which is the reason they are given here. melons are fine hot weather food. they are mostly water, which is pure. during hot weather it is all right to make a meal of melons and nothing else, at any time. the melons are so watery that they dilute the gastric juice very much. the result is that when eaten with concentrated foods they are liable to repeat, which indicates indigestion. fruits are not generally eaten for the great amount of nourishment to be obtained from them. they are very pleasant in flavor and contain salts and acids which are needed by the body. the various fluids of the body are alkaline, and the fruits furnish the salts that help to keep them so. a few secretions and excretions are naturally acid. sometimes the body gets into a too acid state, but that is very rarely due to overeating of fruit. it is generally caused by pathological fermentation of food in the alimentary tract. the salts and acids of fruits are broken up in the stomach and help to form alkaline substances. the water of the fruit is very pure, distilled by nature. the acid fruits are refreshing and helpful to those who have a tendency to be bilious. fruits are cleansers, both of the alimentary tract and of the blood. fruits grow most abundantly in warm climates and that is where they should be used most. in temperate climates they should be eaten most freely during warm weather. young, vigorous people can eat all the fruit they wish at all seasons, within reason. thin, nervous people, and those who are well advanced in years should do most of their fruit eating in summer. in winter there is a tendency to be chilly after a meal of acid fruit. in summer such meals do not add to the burden of life by making the partaker unduly warm. the apple is perhaps the best all-round fruit of all. it is grown in many lands and climates. it is possible to get apples of various kinds, from those that are very tart to those that are so mild that the acid is hardly perceptible to the taste. stout people can eat sour apples with benefit. thin, fidgety ones should use the milder varieties. the juice from apples, sweet cider, freshly expressed, is a very pleasant drink, and may be taken with fruit meals. the avocado is a good salad fruit. it is quite oily. a combination of avocado and lettuce makes a good salad. thanks to rapid transportation, the banana has become a staple. it is quite commonly believed that bananas are very starchy and rather indigestible. this may be true when they are green, but not when they are ripe. green bananas are no more fit for food than are green apples. ripe bananas are neither starchy nor indigestible. when the banana is ripe it contains a trace of starch, all the rest having been changed to sugar. a ripe banana is mellow and sweet, but firm. the skin is either entirely black, or black in spots, but the flesh is unspotted. the best bananas can often be purchased for one-half of the price of those that are not yet fit to eat. bananas are a rich food. weight for weight they contain more nourishment than irish potatoes. a few nuts or a glass of milk and bananas make a good meal. bananas contain so much sugar that it is not necessary to eat bread or other starches with them. those with normal taste will not spoil good bananas by adding sugar and cream. when well masticated the flavor is excellent and can not be improved by using dressings. be sure that the children have learned to masticate well before giving bananas, and then give only ripe ones. the flesh of the banana is so smooth and slippery that children often swallow it in big lumps, and then they frequently suffer. lemonade may be taken with fruit or flesh meals. as usually made it is quite nourishing, for it contains considerable sugar. those who are troubled with sluggish liver may take it with benefit, but the less sugar used the better. other fruit juices may be used likewise, but they should be fresh. if they are bottled, be sure that no fermentation is taking place in them. these juices may be served with the same kind of meals as lemonade. most of them require dilution. grape juice is very rich and a large glassful of the pure juice makes a good summer lunch. it should be sipped slowly. those who like the combination may make a meal of fruit juice mixed with milk, half and half. grapes and strawberries, which are relished by most, disagree with some people. the skin of the concord grape should be rejected, for it irritates many. if they are relished, the skins of most fruits may be eaten. when peeled apples lose a part of their flavor. olives are generally eaten pickled. the fruit in its natural state tastes very disagreeable to most people. the ripe olive is superior in flavor to the green, which is not usually relished at first. the sweet fruits, by which we mean dried currants, raisins, figs and dates, and bananas should be classed with them, serve the body in the same way as do the breadstuffs, and may be substituted for starches at any time. they may be eaten at all seasons of the year, but are used most during cold weather. a moderate amount of them may be eaten with breadstuffs, or they may be taken alone, or with milk, or with nuts, or with acid fruit. they are very nourishing so it does not take much of them to make a meal. to get the full benefit, masticate thoroughly. they contain sugar in its best form, sugar that not impoverished by being deprived of its salts. grape sugar needs very little preparation before it enters the blood. starch and sugar are of equal value as nourishment. it seems that the sugar is available for energy sooner than the starch. americans generally weary quickly of sweet foods, though they consume enormous quantities of refined sugar, but in tropical countries figs and dates are staple in many places and the inhabitants relish them day in and day out as we relish some of out staples. it is a matter of habit. those who do not surfeit themselves do not weary quickly of any particular article of diet. preparation most fruits are best raw. then their acids and salts are in their most available form. those who become uncomfortable after eating acid fruit may know that they have abused their digestive organs and they should take it as an indication to reduce their food intake, simplify their diet, masticate better and eat more raw food. those who overeat of starch or partake of much alcohol cultivate irritable stomachs, which object to the bracing fruit juices. for the sake of a change fruits may be cooked. the more plainly they are cooked the better. always use sugar in moderation, no matter whether the fruit is to be stewed or baked. to stew fruit, clean and if necessary peel. stew in sufficient water until tender. when almost done add what sugar is needed. when stewed thus less sugar is required than if the sweetening is done at the start. stewed fruit can be sweetened by adding raisins, figs or dates. this is relished by many. figs and dates stewed by themselves are too sweet for many tastes. this can be remedied by making a sauce of figs or dates with tart apples or any other acid fruit that appeals in such combinations. _baked apple_: place whole apples in large, deep pan; add about one-third cup of water and one and one-half teaspoonfuls sugar to each apple. put into oven and bake until skins burst and the apples are well done. serve with all the juice. _boiled apple_: place whole apples in a stewing pan; add two teaspoonfuls sugar and one cup or more of water to each apple; use less sugar if desired. cover the vessel tightly and boil moderately until the skins burst and the apples are well done. all stewed fruits should be well done. avoid making the fruit sauces too sweet. _stewed prunes_: a good prune needs no sweetening. stew until tender. it is a good plan to let the prunes soak a few hours before stewing them. raisins may be treated in the same way. prunes may be washed and put into a dish; then add hot water enough to about half cover them; cover the dish very tightly and put aside over night. the prunes need no further preparation before being eaten. if the covering is not tight it will be necessary to use more water. raisins and sundried figs may be treated in the same way. unfortunately, most of our dried fruit is sulphured. sulphurous acid fumes are employed, and you may be sure that this does the fruit no good. if you can get unsulphured fruit, do so. the sulphuring process is popular because it acts as a preservative and it is profitable because it allows the fruit to retain more water without spoiling than would be possible otherwise. _canning fruit_: it is very easy to can fruit, but it requires care. select fruit that is not overripe. the work room should be clean and so should the cans and covers. it is not sufficient to rinse the cans in clean water. both the jars and the covers should be taken from boiling water immediately before being used. use only sound fruit, cook it sufficiently, adding the sugar when the fruit is almost done. if you cook the fruit in syrup, do not have a heavy syrup. put into jar while piping hot, filling the jar as full as possible, put on the cover immediately, turning until it fits snugly; turn jar upside down for a few hours to see if it leaks; tighten again and put in cool place. an even better way, especially for berries, is to fill the jar with fruit, pour syrup over them, put the jars into a receptacle containing water and let this water boil until the berries are done; then fill the jars properly and seal. some berries that lose their color when cooked in syrup retain it when treated this way. canned fruits are not as good as the fresh ones, but better than none. be sure that they are not fermenting when opened. when proper care is exercised a spoiled jar is a rarity. if there is any doubt about the fruit, scald and cool before using. this destroys the ferments. fresh fruit is the best. next comes fruit recently stewed or baked. if other fruit can not be obtained, get good dried fruit and stew it. combinations. fruits may be combined with almost any food, except that which is rich in starch, and even that combination may be used occasionally, although it is not the best. i have seen people who were supposed to be incurable get well when their breakfasts were mostly apple sauce and toast. however, sick people should avoid such combining entirely and healthy ones most of the time. breakfasting on cereals and fruit is a mistake. those who eat thus may say that they feel no bad results, but time will tell. nowhere in our manner of feeding does nature demand of a healthy human being that he walk the chalk line. all she asks is that he be reasonable. so if you feel fine and want a shortcake for dinner take it. but the shortcake should be the meal, not the end of one that has already furnished too much food. fruit combines well with both milk and cheese. the impression to the contrary that has been gained from both medical and lay writers is due to false deductions based on premises not founded on facts. milk and fruit, and nothing else, make very good meals in summer. _fruit salads_: a great variety of these salads can be made. take two or three of the juicy fruits, slice and mix. dress with a little sugar, or salt and olive oil, or simply olive oil, or no dressing. some like a dressing of sour cream or of cottage cheese rather well thinned out. raisins and other sweet fruits may also be used. ripe banana may be one of the ingredients. such a salad may be eaten with a flesh or nut meal, or it may be used as a meal by itself. fruit and cottage cheese make a meal that is both delicious and nourishing. a fruit salad strewed with nuts does the same. strawberries and sliced tomatoes dressed with cottage cheese make a good meal. lettuce, celery and tomatoes may be used in fruit salads. a few fruit salads to serve as examples are: apples, grapes and lettuce; peaches, strawberries and celery; bananas, pineapples and nuts; strawberries, tomatoes and lettuce. combine to suit taste and dress likewise, but avoid large quantities of cream and sugar, not only on your salads, but on all fruits. no acid should be necessary, but if it is desired, use lemon juice or incorporate oranges as a part of the salad. chapter xvii. oils and fats. oils and fats are the most concentrated foods we have. weight for weight, they contain more than twice as much fuel or energy value as any other food. taken in moderation they are easily digested, but if taken in excess they become a burden to the system. about or per cent of the weight of a normal body is fat, and this fat is formed chiefly from the fatty foods taken into the system, supplemented by the sugar and starch. when the body becomes very fat, it is a disease, called obesity. fat people are never healthy. the fat usurps the place that should be occupied by normal tissues and organs. it crowds the heart and the lungs, and even replaces the muscle cells in the heart. the result is that the heart and lungs are overcrowded and overworked and the blood gets insufficient oxygen. not only the lungs pant for breath after a little exercise, but the entire body. much fat is as destructive of health as it is of beauty. those who find themselves growing corpulent should decrease their intake of concentrated foods and increase their physical activity. our chief sources of fat supply are cream and butter, vegetable oils, nuts and the flesh of animals. most meats, especially when mature, contain considerable fat. when the fat is mixed in with the meat, it is more difficult to digest than the lean flesh. fresh fish, most of which contains very little fat, is digested very easily, while the fattest of all flesh, pork, is tedious of digestion. there is an instinctive craving for fat with foods that contain little or none of it. that is why we use butter with cereals and lean fish, and oil dressings on vegetables. in moderation this is all right. fats are not very rich in salts, which must be supplied by other foods. because of their great fuel value, more fats are naturally consumed in cold than in hot climates. the esquimeaux thrive when a large part of their rations is fat. such a diet would soon nauseate people in milder climes. fats and oils are used too much in cooking. fried foods and those cooked in oil are made indigestible. sometimes we read directions not to use animal fats, but to use olive oil or cotton seed oil for frying. it is poor cooking, no matter whether the grease is of animal or vegetable origin. so far as food value and digestibility are concerned, there is no difference between animal and vegetable fats. fresh butter is very good, and so is olive oil. some vegetable oils contain indigestible substances. cotton seed oil and peanut oil are much used. sometimes they are sold in bottles under fancy lables as olive oil. the olive oils from california are fully as good as those imported from spain, italy and france and are more likely to be what is claimed for them than the foreign articles. in the past, much of our cotton seed oil has been bought by firms in southern europe and sent back to us as fine olive oil! such imposture is probably more difficult under our present laws than it was in the past. most oils become rancid easily and then are unfit for consumption. if taken in excess as food they have a splendid opportunity to spoil in the digestive tract, and then they help to poison the system. taken in moderate quantities they are digested in the intestines and taken into the blood by way of the lymphatics. they may be stored in the body for a while, but finally they are burned, giving up much heat and energy. taking oils between meals as medicine or for fattening purposes is folly. people get all they need to eat in their three daily meals. lunching is to be condemned. chapter xviii. milk and other dairy products. ==================================================================== pro- carbohy- calories water tein fat drates ash per lb. -------------------------------------------------------------------- whole milk . . . . . cream . . . . . buttermilk . . . . . butter ..... ... . ... ... cheese, whole milk . . . . . " skimmed milk . . . . . -------------------------------------------------------------------- the dairy products vary greatly. some cows give richer milk than others. butter may be almost pure fat, or it may contain much water and salt. the cheeses are rich or poor in protein and fats according to method of making. cottage cheese may be well drained or quite watery. therefore, this table gives only approximate contents. milk is not a beverage. it is a food. a quart of milk contains as much food and fuel value as eight eggs or twelve ounces of lean beef. that is, a cupful (one-half of a pint) is equal to two eggs or three ounces of lean beef. this shows that milk should not be taken to quench thirst, but to supply nourishment. milk is one of our most satisfactory and economical albuminous foods, even at the present high prices. in many foods from to per cent of the protein goes to waste. in milk the waste does not ordinarily amount to more than about per cent. this fluid generally leaves the stomach within one or one and one-half hours after being ingested. in spite of its merits as a food some writers on dietetics advocate that adults stop using it, giving it only to the young. milk is an excellent food when properly used. when abused it tends to cause discomfort, disease and death, and so does every other food known to man. milk is given in fevers and in other diseases, when the digestive and assimilative processes are suspended. this is a serious mistake and has caused untold numbers of deaths. when the digestion has gone on a strike all feeding is destructive. milk and meat broths, which are generally given, are about the worst foods that could be selected under the circumstances, for they decay very easily, and are excellent food for the numerous bacteria that thrive in the digestive tract during disease. these foods must decay when they are not digested, for the internal temperature of the body during fevers is over one hundred degrees fahrenheit. when bacteria are present in excess they give off considerable poison, which makes the patient worse. if circumstances are such that it is necessary to feed during acute disease, which is always injurious to the patient, let the food be the least harmful obtainable, such as fruit juices. even they do harm. in our country cow's milk is used almost exclusively, and that is the variety that will be discussed in this chapter. in other lands the milk of the mare, the ass, the sheep, the goat and of other animals is used. human milk is discussed in detail in the chapter on infancy. the objection voiced against cow's milk is that it is an unnatural food for man, only fit for the calf, which is equipped with several stomachs and is therefore able to digest the curds which are larger and tougher than the curds formed from human milk. it is said that the curds of cow's milk are so indigestible that the human stomach can not prepare them for entry into the blood. this is probably true, but it is also true of other protein-bearing foods. the digestion and assimilation of proteins are begun in the stomach and completed in the intestines, and the protein in milk is one of the most completely utilized of all proteins. to call a food unnatural means nothing, for we can call nearly all foods unnatural and defend our position. a natural food is presumably a nutritious and digestible aliment that is produced in the locality where it is consumed, one that can be utilized without preparation or preservation. so we may say that a resident of new york should not use figs, dates, bananas and other products of tropical and semi-tropical climates, for they are not natural in the latitude of new york. we can take the position that it is unnatural for people to eat grains, which need much grinding, for the birds are the only living beings supplied with mills (gizzards). we can further say that it is unnatural to eat all cooked and baked foods. but such talk is not helpful. the more a person uses his brain the less power he has left for digestion and therefore it is necessary to prepare some of the foods so that they will be easy to digest. man is such an adaptable creature that we are not sure what he subsisted on before he became civilized and are therefore unable to say what his natural food is. we know that in the tropics fruits play an important part in nourishing savages, while in the frozen north fat flesh is the chief food. perhaps there is no natural food for man. some of those who advocate the disuse of milk have a substitute or imitation to take its place, nut milk made from finely ground nuts and water. like all other imitations, it is inferior to the original. it is more difficult to digest than real milk and the flavor is quite different. the objection that milk is indigestible is not borne out by the experience of those who give it under proper conditions. it is true that milk disagrees with a few, but so do such excellent foods as eggs, strawberries and concord grapes, and many other aliments which are not difficult to digest. this is a matter of individual peculiarity. some can take boiled milk, but are unable to take it fresh, and vice versa. outside of the few exceptions, milk digests in a reasonable time and quite completely. it is easier to digest than the legumes (peas, beans, lentils) which are rich in protein. it is also easier to digest than nuts, which contain much protein. the milk sugar causes no trouble and cream is one of the easiest forms of fat to digest, if taken in moderation. the protein in milk will cause no inconvenience if the milk is eaten slowly, in proper combinations and not to excess. the rennet in the stomach curdles the casein. the hydrochloric acid and the pepsin in the gastric juice then begin to break down and dissolve the clots, and the process of digestion is completed in the small intestines. those who overeat of milk in combination with other foods will derive benefit from omitting the milk. they will also be benefitted if they continue using milk and omit either the starch or the meat. when foods disagree, in nearly every instance it is due to the fact that too much has been eaten and too many varieties partaken of at a meal. some may single out the milk or the meat as the offenders. others may point to the starches, and still others to the vegetables with their large amount of indigestible residue. they are all right and all wrong, for all the foods help to cause the trouble. however, such reasoning does not solve the problem. if the meals cause discomfort and disease, reduce the amount eaten, take fewer varieties at a meal and simplify the cooking. those who eat simple meals and are moderate are not troubled with indigestion. those who eat such mushy foods as oatmeal and cream of wheat usually take milk or cream and sugar with them. this should not be done, for such dressing stimulates the appetite and leads to undermastication. neither children nor adults chew these soft starchy foods enough. the result is that the breakfast ferments in the alimentary tract. after a few months or years of such breakfasts, some kind of disease is sure to develop. mushy starches dressed with rich milk and sugar are responsible for a large per cent. of the so-called diseases of children, which are primarily digestive disturbances. colds, catarrhs and adenoids are, of course, due to improper eating extending over a long period of time. nothing should be eaten with mushy starches except a little butter and salt. after enough starch has been taken, a glass of milk may be eaten. if parents would only realize that they are jeopardizing the health and lives of their dear ones when they feed them habitually on these soft messes, which ferment easily, there would be a remarkable decrease in the diseases of childhood and in the disgraceful infant and childhood mortality, for several hundred thousand children perish annually in this country. milk is often referred to as a perfect food, and it is the perfect food for infants. the young thrive best on the healthy milk given by a female of their own species. every baby should be fed at the breast. the milk contains the elements needed by the body. the table at the head of this chapter shows that milk contains all essential aliments. the ash is composed of the various salts necessary for health, containing potassium, chlorine, calcium, magnesium, iron, silicon and other elements. for the nourishment of the body we need water, protein, fat, carbohydrates and salts, so it will be seen that milk is really a complete food. however, as the body grows the nutritive requirements change and milk is therefore not a balanced food for adults. it may be interesting to note that there is no starch in milk and that infants fed at the breast exclusively obtain no starchy food. many babies get no starch for nine, ten or even twelve months, and this is well, for they do not need it. they grow and flourish best without it. milk is an emulsion. it is made up of numerous tiny globules floating in serum. the size of the globules varies, but the average is said to be about / , of an inch in diameter. these globules are fatty bodies. there are other small bodies, containing protein and fat, which have independent molecular movement. the milk is a living fluid. when it is tampered with it immediately deteriorates. without doubt, nature intended that the milk should go directly from the mammary gland into the mouth of the consumer, but this is not practicable when we take it away from the calf. however, if we are to use sweet milk it is best to consume it as nearly like it is in its natural state as possible. it is quite common to drink milk rapidly. this should not be done. take a sip or a spoonful at a time and move it about in the mouth until it is mixed with saliva. it is not necessary to give it as much mouth preparation as is given to starchy food. if it is drunk rapidly like water large curds from in the stomach. if it is insalivated it coagulates in smaller curds and is more easily digested, for the digestive juices can tear down small soft curds more easily than the large tough ones. milk should not form a part of any meal when other food rich in protein is eaten. our protein needs are small, and it is easy to get too much. whole wheat bread and milk contain all the nourishment needed. on such a diet we can thrive indefinitely. this is information, not a recommendation. the bread should be eaten either before or after partaking of the milk. do not break the bread into the milk. if this is done, mastication will be slighted. bread needs much mastication and insalivation. when liquid is taken with the bread, the saliva does not flow so freely as when it is eaten dry. fruit and milk make a good combination, but no starchy foods are to be taken in this meal. take a glass of milk, either sweet or sour, and what fruit is desired, insalivating both the fruit and the milk thoroughly. if you have read that the combination of fruit and milk has proved fatal, rest assured that those who made such reports only looked at the surface, for other foods and other influences were having their effects on the system. many people die of food-poisoning and apoplexy. these bad results are due to wrong eating covering a long period and it is folly to blame the last meal. it would be queer if fruit and milk were not occasionally a part of the last meal. in winter, figs, dates or raisins with milk make an excellent lunch or breakfast. these fruits take the place of bread, for though they are not starchy, they contain an abundance of fruit sugar, which is more easily digested than the starch. starch must be converted into sugar before the system can use it. on hot days milk and acid fruit make a satisfying meal. many believe that milk and acid fruit should not be taken in the same meal, because the acid curdles the milk. as we have already seen, the milk must be curdled before it can be digested. if this step in digestion is performed by the acid in the fruit no more harm is done than when it is performed by the lactic acid bacteria. fruit juices and milk do not combine to form deadly poisons. if fruit and milk are eaten in moderation and no other food is taken at that meal the results are good. however, if fruit, milk, bread, meat, cake and pickles make up the meal, the results may be bad. such eating is very common. but do not blame the fruit and the milk when the whole meal is wrong. likewise, if a hearty meal has been eaten and before this has had time to digest a lunch is made of fruit and milk, trouble may ensue. all the foods may be good, but a time must come when the body will object to being overfed. in summertime much less food is needed than during the cold months. nevertheless, barring the christmas holidays and thanksgiving, people overeat more in summer than at any other time of the year. picnics often degenerate into stuffing matches. we should expect many cases of serious illness to follow them, and such is the case. sometimes the milk is so carelessly handled that it becomes poisonous and at other times the fruit is tainted, but generally bad combinations and overeating are the factors that cause trouble when the fruit and milk combination is blamed. buttermilk and clabbered milk are more easily digested by many than is the fresh milk. in europe sour milk is a more common food than in this country. here many do not know how excellent it is. two glasses of milk, or less, make a good warm-weather lunch. those who have a tendency to be bilious should use cream very sparingly. bilious people always overeat, otherwise their livers would not be in rebellion. the fat, in the form of cream, arouses decided protest on the part of overburdened livers. a theory has found its way into dietetic literature, sometimes disguised as a truth, to the effect that boiled or hot milk is absorbed directly into the blood stream without being digested. this is contrary to everything we know about digestion and assimilation, and although it is a fine enough theory it does not work out in practice. i have seen bad results when nothing but a small amount of the hot milk was fed to patients with weak digestive power. perhaps others have had better results. when the system demands a rest from food, nothing but water should be given. boiled or natural milk is then as bad as any other food, and worse than most, for in the absence of digestive power it soon becomes a foul mass, swarming with billions of bacteria. the system is compelled to absorb some of the poisons given off by the micro-organisms and the results are disastrous. every food we take must be modified by our bodies before entering the circulation, and milk is no exception. when milk is allowed to stand for a while the sugar ferments, through the action of the lactic acid bacteria. the sugar is turned into lactic acid, which combines with the casein and when this process has continued for a certain length of time the result is clabbered milk or sour milk. the length of time varies with the temperature and the care given the milk. if milk remains sweet for a long time during warm weather, discharge the milkman and patronize one whose product sours more quickly, for milk that remains sweet has been subjected to treatment. all kinds of preservative treatment cause deterioration. if extraordinary care is taken with the milk and it is kept at a temperature of about forty-two degrees fahrenheit, it may remain sweet five or six weeks, provided it is not exposed to the air, but such care is at present not practicable in commercial dairies. the milk contains unorganized ferments which spoil it in time without exposure to bacterial influences. these ferments cause digestion or decay of the milk. fresh butter is a palatable form of fat, which digests easily. like all other milk products, it must be kept clean and cold, or it will soon spoil. butter absorbs other flavors quickly and should therefore not be placed near odorous substances. it is best unsalted and in europe it is very commonly served thus. when people learn to demand unsalted butter they will get good butter, for no one can palm off oleomargarine or other imitations under the guise of fresh unsalted butter. unsalted butter must be fresh or it will be refused by the nose and the palate. salt and other preservatives often conceal age and corruption of foods. butter combines well with starches and vegetables, in fact, it can be used in moderation with any other food, when the body needs fat. butter should not be used to cook starches or proteins in. greasy cooking should be banished from our kitchens. milk is a complex food, highly organized, and therefore is easily injured or spoiled. the general rule is that the more complex a food is, the more easily it spoils. it is rather difficult at present to get wholesome milk enough to supply the people of our large cities. when it is boiled, the milk keeps longer, but boiled milk is spoiled milk. the fine flavor is lost, the casein, which is the principal protein of milk, is toughened, the milk, which is normally a living liquid, is killed, the chemical balance is lost, the organic salts being rendered partly inorganic. milk that is unfit to eat without being boiled is not fit to eat afterwards, for the poisonous end products of bacterial life remain. the milk is soured by the bacteria it contains. the lactic acid bacteria are harmless. when there is a lack of care and cleanliness, other bacteria get into the milk, and these are also harmless to people in good health, and most of them are not injurious to sick people. the bacteria (germs) do not cause disease, but when disease has been established, they offer their kindly offices as scavengers. bacteria thrive in sick people, especially when they are fed when digestive power is lacking. boiling retards the souring of milk, but when fat and protein are boiled together the protein becomes hard to digest. milk is rich in both fat and protein. excessive heat turns the milk brown, the milk sugar being carameled. babies do not thrive on boiled milk. they may look fat, but instead of having the desirable firmness of normal children, they are puffy. children fed on denatured milk fall victims to diseases very easily, especially to diseases which are due to lack of organic salts, such as rickets and malnutrition. pasteurization of milk is very popular. this is objectionable for the same reasons that boiling is condemned, though not to the same extent. pasteurization is heating the milk to about to degrees fahrenheit. this kills many of the bacteria, but many escape and when the milk is cooled off they begin to multiply and flourish again. it is estimated that pasteurized milk contains one-fourth as many bacteria as natural milk. so nothing is gained, and the milk is partly devitalized. the advocates of pasteurization give statistics showing that milk so treated has been instrumental in decreasing infant mortality. but please bear in mind that previously a great deal of milk unfit for consumption was fed to the babies. those who pasteurize milk generally are careful enough to see that they get a good product in the first place. if we can't get good milk we can do without it, for it is not a necessary food, but we can get good milk if we make the effort. if the milk is filthy, boiling or pasteurizing does not remove the dirt. gauthier says of pasteurization: "sometimes it is heated up to degrees (centigrade) with pressure of carbonic acid. but even in this case pasteurization does not destroy all germs, particularly those of tuberculosis, peptonizing bacteria of cowdung, and the dust of houses and streets, etc." even boiling does not kill the spores of bacteria unless it is continued until the milk is rendered entirely unfit for food. to kill these spores it is necessary to boil the milk several times. the spores are small round or oval bodies which form within the bacterial envelope when these micro-organisms are subjected to unfavorable conditions. the spores resist heat and cold that would kill almost any other form of life. when conditions are favorable they develop into bacteria again. after heating, the cream does not rise so quickly nor does it separate so completely as it does in natural milk. this is due to the toughening of the casein in the milk. heating partly disorganizes the delicately balanced salts contained in the milk. the result is that they can not be utilized so easily and completely by the body, for the human organism demands its food in an organic state, that is, in the condition built up by vegetation or by animals. we may consume iron filings and remain anemic, in fact, the effect the iron medication has is to ruin the teeth, digestive organs and other parts of the body as a consequence. but if we partake of such foods as apples, cabbage, lettuce and spinach, the necessary salt is taken into the blood. heating milk also makes it constipating. true, normal people can take boiled milk without becoming constipated, but how many normal people are there? we are sorely enough afflicted in this way now. let us have a supply of natural milk or go without it. it is not my desire to convey the impression that it does any harm to scald or boil milk occasionally, but if done daily it does harm, especially to the young. scalded milk has its proper place in dietetics. occasionally we find a person who has persistent chronic diarrhea. if he is in condition to eat anything, this annoying affliction is usually overcome in a reasonable time if the patient will take boiled or scalded milk in moderation three times a day, and nothing else except water. how are we to obtain good milk? we can do it by using common sense, care and cleanliness. it is well to remember that there are bacteria in all ordinary milk, and that if the milk is from healthy cows and is kept clean and cold these bacteria are harmless. most of them are the lactic acid bacteria, which change the milk sugar into acid. when the milk has attained a certain degree of acidity, the lactic acid bacteria are unable to thrive and the souring process is slowed up and finally stopped. most of the other bacteria in milk perish when lactic acid is formed. this is why stale sweet milk is often harmful, when the same kind of milk allowed to sour can be taken with impunity. if the milk is kept in a cold place the bacteria multiply slowly. if it is kept in a warm place they increase in numbers at a rate that is marvelous, and consequently the milk sours much sooner. even if the milk is kept cold, bacterial growth will soon take place, but it will perhaps not be lactic acid bacteria. it may be a form that causes the milk to become ropy and slimy or one that gives it a bad odor. bacteria are like other forms of vegetation, such as grass, weeds, flowers and trees, in that some flourish best under one condition and others under dissimilar conditions, and they struggle one against the other for subsistence and existence. like flowers there are thousands of different forms of bacteria and they vary according to their food and environment. peculiar odors in milk generally come from certain kinds of food given to the cows, such as turnips; from bacterial action; or from flavors absorbed from other foods or from odors in the air. milk should not be exposed to odorous substances, for it becomes tainted very quickly. sometimes yeast finds its way into milk and causes decomposition of the sugar with the formation of carbon dioxide and alcohol. a count of the bacteria in milk often serves a good purpose, for it shows whether it is good and has had proper care. the consumers have a right to demand milk low in bacteria, for if no preservatives have been used, that means clean milk. if we could live in our pristine state of beatific bliss, if such it was, we would not have to use milk after childhood is past, but our present condition demands the use of easily digested foods and to many milk is almost a necessity. the milk in the udder of a healthy cow is almost surely free from bacteria, but the moment it is exposed to the air these little beings start to drop into the fluid. the bacterial standards given by various city health departments vary. those who are mathematically inclined may find the following figures interesting: in some great cities they allow , bacteria to the cubic centimeter of milk. a cubic centimeter contains about twenty-five drops. in other words, they allow , bacteria per drop. this may seem very lively milk, but these bacteria are so small that about , of them laid end to end measure only about an inch, and it would take , , , , of them to weigh an ounce, according to estimates. these are the tiny vegetables we hear and read so much about, that we are warned against and fear so much. truly the pygmies are having their innings and making cowards of men. the bacteria multiply by the simple process of growing longer and splitting into two, fission, as it is called, and the process is so rapid that within an hour or two after being formed a bacterium may be raising a family of its own. some of the milk brought to the cities contains as many as , , bacteria per cubic centimeter, that is, about , per drop. this milk is either very filthy or it has been poorly cared for and should not be given to babies and young children. the filthiest milk may contain several billion bacteria to the cubic centimeter. by using care milk containing but , or even fewer, bacteria per drop can be produced. from the standpoint of cleanliness this is excellent milk. of course, the dairyman who takes pride enough in his work to produce such milk will sell nothing but what is first-class, and if he has business acumen he can always get more than the market price for his product. the talk about germs has been overdone, but no one can deny that the study of bacteriology has made people more careful about foods. the filthy dairies that were the rule a few years ago are slowly being replaced by dairies that are comfortable, well lighted and clean. do not allow the germs to scare you, for if ordinary precautions are taken no more of them will be present than are necessary, and they are necessary. they thrive best in filth, and they are dangerous only to those who live so that they have no resistance. wholesome milk can be produced only by healthy animals. bovine health can be secured by the same means as human health. the cows must be properly fed and housed. they must have both ventilation and light. they must not be unduly worried. if a nursing of an angry mother's milk is at times poisonous enough to kill a baby, you may be sure that the milk from an abused, irritated and angry cow is also injurious. if the animals are kept comfortable and happy they will do the best producing, both in quality and quantity. it may sound far-fetched to some to advocate keeping animals happy in order to get them to produce much and give quality products, but it is good science and good sense. happy cows give more and better milk than the mistreated ones. the singing hens are the best layers. cows should have fresh green food all the year, and this can be obtained in winter time by using silage. it is a mistake to give cows too much of concentrated foods, such as oil meals and grains. cattle can not long remain well on exclusive rations of too heating and stimulating foods. when fed improperly they soon fall prey to various diseases, such as rheumatism and tuberculosis. it is the same with other domestic animals. the horse when overfed on grain develops stiff joints. the hogs that are compelled to live exclusively on concentrated, heating rations are liable to die of cholera. young turkeys that have nothing but corn and wheat to eat die in great numbers from the disease known as blackhead. it is the same law running all through nature, applying to the high and to the low, that improper nourishment brings disease and death. when cattle roam wild, the green grasses (sundried in winter) are their principal source of food. man should be careful not to deviate too much, for forced feeding is as harmful to animals as it is to man. the following excellent recommendations for the care of milk are given by dr. charles e. north of the new york city milk commission: "no coolers, aerators, straining cloths or strainers should be used. "the hot milk should be taken to the creamery as soon as possible. "the night's milk should be placed in spring or iced water higher than the milk on the inside of the can. it should not be stirred, and the top of the can should be open a little way to permit ventilation. "the milking pails and cans will be sterilized and dried at the creamery, and should be carefully protected until they are used. "brush the udder and wipe with a clean cloth; wash with clean water and dry with a clean towel. "whitewash the cow stable at least twice yearly. "feed no dusty feed until after milking. "remove all manure from cow stable twice daily. "keep barnyard clean and have manure pile at least feet from the stable. "have all stable floors of cement, properly drained. "have abundant windows in cowstables to permit sunlight to reach the floor. "arrange a proper system of ventilation. "do not use milk from any cows suspected of gargot or of any udder inflammation. such milk contains enormous numbers of bacteria. "brush and groom cows from head to foot as horses are groomed. "use no dusty bedding; wood shavings or sawdust give least dust. "use an abundance of ice in water tank for cooling milk." perhaps some will take issue with the doctor on the first paragraph of his recommendation. if straining cloths are used they should be well rinsed in tepid water, washed and then boiled. however, if his recommendations are carried out in letter and spirit no straining is necessary. herr klingelhofer near dusseldorf, germany., runs a model dairy. the cows, stables, milkers, containers, in fact, all things connected with the dairy are scrupulously clean. the milkers do not even touch the milk stools, carrying them strapped to their backs. the milk is strained through sterilized cotton and cooled. the cows are six and seven years old and are milked for ten or twelve months and they are not bred during this time. the first part of the milk drawn from each teat is not used, for that part is not clean, containing dirt and bacteria. this milk is practically free from bacteria, for without adding preservatives it will remain sweet, for as long as thirteen days. if ordinary milk fails to sour in two or three days it shows that it has been treated. according to the country gentleman, it will cost from one cent and a quarter to one cent and three-quarters extra per quart to produce clean milk. healthy adults can take milk teeming with bacteria without harm, but for babies it is best to have very few or none in the milk. at dusseldorf the babies used to die as they do here when fed unclean milk. herr klingelhofer says that when fed on his product "sterben keine." (none die.) this is submitted to those who advocate pasteurizing the milk. denatured milk makes sickly babies. clean natural milk makes healthy babies. the extra cost of less than two cents a quart is not prohibitive. most fathers, no matter how poor, waste more than that daily on tobacco and alcoholics. the extra cost would be more than saved in lessened doctor bills, to say nothing of funeral expenses. the recompense that comes from the satisfaction of having thriving, sturdy, healthy children can not be figured in dollars and cents. dr. robert mond, of london, after investigating for years, has come to the conclusion that sterilized milk predisposes to tuberculosis, instead of preventing it. he believes that milk so treated is so inferior that he would not personally use it. that sterilized milk predisposes to tuberculosis, as well as to other diseases which can attack the body only when it is run down, is natural. any food that has been rendered inferior can not build the robust health that comes to those who live on natural food. adults who use sterilized milk should counteract its bad effects by partaking liberally of fresh fruits and vegetables. if the milk is clean, put into clean containers by careful milkers and is then kept cold until delivered, it will reach the consumers in good condition. do not let the fact that when you consume a glass of milk you are also engulfing some millions of bacteria bother you, for bacteria are necessary to our existence. if all the bacteria on earth should perish, it would also mean the end of the human race. today the progressive farmer is coming to the fore. he is a man who is justly proud of his work, so it will probably not be long before all city people who desire clean milk can get it. the milk cure consists in feeding sick people on nothing but milk for varying periods. generally the patient is told to either take great quantities three or four times a day, or to take smaller quantities perhaps every half hour. the milk cure has no special virtue, except that it is a monotonous diet. the body soon rebels if forced to subsist on an excessive amount of but one kind of food. the individual loses his desire for food and even becomes nauseated. if the advocates of the milk cure would prescribe milk in moderation, instead of in excess, they would have better success. (it is fully as harmful to partake of too much milk as it is to eat excessively of other foods.) the benefit derived from the milk cure comes from the simplicity, not from the milk. a grape cure, an orange cure or a bread and milk cure would be as beneficial. the milk cure is ancient. it was employed twenty-five centuries ago. _clabbered milk_: clabbered milk or sour milk needs no special preparation. put the milk into an earthen or china dish. do not use metal dishes, for the lactic acid acts upon various metals. cover the dish so as to keep particles of matter in the air away, but the covering is not to be airtight. put the dish in a warm place, but not in the sun. milk that sours in the sun or in an air-tight bottle is generally of poor flavor. clabbered milk is a good food. it does not form big, tough curds in the stomach, it is easy to digest, and the lactic acid helps to keep the alimentary tract sweet. the various forms of milk may be used in similar combinations. _buttermilk_: the real buttermilk is what remains of the cream after the fat has been removed by churning. it is slightly acid and has a characteristic taste, to most people very agreeable. the flavor is different from that of artificially made buttermilk. in composition it is almost like whole milk, except that it contains very little fat. many people make buttermilk by beating the clabbered milk thoroughly, until it becomes light. the buttermilk made from sweet milk and the various brands of bacterial ferments obtainable at the drug stores is all right. these ferments have as their basis the lactic acid bacteria, and if the manufacturers wish to call their germs by other names, such as bacillus bulgaricus, no harm is done. it is unnecessary to add any of these ferments, for the milk clabbers about as quickly without them. buttermilk is an excellent food. the casein can be seen in fine flakes in the real buttermilk. adults usually digest buttermilk and clabbered milk more easily than the sweet milk. the lactic acid seems to be quite beneficial. metchnikoff thought for a while that he had discovered how to ward off decay and old age by means of the lactic acid bacteria in milk. milk can be clabbered quickly by adding lemon juice to sweet milk. _junket_: add rennet to milk and let it stand until it thickens. the milk is not to be disturbed while coagulation takes place, for agitation will cause a separation of the whey. the rennet can be bought at the drug stores. _whey_ contains milk sugar, some salts, and a little albumin. it is easily digested, but not very nourishing. it is what is left of the milk after the fat and almost all of the protein are removed. _cottage cheese_: this is sometimes called dutch cheese or white cheese. it is a delicious and nutritious dairy product that is easy to digest. put the clabbered milk in a muslin bag, hang the bag up and allow the milk to lose its whey through drainage. in summer this bag must be kept in a cool place. after draining, beat the curds. then add enough clabbered milk to make the curds soft when well beaten. a small amount of cream may also be added. cottage cheese made in this way is superior in flavor and digestibility to that which has been scalded. no seasoning is needed. a little salt is allowable, but sugar and pepper should not be used. fruit and cottage cheese make a satisfying as well as nutritious meal. delicious cottage cheese is also made by using the whole clabbered milk. hang it up to drain in a bag until it has lost a part of its whey. then beat it until the curds are rather small, but not fine. no milk or cream is to be added to this, for it contains all the fat that is in the whole milk. do not drain this cheese so long that it becomes dry. _other cheeses_: the various cheeses on the market are made principally from ripened curds, with which more or less fat has been mixed. the ripening is a form of decay, and it is no exaggeration to say that some of the very ripe cheeses on the market are rotten. the flavors are due to ferments, molds and bacteria, which split up the proteins and the fats. the mild cheeses are generally good and may be eaten with fruits or vegetables or with bread. two or three ounces are sufficient for the protein part of the meal, taking the place of flesh. use less if less is desired. when cheese becomes very odorous and ripe, no one with normal nose and palate will eat it. people who partake of excessive amounts of meats or alcoholic beverages are often fond of these foul cheeses. one perversion leads to another. cheese of good quality, eaten in moderation, is a nutritious food, easily digested. gauthier says of cheese: "indeed, this casein, which has the composition of muscular tissue, scarcely produces during digestion either residue or toxins." because good cheese is concentrated and of agreeable flavor, it is necessary to guard against overeating. an excess of rich cheese soon causes trouble with the liver or constipation or both. cheese should not be eaten in the same meal with fish, meat, eggs, nuts or legumes, for such combining makes the protein intake too great. there is nothing incompatible about such combinations, but it is safest not to make them. the course dinners, ending up with a savory cheese, crackers and coffee, are abominations. they are health-destroyers. they lead to overeating. as nearly everybody overeats, and because overeating is the greatest single factor in producing disease and premature death, it is advisable not to eat cheese and other foods rich in protein in the same meal. the greater the variety of food, the more surely the diner will overeat. the term, "full cream cheese" is misleading, for cheeses are not made of whole cream. the cream does not contain enough protein (casein) for the manufacture of cheese. some cheeses are made of skimmed milk. others are made of milk which contains part, or even all, of the cream. some have cream added. the cheeses containing but a moderate amount of fat are the best. the popular roquefort cheese is made of a mixture of goat's milk and sheep's milk. the savor is due to bacterial action and fat saponification, which result in ammonia, glycerine, alcohol, fatty acids and other chemicals in very small quantities. the peculiar colorings which run in streaks through some cheeses that are well ripened are due to molds, bacteria and yeasts. gentlemen who would discharge the cook if a moldy piece of bread appeared on the table, eat decaying, moldy cheese with relish. the best cheese of all is cottage cheese. people of normal taste will soon weary of the frequent consumption of strong cheese, but they can take cottage cheese every other day with relish. occasionally put a few caraway seeds in it if this flavor is agreeable. cottage cheese may be eaten plain or with bread, or with fruit or vegetables. it may be used as dressing both on fruit and vegetable salads. cheese should play no part in the alimentation of the sick, with the exception of cottage cheese, which may be given to almost anyone who is in condition to eat anything. the other cheeses are too concentrated for sick people. in acute disease nothing is to be fed. _skimmed milk_ is about the same in composition as buttermilk. it is inferior in flavor, but a good food. it is used a great deal in cooking. milk should not be used very much in cooking. when cooked it does not digest very readily and it has a tendency to make other foods indigestible. _sour cream_ or clabbered cream is best when it is taken from clabbered milk. it may be used as dressing on fruits and salads. sweet cream will clabber, but it is not as delicious as when it clabbers on the milk. _clotted cream_ is made by putting the milk aside in pans in a cool place until the cream rises. then, without disturbing the cream, scald the milk. put the pan aside until the contents are cold and remove the cream, which has a rich, agreeable flavor. this may be used as a dressing. whipped cream and ice cream are so familiar that they hardly need comment. cream is such a rich food that it must be eaten in moderation. otherwise it will cause discomfort and disease. ice cream is made of milk and cream, in varying proportions, flavored to taste and frozen. it is not necessary to add eggs and cornstarch. if eaten slowly it is a good food, but taken in too large quantities and too rapidly it may cause digestive troubles. it is not best to chill the stomach. those with weak digestion should be very careful not to do so. buttermilk is sometimes flavored and frozen. this ice is easy to digest. some doctors recommend this dish to their convalescents. it is an agreeable change, and can be eaten by many who are unable to take care of the rich ice cream. chapter xix. menus. for a balanced dietary we need some building food, protein; some force food, starch, sugar and fat; some of the mineral salts in organic form, best obtained from raw fruits and vegetables; and a medium in which the foods can be dissolved, water. we need a replenishment of these food stuffs at intervals, but it is not necessary to take all of them at the same meal, or even during the same day. those who believe that all alimentary principles must enter into every meal must necessarily injure themselves through too complex eating. in talking of these alimentary principles, reference is made to them only when they are present in appreciable quantities. to have the subject better in hand, let us again classify the most important foods: flesh foods, which are rich in protein. nuts, which contain considerable protein and fat. milk and cheese, which contain much protein. eggs, taken principally for their protein. cereals, the most important contents being starches. tubers, containing much starch. legumes, rich in protein and starch. fresh fruits, well flavored and high in salt contents. sweet fruits, containing much fruit sugar. succulent vegetables, chiefly valuable because of salts and juices. fats and oils, no matter what their source, are concentrated foods which furnish heat and energy when burned in the body. when people are free and active in the fresh air they can eat in a way that would soon ruin the digestive powers of those who lead more artificial lives. it is a well known fact that we can go hunting, fishing, tramping or picnicking and eat mixtures and quantities of foods that would ordinarily give us discomfort. the freedom and activity, the change and the better state of mind give greater digestive power. those who wish to live their best must pay some attention to the combination of food. it is true that very moderate people, those who take no more food than the body demands, can combine about as they please. these moderate people do not care to mix their foods much. they are satisfied with very plain fare. much as we dislike to acknowledge the fact, nearly all of us take too much food, even those who most strongly preach moderation. by combining properly much of the harmful effect of overeating can be overcome. fruitarians. i class as fruitarians those who eat only cereals, fruits and nuts. this may not be a correct definition, but after reading much literature on dietetics it is the best i can do. their combinations should present no difficulties. they should take cereals once or twice a day; nuts once or twice a day; fruit once a day in winter and once or twice a day in summer. the winter fruit should be sweet part of the time. in summer it can be the juicy fruit and berries at all times. the fruitarians should be careful to avoid the habitual combination of acid fruits with their cereals. one meal a day can be made of one or two varieties of fruit and nothing else. nuts may be added to the fruit at times. another meal may be made of some cereal product with nut butter or some kind of vegetable oil. a third meal may be some form of sweet fruit, with which may be eaten either bread or nuts, or better still, combine one sweet fruit with an acid one. most people would consider such a diet very limited, but it is easy to thrive on it, and it is not a tiresome one. there are so many varieties of fruits, nuts and cereals that it is easy to get variety. these foods do not become monotonous when taken in proper amounts. on such a diet it does not make much difference which meal is breakfast, lunch or dinner. the rule should be to take the heartiest meal after the heavy work is done, for hearty meals do not digest well if either mind or body is hard at work. it is not difficult to get all the food necessary in two meals, but inasmuch as the three meal a day plan is prevalent the menus here given include that number of meals. breakfast: apples, baked or raw. lunch: brown rice and raisins. dinner: whole wheat zwieback with nut butter. breakfast: oranges or grapefruit. lunch: pecans and figs. dinner: bread made of rye or whole wheat flour, with nut butter or olive oil. breakfast: any kind of berries. lunch: dates. dinner: whole wheat bread, with or without oil, brazil nuts. these combinations are indeed simple, but these foods are very nourishing and most of them concentrated, so it is best not to mix too much. they are natural foods, which digest easily when taken in moderation, but if eaten to excess they soon produce trouble. it is no hardship to live on simple combinations. we have so much food that we have fallen into the bad habit of partaking of too great variety at a meal. the fact is that those who combine simply enjoy their foods more than those who coax their appetite with too great variety. there is no physical hardship connected with simple eating, and as soon as the mind is made up to it, neither is there any mental hardship. vegetarians. it is difficult to give an acceptable definition for vegetarianism. for a working basis we shall take it for granted that those are vegetarians who reject flesh foods. those who wish can also reject dairy products and eggs. it is largely a matter of satisfying the mind. the chief trouble with the vegetarians is that they believe that the fact that they abstain from flesh will bring them health. so they combine all kinds of foods and take several kinds of starches and fruits at the same meal. the consequence is that they soon get an acid condition of the digestive organs and a great deal of fermentation. among vegetarians, prolapsus of the stomach and bowels is quite common, and this is due to gas pressure displacing the organs. their foods are all right, but their combinations, as a rule, are bad. the various vegetarian roasts, composed of nuts, cereals, legumes and succulent vegetables are hard to digest. it would be much better for them not to make such dishes. a few suggestions for vegetarian combining follow: breakfast: berries and a glass of milk. lunch: baked potatoes and lettuce with oil. dinner: nuts, cooked succulent vegetables, one or two varieties, sliced tomatoes. breakfast: cottage cheese and oranges. lunch: nuts and raisins. dinner: whole wheat bread, stewed onions, butter, salad of lettuce and celery. breakfast: cantaloupe. lunch: buttermilk, bread and butter. dinner: nuts, stewed succulent vegetables, lettuce and sliced tomatoes, with or without oil. breakfast: boiled brown rice with raisins and milk. lunch: grapes. dinner: cooked lentils or baked beans, lettuce and celery. omnivorous people. in this country, most people are omnivorous. the food is plentiful and people believe in generous living. they put upon their tables at each meal enough variety for a whole day and the custom is to eat some of each. some breakfasts are heavy enough for dinners. three heavy meals a day are common. some can eat this way for years and be in condition to work most of the time, but they are never per cent. efficient. they are never as able as they could be. besides, they have their times of illness and grow old while they should be young. they generally die while they should be in their prime, leaving their friends and families to mourn them when they ought to be at their best. they are worn out by their food supply, plus other conventional bad habits. one of the best plans that has been proposed for omnivorous people is that which has been worked out by dr. j. h. tilden. its skeleton is, fruit once a day, starchy food once a day, flesh or other protein with succulent vegetables once a day. i shall make up menus for a few days based on this plan: breakfast: baked apples, a glass of milk. lunch: boiled rice with butter. dinner: roast mutton, spinach and carrots, salad of raw vegetables. breakfast: cantaloupe. lunch: biscuits or toast with butter, buttermilk. dinner: pecans, two stewed succulent vegetables, salad of lettuce, tomatoes and cucumbers, dressing. breakfast: peaches, cottage cheese. lunch: baked potatoes, butter, lettuce. dinner: fresh fish baked, liberal helping of one, two or three of the raw salad vegetables. breakfast: shredded wheat or puffed wheat sprinkled with melted butter, glass of milk. lunch: watermelon. dinner: roast beef, boiled cabbage, stewed onions, butter dressing, sliced tomatoes with salt and oil. the doctor allows considerable dessert. that generally goes with the dinner. it is nonsense to write, "so and so shalt thou eat and not otherwise." the menus here given simply serve as suggestions. where one succulent vegetable is mentioned another may be substituted. one cereal may be substituted for another. one juicy fruit for another. one sweet fruit for another. one legume for another. one food rich in protein for another. in combining food the principal things to remember are: use only a few foods at a meal; use only one hearty, concentrated food in a meal, as a rule, with the exception that various fats and oils in moderation are allowable as dressings for fruits, vegetables and starches; that much fat or oil retards the digestion of the rest of the food; that the habitual combining of acid food with foods heavy in starch is a trouble-maker; that concentrated starchy foods should be taken not to exceed twice a day; that the heating, stimulating foods rich in protein, which include nearly all meats, should be taken only once a day in winter, and less in summer; that either raw fruit or raw vegetables should be a part of the daily food intake, because the salts they contain are essential to health; that fats should be used sparingly in summer, but more freely in winter; that juicy fruits are to be used liberally in summer and sparingly in winter, when the sweet fruits are to take their place a part of the time. the dried sweet fruits are quite different from the fresh juicy ones. the former serve more the purpose of the starches than that of fruits. they are rich in sugar, which produces heat and energy. the same is true of the banana, which is about one-fifth sugar. it is not as sweet as would be expected from this fact. some sugars are sweeter than others. this you can easily verify by tasting some milk sugar and then taking the same amount of commercial sugar made of cane or beets. the food need in summer is surprisingly small, so small that the average person will scarcely believe it. some writers on dietetics advise eating as much in summer as in winter. how they can do so it is difficult to understand, for reason tells us that in summertime practically no food is needed for heating purposes, and that is how most of the food is used. a little experience and experiment show that reason is right. nature herself confirms this fact, for at the tropics she has made it easy for man to subsist on fruits, while in the polar regions she furnishes him the most heating of all foods, fats. because fats are so concentrated it is very easy to take too much of them. an ounce of butter contains as much nourishment as about twenty-five ounces of watermelon. those who simplify their cooking and their combining and partake of food in moderation are repaid many times over in improved health. it is necessary to supply good building material in proper form if we would have health. chapter xx. drink. there is but one real beverage and that is water. the other so-called beverages are foods, stimulants or sedatives. milk is a rich food, one glass having as much food value as two eggs. coffee, tea, chocolate and cocoa are stimulants, with sedative after-effects. their food value depends largely on the amount of milk, cream and sugar put into them. chocolate and cocoa are both drugs and foods. alcohol is a stimulant at first, afterwards a sedative, and at all times an anesthetic. when we think of drinking for the sake of supplying the bodily need of fluid, we should think of water and nothing else. if other liquids are taken, they should be taken as foods or drugs. water is the best solvent known. the alchemists of old spent much time and energy trying to find the universal solvent, believing that thereafter it would be easy to discover a method of making base metals noble. but they never found anything better than water. water is the compound that in its various forms does most to change the earth upon which we live, and it is more necessary for the continuation of life than anything else except air. pure water does not exist in nature, that is, we have never found a compound of the composition h o. water always contains other matter. the various salts are dissolved in it and it absorbs gases. the nearest we come to pure water is distilled. pure water is an unsatisfied compound, and as soon as it is exposed it begins to absorb gases and take up salts and organic matter. pure water differs from clean water. clean or potable water is a compound which contains a moderate amount of salts, but very little of organic matter. bacteria should be practically absent. water that contains much of nitrogenous substances is unfit to use. if the water is very hard, heavily loaded with salts, it should not be used extensively as a drink, for if too much of earthy and mineral matter is taken into the system, the body is unable to get rid of all of them. the result is a tendency for deposits to form in the body. in places where the water is excessively charged with lime it has been noticed that the bones harden too early, which prevents full development of the body. if the bones of the skull are involved, it means that there will not be room enough for the brain. such diseases are rare in this country, but in parts of europe they are not uncommon. if the water is very hard, a good plan is to distill it and then add a little of the hard water to the distilled water. people who partake of an excessive amount of various salts can perhaps drink distilled water to advantage, but those who take but a normal amount of the salts in their foods should have natural water. water forms three-fourths of the human body, more or less. it is needed in every process that goes on within the body. "to be dry is to die." water keeps the various vital fluids in solution so that they can perform their function. without water there would be no sense of taste, no digestion, no absorption of food, no excretion of debris, and hence no life. the water is the vehicle through which the nutritive elements are distributed to the billions of cells of the body, and it is also the vehicle which carries the waste to the various excretory organs. we can live several weeks without food, but only a few days without water. hot water and ice-cold water are both irritants. water may be taken either warm or cool. it is best to avoid the extremes. the amount of water needed each twenty-four hours varies according to circumstances. two quarts is a favorite prescription. those who eat freely of succulent fruits and vegetables do not need as much as those who live more on dry foods. salt in excess calls for an abnormal amount of water, for salt is a diuretic, robbing the tissues of their fluids and consequently more water has to be taken to keep up the equilibrium. naturally, more water is required when the weather is hot than when it is cool. on hot days warm water is more satisfying and quenches thirst more quickly than ice water. warm water also stimulates kidney action, which is often sluggish in summer. ice water is the least satisfactory of all, for the more one drinks the more he wants. a normal body calls for what water it needs, and no more. an abnormal body is no guide for either the amount of food or drink necessary. many people do not like the taste of water, especially in the morning. this means that the body is diseased. to a normal person cool water is always agreeable when it is needed, and it is needed in the morning. people with natural taste do not care for ice water, but other water is relished. the common habit of drinking with meals is a mistake. man is the only animal that does this, and he has to pay dearly for such errors. taking a bite of food and washing it down with fluid lead to undermastication and overeating, and then the body suffers from autointoxication. a mouthful of food followed by a swallow of liquid forces the contents of the mouth into the stomach before the saliva has the opportunity to act. the best way is to drink one or two glasses of water in the morning before breakfast. partake of the breakfast, and all other meals, without taking any liquid. sometimes there is a desire for a drink immediately after the meal is finished. if so, take some water slowly. if it is taken slowly a little will satisfy. if it is gulped down it may be necessary to take one or two glasses of water before being satisfied. those who have a tendency to drink too much during warm weather will find very slow drinking helpful in correcting it. if there is any digestive weakness, the liquid taken immediately after a meal should be warm and should not exceed a cupful. those with robust digestion may take cool water. cold water chills the stomach. digestion will not take place until the stomach has reached the temperature of about one hundred degrees fahrenheit again, and if the stomach contents are chilled repeatedly the tendency is strong for the food to ferment pathologically, instead of being properly digested. for this reason it is not well to drink while there is anything left in the stomach to digest. as stomach digestion generally takes two or three hours at least, it is well to wait this long before taking water after finishing a meal, and then drink all that is desired until within thirty minutes of taking the next meal. if the thirst should become very insistent before two or three hours have elapsed since eating, take warm water. those who eat food simply prepared and moderately seasoned are not troubled much with excessive thirst. two quarts of water daily should be sufficient for the adults under ordinary conditions. here, as in eating, no exact amount will fit everybody. make a habit of drinking at least a glass of water before breakfast, cleaning the teeth and rinsing the mouth before swallowing any, and then take what water the body asks for during the rest of the day. taking too much water is not as injurious as overeating, but waterlogging the body has a weakening effect. to drink with the meals is customary, not because it is necessary, but because we have a number of drinks which appeal to many people. water is the drink par excellence. a food-beverage that is used by many is cambric tea, which is made of hot water, one-third or one-fourth of milk and a little sweetening. children generally like this on account of the sweetness. it may be taken with any meal, when fluid is needed, but the amount should be limited to a cupful. it is not well to dilute the digestive juices too much. the water taken in the morning helps to start the body to cleanse itself. water drinking is a great aid in overcoming constipation. constipated people generally overeat. less food and more water will prove helpful in overcoming the condition. unfortunately for the race, we have accustomed ourselves to partake of beverages containing injurious, poisonous substances. inasmuch as this is the place to discuss the drugs contained in coffee and tea, i shall take the liberty of dwelling upon other habit-forming substances in the same chapter. they are all a part of the drug addictions of the race. for scientific discussion of these various substances i refer you to technical works. in this chapter will be found only a discussion of their relation to people's welfare, that is, to health and efficiency. coffee, tea and chocolate contain a poisonous alkaloid which is generally called caffeine. the theine in tea and the theobromine in cocoa are so similar to caffeine that chemists can not differentiate them. these drinks when first taken cause a gentle stimulation under which more work can be done than ordinarily, but this is followed by a reaction, and then the powers of body and mind wane so much that the average output of work is less than when the body is not stimulated. the temporary apparently beneficial effect is more than offset by the reaction and therefore partaking of these beverages makes people inefficient. coffee is very hard on the nerves, causing irritation, which is always followed by premature physical degeneration. experiments of late indicate that children who use coffee do not come up to the physical and mental standard of those who abstain. the effect on the adults is not so marked because adults are more stable than children. those who are not used to coffee will be unable to sleep for several hours after partaking of a cup. some people drink so much of it that they become accustomed to it. coffee is not generally looked upon as one of the habit-forming drugs, but it is. however, of all the drugs which create a craving in the system for a repetition of the dose, coffee makes the lightest fetters. it is surprising how often health-seekers inform the adviser that they "can not get along without coffee." if they would take a cup a few times a year, it would do no harm, but the daily use is harmful to all, even if they feel no bad effects and make it "very weak," which is a favorite statement of the women. smoking, drinking beer and drinking coffee have a tendency to overcome constipation in those who are not accustomed to these things, but their action can not be depended upon for any length of time and the cure is worse than the disease. tea drinking has much the same effect as coffee drinking, except that it is decidedly constipating. perhaps this is because there is considerable of the astringent tannin in the tea leaves. chocolate is a valuable food. those who eat of other aliments in moderation may partake of chocolate without harm, but if chocolate is used in addition to an excess of other food, the results are bad. the chocolate is so rich that it soon overburdens some of the organs of digestion, especially the liver. the swiss consume much of this food and it is valuable in cases where it is necessary to carry concentrated rations. alcohol in some form seems to have been consumed by even very primitive people as far back as history goes. the bible records an early case of intoxication from wine, and beer was brewed by the ancient egyptians. so much has been consumed that some people have a subconscious craving for it. there are cases on record where the very first drink caused an uncontrollable demand for the drug. fortunately these cases are very rare. alcohol is really not a stimulant, though it gives a feeling of glow, warmth and well-being at first, but this is followed by a great lowering of physical power, which gives rise to disagreeable sensations. then the drinker needs more alcohol to stimulate him again. then there is another depression with renewed demand: there is no end to the craving for the drug once it has mastered the individual. the lungs, heart, digestive organs, muscles, in fact, every structure in the body loses working capacity. alcohol seems to have a special affinity for nervous tissue. a glass of beer or wine taken daily is no more harmful than a cup of coffee per day, but the coffee drinker does not make of himself such a public nuisance and menace as the man often does who drinks alcohol to excess. formerly it was respectable to drink. some of our most noted public men were drunkards. now a drunkard could not maintain himself in a prominent public position very long. to drink like a gentleman was no disgrace. now real gentlemen do not get drunk. in backward russia they are becoming alarmed about the inroads of vodka, and are trying to decrease its consumption. france is trying to teach total abstinence to its young men because it disqualifies so many of them from military service to drink. scandinavia is temperance territory. the german kaiser has recently given a warning against drinking. the united states discourages drinking in the army and navy. field armies are not supplied with alcoholics. drinking is becoming disreputable. it is very difficult to prove the harm done by excessive drinking of tea and coffee, also by the use of much tobacco, even if we do know that it is so. everyone knows something about the deleterious effect of alcohol upon the consumer. solomon wrote: "wine is a mocker, strong drink is raging, and whosoever is deceived thereby is not wise. who hath wounds without cause? who hath redness of eyes?" alcohol permanently impairs both body and mind. depending on how much is taken, it may cause various ills, ranging from inflammation of the stomach to insanity. it reduces the power of the mind to concentrate and it diminishes the ability of the muscles to work. it reduces the resistance of the body and shortens life. its first effect is to lull the higher faculties to sleep. most drunkards do not recover from their disease, for drunkenness is a disease. the various drugs given to cure the afflictions are delusions. strengthening the body, mind and the will and instilling higher ideals are the best methods of cure. suggestive therapeutics, and the awakening of a strong resolve for a better life are powerful aids. proper feeding should not be overlooked, for bad habits do not flourish in a healthy body. civilization necessitates self-control and considerable self-denial. those who go in the line of least resistance are on the road to destruction. it is often necessary to overcome habits which produce temporary gratification of the senses. according to warden tynan of the colorado penitentiary, per cent. of the prisoners are brought there because they use alcohol. it is also well known that moral lapses are most common when the will is weakened through the use of liquor. those who have the welfare of the race at heart are therefore compelled to give considerable thought to this subject. according to past experience, it will not help to try to legislate sobriety into the people. education and industrialism are the factors which it seems to me will be most potent in solving the alcohol problem. morality, which in the last analysis is a form of selfishness, will teach many that it is poor policy to reduce one's efficiency and thereby reduce the earning capacity and enjoyment of life. more and more the employers of labor will realize that the use of alcohol decreases the reliability and worth of the worker. many will take steps like the following: "in formal recognition of the fact, established beyond dispute by the tests of the new psychology, that industrial efficiency decreases with indulgence in alcohol and is increased by abstinence from it, the managers of a manufacturing establishment in chester, penn., have attacked the temperance problem from a new angle. "unlike many railways and some other corporations, they do not forbid their employees to drink, but they offer per cent. advance in wages to all who will take and keep--the teetotaler's pledge. incidentally, a breaking of the promise will mean a permanent severance of relations, but there is no emphasizing of that point, it being confidently expected that the advantage of perfect sobriety will be as well realized on one side as on the other." business has during the past two centuries been the great civilizer, the great moral teacher. it has found that honesty and righteousness pay and that injustice is folly. business has led the way to the acceptance of a new ethics, and new morals. what has been said about alcohol applies to tobacco in a much smaller degree. the use of tobacco seems to lead to the use of alcohol. it retards the development of children. it is surely one of the causes of various diseases. tobacco heart, sore throat and indigestion are well known to physicians. tobacco contains one of the deadliest of poisons known. one-sixteenth of a grain of nicotine may prove fatal. the reason there are so few deaths from acute tobacco poisoning is that but very little of the nicotine is absorbed. men who chew tobacco make themselves disagreeable to others. smoking of cigarettes is to be condemned not only because it poisons the body, but causes inattention and inability to concentrate on the part of the smoker, as well. every little while he feels the desire to take a smoke, and if smoking is forbidden he devises means of getting away. he robs his employer of time for which he is paid and injures himself. the ability to work is decreased by indulgence in smoking. recent experiments show that for a short time there is increased activity after a smoke, but the following depression is greater than the stimulation, so there is an actual loss. a few years ago, according to mr. wilson, who was then secretary of agriculture, there were about , , drug addicts or "dope fiends" in the united states. without doubt this estimate was too high, for the proportion of addicts in the country is not as great as in the large cities. the drugs chiefly used are cocaine, opium, laudanum, morphine and heroin. these drugs are much more destructive than alcohol. cocaine and heroin are the worst. it is very difficult to stop using any of them once the habit has been formed. nearly every "fiend" dies directly or indirectly from the effect of his particular drug. every one weakens the body so that there is not much resistance to offer to acute diseases. every one destroys the will power so that a cure is exceedingly difficult. it is well to bear in mind that all are not possessed of strong enough will power to resist their cravings and that some take to cocaine when they can not get liquor. cocaine is far worse than alcohol. people should be very careful about taking patent medicines. there is no excuse for taking them. the most popular ones have as their basis one of the habit-forming drugs. most of the soothing syrups contain opium in some form. to give babies opiates is a grave error, to speak mildly. it weakens the child, may lay the foundation for a deadly habit later in life, and often an overdose kills outright. well informed mothers avoid such drugs and keep their children reasonably quiet by means of proper care. many of the remedies for nasal catarrh and hay fever contain much cocaine. cocaine is an astringent and a painkiller and people mistake the temporary lessening of discharge from the nose and disappearance of pain for curative effects. but there is nothing curative about it. in a short time the mucous membrane relaxes again and then the discharge is re-established. the nerves which were put out of commission resume their function and then the pain reappears. opium or one of its derivatives is generally present in the patent medicines given for coughs. opium is also an astringent and will suppress secretions, but this is not a cure. excessive secretions are an indication that the body is surcharged with poison and food. let them escape and then live so that there will be internal cleanliness and then there will be no more coughs and colds. the unfortunate people who get into the habit of using these drugs degenerate physically, mentally and morally. they need more and more of their drug to produce the desired effect until they at last take enough daily to kill several normal men. sometimes they are able to keep everybody in ignorance of what they are doing for years. they develop slyness and secretiveness. they become very suspicious. they are nearly always untruthful, and those who deal with them are surprised and wonder why those who used to be open and above-board now are furtive and dishonest. they often lie when there is not the slightest excuse for it. the moral disintegration is often the first sign noticed. after habitually using any of these drugs for a while the body demands the continuation and if the victim is deprived of his accustomed portion there will be a collapse with intense suffering. every tortured nerve in the body seems to call out for the drug. the victim will do anything to get his drug. he will lie, steal, and he may even attack those who are caring for him. for the time being he is insane. many professional men use cocaine. it is a favorite with writers. it often shows in their work. those who write under the inspiration of this drug often do some good work, but they are unable to keep to their subject. their writings lack order. we have enough of such writings to have them classified as "cocaine literature." if there are , , , or even fewer, of these people in our land, it is a serious problem, for every one is a degenerate, to a certain degree. if the medical profession and the druggists would co-operate it would be easy enough to prevent the growth of a new crop of dope fiends. of course, people would have to stop taking patent medicines, which often start the victims on the road to degeneration. then the physicians should stop prescribing habit-forming drugs, as well as all other drugs, and teach the people that physical, mental and moral salvation come through right living and right thinking. unfortunately the medical profession is careless and is responsible for the existence of many of the drug addicts. a patient has a severe pain. what is the easiest way to satisfy him? to give a hypodermic injection of some opiate. the patient, not realizing the danger, demands a pain-killer every time he suffers. he soon learns what he is getting and then he goes to the drug store and outfits himself with a hypodermic outfit and drugs, and the first thing he knows he is a slave, in bondage for life. this is no exaggeration. there are hundreds of thousands of victims to the drug habit who trace their downfall to the treatment received at the hands of reputable physicians, who do not look upon their practice with the horror it should inspire because it is so common. doctors do not always bury their mistakes. some of them walk about for years. in spite of laws against the sale of various drugs, they can be obtained. there are doctors and druggists of easy conscience who are very accommodating, for a price. there is no legitimate need for the use of one-hundredth of the amount of these drugs that is now consumed. a local injection of cocaine for a minor operation is justifiable, but none of the habit-forming drugs should be used in ordinary practice to kill pain, for the proper application of water in conjunction with right living will do it better and there are no evil after effects. massage is often sufficient. to show a little more clearly how some people become addicted to drugs, let us consider one of the latest, heroin: a few years ago this drug, which is an opium derivative, was practically unknown. it is much stronger than morphine and consequently the effect can be obtained more quickly by means of a smaller dose. physicians thought at first that it was not a habit-forming drug, for they could use it over a longer period of time than they could employ morphine, without establishing the craving and the habit. so they began to prescribe heroin instead of morphine, and many a morphine addict was advised to substitute heroin. all went well for a short while, until the victims found that they were enslaved by a drug that was even worse than morphine. now, thanks chiefly to the medical profession, it is estimated that we have in our land several hundred thousand heroin addicts. sallow of face, gaunt of figure, looking upon the world through pin-point pupils, with all of life's beauty, hope and joy gone, they are marching to premature death. the medical profession furnishes more than its proportion of drug addicts. they know the danger of the drugs, but familiarity breeds contempt. if the public but knew how many of their medical advisers, who should always be clear-minded, are befuddled by drugs, there would be a great awakening. one eminent physician who has now been in practice about forty-five years and has had much experience with drug addicts, has said that according to his observations, about one physician in four contracts the drug habit. i believe this is exaggerated, but i am acquainted with a number of physicians who are addicts. physicians who smoke do not condemn the practice. those who drink are likely to prescribe beer and wine for their patients. those who are addicted to drugs use them too liberally in their practice. those who have watched the effects of the various drugs, from coffee to heroin, must condemn their use. it is true that an occasional cup of coffee or tea, a glass of wine or beer does no harm. a cigarette a week would not hurt a boy, nor would on occasional cigar harm a man. but how many people are willing to indulge occasionally? the rule is that they indulge not only daily, but several times a day, and the results are bad. one bad habit leads to another, and the time always comes when it is a choice between disease and early death on one hand, and the giving up of the bad habits on the other, and when this time comes the bonds of habits are often so strong that the victim is unable to break them. i realize that knowledge will not always keep people out of temptation and that some individuals will take the broad way that leads to destruction in spite of anything that may be said. youth is impatient of restraint and ever anxious for new experiences. regarding this serious matter of destructive drug use, much could be done by teaching people their place in society: that is, what they owe to themselves, their families and the public in general. in other words, teach the young people the higher selfishness, part of which consists of considerable self-control, self-denial and self-respect. drugs are too easy to obtain today. some day people will be so enlightened that they will not allow themselves to be medicated. this is the trend of the times. until such a time comes, society should protect itself by making it very difficult to get any of the habit-forming drugs. if necessary, the free hand of the physician should be stayed. much of the confidence blindly given him is misplaced. chapter xxi. care of the skin. the skin is neglected and abused. very few realize how important it is to give this organ the necessary attention. if we were living today as our ancestors doubtless lived, we could neglect the skin, as they did. they wore little or no clothing. the skin, which formerly was very hairy, served as protection. it was exposed to the elements, which toughened it and kept it active. today most people give the skin too great protection, and thus weaken it. the result is that it degenerates and partly loses its function with consequent detriment to the individual's health. a normal skin has a very soft feel, imparting to the fingers a pleasant, vital sensation. it either has color or suggests color. an abnormal skin pleases neither the sense of seeing nor feeling. it may feel inert or it may be inflamed. the skin is a beautiful and complex structure. it is made up of an outer layer called the epidermis and an inner layer, the true skin or corium, which rests upon a subcutaneous layer, composed principally of fat and connective tissue. the epidermis is divided into four layers. it has no blood-vessels and no nerves, but is nourished by lymph which escapes from the vessels deeper in the skin. it is simply protective in nature. the true skin is made up of two indistinct layers, which harbor a vast multitude of nerves, blood-vessels and lymph-vessels. in the skin there are two kinds of glands, the sebaceous and the sweat glands. the sebaceous glands are, as a general rule, to be found in greatest numbers on the hairiest parts of the body and are absent from the palms of the hands and the soles of the feet. they throw off a secretion known as sebum, which is made up principally of dead cells that have undergone fatty degeneration and of other debris. the sebum serves as lubricant. it is generally discharged near or at the shaft of a hair. the sweat glands discharge on the average from one and one-half to two pounds of perspiration per day, more in hot weather and much less when it is cool. they are distributed over the whole external surface of the body. according to krause there are almost , , of them. they carry off water and carbonic acid gas chiefly. the functions of the skin are: to protect the underlying structures; to regulate the heat; to serve as an organ of respiration; to serve as an organ of touch and thermal sensation; to secrete and eliminate various substances from the body; to absorb. the heat regulation is quite automatic. when the external temperature is high there is a relaxation of the skin. the pores open, the perspiration goes to the surface and evaporates, thus cooling the body. when the surface is cool the skin contracts, closing the pores and conserving the heat. radiation always takes place, except when the temperature is very high. the sensation of touch and the ability to feel heat and cold protect us from untold numbers of dangers. they are a part of the equipment which enables us to adjust our selves to our environment. the secretions and excretions are perspiration and sebum. these contain water, carbonic acid, urea, buturic acid, formic acid, acetic acid, salts, the chief being sodium chloride, and many other substances. the respiratory function consists in the absorption of a small amount of oxygen and the giving off of some carbonic acid. a small amount of water can be absorbed by the skin. oils can also be absorbed. in case of malnutrition in children, olive-oil rubs are often helpful. this absorptive function is taken advantage of by physicians who rub various medicaments into the skin. mercury enough to produce salivation can be absorbed in this way. from the above it will be seen that the skin is not only complex in structure, but has many functions. it is impossible to have perfect health without a good skin. under civilized conditions a healthy skin can not be had without giving it some care. the average person has a skin that shows lack of care. fortunately, but little care is needed. a bath should be taken often enough to ensure cleanliness. warm water and soap need not be used more than once or twice a week under ordinary conditions. if the soap causes itching, it is well to use a small amount of olive oil on the body afterwards, rubbing it in thoroughly, and going over the body with a soft cloth after the oil rub, thus removing the oil which would otherwise soil the clothes. if the skin is not kept clean, the millions of pores are liable to be partly stopped up, which results in the retention of a part of the excretory matter within the skin, where it may cause enough irritation to produce some form of cutaneous disorder, or the skin may through disuse become so inactive that too much work is thrown upon the other excretory organs, which may also become diseased from overwork and excessive irritation. soaps are irritants. tallow soaps and olive oil soaps are less irritating than other varieties. whatever kind of soap is used, it should be rinsed off thoroughly, for if some of it is left in the pores of the skin roughness or even mild inflammation may ensue. be especially careful about the soap used for babies, avoiding all highly colored and cheap perfumed soaps. whether to take a daily sponge bath or not is a matter of no great importance, and each individual can safely suit himself. if there is quick reaction and a feeling of warmth and well-being following a cold sponge, it is all right. if the skin remains blue and refuses to react for a long time, the cold sponge bath is harmful. the cold plunge is always a shock, and no matter how strong a person may be, frequent repetition is not to be recommended. people who take cold plunges say that they do no harm, but it is well to remember that life is not merely a matter of today and tomorrow, but of next year, or perhaps forty, fifty or sixty years from today. a daily shock may cause heart disease in the course of twenty or thirty years. a good way to take a cold bath is to get under a warm shower and gradually turn off the warm water. then stand under the cold shower long enough to rinse well the entire surface of the body. those who take cold sponge baths in winter and find them severe, should precede the sponging in cold water with a quick sponging off with tepid water, and they should always take these baths in a warm room. after all baths give the body a good dry rubbing, using brisk movements. bath towels, flesh brushes or the open hands may be used for the dry rubbing. the sponge bath has practically no value as a cleanser. its chief virtue consists in stimulating the circulation of the blood and the lymph in the skin. in summer it is cooling. it is important to have good surface circulation, but this can be attained as well by means of dry rubbing. the rubbing is more important than wetting the skin. a skin that is rubbed enough becomes so active that it practically cleans itself, and it protects against colds and other diseases. some advocate dispensing with the bath entirely, but that is going to extremes. cleanliness is worth while for the self-respect it gives the individual. hot baths are weakening and relaxing, hence weak people should not stay long in the hot bath. cold baths are stimulating to strong people and depressing to those who do not react well from them. swimming is far different from taking a cold bath. a person who can swim with benefit and comfort for twenty minutes would have a chill, perhaps, if he remained for five minutes in the bath tub in water of the same temperature. swimming is such an active exercise that it aids the circulation, keeping the blood pretty well to the surface in spite of the chilling effect of the water. if a very warm bath is taken, there should be plenty of fresh air in the bath room and it is well to sip cold water while in the bath and keep a cloth wrung out of cold water on the forehead. people who are threatened with a severe cold or pneumonia can give themselves no better treatment than to take a hot bath, as hot as they can stand it, lasting for one-half hour to an hour, drinking as much warm water as can be taken with comfort both before and after getting into the tub. this bath must be taken in very warm water, otherwise it will do no good. it is weakening and relaxing, but through its relaxing influence it equalizes the circulation of the blood, bringing much to the surface that was crowding the lungs and other internal organs, thus causing the dangerous congestion that so often ends in pneumonia. after the bath wrap up well so that the perspiration will continue for some time. when the sweating is over, get into dry clothes and remain in bed for six to eight hours. to make assurance doubly sure, give the bowels a good cleaning out with either enemas or cathartics, or both. then eat nothing until you are comfortable. such treatment would prevent much pneumonia and many deaths. the best preventive is to live so that sudden chilling does not produce pneumonia or other diseases, which it will not do in good health. people with serious diseases of the heart, arteries or of the kidneys should not take protracted or severe baths. to sum up the use of water on the skin: use enough to be clean. no more is necessary. the application of water should be followed by thorough drying and dry rubbing. if the reaction is poor, do not remain in cold water long enough to produce chilling. as a rule thin people should use but little cold water, and they should never remain long in cold water. water intelligently applied to the skin in disease is a splendid aid in cleansing the system. it is surprising what a great amount of impurity can be drawn from the body by means of wet packs. however, this is a treatise on health, so we shall not go into details here regarding hydrotherapy. no matter what one's ideas may be on the subject of bathing, there can hardly be more than one opinion regarding the application of dry friction to the skin. those who have noted its excellent results feel that it should be a daily routine. it should be practiced either morning or evening, or both. from five to ten minutes spent thus daily will pay high dividends in health. a vigorous rubbing is exercise not only for the skin, but for nearly every muscle in the body. the dry rubbing keeps the surface circulation vigorous. the surface circulation, and especially the circulation in the hands and the feet, is the first part that begins to stagnate. blood stagnation means the beginning of the process which results in old age. in other words, dry friction to the skin helps to preserve health and youth. skin that is not exercised often becomes very hard and scales off particles of mineral matter. if women would put less dependence on artificial beautifiers and more on scientific massage, they would get much better results. they would avoid many a wrinkle and save their complexions. the neck and the face should never be massaged downwards. the strokes should be either upwards or from side to side, the side strokes generally being toward the median line. such massaging will prevent the sagging of the face muscles for years and help to keep the face free from wrinkles and young in appearance. the massaging should be rather gentle, for if it is too vigorous the tendency is to remove the normal amount of fat that pads and rounds out the face. men can do the same thing, but most men have no objection to wrinkles. however, most men do object to baldness, which can be prevented in nearly every case. to produce hair on a polished pate is a different proposition. it is indeed difficult. if you will look at a picture of the circulation of the blood in the scalp, you will notice that the arteries supplying it come from above the eye sockets in front, from before and behind the ears on the sides, and from the nape of the neck in the rear. they spread out and become smaller and smaller as they travel toward the top of the head, and especially toward the back. the scalp is well supplied with blood, but it is not given much exercise. the tendency is for the blood stream to become sluggish, deposits gradually forming in the walls of the blood-vessels, which make them less elastic and decrease the size of the lumen. the result is less food for the hair roots and food of inferior quality. this process of cutting off the circulation in the scalp is largely aided by the tight hats and caps worn by men, which compress the blood-vessels. it is quite noticeable that people with round heads have a greater tendency to become bald than those with more irregular heads. the reason is probably that the hats fit more snugly on the round-headed people. there are many exceptions. women are not so prone to baldness as men, because they wear hats that do not exclude the air from the hair nor do they compress the blood-vessels. let those men who dislike to lose their hair massage the scalp for a short while daily, beginning above the eyes, in front of the ears and at the nape of the neck and going to the top of the head. then let them wear as sensible hats as possible, avoiding those that exert great pressure on the blood-vessels that feed the scalp. thus they will not only be able to retain their hair much longer than otherwise, but the hair that is well fed does not fade as early as that which lives on half rations. in the case of preserving the hair, an ounce of prevention is worth a ton of cure. the man who can produce a satisfactory hair restorer that will give results without any effort on the part of the men can become a millionaire in a short time. the hair is a modified form of skin. each hair is supplied with blood, and the reason that the hair stands up during intense fear is that to the lower part of the shaft is attached a little muscle. during fear this contracts, as do other involuntary muscles, and then the hair stands up straight instead of being oblique. as a rule people protect the skin too much. the best protection they have against cold is a good circulation. with a poor circulation it is difficult to keep warm in spite of much clothing. coldness is also largely a state of mind. people get the idea of cold into the head and then it is almost impossible for them to keep warm. on the same winter day we may see a man in a thick overcoat trying to shrink into himself, shivering, while a lady passes blithely by, with her bosom bared to the wind. the face tolerates the cold, because it is used to it, the neck and the upper part of the chest likewise, and so it would be with the skin of the entire body if we accustomed it to be exposed. we use too heavy clothes. it is a mistake to hump the back and draw in the shoulders during cold weather, for this reduces the lung capacity, thus depriving the body of its proper amount of oxygen. the result is that there is not enough combustion to produce the necessary amount of heat. wool is warm covering, the best we have. however, it is very irritating to the skin and has a tendency to make the wearer too warm. it does not dry out readily. consequently the wearer remains damp a long time after perspiring. the result is a moist, clammy skin. a skin thus pampered in damp warmth becomes delicate, and like other hot-house products unable to hold its own when exposed to inclement weather. a good way to take cold easily is to wear wool next to the skin. the best recipe for getting cold feet is to wear woolen stockings. wear cotton or linen or silk next to the skin. cotton is satisfactory and cheap. linen is excellent, but a good suit of linen underwear is too costly for the average purse. remie, said to be the linen of the bible, is highly recommended by some. those working indoors should wear the same kind of underwear summer and winter, and it should be very light. if people use heavy underwear in heated rooms, they become too warm. the consequence is that when they go out doors they are chilled, and if they are not in good physical condition colds and other diseases generally result. by wearing outer garments according to climatic conditions one can easily get all the protection necessary. those who take the proper food and enough exercise and dry friction of the skin will not require or desire an excessive amount of clothing. the feel of the wintry blast on the skin is not disagreeable. if we would only give the skin more exercise, through rubbing, and more fresh air, we would soon discard much of our clothing, and wear but enough to make a proper and modest appearance in public, with extra covering on cold days. nothing can be much more ridiculous and uncomfortable than a man in conventional attire on a hot summer's day. of course, thin, nervous people should not expose themselves too much to the cold. most of the diseases known by the name of skin diseases, are digestive troubles and blood disorders manifesting in the skin. as soon as the systemic disease upon which they depend disappears, these so-called skin diseases get well. erysipelas is one of the so-called germ diseases, but it is controlled very quickly by a proper diet. it can not occur in people until they have ruined their health by improper living. pure blood will not allow the development of the streptococcus erysipelatis in sufficient numbers to cause trouble. first the disease develops and then the germ comes along and multiplies in great numbers, giving it type. acne, which is very common for a few years after puberty, shows a bad condition of the blood. even during the changes that occur at puberty no disease will manifest in healthy boys and girls. about this time the young people eat excessively, the result being indigestion and impure blood. the changes that occur in the skin make it a favorable place for irritations to manifest. let the boys and girls eat so that they have bright eyes and clean tongues and there will be very little trouble from disfiguring pimples. eczema is generally curable by means of proper diet and the same is true of nearly all skin diseases that afflict infants. there are diseases of the skin due to local irritants, such as the various forms of trade eczema, scabies (itch), and pediculosis (lousiness), but the fact remains that nearly all skin diseases fail to develop if the individual eats properly, and most of them can be cured, after they have developed, by proper diet and attention to hygiene generally. if the diet is such that irritants are manufactured in the alimentary tract and absorbed into the blood, and then excreted through the skin, where enough irritation is produced to cause disease, it is useless to treat with powders and salves. correct the dietetic errors and the skin will cure itself. specialists in skin diseases often fail because they treat this organ as an independent entity, instead of considering it as a part of the body whose health depends mostly upon the general health. chapter xxii. exercise. nature demands of us that we use our mental and physical powers in order to get the best results. man was made to be active. in former times he had to earn his bread in the sweat of his face or starve. now we have evolved, or is it a partial degeneration, into a state where a sharp mind commands much more of the means of sustenance than does physical exertion. the consequence is that many of those equipped with the keenest minds fail to keep their bodies active. this helps to lessen their resistance and produces early death. some exercise is needed and the question is, how much is necessary and how is it to be taken so that it will not degenerate into drudgery? there are very few with enough persistence to continue certain exercises, no matter how beneficial, if they become a grind. the amount required depends upon the circumstances. ordinarily, a few minutes of exercise each day, supplemented with some walking and deep breathing will suffice. about five minutes of vigorous exercise night and morning are generally enough to keep a person in good physical condition, if he is prudent otherwise. many strive to build up a great musculature. this is a mistake, unless the intention is to become an exhibit for the sake of earning one's living. big muscles do not spell health, efficiency and endurance. even a dyspeptic may be able to build big muscles. what is needed for the work of life is not a burst of strength that lasts for a few moments and then leaves the individual exhausted for the day, but the endurance which enables one to forge ahead day after day. it is generally dangerous to build up great muscles, for if the exercises that brought them into being are stopped, they begin to degenerate so fast that the system with difficulty gets rid of the poisons. then look out for one of the diseases of degeneration, such as inflammation of the kidneys or typhoid fever. the great muscles exhibited from time to time upon the variety stage and in circuses are not normal. man is the only animal that develops them, and they are not brought about by ordinary circumstances. once acquired, they prove a burden, for they demand much daily work to be kept in condition. good muscles are more serviceable than extraordinary ones. vigorous exercise is better than violent exercise. it is well known that many of our picked athletes, men with great original physical endowment, die young. the reason is that they have either been overdeveloped, or at some time they have overtaxed their bodies so in a supreme effort at vanquishing their opponents that a part of the vital mechanism has been seriously affected. then when they settle down to business life they fail to take good care of themselves and they degenerate rapidly. exercising should not be a task, for then it is work. it should be of a kind that interests and pleases the individual, for then it is accompanied by that agreeable mental state from which great good will come to the body. it is necessary for us to think enough of our bodies to supply them with the activity needed for their welfare and we should do this with good grace. exercise enough to bring the various muscles into play and the heart into vigorous action. office workers should take exercises for the part of the body above the waist, plus some walking each day. all should take enough exercise to keep the spine straight and pliable. bending exercises are good for this purpose, keeping the knees straight and touching the floor with the fingers. then bend backward as far as possible. then with hands on the hips rotate the body from the waist. it is very desirable to keep the body erect, for this gives the greatest amount of lung space, and gives the individual a noble, courageous appearance and feeling. the forward slouch is the position of the ape. it is not necessary to pay any attention to the shoulders, if the spine is kept in proper position, for the shoulders will then fall into the right place. being straight is a matter of habit. no one can maintain this position without some effort. at least, one has to make the effort to get and retain the habit. most round-shouldered people could school themselves in two or three months to be straight. those who are moderate in eating need less exercise than others. too great food intake requires much labor to work it off. when the food is but enough to supply materials for repair, heat and energy, there is no need of great effort to burn up the excess. to exercise much and long, then eat enough to compel more exercise, is a waste of good food, time and energy. be moderate in all things if you would have the best that life can give you. always make deep breathing a part of the exercise. no matter what one's physical troubles may be, deep breathing will help to overcome them. it will help to cure cold feet by bringing more oxygen into the blood. it will help to drive away constipation by giving internal massage to the bowels. it will help to overcome torpid liver by the exercise given that organ. it will help to cure rheumatism by producing enough oxygen to burn up some of the foreign deposits in various parts of the body. as an eye-opener deep breathing has alcohol distanced. it costs nothing and has only good after effects. moreover, deep breathing takes no time. a dozen or more deep breaths can be taken morning and night, and every time one steps into the fresh air, without taking one second from one's working time. to have health good blood is necessary, and this can not be had without taking sufficient fresh air into the lungs. proper clothing must also be taken into consideration in connection with breathing and exercise. the clothes must be loose enough to allow free play to limbs, chest and abdomen. men and women were not shaped to wear two and three inch heels. those who persist in this folly must pay the price in discomfort and an unbalanced body. the time to take exercise depends upon circumstances. it is best not to indulge for at least one or two hours after a hearty meal, for exercise interferes with digestion. a very good plan is to take from five to twenty-five minutes of exercise, according to one's requirement, before dressing in the morning and after undressing at night. those who take exercises in a gymnasium or have time for out door games will have no difficulty in selecting proper time. dumbbells, indian clubs, weights, patent exercisers and gymnasium stunts are all right for those who enjoy them. one thing to bear in mind is that short, choppy movements are not as good as the larger movements that bring the big muscles into play. it is well to exercise until there is a comfortable feeling of fatigue. if this is done the heart works vigorously, sending the blood rapidly to all parts of the body, and the lungs also come into full play to supply the needed oxygen. this acts as a tonic to the entire system. the body must be used to keep it from degenerating. a healthy body gives courage and an optimistic outlook upon life. a sluggish liver can hide the most beautiful sunrise, but a healthy body gives the eye power to see beauty on the most dreary day. those who are not accustomed to exercise will be very, sore at first, if they begin too vigorously. the soreness can be avoided by taking but two or three minutes at a time at first, and increasing until the desired amount is taken daily. if the muscles get a little sore and stiff at first, do not quit, for by continuing the exercises, the soreness soon leaves. many begin with great enthusiasm, which soon burns itself out. excessive enthusiasm is like the burning love of those who "can't live" without the object of their affection. it burns so brightly that it soon consumes itself. go to work at a rate that can be kept up. to exercise hard for a few weeks or a few months and then give it up will do no good in the end. however, a person may occasionally let a day or two pass by without taking exercise with benefit. avoid getting into a monotonous grind. i believe that the very best exercises are those which are taken in the spirit of play. no matter who it is, if he or she will make the effort, time enough can be found occasionally to spend at least one-half of a day in the open, and this is very important. we can not long flourish without getting into touch with mother nature, and we need a few hours each week without care and worry in her company. many immediately say, "i can't." get rid of that negative attitude and say, "i can and i will." see how quickly the obstacles melt away. there are many who are slaves to duty. they believe that they must grind away. they think they are indispensable. the world got along very well before they were born and it will roll on in the same old way after they are gathered to their fathers. the thing to do is to break the bonds of the wrong mental attitude and then both time and opportunity will be forthcoming. i shall comment on only a few of the outdoor exercises that are excellent. swimming is one of the finest. there is a great deal of difference between swimming and taking a bath in a tub. some people cannot remain in the water long, but if they have any resistance at all and are active, there will be no bad results. in swimming it is well to take various strokes, swimming on the back, on the side, and on the face. this brings nearly every muscle in the body into play and if the swimmer does not stay in too long it makes him feel fine. if a feeling of chilliness or weariness is experienced, it is time to quit the water, dry off well and take a vigorous dry rub. swims should always be followed with considerable rubbing. the use of a little olive oil on the body, and especially on the feet, is very grateful. no special rule can be laid down for the duration of a swim, but very thin people should generally not remain in the water more than fifteen minutes, and stout, vigorous ones not over an hour. it is best not to go swimming until two hours have elapsed since the last meal. every boy and every girl should be taught to swim, for it may be the means of preserving their lives. it is not difficult. for the benefit of those who start the beginners with the rather tedious and tiresome breast stroke, will say that the easiest way to teach swimming is to get the learner to float on his back. i have taught boys to float in as little as three minutes, and after that everything else is easy. when the beginner can float, he can easily start to paddle a little and make some progress. then he can turn on his side and learn the side stroke, which is one of the best. then he can turn on the face and learn various strokes. this is not the approved way of learning to swim, but it is the easiest and quickest way. to float simply means to get into balance in the water. it is necessary to arch the body, making the spine concave posteriorly, and bending the neck well backward at first. in the beginning it is a great aid to fill the lungs well and breathe rather shallow. this makes the body light in the water. tell the beginner that it does not make any difference whether the feet sink or stay up. it is only necessary to keep the face above water while floating. if there is the slightest tendency to sink, bend the neck a little more, putting the head, farther back in the water, instead of raising it, as most of the learners want to do. remember that the trunk and neck must be kept well arched, the head well back in the water. the moment the beginner doubles up at waist or hips or bends the neck forward, raising the head, he sinks. for speed and fancy swimming professional instruction should be obtained. swimming is one of the best all-round developers, as well as one of the most pleasant of exercises. golf is no longer a rich man's game. the large cities have public links. for an office man it is a splendid game. women can play it with equal benefit. the full vigorous strokes, followed with a walk after the ball, then more strokes, exercise the entire body. it is good for young and old, and for people in all walks of life. tennis is splendid for some people. those who are very nervous and excitable should play at something else, for they are apt to play too hard and use up too much energy. overexercising is just as harmful as excesses in other lines. tennis requires quickness and is a good game for those who are inclined to be sluggish, for it wakes them up. horseback riding is also a fine exercise. the companionship with an intelligent animal, the freedom, the fresh air, the scenery, all give enjoyment of life, and the constant movement acts as a most delicious tonic. there is only one correct way to ride for both sexes, and that is astride. the side saddle position keeps the spine twisted so that it takes away much of the benefit to be derived from riding. out west the approved manner of riding for women is astride. the women of the west make a fine appearance on horseback. tramping is possible for all. if there are hills to be climbed, or mountains, so much the better. put on old clothes and old shoes and have an enjoyable time. fine apparel under the circumstances spoils more than half of the pleasure. playing ball or bicycle riding may be indulged in with benefit. it is not fashionable to ride on bicycles today, yet it is a pleasant mode of covering ground, and if the trunk is kept erect it is a good exercise. jumping rope, playing handball, tossing the medicine ball and sawing wood are good forms of exercise and great fun. the spirit of play and good will easily double the value of any exercise that is taken. dancing is also good if the ventilation is adequate and the hours are reasonable. under various conditions vicarious exercises are valuable, and by that i mean such forms of exercise as massage, osteopathic treatment or vibratory treatment. if anything is wrong with the spine, get an osteopath or a chiropractor. they can help to remedy such defects more quickly than anyone else. they are experts in adjustments and thrusts. some people take exercises while lying in bed or on the floor. one good exercise to take while lying on the back is to go through the motions of riding a bicycle. another is to lie down, then bend the body at the hips, getting into a sitting position; repeat a few times. another is to face the floor, holding the body rigid, supported on the toes and the palms of the hands; slowly raise the body until the arms are straight and slowly lower it again until the abdomen touches the floor; repeat several times. it is impossible to go into detail regarding various exercises here. those who wish to take care of themselves can easily devise a number of good ones, or they can employ a physical culture teacher to give them pointers. here as elsewhere, good sense wins out. it is not necessary to give much time to exercise, but a little is valuable. those who labor with their hands often use but few muscles, and it would be well for them to take corrective exercises so that the body will remain in good condition. there is no excuse for round shoulders and sunken chests. a few weeks, or at most a few months, will correct this in young people. the older the individual, the longer it takes. if the vertebrae have grown together in bony union no correction is possible. it is as necessary to relax as it is to exercise. when weary, take a few minutes off and let go physically and mentally. a little training will enable you to drop everything, and even if it is for but five minutes, the ease gives renewed vigor. it does not matter what position is assumed, if it is comfortable and allows the muscles to lose all tension. at such times it is well to let the eyelids gently close, giving the eyes a rest. eye strain is very exhausting to the whole body and often results in serious discomfort. many do not know how to relax. they think they are relaxed, yet their bodies are in a state of tension. when relaxed any part of the body that may be raised falls down again as though it were dead. people who do much mental work are at times so aroused by ideas that refuse to release their hold until they have been worked out or given expression that they can not sleep for the time being. a few minutes of relaxation then gives rest. when the problem has been solved, the worker is rewarded with sweet slumbers. an occasional night of this kind of wakefulness does no harm, provided no such drugs as coffee, alcohol, strychnine and morphine are used. we are undoubtedly intended to be useful. normal men and women are not content unless they are helpful. hence we have our work or vocation. however, people who get into a rut, and they are liable to if they work all the time at one thing, lose efficiency. therefore it is well to have an avocation or a hobby to sharpen mind and body. it does not make much difference what the hobby is, provided it is interesting. we waste much time that could give us more pleasure if it were intelligently employed. an hour a day given to a subject for a few years in the spirit of play will give a vast fund of information and may in time be of inestimable benefit. those who labor much with the hands would do well to take some time each day for mental recreation, and those who work in mental channels should get joy and benefit from physical efforts. a few hobbies, depending upon circumstances, may be: photography, music, a foreign language, the drama, literature, history, philosophy, painting, gardening, raising chickens, dogs or bees, floriculture, and botany. some people have become famous through their hobbies. they are excellent for keeping the mind fluid, which helps to retain physical youth. there is something peculiarly beneficial about tending and watching growing and unfolding things. it is well known that women remain young longer than men. we have good reason to believe that one of the causes is their intimate relation with children. growing flowers, vegetables, chickens and pups have the same influence in lesser degree. tender, helpless things bring out the best qualities in our natures. we can not be on too intimate terms with nature, so, if possible, select a hobby that brings you closely in contact with her and her products. chapter xxiii. breathing and ventilation. the respiratory apparatus is truly marvelous in beauty and efficiency. medical men complain about nature's way of constructing the alimentary canal, saying that it is partly superfluous, but no such complaint is lodged against the lungs and their accessories. the respiratory system may be likened in form to a well branched tree, with hollow trunk, limbs and leaves: the trachea is the trunk; the two bronchi, one going to the right side and the other to the left side, are the main branches; the bronchioles and their subdivisions are the smaller branches and twigs; the air cells are the leaves. the trachea and bronchi are tubes, furnished with cartilaginous rings to keep them from collapsing. they are lined with mucous membrane. the bronchi give off branches, which in turn divide and subdivide, until they become very fine. upon the last subdivisions are clustered many cells or vesicles. these are the air cells and here the exchange takes place, the blood giving up carbonic acid gas and receiving from the inspired air a supply of oxygen. this exchange takes place through a very thin layer of mucous membrane, the air being on one side and the blood capillaries on the other side. the whole respiratory tract is lined with mucous membrane. this membrane is ciliated, that is, it is studded with tiny hairlike projections, extending into the air passages. these are constantly in motion, much like the grain in a field when the wind is gently blowing. their function is to prevent the entry of foreign particles into the air cells, for their propulsive motion is away from the lungs, toward the external air passages. in some of the large cities where the atmospheric conditions are unfavorable and the air is laden with dust and smoke, the cilia are unable to prevent the entrance of all the fine foreign particles in the air. then these particles irritate the mucous membrane, which secretes enough mucus to imprison the intruders. consequently there is occasionally expulsion of gray or black mucus, which should alarm no one under the circumstances, if feeling well. normally the mucous membrane secretes only enough mucus to lubricate itself, and when there is much expulsion of mucus it means that either the respiratory or the digestive system, or both, are being abused. at such times the sufferer should take an inventory of his habits and correct them. the air cells are made up of very thin membrane. so great is their surface that if they could be flattened out they would form a sheet of about , square feet. we can not explain satisfactorily why it is that through their walls there is an exchange of gases, nor how the respiratory system can act so effectively both as an exhaust of harmful matter and a supply of necessary elements. the distribution of the blood capillaries, so tiny that the naked eye can not make them out, is wonderful. under the microscope they look like patterns of delicate, complex, beautiful lace. the lungs are supplied with more blood than any other, part of the body. a small part of it is for the nourishment of the lung structure, but most of it comes to be purified. after the blood has traveled to various parts of the body to perform its work as a carrier of food, and oxygen and gatherer of waste, it returns to the heart and from the heart it is sent to the lungs. there it gives up its carbonic acid gas and receives a supply of oxygen. then it returns to the heart again and once more it is sent to all parts of the body to distribute the vital element, oxygen. the lungs give off watery vapor, a little animal matter and considerable heat, but their chief function is to exchange the carbonic acid gas of the blood for the oxygen of the air. when the fats, sugars and starches, in their modified form, are burned in the body to produce heat and energy, carbonic acid gas and water are formed. the gas is taken up by the blood stream, which is being deprived of its oxygen at the same time. this exchange turns the blood from red into a bluish tinge. the red color is due to the union of oxygen with the iron in the blood corpuscles, forming rust, roughly speaking. the fine adjustment that exists in nature can be seen by taking into consideration that animals give off carbon dioxide and breathe in oxygen, while vegetation exhales oxygen and inhales carbon dioxide. in other words, animal life makes conditions favorable for plant growth, and vegetation makes possible the existence of animals. an animal of the higher class can live several days without water, several weeks without food, but only a very few minutes without oxygen. when the blood becomes surcharged with carbonic acid gas, and oxygen is refused admittance to the lungs, life ceases in about five or six minutes. from this it can easily be seen how important it is to have a proper supply of oxygen. acute deprivation of this element is immediately fatal, and chronic deprivation of a good supply helps to produce early deterioration and premature death. the lungs can easily be kept in good condition, and when we ponder on the beautiful and effective way in which nature has equipped us with a respiratory apparatus and an inexhaustible store of oxygen, surely we must understand the folly of not helping ourselves to what is so vital, yet absolutely free. wrong eating and impure air are largely responsible for all kinds of respiratory troubles, from a simple cold to the most aggravated form of pulmonary tuberculosis. exercise and deep breathing will to a great extent antidote overeating, but there is a limit beyond which the lungs refuse to tolerate this form of abuse. experiments have shown that if the carbonic acid gas thrown off daily by an adult male were solidified, it would amount to about seven ounces of solid carbon, which comes from fats, sugars and starches that are burned in the body. it is well to remember that there are various forms of burning or combustion. rapid combustion is exemplified in stoves and furnaces, where the carbon of coal or wood rapidly and violently unites with oxygen. slow combustion takes place in the rotting of wood, the rusting of iron and steel and the union of oxygen with organic matter in animal bodies. both processes are the same, varying only in rapidity and intensity. people who daily give off seven ounces of carbon are overworking their bodies. they take in too much food and consequently force too great combustion. this forcing has evil effects on the system, for under forced combustion the body is not able to clean itself thoroughly. some of the soot remains in the flues (the blood-vessels) and is deposited in the various parts of the engine (the body). result: hardening, which means loss of elasticity and aging of the body. aging of the body results in deterioration of the mind. proper breathing is fine, but unless it is also accompanied by proper eating it does not bring the best results. the atmospheric air contains about four parts of carbonic acid gas to , parts of air. the exhaled air becomes quite heavily charged with this gas, about to parts in , . it does not take long before the air in a closed, occupied room is so heavily charged with this gas and so poor in oxygen that its constant rebreathing is detrimental. the blood stream becomes poisoned, which immediately depresses the physical and mental powers. warning is often given by a feeling of languor and perhaps a slight headache. people accustom themselves to impure air so that they apparently feel no bad effects, but this is always at the expense of health. the senses may be blunted, but the evil results always follow. to keep a house sealed up as tightly as possible in order to keep it warm saves fuel bills, but the resultant bodily deterioration and disease cause enough discomfort and result in doctor bills which more than offset this saving. it is poor economy. a constant supply of the purest air obtainable must be furnished to the lungs; otherwise the blood becomes so laden with poison that health, in its best and truest sense, is impossible. the air should be inhaled through the nose. it does not matter much how it is exhaled. the nose is so constructed that it fits the air for the lungs. the inspired air is often too dry, dusty and cold. the normal nose remedies all these defects. the mucous membrane in the nasal passages contains cilia, which catch the dust. the nasal passages are very tortuous so that during its journey through them the air is warmed and takes up moisture. habitual mouth breathing is one of the causes of the hardening and toughening of the mucous membrane of the respiratory passages, for the mouth does not arrest the irritating substances floating in the air, nor does it sufficiently warm and moisten the inspired air. irritation produces inflammation and this in turn causes thickening of the membranes. then it is very easy to acquire some troublesome affliction such as asthma. very cold air is irritating, but the passage through the nose warms it sufficiently. the evil results of mouth breathing are well seen in children, in whom it raises the roof of the mouth and brings the lateral teeth too close together. then the dentists have to correct the deformity and the children are forced to suffer protracted inconvenience. this mouth breathing is mostly due to wrong feeding, especially overfeeding, which causes swelling of the mucous membrane, thus impeding the intake of the air through the nose and forcing it through the mouth. the chief curative measure is obvious. cut down the child's food supply and give food of better quality. remember that children should not be fat. normal breathing is rhythmical, with a slight rise of the abdomen and chest during inspiration and a slight falling during expiration. watch a sleeping baby, and you will understand what is meant. the ratio of breathing to the beating of the heart is about one to four or five. whatever accelerates the heart causes more rapid breathing and vice versa. breathing is practically automatic, and were we living under natural conditions we should need to pay no attention to it, but inasmuch as our mode of life prevents the full use of the lungs a little intelligent consideration is necessary to attain full efficiency. the body should be left as free as possible by the clothes and especially is this true of the chest and waist line. women sin much against themselves in this respect. most of them find it absolutely necessary for their mental welfare to constrict the lower part of the chest and the waist line a great part of the time, for really it would not do to be out of fashion. the statue of venus de milo is generally considered to represent the highest form of female beauty and perfection in sculptural art. if living women would consent to remain beautiful, instead of being slaves to fashion, it would be much better for themselves and for the race. a corseted woman can not breathe properly, even if she can introduce her hand between the body and her corset to prove that she is not constricted. the natural curves of women are more graceful than those produced by the corset. it would be an easy matter to give the breasts sufficient support, if they need support, without constricting the body, and then take enough exercise to keep the waist and abdomen firm and in shape to accord with a normal sense of what is beautiful and proper. woman does right in being as good looking as possible, and it would do man no harm to imitate her in this, for truly, "beauty is its own excuse for being." but beauty and fashion seldom go hand in hand. look at the modes which were the fashion, and you will be compelled to say that many of them are offensive to people of good taste. american women should cease imitating the caprice of the women of the underworld of paris. there are indications that women are liberating themselves somewhat from the chains of fashions, as well as from other ridiculous things, so let us hope that they will soon be brave enough to look as beautiful as nature allows them to be, both in face and figure. the lungs, like every other part of the body, become weakened when not used. the chest cavity enlarges during inspiration, but this enlargement is prevented if there is constriction of the lower ribs and the waist. the normal breathing is abdominal. such breathing is health-imparting. it massages the liver gently with each breath and is mildly tonic to the stomach and the bowels. it truly gives internal exercise. it helps to prevent constipation. shallow breathing causes degeneration of lung tissue, and indirectly degeneration of every tissue in the body, for it deprives the blood of enough oxygen to maintain health. it also prevents the internal exercise of the abdominal organs, which is a necessary activity of the normal organism. shallow breathers only use the upper parts of the lungs. it is not to be wondered at that the lower parts easily degenerate. in pneumonia, for instance, the lower part is usually first affected, and in tuberculosis one often can get the physical indications in the lower part of the lungs posteriorly before they can be found any other place. the upper parts have to be used and consequently they get more exercise and more blood and hence become more resistant. it is well known that when the upper part of the lungs become affected the disease is very grave. men, as well as women, are guilty of shallow breathing. many men are very inactive and their breathing becomes sluggish. this can be remedied by taking vigorous exercise and a few breathing exercises. because abdominal breathing is the correct way, some physical culturists, who mix the so-called new thought with their system, advocate exercising and concentrating the mind on the abdomen at the same time. this is unnecessary, for the proper exercises and the right attitude will cause abdominal breathing without giving the abdomen special thought. man was evidently intended to earn his food through physical exertion and exercise, and so long as he did this the lungs were compelled to expand. a few running exercises or hill or mountain climbs will suffice to prove the truth of this statement. however, now that man can ride on a street car and earn, or at least get, his daily bread by sitting in an office, it is necessary to exercise a little in order to get good results. the farmer who sits crouched up on a plow, mower or binder also fails to use his lungs, but if he gets out and pitches hay or bundles of grain, he is sure to get what oxygen he needs. everyone should get into the habit of breathing deeply several times a day. upon rising in the morning, go to the open window or out of doors and take at least a dozen slow, deep breaths, inhaling slowly, holding the air in the lungs a few moments and exhaling slowly. this should be repeated noon and night. every time when one is in the fresh air, it is well to take a few full breaths. by and by the proper breathing will become a habit, to the great benefit of one's health. there are many breathing exercises, but every intelligent being can make his own exercises, so i shall describe but one. have the hands hanging at the sides, palms facing each other. inhale slowly and at the same time bring the arms, which are to be held straight, forward and upward, or outward and upward, carrying them as far up and back over the head as possible. the arm motion is also to be slow. about the time the arms are in the last position a full inspiration has been taken. hold the position of the arms and the breath a few seconds and then slowly exhale and slowly bring the arms back to the first position. repeat ten or twelve times. if while one is inhaling and raising the arms, one also slowly rises on the toes and slowly resumes a natural foot position while exhaling, the exercise will be even better. hollow-chested young people can attain a good lung capacity and good chest contour in a very reasonable time. persistence in proper breathing and proper exercise will have remarkable results in even two or three months, and at the same time nature will be painting roses on pallid cheeks. it is easy to increase the chest expansion several inches. those who expand less than three and one-half inches should not be satisfied until they have gone beyond this mark. elderly people can also increase their chest expansion and breathing capacity, but it takes more time, for with the years the chest cartilages have a tendency to harden and even to ossify. the less breathing the sooner the ossification comes. many people are afraid of night air, for which there is no reason. the absence of sunshine at night does no more harm than it does on cloudy days. during the night, of all times, fresh air is needed, for less is used, and what little is breathed should be of as good quality as circumstances permit. open the windows wide enough to have the air constantly changing in the bedroom. during the winter it will be necessary to put additional clothes on the bed, for no one can obtain the best of slumbers while chilled. some may find it a better plan to use artificial heat in the foot of the bed. at any rate, during cold weather better covering is required for the legs and for the feet than for any other part of the body. people with good resistance can sleep in a draught without the least harm, but ordinary people should not sleep in a draught. it is easy to use screens so that the wind does not blow upon the face. if the air is kept stirring in the chamber the sleeper gets enough without being in a current. some are in the habit of closing their bedroom windows and doors at night and opening them for a thorough airing during the day. if the bedrooms must be closed, close them during the day and open them wide at night, for that is when the pure air is needed. it does not make much difference whether they are open or closed while being unoccupied. it is actually sickening to enter some bedrooms and be compelled to breathe the foul air. when people are ill the rooms should have fresh air entering at all times. sick people give off more poisons than do those in good health and they need the oxygen to burn up the deposits in the system. an early morning stroll while most people are in bed is very instructive. it will be found that some houses are shut up as tightly as possible and that only a few are properly ventilated. a person who insists on keeping his window open in winter is often looked upon as a freak. what is the result of this close housing? the first result is that the blood is unable to obtain the required amount of oxygen and is poisoned by the rebreathing of the air in the room. in the morning the sleeper wakes feeling only half rested, and it takes a cup of coffee or something else to produce complete awakening. the evil results are cumulative, and after a while the bad habit of breathing impure air at night will be a great factor in building disease of some kind. one reason why some are so afraid of fresh air, especially at night, is that they become so autotoxemic through bad habits, especially improper eating habits, that a slight draught causes them to sneeze and often catch cold and they believe that the fresh air causes the irritation. this is not so. the irritability comes from within, not from without. after becoming accustomed to good ventilation at night it is almost impossible to enter into restful slumbers in a stuffy room. savages are singularly free from respiratory diseases, and the reason is without doubt that they do not house themselves closely. in some parts of the world they fear to let civilized men enter their abodes, for they may bring respiratory diseases. not only the homes, but public places, such as street cars, theaters, schools and churches are too often poorly ventilated. sleeping, or rather dozing in church is so common that it is a matter of jest. my experience has been that drowsiness comes not from the dullness of sermons, but from the impossibility of getting a breath of good air in many churches. please remember that exhaled air is excretory matter, and that it is both unclean and unwholesome to consume it over and over again. draughts do not cause colds. cold air does not cause colds. wet clothes do not cause colds: these things may be minor contributory factors, but the body must be in poor condition before one can catch cold. colds are generally caught at the table. lack of fresh air also helps to produce colds, as well as other diseases. the tendency in our country is to heat buildings too much. europeans are both surprised and uncomfortable when they first enter our dwellings or public meeting places. the temperature in a dwelling should not be forced above seventy degrees fahrenheit by means of artificial heating. the temperature required depends very much upon one's mental attitude and habits. those who take enough exercise have good circulation of the blood in the extremities, and therefore do not need so much artificial heat. the best heating is from within. chapter xxiv. sleep. a young baby should sleep almost all the time, and it will if intelligently cared for. overfeeding is the bane of the baby's life and is the cause of most of its restlessness. the first few months the baby should be awake enough to take its food, and then go to sleep again. as it grows older it sleeps less and less. there is no fixed time for an adult to sleep. the amount varies with different individuals. the idea is quite prevalent that eight hours nightly are necessary. this may be true for some. many do very well on seven hours' sleep, and even less. the great inventor, thomas edison, is said to have had but very little sleep for many years, and it is reported that when interested in some problem he would miss a night or two. yet he has lived longer than the average individual and is now in good health. very few have done as much constructive work as he. many other prominent people have been light sleepers. as people grow older they require less sleep than they did in youth. it is not uncommon for septuagenarians to sleep but five hours nightly. although we can not say how much sleep any individual may require, each person can find out for himself, and this is much better than to try to live by rules, which are often erroneous. those who live as they should otherwise and select a definite hour for retiring and adhere to it, except on special occasions, get all the sleep that is necessary. they awake in the morning refreshed, ready to do a good day's work. during sound sleep all conscious endeavors cease. the vital organs do only enough work to keep the body alive. the breathing is lighter, the circulation is slower and in sound sleep there is no thinking. this letting up in the great activity of body and mind gives an opportunity for the millions of cells, of which the body is composed, to take from the blood what is needed to restore them to normal. during the day many of these cells become worn and weary. at night they recuperate. hence undisturbed sleep is very important. many believe that "early to bed and early to rise" is the proper way, that the hours of sleep before midnight are more refreshing and invigorating than those after. this is merely a belief, perhaps a good one. early retiring leads to regularity, which is very desirable. late retiring often means loose mental and physical habits. those who are regular about their time of retiring and live well otherwise feel refreshed whether they go to bed early or late. children should always retire early, otherwise they do not get enough sleep. the night is the natural sleeping time for most creatures, as well as for man. this is a heritage of ages. there was no artificial illumination during the stone age. man could do nothing during the darkness, so he rested. however, those who must work at night find no trouble in sleeping during the day. the tendency among men is the same as among animals, to sleep more in winter than in summer, not that more sleep is required, but because the winter nights are longer. children should go to bed early. they require more sleep than adults because of the greater cell activity. also, children who stay up late generally become irritable and nervous. it is not well to eat immediately before retiring. the sleep following a late meal is generally interrupted, and there is not that feeling of brightness and clearness of mind, with which one should awake, next morning. lunching before going to bed is a bad habit. some believe they must have an apple, or perhaps a glass of milk, before retiring, for they think that this will bring sleep. the body should not be burdened with extra food to digest during the sleeping hours. this time should be dedicated to the restoring of the body, and the blood contains ample material. dreaming is largely a bad habit. a normal individual rarely dreams, and then generally following some imprudence. dreams begin in childhood and are then due principally to excessive food intake. as a producer of nightmares overfeeding has no equal. during adult life dreaming is caused by bad physical and mental conduct, plus the habit which was formed in childhood. fear, anger, worry, stimulants, too much food, impure air and too warm clothes are some of the causes that produce dreams. like other bad habits, dreaming is difficult to overcome once it is firmly established. the cure consists in righting one's other bad habits and in not thinking about the dreams. a sleep that is disturbed by dreams is not as sound as it should be and consequently not as refreshing as normal sleep. the conscious mind is not completely at rest and, the subconscious mind is running riot. normal sleep is complete unconsciousness. this is the sleep of the just and must be earned. before retiring all the clothes worn during the day should be removed. the night apparel should be light--cotton, linen or silk. the bed should be comfortable, but not too soft. there should be enough covering to keep the sleeper comfortably warm, but not hot. those who cover themselves with so many quilts or blankets that they perspire during the night are not properly refreshed. it prevents sound sleep and makes the skin too sensitive. it reduces a person's resistance to climatic changes. the feet should be kept warm, even if necessary to put artificial heat in the foot of the bed. during cold weather the feet and the legs should have more covering than the rest of the body. from the waist up the covering should be rather light. sound sleep is dependent on relaxation of mind and body. those who live the day over after going to bed do not go to sleep quickly or easily. this habit should be overcome. do business at the business place, during business hours, if you would have the mind fresh. there are days so full of cares that the night does not bring mental relaxation, but those who have begun early in life to practice self-control find these days growing fewer as the years roll by. when they learn their true relationship to the rest of humanity, to the universe and to eternity, they are generally willing and able to let the earth rotate and revolve for a few hours without their personal attention. they realize that worry and anxiety waste time and energy. many complain that they can not sleep. this they repeat to themselves and to others many times a day. at night they ask themselves why they can not sleep. they do it so often that it becomes a powerful negative suggestion frequently strong enough to prevent their going to sleep. it is an obsession. real insomnia exists only in the mind of the sufferer. every physician, sooner or later, has experience with people who say that they can not sleep. the doctors who give such patients sleeping powders or potions make a grave mistake. these drugs are taken at the expense of some of the physical structures, and the day of settlement always comes. perhaps it will find the patient with bankrupted nerves or a failing heart. to be effective, the size of the dose must be increased from time to time. at last the result will be some disease, either physical or mental. those who insist that they "do not sleep at all," or that they sleep "but a few minutes" each night, sleep a few hours, but they make themselves believe that they do not sleep. we are compelled to sleep, and even those who "do not sleep at all" can not remain awake indefinitely. those who are troubled with the no-sleep obsession will soon realize that they sleep as well as others if they cease thinking and talking so much about the subject. i have seen people suffering from this bad habit recover in one week. those who have been taking drugs to induce sleep generally have a few bad nights when they give them up, after which the nervous storm subsides and sleep becomes normal. all drugs should be discarded. the physician who understands more about the working of nature than about the giving of drugs will have the best success in these cases. soothing sleep always comes to people possessed of a controlled mind in a healthy body. if the day has been exhausting and the nerves are so alive and wrought up that sleep will not come, do not allow the mind to delve into worry about it. do not say to yourself: "i wish i could sleep. why can't i sleep?" such fretful thinking produces mental tension, which drives sleep away. instead, say to yourself: "i am very comfortable. i am having a refreshing rest. it does not matter whether i sleep or not." by all means relax the body. choose a comfortable position and remain quiet, having the muscles relaxed. it is remarkable how soon a relaxed body brings tranquility to a disturbed mind. let a man in pugnacious mood relax his face and his fists and in a very short time his anger vanishes. it makes no difference whether a person sleeps eight hours on a certain night. if he is fairly regular about going to bed he will get enough sleep. those who realize this truth do not complain of insomnia. most people who think much have an occasional night when an idea takes such strong possession of the brain and demands so forcibly to be put into proper shape, that they can not sleep. under such circumstances it is as well to to get up and work out the idea. three or four nights like that in the course of a year will do no harm. people rarely sleep well when lying on the back. if the theory of evolution is correct, we were not intended to lie on our backs during sleep. a good position is to lie on the right side, the right leg being anterior to the left, both being flexed. another position that is restful to many is to lie on the abdomen, the arms extended away from the body. the breathing should be entirely nasal. it will not be nasal if there is obstruction in the nose. a healthy person who breathes through his mouth at night must use autosuggestion to overcome the habit. he should suggest to himself, "i will breathe through the nose; i will keep my lips together." if he persists in this, closes the mouth when he goes to sleep, in time the mouth-breathing will cease, and with it the disagreeable habit of snoring. the harmfulness of mouth-breathing is explained in another chapter. at all times the bedroom should be well ventilated. some people are in the habit of sleeping in unventilated bedrooms, but upon rising in the morning they throw the windows open and give the room a good airing. the ventilation does not do much good except when there is someone in the room. during the day the bedroom could be closed with very little harm ensuing, though it is best to have it sunned and aired as much as possible. the sleeping porch is excellent. outdoor sleeping is all right and it is not a modern fad. where benjamin franklin got his information i do not know, but he has this to say about outdoor sleeping: "it is recorded that methusaleh, who, being the longest liver, may be supposed to have best preserved his health, that he slept always in the open air; for when he had lived five hundred years an angel said to him: 'arise, methusaleh, and build thee an house, for thou shalt live five hundred years longer.' but methusaleh answered, and said: 'if i am to live but five hundred years longer, it is not worth while to build me an house; i will sleep in the air as i have been used to do.'" this may partly account for some of his many years. his alleged conversation with the angel indicates that he was a man of equanimity. under ordinary circumstances those who sleep indoors should have one sash of window fully open for each person in the chamber, or more. it is well to have plenty of fresh air, but it is not best to sleep in a draught. when the wind is blowing through the windows it is not necessary to have them wide open, for an aperture of four inches will then give as much fresh air as a sash opening in calmer weather. it is best to get up promptly upon awakening in the morning. remaining in bed half asleep is productive of slothfulness. too much sleeping and dozing make one dull. those who overeat require more sleep than moderate people. the sluggishness and sleepiness following a too heavy meal are familiar to all. animals that do not get food regularly, but are dependent on the vicissitudes of preying for their nourishment, often gorge themselves so that they can not stay awake, but fall into a stupor, which may last for days. man, who is generally assured of three meals a day, has no excuse for this form of self-abuse, but unfortunately he practices it too often. it is a gross habit, one in which people of refinement will not continue to indulge. young children should take a nap each day. they are so active that they need this rest. adults can with profit take a short nap, not to exceed thirty minutes, after lunch. those who are nervous owe it to themselves to take a nap. those who use the brain a great deal will find the midday nap a great restorer. if sleep will not come, they should at least close their eyes and remain relaxed for a short time. a long nap makes one feel stupid. those unfortunate people who are addicted to various enslaving drugs, such as cocaine and morphine, often are very light sleepers. they are deteriorating physically, mentally and morally. such people are ill and are no guides to the needs of healthy people. coffee drinking is a destroyer of sound sleep. at first the coffee seems to soothe the nerves, but in a few hours it has the opposite effect. the habitual use of coffee helps to bring on premature nervous instability and physical degeneration. sleep is self-regulating. if we are normal otherwise we need give the subject no thought except to select a regular time to go to bed and get up promptly in the morning upon awaking. it is easy to drive away sleep. those who wish to enjoy this sweet restorer at its best must be regular. chapter xxv. fasting. fasting is one of the oldest of remedial measures known to man, not only for the ills of the body, but for those of the soul. oriental lore and literature make frequent reference to fasts. from the bible we learn that moses, elijah and christ each fasted forty days, and no bad effects are recorded. addison knew the value of fasting and temperance. he wrote that, "abstinence well-timed often kills a sickness in embryo and destroys the seeds of a disease." unfortunately, he did not live as well as he knew how. hence his brilliant mind had but a short time in which to work and the world is the loser. our own great philosopher, benjamin franklin, had the same knowledge, for he wrote, "against disease known, the strongest fence is the defensive virtue, abstinence." there is much prejudice against fasting, because people do not understand what fasting is and what it accomplishes. fasting is not starving. to fast is to go without food when the body is in such condition that food can not be properly digested and assimilated. to starve is to go without food when the body is in condition to digest and assimilate food and needs nourishment. it is quite generally believed that if food is withheld for six or seven days the result will be fatal. under proper conditions one can go without food for two or three months. perhaps most people could not do without food for the latter period, but fasts of that duration are on record. fat people can live on their tissues for a long time before they are reduced to normal weight, and slender ones can live on water for an extended period. prolonged fasts should not be taken unless necessary, and then they should be taken under the guidance of someone who has had experience and is possessed of common sense. if a person is fearful or surrounded by others who instill fear into him, he should not take a prolonged fast. the gravest danger during the fast is fear. it takes many weeks to die from lack of food, but fear is capable of killing in a few days, or even in a few hours. the healer who undertakes to direct fasts against the wishes of the patient's friends and relatives, who have more influence than he has, injures himself professionally and throws doubt upon the valuable therapeutic measure he advocates. the indications that a fast is needed are pain and fever and acute attacks of all kinds of diseases. some of the more common diseases that call for a complete cessation of eating are: the acute stage of pneumonia, appendicitis, typhoid fever, neuralgia, sciatica, peritonitis, cold, tonsilitis, whooping cough, croup, scarlet fever, smallpox and all other eruptive diseases; colics of kidneys, liver or bowels; all acute alimentary tract disturbances, whether of the stomach or of the bowels. sometimes it is necessary to fast in chronic diseases, especially when there is pain, but as a rule chronic diseases yield to proper hygienic and dietetic treatment without a fast, provided they are curable. here is where many people who advocate fasting go to extremes. a fast is the quickest way out of the trouble, but it is at times very unpleasant. by taking longer time the result can be obtained by proper living and the patient is being educated while he is recovering. in chronic cases it is especially important to eat properly. the only disease of which i know that seems to be unfavorably influenced by fasting is pulmonary tuberculosis in well advanced stages. such patients quickly lose weight and strength on a fast, and they have great difficulty in regaining either. perhaps others have had different experiences and have made observations that do not agree with this, for cases of tuberculosis have been reported cured through fasting. it is well to bear in mind that every case that is diagnosed pulmonary tuberculosis is not tuberculosis. many supposed-to-be cases of tuberculosis, some of them so diagnosed by most reputable specialists, are nothing more than lung irritation due to the absorption of gas and acid from the digestive tract. when the indigestion is cured, the so-called tuberculosis disappears. these are the only tubercular cases that i have seen benefited by fasts, and the improvement is both quick and sure. doubtless tuberculosis in the first stages could be cured by fasting, followed by proper hygienic and dietetic care, for at first tuberculosis is a localized symptom of disordered nutrition. in this stage the disease is no more dangerous than many other maladies that are not considered fatal. the subjects brought to the dissecting table show plainly that a large proportion of them have at some time had pulmonary tuberculosis, the lesions of which were healed, and they afterwards died of some other affliction. however, if a patient is received after the manifestation of profuse night sweats, great flushing of the cheeks, high fever daily, emaciation, expulsion of much mucus from the lungs, and the presence of great lassitude and weakness, the rule is that the nutrition is so badly impaired that nothing will bring the patient back to normal. under such circumstances fasting hastens death. the family and friends are not reticent about placing the blame on the healer. moderate feeding will prolong life and add to the comfort of the sufferer. the customary overfeeding hastens the end. cancer is said to be cured by fasting, but this is very, very doubtful. it is often difficult to differentiate between cancer and benignant tumors at first. benignant tumors frequently disappear on a limited diet. i have seen many tumors disappear under rational treatment, without resorting to the knife, but i have never seen an undoubted case of cancer do so, though some of the tumors in question had been diagnosed cancer. cancers, in the advanced stages, end in the death of the patient in spite of any kind of treatment. by being very careful about the diet, cancer patients can escape nearly all the pain and discomfort that generally accompany this disease. moderation would prevent nearly every case of cancer, and especially moderation in meat eating. it is a disease that should be prevented, for its cure is very doubtful. colds leave in a few days, with no bad after effects, if no food is taken. typhoid fever treated rationally from the start generally disappears in from one week to twelve days if nothing but water is given, and fails to develop the severity that it attains under the giving of foods and drugs. there are no complications. appendicitis is of longer duration, if it is a severe attack, lasting from two to four weeks, but after the first few days the patient is comfortable, under a no-food, let-alone treatment. operation is not necessary. in cases of gall-stones, accompanied by jaundice and colic, it is not necessary to operate. fasting and bathing will bring the body back to normal in a short time. in such cases it is necessary to give the baths as hot as they can be borne, and prolong them until the body is relaxed. it would be easy to enumerate many diseases, telling the benefits to be derived from fasting, but these point the way and are sufficient. the one unfailing symptom of a fast is the loss of weight. this loss is natural and there is nothing alarming about it. as soon as eating is resumed the loss of weight stops. for a while the weight may then remain stationary, but the gain is generally prompt. in time the weight will become normal again. according to chosat, the loss sustained by the various tissues in starvation is as follows: fat..................... per cent. blood................... " spleen.................. " pancreas................ " liver................... " muscles................. " nervous tissues.......... " this table was made from animal experimentation, but agrees very well with other observations, except in the loss of blood, which others have found to be less than per cent. it will be noticed that the highest tissue, nervous tissue, is hardly affected, but the lowest tissue, fat, almost disappears. when an individual needs to fast, his body is suffering from the ingestion of too much food and poor elimination. he overworks his nutrition and overdraws on his nervous energies so much in other lines that the body is unable to throw off the debris which should leave by way of the kidneys, the bowels, the skin and the lungs. he is poisoned by his retained excretions, suffering from what is called autointoxication or self-poisoning. he is filthy internally and needs a cleaning. if he has abused himself so that he lacks the power to assimilate food and throw off waste at the same time, obviously it is proper to stop eating until the lost power is regained. in cases of fever it is a physical crime to eat, for the glands cease secreting the normal juices. the mouth becomes parched for lack of saliva, and the gastric and intestinal juices are not secreted in proper amount or quality. food eaten under such circumstances is not digested. the internal temperature in fever is above degrees fahrenheit, and it does not take long for food to decay in such temperature, especially such aliments as milk and broth, which are the favorite foods for fever patients. these alimentary substances are excellent for growing nearly all the germs that are found in the body in disease. when in pain, it is harmful to eat, for the secretions are then perverted and digestion is interfered with. all violent emotions, such as hatred, jealousy, and anger, mean that no food should be taken until the body has had the opportunity to relax and regain some of its tone. such emotions do not thrive so well in healthy individuals as among the sick, but then perfect health is a rarity. when going without food people are subject to various symptoms, which depend as much on the temperament as on the physical conditions. a hysterical woman can scare inexperienced attendants into doing her will by her antics. she may make them believe that she is dying. on the other hand, well balanced, fearless people can fast for weeks with very little annoyance. fasting is not always pleasant and there are a number of symptoms that are often present. the faster loses weight, at first often as much as two pounds a day. this is mostly water. after the first ten days the loss may be but one-half of a pound, or less, per day. the loss of weight is greatest in heavy people and in those who have high fevers. the tongue becomes badly coated, and the breath foul, showing that the mucous membrane is busy throwing out waste. the tongue remains coated until the system is clean, and then it clears off. most people feel weak when they attempt to walk or work, but they feel strong when resting. others, who are badly food-poisoned, gain strength as the system eliminates the harmful substances from the body. for a day or two the craving for food may be quite insistent and persistent. then hunger generally leaves and does not return until the tongue is clean. the mind becomes clearer as the body becomes cleaner. this benefit to the spirit, or the soul, has been recognized by religious organizations for centuries. a little discharge of blood from the bowels at first should cause no alarm. in some cases a great deal of yellow mucus is thrown into the lower bowel. the liver at times throws off so much bile that it makes the patient alarmed. this should cause no uneasiness. when the bile is forced upward into the stomach it is very disagreeable. the discharges from the bowels are often very dark. there is a tendency toward chilliness, especially to have cold hands and feet. skin eruptions and heart palpitations are occasional symptoms. nervous, irritable and fearful people have symptoms too numerous to mention. the more they are sympathized with the worse they become. many medical men have misinterpreted the symptoms of the fast, and hence they have condemned the procedure. they see the foul coating on the tongue, the loss of weight and at times peculiar mental manifestations. they can smell the foul breath and the disagreeable odor from the skin and from the bowel discharges. these they interpret as signs of physical deterioration and degeneration. these manifestations indicate that the entire body is cleansing itself, throwing out impurities that have accumulated, because the system has had so much work to do that it has lacked the power to be self-cleansing. nothing is needed to prove this fact except to continue the fast until the odors disappear and the tongue becomes clean. the bad odors given off by the body resemble the odors in severe fevers with much wasting, and hence they alarm those who have had little or no experience with protracted fasts. these odors are often bad at the end of about one week of fasting, though there is no fixed period for their appearance. they should cause no alarm for they simply indicate that the body is cleansing itself, and that is exactly what is desired. under proper conditions i have neither seen nor heard of a fatality coming from a short fast. those who are in such physical shape that they will die if fasted from five to ten days would die if they were fed. another symptom that may alarm the attendant is the lowered blood pressure. this is natural and should cause no anxiety. eating and drinking keep the blood pressure up. when the food intake is decreased, the blood pressure is reduced. when the food intake is stopped, the blood pressure is still further reduced. this fact should give the intelligent healer the hint to reduce the food intake in such abnormal conditions as arteriosclerosis and apoplexy. during prolonged fasts the blood pressure generally becomes quite low. some fasting people can continue with light work, and when they are able to do this, it is best, for it keeps them from thinking about themselves all the time. if there is a lack of energy, dispense with work and vigorous exercise. in acute diseases there is no choice. one is compelled to cease laboring. in chronic diseases it depends on the patient and the adviser. dismiss fear from the mind and do not discuss the fast or any of the symptoms with anyone except the adviser. it is best not to tell any outsiders about the fast, for the public has some queer ideas on the subject. if you are afraid, or if you have to fight with neighbors, friends, relatives, or perhaps with the health authorities, as sometimes happens, it is better not to take the fast. drink all the water desired. at first the more one drinks the more quickly the system cleanses itself. a glass of water every hour during the day, or even every half hour is all right. the water may be warm or cold, but it should not be ice-cold nor should it be hot. both extremes produce irritation. in acute inflammation of the stomach, nothing should be given by mouth. small quantities of water may be given by rectum every two or three hours. in appendicitis only very small quantities of water are to be given by mouth at first, until the acute symptoms have subsided. large quantities of fluid may excite violent peristalsis with resulting pain. in all eases of nausea, give nothing by mouth, not even water, until the nausea is gone. symptoms are nature's sign language, and when properly interpreted they tell us what to do and what not to do. even though there be no thirst or desire for water, some should be taken. if it can be taken by mouth give at least a glassful every two hours, not necessarily all at once. some are so sensitive that one-half of a glass of water is all they can tolerate. if the stomach objects to water, give it by rectum. always do this in cases of much nausea. after a few days the water intake may be reduced. take a quick sponge bath every day and if there is any inclination toward chilliness, the water should be tepid or warm. follow with a few minutes of dry towel friction. people who are overweight, with good heart and kidney action, can take prolonged hot baths, if they wish. an olive oil rub immediately after the bath, about twice a week, is grateful. however, this is not necessary. the colon is to be washed out every day. no definite amount of water can be prescribed. occasionally enemas are taken under difficulties, for some cramp when water is introduced into the bowel. those who are not accustomed to enemas should use water about degrees fahrenheit. one quart is a small enema. two quarts make a fairly large one. introduce the water, lie still for a few minutes and then allow it to pass out. if the bowels are very foul, use two or three washings. if there is much fermentation, use some soda in the water. salt, about a tablespoonful to two quarts of water, stimulates the bowels, but its disadvantage is that it draws water from the intestinal walls, thus robbing the blood of a part of its fluid. the same is true of glycerin. perhaps the least harmful ingredient that can be put into the water to stimulate action is enough pure castile soap to render the water opaque. the soap, however, has a tendency to wash away too much of the mucus which lubricates the bowel. on the whole, nothing is better than plain water. if it gives good results use nothing else. those who are very sensitive and weak often find that the expulsion of water from the bowel not only further weakens them, but causes pain. in such cases dr. hazzard recommends a rectal tube (not a colon tube), which is very good, for it allows the emptying of the bowel without any cramping. the tube is to be inserted about six inches. to take the enema, assume either the knee-chest position (kneeling with the shoulders close to the floor) or lie on the right side with the hips elevated. these positions allow water to flow into colon by aid of gravity. when it is necessary to supply liquid to the body by rectum, simply introduce a pint or less of plain water, moderately warm. repeat as often as necessary to keep away thirst, which will rarely be more than every three hours. keep the body warm at all times. if it is difficult to keep warm, go to bed and use enough covers, having the windows open enough to supply fresh air. at night use artificial heat in the foot of the bed. if hot-water bottles, warm bricks or stones are used, they should be quite large; otherwise they become cold by two or three o'clock in the morning, when heat is most needed. if a large receptacle, such as a jug, is used to keep the water in, the bed clothes are lifted off the patient's feet, and this is often a great relief. no special food is suited to break all fasts on. it is necessary to begin with plain food in moderation. overeating or eating of indigestible food at this time may result in sickness and even in death. if the faster lacks self-control, the food should be brought to him in proper quantities by the attendant. if the fast has lasted but two or three days, no special precautions are necessary, except that the first few meals should be smaller than usual. as indiscretions in eating compel nearly all fasts it is necessary to do a little better than previously, or the fast must be repeated. it is best to live so that fasts are not necessary. if the fast has been prolonged it is best to begin feeding liquid foods. what shall we feed? that depends on the patient and circumstances. the juice of the concord grape is not good for it ferments too easily. many of those who are compelled to fast or else die have been so food-poisoned, and their digestive organs have been in such horrible condition for years that they have been unable to eat acid fruits. this is especially true of those who consume large quantities of starch. sometimes they are unable to eat fruit for a while after the fast. at other times the irritability of the digestive organs disappears while food is withheld. for such people broths and milk may be employed. the juice of oranges, pineapples, california grapes, cherries, blackberries or tomatoes may be given. the tomatoes may be made into broth and strained, but nothing is to be added to this broth except salt. stout people should do well on fruit juices. they are not to be so highly recommended for very thin, nervous people, for fruit juices are both thinning and cooling. milk is very useful, and may be given either sweet or clabbered or in the form of buttermilk. thin, nervous people can safely be given broths, preferably of lamb, mutton or chicken. trim away all the fat, grind up the lean meat, and allow it to simmer (not boil) until all the juices are extracted from the meat. strain and put away to cool. when cold, skim off the fat. then warm the broth and serve. this broth is not to be seasoned while it is being cooked, but a little salt may be added when it is ready to serve. to one pound of lean meat there should be about one quart of broth. a teacupful to begin with is enough for a meal, and it is often necessary to give less than this. the gravest mistake is to be in a hurry about returning to full meals. the remarks about moderate feeding also apply to milk and fruit juices. ordinarily, fasts are not broken on starchy foods, but this may be done at times to advantage, especially in cases that have been accustomed to large quantities of starch and but little of the fresh raw foods. the starch must, however, be in an easily digestible state and should be in the form of a very thin gruel made of oatmeal or whole wheatmeal. it should be cooked four to six hours and dressed with nothing but a little salt. a few can break the fast on a full meal without any bad results, but most people can not do it without suffering and the results may be fatal. so it is a safe rule to break the fast on simple liquid food, taken in moderation. four or five days after breaking the fast, one should be able to eat the ordinary foods. the following is a suggestion of the manner in which to feed immediately after a fast of about two weeks: first day: tomato broth once; mutton broth twice. second day: breakfast, orange juice. lunch, buttermilk. dinner, sliced tomatoes. third day: breakfast, buttermilk. lunch, salad of lettuce and tomatoes, dressed with salt. dinner, poached egg, celery. fourth day: breakfast, baked apple and milk. lunch, toasted bread and butter. dinner, lamb chops, stewed green peas, celery. if a meal causes distress, omit the next one and continue omitting meals until comfort and ease have returned. if the digestion is very weak, or if the illness has been protracted, do not feed solids as soon as recommended above. in all cases it is necessary to exercise self-control, moderation and common sense. the meals must be moderate. gradually increase until the amount of food taken is sufficient to do the necessary bodily rebuilding. the longer the fast, the more care should be exercised in the beginning. it is no time to experiment. if the fast is to be of permanent benefit it is necessary to learn how to eat properly afterwards, and to put this knowledge into practice. this is the most important part to emphasize, yet all the books i have read on the subject have failed to pay any attention to it. in nearly every case the fast is necessary because of repeated mistakes in eating and drinking. those mistakes built bodily ills in the first place and if the faster goes back to them they will do it again. the disease does not always take on the same type as it did in the first place, but it is the same old disease. during a fast there is recuperation because the body has a chance to become clean, and a clean body can not long remain unbalanced, provided there are no organic faults. by making mistakes in eating after the fast is over, the body again becomes foul and full of debris and that means more disease. perhaps it may not require more than one-third as much abuse to cause a second break-down as it did to bring about the first one. some people fast repeatedly, and are somewhat proud of it. they should be ashamed of the fact that they must fast time after time, for it shows either ignorance or a weak, undeveloped will power. the fast should teach every intelligent being that it is an emergency measure, and emergencies are but seldom encountered in a well regulated life. food debauches following fasts should be avoided. a little will power properly applied will prevent them. gross eating may compel another fast. we must eat and it is better to eat so that we can take sustenance regularly than to be compelled to go without food at various intervals. he who is moderate in his eating, uses a fair degree of intelligence in the selection of his food, is temperate in other ways and considerate and kind in his dealings with others will not be ill. a fast is efficacious in clearing up a brain that is unable to work well because it is bathed in unclean blood. it is remarkable how well the brain works when the stomach is not overworked. overfeeding the body causes underfeeding of the brain. on a correct diet the brain is efficient and clear and able to bear sustained burdens. there is no question but that a fast, followed by a light diet, containing less of the heavily starchy and proteid foods and more of the succulent vegetables and fresh fruits, with their cleansing juices and health-imparting salts, would result in the recovery of over one-half of the insane. most of them are suffering functionally and here the outlook is very hopeful. christ cured a lunatic "by prayer and fasting." proper feeding would work wonders in prisons. it would also be very beneficial for wayward girls and young men who are passion's slaves. st. peter recommended fasting as an aid to morality, which is another evidence of the profundity of his wisdom. how long should a fast last? until its object has been accomplished. it is rarely necessary to fast a month, but sometimes it is advisable to continue the fast for forty days, or even longer. if the fast is taken on account of pain, continue until the pain is gone. if for fever, until there is no more fever. in chronic cases it is not always necessary to continue the fast until the tongue is clean. when the patient is free from pain and fever and comfortable in every way, start feeding lightly. people who are thin and have sluggish nutrition, one symptom of which is dirty-gray mucous membrane in mouth and throat, should not be fasted any longer than it is absolutely necessary, for they generally react slowly and poorly. if people would miss a meal or two or three as soon as they begin to feel bad, no long fasts would be necessary, because when the system first begins to be deranged it very quickly rights itself when food is withheld. it is impossible for a serious disease to develop in a fasting person, unless he is in an exceptionally bad physical condition at the beginning of the fast, for when food is withheld there is nothing for disease to feed upon. no new disease can originate during a fast. fasts often bring people back to health, who can not recover through any other means known to man, unless it be eating almost nothing--a semi-fast. occasionally a patient dies while on a long fast or immediately thereafter, but please remember that millions die prematurely on this earth every year who never missed their meals for one day. also remember that those who go on prolonged fasts are generally "hopeless cases," who have been given up to die by medical men. people who fast generally become comfortable, so why envy a few men and women an easy departure when they are no longer able to live, and why heap undeserved censure on those who are doing their best to ease the sufferers by means of our most valuable therapeutic measure, fasting? there is much prejudice against fasting, but a calm study of the facts will remove this. typhoid fever, conventionally treated, often proves fatal in per cent. or more of the cases and those who survive have to undergo a long, uncomfortable illness which often leaves them so weakened and with such degenerated bodies that the end is frequently a matter of a few months or years. pneumonia and tuberculosis find a favorable place to develop and in these cases prove very fatal. on the other hand, cases of typhoid treated by the fast, and the other hygienic measures necessary, recover in a short time, there are no evil sequels and the body is in better condition than it was before the onset of the disease. i have never seen a fatality in a properly treated case, and the mortality is conspicuous by its absence. it is the same in curable chronic diseases. where feeding and medicating add to the ills, fasting with proper living afterwards brings health. it is also well to remember that where one individual dies while fasting (not from the effects of fasting, but from the disease for which the fast was begun), perhaps one hundred thousand starve because they have too much to eat. silly as this may sound, it is the truth, and this is s the explanation: overfeeding causes digestive troubles and a breakdown of the assimilative and excretory processes. the more food that is taken while this condition exists the less nourishment is extracted from it. the food ferments pathologically, instead of physiologically, and poisons the body. the more that is eaten under the circumstances, the worse is the poisoning and at last the tired body wearily gives up the fight for existence, perhaps after a long chronic ailment has been suffered, or perhaps during the attack of an acute disease. the chief cause of death is too much food. avicena, the great arabian physician, treated by means of prolonged fasts. for the benefit of those who fear the effects of fasts of a few days' duration a few quotations are given from various sources: "my next marked case is a wonderful illustration of the self-feeding power of the brain to meet an emergency, and a revelation, also, of the possible limitations of the starvation period. this was the case of a frail, spare boy of four years, whose stomach was so disorganized by a drink of solution of caustic potash that not even a swallow of water could be retained. he died on the seventy-fifth day of his fast, with the mind clear to the last hour, and with apparently nothing of the body left but bones, ligaments, and a thin skin; and yet the brain had lost neither weight nor functional clearness. "in another city a similar accident happened to a child of about the same age, in whom it took three months for the brain to exhaust entirely the available body-food."--dr. e. h. dewey. this shows the groundlessness of the fear parents have of allowing their children to fast when necessary. it is beneficial for even the babies who need it. in the cases quoted above the conditions were very unfavorable, for the children were suffering from the effects of lye burns, yet they lived without food seventy-five and ninety days, respectively. if necessary, deprive the children of food, and keep them warm. then comfort yourself with the fact that they are being treated humanely and efficiently. dr. linda burfield hazzard, in the latest edition of her book, fasting for the cure of disease, states that she has treated almost two thousand five hundred people by this method, the fasts varying in duration from eight to seventy five days, many of them being over a month. sixteen of her patients have died while fasting and two on a light diet. this is far from being a mortality of per cent. when the fact is taken into consideration that the people she treated were of the class for whom the average medical man can do nothing the mortality is surprisingly small. however, she has lost a few, and as she is a fighter for her beliefs the prejudice against her and her method of treating disease have proved strong enough to cause her to be imprisoned. dr. hazzard has perhaps the widest experience with fasting of any mortal, living or dead. her book is well worth reading. upton sinclair has also written a book on this subject, entitled the fasting cure. he writes from the viewpoint of an intelligent layman whose observations are not very extensive. the book contains many good ideas. this is from page fifty-seven: "the longest fast of which i had heard when my article was written was seventy eight days; but that record has since been broken, by a man named richard fausel. mr. fausel, who keeps a hotel somewhere in north dakota, had presumably partaken too generously of the good cheer intended for his guests, for he found himself at the inconvenient weight of three hundred and eighty-five pounds. he went to a sanatorium in battle creek and there fasted for forty days (if my recollection serves me), and by dint of vigorous exercise meanwhile, he got rid of one hundred and thirty pounds. i think i never saw a funnier sight than mr. fausel at the conclusion of this fast, wearing the same pair of trousers that he had worn at the beginning of it. but the temptations of hotel-keepers are severe, and when he went back home, he found himself going up in weight again. this time he concluded to do the job thoroughly, and went to macfadden's place in chicago, and set out upon a fast of ninety days. that is a new record--though i sometimes wonder if it is quite fair to call it 'fasting' when a man is simply living upon an internal larder of fat." bernarr macfadden has also written considerable about fasting. c. c. haskell is an advocate and director of such treatment. many physicians employ this healing method. some day the entire medical profession will realize the worth of fasting as a curative agent. as a reminder, please allow me to repeat: when reading and studying about the subject of fasting, do not think of it as a complete cure, for those who return to their improper mode of living will again build disease. after the fast, live right. the efficient body is clean internally. an unclean skin is bad. a foul alimentary tract is worse. but the worst of all is a foul condition of all the tissues, including the blood-stream, a condition in which much of the body's waste is stored up, instead of being excreted. if such a condition can not be remedied through moderation and simplicity in eating, the only thing that will prove of value is temporary abstinence. it would be an easy matter to enumerate many long fasts, such as that of dr. tanner, who proved to an astonished country that fasting for a month or more is not fatal, but on the contrary may be beneficial. or we could cite cases like the fasts carried on by classes under the direction of bernarr macfadden. or we could refer to the experiments of professors fisher and chittenden of yale. however, we will only look into one more case, that of dr. i. j. eales, whose fast created considerable interest several years ago. the doctor was too heavy, so he decided to take a fast to reduce his weight, also for scientific purposes. for thirty days he lived on nothing but water with an occasional glass of lemonade and one cup of coffee. at the end of thirty days he broke his fast on a glass of malted milk. the doctor worked hard during all this period, losing weight all the time, being thirty pounds lighter at the end of his fast than at the beginning. however, he did not lose strength, being able to do as much work and lift as heavy weights at the end of the fast as at the beginning. anyone who is much over weight can with benefit do as the doctor did, for the body will use the stored up fat to produce heat and energy. this fast is fully detailed in dr. eales' book called healthology. fasting is the quickest way to produce internal cleanliness, which is health. when the system is clean the cravings, longings and appetites are not so strong as when the body is full of poisons. for this reason a fast is the best way to destroy the cravings for tobacco, coffee, tea, alcohol and other habit-forming drugs. if, after the fast is over, the individual lives moderately and simply, and is fully determined not to return to the use of these drugs, a permanent cure will be the reward. however, it is very easy to drift back into the old habits. a permanent cure requires that there be no compromise, no saying, "i shall do it this time, but never again." once the old habit is resumed, it is almost certain to be continued. chapter xxvi. attitude of parent toward child. healthy, happy children are the greatest of all rewards. all parents can have such children, and it is a duty they owe themselves, the children and the race. it is a most pleasant duty, for the returns are far greater than the cost. in order to have first-class children parents must be in good physical condition and be controlled mentally. chaotic parents can not have orderly children. the young people learn quickly from their elders and they usually take after one of the parents. they intuitively learn what they can do and what they can not do and how to get their way while we consider them too young to have any understanding. therefore it is important that their first impressions are correct. begin to train the child in the way it should go from the day of birth. the first training will have to do with feeding and sleeping. these points are covered more fully in the next chapter. they are touched upon here to give them emphasis. feed the child three times a day, but never wake it to be fed. if you give the three feeds, the child will soon become accustomed to them and wake when it is time. if the child squirms and frets, it may be uncomfortable from being overfed or it may be thirsty. offer it water but not food. let the child alone. do not bounce it or carry it about. during the first few months the baby needs heat, nourishment and rest, and should have no excitement. it should not be treated as a plaything. after a few months it begins to take notice of things and then you can have much fun with it. the right kind of love consists in doing what is necessary for the infant and no more. obedience to the reasonable requests of the parents is of the greatest importance in the successful raising of children. parents should realize this even before the children are born. from the first, be firm, though gentle, with the little ones. children should be so trained that when they are requested to do a thing, they do it immediately without any repetition. this will save both them and the parents many an unhappy hour. the lives of many parents and many children are made miserable from lack of a little parental firmness at the start. there are many little graces that are not vital, yet they are important, and these should be taught children early, for then they become second nature. among these are good table manners. ungainly table manners have no bearing on the health, but they give an unfavorable impression to others. we are partly judged by the presence or absence of such little graces. training children is like training trees. a sapling can be made to grow in the desired way, but after a few years it will not respond to training. the period of infancy is plastic, and then is the time to plant the seeds in the child's mind and teach good habits. it is not difficult to train the children. if the parents are orderly and firm, instead of wavering, the children almost intuitively fall into line. teach them to obey and they will later be able to command intelligently and considerately. the babies are helpless at first. this softens the hearts of the parents toward them until they become very indulgent. indulging and pampering children are bad for them. kindness consists in doing for them what is for their good, which is not always what they desire. if the children are properly trained at first, they need very little training later on. chapter xxvii. children. statistics are generally very dry and uninteresting, but at times they take on a tragic interest, and the importance of the few submitted here is so great that they should command careful attention. the definite figures used are taken from the mortality statistics, united states census, and they cover the year , which is the last year for which we have definite information. reliable mortality statistics are given only in a part of the country, which is not to our credit. the population is reported in the volume as , , . the registration area, which is the area giving mortality statistics, contains , , people. in this area the total deaths are as follows: under one year.............. , under ten years............. , taking it for granted that the infant and child mortality among the unregistered people is the same, we get the following number of deaths annually among children in the united states, in round numbers: under one year.............. , under ten years............. , this is a very conservative estimate and , is usually given as the number of deaths annually among babies under the age of one year. even under ideal conditions a baby would occasionally die, but the deaths would be so rare that they would be the cause of surprised comment. some become parents who have no right to be, and they bring children into the world who are not physically fit to survive, and these generally die within a few days or weeks of birth. however, these babies are but a small minority and at least ninety-nine out of a hundred should survive. not one baby born physically fit would die if intelligently cared for, and the fact that each year we lose over one-fourth million infants under one year of age in the united states is an indictment of our lives and intelligence, and a challenge to better our ways. every child that is brought into the world should be given an opportunity to live. this is far from the case today. children are so handicapped that they are stunted in body and blunted in mind, if they survive. suppose that every ten years an army of , , men and women between the ages of twenty and thirty were destroyed at one time in this country! the indignation, sorrow and horror would be so great that a means would soon be found to end the periodic slaughter. but we allow this many children under ten to be destroyed every ten years. the slaughter of the innocents does not bring forth much protest, because we are so used to it, and the babies go one by one, all over the country. the procession to the grave gives rise to this thought: "the little one is better off. now he will suffer no more. it is the will of providence." this is a libel on providence, for this enormous mortality is due to parental mistakes, mistakes made mostly through ignorance, but blamable all the same. it behooves parents to obtain knowledge that will prevent such costly and fatal errors. nature's law is the same as man's rule in this that ignorance of the law excuses no one. the results are the same whether we err knowingly or ignorantly. it is difficult to teach people to treat their babies properly, because nearly all the information on the subject is so erroneous. when a teacher brings forth the truth but few accept it, for the vast majority are on the other side. those parents who accept the truth find it difficult, to put it into practice, for every hand is against them. it takes more strength of character and moral courage than the average individual possesses to withstand the criticism of neighbors, friends, relatives and medical advisers. the few who have the courage of their convictions and the right knowledge reap a rich harvest. they have babies who are well. they see their children grow up with sound bodies and clear minds. they are saved much of the worry which is the lot of parents of children raised according to conventional standards. last, but by no means least, they have the satisfaction of giving to the race individuals who are better than their parents or the grandparents. there is much opportunity for human improvement, and the improvement will take place automatically, if we do not prevent it by going contrary to nature. healthy babies spring from normal, healthy parents. if they can have normal grandparents, so much the better, but inasmuch as we can not alter the past, let us give our attention to the present. if we take care of the present, the future will bring forth a population of healthy parents and grandparents, and then the babies will have full opportunity. the past has great influence, for the child of today is heir of the past, modified by the present. he who influences the present leaves his mark on the future. as individuals we do not usually accomplish much during a lifetime, but if we influence our time for the better it is hard to tell where the improvement will cease or what will be the aggregate result. a truth imparted to others acts much like a pebble cast into the water. its influence is felt in ever widening circles. infancy and youth are plastic. both body and mind are susceptible to surrounding influences. if the heredity is unfavorable it can be largely modified by favorable environments. if a child is born of unhealthy parents, but without any serious defect, and is intelligently cared for after birth, it will grow up to be healthy. on the other hand, a child born of healthy parents that is improperly cared for will become ill and perhaps die young. in early years the habits are formed that will largely influence and control the years of maturity. most children learn bad habits from birth. it is as easy to acquire good habits as bad ones, and as people are largely creatures of habits, every parent should aim to give his children a good start. parents seldom do wrong intentionally, but they are careless and many of the parental habits of the race are bad, and for this the future generations must suffer. it is easier and more economical to have healthy babies than to have sickly ones. the healthy way is the simple way. it merely means self-control, common sense and constructive knowledge on the part of the parents. prenatal care. it is commonly believed that a pregnant woman must eat for two. the wise woman will not increase her food intake. if she is not up to par physically at the time of conception she will generally find it advantageous to decrease the food allowance. a healthy baby should not weigh to exceed six, or at most seven, pounds at birth. five pounds would be better. it does not take much food to nourish an infant of that weight, and the baby does not weigh that much until shortly before birth. most of the food is used for fuel but the amount of fuel required to heat a baby that is kept warm within the mother's body is almost negligible. one of the first and most important requisites for having healthy children is to avoid the eating-for-two fallacy. most people overeat, anyway, and there should be no encouragement in this line. the results of overeating are many and serious. the mother grows too heavy or else she becomes dyspeptic. overeating and partaking of food of poor quality are the chief causes of the ills of pregnancy. prospective mothers can be comfortable. pregnancy and childbirth are physiological. normal women suffer very little inconvenience or pain. the suffering during pregnancy, the pain and accidents at childbirth are measures of the mother's abnormality. the greater the inconvenience the farther has the individual strayed from a natural life. the women who live normally from the time of conception, or before, until the birth of the baby will be surprised how little inconvenience there is. for ideal results the father must be kind, considerate and self-controlled. it is a disagreeable fact that many men are brutal and inconsiderate of wives and unborn children. the extent of this brutality can hardly be realized by those who have had no medical experience. perhaps the women are partly to blame, for they do not teach their boys to be considerate and kind and they leave them in ignorance of subjects that are important and that can best be taught by parents. a pregnant woman should be mistress of her body. during this period the husband has morally no marital rights. if boys were educated by their parents on this subject they would be reasonable later on, and the average boy of fourteen or fifteen is old enough to receive such education. gestation should be a period of calm. all excitement and passion are harmful. the mother should be as free from annoyance as possible. cheerfulness should be the rule. those who are not naturally cheerful should cultivate this desirable state of mind. gruesome and horrible topics should not be discussed. the reading should not be along tragic lines. the study of nature and the philosophy of men who have found life sweet are among the helpful mental occupations. the mental attitude has its effect, not only on the mother, but on the unborn babe. that the seed for good or evil is often planted in the child's brain before birth, according to the mental and physical condition of the mother, can hardly be doubted. mothers who live naturally can dismiss all worry on the subject of harm coming to themselves through maternity, for there will be none. the absence of worry has a good effect on both mother and child. the various ills from which mothers suffer are largely caused by eating for two. the overeating causes overweight in those whose nutrition is above par and indigestion in those who have but ordinary digestive capacity. those who are overweight have too high blood pressure and those who have indigestion absorb some of the poisonous products of decomposition from the bowels. headache is a common result. palpitation of the heart comes from gas pressure. the abnormal blood pressure may result in albuminurea, swelling of the lower extremities and overweight of both mother and child. the morning sickness is nearly always due to excessive food intake. if this proves troublesome, reduce the amount of food and simplify the combinations. instead of taking heavy, rich dishes, increase the amount of fresh fruits and vegetables. the birth of a large baby is fraught with danger to mother and child. sometimes one or both are injured and sometimes one or both die. many women are afraid to become mothers for this reason. it would be difficult to estimate how often this fear causes law breaking, for all large cities have their medical men who grow rich through illegal practices among these women. sometimes these doctors are among the respected members of the profession, eminent enough to have a national reputation. the financial reward is great enough to tempt men to break the law and they will continue to do so, so long as present conditions exist. it is important for the prospective mother to be moderate in her eating. three meals a day are sufficient. between meals nothing but water should be swallowed. lunching always leads to overeating. one meal each day can consist of starchy food, but not more than one meal. any one of the starches may be selected, the cereal products, rice, potatoes, chestnuts. if the digestion is good, take matured beans, peas or lentils occasionally, but these are so heavy that they should not be eaten very frequently and always in moderation. with the starchy food selected, take either butter or milk, or a moderate quantity of both. sometimes it is all right to take some fruit with the starchy food, but this should be the exception, not the rule. fruit should generally be eaten by itself or taken with non-starchy foods. starch eating should be limited to one meal a day because an excessive amount of this food causes hardening of the tissues. the baby's bones, which should be very soft, flexible and yielding at birth, will become too hard if much starch is eaten. once a day some kind of proteid food may be taken, but this should also be eaten in moderation, for if it is not, degenerative changes will take place, which will manifest in some one of the disorders common to pregnancy. eggs and the lighter kinds of meats, or nuts or fresh fish may be selected. whatever kind of protein is taken, it should be as fresh as possible. pork should not be used. with the protein, have either fruit or vegetables, and it does not make much difference which. no one could ask for a better meal than good apples and pecans. be sure to eat enough of the raw salad vegetables and of raw fruits to supply the salts needed by the body. for the third meal have fruit. cottage cheese, sweet or clabbered milk or buttermilk may be taken with the fruit. do not take milk twice a day, for if it is taken twice and other proteid food once a day, too much protein is ingested. a glass or two of buttermilk will make a good meal at any time. dr. waugh, who has had over forty years of experience and is well and favorably known on both sides of the atlantic, recommends buttermilk very highly during pregnancy. buttermilk and clabbered milk are better than the sweet milk. the lactic acid seems to have a sweetening effect on the alimentary tract. sweet milk is constipating for many people. the buttermilk and the clabbered milk are not constipating to the same degree. the use of fruit and vegetables has a tendency to prevent constipation. the only internal remedies for which there is any excuse are cathartics, and normal people do not need them. however, it is better to take a mild cathartic or an enema than to allow the colon to become loaded with waste. constipation among eaters of much meat is rather a serious condition, for the waste in the colon of heavy meat eaters is very poisonous. the colonic waste in vegetarians is not so toxic. desserts should be used sparingly and seldom. they are not a necessity, but a habit, and if they are consumed daily they are a bad habit. for the sake of the unborn child, avoid all stimulants and narcotics. alcoholics and coffee should not be used. and it is best to avoid strong spices and rich gravies. a little self-denial and self-control in this line will pay great dividends in healthy, happy, contented babies, and there are no greater blessings. the mother should be active, but should not take any violent exercise. light work is good, but no mother should be asked to do house-cleaning or to stand over the wash-tub. she should have the opportunity of being in the open every day, and of this opportunity she should avail herself. why some women are ashamed of pregnancy is hard for normal-minded people to understand, for the praise of motherhood has been sung by the greatest poets and its glory depicted by the greatest painters of the world. this sense of false modesty is responsible for much of the tight lacing during pregnancy. this is injurious to both the mother and the child, and is one of the reasons for various uncomfortable sensations. it helps to bring on the morning sickness. it is nature's intention that the young should be free and comfortable previous to birth, and for this reason a double bag is supplied between the walls of which there is fluid. the baby lies within the inner bag. the tight lacing prevents the intended freedom, besides weakening the mother's muscles. it also aggravates any tendency there may be toward constipation and swelling of the legs. it prolongs childbirth and makes it more painful. this is too high a price to pay for false modesty and vanity. if it is necessary to support the abdomen and the breasts for the sake of comfort, this can be done without compressing them and the support should come from the shoulders. the skin should be given good attention, for an active skin helps to keep the blood pure and the circulation normal. take a vigorous dry rubbing at least once a day, and twice a day would be better. a quick sponging off with cool water followed with vigorous dry rubbing is good, but the rubbing is of greater importance than the sponging. an olive oil rub is often soothing and may be taken as frequently as desired. if there is a tendency to be ill and nervous, take a good hot bath, staying in the water until there is a feeling of ease, even if it should take more than thirty minutes, provided the heart and the kidneys are working well. defective heart and kidney action contraindicate prolonged hot baths, but such ills will not appear if the mother lives properly. under such conditions missing a few meals can only have good results. when eating is resumed, partake of only enough food to nourish the body, for anything beyond that builds discomfort and disease. these hints, simple as they are, contain enough information to rob gestation and childbirth of their horrors, if they are intelligently observed. if civilized woman desires to be as painfree as the savage, she must lead the simple life. infancy. if the baby lives to be one year old, its chances of surviving are fairly good, but during the first year the mortality is appalling. complete statistics are not available, but in places one-fifth or even one-fourth of the babies born perish during this time. the mortality is chiefly due to overfeeding and giving food of poor quality. the average parent loves his baby. he loves the helpless little thing to death. in oscar wilde's words, "we kill the thing we love." the babies are killed by too much love, which takes the form of overindulgence. about thirty years ago the well known physician, charles b. page, wrote: "how many healthy-born infants die before their first year is reached--babies that for months are mistakenly regarded as pictures of health--'never knew a sick day until they were attacked' with cholera infantum, scarletina, or something else. they are crammed with food, made gross with fat, and for a time are active and cunning, the delight of parents and friends--and then, after a season of constipation, a season of chronic vomiting, and a season of cholera infantum, the little emaciated skeletons are buried in the ground away from the sight of those who have literally loved them to death. this is the fate of one-third of all the children born. as a rule, babies are fed as an ignorant servant feeds the cook-stove--filling the fire-box so full, often, that the covers are raised, the stove smokes and gases at every hole, and the fire is either put out altogether, or, if there is combustion of the whole body of coals, the stove is rapidly burned out and destroyed. with baby, overheating means the fever that consumes him, and, in putting out the fire, too often the fire of life goes out also." fat babies are thought to be healthy babies. this is a mistake, for the fatter the baby, the more liable it is to fill an early grave. thoughtful, knowing people realize that a child that weighs eight pounds or more at birth is an indication of maternal law breaking. both the mother and the child will have to pay for this sooner or later. overweight is a handicap. it prevents complete internal cleansing and combustion, without which health is impossible. because of the false ideas prevalent regarding weight of infants, it is well to put a little emphasis on the subject. if the mother has lived right during pregnancy, the child is often light at birth, sometimes five pounds or less. the average doctor will shake his head and say that the baby's chance to live is very small. the friends, neighbors and relatives will say the same. they are wrong. let the parents remember that light children are not encumbered with fat, and rarely with disease. a light baby is generally all healthy baby, and if properly cared for and not overfed will thrive. parents of such babies should be thankful, instead of being alarmed. it is not natural for babies to weigh nine or ten pounds at birth, and when they do it is a sign of maternal wrong doing, whether she has been cognizant of it or not. babies should not be fat, nor should they be fat when they grow older, if the best results are desired. in babies it is better to strive for quality than for quantity. every mother who is capable of doing so should nurse her baby. there is no food to take the place of the mother's milk. the babies build greater strength and resistance when they are fed naturally than when they are brought up on the bottle. babies thrive wonderfully in an atmosphere of love, and they draw love from the mother's breast with every swallow. from the information available, which is not as complete and definite as could be desired, it appears that from six to thirteen bottle-babies die during the first year where only one breast-fed child perishes. the bottle-baby does not get a fair start. if a mother is ill and worn out she should not be asked to nurse the baby. if the mother has fever she should not risk the baby's health through nursing. some mothers do not have enough milk to feed the baby. nearly all who live properly give enough milk to nourish their infants at first. if there is not enough milk, the child should be allowed to take what there is in the breasts and this should be supplemented with cow's milk. dr. thomas f. harrington said recently: "from to per cent. of all deaths from gastrointestinal disease among infants takes place in the artificially fed; or ten bottle-babies die to one which is breast-fed. in institutions it has been found that the death rate is frequently from to per cent. when babies are separated from their mothers. during the siege of paris ( - ) the women were compelled to nurse their own babies on account of the absence of cow's milk. infant mortality under one year fell from to per cent. during the cotton famine of women were not at work in the mills. they nursed their babies and one-half of the infant mortality disappeared." these are remarkable facts and bring home at least two truths. first, they confirm the superiority of natural feeding over that of artificial feeding. second, they show that when the mother is not overfed the infants are healthier. during the siege of paris food was scarce in that city. people of all classes had to live quite frugally. they could not overeat as in the untroubled time of peace and prosperity, and the result was that both the mothers and the babies were healthier. the infant mortality was only a little over one-fifth of what it was previously. if the french people had heeded the lesson the statesmen and philosophers of that nation would not today have to worry about its almost stationary population. it would be much better if fewer children were born and those few were healthier. what good does the birth of the army of , children which perishes annually accomplish? it leaves the nation poorer in every way. a mother tired and worn with wakeful vigils, and at last left with an aching heart through the loss of her child, is not worth as much as she who has a crooning infant to love, and through her mother-love radiates kindness and good cheer to others. the conditions that weed out so many of our infants tend to weaken the survivors. it costs too much to bring children into the world to waste them so lavishly. this may sound peculiar, but it is enlightened selfishness, which is the highest good, for it brings blessings upon all. artificial feeding lays the foundation for many troubles which may not manifest for several years. the bottle-fed babies are often plump, even fat, but they are not as strong as those who are fed naturally. they take all kinds of children's diseases very quickly. the glandular system, which is so readily disturbed in children, is more easily affected in bottle-fed babies. and so it comes about that they often have swollen salivary glands, or swelling of the glands of the neck or of the tonsils. do not be in a hurry to feed the baby after birth. nature has so arranged that the infant does not require immediate feeding. it is a good plan to wait at least twenty-four hours after birth before placing the baby at the breast, for then all the tumult and excitement have had a chance to subside. many give the baby a cathartic within a few hours after birth. this is a mistake. cathartics are irritants and it is a very poor beginning to abuse the mucous membrane of the intestinal tract immediately. this mucous membrane is delicate and in children the digestive apparatus is easily upset. before birth there was no stomach or bowel digestion, all the nutritive processes taking place in the tissues of the little body. gentle treatment is necessary to bring the best results. cathartics with their harsh action on the delicate membranes are contraindicated. the mother's first milk is cathartic enough to stimulate the bowels to act, but it is nature's cathartic and does no harm. as a rule the baby is fed too often and too much from the time of birth. if the child appears healthy the physician's recommendation will probably be to feed every two hours day and night, or every two hours during the day and every three hours at night. if the little one appears weakly these feedings are increased in number. from ten to twenty-four feedings in twenty-four hours are not uncommon and sometimes infants are nursed or given the bottle two and even three times an hour. the excuse for this is that the baby's stomach is small and cannot hold much food at a time and must for this reason be filled often, for the baby has to grow, and the more food it gets the faster it grows. the baby's stomach is small, because the little one needs very little food. the human being grows and develops for twenty to twenty-five years. this growth is slow and during babyhood the amount of nourishment needed is not great. the child, if properly taken care of, is kept warm. hence it needs but little fuel. the ideas on food needs are so exaggerated that it is hard for parents to realize what moderate amount of food will keep a baby well nourished. an adult in the best of health would be unable to stand such frequent food intake. he would be ill in a short time. babies stand it no better, and the only proof of this fact needed is that in the united states at least , babies under one year of age perish annually. during babyhood nearly all troubles are nutritive ones. with the stomach and bowels in excellent condition baby defies all kinds of diseases, provided it is given the simple, commonsense attentions needed otherwise, such as being kept warm and clean in a well ventilated room. with a healthy alimentary canal, which comes with proper feeding, the little one can withstand the attack of the vast horde of germs which so trouble adult minds, also adult bodies, when people fail to give themselves proper care. the results of too frequent feeding and overfeeding are appalling. the first ill effect is digestive disturbance. then one or more of the ills of childhood make their appearance. these are called diseases, but they are only symptoms of perverted nutrition, though we insist on giving them names. a healthy baby is one that is absolutely normal and well in every way. however, babies today pass for healthy when they are fat and suffering from all kinds of troubles, provided these ills can be tolerated. we need a new standard of health. perfect health is a gift that every normal parent can bestow upon his children, and we should be satisfied with nothing short of this. babies can and should be raised without illness, but, sad to relate, babies, who are always healthy are so rare that they are curiosities. many babies show signs of maternal overfeeding within a few hours or days of birth. one of the common signs is the discharge from the nose. this is aggravated by overfeeding the infant. and thus is laid the foundation, perhaps, for a lifelong catarrh. in due time various diseases such as rickets, swollen glands, formerly called scrofulous, mumps, measles, scarlet fever, diphtheria, pimples, eczema and cholera infantum, make their appearance. parents have been taught to look for these diseases. they have been told that they belong to childhood. this is a libel on nature, for she tends in the direction of health. the prevalent idea at present is that various germs, which are found in water, food, air and earth, are responsible for these diseases, but they are not. the fact that infants properly cared for do not develop one of them is proof enough that germs per se are unable to cause these ills. the germs play their part in most of these diseases, but it is a kindly part. they are scavengers, and attempt to rid the body of its debris and poisons. through false reasoning they are blamed for causing disease, when in fact their multiplication is an effect. they are a by-product of disease. the so-called pathogenic bacteria never thrive in the baby's body until the infant has been overfed or fed on improper food long enough to break down its resistance. the improper feeding not only kills an army of babies each year, but it handicaps the survivors very seriously. the degenerated condition of the system leaves every child with some kind of weakness. the foundation may be laid for indigestion, catarrhal troubles, which may or may not be accompanied with adenoids and impeded breathing, glandular troubles, often precursors of tuberculosis, in fact children may be acquiring any disease during infancy from chronic catarrh to rheumatism. mental ills are also results of senseless feeding. a healthy baby is happy. a sick baby is cross. crossness and anger are mental perversions. anger is temporary insanity. enough overfeeding often results in mental perversity, epilepsy and even in real insanity. a healthy body gives a healthy mind. if people would care for their bodies properly, especially in the line of eating, the asylums for the insane would not be needed for their present purposes. another serious trouble that takes root from infant overfeeding is an abnormal craving for stimulants. this craving may later on be satisfied in many ways. some use coffee, alcohol, habit-forming drugs. others try to satisfy it by overeating. no matter how the sufferer proceeds to satisfy this craving, he does not cure it, for it grows upon what it is fed. morphine calls for more morphine. tobacco calls for more tobacco. an oversupply of food calls for more food or alcohol. the victim at last dies a martyr to his abnormal appetites. comparatively few of those who see the error of their ways have the will power to thrust off the shackles of habit. very few think clearly enough and go far enough back to realize that disease and early death are so largely due to the habits formed for the infant or unborn babe by the parents. and the parents received the same kind of undesirable legacy from their parents, and so it goes, the children suffering for the sins of the parents. the cheerful part of such a retrospect is that there is much room for improvement, that we need not continue this seemingly unending chain of physical bondage to the next generation, and that if the children are not born right or treated right during infancy, there is still time to make a change for the better. nature is kind and with will and determination a change can be made at any time that will result in betterment, provided such grave diseases have not taken hold of the body that recuperation is impossible. this is no excuse for making delays, for the longer errors are permitted the harder they are to overcome. three or four feedings a day are sufficient for any baby. the feedings should be arranged so that they are evenly distributed during the day, and nothing is to be given at night except water. get a nursing bottle or two. keep the bottles and the nipples scrupulously clean. these are to be used as water bottles. the water must also be clean. heat it to or degrees fahrenheit, so that it will be from to degrees warm when it enters the baby's mouth let the baby have some water three or four times during the day, and perhaps it will want some once or twice during the night, but give it no milk at night. overfed babies are irritable and cry often. the mothers interpret this as a sign of hunger. most babies do not know what hunger is. like adults they become thirsty, but instead of getting water to quench their thirst they are given milk. this satisfies for a little while, then the irritability due to milk spoiled, in the alimentary tract causes more restlessness and crying, and they are fed again. the comedy of errors continues until it is turned into a tragedy. how much should the baby be fed at a time? when the parents are healthy and the baby is born right and then fed but three times a day, the food intake will regulate itself. the child will not usually want more than it should have of milk, supplemented with water. the best way to begin is to let the infant take what it desires. that is, let the nursing continue while the infant manifests great pleasure and zest. when the child begins to fool with the breast or bottle, the source of nourishment should be removed immediately. the child will increase its intake gradually. some of the babies will take too much. the evil results will soon be evident, and then the mother must not compromise, but reduce the intake at once. the signs of over-consumption of food by the infants are the same as those shown by adults. they are discomfort and disease. the former manifests in crossness and irritability. the disease may be of any kind, ranging from a rash to a high fever. the baby's stomach is sensitive and resents the excessive amount of food supplied. so the infant often vomits curdled milk, and some times vomits before the milk has time to curdle. this is a form of self-protection. if the mother would heed this sign by withdrawing all food until the stomach is settled, substituting water in the meanwhile, and then reduce the baby's food to within digestive capacity, there would be no more trouble. vomiting is the infant's way of saying, "please do not feed me until my stomach becomes normal again, and then don't give me more than i need, and that is less than i have been getting." remember that it is nature's sign language, which never misleads, and it is so plain that any one with ordinary understanding should get its meaning, in spite of the erroneous popular teachings. after the child has vomited, feed moderately and increase its food supply as its digestive ability increases. if the vomiting is wrongly interpreted and overfeeding is continued, either the baby dies or the stomach establishes a toleration, passing the trouble on to other parts of the body. one organ never suffers long alone. the circulation passes the disease on to other parts, assisted by the sympathetic nerves, which are present in all parts of the body. when the stomach has established its toleration, several things may happen, only a few of which will be discussed, for the process is essentially the same, though the results appear so different. in infants whose digestive power is not very strong the excessive amount of milk curdles, as does the part that is digested. the water of the milk is absorbed, but the curds pass into the colon without being digested and they are discharged in the stool as curds. they are partly decomposed on the journey through the alimentary canal, producing poisons, a part of which is absorbed. a part remains in the colon, making the bowel discharges very offensive. the passage of curds in the stool is a danger signal indicating overfeeding and should be heeded immediately. if it is not, the chances for a ease of cholera infantum, especially in warm weather, are great. cholera infantum is due to overfeeding, or the use of inferior milk, or both. it is a form of milk poisoning, in which the bowels are very irritable. as a matter of self-protection they throw out a large quantity of serum, which soon depletes the system of the poor little sufferer, and death too often claims another young life. if cholera infantum makes its appearance the baby is given its best chance to live if feeding is stopped immediately, warm water given whenever desired, but not too large quantities at a time. give no cathartics, for they irritate an already seriously disturbed mucous membrane, but give a small enema of blood-warm water once or twice a day. keep the baby comfortable, seeing that the feet and abdomen are kept warm, but give plenty of fresh air. medicines only aggravate a malady that is already serious enough. this disease is produced by abuse so grave that in spite of the best nursing, the baby often dies. it is easily prevented. strong babies with great digestive power are often able to digest and assimilate enormous quantities of milk, several quarts a day. they can not use all this food. if they could their size would be enormous within a short time. they do not find it so easy to excrete the excess as to assimilate it. the skin, kidneys, lungs and the bowels find themselves overtaxed. often the mucous membrane of the nose and throat are called upon to assist in the elimination. these are the babies who are said to catch cold easily. their colds are not caught. they are fed to them. this constant abuse of the mucous membrane results in inflammation, subacute in nature, or it may be so mild that it is but an irritation. the result in time may be chronic catarrh or thickening of the mucous membrane of nose and throat. while the catarrh is being firmly established adenoids are quite common. in other cases too much of the work of excretion is thrown upon the skin. the same thing happens to this structure as happens to the mucous membrane. it is made for a limited amount of excretion and when more foreign matter, much of it of a very irritating nature, is deposited for elimination through the skin, it becomes inflamed. it itches. in a little while there is an attack of eczema. the baby scratches, digging its little nails in with a will. the infant soon has its face covered with sores and the scalp is scaly. the proper thing to do is to reduce the feeding greatly. then the acid-producing fermentation in stomach and bowels will cease, but enough food to nourish the body will be absorbed, the skin will have but its normal work to perform, the cause of the irritation is gone and the effects will disappear in a short time. two weeks are often sufficient to bring back the smooth, soft skin that every baby should have. the sufferers from these troubles are almost invariably overweight, and the parents wonder why their babies, who are so healthy, should be troubled thus! mothers owe it to their nursing babies to lead wholesome, simple lives. it is not always possible to live ideally, but every mother can eat simply and control her temper. wholesome food and equanimity will go far toward producing healthful nourishment for the child. stimulants and narcotics should be avoided. meat should not be eaten more than once a day, and it would be better to use less meat and more eggs or nuts. fresh fruits and vegetables should be partaken of daily. they are the rejuvenators and purifiers. the cereal foods should be as near natural as possible. the bread should be made of whole wheat flour mostly. if rice is eaten it should be unpolished. refined sugar should be taken in moderation, if at all. the potatoes are best baked. pure milk is as good for the mother as it is for the child. highly seasoned foods or rich made dishes should be avoided. in short, the mother should live as near naturally as possible. the importance of cheerfulness can hardly be overestimated. a nervous mother who frets or worries, or becomes mastered by any of the negative, depressing passions, poisons her babe a little with each drop of milk the child takes. some mothers are unable to nurse their babies. this is so because of lack of knowledge principally, for women who give themselves proper care are nearly always able to furnish nourishment for their infants. it may be that this function will be largely lost if the present preponderance of artificial feeding continues, and if various inoculations are not stopped. some mothers find it a great pleasure to nurse their babies. others refuse to do so for fear of ruining their figures. no matter what the reason is for depriving the infant of its natural food, the parents should realize that its chances for health and life are diminished by this act. if intelligence and care are used in raising the bottle-fed babies only a few will die, in fact none will die under the circumstances, provided they were born with a normal amount of resistance. so it behooves parents of such babies to be extremely careful. that there are difficulties in the way, or rather inconveniences, can not be denied, but there are no insurmountable obstacles. the best common substitute for mother's milk is cow's milk. if clean and given in moderation it will agree with the child and produce no untoward results. instead of using the same bottle all the time, there should be a number, so that there will be plenty of time to clean them. if three feeds are given each day, there should be six bottles. if four feeds are given, eight bottles. use a set every other day. the bottles should be rinsed out after being used. then boil them in water containing soda or a little lye, rinse in several waters and set them aside. if it is sunny, let them stand in the sun. before using, rinse again in sterile water. the nipples should have equally good care. in feeding babies cleanliness comes before godliness. each bottle is to be used for but one feeding, and as many bottles are to be prepared as there are to be feedings for the day. if the people live in the country it is easy to get pure milk. if in the city one should make arrangements with a reliable milk man possessed of a conscience. it is well to get the milk from a certain cow, instead of taking a mixture coming from many cows. select a healthy animal that does not give very rich milk, such as the holstein. she should have what green food she wants every day, grass in summer, and hay of the best quality and silage in winter. the grain ration should be moderate, for cows that are forced undergo quick degeneration. they are burned out. the cow should not be worried or whipped. she should be allowed to be happy, and animals are happy if they are treated properly. the water supply should be clean, not from one of the filthy tubs or troughs which disgrace some farms. the barn should be light and well ventilated. it should be kept clean and free from the ammonia fumes which are found in filthy stables. the cow should be brushed and the udder washed before each milking. the milker should wash his hands and have on clothes from which no impurities will fall. the first part of the milk drawn should not be put in with that which is to supply the baby. the milk should be drawn into a clean receptacle and immediately strained through sterile surgeon's cotton into glass bottles. these are to be put aside to cool, the contents not exposed to the dust falling from the air. or the milk may be put directly into the nursing bottles and put aside in a cold place until needed. then warm milk to degrees fahrenheit. pardon a little repetition: if possible let the child nurse. if there is not enough milk, let the baby take what there is and give cow's milk in addition. if it is impossible to feed the baby at the breast, get the milk from a healthy cow that is kept clean, well fed and well treated. the cow's milk should be prepared as follows: take equal parts of milk and water. or take two parts of milk and one part of water. mix, and to this may be added sugar of milk in the proportion of one level teaspoonful to the quart. before feeding raise the temperature of the milk to about degrees fahrenheit, so that it will be about degrees when fed. it is best to do the warming in a water bath. milk should not be kept long before being used. limit the age to thirty-six hours after being drawn from the cow. twenty-four hours would be better. the evening milk can safely be given to the infant the next day, if proper precautions have been taken. ordinary milk is quite filthy and upon this babies do not thrive. make an effort to get clean milk for the baby. the composition of human milk and cow's milk is about as follows: ==================================================================== water albumin fat sugar salts -------------------------------------------------------------------- human .......... . . . . . cow's .......... . . . . . -------------------------------------------------------------------- the albumin in human milk is largely of a kind which is not coagulated by souring, while nearly all the albumin in cow's milk coagulates. the uncoagulated albumin is digested and taken up more easily by the baby's nutritive system than that which is coagulated. this is one of the reasons that babies do not thrive so well on cow's milk as on their natural food. the sugar of milk is not like refined sugar. although it is not so easily dissolved in water, and therefore does not taste as sweet as refined sugar, it is better for the child. if sugar is added to the milk, milk sugar should be used. the druggists have it in powder form. the addition of barley water and lime to the baby's milk is folly. the various forms of modified milk do not give as good results as the addition of water and a little milk sugar, as previously described. if you believe in such modifications as the top milk method and the addition of starchy substances and lime water, i refer you to your family physician or text-books on infant feeding. it is difficult to improve on good cow's milk. it is well to remember that the human organism is very adaptable, even in infancy. the principal factors in infant feeding are cleanliness and moderation. bottle-fed babies should be given fruit or vegetable juices, or both, very early and it would be well to give a little of these juices to breast-fed babies too. the latter do not require as much as the former. begin during the first month with a teaspoonful of orange juice put into the drinking bottle once a day. increase gradually until at four or five months the amount may be from one to two tablespoonfuls. do not be afraid to give the orange juice because it is acid, for it splits up quickly in the stomach and is rearranged, forming alkaline salts. it is the fruit that can be obtained at nearly all seasons. it is best to get mild oranges and strain the juice. the fruit is to be in prime condition. instead of orange juice, the juice of raw celery, spinach, cabbage, apples, blackberries and other juicy fruits and vegetables may be employed, but these juices must all come from fruits or vegetables that are in prime condition. no sugar is to be added to either the fruit or the vegetable juices. the mother's milk coagulates in small flakes, easily acted upon by the digestive juices, after which they are readily absorbed. cow's milk coagulates into rather large pieces of albumin which are tough and therefore rather difficult to digest. this happens when the milk is taken rapidly and undiluted. however, when diluted and taken slowly this tendency is overcome to a great degree. for this reason it is best to get nipples with small perforations. either pasteurization or sterilization of milk is almost universally recommended by medical men. even those who do not believe in such procedures generally fail to condemn them without qualifying statements. for a discussion of this fallacy i refer you to the chapter on milk. do not give the little ones any kinds of medicines. they always do harm and never any good. if any exception is made to this, it is in the line of laxatives or mild cathartics, such as small doses of castor oil, cascara segrada or mineral waters, but there is no excuse for giving metallic remedies, such as calomel. if the babies are fed in moderation on good foods they will not become constipated. if they are imprudently handled and become constipated it is necessary to resort to either the enema or some mild cathartic. bear in mind that such remedies do not cure. they only relieve. the cure will come when the errors of life are corrected so that the body is able to perform its work without being obstructed. inoculations and vaccinations are serious blunders, often fatal. the animal products that are rubbed or injected into the little body are poisonous. they are the result of degenerative changes--diseases--in the bodies of rabbits, horses, cows and other animals. nature's law is that health must be deserved or earned. health means cleanliness, so it really is absurd to force into the body these products of animal decay. statistics can be given, showing how beneficial these agents are, but they are misleading. in the days of public and official belief in witchcraft it was not difficult to prove the undoubted existence of witches. whatever the public accepts as true can with the utmost ease be bolstered up with figures. the use of serums, bacterins, vaccines and other products of the biologic laboratory is almost an obsession today. their curative and preventive values are taken for granted. most of the time the children are strong enough to throw off the poisons without showing prolonged or pronounced effects, but every once in a while a child is so poisoned that it takes months for it to regain health and too often death is the end. sometimes the death takes place a few minutes after the injection, but we are informed that the medication had nothing to do with it. to poison the baby's blood deliberately is criminal. give the little one a fair chance to live in health. a properly cared for baby will not be ill for one single day. knowledge and good care will prevent sickness. a baby that is able to remain well a month or a week or a day can remain well every day. at first a normal baby sleeps nearly all the time, from twenty to twenty-two hours a day. the infant should not be disturbed. all that should be done for it is to feed it three times a day, give it some water from the bottle three or four times a day, and keep it clean, dry and warm, but not hot. most babies are bathed daily. this is all right, but the baths are to be given quickly. the water should be about degrees fahrenheit. the soap should be of the mildest, such as a good grade of castile, and it should be well rinsed off, for soap permitted to remain in the pores acts as an irritant. dry the skin so well with a soft cloth that there will be no chapping or roughness. sores, eruptions and inflammations are signs of mismanagement. use no powders that are metallic in character, such as zinc oxide. a dusting powder of finely ground talcum is good. if the child is kept dry and dean and moderately fed the skin will remain in good condition. babies do not thrive without good air. keep the room well ventilated at all times by admitting fresh air from a source that will produce no draughts. it is not necessary to have the baby's room warm. in fact a cool room is better. when the child is to be exposed to the air, take it into a warm room. soft coverings will keep the infant warm. the limbs should be free so that exercise can be had through unrestricted movements. the baby should not be bothered unnecessarily. young parents make the mistake of using the baby for show purposes. for the sake of politeness, others praise the "only baby in the world" unduly, though there are millions of others just as good. let the child alone, thus giving it an opportunity to become as superior as the parents think it is. the showing off process creates excitement and lays the foundation for fretfulness, irritability and nervousness. the child thrives in a peaceful atmosphere. when it is awake it is well to talk to it quietly and soothingly, for thus the infant begins to learn its mother's tongue. good language should be employed. those who teach their children baby-talk are handicapping them, for they will soon have to unlearn this and learn real language. baby-talk may be "cute" at eighteen months, but when children retain that mode of expression beyond the age of four or five it sounds silly. at about the age of nine or ten months the breast-fed babe should be weaned. gradual weaning is perhaps the best. first give one feeding of cow's milk a day and two breast feeds; then two feedings of cow's milk and one at the breast, and at last cow's milk entirely. between the ages of nine and twelve months begin giving starchy foods. at first the child will take very little, and gradually increase. give bread so stale that the child has to soak it with its saliva before it can swallow the bread. working away this way, sucking the stale bread, the child learns to go through the motions of chewing, and this is valuable training. never give bread soaked in milk and never feed milk while bread is being eaten. if the meal is to be bread and milk, give the bread either before any milk is taken, or afterwards. starches are not to be washed down with liquids. instead of giving stale bread, zwieback may be used. occasionally feed a few spoons of very thin and well cooked oatmeal or whole wheat gruel, but the less sloppy food given the better, for it does not get the proper mouth treatment. the wheat products fed the child should be made from whole wheat flour, or at least three-fourths whole wheat and only one-fourth of the white flour. the refined flour is lacking in the salts that the child needs for health and growth. many mothers begin feeding starches when the baby is four or five months old. the child is given potatoes, bread or any other starchy food that may be on the table. this is a mistake, for the child is not prepared to digest starches at that early age. some of the digestive ferments are practically absent during the first few months of life. such feeding will invariably cause trouble. the baby should not be taken to the table. it is quite generally believed that a baby should cry to exercise its lungs. a healthy, comfortable baby will do little or no crying, and it is not necessary. it is not difficult to give the little ones some exercise to fill their lungs. babies can hang on to a finger or a thin rod tenaciously. elevate the infant that does not cry thus a few times above the bed and let it hang for a few seconds each time. this throws the chest forward and exercises the lungs. what is more, this small amount of gymnastic work is thoroughly enjoyed. it helps to build strength and good temper. the crying helps to make the baby ill-tempered and fretful. a little crying now and then is all right, but much indicates discomfort, disease or a spoiled child. it would surprise most mothers how good babies are when they have a chance to be good. after reading this, some are sure to ask how many ounces to feed the baby. i don't know. no one else knows. different babies have different requirements. the key is given above. if the babies become ill it is nearly always due to overfeeding and poor food, so the proper thing to do is to reduce the food intake. a healthy baby is a source of unending joy, while a sick one saps the mother's vitality. it is too bad that the art of efficient child culture is so little known. childhood. children may roughly be divided into two types, the robust and the more delicate or nervous ones. the robust children can stand almost all kinds of abuse with no apparent harm resulting, but the immunity is only apparent. the growing child naturally throws off disease influences easily and quickly, but if the handicap is too great the child loses out in the race. the nervous type can not be abused with impunity, for the bodies of these delicately balanced children are easily disturbed. they must have more intelligent care than is usually bestowed upon the robust type. if the care is not forthcoming they become weak in body, with an unstable nervous system, or perish early. some parents complain because other people's children can do what their own can not and they wonder why. no time should be wasted in making such comparisons, for no two children are exactly alike, as no two leaves and not even two such apparently similar objects as grains of wheat are exactly alike. therefore the care necessary varies somewhat, though it is basically the same. if the nervous type is given proper care, good health will be the result. these children do not tolerate as much exposure or as much food as do the robust children. the important thing is to learn what they require and then see that there is no excess, and in this way allow the child to grow physically strong and mentally efficient. the delicate children are perhaps more fortunate than the stronger ones, for they learn early in life that they have limitations. if they commit excesses the results are so disagreeable that they soon learn to be prudent. this prudence serves as protection so long as life lasts. the robust children on the other hand soon learn that they are strong. they hear their parents boast about it. they get the idea that because they are strong they will always remain so, that nothing will do them any serious harm. by living up to this fallacy they undermine their constitutions. parents should teach their children about the law of compensation as applied to health, that is, he has permanent health who deserves it, and no one else. the children will not always heed true teachings after they have left the parental influence, but the parents have at least done the best they could. the robust children have their troubles, such as chicken-pox, mumps, fevers and measles, but these are thrown off so quickly and with so little inconvenience that they are soon forgotten. as a rule the parents do not realize that these diseases are due to faulty nutrition, and that faulty nutrition is caused by improper feeding. it is generally believed that children must have all the so-called children's diseases. some mothers expose their infants to all of these that may happen to be in the neighborhood, hoping that the children will take them and be through with them. every time a child is sick it is a reflection on either the intelligence or the performance of the parents. it is natural for children to be perfectly well, and they will remain in that happy state if they are given the opportunity. if they are properly fed they will not take any of the children's diseases in spite of repeated exposure. there is not a disease germ known to medical science strong enough to establish itself in the system of an uninjured, healthy child and do damage. the child's health must first be impaired, through poor care, and then the so-called disease germs will find a hospitable dwelling place. if children are given natural food in normal quantities they are disease-proof. feeding them on refined sugar and white flour products, pasteurized or sterilized milk, potatoes fried in grease pickled meats, and various other ruined foods breaks down their resistance and then they fall an easy prey to disease. some parents make the mistake of believing that they can feed their children improperly and ward off disease by vaccinations or inoculations of the products of disease taken from various animals. this is contrary to reason, common sense and nature and it is impossible. any individual who is continually abused in any way, be he infant or adult, will deteriorate. if the disease is not the one that has been feared, it will be some other one. the robust children generally develop into careless adults. that is why so many of them, in fact the vast majority, die before they are fifty years old, although they are equipped with constitutions that were intended to last over a century. they are shining marks for typhoid fever, bright's disease, various forms of heart and liver troubles, rheumatism and pneumonia, all of which are largely caused by too hearty eating. these diseases often come without apparent warning. that is, the victims have thought themselves healthy. however, they have not known what real health is. they have been in a state of tolerable health, not suffering any very annoying aches or pains, but they have lacked the normal state of body which results in a clear, keen mind. as a rule there is enough indigestion present to cause gas in the bowels and a coated tongue. enough food is generally eaten to produce excessive blood pressure. the foundation for such a state of affairs is laid in childhood, yes, often before the child is born. it can readily be seen how important it is for parents to impart a little sound health information to the children. at least, they should teach them what health really is, which many people do not know. when these strong people become sick it is often difficult, or even impossible, to do anything for them, for their habits are so gross and have gained such a mastery that the patients will not or can not change their ways. the weaklings have a better chance to survive to old age, because many of them learn to be careful early in life. in reading the lives of eminent men who have lived long it is common to find that they were never strong. at the age of one year the baby is generally weaned. the ordinary child needs the mother's milk no longer, for by this time the digestive power is great enough to cope with cow's milk and various starches. the most important problem now is how to feed the child. if no errors of importance are made it will enjoy uninterrupted growth and health. if the errors are many and serious there will surely be disease and too often the abuse is so great that death comes and ends the suffering. until the child reaches the age of two years the best foods are milk, whole wheat products and fruits. no other foods are necessary. the simpler the baby's food, and the more naturally and plainly prepared, the better. adults who overeat until they suffer from jaded appetites, may think that they need great variety of food, but it is never necessary for infants or normal adults. milk, whole wheat and fruits contain all the elements needed for growth and strength and health. by all means feed simply. children are perfectly satisfied with bread and milk or simply one kind of fruit at a meal, if they are properly trained. the craving for a great variety of foods at each meal is due to parental mismanagement. children should not be fed more than three times a day. there should be no lunching. the children will get all that is good for them, all they need in three meals. candy should not be given between meals, and fruit is to be looked upon as a food, not as a dainty to be consumed at all hours of the day. if they are not accustomed to lunching, there will be no craving for lunches. if children are used to four or five meals a day they want them and raise annoying objections when deprived of one or two of them. it is easy to get children into bad habits. we can not blame the average mother for giving her children lunches, for she knows no better and sees other mothers doing the same. the children who do not get lunches thrive better than those who always have candy, fruit or bread and jam at their command. it is the same with adults. in the dakotas and minnesota are many scandinavians and germans. during the haying and harvest these people, who are naturally very strong, eat four and five times a day. the heat, the excessive amount of food and the great quantities of coffee consumed cause much sickness during and after the season of hard work and heroic eating. the so-called americans in these communities are generally satisfied with three meals a day, and they are as well nourished and capable of working as those who eat much more. refined sugar made from cane and beets should be given to children sparingly. refined sugar is the chemical which is largely responsible for the perversion of children's tastes. a normal taste is very desirable, for it protects the possessor. a perverted taste, on the contrary, leads him into trouble. sugar is not a good food. it is an extract. it is easy to cultivate a desire for sugar, but to people who are not accustomed to it, concentrated sugar has an unpleasant taste. the perversion of the sense of taste, generally begun with sugar, is made worse by the use of much salt, pepper and various condiments and spices. if the child is fed on unnatural food, highly seasoned, at the age of a few years its taste is so perverted that it does not know how most of the common foods really taste, and refuses to eat the best of them when the health-destroying concoctions to which it has been accustomed can be had. it is natural for children to relish fruit, but some are so perverted in taste that they object to a meal of it if they can get pancakes or waffles with butter and syrup, mushes with sugar and cream, ham or bacon with fried potatoes, or fresh bread and meat with pickles. many parents allow their children to live on this class of food to the exclusion of all natural foods. children need a great deal of the natural salts, and when they live so largely on denatured foods there is always physical deterioration. it is true that to the average eye such children may appear healthy, but they are not in one-half as good physical condition as they could be. tea and coffee should never be given to children. they are bad enough for adults. in children they retard bodily development. the stimulation and sedation are bad for the nervous system. coffee is as harmful as tobacco for the growing child. to warn against alcohol may seem foolish, but some parents really give beer and whiskey to their infants. the beer is given as a beverage and the whiskey as medicine to kill pain and soothe the children. those who have not seen children abused in this way may find it difficult to believe that there is such a profundity of ignorance. these children die easily. others quiet their children with the various soothing syrups. the last analyses that came under my eyes showed that these remedies contained considerable opium, laudanum, morphine and other deadly poisons. morphine and opium are not well borne by children and these "mother's friends" have soothed many a baby into the sleep from which there is no waking. make it a rule to give the children no medicines, either patent or those prescribed by physicians. please remember that any remedy that quiets a child is poisonous. children who get proper care require no medical quieting. condiments should not be used. salt is not necessary despite the popular belief to the contrary, though a small amount does no harm. salt eating is a habit and when carried to excess it is a bad one. salt is a good preservative, but there is little excuse for our using preserved foods extensively. there are so many foods that can be had without being preserved in this country that it would not be difficult to exclude these inferior foods from the dietary. children whose foods are not seasoned do not desire seasoning, provided they are fed on natural foods from the start. they want the seasoning because they are taught to eat their food that way. if they are given fresh fruit every day, such as apples, oranges, cherries, grapes and berries, they get all the seasoning they need and they get it in natural form. the objection is made that such feeding deprives children of many of the good things of life. this is not true. natural foods taste better than the doctored ones every time. nature imparts a flavor to food products which man has never been able to equal, to say nothing of surpassing it. children are taught to like abnormal foods. what is better, to give children good foods upon which they thrive, or denatured foods which taste well to a perverted palate, but are injurious? instead of giving sugar or candy, give raisins, figs, dates or sweet prunes. small children may be given the strained juices of these fruits, obtained either by soaking the raw fruits several hours or by stewing them. children who are given these fruits do not crave refined sugar. they like these natural sugars better than the artificial extract. these sweet fruits take the place of starchy food. very few people know anything definite about food values. those who have studied foods and their values in order to be able to feed children properly generally make the mistake of believing that they should have all the necessary elements at each meal in about the proper proportion. this is a grave mistake and leads to trouble. the child needs salts, protein, sugar and fat, and in the absence of sugar some starch. milk contains all these substances except starch. give one fruit meal and two meals of starch daily. milk may be given with all the meals or it may be given but once or twice. do not overfeed on milk, for it is a rich food. until the child is two years old, confine it in its starch eating pretty much to the products of whole wheat. give no white bread. white bread is an unsatisfying form of food. it is so tasteless and insipid and so deprived of the natural wheat salts that too much has to be eaten to satisfy. children who would be satisfied with a reasonable amount of whole wheat bread eat more white bread and still do not feel satisfied. the same is true of rice, the natural brown rice being so superior to the polished article that there is no comparison. the bread should be toasted in the oven until it is crisp clear through, or else it should be stale. let the bread for toast get stale, and then place it in the oven when this is cooling off. make the slices moderately thin. this is an easy and satisfactory way of making toast. scorched bread--what is usually called toast--is not fit food for young children. after the second year is completed gradually increase the variety of starch. some of the better forms of starch that are easy to obtain are: puffed rice or puffed wheat; brown, unpolished rice; triscuit or shredded wheat biscuit; the prepared corn and wheat flakes; baked potatoes; occasionally well cooked oatmeal or whole wheatmeal gruel. mushes are to be given seldom or never. children seldom chew them well, and they require thorough mastication. the rice is not to be sugared but after the child has had enough, milk may be given. a small amount of butter may be served with either rice or baked potato. the cereal foods should be eaten dry. let the children masticate them, as they should, and as they will not if the starches are moistened with milk. when they have had sufficient of these starches, and but one kind is to be served at a meal, give milk, if milk is to be a part of the meal. to observe the suggestions here given for the manner of feeding starches to children may mean the difference between success and failure in raising them. it is the little things that are important in the care of children. the acid fruits should not be given in the meals containing starchy foods. strong children who have plenty of opportunity to be in the fresh air and who are very active can stand this combination, but it is injurious to the nervous type. it is not a good thing to make such combinations habitually for robust children. a good meal can be made of fruit followed by milk. do not slice the fruit, sprinkle it with sugar and cover it with cream. give the child the fruit and nothing else. neither oranges nor grapefruits are to be sugared. their flavor is better without. if the children want sweets, give them a meal of sweet fruits. when the child is eighteen months old it should have learned to masticate well enough to eat various fruits. apples, oranges, grapefruits, berries, cherries, grapes and melons are among the foods that may be given. if the child does not masticate well, either grind the fruit or scrape it very fine. the sweet fruits require so much mastication that only their juices should be fed until the child is old enough to masticate thoroughly. bananas should also be withheld until there is no doubt about the mastication. they must be thoroughly ripe, the skin being dark in spots and the flesh firm and sweet. a green banana is very starchy, but a ripe one contains hardly any starch and digests easily. at first the meal is fruit, followed with milk. buttermilk or clabbered milk may be substituted for sweet milk. a little later, begin giving cottage cheese occasionally in place of milk, if the child likes it. the succulent vegetables may be given quite early. at the age of two years stewed onions, green peas, cauliflower, egg plant and summer squash may be given. gradually increase the variety until all the succulent vegetables are used. at first it may be necessary to mash these vegetables. the longer children go without meat the better, and if they never acquired the meat-eating habit it would be a blessing. if the parents believe in feeding their children meat, they should wait until the little ones are at least four years old before beginning. meats are digestible enough, but too stimulating for young people. chicken and other fowls may be used at first, and it is best to use young birds. beef and pork should not be on the children's menu. at the age of seven or eight the variety may be increased. however, parents who wish to do the best by their children will give them little or no meat. many of the sorrows that parents suffer through their wayward children would be done away with if the young people were fed on less stimulating foods. eggs are better for children than meat. however, it is not necessary to give them. the children get enough milk to supply all the protein they need. eggs may be given earlier than meat. at the age of two and one-half years an egg may be given occasionally. at three they may be given every other day, one egg at a meal. at five or six years of age, an egg may be given daily, but not more than one at a time. if they are soft boiled, three and one-half minutes will suffice. if hard boiled, cook them fifteen to twenty minutes. an egg boiled seven or eight minutes is not only hard but tough. longer boiling makes the albumin mellow. always prepare eggs simply without using grease. eggs may be given in combination with either fruits or vegetables. milk is not to be taken in the egg meal, for if such combinations are made the child gets more protein than necessary. eggs are easy to digest and the chief objection to their free use in feeding children is that the protein intake will be too great, which causes disease. nuts should not be given until the children are old enough to masticate them thoroughly. the best combination is the same as for eggs. children under six years of age should not have much more than one-half of an ounce of nut meats at a meal. the pecans are the best. children rarely chew nuts well enough, so they should seldom be used. they may be ground very fine and made into nut butter, which may be substituted for ordinary butter. give no butter until the child has completed his second year. the whole milk contains all the fat necessary. butter should always be used in moderation, for although it digests easily, it is a very concentrated food. again the question will be asked: "how much shall i feed my child?" i do not know, but i do know that most children get at least three times as much food as is good for them. people can establish a toleration to a certain poison, and seemingly take it with impunity for a while. some arsenic eaters and morphine addicts take enough of their respective drugs daily to kill a dozen normal men. however, the drugs, if not stopped, always ruin the user in the end. it is the same way with food. children seem to establish a toleration for an excess for a shorter or longer period of time, but the overeating always produces discomfort and disease in the end, and if it is continued it will cause premature death. about one-third or one-fourth of what children eat is needed to nourish them. the rest makes trouble. read the chapters in this book on overeating and on normal food intake. they give valuable pointers. parents know their children best, and the mother can, or should be able to tell when there are signs of impending danger. if there is a decided change in the child's disposition it generally denotes illness. some children become very sweet when they are about to be ill, but most of them are so cranky that they make life miserable for the family. a foul, feverish breath nearly always comes before the attack. a common danger signal is a white line around the mouth. another one is a white, pinched appearance of the nose. a flushed face is quite common. the tongue never looks normal. except the abnormal tongue, these symptoms are not all present before every attack, but one or more of them generally are. no matter what the signs of trouble may be, stop all feeding immediately. if this is done, the disease generally fails to develop, but if feeding is continued there is sure to be illness. these symptoms indicate that the digestion is seriously disturbed. it is folly to feed when there is an acute attack of indigestion. besides, it is very cruel, for it causes much suffering. such symptoms in children are caused by improper eating, and overeating is generally the chief fault. the remedy is very simple: feed less. a coated tongue indicates too much food. a clean tongue shows that the digestive organs are working well. if the tongue is not smooth and a pretty pink in color, it means that the child has had too much food and the meals must be reduced in quantity until the tongue does become normal, which may take a few months in chronic cases. peculiar little protruding spots when red and prominent on the tip and edges of the tongue indicate irritation of the alimentary tract and call for reduction of food intake. the parents can soon learn how much to feed the children if they will be guided by these hints. poor health in the children indicates parental failure, and this is one place where they can not afford to fail. parents must be honest with themselves and not put the blame where the doctors put it--on bacteria, draughts, the weather, etc. sometimes the climate is very trying on the babies, but it never kills those who have intelligent care. if it is found that the child next door, of the same age, eats three or four times as much as your child, do not become alarmed about your little one, but give the neighbor's child a little silent sympathy because its parents are ignorant enough to punish the little one so cruelly. for those who desire more definite hints regarding feeding of children, an outline has been prepared for several days. this is very simple feeding, but it is the kind of feeding that will make a rose bloom in each cheek. the child will be happy and contented and bring joy to the hearts of the parents. breakfast: whole wheat toast, butter and a glass of milk. lunch: a baked apple and a dish of cottage cheese. supper: steamed or boiled brown rice and milk. breakfast: puffed wheat and milk. lunch: oranges and milk. supper: an egg, parsnips and onions, both stewed. breakfast: oatmeal or whole wheat porridge and milk. lunch: berries and milk. supper: baked potato, spinach and a plate of lettuce. breakfast: shredded wheat biscuit and milk. lunch: stewed prunes and milk or cottage cheese. supper: whole wheat toast and milk. these are merely hints. where one juicy fruit is suggested, another may be substituted. in place of the succulent vegetables named, others may be used. any of the starches may be selected in place of the ones given. however, no mistake will be made in using the whole wheat products as the starch mainstay. desserts should not be fed to children often. rich cakes and all kinds of pies should be omitted from the bill of fare. it is true that some children can take care of them, but what is the use of taking chances? a plain custard, lightly flavored, may be given with toast. if ice cream is above suspicion a moderate dish of this with some form of starch may be given, but milk is not to be taken in the same meal with either ice cream or custard. at the end of the third year it is time enough to begin to feed the salad vegetables, though they may be given earlier to children who masticate well. the dressing should be very plain, nothing more than a little salt and olive oil, or some clabbered cream. no dressing is necessary. the salad vegetables may be eaten with the meal containing eggs and the stewed succulent vegetables. at the age of about seven or eight the child may be put on the same diet as the parents, provided they live simply. otherwise, continue in the old way a little longer. for the best results in raising children, simplicity is absolutely necessary. children who are early put on a stimulating diet develop mental and sexual precocity, both of which are detrimental to physical welfare. the first desideratum is to give the children healthy bodies, and then there will be no trouble in giving them what knowledge they need. in overfed boys the sex urge is so strong that they acquire secret habits, and sometimes commit overt acts. too much protein is especially to blame. these facts are not understood by many and the result is that the parents fail in their duty to their children. it is best not to bring young children to the table, if there is anything on it that they should not have, for it nearly always results in improper feeding. the children are curious and they beg for a little of this and a little of that. unthinkingly the parents give them little tastes and bites and before the meal is over they have had from six to twelve different kinds of food, some of them not fit for adult consumption. if the child understands that it is not to ask for these things and abides by this rule, it is all right, but such children are rare. a child that fretfully begs for this and that at the table upsets itself and the parents. make no sudden changes in the manner of feeding, unless the feeding is decidedly wrong. active children get all the exercise they need. they should spend a large part of the day in the open, and this is even more important for the delicate ones. the bedroom should be well ventilated, but the children must be kept cozy and warm or they do not sleep well. after the child is old enough not to soil itself, one or two baths a week are sufficient. there is no virtue in soaking. swimming is different, for here the child is active in the water and it does not weaken him so. swimming should be a part of every child's education. bed time should be early. the children should be tucked in and the light turned off by o'clock, and o'clock is better for children under five. if they want to get up early in the morning, let them, but put them to bed early at night. infants should not be exposed long to the direct rays of the summer sun, for it is liable to cause illness. it upsets the stomach and then there is a feverish spell. if nothing is fed that will generally be all, but it is unnecessary to make babies ill in this way. they should not be chilled either. husband and wife do not agree at all times, but they make a mistake when they disagree in the presence of their children. young people are quick to take advantage of such a state of affairs and they begin to play the parents against each other. when a point comes up where there is a difference of opinion, the decision of the parent who speaks first should stand, at least for the time being. then when they are by themselves, man and wife can discuss the matter if it is not satisfactory, and even quarrel about it, if that gives them pleasure. parents who do not control themselves can not long retain the full respect of their children. lost respect is not very far distant from lost love. people often object to a change in methods, for, they say, the new plan will cause too much trouble. the plan here outlined causes less trouble than the conventional method of caring for children. it is simpler and gives better results. if it were followed out the mortality of children under ten years of age in this country would be reduced from over , annually to less than , . in spite of everything, a number of young people will get into fatal pranks. there are difficulties in the way of raising children properly, but a healthy child is such a great reward that the efforts are paid for a hundred times over. nothing wears the parents out more quickly than a child who is always fretting and crying, always on the brink of disease or in its grasp. in raising children the best way is the easiest way. the child's mental training. a healthy body is the child's first requirement. however, if the mental training is poor, giving wrong views of life, a good physique is of but little service. it is quite generally agreed among observers that the first seven years of life leave the mental impressions which guide the whole life, and that after the age of fourteen the mental trend rarely changes. there are a few individuals with strength enough to make themselves over mentally after reaching adult life, but these are so few that they are almost negligible, and even they are largely influenced by their youth and infancy. it is as easy to form good mental habits as bad ones. it is within the power of all parents to give their children healthy bodies and healthy minds, and this is a duty, which should prove a pleasure. the reason such heritage is so rare is that it requires considerable self-control and most parents live chaotic lives. upon the mentality depends the success in life. "it is the mind that makes the body rich." no matter how great an individual's success may seem in the eyes of the public, if the person lacks the proper perspective, the proper vision and the right understanding, his success is an empty thing. wealth and success are considered synonymous, but i have found more misery in the homes of the rich than among the poor. physical wants can be supplied and the suffering is over, but mental wants can only be satisfied through understanding, which should be cultivated in childhood. "all our problems go back to the child--corrupt politics, dishonesty and greed in commerce, war, anarchism, drunkenness, incompetence and criminality."--moxom. given a healthy body and a good mind, every individual is able to become a useful member of society, and that is all that can be expected of the average individual. all can not be eminent, and it is not necessary. upon the child's mental impressions and the habits formed in infancy and youth depend the mental workings and the habits of later life. therefore it is necessary to nurture the little people in the right kind of atmosphere. if the child is trained properly from infancy there will be no serious bad habits to overcome during later years, and, as all know, habits are the hardest of all bonds to break. to overcome the coffee and alcohol habits is hard, but to overcome bad mental habits is even more difficult. first of all, let the infant alone most of the time. some mothers are so full of love and nonsense that they take their babies up to cuddle and love them at short intervals, and then there are the admiring relatives who like to flatter the parents by telling them that the baby is the finest one they have seen; it is an exceptional baby. so the relatives have to bother the infant and kiss it. this should not be. the child should be kept in a quiet room and should not be disturbed. there are no exceptional babies. they are all much alike, except that some are a little healthier than others. if they are let alone, they have the best opportunity to develop into exceptional men and women. paying too much attention to babies makes them cross and irritable. they soon learn to like and then to demand attention. if they do not get it at once they become ill-tempered and cry until attention is given. thus the foundation of bad temper is laid in the very cradle. they gain their ends in infancy by crying. later on they develop the whining habit. when they grow older they fret and worry. such dispositions are the faults of the parents. it does not take long for children to learn how to get their way, and if they can do it by being disagreeable, you may be sure that they will develop the worst side of their nature. let the child understand that being disagreeable buys nothing, and there will soon be an end of it. children who are well and well cared for are happy. they cause their elders almost no trouble. to lavish an excessive amount of care on a baby may be agreeable to the mother at first, but it is different when it comes to caring for an ill-tempered, spoiled child of eight or nine years. many crimes are committed in the name of love. many babies are killed by love. unless love is tempered by understanding it is as lethal as poison. many parents think they are showing love when they indulge their children, but instead they are putting them onto the road that leads to physical and mental decay. true love is helpful, kind and patient. the spurious kind is noisy, demonstrative and impatient. do what is necessary for children, but do not allow them to cause unnecessary work. what they can do for themselves they should do. they can be taught to be helpful very early. they should be taught to be neat and tidy. they should learn to dress themselves and how to keep their rooms and personal effects in good order early in life, no matter how many servants there may be. these little things are reflected in their later lives. they help to form the individual's character. it is what we do that largely make us what we are, and every little act and every thought has a little influence in shaping our lives. an orderly body helps to make an orderly mind and vice versa. many of the rich children are unfortunate indeed. some times poor parents have so many children that each one gets scant attention, but the children of many of the rich get no parental attention. the parents are too busy accumulating or preserving a fortune and climbing a social ladder to bother with their children. their raising is delegated to servants. at times the little ones are put on display for a few minutes and then the parents are as proud of them as they are of the expensive paintings that adorn the walls or the blooded dogs and horses in kennels and stables. no amount of paid service can compensate for the lack of parental love. the ideal today, especially for female children, seems to be to make ornaments of them, to train them to be useless. girls, as well as boys, should be taught to be useful. they should be taught that those who do not labor are parasites. if some do not work, others have to work too hard. the story is told of mark twain that he dined with an english nobleman who boasted that he was an earl and did not labor. "in our country," said mark twain, "we do not call people of your class earls; we call them hoboes." it does not matter how wealthy parents are, they should teach their children how to earn a living, and they should instill into them the ideal of service, for a life of idleness is a failure. the shirkers and wasters are not happy. the greatest contentment in life comes from the performance of good work. ecstatic love and riotous pleasure can not last. work with love and pleasure is good. but love and pleasure without work are corroding. children who are waited upon much become selfish. they soon become grafters, expecting and taking everything and giving nothing. this is immoral, for life is a matter of compensation, and consists in giving as well as in taking. children should be taught consideration for others, and should not be allowed to order the servants around; not that it harms the servants, but it has a bad effect on the children. because the child's period of development is so long, it is important to have a proper adjustment in the home between parents and the children. lack of adjustment wears out the parents, especially the mother, and gives false impressions to the young people. to prevent friction and get good results, children should be taught obedience. obedience is one of the stepping stones to ability to command. in those homes where the words of the parents are law there is but little friction. obedience should be taught from the very start. as soon as the child realizes that the parents mean what they say and that it is useless to fret and complain about a command, that is the end of the matter. how different it is with disobedient children! the parents have to tell them what to do several times and then the bidding often remains undone. begin to teach obedience and promptness as soon as the children understand, for it is more difficult later. the older the children the harder it is. children know so little and are so conceited that they do not realize that because of lack of experience, observation and reflection they can not safely guide themselves at all times. when they are allowed to act so that they are a nuisance to others and harmful to themselves, they do not give up this license with good grace. there are times to be firm and then firmness should be used. it is necessary for the parents to cooperate. various parents have different ways of correcting their children, and it is not difficult to make them realize that obedience is a part of the plan of early life. to illustrate: if the children are called for a meal, they should come promptly. if there is a tendency to lag, tell them that if they do not come when called they will get nothing to eat until next mealtime, and act accordingly. this is no cruelty, for no one is harmed by missing a meal. it generally proves very effective. at the table, serve the children what your experience has told you they can take with benefit, without saying anything about it. if they ask for anything else, give it if you think proper. if not, say no. if they start to beg and whine, tell them that such conduct will result in their being sent away from the table, and if they still continue, do as you have said, and let there be no weakening. this may cause a few very disagreeable experiences at first, but it is much better to have a few of them and be through, than to continue year after year to have such trouble. some children can eat everything with apparent impunity and their parents usually pay no attention to what they eat. but there are others who become ill if they are improperly fed. children who are often feverish and take all the diseases peculiar to the young, are maltreated. they are not properly fed. those who are prone to convulsions must be fed with great care, or there is danger of their becoming epileptics. firmness in such cases generally means the difference between health and disease or even death. by all means be firm in such matters. indulging the children to excess is invariably harmful. when your children become ill and die, you can truly say, "behold my handiwork." in the same way teach the children to do promptly whatever they are told to do. if they are told to go to bed, it should be done without delay or protest. all the little duties that fall to their lot should likewise be accomplished promptly. however, the parents should be reasonable and they should avoid bombarding their children with commands to do or not to do a thousand and one things that do not matter at all. let the children alone except when it is really necessary to direct them. unfortunately, most of the parents are blind to their own faults, but see very clearly those of others. the mistakes they make in their own families open their eyes to those of others, and then they are often very impatient. i know one gentleman who has excellent knowledge of the proper training of the young, but as a parent he is a total failure. he is so explosive and lacking in patience and firmness, perhaps also in love, that his knowledge has not helped him. it is not what we know, but what we apply, that makes or mars. obedience reduces friction and trains the children into habits of efficiency. it is not only valuable in preserving the health of the parents, but in increasing the child's earning capacity when the time comes to labor in earnest. plato said that democracies are governed as well as they deserve to be. likewise, parents get as much obedience, respect, affection and love as they deserve, and the three latter are largely dependent upon the former. it would be difficult to overemphasize the importance of obedience. in nature we find that the animals teach their young how to live independently as soon as they have the strength to care for themselves. this is what parents should teach their children. this may cause the mother pain, for many mothers like to keep their children helpless, dependent and away from contact with the world as long as possible. wise mothers do not handicap their children thus. the best parents are those who teach their children early how to make their own way. doubtless the greatest happiness is to be found in a congenial family, where the parents understand and love each other and their children. those parents who are so busy that they lack the time to become acquainted with their infants and keep up this intimacy, are losing a part of life that neither money nor social position can give them. many wait until too late to get on intimate terms with their children. when young, the children are naturally loving and then the beautiful ties which neither time nor misfortune can sunder are formed. when the children are grown it is too late to establish such a relation. then they look at their parents with as critical eyes as they use toward other people, and though they may become very good friends, the tender love is lacking. love between man and woman is unstable, but the beautiful love that springs from companionship of children and parents lasts until the end. while some mothers neglect their children, many become too absorbed in them. the children become all of the mother's life. as the young people become older, their horizon naturally widens. during infancy the parents can fill the child's whole life, but soon other interests crave attention. there is always a tragedy in store for the mother who refuses to see that her children, as they grow older, will demand the human experience necessary for individual growth and development. if the mother has no other interest than her children she will one day be left with a heart as empty as the home from which the children are gone. there are so many interesting things in this world, and every mother should have her hobby. she should have at least one hour each day sacred to herself, in which she can relax and cultivate the mind. this will help to fill the coming years, which too often prove barren. loving parents get all the reward they should expect from the beautiful intimacy that exists between them and their growing children. so-called ungrateful children have incompetent parents. parents have no right to demand gratitude. they do no more for their children than was done for themselves in the morning of their lives. the right kind of parents never want for rewards. they are repaid every day so long as they live. children grow under the care of their parents, but the parents also grow and expand in understanding, sympathy and love through association with their children. today society does not treat the mothers with the proper consideration. the mothers deserve well, for they have to give many of their best years to the children. these are the productive years, and generally unfit the women to go into economic competition with the rest of the world afterwards. society owes it to the mothers of the race to see that they are not made to suffer for fulfilling their destiny. motherhood today is as dangerous as the soldier's life, though it ought not to be, and it is more difficult to raise children than to conduct a successful business. however, the financial rewards for motherhood are generally nil. the least society can do is to see that these women do not want for the necessities of life. most children are interrogation points. this is well, for they learn through curiosity. the questions should be answered honestly, or not at all. it is common to give untrue answers. this is poor policy, for the answers are a part of the child's education and untruths make the young people ignorant and superstitious. it takes considerable patience to raise a child and he who is unwilling to exercise a little patience has no right to become a parent. whether to use corporeal punishment or not is a question that the parents must decide for themselves. many parents are in the habit of nagging their children. it is, "don't do this," and "don't do that," until the little ones feel as exasperated as the americans in berlin, where everything that one has an impulse to do is "verboten." the children have not yet acquired caution, nor are they able to think of more than one or two things at a time. consequently they forget what they are not to do, and then parental wrath descends upon them. parents can well afford to be deaf and blind to many things that happen. those mothers who are ever shouting prohibitions soon cultivate a fretful, irritable tone that is bad for all concerned, and which does not breed respect and obedience. make it a rule not to interfere with the children except when it is necessary, and tell them to do but one thing at a time. if too many commands and prohibitions are issued, the children are prone to forget them all. if they are talked to less, what is said is more deeply impressed on their minds, and the chances are that they will remember. boisterousness is not badness, but indicates a state of well-being, which results in bodily activity, including the use of the vocal cords. it is common to all young animals, and the human animal is the only one that is severely punished for manifesting happiness. if the parents decide that corporeal punishment is necessary, they should be sure that it has been deserved, for a child resents being punished unjustly, and undeserved punishment is always harmful. many parents become so angry that they inflict physical punishment to relieve their own feelings, and this is very wrong. if a parent calmly decides that his child needs punishment, perhaps this is the case. the punishment should be given calmly. nothing can be more cowardly and disgusting than the brutal assault of an angry parent upon a defenseless child, and such parents always regret their actions if they have any conscience, but they are generally of such poor moral fibre and so full of false pride that they fail to apologize to the children for the injustice done. these parents inflict suffering upon their children, but they punish themselves most of all, for they kill filial regard and love. children have a very keen sense of fair play. if it is decided to administer corporeal punishment, it should have enough sting to it so that it will be remembered. parents who temper their justice with patience and love are not compelled to resort to corporeal punishment often. children should never be hit on the head. pulling or boxing the ears should not be recognized as civilized warfare. blows on the head may partly destroy the hearings and affect the brain. another thing that may not come under the head of punishment in the strictest sense, is lifting children by one of the arms. women are prone to do this. often it partly dislocates the elbow joint. the children whine and no one knows exactly what is the matter. if one arm is occupied and the child has to be lifted from curb to street or over a puddle, stoop and pass the unoccupied arm about the child's body and no harm will be done. no one should suggest to the child that it is bad. it is better to dwell upon goodness. if a child is often told that it is bad, it will soon begin to live up to its name and reputation, just as adults often do. many parents are in the habit of scaring their children. if the little ones cry or disobey, they are told that the boogy-man is coming after them, or they are threatened with being put out into the dark, or perhaps some animal or bad person is coming to get them. fear is injurious to everybody, being ruinous to both the body and the mind, and it is especially bad for growing children. the fear instilled in them during childhood remains with some people to the end of life. it is not uncommon to find people who dare not go out alone after dark because they were scared in childhood. children like exciting stories that would naturally inspire fear, but it is not difficult for the reader or story teller to inform the little ones that there are no big black bears or bold robbers in the neighborhood, and that now there is nothing to fear in the darkness. many teach the children to be ashamed of their bodies. every part of the body has its use and whatever is useful is good. those who do not abuse their bodies have nothing of which to be ashamed. the education of children in the past has been along wrong lines. it has been the aim to cram them full of isolated facts, many of them untrue. we are slowly outgrowing this tendency, but too much remains. thanks largely to froebel and doctor montessori, our methods are growing more natural. the adult learns by doing and so does the child. doctor montessori teaches the children to use all their senses. she gives them fabrics of various textures and objects of different shapes and colors. thus they learn colors, forms, smoothness, roughness, etc. she teaches them how to dress and undress and how to take their baths. she lets them go about the schoolroom instead of compelling them to sit still at their desks in cramped positions. in this way they get knowledge that they never forget. they learn to read and write and figure in playful ways through the proper direction of their curiosity. little tots of four, or even younger, are often able to read, and there has been no forcing. all has come about through utilizing the child's curiosity. if children are delicate, they should not be put into a schoolroom with thirty or forty other children. keep such children outdoors when the weather permits and allow them to become strong. the education will take care of itself later. there is nothing to be gained by overtaxing a delicate child in the schoolroom, which too often is poorly ventilated, and having a funeral a little later. children should be taught the few simple fundamental rules of nutrition until they are second nature. a thorough knowledge of the fact that it is very injurious to eat when there is bodily or mental discomfort is worth ten thousand times as much to a child as the ability to extract cube root or glibly recite, "arma virumque cano trojae," etc. the realization that underchewing and overeating will cause mental and physical degeneration is much more valuable than the ability to demonstrate that a straight line is the shortest distance between two points. this knowledge can be given so unobtrusively that the child does not realize that it is learning, for there are many opportunities. when a child gets sick and is old enough to understand, instead of sympathizing with it explain how the illness came about, and please remember that in explaining you can leave the germs out of the question, for diseases of childhood are almost entirely due to improper feeding. the value of education like that is beyond any price, for it is a form of health insurance. reforming the race, means that we must begin with the children. in parts of europe cultured people have a working knowledge of two or three languages. this is certainly convenient. those who wish their children to know one or two tongues beside english should remember that in infancy two tongues are learned as readily as one, if they are spoken. those who can use three languages when they are four years old are not infant prodigies. they have had the opportunity to learn, and languages are simply absorbed. the language teaching in the public schools is a joke. after taking several years of french or german the school children can not speak about the common things of life in those tongues, though they may know more about the grammar than the natives. in other words, they know the science of the language, but not the language itself. a time comes when the child wants to know about the origin of life. if the parents have been companions, they can impart this knowledge better than anyone else. if they are unable to explain, the family doctor should be able to impart the knowledge with delicacy. i do not believe that such knowledge should be imparted to mixed classes in the public schools, as advocated by some. if the parents do their duty, there will be no need of public education in sex hygiene. the doctor should be an educator, so he merits consideration here. nearly all families have their medical advisers, and these professional people have it in their power to bring more sunshine into the homes than their fees will pay for. on the other hand, they can, and too often do, give both advice and remedies that are harmful they should sow seeds of truth. if the infant is properly cared for, it is never ill. inasmuch as there are but few families with sufficient knowledge to keep their babies healthy at all times, there are many calls for the doctor. parents are generally unduly alarmed about their infants. nearly always the trouble is primarily in the alimentary tract, due to improper feeding, and the doctor with his wide experience can relieve the parental anxiety, and at the same time tell them where they have made their mistakes and how they have brought suffering upon their little ones. of course, there should be no dosing with medicine and no injections of foreign matter into the blood stream. rest, quiet, cleanliness and warmth are what the children need to restore them to health. the right kind of physician when acting as adviser to intelligent parents who wish to do the best by their children will see to it that there is little or no disease. if the parents do not know what to do, the most economical procedure is to consult a physician who has understanding of and confidence in nature. pay no attention to the women of many words who give advice "because they have had many children and have buried them all." it is not as difficult to raise healthy children as sickly ones. it is so simple that it takes many pages to explain it. chapter xxviii. duration of life. old age today brings to mind a picture of decrepitude and decay. this is because there is practically no natural old age. those who live so that they are unhealthy during the early years of life will not be well if they reach advanced years. old people can be well in body and sound in mind. in order to attain this desirable end, it is necessary to live properly during the first part of life. it is true that people may dissipate and reform and then live long in comfort, but usually those who spend too lavishly destroy their capital and go into physical or mental bankruptcy. there are many who during their prime say that they do not wish to grow old. their desire for a short life can easily be satisfied. all that is necessary is to live in the conventional manner and the chance of dying before reaching the age of fifty or sixty is good. a few live to be seventy or more in spite of dissipation, but these are the exceptions. they were endowed with excellent constitutions to begin with, constitutions that were made to last over one hundred years. where we find one who has lived long in spite of intemperance, thousands have died from it. most people desire to remain on earth long and they can have their wish. they can advance in years healthy in body and with growing serenity of mind. physical and mental well-being are necessary to attain one's life's expectancy. old age should not be considered as apart from the rest of life. it is but one of the natural phases. those who do not live to be old have failed to live completely. those who express their desire to die young generally change their mind when they face death. man clings to life. old age is a desirable condition. the physical tempests have been subdued, if the life has been well spent. on the other hand, the faults and foibles of the self-indulgent are accentuated and in such cases old age is a misfortune. no one knows what man's natural length of life is. anatomists and physiologists compare the human body with the bodies of various animals. in this they are justified, for we all develop according to the same laws. most of the animals, when allowed to live as nature intended them to live, reach an age of from five to six times the length of the period of their growth. human beings, with their ability to control their environment, should be able to do even better than that. man reaches physical maturity between twenty and twenty-five years of age. this would make his natural age one hundred and twenty-five to one hundred and fifty years. there are cases on record that have lived longer and it may be that if man would cease going in the way of self-destruction and spend more thought and time on the welfare of the race, life would be prolonged beyond even one hundred and fifty years. r. t. trall, m. d., thought that man should live to be two hundred years old. "what man has done man can do." if long life is worth while, doubtless a time will come when long life will be enjoyed. the worry, fretting and foolish haste of today will doubtless be partly done away with some time. then men and women will have time to live, instead of merely existing, as most people do today. men have lived long and found life good. long life for its own sake is perhaps not to be desired, but the benefit that can be bestowed upon the race by those advanced in years is desirable. occasionally a brilliant individual appears on the scene, doing superior work in life's morning, but most of the work that has been found worthy of the consideration of the ages has been done by men of mature years. galen, the famous physician, is said to have lived to a great age. it is hard to tell exactly how old he was, but he was probably well past the century mark at his death. his long life gave him time to do work that is appreciated after the lapse of eighteen centuries. for many hundred years after his death he dominated the practice of medicine and he is today spoken of as often as any living medical man. thomas parr, an englishman, died at the age of one hundred and fifty-two. he was hale and hearty to the very end. unfortunately, his reputation traveled far. he was brought to the english court, where he was wined and dined, and as a consequence he died. before this he had always led the simple life. an autopsy was performed and the physicians found his organs in excellent condition. the only reason they could give for his death was his departure from the simple life which he had led in his home. henry jenkins, also an englishman, lived to the age of one hundred and sixty-nine years. he lived very frugally and was always on friendly terms with nature. his favorite drink was water, though he partook in moderation of "hop bitters." he was moderate in all things, and it is said that he was never really ill until near the end of life. he was not shriveled and shrunken, but a wholesome looking man. king charles ii. sent a carriage to bring mr. jenkins to london, when he was one hundred and sixty years old. the old gentleman declined to ride and walked the two hundred miles to the metropolis. the king questioned him regarding his life and desired to know the reason for his longevity. mr. jenkins replied that he had always been sober and temperate and that this was the reason for his many years. the merry monarch was neither sober nor temperate, and you may be sure that this reply did not please him. mr. jenkins was wiser than mr. parr had been, refusing to dissipate, even though he was old. consequently he returned to his home to enjoy life nine years longer. these two cases are authentic. all are familiar with the records given in the bible. whether they are figurative or not it is hard to tell. however, so many cases of longevity are recorded that they in all probability have a basis in fact. the hebrews of old must have been a long-lived people. one hundred and twenty years was not an extreme age. in genesis is the record of many over five hundred years old, and a few over nine hundred years of age. at the time of the apostles the life span of the hebrews had grown shorter and hence the dictum of three score years and ten. between the time of moses and that of the apostles the hebrews had advanced--or shall we say degenerated?--from a semi-barbarous people to one that had the graces and also the vices of a higher civilization. the hebrews of old were husbandmen, who lived simply and got their vigor from the soil. the cause of so much unnecessary suffering and of the premature deaths has been discussed elsewhere in this book. in short, it is wrong living and wrong thinking. impure air and bad food kill no more surely than does worry. the bodies of children are composed largely of water. the structures are flexible and elastic. the bones are made up mostly of cartilaginous structure. as the children grow older more solids are deposited in the body and the proportion of solid matter to water grows greater. lime is deposited in the bones. when they are limy throughout they are said to be ossified. after this process is complete no more growth can take place. bone formation continues until about the age of twenty-five. at this age the body is efficient. the fluids circulate without obstruction. could this condition be maintained, there would be no decay. during the early years of life the food intake in proportion to the weight of the body is great. the child is active and uses much fuel to produce power and to repair the waste. considerable food is required for body building. at this time a broken bone mends quickly and cuts heal in a short time. with advancing years come slowness and sluggishness of the various vital activities. the slowing up can be retarded almost indefinitely by proper care of the body. if the circulation could be maintained and the purity of the blood stream guarded, old age would be warded off. a healthy body is able to cleanse itself under favorable conditions and so long as the body is clean through and through there is no opportunity for disease to take place and there can be no aging. by aging i mean not so much the number of years one has lived as the amount of hardening and degeneration of the body that take place. some are as old at forty as others are at seventy. when people have reached physical maturity they should begin to reduce their food intake. there is no need for building material then. all that is necessary is enough to repair the waste and to keep up the temperature. the individual at twenty-seven should eat a little less than when he was twenty and by the age of thirty-five he should have reduced his food still more and made his meals very simple. children enjoy the gratification of the sense of taste, but at the age of thirty-five a man has lived enough and experienced enough so that he should know that the overgratification of appetites is an evanescent and unprofitable pleasure, always costing more than it is worth. it is best to grow into good habits while young, for it is difficult to do so after one has grown old. the man who reforms after fifty is the exception. children are fond of cereal foods and sugars. they can eat these foods two or three times a day and thrive. a man of thirty-five should make it a general rule to limit his starch eating to once a day. various physiologists say that as much as sixteen ounces of dry starch (equivalent to about thirty ounces of ordinary bread) are necessary each day. this is entirely too much. very few people can profitably eat more than four ounces of dry starch a day, and for many this is too much. through eating as much as is popularly and professionally advocated, early decay and death result. the arteries are normally pliable and elastic. when too much food is taken, the system is unable to cleanse itself. debris is left at various points. one of the favorite lodging places is in the coats of the arteries. after considerable deposits have been formed the arteries lose their elasticity. they become hard and unyielding. a normal radial artery can easily be compressed with one finger. sometimes the radial artery becomes so hard that it is difficult to compress it with three fingers. as the arteries grow harder they become more brittle and sometimes they break, often a fatal accident. this hardness of the arteries impedes the circulation, for the tone and natural elasticity of the vessel walls is one of the aids to a normal circulation. so long as the arteries are normal all parts of the body are bathed in a constantly changing stream of blood. the muscles, the nerves, the bones, in fact all parts of the body, remove from the blood stream those elements that are necessary for repairing or building the various tissues. they also throw into the blood stream the refuse and waste due to the constant repair and combustion going on all over the body. the blood then leaves this refuse with the skin, lungs, kidneys and bowels, which throw it out of the body. so long as there are enough fuel and food, but not too much, and so long as all the debris is carried away, there is health. but let this process be thrown out of balance and there will be disease. the food intake is seldom too small, though the digestion is frequently so poor that not enough good food gets into the blood. old age is largely due to overeating and eating the wrong kinds of food. this is how overeating causes premature aging, when it does not kill more quickly: when too much food is taken, too much is absorbed into the blood, provided the nutritive processes are active. then all the food in the blood can not be used for repair and fuel. the balance must either be excreted or stored away in the body as deposits. if this storing takes place in the joints, the result may be rheumatism or gout and at times even a complete locking of the joints (anchylosis). if it is stored in the walls of the blood-vessels they become hard and unyielding. no matter where deposits take place, some of them will be found in the walls of the blood-vessels. when these vessels grow hard they decrease in caliber. the result is that the heart is compelled to work very hard, but even then enough blood is not forced through the vessels. the circulation becomes sluggish. the blood in the various parts becomes stagnant. then insufficient good oxygen and first-class nourishment are brought to the parts and not enough waste is carried away. now the billions of cells of which the body is composed are constantly bathed in poisonous blood. the result is lowering of physical tone, or degeneration, of the whole body. the hands and the feet suffer most at first from the poor blood supply and become cold easily. those who suffer constantly from cold hands and feet should know that they are aging, although they may be but twenty years old. such a condition as this often gives rise to varicose veins in the legs. the feet are so far away from the heart, and it is such a long upgrade return of the blood, that the circulation in the lower extremities easily becomes sluggish. the flabby, relaxed tissues and the hardened blood-vessels allow the blood to stagnate. this is why senile gangrene is so common in the feet and so often fatal. the brain gets a copious blood supply, yet the hardening of the arteries often deprives this organ of its necessary nourishment. then the higher faculties begin to abdicate. if the hardening is extensive senile softening of the brain may take place. this is always due to a lack of pure blood. sometimes the arteries are brittle enough to break. baldness is another symptom of physical decay. the hair follicles are not properly nourished, for the arteries have become so contracted and the tissues of the scalp so hardened that there is not enough blood to feed the hair roots. baldness begins on top of the head, generally the only part affected, because it is farthest away from the blood supply. baldness is also partly due to man's headwear. women are rarely bald. there is a saying that there are no bald men in the poorhouse. even if this were true, it would not be very consoling, for the bald heads on the street cleaning forces are numerous. overeating also causes premature aging because if results in fermentation in the alimentary tract. the acids produced cause degeneration of various tissues, having an especially bad effect on the nervous system, which reflects the evil to other parts of the body. it is well to bear in mind how this comes about: first there is overeating; too much food improperly prepared is taken into the blood stream; this makes the blood impure; deposits, causing hardening of the tissues and reduction of the lumen of the vessels, are formed; the blood grows more impure and the circulation sluggish; the tissues are constantly bathed in impure blood, causing further degeneration. when a certain point is reached nature can tolerate no more and life flits away. those who wish to remain young must give some thought to the selection of their food, especially if they are hearty eaters. if only sufficient food is taken to keep the body well nourished it does not make much difference what is eaten, provided it contains sufficient of fresh foods, for when only enough food is taken to supply fuel and repairing material, the food will all be used and none is left to ferment in the digestive tract and form deposits in the body. the body will then keep itself clean, or at least the formation of deposits takes place so slowly that it is hardly perceptible. this can be compared with the process taking place in the flues of a boiler. stoke properly and they remain clean. choke the firebox with an excess of coal and the combustion is so incomplete that the flues are soon filled up and the grates are often burned out. just so with the body: feed too heavily and the digestive organs are burned by the abnormal amount of acid produced and the blood-vessels are filled with debris. as most people lack the self-control to eat a normal amount of food, they should select foods that are compatible and that are not too concentrated. too much meat causes degeneration of all parts of the body and hardening. too much starch causes acidity and hardening. the fruits and the light vegetables have a tendency to overcome these degenerating processes. starch is surely the chief offender in aging people. it is such a concentrated food that overeating is easy, especially when it is taken in the soft forms, such as mushes, fresh bread, griddle cakes and mashed potatoes. if people would masticate their starchy foods thoroughly it would greatly reduce the danger of overeating. it is common to eat bread three times a day and in addition to take potatoes once or twice a day. those who consume so much starch carry into the system more food than can be used and more of the mineral salts than can be excreted. the result is the formation of deposits, chiefly of lime carbonate and lime phosphate; fatty deposits are also common. in order to live long and comfortably it would be well to reduce the starch intake to once a day. the meats also are objectionable when taken in excess. to them can be attributed the chief blame for the formation of gelatinous deposits in the body. however, they do not carry so much earthy matter into the blood stream as do the starches. it is best to partake of meat but once a day, or even more seldom. meat should certainly not be taken more than twice a day even by those who are advanced in years. people who care enough for starch to take it three times a day, or are compelled to live chiefly upon it, grow old and homely more quickly than do those who are able to partake more plentifully of the more expensive proteins. the flesh obtained from young animals and birds is not so heavily charged with earthy matters as is that which is obtained from old animals and birds. fruits and nuts do not carry so much earthy matter as do the starches and meats. the sweet fruits could with profit partly take the place of the starchy foods. the sugar they contain, which has the same nutritive value as starches, needs very little preparation before entering the blood stream. thus a large part of the energy required for starch digestion is saved. on the other hand, the use of too much refined sugar is even worse than an excessive intake of starch. nuts are not difficult to digest if they are well masticated.. the objection to acid fruits during the latter years of life is that they thin the blood and cause chilliness. this is true if they are partaken of too liberally. it is not necessary to refrain from eating acid fruits, but they should be taken in moderation and the mild ones should be selected. pears, mild apples and grapes are better than oranges, grapefruits and apricots. those who have learned moderation can eat all the fruit desired, for they will not be harmed by what a normal appetite craves. vegetables carry considerable earthy matter, but on account of their helpfulness in keeping the blood sweet they should be eaten several times a week. those who think that overeating of starch is too harshly condemned are referred to the horse. when he is allowed to roam about and partake of his natural food, grass, he stays well and lives to be forty or more years old. when compelled to eat great quantities of corn and oats, which are very rich in starch, the horse becomes listless and slow at an early age. he is old at fifteen and before twenty he is generally dead. when horses suffer from stiffness in the joints a few weeks spent in pasture, where they have nothing but green grass and water, remove the stiffness and make them younger. this shows what partaking of nature's green salad does for them. any good stock man will tell you that feeding too much grain "burns a cow out." it does exactly the same for a human being, burns him out and fills him with clinkers. many people think that it is a hardship to be moderate in eating and drinking, but it is not. it brings such a feeling of well-being and comfort that it is unbelievable to those who have not experienced it. many envy the rich, thinking that they can and do live riotously. rich men must live as simply as though they were poor or else they soon lose the mental efficiency that brought them their fortunes, for when health is gone mental power is reduced. according to information in the saturday evening post, the eating habits of many of our most influential business men are very simple and the amount of food partaken of small. john d. rockefeller could hardly live more simply and plainly than he does. william rockefeller, george f. baker, james stillman, otto h. kahn, thomas fortune ryan, george w. perkins, j. ogden armour, john h. patterson, jacob h. schiff and andrew carnegie, all business giants with money enough to subsist on the most expensive delicacies, are said to live more plainly than does the average american who is complaining of the high cost of living. it is the price they have had to pay for success and it is the price that you and i will have to pay to live successfully, though our success may not take the form of financial power. the one conspicuous exception among the financially great to the rule of simplicity was j. p. morgan. his eating habits were somewhat gross, but on account of his rugged constitution he lived to be more than seventy-five years old. if he had given himself just a little more care he would be alive today. they say that his strong black cigars did him no apparent harm, but those who read of his last illness understandingly cannot agree to that statement. mr. morgan started with enough vitality to live and work far beyond the century mark. john d. rockefeller was not physically strong when young. he has been compelled to take good care of himself and to be moderate. now he is past seventy and enjoying good health. john w. gates died a martyr to excess, partly excess of food. he lacked balance. his son followed in his footsteps and died young. frank a. vanderlip, who is looming large on the financial horizon takes but two meals a day, from which he gets enough sustenance to do good work and he says that this plan makes for efficiency. perhaps now that such men as mr. vanderlip live well on two meals a day, it is time to cease calling those who live thus faddists. eating three meals a day is a habit and many can and do get along very well on two meals, and a few take only one meal daily. e. h. harriman also lived simply. he illustrates the evil of a poorly controlled mind. he died when but little past sixty, probably because his frail body was too weak to harbor his great ambition. he took his business wherever he went. when ill and business was forbidden by his physician, mr. harriman had a telephone concealed in his bedroom and as soon as the doctor was gone, he was on the wire. another cause of premature aging is the drinking of very hard water. the earthy matter is absorbed into the blood stream with the water, and a part of it is deposited in the various tissues. people beyond middle age should drink water containing only a small portion of salts. those who partake of fresh fruits or fresh vegetables daily get all the salts that the system needs. even the young should not drink water that is exceedingly hard. we can well illustrate the harm that comes from the excessively hard water by referring to the disease known as cretinism. this disease is quite prevalent in some parts of europe. they say that the disease is hereditary, which is questionable. what is inherited is the environment and the habits of the parents. the chief cause is without doubt the superabundance of earthy matter in the drinking water. the cretins are ill-favored in face and figure. they do not reach normal mental or physical maturity. they are old long before the normal person has reached his prime. they die young, rarely living to be over thirty years old. the bones are completely ossified early, which is the cause of their small stature and their stupidity. the bones of the skull harden so early that the brain has no room to expand. there is no need of suffering, even in a mild degree, from the disease of cretinism. if the water is very hard it is easy to distill what is needed for drinking purposes. such water should at least be boiled. it is much better to have a teakettle lined with earthy matters than to have such a lining in our arteries. the excessive use of table salt is another cause of early aging. it is a good preservative and pickles meat very well. people have long used salt as a preservative and perhaps they got the salt-eating habit in this way, first using it on the foods to be preserved, and then on nearly all foods. salts to excess, especially table salt, help to mummify or pickle those who partake of them too liberally. the addition of sodium chloride to foods is unnecessary. we get all we need of this salt in our fruits, vegetables and cereals. salt should be used in moderation. alcohol, tobacco and coffee are harmful. however, it will be found that most of the old people have used one or more of these drugs for many years and this is often largely responsible for their reaching old age. overeating causes more deaths than any other single factor. the use of tobacco, coffee or alcohol has a tendency to reduce the desire for food and thus these drugs at times prove to be conservers of individual lives, though they are undoubted racial evils. they never can or will take the place of self-control. the senses were given us to use for our protection, but most people abuse them for temporary gratification, and thus they go in the way of self-destruction. other things being equal, a healthy child will live longer than a weakly one. but other things are not equal, so it often happens that a weakling has as much chance to survive as a healthy person. strong people frequently squander their inheritance by the time they are forty or fifty years old. healthy people are very imprudent. they are well so they think they will always remain well. what a surprise it is when after thirty they discover that they cannot do with impunity what they could do before with apparently no bad results! when warned about their eating habits they boast that they can "eat tacks". smoking and drinking are harmless, they say! but the day of reckoning always comes and the account is often so great that under the conventional treatment of today they die. the weakling has been compelled to be careful. habits of moderation grew upon him in youth, and his health has improved as he has advanced in years. he may never be strong, but great physical strength is not essential to health. thus the strong often perish and the weak survive. if both classes lived with equal care the strong would outlive and outwork the weak every time. it is necessary to give the skin some care if continued good health is desired during the latter part of life. the skin has a tendency to grow hard, which should not be allowed. it will always remain soft if it is properly cared for. when our ancestors roved forests and plains with scarcely any attire, the skin exposed to the rain and the sunshine, there was no need to give it special care. it served its purpose of protecting their bodies and was exercised through its immediate contact with the elements in all kinds of weather. now the skin has little opportunity to exercise its protective function and the result is that it is not as active as it should be. the skin must be active to rid itself of the waste that the blood-vessels leave with it. the best exercise for this important organ is rubbing. the whole body should be rubbed every day and it would be well to do this twice a day. an occasional olive oil rub is also good. the rubbings make the body hardier. they also help to keep the circulation active and the skin smooth and soft. the blood is brought near the surface. the tendency as we grow older is for the circulation to grow less and less near the surface and in the extremities. this is slow death. the daily rub is more important than the daily bath. if we have enough rubbing very little bathing is necessary, for an active skin cleans itself. there are many men who have lived in the conventional way until the age of forty, fifty or sixty. they have been healthy, which means that they have been able to work most of the time, but have had their share of ills, which have incapacitated them for work or business at various times. they find after reaching a certain age that they are surely going down hill physically and that they are not as active mentally as previously. the question is, can anything be done under the circumstances? very few of these people are in such a bad physical state that death is inevitable within the next few years. if they seek the right advice and follow it, they can generally continue to live in improved health for thirty to sixty years more. a celebrated case in point is that of louis cornaro, an italian, who died in the year at the age of one hundred and two years. in his youth he was very indiscreet and dissipated. he lived riotously until he was forty years old, and then he found himself in such poor physical condition that it was only a question of a few months until the end would come. he had everything to make life worth living, except health, so he decided to attempt to regain health and prolong his life. he quit his old life, began to live simply and instead of being a waster he became a useful citizen. we are unable to get much definite information about his habits from what he wrote but we learn that he reduced the quantity of food taken and used fewer varieties. also, he drank sparingly of wine. he did not have any definite ideas regarding diet except that it is best to eat moderately and avoid the foods that disagree with one. in his own words: "little by little i began to draw myself away from my disorderly life, and, little by little, to embrace the orderly one. in this manner i gave myself up to the temperate life, which has not since been wearisome to me; although, on account of the weakness of my constitution, i was compelled to be extremely careful with regard to the quality and quantity of my food and drink. however, those persons who are blessed with strong constitutions may make use of many other kinds and qualities of food and drink, and partake of them, in greater quantities, than i do; so that, even though the life they follow be the temperate one, it need not be as strict as mine, but much freer." these sentences were written fifty or sixty years after he changed his mode of life, and show how well mr. cornaro realized the important fact that all people need not be treated alike. they also show that after making the change, mr. cornaro did not find it difficult to live simply enough to enjoy health. in nearly every instance it is temporarily disagreeable to forsake the path that is leading to death and take the one that leads to life, but after one gets used to the new way, it appears more beautiful and is more pleasant than the old. if cornaro had died at forty, as nearly every person situated as he was would have done, his life would have been a total loss. a few of those who were his boon companions and dissipated with him would have thought of him for a few years and regretted his early passing, for "he was a jolly good fellow." he lived a useful life, for over sixty years thereafter, and has left us in his debt for his beautiful exhortations to be temperate. many of the physical wrecks we meet, who will probably live from a few months to a few years more, if they continue in the old way, are in the same boat as mr. cornaro was at forty. they have had enough experience to begin to do good work, to be of some benefit to humanity. instead of living and giving the world their best, they die. the world has had to educate these people, and it is expensive. instead of living on and doing their work, they leave us when they ought to begin to repay us for what we have done for them. they are quitters. suppose andrew carnegie had died at the time he sold out his steel business. to most people he would have left an unsavory memory, for though we should have considered him successful from the business standpoint, many of us would say that the means were not justified by the end. however, mr. carnegie has spent many years since in furthering the cause of the spread of knowledge and in working for universal peace. perhaps when carnegie, the man of business, is well nigh forgotten, carnegie, the educator, will be held in tender and thankful memory. he is now influencing the times for good and this influence will go down the ages. a man has no right to say that he is weary of life and that he wants to die. the race has a claim on him. we learn through our mistakes. the race in general has to pay and suffer for every individual's education. when a man has acquired a measure of wisdom through experience, we have a right to claim it as our own. many men are wise in their own lines, but they have been so busy attending to the affairs that brought them success that they have omitted to learn how to have health. these people owe it to themselves and to humanity to take enough time to learn how to live so that they can work in health. the better the health the finer their product. health and efficiency go hand in hand. what is a man to do when he has reached middle age and finds himself degenerating? a man ought to know how to live at forty, but if he does not he should immediately learn. it may be true that "a man is a fool or a physician at forty," yet there is time and if a man lacks wisdom at forty he should immediately acquire some. such an individual should get the best health adviser possible, avoiding any man who would have him take drugs. what he needs is not medicine, but to learn how to live. i am confident that the careful reader will find enough knowledge in this book to give him the key to the situation. if the sufferer uses narcotics and stimulants, they must be stopped immediately. even the least harmful of these, such as beer and light wine, should be avoided until good health has been won. these beverages need never be used. if they are taken rarely and in moderation they do no harm. in every case that has come under my observation it has been necessary to simplify the food intake, that is, to reduce the quantity and the number of articles of food taken at each meal, also to simplify the cooking. the result is that the individual gets less food, but it is of better quality, for the conventional cooking spoils much of the food. most of these men neglect to exercise. it is necessary to be active and in the open, also to take good care of that important organ, the skin. constipation is common, and it is a very annoying symptom, which disappears in time under proper living. the absorption of poisons from a constipated lower bowel is one of the factors that causes premature aging. when the constipation is overcome there are a feeling of physical well-being and a mental clearness which are impossible in the presence of constipation. the treatment of such a condition is very much the same as the treatment of catarrh or any other curable disease, that is, find the errors of living and correct them. it is really surprising how little food people need after they are fifty or sixty years old. if such people eat enough to be well nourished, but not enough to produce any bad feelings there will be no disease. people who die from disease are physical failures, for the natural end does not come in a physical upheaval. those who live as they should will pass away without any pain. the organism simply grows weary and goes into the last sleep. there are people who say that there needs be no physical death. harry gaze wrote an entertaining book on the subject some years ago and gave lectures in this country. it will not convince the average student of nature that people can live forever, for in nature there is constant change. the order of life is birth, development, reproduction, decline and death. it is not likely that man is an exception. it is believed that in olden times men were larger and lived longer than they do today. there is not much foundation for such a belief to rest upon, except in a few cases. the last census shows that there are several thousand centennarians in the united states. in the technical world for march, , appeared an article by byron c. utecht, entitled, "when is man old?" this magazine is careful in gathering its facts. i shall quote a few paragraphs: "abraham wilcox, of fort worth, texas, is one hundred and twelve years old, but he takes keen enjoyment in life. he walks two miles or more every day as a constitutional and, occasionally, he even takes a small glass of beer. he looks forward with all the enthusiasm of a boy to a visit to the panama-pacific exposition in . mr. wilcox reads the newspapers every day and is interested in everything about him, from the food being prepared for his dinner to the latest feats by aeroplanes. this aged man looks forty or fifty years younger than he really is. his skin is white but not deeply lined. his vision is excellent and he walks nearly erect. thirty years ago he gave up smoking, as his doctors warned him he was near death from old age and that the use of tobacco would only hasten the end." "in the ozark mountains of marion county, arkansas, just across the missouri line, lives mrs. elmyra wagoner. she, too, is one hundred and twelve years old. there are a thousand wrinkles in her face and she looks her age, but in her actions she is sixty. up until a very few years ago, when still past the hundred-year mark, mrs. wagoner kept a large garden and was able to work in the fields. while she has given up outdoor work, she is still active. on inclement days she sits by the fireplace in her mountain home and spins. on pleasant days she may be found walking about the yard. recently her great-great-granddaughter was married at protein, missouri, six miles from the wagoner home. this woman of one hundred and twelve years walked to the wedding, enjoyed it, and then walked back home, a distance that would tire many persons half that age. there are scores of persons at protein who vouch for this and they tell of similar feats by mrs. wagoner showing remarkable physical power. "asked to give the causes of her longevity, the aged woman smiled and said that she hated to admit she was getting old. 'clean, honest living, plenty of work, plenty of good food, and a desire to help others when sick or in trouble, i think gave me my long lease of life. i was always so busy caring for others and thinking of them that i never had time to worry whether i was getting old or not.'" "asa goodwin, of serrett, alabama, is one hundred and six years old. his endurance powers are even more remarkable than those of mrs. wagoner or abraham wilcox. he walks five miles every day. he works several hours daily in his garden, eats anything he likes, and reads without glasses. his family is probably the largest in the united states. a reunion recently held in his honor was attended by eight hundred and fifty persons, three hundred and fifty being blood relatives. goodwin has been a hunter all his life and he frequently takes down his rifle and proves that his aim is still good. he ascribes his length of life and vitality to his great interest in outdoor sport and hunting, when a young man, developing a rugged constitution that lasted him many years after he was forced to quit strenuous work because of 'old age.' he asserts that he was so busy living that he reached one hundred and six years before he realized it and wants to live fifty years more if possible. 'i feel as if i could do it, too,' he declares. 'i now can take my ease and comfort and the world looks good to me. i have always lived a temperate life, never drank, never kept late hours, and still have had as much or more fun than the average man, i think. it is only now when i have nothing to do that i get to worrying and when i find myself in that condition i take a walk or weed the garden and then feel better.'" these people are not in what some call the higher walks of life, but they have succeeded in living, where almost all fail. they have been useful members of society, satisfied to take life as it comes, and thus they have gathered much of the sweet. they have enjoyed life, and those who enjoy give enjoyment to others. it takes an audience to make even the best of plays. mrs. wagoner is not rich, but she has a philosophy that is riches enough. she knows that she receives through giving. she has lived this knowledge, which has brought blessings upon her. these people have all led simple lives and they have worked. there is no secret about growing old gracefully. it means self-control, simple living, work for body and mind, cleanliness of body and mind, and the most important part of physical cleanliness is a clean colon. it is necessary to have a tranquil mind most of the time, for anger and worry are injurious to health. the average span of life is lengthening. in the sixteenth century the average european did not live to be twenty years old. now he lives to be about forty. the same increase has taken place in america. in india and china the average of life is still below twenty-four years. as civilization advances the tendency is for the average of life to lengthen, provided life does not grow so complex that knowledge is antidoted by too great artificiality. however, it is well to note that it is not the last part of life that is being lengthened. we are allowing less and less infants to die as the years roll on. the proportion of the adult population that reaches advanced age is no greater than in the past. our mode of life is so wrong that tuberculosis, typhoid fever, cancer, kidney diseases, pneumonia and circulatory degeneration carry off immense numbers of those whom we call middle aged, but who are really young people. these are diseases of degeneration. it is to our interest to reduce these diseases. proper living will do it. the life expectancy of people over fifty is even less than it was thirty years ago. middle aged people die from diseases caused by bad habits, extended over a period of years. therefore, these people should learn to live well if they would live longer. the diet of the old can be about the same as that of an adult in the prime of life, except that less should be eaten. those who live correctly have no digestive disturbances. it will be noted by those who are normal that there is not a desire for as much food as earlier in life, and this should be a guide. old people get all the nourishment they need in two moderate meals a day. if the three-meal-a-day plan is preferred, it is all right, but then less should be taken at each meal. white flour products are easier to digest than the whole wheat products, but normal people can digest the latter very well and it is a better food than white flour. i know one gentleman in his eighth decade of life who has grown stronger and younger by abandoning the conventional eating habits and living mostly on moderate meals of milk and whole wheat biscuits. as cornaro said, some need more than others, but all should be moderate. one meal a day of milk and biscuits is all right. these biscuits should be well baked and well masticated. the milk should be taken slowly. another meal can be meat or eggs or fish with some of the cooked and raw succulent vegetables. if a third meal is taken, it may consist of clabbered milk or buttermilk; or of one of the sweet fruits, and the sweet fruits may be used any time in place of bread or biscuits. cottage cheese is a good food at any time, and may be taken with fruits, either acid or sweet. as often as desired, in summer, take fruit. because the very acid, juicy fruits have a tendency to cause chilliness and to thin the blood, it is well to take them in moderation during advanced years, but that does not mean that those who like them should avoid them. in winter time the sweet fruit is best. mild apples and bananas may be used as often as there is a desire for them. oranges should be taken more rarely, as well as grapefruit, pineapples and other fruits that are heavily charged with acid. as a general rule, the starchy foods should be eaten but once a day, but those who are very moderate may take them twice a day without bad results. vegetarians have eggs and milk to take the place of flesh foods. they also have lentils, peas, beans and the protein in the whole wheat and other cereals. lentils, peas and beans must be taken in moderation, for they are rich in nutriment and if too much is eaten they soon cause disease. nuts, if well masticated, are also all right. the general basis of feeding should be starch once a day and protein once a day in moderation. all kinds of starch and all kinds of protein may be used. fruits more moderately than during the earlier years of life is best. all the succulent vegetables that are desired may be partaken of. by cooking the foods simply, as recommended in this book, they are rendered easier to digest than under the conventional manner of cooking. simple cooking will help to preserve health and prolong life. work is one of the greatest blessings of life. those who would live long and be useful must exercise both body and mind. like all other blessings, if it is carried to excess it is injurious. it is unfortunate that some people must work too hard because there is a class of people who do nothing useful, being content to be wasters. work has been looked upon as a curse. this is a mistake. those who live in the hope and expectation that they may some day cease working in order to enjoy life, will find when they reach the goal that life without work is not worth while. those who can afford it can with benefit lessen the amount of productive work they do and evolve more into cultural lines, but it is dangerous to cease working. the human being is so constituted that without activity of body and mind there is degeneration. what is sadder than to see a capable individual who has won a competence and then has retired to enjoy it! he does not enjoy it. either he has to get into some line of work, physical or mental, or he soon dies. we must have a lively interest in something or there is stagnation. there are many beautiful things in life, and we should cultivate them while we are young enough to be able to learn to enjoy them. the loftiest spirits of the ages have left their inspirations and their aspirations with us in poetry, prose, music, painting, statuary and in other forms. we should try to cultivate understanding of these subjects, not necessarily all of them, but of one or more, for with understanding come the elevation and broadening of mind that are always present when there is sympathy, and sympathy is closely related to understanding. culture along one or more lines broadens the mind and makes a person more worth while not only to himself, but to others. we can not estimate the value of the beauty in life in dollars and cents, but he is poor indeed who is rich in worldly goods alone. it is necessary to be interested in the activities about us. those who think of nothing or no one except themselves are almost dead to the world, even though they go through the same physical activities as other people. the tendency is to get into a rut with advancing years and remain there. it is easy to keep both a pliable mind and a pliable body in spite of age, and this can be done by intelligent use. a short time daily should be spent in becoming informed of what is happening throughout the world and thinking it over. a mental hobby is most excellent. a garden or a few birds can furnish an almost inexhaustible source of interest. those who doubt this should read of the comedy and tragedy among such humble beings as the spider, the fly and the beetle. j. h. fabre has written charmingly about these, investing them with an interest rarely to be found in good fiction. this naturalist is a good example of what can be accomplished when one has years to do it in and is content to labor along from day to day without giving too much thought for the morrow. at fifty mr. fabre was practically unknown. now, at about ninety, he is one of the most admired and best loved of men. his recognition came late and he has done much of his best work during his later years. if mr. fabre had died at the average age of forty, the world would have been deprived of his beautiful insight. another cause of old age is getting mentally old. an individual begins to grow old by dwelling on the subject. the girl of thirteen must cease romping and racing about because it is not lady-like. at twenty-five it is very, very undignified to run a little. at forty a woman must be rather sedate, for being natural would mean frivolity. people are continually growing too old to do this and that, not because they have lost the desire and the ability, but because it is unbecoming at their age. this is folly. keep a young heart all through life. a heartfelt laugh is one of nature's best tonics. there is no more harm in dancing at fifty than at fifteen and not so much danger. the relaxation of muscles and sagging of the face are as much the result of mental attitude as of loss of tonicity. thinking young and associating with children are helpful and healthful. people who are very stiff and dignified are mentally sterile. the charming people are the ones who are willing and able to understand and sympathize with the aims and aspirations of others, and in order to do so it is necessary to thaw out. the art of life is delightful if properly developed. worry is such a detriment that its victims can neither live nor work as they should. it is necessary to overcome this bad habit. most of the worry is due to narrow selfishness. much of it is caused by the fact that others will not do as we do. to try to make others accept our standards and then worry and fret because they will not is folly. when force is employed to convert anyone the conversion is but superficial and lasts only so long as the converted individual's hypocrisy holds out. to get the best out of life we have to be broad, forbearing, patient and forgiving. a normal old age is beautiful. it is the privilege, nay more, the duty of every intelligent being to attain it. when we adjust ourselves we shall live longer. it is with old age as it is with health. we can have it if we wish it. accidents alone can deprive us of either. let us hope that the day will come when men and women will not be satisfied to die as life is but beginning, but that they will live as they should and could live, thus proving a blessing to the race. chapter xxix. evolving into health. by the time most people are twenty years old they have some kind of disease. it may be only a slight catarrh, a touch of indigestion, trouble with the eyes, defective hearing, or some other ill. very seldom do we meet a person of this age who is perfectly well. most people are taught to believe that health is something mysterious which may come to them or may pass them by, but that they have little or nothing to do with it. if they are well, they are fortunate, but if they are ill they are not to blame. most of them go to conventional physicians when they are ill, expecting to be cured. they take medicine or injections of serums or they are operated upon. when they are through with the doctors they are no wiser than they were before. a few have friends who tell them that they must change their mode of living if they would have health. they are interested enough to go to a healer who believes in nature. he tells them that they are well or ill according to their desserts, that they can be well at all times, if they wish, for if they live as they should health is a natural consequence. this sounds like nonsense at first. it is different from anything else they have heard. the sufferer often makes up his mind that the healer is a fool or a faker. he remembers that when he went to the conventional physicians they sounded and thumped him and examined all his excretions. they were very thorough and scientific. the natural healer does not generally go into so many details. he asks enough and examines enough to find the trouble and then he stops. this the patient charges against him, for he takes for granted that the healer is brief from lack of knowledge. so he goes back to his old physician. as his trouble is due to deranged nutrition, he does not get well. he thinks over what the natural healer said, and the more he thinks about it the more reasonable it sounds, and he returns again. this time he gets instructions, and he follows them enough to get benefit, but not faithfully enough to get well. he is convinced that the conventional physicians are wrong, but still believes that the natural healer can hardly be right. after a while he makes up his mind to get down to business and he goes to the healer for instructions and follows them. the results are surprising. the trouble he has had for years may disappear within a month or two, or it may become less and less apparent, but take considerable time before it leaves entirely. the healer gives instructions. the most important ones are those concerning the diet. a plan is given that brings good results. the healer fails to explain that this is but one correct method of feeding, that there are other good ones. the patient is enthused over the benefits derived, he makes up his mind that he is living the only correct life, and he too often becomes a food crank, trying to force his ideas upon all about him. here the healer is at fault, for he should explain that some method is necessary, but that there is no one and only method of feeding. if the patient is fairly intelligent, in time he realizes that it is not so much what he eats as his manner of eating and moderation that are helpful, and that any plan in which moderation and simplicity are followed is better than the ordinary way of eating. as the patient evolves into health and gets a broader view of the art of living, he gets a better perspective of life. he learns that under like conditions like causes always produce like effects, that the law of compensation is always operative, and we therefore get what we deserve. he loses his fear of many things that caused him grave concern previously. he sees in sickness and death the working of natural law, not of chance. some patients realize that healers who work in accordance with nature are right, at the very start, but most people are not so logically constructed. it often takes from one to three years before people make up their mind to order their lives so that they can have health at their command. in the old way, the doctor was supposed to cure, which was impossible. in the new way, the healer educates people and then if they live their knowledge they get health. the healer must instruct in the care of all parts of the body, weeding out bad habits and trying to instill good ones in their place. eating according to correct principles is the most helpful and powerful aid in regaining health. the patient finds that as the years pass his tastes change, becoming more simple and more moderate. he is well nourished on one-half to one-third of what he used to consume and consider necessary. the following is the last half of a month's record of food intake for a man in the thirties. some years ago he changed his manner of living in order to regain health, in which he succeeded. now he takes only one or two meals a day, according to his desires, not that he has any objection to three meals a day, but he finds it best to eat more seldom. he is in good physical condition, as heavy as he ought to be, and he has not had any real physical trouble for a number of years. his work is mental, but he walks considerably and swims from three to six times a week, besides taking a few set exercises. it was taken in spring, the weather averaging cool. this is a little lighter than usual, because the record was taken during a period of exceptionally hard mental work. in cold weather heavier foods are taken. lunch: nothing. dinner: three slices of rye toast, very thin, celery, three slices broiled onion, dish of peas, glass of beer. dinner at noon: roast lamb, dish of spinach, one and one-half dishes summer squash, lettuce and tomato salad. supper: nothing. lunch: dish of baked lentils, vegetable soup, lettuce. dinner: two small oranges, cottage cheese. lunch: piece of gingerbread, cup of cocoa, two lumps of sugar. dinner: two small oranges, cottage cheese. lunch: dish of stewed prunes, tablespoonful cottage cheese. dinner: two eggs, two slices buttered toast. lunch: small grapefruit. dinner: vegetable soup, dish of stewed turnips, dish of peas. lunch: nothing. dinner: half a grapefruit, three stewed figs, glass of milk. lunch: dish of strawberries, large dish of rhubarb with grapefruit juice in it and cream on the side; half serving cream cheese. dinner: two small baked apples. lunch: small grapefruit. dinner: two eggs, dish of turnips, dish of spinach, sliced tomatoes. lunch: one raw apple. dinner: two shredded wheat biscuits, glass of milk. lunch: dish of rhubarb. dinner: vegetable soup, one egg, a boiled potato. lunch: dish of rhubarb. dinner: sweet potato, dish of parsnips, stewed peas. lunch: dish of ice cream, piece of white cake. dinner: cheese cake, dish of fruit salad. lunch: one hard boiled egg, about one and one-half slices white bread, two big radishes, one young onion, butter. dinner: nothing. the servings are the ordinary restaurant servings. no dressings were used except the ones mentioned. this man used to be very fond of sweets and employed salt freely. now he finds his foods more agreeable when taken plain, for they have a better flavor. he rarely uses salt or pepper. he has simplified his food intake because he finds he feels better and stronger and is able to think to better advantage than he did when he partook of a greater variety and amount of food at each meal. food scientists say that from two thousand, seven hundred to three thousand, three hundred calories are needed daily, but you will note that this man generally keeps below one-half of this, if you are able to figure food values. people who are trying to get well are often called fools and cranks when they treat themselves properly, but this does not matter, for such fools generally live to see their wise critics prematurely consigned to the earth. when taking health advice, try to keep your balance. get thoroughly well before you try to guide others. chapter xxx. retrospect. several hundred pages have been devoted to those matters which must receive attention in order to have good physical and mental health, so as to be able to get the most out of life and give the most, that is, in order to live fully. the basis of health is internal cleanliness, and to attain this it is necessary to exercise self-control and moderation, as well as to cultivate good will and kindliness towards others. kindness and love lubricate life and make the running smooth. envy, spite, hatred and the other negative emotions act like sand in the bearings, producing friction in the vital machinery, which they destroy in the end. success in life means balance, poise, adjustment. we must adjust ourselves so as to be in harmony with others, and we must be in harmony with nature. our minds will at times be in opposition to the laws of nature. then we must exercise enough self-control to bring them into harmony again, for natural laws are no respecters of persons. it is said that we break these laws, but that is not true. if we disregard them often enough they break us. we must realize our unity with nature, our at-one-ment. we must realize that we are a part of nature, not above it, and hence that we are governed by the same fixed laws that govern the rest of nature. these laws are for our good. attempts to escape from their workings indicate a lack of understanding. discord produces disease and death. harmony leads to health and long life. the adjustment must be both physical and mental. the physical part means to live or adjust ourselves so that all the functions of the body are carried on normally. the body is self-regulating and if we do nothing harmful health will be our portion. however, life under our present civilization is so complex that the demands upon our nervous systems are excessive. it is easy to live so that we can have health, but to do so is not conventional, and hence not very popular. in order to have good physical health under present conditions, it is necessary to make some effort. the effort is not great enough to be onerous and does not require much time. it is important to get health knowledge, which the majority lacks today. this knowledge is most excellent, but it does not benefit the individual unless it is applied. we all wish to have health, but this is not enough. we must will to have it. when we say that we cannot, it should generally be interpreted to mean that we will not. some important subjects regarding which special knowledge should be secured are: food, drink, exercise, care of the skin, sleep, work and play, breathing, clothing, and mental attitude. these subjects, as well as others, have been quite extensively discussed. it is impossible to give full information in tabloid form. it is also impossible to read a book of this character once and get all the information it contains. those who are in earnest will study the subject, instead of merely reading it. allow me to remind you that nearly all of our diseases are due to faulty dietary habits. so it was in the time of hippocrates, according to that sage, and so it is today. it is a common statement that about per cent. of our physical ills come from improper diet, and this is the truth. it follows from this that it is most important to know about correct feeding habits, and put them in practice. improper diet results in faulty nutrition, after which physical and mental ills make their appearance. there are many systems of feeding, and nearly all of them will bring good results if the most important prescription is followed, namely, moderation. simplicity leads to moderation. those who are reasonable about their food intake often serve as targets for the shafts of ridicule launched at them by those who are ignorant of the subject or too self-indulgent to exercise a little self-control. ridicule is one of the most deadly of weapons, but it never harms those who have the hardihood of getting down to basic facts and classifying things and ideas according to their true value. why should we be guided by the wit and sarcasm of indolent voluptuaries who daily desecrate their bodies through ruinous indulgences? there is no need of becoming harsh and austere, nor is it necessary to fall into deadly habits of self-indulgence. sometimes we can go with the current with benefit, but at times it is also necessary to paddle up-stream. life demands a certain amount of hardihood from those who would live in health, and this comes not from self-indulgence, but from self-denial. it is necessary to do almost daily something that we are not inclined to do. it is well to remember that if the eating is correct, it is difficult to become physically deranged, and consequently to become mentally deranged. allow me to repeat four short sentences which are helpful and most important guides, sentences which ought to form a part of every child's education: if ill, eat nothing, but live on water. eat only when there is a desire for food. masticate all foods thoroughly. always be moderate in your food intake. these are the four golden rules regarding eating, and if they were adhered to, they would save us from an incalculable amount of sin and suffering. they would increase the duration of life and the joy of living. they would add to our physical and mental prosperity. hence they are worthy of the emphasis given them. in brief: physical health is based on internal cleanliness, which can be attained only through moderation, that is, by not habitually overburdening the system, especially with food. our bodies thrive when used, but not when abused. it is necessary for our physical well-being to get air, sunshine, water, food, sleep, rest, exercise, work and play in proper proportion, and in addition cultivate a kindly, balanced spirit. drugs, such as alcohol, coffee, morphine, bromine, and hundreds of others which could be named, are not only unnecessary, but harmful. the mental side is as important as the physical side. with a healthy body it is easy to have a happy outlook. indigestion and biliousness can make a dreary waste out of the most beautiful landscape. the body and mind react and interact, one upon the other. when one is poised it is easy to get the other into balance. it requires a poised body to produce the best fruitage--a fine spirit. it is necessary to be honest with one's self. face life courageously and honestly. if you do, you will soon realize that the physical and mental ills from which you suffer are mostly of your own making. then you can choose whether to let them continue or to end them, but if you choose to remain ill, bear your cross uncomplainingly, for you have no right to afflict others with your self-imposed sufferings. on the other hand, try to see life from the view point of others, and you will often find that what you think is the highest good and most desirable in life does not seem worthy of great effort to them. variety adds spice to life. to impose one's own views and ways on others has always seemed desirable to the majority of people, but it is the height of folly and stupidity. so long as the race exists there will be many men of many minds, and it is best so. we can not force any benefit, such as health or goodness, upon others. instead of attracting, the process of forcing repels. what we can do mentally to benefit ourselves and others is to get adjusted, to cultivate kindness and charity, to be broad-minded and forgiving, to be slow to take and give offense, to accept the little buffetings that fate has in store for us all with good grace, and through it all to possess our souls in patience. physically, be moderate. mentally, cultivate equanimity. he is not far from every one of us. for in him we live and move not less than in him we have our being. "out of darkness comes the hand reaching through nature,--moulding man." _health:_ five lay sermons to working-people. by john brown, m.d. boston: james r. osgood and company, _late ticknor and fields, and fields, osgood, & co._ . _affectionately inscribed to the memory of the_ rev. james trench, _the heart and soul of the canongate mission, who, while he preached a pure and a fervent gospel to its heathens, taught them also and therefore to respect and save their health, and was the originator and keeper of their library and penny bank, as well as their minister._ preface. three of these sermons were written for, and (shall i say?) preached some years ago, in one of the earliest missionary stations in edinburgh, established by broughton place congregation, and presided over at that time by the reverend james trench; one of the best human beings it was ever my privilege to know. he is dead; dying in and of his work,--from typhus fever caught at the bedside of one of his poor members--but he lives in the hearts of many a widow and fatherless child; and lives also, i doubt not, in the immediate vision of him to do whose will was his meat and his drink. given ten thousand such men, how would the crooked places be made straight, and the rough places plain, the wildernesses of city wickedness, the solitary places of sin and despair, of pain and shame, be made glad! this is what is to regenerate mankind; this is the leaven that some day is to leaven the lump. the other two sermons were never preached, except in print; but they were composed in the same key. i say this not in defence, but in explanation. i have tried to speak to working men and women from my lay pulpit, in the same words, with the same voice, with the same thoughts i was in the habit of using when doctoring them. this is the reason of their plain speaking. there is no other way of reaching these sturdy and weather and work-beaten understandings; there is nothing fine about them outside, though they are often as white in the skin under their clothes as a duchess, and their hearts as soft and tender as jonathan's, or as rachel's, or our own grizel baillie's; but you must speak out to them, and must not be mealy-mouthed if you wish to reach their minds and affections and wills. i wish the gentlefolks could hear and could use a little more of this outspokenness; and, as old porson said, condescend to call a spade a spade, and not a horticultural implement; five letters instead of twenty-two, and more to the purpose. you see, my dear working friends, i am great upon sparing your strength and taking things cannily. "all very well," say you; "it is easy speaking, and saying, take it easy; but if the pat's on the fire it maun bile." it must, but you needn't poke up the fire forever, and you may now and then set the kettle on the hob, and let it sing, instead of leaving it to burn its bottom out. i had a friend who injured himself by overwork. one day i asked the servant if any person had called, and was told that some one had. "who was it?" "o, it's the little gentleman that _aye rins when he walks_!" so i wish this age would walk more and "rin" less. a man can walk farther and longer than he can run, and it is poor saving to get out of breath. a man who lives to be seventy, and has ten children and (say) five-and-twenty grandchildren, is of more worth to the state than three men who die at thirty, it is to be hoped unmarried. however slow a coach seventy may have been, and however energetic and go-ahead the three thirties, i back the tortoise against the hares in the long run. i am constantly seeing men who suffer, and indeed die, from living too fast; from true though not consciously immoral dissipation or scattering of their lives. many a man is bankrupt in constitution at forty-five, and either takes out a _cessio_ of himself to the grave, or goes on paying ten per cent for his stock-in-trade; he spends his capital instead of merely spending what he makes, or better still, laying up a purse for the days of darkness and old age. a queer man, forty years ago,--mr. slate, or, as he was called, _sclate_, who was too clever and not clever enough, and had not wisdom to use his wit, always scheming, full of "go," but never getting on,--was stopped by his friend, sir walter scott,--that wonderful friend of us all, to whom we owe jeanie deans and rob roy, meg merrilies and dandie dinmont, jinglin' geordie, cuddie headrigg, and the immortal baillie,--one day in princess street. "how are ye getting on, sclate?" "oo, just the auld thing, sir walter; _ma pennies a' gang on tippenny eerands_." and so it is with our nervous power, with our vital capital, with the pence of life; many of them go on "tippenny eerands." we are forever getting our bills renewed, till down comes the poor and damaged concern with dropsy or consumption, blazing fever, madness, or palsy. there is a western banking system in living, in using our bodily organs, as well as in paper-money. but i am running off into another sermon. health of mind and body, next to a good conscience, is the best blessing our maker can give us, and to no one is it more immediately valuable than to the laboring man and his wife and children; and indeed a good conscience is just moral health, the wholeness of the sense and the organ of duty; for let us never forget that there is a religion of the body, as well as, and greatly helpful of, the religion of the soul. we are to glorify god in our souls and in our bodies, for the best of all reasons, _because they are his_, and to remember that at last we must give account, not only of our thoughts and spiritual desires and acts, but _all the deeds done in our body_. a husband who, in the morning before going to his work, would cut his right hand off sooner than injure the wife of his bosom, strangles her that same night when mad with drink; that is a deed done in his body, and truly by his body, for his judgment is gone; and for that he must give an account when his name is called; his judgment was gone; but then, as the child of a drunken murderer said to me, "a' but, sir, wha goned it?" i am not a teetotaler. i am against teetotalism as a doctrine of universal application; i think we are meant to use these things as not abusing them,--this is one of the disciplines of life; but i not the less am sure that drunkenness ruins men's bodies,--it is not for me to speak of souls,--is a greater cause of disease and misery, poverty, crime, and death among the laboring men and women of our towns, than consumption, fever, cholera, and all their tribe, with thieving and profligacy and improvidence thrown into the bargain: these slay their thousands; this its tens of thousands. do you ever think of the full meaning of "he's the waur o' drink?" how much the waur?--and then "dead drunk,"--"mortal." can there be anything more awfully significant than these expressions you hear from children in the streets? * * * * * you will see in the woodcut a good illustration of the circulation of the blood: both that through our lungs, by which we breathe and burn, and that through the whole body, by which we live and build. that hand grasps the heart, the central depot, with its valves opening out and in, and, by its contraction and relaxation, makes the living fluid circulate everywhere, carrying in strength, life, and supply to all, and carrying off waste and harm. none of you will be the worse of thinking of that hand as his who makes, supports, moves, and governs all things,--that hand which, while it wheels the rolling worlds, gathers the lambs with his arm, carries them in his bosom, and gently leads those that are with young, and which was once nailed for "our advantage on the bitter cross." j. b. rutland street, december , . contents. preface sermon i. the doctor: our duties to him " ii. the doctor: his duties to you " iii. children, and how to guide them " iv. health " v. medical odds and ends health. sermon i. the doctor: our duties to him. everybody knows the doctor; a very important person he is to us all. what could we do without him? he brings us into this world, and tries to keep us as long in it as he can, and as long as our bodies can hold together; and he is with us at that strange and last hour which will come to us all, when we must leave this world and go into the next. when we are well, we perhaps think little about the doctor, or we have our small joke at him and his drugs; but let anything go wrong with our body, that wonderful tabernacle in which our soul dwells, let any of its wheels go wrong, then off we fly to him. if the mother thinks her husband or her child dying, how she runs to him, and urges him with her tears! how she watches his face, and follows his searching eye, as he examines the dear sufferer; how she wonders what he thinks,--what would she give to know what he knows! how she wearies for his visit! how a cheerful word from him makes her heart leap with joy, and gives her spirit and strength to watch over the bed of distress! her whole soul goes out to him in unspeakable gratitude when he brings back to her from the power of the grave her husband or darling child. the doctor knows many of our secrets, of our sorrows, which no one else knows,--some of our sins, perhaps, which the great god alone else knows; how many cares and secrets, how many lives, he carries in his heart and in his hands! so you see he is a very important person the doctor, and we should do our best to make the most of him, and to do our duty to him and to ourselves. a thinking man feels often painfully what a serious thing it is to be a doctor, to have the charge of the lives of his fellow-mortals, to stand, as it were, between them and death and eternity and the judgment-seat, and to fight hand to hand with death. one of the best men and greatest physicians that ever lived, dr. sydenham, says, in reference to this, and it would be well if all doctors, young and old, would consider his words:-- "it becomes every man who purposes to give himself to the care of others, seriously to consider the four following things: _first_, that he must one day give an account to the supreme judge of all the lives intrusted to his care. _secondly_, that all his skill and knowledge and energy, as they have been given him by god, so they should be exercised for his glory and the good of mankind, and not for mere gain or ambition. _thirdly_, and not more beautifully than truly, let him reflect that he has undertaken the care of no mean creature, for, in order that we may estimate the value, the greatness of the human race, the only begotten son of god became himself a man, and thus ennobled it with his divine dignity, and, far more than this, died to redeem it; and _fourthly_, that the doctor, being himself a mortal man, should be diligent and tender in relieving his suffering patients, inasmuch as he himself must one day be a like sufferer." i shall never forget a proof i myself got twenty years ago, how serious a thing it is to be a doctor, and how terribly in earnest people are when they want him. it was when cholera first came here in . i was in england at chatham, which you all know is a great place for ships and sailors. this fell disease comes on generally in the night; as the bible says, "it walks in darkness," and many a morning was i roused at two o'clock to go and see its sudden victims, for then is its hour and power. one morning a sailor came to say i must go three miles down the river to a village where it had broken out with great fury. off i set. we rowed in silence down the dark river, passing the huge hulks, and hearing the restless convicts turning in their beds in their chains. the men rowed with all their might: they had too many dying or dead at home to have the heart to speak to me. we got near the place; it was very dark, but i saw a crowd of men and women on the shore, at the landing-place. they were all shouting for the doctor; the shrill cries of the women, and the deep voices of the men coming across the water to me. we were near the shore, when i saw a big old man, his hat off, his hair gray, his head bald; he said nothing, but turning them all off with his arm, he plunged into the sea, and before i knew where i was, he had me in his arms. i was helpless as an infant. he waded out with me, carrying me high up in his left arm, and with his right levelling every man or woman who stood in his way. it was big joe carrying me to see his grandson, little joe; and he bore me off to the poor convulsed boy, and dared me to leave him till he was better. he did get better, but big joe was dead that night. he had the disease on him when he carried me away from the boat, but his heart was set upon his boy. i never can forget that night, and how important a thing it was to be able to relieve suffering, and how much old joe was in earnest about having the doctor. now, i want you to consider how important the doctor is to you. nobody needs him so much as the poor and laboring man. he is often ill. he is exposed to hunger and wet and cold, and to fever, and to all the diseases of hard labor and poverty. his work is heavy, and his heart is often heavy, too, with misery of all kinds,--his heart weary with its burden,--his hands and limbs often meeting with accidents,--and you know if the poor man, if one of you falls ill and takes fever, or breaks his leg, it is a far more serious thing than with a richer man. your health and strength are all you have to depend on; they are your stock-in-trade, your capital. therefore i shall ask you to remember _four things_ about your duty to the doctor, so as to get the most good out of him, and do the most good to him too. _ st_, it is your duty to trust the doctor; _ dly_, it is your duty to obey the doctor; _ dly_, it is your duty to speak the truth to the doctor, the whole truth, and nothing but the truth; and, _ thly_, it is your duty to reward the doctor. and so now for the _first_. it is your duty to _trust_ the doctor, that is, to believe in him. if you were in a ship, in a wild storm, and among dangerous rocks, and if you took a pilot on board, who knew all the coast and all the breakers, and had a clear eye, and a firm heart, and a practised hand, would you not let him have his own way? would you think of giving him your poor advice, or keep his hand from its work at the helm? you would not be such a fool, or so uncivil, or so mad. and yet many people do this very same sort of thing, just because they don't really trust their doctor; and a doctor is a pilot for your bodies when they are in a storm and in distress. he takes the helm, and does his best to guide you through a fever; but he must have fair play; he must be trusted even in the dark. it is wonderful what cures the very sight of a doctor will work, if the patient believes in him; it is half the battle. his very face is as good as a medicine, and sometimes better,--and much pleasanter too. one day a laboring man came to me with indigestion. he had a sour and sore stomach, and heartburn, and the water-brash, and wind, and colic, and wonderful misery of body and mind. i found he was eating bad food, and too much of it; and then, when its digestion gave him pain, he took a glass of raw whiskey. i made him promise to give up his bad food and his worse whiskey, and live on pease-brose and sweet milk, and i wrote him a prescription, as we call it, for some medicine, and said, "take _that_, and come back in a fortnight and you will be well." he did come back, hearty and hale;--no colic, no sinking at the heart, a clean tongue, and a cool hand, and a firm step, and a clear eye, and a happy face. i was very proud of the wonders my prescription had done; and having forgotten what it was, i said, "let me see what i gave you." "o," says he, "i took it." "yes," said i, "but the prescription." "_i took it_, as you bade me. i swallowed it." he had actually eaten the bit of paper, and been all that the better of it; but it would have done him little, at least less good had he not trusted me when i said he would be better, and attended to my rules. so, take my word for it, and trust your doctor; it is his due, and it is for your own advantage. now, our next duty is to _obey_ the doctor. this you will think is simple enough. what use is there in calling him in, if we don't do what he bids us? and yet nothing is more common--partly from laziness and sheer stupidity, partly from conceit and suspiciousness, and partly, in the case of children, from false kindness and indulgence--than to disobey the doctor's orders. many a child have i seen die from nothing but the mother's not liking to make her swallow a powder, or put on a blister; and let me say, by the by, teach your children at once to obey you, and take the medicine. many a life is lost from this, and remember you may make even willie winkie take his castor-oil in spite of his cries and teeth, _by holding his nose_, so that he must swallow. _thirdly, you should tell the truth, the whole truth, and nothing but the truth_, to your doctor. he may be never so clever, and never so anxious, but he can no more know how to treat a case of illness without knowing all about it, than a miller can make meal without corn; and many a life have i seen lost from the patient or his friends concealing something that was true, or telling something that was false. the silliness of this is only equal to its sinfulness and its peril. i remember, in connection with that place where big joe lived and died, a singular proof of the perversity of people in not telling the doctor the truth,--as you know people are apt to send for him in cholera when it is too late, when it is a death rather than a disease. but there is an early stage, called premonitory,--or warning,--when medicines can avail. i summoned all the people of that fishing-village who were well, and told them this, and asked them if they had any of the symptoms. they all denied having any (this is a peculiar feature in that terrible disease, they are afraid to _let on_ to themselves, or even the doctor, that they are "in for it"), though from their looks and from their going away while i was speaking, i knew they were not telling the truth. well, i said, "you must, at any rate, every one of you take some of this," producing a bottle of medicine. i will not tell you what it was, as you should never take drugs at your own hands, but it is simple and cheap. i made every one take it; only one woman going away without taking any; she was the only one of all those _who died_. _lastly, it is your duty to reward_ your doctor. there are four ways of rewarding your doctor. the first is by giving him your money; the second is by giving him your gratitude; the third is by your doing his bidding; and the fourth is by speaking well of him, giving him a good name, recommending him to others. now, i know few if any of you can pay your doctor, and it is a great public blessing that in this country you will always get a good doctor willing to attend you for nothing, and this _is_ a great blessing; but let me tell you,--i don't think i need tell you,--try and pay him, be it ever so little. it does you good as well as him; it keeps up your self-respect; it raises you in your own eye, in your neighbor's, and, what is best, in your god's eye, because it is doing what is right. the "man of independent mind," be he never so poor, is "king of men for a' that"; ay, and "for twice and mair than a' that"; and to pay his way is one of the proudest things a poor man can say, and he may say it oftener than he thinks he can. and then let me tell you, as a bit of cool, worldly wisdom, that your doctor will do you all the more good, and make a better job of your cure, if he gets something, some money for his pains; it is human nature and common sense, this. it is wonderful how much real kindness and watching and attendance and cleanliness you may get _for so many shillings a week_. nursing is a much better article at that,--much,--than at _nothing_ a week. but i pass on to the other ways of paying or rewarding your doctor, and, above all, _to gratitude_. honey is not sweeter in your mouths, and light is not more pleasant to your eyes, and music to your ears, and a warm, cosey bed is not more welcome to your wearied legs and head, than is the honest, deep gratitude of the poor to the young doctor. it is his glory, his reward; he fills himself with it, and wraps himself all round with it as with a cloak, and goes on in his work, happy and hearty; and the gratitude of the poor is worth the having, and worth the keeping, and worth the remembering. twenty years ago i attended old sandie campbell's wife in a fever, in big hamilton's close in the grassmarket,--two worthy, kindly souls they were and are. (sandie is dead now.) by god's blessing, the means i used saved "oor kirsty's" life, and i made friends of these two forever; sandie would have fought for me if need be, and kirsty would do as good. i can count on them as my friends, and when i pass the close-mouth in the west port, where they now live, and are thriving, keeping their pigs, and their hoary old cuddie and cart, i get a courtesy from kirsty, and see her look after me, and turn to the women beside her, and i know exactly what she is saying to them about "dr. broon." and when i meet old sandie, with his ancient and long-lugged friend, driving the draff from the distillery for his swine, i see his gray eye brighten and glisten, and he looks up and gives his manly and cordial nod, and goes on his way, and i know that he is saying to himself, "god bless him! he saved my kirsty's life," and he runs back in his mind all those twenty past years, and lays out his heart on all he remembers, and that does him good and me too, and nobody any ill. therefore, give your gratitude to your doctor, and remember him, like honest sandie; it will not lose its reward and it costs you nothing; it is one of those things you can give and never be a bit the poorer, but all the richer. one person i would earnestly warn you against, and that is the _quack doctor_. if the real doctor is a sort of god of healing, or rather our god's cobbler for the body, the quack is the devil for the body, or rather the devil's servant against the body. and like his father, he is a great liar and cheat. he offers you what he cannot give. whenever you see a medicine that cures everything, be sure it cures nothing; and remember, it may kill. the devil promised our saviour all the kingdoms of the world if he would fall down and worship him; now this was a lie, he could not give him any such thing. neither can the quack give you his kingdoms of health, even though you worship him as he best likes, by paying him for his trash; he is dangerous and dear, and often deadly,--have nothing to do with him. we have our duties to one another, yours to me, and mine to you: but we have all our duty to one else,--to almighty god, who is beside us at this very moment--who followed us all this day, and knew all we did and didn't do, what we thought and didn't think,--who will watch over us all this night,--who is continually doing us good,--who is waiting to be gracious to us,--who is the great physician, whose saving health will heal all our diseases, and redeem our life from destruction, and crown us with loving-kindness and tender mercies,--who can make death the opening into a better life, the very gate of heaven; that same death which is to all of us the most awful and most certain of all things, and at whose door sits its dreadful king, with that javelin, that sting of his, which is sin, our own sin. death would be nothing without sin, no more than falling asleep in the dark to awake to the happy light of the morning. now, i would have you think of your duty to this great god, our father in heaven; and i would have you to remember that it is your duty to trust him, to believe in him. if you do not, your soul will be shipwrecked, you will go down in terror and in darkness. it is your duty to _obey_ him. whom else in all this world should you obey, if not him? and who else so easily pleased, if we only do obey? it is your duty to speak the truth to him, not that he needs any man to tell him anything. he knows everything about everybody; nobody can keep a secret from him. but he hates lies; he abhors a falsehood. he is the god of truth, and must be dealt honestly with, in sincerity and godly fear; and, lastly, you must in a certain sense _reward_ him. you cannot give him money, for the silver and gold, the cattle upon a thousand hills, are all his already, but you can give him your grateful lives; you can give him your hearts; and as old mr. henry says, "thanksgiving is good, but thanks-living is better." one word more; you should call your doctor early. it saves time; it saves suffering; it saves trouble; it saves life. if you saw a fire beginning in your house, you would put it out as fast as you could. you might perhaps be able to blow out with your breath what in an hour the fire-engine could make nothing of. so it is with disease and the doctor. a disease in the morning when beginning is like the fire beginning; a dose of medicine, some simple thing, may put it out, when if left alone, before night it may be raging hopelessly, like the fire if left alone, and leaving your body dead and in the ruins in a few hours. so, call in the doctor soon; it saves him much trouble, and may save you your life. and let me end by asking you to call in the great physician; to call him instantly, to call him in time; there is not a moment to lose. he is waiting to be called; he is standing at the door. but he must be _called_,--he may be called too late. sermon ii. the doctor: his duties to you. you remember our last sermon was mostly about your duties to the doctor. i am now going to speak about his duties to you; for you know it is a law of our life, that there are no one-sided duties,--they are all double. it is like shaking hands, there must be two at it; and both of you ought to give a hearty grip and a hearty shake. you owe much to many, and many owe much to you. the apostle says, "owe no man anything but to love one another"; but if you owe that, you must be forever paying it; it is always due, always running on; and the meanest and most helpless, the most forlorn, can always pay and be paid in that coin, and in paying can buy more than he thought of. just as a farthing candle, twinkling out of a cotter's window, and, it may be, guiding the gudeman home to his wife and children, sends its rays out into the infinite expanse of heaven, and thus returns, as it were, the light of the stars, which are many of them suns. you cannot pass any one on the street to whom you are not bound by this law. if he falls down, you help to raise him. you do your best to relieve him, and get him home; and let me tell you, to your great gain and honor, the poor are far more ready and better at this sort of work than the gentlemen and ladies. you do far more for each other than they do. you will share your last loaf; you will sit up night after night with a neighbor you know nothing about, just because he is your neighbor, and you know what it is to be neighbor-like. you are more natural and less selfish than the fine folks. i don't say you are better, neither do i say you are worse; that would be a foolish and often mischievous way of speaking. we have all virtues and vices and advantages peculiar to our condition. you know the queer old couplet,-- "them what is rich, them rides in chaises; them what is poor, them walks like blazes." if you were well, and not in a hurry, and it were cold, would you not much rather "walk like blazes" than ride listless in your chaise? but this i know, for i have seen it, that according to their means, the poor bear one another's burdens far more than the rich. there are many reasons for this, outside of yourselves, and there is no need of your being proud of it or indeed of anything else; but it is something to be thankful for, in the midst of all your hardships, that you in this have more of the power and of the luxury of doing immediate, visible good. you pay this debt in ready-money, as you do your meal and your milk; at least you have very short credit, and the shorter the better. now, the doctor has his duties to you, and it is well that he should know them, and that you should know them too; for it will be long before you and he can do without each other. you keep each other alive. disease, accidents, pain, and death reign everywhere, and we call one another _mortals_, as if our chief peculiarity was that we must die, and you all know how death came into this world. "by one man sin entered the world, and death by sin; and so death passed upon all men, for that all have sinned"; and disease, disorder, and distress are the fruits of sin, as truly as that apple grew on that forbidden tree. you have nowadays all sorts of schemes for making bad men good, and good men better. the world is full of such schemes, some of them wise and some foolish; but to be wise they must all go on the principle of lessening misery by lessening _sin_; so that the old weaver at kilmarnock, who at a meeting for abolishing slavery, the corn laws, and a few more things, said, "mr. preses, i move that we abolish original sin," was at least beginning at the right end. only fancy what a world it would be, what a family any of ours would be, when everybody did everything that was right, and nothing that was wrong, say for a week! the world would not know itself. it would be inclined to say with the "wee bit wifiekie," though reversing the cause, "this is no me." i am not going to say more on this point. it is not my parish. but you need none of you be long ignorant of who it is who has abolished death, and therefore vanquished sin. well, then, it is the duty of the doctor in the first place, to _cure us_; in the second, _to be kind to us_; in the third, to be _true to us_; in the fourth, to keep _our secrets_; in the fifth, to _warn us_, and, best of all, to _forewarn us_; in the sixth, to _be grateful to us_; and, in the last, to _keep his time and his temper_. and, _first_, it is the duty of the doctor to _cure_ you,--if he can. that is what we call him in for; and a doctor, be he never so clever and delightful, who doesn't cure, is like a mole-catcher who can't catch moles, or a watchmaker who can do everything but make your watch go. old dr. pringle of perth, when preaching in the country, found his shoes needed mending, and he asked the brother whom he was assisting to tell him of good cobbler, or as he called him, a _snab_. his friend mentioned a "tammas rattray, a godly man, and an elder." "but," said dr. pringle, in his snell way, "can he mend my shoon? that's what i want; i want a shoemaker; i'm not wanting an elder." it turned out that tammas was a better elder than a shoemaker. a doctor was once attending a poor woman in labor; it was a desperate case, requiring a cool head and a firm will; the good man--for he _was_ good--had neither of these, and, losing his presence of mind, gave up the poor woman as lost, and retired into the next room to pray for her. another doctor, who, perhaps, wanted what the first one had, and certainly had what he wanted, brains and courage, meanwhile arrived, and called out, "where is doctor ----?" "o, he has gone into the next room to pray!" "pray! tell him to come here this moment, and help me; he can work and pray too"; and with his assistance the snell doctor saved that woman's life. this, then, is the doctor's first duty to you,--to cure you,--and for this he must, in the first place, be up to his business; he must know what to do, and, secondly, he must be able to do it; he must not merely do as a pointer dog does, stand and say, "there it is," and no more, he must point and shoot too. and let me tell you, moreover, that unless a man likes what he is at, and is in earnest, and sticks to it, he will no more make a good doctor than a good anything else. doctoring is not only a way for a man to do good by curing disease, and to get money to himself for doing this, but it is also a study which interests for itself alone, like geology, or any other science; and moreover it is a way to fame and the glory of the world; all these four things act upon the mind of the doctor, but unless the first one is uppermost, his patient will come off second-best with him; he is not the man for your lives or for your money. they tell a story, which may not be word for word true, but it has truth and a great principle in it, as all good stories have. it is told of one of our clever friends, the french, who are so knowing in everything. a great french doctor was taking an english one round the wards of his hospital; all sort of miseries going on before them, some dying, others longing for death, all ill; the frenchman was wonderfully eloquent about all their diseases, you would have thought he saw through them, and knew all their secret wheels like looking into a watch or into a glass beehive. he told his english friend what would be seen in such a case, _when the body was opened_! he spent some time in this sort of work, and was coming out, full of glee, when the other doctor said: "but, doctor ----, you haven't _prescribed_ for these cases." "o, neither i have!" said he, with a grumph and a shrug; "i quite forgot _that_"; that being the one thing why these poor people were there, and why he was there too. another story of a frenchman, though i dare say we could tell it of ourselves. he was a great professor, and gave a powerful poison as a medicine for an ugly disease of the skin. he carried it very far, so as to weaken the poor fellow, who died, just as the last vestige of the skin disease died too. on looking at the dead body, quite smooth and white, and also quite dead, he said, "ah, never mind; he was _dead cured_." so let me advise you, as, indeed, your good sense will advise yourselves, to test a doctor by this: is he in earnest? does he speak little and do much? does he make your case his first care? he may, after that, speak of the weather, or the money-market; he may gossip, and even _haver_; or he may drop, quietly and shortly, some "good words,"--the fewer the better; something that causes you to think and feel; and may teach you to be more of the publican than of the pharisee, in that story you know of, when they two went up to the temple to pray; but, generally speaking, the doctor should, like the rest of us, stick to his trade and mind his business. _secondly_, it is the doctor's duty to be _kind_ to you. i mean by this, not only to speak kindly, but to _be_ kind, which includes this and a great deal more, though a kind word, as well as a merry heart, does good like a medicine. cheerfulness, or rather cheeriness, is a great thing in a doctor; his very foot should have "music in't, when he comes up the stair." the doctor should never lose his power of pitying pain, and letting his patient see this and feel it. some men, and they are often the best at their proper work, can let their hearts come out only through their eyes; but it is not the less sincere, and to the point; you can make your mouth say what is not true; you can't do quite so much with your eyes. a doctor's eye should command, as well as comfort and cheer his patient; he should never let him think disobedience or despair possible. perhaps you think doctors get hardened by seeing so much suffering; this is not true. pity as a motive, as well as a feeling ending in itself, is stronger in an old doctor than in a young, so he be made of the right stuff. he comes to know himself what pain and sorrow mean, what their weight is, and how grateful he was or is for relief and sympathy. _thirdly_, it is his duty to be _true_ to you. true in word and in deed. he ought to speak nothing but the truth, as to the nature, and extent, and issues of the disease he is treating; but he is not bound, as i said you were, to tell _the whole truth_,--that is for his own wisdom and discretion to judge of; only, never let him tell an untruth, and let him be honest enough, when he can't say anything definite, to say nothing. it requires some courage to confess our ignorance, but it is worth it. as to the question, often spoken of,--telling a man he is dying,--the doctor must, in the first place, be sure the patient is dying; and, secondly, that it is for his good, bodily and mental, to tell him so: he should almost always warn the friends, but, even here, cautiously. _fourthly_, it is his duty to _keep your secrets_. there are things a doctor comes to know and is told which no one but he and the judge of all should know; and he is a base man, and unworthy to be in such a noble profession as that of healing, who can betray what he knows must injure, and in some cases may ruin. _fifthly_, it is his duty to _warn_ you against what is injuring your health. if he finds his patient has brought disease upon himself by sin, by drink, by overwork, by over-eating, by over-anything, it is his duty to say so plainly and firmly, and the same with regard to the treatment of children by their parents; the family doctor should forewarn them; he should explain, as far as he is able and they can comprehend them, the laws of health, and so tell them how to _prevent disease_, as well as do his best to _cure_ it. what a great and rich field there is here for our profession, if they and the public could only work well together! in this, those queer, half-daft, half-wise beings, the chinese, take a wiser way; they pay their doctor for keeping them well, and they stop his pay as long as they are ill! _sixthly_, it is his duty to be _grateful_ to you; st, for employing him, whether you pay him in money or not, for a doctor, worth being one, makes capital, makes knowledge, and therefore power, out of every case he has; dly, for obeying him and getting better. i am always very much obliged to my patients for being so kind as to be better, and for saying so; for many are ready enough to say they are worse, not so many to say they are better, even when they are; and you know our scotch way of saying, "i'm no that ill," when "i" is in high health, or, "i'm no ony waur," when "i" is much better. don't be niggards in this; it cheers the doctor's heart, and it will lighten yours. _seventhly_, and lastly, it is the doctor's duty _to keep his time and his temper_ with you. any man or woman who knows how longed for a doctor's visit is, and counts on it to a minute, knows how wrong, how painful, how angering it is for the doctor not to keep his time. many things may occur, for his urgent cases are often sudden, to put him out of his reckoning; but it is wonderful what method, and real consideration, and a strong will can do in this way. i never found dr. abercrombie a minute after or _before_ his time (both are bad, though one is the worser), and yet if i wanted him in a hurry, and stopped his carriage in the street, he could always go with me at once; he had the knack and the principle of being true in his times, for it is often a matter of _truth_. and the doctor must keep his _temper_: this is often worse to manage than even his time, there is so much unreason, and ingratitude, and peevishness, and impertinence, and impatience, that it is very hard to keep one's tongue and eye from being angry: and sometimes the doctor does not only well, but the best, when he is downrightly angry, and astonishes some fool, or some insolent, or some untruth doing or saying patient; but the doctor should be patient with his patients, he should bear with them, knowing how much they are at the moment suffering. let us remember him who is full of compassion, whose compassion never fails; whose tender mercies are new to us every morning, as his faithfulness is every night; who healed all manner of diseases, and was kind to the unthankful and the evil; what would become of us, if he were as impatient with us as we often are with each other? if you want to be impressed with the almighty's infinite loving-kindness and tender mercy, his forbearance, his long-suffering patience, his slowness to anger, his divine ingeniousness in trying to find it possible to spare and save, think of the israelites in the desert, and read the chapter where abraham intercedes with god for sodom, and these wonderful "peradventures." but i am getting tedious, and keeping you and myself too long, so good night. let the doctor and you be honest and grateful, and kind and cordial, in one word, dutiful to each other, and you will each be the better of the other. i may by and by say a word or two to you on your _health_, which is your wealth, that by which you are and do well, and on your _children_, and how to guide it and them. sermon iii. children, and how to guide them. our text at this time is children and their treatment, or as it sounds better to our ears, bairns, and how to guide them. you all know the wonder and astonishment there is in a house among its small people when a baby is born; how they stare at the new arrival with its red face. where does it come from? some tell them it comes from the garden, from a certain kind of cabbage; some from "rob rorison's bonnet," of which wha hasna heard? some from that famous wig of charlie's, in which the cat kittled, when there was three o' them leevin', and three o' them dead; and you know the doctor is often said to bring the new baby in his pocket; and many a time have my pockets been slyly examined by the curious youngsters,--especially the girls!--in hopes of finding another baby. but i'll tell you where all the babies come from; _they all come from_ _god_; his hand made and fashioned them; he breathed into their nostrils the breath of life,--of his life. he said, "let this little child be," and it was. a child is a true creation; its soul, certainly, and in a true sense, its body too. and as our children came from him, so they are going back to him, and he lends them to us as keepsakes; we are to keep and care for them for his sake. what a strange and sacred thought this is! children are god's gifts to us, and it depends on our guiding of them, not only whether they are happy here, but whether they are happy hereafter in that great unchangeable eternity, into which you and i and all of us are fast going. i once asked a little girl, "who made you?" and she said, holding up her apron as a measure, "god make me that length, and i growed the rest myself." now this, as you know, was not quite true, for she could not grow one half-inch by herself. god makes us grow as well as makes us at first. but what i want you to fix in your minds is, that children come from god, and are returning to him, and that you and i, who are parents, have to answer to him for the way we behave to our dear children,--the kind of care we take of them. now, a child consists, like ourselves, of a body and a soul. i am not going to say much about the guiding of the souls of children,--that is a little out of my line,--but i may tell you that the soul, especially in children, depends much, for its good and for its evil, for its happiness or its misery, upon the kind of body it lives in: for the body is just the house that the soul dwells in; and you know that, if a house be uncomfortable, the tenant of it will be uncomfortable and out of sorts; if its windows let the rain and wind in, if the chimney smoke, if the house be damp, and if there be a want of good air, then the people who live in it will be miserable enough; and if they have no coals, and no water, and no meat, and no beds, then you may be sure it will soon be left by its inhabitants. and so, if you don't do all you can to make your children's bodies healthy and happy, their souls will get miserable and cankered and useless, their tempers peevish; and if you don't feed and clothe them right, then their poor little souls will leave their ill-used bodies,--will be starved out of them; and many a man and woman have had their tempers, and their minds and hearts, made miseries to themselves, and all about them, just from a want of care of their bodies when children. there is something very sad, and, in a true sense, very unnatural, in an unhappy child. you and i, grown-up people, who have cares, and have had sorrows and difficulties and sins, may well be dull and sad sometimes; it would be still sadder, if we were not often so; but children should be always either laughing and playing, or eating and sleeping. play is their business. you cannot think how much useful knowledge, and how much valuable bodily exercise, a child teaches itself in its play; and look how merry the young of other animals are: the kitten making fun of everything, even of its sedate mother's tail and whiskers; the lambs, running races in their mirth; even the young asses,--the baby-cuddie,--how pawky and droll and happy he looks with his fuzzy head, and his laughing eyes, and his long legs, stot, stotting after that venerable and _sair nauden-doun lady_, with the long ears, his mother. one thing i like to see, is a child clean in the morning. i like to see its plump little body well washed, and sweet and _caller_ from top to bottom. but there is another thing i like to see, and that is a child dirty at night. i like a _steerin' bairn_,--goo-gooin', crowing and kicking, keeping everybody alive. do you remember william miller's song of "wee willie winkie?" here it is. i think you will allow, especially you who are mothers, that it is capital. "wee willie winkie rins through the toun, up stairs an' doon stairs in his nicht-goun, tirlin' at the window, crying at the lock, 'are the weans in their bed, for it's noo ten o'clock?' "'hey willie winkie, are ye comin' ben! the cat's singin' gray thrums to the sleepin' hen, the dog's speldert on the floor, and disna gi'e a cheep, but here's a waakrife laddie! that winna fa' asleep.' "'onything but sleep, you rogue! glow'rin' like the moon! rattlin' in an airn jug wi' an airn spoon, rumblin', tumblin' roun' about, crawin' like a cock, skirlin' like a kenna-what, wauk'nin' sleepin' folk. "'hey, willie winkie, the wean's in a creel! wamblin' aff a bodie's knee like a verra eel, ruggin' at the cat's lug, and ravelin' a' her thrums,-- hey, willie winkie,-- see, there he comes!' "wearied is the mither that has a stoorie wean, a wee stumpie stousie, wha canna rin his lane, that has a battle aye wi' sleep afore he'll close an e'e,-- but ae kiss frae aff his rosy lips gi'es strength anew to me." is not this good? first-rate! the cat singin' gray thrums, and the wee stumpie stousie, ruggin' at her lug, and ravlin' a' her thrums; and then what a din he is making!--rattlit' in an airn jug wi' an airn spoon, skirlin' like a kenna-what, and ha'in' a battle aye wi' sleep. what a picture of a healthy and happy child! now, i know how hard it is for many of you to get meat for your children, and clothes for them, and bed and bedding for them at night, and i know how you have to struggle for yourselves and them, and how difficult it often is for you to take all the care you would like to do of them, and you will believe me when i say, that it is a far greater thing, because a far harder thing, for a poor, struggling, and it may be weakly woman in your station, to bring up her children comfortably, than for those who are richer; but still you may do a great deal of good at little cost either of money or time or trouble. and it is well-wared pains; it will bring you in two hundred percent in real comfort, and profit, and credit; and so you will, i am sure, listen good-naturedly to me, when i go over some plain and simple things about the health of your children. to begin with their _heads_. you know the head contains the brain, which is the king of the body, and commands all under him; and it depends on his being good or bad whether his subjects,--the legs, and arms, and body, and stomach, and our old friends the bowels, are in good order and happy, or not. now, first of all, keep the head cool. nature has given it a nightcap of her own in the hair, and it is the best. and keep the head clean. give it a good scouring every saturday night at the least; and if it get sore and scabbit, the best thing i know for it is to wash it with soft soap (black soap), and put a big cabbage-blade on it every night. then for the _lungs_, or _lichts_,--the bellows that keep the fire of life burning,--they are very busy in children, because a child is not like grown-up folk, merely keeping itself up. it is doing this, and growing too; and so it eats more, and sleeps more, and breathes more in proportion than big folk. and to carry on all this business it must have fresh air, and lots of it. so, whenever it can be managed, a child should have a good while every day in the open air, and should have well-aired places to sleep in. then for their _nicht-gowns_, the best are long flannel gowns; and children should be always more warmly clad than grown-up people,--cold kills them more easily. then there is the _stomach_, and as this is the kitchen and great manufactory, it is almost always the first thing that goes wrong in children, and generally as much from too much being put in, as from its food being of an injurious kind. a baby, for nine months after it is born, should have almost nothing but its mother's milk. this is god's food, and it is the best and the cheapest, too. if the baby be healthy it should be weaned or spained at nine or ten months; and this should be done gradually, giving the baby a little gruel, or new milk, and water and sugar, or thin bread-berry once a day for some time, so as gradually to wean it. this makes it easier for mother as well as baby. no child should get meat or hard things till it gets teeth to chew them, and no baby should ever get a drop of whiskey, or any strong drink, unless by the doctor's orders. whiskey, to the soft, tender stomach of an infant, is like vitriol to ours; it is a burning poison to its dear little body, as it may be a burning poison and a curse to its never-dying soul. as you value your children's health of body, and the salvation of their souls, never give them a drop of whiskey; and let mothers, above all others, beware of drinking when nursing. the whiskey passes from their stomachs into their milk, and poisons their own child. this is a positive fact. and think of a drunk woman carrying and managing a child! i was once, many years ago, walking in lothian street, when i saw a woman staggering along very drunk. she was carrying a child; it was lying over her shoulder. i saw it slip, slippin' farther and farther back. i ran, and cried out; but before i could get up, the poor little thing, smiling over its miserable mother's shoulder, fell down, like a stone, on its head on the pavement; it gave a gasp, and turned up its blue eyes, and had a convulsion, and its soul was away to god, and its little soft, waefu' body lying dead, and its idiotic mother grinning and staggering over it, half seeing the dreadful truth, then forgetting it, and cursing and swearing. that was a sight! so much misery, and wickedness, and ruin. it was the young woman's only child. when she came to herself, she became mad, and is to this day a drivelling idiot, and goes about forever seeking for her child, and cursing the woman who killed it. this is a true tale, too true. there is another practice which i must notice, and that is giving children laudanum to make them sleep, and keep them quiet, and for coughs and windy pains. now, this is a most dangerous thing. i have often been called in to see children who were dying, and who did die, from laudanum given in this way. i have known four drops to kill a child a month old; and ten drops one a year old. the best rule, and one you should stick to, as under god's eye as well as the law's, is, never to give laudanum without a doctor's line or order. and when on this subject, i would also say a word about the use of opium and laudanum among yourselves. i know this is far commoner among the poor in edinburgh than is thought. but i assure you, from much experience, that the drunkenness and stupefaction from the use of laudanum is even worse than that from whiskey. the one poisons and makes mad the body; the other, the laudanum, poisons the mind, and makes it like an idiot's. so, in both matters beware; death is in the cup, murder is in the cup, and poverty and the workhouse, and the gallows, and an awful future of pain and misery,--all are in the cup. these are the wages the devil pays his servants with for doing his work. but to go back to the bairns. at first a word on our old friends, the bowels. let them alone as much as you can. they will put themselves and keep themselves right, if you take care to prevent wrong things going into the stomach. no sour apples, or raw turnips or carrots; no sweeties or tarts, and all that kind of abomination; no tea, to draw the sides of their tender little stomachs together; no whiskey, to kill their digestion; no _gundy_, or _taffy_, or _lick_, or _black man_, or _jib_; the less sugar and sweet things the better; the more milk and butter and fat the better; but plenty of plain, halesome food, parritch and milk, bread and butter, potatoes and milk, good broth,--kail as we call it. you often hear of the wonders of cod-liver oil, and they are wonders; poor little wretches who have faces like old puggies, and are all belly and no legs, and are screaming all day and all night too,--these poor little wretches under the cod-liver oil, get sonsy, and rosy, and fat, and happy, and strong. now, this is greatly because the cod-liver oil is capital _food_. if you can't afford to get cod-liver oil for delicate children, or if they reject it, give them plain olive oil, a tablespoonful twice a day, and take one to yourself, and you will be astonished how you will both of you thrive. some folk will tell you that children's feet should be always kept warm. i say no. no healthy child's feet are warm; but the great thing is to keep the body warm. that is like keeping the fire good, and the room will be warm. the chest, the breast, is the place where the fire of the body,--the heating apparatus,--is, and if you keep it warm, and give _it_ plenty of fuel, which is fresh air and good food, you need not mind about the feetikins, they will mind themselves; indeed, for my own part, i am so ungenteel as to think bare feet and bare legs in summer the most comfortable wear, costing much less than leather and worsted, the only kind of soles that are always fresh. as to the moral training of children, i need scarcely speak to you. what people want about these things is, not knowledge, but the will to do what is right,--what they know to be right, and the moral power to do it. whatever you wish your child to be, be it yourself. if you wish it to be happy, healthy, sober, truthful, affectionate, honest, and godly, be yourself all these. if you wish it to be lazy and sulky, and a liar, and a thief, and a drunkard, and a swearer, be yourself all these. as the old cock crows, the young cock learns. you will remember who said, "train up a child in the way he should go, and when he is old he will not depart from it." and you may, as a general rule, as soon expect to gather grapes from thorns, and figs from thistles, as get good, healthy, happy children from diseased and lazy and wicked parents. let me put you in mind, seriously, of one thing that you ought to get done to all your children, and that is, to have them vaccinated, or inoculated with the cow-pock. the best time for this is two months after birth, but better late than never, and in these times you need never have any excuse for its not being done. you have only to take your children to the old or the new town dispensaries. it is a real crime, i think, in parents to neglect this. it is cruel to their child, and it is a crime to the public. if every child in the world were vaccinated, which might be managed in few years, that loathsome and deadly disease, the small-pox, would disappear from the face of the earth; but many people are so stupid, and so lazy, and so prejudiced, as to neglect this plain duty, till they find to their cost that it is too late. so promise me, all seriously in your hearts, to see to this if it is not done already, and see to it immediately. be always frank and open with your children. make them trust you and tell you all their secrets. make them feel at ease with you, and make _free_ with them. there is no such good plaything for grown-up children like you and me as _weans_, wee ones. it is wonderful what you can get them to do with a little coaxing and fun. you all know this as well as i do, and you all practise it every day in your own families. here is a pleasant little story out of an old book. "a gentleman having led a company of children beyond their usual journey, they began to get weary, and all cried to him to carry them on his back, but because of their multitude he could not do this. 'but,' says he, 'i'll get horses for us all'; then cutting little wands out of the hedge as ponies for them, and a great stake as a charger for himself, this put mettle in their little legs, and they rode cheerily home." so much for a bit of ingenious fun. one thing, however poor you are, you can give your children, and that is your prayers, and they are, if real and humble, worth more than silver or gold,--more than food and clothing, and have often brought from our father who is in heaven, and hears our prayers, both money and meat and clothes, and all worldly good things. and there is one thing you can always teach your child; you may not yourself know how to read or write, and therefore you may not be able to teach your children how to do these things; you may not know the names of the stars or their geography, and may therefore not be able to tell them how far you are from the sun, or how big the moon is; nor be able to tell them the way to jerusalem or australia, but you may always be able to tell them who made the stars and numbered them, and you may tell them the road to heaven. you may always teach them to pray. some weeks ago, i was taken out to see the mother of a little child. she was very dangerously ill, and the nurse had left the child to come and help me. i went up to the nursery to get some hot water, and in the child's bed i saw something raised up. this was the little fellow under the bedclothes kneeling. i said, "what are you doing?" "i am praying god to make mamma better," said he. god likes these little prayers and these little people,--for of such is the kingdom of heaven. these are his little ones, his lambs, and he hears their cry; and it is enough if they only lisp their prayers. "abba, father," is all he needs; and our prayers are never so truly prayers as when they are most like children's in simplicity, in directness, in perfect fulness of reliance. "they pray right up," as black uncle tom says in that wonderful book, which i hope you have all read and wept over. i forgot to speak about punishing children. i am old-fashioned enough to uphold the ancient practice of warming the young bottoms with some sharpness, if need be; it is a wholesome and capital application, and does good to the bodies, and the souls too, of the little rebels, and it is far less cruel than being sulky, as some parents are, and keeping up a grudge at their children. warm the bott, say i, and you will warm the heart too; and all goes right. and now i must end. i have many things i could say to you, but you have had enough of me and my bairns, i am sure. go home, and when you see the little curly pows on their pillows, sound asleep, pour out a blessing on them, and ask our saviour to make them his; and never forget what we began with, that they came from god, and are going back to him, and let the light of eternity fall upon them as they lie asleep, and may you resolve to dedicate them and yourselves to him who died for them and for us all, and who was once himself a little child, and sucked the breasts of a woman, and who said that awful saying, "whosoever shall offend one of these little ones, it had been better for him that a millstone were hanged about his neck, and that he were drowned in the midst of the sea." sermon iv. health. my dear friends,--i am going to give you a sort of sermon about your health,--and you know a sermon has always a text; so, though i am only a doctor, i mean to take a text for ours, and i will choose it, as our good friends the ministers do, from that best of all books, the bible. job ii. : "all that a man hath will he give for his life." this, you know, was said many thousands of years ago by the devil, when, like a base and impudent fellow, as he always was and is, he came into the presence of the great god, along with the good angels. here, for once in his life, the devil spoke the truth and shamed himself. what he meant, and what i wish you now seriously to consider, is, that a man--you or i--will lose anything sooner than life; we would give everything for it, and part with all the money, everything we had, to keep away death and to lengthen our days. if you had £ in a box at home, and knew that you would certainly be dead by to-morrow unless you gave the £ , would you ever make a doubt about what you would do? not you! and if you were told that if you got drunk, or worked too hard, or took no sort of care of your bodily health, you would turn ill to-morrow and die next week, would you not keep sober, and work more moderately, and be more careful of yourself? now, i want to make you believe that you are too apt to do this very same sort of thing in your daily life, only that instead of to-morrow or next week, your illness and your death comes next year, or at any rate, some years sooner than otherwise. _but your death is actually preparing already, and that by your own hands_, by your own ignorance, and often by your own foolish and sinful neglect and indulgence. a decay or rottenness spreads through the beams of a house, unseen and unfeared, and then, by and by down it comes, and is utterly destroyed. so it is with our bodies. you plant, by sin and neglect and folly, the seeds of disease by your own hands; and as surely as the harvest comes after the seed-time, so will you reap the harvest of pain, and misery, and death. and remember there is nobody to whom health is so valuable, is worth so much, as the poor laboring man; it is his stock-in-trade, his wealth, his capital; his bodily strength and skill are the main things he can make his living by, and therefore he should take better care of his body and its health than a rich man; for a rich man may be laid up in his bed for weeks and months, and yet his business may go on, for he has means to pay his men for working under him, or he may be what is called "living on his money." but if a poor man takes fever, or breaks his leg, or falls into a consumption, his wife and children soon want food and clothes: and many a time do i see on the streets poor, careworn men, dying by inches of consumption, going to and from their work, when, poor fellows, they should be in their beds; and all this just because they cannot afford to be ill and to lie out of work,--they cannot spare the time and the wages. now, don't you think, my dear friends, that it is worth your while to attend to your health? if you were a carter or a coach-driver, and had a horse, would you not take care to give him plenty of corn, and to keep his stable clean and well aired, and to curry his skin well, and you would not kill him with overwork, for, besides the cruelty, this would be a dead loss to you,--it would be so much out of your pocket? and don't you see that god has given you your bodies to work with, and to please him with their diligence; and it is ungrateful to him, as well as unkind and wicked to your family and yourself, to waste your bodily strength, and bring disease and death upon yourselves? but you will say, "how can we make a better of it? we live from hand to mouth; we can't have fine houses and warm clothes, and rich food and plenty of it." no, i know that; but if you have not a fine house, you may always have a clean one, and fresh air costs nothing,--god gives it to all his children without stint,--and good plain clothes and meal may now be had cheaper than ever. health is a word that you all have some notion of, but you will perhaps have a clearer idea of it when i tell you what the word comes from. health was long ago _wholth_, and comes from the word _whole_ or _hale_. the bible says, "they that are whole need not a physician"; that is, healthy people have no need of a doctor. now, a man is whole when, like a bowl or any vessel, he is entire, and has nothing broken about him; he is like a watch that goes well, neither too fast nor too slow. but you will perhaps say, "you doctors should be able to put us all to rights, just as a watchmaker can clean and sort a watch; if you can't, what are you worth?" but the difference between a man and a watch is, that you must try to mend the man when he is going. you can't stop him and then set him agoing; and, you know, it would be no joke to a watchmaker, or to the watch, to try and clean it while it was going. but god, who does everything like himself, with his own perfectness, has put inside each of our bodies a doctor of his own making,--one wiser than we with all our wisdom. every one of us has in himself a power of keeping and setting his health right. if a man is overworked, god has ordained that he desires rest, and that rest cures him. if he lives in a damp, close place, free and dry air cures him. if he eats too much, fasting cures him. if his skin is dirty, a good scrubbing and a bit of yellow soap will put him all to rights. what we call disease or sickness is the opposite of health, and it comes on us,-- st. by descent from our parents. it is one of the surest of all legacies; if a man's father and mother are diseased, naturally or artificially, he will have much chance to be as bad, or worse. dly. hard work brings on disease, and some kinds of work more than others. masons who hew often fall into consumption; laborers get rheumatism, or what you call "the pains"; painters get what is called their colic, from the lead in the paint, and so on. in a world like ours, this set of causes of disease and ill health cannot be altogether got the better of; and it was god's command, after adam's sin, that men should toil and sweat for their daily bread; but more than the half of the bad effects of hard work and dangerous employments might be prevented by a little plain knowledge, attention, and common sense. dly. sin, wickedness, foolish and excessive pleasures, are a great cause of disease. thousands die from drinking, and from following other evil courses. there is no life so hard, none in which the poor body comes so badly off, and is made so miserable, as the life of a drunkard or a dissolute man. i need hardly tell you, that this cause of death and disease you can all avoid. i don't say it is easy for any man in your circumstances to keep from sin; he is a foolish or ignorant man who says so, and that there are no temptations to drinking. you are much less to blame for doing this than people who are better off; but you can keep from drinking, and you know as well as i do, how much better and happier, and healthier and richer and more respectable you will be if you do so. thly and lastly. disease and death are often brought on from ignorance, from not knowing what are called the _laws of health_,--those easy, plain, common things which, if you do, you will live long, and which, if you do not do, you will die soon. now, i would like to make a few simple statements about this to you; and i will take the body bit by bit, and tell you some things that you should know and do in order to keep this wonderful house that your soul lives in, and by the deeds done in which you will one day be judged,--and which is god's gift and god's handiwork,--clean and comfortable, hale, strong, and hearty; for you know that, besides doing good to ourselves and our family and our neighbors with our bodily labor, we are told that we should glorify god in our bodies as well as in our souls, for they are his, more his than ours,--he has bought them by the blood of his son jesus christ. we are not our own, we are bought with a price; therefore ought we to glorify god with our souls and with our bodies, which are his. now, first, for _the skin_. you should take great care of it, for on its health a great deal depends; keep it clean, keep it warm, keep it dry, give it air; have a regular scrubbing of all your body every saturday night; and, if you can manage it, you should every morning wash not only your face, but your throat and breast, with cold water, and rub yourself quite dry with a hard towel till you glow all over. you should keep your hair short if you are men; it saves you a great deal of trouble and dirt. then, the inside of your _head_,--you know what is inside your head,--your brain; you know how useful it is to you. the cleverest pair of hands among you would be of little use without brains: they would be like a body without a soul, a watch with the mainspring broken. now, you should consider what is best for keeping the brain in good trim. one thing of great consequence is _regular sleep, and plenty of it_. every man should have at the least eight hours in his bed every four-and-twenty hours, and let him sleep all the time if he can; but even if he lies awake it is a rest to his wearied brain, as well as to his wearied legs and arms. _sleep is the food of the brain._ men may go mad and get silly, if they go long without sleep. too much sleep is bad; but i need hardly warn you against that, or against too much meat. you are in no great danger from these. then, again, whiskey and all kinds of intoxicating liquors in excess are just so much poison to the brain. i need not say much about this, you all know it; and we all know what dreadful things happen when a man poisons his brain and makes it mad, and like a wild beast with drink; he may murder his wife, or his child, and when he comes to himself he knows nothing of how he did it, only the terrible thing is certain, that he _did_ do it, and that he may be hanged for doing something when he was mad, and which he never dreamt of doing when in his senses: but then he knows that he made himself mad, and he must take all the wretched and tremendous consequences. from the brains we go to the _lungs_,--you know where they are,--they are what the butchers call the _lichts_; here they are, they are the bellows that keep the fire of life going; for you must know that a clever german philosopher has made out that we are all really burning,--that our bodies are warmed by a sort of burning or combustion, as it is called,--and fed by breath and food, as a fire is fed with coals and air. now the great thing for the lungs is plenty of fresh air, and plenty of room to play in. about seventy thousand people die every year in britain from that disease of the lungs called consumption,--that is, nearly half the number of people in the city of edinburgh; and it is certain that more than the half of these deaths could be prevented if the lungs had fair play. so you should always try to get your houses well ventilated, that means to let the air be often changed, and free from impure mixtures; and you should avoid crowding many into one room, and be careful to keep everything clean, and put away all filth; for filth is not only disgusting to the eye and the nose, but is dangerous to the health. i have seen a great deal of cholera, and been surrounded by dying people, who were beyond any help from doctors, and i have always found that where the air was bad, the rooms ill ventilated, cleanliness neglected, and drunkenness prevailed, there this terrible scourge, which god sends upon us, was most terrible, most rapidly and widely destructive. believe this, and go home and consider well what i now say, for you may be sure it is true. now we come to the _heart_. you all know where it is. it is the most wonderful little pump in the world. there is no steam-engine half so clever at its work, or so strong. there it is in every one of us, beat, beating,--all day and all night, year after year, never stopping, like a watch ticking; only it never needs to be wound up,--god winds it up once for all. it depends for its health on the state of the rest of the body, especially the brains and lungs. but all violent passions, all irregularities of living, damage it. exposure to cold when drunk, falling asleep, as many poor wretches do, in stairs all night,--this often brings on disease of the heart; and you know it is not only dangerous to have anything the matter with the heart, it is the commonest of all causes of sudden death. it gives no warning; you drop down dead in a moment. so we may say of the bodily as well as of the moral organ, "keep your heart with all diligence; for out of it are the issues of life." we now come to the _stomach_. you all know, i dare say, where it lies! it speaks for itself. our friends in england are very respectful to their stomachs. they make a great deal of them, and we make too little. if an englishman is ill, all the trouble is in his stomach; if an irishman is ill, it is in his heart, and he's "kilt entirely"; and if a scotsman, it is in his "heed." now, i wish i saw scots men and women as nice and particular about their stomachs, or rather about what they put into them, as their friends in england. indeed, so much does your genuine john bull depend on his stomach, and its satisfaction, that we may put in his mouth the stout old lines of prior:-- "the plainest man alive may tell ye the seat of empire is the belly: from hence are sent out those supplies, which make us either stout or wise; the strength of every other member is founded on your belly-timber; the qualms or raptures of your blood rise in proportion to your food, your stomach makes your fabric roll, just as the bias rules the bowl: that great achilles might employ the strength designed to ruin troy, he dined on lions' marrow, spread on toasts of ammunition bread; but by his mother sent away, amongst the thracian girls to play, effeminate he sat and quiet; strange product of a cheese-cake diet. observe the various operations, of food and drink in several nations. was ever tartar fierce or cruel, upon the strength of water-gruel? but who shall stand his rage and force, if first he rides, then eats his horse! salads and eggs, and lighter fare, turn the italian spark's guitar; and if i take dan congreve right, pudding and beef make britons fight." good cooking is the beauty of a dinner. it really does a man as much good again if he eats his food with a relish, and with a little attention, it is as easy to cook well as ill. and let me tell the wives, that your husbands would like you all the better, and be less likely to go off to the public-house, if their bit of meat or their drop of broth were well cooked. laboring men should eat well. they should, if possible, have meat--_butcher-meat_--ever day. good broth is a capital dish. but, above all, keep whiskey out of your stomachs; it really plays the very devil when it gets in. it makes the brain mad, it burns the coats of the stomach; it turns the liver into a lump of rottenness; it softens and kills the heart; it makes a man an idiot and a brute. if you really need anything stronger than good meat, take a pot of wholesome porter or ale; but i believe you are better without even that. you will be all the better able to afford good meat, and plenty of it. with regard to your _bowels_,--a very important part of your interior,--i am not going to say much, except that neglect of them brings on many diseases; and laboring men are very apt to neglect them. many years ago, an odd old man, at green-cock, left at his death a number of sealed packets to his friends, and on opening them they found a bible, £ , and a box of pills, and the words, "fear god, and keep your bowels open." it was good advice, though it might have been rather more decorously worded. if you were a doctor, you would be astonished how many violent diseases of the mind, as well as of the body, are produced by irregularity of the bowels. many years ago, an old minister, near linlithgow, was wakened out of his sleep to go to see a great lady in the neighborhood who was thought dying, and whose mind was in dreadful despair, and who wished to see him immediately. the old man, rubbing his eyes, and pushing up his kilmarnock nightcap, said, "and when were her leddyship's booels opened?" and finding, after some inquiry, that they were greatly in arrears, "i thocht sae. rax me ower that pill-box on the chimney-piece, and gie my compliments to leddy margret, and tell her to tak thae twa pills, and i'll be ower by and by mysel'." they did as he bade them. they did their duty, and the pills did theirs, and her leddyship was relieved, and she was able at breakfast-time to profit by the christian advice of the good old man, which she could not have done when her nerves were all wrong. the old greeks, who were always seeking after wisdom, and didn't always find it, showed their knowledge and sense in calling depression of mind melancholy, which means black bile. leddy margret's liver, i have no doubt, had been distilling this perilous stuff. my dear friends, there is one thing i have forgot to mention, and that is about keeping common-stairs clean; you know they are often abominably filthy, and they aggravate fever, and many of your worst and most deadly diseases; for you may keep your own houses never so clean and tidy, but if the common-stair is not kept clean too, all its foul air comes into your rooms, and into your lungs, and poisons you. so let all in the stair resolve to keep it clean, and well aired. but i must stop now. i fear i have wearied you. you see i had nothing new to tell you. the great thing in regulating and benefiting human life, is not to find out new things, but to make the best of the old things,--to live according to nature, and the will of nature's god,--that great being who bids us call him our father, and who is at this very moment regarding each one of us with far more than any earthly father's compassion and kindness, and who would make us all happy if we would but do his bidding, and take his road. he has given us minds by which we may observe the laws he has ordained in our bodies, and which are as regular and as certain in their effects, and as discoverable by us as the motions of the sun, moon, and stars in the heavens; and we shall not only benefit ourselves and live longer and work better and be happier, by knowing and obeying these laws, from love to ourselves, but we shall please him, we shall glorify him, and make him our _friend_,--only think of that! and get his blessing, by taking care of our health, from love to him, and a regard to his will, in giving us these bodies of ours to serve him with, and which he has, with his own almighty hands, so fearfully and wonderfully made. i hope you will pardon my plainness in speaking to you. i am quite in earnest, and i have a deep regard, i may say a real affection, for you; for i know you well. i spent many of my early years as a doctor in going about among you. i have attended you long ago when ill; i have delivered your wives, and been in your houses when death was busy with you and yours, and i have seen your fortitude, energy, and honest, hearty, generous kindness to each other; your readiness to help your neighbors with anything you have, and to share your last sixpence and your last loaf with them. i wish i saw half as much real neighborliness and sympathy among what are called your betters. if a poor man falls down in a fit on the street, who is it that takes him up and carries him home, and gives him what he needs? it is not the man with a fine coat and gloves on,--it is the poor, dirty-coated, hard-handed, warm-hearted laboring man. keep a good hold of all these homely and sturdy virtues, and add to them temperance and diligence, cleanliness and thrift, good knowledge, and, above all, the love and the fear of god, and you will not only be happy yourselves, but you will make this great and wonderful country of ours which rests upon you still more wonderful and great. sermon v. medical odds and ends. my dear friends,--we are going to ring in now, and end our course. i will be sorry and glad, and you will be the same. we are this about everything. it is the proportion that settles it. i am, upon the whole, as we say, sorry, and i dare say on the whole you are not glad. i dislike parting with anything or anybody i like, for it is ten to one if we meet again. my text is, "_that his way may he known upon earth; his saving health to all nations._" you will find it in that perfect little psalm, the th. but before taking it up, i will, as my dear father used to say,--you all remember him, his keen eye and voice; his white hair, and his grave, earnest, penetrating look; and you should remember and possess his canongate sermon to you,--"the bible, what it is, what it does, and what it deserves,"--well, he used to say, let us _recapitulate_ a little. it is a long and rather kittle word, but it is the only one that we have. he made it longer, but not less alive, by turning it into "a few recapitulatory remarks." what ground then have we travelled over? _first_, our duties to and about the doctor; to call him in time, to trust him, to obey him, to be grateful to, and to pay him with our money and our hearts and our good word, if we have all these; if we have not the first, with twice as much of the others. _second_, the doctor's duties to us. he should be able and willing to cure us. that is what he is there for. he should be sincere, attentive, and tender to us, keeping his time and our secrets. we must tell him all we know about our ailments and their causes, and he must tell us all that is good for us to know, and no more. _third_, your duties to your children; to the wee willie winkies and the little wifies that come toddlin' hame. it is your duty to _mind_ them. it is a capital scotch use of this word: they are to be in your mind; you are to exercise your understanding about them; to give them simple food; to keep goodies and trash, and raw pears and whiskey, away from their tender mouths and stomachs; to give them that never-ending meal of good air, night and day, which is truly food and fire to them and you; to _be_ good before as well as to them, to speak and require the truth in love,--that is a wonderful expression, isn't it?--the truth in love; that, if acted on by us all, would bring the millennium next week; to be plain and homely with them, never _spaining_ their minds from you. you are all sorry, you mothers, when you have to spain their mouths; it is a dreadful business that to both parties; but there is a spaining of the affections still more dreadful, and that need never be, no, never, neither in this world nor in that which is to come. dr. waugh, of london, used to say to bereaved mothers, rachels weeping for their children, and refusing to be comforted, for that simplest of all reasons, because they were not, after giving them god's words of comfort, clapping them on the shoulders, and fixing his mild deep eyes on them (those who remember those eyes well know what they could mean), "my woman, your bairn is where it will have two fathers, but never but one mother." you should also, when the time comes, explain to your children what about their own health and the ways of the world they ought to know, and for the want of the timely knowledge of which many a life and character has been lost. show them, moreover, the value you put upon health, by caring for your own. do your best to get your sons well married, and soon. by "well married," i mean that they should pair off old-fashionedly, for love, and marry what deserves to be loved, as well as what is lovely. i confess i think falling in love is the best way to begin; but then the moment you fall, you should get up and look about you, and see how the land lies, and whether it is as goodly as it looks. i don't like walking into love, or being carried into love; or, above all, being sold or selling yourself into it, which, after all, is not it. and by "soon," i mean as soon as they are keeping themselves; for a wife, such a wife as alone i mean, is cheaper to a young man than no wife, and is his best companion. then for your duties to yourselves. see that you make yourself do what is _immediately_ just to your body, feed it when it is really hungry; let it sleep when it, not its master, desires sleep; make it happy, poor hard-working fellow! and give it a gambol when it wants it and deserves it, and as long as it can execute it. dancing is just the music of the feet, and the gladness of the young legs, and is well called the poetry of motion. it is like all other natural pleasures, given to be used, and to be not abused, either by yourself or by those who don't like it, and don't enjoy your doing it,--shabby dogs these, beware of them! and if this be done, it is a good and a grace, as well as pleasure, and satisfies some good end of our being, and in its own way glorifies our maker. did you ever see anything in this world more beautiful than the lambs running races and dancing round the big stone of the field; and does not your heart get young when you hear,-- "here we go by jingo ring, jingo ring, jingo ring; here we go by jingo ring, about the merry ma tanzie." this is just a dance in honor of poor old pagan jingo; measured movements arising from and giving happiness. we have no right to keep ourselves or others from natural pleasures; and we are all too apt to interfere with and judge harshly the pleasures of others; hence we who are stiff and given to other pleasures, and who, now that we are old, know the many wickednesses of the world, are too apt to put the vices of the jaded, empty old heart, like a dark and ghastly fire burnt out, into the feet and the eyes, and the heart and the head of the young. i remember a story of a good old antiburgher minister. it was in the days when dancing was held to be a great sin, and to be dealt with by the session. jessie, a comely, and good, and blithe young woman, a great favorite of the minister's, had been guilty of dancing at a friend's wedding. she was summoned before the session to be "dealt with,"--the grim old fellows sternly concentrating their eyes upon her, as she stood trembling in her striped short-gown, and her pretty bare feet. the doctor, who was one of divinity, and a deep thinker, greatly pitying her and himself, said, "jessie, my woman, were ye dancin'?" "yes," sobbed jessie. "ye maun e'en promise never to dance again, jessie." "i wull, sir; i wull promise," with a courtesy. "now, what were ye thinking o', jessie, when ye were dancin'? tell us truly," said an old elder, who had been a poacher in youth. "nae ill, sir," sobbed out the dear little woman. "then, jessie, my woman, aye dance," cried the delighted doctor. and so say i, to the extent, that so long as our young girls think "nae ill," they may dance their own and their feet's fills; and so on with all the round of the sunshine and flowers god has thrown on and along the path of his children. _lastly_, your duty to your own bodies: to preserve them; to make, or rather let--for they are made so to go--their wheels go sweetly; to keep the _girs_ firm round the old barrel; neither to over nor under work our bodies, and to listen to their teaching and their requests, their cries of pain and sorrow; and to keep them as well as your souls unspotted from the world. if you want to know a good book on physiology, or the laws of health and of life, get dr. combe's _physiology_; and let all you mothers get his delightful _management of infancy_. you will love him for his motherly words. you will almost think he might have worn petticoats,--for tenderness he might; but in mind and will and eye he was every inch a man. it is now long since he wrote, but i have seen nothing so good since; he is so intelligent, so reverent, so full of the solemnity, the sacredness, the beauty, and joy of life, and its work; so full of sympathy for suffering, himself not ignorant of such evil,--for the latter half of his life was a daily, hourly struggle with death, fighting the destroyer from within with the weapons of life, his brain and his conscience. it is very little physiology that you require, so that it is physiology, and is suitable for your need. i can't say i like our common people, or indeed, what we call our ladies and gentlemen, poking curiously into all the ins and outs of our bodies as a general accomplishment, and something to talk of. no, i don't like it. i would rather they chose some other _ology_. but let them get enough to give them awe and love, light and help, guidance and foresight. these, with good sense and good senses, humility, and a thought of a hereafter in this world as well as in the next, will make us as able to doctor ourselves--especially to act in the _preventive service_, which is your main region of power for good--as in this mortal world we have any reason to expect. and let us keep our hearts young, and they will keep our legs and our arms the same. for we know now that hearts are kept going by having strong, pure, lively blood; if bad blood goes into the heart, it gets angry, and shows this by beating at our breasts, and frightening us; and sometimes it dies of sheer anger and disgust, if its blood is poor or poisoned, thin and white. "he may dee, but he'll never grow auld," said a canty old wife of her old minister, whose cheek was ruddy like an apple. _run for the doctor_; don't saunter to him, or go in, by the by, as an old elder of my father's did, when his house was on fire. he was a perfect nathanael, and lived more in the next world than in this, as you will soon see. one winter night he slipped gently into his neighbor's cottage, and found james somerville reading aloud by the blaze of the licht coal; he leant over the chair, and waited till james closed the book, when he said, "by the by, i am thinkin' ma hoose is on fire!" and out he and they all ran, in time to see the auld biggin' fall in with a glorious blaze. so it is too often when that earthly house of ours--our cottage, our tabernacle--is getting on fire. one moment your finger would put out what in an hour all the waters of clyde would be too late for. if the doctor is needed, the sooner the better. if he is not, he can tell you so, and you can rejoice that he had a needless journey, and pay him all the more thankfully. so run early and at once. how many deaths--how many lives of suffering and incapacity--may be spared by being in time! by being a day or two sooner. with children this is especially the case, and with workingmen in the full prime of life. a mustard plaster, a leech, a pill, fifteen drops of ipecacuanha wine, a bran poultice, a hint, or a stitch in time, may do all and at once, when a red-hot iron, a basinful of blood, all the wisdom of our art, and all the energy of the doctor, all your tenderness and care, are in vain. many a child's life is saved by an emetic at night, who would be lost in twelve hours. so send in time; it is just to your child or the patient, and to yourself; it is just to your doctor; for i assure you we doctors are often sorry, and angry enough, when we find we are too late. it affronts us, and our powers, besides affronting life and all its meanings, and him who gives it. and we really _enjoy_ curing; it is like running and winning a race,--like hunting and finding and killing our game. and then remember to go to the doctor early in the day, as well as in the disease. i always like my patients to send and say that they would like the doctor "to call before he goes out!" this is like an irish message, you will say; but there is "sinse" in it. fancy a doctor being sent for, just as he is in bed, to see some one, and on going he finds they had been thinking of sending in the morning, and that he has to run neck and neck with death, with the odds all against him. i now wind up with some other odds and ends. i give you them as an old wife would empty her pockets,--such wallets they used to be!--in no regular order; here a bit of string, now a bit of gingerbread, now an "aiple," now a bunch of keys, now an old almanac, now three _bawbees_ and a bad shilling, a "wheen" buttons all marrowless, a thimble, a bit of black sugar, and maybe at the very bottom a "goold guinea." _shoes._--it is amazing the misery the people of civilization endure in and from their shoes. nobody is ever, as they should be, comfortable at once in them; they hope in the long-run and after much agony, and when they are nearly done, to make them fit, especially if they can get them once well wet, so that the mighty knob of the big toe may adjust himself and be at ease. for my part, if i were rich, i would advertise for a clean, wholesome man, whose foot was exactly my size, and i would make him wear my shoes till i could put them on, and not know i was in them.[ ] why is all this? why do you see every man's and woman's feet so out of shape? why are there corns, with their miseries and maledictions? why the virulence and unreachableness of those that are "soft"? why do our nails grow in, and sometimes have to be torn violently off? [ ] frederick the great kept an aid-de-camp for this purpose, and, poor fellow! he sometimes wore them too long, and got a kicking for his pains. all because the makers and users of shoes have not common sense, and common reverence for god and his works enough to study the shape and motions of that wonderful pivot on which we turn and progress. because fashion,--that demon that i wish i saw dressed in her own crinoline, in bad shoes, a man's old hat, and trailing petticoats, and with her (for she must be a _her_) waist well nipped by a circlet of nails with the points inmost, and any other of the small torments, mischiefs, and absurdities she destroys and makes fools of us with,--whom, i say, i wish i saw drummed and hissed, blazing and shrieking, out of the world,--because this contemptible slave, which domineers over her makers, says the shoe must be elegant, must be so and so, and the beautiful living foot must be crushed into it, and human nature must limp along princess street and through life natty and wretched. it makes me angry when i think of all this. now, do you want to know how to put your feet into new shoes, and yourself into a new world? go and buy from edmonston and douglas sixpence worth of sense, in _why the shoe pinches_; you will, if you get your shoemaker to do as it bids him, go on your ways rejoicing; no more knobby, half-dislocated big toes; no more secret parings, and slashings desperate, in order to get on that pair of exquisite boots or shoes. then there is the _infirmary_.--nothing i like better than to see subscriptions to this admirable house of help and comfort to the poor, advertised as from the quarry men of craigleith; from mr. milne the brassfounder's men; from peeblesshire; from the utmost orkneys; and from those big, human mastiffs, the navvies. and yet we doctors are often met by the most absurd and obstinate objections by domestic servants in town, and by country people, to going there. this prejudice is lessening, but it is still great. "o, i canna gang into the infirmary; i would rather dee!" would you, indeed? not you, or, if so, the sooner the better. they have a notion that they are experimented on, and slain by the surgeons; neglected and poisoned by the nurses, etc., etc. such utter nonsense! i know well about the inner life and work of at least our infirmary, and of that noble old minto house, now gone; and i would rather infinitely, were i a servant, 'prentice boy, or shopman, a porter, or student, and anywhere but in a house of my own, and even then, go straight to the infirmary, than lie in a box-bed off the kitchen, or on the top of the coal-bunker, or in a dark hole in the lobby, or in a double-bedded room. the food, the bedding, the physicians, the surgeons, the clerks, the dressers, the medicines, the wine and porter,--and they don't scrimp these when necessary,--the books, the bibles, the baths, are all good,--are all better far than one man in ten thousand can command in his own house. so off with a grateful heart and a fearless to the infirmary, and your mistress can come in and sit beside you; and her doctor and yours will look in and single you out with his smile and word, and cheer you and the ward by a kindly joke, and you will come out well cured, and having seen much to do you good for life. i never knew any one who was once in, afraid of going back; they know better. there are few things in human nature finer than the devotion and courage of medical men to their hospital and charitable duties; it is to them a great moral discipline. not that they don't get good--selfish good--to themselves. why shouldn't they? nobody does good without getting it; it is a law of the government of god. but, as a rule, our medical men are not kind and skilful and attentive to their hospital patients, because this is to make them famous, or even because through this they are to get knowledge and fame; they get all this, and it is their only and their great reward. but they are in the main disinterested men. honesty is the best policy; but, as dr. whately, in his keen way, says, "that man is not honest who is so for this reason," and so with the doctors and their patients. and i am glad to say for my profession, few of them take this second-hand line of duty. _beards._--i am for beards out and out, because i think the maker of the beard was and is. this is reason enough; but there are many others. the misery of shaving, its expense, its consumption of time,--a very corporation existing for no other purpose but to shave mankind. campbell the poet, who had always a bad razor, i suppose, and was late of rising, said he believed the man of civilization who lived to be sixty had suffered more pain in littles every day in shaving than a woman with a large family had from her lyings-in. this would be hard to prove; but it is a process that never gets pleasanter by practice; and then the waste of time and temper,--the ugliness of being ill or unshaven. now, we can easily see advantages in it; the masculine gender is intended to be more out of doors, and more in all weathers than the smooth-chinned ones, and this protects him and his adam's apple from harm. it acts as the best of all respirators to the mason and the east-wind. besides, it is a glory; and it must be delightful to have and to stroke a natural beard, not one like bean-stalks or a bottle-brush, but such a beard as abraham's or abd-el-kader's. it is the beginning ever to cut, that makes all the difference. i hazard a theory, that no hair of the head or beard should ever be cut, or needs it, any more than the eyebrows or eyelashes. the finest head of hair i know is one which was never cut. it is not too long; it is soft and thick. the secret where to stop growing is in the end of the native untouched hair. if you cut it off, the poor hair does not know when to stop; and if our eyebrows were so cut, they might be made to hang over our eyes, and be wrought into a veil. besides, think of the waste of substance of the body in hewing away so much hair every morning, and encouraging an endless rotation of crops! well, then, i go in for the beards of the next generation, the unshorn beings whose beards will be wagging when we are away; but of course they must be clean. but how are we to sup our porridge and kail? try it when young, when there is just a shadowy down on the upper lip, and no fears but they will do all this "elegantly" even. nature is slow and gentle in her teaching even the accomplishment of the spoon. and as for women's hair, don't plaster it with scented and sour grease, or with any grease; it has an oil of its own. and don't tie up your hair tight, and make it like a cap of iron over your skull. and why are your ears covered? you hear all the worse, and they are not the cleaner. besides, the ear is beautiful in itself, and plays its own part in the concert of the features. go back to the curls, some of you, and try in everything to dress as it becomes you, and as you become; not as that fine lady, or even your own tibbie or grizzy chooses to dress, it may be becomingly to her. why shouldn't we even in dress be more ourselves than somebody or everybody else? i had a word about _teeth_. don't get young children's teeth drawn. at least, let this be the rule. bad teeth come of bad health and bad and hot food, and much sugar. i can't say i am a great advocate for the common people going in for tooth-brushes. no, they are not necessary in full health. the healthy man's teeth clean themselves, and so does his skin. a good dose of gregory often puts away the toothache. it is a great thing, however, to get them early stuffed, if they need it; that really keeps them and your temper whole. for appearance' sake merely, i hate false teeth, as i hate a wig. but this is not a matter to dogmatize about. i never was, i think, deceived by either false hair, or false teeth, or false eyes, or false cheeks, for there are in the high--i don't call it the great--world, plumpers for making the cheeks round, as well as a certain dust for making them bloom. but you and i don't enjoy such advantages. _rheumatism_ is peculiarly a disease of the workingman. one old physician said its only cure was patience and flannel. another said six weeks. but i think good flannel and no drunkenness (observe, i don't say no drinking, though very nearly so) are its best preventives. it is a curious thing, the way in which cold gives rheumatism. suppose a man is heated and gets cooled, and being very well at any rate, and is sitting or sleeping in a draught; the exposed part is chilled; the pores of its skin, which are always exuding and exhaling waste from the body, contract and shut in this bad stuff; it--this is my theory--not getting out is taken up by a blunder of the deluded absorbents, who are always prowling about for something, and it is returned back to the centre, and finds its way into the blood, and poisons it, affecting the heart, and carrying bad money, bad change, bad fat, bad capital all over the body, making nerves, lungs, everything unhappy and angry. this vitiated blood arrives by and by at the origin of its mischief, the chilled shoulder, and here it wreaks its vengeance, and in doing so, does some general good at local expense. it gives pain; it produces a certain inflammation of its own, and if it is not got rid of by the skin and other ways, it may possibly kill by the rage the body gets in, and the heat; or it may inflame the ill-used heart itself, and then either kill, or give the patient a life of suffering and peril. the medicines we give act not only by detecting this poison of blood, which, like yeast, leavens all in its neighborhood, but by sending it out of the body like a culprit. _vaccination._--one word for this. never neglect it; get it done within two months after birth, and see that it is well done; and get all your neighbors to do it. _infectious diseases._--keep out of their way; kill them by fresh air and cleanliness; defy them by cheerfulness, good food (_better_ food than usual, in such epidemics as cholera), good sleep, and a good conscience. when in the midst of and waiting on those who are under the scourge of an epidemic, be as little very close to the patient as you can, and don't inhale his or her breath or exhalations when you can help it; be rather in the current to, than from him. be very cleanly in putting away all excretions at once, and quite away; go frequently into the fresh air; and don't sleep in your day clothes. do what the doctor bids you; don't crowd round your dying friend; you are stealing his life in taking his air, and you are quietly killing yourself. this is one of the worst and most unmanageable of our scottish habits, and many a time have i cleared the room of all but one, and dared them to enter it. then you should, in such things as small-pox, as indeed in everything, carry out the divine injunction, "_whatsoever_ ye would that men should do unto you, do ye even so to them." don't send for the minister to pray with and over the body of a patient in fever or delirium, or a child dying of small-pox or malignant scarlet fever; tell him, by all means, and let him pray with you, and for your child. prayers, you know, are like gravitation, or the light of heaven; they will go from whatever place they are uttered; and if they are real prayers, they go straight and home to the centre, the focus of all things; and you know that poor fellow with the crust of typhus on his lips, and its nonsense on his tongue,--that child tossing in misery, not knowing even its own mother,--what can they know, what heed can they give to the prayer of the minister? he may do all the good he can,--the most good maybe when, like moses on the hillside, in the battle with amalek, he uplifts his hands apart. no! a word spoken by your minister to himself and his god, a single sigh for mercy to him who is mercy, a cry of hope, of despair of self, opening into trust in him, may save that child's life, when an angel might pour forth in vain his burning, imploring words into the dull or wild ears of the sufferer, in the vain hope of getting _him_ to pray. i never would allow my father to go to typhus cases; and i don't think they lost anything by it. i have seen him rising in the dark of his room from his knees, and i knew whose case he had been laying at the footstool. and now, my dear friends, i find i have exhausted our time, and never yet got to the sermon, and its text--"_that the way of god_"--what is it? it is his design in setting you here; it is the road he wishes you to walk in; it is his providence in your minutest as in the world's mightiest things; it is his will expressed in his works and word, and in your own soul it is his salvation. that it "_may be known_," that the understandings of his intelligent, responsible, mortal and immortal creatures should be directed to it, to study and (as far as we ever can or need) to understand that which, in its fulness, passes all understanding; that it may be known "_on the earth_," here, in this very room, this very minute; not, as too many preachers and performers do, to be known only in the next world,--men who, looking at the stars, stumble at their own door, and it may be _smoor_ their own child, besides despising, upsetting, and extinguishing their own lantern. no! the next world is only to be reached through this; and our road through this our wilderness is not safe unless on the far beyond there is shining the lighthouse on the other side of the dark river that has no bridge. then "_his saving health_"; his health--whose?--god's--his soundness, the wholeness, the perfectness, that is alone in and from him,--health of body, of heart, and brain, health to the finger-ends, health for eternity as well as time. "_saving_"; we need to be saved, and we are salvable, this is much; and god's health can save us, that is more. when a man or woman is fainting from loss of blood, we sometimes try to save them, when all but gone, by transfusing the warm rich blood of another into their veins. now this is what god, through his son, desires to do; to transfuse his blood, himself, through his son, who is himself, into us, diseased and weak. "_and_" refers to his health being "_known_," recognized, accepted, used, "_among all nations_"; not among the u.p.s, or the frees, or the residuaries, or the baptists, or the new jerusalem people,--nor among us in the canongate, or in biggar, or even in old scotland, but "among all nations"; then, and only then, will the people praise thee, o god; will all the people praise thee. then, and then only, will the earth yield her increase, and god, even our own god, will bless us. god will bless us, and all the ends of the earth shall fear him. and now, my dear and patient friends, we must say good night. you have been very attentive, and it has been a great pleasure to me as we went on to preach to you. we came to understand one another. you saw through my jokes, and that they were not always nothing but jokes. you bore with my solemnities, because i am not altogether solemn; and so good night, and god bless you, and may you, as don quixote, on his death-bed, says to sancho, may you have your eyes closed by the soft fingers of your great-grandchildren. but no, i must shake hands with you, and kiss the bairns,--why shouldn't i? if their mouths are clean and their breath sweet? as for you, _ailie_, you are wearying for the child; and he is tumbling and fretting in his cradle, and wearying for you; good by, and away you go on your milky way. i wish i could (unseen) see you two enjoying each other. and good night, my bonnie _wee wifie_; you are sleepy, and you must be up to make your father's porridge; and _master william winkie_, will you be still for one moment while i address you? well, master william, _wamble_ not off your mother's lap, neither rattle in your excruciating way in an airn jug wi' an airn spoon; no more crowing like a cock, or skirlin' like a kenna-what. i had much more to say to you, sir, but you will not bide still; off with you, and a blessing with you. good night, _hugh cleland_, the best smith of any smiddy; with your bowly back, your huge arms, your big heavy brows and eyebrows, your clear eye, and warm unforgetting heart. and you, _john noble_, let me grip your horny hand, and count the queer knobs made by the perpetual mell. i used, when i was a willie winkie, and wee, to think that you were born with them. never mind, you were born for them, and of old you handled the trowel well, and built to the plumb. _thomas bertram_, your loom is at a discount, but many's the happy day i have watched you and your shuttle, and the interweaving treadles, and all the mysteries of setting the "wab." you are looking well, and though not the least of an ass, you might play bottom must substantially yet. _andrew wilson_, across the waste of forty years and more i snuff the fragrance of your shop; have you forgiven me yet for stealing your paint-pot (awful joy!) for ten minutes to adorn my rabbit-house, and for blunting your pet _furmer_? wise you were always, and in the saw-pit you spoke little, and wore your crape. yourself wears well, but take heed of swallowing your shavings unawares, as is the trick of you "wrights"; they confound the interior and perplex the doctor. _rob rough_, you smell of rosin, and your look is stern, nevertheless, or all the rather, give me your hand. what a grip! you have been the most sceptical of all my hearers; you like to try everything, and you hold fast only what you consider good; and then on your _crepida_ or stool, you have your own think about everything human and divine, as you smite down errors on the lapstane, and "yerk" your arguments with a well-rosined lingle; throw your window open for yourself as well as for your blackbird; and make your shoes not to pinch. i present you, sir, with a copy of the book of the wise switzer. and nimble _pillans_, the clothier of the race, and quick as your needle, strong as your corduroys, i bid you good night. may you and the cooper be like him of fogo, each a better man than his father; and you, _mungo_ the mole-catcher, and _tod laurie_, and _sir robert_ the cadger, and all the other odd people, i shake your fists twice, for i like your line. i often wish i had been a mole-catcher, with a brown velveteen, or (fine touch of tailoric fancy!) a moleskin coat; not that i dislike moles,--i once ate the fore-quarter of one, having stewed it in a florence flask, some forty years ago, and liked it,--but i like the killing of them, and the country by-ways, and the regularly irregular life, and the importance of my trade. and good night to you all, you women-folks. _marion graham_ the milkwoman; _tibbie meek_ the single servant; _jenny muir_ the sempstress; _mother johnston_ the howdie, thou consequential mrs. gamp, presiding at the gates of life; and you in the corner there, _nancy cairns_, gray-haired, meek and old, with your crimped mutch as white as snow; the shepherd's widow, the now childless mother, you are stepping home to your _bein_ and lonely room, where your cat is now ravelling a' her thrums, wondering where "she" is. good night to you all, big and little, young and old; and go home to your bedside, there is some one waiting there for you, and his son is here ready to take you to him. yes, he is waiting for every one of you, and you have only to say, "father, i have sinned,--take me"--and he sees you a great way off. but to reverse the parable; it is the first-born, your elder brother, who is at your side, and leads you to your father, and says, "i have paid his debt"; that son who is ever with him, whose is all that he hath. i need not say more. you know what i mean. you know who is waiting, and you know who it is who stands beside you, having the likeness of the son of man. good night! the night cometh in which neither you nor i can work,--may we work while it is day; whatsoever thy _hand_ findeth to do, do it with thy might, for there is no work or device in the grave, whither we are all of us hastening; and when the night is spent, may we all enter on a healthful, a happy, an everlasting to-morrow! cambridge: printed by welch, bigelow, & co. vest-pocket series of standard and popular authors. the great popularity of the "little classics" has proved anew the truth of dr. johnson's remark: "books that you may carry to the fire, and hold readily in your hand, are the most useful after all." the attractive character of their contents has been very strongly commended to public favor by the convenient size of the volumes. these were not too large to be carried to the fire or held readily in the hand, and consequently they have been in great request wherever they have become known. _the vest-pocket series_ consists of volumes yet smaller than the "little classics." their lilliputian size, legible type, and flexible cloth binding make them peculiarly convenient for carrying on short journeys; and the excellence of their contents makes them desirable always and everywhere. the series includes stories, essays, sketches, and poems selected from the writings of _emerson_, _longfellow_, _whittier_, _hawthorne_, _carlyle_, _aldrich_, _hood_, _gray_, _aytoun_, _tennyson_, _lowell_, _holmes_, _browning_, _macaulay_, _milton_, _campbell_, _owen meredith_, _pope_, _thomson_, and others of equal fame. the volumes are beautifully printed, many of them illustrated, and bound in flexible cloth covers, at a uniform price of =fifty cents each.= james r. osgood & co., publishers, boston. works of dr. john brown. "_of all the john browns, commend us to dr. john brown, the physician, the man of genius, the humorist, the student of men, women, and dogs. by means of two beautiful volumes he has given the public a share of his by-hours; and more pleasant hours it would be difficult to find in any life._"--london times. spare hours. first series, i vol. mo. cloth, $ . ; half calf, $ . . _contents._--rab and his friends.--"with brains, sir."--the mystery of black and tan.--her last half-crown.--our dogs.--queen mary's child-garden.--presence of mind and happy guessing.--my father's memoir.--mystifications.--"oh, i'm wat, wat!"--arthur h. hallam.--education through the senses.--vaughan's poems.--dr. chalmers.--dr. george wilson.--st. paul's thorn in the flesh.--the black dwarf's bones.--notes on art. "dr. john brown is a medical practitioner in edinburgh, whose leisure mements have been devoted to the cultivation of letters, and who, without the slightest degree of formality or reserve, pours out his feelings on paper, showing himself equally at home in the sphere of genial criticism, pathetic sentiment, and gay and sportive humor. his confessions have the frankness of montaigne, and almost the playful _naïveté_ of charles lamb, combined with a vein of tender earnestness that stamps the individuality of the writer. the tone of his remarks is uniformly healthful, showing a genuine love of nature, and a cordial sympathy with all conditions of humanity."--_new york tribune._ =spare hours.= second series, i vol. mo. with steel portrait and illustrations. cloth, $ . ; half calf, $ . . _contents._--john leech.--marjorie fleming.--jeems the door-keeper.--minchmoor.--the enterkin.--health: five lay sermons to working-people.--the duke of athole.--struan.--thackeray's death.--thackeray's literary career.--more of "our dogs."--plea for a dog home.--"bibliomania."--"in clear dream and solemn vision."--a jacobite family. "an excellent portrait of the author, showing a broad brow, and a face replete with sense, shrewdness, humor, and resolute force, adds to the attractiveness of one of the most attractive volumes of essays published for a long period."--_boston transcript._ =rab and his friends.= paper, cents. "dr. brown's masterpiece is the story of a dog called 'rab.' the tale moves from the most tragic pathos to the most reckless humor, and could not have been written but by a man of genius. whether it moves to laughter or to tears, it is perfect in its way, and immortalizes its author."--_london times._ "a veritable gem. it is true, simple, pathetic, and touched with an antique grace."--_fraser's magazine._ =marjorie fleming ("pet marjorie").= paper, cents. "a story of one of the most exquisite children, miraculously brilliant, thoughtful, and fascinating."--_detroit post._ "a quaint, winning, sympathetic, beautiful sketch of child-life."--_springfield republican._ james r. osgood & co., publishers, boston. power through repose by annie payson call new edition with additions _personality binds--universality expands._ francoise delsarte. when the body is perfectly adjusted, perfectly supplied with force, perfectly free and works with the greatest economy of expenditure, it is fitted to be a perfect instrument alike of impression, experience, and expression. w. r. alger. i. the guidance of the body the literature relating to the care of the human body is already very extensive. much has been written about the body's proper food, the air it should breathe, the clothing by which it should be protected, the best methods of its development. that literature needs but little added to it, until we, as rational beings, come nearer to obeying the laws which it discloses, and to feeling daily the help which comes from that obedience. it is of the better use, the truer guidance of this machine, that i wish especially to write. although attention is constantly called to the fact of its misuse,--as in neglected rest and in over-strain,--in all the unlimited variety which the perverted ingenuity of a clever people has devised, it seems never to have come to any one's mind that this strain in all things, small and great, is something that can be and should be studiously abandoned, with as regular a process of training, from the first simple steps to those more complex, as is required in the work for the development of muscular strength. when a perversion of nature's laws has continued from generation to generation, we, of the ninth or tenth generation, can by no possibility jump back into the place where the laws can work normally through us, even though our eyes have been opened to a full recognition of such perversion. we must climb back to an orderly life, step by step, and the compensation is large in the constantly growing realization of the greatness of the laws we have been disobeying. the appreciation of the power of a natural law, as it works through us, is one of the keenest pleasures that can come to man in this life. the general impression seems to be that common-sense should lead us to a better use of our machines at once. whereas, common-sense will not bring a true power of guiding the muscles, any more than it will cause the muscles' development, unless having the common-sense to see the need, we realize with it the necessity for cutting a path and walking in it. for the muscles' development, several paths have been cut, and many who are in need are walking in them, but, to the average man, the road to the best kind of muscular development still remains closed. the only training now in use is followed by sleight-of-hand performers, acrobats, or other jugglers, and that is limited to the professional needs of its followers. again, as the muscles are guided by means of the nerves, a training for the guidance of the muscles means, so far as the physique is concerned, first, a training for the better use of the nervous force. the nervous system is so wonderful in its present power for good or ill, so wonderful in its possible power either way, and so much more wonderful as we realize what we do not know about it, that it is not surprising that it is looked upon with awe. neither is it strange that it seems to many, especially the ignorant, a subject to be shunned. it is not uncommon for a mother, whose daughter is suffering, and may be on the verge of nervous prostration because of her misused nerves, to say, "i do not want my daughter to know that she has nerves." the poor child knows it already in the wrong way. it is certainly better that she should know her nerves by learning a wholesome, natural use of them. the mother's remark is common with many men and women when speaking of themselves,--common with teachers when talking to or of their pupils. it is of course quite natural that it should be a prevailing idea, because hitherto the mention of nerves by man or woman has generally meant perverted nerves, and to dwell on our perversions, except long enough to shun them, is certainly unwholesome in the extreme. ii. perversions in the guidance of the body so evident are the various, the numberless perversions of our powers in the misuse of the machine, that it seems almost unnecessary to write of them. and yet, from another point of view, it is very necessary; for superabundant as they are, thrusting their evil results upon us every day in painful ways, still we have eyes and see not, ears and hear not, and for want of a fuller realization of these most grievous mistakes, we are in danger of plunging more and more deeply into the snarls to which they bring us. from nervous prostration to melancholia, or other forms of insanity, is not so long a step. it is of course a natural sequence that the decadence of an entire country must follow the waning powers of the individual citizens. although that seems very much to hint, it cannot be too much when we consider even briefly the results that have already come to us through this very misuse of our own voluntary powers. the advertisements of nerve medicines alone speak loudly to one who studies in the least degree the physical tendencies of the nation. nothing proves better the artificial state of man, than the artificial means he uses to try to adjust himself to nature's laws,--means which, in most cases, serve to assist him to keep up a little longer the appearance of natural life. for any simulation of that which is natural must sooner or later lead to nothing, or worse than nothing. even the rest-cures, the most simple and harmless of the nerve restorers, serve a mistaken end. patients go with nerves tired and worn out with misuse,--commonly called over-work. through rest, nature, with the warm, motherly help she is ever ready to bring us, restores the worn body to a normal state; but its owner has not learned to work the machine any better,--to drive his horses more naturally, or with a gentler hand. he knows he must take life more easily, but even with a passably good realization of that necessity, he can practise it only to a certain extent; and most occupants of rest-cures find themselves driven back more than once for another "rest." nervous disorders, resulting from overwork are all about us. extreme nervous prostration is most prevalent. a thoughtful study of the faces around us, and a better understanding of their lives, brings to light many who are living, one might almost say, in a chronic state of nervous prostration, which lasts for years before the break comes. and because of the want of thought, the want of study for a better, more natural use of the machine, few of us appreciate our own possible powers. when with study the appreciation grows, it is a daily surprise, a constantly increasing delight. extreme nervous tension seems to be so peculiarly american, that a german physician coming to this country to practise became puzzled by the variety of nervous disorders he was called upon to help, and finally announced his discovery of a new disease which he chose to call "americanitis." and now we suffer from "americanitis" in all its unlimited varieties. doctors study it; nerve medicines arise on every side; nervine hospitals establish themselves; and rest-cures innumerable spring up in all directions,--but the root of the matter is so comparatively simple that in general it is overlooked entirely. when illnesses are caused by disobedience to the perfect laws of nature, a steady, careful obedience to these laws will bring us to a healthful state again. nature is so wonderfully kind that if we go one-tenth of the way, she will help us the other nine-tenths. indeed she seems to be watching and hoping for a place to get in, so quickly does she take possession of us, if we do but turn toward her ever so little. but instead of adopting her simple laws and following quietly her perfect way, we try by every artificial means to gain a rapid transit back to her dominion, and succeed only in getting farther away from her. where is the use of taking medicines to give us new strength, while at the same time we are steadily disobeying the very laws from the observance of which alone the strength can come? no medicine can work in a man's-body while the man's habits are constantly counteracting it. more harm than good is done in the end. where is the use of all the quieting medicines, if we only quiet our nerves in order that we may continue to misuse them without their crying out? they will cry out sooner or later; for nature, who is so quick to help us to the true way of living, loses patience at last, and her punishments are justly severe. or, we might better say, a law is fixed and immovable, and if we disobey and continue to disobey it, we suffer the consequences. iii. rest in sleep how do we misuse our nervous force? first, let us consider, when should the body be completely at rest? the longest and most perfect rest should be during sleep at night. in sleep we can accomplish nothing in the way of voluntary activity either of mind or body. any nervous or muscular effort during sleep is not only useless but worse,--it is pure waste of fuel, and results in direct and irreparable harm. realizing fully that sleep is meant for rest, that the only gain is rest, and that new power for use comes as a consequence,--how absurd it seems that we do not abandon ourselves completely to gaining all that nature would give us through sleep. suppose, instead of eating our dinner, we should throw the food out of the window, give it to the dogs, do anything with it but what nature meant we should, and then wonder why we were not nourished, and why we suffered from faintness and want of strength. it would be no more senseless than the way in which most of us try to sleep now, and then wonder why we are not better rested from eight hours in bed. only this matter of fatiguing sleep has crept upon us so slowly that we are blind to it. we disobey mechanically all the laws of nature in sleep, simple as they are, and are so blinded by our own immediate and personal interests, that the habit of not resting when we sleep has grown to such an extent that to return to natural sleep, we must think, study, and practise. few who pretend to rest give up entirely to the bed, a dead weight,--letting the bed hold them, instead of trying to hold themselves on the bed. watch, and unless you are an exceptional case (of which happily there are a few), you will be surprised to see how you are holding yourself on the bed, with tense muscles, if not all over, so nearly all over that a little more tension would hardly increase the fatigue with which you are working yourself to sleep. the spine seems to be the central point of tension--it does not _give_ to the bed and rest there easily from end to end; it touches at each end and just so far along from each end as the man or woman who is holding it will permit. the knees are drawn up, the muscles of the legs tense, the hands and arms contracted, and the fingers clinched, either holding the pillow or themselves. the head, instead of letting the pillow have its full weight, holds itself onto the pillow. the tongue cleaves to the roof of the mouth, the throat muscles are contracted, and the muscles of the face drawn up in one way or another. this seems like a list of horrors, somewhat exaggerated when we realize that it is of sleep, "tired nature's sweet restorer," that we are speaking; but indeed it is only too true. of course cases are not in the majority where the being supposed to enjoy repose is using _all_ these numerous possibilities of contraction. but there are very few who have not, unconsciously, some one or two or half-dozen nervous and muscular strains; and even after they become conscious of the useless contractions, it takes time and watchfulness and patience to relax out of them, the habit so grows upon us. one would think that even though we go to sleep in a tense way, after being once soundly off nature could gain the advantage over us, and relax the muscles in spite of ourselves; but the habits of inheritance and of years are too much for her. although she is so constantly gracious and kind, she cannot go out of her way, and we cannot ask her to do so. how simple it seems to sleep in the right way; and how wholesome it is even to think about it, in contrast to the wrong way into which so many of us have fallen. if we once see clearly the great compensation in getting back to the only way of gaining restful sleep, the process is very simple, although because we were so far out of the right path it often seems slow. but once gained, or even partially gained, one great enemy to healthful, natural nerves is conquered, and has no possibility of power. of course the mind and its rapid and misdirected working is a strong preventive of free nerves, relaxed muscles, and natural sleep. "if i could only stop myself from thinking" is a complaint often heard, and reason or philosophy does not seem to touch it. even the certain knowledge that nothing is gained by this rapid thought at the wrong time, that very much is lost, makes no impression on the overwrought mind,--often even excites it more, which proves that the trouble, if originally mental, has now gained such a hold upon the physique that it must be attacked there first. the nerves should be trained to enable the body to be an obedient servant to a healthy mind, and the mind in giving its attention to such training gains in normal power of direction. if you cannot stop thinking, do not try; let your thoughts steam ahead if they will. only relax your muscles, and as the attention is more and more fixed on the interesting process of letting-go of the muscles (interesting, simply because the end is so well worth gaining), the imps of thought find less and less to take hold of, and the machinery in the head must stop its senseless working, because the mind which allowed it to work has applied itself to something worth accomplishing. the body should also be at rest in necessary reclining in the day, where of course all the laws of sleep apply. five minutes of complete rest in that way means greater gain than an hour or three hours taken in the usual manner. i remember watching a woman "resting" on a lounge, propped up with the downiest of pillows, holding her head perfectly erect and in a strained position, when it not only would have been easier to let it fall back on the pillow, but it seemed impossible that she should not let it go; and yet there it was, held erect with an evident strain. hers is not an unusual case, on the contrary quite a common one. can we wonder that the german doctor thought he had discovered a new disease? and must he not be already surprised and shocked at the precocious growth of the infant monster which he found and named? "so prone are mortals to their own damnation, it seems as though a devil's use were gone." there is no better way of learning to overcome these perversions in sleep and similar forms of rest, than to study with careful thought the sleep of a wholesome little child. having gained the physical freedom necessary to give perfect repose to the body, the quiet, simple dropping of all thought and care can be made more easily possible. so we can approach again the natural sleep and enjoy consciously the refreshment which through our own babyhood was the unconscious means of giving us daily strength and power for growth. to take the regular process, first let go of the muscles,--that will enable us more easily to drop disturbing thoughts; and as we refuse, without resistance, admittance to the thoughts, the freedom from care for the time will follow, and the rest gained will enable us to awaken with new life for cares to come. this, however, is a habit to be established and thoughtfully cultivated; it cannot be acquired at once. more will be said in future chapters as to the process of gaining the habit. iv. other forms of rest do you hold yourself on the chair, or does the chair hold you? when you are subject to the laws of gravitation give up to them, and feel their strength. do not resist these laws, as a thousand and one of us do when instead of yielding gently and letting ourselves sink into a chair, we _put_ our bodies rigidly on and then hold them there as if fearing the chair would break if we gave our full weight to it. it is not only unnatural and unrestful, but most awkward. so in a railroad car. much, indeed most of the fatigue from a long journey by rail is quite unnecessary, and comes from an unconscious officious effort of trying to carry the train, instead of allowing the train to carry us, or of resisting the motion, instead of relaxing and yielding to it. there is a pleasant rhythm in the motion of the rapidly moving cars which is often restful rather than fatiguing, if we will only let go and abandon ourselves to it. this was strikingly proved by a woman who, having just learned the first principles of relaxation, started on a journey overstrained from mental anxiety. the first effect of the motion was that most disagreeable, faint feeling known as car-sickness. understanding the cause, she began at once to drop the unnecessary tension, and the faintness left her. then she commenced an interesting novel, and as she became excited by the plot her muscles were contracted in sympathy (so-called), and the faintness returned in full force, so that she had to drop the book and relax again; and this process was repeated half-a-dozen times before she could place her body so under control of natural laws that it was possible to read without the artificial tension asserting itself and the car-sickness returning in consequence. the same law is illustrated in driving. "i cannot drive, it tires me so," is a common complaint. why does it tire you? because instead of yielding entirely and freely to the seat of the carriage first, and then to its motion, you try to help the horses, or to hold yourself still while the carriage is moving. a man should become one with a carriage in driving, as much as one with his horse in riding. notice the condition in any place where there is excuse for some anxiety,--while going rather sharply round a corner, or nearing a railroad track. if your feet are not pressed forcibly against the floor of the carriage, the tension will be somewhere else. you are using nervous force to no earthly purpose, and to great earthly loss. where any tension is necessary to make things better, it will assert itself naturally and more truly as we learn to drop all useless and harmful tension. take a patient suffering from nervous prostration for a long drive, and you will bring him back more nervously prostrated; even the fresh air will not counteract the strain that comes from not knowing how to relax to the motion of the carriage. a large amount of nervous energy is expended unnecessarily while waiting. if we are obliged to wait for any length of time, it does not hurry the minutes or bring that for which we wait to keep nervously strained with impatience; and it does use vital force, and so helps greatly toward "americanitis." the strain which comes from an hour's nervous waiting, when simply to let yourself alone and keep still would answer much better, is often equal to a day's labor. it must be left to individuals to discover how this applies in their own especial cases, and it will be surprising to see not only how great and how common such strain is, but how comparatively easy it is to drop it. there are of course exceptional times and states when only constant trying and thoughtful watchfulness will bring any marked result. we have taken a few examples where there is nothing to do but keep quiet, body and brain, from what should be the absolute rest of sleep to the enforced rest of waiting. just one word more in connection with waiting and driving. you must catch a certain train. not having time to trust to your legs or the cars, you hastily take a cab. you will in your anxiety keep up exactly the same strain that you would have had in walking,--as if you could help the carriage along, or as if reaching the station in time depended upon your keeping a rigid spine and tense muscles. you have hired the carriage to take you, and any activity on your part is quite unnecessary until you reach the station; why not keep quiet and let the horses do the work, and the driver attend to his business? it would be easy to fill a small volume with examples of the way in which we are walking directly into nervous prostration; examples only of this one variety of disobedience,--namely, of the laws of_ rest._ and to give illustrations of all the varieties of disobedience to nature's laws in _activity_ would fill not one small book, but several large ones; and then, unless we improve, a year-book of new examples of nervous strain could be published. but fortunately, if we are nervous and short-sighted, we have a good share of brain and commonsense when it is once appealed to, and a few examples will open our eyes and set us thinking, to real and practical results. v. the use of the brain let us now consider instances where the brain alone is used, and the other parts of the body have nothing to do but keep quiet and let the brain do its work. take thinking, for instance. most of us think with the throat so contracted that it is surprising there is room enough to let the breath through, the tongue held firmly, and the jaw muscles set as if suffering from an acute attack of lockjaw. each has his own favorite tension in the act of meditation, although we are most generous in the force given to the jaw and throat. the same superfluous tension may be observed in one engaged in silent reading; and the force of the strain increases in proportion to the interest or profundity of the matter read. it is certainly clear, without a knowledge of anatomy or physiology, that for pure, unadulterated thinking, only the brain is needed; and if vital force is given to other parts of the body to hold them in unnatural contraction; we not only expend it extravagantly, but we rob the brain of its own. when, for purely mental work, all the activity is given to the brain, and the body left free and passive, the concentration is better, conclusions are reached with more satisfaction, and the reaction, after the work is over, is healthy and refreshing. this whole machine can be understood perhaps more clearly by comparing it to a community of people. in any community,--church, state, institution, or household,--just so far as each member minds his own business, does his own individual work for himself and for those about him, and does not officiously interfere with the business of others, the community is quiet, orderly, and successful. imagine the state of a deliberative assembly during the delivery of a speech, if half-a-dozen of the listeners were to attempt to help the speaker by rising and talking at the same time; and yet this is the absurd action of the human body when a dozen or more parts, that are not needed, contract "in sympathy" with those that have the work to do. it is an unnecessary brace that means loss of power and useless fatigue. one would think that the human machine having only one mind, and the community many thousands, the former would be in a more orderly state than the latter. in listening attentively, only the brain and ears are needed; but watch the individuals at an entertaining lecture, or in church with a stirring preacher. they are listening with their spines, their shoulders, the muscles of their faces. i do not refer to the look of interest and attention, or to any of the various expressions which are the natural and true reflection of the state of the mind, but to the strained attention which draws the facial muscles, not at all in sympathy with the speaker, but as a consequence of the tense nerves and contracted muscles of the listener. "i do not understand why i have this peculiar sort of asthma every sunday afternoon," a lady said to me. she was in the habit of hearing, sunday morning, a preacher, exceedingly interesting, but with a very rapid utterance, and whose mind travelled so fast that the words embodying his thoughts often tumbled over one another. she listened with all her nerves, as well as with those needed, held her breath when he stumbled, to assist him in finding his verbal legs, reflected every action with twice the force the preacher himself gave,--and then wondered why on sunday afternoon, and at no other time, she had this nervous catching of the breath. she saw as soon as her attention was drawn to the general principles of nature, how she had disobeyed this one, and why she had trouble on sunday afternoon. this case is very amusing, even laughable, but it is a fair example of many similar nervous attacks, greater or less; and how easy it is to see that a whole series of these, day after day, doing their work unconsciously to the victim, will sooner or later bring some form of nervous prostration. the same attitudes and the same effects often attend listening to music. it is a common experience to be completely fagged after two hours of delightful music. there is no exaggeration in saying that we should be _rested_ after a good concert, if it is not too long. and yet so upside-down are we in our ways of living, and, through the mistakes of our ancestors, so accustomed have we become to disobeying nature's laws, that the general impression seems to be that music cannot be fully enjoyed without a strained attitude of mind and body; whereas, in reality, it is much more exquisitely appreciated and enjoyed in nature's way. if the nerves are perfectly free, they will catch the rhythm of the music, and so be helped back to the true rhythm of nature, they will respond to the harmony and melody with all the vibratory power that god gave them, and how can the result be anything else than rest and refreshment,--unless having allowed them to vibrate in one direction too long, we have disobeyed a law in another way. our bodies cannot by any possibility be _free,_ so long as they are strained by our own personal effort. so long as our nervous force is misdirected in personal strain, we can no more give full and responsive attention to the music, than a piano can sound the harmonies of a sonata if some one is drawing his hands at the same time backwards and forwards over the strings. but, alas! a contracted personality is so much the order of the day that many of us carry the chronic contractions of years constantly with us, and can no more free ourselves for a concert at a day's or a week's notice, than we can gain freedom to receive all the grand universal truths that are so steadily helpful. it is only by daily patience and thought and care that we can cease to be an obstruction to the best power for giving and receiving. there are, scattered here and there, people who have not lost the natural way of listening to music,--people who are musicians through and through so that the moment they hear a fine strain they are one with it. singularly enough the majority of these are fine animals, most perfectly and normally developed in their senses. when the intellect begins to assert itself to any extent, then the nervous strain comes. so noticeable is this, in many cases, that nervous excitement seems often to be from misdirected intellect; and people under the control of their misdirected nervous force often appear wanting in quick intellectual power,--illustrating the law that a stream spreading in all directions over a meadow loses the force that the same amount of water would have if concentrated and flowing in one channel. there are also many cases where the strained nerves bring an abnormal intellectual action. fortunately for the saving of the nation, there are people who from a physical standpoint live naturally. these are refreshing to see; but they are apt to take life too easily, to have no right care or thought, and to be sublimely selfish. another way in which the brain is constantly used is through the eyes. what deadly fatigue comes from time spent in picture galleries! there the strain is necessarily greater than in listening, because all the pictures and all the colors are before us at once, with no appreciable interval between forms and subjects that differ widely. but as the strain is greater, so should the care to relieve it increase. we should not go out too far to meet the pictures, but be quiet, and let the pictures come to us. the fatigue can be prevented if we know when to stop, and pleasure at the time and in the memory afterwards will be surprisingly increased. so is it in watching a landscape from the car window, and in all interests which come from looking. i am not for one instant condemning the _natural_ expression of pleasure, neither do i mean that there should be any apparent nonchalance or want of interest; on the contrary, the real interest and its true expression increase as we learn to shun the shams. but will not the discovery of all this superfluous tension make one self-conscious? certainly it will for a time, and it must do so. you must be conscious of a smooch on your face in order to wash it off, and when the face is clean you think no more of it. so you must see an evil before you can shun it. all these physical evils you must be vividly conscious of, and when you are so annoyed as to feel the necessity of moving from under them self-consciousness decreases in equal ratio with the success of your efforts. whenever the brain alone is used in thinking, or in receiving and taking note of impressions through either of the senses, new power comes as we gain freedom from all misdirected force, and with muscles in repose leave the brain to quietly do its work without useless strain of any kind. it is of course evident that this freedom cannot be gained without, first, a consciousness of its necessity. the perfect freedom, however, when reached, means freedom from self-consciousness as well as from the strain which made self-consciousness for a time essential. vi. the brain in its direction of the body we come now to the brain and its direction of other parts of the body. what tremendous and unnecessary force is used in talking,--from the aimless motion of the hands, the shoulders, the feet, the entire body, to a certain rigidity of carriage, which tells as powerfully in the wear and tear of the nervous system as superfluous motion. it is a curious discovery when we find often how we are holding our shoulders in place, and in the wrong place. a woman receiving a visitor not only talks all over herself, but reflects the visitor's talking all over, and so at the end of the visit is doubly fatigued. "it tires me so to see people" is heard often, not only from those who are under the full influence of "americanitis," but from many who are simply hovering about its borders. "of course it tires you to see people, you see them with, so much superfluous effort," can almost without exception be a true answer. a very little simple teaching will free a woman from that unnecessary fatigue. if she is sensible, once having had her attention brought and made keenly alive to the fact that she talks all over, she will through constant correction gain the power of talking as nature meant she should, with her vocal apparatus only, and with such easy motions as may be needed to illustrate her words. in this change, so far from losing animation, she gains it, and gains true expressive power; for all unnecessary motion of the body in talking simply raises a dust, so to speak, and really blurs the true thought of the mind and feeling of the heart. the american voice--especially the female voice--is a target which has been hit hard many times, and very justly. a ladies' luncheon can often be truly and aptly compared to a poultry-yard, the shrill cackle being even more unpleasant than that of a large concourse of hens. if we had once become truly appreciative of the natural mellow tones possible to every woman, these shrill voices would no more be tolerated than a fashionable luncheon would be served in the kitchen. a beautiful voice has been compared to corn, oil, and wine. we lack almost entirely the corn and the oil; and the wine in our voices is far more inclined to the sharp, unpleasant taste of very poor currant wine, than to the rich, spicy flavor of fine wine from the grape. it is not in the province of this book to consider the physiology of the voice, which would be necessary in order to show clearly how its natural laws are constantly disobeyed. we can now speak of it only with regard to the tension which is the immediate cause of the trouble. the effort to propel the voice from the throat, and use force in those most delicate muscles when it should come from the stronger muscles of the diaphragm, is like trying to make one man do the work of ten; the result must eventually be the utter collapse of the one man from over-activity, and loss of power in the ten men because of muscles unused. clergyman's sore throat is almost always explainable in this way; and there are many laymen with constant trouble in the throat from no cause except the misuse of its muscles in talking. "the old philosopher said the seat of the soul was in the diaphragm. however that may be, the word begins there, soul and body; but you squeeze the life out of it in your throat, and so your words are born dead!" was the most expressive exclamation of an able trainer of the voice. few of us feel that we can take the time or exercise the care for the proper training of our voices; and such training is not made a prominent feature, as it should be, in all american schools. indeed, if it were, we would have to begin with the teachers; for the typical teacher's voice, especially in our public schools, coming from unnecessary nervous strain is something frightful. in a large school-room a teacher can be heard, and more impressively heard, in common conversational tones; for then it is her mind that is felt more than her body. but the teacher's voice mounts the scale of shrillness and force just in proportion as her nervous fatigue increases; and often a true enthusiasm expresses itself--or, more correctly, hides itself--in a sharp, loud voice, when it would be far more effective in its power with the pupils if the voice were kept quiet. if we cannot give time or money to the best development of our voices, we can grow sensitive to the shrill, unpleasant tones, and by a constant preaching of "lower your voices," "speak more quietly," from the teacher to herself, and then to her pupils, from mother to child, and from every woman to her own voice, the standard american voice would change, greatly to the national advantage. i never shall forget the restful pleasure of hearing a teacher call the roll in a large schoolroom as quietly as she would speak to a child in a closet, and every girl answering in the same soft and pleasant way. the effect even of that daily roll-call could not have been small in its counteracting influence on the shrill american tone. watch two people in an argument, as the excitement increases the voice rises. in such a case one of the best and surest ways to govern your temper is to lower your voice. indeed the nervous system and the voice are in such exquisite sympathy that they constantly act and react on each other. it is always easier to relax superfluous tension after lowering the voice. "take the bone and flesh sound from your voice" is a simple and interesting direction. it means do not push so hard with your body and so interfere with the expression of your soul. thumping on a piano, or hard scraping on a violin, will keep all possible expression from the music, and in just the same proportion will unnecessary physical force hide the soul in a voice. indeed with the voice--because the instrument is finer--the contrast between nature's way and man's perversion is far greater. one of the first cares with a nervous invalid, or with any one who suffers at all from overstrained nerves, should be for a quiet, mellow voice. it is not an invariable truth that women with poorly balanced nerves have shrill, strained voices. there is also a rigid tone in a nervously low voice, which, though not unpleasant to the general ear, is expressive to one who is in the habit of noticing nervous people, and is much more difficult to relax than the high pitched voices. there is also a forced calm which is tremendous in its nervous strain, the more so as its owner takes pride in what she considers remarkable self-control. another common cause of fatigue with women is the useless strain in sewing. "i get so tired in the back of my neck" is a frequent complaint. "it is because you sew with the back of your neck" is generally the correct explanation. and it is because you sew with the muscles of your waist that they feel so strangely fatigued, and the same with the muscles of your legs or your chest. wherever the tired feeling comes it is because of unnatural and officious tension, which, as soon as the woman becomes sensible of it, can be stopped entirely by taking two or three minutes now and then to let go of these wrongly sympathetic muscles and so teach them to mind their own business, and sew with only the muscles that are needed. a very simple cause of over-fatigue in sewing is the cramped, strained position of the lungs; this can be prevented without even stopping in the work, by taking long, quiet, easy breaths. here there must be _no exertion whatever_ in the chest muscles. the lungs must seem to expand from the pressure of the air alone, as independently as a rubber ball will expand when external pressure is removed, and they must be allowed to expel the air with the same independence. in this way the growth of breathing power will be slow, but it will be sure and delightfully restful. frequent, full, quiet breaths might be the means of relief to many sufferers, if only they would take the trouble to practise them faithfully,--a very slight effort compared with the result which will surely ensue. and so it is with the fatigue from sewing. i fear i do not exaggerate, when i say that in nine cases out of ten a woman would rather sew with a pain in her neck than stop for the few moments it would take to relax it and teach it truer habits, so that in the end the pain might be avoided entirely. then, when the inevitable nervous exhaustion follows, and all the kindred troubles that grow out of it she pities herself and is pitied by others, and wonders why god thought best to afflict her with suffering and illness. "thought best!" god never thought best to give any one pain. he made his laws, and they are wholesome and perfect and true, and if we disobey them we must suffer the consequences! i knock my head hard against a stone and then wonder why god thought best to give me the headache. there would be as much sense in that as there is in much of the so-called christian resignation to be found in the world to-day. to be sure there are inherited illnesses and pains, physical and mental, but the laws are so made that the compensation of clear-sightedness and power for use gained by working our way rightly out of all inheritances and suffering brought by others, fully equalizes any apparent loss. in writing there is much unnecessary nervous fatigue. the same cramped attitude of the lungs that accompanies sewing can be counteracted in the same way, although in neither case should a cramped attitude be allowed at all still the relief of a long breath is always helpful and even necessary where one must sit in one position for any length of time. almost any even moderately nervous man or woman will hold a pen as if some unseen force were trying to pull it away, and will write with firmly set jaw, contracted throat, and a powerful tension in the muscles of the tongue, or whatever happens to be the most officious part of this especial individual community. to swing the pendulum to another extreme seems not to enter people's minds when trying to find a happy medium. writer's paralysis, or even the ache that comes from holding the hand so long in a more or less cramped attitude, is easily obviated by stopping once in an hour or half hour, stretching the fingers wide and letting the muscles slowly relax of their own accord. repeat this half-a-dozen times, and after each exercise try to hold the pen or pencil with natural lightness; it will not take many days to change the habit of tension to one of ease, although if you are a steady writer the stretching exercise will always be necessary, but much less often than at first. in lifting a heavyweight, as in nursing the sick, the relief is immediate from all straining in the back, by pressing hard with the feet on the floor and _thinking_ the power of lifting in the legs. there is true economy of nervous force here, and a sensitive spine is freed from a burden of strain which might undoubtedly be the origin of nervous prostration. i have made nurses practise lifting, while impressing the fact forcibly upon them by repetition before they lift, and during the process of raising a body and lowering it, that they must use entirely the muscles of the legs. when once their minds have full comprehension of the new way, the surprise with which they discover the comparative ease of lifting is very pleasant. the whole secret in this and all similar efforts is to use muscular instead of nervous force. direct with the directing power; work with the working power. vii. the direction of the body in locomotion lifting brings us to the use of the entire body, which is considered simply in the most common of all its movements,--that of walking. the rhythm of a perfect walk is not only delightful, but restful; so that having once gained a natural walk there is no pleasanter way to rest from brain fatigue than by means of this muscle fatigue. and yet we are constantly contradicting and interfering with nature in walking. women--perhaps partly owing to their unfortunate style of dress--seem to hold themselves together as if fearing that having once given their muscles free play, they would fall to pieces entirely. rather than move easily forward, and for fear they might tumble to pieces, they shake their shoulders and hips from side to side, hold their arms perfectly rigid from the shoulders down, and instead of the easy, natural swing that the motion of walking would give the arms, they go forward and back with no regularity, but are in a chronic state of jerk. the very force used in holding an arm as stiff as the ordinary woman holds it, would be enough to give her an extra mile in every five-mile walk. then again, the muscles of the throat must help, and more than anywhere else is force unnecessarily expended in the waist muscles. they can be very soon felt, pushing with all their might--and it is not a small might--officiously trying to assist in the action of the legs; whereas if they would only let go, mind their own business, and let the legs swing easily as if from the shoulders, they might reflect the rhythmic motion, and gain in a true freedom and power. of course all this waste of force comes from nervous strain and is nervous strain, and a long walk in the open air, when so much of the new life gained is wrongly expended, does not begin to do the good work that might be accomplished. to walk with your muscles and not use superfluous nervous force is the first thing to be learned, and after or at the same time to direct your muscles as nature meant they should be directed,--indeed we might almost say to let nature direct them herself, without our interference. hurry with your muscles and not with your nerves. this tells especially in hurrying for a train, where the nervous anxiety in the fear of losing it wakes all possible unnecessary tension and often impedes the motion instead of assisting it. the same law applies here that was mentioned before with regard to the carriage,--only instead of being quiet and letting the carriage take you, be quiet and let your walking machine do its work. so in all hurrying, and the warning can hardly be given too many times, we must use our nerves only as transmitters--calm, well-balanced transmitters--that our muscles may be more efficient and more able servants. the same mistakes of unnecessary tension will be found in running, and, indeed, in all bodily motion, where the machine is not trained to do its work with only the nerves and muscles needed for the purpose. we shall have opportunity to consider these motions in a new light when we come to the directions for gaining a power of natural motion; now we are dealing only with mistakes. viii. nervous strain in pain and sickness there is no way in which superfluous and dangerous tension is so rapidly increased as in the bearing of pain. the general impression seems to be that one should brace up to a pain; and very great strength of will is often shown in the effort made and the success achieved in bearing severe pain by means of this bracing process. but alas, the reaction after the pain is over--that alone would show the very sad misuse which had been made of a strong will. not that there need be no reaction; but it follows naturally that the more strain brought to bear upon the nervous system in endurance, the greater must be the reaction when the load is lifted. indeed, so well is this known in the medical profession, that it is a surgical axiom that the patient who most completely controls his expression of pain will be the greatest sufferer from the subsequent reaction. while there is so much pain to be endured in this world, a study of how best to bear it certainly is not out of place, especially when decided practical effects can be quickly shown as the result of such study. so prevalent is the idea that a pain is better borne by clinching the fists and tightening all other muscles in the body correspondingly, that i know the possibility of a better or more natural mode of endurance will be laughed at by many, and others will say, "that is all very well for those who can relax to a pain,--let them gain from it, i cannot; it is natural for me to set my teeth and bear it." there is a distinct difference between what is natural to us and natural to nature, although the first term is of course misused. pain comes from an abnormal state of some part of the nervous system. the more the nerves are strained to bear pain, the more sensitive they become; and of course those affected immediately feel most keenly the increased sensitiveness, and so the pain grows worse. reverse that action, and through the force of our own inhibitory power let a new pain be a reminder to us to _let go,_ instead of to hold on, and by decreasing the strain we decrease the possibility of more pain. whatever reaction may follow pain then, will be reaction from the pain itself, not from the abnormal tension which has been held for the purpose of bearing it. but--it will be objected--is not the very effort of the brain to relax the tension a nervous strain? yes, it is,--not so great, however, as the continued tension all over the body, and it grows less and less as the habit is acquired of bearing the pain easily. the strain decreases more rapidly with those who having undertaken to relax, perceive the immediate effects; for, of course, as the path clears and new light comes they are encouraged to walk more steadily in the easier way. i know there are pains that are better borne and even helped by a certain amount of _bracing,_ but if the idea of bearing such pain quietly, easily, naturally, takes a strong hold of the mind, all bracing will be with a true equilibrium of the muscles, and will have the required effect without superfluous tension. one of the most simple instances of bearing pain more easily by relaxing to it occurs while sitting in the dentist's chair. most of us clutch the arms, push with our feet, and hold ourselves off the chair to the best of our ability. every nerve is alive with the expectation of being hurt. the fatigue which results from an hour or more of this dentist tension is too well known to need description. most of the nervous fatigue suffered from the dentist's work is in consequence of the unnecessary strain of expecting a hurt and not from any actual pain inflicted. the result obtained by insisting upon making yourself a dead weight in the chair, if you succeed only partially, will prove this. it will also be a preliminary means of getting well rid of the dentist fright,--that peculiar dread which is so well known to most of us. the effect of fright is nervous strain, which again contracts the muscles. if we drop the muscular tension, and so the nervous strain, thus working our way into the cause by means of the effect, there will be no nerves or muscles to hold the fright, which then so far as the physique is concerned cannot exist. _so far as the physique is concerned,--_that is emphatic; for as we work inward from the effect to the cause we must be met by the true philosophy inside, to accomplish the whole work. i might relax my body out of the nervous strain of fright all day; if my mind insisted upon being frightened it would simply be a process of freeing my nerves and muscles that they might be made more effectually tense by an unbalanced, miserably controlled mind. in training to bring body and mind to a more normal state, the teacher must often begin with the body only, and use his own mind to gently lead the pupil to clearer sight. then when the pupil can strike the equilibrium between mind and body,--he must be left to acquire the habit for himself. the same principles by which bearing the work of the dentist is made easier, are applicable in all pain, and especially helpful when pain is nervously exaggerated. it would be useless and impossible to follow the list of various pains which we attempt to bear by means of additional strain. each of us has his own personal temptation in the way of pain,--from the dentist's chair to the most severe suffering, or the most painful operation,--and each can apply for himself the better way of bearing it. and it is not perhaps out of place here to speak of the taking of ether or any anaesthetic before an operation. the power of relaxing to the process easily and quietly brings a quicker and pleasanter effect with less disagreeable results. one must take ether easily in mind and body. it a man forces himself to be quiet externally, and is frightened and excited mentally, as soon as he has become unconscious enough to lose control of his voluntary muscles, the impression of fright made upon the brain asserts itself, and he struggles and resists in proportion. these same principles of repose should be applied in illness when it comes in other forms than that of pain. we can easily increase whatever illness may attack us by the nervous strain which comes from fright, anxiety, or annoyance. i have seen a woman retain a severe cold for days more than was necessary, simply because of the chronic state of strain she kept herself in by fretting about it; and in another unpleasantly amusing case the sufferer's constantly expressed annoyance took the form of working almost without intermission to find remedies for herself. without using patience enough to wait for the result of one remedy, she would rush to another until she became--so to speak--twisted and snarled in the meshes of a cold which it took weeks thoroughly to cure. this is not uncommon, and not confined merely to a cold in the head. we can increase the suffering of friends through "sympathy" given in the same mistaken way by which we increase our own pain, or keep ourselves longer than necessary in an uncomfortable illness. ix. nervous strain in the emotions the most intense suffering which follows a misuse of the nervous power comes from exaggerated, unnecessary, or sham emotions. we each have our own emotional microscope, and the strength of its lens increases in proportion to the supersensitiveness of our nervous system. if we are a little tired, an emotion which in itself might hardly be noticed, so slight is the cause and so small the result, will be magnified many times. if we are very tired, the magnifying process goes on until often we have made ourselves ill through various sufferings, all of our own manufacture. this increase of emotion has not always nervous fatigue as an excuse. many people have inherited emotional magnifying glasses, and carry them through the world, getting and giving unnecessary pain, and losing more than half of the delight of life in failing to get an unprejudiced view of it. if the tired man or woman would have the good sense to stop for one minute and use the power which is given us all of understanding and appreciating our own perverted states and so move on to better, how easy it would be to recognize that a feeling is exaggerated because of fatigue, and wait until we have gained the power to drop our emotional microscopes and save all the evil results of allowing nervous excitement to control us. we are even permitted to see clearly an inherited tendency to magnify emotions and to overcome it to such an extent that life seems new to us. this must be done by the individual himself, through a personal appreciation of his own mistakes and active steps to free himself from them. no amount of talking, persuading, or teaching will be of the slightest service until that personal recognition comes. this has been painfully proved too often by those who see a friend suffering unnecessarily, and in the short-sighted attempt to wrench the emotional microscope from his hand, simply cause the hold to tighten and the magnifying power to increase. a careful, steady training of the physique opens the way for a better practice of the wholesome philosophy, and the microscope drops with the relaxation of the external tension which has helped to hold it. emotions are often not even exaggerated but are from the beginning imaginary; and there are no more industrious imps of evil than these sham feelings. the imps have no better field for their destructive work than in various forms of morbid, personal attachment, and in what is commonly called religion,--but which has no more to do with genuine religion than the abnormal personal likings have to do with love. it is a fact worthy of notice that the two powers most helpful, most strengthening, when sincerely felt and realized, are the ones oftenest perverted and shammed, through morbid states and abnormal nervous excitement. the sham is often so perfect an image of the reality that even the shammer is deceived. to tell one of these pseudo-religious women that the whole attitude of her externally sanctified life is a sham emotion, would rouse anything but a saintly spirit, and surprise her beyond measure. yet the contrast between the true, healthful, religious feeling and the sham is perfectly marked, even though both classes follow the same forms and belong to the same charitable societies. with the one, religion seems to be an accomplishment, with a rivalry as to who can carry it to the finest point; with the other, it is a steadily growing power of wholesome use. this nervous strain from sham emotions, it must be confessed, is more common to the feminine nature. so dangerously prevalent is it that in every girls' school a true repression of the sham and a development of real feeling should be the thoughtful, silent effort of all the teachers. any one who knows young girls feels deeply the terrible harm which comes to them in the weakening of their delicate, nervous systems through morbid, emotional excitement. the emotions are vividly real to the girls, but entirely sham in themselves. great care must be taken to respect the sense of reality which a young girl has in these mistakes, until she can be led out so far that she herself recognizes the sham; then will come a hearty, wholesome desire to be free from it. a school governed by a woman with strong "magnetism," and an equally strong love of admiration and devotion, can be kept in a chronic state of hysteria by the emotional affection of the girls for their teacher. when they cannot reach the teacher they will transfer the feeling to one another. where this is allowed to pervade the atmosphere of a girls' school, those who escape floods of tears or other acute hysterical symptoms are the dull, phlegmatic temperaments. often a girt will go from one of these morbid attachments to another, until she seems to have lost the power for a good, wholesome affection. strange as it may seem, the process is a steady hardening of the heart. the same result comes to man or woman who has followed a series of emotional flirtations,--the perceptions are dulled, and the whole tone of the system, mental and physical, is weakened. the effect is in exact correspondence in another degree with the result which follows an habitual use of stimulants. most abnormal emotional states are seen in women--and sometimes in men--who believe themselves in love. the suffering is to them very real. it seems cruel to say, "my dear, you are not in the least in love with that man; you are in love with your own emotions. if some one more attractive should appear, you could at once transfer your emotional tortures to the seemingly more worthy object." such ideas need not be flung in so many words at a woman, but she may be gently led until she sees clearly for herself the mistake, and will even laugh at the morbid sensations that before seemed to her terribly real. how many foolish, almost insane actions of men and women come from sham emotions and the nervous excitement generated by them, or from nervous excitement and the sham emotions that result in consequence! care should be taken first to change the course of the nervous power that is expressing itself morbidly, to open for it a healthy outlet, to guide it into that more wholesome channel, and then help the owner to a better control and a clearer understanding, that she may gain a healthy use of her wonderful nervous power. a gallop on horseback, a good swim, fresh air taken with any form of wholesome fun and exercise is the way to begin if possible. a woman who has had all the fresh air and interesting exercise she needs, will shake off the first sign of morbid emotions as she would shake off a rat or any other vermin. to one who is interested to study the possible results of misdirected nervous power, nothing could illustrate it with more painful force than the story by rudyard kipling, "in the matter of a private." real emotions, whether painful or delightful, leave one eventually with a new supply of strength; the sham, without exception, leave their victim weaker, physically and mentally, unless they are recognized as sham, and voluntarily dismissed by the owner of the nerves that have been rasped by them. it is an inexpressibly sad sight to see a woman broken, down and an invalid, for no reason whatever but the unnecessary nervous excitement of weeks and months of sham emotion. hardly too strong an appeal can be made to mothers and teachers for a careful watchfulness of their girls, that their emotions be kept steadily wholesome, so that they may grow and develop into that great power for use and healthful sympathy which always belongs to a woman of fine feeling. there is a term used in college which describes most expressively an intense nervous excitement and want of control,--namely, "dry drunk." it has often seemed to me that sham emotions are a woman's form of getting drunk, and nervous prostration is its delirium tremens. not the least of the suffering caused by emotional excitement comes from mistaken sympathy with others. certain people seem to live on the principle that if a friend is in a swamp, it is necessary to plunge in with him; and that if the other man is up to his waist, the sympathizer shows his friendliness by allowing the mud to come up to his neck. whereas, it is evident that the deeper my friend is immersed in a swamp, the more sure i must be to keep on firm ground that i may help him out; and sometimes i cannot even give my hand, but must use a long pole, the more surely to relieve him from danger. it is the same with a mental or moral swamp, or most of all with a nervous swamp, and yet so little do people appreciate the use of this long pole that if i do not cry when my friend cries, moan when my friend moans, and persistently refuse to plunge into the same grief that i may be of more real use in helping him out of it, i am accused by my friend and my friend's friend of coldness and want of sympathy. people have been known to refuse the other end of your pole because you will not leave it and come into the swamp with them. it is easy to see why this mistaken sympathy is the cause of great unnecessary nervous strain. the head nurse of a hospital in one of our large cities was interrupted while at dinner by the deep interest taken by the other nurses in seeing an accident case brought in. when the man was put out of sight the nurses lost their appetite from sympathy; and the forcible way with which their superior officer informed them that if they had any real sympathy for the man they would eat to gain strength to serve him, gave a lesson by which many nervous sympathizers could greatly profit. of course it is possible to become so hardened that you "eat your dinner" from a want of feeling, and to be consumed only with sympathy for yourself; but it is an easy matter to make the distinction between a strong, wholesome sympathy and selfish want of feeling, and easier to distinguish between the sham sympathy and the real. the first causes you to lose nervous strength, the second gives you new power for wholesome use to others. in all the various forms of nervous strain, which we study to avoid, let us realize and turn from false sympathy as one to be especially and entirely shunned. sham emotions are, of course, always misdirected force; but it is not unusual to see a woman suffering from nervous prostration caused by nervous power lying idle. this form of invalidism comes to women who have not enough to fill their lives in necessary interest and work, and have not thought of turning or been willing to turn their attention to some needed charity or work for others. a woman in this state is like a steam-engine with the fire in full blast, and the boiler shaking with the power of steam not allowed to escape in motive force. a somewhat unusual example of this is a young woman who had been brought up as a nervous invalid, had been through nervous prostration once, and was about preparing for another attack, when she began to work for a better control of her nervous force. after gaining a better use of her machine, she at once applied its power to work,--gradually at first and then more and more, until she found herself able to endure what others had to give up as beyond their strength. the help for these, and indeed for all cases, is to make the life objective instead of subjective. "look out, not in; look up, not down; lend a hand," is the motto that must be followed gently and gradually, but _surely,_ to cure or to prevent a case of "americanitis." but again, good sense and care must be taken to preserve the equilibrium; for nervous tension and all the suffering that it brings come more often from mistaken devotion to others than from a want of care for them. too many of us are trying to make special providences of ourselves for our friends. to say that this short-sighted martyrdom is not only foolish but selfish seems hard, but a little thought will show it to be so. a woman sacrifices her health in over-exertion for a friend. if she does not distress the object of her devotion entirely out of proportion to the use she performs, she at least unfits herself, by over-working, for many other uses, and causes more suffering than she saves. so are the great ends sacrificed to the smaller. "if you only knew how hard i am trying to do right" comes with a strained face and nervous voice from many and many a woman. if she could only learn in this case, as in others, of "vaulting ambition that o'er-leaps itself and falls upon the other side;" if she could only realize that the very strained effort with which she tries, makes it impossible for her to gain,--if she would only "relax" to whatever she has to do, and then try, the gain would be incomparable. the most intense sufferers from nervous excitement are those who suppress any sign of their feeling. the effort to "hold in" increases the nervous strain immensely. as in the case of one etherized, who has suppressed fright which he feels very keenly, as soon as the voluntary muscles are relaxed the impression on the brain shows itself with all the vehemence of the feeling,--so when the muscles are consciously relaxed the nervous excitement bursts forth like the eruption of a small volcano, and for a time is a surprise to the man or woman who has been in a constant effort of suppression. the contrast between true self-control and that which is merely repressed feeling, is, like all contrast between the natural and the artificial, immeasurable; and the steadily increasing power to be gained by true self-control cannot be conveyed in words, but must be experienced in actual use. many of us know with what intense force a temper masters us when, having held in for some time, some spring is touched which makes silence impossible, and the sense of relief which follows a volley of indignant words. to say that we can get a far greater and more lasting relief without a word, but simply through relaxing our muscles and freeing our excited nerves, seems tame; but it is practically true, and is indeed the only way from a physical standpoint that one may be sure of controlling a high temper. in that way, also, we keep the spirit, the power, the strength, from which the temper comes, and so far from being tame, life has more for us. we do not tire ourselves and lose nervous force through the wear and tear of losing our temper. to speak expressively, if not scientifically, let go, and let the temper slip over your nerves and off,--you do not lose it then, for you know where it is, and you keep all the nervous force that would have been used in suppression or expression for better work. that, the reader will say, is not so easy as it sounds. granted, there must be the desire to get a true control of the temper; but most of us have that desire, and while we cannot expect immediate success, steady practice will bring startling results sooner than we realize. there must be a clear, intelligent understanding of what we are aiming at, and how to gain it; but that is not difficult, and once recognized grows steadily as we gain practical results. let the first feeling of anger be a reminder to "let go." but you will say, "i do not want to let go,"--only because your various grandfathers and grandmothers were unaccustomed to relieving themselves in that manner. when we give way to anger and let it out in a volley of words, there is often a sense of relief, but more often a reaction which is most unpleasant, and is greatly increased by the pain given to others. the relief is certain if we "relax;" and not only is there then no painful reaction, but we gain a clear head to recognize the justice or injustice of our indignation, and to see what can be done about its cause. petty irritability can be met in the same way. as with nervous pain it seems at first impossible to "relax to it;" but the rubicon once crossed, we cannot long be irritable,--it is so much simpler not to be, and so much more comfortable. if when we are tempted to fly into a rage or to snap irritably at others we could go through a short process of relaxing motions, the effect would be delightful. but that would be ridiculous; and we must do our relaxing in the privacy of the closet and recall it when needed outside, that we may relax without observation except in its happy results. i know people will say that anything to divert the mind will cure a high temper or irritability. that is only so to a limited extent; and so far as it is so, simply proves the best process of control. diversion relieves the nervous excitement, turning the attention in another direction,--and so is relaxing so far as it goes. much quicker and easier than self-control is the control which allows us to meet the irritability of others without echoing it. the temptation to echo a bad temper or an irritable disposition in others, we all know; but the relief which comes to ourselves and to the sufferer as we quietly relax and refuse to reflect it, is a sensation that many of us have yet to experience. one keeps a clear head in that way, not to mention a charitable heart; saves any quantity of nervous strain, and keeps off just so much tendency to nervous prostration. practically the way is opened to this better control through a physical training which gives us the power of relaxing at will, and so of maintaining a natural, wholesome equilibrium of nerves and muscles. personal sensitiveness is, to a great degree, a form of nervous tension. an individual case of the relief of this sensitiveness, although laughable in the means of cure, is so perfectly illustrative of it that it is worth telling. a lady who suffered very much from having her feelings hurt came to me for advice. i told her whenever anything was said to wound her, at once to imagine her legs heavy,--that relaxed her muscles, freed her nerves, and relieved the tension caused by her sensitive feelings. the cure seemed to her wonderful. it would not have done for her to think a table heavy, or a chair, or to have diverted her mind in any other way, for it was the effect of relaxation in her own body that she wanted, which came from persistently thinking her legs heavy. neither could her sensitiveness have taken a very deep hold, or mere outside relaxation would not have reached it; but that outside process had the effect of greatly assisting in the power to use a higher philosophy with the mind. self-consciousness and all the personal annoyances that come with or follow it are to so great an extent nervous tension, that the ease with which they may be helped seems sometimes like a miracle to those who study for a better guidance of their bodies. of worries, from the big worries with a real foundation to the miserable, petty, nagging worries that wear a woman's nervous system more than any amount of steady work, there is so much to be said that it would prove tedious, and indeed unnecessary to recount them. a few words will suggest enough toward their remedy to those who are looking in the right direction, and to others many words would be of no avail. the petty worries are the most wearing, and they fortunately are the most easily helped. by relaxing the muscular contractions invariably accompanying them we seem to make an open channel, and they slip through,--which expression i am well aware is not scientific. the common saying, "cares roll off her like water off a duck's back," means the same thing. some human ducks are made with backs eminently fitted for cares to slip from; but those whose backs seem to be made to hold the cares can remould themselves to the right proportions, and there is great compensation in their appreciation of the contrast. never resist a worry. it is increased many times by the effort to overcome it. the strain of the effort makes it constantly more difficult to drop the strain of the worry. when we quietly go to work to relax the muscles and so quiet the nerves, ignoring a worry, the way in which it disappears is surprising. then is the time to meet it with a broad philosophizing on the uselessness of worry, etc., and "clinch" our freedom, so to speak. it is not at the first attempt to relax, or the second, or the ninth, that the worry will disappear for many of us, and especially for worriers. it takes many hours to learn what relaxing is; but having once learned, its helpful power is too evident for us not to keep at it, if we really desire to gain our freedom. to give the same direction to a worrier that was so effective with the woman whose feelings were easily hurt, may seem equally ridiculous; but in many cases it will certainly prove most useful. when you begin to worry, think your legs heavy. your friends will appreciate the relief more than you do, and will gain as you gain. a recital of all the emotional disturbances which seem to have so strong a hold on us, and which are merely misdirected nervous force, might easily fill a volume; but a few of the most common troubles, such as have been given, will perhaps suffice to help each individual to understand his own especial temptations in that direction,--and if i have made even partially clear the ease with which they may be relieved through careful physical training, it is all i can hope for. the body must be trained to obey the mind; the mind must be trained to give the body commands worth obeying. the real feelings of life are too exquisite and strengthening in their depth and power to be crowded out by those gross forms of nervous excitement which i can find no better name for than sham emotions. if we could only realize this more broadly, and bring up the children with a wholesome dread of morbid feeling what a marked change would there be in the state of the entire race! all physicians agree that in most cases it is not overwork, it is not mental strain, that causes the greater number of cases of nervous disturbance, but that they are more often brought on by emotional strain. the deepest grief, as well as the greatest joy, can be met in a way to give new strength and new power for use if we have a sound philosophy and a well-guided, wholesome body to meet it. but these last are the work of years; and neither the philosophy nor the physical strength can be brought to bear at short notice, although we can do much toward a better equilibrium even late in life. various forms of egotism, if not exactly sham emotions, are the causes of great nervous strain. every physician knows the intense egotism which often comes with nervous prostration. some one has very aptly said that insanity is only egotism gone to seed. it often seems so, especially when it begins with nervous prostration. we cannot be too careful to shun this nervous over-care for self. we inherit so strongly the subjective way of living rather than the objective, that it impresses itself upon our very nerves; and they, instead of being open channels for the power always at our command to pass freely to the use for which it is intended, stop the way by means of the attention which is so uselessly turned back on ourselves, our narrow personal interests, and our own welfare. how often we see cases where by means of the nervous tension all this has increased to a disease, and the tiresome _ego_ is a monster in the way of its owner and all his would-be friends. "i cannot bear this." "i shall take cold." "if you only knew how i suffered." why should we know, unless through knowing we can give you some relief? and so it goes, i--i--i--forever, and the more the more nervous prostration. keep still, that all which is good may come to you, and live out to others that your life may broaden for use. in this way we can take all that nature is ready to give us, and will constantly give us, and use it as hers and for her purposes, which are always the truest and best then we live as a little child would live,--only with more wisdom. x. nature's teaching nature is not only our one guide in the matter of physical training, she is the chief engineer who will keep us in order and control the machine, if we aim to fulfil her conditions and shun every personal interference with the wholesome working of her laws. here is where the exquisite sense of growing power comes. in studying nature, we not only realize the strength that comes from following her lead, but we discover her in ourselves gently moving us onward. we all believe we look to nature, if we think at all; and it is a surprise to find how mistaken we are. the time would not be wasted if we whose duties do not lead us to any direct study of natural life for personal reasons, would take fifteen minutes every day simply to think of nature and her methods of working, and to see at the same time where, so far as we individually are concerned, we constantly interfere with the best use of her powers. with all reverence i say it, this should be the first form of prayer; and our ability to pray sincerely to god and live in accordance with his laws would grow in proportion to our power of sincere sympathy with the workings of those laws in nature. try to realize the quiet power of all natural growth and movement, from a blade of grass, through a tree, a forest of trees, the entire vegetable growth on the earth, the movement of the planets, to the growth and involuntary vital operations of our own bodies. no words can bring so full a realization of the quiet power in the progress of nature as will the simple process of following the growth of a tree in imagination from the working of its sap in the root up to the tips of the leaves, the blossoms, and the fruit. or beginning lower, follow the growth of a blade of grass or a flower, then a tree, and so on to the movement of the earth, and then of all the planets in the universe. let your imagination picture so vividly all natural movements, little by little, that you seem to be really at one with each and all. study the orderly working of your own bodily functions; and having this clearly in mind, notice where you, in all movements that are or might be under the control of your will, are disobeying nature's laws. nature shows us constantly that at the back of every action there should be a great repose. this holds good from the minutest growth to the most powerful tornado. it should be so with us not only in the simple daily duties, but in all things up to the most intense activity possible to man. and this study and realization of nature's method which i am pleading for brings a vivid sense of our own want of repose. the compensation is fortunately great, or the discouragement might be more than could be borne. we must appreciate a need to have it supplied; we must see a mistake in order to shun it. how can we expect repose of mind when we have not even repose of muscle? when the most external of the machine is not at our command, surely the spirit that animates the whole cannot find its highest plane of action. or how can we possibly expect to know the repose that should be at our command for every emergency, or hope to realize the great repose behind every action, when we have not even learned the repose in rest? think of nature's resting times, and see how painful would be the result of a digression. our side of the earth never turns suddenly toward the sun at night, giving us flashes of day in the darkness. when it is night, it is night steadily, quietly, until the time comes for day. a tree in winter, its time for rest, never starts out with a little bud here and there, only to be frost bitten, and so when spring-time comes, to result in an uneven looking, imperfectly developed tree. it rests entirely in its time for rest; and when its time for blooming comes, its action is full and true and perfect. the grass never pushes itself up in little, untimely blades through the winter, thus leaving our lawns and fields full of bare patches in the warmer season. the flowers that close at night do not half close, folding some petals and letting others stay wide open. indeed, so perfectly does nature rest when it is her time for resting, that even the suggestion of these abnormal actions seems absolutely ridiculous. the less we allow ourselves to be controlled by nature's laws, the more we ignore their wonderful beauty; and yet there is that in us which must constantly respond to nature unconsciously, else how could we at once feel the absurdity of any disobedience to her laws, everywhere except with man? and man, who is not only free to obey, but has exquisite and increasing power to realize and enjoy them in all their fulness, lives so far out of harmony with these laws as ever to be blind to his own steady disobedience. think of the perfect power for rest in all animals. lift a cat when she is quiet, and see how perfectly relaxed she is in every muscle. that is not only the way she sleeps, but the way she rests; and no matter how great or how rapid the activity, she drops all tension at once when she stops. so it is with all animals, except in rare cases where man has tampered with them in a way to interfere with the true order of their lives. watch a healthy baby sleeping; lift its arm, its leg, or its head carefully, and you will find each perfectly relaxed and free. you can even hold it on your outspread hands, and the whole little weight, full of life and gaining new power through the perfect rest, will give itself entirely to your hands, without one particle of tension. the sleep that we get in babyhood is the saving health of many. but, alas! at a very early age useless tension begins, and goes on increasing; and if it does not steadily lead to acute "americanitis," it prevents the perfect use of all our powers. mothers, watch your children with a care which will be all the more effective because they will be unconscious of it; for a child's attention should seldom be drawn to its own body. lead them toward the laws of nature, that they may grow in harmony with them, and so be saved the useless suffering, strain, and trouble that comes to us americans. if we do not take care, the children will more and more inherit this fearful misuse of the nervous force, and the inheritance will be so strong that at best we can have only little invalids. how great the necessity seems for the effort to get back into nature's ways when we reflect upon the possibilities of a continued disobedience! to be sure, nature has repose itself and does not have to work for it. man is left free to take it or not as he chooses. but before he is able to receive it he has personal tendencies to restlessness to overcome. and more than that, there are the inherited nervous habits of generations of ancestors to be recognized and shunned. but repose is an inmost law of our being, and the quiet of nature is at our command much sooner than we realize, if we want it enough to work for it steadily day by day. nothing will increase our realization of the need more than a little daily thought of the quiet in the workings of nature and the consequent appreciation of our own lack. ruskin tells the story with his own expressive power when he says, "are not the elements of ease on the face of all the greatest works of creation? do they not say, not there has been a great _effort _here, but there has been a great power here?" the greatest act, the only action which we know to be power in itself, is the act of creation. behind that action there lies a great repose. we are part of creation, we should be moved by its laws. let us shun everything we see to be in the way of our own best power of action in muscle, nerve, senses, mind, and heart. who knows the new perception and strength, the increased power for use that is open to us if we will but cease to be an obstruction? freedom within the limits of nature's laws, and indeed there is no freedom without those limits, is best studied and realized in the growth of all plants,--in the openness of the branch of a vine to receive the sap from the main stem, in the free circulation of the sap in a tree and in all vegetable organisms. imagine the branch of a vine endowed with the power to grow according to the laws which govern it, or to ignore and disobey those laws. imagine the same branch having made up its vegetable mind that it could live its own life apart from the vine, twisting its various fibres into all kinds of knots and snarls, according to its own idea of living, so that the sap from the main stem could only reach it in a minimum quantity. what a dearth of leaf, flower, and fruit would appear in the branch! yet the figure is perfectly illustrative of the way in which most of us are interfering with the best use of the life that is ours. freedom is obedience to law. a bridge can be built to stand, only in obedience to the laws of mechanics. electricity can be made a useful power only in exact obedience to the laws that govern it, otherwise it is most destructive. has man the privilege of disobeying natural laws, only in the use of his own individual powers? clearly not. and why is it that while recognizing and endeavoring to obey the laws of physics, of mechanics, and all other laws of nature in his work in the world, he so generally defies the same laws in their application to his own being? the freedom of an animal's body in obeying the animal instincts is beautiful to watch. the grace and power expressed in the freedom of a tiger are wonderful. the freedom in the body of a baby to respond to every motion and expression is exquisite to study. but before most children have been in the world three years their inherited personal contractions begin, and unless the little bodies can be watched and trained out of each unnecessary contraction as it appears, and so kept in their own freedom, there comes a time later, when to live to the greatest power for use they must spend hours in learning to be babies all over again, and then gain a new freedom and natural movement. the law which perhaps appeals to us most strongly when trying to identify ourselves with nature is the law of rhythm: action, re-action; action, re-action; action, re-action,--and the two must balance, so that equilibrium is always the result. there is no similar thought that can give us keener pleasure than when we rouse all our imagination, and realize all our power of identifying ourselves with the workings of a great law, and follow this rhythmic movement till we find rhythm within rhythm,--from the rhythmic motion of the planets to the delicate vibrations of heat and light. it is helpful to think of rhythmic growth and motion, and not to allow the thought of a new rhythm to pass without identifying ourselves with it as fully as our imagination will allow. we have the rhythm of the seasons, of day and night, of the tides, and of vegetable and animal life,--as the various rhythmic motions in the flying of birds. the list will be endless, of course, for the great law rules everything in nature, and our appreciation of it grows as we identify ourselves with its various modes of action. one hair's variation in the rhythm of the universe would bring destruction, and yet we little individual microcosms are knocking ourselves into chronic states of chaos because we feel that we can be gods, and direct our own lives so much better than the god who made us. we are left in freedom to go according to his laws, or against them; and we are generally so convinced that our own stupid, short-sighted way is the best, that it is only because nature tenderly holds to some parts of us and keeps them in the rhythm, that we do not hurl ourselves to pieces. _this law of rhythm--or of equilibrium in motion and in rest--is the end, aim, and effect of all true physical training for the development and guidance of the body._ its ruling power is proved in the very construction of the body,--the two sides; the circulation of the blood, veins and arteries; the muscles, extensor and flexor; the nerves, sensory and motor. when the long rest of a body balances the long activity, in day and night; when the shorter rests balance the shorter activity, as in the various opportunities offered through the day for entire rest, if only a minute at a time; when the sensory and motor nerves are clear for impression and expression; when the muscles in parts of the body not needed are entirely quiet, allowing those needed for a certain action to do their perfect work; when the co-ordination of the muscles in use is so established that the force for a movement is evenly divided; when the flexor rests while its antagonizing muscle works, and _vice versa,--_ when all this which is merely a _natural power for action and rest _is automatically established, then the body is ready to obey and will obey the lightest touch of its owner, going in whatever direction it may be sent, artistic, scientific, or domestic. as this exquisite sense of ease in a natural movement grows upon us, no one can describe the feeling of new power or of positive comfort which comes with it; and yet it is no miracle, it is only natural. the beasts have the same freedom; but they have not the mind to put it to higher uses, or the sense to enjoy its exquisite power. often it seems that the care and trouble to get back into nature's way is more than compensated for in the new appreciation of her laws and their uses. but the body, after all, is merely a servant; and, however perfect its training may have been, if the man, the master, puts his natural power to mean or low uses, sooner or later the power will be lost. self-conscious pride will establish its own contractions. the use of a natural power for evil ends will limit itself sooner or later. the love for unwholesome surroundings will eventually put a check on a perfectly free body, although sometimes the wonder is that the check is so long in coming. if we have once trained ourselves into natural ways, so akin are the laws of nature and spirit, both must be obeyed; and to rise to our greatest power means always to rise to our greatest power for use. "a man's life is god's love for the use for which he was made;" a man's power lies in the best direction of that use. this is a truth as practical as the necessity for walking on the feet with the head up. xi. the child as an ideal while the path of progress in the gaining of repose could not be traced thus far without reference to the freedom of a baby, a fuller consideration of what we may learn from this source must be of great use to us. the peace and freshness of a little baby are truly beautiful, but are rarely appreciated. few of us have peace enough in ourselves to respond to these charms. it is like playing the softest melody upon a harp to those whose ears have long been closed. let us halt, and watch, and listen, and see what we shall gain! throughout the muscular system of a normal, new-born baby it is impossible to find any waste of force. an apparent waste will, upon examination, prove itself otherwise. its cry will at first seem to cause contractions of the face; but the absolute removal of all traces of contraction as the cry ceases, and a careful watching of the act itself, show it to be merely an exaggeration of muscular action, not a permanent contraction. each muscle is balanced by an opposing one; in fact, the whole thing is only a very even stretching of the face, and, undoubtedly, has a purpose to accomplish. examine a baby's bed, and see how distinctly it bears the impression of an absolute giving up of weight and power. they actually _do_ that which we only theorize about, and from them we may learn it all, if we will. a babe in its bath gives us another fine opportunity for learning to be simple and free. it yields to the soft pressure of the water with a repose which is deeply expressive of gratitude; while we, in our clumsy departures from nature's state, often resist with such intensity as not to know--in circumstances just as simply useful to us--that we have anything for which to be grateful. in each new experience we find it the same, the healthy baby yields, _lets himself go,_ with an case which must double his chances for comfort. could we but learn to do so, our lives would lengthen, and our joys and usefulness strengthen in exact proportion. all through the age of unconsciousness, this physical freedom is maintained even where the mental attitude is not free. baby wrath is as free and economical of physical force as are the winsome moods, and this until the personality has developed to some extent,--that is, _until the child reflects the contractions of those around him._ it expends itself in well-balanced muscular exercise, one set of muscles resting fully in their moment of non-use, while another set takes up the battle. at times it will seem that all wage war together; if so, the rest is equal to the action. it is not the purpose of this chapter to recommend anger, even of the most approved sort; but if we will express the emotion at all, let us do it as well as we did in our infancy! channels so free as this would necessitate, would lessen our temptations to such expression; we, with mature intellects, would see it for what it is, and the next generation of babies would less often exercise their wonderfully balanced little bodies in such an unlovely waste. note the perfect openness of a baby throat as the child coos out his expression of happiness. could anything be more free, more like the song of a bird in its obedience to natural laws? alas, for how much must we answer that these throats are so soon contracted, the tones changed to so high a pitch, the voice becoming so shrill and harsh! can we not open our throats and become as these little children? the same _openness_ in the infant organism is the child's protection in many dangers. falls that would result in breaks, strains, or sprains in us, leave the baby entirely whole save in its "feelings," and often there, too, if the child has been kept in the true state mentally. watch a baby take its food, and contrast it with our own ways of eating. the baby draws it in slowly and evenly, with a quiet rhythm which is in exact accord with the rhythmic action of its digestive organs. you feel each swallow taken in the best way for repair, and for this reason it seems sometimes as if one could see a baby grow while feeding. there cannot be a lovelier glimpse of innocent physical repose than the little respites from the fatigue of feeding which a baby often takes. his face moist, with open pores, serene and satisfied, he views the hurry about him as an interesting phase of harmless madness. he is entirely outside of it until self-consciousness is quite developed. the sleep of a little child is another opportunity for us to learn what we need. every muscle free, every burden dropped, each breath carries away the waste, and fills its place with the needed substance of increasing growth and power. in play, we find the same freedom. when one idea is being executed, every other is excluded. they do not think _dolls_ while they roll _hoop!_ they do not think of work while they play. examine and see how we do both. the baby of one year, sitting on the shore burying his fat hand in the soft warm sand, is for the time being alive _only_ to its warmth and softness, with a dim consciousness of the air and color about him. if we could engross ourselves as fully and with as simple a pleasure, we should know far more of the possible power of our minds for both work and rest. it is interesting to watch normal children in these concentrations, because from their habits we may learn so much which may improve our own sadly different manner of living. it is also interesting but pathetic to see the child gradually leaving them as he approaches boyhood, and to trace our part in leading him away from the true path. the baby's perfect placidity, caused by mental and bodily freedom, is disturbed at a very early age by those who should be his true guides. it would be impossible to say when the first wrong impression is made, but it is so early that a true statement of the time could only be accepted from scientific men. for mothers and fathers have often so dulled their own sensitiveness, that they are powerless to recognize the needs of their children, and their impressions are, in consequence, untrustworthy. at the time the pangs of teething begin, it is the same. the healthy child left to itself would wince occasionally at the slight pricking pain, and then turn its entire attention elsewhere, and thus become refreshed for the next trial. but under the adult influence the agony of the first little prick is often magnified until the result is a cross, tired baby, already removed several degrees from the beautiful state of peace and freedom in which nature placed him under our care. the bodily freedom of little children is the foundation of a most beautiful mental freedom, which cannot be wholly destroyed by us. this is plainly shown by the childlike trust which they display in all the affairs of life, and also in their exquisite responsiveness to the spiritual truths which are taught to them. the very expression of face of a little child as it is led by the hand is a lesson to us upon which pages might be written. had we the same spirit dwelling in us, we more often should feel ourselves led "beside the still waters," and made "to lie down in green pastures." we should grow faster spiritually, because we should not make conflicts for ourselves, but should meet with the lord's quiet strength whatever we had to pass through. let us learn of these little ones, and help them to hold fast to that which they teach us. let us remember that the natural and the ideal are truly one, and endeavor to reach the latter by means of the former. when through hereditary tendency our little child is not ideal,--that is, natural,--let us with all the more earnestness learn to be quiet ourselves that we may lead him to it, and thus open the channels of health and strength. xii. training for rest but how shall we gain a natural repose? it is absurd to emphasize the need without giving the remedy. "i should be so glad to relax, but i do not know how," is the sincere lament of many a nervously strained being. there is a regular training which acts upon the nervous force and teaches its proper use, as the gymnasium develops the muscles. this, as will be easily seen, is at first just the reverse of vigorous exercise, and no woman should do powerful muscular work without learning at the same time to guide her body with true economy of force. it is appalling to watch the faces of women in a gymnasium, to see them using five, ten, twenty times the nervous force necessary for every exercise. the more excited they get, the more nervous force they use; and the hollows under their eyes increase, the strained expression comes, and then they wonder that after such fascinating exercise they feel so tired. a common sight in gymnasium work, especially among women, is the nervous straining of the muscles of the arms and hands, while exercises meant for the legs alone are taken. this same muscular tension is evident in the arm that should be at rest while the other arm is acting; and if this want of equilibrium in exercise is so strikingly noticeable in the limbs themselves, how much worse it must be all through the less prominent muscles! to guide the body in trapeze work, every well-trained acrobat knows he must have a quiet mind, a clear head, and obedient muscles. i recall a woman who stands high in gymnastic work, whose agility on the triple bars is excellent, but the nervous strain shown in the drawn lines of her face before she begins, leaves one who studies her carefully always in doubt as to whether she will not get confused before her difficult performance is over, and break her neck in consequence. a realization also of the unnecessary nervous force she is using, detracts greatly from the pleasure in watching her performance. if we were more generally sensitive to misdirected nervous power, this interesting gymnast, with many others, would lose no time in learning a more quiet and naturally economical guidance of her muscles, and gymnasium work would not be, as dr. checkley very justly calls it, "more often a straining than a training." to aim a gun and hit the mark, a quiet control of the muscles is necessary. if the purpose of our actions were as well defined as the bull's eye of a target, what wonderful power in the use of our muscles we might very soon obtain! but the precision and ease in an average motion comes so far short of its possibility, that if the same carelessness were taken as a matter of course in shooting practice, the side of a barn should be an average target. gymnasium work for women would be grand in its wholesome influence, if only they might learn the proper _use_ of the body while they are working for its development. and no gymnasium will be complete and satisfactory in its results until the leader arranges separate classes for training in economy of force and rhythmic motion. in order to establish a true physical balance the training of the nerves should receive as much attention as the training of the muscles. the more we misuse our nervous force, the worse the expenditure will be as muscular power increases; i cannot waste so much force on a poorly developed muscle as on one that is well developed. this does not by any means argue against the development of muscle; it argues for its proper use. where is the good of an exquisitely formed machine, if it is to be shattered for want of control of the motive power? it would of course be equally harmful to train the guiding power while neglecting entirely flabby, undeveloped muscles. the only difference is that in the motions for this training and for the perfect co-ordinate use of the muscles, there must be a certain amount of even, muscular development; whereas although the vigorous exercise for the growth of the muscles often helps toward a healthy nervous system, it more often, where the nervous force is misused, exaggerates greatly the tension. in every case it is equilibrium we are working for, and a one-sided view of physical training is to be deplored and avoided, whether the balance is lost on the side of the nerves or the muscles. take a little child early enough, and watch it carefully through a course of natural rhythmic exercises, and there will be no need for the careful training necessary to older people. but help for us who have gone too far in this tension comes only through patient study. so far as i can, i will give directions for gaining the true relaxation. but because written directions are apt to be misunderstood, and so bring discouragement and failure, i will purposely omit all but the most simple means of help; but these i am sure will bring very pleasant effects if followed exactly and with the utmost patience. the first care should be to realize how far you are from the ability to let go of your muscles when they are not needed; how far you are from the natural state of a cat when she is quiet, or better still from the perfect freedom of a sleeping baby; consequently how impossible it is for you ever to rest thoroughly. almost all of us are constantly exerting ourselves to hold our own heads on. this is easily proved by our inability to let go of them. the muscles are so well balanced that nature holds our heads on much more perfectly than we by any possibility can. so it is with all our muscles; and to teach them better habits we must lie flat on our backs, and try to give our whole weight to the floor or the bed. the floor is better, for that does not yield in the least to us, and the bed does. once on the floor, give way to it as far as possible. every day you will become more sensitive to tension, and every day you will be better able to drop it. while you are flat on your backs, if you can find some one to "prove" your relaxation, so much the better. let your friend lift an arm, bending it at the different joints, and then carefully lay it down. see if you can give its weight entirely to the other person, so that it seems to be no part of you, but as separate as if it were three bags of sand, fastened loosely at the wrist, the elbow, and the shoulder; it will then be full of life without tension. you will find probably, either that you try to assist in raising the arm in your anxiety to make it heavy, or you will resist so that it is not heavy with its own weight but with i your personal effort. in some cases the nervous force is so active that the arm reminds one of a lively eel. then have your legs treated in the same way. it is good even to have some one throw your arm or your leg up and catch it; also to let it go unexpectedly. unnecessary tension is proved when the limb, instead of dropping by the pure force of gravity, sticks fast wherever it was left. the remark when the extended limb is brought to the attention of its owner is, "well, what did you want me to do? you did not say you wanted me to drop it,"--which shows the habitual attitude of tension so vividly as to be almost ridiculous; the very idea being, of course, that you are not wanted to do anything but _let go,_ when the arm would drop of its own accord. if the person holding your arm says, "now i will let go, and it must drop as if a dead weight," almost invariably it will not be the force of gravity that takes it, but your own effort to make it a dead weight; and it will come down with a thump which shows evident muscular effort, or so slowly and actively as to prove that you cannot let it alone. constant and repeated trial, with right thought from the pupil, will be certain to bring good results, so that at least he or she can be sure of better power for rest in the limbs. unfortunately this first gain will not last. unless the work goes on, the legs and arms will soon be "all tightened up" again, and it will seem harder to let go than ever. the next care must be with the head. that cannot be treated as roughly as the limbs. it can be tossed, if the tosser will surely catch it on his open hand. never let it drop with its full weight on the floor, for the jar of the fall, if you are perfectly relaxed, is unpleasant; if you are tense, it is dangerous. at first move it slowly up and down. as with the arms, there will be either resistance or attempted assistance. it seems at times as though it were and always would be impossible to let go of your own head. of course, if you cannot give up and let go for a friend to move it quietly up and down, you cannot let go and give way entirely to the restful power of sleep. the head must be moved up and down, from side to side, and round and round in opposite ways, gently and until its owner can let go so completely that it seems like a big ball in the hands that move it. of course care must be taken to move it gently and never to extremes, and it will not do to trust an unintelligent person to "prove" a body in any way. ladies' maids have been taught to do it very well, but they had in all cases to be carefully watched at first. the example of a woman who had for years been an invalid is exceedingly interesting as showing how persistently people "hold on." although the greater part of her time had been spent in a reclining attitude, she had not learned the very rudiments of relaxation, and could not let go of her own muscles any more easily than others who have always been in active life. think of holding yourself on to the bed for ten years! her maid learned to move her in the way that has been described, and after repeated practice, by the time she had reached the last movement the patient would often be sleeping like a baby. it did not cure her, of course; that was not expected. but it taught her to "relax" to a pain instead of bracing up and fighting it, and to live in a natural way so far as an organic disease and sixty years of misused and over-used force would allow. having relaxed the legs and arms and head, next the spine and all the muscles of the chest must be helped to relax. this is more difficult, and requires not only care but greater muscular strength in the lifter. if the one who is lifting will only remember to press hard on the floor with the feet, and put all the effort of lifting in the legs, the strain will be greatly lessened. take hold of the hands and lift the patient or pupil to a sitting attitude. here, of course, if the muscles that hold the head are perfectly relaxed, the head will drop back from its own weight. then, in letting the body back again, of course, keep hold of the hands,--_never_ let go; and after it is down, if the neck has remained relaxed, the head will be back in a most uncomfortable attitude, and must be lifted and placed in the right position. it is some time before relaxation is so complete as that. at first the head and spine will come up like a ramrod, perfectly rigid and stiff. there will be the same effort either to assist or resist; the same disinclination to give up; often the same remark, "if you will tell me what you want me to do, i will do it;" the same inability to realize that the remark, and the feeling that prompts it, are entirely opposed to the principle that you are _wanted to do nothing, and to do nothing with an effort is impossible._ in lowering the body it must "give" like a bag of bones fastened loosely together and well padded. sometimes when it is nearly down, one arm can be dropped, and the body let down the rest of the way by the other. then it is simply giving way completely to the laws of gravity, it will fall over on the side that is not held, and only roll on its back as the other arm is dropped. care must always be taken to arrange the head comfortably after the body is resting on the ground. sometimes great help is given toward relaxing the muscles of the chest and spine by pushing the body up as if to roll it over, first one side and then the other, and letting it roll back from its own weight. it is always good, after helping the separate parts to a restful state, to take the body as a whole and roll it over and over, carefully, and see if the owner can let you do so without the slightest effort to assist you. it will be easily seen that the power, once gained, of remaining perfectly passive while another moves you, means a steadily increasing ability to relax at all times when the body should be given to perfect rest. this power to "let go" causes an increasing sensitiveness to all tension, which, unpleasant as it always is to find mistakes of any kind in ourselves, brings a very happy result in the end; for we can never shun evils, physical or spiritual, until we have recognized them fully, and every mistaken way of using our machine, when studiously avoided, brings us nearer to that beautiful unconscious use of it which makes it possible for us to forget it entirely in giving it the more truly to its highest use. after having been helped in some degree by another, and often without that preliminary help, come the motions by which we are enabled to free ourselves; and it is interesting to see how much more easily the body will move after following this course of exercises. take the same attitude on the floor, giving up entirely in every part to the force of gravity, and keep your eyes closed through the whole process. then stop and imagine yourself heavy. first think one leg heavy, then the other, then each arm, and both arms, being sure to keep the same weight in the legs; then your body and head. use your imagination to the full extent of its power, and think the whole machine heavy; wonder how the floor can hold such a weight. begin then to take a deep breath. inhale through the nose quietly and easily. let it seem as if the lungs expanded themselves with, out voluntary effort on your part. fill first the lower lungs and then the upper. let go, and exhale the air with a sense of relief. as the air leaves your lungs, try to let your body rest back on the floor more heavily, as a rubber bag would if the air were allowed to escape from it. repeat this breathing exercise several times; then inhale and exhale rhythmically, with breaths long enough to give about six to a minute, for ten times, increasing the number every day until you reach fifty. this eventually will establish the habit of longer breaths in the regular unconscious movement of our lungs, which is most helpful to a wholesome physical state. the directions for deep breathing should be carefully followed in the deep breaths taken after each motion. after the deep breathing, drag your leg up slowly, very slowly, trying to have no effort except in the hip joint, allowing the knee to bend, and dragging the heel heavily along the floor, until it is up so far that the sole of the foot touches without effort on your part. stop occasionally in the motion and let the weight come into the heel, then drag the foot with less effort than before,--so will the strain of movement be steadily decreased. let the leg slip slowly down, and when it is nearly flat on the floor again, let go, so that it gives entirely and drops from its own weight. if it is perfectly free, there is a pleasant little spring from the impetus of dropping, which is more or less according to the healthful state of the body. the same motion must be repeated with the other leg. every movement should be slower each day. it is well to repeat the movements of the legs for three times, trying each time to move more slowly, with the leg heavier than the time before. after this, lift the arm slowly from the shoulder, letting the hand hang over until it is perpendicular to the floor. be careful to think the arm heavy, and the motive power in the shoulder. it helps to relax if you imagine your arm held to the shoulder by a single hair, and that if you move it with a force beyond the minimum needed to raise it, it will drop off entirely. to those who have little or no imagination this will seem ridiculous; to others who have more, and can direct it usefully, this and similar ways will be very helpful. after the arm is raised to a perpendicular position, let the force of gravity have it,--first the upper arm to the elbow, and then the forearm and hand, so that it falls by pieces. follow the same motion with the other arm, and repeat this three times, trying to improve with each repetition. next, the head must be moved slowly,--so slowly that it seems as though it hardly moved at all,--first rolled to the left, then back and to the right and back again; and this also can be repeated three times. after each of the above motions there should be two or three long, quiet breaths. to free the spine, sit up on the floor, and with heavy arms and legs, head dropped forward, let it go back slowly and easily, as if the vertebrae were beads on a string, and first one bead lay flat, then another and another, until the whole string rests on the floor, and the head falls back with its own weight. this should be practised over and over before the movement can be perfectly free; and it is well to begin on the bed, until you catch the idea and its true application. after, and sometimes before, the process of slow motions, rolling over loosely on one side should be practised,--remaining there until the weight all seems near the floor, and then giving way so that the force of gravity seems to "flop" it back (i use "flop" advisedly); so again resting on the other side. but one must go over by regular motions, raising the leg first heavily and letting it fall with its full weight over the other leg, so that the ankles are crossed. the arm on the same side must be raised as high as possible and dropped over the chest. then the body can be rolled over, and carried as it were by the weight of the arm and leg. it must go over heavily and freely like a bag of loose bones, and it helps greatly to freedom to roll over and over in this way. long breaths, taken deeply and quietly, should be interspersed all through these exercises for extreme relaxation. they prevent the possibility of relaxing too far. and as there is a pressure on every muscle of the body during a deep inspiration, the muscles, being now relaxed into freedom, are held in place, so to speak, by the pressure from the breath,--as we blow in the fingers of a glove to put them in shape. remember always that it is equilibrium we are working for, and this extreme relaxation will bring it, because we have erred so far in the opposite direction. for instance, there is now no balance at all between our action and our rest, because we are more or less tense and consequently active all through the times when we should be entirely at rest; and we never can be moved by nature's rhythm until we learn absolute relaxation for rest, and so gain the true equilibrium in that way. then again, since we use so much unnecessary tension in everything we do, although we cannot remove it entirely until we learn the normal motion of our muscles, still after an hour's practice and the consequent gain in extreme relaxation, it will be impossible to attack our work with the same amount of unnecessary force, at least for a time; and every day the time in which we are able to work, or talk, or move with less tension will increase, and so our bad habits be gradually changed, if not to good, to better ones. so the true equilibrium comes gradually more and more into every action of our lives, and we feel more and more the wholesome harmony of a rhythmic life. we gradually swing into rhythm with nature through a child-like obedience to her laws. of one thing i must warn all nervous people who mean to try the relief to be gained from relaxation. the first effects will often be exceedingly unpleasant. the same results are apt to follow that come from the reaction after extreme excitement,--all the way from nervous nausea and giddiness to absolute fainting. this, as must be clearly seen, is a natural result from the relaxation that comes after years of habitual tension. the nerves have been held in a chronic state of excitement over something or nothing; and, of course, when their owner for the first time lets go, they begin to feel their real state, and the result of habitual strain must be unpleasant. the greater the nervous strain at the beginning, the more slowly the pupil should advance, practising in some cases only five minutes a day. and with regard to those people who "live on their nerves," not a few, indeed very many, are so far out of the normal way of living that they detest relaxation. a hearty hatred of the relaxing motions is often met, and even when the mind is convinced of the truth of the theory, it is only with difficulty that such people can persuade themselves or be persuaded by others to work steadily at the practice until the desired result is gained. "it makes me ten times more nervous than i was before." "oh, no, it does not; it only makes you realize your nervousness ten times more." "well, then, i do not care to realize my nervousness, it is very disagreeable." "but, unfortunately, if you do not realize it now and relax into nature's ways, she will knock you hard against one of her stone walls, and you will rebound with a more unpleasant realization of nervousness than is possible now." the locomotive engine only utilizes nineteen per cent of the amount of fuel it burns, and inventors are hard at work in all directions to make an engine that will burn only the fuel needed to run it. here is a much more valuable machine--the human engine--burning perhaps eighty-one per cent more than is needed to accomplish its ends, not through the mistake of its divine maker, but through the stupid, short-sighted thoughtlessness of the engineer. is not the economy of our vital forces of much greater importance than mechanical or business economy? it is painful to see a man--thin and pale from the excessive nervous force he has used, and from a whole series of attacks of nervous prostration--speak with contempt of "this method of relaxation." it is not a method in any sense except that in which all the laws of nature are methods. no one invented it, no one planned it; every one can see, who will look, that it is nature's way and the only true way of living. to call it a new idea or method is as absurd as it would be, had we carried our tension so far as to forget sleep entirely, for some one to come with a "new method" of sleep to bring us into a normal state again; and then the people suffering most intensely from want of "tired nature's sweet restorer" would be the most scornful in their irritation at this new idea of "sleep." again, there are many, especially women, who insist that they prefer the nervously excited state, and would not lose it. this is like a man's preferring to be chronically drunk. but all these abnormal states are to be expected in abnormal people, and must be quietly met by nature's principles in order to lead the sufferers back to nature's ways. our minds are far enough beyond our bodies to lead us to help ourselves out of mistaken opinions; although often the sincere help of others takes us more rapidly over hard ground and prevents many a stumble. great nervous excitement is possible, every one knows, without muscular tension; therefore in all these motions for gaining freedom and a better physical equilibrium in nerve and muscle, the warning cannot be given too often to take every exercise easily. do not work at it, go so far even as not to care especially whether you do it right or not, but simply do what is to be done without straining mind or body by effort. it is quite possible to make so desperate an effort to relax, that more harm than good is done. particularly harmful is the intensity with which an effort to gain physical freedom is made by so many highly strung natures. the additional mental excitement is quite out of proportion to the gain that may come from muscular freedom. for this reason it is never advisable for one who feels the need of gaining a more natural control of nervous power to undertake the training without a teacher. if a teacher is out of the question, ten minutes practice a day is all that should be tried for several weeks. xiii. training for motion "in every new movement, in every unknown attitude needed in difficult exercises, the nerve centres have to exercise a kind of selection of the muscles, bringing into action those which favor the movement, and suppressing those which oppose it." this very evident truth dr. lagrange gives us in his valuable book on the physiology of exercise. at first, every new movement is unknown; and, owing to inherited and personal contractions, almost from the earliest movement in a child's learning to walk to the most complicated action of our daily lives, the nerve centres exercise a mistaken selection of muscles,--not only selecting more muscles than are needed for perfect co-ordination of movement, but throwing more force than necessary into the muscles selected. to a gradually increasing extent, the contracting force, instead of being withdrawn when the muscle is inactive, remains; and, as we have already seen, an arm or leg that should be passive is lifted, and the muscles are found to be contracted as if for severe action. to the surprise of the owner the contraction cannot be at once removed. help for this habitual contraction is given in the preceding chapter. further on dr. lagrange tells us that "besides the apprenticeship of movements which are unknown, there is the improvement of already known movements." when the work of mistaken selection of muscles has gone on for years, the "improvement of already known movements," from the simplest domestic action to the accomplishment of very great purposes, is a study in itself. one must learn first to be a grown baby, and, as we have already seen, gain the exquisite passiveness of a baby; then one must learn to walk and to move by a natural process of selection, which, thanks to the contractions of his various ancestors, was not the process used for his original movements. this learning to live all over again is neither so frightful nor so difficult as it sounds. having gained the passive state described in the last chapter, one is vastly more sensitive to unnecessary tension; and it seems often as though the child in us asserted itself, rising with alacrity to claim its right of natural movement, and with a new sense of freedom in the power gained to shun inherited and personal contractions. certainly it is a fact that freedom of movement is gained through shunning the contractions. and this should always be kept in mind to avoid the self-consciousness and harm which come from a studied movement, not to mention the very disagreeable impression such movements give to all who appreciate their artificiality. motion in the human body, as well as music, is an art. an artist has very aptly said that we should so move that if every muscle struck a note, only harmony would result. were it so the harmony would be most exquisite, for the instrument is nature's own. we see how far we are from a realization of natural movement when we watch carefully and note the muscular discords evident to our eyes at all times. even the average ballet dancing, which is supposed to be the perfection of artistic movement, is merely a series of pirouettes and gymnastic contortions, with the theatrical smile of a pretty woman to throw the glare of a calcium light over the imperfections and dazzle us. the average ballet girl is not adequately trained, from the natural and artistic standpoint. if this is the case in what should be the quintessence of natural, and so of artistic movement, it is to a great degree owing to the absolute carelessness in the selection of the muscles to be used in every movement of daily life. many exercises which lead to the freedom of the body are well known in the letter--not in the spirit--through the so-called "delsarte system." if they had been followed with a broad appreciation of what they were meant for and what they could lead to, before now students would have realized to a far greater extent what power is possible to the human body. but so much that is good and helpful in the "delsarte system" has been misused, and so much of what is thoroughly artificial and unhealthy has been mixed with the useful, that one hesitates now to mention delsarte. either he was a wonderful genius whose thoughts and discoveries have been sadly perverted, or the inconsistencies of his teachings were great enough to limit the true power which certainly can be found in much that he has left us. besides the exercises already described there are many others, suited to individual needs, for gaining the freedom of each part of the body and of the body as a whole. it is not possible to describe them clearly enough to allow them to be followed without a teacher, and to secure the desired result. indeed, there would be danger of unpleasant results from misunderstanding. the object is so to stand that our muscles hold us, with the natural balance given them, instead of trying, as most of us do, to hold our muscles. in moving to gain this natural equilibrium we allow our muscles to carry us forward, and when they have contracted as far as is possible for one set, the antagonizing muscles carry us back. so it is with the side-to-side poising from the ankles, and the circular motion, which is a natural swinging of the muscles to find their centre of equilibrium, having once been started out of it. to stand for a moment and _think_ the feet heavy is a great help in gaining the natural poising motions, but care should always be taken to hold the chest well up. indeed, we need have no sense of effort in standing, except in raising the chest,--and that must be as if it were pulled up outside by a button in its centre, but there must be no strain in the effort. the result of the exercises taken to free the head is shown in the power to toss the head lightly and easily, with the waist muscles, from a dropped forward to an erect position. the head shows its freedom then by the gentle swing of the neck muscles, which is entirely involuntary and comes from the impetus given them in tossing the head. tension in the muscles of the neck is often very difficult to overcome; because, among other reasons, the sensations coming from certain forms of nervous over-strain are very commonly referred to the region of the base of the brain. it is not unusual to find the back of the neck rigid in extreme tension, and whether the strain is very severe or not, great care must be taken to free it by slow degrees, and the motions should at first be practised only a few minutes at a time. i can hardly warn readers too often against the possibility of an unpleasant reaction, if the relaxing is practised too long, or gained too rapidly. then should come exercises for freeing the arms; and these can be taken sitting. let the arms hang heavily at the sides; raise one arm slowly, feeling the weight more and more distinctly, and only contracting the shoulder muscles. it is well to raise it a few inches, then drop it heavily and try again,--each time taking force out of the lower muscles by thinking the arm heavy, and the motive power in the shoulder. if the arm itself can rest heavily on some one's hand while you are still raising it from the shoulder, that proves that you have succeeded in withdrawing the useless tension. most arms feel stiff all the way along, when the owners raise them. your arm must be raised until high overhead, the hand hanging from the wrist and dropped into your lap or down at the side, letting the elbow "give," so that the upper arm drops first, and then the fore arm and hand,--like three heavy sand-bags sewed together. the arm can be brought up to the level of the shoulder, and then round in front and dropped. to prove its freedom, toss it with the shoulder muscles from the side into the lap. watch carefully that the arm itself has no more tension than if it were a sand-bag hung at the side, and could only be moved by the shoulder. after practising this two or three times so that the arms are relaxed enough to make you more sensitive to tension, one hundred times a day you will find your arms held rigidly, while you are listening or talking or walking. every day you will grow more sensitive to the useless tension, and every day gain new power to drop it. this is wherein the real practice comes. an hour or two hours a day of relaxing exercises will amount to nothing if at the same time we are not careful to use the freedom gained, and to do everything more naturally. it is often said, "but i cannot waste time watching all day to see if i am using too much force." there is no need to watch; having once started in the right direction, if you drop useless muscular contraction every time you notice it, that is enough. it will be as natural to do that as for a musician to correct a discord which he has inadvertently made on the piano. there are no motions so quieting, so helpful in the general freeing of the body, as the motions of the spine. there are no motions more difficult to describe, or which should be more carefully directed. the habitual rigidity of the spine, as compared with its possible freedom, is more noticeable in training, of course, than is that of any other part of the body. each vertebra should be so distinctly independent of every other, as to make the spine as smoothly jointed as the toy snakes, which, when we hold the tip of the tail in our fingers, curve in all directions. most of us have spinal columns that more or less resemble ramrods. it is a surprise and delight to find what can be accomplished, when the muscles of the spine and back are free and under control. of course the natural state of the spine, as the seat of a great nervous centre, affects many muscles of the body, and, on the other hand, the freedom of these muscles reacts favorably upon the spine. the legs are freed for standing and walking by shaking the foot free from the ankle with the leg, swinging the fore leg from the upper leg, and so freeing the muscles at the knee, and by standing on a footstool and letting one leg hang off the stool a dead weight while swinging it round from the hip. greater freedom and ease of movement can be gained by standing on the floor and swinging the leg from the hip as high as possible. be sure that the only effort for motion is in the muscles of the hip. there are innumerable other motions to free the legs, and often a great variety must be practised before the freedom can be gained. the muscles of the chest and waist are freed through a series of motions, the result of which is shown in the ability to toss the body lightly from the hips, as the head is tossed from the waist muscles; and there follows the same gentle involuntary swing of the muscles of the waist which surprises one so pleasantly in the neck muscles after tossing the head, and gives a new realization of what physical freedom is. in tossing the body the motion must be successive, like running the scale with the vertebrae. in no motion should the muscles work _en masse._ the more perfect the co-ordination of muscles in any movement, the more truly each muscle holds its own individuality. this power of freedom in motion should be worked for after once approaching the natural equilibrium. if you rest on your left leg, it pushes your left hip a little farther out, which causes your body to swerve slightly to the right,--and, to keep the balance true, the head again tips to the left a little. now rise slowly and freely from that to standing on both feet, with body and head erect; then drop on the right foot with the body to left, and head to right. here again, as in the motions with the spine, there is a great difference in the way they are practised. their main object is to help the muscles to an independent individual co-ordination, and there should be a new sense of ease and freedom every time we practise it. hold the chest up, and push yourself erect with the ball of your free foot. the more the weight is thought into the feet the freer the muscles are for action, provided the chest is well raised. the forward and back spinal motion should be taken standing also; and there is a gentle circular motion of the entire body which proves the freedom of all the muscles for natural movement, and is most restful in its result. the study for free movement in the arms and legs should of course be separate. the law that every part moves from something prior to it, is illustrated exquisitely in the motion of the fingers from the wrist. here also the individuality of the muscles in their perfect co-ordination is pleasantly illustrated. to gain ease of movement in the fore arm, its motive power must seem to be in the upper arm; the motive power for the entire arm must seem to be centred in the shoulder. when through various exercises a natural co-ordination of the muscles is gained, the arm can be moved in curves from the shoulder, which remind one of a graceful snake; and the balance is so true that the motion seems hardly more than a thought in the amount of effort it takes. great care should be given to freeing the hands and fingers. because the hand is in such constant communication with the brain, the tension of the entire body often seems to be reflected there. sometimes it is even necessary to train the hand to some extent in the earliest lessons. exercises for movement in the legs are to free the joints, so that motions may follow one another as in the arm,--the foot from the ankle; the lower leg from the upper leg; the upper leg from the hip; and, as--in the arm, the free action of the joints in the leg comes as we seem to centre the motive power in the hip. there is then the same grace and ease of movement which we gain in the arm, simply because the muscles have their natural equilibrium. thus the motive power of the body will seem to be gradually drawn to an imaginary centre in the lower part of the trunk,--which simply means withdrawing superfluous tension from every part. the exercise to help establish this equilibrium is graceful, and not difficult if we take it quietly and easily, using the mind to hold a balance without effort. raise the right arm diagonally forward, the left leg diagonally back,--the arm must be high up, the foot just off the floor, so that as far as possible you make a direct line from the wrist to the ankle; in this attitude stretch all muscles across the body from left to right slowly and steadily, then relax quite as slowly. now, be sure your arm and leg are free from all tension, and swing them very slowly, as if they were one piece, to as nearly a horizontal position as they can reach; then slowly pivot round until you bring your arm diagonally back and your leg diagonally forward; still horizontal, pivot again to the starting point; then bring leg down and arm up, always keeping them as in a line, until your foot is again off the floor; then slowly lower your arm and let your foot rest on the floor so that gradually your whole weight rests on that leg, and the other is free to swing up and pivot with the opposite arm. all this must be done slowly and without strain of any kind. the motions which follow in sets are for the better daily working of the body, as well as to establish its freedom. the first set is called the "big rhythms," because it takes mainly the rhythmic movement of the larger muscles of the body, and is meant, through movements taken on one foot, to give a true balance in the poise of the body as well as to make habitual the natural co-ordination in the action of all the larger muscles. it is like practising a series of big musical chords to accustom our ears to their harmonies. the second set, named the "little rhythms,"--because that is a convenient way of designating it,--is a series meant to include the movement of all the smaller muscles as well as the large ones, and is carried out even to the fingers. the third set is for spring and rapid motion, especially in joints of arms and legs. of course having once found the body's natural freedom, the variety of motions is as great as the variety of musical sounds and combinations possible to an instrument which will respond to every tone in the musical scale. it is in opening the way for this natural motion that the exquisite possibilities in motion purely artistic dawn upon us with ever-increasing light. and as in music it is the sonata, the waltz, or the nocturne we must feel, not the mechanical process of our own performance,--so in moving, it is the beautiful, natural harmonies of the muscles, from the big rhythms to all the smaller ones, that we must feel and make others feel, and not the mere mechanical grace of our bodies; and we can move a sonata from the first to the last, changing the time and holding the theme so that the soul will be touched through the eye, as it is through the ear now in music. but, according to the present state of the human body, more than one generation will pass before we reach, or know the beginning of, the highest artistic power of motion. if art is nature illuminated, one must have some slight appreciation and experience of nature before attempting her illumination. the set of motions mentioned can be only very inadequately described in print. but although they are graceful, because they are natural, the first idea in practising them is that they are a means to an end, not an end in themselves. for in the big and little rhythms and the springing motions, in practising them over and over again we are establishing the habit of natural motion, and will carry it more and more into everything we do. if the work of the brain in muscular exercise were reduced to its minimum, the consequent benefit from all exercise would greatly increase. a new movement can be learned with facility in proportion to the power for dropping at the time all impressions of previous movements. in training to take every motion easily, after a time the brain-work is relieved, for we move with ease,--that is, with a natural co-ordination of muscles, automatically,--in every known motion; and we lessen very greatly the mental strain, in learning a new movement, by gaining the power to relax entirely at first, and then, out of a free body, choose the muscles needed, and so avoid the nervous strain of useless muscular experiment. so far as the mere muscular movement goes, the sensation is that of being well oiled. as for instance, in a natural walk, where the swinging muscles and the standing muscles act and rest in alternate rhythmic action, the chest is held high, the side muscles free to move in, harmony with the legs, and all the spring in the body brought into play through inclining slightly forward and pushing with the ball of the back foot, the arms swinging naturally without tension. walking with a free body is often one of the best forms of rest, and in the varying forms of motion arranged for practice we are enabled to realize, that "perfect harmony of action in the entire man invigorates every part." xiv. mind training it will be plainly seen that this training of the body is at the same time a training of the mind, and indeed it is in essence a training of the will. for as we think of it carefully and analyze it to its fundamental principles, we realize that it might almost be summed up as in itself a training of the will alone. that is certainly what it leads to, and where it leads from. maudsley tells us that "he who is incapable of guiding his muscles, is incapable of concentrating his mind;" and it would seem to follow, by a natural sequence, that training for the best use of all the powers given us should begin with the muscles, and continue through the nerves and the senses to the mind,--all by means of the will, which should gradually remove all personal contractions and obstructions to the wholesome working of the law of cause and effect. help a child to use his own ability of gaining free muscles, nerves clear to take impressions through every sense, a mind open to recognize them, and a will alive with interest in and love for finding the best in each new sensation or truth, and what can he not reach in power of use to others and in his own growth. the consistency of creation is perfect. the law that applies to the guidance of the muscles works just as truly in training the senses and the mind. a new movement can be learned with facility in proportion to the power of dropping at the time all impressions of previous movements. quickness and keenness of sense are gained only in proportion to the power of quieting the senses not in use, and erasing previous impressions upon the sense which is active at the time. true concentration of mind means the ability to drop every subject but that centred upon. tell one man to concentrate his mind on a difficult problem until he has worked it out,--he will clinch his fists, tighten his throat, hold his teeth hard together, and contract nobody knows how many more muscles in his body, burning and wasting fuel in a hundred or more places where it should be saved. this is _not_ concentration. concentration means the focussing of a force; and when the mathematical faculty of the brain alone should be at work, the force is not focussed if it is at the same time flying over all other parts of the body in useless strain of innumerable muscles. tell another man, one who works naturally, to solve the same problem,--he will instinctively and at once "erase all previous impressions" in muscle and nerve, and with a quiet, earnest expression, not a face knotted with useless strain, will concentrate upon his work. the result, so far as the problem itself is concerned, may be the same in both cases; but the result upon the physique of the men who have undertaken the work will be vastly different. it will be insisted upon by many, and, strange as it may seem, by many who have a large share of good sense, that they can work better with this extra tension. "for," the explanation is, "it is natural to me." that may be, but it is not natural to nature; and however difficult it may be at first to drop our own way and adopt nature's, the proportionate gain is very great in the end. normal exercise often stimulates the brain, and by promoting more vigorous circulation, and so greater physical activity all over the body, helps the brain to work more easily. therefore some men can think better while walking. this is quite unlike the superfluous strain of nervous motion, which, however it may seem to help at the time, eventually and steadily lessens mental power instead of increasing it. the distinction between motion which wholesomely increases the brain activity and that which is simply unnecessary tension, is not difficult to discern when our eyes are well opened to superfluous effort. this misdirected force seems to be the secret of much of the overwork in schools, and the consequent physical break-down of school children, especially girls. it is not that they have too much to do, it is that they do not know how to study naturally, and with the real concentration which learns the lesson most quickly, most surely, and with the least amount of effort. they study a lesson with all the muscles of the body when only the brain is needed, with a running accompaniment of worry for fear it will not be learned. girls can be, have been, trained out of worrying about their lessons. nervous strain is often extreme in students, from lesson-worry alone; and indeed in many cases it is the worry that tires and brings illness, and not the study. worry is brain tension. it is partly a vague, unformed sense that work is not being done in the best way which makes the pressure more than it need be; and instead of quietly studying to work to better advantage, the worrier allows herself to get more and more oppressed by her anxieties,--as we have seen a child grow cross over a snarl of twine which, with very little patience, might be easily unravelled, but in which, in the child's nervous annoyance, every knot is pulled tighter. perhaps we ought hardly to expect as much from the worried student as from the child, because the ideas of how to study arc so vague that they seldom bring a realization of the fact that there might be an improvement in the way of studying. this possible improvement may be easily shown. i have taken a girl inclined to the mistaken way of working, asked her to lie on the floor where she could give up entirely to the force of gravity,--then after helping her to a certain amount of passivity, so that at least she looked quiet, have asked her to give me a list of her lessons. before opening her mouth to answer, she moved in little nervous twitches, apparently every muscle in her body, from head to foot. i stopped her, took time to bring her again to a quiet state, and then repeated the question. again the nervous movement began, but this time the child exclaimed, "why, isn't it funny? i cannot think without moving all over!" here was the rubicon crossed. she had become alive to her own superfluous tension; and after that to train her not only to think without moving all over, but to answer questions easily and quietly and so with more expression, and then to study with greatly decreased effort, was a very pleasant process. every boy and girl should have this training to a greater or less degree. it is a steady, regular process, and should be so taken. we have come through too many generations of misused force to get back into a natural use of our powers in any rapid way; it must come step by step, as a man is trained to use a complicated machine. it seems hardly fair to compare such training to the use of a machine,--it opens to us such extensive and unlimited power. we can only make the comparison with regard to the first process of development. a training for concentration of mind should begin with the muscles. first, learn to withdraw the will from the muscles entirely. learn, next, to direct the will over the muscles of one arm while the rest of the body is perfectly free and relaxed,--first, by stretching the arm slowly and steadily, and then allowing it to relax; next, by clinching the fist and drawing the arm up with all the force possible until the elbow is entirely bent. there is not one person in ten, hardly one in a hundred, who can command his muscles to that slight extent. at first some one must lift the arm that should be free, and drop it several times while the muscles of the other arm are contracting; that will make the unnecessary tension evident. there are also ways by which the free arm can be tested without the help of a second person. the power of directing the will over various muscles that should be independent, without the so-called sympathetic contraction of other muscles, should be gained all over the body. this is the beginning of concentration in a true sense of the word. the necessity for returning to an absolute freedom of body before directing the will to any new part cannot be too often impressed upon the mind. having once "sensed" a free body--so to speak--we are not masters until we gain the power to return to it at a moment's notice. in a second we can "erase previous impressions" for the time; and that is the foundation, the rock, upon which our house is built. then follows the process of learning to think and to speak in freedom. first, as to useless muscular contractions. watch children work their hands when reciting in class. tell them to stop, and the poor things will, with great effort, hold their hands rigidly still, and suffer from the discomfort and strain of doing so. help them to freedom of body, then to the sense that the working of their hands is not really needed, and they will learn to recite with a feeling of freedom which is better than they can understand. sometimes a child must be put on the floor to learn to think quietly and directly, and to follow the same directions in this manner of answering. it would be better if this could always be done with thoughtful care and watching; but as this would be inappropriate with large classes, there are quieting and relaxing exercises to be practised sitting and standing, which will bring children to a normal freedom, and help them to drop muscular contractions which interfere with ease and control of thought and expression. pictures can be described,--scenes from shakespeare, for instance,--in the child's own words, while making quiet motions. such exercise increases the sensitiveness to muscular contraction, and unnecessary muscular contraction, beside something to avoid in itself, obviously makes thought _indirect._ a child must think quietly, to express his thought quietly and directly. this exercise, of course, also cultivates the imagination. in all this work, as clear channels are opened for impression and expression, the faculties themselves naturally have a freer growth. the process of quiet thought and expression must be trained in all phases,--from the slow description of something seen or imagined or remembered, to the quick and correct answer required to an example in mental arithmetic, or any other rapid thinking. this, of course, means a growth in power of attention,--attention which is real concentration, not the strained attention habitual to most of us, and which being abnormal in itself causes abnormal reaction. and this natural attention is learned in the use of each separate sense,--to see, to hear, to taste, to smell, to touch with quick and exact impression and immediate expression, if required, and a in obedience to the natural law of the conservation of human energy. with the power of studying freely, comes that of dropping a lesson when it is once well learned, and finding it ready when needed for recitation or for any other use. the temptation to take our work into our play is very great, and often cannot be overcome until we have learned how to "erase all previous impressions." the concentration which enables us all through life to be intent upon the one thing we are doing, whether it is tennis or trigonometry, and drop what we have in hand at once and entirely at the right time, free to give out attention fully to the next duty or pleasure, is our saving health in mind and body. the trouble is we are afraid. we have no trust. a child is afraid to stop thinking of a lesson after it is learned,--afraid he will forget it. when he has once been persuaded to drop it, the surprise when he takes it up again, to find it more clearly impressed upon his mind, is delightful. one must trust to the digestion of a lesson, as to that of a good wholesome dinner. worry and anxiety interfere with the one as much as with the other. if you can drop a muscle when you have ceased using it, that leads to the power of dropping a subject in mind; as the muscle is fresher for use when you need it, so the subject seems to have grown in you, and your grasp seems to be stronger when you recur to it. the law of rhythm must be carefully followed in this training for the use of the mind. do not study too long at a time. it makes a natural reaction impossible. arrange the work so that lessons as far unlike as possible may be studied in immediate succession. we help to the healthy reaction of one faculty, by exercising another that is quite different. this principle should be inculcated in classes, and for that purpose a regular programme of class work should be followed, calculated to bring about the best results in all branches of study. the first care should be to gain quiet, as through repose of mind and body we cultivate the power to "erase all previous impressions." in class, quiet, rhythmic breathing, with closed eyes, is most helpful for a beginning. the eyes must be closed and opened slowly and gently, not snapped together or apart; and fifty breaths, a little longer than they would naturally be, are enough to quiet a class. the breaths must be counted, to keep the mind from wandering, and the faces must be watched very carefully, for the expression often shows anything but quiet. for this reason it is necessary, in initiating a class, to begin with simple relaxing motions; later these motions will follow the breathing. then follow exercises for directing the muscles. the force is directed into one arm with the rest of the body free, and so in various simple exercises the power of directing the will only to the muscles needed is cultivated. after the muscle-work, the pupils are asked to centre their minds for a minute on one subject,--the subject to be chosen by some member, with slight help to lead the choice to something that will be suggestive for a minute's thinking. at first it seems impossible to hold one subject in mind for a minute; but the power grows rapidly as we learn the natural way of concentrating, and instead of trying to hold on to our subject, allow the subject to hold us by refusing entrance to every other thought. in the latter case one suggestion follows another with an ease and pleasantness which reminds one of walking through new paths and seeing on every side something fresh and unexpected. then the class is asked to think of a list of flowers, trees, countries, authors, painters, or whatever may be suggested, and see who can think of the greatest number in one minute. at first, the mind will trip and creak and hesitate over the work, but with practice the list comes steadily and easily. then follow exercises for quickness and exactness of sight, then for hearing, and finally for the memory. all through this process, by constant help and suggestion, the pupils are brought to the natural concentration. with regard to the memory, especial care should be taken, for the harm done by a mechanical training of the memory can hardly be computed. repose and the consequent freedom of body and mind lead to an opening of all the faculties for better use; if that is so, a teacher must be more than ever alive to lead pupils to the spirit of all they are to learn, and make the letter in every sense suggestive of the spirit. first, care should be taken to give something worth memorizing; secondly, ideas must be memorized before the words. a word is a symbol, and in so far as we have the habit of regarding it as such, will each word we hear be more and more suggestive to us. with this habit well cultivated, one sees more in a single glance at a poem than many could see in several readings. yet the reader who sees the most may be unable to repeat the poem word for word. in cultivating the memory, the training should be first for the attention, then for the imagination and the power of suggestive thought; and from the opening of these faculties a true memory will grow. the mechanical power of repeating after once hearing so many words is a thing in itself to be dreaded. let the pupil first see in mind a series of pictures as the poem or page is read, then describe them in his own words, and if the words of the author are well worth remembering the pupil should be led to them from the ideas. in the same way a series of interesting or helpful thoughts can be learned. avoidance of mere mechanism cannot be too strongly insisted upon; for exercise for attaining a wholesome, natural guidance of mind and body cannot be successful unless it rouses in the mind an appreciation of the laws of nature which we are bound to obey. a conscious experience of the results of such obedience is essential to growth. xv. artistic considerations although so much time and care are given to the various means of artistic expression, it is a singular fact that comparatively little attention is given to the use of the very first instrument which should be under command before any secondary instrument can be made perfectly expressive. an old artist who thanked his friend for admiring his pictures added: "if you could only see the pictures in my brain. but--" pointing to his brain and then to the ends of his fingers--"the channels from here to here are so long!" the very sad tone which we can hear in the wail of the painter expresses strongly the deficiencies of our age in all its artistic efforts. the channels are shorter just in proportion to their openness. if the way from the brain to the ends of the fingers is perfectly clear, the brain can guide the ends of the fingers to carry out truly its own aspirations, and the honest expression of the brain will lead always to higher ideals. but the channels cannot be free, and the artist will be bound so long as there is superfluous tension in any part of the body. so absolutely necessary, is it for the best artistic expression that the body should throughout be only a servant of the mind, that the more we think of it the more singular it seems that the training of the body to a childlike state is not regarded as essential, and taken as a matter of course, even as we take our regular nourishment. the artificial is tension in its many trying and disagreeable phases. art is freedom, equilibrium, rhythm,--anything and everything that means wholesome life and growth toward all that is really the good, the true, and the beautiful. art is immeasurably greater than we are. if we are free and quiet, the poem, the music, the picture will carry us, so that we shall be surprised at our own expression; and when we have finished, instead of being personally elated with conceited delight in what we have done, or exhausted with the superfluous effort used, we shall feel as if a strong wind had blown through us and cleared us for better work in the future. every genius obeys the true principle. it is because a genius is involuntarily under the law of his art that he is pervaded by its power. but we who have only talent must learn the laws of genius, which are the laws of nature, and by careful study and steady practice in shunning all personal obstructions to the laws, bring ourselves under their sway. who would wish to play on a stringed instrument already vibrating with the touch of some one else, or even with the last touch we ourselves gave it. what noise, what discord, with no possible harmonies! so it is with our nerves and muscles. they cannot be used for artistic purposes to the height of their best powers while they are tense and vibrating to our own personal states or habits; so that the first thing is to free them absolutely, and not only keep them free by constant practice, but so train them that they will become perfectly free at a moment's notice, and ready to respond clearly to whatever the heart and the mind want to express. the finer the instrument, the lighter the touch it will vibrate to. indeed it must have a light touch to respond clearly with musical harmonies; any other touch would blur. with a fine piano or a violin, whether the effect is to be _piano_ or _fortissimo,_ the touch should be only with the amount of force needed to give a clear vibration, and the ease with which a fortissimo effect is thus produced is astonishing. it is only those with the most delicate touch who can produce from a fine piano grand and powerful harmonies without a blur. the response in a human instrument to a really light touch is far more wonderful than that from any instrument made by man; and bodily effort blurs just as much more in proportion. the muscles are all so exquisitely balanced in their power for co-ordinate movement, that a muscle pulling one way is almost entirely freed from effort by the equalizing power of the antagonizing muscle; and at some rare moments when we have really found the equilibrium and can keep it, we seem to do no more than _think_ a movement or a tone or a combination of words, and they come with so slight a physical exertion that it seems like no effort at all. so far are we from our possibilities in this lightness of touch in the use of our bodies, that it is impossible now for most of us to touch as lightly as would, after training, bring the most powerful response. one of the best laws for artistic practice is, "every day less effort, every day more power." as the art of acting is the only art where the whole body is used with no subordinate instrument, let us look at that with regard to the best results to be obtained by means of relief from superfluous tension. the effects of unnecessary effort are strongly felt in the exhaustion which follows the interpretation of a very exciting role. it is a law without exception, that if i absorb an emotion and allow my own nerves to be shaken by it, i fail to give it in all its expressive power to the audience; and not only do i fall far short in my artistic interpretation, but because of that very failure, come off the stage with just so much nervous force wasted. certain as this law is, and infallible as are its effects, it is not only generally disbelieved, but it is seldom thought of at all. i must feet juliet in my heart, understand her with my mind, and let her vibrate clearly _across_ my nerves, to the audience. the moment i let my nerves be shaken as juliet's nerves were in reality, i am absorbing her myself, misusing nervous force, preparing to come off the stage thoroughly exhausted, and keeping her away from the audience. the present low state of the drama is largely due to this failure to recognize and practise a natural use of the nervous force. to work up an emotion, a most pernicious practice followed by young aspirants, means to work your nerves up to a state of mild or even severe hysteria. this morbid, inartistic, nervous excitement actually trains men and women to the loss of all emotional control, and no wonder that their nerves play the mischief with them, and that the atmosphere of the stage is kept in its present murkiness. the power to work the nerves up in the beginning finally carries them to the state where they must be more artificially urged by stimulants; and when the actor is off the stage he has no self-control at all. this all means misused and over-used force. in no schools is the general influence so absolutely morbid and unwholesome, as in most of the schools of elocution and acting. the methods by which the necessity for artificial stimulants can be overcome are so simple and so pleasant and so immediately effective, that it is worth taking the time and space to describe them briefly. of course, to begin with, the body must be trained to perfect freedom in repose, and then to freedom in its use. a very simple way of practising is to take the most relaxed attitude possible, and then, without changing it, to recite _with all the expression that belongs to it_ some poem or selection from a play full of emotional power. you will become sensitive at once to any new tension, and must stop and drop it. at first, an hour's daily practice will be merely a beginning over and over,--the nervous tension will be so evident,--but the final reward is well worth working and waiting for. it is well to begin by simply inhaling through the nose, and exhaling quietly through the mouth several times; then inhale and exhale an exclamation in every form of feeling you can think of let the exclamation come as easily and freely as the breath alone, without superfluous tension in any part of the body. so much freedom gained, inhale as before, and exhale brief expressive sentences,--beginning with very simple expressions, and taking sentences that express more and more feeling as your freedom is better established. this practice can be continued until you are able to recite the potion scene in juliet, or any of lady macbeth's most powerful speeches, with an case and freedom which is surprising. this refers only to the voice; the practice which has been spoken of in a previous chapter brings the same effect in gesture. it will be readily seen that this power once gained, no actor would find it necessary to skip every other night, in consequence of the severe fatigue which follows the acting of an emotional role. not only is the physical fatigue saved, but the power of expression, the power for intense acting, so far as it impresses the audience, is steadily increased. the inability of young persons to express an emotion which they feel and appreciate heartily, can be always overcome in this way. relaxing frees the channels, and the channels being open the real poetic or dramatic feeling cannot be held back. the relief is as if one were let out of prison. personal faults that come from self-consciousness and nervous tension may be often cured entirely without the necessity of drawing attention to them, simply by relaxing. dramatic instinct is a delicate perception of, quick and keen sympathies for, and ability to express the various phases of human nature. deep study and care are necessary for the best development of these faculties; but the nerves must be left free to be guided to the true expression,--neither allowed to vibrate to the ecstatic delight of the impressions, or in mistaken sympathy with them, but kept clear as conductors of all the heart can feel and the mind understand in the character or poem to be interpreted. this may sound cold. it is not; it is merely a process of relieving superfluous nervous tension in acting, by which obstructions are removed so that real sympathetic emotions can be stronger and fuller, and perceptions keener. those who get no farther than emotional vibrations of the nerves in acting, know nothing whatever of the greatness or power of true dramatic instinct. there are three distinct schools of dramatic art,--one may be called dramatic hysteria, the second dramatic hypocrisy. the first means emotional excitement and nervous exhaustion; the second artificial simulation of a feeling. dramatic sincerity is the third school, and the school that seems most truly artistic. what a wonderful training is that which might,--which ought to be given an actor to help him rise to the highest possibility of his art! a free body, exquisitely responsive to every command of the mind, is absolutely necessary; therefore there should be a perfect physical training. a quick and keen perception to appreciate noble thoughts, holding each idea distinctly, and knowing the relations of each idea to the others, must certainly be cultivated; for in acting, every idea, every word, should come clearly, each taking its own place in the thought expressed. broad human sympathies, the imaginative power of identifying himself with all phases of human nature, if he has an ideal in his profession above the average, an actor cannot lack. this last is quite impossible without broad human charity; for "to observe truly you must sympathize with those you observe, and to sympathize with them you must love them, and to love them you must forget yourself." and all these requisites--the physical state, the understanding, and the large heart--seem to centre in the expression of a well-trained voice,--a voice in which there is the minimum of body and the maximum of soul. by training, i always mean a training into nature. as i have said before, if art is nature illuminated, we must find nature before we can reach art. the trouble is that in acting, more than in any other art, the distinction between what is artistic and what is artificial is neither clearly understood nor appreciated; yet so marked is the difference when once we see it, that the artificial may well be called the hell of art, as art itself is heavenly. sincerity and simplicity are the foundations of art. a feigning of either is often necessary to the artificial, but many times impossible. although the external effect of this natural training is a great saving of nervous force in acting, the height of its power cannot be reached except through a simple aim, from the very heart, toward sincere artistic expression. so much for acting. it is a magnificent study, and should be more truly wholesome in its effects than any other art, because it deals with the entire body. but, alas i it seems now the most thoroughly morbid and unwholesome. all that has been said of acting will apply also to singing, especially to dramatic singing and study for opera; only with singing even more care should be taken. no singer realizes the necessity of a quiet, absolutely free body for the best expression of a high note, until having gained a certain physical freedom without singing, she takes a high note and is made sensitive to the superfluous tension all over the body, and later learns to reach the same note with the repose which is natural; then the contrast between the natural and the unnatural methods of singing becomes most evident,--and not with high notes alone, but with all notes, and all combinations of notes. i speak of the high note first, because that is an extreme; for with the majority of singers there is always more or less fear when a high note is coming lest it may not be reached easily and with all the clearness that belongs to it. this fear in itself is tension. for that reason one must learn to relax to a high note. a free body relieves the singer immensely from the mechanism of singing. so perfect is the unity of the body that a voice will not obey perfectly unless the body, as a whole, be free. once secure in the freedom of voice and body to obey, the song can burst forth with all the musical feeling, and all the deep appreciation of the words of which the singer is capable. now, unfortunately, it is not unusual in listening to a public singer, to feel keenly that he is entirely adsorbed in the mechanism of his art. if this freedom is so helpful, indeed so necessary, to reach one's highest power in singing, it is absolutely essential on the operatic stage. with it we should have less of the wooden motion so common to singers in opera. when one is free, physically free, the music seems to draw out the acting. with a great composer and an interpreter free to respond, the music and the body of the actor are one in their power of expressing the emotions. and the songs without words of the interludes so affect the spirit of the singer that, whether quiet or in motion, he seems, through being a living embodiment of the music, to impress the sense of seeing so that it increases the pleasure of hearing. i am aware that this standard is ideal; but it is not impossible to approach it,--to come at least much nearer to it than we do now, when the physical movements on the stage are such, that one wants to listen to most operas with closed eyes. we have considered artistic expression when the human body alone is the instrument. when the body is merely a means to the use of a secondary instrument, a primary training of the body itself is equally necessary. a pianist practises for hours to command his fingers and gain a touch which will bring the soul from his music, without in the least realizing that so long as he is keeping other muscles in his body tense, and allowing the nervous force to expend itself unnecessarily in other directions, there never will be clear and open channels from his brain to his fingers; and as he literally plays with his brain, and not with his fingers, free channels for a magnetic touch are indispensable. to watch a body _give_ to the rhythm of the music in playing is most fascinating. although the motion is slight, the contrast between that and a pianist stiff and rigid with superfluous tension is, very marked, and the difference in touch when one relaxes to the music with free channels has been very clearly proved. beside this, the freedom in mechanism which follows the exercises for arms and hands is strikingly noticeable. with the violin, the same physical equilibrium of motion must be gained; in fact it is equally necessary in all musical performance, as the perfect freedom of the body is always necessary before it can reach its highest power in the use of any secondary instrument. in painting, the freer a body is the more perfectly the mind can direct it. how often we can see clearly in our minds a straight line or a curve or a combination of both, but our hands will not obey the brain, and the picture fails. it does not by any means follow that with free bodies we can direct the hand at once to whatever the brain desires, but simply that by making the body free, and so a perfect servant of the mind, it can be brought to obey the mind in a much shorter time and more directly, and so become a truer channel for whatever the mind wishes to accomplish. in the highest art, whatever form it may take, the law of simplicity is perfectly illustrated. it would be tiresome to go through a list of the various forms of artistic expression; enough has been said to show the necessity for a free body, sensitive to respond to, quick to obey, and open to express the commands of its owner. xvi. tests adopting the phrase of our forefathers, with all its force and brevity, we say, "the proof of the pudding is in the eating." if the laws adduced in this book are nature's laws, they should preserve us in health and strength. and so they do just so far as we truly and fully obey them. then are students and teachers of these laws never ill, never run down, "nervous," or prostrated? yes, they are sometimes ill, sometimes run down and overworked, and suffer the many evil effects ensuing; but the work which has produced these results is much greater and more laborious than would have been possible without the practice of the principles. at the same time their states of illness occur because they only partially obey the laws. in the degree which they obey they will be preserved from the effects of tensity, overstrung nerves, and generally worn-out bodies; and in sickness coming from other causes--mechanical, hereditary, etc.--again, according to their obedience, they will be held in all possible physical and mental peace, so that the disease may wither and drop like the decayed leaf of a plant. as well might we ask of the wisest clergyman in the land, do his truths _never_ fail him? is he _always_ held in harmony and nobility by their power? however great and good the man may be, this state of perfection will never be reached in this world. in exact parallel to the spiritual laws upon which all universal truth, of all religions, is founded, are the truths of this teaching of physical peace and equilibrium. as religion applies to all the needs of the soul, so this applies to all the needs of the body. as a man may be continually progressing in nobility of thought and action, and yet find himself under peculiar circumstances tried even to the stumbling point,--so may the student of bodily quiet and equilibrium, who appears even to a very careful observer to be in surprising possession of his forces, under a similar test stumble and fall into some form of the evil effects out of which he has had power to lead others. it is important that this parallelism should be recognized, that the unity of these truths may be finally accomplished in the living; therefore we repeat, is this any more possible than that the full control of the soul should be at once possessed? think of the marvellous construction of the human body,--the exquisite adjustment of its economy. could a power of control sufficient to apply to its every detail be fully acquired at once, or even in a life-time? but when one does fall who has made himself even partially at one with nature's way of living, the power of patient waiting for relief is very different. he separates himself from his ailments in a way which without the preparation would be to him unknown. he has, without drug or other external assistance, an anodyne always within himself which he can use at pleasure. he positively experiences that "underneath are the everlasting arms," and the power to experience this gives him much respite from pain. pain is so often prolonged and accentuated _by dwelling in its memory, _living in a self-pity of the time when it shall come again! the patient who comes to his test with the bodily and mental repose already acquired, cuts off each day from the last, each hour from the last, one might almost say each breath from the last, so strong is his confidence in the renewal of forces possible to those who give themselves quite trustfully into nature's hands. it is not that they refuse external aid or precaution. no; indeed the very quiet within makes them feel most keenly when it is orderly to rest and seek the advice of others. also it makes them faithful in following every direction which will take them back into the rhythm of a healthful life. but while they do this they do not centre upon it. they take the precautions as a means and not as an end. they centre upon that which they have within themselves, and they know that that possible power being in a state of disorder and chaos no one or all of the outside measures are of any value. as patients prepared by the work return into normal life, the false exhilaration, which is a sure sign of another stumble, is seen and avoided. they have learned a serious lesson in economy, and they profit by it. where they were free before, they become more so; and where they were not, they quietly set themselves toward constant gain. they work at lower pressure, steadily gaining in spreading the freedom and quiet deeper into their systems, thus lessening the danger of future falls. let us state some of the causes for "breaking down," even while trying well to learn nature's ways. first, a trust in one's own capacity for freedom and quiet. "i can do this, now that i know how to relax." when truly considered, the thing is out of reason, and we should say, "because i know how to relax, i see that i must not do this." the case is the same with the gymnast who greatly overtaxes his muscle, having foolishly concluded that because he has had some training he can successfully meet the test. there is nothing so truly stupid as self-satisfaction; and these errors, with all others of the same nature, re fruits of our stupidity, and unless shunned surely lead us into trouble. some natures, after practice, relax so easily that they are soon met by the dangers of overrelaxation. let them remember that it is really equilibrium they are seeking, and by balancing their activity and their relaxation, and relaxing only as a means to an end,--the end of greater activity and use later,--they avoid any such ill effect. as the gymnast can mistake the purpose of his muscular development, putting it in the place of greater things, regarding it as an end instead of a means,--so can he who is training for a better use of his nervous force. in the latter case, the signs of this error are a slackened circulation, a loathing to activity, and various evanescent sensations of peace and satisfaction which bear no test, vanishing as soon as they are brought to the slightest trial. unless you take up your work with fresh interest and renewed vigor each time after practice, you may know that all is not as it should be. to avoid all these mistakes, examine the work of each day and let the next improve upon it. if you are in great need of relaxing, take more exercise in the fresh air. if unable to exercise, get your balance by using slow and steady breaths, which push the blood vigorously over its path in the body, and give one, to a degree, the effect of exercise. do not mistake the disorders which come at first, when turning away from an unnatural and wasteful life of contractions, for the effects of relaxing. such disorders are no more caused by relaxing than are the disorders which beset a drunkard or an opium-eater, upon refusing to continue in the way of his error, primarily caused by the abandonment of his evil habit, even though the appearance is that he must return to it in order to re-establish his pseudo-equilibrium. one more cause of trouble, especially in working without a guide, is the habit of going through the form of the exercises without really doing them. the tests needed here have been spoken of before. do not separate your way of practising from your way of living, but separate your life entirely from your practice while practising, trying outside of this time always to accomplish the agreement of the two,--that is, live the economy of force that you are practising. you can be just as gay, just as vivacious, but without the fatiguing after-effects. as you work to gain the ideal equilibrium, if your test comes, do not be staggered nor dismayed. avoid its increase by at once giving careful consideration to the causes, and dropping them. keep your life quietly to the form of its usual action, as far as you wisely can. if you have gained even a little appreciation of equilibrium, you will not easily mistake and overdo. when you find yourself becoming bound to the dismal thought of your test and its terrors, free yourself from it every time, by concentrating upon the weight of your body, or the slowness of the slowest breaths you can draw. keep yourself truly free, and these feelings of discouragement and all other mental distortions will steadily lose power, until for you they are no more. if they last longer than you think they should, persist in every endeavor, knowing that the after-result, in increased capacity to help yourself and others, will be in exact ratio to your power of persistency without succumbing. the only way to keep truly free, and therefore ready to profit by the help nature always has at hand, is to avoid thought of your form of illness as far as possible. the man with indigestion gives the stomach the first place in his mind; he is a mass of detailed and subdued activity, revolving about a monstrous stomach,--his brain, heart, lungs, and other organs, however orderly they may be, are of no consideration, and are slowly made the degraded slaves of himself and his stomach. the man who does not sleep, worships sleep until all life seems _sleep,_ and no life any importance without it. he fixes his mind on not sleeping, rushes for his watch with feverish intensity if a nap does come, to gloat over its brevity or duration, and then wonders that each night brings him no more sleep. there is nothing more contracting to mind and body than such idol-worship. neither blood nor nervous fluid can flow as it should. let us be sincere in our work, and having gained even one step toward a true equilibrium, hold fast to it, never minding how severely we are tempted. we see the work of quiet and economy, the lack of strain and of false purpose, in fine old nature herself; let us constantly try to do our part to make the picture as evident, as clear and distinct, in god's greater creation,--human nature. xvii the rational care of self a woman who had had some weeks of especially difficult work for mind and body, and who had finished it feeling fresh and well, when a friend expressed surprise at her freedom from fatigue, said, with a smiling face: "oh! but i took great care of myself all through it: i always went to bed early, and rested when it was possible. i was careful to eat only nourishing food, and to have exercise and fresh air when i could get them. you see i knew that the work must be accomplished, and that if i were over-tired i could not do it well." the work, instead of fatiguing, had evidently refreshed her. if that same woman had insisted, as many have in similar cases, that she had no time to think of herself; or if such care had seemed to her selfish, her work could not have been done as well, she would have ended it tired and jaded, and would have declared to sympathizing friends that it was "impossible to do a work like that without being all tired out," and the sympathizing friends would have agreed and thought her a heroine. a well-known author, who had to support his wife and family while working for a start in his literary career, had a commercial position that occupied him every day from nine to five. he came home and dined at six, went to bed at seven, slept until three, when he got up, made himself a cup of coffee, and wrote until he breakfasted at eight. he got all the exercise he needed in walking to and from his outside work and was able to keep up this regular routine, with no loss of health, until he could support his family comfortably on what he earned from his pen. then he returned to ordinary hours. a brain once roused will take a man much farther than his strength; if this man had come home tired and allowed himself to write far into the night, and then, after a short sleep, had gone to the indispensable earning of his bread and butter, the chances are that his intellectual power would have decreased, until both publishers and author would have felt quite certain that he had no power at all. the complacent words, "i cannot think of myself," or, "it is out of the question for me to care for myself," or any other of the various forms in which the same idea is expressed, come often from those who are steadily thinking of themselves, and, as a natural consequence, are so blinded that they cannot see the radical difference between unselfish care for one's self, as a means to an end, and the selfish care for one's self which has no other object in view. the wholesome care is necessary to the best of all good work. the morbid care means steady decay for body and soul. we should care for our bodies as a violinist cares for his instrument. it is the music that comes from his violin which he has in mind, and he is careful of his instrument because of its musical power. so we, with some sense of the possible power of a healthy body, should be careful to keep it fully supplied with fresh air; to keep it exercised and rested; to supply it with the quality and quantity of nourishment it needs; and to protect it from unnecessary exposure. when, through mistake or for any other reason, our bodies get out of order, instead of dwelling on our discomfort, we should take immediate steps to bring them back to a normal state. if we learned to do this as a matter of course, as we keep our hands clean, even though we had to be conscious of our bodies for a short time while we were gaining the power, the normal care would lead to a happy unconsciousness. carlyle says, and very truly, that we are conscious of no part of our bodies until it is out of order, and it certainly follows that the habit of keeping our bodies in order would lead us eventually to a physical freedom which, since our childhood, few of us have known. in the same way we can take care of our minds with a wholesome spirit. we can see to it that they are exercised to apply themselves well, that they are properly diverted, and know how to change, easily, from one kind of work to another. we can be careful not to attempt to sleep directly after severe mental work, but first to refresh our minds by turning our attention into entirely different channels in the way of exercise or amusement. we must not allow our minds to be over-fatigued any more than our bodies, and we must learn how to keep them in a state of quiet readiness for whatever work or emergency may be before them. there is also a kind of moral care which is quite in line with the care of the mind and the body, and which is a very material aid to these,--a way of refusing to be irritable, of gaining and maintaining cheerfulness, kindness, and thoughtfulness for others. it is well known how much the health of any one part of us depends upon all the others. the theme of one of howells's novels is the steady mental, moral, and physical degeneration of a man from eating a piece of cold mince-pie at midnight, and the sequence of steps by which he is led down is a very natural process. indeed, how much irritability and unkindness might be traced to chronic indigestion, which originally must have come from some careless disobedience of simple physical laws. when the stomach is out of order, it needs more than its share of vital force to do its work, and necessarily robs the brain; but when it is in good condition this force may be used for mental work. then again, when we are in a condition of mental strain or unhealthy concentration, this condition affects our circulation and consumes force that should properly be doing its work elsewhere, and in this way the normal balance of our bodies is disturbed. the physical and mental degeneration that follows upon moral wrong-doing is too well known to dwell upon. it is self-evident in conspicuous cases, and very real in cases that are too slight to attract general attention. we might almost say that little ways of wrongdoing often produce a worse degeneration, for they are more subtle in their effects, and more difficult to realize, and therefore to eradicate. the wise care for one's self is simply steering into the currents of law and order,--mentally, morally, and physically. when we are once established in that life and our forces are adjusted to its currents, then we can forget ourselves, but not before: and no one can find these currents of law and order and establish himself in them, unless he is working for some purpose beyond his own health. for a man may be out of order physically, mentally, or morally simply for the want of an aim in life beyond his own personal concerns. no care is to any purpose--indeed, it is injurious--unless we are determined to work for an end which is not only useful in itself, but is cultivating in us a living interest in accomplishment, and leading us on to more usefulness and more accomplishment. the physical, mental, and moral man are all three mutually interdependent, but all the care in the world for each and all of them can only lead to weakness instead of strength, unless they are all three united in a definite purpose of useful life for the benefit of others. even a hobby re-acts upon itself and eats up the man who follows it, unless followed to some useful end. a man interested in a hobby for selfish purposes alone first refuses to look at anything outside of his hobby, and later turns his back on everything but his own idea of his hobby. the possible mental contraction which may follow, is almost unlimited, and such contraction affects the whole man. it is just as certain a law for an individual that what he gives out must have a definite relation to what he takes in, as it is for the best strength of a country that its imports and exports should be in proper balance. indeed, this law is much more evident in the case of the individual, if we look only a little below the surface. a man can no more expect to live without giving out to others than a shoemaker can expect to earn his bread and butter by making shoes and leaving them piled in a closet. to be sure, there are many men who are well and happy, and yet, so far as appearances go, are living entirely for themselves, with not only no thought of giving, but a decided unwillingness to give. but their comfort and health are dependent on temporary conditions, and the external well-being they have acquired would vanish, if a serious demand were made upon their characters. happy the man or woman who, through illness of body or soul, or through stress of circumstances, is aroused to appreciate the strengthening power of useful work, and develops a wholesome sense of the usefulness and necessity of a rational care of self! try to convince a man that it is better on all accounts that he should keep his hands clean and he might answer, "yes, i appreciate that; but i have never thought of my hands, and to keep them clean would make me conscious of them." try to convince an unselfishly-selfish or selfishly-unselfish person that the right care for one's self means greater usefulness to others, and you will have a most difficult task. the man with dirty hands is quite right in his answer. to keep his hands clean would make him more conscious of them, but he does not see that, after he had acquired the habit of cleanliness, he would only be conscious of his hands when they were dirty, and that this consciousness could be at any time relieved by soap and water. the selfishly-unselfish person is right: it is most pernicious to care for one's self in a self-centred spirit; and if we cannot get a clear sense of wholesome care of self, it is better not to care at all. with a perception of the need for such wholesome care, would come a growing realization of the morbidness of all self-centred care, and a clearer, more definite standard of unselfishness. for the self-centred care takes away life, closes the sympathies, and makes useful service obnoxious to us; whereas the wholesome care, with useful service as an end, gives renewed life, an open sympathy, and growing power for further usefulness. we do not need to study deeply into the laws of health, but simply to obey those we know. this obedience will lead to our knowing more laws and knowing them better, and it will in time become a very simple matter to distinguish the right care from the wrong, and to get a living sense of how power increases with the one, and decreases with the other. xviii. our relations with others every one will admit that our relations to others should be quiet and clear, in order to give us freedom for our work. indeed, to make these relations quiet and happy is the special work that some of us have to do. there are laws for health, laws for gaining and keeping normal nerves, laws for honest, kindly action toward others,--but the obedience to all these is a dead obedience, and does not lead to vigorous life, unless accompanied by a hearty love for work and play with those to whom we stand in natural relations,--both young and old. it is with life as it is with art, what we do must be done with love, or it will have no force. without the living spark of love, we may have the appearance, but never the spirit, of useful work or quiet content. stagnation is not peace, and there can be no life, and so no living peace, without happy relations with those about us. the more we realize the practical strength of the law which bids us love our neighbor as ourselves, and the more we act upon it, the more quickly we gain the habit of pleasant, patient friendliness, which sooner or later may beget the same friendliness in return. in this kind of friendly relation there is a savor which so surpasses the unhealthy snap of disagreement, that any one who truly finds it will soon feel the fallacy of the belief that "between friends there must be a little quarrelling, to give spice to friendship." to be willing that every one should be himself, and work out his salvation in his own way, seems to be the first principle of the working plan drawn from the law of loving your neighbor as yourself. if we drop all selfish resistance to the ways of others, however wrong or ignorant they may be, we are more free to help them to better ways when they turn to us for help. it is in pushing and being pushed that we feel most strain in all human relations. we wait willingly for the growth of plants, and do not complain, or try in abnormal ways to force them to do what is entirely contrary to the laws of nature; and if we paid more attention to the laws of human nature, we should not stunt the growth of children, relatives, and friends by resisting their efforts,--or their lack of effort,--or by trying to force them into ways that we think must be right for them because we are sure they are right for us. there is a selfish, restless way of pushing others "for their own good" and straining to "help" them, and there is a selfish, entirely thoughtless way of letting them alone; it is difficult to tell which is the worse, or which does more harm. the first is the attitude of unconscious hypocrisy; the second is that of selfish indifference. it is in letting alone, with a loving readiness to help, that we find strength and peace for ourselves in our relations with others. all great laws are illustrated most clearly in their simplest forms, and there is no better way to get a sense of really free and wholesome relations with others than from the relations of a mother with her baby. even healthy reciprocity is there, in all the fulness of its best beginnings, and the results of wholesome, rational, maternal care are evident to the delighted observer in the joyous freedom with which the baby mind develops according to the laws of its own life. heidi is a baby not yet a year old, and is left alone a large part of the day. having no amusements imposed upon her, she has formed the habit of entertaining herself in her own way; she greets you with the most fascinating little gurgles, and laughs up at you when you stop and speak to her as if to say, "how do you do? i am having a _very_ happy time!" five minutes' smiling and being smiled at by her gives a friend who stops to talk "a _very_ happy time" too. if you take her up for a little while, she stays quietly and looks at you, then at the trees or at something in the room, then at her own hand. if you say "ah," or "oo," she answers with a vowel too; so the conversation begins and goes on, with jolly little laughter every now and then, and when you give her a gentle kiss and put her down, her good-bye is a very contented one, and her "thank you; please come again," is quite as plainly understood as if she had said it. you leave her, feeling that you have had a very happy visit with one of your best friends. heidi is not officiously interfered with; she has the best of care. when she cries, every means is taken to find the cause of her trouble; and when the trouble is remedied, she stops. she is a dear little friend, and gives and takes, and grows. another baby of the same age is peggy. she is needlessly handled and caressed. she is kissed a hundred times a day with rough affection, which is mistaken for tenderness and love. she is "bounced" up and down and around; and the people about her, who believe themselves her friends and would be heartbroken if she were taken from them, talk at her, and not with her; they make her do "cunning little things," and then laugh and admire; they try over and over to force her to speak words when her little brain is not ready for the effort; and when she is awake, she is almost constantly surrounded by "loving" noise. peggy is capable of being as good a friend as heidi, but she is not allowed to be. her family are so overwhelmed by their own feelings of love and admiration that they really only love themselves in her, for they give her not the slightest opportunity to be herself. the poor baby has sleepless, crying nights, and a little irritating illness hanging about her all the time; the doctor is called, and every one wonders why she should be ill; every one worries about her; but the caressing and noisy affection go on. although much of the difference between these two babies could probably be accounted for by differences of heredity and temperament, it nevertheless remains true that it is very largely the result of a difference between wise and foolish parents. the real friendship which her mother gave to heidi, and which resulted in her happy, placid ways and quickly responsive intelligence, meets with a like response in older children; and reciprocal friendship grows in strength and in pleasure both for child and older friend, as the child grows older. when a child is permitted the freedom of his own individuality, he can show the best in himself. when he is tempted to go wrong, he can be rationally guided in the right way in such a manner that he will accept the guidance as an act of friendship; and to that friendship he will feel bound in honor to be true, because he knows that we, his friends, are obeying the same laws. of course all this comes to him from no conscious action of his own mind, but from an unconscious, contented recognition of the state of mind of his older friends. a poor woman, who lived in one room with her husband and two children, said once in a flash of new intelligence, "now i see: the more i hollers, the more the children hollers; i am not going to holler any more." there are various grades of "hollering;" we "holler" often without a sound, and the child feels it, and "hollers" with many sounds which are distressing to him and to us. it is primarily true with babies and young children that "if you want to have a friend, you must be a friend." if we want courtesy and kindliness from a child, we must be courteous and kindly to him. not in outside ways alone,--a child quickly feels the sham of mere superficial attention,--but sincerely, with a living interest. so should we truly, from our inmost selves, meet a child as if he were of our own age, and as if we were of his age. this sounds like a paradox, but indeed the one proposition is essential to the other. if we meet a child only as if he were of our age, our attitude tends to make him a little prig; if we meet him as if we were as young as he is, his need for maturer influences produces a lack of balance which we must both feet; but if we sincerely meet him as if the exchange of age were mutual, we find common ground and valuable companionship. this mutual understanding is the basis of all true friendship. only read, instead of "age," "habit of mind," "character," "state," and we have the whole. it is aiming for reciprocal relations, from the best in us to the best in others, and from the best in others to the best in ourselves. it is the foundation of all that is strengthening, and quiet, and happy, in all human intercourse with young and old. to gain the friendly habit is more difficult with our contemporaries than it is with children. we have no right to guide older people unless they want to be guided, and they often want to guide us in ways we do not like at all. we have no right to try to change their opinions, unless they ask us for new light; and they often insist upon trying to change ours whether we ask them or not. there is sure to be selfish resistance in us when we complain of it in others, and we must acknowledge it and get free from it before we can give or find the most helpful sympathy. a healthy letting people alone, and a good wholesome scouring of ourselves, will, if it is to come at all, bring open friendliness. if it is not to come, then the healthy letting people alone should continue, for it is possible to live in the same house with a wilful and trying character, and live at peace, if he is lovingly let alone. if he is unlovingly let alone, the peace will be only on the outside, and must sooner or later give way to storms, or, what is much worse, harden into unforgiving selfishness. our influence with others depends primarily upon what we are, and only secondarily upon what we think or upon what we say. it is so with babies and young children, and more so with our older friends. if we honestly feel that there is something for us to learn from another, however wrong or ignorant, in some ways, he may seem, we are not only more able to find and profit by the best in him, but also to give to him in return whatever he may be ready to receive. how little quiet comfort there is in families where useless resistance to one another is habitual! members of one family often live along together with more or less appearance of good fellowship, but with an inner strain which gives them drawn faces and tired bodies, or else throws them back upon themselves in the enjoyment of their own selfishness; and sometimes there is not even the appearance of good fellowship, but a chronic resistance and disagreement, all for the want of a little sympathy and common sense. it is the sensitive people that suffer most, and their sensitiveness is deplored by the family and by themselves. if they could only know how great a gift their sensitiveness is! to appreciate this, it must be used to find and feel the good in others, not to make us abnormally alive to real or fancied slights. we must use it to enlarge our sympathies and help us understand the wrong-doing of others enough to point the way, if possible, to better things, not merely to criticise and blame them. only in such ways can we learn to realize and use the delicate power of sensitiveness. selfish sensitiveness is a blessing turned to a curse; but the more lovingly sensitive we become to the need of moral freedom in our friends, the dearer we are led to our own. there are no human relations that do not illustrate the law which bids me "love my neighbor as myself;" especially clearly is it revealed,--in its breach of observance,--in the comparatively external relations of host and guest in ordinary social life, and in the happiness that can be given and received when it is readily obeyed. a lady once said, "i go into my bedroom and take note of all the conveniences i have there, and then look about my guest chamber to see that it is equally well and appropriately furnished." she succeeds in her object in the guest chamber if she is the kind of hostess to her guest that she would have her guest be to her; not that her guest's tastes are necessarily her own, but that she knows how to find out what they are and how to satisfy them. it is often difficult to love our neighbor as ourselves because we do not know how to love ourselves. we are selfish, or stupid, or aggressive with ourselves, or try too hard for what is right and good, instead of trusting with inner confidence and reverence to a power that is above us. over-thoughtfulness for others, in little things or great, is oppressive, and as much an enemy to peace, as the lack of any thoughtfulness at all. it is like too much attention to the baby, and comes from the same kind of selfish affection, with--frequently the added motive of wanting to appear disinterested. one might give pages of examples showing the right and the wrong way in all the varied relations of life, but they would all show that the right way comes from obedience to the law of unselfishness. to obey this law we must respect our neighbor's rights as we respect our own; we must gain and keep the clear and quiet atmosphere that we like to find about our friend; we must shun everything that would interfere with a loving kindliness toward him, as we would have him show the same kindliness toward us. we must know that we and our friends are one, and that, unless a relation is a mutual benefit, it is no true relation at all. but, first of all, we must remember that a true appreciation of the wonderful power of this law comes only with daily, patient working, and waiting for the growth it brings. in so far as we are truly the friend of one, whether he be baby, child, or grown man,--shall we be truly the friend of all; in so far as we are truly the friend of all, shall we be truly the friend of every one; and, as we find the living peace of this principle, and a greater freedom from selfishness,--whether of affection or dislike,--those who truly belong to us will gravitate to our sides, and we shall gravitate to theirs. each one of us will understand his own relation to the rest,--whether remote or close,--for in that quiet light it will be seen to rest on intelligible law, which only the fog and confusion of selfishness concealed. xix. the use of the will it is not generally recognized that the will can be trained, little by little, by as steadily normal a process as the training of a muscle, and that such training must be through regular daily exercise, and as slow in its effects as the training of a muscle is slow. perhaps we are unconsciously following, as a race, the law that froebel has given for the beginnings of individual education, which bids us lead from the "outer to the inner," from the known to the unknown. there is so much more to be done to make methods of muscular training perfect, that we have not yet come to appreciate the necessity for a systematic training of the will. every individual, however, who recognizes the need of such training and works accordingly, is doing his part to hasten a more intelligent use of the will by humanity in general. when muscles are trained abnormally their development weakens, instead of strengthening, the whole system. great muscular strength is often deceptive in the appearance of power that it gives; it often effectually hides, under a strong exterior, a process of degeneration which is going on within, and it is not uncommon for an athlete to die of heart disease or pulmonary consumption. this is exactly analogous to the frequently deceptive appearance of great strength of will. the will is trained abnormally when it is used only in the direction of personal desire, and the undermining effect upon the character in this case is worse than the weakening result upon the body in the case of abnormal muscular development. a person who is persistently strong in having his own way may be found inconsistently weak when he is thwarted in his own way. this weakness is seldom evident to the general public, because a man with a strong will to accomplish his own ends is quick to detect and hide any appearance of weakness, when he knows that it will interfere with whatever he means to do. the weakness, however, is none the less certainly there, and is often oppressively evident to those from whom he feels that he has nothing to gain. when the will is truly trained to its best strength, it is trained to obey; not to obey persons or arbitrary ideas, but to obey laws of life which are as fixed and true in their orderly power, as the natural laws which keep the suns and planets in their appointed spheres. there is no one who, after a little serious reflection, may not be quite certain of two or three fixed laws, and as we obey the laws we know, we find that we discover more. to obey truly we must use our wills to yield as well as to act. often the greatest strength is gained through persistent yielding, for to yield entirely is the most difficult work a strong will can do, and it is doing the most difficult work that brings the greatest strength. to take a simple example: a small boy with a strong will is troubled with stammering. every time he stammers it makes him angry, and he pushes and strains and exerts himself with so much effort to speak, that the stammering, in consequence, increases. if he were told to do something active and very painful, and to persist in it until his stammering were cured, he would set his teeth and go through the work like a soldier, so as to be free from the stammering in the shortest possible time. but when he is told that he must relax his body and stop pushing, in order to drop the resistance that causes his trouble, he fights against the idea with all his little might. it is all explained to him, and he understands that it is his only road to smooth speaking; but the inherited tendency to use his will only in resistance is so strong, that at first it seems impossible for him to use it in any other way. the fact that the will sometimes gains its greatest power by yielding seems such a paradox that it is not strange that it takes us long to realize it. indeed, the only possible realization of it is through practice. the example of the little stammering boy is an illustration that applies to many other cases of the same need for giving up resistance. no matter how actively we need to use our wills, it is often, necessary to drop all self-willed resistance first, before we begin an action, if we want to succeed with the least possible effort and the best result. when we use the will forcibly to resist or to repress, we are simply straining our nerves and muscles, and are exerting ourselves in a way which must eventually be weakening, not only to them, but to the will itself. we are using the will normally when, without repression or unnecessary effort, we are directing the muscles and nerves in useful work. we want "training and not straining" as much for the will as for the body, and only in that way does the will get its strength. the world admires a man for the strength of his will if he can control the appearance of anger, whereas the only strength of will that is not spurious is that which controls the anger itself. we have had the habit for so long of living in appearances, that it is only by a slow process that we acquire a strong sense of their frailty and lack of genuine value. in order to bring the will, by training, out of the region of appearances into that of realities, we must learn to find the true causes of weakness and use our wills little by little to remove them. to remove the external effect does no permanent good and produces an apparent strength which only hides an increasing weakness. imagine, for instance, a woman with an emotional, excitable nature who is suffering from jealousy; she does not call it jealousy, she calls it "sensitive nerves," and the doctors call it "hysteria." she has severe attacks of "sensitive nerves" or "hysteria" every time her jealousy is excited. it is not uncommon for such persistent emotional strain, with its effect upon the circulation and other functions of the body, to bring on organic disease. in such a case the love of admiration, and the strength of will resulting from that selfish desire, makes her show great fortitude, for which she receives much welcome praise. that is the effect she wants, and in the pose of a wonderful character she finds it easy to produce more fortitude--and so win more admiration. a will that is strong for the wrong, may--if taken in time--become equally strong for the right. perversion is not, at first, through lack of will, but through the want of true perception to light the way to its intelligent use. a man sometimes appears to be without power of will who is only using a strong will in the wrong way, but if he continues in his wrong course long enough, his weakness becomes real. if a woman who begins her nervous degeneration by indulging herself in jealousy--which is really a gross emotion, however she may refine it in appearance--could be made to see the truth, she would, in many cases, be glad to use her will in the right direction, and would become in reality the beautiful character which her friends believe her to be. this is especially true because this moral and nervous perversion often attacks the finest natures. but when such perversion is allowed to continue, the sufferer's strength is always prominent in external dramatic effects, but disappears oppressively when she is brought face to face with realities. many people who are nervous invalids, and many who are not, are constantly weakening themselves and making themselves suffer by using their wills vigorously in every way _but_ that which is necessary to their moral freedom: by bearing various unhappy effects with so-called stoicism, or fighting against them with their eyes tight shut to the real cause of their suffering, and so hiding an increasing weakness under an appearance of strength. a ludicrous and gross example of this misuse of the will may be observed in men or women who follow vigorously and ostentatiously paths of self-sacrifice which they have marked out for themselves, while overlooking entirely places where self-denial is not only needed for their better life, but where it would add greatly to the happiness and comfort of others. it is curious a such weakness is common with people who are apparently very intelligent; and parallel with this are cases of men who are remarkably strong in the line of their own immediate careers, and proportionately weak in every other phase of their lives. we very seldom find a soldier, or a man who is powerful in politics, who can answer in every principle and action of his life to wordsworth's "character of the happy warrior." absurd as futile self-sacrifice seems, it is not less well balanced than the selfish fortitude of a jealous woman or than the apparent strength of a man who can only work forcibly for selfish ends. the wisest use of the will can only grow with the decrease of self-indulgence. "nervous" women are very effective examples of the perversion of a strong will. there are women who will work themselves into an illness and seem hopelessly weak when they are not having their own way, who would feel quite able to give dinner parties at which they could be prominent in whatever role they might prefer, and would forget their supposed weakness with astonishing rapidity. when things do not go to please such women, they are weak and ill; when they stand out among their friends according to their own ideal of themselves and are sufficiently flattered, they enter into work which is far beyond their actual strength, and sooner or later break down only to be built up on another false basis. this strong will turned the wrong way is called "hysteria," or "neurasthenia," or "degeneracy." it may be one of these or all three, _in its effect,_ but the training of the will to overcome the cause, which is always to be found in some kind of selfishness, would cure the hysteric, give the neurasthenic more wholesome nerves, and start the degenerate on a course of regeneration. at times it would hardly surprise us to hear that a child with a stomach-ache crying for more candy was being treated for "hysteria" and studied as a "degenerate." degenerate he certainly is, but only until he can be taught to deny himself candy when it is not good for him, with quiet and content. there are many petty self-indulgences which, if continually practised, can do great and irreparable harm in undermining the will. every man or woman knows his own little weaknesses best, but that which leads to the greatest harm is the excuse, "it is my temperament; if i were not tardy, or irritable, or untidy,"--or whatever it may be,--"i would not be myself." our temperament is given us as a servant, not as a master; and when we discover that an inherited perversion of temperament can be trained to its opposite good, and train it so, we do it not at a loss of individuality, but at a great gain. this excuse of "temperament" is often given as a reason for not yielding. the family will is dwelt upon with a pride which effectually prevents it from keeping its best strength, and blinds the members of the family to the weakness that is sure to come, sooner or later, as a result of the misuse of the inheritance of which they are so proud. if we train our wills to be passive or active, as the need may be, in little things, that prepares us for whatever great work may be before us, just as in the training of a muscle, the daily gentle exercise prepares it to lift a great weight. whether in little ways or in great ways, it is stupid and useless to expect to gain real strength, unless we are working in obedience to the laws that govern its development. we have a faculty for distinguishing order from disorder and harmony from discord, which grows in delicacy and strength as we use it, and we can only use it through refusing disorder and choosing order. as our perception grows, we choose more wisely, and as we choose more wisely, our perception grows. but our perceptions must work in causes, not at all in effects, except as they lead us to a knowledge of causes. we must, above all, train our wills as a means of useful work. it is impossible to perfect ourselves for the sake of ourselves. it is a happy thing to have been taught the right use of the will as a child, but those of us who have not been so taught, can be our own fathers and our own mothers, and we must be content with a slow growth. we are like babies learning to walk. the baby tries day after day, and does not feel any strain, or wake in the morning with a distressing sense of "oh! i must practise walking to-day. when shall i have finished learning?" he works away, time after time falling down and picking himself up, and some one day finally walks, without thinking about it any more. so we, in the training of our wills, need to work patiently day by day; if we fall, we must pick ourselves up and go on, and just as the laws of balance guide the baby, so the laws of life will carry us. when the baby has succeeded in walking, he is not elated at his new power, but uses it quietly and naturally to accomplish his ends. we cannot realize too strongly that any elation or personal pride on our part in a better use of the will, not only obstructs its growth, but is directly and immediately weakening. a quiet, intelligent use of the will is at the root of all character; and unselfish, well-balanced character, with the insight which it develops, will lead us to well-balanced nerves. summing up to sum it all up, the nerves are conductors for impression and expression. as channels, they should be as free as emerson's "smooth hollow tube," for transmission from without in, and from within out. thus the impressions will be clear, and the expressions powerful. the perversions in the way of allowing to the nerves the clear conducting power which nature would give them are, so far as the body is concerned, unnecessary fatigue and strain caused by not resting entirely when the times come for rest, and by working with more than the amount of force needed to accomplish our ends,--thus defying the natural laws of equilibrium and economy. not only in the ways mentioned do we defy these most powerful laws, but, because of carelessness in nourishment and want of normal exercise out of doors, we make the establishment of such equilibrium impossible. the nerves can never be open channels while the body wants either proper nourishment, the stimulus that comes from open air exercise, perfect rest, or true economy of force in running the human machine. the physical training should be a steady shunning of personal perversions until the nervous system is in a natural state, and the muscles work in direct obedience to the will with the exquisite co-ordination which is natural to them. the same equilibrium must be found in the use of the mind. rest must be complete when taken, and must balance the effort in work,--rest meaning often some form of recreation as well as the passive rest of steep. economy of effort should be gained through normal concentration,--that is, the power of erasing all previous impressions and allowing a subject to hold and carry us, by dropping every thought or effort that interferes with it, in muscle, nerve, and mind. the nerves of the senses must be kept clear through this same ability to drop all previous impressions. first in importance, and running all through the previous training, is the use of the will, from which all these servants, mental and physical, receive their orders,--true or otherwise as the will itself obeys natural and spiritual laws in giving them. the perversions in the will to be shunned are misuse of muscles by want of economy in force and power of direction; abuse of the nervous system by unwisely dwelling upon pain and illness beyond the necessary care for the relief of either, or by allowing sham emotions, irritability, and all other causes of nervous distemper to overcome us. the remedy for this is to make a peaceful state possible through a normal training of the physique; to realize and follow a wholesome life in all its phases; to recognize daily more fully through obedience the great laws of life by which we must be governed, as certainly as an engineer must obey the laws of mechanics if he wants to build a bridge, that will stand, as certainly as a musician must obey the laws of harmony if he would write good music, as surely as a painter must obey the laws of perspective and of color if he wishes to illuminate nature by means of his art. no matter what our work in life, whether scientific, artistic, or domestic, it is the same body through which the power is transmitted; and the same freedom in the conductors for impression and expression is needed, to whatever end the power may be moved, from the most simple action to the highest scientific or artistic attainment. the quality of power differs greatly; the results are widely different, but the laws of transmission are the same. so wonderful is the unity of life and its laws! the end. team. this file was produced from images generously made available by the bibliothèque nationale de france (bnf/gallica) at http://gallica.bnf.fr hygeia a city of health by benjamin ward richardson m.d., f.r.s. [illustration] to edwin chadwick, c.b. my dear mr. chadwick, _i wrote this address with the intention of dedicating it to you, as a simple but hearty acknowledgment by a sanitary student, himself well ripened in the work, of your pre-eminent position as the living leader of the sanitary reformation of this century. the favour the address has received indicates notably two facts: the advance of public opinion on the subject of public health, and the remarkable value and influence of your services as the sanitary statesman by whom that opinion has been so wisely formed and directed. in this sense of my respect for you, and of my gratitude, pray accept this trifling recognition, and believe me to be, ever faithfully yours_, b.w. richardson. prefatory note. the immediate success of this address caused me to lay it aside for some months, to see if the favour with which it was received would remain. i am satisfied to find that the good fortune which originally attended the effort holds on, and that in publishing it now in a separate form i am acting in obedience to a generally expressed desire. since the delivery of the address before the health department of the social science congress, over which i had the honour to preside, at brighton, in october last, every day has brought some new suggestion bearing on the subjects discussed, and the temptation has been great to add new matter, or even to recast the essay and bring it out as a more compendious work. on reflection i prefer to let it take its place in literature, in the first instance, in its original and simple dress. hinde street, w.: _august_ , . hygeia, a city of health we meet in this assembly, a voluntary parliament of men and women, to study together and to exchange knowledge and thought on works of every-day life and usefulness. our object, to make the present existence better and happier; to inquire, in this particular section of our congress:--what are the conditions which lead to the pain and penalty of disease; what the means for the removal of those conditions when they are discovered? what are the most ready and convincing methods of making known to the uninformed the facts: that many of the conditions are under our control; that neither mental serenity nor mental development can exist with an unhealthy animal organisation; that poverty is the shadow of disease, and wealth the shadow of health? these objects relate to ourselves, to our own reliefs from suffering, to our own happiness, to our own riches. we have, i trust and believe, yet another object, one that relates not to ourselves, but to those who have yet to be; those to whom we may become known, but whom we can never know, who are the ourselves, unseen to ourselves, continuing our mission. we are privileged more than any who have as yet lived on this planet in being able to foresee, and in some measure estimate, the results of our wealth of labour as it may be possibly extended over and through the unborn. a few scholars of the past, like him who, writing to the close of his mortal day, sang himself to his immortal rest with the '_gloria in excelsis_,' a few scholars might foresee, even as that baeda did, that their living actual work was but the beginning of their triumphant course through the ages,--the momentum. but the masses of the nations, crude and selfish, have had no such prescience, no such intent. 'let us eat and drink, for to-morrow we die!' that has been the pass, if not the password, with them and theirs. we, scholars of modern thought, have the broader, and therefore more solemn and obligatory knowledge, that however many to-morrows may come, and whatever fate they may bring, we never die; that, strictly speaking, no one yet who has lived has ever died; that for good or for evil our every change from potentiality into motion is carried on beyond our own apparent transitoriness; that we are the waves of the ocean of life, communicating motion to the expanse before us, and leaving the history we have made on the shore behind. thus we are led to feel this greater object: that to whatever extent we, by our exertions, confer benefits on those who live, we extend the advantage to those who have to live; that one good thought leading to practical useful action from one man or woman, may go to the virtue of thousands of generations; that one breath of health wafted by our breath may, in the aggregate of life saved by it, represent in its ultimate effect all the life that now is or has been. at the close of a parliamentary session, an uneventful leader of a section of parliament banters his more eventful rival, and enlivening his criticism by a sneer at our congress, challenges the contempt of his rival, as if to draw it forth in the same critical direction. alas! it is too true that great congresses, like great men, and even like parliaments, do live sometimes for many years and talk much, and seem to miss much and advance little; so that in what relates to the mere present it were wrong, possibly, to challenge the sally of the statesman who, from his own helpless height, looked down on our weakness. but inasmuch as no man knoweth the end of the spoken word, as that which is spoken to-day, earnestly and simply, may not reappear for years, and may then appear with force and quality of hidden virtue, there is reason for our uniting together beyond the proof of necessity which is given in the fact of our existence. perchance some day our natural learning, gathered in our varied walks of life, and submitted in open council, may survive even parliamentary strife; perchance our resolutions, though no sign-manual immediately grace them, are the informal bills which ministers and oppositions shall one day discuss, parliaments pass, royal hands sign, and the fixed administrators of the will of the nation duly administer. these thoughts on the future, rather than on the passing influence of our congressional work, have led me to the simple design of the address which, as president of this section, i venture to submit to you to-day. it is my object to put forward a theoretical outline of a community so circumstanced and so maintained by the exercise of its own freewill, guided by scientific knowledge, that in it the perfection of sanitary results will be approached, if not actually realised, in the co-existence of the lowest possible general mortality with the highest possible individual longevity. i shall try to show a working community in which death,--if i may apply so common and expressive a phrase on so solemn a subject,--is kept as nearly as possible in its proper or natural place in the scheme of life. health and civilisation. before i proceed to this task, it is right i should ask of the past what hope there is of any such advancement of human progress. for, as my lord of verulam quaintly teaches, 'the past ever deserves that men should stand upon it for awhile to see which way they should go, but when they have made up their minds they should hesitate no longer, but proceed with cheerfulness,' for a moment, then, we will stand on the past. from this vantage-ground we gather the fact, that onward with the simple progress of true civilisation the value of life has increased. ere yet the words 'sanitary science' had been written; ere yet the heralds of that science (some of whom, in the persons of our illustrious colleagues, edwin chadwick and william fair, are with us in this place at this moment), ere yet these heralds had summoned the world to answer for its profligacy of life, the health and strength of mankind was undergoing improvement. one or two striking facts must be sufficient in the brief space at my disposal to demonstrate this truth. in england, from to , heberden calculated that the general mortality diminished one-fourth. in france, during the same period, the same favourable returns were made. the deaths in france, berard calculated, were in in the year , and during the eight years, from to , in , or a fourth less. in , out of new-born infants, in france, died in the two first years; in the later period, extending from the time of the census that was taken in to , only of the same age died, an augmentation of infant life equal to per cent. in as many as per cent. died before reaching the age of ten years; in the later period , or about a fifth less. in only persons per cent. attained the age of years; in the later period , or eleven more, reached that term. in but persons per cent, arrived at years; in the later period arrived at that age. side by side with these facts of the statist we detect other facts which show that in the progress of civilisation the actual organic strength and build of the man and woman increases. as in the highest developments of the fine arts the sculptor and painter place before us the finest imaginative types of strength, grace, and beauty, so the silent artist, civilisation, approaches nearer and nearer to perfection, and by evolution of form and mind developes what is practically a new order of physical and mental build. peron,--who first used, if he did not invent, the little instrument, the dynamometer, or muscular-strength measurer,--subjected persons of different stages of civilisation to the test of his gauge, and discovered that the strength of the limbs of the natives of van diemen's land and new holland was as degrees of power, while that of the frenchmen was , and of the englishmen . the same order of facts are maintained in respect to the size of body. the stalwart englishman of to-day can neither get into the armour nor be placed in the sarcophagus of those sons of men who were accounted the heroes of the infantile life of the human world. we discover, moreover, from our view of the past, that the developments of tenacity of life and of vital power have been comparatively rapid in their course when they have once commenced. there is nothing discoverable to us that would lead to the conception of a human civilisation extending back over two hundred generations; and when in these generations we survey the actual effect of civilisation, so fragmentary and overshadowed by persistent barbarism, in influencing disease and mortality, we are reduced to the observation of at most twelve generations, including our own, engaged, indirectly or directly, in the work of sanitary progress. during this comparatively brief period, the labour of which, until within a century, has had no systematic direction, the changes for good that have been effected are amongst the most startling of historical facts. pestilences which decimated populations, and which, like the great plague of london, destroyed , people in a single week, have lost their virulency; gaol fever has disappeared, and our gaols, once each a plague-spot, have become, by a strange perversion of civilisation, the health spots of, at least, one kingdom. the term, black death, is heard no more; and ague, from which the london physician once made a fortune, is now a rare tax even on the skill of the hardworked union medical officer. from the study of the past we are warranted, then, in assuming that civilisation, unaided by special scientific knowledge, reduces disease and lessens mortality, and that the hope of doing still more by systematic scientific art is fully justified. i might hereupon proceed to my project straightway. i perceive, however, that it may be urged, that as mere civilising influences can of themselves effect so much, they might safely be left to themselves to complete, through the necessity of their demands, the whole sanitary code. if this were so, a formula for a city of health were practically useless. the city would come without the special call for it. i think it probable the city would come in the manner described, but how long it would be coming is hard to say, for whatever great results have followed civilisation, the most that has occurred has been an unexpected, unexplained, and therefore uncertain arrest of the spread of the grand physical scourges of mankind. the phenomena have been suppressed, but the root of not one of them has been touched. still in our midst are thousands of enfeebled human organisms which only are comparable with the savage. still are left amongst us the bases of all the diseases that, up to the present hour, have afflicted humanity. the existing calendar of diseases, studied in connection with the classical history of the diseases written for us by the longest unbroken line of authorities in the world of letters, shows, in unmistakable language, that the imposition of every known malady of man is coeval with every phase of his recorded life on the planet. no malady, once originated, has ever actually died out; many remain as potent as ever. that wasting fatal scourge, pulmonary consumption, is the same in character as when coelius aurelianus gave it description. the cancer of to-day is the cancer known to paulus eginæta. the black death, though its name is gone, lingers in malignant typhus. the great plague of athens is the modern great plague of england, scarlet fever. the dancing mania of the middle ages and the convulsionary epidemic of montmartre, subdued in their violence, are still to be seen in some american communities, and even at this hour in the new forest of england. small-pox, when the blessed protection of vaccination is withdrawn, is the same virulent destroyer as it was when the arabian rhazes defined it. ague lurks yet in our own island, and, albeit the physician is not enriched by it, is in no symptom changed from the ague that celsus knew so well. cholera, in its modern representation is more terrible a malady than its ancient type, in so far as we have knowledge of it from ancient learning. and that fearful scourge, the great plague of constantinople, the plague of hallucination and convulsion which raged in the fifth century of our era, has in our time, under the new names of tetanoid fever and cerebro-spinal meningitis, been met with here and in france, and in massachusetts has, in the year , laid victims in the dust. i must cease these illustrations, though i could extend them fairly over the whole chapter of disease, past and present. suffice it if i have proved the general propositions, that disease is now as it was in the beginning, except that in some examples of it it is less virulent; that the science for extinguishing any one disease has yet to be learned; that, as the bases of disease exist, untouched by civilisation, so the danger of disease is ever imminent, unless we specially provide against it; that the development of disease may occur with original virulence and fatality, and may at any moment be made active under accidental or systematic ignorance. a city of health. i now come to the design i have in hand. mr. chadwick has many times told us that he could build a city that would give any stated mortality, from fifty, or any number more, to five, or perhaps some number less, in the thousand annually. i believe mr. chadwick to be correct to the letter in this statement, and for that reason i have projected a city that shall show the lowest mortality. i need not say that no such city exists, and you must pardon me for drawing upon your imaginations as i describe it. depicting nothing whatever but what is at this present moment easily possible, i shall strive to bring into ready and agreeable view a community not abundantly favoured by natural resources, which, under the direction of the scientific knowledge acquired in the past two generations, has attained a vitality not perfectly natural, but approaching to that standard. in an artistic sense it would have been better to have chosen a small town or large village than a city for my description; but as the great mortality of states is resident in cities, it is practically better to take the larger and less favoured community. if cities could be transformed, the rest would follow. our city, which may be named _hygeia_, has the advantage of being a new foundation, but it is so built that existing cities might be largely modelled upon it. the population of the city may be placed at , , living in , houses, built on , acres of land,--an average of persons to an acre. this may be considered a large population for the space occupied, but, since the effect of density on vitality tells only determinately when it reaches a certain extreme degree, as in liverpool and glasgow, the estimate may be ventured. the safety of the population of the city is provided for against density by the character of the houses, which ensures an equal distribution of the population. tall houses overshadowing the streets, and creating necessity for one entrance to several tenements, are nowhere permitted. in streets devoted to business, where the tradespeople require a place of mart or shop, the houses are four stories high, and in some of the western streets where the houses are separate, three and four storied buildings are erected; but on the whole it is found bad to exceed this range, and as each story is limited to feet, no house is higher than feet. the substratum of the city is of two kinds. at its northern and highest part, there is clay; at its southern and south-eastern, gravel. whatever disadvantages might spring in other places from a retention of water on a clay soil, is here met by the plan that is universally followed, of building every house on arches of solid brickwork. so, where in other towns there are areas, and kitchens, and servants' offices, there are here subways through which the air flows freely, and down the inclines of which all currents of water are carried away. the acreage of our model city allows room for three wide main streets or boulevards, which run from east to west, and which are the main thoroughfares. beneath each of these is a railway along which the heavy traffic of the city is carried on. the streets from north to south which cross the main thoroughfares at right angles, and the minor streets which run parallel, are all wide, and, owing to the lowness of the houses, are thoroughly ventilated, and in the day are filled with sunlight. they are planted on each side of the pathways with trees, and in many places with shrubs and evergreens. all the interspaces between the backs of houses are gardens. the churches, hospitals, theatres, banks, lecture-rooms, and other public buildings, as well as some private buildings such as warehouses and stables, stand alone, forming parts of streets, and occupying the position of several houses. they are surrounded with garden space, and add not only to the beauty but to the healthiness of the city. the large houses of the wealthy are situated in a similar manner. the streets of the city are paved throughout with the same material. as yet wood pavement set in asphalte has been found the best. it is noiseless, cleanly, and durable. tramways are nowhere permitted, the system of underground railways being found amply sufficient for all purposes. the side pavements, which are everywhere ten feet wide, are of white or light grey stone. they have a slight incline towards the streets, and the streets have an incline from their centres towards the margins of the pavements. from the circumstance that the houses of our model city are based on subways, there is no difficulty whatever in cleansing the streets, no more difficulty than is experienced in paris. that disgrace to our modern civilisation, the mud cart, is not known, and even the necessity for mr. e.h. bayley's roadway moveable tanks for mud sweepings,--so much wanted in london and other towns similarly built,--does not exist. the accumulation of mud and dirt in the streets is washed away every day through side openings into the subways, and is conveyed, with the sewage, to a destination apart from the city. thus the streets everywhere are dry and clean, free alike of holes and open drains. gutter children are an impossibility in a place where there are no gutters for their innocent delectation. instead of the gutter, the poorest child has the garden; for the foul sight and smell of unwholesome garbage, he has flowers and green sward. it will be seen, from what has been already told, that in this our model city there are no underground cellars, kitchens, or other caves, which, worse than those ancient british caves that nottingham still can show the antiquarian as the once fastnesses of her savage children, are even now the loathsome residences of many millions of our domestic and industrial classes. there is not permitted to be one room underground. the living part of every house begins on the level of the street. the houses are built of a brick which has the following sanitary advantages:--it is glazed, and quite impermeable to water, so that during wet seasons the walls of the houses are not saturated with tons of water, as is the case with so many of our present residences. the bricks are perforated transversely, and at the end of each there is a wedge opening, into which no mortar is inserted, and by which all the openings are allowed to communicate with each other. the walls are in this manner honeycombed, so that there is in them a constant body of common air let in by side openings in the outer wall, which air can be changed at pleasure, and, if required, can be heated from the firegrates of the house. the bricks intended for the inside walls of the house, those which form the walls of the rooms, are glazed in different colours, according to the taste of the owner, and are laid so neatly, that the after adornment of the walls is considered unnecessary, and, indeed, objectionable. by this means those most unhealthy parts of household accommodation, layers of mouldy paste and size, layers of poisonous paper, or layers of absorbing colour stuff or distemper, are entirely done away with. the walls of the rooms can be made clean at any time by the simple use of water, and the ceilings, which are turned in light arches of thinner brick, or tile, coloured to match the wall, are open to the same cleansing process. the colour selected for the inner brickwork is grey, as a rule, that being most agreeable to the sense of sight; but various tastes prevail, and art so much ministers to taste, that, in the houses of the wealthy, delightful patterns of work of pompeian elegance are soon introduced. as with the bricks, so with the mortar and the wood employed in building, they are rendered, as far as possible, free of moisture. sea sand containing salt, and wood that has been saturated with sea water, two common commodities in badly built houses, find no place in our modern city. the most radical changes in the houses of our city are in the chimneys, the roofs, the kitchens, and their adjoining offices. the chimneys, arranged after the manner proposed by mr. spencer wells, are all connected with central shafts, into which the smoke is drawn, and, after being passed through a gas furnace to destroy the free carbon, is discharged colourless into the open air. the city, therefore, at the expense of a small smoke rate, is free of raised chimneys and of the intolerable nuisance of smoke. the roofs of the houses are but slightly arched, and are indeed all but flat. they are covered either with asphalte, which experience, out of our supposed city, has proved to last long and to be easily repaired, or with flat tile. the roofs, barricaded round with iron palisades, tastefully painted, make excellent outdoor grounds for every house. in some instances flowers are cultivated on them. the housewife must not be shocked when she hears that the kitchens of our model city, and all the kitchen offices, are immediately beneath these garden roofs; are, in fact, in the upper floor of the house instead of the lower. in every point of view, sanitary and economical, this arrangement succeeds admirably. the kitchen is lighted to perfection, so that all uncleanliness is at once detected. the smell which arises from cooking is never disseminated through the rooms of the house. in conveying the cooked food from the kitchen, in houses where there is no lift, the heavy weighted dishes have to be conveyed down, the emptied and lighter dishes upstairs. the hot water from the kitchen boiler is distributed easily by conducting pipes into the lower rooms, so that in every room and bedroom hot and cold water can at all times be obtained for washing or cleaning purposes; and as on every floor there is a sink for receiving waste water, the carrying of heavy pails from floor to floor is not required. the scullery, which is by the side of the kitchen, is provided with a copper and all the appliances for laundry work; and when the laundry work is done at home the open place on the roof above makes an excellent drying ground. in the wall of the scullery is the upper opening to the dust-bin shaft. this shaft, open to the air from the roof, extends to the bin under the basement of the house. a sliding door in the wall opens into the shaft to receive the dust, and this plan is carried out on every floor. the coal-bin is off the scullery, and is ventilated into the air through a separate shaft, which also passes through the roof. on the landing in the second or middle stories of the three-storied houses there is a bathroom, supplied with hot and cold water from the kitchen above. the floor of the kitchen and of all the upper stories is slightly raised in the centre, and is of smooth, grey tile; the floor of the bath-room is the same. in the living-rooms, where the floors are of wood, a true oak margin of floor extends two feet around each room. over this no carpet is ever laid. it is kept bright and clean by the old-fashioned bees'-wax and turpentine, and the air is made fresh and is ozonised by the process. considering that a third part of the life of man is, or should be, spent in sleep, great care is taken with the bed-rooms, so that they shall be thoroughly lighted, roomy, and ventilated. twelve hundred cubic feet of space is allowed for each sleeper, and from the sleeping apartments all unnecessary articles of furniture and of dress are rigorously excluded. old clothes, old shoes, and other offensive articles of the same order, are never permitted to have residence there. in most instances the rooms on the first floor are made the bed-rooms, and the lower the living-rooms. in the larger houses bed-rooms are carried out in the upper floor for the use of the domestics. to facilitate communication between the kitchen and the entrance-hall, so that articles of food, fuel, and the like may be carried up, a shaft runs in the partition between two houses, and carries a basket lift in all houses that are above two stories high. every heavy thing to and from the kitchen is thus carried up and down from floor to floor and from the top to the basement, and much unnecessary labour is thereby saved. in the two-storied houses the lift is unnecessary. a flight of outer steps leads to the upper or kitchen floor. the warming and ventilation of the houses is carried out by a common and simple plan. the cheerfulness of the fireside is not sacrificed; there is still the open grate in every room, but at the back of the firestove there is an air-box or case which, distinct from the chimney, communicates by an opening with the outer air, and by another opening with the room. when the fire in the room heats the iron receptacle, fresh air is brought in from without, and is diffused into the room at the upper part on a plan similar to that devised by captain galton. as each house is complete within itself in all its arrangements, those disfigurements called back premises are not required. there is a wide space consequently between the back fronts of all houses, which space is, in every instance, turned into a garden square, kept in neat order, ornamented with flowers and trees, and furnished with playgrounds for children, young and old. the houses being built on arched subways, great convenience exists for conveying sewage from, and for conducting water and gas into, the different domiciles. all pipes are conveyed along the subways, and enter each house from beneath. thus the mains of the water pipe and the mains of the gas are within instant control on the first floor of the building, and a leakage from either can be immediately prevented. the officers who supply the commodities of gas and water have admission to the subways, and find it most easy and economical to keep all that is under their charge in perfect repair. the sewers of the houses run along the floors of the subways, and are built in brick. they empty into three cross main sewers. they are trapped for each house, and as the water supply is continuous, they are kept well flushed. in addition to the house flushings there are special openings into the sewers by which, at any time, under the direction of the sanitary officer, an independent flushing can be carried out. the sewers are ventilated into tall shafts from the mains by means of a pneumatic engine. the water-closets in the houses are situated on the middle and basement floors. the continuous water-supply flushes them without danger of charging the drinking water with gases emanating from the closet; a danger so imminent in the present method of cisterns, which supply drinking as well as flushing water. as we walk the streets of our model city, we notice an absence of places for the public sale of spirituous liquors. whether this be a voluntary purgation in goodly imitation of the national temperance league, the effect of sir wilfrid lawson's permissive bill and most permissive wit and wisdom, or the work of the good templars, we need not stay to inquire. we look at the fact only. to this city, as to the town of st. johnsbury, in vermont, which mr. hepworth dixon has so graphically described, we may apply the description mr. dixon has written: 'no bar, no dram shop, no saloon defiles the place. nor is there a single gaming hell or house of ill-repute.' through all the workshops into which we pass, in whatever labour the men or women may be occupied,--and the place is noted for its manufacturing industry,--at whatever degree of heat or cold, strong drink is unknown. practically, we are in a total abstainers' town, and a man seen intoxicated would be so avoided by the whole community, he would have no peace to remain. and, as smoking and drinking go largely together, as the two practices were, indeed, original exchanges of social degradations between the civilised man and the savage, the savage getting very much the worst of the bargain, so the practices largely disappear together. pipe and glass, cigar and sherry-cobbler, like the siamese twins, who could only live connected, have both died out in our model city. tobacco, by far the most innocent partner of the firm, lived, as it perhaps deserved to do, a little the longest; but it passed away, and the tobacconist's counter, like the dram counter, has disappeared. the streets of our city, though sufficiently filled with busy people, are comparatively silent. the subways relieve the heavy traffic, and the factories are all at short distances from the town, except those in which the work that is carried on is silent and free from nuisance. this brings me to speak of some of the public buildings which have relation to our present studies. it has been found in our towns, generally, that men and women who are engaged in industrial callings, such as tailoring, shoe-making, dressmaking, lace-work and the like, work at their own homes amongst their children. that this is a common cause of disease is well understood. i have myself seen the half-made riding-habit that was ultimately to clothe some wealthy damsel rejoicing in her morning ride act as the coverlet of a poor tailor's child stricken with malignant scarlet fever. these things must be, in the ordinary course of events under our present bad sanitary system. in the model city we have in our mind's eye, these dangers are met by the simple provision of workmen's offices or workrooms. in convenient parts of the town there are blocks of buildings, designed mainly after the manner of the houses, in which each workman can have a work-room on payment of a moderate sum per week. here he may work as many hours as he pleases, but he may not transform the room into a home. each block is under the charge of a superintendent, and also under the observation of the sanitary authorities. the family is thus separated from the work, and the working man is secured the same advantages as the lawyer, the merchant, the banker now possesses: or to make the parallel more correct, he has the same advantage as the man or woman who works in a factory, and goes home to eat and to sleep. in most towns throughout the kingdom the laundry system is dangerous in the extreme. for anything the healthy householder knows, the clothes he and his children wear have been mixed before, during, and after the process of washing, with the clothes that have come from the bed or the body of some sufferer from a contagious malady. some of the most fatal outbreaks of disease i have met with have been communicated in this manner. in our model community this danger is entirely avoided by the establishment of public laundries, under municipal direction. no person is obliged to send any article of clothing to be washed at the public laundry; but if he does not send there he must have the washing done at home. private laundries that do not come under the inspection of the sanitary officer are absolutely forbidden. it is incumbent on all who send clothes to the public laundry from an infected house to state the fact. the clothes thus received are passed for special cleansing into the disinfecting rooms. they are specially washed, dried and prepared for future wear. the laundries are placed in convenient positions, a little outside the town; they have extensive drying grounds, and, practically, they are worked so economically, that homewashing days, those invaders of domestic comfort and health, are abolished. passing along the main streets of the city we see in twenty places, equally distant, a separate building surrounded by its own grounds,--a model hospital for the sick. to make these institutions the best of their kind, no expense is spared. several elements contribute to their success. they are small, and are readily removable. the old idea of warehousing diseases on the largest possible scale, and of making it the boast of an institution that it contains so many hundred beds, is abandoned here. the old idea of building an institution so that it shall stand for centuries, like a norman castle, but, unlike the castle, still retain its original character as a shelter for the afflicted, is abandoned here. the still more absurd idea of building hospitals for the treatment of special organs of the body, as if the different organs could walk out of the body and present themselves for treatment, is also abandoned. it will repay us a minute of time to look at one of these model hospitals. one is the _fac simile_ of the other, and is devoted to the service of every five thousand of the population. like every building in the place, it is erected on a subway. there is a wide central entrance, to which there is no ascent, and into which a carriage, cab, or ambulance can drive direct. on each side the gateway are the houses of the resident medical officer and of the matron. passing down the centre, which is lofty and covered in with glass, we arrive at two sidewings running right and left from the centre, and forming cross-corridors. these are the wards: twelve on one hand for male, twelve on the other for female patients. the cross-corridors are twelve feet wide and twenty feet high, and are roofed with glass; the corridor on each side is a framework of walls of glazed brick, arched over head, and divided into six segments. in each segment is a separate, light, elegant removable ward, constructed of glass and iron, twelve feet high, fourteen feet long, and ten feet wide. the cubic capacity of each ward is , feet. every patient who is ill enough to require constant attendance has one of these wards entirely to himself, so that the injurious influences on the sick, which are created by mixing up, in one large room, the living and the dying; those who could sleep, were they at rest, with those who cannot sleep, because they are racked with pain; those who are too nervous or sensitive to move, or cough, or speak, lest they should disturb others; and those who do whatever pleases them:--these bad influences are absent. the wards are fitted up neatly and elegantly. at one end they open into the corridor, at the other towards a verandah which leads to a garden. in bright weather those sick persons, who are even confined to bed, can, under the direction of the doctor, be wheeled in their beds out into the gardens without leaving the level floor. the wards are warmed by a current of air made to circulate through them by the action of a steam-engine, with which every hospital is supplied, and which performs such a number of useful purposes, that the wonder is, how hospital management could go on without the engine. if at any time a ward becomes infectious, it is removed from its position and is replaced by a new ward. it is then taken to pieces, disinfected, and laid by ready to replace another that may require temporary ejection. the hospital is supplied on each side with ordinary baths, hot-air baths, vapour baths, and saline baths. a day sitting-room is attached to each wing, and every reasonable method is taken for engaging the minds of the sick in agreeable and harmless pastimes. two trained nurses attend to each corridor, and connected with the hospital is a school for nurses, under the direction of the medical superintendent and the matron. from this school, nurses are provided for the town; they are not merely efficient for any duty in the vocation in which they are always engaged, either within the hospital or out of it, but from the care with which they attend to their own personal cleanliness, and the plan they pursue of changing every garment on leaving an infectious case, they fail to be the bearers of any communicable disease. to one hospital four medical officers are appointed, each of whom, therefore, has six resident patients under his care. the officers are called simply medical officers, the distinction, now altogether obsolete, between physicians and surgeons being discarded. the hospital is brought, by an electrical wire, into communication with all the fire-stations, factories, mills, theatres, and other important public places. it has an ambulance always ready to be sent out to bring any injured persons to the institution. the ambulance drives straight into the hospital, where a bed of the same height on silent wheels, so that it can be moved without vibration into a ward, receives the patient. the kitchens, laundries, and laboratories are in a separate block at the back of the institution, but are connected with it by the central corridor. the kitchen and laundries are at the top of this building, the laboratories below. the disinfecting-room is close to the engine-room, and superheated steam, which the engine supplies, is used for disinfection. the out-patient department, which is apart from the body of the hospital, resembles that of the queen's hospital, birmingham,--the first out-patient department, as far as i am aware, that ever deserved to be seen by a generous public. the patients waiting for advice are seated in a large hall, warmed at all seasons to a proper heat, lighted from the top through a glass roof, and perfectly ventilated. the infectious cases are separated carefully from the rest. the consulting rooms of the medical staff are comfortably fitted, the dispensary is thoroughly officered, and the order that prevails is so effective that a sick person, who is punctual to time, has never to wait. the medical officers attached to the hospital in our model city are allowed to hold but one appointment at the same time, and that for a limited period. thus every medical man in the city obtains the equal advantage of hospital practice, and the value of the best medical and surgical skill is fairly equalised through the whole community. in addition to the hospital building is a separate block, furnished with wards, constructed in the same way as the general wards, for the reception of children suffering from any of the infectious diseases. these wards are so planned that the people, generally, send sick members of their own family into them for treatment, and pay for the privilege. supplementary to the hospital are certain other institutions of a kindred character. to check the terrible course of infantile mortality of other large cities,--the in the , of mortality under five years of age, homes for little children are abundant. in these the destitute young are carefully tended by intelligent nurses; so that mothers, while following their daily callings, are enabled to leave their children under efficient care. in a city from which that grand source of wild mirth, hopeless sorrow and confirmed madness, alcohol, has been expelled, it could hardly be expected that much insanity would be found. the few who are insane are placed in houses licensed as asylums, but not different in appearance to other houses in the city. here the insane live, in small communities, under proper medical supervision, with their own gardens and pastimes. the houses of the helpless and aged are, like the asylums, the same as the houses of the rest of the town. no large building of pretentious style uprears itself for the poor; no men badged and badgered as paupers walk the place. those poor who are really, from physical causes, unable to work, are maintained in a manner showing that they possess yet the dignity of human kind; and that, being worth preservation, they are therefore worthy of respectful tenderness. the rest, those who can work, are employed in useful labours, which pay for their board. if they cannot find work, and are deserving, they may lodge in the house and earn their subsistence; or they may live from the house and receive pay for work done. if they will not work, they, as vagrants, find a home in prison, where they are compelled to share the common lot of mankind. our model city is of course well furnished with baths, swimming baths, turkish baths, playgrounds, gymnasia, libraries, board schools, fine-art schools, lecture halls, and places of instructive amusement. in every board-school drill forms part of the programme. i need not dwell on these subjects, but must pass to the sanitary officers and offices. there is in the city one principal sanitary officer, a duly qualified medical man elected by the municipal council, whose sole duty it is to watch over the sanitary welfare of the place. under him, as sanitary officers, are all the medical men who form the poor law medical staff. to him these make their reports on vaccination and every matter of health pertaining to their respective districts; to him every registrar of births and deaths forwards copies of his registration returns; and to his office are sent, by the medical men generally, registered returns of the cases of sickness prevailing in the district. his inspectors likewise make careful returns of all the known prevailing diseases of the lower animals and of plants. to his office are forwarded, for examination and analysis, specimens of foods and drinks suspected to be adulterated, impure, or otherwise unfitted for use. for the conduction of these researches the sanitary superintendent is allowed a competent chemical staff. thus, under this central supervision, every death, every disease of the living world in the district, and every assumable cause of disease, comes to light and is subjected, if need be, to inquiry. at a distance from the town are the sanitary works, the sewage pumping works, the water and gas works, the slaughter-houses and the public laboratories. the sewage, which is brought from the town partly by its own flow and partly by pumping apparatus, is conveyed away to well-drained sewage farms belonging to, but at a distance from, the city where it is utilised. the water supply, derived from a river which flows to the south-west of the city, is unpolluted by sewage or other refuse, is carefully filtered, is tested twice daily, and if found unsatisfactory is supplied through a reserve tank, after it has been made to undergo further purification. it is carried through the city everywhere by iron pipes. leaden pipes are forbidden. in the sanitary establishment are disinfecting rooms, a mortuary, and ambulances for the conveyance of persons suffering from contagious disease. these are at all times open to the use of the public, subject to the few and simple rules of the management. the gas, like the water, is submitted to regular analysis by the staff of the sanitary officer, and any fault which may be detected, and which indicates a departure from the standard of purity framed by the municipal council, is immediately remedied, both gas and water being exclusively under the control of the local authority. the inspectors of the sanitary officer have under them a body of scavengers. these, each day, in the early morning, pass through the various districts allotted to them, and remove all refuse in closed vans. every portion of manure from stables, streets, and yards is in this way removed daily, and transported to the city farms for utilisation. two additional conveniences are supplied by the scientific work of the sanitary establishment. from steam-works steam is condensed, and a large supply of distilled water is obtained and preserved in a separate tank. this distilled water is conveyed by a small main into the city, and is supplied at a moderate cost for those domestic purposes for which hard water is objectionable. the second sanitary convenience is a large ozone generator. by this apparatus ozone is produced in any required quantity, and is made to play many useful purposes. it is passed through the drinking water in the reserve reservoir whenever the water shows excess of organic impurity, and it is conveyed into the city for diffusion into private houses, for purposes of disinfection. the slaughter-houses of the city are all public, and are separated by a distance of a quarter of a mile from the city. they are easily removable edifices, and are under the supervision of the sanitary staff. the jewish system of inspecting every carcase that is killed is rigorously carried out, with this improvement, that the inspector is a man of scientific knowledge. all animals used for food,--cattle, fowls, swine, rabbits,--are subjected to examination in the slaughter-house, or in the market, if they be brought into the city from other depôts. the slaughter-houses are so constructed that the animals killed are relieved from the pain of death. they pass through a narcotic chamber, and are brought to the slaughterer oblivious of their fate. the slaughter-houses drain into the sewers of the city, and their complete purification daily, from all offal and refuse, is rigidly enforced. the buildings, sheds, and styes for domestic food-producing animals are removed a short distance from the city, and are also under the supervision of the sanitary officer; the food and water supplied for these animals comes equally, with human food, under proper inspection. one other subject only remains to be noticed in connection with the arrangements of our model city, and that is the mode of the disposal of the dead. the question of cremation and of burial in the earth has been considered, and there are some who advocate cremation. for various reasons the process of burial is still retained. firstly, because the cremation process is open to serious medico-legal objections; secondly, because, by the complete resolution of the body into its elementary and inodorous gases in the cremation furnace, that intervening chemical link between the organic and inorganic worlds, the ammonia, is destroyed, and the economy of nature is thereby dangerously disturbed; thirdly, because the natural tendencies of the people lead them still to the earth, as the most fitting resting-place into which, when lifeless, they should be drawn. thus the cemetery holds its place in our city, but in a form much modified from the ordinary cemetery. the burial ground is artificially made of a fine carboniferous earth. vegetation of rapid growth is cultivated over it. the dead are placed in the earth from the bier, either in basket work or simply in the shroud; and the monumental slab, instead of being set over or at the head or foot of a raised grave, is placed in a spacious covered hall or temple, and records simply the fact that the person commemorated was recommitted to earth in those grounds. in a few months, indeed, no monument would indicate the remains of any dead. in that rapidly-resolving soil the transformation of dust into dust is too perfect to leave a trace of residuum. the natural circle of transmutation is harmlessly completed, and the economy of nature conserved. results. omitting, necessarily, many minor but yet important details, i close the description of the imaginary health city. i have yet to indicate what are the results that might be fairly predicted in respect to the disease and mortality presented under the conditions specified. two kinds of observation guide me in this essay: one derived from statistical and sanitary work; the other from experience, extended now over thirty years, of disease, its phenomena, its origins, its causes, its terminations. i infer, then, that in our model city certain forms of disease would find no possible home, or, at the worst, a home so transient as not to affect the mortality in any serious degree. the infantile diseases, infantile and remittent fevers, convulsions, diarrhoea, croup, marasmus, dysentery, would, i calculate, be almost unknown. typhus and typhoid fevers and cholera could not, i believe, exist in the city except temporarily, and by pure accident; small-pox would be kept under entire control; puerperal fever and hospital fever would, probably, cease altogether; rheumatic fever, induced by residence in damp houses, and the heart disease subsequent upon it, would be removed. death from privation and from purpura and scurvy would certainly cease. delirium tremens, liver disease, alcoholic phthisis, alcoholic degeneration of kidney and all the varied forms of paralysis, insanity, and other affections due to alcohol, would be completely effaced. the parasitic diseases arising from the introduction into the body, through food, of the larvae of the entozoa, would cease. that large class of deaths from pulmonary consumption, induced in less favoured cities by exposure to impure air and badly ventilated rooms, would, i believe, be reduced so as to bring down the mortality of this signally fatal malady one third at least. some diseases, pre-eminently those which arise from uncontrollable causes, from sudden fluctuations of temperature, electrical storms, and similar great variations of nature, would remain as active as ever; and pneumonia, bronchitis, congestion of the lungs, and summer cholera, would still hold their sway. cancer, also, and allied constitutional diseases of strong hereditary character, would yet, as far as i can see, prevail. i fear, moreover, it must be admitted that two or three of the epidemic diseases, notably scarlet fever, measles, and whooping cough, would assert themselves, and, though limited in their diffusion by the sanitary provisions for arresting their progress, would claim a considerable number of victims. with these last facts clearly in view, i must be careful not to claim for my model city more than it deserves; but calculating the mortality which would be saved, and comparing the result with the mortality which now prevails in the most favoured of our large english towns, i conclude that an average mortality of eight per thousand would be the maximum in the first generation living under this salutary _régime_. that in a succeeding generation mr. chadwick's estimate of a possible mortality of five per thousand would be realised, i have no reasonable doubt, since the almost unrecognised, though potent, influence of heredity in disease would immediately lessen in intensity, and the healthier parents would bring forth the healthier offspring. as my voice ceases to dwell on this theme of a yet unknown city of health, do not, i pray you, wake as from a mere dream. the details of the city exist. they have been worked out by those pioneers of sanitary science, so many of whom surround me to-day, and specially by him whose hopeful thought has suggested my design. i am, therefore, but as a draughtsman, who, knowing somewhat your desires and aspirations, have drawn a plan, which you in your wisdom can modify, improve, perfect. in this i know we are of one mind, that though the ideal we all of us hold be never reached during our lives, we shall continue to work successfully for its realisation. utopia itself is but another word for time; and some day the masses, who now heed us not, or smile incredulously at our proceedings, will awake to our conceptions. then our knowledge, like light rapidly conveyed from one torch to another, will bury us in its brightness. _by swift degrees the love of nature works and warms the bosom: till at last, sublimed to rapture and enthusiastic heat, we feel the present deity, and taste the joy of god to see a happy world!_ note: project gutenberg also has an html version of this file which includes the original illustrations. see -h.htm or -h.zip: (http://www.gutenberg.net/dirs/ / / / / / -h/ -h.htm) or (http://www.gutenberg.net/dirs/ / / / / / -h.zip) the woods hutchinson health series a handbook of health by woods hutchinson, a. m., m. d. sometime professor of anatomy, university of iowa; professor of comparative pathology and methods of science teaching, university of buffalo; lecturer, london medical graduates' college and university of london; and state health officer of oregon. author of "preventable diseases," "conquest of consumption," "instinct and health," etc. houghton mifflin company boston new york chicago copyright, , by woods hutchinson all rights reserved tenth impression preface looking upon the human body from the physical point of view as the most perfect, most ingeniously economical, and most beautiful of living machines, the author has attempted to write a little handbook of practical instruction for the running of it. and seeing that, like other machines, it derives the whole of its energy from its fuel, the subject of foods--their properties, uses, and methods of preparation--has been gone into with unusual care. an adequate supply of clean-burning food-fuel for the human engine is so absolutely fundamental both for health and for efficiency--we are so literally what we have eaten--that to be well fed is in very fact two-thirds of the battle of life from a physiological point of view. the whole discussion is in accord with the aim, kept in view throughout the book, of making its suggestion and advice positive instead of negative, pointing out that, in the language of the old swordsman, "attack is the best defense." if we actively do those things that make for health and efficiency, and which, for the most part, are attractive and agreeable to our natural instincts and unspoiled tastes,--such as exercising in the open air, eating three square meals a day of real food, getting nine or ten hours of undisturbed sleep, taking plenty of fresh air and cold water both inside and out,--this will of itself carry us safely past all the forbidden side paths without the need of so much as a glance at the "don't" and "must not" with which it has been the custom to border and fence in the path of right living. on the other hand, while fully alive to the undesirability, and indeed wickedness, of putting ideas of dread and suffering into children's minds unnecessarily, yet so much of the misery in the world is due to ignorance, and could have been avoided if knowledge of the simplest character had been given at the proper time, that it has been thought best to set forth the facts as to the causation and nature of the commonest diseases, and the methods by which they may be avoided. this is peculiarly necessary from the fact that most of the gravest enemies of mankind have come into existence within a comparatively recent period of the history of life,--only since the beginning of civilization, in fact,--so that we have as yet developed no natural instincts for their avoidance. nor do we admit that we are adding anything to the stock of fears in the minds of children--the nurse-maid and the bad boys in the next alley have been ahead of us in this respect. the child-mind is too often already filled with fears and superstitions of every sort, passed down from antiquity. modern sanitarians have been accused of merely substituting one fear for another in the mind of the child--bacilli instead of bogies. but, even if this be true, there are profound and practical differences between the two terrors. one is real, and the other imaginary. a child cannot avoid meeting a bacillus; he will never actually make the acquaintance of a bogie. children, like savages and ignorant adults, believe and invent and retail among themselves the most extraordinary and grotesque theories about the structure and functions of their bodies, the nature and causation of their illnesses and aches and pains. a plain and straightforward statement of the actual facts about these things not only will not shock or repel them, or make them old before their time, but, on the contrary, will interest them greatly, relieve their minds of many unfounded dreads, and save them from the commonest and most hurtful mistakes of humanity--those that are committed through ignorance. the author. contents page i. running the human automobile ii. why we have a stomach what keeps us alive the digestive system the journey down the food tube iii. the food-fuel of the body-engine what kind of food should we eat? the three great classes of food-fuel iv. the coal foods proteins, or "meats" v. the coal foods (_continued_) starches sugars vi. the coal foods (_continued_) animal fats nuts vii. kindling and paper foods--fruits and vegetables viii. cooking ix. our drink filling the boiler of the body-engine where our drinking water comes from causes and dangers of polluted water methods of obtaining pure water home methods of purifying water x. beverages, alcohol, and tobacco alcohol tobacco xi. the heart-pump and its pipe-line system the blood vessels the heart xii. the care of the heart-pump and its pipe lines xiii. how and why we breathe xiv. how to keep the lung-bellows in good condition the need of pure air colds, consumption, and pneumonia how to conquer consumption pneumonia xv. the skin our wonderful coat the glands in the skin the nails the blood-mesh of the skin the nerves in the skin xvi. how to keep the skin healthy clothing baths and bathing care of the nails diseases and disturbances of the skin xvii. the plumbing and sewering of the body xviii. the muscles xix. the stiffening rods of the body-machine xx. our telephone exchange and its cables xxi. the hygiene of bones, nerves, and muscles how to get and keep a good figure our feet sleep and rest disorders of muscles and bones troubles of the nervous system xxii. exercise and growth xxiii. the lookout department the nose the tongue the eye the ear our spirit-levels xxiv. the speech organs xxv. the teeth, the ivory keepers of the gate xxvi. infections, and how to avoid them xxvii. accidents and emergencies questions and exercises glossary and index illustrations page to attempt to run an automobile without knowing how would be regarded as foolhardy where sun-power is made into food for us the food route in the digestive system the salivary glands a section of the lining surface of the stomach a longitudinal section of stomach, or peptic, glands a cheap home-made ice box a baby-milk station clean, dry sunning yards at a model dairy cleanliness before milking the milking hour at a model dairy milking by vacuum process washing the bottles at a model dairy bacteria in clean and in dirty milk danger from dipped milk milk inspection at the retail store a thorough baking, and a valuable crust an ideal bakery with light, air, and cleanliness a basement bakery--a menace to the public health candy, like other foods, should be clean a small store, cleanly and honest the joy of his own garden patch the kitchen should be cared for as one of the most important rooms in the house a knowledge of cooking is a valuable part of a good education boys, as well as girls, should know how to cook the chained cup the spouting fountain nature's filter-bed an example of good farm drainage the danger spot on the farm typhoid epidemic in the mohawk-hudson valley artesian well borings a city water supply brought from the far hills a reservoir and costly dam scraping the sediment from the bottom of a reservoir the domestic filter in use a milk station in a city park proportion of alcohol in light wine, in beer, in whiskey a board of health examination for working papers a test of clear head and steady nerves blood corpuscles surface veins and deep-lying arteries of inner side of right arm and hand diagram of artery, capillaries, and vein the exterior of the heart diagram of valves in the veins and heart the blood-route trought the heart the school physician examining heart and lungs rowing is a splendid exercise for heart and lungs the great essential to life--air diagram of the air tubes and lungs "improving their wind" the "dark room" danger of the tenements ventilating the pupils, as well as the classroom a well-aired classroom a healthful arrangement of windows and shades a healthful bedroom disease germs a vacuum cleaner exercise in the cold is a good preventive of colds a year of consumption on manhattan island consumption in chicago a report-form from a health department laboratory a sign that ought not to be necessary a comparative death-rate from contagious diseases a tuberculosis tent colony in winter an outdoor classroom for tuberculous children the layers of the skin the glands in the skin results of tight clothing a comfortable dress for outdoor study in cold weather as a tonic, swimming is the best form of bathing the urinary system the muscle-sheet use of muscles in bowling use of muscles in football patella and muscle the human skeleton the spinal column a ball-and-socket joint a hinge joint lengthwise section of bone cross section of bone the nervous system the position of the body is an index to its health imprint of ( ) arched foot and ( ) flat foot the result of wearing a fashionable shoe callus formed around a fracture a trained body tug of war the giant stride school gardening a wasted chance for public health an obstacle race the high jump adenoids mouth-breathers the apparatus of vision a school eye-test disinfecting a baby's eyes at birth the apparatus of hearing the vocal cords teeth--a question of care a tooth the replacing of the milk teeth a tooth-brush drill the winning fight death-rate from measles death-rate from diphtheria and croup bill of health germs of malaria culex anopheles oiling a breeding ground of mosquitoes an educational fly poster a breeding place of flies and filth a tourniquet poison ivy the new method of artificial breathing plates in color diagram of the circulatory system _facing_ diagram showing general plan and position of body-machinery _facing_ a handbook of health chapter i running the human automobile the body-automobile. if you were to start to-morrow morning on a long-distance ride in an automobile, the first thing that you would do would be to find out just how that automobile was built; how often it must have fresh gasoline; how its different speed gears were worked; what its tires were made of; how to mend them; and how to cure engine troubles. to attempt to run an automobile, for even a ten-mile ride, with less information than this, would be regarded as foolhardy. yet most of us are willing to set out upon the journey of life in the most complicated, most ingenious, and most delicate machine ever made--our body--with no more knowledge of its structure than can be gained from gazing in the looking-glass; or of its needs, than a preference for filling up its fuel tank three times a day. more knowledge than this is often regarded as both unnecessary and unpleasant. yet there are few things more important, more vital to our health, our happiness, and our success in life, than to know how to steer and how to road-repair our body-automobile. this we can learn only from physiology and hygiene. the general plan of the human automobile is simple. complicated as our body-automobile looks to be, there are certain things about the plan and general build of it which are plain enough. it has a head end, where fuel supplies are taken in and where its lamps and other look-out apparatus are carried; a body in which the fuel is stored and turned into work or speed, and into which air is drawn to help combustion and to cool the engine pipes. it has a pair of fore-wheels (the arms) and a pair of hind-wheels (the legs), though these have been reduced to only one spoke each, and swing only about a quarter of the way around and back again when running, instead of round and round. it has a steering gear (the brain), just back of the headlights, and a system of nerve electric wires connecting all parts of it. it gets warm when it runs, and stops if it is not fed. [illustration: to attempt to run an automobile without knowing how would be regarded as foolhardy] there is not an unnecessary part, or unreasonable "cog," anywhere in the whole of our bodies. it is true that there are a few little remnants which are not quite so useful as they once were, and which sometimes cause trouble. but for the most part, all we have to do is to look long and carefully enough at any organ or part of our bodies, to be able to puzzle out just what it is or was intended to do, and why it has the shape and size it has. why the study of physiology is easy. there is one thing that helps to make the study of physiology quite easy. it is that you already know a good deal about your body, because you have had to live with it for a number of years past, and you can hardly have helped becoming somewhat acquainted with it during this time. you have, also, another advantage, which will help you in this study. while your ideas of how to take care of your body are rather vague, and some of them wrong, most of them are in the main right, or at least lead you in the right direction. you all know enough to eat when you are hungry and to drink when you are thirsty, even though you don't always know when to stop, or just what to eat. you like sunny days better than cloudy ones, and would much rather breathe fresh air than foul. you like to go wading and swimming when you are hot and dusty, and you don't need to be told to go to sleep when you are tired. you would much rather have sugar than vinegar, sweet milk than sour milk; and you dislike to eat or drink anything that looks dirty or foul, or smells bad. these inborn likes and dislikes--which we call _instincts_--are the forces which have built up this wonderful body-machine of ours in the past and, if properly understood and trained, can be largely trusted to run it in the future. how to follow these instincts intelligently, where to check them, where to encourage them, how to keep the proper balance between them, how to live long and be useful and happy--this is what the interesting study of physiology and hygiene will teach you. chapter ii why we have a stomach what keeps us alive the energy in food and fuel. the first question that arises in our mind on looking at an engine or machine of any sort is, what makes it go? if we can succeed in getting an answer to the question, what makes the human automobile go? we shall have the key to half its secrets at once. it is fuel, of course; but what kind of fuel? how does the body take it in, how does it burn it, and how does it use the energy or power stored up in it to run the body-engine? man is a bread-and-butter-motor. the fuel of the automobile is gasoline, and the fuel of the man-motor we call food. the two kinds of fuel do not taste or smell much alike; but they are alike in that they both have what we call _energy_, or power, stored up in them, and will, when set fire to, burn, or explode, and give off this power in the shape of heat, or explosions, which will do work. food and fuel are the result of life. fuels and foods are also alike in another respect; and that is, that, no matter how much they may differ in appearance and form, they are practically _all the result of life_. this is clear enough as regards our foods, which are usually the seeds, fruits, and leaves of plants, and the flesh of animals. it is also true of the cord-wood and logs that we burn in our stoves and fireplaces. but what of coal and gasoline? they are minerals, and they come, as we know, out of the depths of the earth. yet they too are the product of life; for the layers of coal, which lie sixty, eighty, one hundred and fifty feet below the surface of the earth, are the fossilized remains of great forests and jungles, which were buried millions of years ago, and whose leaves and branches and trunks have been pressed and baked into coal. gasoline comes from coal oil, or petroleum, and is simply the "juice" which was squeezed out of these layers of trees and ferns while they were being crushed and pressed into coal. how the sun is turned into energy by plants and animals. where did the flowers and fruits and leaves that we now see, and the trees and ferns that grew millions of years ago, get this power, part of which made them grow and part of which was stored away in their leaves and branches and seeds? from the one place that is the source of all the force and energy and power in this world, the sun. that is why plants will, as you know, flourish and grow strong and green only in the sunlight, and why they wilt and turn pale in the dark. when the plant grows, it is simply sucking up through the green stuff (_chlorophyll_) in its leaves the heat and light of the sun and turning it to its own uses. then this sunlight, which has been absorbed by plants and built up into their leaves, branches, and fruits, and stored away in them as energy or power, is eaten by animals; and they in turn use it to grow and move about with. plants can use this sun-power only to grow with and to carry out a few very limited movements, such as turning to face the sun, reaching over toward the light, and so on. but animals, taking this power at second-hand from plants by eating their leaves or fruits, can use it not merely to grow with, but also to run, to fight, to climb, to cry out, and to carry out all those movements and processes which we call life. plants, on the other hand, are quite independent of animals; for they can take up, or drink, this sun-power directly, with the addition of water from the soil sucked up through their roots, and certain salts[ ] melted in it. plants can live, as we say, upon non-living foods. but animals must take their supply of sun-power at second-hand by eating the leaves and the fruits and the seeds of plants; or at third-hand by eating other animals. [illustration: where sun-power is made into food for us] all living things, including ourselves, are simply bundles of sunlight, done up in the form of cabbages, cows, and kings; and so it is quite right to say that a healthy, happy child has a "sunny" disposition. plants and animals differ in their way of taking food. as plants take in their sun-food and their air directly through their leaves, and their drink of salty water through their roots, they need no special opening for the purpose of eating and drinking, like a mouth; or place for storing food, like a stomach. they have mouths and stomachs all over them, in the form of tiny pores on their leaves, and hair-like tubes sticking out from their roots. they can eat with every inch of their growing surface. but animals, that have to take their sun-food or nourishment at second-hand, in the form of solid pieces of seeds, fruits, or leaves of plants, and must take their drink in gulps, instead of soaking it up all over their surface, must have some sort of intake opening, or mouth, somewhere on the surface; and some sort of pouch, or stomach, inside the body, in which their food can be stored and digested, or melted down. by this means they also get rid of the necessity of staying rooted in one place, to suck up moisture and food from the soil. one of the chief and most striking differences between plants and animals is that animals have mouths and stomachs, while plants have not. the digestive system how the food reaches the stomach. our body, then, has an opening, which we call the _mouth_, through which our food-fuel can be taken in. a straight delivery tube, called the _gullet_, or _esophagus_, runs down from the mouth to a bag, or pouch, called the _stomach_, in which the food is stored until it can be used to give energy to the body, just as the gasoline is stored in the automobile tank until it can be burned. the mouth opening is furnished with _lips_ to open and close it and assist in picking up our food and in sucking up our drink; and, as much of our food is in solid form, and as the stomach can take care only of fluid and pulpy materials, nature has provided a mill in the mouth in the form of two arches, of semicircles, of _teeth_, which grind against each other and crush the food into a pulp. [illustration: the food route in the digestive system in this diagram the entire alimentary canal is shown enlarged, and the small intestine greatly shortened, in order to show distinctly the course of the food in the process of digestion.] in the bottom or floor of the mouth, there has grown up a movable bundle of muscles, called the _tongue_, which acts as a sort of waiter, handing the food about the mouth, pushing it between the teeth, licking it out of the pouches of the cheeks to bring it back into the teeth-mill again, and finally, after it has been reduced to a pulp, gathering it up into a little ball, or _bolus_, and shooting it back down the throat, through the gullet, into the stomach. the intestines. when the food has been sufficiently melted and partially digested in the stomach, it is pushed on into a long tube called the _intestine_, or _bowel_. during its passage through this part of the food tube, it is taken up into the veins, and carried to the heart. from here it is pumped all over the body to feed and nourish the millions of little cells of which the body is built. this bowel tube, or intestine, which, on account of its length, is arranged in coils, finally delivers the undigested remains of the food into a somewhat larger tube called the _large intestine_, in the lower and back part of the body, where its remaining moisture is sucked out of it, and its solid waste material passed out of the body through the _rectum_ in the form of the _feces_. the journey down the food tube the flow of saliva and "appetite juice." we are now ready to start some food-fuel, say a piece of bread, on its journey down our food tube, or _alimentary canal_. one would naturally suppose that the process of digestion would not begin until the food got well between our teeth; but, as a matter of fact, it begins before it enters our lips, or even before it leaves the table. if bread be toasted or freshly baked, the mere smell of it will start our mouths to watering; nay, even the mere sight of food, as in a pastry cook's window, with the glass between us and it, will start up this preparation for the feast. this flow of saliva in the mouth is of great assistance in moistening the bread while we are chewing it; but it goes farther than this. some of the saliva is swallowed before we begin to eat; and this goes down into the stomach and brings word to the juices there to be ready, for something is coming. as the food approaches the mouth, a message also is telegraphed down the nerves to the stomach, which at once actively sets to work pouring out a digestive juice in readiness, called the "appetite juice." this shows how important are, not merely a good appetite, but also attractive appearance and flavor in our food; for if this appetite juice is not secreted, the food may lie in the stomach for hours before the proper process of digestion, or melting, begins. the salivary glands. now, where does this saliva in the mouth come from? it is poured out from the pouches of the cheeks, and from under the tongue, by some little living sponges, or juice factories, known as _salivary glands_.[ ] [illustration: the salivary glands in this diagram are shown the three glands (_g_) of the left side. the duct (_d_) from the parotid gland empties through the lining of the cheek; those from the lower glands empty at the front of the mouth under the tongue (_t_). _n_, nerve; _a_, artery; _v_, vein.] all the juices poured out by these glands, indeed nearly all the fluids or juices in our bodies, are either _acid_ or _alkaline_. by acid we mean sour, or sharp, like vinegar, lemon juice, vitriol (_sulphuric acid_), and _carbonic acid_ (which forms the bubbles in and gives the sharp taste to plain soda-water). by alkaline we mean "soap-like" or flat, like soda, lye, lime, and soaps of all sorts. if you pour an acid and an alkali together--like vinegar and soda--they will "fizz" or effervesce, and at the same time _neutralize_ or "kill" each other. the use of the saliva. as the chief purpose of digestion is to prepare the food so that it will dissolve in water, and then be taken up by the cells lining the food-tube, the saliva, like the rest of the body juices, consists chiefly of water. nothing is more disagreeable than to try to chew some dry food--like a large, crisp soda cracker, for instance--which takes more moisture than the salivary glands are able to pour out on such short notice. you soon begin to feel as if you would choke unless you could get a drink of water. but it is not altogether advisable to take this short cut to relief, because the salivary juice contains what the drink of water does not--a _ferment_, or digestive substance (_ptyalin_), which possesses the power of turning the _starch_ in our food into _sugar_. as starch is only very slowly soluble, or "meltable," in water, while sugar is very readily so, the saliva is of great assistance in the process of melting, known as _digestion_. the changing of the starch to sugar is the reason why bread or cracker, after it has been well chewed, begins to taste sweetish. this change in the mouth, however, is not of such great importance as we at one time thought, because even with careful mastication, a certain amount of starch will be swallowed unchanged. nature has provided for this by causing another gland farther down the canal, just beyond the stomach, called the _pancreas_, to pour into the food tube a juice which is far stronger in sugar-making power than the saliva, and this will readily deal with any starch which may have escaped this change in the mouth. moreover, this "sugaring" of starch goes on in the stomach for twenty to forty minutes after the food has been swallowed. starchy foods, like bread, biscuit, crackers, cake, and pastry, are really the only ones which require such thorough and elaborate chewing as we sometimes hear urged. other kinds of food, like meat and eggs--which contain no _starch_ and consequently are not acted upon by the saliva--need be chewed only sufficiently long and thoroughly to break them up and reduce them to a coarse pulp, so that they can be readily acted upon by the acid juice of the stomach. down the gullet. when the food has been thoroughly moistened and crushed in the mouth and rolled into a lump, or bolus, at the back of the tongue, it is started down the elevator shaft which we call the gullet, or esophagus. it does not fall of its own weight, like coal down a chute, but each separate swallow is carried down the whole nine inches of the gullet by a wave of muscular action. so powerful and closely applied is this muscular pressure that jugglers can train themselves, with practice, to swallow standing on their heads and even to drink a glass of water in that position; while a horse or a cow always drinks "up-hill." this driving power of the food tube extends throughout its entire length; it is carried out by a series of circular rings of muscles, which are bound together by other threads of muscle running lengthwise, together forming the so-called _muscular coat_ of the tube. by contracting, or squeezing down in rapid succession, one after another, they move the food along through the tube. the failure of these little muscles to act properly is one of the causes of constipation and biliousness. sometimes the action of the muscles is reversed, and then we get a gush of acid, or bitter, half-digested food up into the mouth, which we call "heart-burn" or "water-brash." the stomach--its shape, position, and size. by means of muscular contraction, then, the gullet-elevator carries the food into the stomach. this is a comparatively simple affair, merely a ballooning out, or swelling, of the food tube, like the bulb of a syringe, making a pouch, where the food can be stored between meals, and where it can undergo a certain kind of melting or dissolving. this pouch is about the shape of a pear, with its larger end upward and pointing to the left, and its smaller end tapering down into the intestine, or bowel, on the right, just under the liver. the middle part of the stomach lies almost directly under what we call the "pit of the stomach," though far the larger part of it lies above and to the left of this point, going right up under the ribs until it almost touches the heart, the diaphragm only coming between.[ ] this is one of the reasons why, when we have an attack of indigestion, and the stomach is distended with gas, we are quite likely to have palpitation and shortness of breath as well, because the gas-swollen left end of the stomach is pressing upward against the diaphragm and thus upon the heart and the lungs. most cases of imagined heart trouble are really due to indigestion. the lining surface of the stomach. now let us look more carefully at the lining surface of the stomach, for it is very wonderful. like all other living surfaces, it consists of tiny, living units, or "body bricks" called _cells_, packed closely side by side like bricks in a pavement. we speak of the _mucous membrane_, or lining, of our food tube, as if it were one continuous sheet, like a piece of calico or silk; but we must never forget that it is made up of living ranks of millions of tiny cells standing shoulder to shoulder. these cells are always actively at work picking out the substances they need, and manufacturing out of them the ferments and acids, or alkalies, needed for acting upon the food in their particular part of the tube, whether it be the mouth, the stomach, or the small intestine. [illustration: a section of the lining surface of the stomach (greatly magnified) showing the mouths of the stomach glands, and the furrows, or folds, of the lining.] the peptic juice. the cells of the stomach glands manufacture and pour out a slightly sour, or acid, juice containing a ferment called _pepsin_. the acid, which is known as _hydrochloric acid_, and the pepsin together are able to melt down pieces of meat, egg, or curds of milk, and dissolve them into a clear, jelly-like fluid, or thin soup, which can readily be absorbed by the cells lining the intestine.[ ] you can see now why you shouldn't take large doses of soda or other alkalies, just because you feel a little uncomfortable after eating. they will make your stomach less acid and perhaps relieve the discomfort, but they stop or slow down digestion. neither is it well to swallow large quantities of ice-water, or other very cold drinks, at meal times, or during the process of digestion. as digestion is largely getting the food dissolved in water, the drinking of moderate quantities of water, or other fluids, at meals is not only no hindrance, but rather a help in the process. the danger comes only when the drink is taken so cold as to check digestion, or when it is used to wash down the food in chunks, before it has been properly ground by the teeth. [illustration: a longitudinal section of stomach, or peptic, glands (greatly magnified) the long duct of each gland is but a deep fold of the stomach lining (see note, p. ). into this duct the ranks of cells around it pour out the peptic juice.] digestion in the stomach. although usually a single, pear-shaped pouch, the stomach, during digestion, is practically divided into two parts by the shortening, or closing down, of a ring of circular muscle fibres about four inches from the lower end, throwing it into a large, rounded pouch on the left, and a small, cone-shaped one on the right. the gullet, of course, opens into the large left-hand pouch; and here the food is stored as it is swallowed until it has become sufficiently melted and acidified (mixed with acid juice) to be ready to pass on into the smaller pouch. here more acid juice is poured out into it, and it is churned by the muscles in the walls of the stomach until it is changed to a jelly-like substance. digestion in the small intestine. the food-pulp now passes on into the _small intestine_, where it is acted upon by two other digestive juices--the _bile_, which comes from the _liver_, and the _pancreatic juice_, which is secreted by the pancreas. the liver and the pancreas are a pair of large glands which have budded out, one on each side of the food tube, about six inches below where the food enters the small intestine from the stomach. the liver[ ] weighs nearly three pounds, and the pancreas about a quarter of a pound. of these two glands, the pancreas, though the smaller, is far more important in digestion. in fact, it is the most powerful digestive gland in the body. its juice, the pancreatic juice, can do everything that any other digestive juice can, and do it better. it contains a ferment for turning starch into sugar, which is far more powerful than that of the saliva; also another (_trypsin_), which will dissolve meat-stuffs nearly twice as fast as the pepsin of the stomach can; and still another, not possessed by either mouth or stomach glands, which will melt fat, so that it can be sucked up by the lining cells of the intestine. what does this great combination of powers in the pancreas mean? it means that we have now reached the real centre and chief seat of digestion, namely, the small intestine, or upper bowel. this is where the food is really absorbed, taken up into the blood, and distributed to the body. all changes before this have been merely preparatory; all after it are simply a picking up of the pieces that remain. in general appearance, this division of the food tube is very simple--merely a tube about twenty feet long and an inch in diameter, thrown into coils, so as to pack into small space, and slung up to the backbone by broad loops of a delicate tissue (_mesentery_). it looks not unlike twenty feet of pink garden hose. the intestine also is provided with glands that pour out a juice known as the _intestinal juice_, which, although not very active in digestion, helps to melt down still further some of the sugars, and helps to prevent putrefaction, or decay, of the food from the bacteria[ ] which swarm in this part of the tube. by the time the food has gone a third of the way down the small intestine, a good share of the starches in it have been turned into sugar and absorbed by the blood vessels in its wall; and the meats, milk, eggs, and similar foods have been digested in the same way. there still remains the bulk of the fats to be disposed of. these fats are attacked by the pancreatic juice and the bile, and made ready for digestion. like other foods, they are then eaten by the cells of the intestinal wall; but instead of going directly into the blood vessels, as the sugars and other food substances do, they are passed on into another set of little tubes or vessels, called the _lymphatics_. in these they are carried through the _lymph glands_ of the abdomen into the great _lymph duct_, which finally pours them into one of the great veins not far from the heart. tiny, branching lymphatic tubes are found all over the body, picking up what the cells leave of the fluid which has seeped out of the arteries for their use and returning it to the veins through the great lymph duct. all these different food substances, in the process of digestion, do not simply soak through the lining cells of the food tube, as through a blotting paper or straining cloth, but are actually eaten by the cells and very much changed in the process, and are then passed through the other side of the cells, either into the blood vessels of the wall of the intestine or into the lymph vessels, practically ready for use by the living tissues of the body. it is in the cells then that our food is turned into blood, and it is there that what we have eaten becomes really a part of us. it may even be said that we are living upon the leavings of the little cell citizens that line our food tube; but they are wonderfully decent, devoted little comrades of the rest of our body cells, and generous in the amount of food they pass on to the blood vessels. as the food-pulp is squeezed on from one coil to another through the intestine, it naturally has more and more of its nourishing matter sucked out of it; until, by the time it reaches the last loop of the twenty feet of the small intestine, it has lost over two-thirds of its food value. the final stage--the journey through the large intestine. from the small intestine what remains of the food-pulp is poured into the last section of the food tube, which enlarges to from two to three inches in diameter. it is known as the large intestine, or large bowel. this section is only about five feet long. the first three-fourths of it is called the _colon_; the last or lowest quarter, the rectum, the discharge-pipe of the food tube. the principal use of the colon is to suck out the remaining traces of nourishing matter from the food and the water in which it is dissolved, thus gradually drying the food-pulp down to a solid or pasty form, in which condition it collects in a large "s" shaped loop of the bowel just above the rectum, until discharged. the waste materials. by the time that the remains of the food-pulp have reached the middle of the large intestine, they have lost all their nutritive value and most of their water. all the way down from the upper part of the small intestine they have been receiving solid waste substances poured out by the glands of the intestines; indeed, the bulk of the feces is made up of these intestinal secretions, not, as is generally supposed, of the undigested remains of the food. ninety-five per cent of our food is absorbed; the body-engine burns up its fuel very clean. the next largest part of the feces is bacteria, or germs; and the third and smallest, the indigestible fragments and remainders of food, such as vegetable fibres, bran, fruit skins, pits, seeds, etc. hence the feces are not only worthless from a food point of view, but full of all sorts of possibilities for harm; and the principal interest of the body lies in getting rid of them as promptly and regularly as possible. it can easily be seen how important it is that a habit should be formed, which nothing should be allowed to break, of promptly and regularly getting rid of these waste materials. for most persons, once in twenty-four hours is normal; for some, twice or even three times in the day. whatever interval is natural, it should be attended to, beginning at a fixed hour every morning. constipation, and how to prevent it. constipation should not be treated by the all too common method of swallowing salts, which will cause a flood of watery matters to be poured through the food tube and sluice it clean of both poisons and melting food at the same time, leaving it in an exhausted and disturbed condition afterwards; nor by taking some irritating vegetable cathartic, generally in the form of pills, which sets up a violent action of the muscles of the food tube, driving its contents through at headlong speed; nor by washing out the lower two or three feet of the bowel with injections of water; although any or all of these may be resorted to occasionally for temporary relief. a very large portion of the food eaten is sucked out of the food tube into the blood vessels, passes through a large area of the body, and is poured out again as waste through the glands of the lining of the lower third of the bowel. constipation, therefore, is caused by disturbances which interfere with these processes _all over the body_, not only in the stomach and bowels. its only real and permanent cure is through exercise in the open air, sleep, and proper ventilation of bedrooms, with abundance of nourishing food, including plenty of green vegetables and fresh fruits. the appendix and appendicitis. the beginning of the large bowel, where the small bowel empties into it, is the largest part of it, and forms a curious pouch called the _cecum_, or "blind" pouch. from one side of this projects a little wormlike tube, twisted and coiled upon itself, from three to six inches long and of about the size of a slate pencil. this is the famous _appendix vermiformis_ (meaning, "wormlike tag"), which is such a frequent source of trouble. it is the shrunken and shriveled remains of a large pouch of the intestine which once opened into the cecum, and was used originally as a sort of second stomach for delaying and digesting the remains of the food. the reason why it gives rise to so much trouble is that it is so small--scarcely larger than will admit a knitting-needle--and so twisted upon itself that germs or other poisonous substances swallowed with the food may get into it, start a swelling or inflammation, get trapped in there by the closing of the narrow mouth of the tube, and form an abscess, which leaks through, or bursts into, the cavity of the body, called the _peritoneum_. this causes a very serious and often fatal blood poisoning. fortunately, _appendicitis_, or inflammation of the appendix, is not a very common disease, causing only one in one hundred of all deaths that occur; and these are mostly cases that were not treated promptly. yet, if you have a severe, constant pain, rather low down in the right-hand corner of your abdomen, and if, when you press your hand firmly down in that corner, it hurts, or you feel a lump, it is decidedly safest to call a doctor and let him see what the condition really is, and advise you what to do. footnotes: [ ] the term _salts_ includes, as will be explained later, a large number of substances, like ordinary table salt, baking soda, and the laxative salts. [ ] there are three pairs of these: one just below the ears and behind the angles of the jaw, known as the _parotid_; one under the middle of the lower jaw known as the _submaxillary_; and a small pair just under the tip of the tongue, called the _sublingual_. these glands have grown up from the very simplest of beginnings. at first there was just a little pocketing or pouching down of the mucous lining, like the finger of a glove; then a couple of smaller hollow fingers budded off from the bottom of the first finger; then four smaller fingers from the bottom of these; and so on, until a regular little hollow tree or shrub of these tiny tubes was built up, all discharging through the original hollow stem, which has now become what we call the _duct_ of the gland. every secreting gland in the body--the stomach (or peptic) glands, the salivary glands, the liver, the pancreas--is built up upon this simple plan. the saliva and the juice of the pancreas and that of the liver (bile) are alkaline, as are also the blood and most juices of the body. the stomach juice is acid, as also are the urine and the perspiration. [ ] it is wonderfully elastic and constantly changing in size, contracting till it will scarcely hold a quart when empty, and expanding, as food or drink is put into it, until it will easily hold two quarts, or even a gallon or more when greatly distended, as by gas. [ ] if you take some pepsin which has been extracted from the stomach of a pig or a calf, melt it in water in a glass tube, then drop one or two little pieces of meat or hard-boiled white of egg into it, you can see them slowly melt away like sugar in a cup of coffee. if you add a few drops of hydrochloric acid, the melting will go on much faster; and if you warm up the tube to about the heat of the body, it will proceed faster still. so nature knew just what she was doing when she provided pepsin and acid and warmth in the stomach. [ ] the liver and the bile are more fully described in chapter xvii. [ ] tiny plant cells, known also as _germs_, which cause fermentation, decay, and many diseases. chapter iii the food-fuel of the body-engine what kind of food should we eat? generally speaking, our appetites will guide us. our whole body is an ingenious machine for catching food, digesting it, and turning the energy, or fuel value, which it contains, into life, movement, and growth. naturally, two things follow: first, that the kind and amount of food which we eat is of great importance; and second, that from the millions of years of experience that the human body has had in trying all sorts of foods, it has adapted itself to certain kinds of food and developed certain likes and dislikes which we call _appetites_. those who happened to like unhealthy and unwholesome foods were poisoned, or grew thin and weak and died off, so that we are descended solely from people who had sound and reliable food appetites; and, in the main, what our instincts and appetites tell us about food is to be depended upon. the main questions which we have to consider are: how much of the different kinds of food it is best for us to eat, and in what proportions we should use them. both men and animals, since the world began, have been trying to eat and digest almost everything that they could get into their mouths. and what we now like and prepare as foods are the things which have stood the test, and proved themselves able to yield strength and nourishment to the body. so practically every food that comes upon our tables has some kind of real food value, or it wouldn't appear there. the most careful study and analysis have shown that almost every known food has some peculiar advantage, such as digestibility, or cheapness, or pleasant taste as flavoring for other more nutritious, but less interesting, foods. but some foods have much higher degrees of nutritiousness or digestibility or wholesomeness than others; so that our problem is to pick out from a number of foods that "taste good" to us, those which are the most nutritious, the most digestible, and the most wholesome, and to see that we get plenty of them. it is not that certain foods, or classes of food, are "good," and should be eaten to the exclusion of all others; nor that certain foods, or classes of food, are "bad," and should be excluded from our tables entirely; but that certain foods are more nutritious, or more wholesome, than others; and that it is best to see that we get plenty of the former before indulging our appetites upon the latter. beware of tainted food. the most dangerous fault that any food can have is that it shall be tainted, or spoiled, or smell bad. spoiling, or tainting, means that the food has become infected by some germs of putrefaction, generally _bacteria_ or _moulds_ (see chapter xxvi). it is the poisons--called _ptomaines_, or _toxins_--produced by these germs which cause the serious disturbances in the stomach, and not either the amount or the kind of food itself. even a regular "gorge" upon early apples or watermelon or cake or ice cream will not give you half so bad, nor so dangerous, colic as one little piece of tainted meat or fish or egg, or one cupful of dirty milk, or a single helping of cabbage or tomatoes that have begun to spoil, or of jam made out of spoiled berries or other fruit. this spoiling can be prevented by strict cleanliness in handling foods, especially milk, meat, and fruit; by keeping foods screened from dust and flies; and by keeping them cool with ice in summer time, thus checking the growth of these "spoiling" germs. the refrigerator in the kitchen prevents colic or diarrhea, ice in hot weather is one of the necessaries of life. smell every piece of food to be eaten, in the kitchen before it is cooked, if possible; but if not, at the table avoid everything that has an unpleasant odor, or tastes queer, and you will avoid two-thirds of the colic, diarrhea, and bilious attacks which are so often supposed to be due to eating too much. [illustration: a cheap home-made ice box this should not cost over twenty-five cents. the sketch shows an ordinary soap box; inside is a tin pail surrounded by a sheet of tin, so that there is a circular air space between the pail and the sheet of tin. sawdust is packed around the tin, and cracked ice (two cents a day) fills the tin pail around the milk bottle. the newspapers inside the cover help to keep out the warmth of the outside air. recommended by the boards of health of new york city and chicago.] variety in food is necessary. man has always lived on, and apparently required, a great variety of foods, animal and vegetable--fish and flesh, nuts, fruit, grains, fat, sugar, and vegetables. indeed, it was probably because man could live on anything and everything that he was able to survive in famines and to get so far ahead of all other sorts of animals. we still need a great variety of different sorts of food in order to keep our health; so our tendency to become tired of a certain food, after we have had it over and over and over again, for breakfast, dinner, and supper, is a sound and healthy one. there is no "best food"; nor is there any one food on which we can live and work, as an engine will work all its "life" on one kind of coal, wood, or oil. no one kind of food contains all the stuffs that our body is made of and needs, in exactly the right proportions. it takes a dozen or more different kinds of food to supply these, and the body picks out what it wants, and throws away the remainder. even the best and most nutritious and digestible single food, like meat, or bread and butter, or sugar, is not sufficient by itself; nor will it do for every meal in the day, or every day in the week. we must eat other things with it; and we must from time to time change it for something which may even be not quite so nutritious, in order to give our body the opportunity to select from a great variety of foods the particular things which its wonderful instincts and skill can use to build it up and keep it healthy. this is why every grocery store, every butcher shop, every fish market, and every confectioner's shows such a great variety of different kinds of foods put up and prepared in all sorts of ways. although nearly two-thirds of the actual fuel which we put into our body-boilers is in the form of a dozen or fifteen great staple foods, like bread, meat, butter, sugar, eggs, milk, potatoes, and fish, yet all the lighter foods, also, are needed for perfect health. it is possible, by careful selection, and by taking a great deal of trouble, to supply all the elements of the body from animal foods alone, or from vegetable foods alone. but practically, it has everywhere, and in all ages, been found that the best and most healthful diet is a proper combination of animal and vegetable foods. our starches, for instance, which furnish most of our fuel,--though they give us _comparatively little_ to _build up_, or _repair_, the body with,--are found, as we have seen, in the vegetable kingdom, in grains and fruits; while most of our proteins and fats, which chiefly give us the materials with which to build up, or repair, the body, are found in the animal kingdom. there is no advantage whatever in trying to exclude either animal food or vegetable food from our dietary. both animal and vegetable foods are wholesome in their proper place, and their proper place is on the table together. those nations which live solely, or even chiefly, upon one or two kinds of staple foods, such as rice, potatoes, corn-meal, or yams, do so solely because they are too poor to afford other kinds of food, or too lazy, or too uncivilized, to get them; and instead of being healthier and longer-lived than civilized races, they are much more subject to disease and live only about half as long. the three great classes of food-fuel food is fuel. now what is the chief quality which makes one kind of food preferable to another? as our body machine runs entirely upon the energy or "strength" which it gets out of its food, _a good food must have plenty of fuel value_; that is to say, it must be capable of burning and giving off heat and steaming-power. other things being equal, the more it has of this fuel value, the more desirable and valuable it will be as a food. from this point of view, foods may be roughly classified, after the fashion of the materials needed to build a fire in a grate or stove, as coal foods, kindling foods, and paper foods. although coal, kindling, and paper are of very different fuel values, they are all necessary to start the fire in the grate and to keep it burning properly. moreover, any one of them would keep a fire going alone, after a fashion, provided that you had a grate or furnace large enough to burn it in, and could shovel it in fast enough; and the same is true, to a certain degree, of the foods in the body. how to judge the fuel value of foods. one of the best ways of roughly determining whether a given food belongs in the coal, the kindling, or the paper class, is to take a handful or spoonful of it, dry it thoroughly by some means,--evaporating, or driving off the water,--and then throw what is left into a fire and see how it will burn. a piece of beef, for instance, would shrink a good deal in drying; but about one-third of it would be left, and this dried beef would burn quite briskly and would last for some time in the fire. a piece of bread of the same size would not shrink so much, but would lose about the same proportion of its weight; and it also would burn with a clear, hot flame, though not quite so long as the beef. a piece of fat of the same size would shrink very little in drying and would burn with a bright, hot flame, nearly twice as long as either the beef or the bread. these would all be classed as coal foods. then if we were to dry a slice of apple, it would shrink down into a little leathery shaving; and this, when thrown into the fire, would burn with a smudgy kind of flame, give off very little heat, and soon smoulder away. a piece of raw potato of the same size would shrink even more, but would give a hotter and cleaner flame. a leaf of cabbage, or a piece of beet-root, or four or five large strawberries would shrivel away in the drying almost to nothing and, if thoroughly dried, would disappear in a flash when thrown on the fire. these, then, except the potato, we should regard as kindling foods. but it would take a large handful of lettuce leaves, or a big cup of beef-tea, or a good-sized bowl of soup, or a big cucumber, or a gallon of tea or coffee, to leave sufficient solid remains when completely dried, to make more than a flash when thrown into the fire. these, then, are paper foods, with little fuel value. chapter iv the coal foods kinds of coal foods. there are many different kinds of coal foods, such as pork, mutton, beef, bread, corn-cakes, bacon, potatoes, rice, sugar, cheese, butter, and so on. but when you come to look at them more closely, and to take them to pieces, or, as we say, analyze them, you will see that they all fall into three different kinds or classes: ( ) _proteins_, such as meat, milk, fish, eggs, cheese, etc. ( ) _starch-sugars_ (_carbohydrates_), found pure as laundry starch and as white sugar; also found, as starch, making up the bulk of wheat and other grains, and of potatoes, rice, peas; also found, as sugar, in honey, beet-roots, sugar cane, and the sap of maple trees. ( ) _fats_, found in fat meats, butter, oil, nuts, beeswax, etc. this whole class of coal foods can be recognized by the fact that usually some one of them will form the staple, or main dish, of almost any regular meal, which is generally a combination of all three classes--a protein in the shape of meat; a starch-sugar in the form of bread, potatoes, or rice; and a fat in the form of butter in northern climates, or of olive oil in the tropics. proteins, or "meats" proteins, the "first foods." there are proteins, or "meats," both animal and vegetable; and no one can support life without protein in some form. this is because proteins alone contain sufficient amounts of the great element called _nitrogen_, which forms a large part of every portion of our bodies. this is why they are called proteins, meaning "first foods," or most necessary foods. whatever we may live on in later life, we all began on a diet of liquid meat (milk), and could have survived and grown up on nothing else. composition of proteins. nearly all our meats are the muscle of different sorts of animals, made of a soft, reddish, animal pulp called _myosin_; the other principal proteins being white of egg, curd of milk, and a gummy, whitish-gray substance called _gluten_, found in wheat flour. this gluten is the stuff that makes the paste and dough of wheat flour sticky, so that you can paste things together with it; while that made from corn meal or oatmeal will fall to pieces when you take it up. the jelly-like or pulp-like myosin in meat is held together by strings or threads of tough, fibrous stuff; and the more there is of this fibrous material in a particular piece or "cut," of meat, the tougher and less juicy it is. the thick, soft muscles, which lie close under the backbone in the small of the back, in all animals, have less of this tough and indigestible fibrous stuff in them, and cuts across them give us the well-known porter-house, sirloin, or tenderloin steaks, and the best and tenderest mutton and pork chops. fuel value of meats. weight for weight, most of the butcher's meats--beef, pork, mutton, and veal--have about the same food value, differing chiefly in the amount of fat that is mixed in with their fibres, and in certain flavoring substances, which give them, when roasted, or broiled, their special flavors. the different flavors are not of any practical importance, except in the case of mutton, which some people dislike and therefore can take only occasionally, and in small amounts. the amount of fat in meats, however, is more important; and depends largely upon how well the animal has been fed. there is usually the least amount of fat in mutton, more in beef, and by far the greatest amount in pork. this fat adds to the fuel value of meat, but makes it a little slower of digestion; and its presence in large amounts in pork, together with the fact that it lies, not only in layers and streaks, but also mixed in between the fibres of the lean as well has caused this meat to be regarded as richer and more difficult of digestion than either beef or mutton. this, however is not quite fair to the pork, because smaller amounts of it will satisfy the appetite and furnish the body with sufficient fuel and nutrition. if it be eaten in moderate amounts and thoroughly chewed, it is a wholesome and valuable food. veal is slightly less digestible than beef or mutton, on account of the amount of slippery _gelatin_ in and among its fibres; but if well cooked and well chewed, it is wholesome. the other meats--chicken, duck, and other poultry, game, etc.--are of much less nutritive value than either beef, pork, or mutton, partly because of the large amount of waste in them, in the form of bones, skin, and tendons, and partly from the greater amount of water in them. but their flavors make them an agreeable change from the staple meats. fish belongs in the same class as poultry and consists of the same muscle substance, but, as you can readily see by the way that it shrinks when dried, contains far more water and has less fuel value. some of the richer and more solid fishes, like salmon, halibut, and mackerel, contain, in addition to their protein, considerable amounts of fat and, when dried or cured, give a rather high fuel value at moderate cost. but the peculiar flavor of fish, its large percentage of water, and the special make-up of its protein, give it a very low food value, and render it, on the whole, undesirable as a permanent staple food. races and classes who live on it as their chief meat-food are not so vigorous or so healthy as those who eat also the flesh of animals. as a rule, it is not best to use fish as the main dish of a meal oftener than two or three times a week. [illustration: a baby-milk station the milk sold here for a few cents is perfectly clean and pure, and is variously adapted to the needs of different babies. in many cities such milk stations have been established.] milk. milk is an interesting food of great value because it combines in itself all three of the great classes of food-stuffs,--protein, starch-sugar, and fat. its protein is a substance called _casein_, which forms the bulk of curds, and which, when dried and salted, is called cheese. the fat is present in little tiny globules which give milk its whitish or milky color. when milk is allowed to stand, these globules of fat, being lighter, float up to the top and form a layer which is called cream. when this cream is skimmed off and put into a churn, and shaken or beaten violently so as to break the little film with which each of these droplets is coated, they run together and form a yellow mass which we call butter. in addition to the curd and fat, milk contains also sugar, called milk-sugar (_lactose_), which gives it its sweetish taste. and as a considerable part of the casein, or curd, is composed of another starch-like body, or animal starch, this makes milk quite rich in the starch-sugar group of food-stuffs. all these substances, of course, in milk are dissolved in a large amount of water, so that when milk is evaporated, or dried, it shrinks down to barely one-sixth of its former bulk. it is, in fact, a liquid meat, starch-sugar, and fat in one; and that is why babies are able to live and thrive on it alone for the first six months of their lives. it is also a very valuable food for older children, though, naturally, it is not "strong" enough and needs to be combined with bread, puddings, meat, and fat. soups and broths. soups, broths, and beef teas are water in which meats, bones, and other scraps have been boiled. they are about ninety-eight per cent water, and contain nothing of the meat or bones except some of their flavor, and a little gelatin. they have little or no nutritive or fuel value, and are really paper foods, useful solely as stimulants to appetite and digestion, enabling us to swallow with relish large pieces of bread or crackers, or the potatoes, rice, pea-meal, cheese, or other real foods with which they are thickened. their food value has been greatly exaggerated, and many an unfortunate invalid has literally starved on them. ninety-five per cent of the food value of the meat and bones, out of which soups are made, remains at the bottom of the pot, after the soup has been poured off. the commercial extracts of meat are little better than frauds, for they contain practically nothing but flavoring matters. protein in vegetables. several vegetable substances contain considerable amounts of protein. one of these has already been mentioned,--the gluten or sticky part of bread,--and this is what has given wheat its well-deserved reputation as the best of all grains out of which to make flour for human food. there is also another vegetable protein, called _legumin_, found in quite large amounts in dried beans and peas; but this is of limited food value, first because it is difficult of digestion, and secondly because with it, in dried peas and beans, are found a pungent oil and a bitter substance, which give them their peculiar strong flavor, both of which are quite irritating to the average person's digestion. so distressing and disturbing are these flavoring substances to the civilized stomach, that, after thousands of attempts to use them more largely, it has been found that a full meal of beans once or twice a week is all that the comfort and health of the body will stand. this is really a great pity, for beans and peas are both nourishing and cheap. nuts also contain much protein, but are both difficult of digestion and expensive. virtues and drawbacks of meats. taken all together, the proteins, or meats, are the most nutritious and wholesome single class of foods. their chief drawback is their expense, which, in proportion to their fuel value, is greater than that of the starches. then, on account of their attractiveness, they may be eaten at times in too large amounts. they are also somewhat more difficult to keep and preserve than are either the starches or the fats. the old idea that, when burned up in the body, they give rise to waste products, which are either more poisonous or more difficult to get rid of than those of vegetable foods, is now regarded as having no sufficient foundation. neither is the common belief that meats cause _gout_ well founded. the greatest danger connected with meats is that they may become tainted, or begin to spoil, or decay, before they are used. unfortunately, the ingenious cook has invented a great many ways of smothering, or disguising, the well-marked bad taste of decayed, or spoiled, meat by spices, onions, and savory herbs. so, as a general thing, the safest plan, especially when traveling or living away from home, is to avoid as far as possible hashes, stews, and other "made" dishes containing meat. this is one of the ways in which spices and onions have got such a bad reputation for "heating the blood," or upsetting the stomach, when it is really the decayed meat which they are used to disguise that causes the trouble. highly spiced dishes rob you of the services of your best guide to the wholesomeness of food--your nose. risks of dirty milk. the risks from tainting or spoiling are particularly great in the case of milk, partly on account of the dusty and otherwise uncleanly barns and sheds in which it is often handled and kept, and from which it is loaded with a heavy crop of bacteria at the very start; and partly because the same delicateness which makes it so easily digestible for babies, makes it equally easy for germs and bacteria to grow in it and spoil, or sour, it. you all know how disagreeable the taste of spoiled milk is; and it is as dangerous as it is disagreeable. a very large share of the illnesses of babies and young children, particularly the diseases of stomach and bowels which are so common in hot weather, are due to the use of spoiled, dirty milk. [illustration: clean, dry sunning yards at a model dairy] there is one sure preventive for all these dangers, and that is _absolute cleanliness_ from cow to customer. all the changes that take place in milk are caused by germs of various sorts, usually floating in the air, that get into it. if the milk is so handled and protected, from cow to breakfast table, that these germs cannot get into it, it will remain sweet for several days. [illustration: currying the cow washing the udders cleanliness before milking] boards of health all over the world now are insisting upon absolutely clean barns and cleanly methods of handling, shipping, and selling milk. in most of our large cities, milk-men are not allowed to sell milk without a license; and this license is granted only after a thorough examination of their cattle, barns, and milk-houses. these clean methods of handling milk cost very little; they take only time and pains. nowadays, in the best dairies, it is required that the barns or sheds in which cows are milked shall have tight walls and roofs and good flooring; that the walls and roofs shall be kept white-washed; and the floor be cleaned and washed before each milking, so that no germs from dust or manure can float into the milk. then the cows are kept in a clean pasture, or dry, graveled yard, instead of a muddy barnyard; and are either brushed, or washed down with a hose before each milking, so that no dust or dirt will fall from them into the milk. the men who are to milk wash their hands thoroughly with soap and water, and put on clean white canvas or cotton overalls, jackets, and caps. as soon as the milk has been drawn into the pails, it is carried into the milk-room and cooled down to a temperature of about forty-two degrees--that is, about ten degrees above freezing point. this is to prevent the growth of such few germs as may have got into it, in spite of all the care that has been taken. then the milk is drawn into bottles; and the bottles are tightly capped by a water-proof pasteboard disc, or cover, which is not removed until the milk is brought into the house and poured into the glass, or cup, for use. [illustration: the milking hour at a model dairy] milk handled like this costs from two to four cents a quart more to produce than when drawn from a cow smeared with manure, in a dark, dirty, strong-smelling barn, by a milker with greasy clothing and dirty hands; and then ladled out into pitchers in the open street, giving all the dust and flies that happen to be in the neighborhood a chance to get into it! but it is doubly worth the extra price, because, besides escaping stomach and bowel troubles, you get more cream and higher food value. there is one-third more food value in clean milk than in dirty milk, because its casein and sugar have not been spoiled and eaten by swarms of bacteria. how great a difference careful cleanliness of this sort can make in milk is shown by the difference in the number of bacteria that the two kinds of milk contain. ordinary milk bought from the wagons in the open street, or from the cans in the stores, will contain anywhere from _a million_ to a _million and a half_ bacteria to the cubic centimeter (about fifteen drops); and samples have actually been taken and counted, which showed _five_ and _six millions_. [illustration: milking by vacuum process this method is used in many large dairies to avoid handling the udders or the milk. its chief drawback is that the long tubes are very difficult to keep clean.] such a splendid food for germs is milk, and so rapidly do they grow in it, that dirty milk will actually contain more of them to the cubic inch than sewage, as it flows in the sewers. now see what a difference a little cleanliness will make! good, clean, carefully handled milk, instead of having a million, or a million and a half, bacteria, will have less than ten thousand; and very clean milk may contain as low as three or four hundred, and these of harmless sorts. the whole gospel of the care of milk can be summed up in two sentences: ( ) _keep dirt and germs out of the milk._ ( ) _keep the milk cool._ [illustration: washing the bottles at a model dairy the inside of the bottle is thoroughly cleansed by the revolving brush.] besides the germs of the summer diseases of children, which kill more than fifty thousand babies every year in the united states, dirty milk may also contain typhoid germs and consumption germs. the typhoid germs do not come from the body of the cow, but get into the milk through its being handled by people who have, or have just recovered from, typhoid, or who are nursing patients sick with typhoid, and who have not properly washed their hands; or from washing the cans, or from watering the milk with water taken from a well or stream infected with typhoid. it is estimated that about one-eighth of all the half million cases of typhoid that occur in the united states every year are carried through dirty milk. [illustration: bacteria in clean and in dirty milk] [illustration: danger from dipped milk the milk that spills or spatters over the hand drips back into the can and may seriously infect the main supply.] the germs of consumption, or _tuberculosis_, that are present in milk may come from a cow that has the disease; or from consumptive human beings who handle the milk; or from the dust of streets or houses--which often contains disease germs. the latter sources are far the more dangerous; for, as is now pretty generally agreed, although the tuberculosis of cattle can be given to human beings, it is not very actively dangerous to them; and probably not more than three or four per cent of all cases of tuberculosis come from this source. the idea, however, of allowing the milk of cows diseased from any cause to be used for human food, is not to be tolerated for a moment. all good dairymen and energetic boards of health now insist upon dairy herds being tested for tuberculosis, and the killing, or weeding out, of all cows that show they have the disease. [illustration: milk inspection at the retail store it is well to have the quality and purity of the milk tested just before it goes to the consumer, but it is far more important that it should be examined by state inspectors at the dairy farms.] cheese. cheese is the curd of milk squeezed dry of its liquid (_whey_), salted, pressed into a mould, and allowed to ferment slowly, or "ripen," in which process a considerable part of its casein is turned into fat. it is a cheap, concentrated, and very nutritious food, and in small amounts is quite appetizing. but unfortunately, the acids and extracts which have formed in the process of fermentation and ripening are so irritating to the stomach, that it can usually be eaten only in small amounts, without upsetting the digestion. its chief value is as a relish with bread, crackers, potatoes, or macaroni. in moderate amounts, it is not only appetizing and digestible, but will assist in the digestion of other foods; hence the custom of eating a small piece of "ripe" cheese at the end of a heavy meal. chapter v the coal foods (_continued_) starches sources of starch. the starches are valuable and wholesome foods. they form the largest part, both in bulk and in fuel value, of our diet, and have done so ever since man learned how to cultivate the soil and grow crops of grain. the reason is clear: one acre of good land will grow from ten to fifteen times the amount of food in the form of starch in grains or roots, as of meat in the shape of cattle or sheep. consequently, starch is far cheaper, and this is its great advantage. our chief supply of starch is obtained from the seed of certain most useful grasses, which we call wheat, oats, barley, rye, rice, and corn, and from the so-called "roots" of the potato. potatoes are really underground buds packed with starch, and their proper name is tubers. starch, when pure or extracted, is a soft, white powder, which you have often seen as cornstarch, or laundry starch. as found in grains, it is mixed with a certain amount of vegetable fibre, covered with husks, or skin, and has the little germ or budlet of the coming plant inside it. it has been manufactured and laid down by little cells inside their own bodies, which make up the grains; so that each particular grain of starch is surrounded by a delicate husk--the wall of the cell that made it. this means that grains and other starch foods have to be prepared for eating by grinding and cooking. the grinding crushes the grains into a powder so that the starch can be sifted out from the husks and coating of the grain, and the fibres which hold it together; and the cooking causes the tiny starch grain to swell and burst the cell wall, or bag, which surrounds it. starches as fuel. the starches contain no nitrogen except a mere trace in the framework of the grains or roots they grow in. they burn very clean; that is, almost the whole of them is turned into carbon dioxid gas and water.[ ] this burning quality makes the starches a capital fuel both in the body and out of it. you may have heard of how settlers out on the prairies, who were a long way from a railroad and had no wood or coal, but plenty of corn, would fill their coal scuttles with corn and burn that in their stoves; and a very bright, hot fire it made. one of the chief weaknesses of the starches is that they burn up too fast, so that you get hungry again much more quickly after a meal made entirely upon starchy foods, like bread, crackers, potatoes, or rice, than you do after one which has contained some meat, particularly fat, which burns and digests more slowly. how starch is changed into sugar. as we learned in chapter ii, the starches can be digested only after they are turned into sugars in the body. if you put salt with sugar or starch, although it will mix perfectly and give its taste to the mixture, neither the salt nor the starch nor the sugar will have changed at all, but will remain exactly as it was in the first place, except for being mixed with the other substances. but if you were to pour water containing an acid over the starch, and then boil it for a little time, your starch would entirely disappear, and something quite different take its place. this, when you tasted it, you would find was sweet; and, when the water was boiled off, it would turn out to be a sugar called _glucose_. again, if you should pour a strong acid over sawdust, it would "char" it, or change it into another substance, _carbon_. in both of these cases--that of the starch and of the sawdust--what we call a _chemical change_ would have taken place between the acid and the starch, and between the strong acid and the sawdust. if we looked into the matter more closely, we should find that what has happened is that the starch and the sawdust have changed into quite different substances. starches are _insoluble_ in water; that is, although they can be softened and changed into a jelly-like substance, they cannot be completely melted, or dissolved, like salt or sugar. sugar, on the other hand, is a perfectly _soluble_ or "meltable" substance, and can soak or penetrate through any membrane or substance in the body. therefore all the starches which we eat--bread, biscuit, potato, etc.--have to be acted upon by the ferments of our saliva and our pancreatic juice, and turned into sugar, called glucose, which can be easily poured into the blood and carried wherever it is needed, all over the body. thus we see what a close relation there is between starch and sugar, and why the group we are studying is sometimes called the starch-sugars. wheat--our most valuable starch food. the principal forms in which starch comes upon our tables are meals and flours, and the various breads, cakes, mushes, and puddings made out of these. far the most valuable and important of all is wheat flour, because this grain contains, as we have seen, not only starch, but a considerable amount of vegetable "meat," or gluten, which is easily digested in the stomach. this gluten, however, carries with it one disadvantage--its stickiness, or gumminess. the dough or paste made by mixing wheat flour with water is heavy and wet, or, as we say, "soggy," as compared with that made by mixing oatmeal or corn meal or rice flour with water. if it is baked in this form, it makes a well-flavored, but rather tough, leathery sort of crust; so those races that use no _leavening_, or rising-stuff, in their wheat bread, roll it out into very thin sheets and bake it on griddles or hot stones. most races that have wheat, however, have hit upon a plan for overcoming this heaviness and sogginess, and that is the rather ingenious one of mixing some substance in the dough which will give off bubbles of a gas, _carbon dioxid_, and cause it to puff up and become spongy and light, or, as we say, "full of air." this is what gives bread its well-known spongy or porous texture; but the tiny cells and holes in it are filled, not with air, but with carbon dioxid gas. making bread with yeast. there are several ways of lightening bread with carbon dioxid gas. the oldest and commonest is by mixing in with the flour and water a small amount of the frothy mass made by a germ, or microbe, known as _yeast_ or the _yeast plant_. then the dough is set away in a warm place "to rise," which means that the busy little yeast cells, eagerly attacking the rich supply of starchy food spread before them, and encouraged by the heat and moisture, multiply by millions and billions, and in the process of growing and multiplying, give off, like all other living cells, the gas, carbon dioxid. this bubbles and spreads all through the mass, the dough begins to rise, and finally swells right above the pan or crock in which it was set. if it is allowed to stand and rise too long, it becomes sour, because the yeast plant is forming, at the same time, three other substances--alcohol, lactic acid (which gives an acid taste to the bread), and vinegar. usually they form in such trifling amounts as to be quite unnoticeable. when the bread has become light enough, it is put into the oven to be baked. the baking serves the double purpose of cooking and thus making the starch appetizing, and of killing the yeast germs so that they will carry their fermentation no further. bread that has not been thoroughly baked, if it is kept too long, will turn sour, because some of the yeast germs that have escaped will set to work again. [illustration: a thorough baking, and a valuable crust note the cleanly way of handling the food.] that part of the dough that lies on the surface of the loaf, and is exposed to the direct heat of the oven has its starch changed into a substance somewhat like sugar, known as _dextrin_, which, with the slight burning of the carbon, gives the outside, or crust, of bread its brownish color, its crispness, and its delicious taste. the crust is really the most nourishing part of the loaf, as well as the part that gives best exercise to the teeth. making bread with soda or baking-powders. another method of giving lightness to bread is by mixing an acid like sour milk and an alkali like soda with the flour, and letting them effervesce[ ] and give off carbon dioxid. this is the mixture used in making the famous "soda biscuit." still another method is by the use of _baking-powders_, which are made of a mixture of some cheap and harmless acid powder with an alkaline powder--usually some form of soda. as long as these powders are kept dry, they will not act upon each other; but as soon as they are moistened in the dough, they begin to give off carbon dioxid gas. [illustration: an ideal bakery with light, air, and cleanliness] neither sour milk and soda nor baking-powder will make as thoroughly light and spongy and digestible bread as will yeast. if, however, baking-powders are made of pure and harmless materials, used in proper proportions so as just to neutralize each other, and thus leave no excess of acid or alkali, and if the bread is baked very thoroughly, they make a wholesome and nutritious bread, which has the advantage of being very quickly and easily made. the chief objection to soda or baking-powder bread is that, being often made in a hurry, the acid and the alkali do not get thoroughly mixed all through the flour, and consequently do not raise or lighten the dough properly, and the loaf or biscuit is likely to be heavy and soggy in the centre. this heavy, soggy stuff can be neither properly chewed in the mouth, nor mixed with the digestive juices, and hence is difficult to digest. if, however, soda biscuits are made thin and baked thoroughly so as to make them at least half or two-thirds crust, they are perfectly digestible and wholesome, and furnish a valuable and appetizing variety for our breakfast and supper tables. [illustration: a basement bakery--a menace to the public health disease germs multiply in the dark and damp of the basement. the clothing hanging up in this bakery is a very probable source of infection.] bran or brown bread. flour made by grinding the wheat-berry without sifting the husks, or bran, out of it is called "whole-wheat" meal; and bread made from it is the brown "bran bread" or "graham bread." it was at one time supposed that because brown bread contained more nitrogen than white bread, it was more wholesome and nutritious, but this has been found to be a mistake, because the extra nitrogen in the brown bread is in the form of husks and fibres, which the stomach is quite unable to digest. weight for weight, white bread is more nutritious than brown. the husks and fibres, however, which will not digest, pass on through the bowels unchanged and stir up the walls of the intestines to contract; hence they are useful in small quantities in helping to keep the bowels regular. but, like any other stimulus, too much of it will irritate and disturb the digestion, and cause diarrhea; so that it is not best to eat more than one-fifth of our total bread in the form of brown bread. dyspeptics who live on brown bread, or on so-called "health foods," are simply feeding their dyspepsia. "breakfast foods." the same defect exists in most of the breakfast cereals which flood our tables and decorate our bill-boards. some of these are made of the waste of flouring mills, known as "middlings," "shorts," or bran, which were formerly used for cow-feed. the claims of many of them are greatly exaggerated, for they contain no more nourishment, or in no more digestible form, than the same weight of bread; and they cost from two to five times as much. as they come on our tables, they are nearly seven-eighths water; and the cream and sugar taken with them are of higher food value than they are. they should never be relied upon as the main part of a meal. corn meal. corn meal is one of the richest meals in nutritive value for its price, as it has an abundance of starch and a small amount of fat. it is, however, poor in nitrogen, and like the other grains, in countries where wheat will grow, it is chiefly valuable for furnishing cakes, fritters, and mushes to give variety to the diet, and help to regulate the bowels. oatmeal. oatmeal comes the nearest to wheat in the amount of nitrogen or protein, but the digestible part of this is much smaller than in wheat, and the indigestible portion is decidedly irritating to the bowels, so that if used in excess of about one-fifth of our total starch-food required, it is likely to upset the digestion. rye. rye also contains a considerable amount of gluten, but is much poorer in starch than wheat is; and the bread made out of its flour--the so-called "black bread" of france and germany--is dark, sticky, and inclined to sour readily. most of the "rye" bread sold in the shops, or served on our tables, is made of wheat flour with a moderate mixture of rye to give the sour taste. rice. rice consists chiefly of starch, and makes nutritious puddings or cakes, and may be used as a vegetable, in the place of potatoes, with meat and fish. it is, however, lacking in flavor, and when properly cooked, contains so much water that it has to be eaten in very large amounts to furnish much nutrition. potatoes. the only important starchy food outside of the grains is potatoes. these contain considerable amounts of starch, but mixed with a good deal of cellulose, or vegetable fibre, and water, so that, like rice, large amounts of them must be eaten in order to furnish a good fuel supply. they, however, make a very necessary article of diet in connection with meats, fish, and other vegetables. as a rough illustration of the fuel value of the different starch foods, it may be said that in order to get the amount of nourishment contained in an ordinary pound loaf of wheat or white bread, it would be necessary to eat about seven pounds of cooked rice, as it comes on the table; about twelve pounds of boiled potatoes; or a bowl of oatmeal porridge about the size of a wash-basin. sugars where sugar is obtained. the other great member of the starch, or carbohydrate, group of foods is sugar. this is a scarcer and more expensive food than starch because, instead of being found in solid masses in grains and roots like starch, it is scattered, very thinly, through the fruits, stems, and roots of a hundred different plants, seldom being present in greater amounts than two or three per cent. it is, however, so valuable a food, with so high a fuel value, and is so rapidly digested and absorbed, that man has always had a very keen desire for it, or, as we say, a "sweet tooth," and has literally searched the whole vegetable kingdom the world over to discover plants from which it could be secured in larger amounts. during the last two hundred years it has been obtained chiefly from two great sources: the juicy stem of a tall, coarse reed, or cane, the sugar-cane, growing in the tropics; and (within the last fifty years) the sweet juice of the large root of a turnip-like plant, the beet. another source of sugar, in the earlier days of this country, was the juice or sap of the sugar maple, which is still greatly relished as a luxury, chiefly in the form of syrup. honey is nearly pure sugar together with certain ferments and flavoring extracts, derived in part from the flowers from which it is gathered, and in part from the stomach, or crop, of the bee. the food value of sugar. in the early days of its use, sugar, on account of its expensiveness, was looked upon solely as a luxury, and used sparingly--either as a flavoring for less attractive foods, or as a special treat; and like most new foods, it was declared to be unwholesome and dangerous. but sugar is now recognized as one of our most useful and valuable foods. in fuel value, it is the equal, indeed the superior, weight for weight, of starch; and as all starch has to be changed into it before it can be used by the body, it is evident that sugar is more easily digested and absorbed than starch, and furnishes practically a ready-made fuel for our muscles. how we should use sugar. the drawbacks of sugar are that, on account of its exceedingly attractive taste, we may eat too much of it; and that, because it is so satisfying, if we do eat too much of it either between meals or at the beginning of meals, our appetites will be "killed" before we have really eaten a sufficient supply of nourishing food. but all we have to do to avoid these dangers is to use common sense and a little self-control, without which any one of our appetites may lead us into trouble. on account of this satisfying property, sugar is best eaten at, or near, the close of a meal; and taken at that time, there is no objection to its use nearly pure, as in the form of sweet-meats, or good wholesome candy. its alleged injurious effects upon the teeth are largely imaginary and no greater than those of the starchy foods. the teeth of various tropical races which live almost entirely on sugar-cane during certain seasons of the year are among the finest in the world; and any danger may be entirely avoided by proper brushing and cleaning of the teeth and gums after eating. [illustration: candy, like other foods, should be clean. candy sold on the street is always questionable. it should never be bought from a cart or stand that is not covered with glass.] if eaten in excess, sugar quickly gives rise to fermentation in the stomach and bowels; but so do the starches and the fats, if over-indulged in. its real value as a food may be judged from the fact that the german army has made it a part of its field ration in the shape of cakes of chocolate, and that the united states government buys pure candy by the ton, for the use of its soldiers. footnotes: [ ] on this account, they are often spoken of as carbohydrates, or "carbon-water stuffs." [ ] see page . chapter vi the coal foods (_continued_) animal fats the digestibility of fats. we have now come to the last group of the real coal foods, namely, the fats. fats are the "hottest" and most concentrated fuel that we possess, and might be described as the "anthracites," or "hard coals" of our coal foods. they are, also, as might be expected from their "strength" or concentration, among the slowest to digest of all our foods, so that, as a rule, we can eat them only in very moderate amounts, seldom exceeding one-tenth to one-sixth of our total food-fuel. it is not, however, quite correct to say that fats are hard to digest, because, although from their solid, oily character, they take a longer time to become digested and absorbed by the body than most other foods, yet they are as perfectly and as completely digested, with the healthy person, as any other kind of food. indeed, it is this slowness of digestion which gives them their well-known staying-power as a food. their place in our diet. the wholesomeness of fats is well shown by our appetite for them, which is very keen for small amounts of them--witness, for instance, how quickly we notice and how keenly we object to the absence of butter on our bread or potatoes. to have our "bread well-buttered" is a well known expression for comfort and good fortune; yet a very little excess will turn our enjoyment into disgust. fat, and particularly the cold fat of meat, "gags" us if we try to eat too much of it. fortunately, most of these fat-foods are quite expensive, pound for pound, and hence we are not often tempted to eat them in excess. within proper limits, then, fats are an exceedingly important and useful food--a valuable member of the great family of coal foods. the advantages of fat as a ration. the high fuel value and the small bulk of fats give them a very great practical advantage whenever supplies of food have to be carried for long distances, or for considerable lengths of time, as in sea voyages and hunting and exploring trips. so that in provisioning ships for a long voyage, or fitting out an expedition for the arctic regions, fats, in the shape of bacon or pork, pemmican,[ ] or the richer dried fishes, like salmon, mackerel, and herring, will be found to play an important part. fats also have the great advantage, like the starches, of keeping well for long periods, especially after they have been melted and sterilized by boiling, or "rendering," as in the case of lard, or have had moderate amounts of salt added to them, as in butter. if you were obliged to pick out a ration which would keep you alive, give you working power, and fit into the smallest possible bulk, you would take a protein, a sugar, and a fat in about equal amounts. indeed, the german emergency field-ration, intended to keep soldiers in the field for three or four days without their baggage-wagons, or cook-trains, is made up of bacon, pea-meal, and chocolate. a small packet of these, which weighs only a little over two pounds, and which can be slipped into the knapsack, will, with plenty of water, keep a soldier in fighting trim for three days. butter. the most useful and wholesome single fat is the one which is in greatest demand--butter. this, as we have seen, is the churned and concentrated fat of milk, to which a little salt has been added to keep the milk-acid (_lactic acid_) which cannot be entirely washed out of it, from "turning it sour" or rancid. the rancid, offensive taste of bad or "strong" butter is due to the formation of another acid call _butyric_ ("buttery") _acid_. butter is the best and most wholesome of our common fats because it is most easily digested, most readily absorbed, and least likely to give rise to this butyric acid fermentation. we should be particularly careful, even more so almost than with other foods, to see that it is perfectly sweet and good, because when we swallow rancid butter, we are simply swallowing a ready-made attack of indigestion. most people's stomachs are strong enough to deal with small amounts of rancid butter without discomfort; but it is a strain on them that ought to be avoided, especially when good butter is simply a matter of strict cleanliness and care in handling and churning the cream, and of keeping the butter cool after it has been made. plenty of sweet butter is one of the most important and necessary elements in our diet, especially in childhood. and if children are allowed to eat pretty nearly as much as they want of it on their bread or potatoes, and plenty of its liquid form, cream, on their berries and puddings, it will save the necessity of many a dose of cod-liver oil, or bitter physic. cream is far superior to either cod-liver or castor oil for keeping us in health. oleomargarine. on account of the expensiveness of butter, there are a number of substitutes sold, which go under the name of _oleomargarine_. these are made of the fat, or suet, of beef or mutton, mixed with a certain amount of cream and real butter, to give them an agreeable flavor. they are wholesome and useful fats, and for cooking purposes may very largely be substituted for butter. owing to the fact that their fat is freer from the milk acids, they keep better than butter; and sweet, sound oleomargarine is to be preferred to rank, rancid butter. but it is not so readily digestible as butter is; is more liable to give rise to the butyric acid fermentations in the stomach; is not nearly so appetizing; and its sale as, and under the name of, _butter_ is a fraud which the law rightly forbids and punishes. [illustration: a small store, cleanly and honest the milk is well kept, the bread and candies are under glass, and "butterine" is not sold as butter.] lard. the next most useful and generally used pure fat is lard--the rendered, or boiled-down, fat of pork. it is a useful substitute for butter in cooking, where butter is scarce. but, even in pastry or cakes, it has neither the flavor nor the digestibility of butter, and the latter should always be used when it can be had. bacon and ham. the most useful and digestible fat meats are bacon and ham, as the dried, salted, and usually smoked, meat of the pig is called. like all other fats, they can be eaten only in moderate amounts; but thus eaten, they are both appetizing, digestible, and very nutritious. one good slice of breakfast bacon, for instance, contains as much fuel value as two large saucers of mush or breakfast food, or two eggs, or two large slices of bread, or three oranges, or two small glasses of milk, or a quart of berries. nuts how nuts should be used. another form of fat is the "meat" of different nuts--walnuts, pecans, almonds, etc. these are quite rich in fats, and also contain a fair amount of proteins, and are, in small quantities, like other fats, appetizing and useful articles of food. but they should not be depended upon to furnish more than a small amount of the whole food supply, or even of its necessary fat, because nearly all nuts contain pungent or bitter aromatic oils and ferments, which give them their flavors, but which are likely to upset the digestion. this is particularly true of the peanut, which is not a true nut at all, but is, as its name indicates, a kind of pea grown underground. peanuts, on account of their large amount of these irritating substances, are among the most indigestible and undesirable articles of diet in common use. a certain amount of these irritating substances present in nuts may be destroyed by careful roasting and salting; but this must be most carefully done, and it shrinks them in bulk so that the finished product is far more expensive than butter or fat meat of the same nutritive value. good salted almonds, for instance, cost fifty to eighty cents a pound. the proper place for nuts is where they usually come on our tables--at the end of a meal. those who attempt to cure themselves of dyspepsia by a nut diet are simply making permanent their disease. footnotes: [ ] pemmican is a sort of "canned beef" made originally out of the best parts of venison and buffalo-meat. this is boiled, and packed into skin bags; then melted fat is poured in, so as to fill up all the chinks and form a thick layer over the surface. it is now made of beef packed in canvas bags, and is much used by polar expeditions and alaskan miners. chapter vii kindling and paper foods--fruits and vegetables the special uses of fruits and vegetables. we come now to the very much larger but much less important class of foods--the kindling foods, which help the coal foods to burn, and supply certain stuffs and elements which the body needs and which the coal foods do not contain. these are the vegetables--other than potatoes and dried peas and beans--and fruits. fruits and vegetables contain certain mineral elements, which are not present in sufficient proportions in the meats, starches, and fats. furthermore, the products of their digestion and burning in the body help to neutralize, or render harmless, the waste products from meats, starches, and fats. thirdly, they have a very beneficial effect upon the blood, the kidneys, and the skin. in fact, the reputation of fruits and fresh vegetables for "purifying the blood" and "clearing the complexion" is really well deserved. the keenness of our liking for fruit at all times, and our special longing for greens and sour things in the spring, after their scarcity in our diet all winter, is a true sign of their wholesomeness. not the least of their advantages is that they contain a very large proportion of water; and this, though diminishing their fuel value, supplies the body with a naturally filtered and often distilled supply of this necessary element of life. one of the best ways of avoiding that burning summer thirst, which leads you to flood your unfortunate stomach with melted icebergs, in the form of ice water, ice cold lemonade, or soda water, is to take an abundance of fresh fruits and green vegetables. many of the vegetables contain small amounts of starch, but few of them enough to count upon as fuel, except potatoes, which we have already classed with the coal foods. most fruits contain a certain amount of sugar--how much can usually be estimated from their taste, and how little can be gathered from the statement that even the sweetest of fruits, like ripe pears or ripe peaches, contain only about eight per cent of sugar. they are all chiefly useful as flavors for the less interesting staple foods, particularly the starches. in fact, our instinctive use of them to help down bread and butter, or rice, or puddings of various sorts, is a natural and proper one. like the vegetables, they contain various salts which are useful in neutralizing certain acid substances formed in the body. soldiers in war, or sailors upon long voyages, who are fed upon a diet consisting chiefly of salted or preserved meat, with bread or hard biscuit and sugar, but without either fruits or fresh vegetables, are likely to develop a disease called scurvy. little more than a century ago, hundreds of deaths occurred every year in the british and french navies from this disease, and the crews of many a long exploring voyage--like captain cook's--or of searchers for the north pole, have been completely disabled or even destroyed entirely by scurvy. it was discovered that by adding to the diet fruit, or fresh vegetables like cabbage or potatoes, scurvy could be entirely prevented, or cured.[ ] their low fuel value. how little real fuel value fruits and vegetables have, may be easily seen from the following table. in order to get the nourishment contained in a pound loaf of bread, or a pound of roast beef, you would have to eat: large apples or pears ( lbs.); - / qts. of strawberries; a dozen bananas ( - / lbs.); lbs. of onions; doz. large cucumbers ( lbs.); lbs. of cabbage; / bushel of lettuce or celery. apples, the most wholesome fruit. head and shoulders above all the other fruits stands that delight of our childhood days, apples. well ripened, or properly cooked, they are readily digested by the average stomach; though some delicate digestions have difficulty with them. they contain a fair amount of acids, and from five to seven per cent of sugar. their general wholesomeness and permanent usefulness may be gathered from the fact that they are one of the few fruits which you can eat almost daily the year round, or at very frequent intervals, without getting tired of them. food that you don't get tired of is usually food which is good for you. dried apples are much inferior to the fresh fruit, because they become toughened in drying, and because growers sometimes smoke them with fumes of sulphur in the process, in order to bleach or whiten them; and this turns them into a sort of vegetable leather. other fruits--their advantages and drawbacks. next in usefulness probably come pears, though these have the disadvantage of containing a woody fibre, which is rather hard to digest, and they are, of course, poorer "keepers" than apples. then come peaches, which have one of the most delicious flavors of all fruits, but which tend to set up fermentation and irritation in delicate stomachs, though in the average stomach, when eaten in moderation, they are wholesome and good. then come the berries--strawberries, raspberries, blackberries,--all excellent and wholesome, when fresh in their season, or canned or preserved. one warning, however, should be given about these most delicious, fragrant berries; and as it happens to apply also to several of our most attractive foods, it is well to mention it here. while perfectly wholesome and good for the majority of people, strawberries, for instance, are to a few--perhaps one in twenty--so irritating and indigestible as to be mildly poisonous. the other foods which may play this kind of trick with the stomachs of certain persons are oranges, bananas, melons, clams, lobsters, oysters, cheese, sage, and parsley, and occasionally, but very rarely, eggs and mutton. this is a matter which each of you can readily find out by experiment. if strawberries, melons, and other fruits agree with you, then eat freely of them, in due moderation. but if, after three or four trials, you find that they do not agree with you, but make your stomach burn, and perhaps give you an attack of nettle-rash or hives, or a headache, then let them alone. the banana is of some food value because it contains not only sugar, but considerable quantities of starch--about the same amount as potatoes. but, if bananas are not fully ripe, both their starch and sugar are highly indigestible; while, if over-ripe, they have developed in them irritating substances, which are likely to upset the digestion and cause hives or eczema, especially in children. bananas should therefore be regarded rather as a luxury and an agreeable variety than as a substantial part of the diet. food values of the different vegetables. the vegetables depend for their value almost solely upon the alkaline salts and the water in them, and upon their flavor, which gives an agreeable variety to the diet. parsnips, beets, and carrots are among the most nutritious, as they contain some starch and sugar; but they so quickly pall upon the taste that they can be used only in small amounts. turnips and cabbages possess the merit of being cheap and very easily grown. they contain valuable earthy salts, plenty of pure water, and a trace of starch. but these advantages are offset by their large amount of tough, woody vegetable fibre; this is incapable of digestion, and though in moderate amounts it is valuable in helping to regulate the movements of the bowels, in excess it soon becomes irritating. both of them, particularly cabbages, contain, also, certain flavoring extracts, very rich in sulphur and exceedingly irritating to the stomach, which cause them to disagree with some persons. if these are got rid of by brisk boiling in at least two waters, then cabbage is a fairly wholesome and digestible dish for the average stomach. and because of its cheapness and "keeping" power, it is often the only vegetable that can be secured at a reasonable cost at certain seasons of the year. onions, especially the milder and larger ones, are an excellent and wholesome vegetable, containing small amounts of starch, although their pungent flavor, due to an aromatic oil, makes them so irritating to some stomachs as to be quite indigestible. sweet corn, whether fresh or dried, is wholesome, and has a fair degree of nutritive value, as it contains fair amounts of both starch and sugar. it should, however, be very thoroughly chewed and eaten moderately, on account of the thick, firm indigestible husk which surrounds the kernel. tomatoes are an exceedingly valuable, though rather recent addition to our dietary. their fresh, pungent acid is, like the fruit acids, wholesome and beneficial; and they can be preserved or canned without losing any of their flavor. they were at one time denounced as being indigestible, and even as the cause of cancer; but these charges were due to ignorance and distrust of anything new. lighter vegetables, or paper foods. the lighter vegetables such as lettuce, celery, spinach, cucumbers, and parsley have, in a previous chapter, been classed with the paper foods. they are all agreeable additions to the diet on account of their fresh taste and pleasant flavor, though they contain little or no nutritive matter. the advantages of a vegetable garden. notwithstanding their slight fuel value, there are few more valuable and wholesome elements in the diet than an abundant supply of fresh green vegetables. everyone who is so situated that he can possibly arrange for it, should have a garden, if only the tiniest patch, and grow them for his own use, both on account of their greater wholesomeness and freshness when so grown, and because of the valuable exercise in the open air, and the enjoyment and interest afforded by their care. [illustration: the joy of his own garden patch] footnotes: [ ] as vegetables and fruit are bulky and likely to spoil, on the long voyages of sailing vessels before steamships were invented bottles of the juice of limes (a small kind of lemon) were added, instead, to the hard-tack and "salt-horse" of the ship's stores. because of this custom, the long-voyage merchantmen who carried cargoes round the horn or the cape were for years nicknamed "lime-juicers." chapter viii cooking why we cook our food. while some of all classes of food may be eaten raw, yet we have gradually come to submit most of our foods to the heat of a fire, in various ways; this process is known as _cooking_. while cooking usually wastes a little, and sometimes a good deal, of the fuel value of the food and, if carelessly or stupidly done, may make it less digestible, in the main it makes it both more digestible and safer, though much more expensive. this it does in three ways: by making it taste better; by softening it so as to make it more easily masticated; and by sterilizing it, or destroying any germs or animal parasites which may be in it. cooking improves the taste of food. it may seem almost absurd to regard changing the taste of a food as of sufficient importance to justify the expense and trouble of a long process like cooking. yet this was probably one of the main reasons why cooking came into use in the first place; and it is still one of the most important reasons for continuing it. no one would feel attracted by a plate of slabs of raw meat, with a handful of flour, a raw potato or two, and some green apples; but cook these and you immediately have an appetizing and attractive meal. any food, to be a thoroughly good food, must "taste good"; otherwise, part of it will fail to be digested, and will sooner or later upset the stomach and clog the appetite. cooking makes food easier to chew and digest. the second important use of cooking is that it makes food both easier to masticate and easier to digest. as we have seen, it bursts the little coverings of the starchy grains, and makes the tough fibres of grains and roots crisp and brittle, as is well illustrated in the soft, mealy texture of a baked potato, and in the crispness of parched wheat or corn. it _coagulates_, or curdles, the jelly-like pulp of meat, and the gummy white of the egg, and the sticky gluten of wheat flour, so that they can be ground into tiny pieces between the teeth. [illustration: the kitchen should be cared for as one of the most important rooms in the house] we could hardly eat the different kinds of grains and meals and flours in proper amounts at all, unless they were cooked; indeed they require much longer and more thorough baking, or boiling, than meats. the amount of cooking required should always be borne in mind when counting the cost of a diet, as the fuel, time, and labor consumed in cooking vegetable articles of diet often bring up their expense much more nearly to that of meats than the cost of the raw material in the shops would lead us to expect. cooking sterilizes food. a third, and probably on the whole, the most valuable and important service rendered by cooking is, that it sterilizes our food and kills any germs, or animal parasites, which may have been in the body of the animal, or in the leaves of the plant, from which it came; or, as is far the commoner and greater danger, may have got on it from dirty or careless handling, or exposure to dust. while it was undoubtedly the great improvement that cooking makes in the taste of food that first led our ancestors--and probably chiefly induces us--to use the process, it is hardly probable that they would have continued to bear the expense, trouble, and numerous discomforts of cooking, had they not noticed this significant fact: that those families and tribes that had the habit of thoroughly cooking their food, suffered least from diseases of the stomach and intestines, and hence lived longer and survived in greater numbers than the "raw fooders." we are perfectly right in spending a good deal of time, care, and thought on cooking, preparing, and serving our food, for we thus lengthen our lives and diminish our sicknesses. civilized man is far healthier than any known "noble savage," in spite of what poets and story-tellers say to the contrary. the three methods of cooking. the three[ ] chief methods of cooking--_baking_, or roasting; _boiling_, or stewing; and _frying_--have each their advantages as well as disadvantages. no one of them would be suitable for all kinds of food; and no one of them is to be condemned as unwholesome in itself, if intelligently done; although all of them, if carelessly, or stupidly, carried out, will waste food, and render it less digestible instead of more so. in the main, the methods that are in common use for each particular kind of food, or under each special condition, are reasonable and sensible--the result of hundreds of years of experimenting. the only exceptions are that, on account of its ease and quickness, frying is resorted to rather more frequently than is best; while boiling is more popular than it should be, on account of the small amount of thought and care involved in the process. roasting, or baking. roasting, or baking, is probably the highest form of the art of cooking, developing the finest flavors, causing less waste of food value, and requiring the greatest skill and care. on general principles, we may say that almost anything which can be roasted or baked, should be roasted or baked. on the other hand, roasting or baking has the disadvantage of taking a great deal of fuel and of time, and of being exceedingly fatiguing and annoying for the cook, making the labor cost high; and it cannot be used where a meal is needed in a hurry. if the process is carelessly done and carried too far, it may also waste a great deal of the food material, either by burning or scorching, or by the commoner and almost equally wasteful process of turning the whole outside of the roast--particularly in the case of meat--into a hard, tough, leathery substance, which it is almost impossible either to chew or to digest. boiling. the advantages of boiling are that it is the easiest of all forms of cookery, and within the grasp of the lowest intelligence; that, on account of keeping the food continually surrounded by water, it leads to less waste and is far less likely than either baking or frying to result in destroying part of the food if not carefully watched; and that it can be used in cooking many cheap, coarse foods, such as the mushes, graham meal, corn meal, hominy, potatoes, cabbages, turnips, etc., which furnish the bulk of our food. on the other hand, from the point of view of fuel used, it is the most expensive of all forms of cooking; and unless a fire is being kept up for other purposes, which allows boiling or stewing to go on on the back of the stove as an "extra," without additional expense, careful experiments have shown that the prolonged boiling needed by many of these cheaper and coarser foods, especially such as are recommended by most diet reformers, brings their total cost up to that of bread, milk, eggs, sugar, and the cheaper cuts of meat,--all of which are more wholesome and more appetizing foods. [illustration: a knowledge of cooking is a valuable part of a good education] the supposed saving in boiling meat, that you get two courses, soup and meat, out of one joint, is imaginary; for, as we have seen, the soup or water in which meat has been boiled contains little, or nothing, of the fuel value, or nourishing part of the meat; and all the flavor that is saved in this is lost by the boiled meat, rendering it not only much less appetizing, but also less digestible. you cannot have the flavor of your food in two places at once. if you save it in the soup, you lose it from the meat. frying. the chief advantages of frying are its marked saving of time, of fuel, and of discomfort to the cook; it also develops the appetizing flavors of the food to a very high degree. a wholesome, appetizing meal can be prepared by frying, much more quickly than by either baking or boiling, and with less than half the fuel expense. [illustration: boys, as well as girls, should know how to cook] the drawbacks of frying come chiefly from unintelligent and careless methods of applying it. it is somewhat wasteful of food material, particularly of meats; although, if the fat which is fried out in the process can be used in other cooking, or turned into a gravy, a good deal of this waste can be avoided. as, in frying, some form of fat has to be used to keep the food from burning, this fat is apt to form a coating over the surface and, if used in excessive amounts, at too low a temperature, may soak deeply into the food, thus coating over every particle of it with a thick, water-proof film, which prevents the juices of the stomach and the upper part of the bowel from attacking and digesting it. this undesirable result, however, can be entirely avoided by having both the pan and the melted fat which it contains, _very_ hot, before the steak, chop, potatoes, or buckwheat cakes are put into the pan. when this is done, the heat of the pan and of the boiling fat instantly sears over the whole surface of the piece of food, and forms a coating which prevents the further penetration of the fat. quick frying is, as a rule, a safe and wholesome form of cooking. slow frying, which means stewing in melted grease for twenty or thirty minutes, is one of the most effective ways ever invented of spoiling good food and ruining digestion. why every one should learn how to cook. every boy and every girl ought to know how to cook. cooking is a most interesting art, and a knowledge of it is a valuable part of a good education. everybody would find such a knowledge exceedingly useful at some time in his life; and most of us, all our lives long. as a life-saving accomplishment, it is much more valuable than knowing how to swim. every schoolhouse of more than five rooms should have a kitchen and a lunch room as part of its equipment, and classes should take turns in cooking and serving lunches for the rest of the children.[ ] footnotes: [ ] for meats a fourth method may be used--_broiling_, which for flavor and wholesomeness is superior to any other, but requires a special and rather expensive type of clear, hot fire and a high degree of skill. [ ] whenever lunches are brought by children, or the school-lunch is a problem, if possible equip a spare room with a gas or a coal stove, sink, tables, chairs, necessary dishes, etc., and let classes under direction of teacher take turns in purchasing food supplies for lunch; cooking and serving lunch; planning dietaries with reference to balanced nutrition, digestibility, and cheapness; washing pots, pans, and dishes; cleaning kitchen; protecting and storing foods; finding risks of spoiling, contamination, infection, fly-visiting; and practicing other forms of kitchen hygiene. chapter ix our drink filling the boiler of the body-engine the need of water in the body-engine. if you have ever taken a long railway journey, you will remember that, about every two or three hours, you would stop longer than usual at some station, or switch, for the engine to take in water. no matter how briskly the fire burns in the furnace, or how much good coal you may shovel into it, if there be no water in the boiler above it to expand and make steam, the engine will do no work. and an abundant supply of water is just as necessary in our own bodies, although not used in just the same way as in the engine. the singular thing about water, both in a locomotive and in our own bodies is that, absolutely necessary as it is, it is neither burned up nor broken down in any way, in making the machine go; so that it gives off no energy, as our food does, but simply changes its form slightly. exactly the same amount of water, to the ounce, or even the teaspoonful, that is poured into the boiler of an engine, is given off through its funnel and escape-pipes in the form of steam; and precisely the same amount of water which we pour into our stomachs will reappear on the surface of the body again in the form of the vapor from the lungs, the perspiration from the skin, and the water from the kidneys. it goes completely through the engine, or the body, enables the one to work and the other to live, and yet comes out unchanged. just how water works in the engine we know--the heat from the furnace changes it into steam, which means that heat expands it, or makes it fill more space. this swelling pushes forward the cylinder that starts the wheels of the engine. the next puff gives them another whirl, and in a few minutes the big locomotive is puffing steadily down the track. water is necessary to life. just how water works in the body we do not know, as most of it is not even turned into steam or vapor. but this much we do know, that life cannot exist in the absence of water. odd as it may seem to us at first sight, ninety-five, yes, ninety-nine per cent of our body cells are water-animals, and can live and grow only when literally swimming in water. the scaly cells on the surface of our skin, our hair, and the tips of our nails are the only parts of us that live in air. in fact, over five-sixths of the weight and bulk of our bodies is made up of water. some one has quaintly, but truthfully, described the human body as composed of a few pounds of charcoal, a bushel of air, half a peck of lime, and a couple of handfuls of salt dissolved in four buckets of water. the reason why nearly all our foods, as we have seen, contain such large amounts of water is that they, also, are the results of life--the tissues and products of plants or animals. water frees the body from waste substances. water in the body, then, is necessary to life itself. but another most important use is to wash out all the waste substances from the different organs and tissues and carry them to the liver, the kidneys, the lungs, and the skin, where they can be burned up and got rid of. we must keep our bodies well flushed with water, just as we should keep a free current of water flowing through our drain-pipes and sewers. it keeps the body from getting over-heated. in summer time, or in hot climates the year round, an abundant supply of water is of great importance in keeping the body from becoming overheated, by pouring itself out on the skin in the form of perspiration, and cooling us by evaporation, as we shall see in the chapter on the skin. the meaning of thirst. none of us who has ever been a mile or more away from a well, or brook, on a hot summer's day needs to be told how necessary water is, for comfort as well as for health. the appetite which we have developed for it--_thirst_, as we call it--is the most tremendous and powerful craving that we can feel, and the results of water starvation are as serious and as quick in coming as is the keenness of our thirst. men in fairly good condition, if they are at rest, and not exposed to hardship, and have plenty of water to drink, can survive without food for from two to four weeks; but if deprived of water, they will perish in agony in from two to three days. [illustration: the chained cup an "exchange" for disease germs.] we should drink three pints of water a day. although all our foods, either as we find them in the state of nature, or as they come on the table cooked and prepared for eating, contain large quantities of water, this is not enough for the needs of the body; to keep in good health we must also drink in some form about three pints, or six glassfuls, of water in the course of the day. part of this goes, as you will remember (p. ), to dissolve the food so that it can be readily absorbed by our body cells in the process of digestion. where our drinking water comes from water contained in our food is pure. seeing that five-sixths of our food is water, it is clearly of the greatest importance that that water should be pure. that part of our water supply which we get in and with our foods is fortunately, for the most part, almost perfectly pure, having been specially filtered by the plants or animals which originally drank it, or having been boiled in the process of cooking. [illustration: the spouting fountain where no lips need touch the cup.] water is always in motion. the part of our water supply which we take directly, in the form of drinking water, is, however, unfortunately anything but free from danger of impurities. the greatest difficulty with water is that it will not "stay put"--it is continually on the move. the same perpetual circulation, with change of form, but without loss of substance, which is taking place in the engine and in our bodies, is taking place in the world around us. the water from the ocean, the lakes, and the rivers is continually evaporating under the heat of the sun and rising in the form of vapor, or invisible steam, into the air. there it becomes cooler, and forms the clouds; and when these are cooled a little more, the vapor changes into drops of water and pours down as rain, or, if the droplets freeze, as snow or hail. the rain falls upon the leaves of the trees and the spears of the grass, or the thirsty plowed ground, soaks down into the soil and "seeps" or drains gradually into the streams and rivers, and down these into the lakes and oceans, to be again pumped up by the sun. all we can do is to catch what we need of it, "on the run," somewhere in the earthy part of its circuit. why our drinking water is likely to be impure. every drop of water that we drink or use, fell somewhere on the surface of the earth, in the form of rain or snow; and if we wish to find out whether it is pure and safe, we must trace its course through the soil, or the streams, from the point where it fell. our drinking water has literally washed "all outdoors" before it reaches us, and what it may have picked up in that washing makes the possibilities of its danger. as it falls from the skies, it is perfectly pure--except in large cities or manufacturing centres, where rain water contains small amounts of soot, smoke-acids, and dust, but even these are in such small amounts as to be practically harmless. but the moment it reaches the ground, it begins to soak up something out of everything that it touches; and here our dangers begin. risks from leaf mould. practically the whole surface of the earth is covered with some form of vegetation--grass, trees, or other green plants. these dying down and decaying year after year, form a layer of vegetable mould such as you can readily scratch up on the surface of the ground in a forest or old meadow; this is known as leaf mould, or _humus_. as the water soaks through this mould, it becomes loaded with decaying vegetable matter, which it carries with it down into the soil. most of this, fortunately, is comparatively harmless to the human digestion. but some of this vegetable matter, such as we find in the water from bogs or swamps, or even heavy forests, will sometimes upset the digestion; hence, the natural dislike that we have for water with a marshy, or "weedy," taste. [illustration: nature's filter-bed the spring water is pure; the brook may gather infection as it goes.] nature's filter-bed. when, however, this peaty water soaks on down through the grass, roots, and leaf mold, into the soil, it comes in contact with nature's great filter-bed--the second place in the circuit where the water is again made perfectly pure. this filter-bed consists of a layer of more or less spongy, porous soil, or earth, swarming with millions of tiny vegetable germs known as bacteria. these eagerly pick out all the decaying vegetable substances of the water and feed upon them, changing them into harmless carbon dioxid water, and small amounts of _ammonia_. not only will this filter-bed, or spongy mat of bacteria, burn up and remove all traces of vegetable decay, but if the rain happens to have soaked through the decaying body of a bird or animal or insect, the bacteria will just as eagerly feed upon these animal substances and change them into harmless gases and salts.[ ] by the time the rain water has reached the deeper layers of the soil, it is again perfectly pure and has also, in seeping through the soil, picked up certain mineral salts (such as _calcium_, _sodium_, and _magnesium_) which are of use in the body; so that in an open or thinly settled country, the water in streams, rivers, and lakes is usually fairly pure and quite wholesome. that is why, in ancient times, the great majority of villages and towns and camps were situated on the bank of some stream, where a supply of water could easily be obtained. causes and dangers of polluted water wells--the oldest method of supplying water. it was long ago discovered that, by digging pits or holes in the ground, the rain water, in its steady flow toward the streams and lakes, could be caught or trapped, and that if the pit were made deep enough, a sufficient amount would accumulate during the winter or spring to last well on into the summer, unless the season were unusually dry. these pits, or water traps, are our familiar _wells_, from which most of our water supply, except in the large cities, is still taken. these wells were naturally dug, or sunk, as near as might be to the house, so as to shorten the distance that the water had to be carried; and from this arose their chief and greatest source of danger. the danger to wells from household waste. every house has, like our bodies, a certain amount of waste, which must be got rid of. some of this material can, of course, be fed to pigs and chickens, and in that way disposed of. but the simplest and easiest thing to do with the watery parts of the household waste is to take them to the back door and throw them out on the ground, while table-scraps and other garbage are thrown into the long grass, or bushes--a method which is still, unfortunately, pursued in a great many houses in the country and the suburbs of towns. if the area over which they are thrown is large enough, and particularly if the soil is porous and well covered with vegetation, nature's filter-bed--the soil, the bacteria, and the roots of the grass and other plants combined--will purify a surprising amount of waste; but there is always the danger, particularly in the wet weather of spring and of late fall, that the soil will become charged with more of these waste matters than the bacteria can destroy, and that these waste poisons will be washed down in the rain water right into the pit, or trap, which has been dug for it--the well. [illustration: an example of good farm drainage here the farmhouse is set above the barn, pens, and cattle yard, and at some distance from them. the drainage from these is into the lower fields, so that a well driven into the high ground not far from the house is presumably safe.] the danger from outbuildings. this danger is further increased by the fact that for the same reason--the vital need of plenty of water for all living creatures--the hen coop, the pig pen, the cow stable, and the horse barn are all likely to be built clustering around this same well. if the fertilizer from these places is, as it should be in all intelligent farming, protected from the rain so as not to have all its strength washed out of it, and removed and spread on the soil at frequent intervals, the well may even yet escape contamination; but the chances are very strongly against it. if you will figure out that a well drains the surface soil in every direction for a distance from ten to thirty times its own depth, and that the average well is about twenty-five feet deep, you can readily see what a risk of contaminating the well is caused by every barn, outhouse, or pen within from sixty to a hundred and fifty yards from its mouth. every well from which drinking water is taken should be at least fifty, and better, a hundred and fifty, yards away from any stable, outhouse, or barn; or set well up-hill from it, so that all drainage runs away from its basin. this, of course, is possible only in the country, or in villages or small towns, where houses have plenty of ground about them. consequently, the health laws of most cities and states forbid the use of shallow wells for drinking purposes in cities of over , population. causes which produce pure well water. occasionally a well will be driven through a layer of rock or hard water-proof clay, before the water-bearing layer of soil, or sand, is struck, so that its water will be drawn, not from the rain that falls on the surface of the ground immediately about it, but from that which has fallen somewhere at a considerable distance and filtered down through the soil. this water, on account of the many, many layers of soil through which it has filtered, and the long distance it has come, is usually fairly pure, so far as animal or vegetable impurities are concerned, though it is apt to have become too strong in certain salty and mineral substances, which give it a taste of salt, or iron, or sulphur. if, however, it is free from these salty substances, it makes a very pure and wholesome drinking water; and if the upper part of the well shaft be lined with bricks and cement, so that the surface water cannot leak into it, it may be used with safety for drinking purposes even in the heart of a city. [illustration: the danger spot on the farm the milk inspector on visiting this dairy farm found that the well was receiving the drainage of both house and privy. the well water was used for drinking and for washing the milk pails (seen behind the fence).] the greatest single danger to well water. the greatest single danger to the purity of well water is the privy vault. this is doubly dangerous, first, because it is dug below the level at which the bacteria in the soil are most abundant and active, so that they cannot attack and break up its contents; and the impurities, therefore, are gradually washed down by the rain water into the soil, unchanged, and seep directly into the well. the other reason is that its contents may contain the germs of serious diseases, particularly typhoid fever and other bowel troubles. these germs and their poisons would usually be destroyed by the bacteria of the soil, if not poured out in too large quantities; but in the privy vault they escape their attack, and so are carried on with the slow leakage of water into the well; then those who use that water are very liable to have typhoid fever and other serious diseases. early methods of prevention. on account of these filth-dangers, it began, a century or so ago, to be the custom in cleanly and thoughtful households to provide, first, ditches, and then, lines of pipes, made out of hollow wood or baked clay, and later of iron, called drains, through which all the watery parts of household wastes could be carried away and poured out at some distance from the house. then toilets, or flush-closets, were built, and this kind of waste was carried completely away from the house, and beyond danger of contaminating the wells. how streams were contaminated. for a time this seemed to end the danger, as the waste was soaked up by the soil, and eaten by its hungry bacteria and drunk up again by the roots of plants. but when ten or a dozen houses began to combine and run their drain-pipes together into a large drain called a sewer, then this could not open upon the surface of the ground, but had to be run into some stream, or brook, in order to be carried away. as cities and towns, which had been obliged to give up their wells, were beginning to collect the water from these same brooks and streams in reservoirs and deliver it in pipes to all their houses, it can be easily seen that we had simply exchanged one danger for another. the loss of life from typhoid fever. for a time, indeed, it looked as if the new danger were the greater of the two, because, when the typhoid germs were washed into a well, they poisoned or infected only one, or at most two or three, families who used the water from that well. but when they were carried into a stream which was dammed to form a reservoir to supply a town with water, then the whole population of the town might become infected. a great many epidemics of typhoid fever occurred in just this way, before people realized how great this danger was. simply from the pouring of the wastes from one or two typhoid fever cases into the streams leading into the water reservoir used by a town, five hundred, a thousand, or even three or four thousand cases of typhoid have developed within a few weeks, with from one hundred to five hundred deaths. [illustration: typhoid epidemic in the mohawk-hudson valley, - in - typhoid fever broke out in schenectady on the mohawk river. following this, cohoes and west troy, which drew their water supply from the mohawk below schenectady, and albany, which drew its supply from the hudson below the mouth of the mohawk, suffered from typhoid epidemics; while waterford and troy, which drew their supplies from the hudson _above_ the mouth of the mohawk, and the river towns that, like lansingburgh, drew from other sources, entirely escaped the infection.] in fact, even to-day, when these dangers are better understood, and while most of our big cities are getting fairly clear of typhoid, so ignorant and careless are the smaller towns, villages, and private houses all over the united states, that over , deaths[ ] from typhoid fever occur every year in a country which prides itself upon its cleanliness and its intelligence. this means, too, that there are at least half a million people sick of the disease, and in bed or utterly prevented from working, for from five to fifteen weeks each. all of which frightful loss of human life and human labor, to say nothing of the grief, bereavement, and anxiety of the two million or more families and relatives of these typhoid victims, is due to eating dirt and drinking filth. dirt is surely the most expensive thing there is, instead of the cheapest. methods of obtaining pure water wise planning and spending of money is necessary. if our city wells are defiled by manure heaps and vault-privies, and our streams by sewage, where are we to turn for pure water? all that is required is foresight and a little intelligent planning and wise spending of money. of course the community must take hold of the problem, through a board of health, or health officer, appointed for the purpose; and this is why questions of health are coming to play such an important part in legislation, and even in politics. no matter how fast a city is growing or how much money its inhabitants are making, if it has an impure water supply or a bad sewage system, there will be disease and death, suffering and unhappiness among its people, which no amount of money can make up for. cleanliness is not only next to godliness, but one of the most useful forms of it; and a city can afford to spend money liberally to secure it--in fact, it is the best investment a city can make. artesian and deep wells. the earliest, and still the most eagerly sought-for, source of pure water supply is springs or deep wells, such as we have referred to. both of these are fed by rain water which has fallen somewhere upon the surface of the earth. as the layers of earth or rock, of which the crust of the earth is made up, do not run level, or horizontal, but are tilted and tipped in all directions, this rain water soaks down until it reaches one of these sloping layers that is so hard, or tough, as to be waterproof, and then runs along over its surface in a sort of underground stream. if anywhere in the course of this stream a very deep well shaft is driven right down through the soil until it strikes the surface of this sloping layer of rock, then the water will rise in this shaft to the level of the highest point from which it is running. [illustration: artesian well borings the sketch shows a wide section from northern illinois to central wisconsin, in which the cities have rejected the water supplies afforded by the rivers, choosing instead to bore down almost to hard rock to insure the purity of the supply.] if this highest point of the waterproof layer be many miles away, up in the hills above the surface of the ground where the well is dug, then the water will rise to the surface and sometimes even spout twenty, thirty, or fifty feet above it. this forms what is known as a _gushing_, or _artesian_, well (from artois, a province in france, in which such wells were first commonly used) and furnishes a very pure and valuable source of water supply. if it rises only twenty, thirty, or fifty feet in the well-shaft, but keeps flowing in at a sufficient rate, then we get what is known as a "living," or _permanent_ well, and this also is a very valuable and pure source of water supply. springs. springs are formed on the same plan as the deep well, but with the difference that the waterproof layer on top of which the water is running either crops out on the surface again, lower down the mountain, or folds upon itself and comes up again to the surface some distance away from the mountain chain, out on the level. this is why springs are usually found in or near mountainous or hilly regions. if the water of a spring has gone deep enough into, or far enough through, the layers of the earth, it may, like water of some of the artesian wells, contain certain salts and minerals, particularly soda, sulphur, and iron. such springs are often highly valued as mineral water, healing springs, or baths, partly because of these salts, partly on account of their peculiar taste. most of the virtues ascribed to mineral waters or springs are due, however, to their _pure water_, and its cleansing effects internally and externally when freely used. springs are among the most highly prized sources of water supply, because they have gone underground sufficiently deep to become well filtered and cooled to a low temperature, and usually not far enough to become too heavily loaded with salts or minerals like the waters of the deep wells. it must, however, be remembered that they also come from rain-water, and that in hilly or broken regions the source of that rain water may be the surface of the ground only a few hundred yards up the hill or mountain, and impurities there may affect it. much of the delightful sparkle of spring water is due, as in the case of the popular soda water, to the presence of carbon dioxid, only in spring water it is produced by the decomposition of vegetable matter in it. as springs usually break out in a hollow or at the foot of a hill, unless carefully closed in they are quite liable to contamination from rain water from the surrounding surface of the ground. where springs of a sufficient size can be reached, or a sufficiently "live" series of deep wells can be bored, these furnish a safe source of water supply for cities. but of course not more than one city in five or ten is so favored. mountain reservoirs. two other methods of securing a water supply are now generally adopted. one is to pick out some stream up in the hills or mountains, within fifteen miles or so of the city, and put in a dam, thus making a reservoir, or to enlarge some lake which already exists there. at the same time, the entire valley, or slope of the mountain, which this stream or lake drains of its surface water, is bought up by the government, or turned into a forest reserve, so that no houses can be built or settlement of any kind permitted upon it. it can still be used for lumber supply, for pastures, and, within reasonable limits, for a great public hunting and fishing reserve and camping resort. [illustration: a city water supply brought from the far hills] almost every intelligent and farsighted town, which has not springs or deep wells, is looking toward the acquirement of some such area as this for its source of pure water. many great cities go from thirty to fifty miles, and some even a hundred and fifty miles, in order to reach such a source, carrying the water into the city in a huge water-pipe, or _aqueduct_. these cities find that the millions of dollars saved by the prevention of death and disease amount to many times the cost of such a system, while the water rents gladly paid by both private houses and manufacturing establishments give good interest on the investment. any town can afford to go a mile for every thousand of its population for such a source of water supply as this; and secure, _gratis_, a valuable forest preserve, public park, and beauty spot.[ ] filtration. the other method, which has to be adopted by cities situated on level plains, or at the mouths of great rivers, is to take the water of some lake, or river, as far out in the former, or as high up the latter, as possible, and purify it by filtration. this can be done at a moderate expense by preparing great settling-basins and filter-beds. the first are great pools or small lakes, into which the water is run and held until most of the mud and coarser dirt has settled or sunk. then this clear water above the sediment is run on to great beds, first of gravel, then of coarse sand, then of fine sand; and if these beds are large enough, and frequently changed and cleaned, so that they do not become clogged, and the process is carried out slowly, the water, when it comes through the last bed, is pure enough to drink safely.[ ] [illustration: a reservoir and costly dam] one of these sources of a safe and wholesome water-supply--the deep flowing well, or spring; the water shut up in the mountains in its lake or reservoir; or the slow filter-bed--should be used by every intelligent and progressive town of more than a thousand inhabitants. sewage and its disposal. at the same time, while seeking a source of water-supply far removed from any possibility of contagion, we must not neglect the other end of the problem, the protecting of our rivers and lakes from pollution so far as possible; for the water from these must necessarily be used by thousands of people along their banks, either directly, or in the form of shallow wells, sunk not far from the water's edge. moreover, so foul are many of our rivers and streams becoming in thickly settled regions that fish can no longer live in them, and it is hardly safe to bathe in them.[ ] fortunately, however, a great deal of the worst contamination can be prevented by using modern methods of disposing of sewage, such as filter-beds and sewage farms. all of these methods use the bacteria of the soil, or crops growing in it, to eat up the waste and thus purify the sewage. [illustration: scraping the sediment from the bottom of a reservoir] home methods of purifying water boiling. where the water that you are obliged to drink is not known to be pure, then it can be made quite safe for drinking purposes by the simple process of boiling it for about ten or fifteen minutes. but this, except in travelling or in emergencies, is a lazy, slipshod substitute for pure water, and extremely unsatisfactory as well; for the boiling drives off all its air and other gases, and throws down most of the salts, so that boiled water has a flat, insipid taste. these salts, although sometimes regarded as impurities, are not such in any true sense; for the lime and soda especially are of considerable value in the body, so that boiled or sterilized water is neither a pleasant nor a wholesome permanent drink. instead of boiling the water, get to work to protect your own well from filth of all sorts, if you drink well water; or, if not, to help the board of health to agitate, and keep on agitating, until something is done to compel your selectmen or city council to secure a pure supply. [illustration: the domestic filter in use unless the sand and charcoal in the glass bulb is very frequently cleaned, it serves merely as a "catch-all" for impurities, through which the water must flow.] domestic filters. much the same must be said of _private_ or _domestic filters_. these are, at best, temporary substitutes, and should not be depended upon for permanent use. many of them are made to sell rather than to purify, and will remove only the larger or mechanical impurities from the water. others, while they work well at first, are exceedingly likely to become clogged, when the tendency is to punch at them to make them work faster, thus either poking a hole through them or cracking the filter-shell, so that a stream of water flows steadily through, just as impure as when it entered. private filters, like boiling water, are only temporary ways of meeting conditions _which ought not to be allowed to exist at all_ in civilized communities, or in your own homes. a score of court decisions in all parts of the world have now held that the water company is legally responsible for all avoidable pollution of public water-supplies, and nine tenths of pollutions _are_ avoidable. footnotes: [ ] these gases and salts are eagerly sucked up by the roots of plants, so that the soil bacteria are our best friends, changing poisonous decaying things into harmless plant-foods. they are the chief secret of the fertility of a soil; and the more there are of them the richer a soil is. [ ] this makes fourteen times as many deaths from typhoid in proportion to the population as occur in germany. [ ] new york city, for instance, goes forty miles up into the hills to the great croton reservoir for its water supply; and as this is proving insufficient, is preparing to go ninety-five miles up into the ramapo hills to secure control of a whole country-side for a permanent source of supply. portland, oregon, nearly twenty years ago, with then a population of some , , built an aqueduct sixty miles up into the mountains to a lake on the side of mt. hood, and has reaped the advantages of its foresight ever since, in a low death rate and a rapid growth ( , in ), as well as a financial profit on its investment. los angeles, california, is preparing to build an aqueduct a hundred and thirty miles, and tunnel two mountain ranges in order to reach an inexhaustible supply of water. [ ] of late, currents of electricity are passed through the water (setting free _oxygen_ or _ozone_) which make the purifying of it much more rapid and complete. it is, however, often considered safer to pass the water through still another filter bed, consisting of layers of charcoal, which has the power of gathering oxygen in its pores, to attack and _oxidize_, or burn up, the remaining impurities in the water. a sort of scum forms over the surface of the last and finest bed of sand or charcoal, and if this scum is not too frequently removed, though it makes the filtering slower, the water comes out purer. on examining this scum, we find it to consist of a thick mat of our old friends, the purifying bacteria of the soil. so that the last step of our artificial filtration is simply an imitation of nature's great filter-bed. [ ] several streams emptying into the ohio river from a thickly settled region are said to be actually pumped out into waterworks systems, used for drinking, washing, and manufacturing, and run back into the river again through sewers by the different cities along its banks, at such frequent intervals that every drop of water in them passes through waterworks systems and sewers _three times_ before it reaches the mouth of the stream. chapter x beverages, alcohol, and tobacco the popularity of beverages. for some curious reason, the habit has grown up of taking a large part of the six glasses of water that we require daily in the form of mixtures known as beverages. these beverages are always much more expensive than pure water; are often quite troublesome to secure and prepare; have little, or no, food value; are of doubtful value even in small amounts; and injurious in large ones. why they should ever have come into such universal use, in all races and in all ages of the world, is one of the standing puzzles of human nature. they practically _all consist of from ninety to ninety-eight per cent_ of water, the food elements that may be added to them being in such trifling amounts as to be practically of no value. they serve no known useful purpose in the body, save as a means of introducing the water which they contain; and yet mankind has used them ever since the dawn of history. we have no natural appetite for beverages. it is a most striking fact that, although these beverages have been drunk by the race for centuries, we _have never developed an instinct or natural appetite for them_! no child ever yet was born with an appetite or natural liking for beer or whiskey; and very few children really like the taste of tea or coffee the first time, although they soon learn to drink them on account of the sugar and cream in them. thus, nature has clearly marked them off from all the _real_ foods on our tables, showing that they are not essential to either life or health; and that they are absolutely unnecessary, and almost always harmful in childhood and during the period of growth. if no child ever drank alcohol until he really craved it, as he craves milk, sugar, and bread and butter, there would be no drunkards in the world. our other food-instincts have shown themselves worthy to be trusted--why not trust this one, and let these beverages, especially alcohol, absolutely alone? statistics from the alcoholic wards of our great hospitals show that of those who become drunkards, nearly ninety per cent _begin to drink before they are twenty years old_. of that ninety per cent, over two-thirds took their first drink, not because they felt any craving for it, or even thought it would taste good, but because they saw others doing it; or thought it would be a "manly" thing to do; or were afraid that they would be laughed at if they didn't! whatever vices and bad habits our natural appetites, and so-called "animal instincts," may lead us into, drunkenness is not one of them. this striking hint on the part of nature, that alcoholic beverages are unnecessary, is fully confirmed by the overwhelming majority of hundreds of tests which have been made in the laboratory, showing clearly that, while these beverages may give off trifling amounts of energy in the body, their real effects and the sole reason for their use are their stimulating, or their discomfort-deadening (_narcotic_) effect. and the more carefully we study them, the heavier we find the price that has to be paid for any temporary relief or enjoyment which they may seem to give. tea, coffee, and cocoa. the "weakest" and most commonly used of these beverages or amusement foods, are tea, coffee, and cocoa. these have an agreeable taste, mildly stimulate the nervous system, and, when used in moderation by adults, seldom do much harm. to a small percentage of individuals, who are specially sensitive to their effects, they seem to act as mild poison-foods, much in the same way as strawberries, cheese, or lobsters do to others. tea is made from the green leaves of a shrub growing in hilly districts in china, japan, and southern india. the finer and more delicately flavored brands are from the young leaves, shoots, and flowers of the plant; while the coarser and cheaper are from the old leaves, stalks, and even twigs--the latter containing the most _tannin_, which, as we shall see, is the most injurious element in tea. coffee is made from the seeds of a cherry-like berry growing upon a shrub, or low tree, on tropical hillsides. the bulk of our supply comes from south america, and is known as "rio" coffee, from rio janeiro, the port in brazil from which most of it is shipped. that from the east indies is known as java, and that from arabia as mocha; though these last two are now but little more than trade-names for certain finer varieties of coffee, no matter where grown. cocoa and chocolate are made from the bean-like seeds of a small tree growing in the tropics and, in cake, or solid, form, contain considerable amounts of fat, and usually sugar and vanilla, which have been added to them to improve their flavor. as, however, only a teaspoonful or so of the powdered cocoa, or chocolate, goes to make a cupful, the actual food value of cocoa or chocolate, unless made with milk, is not much greater than that of tea or coffee with cream and sugar. they contain less _caffein_ than either tea or coffee, but are liable to clog rather than to increase the appetite for other foods. effects of tea, coffee, and cocoa. though the flavors of tea, coffee, and cocoa are so different, they all depend for their effect upon a spicy-tasting substance, called caffein from its having been first separated out of coffee. the caffein of tea is sometimes called _thein_, and that of cocoa _theobromin_; but they are all practically the same substance. part of the taste of these beverages is due to the caffein, but the special flavor of each is given by spicy oils and other substances which it contains. caffein acts as a mild stimulant both to the nervous system and brain, and to the heart; as is shown by the way in which tea or coffee will wake us up or refresh us when tired, or, if drunk too late at night, keep us from going to sleep. if used in large amounts, especially if taken as a substitute for food, tea and coffee upset the nervous system and disturb the heart, and produce an unwholesome craving for more. [illustration: a milk station in a city park many cities have established such stations, where people can buy, for a cent or two, a drink that is far better than soda water or any other beverage.] their chief value lies in the hot water they contain, which has been sterilized by boiling, while its heat assists the process of digestion; and in the fact that their agreeable taste sometimes gives us an appetite and enables us to eat more of less highly flavored foods, like bread, crackers, potatoes, or rice, than we would without them. they are, also, usually taken with cream, or milk, or sugar, which are real foods and bring their fuel value up to about half that of skimmed milk. so far as they stimulate the appetite and increase the amount of food eaten, they are beneficial; but when taken as a substitute for real food, they are most injurious. a cup of coffee, for instance, makes a very poor breakfast to start the day on; for although it gives you a comforting sense of having eaten something warm and satisfying, it contains very little real food, and soon leaves you feeling empty and tired; just as an engine would give out if you put a handful of shavings into its fire-box, and expected it to do four hours' work on them. the most disturbing effects of tea and coffee upon the digestion are due to the tannin which they contain if boiled too long, especially in the case of tea. this tannin, fortunately, will not dissolve in water except by prolonged boiling or steeping; so that if tea is made by pouring boiling water over the tea leaves and pouring it off again as soon as it has reached the desired strength and flavor, and coffee by being just brought to a boil and then not allowed to stand more than ten or fifteen minutes before use, no injurious amounts of tannin will be found in them. tea, made by prolonged stewing on the back of the stove, owes its bitter, puckery taste to tannin, and is better suited for tanning leather than for putting into the human stomach. boys and girls up to fifteen or sixteen years of age are much better off without tea, coffee, or cocoa; for they need no artificial stimulants to their appetites, while at the same time their nervous systems are more liable to injury from the harmful effects of over-stimulation. if the beverages are taken at all, they should be taken very weak, and with plenty of milk and cream as well as sugar. alcohol how alcohol is made. the most dangerous addition that man has ever made to the water which he drinks is alcohol. it is made by the action of the yeast plant on wet sugar or starch--a process called _fermentation_. usually the sugar or starch is in the form of the juice of fruits; or is a pulp, or mash, made from crushed grains like barley, corn, or rye. as the spores of this yeast plant are floating about almost everywhere in the air, all that is usually necessary is to let some fruit juice or grain pulp stand at moderate warmth, exposed to the air, when it will begin to "sour," or ferment. wine. when the yeast plant is set to work in a tub or vat of grape juice, it attacks the fruit sugar contained in the juice, and splits it up into alcohol and carbon dioxid, so that the juice becomes bubbly and frothy from the gas. when from seven to fifteen per cent of alcohol has been produced, the liquid is called wine. it contains, besides alcohol, some unchanged fruit sugar, fruit acids, and some other products of fermentation (known as _ethers_ and _aldehydes_), which give each kind of wine its special flavor. beer, ale, and cider. if the yeast germ be set to work in a pulp or mash of crushed barley or wheat, the starch of which has been partly turned into sugar by malting, it breaks up the sugar into alcohol and carbon dioxid. when it has brewed enough of the starch to produce somewhere from four to eight per cent of alcohol, then the liquid, which still contains about three or four per cent of a starch-sugar called _maltose_, is called beer, or ale. it is usually flavored with hops to give it a bitter taste and make it keep better. if the same process be carried out in apple juice, we get the well known hard cider with its biting taste. whiskey, brandy, and rum. when left to itself, the process of fermentation in most of these sugary or starchy liquids will come to a standstill after a while, because the alcohol, when it reaches a certain strength in the liquid, is, like all other toxins, or poisons produced by germs, a poison also to the germ that produces it. the yeast-bacteria probably produce alcohol as a poison to kill off other germs which compete with them for their share of the sugar or starch. so even the origin of this curious drug-food shows its harmful character. we should hardly pick out the poison produced by one germ to kill another germ as likely to make a useful and wholesome food. [illustration: proportion of alcohol in light wine in beer in whiskey the liquid shows what part of a tumblerful of each is alcohol.] if man had been content to leave this fermentation process to nature, it is probable that many of the worst effects of alcohol would never have been heard of. but these lighter forms of alcoholic drinks did not satisfy the unnatural cravings which they had themselves created. some people never can leave even bad-enough alone. so man, with an ingenuity which might have been much better used, sought a way of getting a liquor which would contain more alcohol than nature, unaided, could be made to brew in it. a little experimenting showed that the alcohol in fermenting juices was lighter than water; so that by gently heating the fermenting mass, the alcohol would evaporate and pass off as vapor, with a little of the steam from the water. then, by catching this vapor in a closed vessel and pouring cold water over the outside of the vessel, it could be condensed again in the form of a clear, brownish fluid of burning taste, containing nearly fifty per cent of alcohol, instead of the original five or six. this evaporated or distilled mixture of alcohol and water, if made from a mash of corn, wheat, rye, or potatoes, is called whiskey; if from fruit-juice, brandy. a similar liquor, made out of fermented rice, is known as _arrack_ in india, or _saké_ in japan; and the liquor made from fermented molasses is called rum. alcohol not a true food, but a drug. the much disputed question as to whether alcohol is a food or not, is really of little or no practical importance. it is quite true, as might be expected, from its close relation to sugar and the readiness, for instance, with which it will burn in an alcohol lamp or stove, that alcohol, in small amounts, is capable of being burned in the body, thus giving it energy. this may give it a certain limited value in some forms of sickness, as, for instance, in certain fevers and infections, when the stomach does not seem to be able to digest food. but here it acts as a medicine rather than as a true food and, like all other medicines, should be used only under skilled medical advice and control. for practical purposes, any trifling food value it may have is more than offset by its later poisonous and disturbing effects and, secondly, by its enormous expensiveness. the greatest amount of alcohol that could be consumed in the body at all safely would barely supply one-tenth of the total fuel value needed; and if any one were to attempt to supply the body with energy by the use of alcohol, he would be blind drunk before he had taken one-third of the amount required. from the point of view of expense alone, to take alcohol for food is like killing buffalos for their tongues and letting the rest of the carcass go to waste, as the indians and pioneer hunters of the plains used to do. it never has more than a fraction of the food value of the grain or fruit out of which it was made; and the amount of nutriment that it contains costs ten times as much as it would in any of the staple foods. moreover, when it is taken with an ordinary supply of food, it is found that, for every ounce of alcohol burned in the body, a similar amount of the other food is prevented from being consumed, and probably goes to waste, owing to the harmful effects of alcohol upon digestion. therefore, to talk of alcohol as a food is really absurd. the effect of alcohol on digestion. it has been urged by some that alcohol increases the appetite, and enables one to digest larger amounts of food. the early experiments seemed to support this claim by showing that alcohol, well diluted, and in moderate amounts, increased appetite and the flow of the gastric juice. when the experiments were carried a little further, however, it was clearly shown that its presence in the stomach and intestines, in such amounts as would result from a glass of beer, or one or two glasses of claret-wine with a meal, interfered with the later stages of digestion, so that the later harmful effects overbalanced any earlier good effects. its effect on the temperature of the body. another claim urged in its favor was that it warmed the body and protected it against cold. it ought to have been easy for any one with a sense of humor to judge the value of this claim by the fact that it was equally highly commended by its users as a means of keeping them cool in hot weather. its supposed effects in the case of both heat and cold were due to the same fact: it deadened the nerves for a time to whatever sense of discomfort one might then be suffering from, but made no change whatever in the condition of the body that caused the discomfort. any drug which has this deadening effect on the nerves is called a narcotic; and it is in this class that alcohol belongs, together with the stronger narcotics, _opium_, _chloroform_, _ether_, and _chloral_. in fact, it was quickly found in the bitter school of experience that alcohol, though producing an apparent glow of warmth for the time, instead of increasing our power to resist cold, rapidly and markedly lessens it; so that those who drink heavily are much more likely to die from cold and exposure than those who let alcohol alone. nowadays, arctic explorers, explorers in the tropics, officers of armies upon forced marches, and those who have to train themselves for the most severe strains on their powers of endurance, all bear testimony to the fact that the use of alcohol is harmful instead of helpful under these conditions, and that it is not for a moment to be compared to real foods, like meat, sugar, or fat. its effects on working power. then it was claimed that alcohol increased the working power of the body; that more work and better work would be done by men at hard labor, if a little beer, or wine, was taken with their meals. indeed, most of those who take alcohol believe that they work faster and better, and with less effort with it than without it. but the moment that this _feeling_ of increased power and strength was submitted to careful tests in the laboratory and in the workshop, it was found that instead of _more_ being accomplished when alcohol was taken, even in very moderate amounts, _less_ was accomplished by from six to twelve per cent. the false sense of increased vigor and power was due to the narcotic power of alcohol to deaden the sensations of fatigue and discomfort. it was discovered long ago, almost as soon as men began to put themselves into training for athletic feats or contests, that alcohol was not only useless, but very injurious. any champion who, on the eve of a contest, "breaks training" by "taking a drink," knows that he is endangering his record and giving his competitors an advantage over him. its deadening effect. in short, we must conclude that the so-called stimulating effects of alcohol are really due to its power of deadening us to sensations of discomfort or fatigue. its boasted power of making men more "sociable" by loosening their tongues is due to precisely the same effect: it takes off the balance-wheels of custom, reserve, and propriety--too often of decency, as well. this is where the greatest and most serious danger of alcohol comes in, that even in the smallest doses, it begins to deaden us both mentally and morally, and thus lessens our power of control. this loss of control steadily increases with each successive drink until finally the man, completely under the influence of liquor, reaches a stage when he can neither think rationally nor speak intelligently, nor even walk straight or stand upright--making the most humiliating and disgusting spectacle which humanity can present. harmful effects on the body. all doctors and scientists and thoughtful men are now practically agreed: first, that alcohol in excess is exceedingly dangerous and injurious, and one of the most serious enemies that modern civilization has to face. second, that even in the smallest doses, as a deadener of the sense of discomfort, it blinds the man who takes it to the harm it is doing and, as soon as its temporary comforting effects begin to pass off, naturally leads its victim to resort to it again in increasing doses. in fact, unlike a true food which quickly satisfies, the use of alcohol too often creates an appetite that grows by what it feeds on, and is never satisfied. for every natural appetite or instinct, nature provides a check; but she provides none for tastes that must be acquired. the last man to find out that he is taking too much is the drinker himself. taken first to relieve discomfort, its own poisonous after-effects create a new and permanent demand for it. the third point on which agreement is almost unanimous among scientists and physicians is that, as will be seen in later chapters, there are a considerable number of diseases of the liver, of the heart and blood vessels, of the kidneys, and of the nervous system, which are produced by, or almost always associated with, alcohol. there are, for instance, three different kinds of alcoholic insanity. it is true that these disease-changes most commonly occur in the tissues of those who use alcohol to excess; and it is also probably true that what the alcoholic poison is doing in these cases, is picking out the weak spots in the body and the weaker individuals in the community. even the strongest and best of us have our little weaknesses of digestion, of nerves, and of disposition that we know of, as well as others that we are not acquainted with. and what is the use of running the risk of having these picked out and made worse in this dangerous and unpleasant manner, just for the sake of a little temporary indulgence? moreover, while it is admitted that most of these harmful effects of alcohol are produced by its use in excess, it is daily becoming a more and more difficult matter to decide just how much is "excess." it certainly differs widely in different individuals, and in different organs and parts in the same body. an amount of alcohol which one man might possibly take without harm may greatly injure another; and its frequent use, though it does not produce the slightest sign of intoxication, or even of discomfort, or headache, may be slowly and fatally damaging the cells of the liver or kidney. in fact, the conviction is growing among scientists that alcohol does the greatest harm in this slow, insidious way without its user's realizing it in any way until too late to break the fearful habit. it may even be perfectly true that alcohol seriously injures not more than ten or fifteen per cent of those who take it in small quantities; but how can you tell whether you, or your liver, or kidney, or nerve cells, belong in the ten per cent or the ninety per cent class? on general principles, it would hardly seem worth while making the test simply for the sake of finding out. you never can _quite_ tell what alcohol has done to you, until the _post mortem_ (after death) examination--and then the question will not interest you very much. its effect upon character. just as alcohol deadens the body and the senses, especially the higher ones--so it has a terrible effect upon the mental and moral sides of our natures. the results of the use of alcohol are so well known that it is unnecessary here to either describe or picture them. all that is needed is to keep our eyes open upon the street, and read the police reports. what good effects upon man's better nature has alcohol to show as an offset for this dreadful tendency to bring out the worst and lowest in man? increasing knowledge of the bad effects of alcohol is decreasing its use. it is most impressive that almost everything we have found out about alcohol in the short time that we have been studying it carefully has been to its discredit. fifty years ago beer and wine, all over the civilized world, were commonly regarded as foods. now they are not considered true foods, but harmful beverages. fifty years ago alcohol was believed to improve the digestion and increase the appetite. now we know that it does neither. it was believed to increase working power, and has now been clearly shown to diminish it. it was supposed to increase the thinking power and stimulate the imagination, and now we know that it dulls and muddles both. fifty years ago it was freely used as medicine for all sorts of illnesses, both by doctor and patient; it was supposed to stimulate the heart, to sustain the strength, to increase the power of the body to resist disease, and to sustain and support life in emergencies. now we know that practically all these claims are unfounded, and that such value as it has in medicine is chiefly as a narcotic, as a deadener of the sense of discomfort. as a result, it is already used in medicine only about one-fourth as much as it was fifty years ago, and its use is still steadily decreasing. fifty years ago, in this country, in england, and on the continent of europe, farm laborers and servants living in the house, expected so many pints or quarts of ale or beer a day, as part of their regular food rations, just as they now would expect milk or tea or coffee. it was only a few years ago that the great steamship companies stopped issuing _grog_, or raw spirits, to the sailors in their employ, as part of their daily ration, because they at last came to realize how harmful were its effects. and a score of similar instances could be mentioned, showing that the unthinking and general use of alcohol as a beverage at our tables is steadily and constantly diminishing. great temperance societies are springing up in this and other civilized countries and are having a powerful influence in showing the harm of the use of alcohol and in inducing people to abstain from using it. this movement is only fairly started, but is being hastened by such practical and important influences as the experience of many of the great business corporations, such as railroads, steamship companies, insurance companies, banks, and trust companies, which support the findings of science against alcohol in almost every respect. on account of the manner in which alcohol unconsciously dulls the senses and blurs the judgment, these companies began long ago weeding out from their employ all men who were known to drink to excess; then they began to reject those who were likely to occasionally over-indulge, or take it too freely; and now, finally, many of them, particularly the railway and steamship companies, will not employ--except in the lowest and poorest paid classes of their service--and will not promote to any position which puts men in charge of human life and limb, those who use alcohol in any form or amount. nearly all the captains, for instance, of our great trans-atlantic liners, whose duties in storm or fog keep them on the bridge on continuous duty for forty-eight, sixty, and even seventy-two hours at a stretch, with thousands of lives depending upon their courage and their judgment, are total abstainers. and while twenty-five years ago they used to think that they could not go through these long sieges of storm duty without plenty of wine or whiskey, they now find that they are far better off without any alcoholic drink. another powerful force in the same direction is our insurance companies, practically all of whom now will refuse to insure any man known habitually to use alcohol to excess, because where lists have been kept of their policy-holders showing which were users of alcohol and which total abstainers, their records show that the death rate among the users of alcohol is some twenty per cent greater than among the total abstainers. a similar result has also been reached in the companies that insure against sickness, whose drinking members average nearly twice as many weeks of sickness during the year as the abstaining ones. so both of these two great groups of business corporations are becoming powerful agencies for the promotion of temperance. within fifty years from now the habitual use of alcohol will probably have become quite rare. it is already becoming "good form" among the best people not to drink; and the fashion will spread, as the bad effects of alcohol become more generally understood. tobacco smoking, a senseless habit. smoking is the curious act of drawing smoke into the mouth and puffing it out again. why this custom should have become so widespread is even a greater puzzle than is the drinking of alcohol. in civilized countries at least, it is a custom of much more recent growth than "drinking," as it was introduced into europe from america by the early explorers, notably those sent out by sir walter raleigh. as tobacco-smoke is neither a solid nor a liquid, but only a gas, no one could even pretend that it is of any value, either as food or drink. all that can be said of smoking, even by the most inveterate smoker, is that it is a habit, of no possible use or value to body or mind, and of great possibilities of harm. another singular thing about smoking is that its effects vary so greatly according to the individual who practices it, that scarcely any two smokers can agree as to the exact reason why they smoke, except that in some vague way smoking gives them pleasure. the only thing that they do agree upon is that they miss it greatly, and crave it keenly whenever they stop it. the only thing that stands out clearly about smoking is that while it does no good, and does not even give one definite and uniform kind of pleasure, it does form a powerful and over-mastering habit, which is exceedingly difficult to break, and develops a craving which can be satisfied only by continuing, or returning, to it. it is very difficult to break the habit of smoking. as a matter of practical experience, not one smoker in fifty who tries to swear off ever succeeds in doing so permanently. why then should any one form a habit, which is of no benefit whatever, which is expensive, unpleasant to others, and which may become exceedingly injurious, simply for the sake of saddling one's self with a craving which will probably never be got rid of all the rest of one's life? the strongest and most positive thing that a smoker can say about his pipe, or cigar, or cigarette, is that he could not get along without it; and he will usually add that he wishes he had never begun to use it. you are better off in every way by letting tobacco strictly alone, and never teaching yourself to like it. tobacco is not a natural taste. as might be expected, in the case of such an utterly useless drug, we have no natural liking or instinct for it; and the taste for it has to be acquired just as in the case of alcohol, only as a rule with greater difficulty and with more painful experiences of headache, nausea, and other discomforts. [illustration: a board of health examination for working papers the board of health of the city of new york requires that all children between the ages of fourteen and sixteen shall have certificates of good health before they can be employed in business. any employer who hires a child without such a certificate is liable to a heavy fine. this law is to protect the health of both the worker and the public.] nicotine, a powerful poison. tobacco contains and depends largely for its effects upon considerable amounts of a substance called _nicotine_. this is a powerful poison, even in very small doses, with only feeble narcotic, or pain-deadening, powers; but fortunately, the larger part of it is destroyed in the process of burning. enough, however, is carried over in the smoke, or absorbed through the butt of the cigar or cigarette, or the mouth-piece of the pipe, to injure the nervous system, especially in youth. as will be seen in the chapter upon the "care of the heart," it especially attacks the nerves supplying the heart, and is thus most harmful to growing boys. on account of its injurious effects upon the nerves of the heart, smoking has long been forbidden by trainers and coachers to all athletes who are training for a contest or race. in addition to its poisonous effects upon the nervous system, tobacco also does great harm to boys and young men by providing them with an attractive means of filling up their time and keeping themselves amused without either bodily or mental effort. the boy who smokes habitually will find it much easier to waste his time in day-dreams and gossip, and tends to become a loafer and an idler. the advantage that non-smokers have over smokers. when both of these influences are taken together, it is little wonder that the investigations of dr. seaver, the medical director of yale, showed that out of the men in the class of , those not using tobacco during their college course had gained, over the users of tobacco, twenty-two per cent in weight, twenty-nine per cent in height, nineteen per cent in growth of chest, and sixty-six per cent in increase of lung capacity. [illustration: a test of clear head and steady nerves the boy who smokes cigarettes finds it increasingly difficult to obtain a position in a bank or other large commercial house.] in the amherst graduating class for the same year, the non-users of tobacco had gained twenty-four per cent more in weight, thirty-seven per cent more in height, and forty-two per cent more in growth of chest than had the smokers. in lung capacity, the tobacco users had lost two cubic inches, while the abstainers had gained six cubic inches. as a wet-blanket upon ambition, a drag upon development, and a handicap upon success in life, the cigarette has few equals and no superiors. the stained fingers and sallow complexion of the youthful cigarette smoker will generally result in his being rejected when applying for a position. the employer knows that the non-smoking boy is much more likely to succeed in his work and win his way to a position of trust and influence than is the "cigarette fiend." especially in these days of sharp competition, no boy can afford to contract a habit which will so handicap him in making his way as will the cigarette habit. chapter xi the heart-pump and its pipe-line system the blood vessels where the body does its real eating. when once the food has been dissolved in the food-tube and absorbed by the cells of its walls, the next problem is how it shall be sent all over the body to supply the different parts that are hungry for it; for we must remember that the real eating of the food is done by the billions upon billions of tiny living cells of which the body is made up. the pipe lines of the body. what do we do when we want to carry water, or oil, or sewage, quickly and surely from one place to another? we put down a pipe line. we are wonderfully proud of our systems of water and gas supply, and of the great pipe lines that carry oil from wells in ohio and indiana clear to the atlantic coast. but the very first man that ever laid a pipe to carry water was simply imitating nature--only about ten or fifteen million years behind her. no sooner has our food passed through the cells in the wall of the food-tube, than it goes straight into a set of tiny tubes--the blood-pipes, or _blood vessels_--which carry it to the heart; and the heart pumps it all over the body. veins and arteries. these blood-tubes running from the walls of the food-tube to the heart are called _veins_; and the other tubes through which the heart pumps the blood all over the body are called _arteries_. if you will spell this last word "air-teries," it may help you to remember why the name was given to these tubes ages ago. when the body was examined after death, they were found to be empty and hence were not unnaturally supposed to carry air throughout the body, and "air-teries" they have remained ever since. while absurd in one way, the name is not so far amiss in another, for an important part of their work is to carry all over the body swarms of tiny baskets, or sponges, of oxygen taken from the air. why the blood is red. the first and main purpose of the blood-pipes and the heart is to carry the dissolved food from the stomach and intestines to the cells all over the body. but the cells need air as well as food; and, to carry this, there are little basket-cells--the _red corpuscles_. take a drop of blood and put it under a microscope, and you will see what they look like. the field will be simply crowded with tiny, rounded lozenges--the red cells of the blood, which give it its well-known color. [illustration: blood corpuscles (greatly magnified) _a_, red blood; _b_, white blood.] the white corpuscles or scavengers of the blood. as the blood-tubes are not only supply-pipes but sewers and drainage canals as well, it is a good thing to have some kind of tiny animals living and moving about in them, which can act as scavengers and eat up some of the waste and scraps; and hence your microscope will show you another kind of little blood corpuscle, known, from the fact that it is not colored, as the _white corpuscle_. these corpuscles are little cells of the body, which in shape and behavior are almost exactly like an _ameba_--a tiny "bug," seen only under the microscope, that lives in ditch-water. under the microscope the white corpuscles look like little round disks, about one-third larger than the red corpuscles, and with a large kernel, or _nucleus_, in their centre. they have the same power of changing their shape, of surrounding and swallowing scraps of food, as has the ameba, and are a combination of scavengers and sanitary police. when disease germs get into the blood, they attack and endeavor to eat and digest them; and whenever inflammation, or trouble of any sort, begins in any part of the body, they hurry to the scene in thousands, clog the blood-tubes and squeeze their way out through the walls of the smallest blood-tubes to attack the invaders or repair the damage. this causes the well-known swelling and reddening which accompanies inflammation. blood, then, is a sticky red fluid, two-thirds of which is food-soup, and the other third, corpuscles. how tiny the blood-corpuscles are, may be guessed from the fact that there are about , , red cells and , white cells in every _cubic centimetre_ (fifteen drops) of our blood. how the blood circulates through the body. now let us see how some portion of the body, say the right thumb, gets its share of food and of oxygen through the blood. we will start at the very beginning. the food, of course, is put into the mouth, chewed by the teeth, and softened and digested in the stomach and intestines. it is then taken up by the cells of the mucous coat of the intestines and passed into the network of tiny blood-pipes surrounding them, between the lining of the bowels and their muscular coat. these tiny blood-pipes, called _capillaries_, run together to form larger pipes--the small veins; and the small veins from the walls of the intestine and stomach finally run together into one large pipe, or trunk-line (called the _portal vein_), which carries them to the liver. [illustration: diagram of the circulatory system all details are omitted. the connection between arteries and veins is shown only in the brain. both heart and blood vessels are considerably enlarged to show clearly the course of the blood.] in passing through the liver, the blood is purified of some irritating substances picked up from the food-tube, and the melted food which it contains is further prepared for the use of the cells of the body. the portal vein of the liver breaks up into a network of veins, and these again break up into a number of tiny capillaries, in which the blood is acted upon by the cells of the liver. these capillaries gather together again to form veins, and finally unite into two large veins at the back of the liver, which run directly into the great trunk-pipe of all the veins of the body--the _vena cava_ (or "empty vein," so called because it is always found empty after death), about an inch from where this opens into the right side of the heart. in the vena cava the blood from the food-tube, rich in food, but poor in oxygen, mixes with the impure, or used-up, blood brought back by the veins from all over the body and, passing into the right side of the heart, is pumped by the heart through a large blood-pipe to the lungs. this large blood-pipe divides into two branches, one for each lung; and these again break up into smaller branches, and finally into tiny capillaries, which are looped about in fine meshes, or networks, around the air-cells of the lung. here, through the thin and delicate walls of the capillaries the blood cells give off, or breathe out, their carbon dioxid and other waste gases (which are passed out with our outgoing breath), and at the same time they breathe in oxygen which our incoming breath has drawn into the lungs. this oxygen is picked up by, and combines with, the red coloring matter of the millions of little oxygen sponges, or baskets--the red corpuscles--and turns them a light red color, causing the blood to become bright red, such as runs in the arteries and is known as _arterial blood_. the loops of tiny capillaries around the air cells of the lungs run together again to form larger pipes; and these unite, at the point of each lung nearest the heart, to form two large blood pipes--one from each lung--which pour the rich, pure blood, loaded with both food and oxygen into the left side of the heart. the left side of the heart pumps this blood out into the great main delivery-pipe for pure blood, known as the _aorta_, and this begins to give off branches to the different parts of the body, within a few inches of where it leaves the heart. [illustration: surface veins and deep-lying arteries of inner side of right arm and hand the deep-lying veins that run parallel to the arteries have been omitted; so have the veins of three of the fingers.] one of the first of these branches to be given off by the aorta is a large blood pipe, or artery, to supply the shoulder and arm; this artery runs across the chest, thence across the armpit, and down the arm to the elbow. here it divides into two branches, one to supply the right, and the other the left, side of the forearm and hand. these branches have by this time got down to about the size of a wheat straw; the one supplying the right side is the artery which we feel throbbing in the wrist, and which we use in counting the pulse. from it run off smaller branches to supply the thumb and fingers. these branches break up again into still smaller branches, and they into a multitude of tiny capillaries, which run in every direction among all the muscle cells, delivering the food and oxygen at their very doors, as it were. the muscle cells eagerly suck out the food-stuffs, and breathe in the oxygen of the blood; at the same time, they pour into it their waste stuffs of all sorts, including carbon dioxid. these rob the blood of its bright red oxygen color and turn it a dirty purplish, or bluish, tint. the loops of capillaries again run together, as they did in the liver and in the lung, to form tiny veins; and these run together at the base of the thumb and in the wrist, to form larger ones through which the now poor and dirty blood is carried back up the arm over much the same course as it took in coming down it. indeed, the veins usually run parallel with, and often directly alongside of, the arteries. the blood passes through the armpit, across the chest, into the great main pipe for impure blood, the vena cava, and through this into the right side of the heart, where it again meets the rich, but waste-laden blood from the food tube and liver, and starts on its circuit through the lungs and around the body again. the blood reaches every portion of our body in precisely this same manner, only taking a different branch of the great pure-blood delivery pipe, the aorta, according to the part of the body which it is to reach, and coming back by a different vein-pipe. why the arteries are more deeply placed than the veins. in the limbs and over the surface of the body generally, the arteries are more deeply placed than the veins, so as to protect them from injury, because the blood in the arteries is driven at much higher pressure than in the veins and spurts out with dangerous rapidity, if they are cut. some of the veins, indeed, run quite a little distance away from any artery and quite close to the surface of the body, so that you can see them as bluish streaks showing through the skin, particularly upon the front and inner side of the arms. the capillaries. of course, the blood pipes into which the food is sucked through the walls of the food tube, and those in the lung, through which the oxygen is breathed, as well as those in the thumb through which food is taken to the muscle-cells, have the tiniest and thinnest walls imaginable. for once, the name given them by the wise men--capillaries (from the latin _capilla_, a little hair)--fits them beautifully, except that the hairs in this case are hollow, and about one-twentieth of the size of the finest hair you can see with the naked eye. so tiny are they that they compare with the big veins near the heart into which they finally empty much as the smallest and slenderest twigs of an elm do with its trunk. what they lack in size, however, they more than make up in numbers; and a network of them as fine and close as the most delicate gauze goes completely around the food tube between its mucous lining and muscular coat. though thickest and most abundant on the inner and outer surfaces of the body, every particle of the body substance is shot through and through with a network of these tiny tubes. so close and fine is this network in the skin, for instance, that, as you can readily prove, it is impossible to thrust the point of the finest needle through the skin without piercing one of them and "drawing blood," as we say, or making it bleed. from this network of tiny, thin-walled tubes, the body-cells draw their food from the blood. [illustration: diagram of artery, capillaries, and vein] the meaning of good color. it is the red blood in this spongy network of tiny vessels that gives a pink coloring to our lips and the flush of health to our cheeks. whenever for any reason the blood is less richly supplied with food or oxygen, or more loaded with "smoke" and other body dirt than it should be, we lose this good color and become pale or sallow. if we will remember that our hearts, our livers, our brains, and our stomachs, are at the same time often equally "pale" and sallow--that is, badly supplied with blood--as our complexions, we can readily understand why it is that we are likely to have poor appetites, poor memories, bad tastes in our mouths, and are easily tired whenever, as we say, our "blood is out of order." the blood is the life. starve or poison that, and you starve or poison every bit of living stuff in the body. the heart structure and action of the heart. now what is it that keeps the blood whirling round and round the body in this wonderful way? it is done by a central pump (or more correctly, a little explosive engine), with thick muscular walls, called the _heart_, which every one knows how to find by putting the hand upon the left side of the chest and feeling it beat. the heart is really a bulb, or pouch, which has ballooned out from the central feed pipe of the blood supply system, somewhat in the same way that the stomach has ballooned out from the food tube. the walls of this pouch, or bulb, are formed of a thick layer of very elastic and powerful muscles almost as thick as the palm of your hand. when the great vein trunk has poured blood into this pouch until it is swollen full and tight, these muscles in its walls shut down sharply and squirt or squeeze the blood in the heart-pouch into the great artery-pipe, the aorta. in fact, you can get a very fair, but rough, idea of the way in which the heart acts by putting your half-closed hand down into a bowl of water and then suddenly squeezing it till it is shut tight, driving the water out of the hollow of your hand in a jet, or squirt. "but," some of you will ask at once, "what is to prevent the blood in the heart, when the muscle wall squeezes down upon it, from shooting backward into the vena cava, instead of forward into the aorta?" nature thought of that long ago, and ingeniously but very simply guarded against it by causing two little folds of the lining of the blood pipes to stick up both where the vena cava enters the heart and where the aorta leaves it, so as to form little flaps which act as valves. these valves allow the blood to flow forward, but snap together and close the opening as soon as it tries to flow backward. while largest and best developed in the heart, these valves are found at intervals of an inch or two all through the veins in most parts of the body, allowing the blood to flow freely toward the heart, but preventing it from flowing back. as the heart has to pump all the blood in the body twice,--once around and through the lungs, and once around and through the whole of the body,--it has become divided into two halves, a right half, which pumps the blood through the lungs and is slightly the smaller and the thinner walled of the two; and a left half, which pumps the purified blood, after it has come back from the lungs, all over the rest of the body. [illustration: the exterior of the heart showing the strands of muscle that compose it, the arteries and veins that feed and drain the muscle coat, and fat protecting these.] each half, or side, of the heart has again divided itself into a receiving cavity, or pouch, known as the _auricle_; and a pumping or delivering pouch, known as the _ventricle_. and another set of valves has grown up between the auricle and the ventricle on each side of the heart. these valves have become very strong and tough, and are tied back in a curious and ingenious manner by tough little guy ropes of tendon, or fibrous tissues, such as you can see quite plainly in the heart of an ox. it is important for you to remember this much about them, because, as we shall see in the next chapter, these valves are one of the parts of the heart most likely to wear out, or become diseased. [illustration: diagram of valves in the veins and heart in _a_ the blood flows forward naturally. in _b_ and _c_ is shown what would happen were the blood to reverse its course, as it does when it meets an obstruction: the pockets would fill until they met and closed the passageway.] heart beat and pulse. the heart fills and empties itself about eighty times a minute, varying from one hundred and twenty times for a baby, and ninety for a child of seven, to eighty for a woman, and seventy-two for a full-grown man. when the walls of the ventricles squeeze down to drive out their blood into the lungs and around the body, like all other muscles they harden as they contract and thump the pointed lower end, or _apex_, of the heart against the wall of the chest, thus making what is known as the _beat_ of the heart, which you can readily feel by laying your hand upon the left side of your chest, especially after you have been running or going quickly upstairs. as each time the heart beats, it throws out half a teacupful of blood into the aorta, this jet sends a wave of swelling down the arteries all over the body, which can be felt clearly as far away as the small arteries of the wrist and the ankle. this wave of swelling, which, of course, occurs as often as the heart beats, is called the _pulse_; and we "take" it, or count and feel its force and fullness, to estimate how fast the heart is beating and how well it is doing its work. we generally use an artery in the wrist (_radial_) for this purpose because it is one of the largest arteries in the body which run close to the surface and can be easily reached. summary of the circulation of the blood. we will now sum up, and put together in their order, the different things we have learned about the circulation of the blood through the body. [illustration: the blood-route through the heart _r.a._, right auricle; _l.a._, left auricle; _r.v._, right ventricle; _l.v._, left ventricle; _a_, aorta; _p.a._, pulmonary artery; _p.v._, pulmonary veins; _v.c.s._, vena cava superior; _v.c.i._, vena cava inferior. at the entrance to the pulmonary artery are shown two of the pockets of the valve, the third pocket having been cut away with the front side of the artery. the other blood-tubes have similar valves, not shown in the diagram.] starting from the great vein trunk, the vena cava, it pours into the receiving chamber, or auricle, of the right side of the heart, passes between the valves of the opening into the lower chamber, the right ventricle. when this is full, the muscles in the wall of the ventricle contract, the valve flaps fly up, and the blood is squirted out through the pulmonary artery to the lungs. here it passes through the capillaries round the air cells, loses its carbon dioxid, takes in oxygen, and is gathered up and returned through great return pipes to the receiving chamber, or auricle, of the left side of the heart. here it collects while the ventricle below is emptying itself, then pours down between the valve flaps through the opening to the left ventricle. when this is full, it contracts; the valves fly up and close the orifice; and the blood is squirted out through another valve-guarded opening, into the great main artery, the aorta. this carries it, through its different branches, all over the body, where the tissues suck out their food and oxygen through the walls of the capillaries, and return it through the small veins into the large vein pipes, which again deliver it into the vena cava, and so to the right side of the heart from which we started to trace it. although the two sides of the heart are doing different work, they contract and empty themselves, and relax and fill themselves, at the same time, so that we feel only one beat of the whole heart. one of the most wonderful things about the entire system of blood tubes is the way in which each particular part and organ of the body is supplied with exactly the amount of blood it needs. if the whole body is put to work, so that a quicker circulation of blood, with its millions of little baskets of oxygen, is needed to enable the tissues to breathe faster, the heart meets the situation by beating faster and harder. this, as you all know, you can readily cause by running, or jumping, or wrestling. chapter xii the care of the heart-pump and its pipe-lines the effect of work upon the heart. whatever else in this body of ours may be able to take a rest at times, the heart never can. when it stops, we stop! naturally, with such a constant strain upon it, we should expect it to have a tendency to give way, or break down, at certain points. the real wonder is that it breaks down so seldom. it has great powers of endurance and a wonderful trick of patching up break-downs and adjusting itself to strains. every kind of work, of course, done in the body throws more work upon the heart. when we run, or saw wood, our muscles contract, and need more food-fuel to burn, and pour more waste-stuff into the blood to be thrown off through the lungs; so the heart has to beat harder and faster to supply these calls. when our stomach digests food, it needs a larger supply of blood in its walls, and the heart has to pump harder to deliver this. even when we think hard or worry over something, our brain cells need more blood, and the ever-willing heart again pumps it up to them. this is the chief reason why we cannot do more than one of these things at a time to advantage. if we try to think hard, run foot races, and digest our dinner all at one and the same time, neither head, stomach, nor muscles can get the proper amount of blood that it requires; we cannot do any one of the three properly, and are likely to develop a headache, or an attack of indigestion, or a "stitch in the side," and sometimes all three. so the circulation has a great deal to do with the intelligent planning and arranging of our work, our meals, and our play. if we are going to increase our endurance, we must increase the power of our heart and blood vessels, as well as that of our muscles. the real thing to be trained in the gymnasium and on the athletic field is the heart rather than the muscles. fortunately, however, the heart is itself a muscle, alive and growing, and with the same power of increasing in strength and size that any other muscle has. so that up to a proper limit, all these things which throw strain upon the heart in moderate degree, such as running, working, and thinking, are not only not harmful, but beneficial to it, increasing both its strength and its size. the heart, for instance, of a thoroughbred race-horse is nearly twice the size, in proportion to his body weight, of the heart of a dray-horse or cart-horse; and a deer has more than twice as large a heart as a sheep of the same weight. [illustration: the school physician examining heart and lungs] the important thing to bear in mind in both work and play, in athletic training, and in life, is that this work must be kept easily within the powers of the heart and of the other muscles, and must be increased gradually, and never allowed to go beyond a certain point, or it becomes injurious, instead of beneficial; hurtful, instead of helpful. over-work in the shop or factory, overtraining in the gymnasium or on the athletic field, both fall first and heaviest upon the heart. importance of food, air, and exercise. at the same time, the system must be kept well supplied through the stomach with the raw material both for doing this work and for building up this new muscle. when anyone, in training for an event, gets "stale," or overtrained, and loses his appetite and his sleep, he had better stop at once, for that is a sign that he is using more energy than his food is able to give him through his stomach; and the stomach has consequently "gone on a strike." how to avoid heart overstrain and heart disease. the way, then, to avoid overstrain and diseases of the heart and blood vessels is:-- first, to take plenty of exercise, but to keep that exercise within reasonable limits, which, in childhood, ought to be determined by a school physician, and in workshops and factories by a state factory physician. second, to take that exercise chiefly in the open air, and as much of it as possible in the form of play, so that you can stop whenever you begin to feel tired or your heart throbs too hard--in other words, whenever nature warns you that you are approaching the danger line. third, to keep yourself well supplied with plenty of nutritious, wholesome, digestible food, so as to give yourself, not merely power to do the work, but something besides to grow on. fourth, to avoid poisonous and hurtful things like the toxins of infectious diseases; and alcohol, tobacco, and other narcotics, which have a harmful effect upon the muscles, valves, or nerves of your heart, or the walls of your blood vessels. fortunately, the heart is so wonderfully tough and elastic, and can repair itself so rapidly, that it usually takes at least two, and sometimes three, causes acting together, to produce serious disease or damage. for instance, while muscular overwork and overstrain alone may cause serious and even permanent damage to the heart, they most frequently do so in those who are underfed, or badly housed, or recovering from the attack of some infectious disease. while the poisons of rheumatism and alcohol will alone cause serious damage to the valves of the heart and walls of the blood vessels, yet they again are much more liable to do so in those who are overworked, or underfed, or overcrowded. the disease of the stiffening of the arteries. the points at which our pipe-line system is most likely to give way are the valves of the heart, and, more likely still, the muscles of the heart wall and of the walls of the blood vessels. these little muscles are slowly, but steadily, changing all through life, becoming stiffer and less elastic, less alive, in fact, until finally, in old age, they become stiff and rigid, turning into leathery, fibrous tissue, and may even become so soaked with lime salts as to become brittle, so that they may burst under some sudden strain. when this occurs in one of the arteries of the brain, it causes an attack of _apoplexy_, or a "stroke of paralysis." overstrain, or toxins in the blood, may bring about this stiffening of the arteries too soon, and then, we say that the person is "old before his time." a man is literally "as old as his arteries." the causes which will hasten the stiffening of the arteries are, first of all, prolonged overwork and overstrain,--due especially to long hours of steady work in unwholesome shops or surroundings; second, the presence in the blood of the poisons of the more chronic infectious diseases, like tuberculosis; third, the waste products that are formed in our own body, and are not properly got rid of through lungs, skin, and kidneys; and fourth, the use of alcohol, tobacco, and other narcotics. the bad effects of alcohol. alcohol is particularly likely to damage the walls of the blood vessels and the heart, first, because it is a direct poison to their cells, when taken in excess, and often in what may appear to be moderate amounts, if long continued; secondly, because it is frequently taken, especially by the poorer, underfed class of workers, as a substitute for food, causing them literally to "spend their money for that which is not bread," and to leave their tissues half-starved; and thirdly, because, by its narcotic effects, it decreases respiration and clogs the kidneys and the skin, thus preventing the waste products from leaving the body. how the heart valves may be injured. the valves of the heart are likely to give way, partly because they are under such constant strain, snapping backward and forward day and night; and partly, because, in order to be thin enough and strong enough for this kind of work, they have become turned, almost entirely, into stringy, half-dead, fibrous tissue, which has neither the vitality nor the resisting power of the live body-stuffs like muscles, gland-cells, and nerves. they are so tough, however, that they seldom give way under ordinary wear and tear, as the leather of a pump valve, or of your shoes, might; but the thing which damages them, nine times out of ten, is the germs or poisons of some infectious disease. these poisons circulating through the blood, sometimes set up a severe inflammation in the valves and the lining of the heart. ulcers, or little wart-like growths, form on the valves; and these may either eat away and destroy entirely parts of the valves or, when they heal, leave scars which shorten and twist the valves out of shape, so that they can no longer close the openings. when this has happened, the heart is in the condition of a pump which will not hold water, because the leather valve in its bucket is broken or warped; and we say that the patient has _valvular_ or _organic_ heart disease. the disease which most frequently causes this serious defect is rheumatism, or rheumatic fever; but it may also occur after pneumonia, typhoid, blood poisoning, or even after a common cold, or an attack of the grip. this is one of several reasons why we should endeavor, in every way, to avoid and stop the spread of these infectious diseases; not only are they dangerous in themselves, but although only two of them, rheumatism and pneumonia, frequently attack the heart, all of them do so occasionally, and together they cause nearly nine-tenths of all cases of organic heart disease. should you be unfortunate enough to catch one of these diseases, the best preventive against its attacking the heart, or causing serious damage, if it does, is a very simple one--rest in bed until the fever is all gone and your doctor says it is perfectly safe for you to get up; and avoid any severe muscular strain for several months afterward. this is a most important thing to remember _after all infections and fevers_, no matter how mild. even where the heart valves have been seriously attacked, as in rheumatism, they will often recover almost completely if you keep at rest, and your heart is not overtaxed by the strain of heavy, muscular work, before it has entirely recovered. ten days' "taking it easy" after a severe cold, or a bad sore throat, may save you a serious strain upon the heart, from which you might be months or even years in recovering. but even where serious damage has been done to the heart, so that one of its valves leaks badly, nature is not at the end of her resources. she simply sets to work to build up and strengthen and thicken the heart muscle until it is strong enough to overcome the defect and pump blood enough to keep the body properly supplied--just as, if you are working with a leaky pump, you will have to pump harder and faster in order to keep a good stream of water flowing. it is astonishing how completely she will make good the loss of even a considerable part of a valve. doctors no longer forbid patients with heart disease to take exercise, but set them at carefully planned exercise in the open air, particularly walking and hill-climbing; at the same time feeding them well, so as to assist nature in building up and strengthening the heart muscle until it can overcome the defect. in this way, they may live, with reasonable care, ten, fifteen, or twenty years--often, in fact, until they die of something else. don't worry about your heart if it should happen to palpitate, or take a "hop-skip-and-jump" occasionally. you will never get real heart disease until you have had some fever or serious illness, which leaves you short of breath for a long time afterward. danger to the heart through the nervous system. the other chief way in which the heart may be affected is through the nervous system. being the great supply pump for the entire body, it is, of course, connected most thoroughly and elaborately by nerve wires with the brain and, through it, with every other organ in the body. so delicately is it geared,--set on such a hair-trigger, as it were,--that it not only beats faster when work is done anywhere in the body, but begins to hurry in anticipation of work to be done anywhere. you all know how your heart throbs and beats like a hammer and goes pit-a-pat when you are just expecting to do something important,--for instance, to speak a piece or strike a fast ball,--or even when you are greatly excited watching somebody else do something, as in the finish of a close race. two-thirds of the starts and jumps and throbbings that the heart makes, are due to excitement, or nervous overstrain, or the fact that your dinner is not digesting properly; and they don't indicate anything serious at all, but are simply useful danger signals to you that something is not just right. in work and in athletics for instance, this rapid and uncomfortably vigorous action of the heart is one of nature's best checks and guides. when your heart begins to throb and plunge uncomfortably, you should slow up until it begins to quiet down again, and you will seldom get into serious trouble. the next time you try the same feat, you will probably find that you can go a little farther, or faster, without making it throb. indeed, getting into training is very largely getting the heart built up and educated, so that you can run or play, or wrestle hard without overtaxing it. whatever you can do within the limits of your heart is safe, wholesome, and invigorating; whatever goes beyond this, is dangerous and likely to be injurious. [illustration: rowing is a splendid exercise for heart and lungs] occasionally, however, some of the nerves which control the heart become disturbed or diseased so that, instead of the heart's simply beating harder and faster whenever more blood is really needed, it either throbs and beats a great deal harder and faster than is necessary, or goes racing away on its own account, and beats "for dear life," when there is no occasion for it, thus tiring itself out without doing any good, and producing a very unpleasant feeling of nervousness and discomfort. this may be due to overwork, whether with muscles or brain; or to worry or loss of sleep, in which case it means that you must put on the brakes, take plenty of rest and exercise in the open air, and get plenty of sleep. then these danger signals, having accomplished their warning purpose, will disappear. other causes of heart trouble. at other times, this palpitation is due to the presence of poisons in the blood, either those of infectious disease, or of certain waste products produced in the body in excess, as, for instance, when your digestion is out of order, or your skin, kidneys, and bowels are not working properly; or it is due to tea, coffee, or tobacco. effects of tea and coffee. tea and coffee, if taken in excess, will sometimes produce very uncomfortable palpitation, or rapid over-action of the heart, with restlessness and inability to sleep. they usually act in this way only when taken in large amounts, or upon a small percentage of persons who are peculiarly affected by them; and this palpitation is seldom serious, and disappears when their excessive use is stopped. tobacco and its dangers to the heart. tobacco has a very injurious effect upon the nerves of the heart in the young, making them so irritable that the heart will beat very rapidly on the least exertion; so that gradually one becomes less and less inclined to attempt exertion of any sort, whether bodily or mental, and falls into a stagnant, stupid sort of condition which seriously interferes with both growth and progress. in other cases, tobacco dulls and deadens the nerves controlling the heart, as it does the rest of the nervous system and the brain, so that the smoker feels as if nothing were worth while doing very hard, and it becomes difficult for him to fix his mind upon a subject. at the same time, it dulls the appetite so that one takes less wholesome food; and it checks, or clogs up, the sewer-pipes of the skin, the liver, and the kidneys. of course, as you know, all trainers and coaches, even though they be habitual smokers themselves, absolutely forbid tobacco in any form to athletes who are training for a contest, on account of its effects upon the nervous system and the heart. a certain percentage of individuals are peculiarly susceptible to tobacco, so that it has a special poisonous effect upon the nerves of the heart, causing a rapid pulse and shortness of breath, known as _tobacco heart_. this is not of very common occurrence; but it is exceedingly troublesome when it does occur, and it takes a long time to get over it, even after the use of tobacco has been stopped entirely. sometimes it leads to permanent damage of the nerves and of the heart. give your heart plenty of vigorous exercise, but don't make it beat uncomfortably hard. give it plenty of food, sleep, and fresh air; _avoid poisoning it_, either with the toxins of diseases, or with your own waste-poisons, or alcohol, or tobacco; and it will serve you faithfully till a good old age. chapter xiii how and why we breathe life is shown by breathing. if you wanted to find out whether a little black bunch up in the branches of a tree were a bird or a cluster of leaves, or a brown blur in the stubble were a rabbit or a clod, the first thing you would probably look for would be to see whether it moved, and secondly, if you could get close enough without its moving away, whether it were breathing. you would know perfectly well if you saw it breathing that it was alive, and that, if it were not breathing at all, it would probably be dead, or very nearly so. why is breathing so necessary to life that it lasts practically as long as life does, and when it stops, life stops too? animals can stop eating for days, or even weeks, and yet live, especially if they were fairly fat when they began to fast. indeed, some animals, like woodchucks, bears, and marmots, will go to sleep in the fall, and sleep right on through to spring without eating a mouthful. but if any animal or bird is prevented from breathing for three minutes, it will die. short storage supply of air. there is a difference between the kind of things that you take in when you breathe and the kind of things you take in when you eat or drink. food and drink are solids and liquids; and the body is a great sponge of one soaked full of the other, so that large amounts of food and water can be stored up in the body. but what you take in when you breathe is, of course, air--which is neither a solid nor a liquid, but a gas, very light and bulky. of gases the body can soak up and hold only a very small amount; so its storage supply of them will be used up completely in about three minutes, and then it dies if it cannot get more air. why our bodies need air-oxidation. the body is made up of millions of tiny living animals called cells, which eat the food that is brought to them from the blood and pour their waste and dirt back again into the same current. now, what would happen if we were to throw all the garbage from the kitchen, and the wash water from the kitchen sink, and the dirty water from the bathroom right into the well out of which we pumped our drinking water? we should simply be poisoned within two or three days, if indeed we could manage to drink the disgusting mixture at all. that is exactly what would happen to our body cells if they were not provided with some way of getting rid of their waste and dirt. [illustration: the great essential to life--air if the air, supplied to the diver through the tube, is cut off for three minutes, or even less, the diver cannot live.] part of the waste that comes from our body cells is either watery, or easily dissolved in water; and this is carried in the blood to a special set of filter organs--the liver and the kidneys--and poured out of the body as the _urine_. another part of it, when circulating through the skin, is passed off in the form of that watery vapor which we call perspiration, or sweat. but part of the waste can be got rid of only by burning, and what we call burning is another name for combining with oxygen, or to use one word--_oxidation_; and this is precisely the purpose of the carrying of oxygen by the little red blood cells from the lungs to the deeper parts of the body--to burn up, or oxidize, these waste materials which would otherwise poison our cells. when they are burnt, or oxidized, they become almost harmless. why the red cells carry only oxygen to the body. but why do not the red cells carry air instead of just oxygen? this is simply a clever little economy of space on nature's part. as a chemist will tell you the air which we breathe is a mixture of two gases--one called nitrogen and the other oxygen; just as syrup, for instance, is a mixture of sugar and water. then too, as in syrup, there are different amounts of the two substances in the mixture: as syrup is made up of about one-quarter sugar and three-quarters water, so air is made up of one-fifth oxygen and four-fifths nitrogen. now the interesting thing about this mixture, which we call air, is that the only really "live" and vital part of it for breathing purposes is the one-fifth of oxygen, the four-fifths of nitrogen being of no use to our lungs. in fact, if you split up the air with an electric current, or by some other means, and thus divide it into a small portion of pure oxygen (one-fifth), and a very much larger portion (four-fifths) of nitrogen, the latter would as promptly suffocate the animal that tried to breathe it as if he were plunged under water.[ ] it may perhaps be difficult to think of anything burning inside of your bodies where everything is moist, especially as you do not see any flame; but you do find there one thing which always goes with burning, and that is warmth, or heat. this slow but steady and never-ceasing burning, or oxidation, of the waste and dirt inside your bodies is what keeps them warm. when you run fast, or wrestle, or work hard, your muscle-cells work faster, and make more waste, and you breathe faster to get in the oxygen to burn this up--in other words, you fan the body fires, and in consequence you get a great deal hotter, and perhaps perspire in order to get rid of your surplus heat. the ocean of air. where does the blood in the body go in order to get this oxygen, which is so vital to it? naturally, somewhere upon the surface of the body, because we are surrounded by air wherever we sit, or stand, or move, just as fishes are by water. all outdoors, as we say, is full of air. we are walking, just as fishes swim, at the bottom of an ocean of air some thirty miles deep; and the nearer we get up toward the surface of that ocean, as, for instance, when we climb a high mountain, the lighter and thinner the air becomes. above ten thousand feet we often have great difficulty in breathing properly, because the air is so thin and weak in oxygen. how the lungs grew up. in the simplest forms of life, any part of the soft and delicate surface will do for the blood to reach, in order to throw off its load of carbon "smoke" and take on its supply of oxygen. in fact, animals like jellyfish and worms are lungs all over. but as bodies begin to get bigger, and the skin begins to toughen and harden, this becomes more and more difficult, although even the highest and biggest animals like ourselves still throw off a certain amount of this carbon dioxid and other gases through the skin. accordingly, certain parts of the surface of the body are set apart specially for this business of breathing; and as we already have an opening into the body provided by the mouth and food tube, the simplest thing to do is to use the mouth for taking in air, when it is not being used for taking in food, and to set aside some part of the food tube for breathing purposes. [illustration: diagram of the air tubes and lungs the arrows show the direction of the incoming air.] the lungs sprout out from the front of the gullet, just below the root of the tongue, in the days when we are getting ready to be born. the sprout divides into two, forming the beginning of the pair of lungs. each lung sprout again divides into two, and each of the two smaller buds again into two, until finally we have the whole chest filled up with a "lung-tree" whose trunk stems and leaves are hollow. the stem of the tree or bush becomes the windpipe (_trachea_). the first two branches into which it divides form the right and left lung tubes, known as _bronchi_. the third, fourth, fifth, sixth, etc., divisions, and so on, form what are known as the _bronchial tubes_. these keep on splitting into tinier and tinier twigs, until they end, like the bush, in little leaves, which in the lung, of course, are hollow and are called the air cells (_alveoli_). this budding off of the lungs from the gullet is the reason why the air we breathe and the food we swallow go down the same passage. every mouthful of our food slides right across the opening of the windpipe, which has to be protected by a special flap, or trap-door of gristle, called the _epiglottis_. if you try to eat and talk at the same time, the epiglottis doesn't get warning of the coming of a swallow of food in time to cover the opening of the windpipe, and the food goes down the wrong way and you cough and choke. now, if you will just place your fingers upon the front of your neck and slide them up and down, you will, at once, feel your windpipe--a hard, rounded tube with ridges running across it,--while, no matter how carefully you feel, or how deeply you press, you cannot feel your gullet or esophagus at all. just take a mouthful of water, however, put your fingers deeply on each side of the windpipe, and swallow, and you will feel something shoot down the esophagus, between your fingers, toward the stomach. both of these tubes were made of exactly the same materials to begin with. why have they become so different? a moment's thought will tell you. one, the gullet, has only to swallow solid food or drink, so that its walls can remain soft, and indeed fall together, except when it is actually swallowing. the other tube, the air-pipe or windpipe, has to carry air, which neither will fall of its own weight, nor can readily be gulped down or belched up. it is absolutely necessary that its walls should become stiff enough to keep it open constantly and let the air flow backward and forward. so we find growing up in the walls of this air pipe, cells which turn themselves into rings of gristle, or cartilage. what the breath is. as you know, your "breath," as you call it,--that is to say, the used-up air which you blow out of your lungs,--is different in several ways from pure, or unused air. in the first place, it is likely to have a slight musky or mousy odor about it. you never like to breathe any one else's breath, or have any one breathe in your face. this dislike is due to certain gases, consisting of impurities from the blood, the cells of the lungs, the throat, the nose, and, if the mouth is open, the teeth. these are not only offensive and disagreeable to smell, but poisonous to breathe. then your breath is much warmer than the rest of the air. in fact, on a very cold morning you may have tried to warm up your fingers by breathing on them; and you have also noticed that if a number of people are shut up in a room with doors and windows closed, it soon begins to feel hot as well as stuffy. this heat, of course, is given off from the blood in the lungs and in the walls of the throat and nose, as the air passes in and out again. when you stand at the window on a cold day, the glass just in front of your mouth clouds over, so that you can no longer see through it; and if you rub your finger across this cloud, it comes away wet. evidently, the air is moister than it was when you breathed it in; this moisture also has been given off from the blood in the lungs. but what of the principal waste gas that the blood gives off in the lungs--the carbon "smoke," or carbon dioxid? can you see any trace of this in the breath? no, you cannot, for the reason that this gas is like air, perfectly clear and transparent, and never turns to moisture at any ordinary temperature. but it has a power of combining with certain other things and forming substances which, because they are combinations of carbon, are called _carbonates_. the commonest substance with which it will do this is lime. if you take a glass or a bottle two-thirds full of lime water, and breathe into it through a glass tube or straw, you will see in a very few minutes that it is becoming milky or cloudy from the formation of visible carbonate of lime, which, when you get enough of it, makes ordinary limestone. so, although you cannot see, or smell, this carbon "smoke" in your breath, you can readily prove that it is present. [illustration: "improving their wind"] how and why our breathing varies. when you run or wrestle, you breathe faster in order to draw more air into the lungs. at the same time, your heart beats faster in order to drive a larger amount of blood through the lungs. if you run too far, or wrestle too hard, your heart and your lungs both go faster and faster, until finally they reach a point when they cannot go any quicker, and the poisonous waste substances are formed in your muscles faster than they can possibly be burned up, even by the quickest breathing and the hardest pumping of your heart. then you begin to get "out of breath"; and if you were compelled--in order to save your life, for instance--to keep on running, or fighting, you would at last be suffocated by your own waste and dirt, and fall exhausted, or unconscious. on the other hand, by carefully training your muscles and your heart and your lungs by exercises of various sorts in the open air, beginning with easy ones and going on to harder and longer ones, you can "improve your wind," so that your heart will be able to pump more blood through the lungs per minute, and your lungs will be able to expand themselves more fully and more rapidly without fatigue. if you can recall having had a fever of any sort, even a slight one, such as comes with a sore throat or a bad cold, you may remember that you breathed faster and that your heart beat faster, and yet you were not doing any work with your muscles. the cause, however, is the same; namely, the amount of waste that is being produced in the body--in this case, by the poisons (toxins) of the germs that cause the fever. the more waste that is formed in the body, the more effort the heart and lungs will make to try to get rid of it. the ribs. how does the air get in and out of the lung tubes? evidently you do not and cannot swallow it as you would food or drink; and as it will not run down of its own accord when you simply open your mouth, nature has had to devise a special bit of machinery for the purpose of sucking it in and pressing it out again. this she has done in a rather ingenious manner by causing certain of the muscle-rings in the wall of the chest to turn first into gristle, or cartilage, and then later into bone, making what are known as the _ribs_; these run round the chest much as hoops do round a barrel, or as the whalebone rings did in the old-fashioned hoop skirt. when the muscles of the chest pull these ribs up, the chest is made larger,--like a bellows when you lift the handle,--air is sucked in, and we "breathe in" as we say; when the muscles let go, the ribs sink, the chest flattens and becomes smaller, the air is driven out, and we "breathe out." footnotes: [ ] this nitrogen, though of no value for breathing, is of great value as a food, forming, as we have seen, an important part of all meats, or proteins, which build the tissues of our bodies. it can, however, be taken from the air only with great difficulty, by a very roundabout route; the bacteria of the soil eat it first, then they pass it on as food to the roots of plants; animals eat plants, and we eat the animals, and thus get most of our nitrogen. chapter xiv how to keep the lung-bellows in good condition the need of pure air free air is pure. as air, in the form of wind, actually sweeps all outdoors, day and night, it clearly is likely to pick up a good many different kinds of dust and dirt, which may not be wholesome when breathed into our lungs. fortunately, nature's great outdoor system of purifying the air is almost perfect, so that it is only when we build houses and shut in air from the great outdoor circulation, that "dirt" that is really dangerous begins to get into it. caged air is the only air that is dangerous. free-moving air is always perfectly safe to breathe any hour of the day or night, or any season of the year. shut-in and stagnant air is foul. this restless air-gas cannot be stored outside of the body, any better than it can be inside. for one thing, it is too bulky; and for another, it begins to become impure in various ways, as soon as it is shut up. it is the most unmanageable food that we "eat," for we can neither cook it nor wash it like solid food, nor filter it nor boil it like water, except on a very limited scale. we can do nothing to it except to foul it, which we do with every breath that we breathe, every fire that we make, every factory that we build. our only chance of safety, our only hope of life, is to connect every room and every corner of those little brick and mortar boxes, those caged sections of out-of-doors, that we call houses, with nature's great system of air supply, "all outdoors." fortunately, the only thing needed to make the connection is to open a window--no need to send for a plumber or put in a meter, and there is no charge for the supply after connections have been made. the enormous amount of air. air outdoors is everywhere, for practical purposes, absolutely pure, just as water is when it comes down from the clouds. and like water, its only dangerous impurities are what we put there ourselves. the purity of outdoor air is due mainly to the fact that there is such an enormous amount of it, not only the miles and miles of it that stretch away on every side of us, but nearly thirty miles of it straight up above our heads; its purity is also due to the fact that, like water, it is always in motion. when heated by the sun, it expands; and, in doing so, it rises because it is less dense and therefore lighter. as soon as the pressure of the air above is lessened, air rushes in below from all the cooler regions around. this rushing of air we call a _wind_. if the low pressure lies to the north of us, the air rushes northward over us to fill it, and we say the wind is from the south; if the air is flowing to the south of us, we say the wind is from the north. how air is purified. in these winds certain small amounts of dust, or dirt, or leaf mould are whirled up into the air, but these are promptly washed down again whenever it rains; and the same is true of the smoke impurities in the air of our great cities. air is also constantly being purified by the heat and light of the sunbeams, burned clean in streaks by the jagged bolt of the lightning in summer, and frozen sweet and pure by the frosts every winter. so that air in the open, or connected with the open, and free to move as it will, is always pure and wholesome. but to be sure of this, it must be "eaten alive"--that is, in motion. stagnant air is always dead and, like all dead things, has begun to decay. the carbon dioxid in the air. air, as you will remember (p. ), is a mixture of oxygen and nitrogen, and its value in the body is that it gives off part of its oxygen to combine with the body wastes and burn them to carbon dioxid. oddly enough, even pure outdoor air contains tiny traces of carbon dioxid; but the amount is so very small as to be of no practical importance, in spite of the fact that every kind of animal that lives and moves upon the earth is pouring it out from his lungs every second. the rapidity with which it disappears is due in part to the rapidity with which it rises and spreads, or is blown, in every direction; and in part to the wonderful arrangement by which, while animals throw off this poisonous gas as waste, plants eagerly suck it in through the pores in their leaves and eat it, turning it into the carbohydrates, starch and sugar, which, in turn, become valuable foods for the animals. so perfect is this system of escape, or blowing away, of carbon dioxid, combined with its being eaten up by plants, that even the air over our great cities and manufacturing towns contains only the merest trifle more of carbon dioxid than that over the open country. its other smoke-impurities, dirts and dusts, escape, or are blown away so rapidly that they are seldom thick enough to be injurious to health, except in the narrowest and darkest streets; so that it is always safe to open your windows wide for air, wherever you may live. the principal danger from smoke is that it cuts off the sunlight. the necessity for ventilation--impurities of indoor air. the worst impurities in air are those that come from our own breaths and our own bodies; and, unexpectedly enough, carbon dioxid is not one of them. in spite of hundreds of experiments, we do not yet know exactly what these impurities are, though they are doubtless given off from our lungs, our skins, our mouths, and teeth, especially if the latter are not kept clean and sweet, but left dirty and decaying. we do know, however, to a certainty that air shut up in a room, or house, with people, rapidly becomes poisonous and unwholesome. as we breathe on an average about eighteen or twenty times to the minute when we are grown up, and twenty-five to thirty times a minute when we are children, you can readily see how quickly the air in an ordinary-sized room will be used up, and how foul and unfit for further breathing it will become from being loaded with these bad-smelling lighter gases, with the carbon "smoke," with heat, and with moisture. the only way in which a room can be kept fit for human beings to breathe in is to have a draught, or current of air, pouring into it through open windows, or open doors, or ventilating shafts, at least as rapidly as it is being breathed by the persons who occupy that room. by hundreds of tests this has now been found to be on an average about four bushels a minute for each person, and any system of proper ventilation must supply this amount of air in order to make a room fit to sit in. if a man, for instance, accidentally gets shut into a bank-vault, or other air-tight box or chamber, it will be only a few minutes before he begins to feel suffocated; and in a few hours he will be dead, unless some one opens the door. a century ago, when the voyage from europe to america was made in sailing vessels, whenever a violent storm came up, in the smaller and poorer ships the hatches were closed and nailed down to keep the great waves which swept over the decks from pouring down the cabin-stairs and swamping the ship. if they were kept closed for more than two days, it was no uncommon thing to find two or three children or invalids among the unfortunate emigrants dead of slow suffocation; and many of those who were alive would later have pneumonia and other inflammations of the lungs. on one or two horrible occasions, when the crew had had a hard fight to save the ship and were afraid to open the hatches even for a moment, nearly one-third of the passengers were found dead when the storm subsided. so it is well to remember that we are fearfully poisonous to ourselves, unless we give nature full chance to ventilate us. there are also other ways in which the air in houses may be made impure besides by our own bodies, but none of them is half so serious or important. all the lights that we burn in a house, except electric ones, are eating up oxygen and giving off carbon dioxid. in fact, a burning gas jet will do almost as much toward fouling the air of a room as a grown man or woman, and should be counted as a person when arranging for ventilation. if gas pipes should leak, so that the gas escapes into a room, it is very injurious and unwholesome--indeed, in sufficient amounts, it will suffocate. or, if the sewer pipes in the walls of the house, or in the ground under the cellar, are not properly trapped and guarded, _sewer gas_ may escape into the house from them, and this also is most unwholesome, and even dangerous. cellar and kitchen air. houses in which fruit and vegetables are stored in the cellar become filled with very unpleasant odors from the decay of these. others again, where the kitchen is not properly ventilated, get the smoke of frying and the smell of cooking all through them. but such sources of impurity, while injurious and always to be strictly avoided, are neither half so dangerous when they occur, nor one-tenth so common as the great chief cause of impure air--our breaths and the other gases from our bodies, with the germs they contain. drafts not dangerous. now comes the practical question, how are we to get rid of these breath-poisons? from the carelessness of builders, and the porous materials of which buildings are made, most houses are very far from air-tight, and a considerable amount of pure air will leak in around window-casings, door-frames, knot-holes, and other cracks, and a corresponding amount of foul air leak out. but this is not more than one-fifth enough to keep the air fresh when the rooms are even partially occupied, still less when they are crowded full of people. as each individual, breathing quietly, requires about four bushels of air (one and a half cubic yards) a minute, it is easy to see that, when there are ten or more people in a room, there ought to be a steady current of air pouring into that room; and when there are twenty or even forty people, as in an average schoolroom, the current of air (provided there _is_ one) must move so fast to keep up the supply that the people in the room begin to notice it and call it "a draft." it would be difficult to ventilate a room for even four or five persons without producing, in parts of it, a noticeable draft of air. in fact, it is pretty safe to say that, if somebody doesn't feel a draft the room is not being properly ventilated. at one time this was considered a very serious drawback--drafts were supposed to be so dangerous. but now we know that a draft is only air in motion, and that air in motion is the _only air that is sure to be pure_. there is nothing to be afraid of in a draft which is not too strong, if you are clean outside and in, and reasonably vigorous. if the draft is too strong, move away from the window or the door. colds are very seldom caught from the cold, pure air of a draft, but nearly always from the germs, or dirt, in the still, foul air of a tightly closed room. this fact has swept away the chief objection to the _direct_, or natural, method of ventilating through open windows. methods of ventilation. fortunately, as often happens, the simplest and most natural method of ventilation is the best one. open the windows, and let the fresh air pour in. if there be any room which hasn't windows enough in it to ventilate it properly, it is unfit for human occupation, and is seldom properly lighted. most elaborate and ingenious systems of ventilation have been devised and put into our larger houses, and public buildings like libraries, court-houses, capitols, and schools. some of them drive the air into each room by means of a powerful steam, or electric, fan in the basement; others suck the used-up air out of the upper part of each room, thus creating an area of low pressure, to fill which the fresh air rushes in through air-tubes or around doors and windows. they have elaborate methods of warming, filtering, and washing the air they distribute. some work fairly well, some don't; but they all have one common defect--that what they pump into the rooms is not _fresh_ air, though it may conform to all the chemical tests for that article. "the proof of the pudding is in the eating," and fresh air is air that will make those who breathe it _feel_ fresh, which the cooked and strained product of these artificial ventilating systems seldom does. [illustration: the "dark room" danger of the tenements the rooms "ventilate" from one to another; bedroom, dining-room, and kitchen being practically one room, with only one window opening to the _outer air_. most of the old small tenements were built on this plan and are accountable for much of the lung disease in cities to-day.] if they could be combined with the natural, window system of ventilation, they would be less objectionable; but the first demand of nearly all of them is that the windows must be kept shut for fear of breaking the circuit of their circulation. any system of ventilation, or anything else, that insists on all windows being kept shut is radically wrong. it is only fair to say, however, that most of these systems of ventilation attempt the impossible, as well as the undesirable thing of keeping people shut up too long. no room can be, or ought to be, ventilated so that its occupants can stay in it all day long without discomfort. in ventilating, we ought to _ventilate the people in the room_, as well as the room itself. this can only be done successfully by turning the people out of doors, at least every two or three hours if grown-ups, and every hour or so if children. that is what school recesses are for, and they might well be longer and more frequent. [illustration: ventilating the pupils, as well as the classroom] the first and chief thing necessary for the good ventilation of houses and schools is plenty of windows, which are also needed to give proper light for working purposes, and to let in the only ever-victorious enemy of germs and disease--sunlight. secondly, and not less important, the windows should fit properly, and be perfectly hung and balanced, so that the sash will come down at a finger's touch, stay exactly where it is put, and go up again like a feather, instead of having to be pried loose, wrested open, held in place with a stick, and shoved up, or down again, only with a struggle. [illustration: a well-aired classroom the windows to the left of the pupils cannot, of course, be shown in the picture, but it can be seen that the lighting of the room is chiefly from that side. notice that the windows are both down from the top and up from the bottom.] there should be, if possible, windows on two sides of every room, or, if not, a large transom opening into a hall which has plenty of windows in it. with this equipment and a good supply of heat, any room can be properly ventilated and kept so. but it _will not ventilate itself_. ventilation, like the colors of the great painter turner, must be "mixed with brains"; and those brains must be in the room itself, not down in the basement. in the schoolroom, each teacher and pupil should regard the ventilation of the room as the most important single factor in the success of their work. the teacher has a sensitive thermometer and guide in, first, her own feelings and, second, the looks and attention of her pupils. there should be vacant seats or chairs in every room so that those too near the window in winter can move out of the strong current of cold air. [illustration: a healthful arrangement of windows and shades the windows face in more than one direction. the shades are hung in the middle, not only regulating the light in the room, but allowing free passage of air at the top.] windows should reach well up toward the ceiling and be opened _at the top_, because the foul air given off from the lungs at the temperature of the body is warmer than the air of the room and consequently rises toward the ceiling. it is just as important in ventilation to _let the foul air out_ as to let the fresh air in. in fact, one is impossible without the other. air, though you can neither see it, nor grasp it, nor weigh it, is just as solid as granite when it comes to filling or emptying a room. not a foot, not an inch of it can be forced into a room anywhere, until a corresponding foot or inch is let out of it somewhere. therefore, never open a window at the bottom until you have opened it at the top. if you do, the cold fresh air will pour in onto the floor, while the hot foul air will rise and bank up against the ceiling in a layer that gets thicker and thicker, and comes further and further down, until you may be actually sitting with your head and shoulders in a layer of warm foul air, and your body and feet in a pool of cool pure air. then you will wonder why your head is so hot, and your feet so cold! currents and circulation of air. in fact, this tendency of hot air to rise, and of cold air to sink, or rush in and take its place, which is the mainspring of nature's outdoor system of ventilation, is one of our greatest difficulties when we wall in a tiny section of the universe and call it a room. the difficulty is, of course, greatest in winter time, when the only pure air there is--that out of doors--is usually cold. this is one of the few points at which our instincts seem to fail us. for when it comes to a choice between being warm or well ventilated, we are sadly prone to choose the former every time. still we would much rather be warm _and_ well ventilated than hot and stuffy, and this is what we should aim for. the main problem is the cost of the necessary fuel, as it naturally takes more to heat a current of air which is kept moving through the room, no matter how slowly, than it does a room full of air which is boxed in, as it were, and kept from moving on after it has been warmed. the extra fuel, however, means the difference between comfort and stuffiness, between health and disease. fortunately, the very same cold which makes a room harder to heat makes it easier to ventilate. when air is warmed, it expands and makes a "low pressure," which sucks the surrounding cooler air into it, as in the making of winds; so that the warmer the air inside the room, or the colder the air outside of it, which is practically the same thing, the more eagerly and swiftly will the outdoor air rush into it. so keen is this draft, so high this pressure, that some loosely-built houses and rooms, with only a few people in them, will in very cold weather be almost sufficiently ventilated through the natural cracks and leaks without opening a window or a door at all. and what is of great practical importance, an opening of an inch or two at the top of a window will admit as much fresh air on a cold day as an opening of a foot and a half in spring or summer, so swiftly does cold air pour in. bearing this in mind, and also that it is always best to ventilate through as many openings as possible, both to keep drafts of cold air from becoming too intense, and to give as many openings for the escape of the foul air as possible, there will be little difficulty in keeping any room which has proper window arrangements well ventilated in winter. an opening of an inch at the top of each of three windows is better than a three-inch opening at the top of one. but you must use your brains about it, watching the direction of the wind, and frequently changing the position of the window sashes to match the changes of heat in the room, or of cold outside. no arrangement of windows, however perfect, is likely to remain satisfactory for more than an hour at a time, except in warm weather. this watchfulness and attention takes time, but it is time well spent. "eternal vigilance" is the price of good ventilation, as well as of liberty; and you will get far more work done in the course of a morning by interrupting it occasionally to go and raise or lower a window, than you will by sitting still and slaving in a stuffy, ill-smelling room. plenty of heat needed. any method of heating--open fireplace, stove, hot air, furnace, hot water, or steam--which will keep a room _with the windows open_ comfortably warm in cold weather is satisfactory and healthful. the worst fault, from a sanitary point of view, that a heating system can have is that it does not give enough warmth, so that you are compelled to keep the windows shut. too little heat is often as dangerous as too much; for you will insist on keeping warm, no matter what it may cost you in the future, and a cold room usually means hermetically sealed windows. remember that coal is cheaper than colds, to say nothing of consumption and pneumonia. [illustration: a healthful bedroom windows on two sides; shades rolling from the middle; draperies few and washable; no carpet, but rugs by the bedside.] ventilating the bedroom. the same principles that apply to ventilating a living-room or day-room apply to ventilating a bedroom. here you can almost disregard drafts, except in the very coldest weather, and, by putting on plenty of covering, sleep three hundred days out of the year with your windows wide open and your room within ten degrees of the temperature outdoors. you need not be afraid of catching cold. on the contrary, by sleeping in a room like this you will escape three out of four colds that you usually catch. sleeping with the windows wide open is the method we now use to cure consumption, and it is equally good to prevent it. no bedroom window ought to be closed at the top, except when necessary to keep rain or snow from driving in. close the windows for a short time before going to bed, and again before rising in the morning, to warm up the room to undress and dress in; or have a small inside dressing-room, with your bed out on a screened balcony or porch. but sleep at least three hundred nights of the year with the free air of heaven blowing across your face. you will soon feel that you cannot sleep without it. in winter, have a light-weight warm comforter and enough warm, but light, blankets on your bed, and leave the heat on in the room, if necessary--but _open the windows_. colds, consumption, and pneumonia disease germs. in all foul air there are scores of different kinds of germs--many of them comparatively harmless, like the yeasts, the moulds, the germs that sour milk, and the bacteria that cause dead plants and animals to decay. but among them there are a dozen or more kinds which have gained the power of living in, and attacking, the human body. in so doing, they usually produce disease, and hence are known as _disease germs_. [illustration: disease germs (greatly magnified) ( ) bacilli of tuberculosis; ( ) bacilli of typhoid fever.] these germs--most of which are known, according to their shape, as _bacilli_ ("rod-shaped" organisms), or as _cocci_ (round, or "berry-shaped" organisms)--are so tiny that a thousand of them would have to be rolled together in a ball to make a speck visible to the naked eye. but they have some little weight, after all, and seldom float around in the air, so to speak, of their own accord, but only where currents of air are kept stirred up and moving, without much opportunity to escape, and especially where there is a good deal of dust floating, to the tiny particles of which they seem to cling and be borne about like thistle-down. this is one reason why dusty air has always been regarded as so unwholesome, and why a very high death rate from consumption, and other diseases of the lungs, is found among those who work at trades and occupations in which a great deal of dust is constantly driven into the air, such as knife-grinders, stone-masons, and printers, and workers in cotton and woolen mills, shoddy mills, carpet factories, etc. [illustration: a vacuum cleaner most of the dust being emptied from the bag, would, in ordinary sweeping, have been merely blown around the room. by the vacuum process the dust is sucked up through the tube into the storing receptacle.] in cleaning a room and its furniture, it is always best to use a carpet sweeper, a vacuum cleaner, or a damp cloth, as much as possible, the broom as little as may be, and the feather duster never. the two latter stir up disease germs resting peacefully on the floor or furniture, and set them floating in the air, where you can suck them into your lungs. there are three great groups of disease germs which may be found floating in the air wherever people are crowded together without proper ventilation--for most of these disease germs cannot live long outside of the body, and hence come more or less directly from somebody else's lungs, throat, or nose. the most numerous, but fortunately the mildest group, of these are the germs of various sorts which give rise to _colds_, _coughs_, and _sore throats_. then there are two other exceedingly deadly germs, which kill more people than any other disease known to humanity--the bacillus of consumption, and the coccus of pneumonia. our best protection against all these is, first, to have our rooms well ventilated, well lighted, and well sunned; for most of these germs die quickly when exposed to direct sunlight, and even to bright, clear daylight. the next most important thing is to avoid, so far as we can, coming in contact with people who have any of these diseases, whether mild or severe; and the third is to build up our vigor and resisting power by good food, bathing, and exercise in the open air, so that these germs cannot get a foothold in our throats and lungs. colds. two-thirds of all colds are infectious, and due, not to cold pure air, but to foul, stuffy air, with the crop of germs that such air is almost certain to contain. they should be called "fouls," not "colds." they spread from one person to another; they run through families, schools, and shops. they are accompanied by fever, with headache, backache, and often chills; they "run their course" until the body has manufactured enough antitoxins to stop them, and then they get well of their own accord. this is why so many different remedies have a great reputation for curing colds. if you "catch cold," stay in your own room or in the open air for a few days, if possible, and keep away from everybody else. you only waste your time trying to work in that condition, and will get better much more quickly by keeping quiet, and will at the same time avoid infecting anybody else. get your doctor to tell you what mild antiseptic to use in your nose and throat; and then keep it in stock against future attacks. often it is advisable to rest quietly in bed a few days, so as not to overtax the body in its weakened condition. [illustration: exercise in the cold is a good preventive of colds] keep away from foul, stuffy air as much as possible, especially in crowded rooms; bathe or splash in cool water every morning; sleep with your windows open; and take plenty of exercise in the open air; and you will catch few colds and have little difficulty in throwing off those that you do catch. colds are comparatively trifling things in themselves; but, like all infections however mild, they may set up serious inflammations in some one of the deeper organs--lungs, kidneys, heart, or nervous system, and frequently make an opening for the entrance of the germs of tuberculosis or pneumonia. don't neglect them; and if you find that you take cold easily, find out what is wrong with yourself, and reform your unhealthful habits. [illustration: a year of consumption on manhattan island every black dot represents one case reported. the groupings show how rapidly the disease spreads from one household to another in the same locality.] how to conquer consumption different forms of tuberculosis. the terrible disease tuberculosis is the most serious and deadly enemy which the human body has to face. it kills every year, in the united states, over a hundred and fifty thousand men, women, and children--_more lives than were lost in battle in the four years of our civil war_. it is caused by a tiny germ--the _tubercle bacillus_--so called because it forms little mustard-seed-like lumps, or masses, in the lungs, called _tubercles_, or "little tubers." for some reason it attacks most frequently and does its greatest damage in the lungs, where it is called _consumption_; but it may penetrate and attack any tissue or part of the body. tuberculosis of the glands, or "kernels," of the neck and skin, is called _scrofula_; tuberculosis of the hip is _hip-joint disease_; and tuberculosis of the knee, _white swelling_. "spinal disease" and "hunch-back" are, nine times out of ten, tuberculosis of the backbone. tuberculosis of the bowels often causes fatal wasting away, with diarrhea, in babies and young children; and tuberculosis of the brain (called _tubercular meningitis_) causes fatal convulsions in infancy. [illustration: consumption in chicago four hundred and seventy-seven cases in one month--february, .] tuberculosis of the lungs--how to keep it from spreading. tuberculosis of the lungs is the most dangerous of all forms, both because the lungs appear to have less power of resistance against the tubercle bacillus, and also because from the lung, the bacilli can readily be coughed up and blown into the air again, or spit onto the floor, to be breathed into the lungs of other people, and thus give them the disease. two-thirds of all who die of tuberculosis die of the pulmonary, or lung, form of the disease, popularly called consumption. the first thing then to be done to put a stop to this frightful waste of human life every year is to _stop the circulation of the bacillus from one person to another_. this can be done partially and gradually by seeing that every consumptive holds a handkerchief, or cloth, before his mouth whenever he coughs; that he uses a paper napkin, pasteboard box, flask, or other receptacle whenever he spits; and that these things in which the sputum is caught are promptly burned, boiled, or otherwise sterilized by heat. the only sure and certain way, however, of stopping its spread is by placing the consumptive where he is in no danger of infecting any one else. and as it fortunately so happens that such a place--that is to say, a properly regulated sanatorium, or camp--is the place which will give him his best chance of recovery, at least five times as good as if he were left in his own home, this is the plan which is almost certain to be adopted in the future. its only real drawback is the expense. but when you remember that consumption destroys a hundred and fifty thousand lives every year in this country alone, and that it is estimated that every human life is worth at least three thousand dollars to the community, you will see at once that consumption costs us in deaths alone, four hundred and fifty million dollars a year! and when you further remember that each person who dies has usually been sick from two to three years, and that two-thirds of such persons are workers, or heads of families, and that tens of thousands of other persons who do not die of it, have been disabled for months and damaged or crippled for life by it, you can readily see what an enormous sum we could well afford to pay in order to stamp it out entirely. one of the most important safeguards against the disease is the law that prevents spitting in public places. not only the germs of consumption, but those of pneumonia, colds, catarrhs, diphtheria, and other diseases, can be spread by spitting. the habit is not only dangerous, but disgusting, unnecessary, and vulgar, so that most cities and many states have now passed laws prohibiting spitting in public places, under penalty of fine and imprisonment. [illustration: a report-form from a health department laboratory in a suspected case, the physician sends a specimen of the sputum to the laboratory to be tested, and receives a reply according to the result of the test. the form is filled in with the name of the patient and signed by the director of the laboratory.] the next best safeguard is plenty of fresh air and sunlight in every room of the house. these things are doubly helpful, both because they increase the vigor and resisting power of those who occupy the rooms and might catch the disease, and because direct sunlight, and even bright daylight, will rapidly kill the bacilli when it can get directly at them. how great is the actual risk of infection in crowded, ill-ventilated houses is well shown by the reports of the tuberculosis dispensaries of new york and other large cities. whenever a patient comes in with tuberculosis, they send a visiting nurse to his home, to show him how best to ventilate his rooms, and to bring in all the other members of the family to the dispensary for examination. no less than from _one-fourth to one-half_ of the children in these families are found to be already infected with tuberculosis. the places where we look for our new cases of tuberculosis now are in the same rooms or houses with old ones. a careful consumptive is no source of danger; but alas, not more than one in three are of that character. [illustration: a sign that ought not to be necessary but, being necessary, it should be strictly respected and obeyed.] it has been estimated that any city or county could provide proper camps, or sanatoria, to accommodate all its consumptives and cure two-thirds of them in the process, support their families meanwhile, and stop the spread of the disease, at an expense not to exceed five dollars each per annum for five years, rapidly diminishing after that. if this were done, within thirty years consumption would probably become as rare as smallpox is now. some day, when the community is ready to spend the money, this will be done, but in the mean time, we must attack the disease by slower and less certain methods. [illustration: a comparative death-rate of contagious diseases note the number of deaths from tuberculosis to one from smallpox; yet smallpox before the days of vaccination and quarantine, was the universal scourge. similarly, by preventive measures, we are controlling the other diseases. why not also tuberculosis? (statistics for greater new york, ; total number of deaths from all causes, , .)] why the fear and danger of consumption have been lessened. terrible and deadly as consumption is, we no longer go about in dread of it, as people did twenty-five years ago, before we knew what caused it; for we know now that it is preventable and that two-thirds of the cases can be cured after they develop. the word consumption is no longer equivalent to a sentence of death. the deaths from tuberculosis each year have diminished almost one-half in the last forty years, in nearly every civilized country in the world; and this decrease is still going on. the methods which have brought about this splendid progress, and which will continue it, if we have the intelligence and the determination to stick to them, are:--first, the great improvements in food supply, housing, ventilation, drainage, and conditions of life in general, due to the progress of modern civilization and science, combined with a marked increase in wages in the great working two-thirds of the community. second, the discovery that consumption is caused by a bacillus, and by that alone, and is spread by the scattering of that bacillus into the air, or upon food, drink, or clothing, to be breathed in or eaten by other victims. third, increase of medical skill and improved methods of recognizing the disease at a very early stage. a case of consumption discovered early means a case cured, eight times out of ten. its cure and prevention. fortunately, the same methods which will cure the disease will also prevent it. the best preventatives are food, fresh air, and sunshine. eat plenty of nourishing food three times a day, especially of milk, eggs, and meat. sit or work in a gentle current of air, keep away from those who have the disease, sleep with your windows open, take plenty of exercise in the open air, and you need have little fear of consumption. in the camps, or sanatoria, for the cure of consumption, these methods are simply carried a little further, to make up for previous neglect. the patients sit or lie out of doors all day long, usually in reclining chairs, in summer under the trees, and in winter on porches, with just enough roof to protect them from rain or snow. they sleep in tents, or in shacks, which are closed in only on three sides, leaving the front open to the south. they dress and undress in a warm room, or the curtains of the tent are dropped, or the shutters of the shack closed night and morning until the room is warmed up. in cold climates they dress day and night almost as if they were going on an arctic relief expedition, and spend twenty-four hours out of the twenty-four in the open air. [illustration: a tuberculosis tent colony in winter] they eat three square meals a day, consisting of everything that is appetizing, nutritious, and wholesome, with plenty of butter, or other fats; and in addition, drink from one to three pints of new milk and swallow from six to twelve raw eggs a day. you would think they would burst on such a diet, but they don't; they simply gain from two to four pounds a week, lose their fever and their cough, get rid of their night sweats, and usually in from two to five weeks are able to be up and about the camp, taking light exercise. when they have reached their full, normal, or healthy weight for their height and age, their amount of food is reduced, but still kept at what would be considered full diet for a healthy man at hard work. if sick people can be made well by this open air treatment, those of us that are well ought not be afraid to have a window open all night. two-thirds of the treatment that would cure you of consumption will prevent your ever having it. while tuberculosis chiefly attacks the lungs, it is really a disease of the entire body, or system, and cannot attack you if you will keep yourself strong, vigorous, and clean in every sense of the word. how to recognize the disease in its early stages. to recognize the disease early is, of course, work for the doctor; but he must be helped by the intelligence of the patient, or the patient's family, or he may not see the case until it is so far advanced as to have lost its best chance of cure. we can now recognize consumption before the lungs are seriously diseased. among the most useful methods with children is the rubbing or scratching of a few drops of the toxin of the tubercle bacillus, tailed _tuberculin_, into the skin. if the children are healthy, this will leave no mark, or reddening, at all; but if they have tuberculosis, in two-thirds of the cases it will make a little reddening and swelling like a very mild vaccination. but in order to get any good from this, cases must be brought to a doctor, early, without waiting for a bad cough, or for night sweats. signs of consumption. the signs that ought to make us suspicious of a possible beginning of tuberculosis are first, loss of weight without apparent cause; fever, or flushing of the cheeks, with or without headache, every afternoon or evening; and a tendency to become easily tired and exhausted without unusual exertion. whenever these three signs are present, without some clear cause, such as a cold, or unusual overwork or strain, especially if they be accompanied by a rapid pulse and a tendency to get out of breath readily in running upstairs, they should make us suspect tuberculosis; and if they keep up, it is advisable to go at once and have the lungs thoroughly examined. nine cases out of ten, seen at this stage, are curable--many of them in a few months. even if we should not have the disease, if we have these symptoms we need to have our health improved; and a course of life in the open air, good feeding, and rest, which would cure us if we had tuberculosis, will build us up and prevent us from developing it. [illustration: an outdoor classroom for tuberculous children the roof and the side awnings are the only obstructions to the outer air.] pneumonia its cause and prevention. the other great disease of the lungs is _pneumonia_, formerly known as inflammation of the lungs. this is rapid and sudden, instead of slow and chronic like tuberculosis, but kills almost as many people; and unfortunately, unlike tuberculosis, is not decreasing. in fact in some of our large cities, it is rapidly increasing. although we know it is due to a germ, we don't yet know exactly how that germ is conveyed from one victim to another. one thing, however, of great practical importance we do know, and that is that pneumonia is a disease of overcrowding and foul air, like tuberculosis; that it occurs most frequently at that time of the year--late winter and early spring--when people have been longest crowded together in houses and tenements; and that it falls most severely upon those who are weakened by overcrowding, under-feeding, or the excessive use of alcohol. how strikingly this is true may be seen from the fact that, while the death-rate of the disease among the rich and those in comfortable circumstances, who are well-fed and live in good houses, is only about five per cent,--that is, one in twenty,--among the poor, especially in the crowded districts of our large cities, the death-rate rises to twenty per cent, or one in five; while among the tramp and roustabout classes, who have used alcohol freely, and among chronic alcoholics, it reaches forty per cent. the same steps should be taken to prevent its spread as in tuberculosis--destroying the sputum, keeping the patient by himself, and thoroughly ventilating and airing all rooms. as the disease runs a very rapid course, usually lasting only from one to three weeks, this is a comparatively easy thing to do. though pneumonia is commonly believed to be due to exposure to cold or wet, like colds, it has very little to do with these. you will not catch pneumonia after breaking through the ice or getting lost in the snow, unless you already have the germs of the disease in your mouth and throat, and your constitution has already been run down by bad air, under-feeding, overwork, or dissipation. arctic explorers, for instance, never catch pneumonia in the frozen north. chapter xv the skin our wonderful coat what the skin is. the skin is the most wonderful and one of the most important structures in the body. we are prone to think lightly of it because it lies on the surface, and to speak of it as a mere coating, or covering--a sort of body husk; but it is very much more than this. not only is it waterproof against wet, a fur overcoat against cold, and a water jacket against heat, all in one, but it is also a very important member of the "look-out department," being the principal organ of one of our senses, that of touch. the eyes in the beginning were simply little colored patches of the skin, sunk into the head for the purpose of specializing on the light-rays. the smelling areas of the nose also were pieces of the skin, as were also the ears. not only so, but--although it is a little hard for you to understand how this could have happened--the whole brain and nervous system is made up of folds of the skin tucked in from the surface of the back; so that we can say that the skin, with the organs that belong to it and have grown from it--the eyes, nose, ears, brain, and nerves--forms the most wonderful part of the body. everything that we know of the world outside of us is told us by the skin and the look-out organs that have grown out of it. the skin is not only the surface part and coating of the body, far superior to any six different kinds of clothing which have yet been invented, but it is related to, and assists in, the work of nearly half the organs in the body. not only all that we learn by touch and pressure, but everything that we know of heat and cold, of moisture and dryness, and most of pain, comes to us through our skin, through the little bulbs on the ends of the nerve twigs in it. it also helps the lungs to breathe, the kidneys to purify the blood, and the heart to control the flow of blood through the body. a healthy skin is of very great importance; and part of this health we can secure directly, by washing and bathing, scrubbing and kneading and rubbing, because the skin lies right on the surface, where we can readily get at it. but, on the other hand, no amount of attention from the outside alone will keep it healthy. all the organs inside the body must be kept healthy if the skin is to be kept in good condition. although the external washing and cleaning are very important, the greater part of the work of developing a healthy skin and a good complexion must be done from the inside. the two layers which make up the skin. like our "internal skin," the mucous membrane, which lines our stomach and bowels, the skin is made up of two layers--a deeper, or basement, sheet, woven out of tough strands of fibrous stuff (_derma_); and a surface layer (_epidermis_) composed of cells lying side by side like the bricks in a pavement, or the tiles on a floor, and hence called "pavement" (_epithelial_) cells. these pavement cells are fastened on the basement membrane much as the kernels of corn grow on a cob; only, instead of there being but one layer, as on a cob of corn, there are a dozen or fifteen of them, one above the other, each one dovetailing into the row below it, as the corn kernels do into the surface of the cob. as they grow up toward the surface from the bottom, they become flatter and flatter, and drier, until the outer surface layer becomes thin, fine, dry, slightly greasy scales, like fish-scales, of about the thickness of the very finest and driest bran. we are continually shedding our skin. one way in which the skin keeps itself so wonderfully clean and fresh is by continually shedding from its surface showers of these fine, dry, scaly cells, which drop, or are rubbed off, as they dry. this is the reason why no mark, not even a stain or dye, upon the skin, will stay there long; for no matter how deeply it may have soaked into the layers of the pavement-cells, every cell touched by it will ultimately grow up to the surface, dry up, and fall off, carrying the stain with it. if you want to make a mark on the skin that will be permanent, you have to prick the colors into it so deeply that they will go through the basement layer and reach cells which will not grow toward the surface. this "pricking-in" operation is known as _tattooing_; and it is as foolish as it is painful, for blood-poisoning and other diseases may be carried into the system in the process. [illustration: the layers of the skin _e_, epidermis; _c_, capillaries; _d_, dermis; _f_, fat globules and connecting fibres.] perhaps you will wonder why, if you are shedding these scales from all over your surface every day, you don't see them. this is simply because they are so exceedingly small, thin, and delicate, that you cannot see them unless you get a large number of them together; and when you are changing your clothing, bathing, etc., they are rubbed off and float away. if a part of the body has been shut in--as when a broken arm, for instance, is in a cast, which cannot be changed for several weeks--when finally you take off the bandage, you will find inside it spoonfuls--i had almost said handfuls--of fine scales, which have been shed from the skin and held in by the wrappings. the glands in the skin sweat glands. like all the pavement (epithelial) surfaces of the body, inside and out, the skin has the power of making glands by dipping down little pouches or pockets into the layers below. in the skin, these little gland-pockets are of two kinds, the _sweat glands_ and the _hair glands_. the sweat glands are tiny tubes which go twisting down through the different pavement layers, through the basement layer, and right into the coat of fat, which lies just under the skin. the tube of the sweat gland soaks, or picks, out of the blood some of the waste-stuff--just as the kidney tube does in the kidney,--together with a good deal of water and a small amount of delicate oil, and pours them out on the surface of the body in the form of the "sweat," or _perspiration_. as you will remember, when the muscles work hard and pour more waste into the blood, then the heart pumps larger amounts of blood out into the skin; and this causes it to redden. the sweat glands work harder to purify this extra blood, and they pour out the waste and oil and water on the surface. as soon as this water gets upon our hot skin, it begins to evaporate and cool us off, as well as to carry off some of the waste in the form of gas. the trace of oil in the perspiration helps to lubricate the skin and keep it soft; but when too much of it is poured out we have that greasy feeling, which we have all felt after perspiring freely. from all this cooling and breathing and blood-purifying work going on upon the surface of our skin, you can easily see why it is so important that all our clothing should be loose and porous and that next the skin easily washed; else it will very soon become clogged up and greasy, and shut off the breathing and blood-purifying work of the skin and make it dirty and unhealthy. this continual mist of water, rising and bubbling up through our skin like springs out of a hillside, is another of nature's wonderful ways of cleansing the skin and of preventing any kind of dirt from permanently sticking to or lodging in it. remember, you do not need to dig below the surface when you wash. hair glands. the other kind of skin glands, the hair glands, are also pouches growing out from the deepest part of the stem of the hair, known as the root, or _hair bulb_. [illustration: the glands in the skin _s_, sweat gland; _h_, hair bulb; _o_, oil gland; _t_, touch bulb at tip of nerve.] from the root of the hairs, two or three little bundles of muscle run up toward the surface of the skin. when these contract, they pull the root of the hair up toward the surface, causing the hair to stand erect, or "bristle," as we say. this is what makes the hair on a dog's or a cat's back stand up when he is angry; but the commonest use of the movement is, when animals are cold, to make their coats stand out so as to hold more air and retain the body-heat better. we have lost most of our hairy coating, but whenever we get chilly, whether from cold or from fright, these little muscles of our hair bulbs contract and pull the hair glands of our skin up toward the surface, so that it looks all "pimply" or "goose-skinned." each hair pouch has sprouted out from its sides a pair of tiny pouches, which form _oil glands_ to lubricate the hair and keep it sleek and flexible. it is hard to beat nature at her own game, and her method of oiling the hair is far superior to any hair oil that can be put on from the outside. keep your hair well brushed and washed, and nature will oil it for you much better than any hair oil or scalp reviver ever invented.[ ] the nails how the nails are made. another "trade," which our wonderful skin has literally "at its fingers' ends," is that of making nails. indeed, every kind of scale, armor, fur, feather, and leather coating possessed by bird, beast, or fish was made by, and out of, the skin. nail-making, however, is one of its simplest feats, as it is carried out merely by turning a little patch, or area, of itself into a horn-like substance. this, the skin of insects, of fishes, of crocodiles, etc., does all over the surface of their bodies; but in animals and birds only a number of little patches at the tips of the toes harden up in this way, to form the claws or nails; and in birds, the beak; and in some animals, the horns. so it is quite correct to call the substance of our nails "horn-like." in some animals and birds, these little horny patches at the ends of the toes grow out into long, curved hooks, or broad, digging chisels and scoops; but on our own fingers, they simply make a little mould over the finger-tip. if, however, they are protected from being broken off, they will grow four or five inches long; in fact, they are carefully trained to do this by some of the upper classes in china, merely for the purpose of showing that they have never been obliged to degrade themselves, as they foolishly regard it, by working with their hands. you can easily prove that the nails do grow constantly from the root or base, out toward the tip, by watching, some time when you have pounded one of your nails, how the black or discolored patch in it will grow steadily outward toward the tip, where it will be broken off and shed. you cannot see the softest and youngest row, or layer, of the nail cells at the base, because a fold of skin, the _nail fold_, has been doubled, or folded, over them to protect them while they are young and soft. it is not best to push this fold of skin back too much, as, by so doing, you may uncover the young nail cells while they are soft and tender, and expose them to injury. the reason why there is a little whitish crescent at the base of the nail is that the cells of the nail do not grow hard and horn-like and transparent until they have grown out a quarter of an inch or so from under the fold, but at first look whitish, or opaque, like the rest of the skin. health shown by the color of the nails. your nails and your lips are not really any redder, or pinker, than the rest of your skin; but the cells forming them are clear and transparent and allow the red blood to show through. this is why we often look at the nails and lips to see what the color of the blood is like, and how well or badly it is circulating. if the blood is _anemic_, or thin, then both lips and nails are pale and dull. if the blood is healthy and the circulation good, then the nails are pink, and the lips clear red. if, on the other hand, the circulation is bad, as in some forms of lung disease and heart disease, so that the blood is loaded with carbonic acid until it is blue and dark, then the lips may become purplish or dark blue, and the finger nails nearly the same color. the blood-mesh of the skin the blood vessels under the skin. not merely the nails and the lips, but the whole surface of the skin is underlaid with a thick mat, or network, of blood vessels. these vessels are all quite small, so that a cut has to go down completely through the skin, and generally well down into the muscles, before it will reach any blood vessel which will bleed at a dangerous rate. but there are so many of them, and they cover such a wide surface throughout the body, that they are actually capable of holding, at one time, nearly one-tenth of all the blood in the body. this "water-jacket" coat of tiny blood vessels all over our body has some very important uses: it allows the heart to pump large amounts of blood out to the surface to be purified by the sweat glands, and to breathe out a little of its carbon dioxid and other gas-poisons. the skin as a heat regulator. heat, as well as waste, is given off by the blood when it is poured out to the surface; so another most important use of the skin is as a heat regulator. as we have already seen, every movement which we make with our muscles, whether of arms and limbs, heart, or food tube, causes heat to be given off. we very well know, when we work hard at anything, we are likely to "get warmed up." although a certain amount of this heat is necessary to our bodily health, too much of it is very dangerous. just as it is best for the temperature, or heat, of a room to be at about a certain level, somewhere from ° to ° f., so it is best for the interior of our bodies to be kept at about a certain heat. this, as we can show by putting a little glass thermometer under the tongue, or in the armpit, and holding it there for a few minutes, is a little over ° f. ( . ° to be exact); and this we call "body heat," or "blood heat," or "normal temperature." our body cells are, in one way, a very delicate and sensitive sort of hot-house plants, though tough enough in other respects. whenever our body heat goes down more than five or six degrees, or up more than two or three degrees, then trouble at once begins. if our temperature goes down, as from cold or starvation, we begin to be drowsy and weak, and finally die. if, on the other hand, our temperature climbs up two, three, or four degrees, then we begin to be dizzy and suffer from headache and say we have "a fever." a fever, or rise of temperature, that can be noted with a thermometer, is usually due to disease germs of some sort in the body; and most of the discomfort that we suffer is really due more to the poisons (toxins) of the germs than to the mere increase of heat, though this alone will finally work serious damage. however, as we well know from repeated experience, we need only to run or work hard in the sun for a comparatively short time to make ourselves quite hot enough to be very uncomfortable; and if we had no way to relieve ourselves by getting rid of some of this heat, we should either have to stop work at once, or become seriously ill. this relief, however, is just what nature has provided for in this thick coat of blood vessels in our skin; it enables us to throw great quantities of blood out to the surface where it can get rid of, or, as the scientists say, "radiate," its heat. this cooling process is hastened by the evaporation of the perspiration poured out at the same time, as we have seen. one of the chief things in training for athletics is teaching our skin and heart together to get rid of the heat made by our muscles, as fast, or nearly as fast, as we make it, thus enabling us to keep on running, or working, without discomfort. as soon as we stop running, or working, the heart begins to slow down, the blood vessels in the skin contract and diminish in size, the flush fades, and we begin to cool off. we are not making either as much heat or as much waste as we were, and hence do not need to get rid of so much through our skins. when we feel cold, just the opposite kinds of change occur in the skin. the blood vessels in the skin contract so as to keep as much of our warm blood as possible in the deeper parts of our body, and prevent its losing heat. as blood showing through the pavement-layer of the skin is what gives us our color, or complexion, our skin becomes pale and pasty-looking; and if all the blood is driven in from the surface, our lips and finger nails will become blue with cold. here again, by changes in the skin, nature is simply trying to protect herself from the loss of too much heat. if we exercise briskly, or eat a good warm meal, and thus make more heat inside of our body, then there is no longer any need to save its surface loss in this way; and the blood vessels in our skin fill up, the heart pumps harder, and the warm, rich color comes back to our faces and lips and finger nails. so perfectly and wonderfully does this skin mesh of ours work, by increasing or preventing the loss of heat, that it is almost impossible to put a healthy man under conditions that will raise or lower his temperature more than about a degree, that is to say, about one per cent above, or below, its healthful level. men studying this power of the skin have shut themselves into chambers, or little rooms, built like ovens, with a fire in the wall or under the floor, and found that if they had plenty of water to drink and perspired freely, they could stand a temperature of over ° f. without great discomfort and without raising the temperature of their own bodies more than about one degree. if, however, the air in the chamber was moistened with the vapor of water, or steam, so that the perspiration could no longer evaporate freely from the surface of their bodies, then they could not stand a temperature much above ° or ° without discomfort. other men, who were trained athletes, have been put to work in a closed chamber, at very vigorous muscular exercise, so as to make them perspire freely. but while a thermometer placed in that chamber showed that the men were giving off enormous amounts of heat to the air around them, another thermometer placed under their tongues showed that they were raising the temperature of their own bodies only about half a degree. one man, however, happened to try this test one morning when he was not feeling very well, and didn't perspire properly, and the thermometer under his tongue went up nearly four degrees. the nerves in the skin how we tell things from touch, and feel heat and cold and pain. last of all, the skin is the principal organ of the sense of touch, and also of the "temperature sense"--the sense of heat and cold--and of the sense that feels pain. all these feelings are attended to by little bulbs lying in the deeper part of the skin and forming the tips of tiny nerve twigs,[ ] which run inward to join larger nerve branches and finally reach the spinal cord. there are millions of these little bulbs scattered all over the surface of the skin, but they are very much thicker and more numerous in some parts than in others; and that is why, as you have often noticed, certain parts of the skin are more sensitive than others. they are thickest, for instance, on the tips of our fingers and on our lips, and fewest over the back of the neck and shoulders, and across the lower part of the hips.[ ] for a long time, it was supposed that all these little nerve-bulbs in the skin did the same kind of work, because they looked, under the microscope, exactly alike; but it was found that they divide the work up among them, so that some of them give their entire attention to heat, and others to cold, others to touch, and others again to pain. so carefully has the work been mapped out among them that they report to different centres in the brain and spinal cord, so that we now understand why, in diseases which happen to attack one or other of these centres, we may lose our sense of heat and cold, as in that terrible disease, _leprosy_; or our sense of touch, as in _paralysis_; or we may even, in some very rare cases, lose our sense of pain, and yet have all our other senses perfect. footnotes: [ ] hairs are of value chiefly as protection against cold and wet, although we have got rid of them and substituted clothing for this purpose, except on the top of our heads; but their roots also are very richly supplied with nerves so that they form almost a sort of feelers, or organs of sense. many animals that move about much in the dark, like cats and bats, for instance, have their lips or faces studded with long, delicate, stiff hairs called whiskers, which act in this way and prevent their bumping into objects in the dark. and it is probable that the bristling of the hair on a dog's back, when he is angry or frightened, is in part for this purpose--to enable him to slip aside and dodge a blow, even after it has touched the ends of the hairs. this great sensitiveness of the hair roots is what makes it hurt so when any one pulls your hair. [ ] see the diagram of the skin on page . [ ] you can easily test this by a very simple experiment. take a pair of dividers; or, if you haven't these, a couple of long pins or needles will do. set them with their points a quarter of an inch apart. then touch these points, first closing your eyes, so that you will not be able to see them, to the tip of one of your fingers, and you will readily feel that _two_ points touch the skin. turn your hand over and touch the back of it with the two points, and they will feel like one point. carry the test further, over other parts of the body, and you will find that they are much less sensitive; thus you will find that at the back of the neck, or over the shoulder-blades, you will have to put the points nearly an inch apart before you can tell that there are two of them. this simply means that you have to touch two separate touch bulbs before you can get the idea of "two-ness." as these bulbs are an inch or more apart in the skin of the back, you have to spread the points of the dividers that distance. you can also prove that the touching of two nerve-buds gives the idea of "two-ness" by crossing two of your fingers and placing a pea, or small round piece of chalk, between their crossed tips. if you close your eyes and roll the pea on the table, or desk, you will think you have two peas between your fingers. chapter xvi how to keep the skin healthy clothing clothes should be loose and comfortable. man is the only animal that has no natural suit of clothing. birds have feathers, and animals have fur, or hair, which they shed in summer and thicken up in winter without even thinking about it, so that they do not have to bother with either overcoats or flannels. the wise men say that man originally had a full suit of hair like other animals, and that he gradually got rid of it, as he became human. whether this be true or not, the fact remains that he has none now; and consequently he must invent and manufacture something to take its place. originally, in the time of our savage ancestors, clothing was worn chiefly as protection from cold at night, so that all the earlier forms of clothing were of a more or less blanket-or cloak-like form, and wrapped, or swathed, the whole body without fitting closely to the limbs. it is interesting to remember this fact, because even our most highly civilized forms of clothing still show this same tendency. the skirt, for instance, is simply a survival of the lower end of the blanket, which has never been cut down to fit the limbs. the principles upon which garments should be built are two: first, they should fit closely enough to the body and limbs to protect them from either injury or cold, even while free activity of every sort is allowed--you could not wrestle in a blanket or run very far in a sack. second, they should be thick enough to protect us from cold, and yet at the same time porous enough not to interfere with the natural breathing and ventilating of the skin. a garment should be as loose as possible without interfering with our movements, and as free and as light as can be worn with reasonable warmth and protection. the less clothing you can wear and be comfortable, the better. we should particularly avoid binding or cramping the chest and the hips and waist. if clothing is too tight about the chest, it interferes both with free movement of the arms and, what is even more important, with the breathing movements of the chest. if too tight about the waist and hips, it badly cripples the lower limbs and interferes with the proper movements of the diaphragm in breathing, and with the passage of the food and the blood through the bowels. your instincts are perfectly right that make you dislike to be squeezed or pinched or cramped in any way, or at any point, by your clothing; and if you will only follow these instincts all through your lives, you will be far healthier and happier. the texture of clothing. just as for ages we have experimented with different kinds of food, so we have with different kinds of material for clothing. we have used the skins of animals; mats woven out of leaves and grasses; the feathers of birds; the skins of fishes; cloths made of wool and of cotton; and even the cocoon spun by certain caterpillars, which we call _silk_. but of all these materials, practically only two have stood the test of the ages and proved themselves the most suitable and best all-round clothing materials--wool and cotton. woolen cloth, woven from the fleece of sheep or goats or camels or llamas or alpacas, has three great advantages, which make it _the_ outside clothing of the human species. first, it is sufficiently tough and lasting to withstand rips and tugs and ordinary wear and tear; second, it is warm--that is, it retains well the body heat; and third, it is porous, so that it will allow gases and perspiration from the surface of the body to pass through it in one direction, and air for the skin to breathe, in the other. [illustration: results of tight clothing ( ) the normal thorax. ( ) the thorax and organs cramped and lifted by pressure of the clothing. (from an x-ray photograph.--after dickinson.)] no clothing, of course,--not even fur,--has any warmth in itself; it simply has the power of retaining, or keeping in, the warmth of the body that it covers. the best and most effective way of retaining the body warmth is to surround the body with a layer of dead, or still, air, which is the best non-conductor of heat known. hence, porous garments, like loosely-woven flannels, blankets, and other woolen cloths, are warm because they contain or hold large amounts of air in their spongy mesh. the reason why furs are so warm is that their soft, furry under-hairs, or "pelt" as the furriers call it, entangle and hold an enormous amount of air. the fur of ordinary sealskin, for instance, is about half an inch deep; and _ninety per cent_ of this half-inch is air. if you wet it, its fur "slicks down" to almost nothing, although the most drenching wetting will not wash all the air out of it, but still leaves a dry layer next to the skin. the fur of mink skin, coon skin, or wolf skin, is an inch thick; and nearly eighty per cent of this thickness is air. the great advantage for clothing purposes of wool over fur is that the wool is porous through and through, while the fur is borne upon, and backed by, a layer of leather--the skin of the animal upon which it grew--which layer, after tanning and curing, becomes almost absolutely air-tight. as a matter of fact, furs are worn mostly for display and are most unwholesome and undesirable garments. the only real excuse for their use, save for ornament in small pieces or narrow strips, is on long, cold rides in the winter, and among lumbermen, frontiersmen, and explorers. they hold in every particle of perspiration and poisonous gas thrown off by the skin, and if worn constantly, make it pale, weak, and flabby; and the moment we take them off, we take cold. for outer garments and general wear, nothing yet has been discovered equal to wool, particularly at the cooler times of the year. but for under wear, in the hotter seasons and climates, wool has certain disadvantages. it is likely to be rough and tickling to most skins, which makes it uncomfortable, especially in warm weather. it is also difficult and troublesome to wash woolens without shrinking them; and, as soon as they do shrink, not only do they become uncomfortably tight, but the natural pores in them which make them so valuable close up, and they become almost air-tight. finally, when loaded with perspiration, woolens easily become offensive, so that they must be frequently changed and washed; and as they are also high in price, it is easily seen that there are practical drawbacks to their use. cotton is much softer and pleasanter to the skin than wool, is cooler in hot weather, is much cheaper, and is very easily washed without losing either its shape or its porousness. it can be so woven as to be almost as porous as wool, and to retain that porousness even when saturated with perspiration. it does not soak up and retain the oils and odors of perspiration in the way that wool does; and on the whole, for under wear, and for general wear at the warm seasons of the year, it is not only more comfortable, but far more healthful, than wool. persons of fair health and reasonably vigorous outdoor habits, whose skins are well bathed and ventilated, can wear properly woven cotton or linen undergarments the whole year round with perfect safety. [illustration: a comfortable dress for outdoor study in cold weather the thick bags pulled up to the shoulders keep the body surrounded by a layer of warm air.] linen and silk both make admirable and healthful under wear, if woven with a properly porous mesh. linen has the advantage of remaining more porous than cotton, when moist with perspiration. but for healthy people they have no advantages over cotton that are not offset by their higher prices. baths and bathing bathing as a means of cleanliness. it has been said that one of the reasons why man lost his hairy coat was that he might be able to wash himself better and keep cleaner. however this may be, he has to wash a great deal oftener than other animals, most of whom get along very well with currying, licking, and other forms of dry washes, and an occasional swim in a river or lake. you can readily see how necessary for us washing is, when you remember the quarts of watery perspiration, which are poured out upon our skins every day, and the oily and other waste matters, some of them poisons, which the perspiration leaves upon our skins. especially is some means of washing necessary when the free evaporation of perspiration and the free breathing of the skin has been interfered with by clothing which is water-tight or too thick. bathing as a tonic. but bathing is of much greater value than simply as a means of cleansing. splashing the body with water is the most valuable means that we have of toning up and hardening the skin, and protecting us against the effects of cold. the huge and wonderfully elaborate network of blood vessels that lies in and just under our skins all over our bodies is, from the point of view of circulation, second only in importance to our hearts, and from the point of view of taking cold, and of resisting the attack of disease, one of the most important structures in our entire body. if, by means of daily baths, you keep this mesh of blood vessels in your skin toned up, vigorous, and elastic, and full of red blood, it will do more to keep you in perfect health and vigor than almost any other one thing, except an abundance of food, and plenty of fresh air and exercise. a healthy skin is the best undergarment ever invented. right and wrong bathing. the best form of bath is either the tub or the shower bath; and the cooler the water, provided that you warm up to it quickly and pleasantly, the greater the tonic effect, the more exhilaration and pleasure you will get out of it, and the more it will harden your skin against cold. but it should never under any circumstances be any cooler than you can _readily_ and pleasantly react, or warm up to, during the bath and afterward. the habit of plunging into a great tub of ice-cold water all winter long, except for people of vigorous constitutions and active habits, may often do quite as much harm as good. have your bath water just cool enough to give you a slight, pleasant shock, as you plunge into it, or turn it on, so that you will enjoy the glow and sense of exhilaration that follows; and you will get all the good there is out of the cold bath, and none of the harm. by beginning with moderately cool water you will find that you come to enjoy it cooler and cooler. if a bath-room is not at hand, a large wash-bowl of cool, or cold, water into which you can dip your hands and splash well over the upper half of your body every morning, and once or twice a week all over your body, will keep your skin clean and vigorous. if you cannot warm up properly after a cool bath, there is something wrong about your habits of life; and you had better change them, and keep changing them, until you find you can enjoy it. for some delicate children, a quick plunge into, or splash with, very hot water in the morning will give somewhat the same tonic effect as stronger ones can get from cold water. [illustration: as a tonic, swimming is the best form of bathing] warm baths are best taken at night, just before going to bed, though the danger of catching cold after them on account of their "opening up the pores of the skin," has been very greatly exaggerated. they have, however, a relaxing effect upon the skin, and take out an undue amount of the natural oil which nature provides for its oiling and softening, so that, except for special reasons, it is best not to take them oftener than once, or twice, a week. soaps and scrubbing brushes. as part of the perspiration deposited upon our skins is in the form of a delicate oil, and as this oil may become mixed with dirt, or dust, and form a mixture not readily soluble in water, it is at times advisable to add to the water something that will dissolve oil. the commonest thing used for this purpose is soap, which is a combination of an _alkali_--most commonly _soda_, though occasionally _potash_ (lye) is used in the soft soaps--with a fat or an oil. the combination of the two, which we call soap, has been invented for two reasons; one, that it makes a convenient, solid form in which the alkali, needed to dissolve the body oil, can be used in such strength as not to burn or injure the skin; the other, that the fat in the soap will, to some extent, take the place of the natural oil, or fat, which it washes off. necessary as soap is, it should be used very moderately. you should never lather and scrub your skin as if it were a kitchen floor, for the reason that, with the dirt, the alkali also washes and dissolves out a considerable amount of the natural oil of the skin, and leaves it harsh and dry. on this account, it is best not to use soap upon the covered portions of the body, and in the full bath, oftener than once or twice a week; and upon the face, oftener than once or twice a day. but the hands may be washed with soap more frequently. it is also best to avoid the too frequent use of hot water, even upon the hands and face, for the same reason; it takes out too much of the natural oil of the skin, along with the dirt. unless the dirt be of some infectious, or offensive, character, it is often best to content yourself with washing off just the "big dirt," and wait for the bubbling up of the perspiration through your skin to bring the deeper dirt up to the surface, and wash that off later, in the course of two or three hours. soaps to be avoided. soaps that lather too quickly and easily should always be avoided, for this shows that they contain an excessive amount of soda or other alkali. it is also best to avoid, or at least be very wary of, any soaps which are dark-colored or heavily perfumed, as these disguises may indicate the presence of decaying, offensive fats, and even of grease extracted from garbage. this is what strong perfumes in soaps are chiefly used for. beware of all such, and especially of tar soaps, for the black color and the strong odor of tar can cover up any amount of bad quality. medicated soaps (soaps containing medicines) are also best let alone. they are only fit to be used on the advice of a doctor. most of them are out and out humbugs, and make up for their richness in drugs by their poorness in good, pure fat and alkali. moreover, what may suit one particular diseased condition of the skin is quite as likely to be injurious as helpful to another. any drug which has the power of curing disease is almost certain to be irritating to a healthy skin; and nothing can be put into a soap beyond pure, sweet fat, or oil, and good soda, which will make it any better, or more wholesome, for a healthy skin. if your skin be red, or itchy, or scaly, or out of condition in any way, go to a doctor and get the appropriate treatment for that particular disease, instead of smearing on the surface of your body some drug of which you know nothing, in the hope of its being the proper thing for the little patch of diseased skin. avoid using skin brushes. scrubbing brushes and skin brushes of all sorts should be used even more sparingly than soap or hot water, for the same reason. nature did not coat us over with either boards or rubber, but with delicate, velvety, sensitive, living skin worth ten times as much as any sort of leather, bark, rubber, or cloth, for resisting cold, heat, and injuries. it is most important for the health of the skin that we keep that velvety coating unscratched and unbroken. the use of brushes and bristles of all sorts, therefore, should be chiefly restricted to the hair and the finger nails, as for every ounce of dirt that they take out of the skin, they do a pound of damage to it. they scrub off the delicate epidermis, as well as the natural oil in it, and leave it dry and irritated and ready to crack open. then more dirt gets into the cracks just formed, and more scrubbing with bristles and hot water and soap is indulged in to get it out. this opens the cracks still further, and the next layer of dirt is worked in still deeper. wash frequently with cold or cool water, occasionally with hot water, and sparingly with soap; and limit the use of brushes to the nails and the hair. care of the nails importance of clean nails. on account of their constant use, your hands are brought in contact with dusty or dirty substances in your work and in your play; and it is very easy for some of this dirt, and such germs as it may contain, to lodge in the little chink under the free edge of the nail, between it and the rounded end of the finger. it is of great importance that this nail chink should be kept clean, not only because it looks both ugly and untidy to have the ends of your fingers "in mourning," with black bands across them, but also because the germs lodged under your nails may get onto your food the next time that you eat, and set up irritation and fermentation in your stomach. they may also cause other trouble; for instance, if your collar chafes the back of your neck, and to relieve the itching you rub it a little too hard with your finger, your nail may scratch the skin; and if it be blackened with infectious dirt, this may get into the little scratch and give rise to a boil, or a festering sore. how to clean the nails. this cleaning of the nails, however, must be done carefully and gently; for, if too harsh methods are used, the delicate skin on the under surface of the nail will be torn, the nail will be roughened or split, the dirt will work in just that much deeper next time, and the germs in it may set up inflammations under the nail. for this reason it is best not to use a sharp-pointed knife in cleaning the nails, but a blunt-pointed nail cleaner, such as can be bought for a few cents at any drug store, or such as many pocket-knives are now provided with. it is also best to trim the nails with a file or with scissors, instead of a knife, as the latter may split or tear the nail, or cut down to the quick. before any of these are used, the nails should be thoroughly softened in warm water, and scrubbed with a moderately stiff nailbrush, such as should be kept on every washstand. it is also best not to push back the fold of skin at the base of the nails, with instruments of any sort; or indeed, with anything harder than the ball of the thumb or finger. this fold protects the delicate growing part, or root, of the nail; and if it is shoved back too vigorously, the root may become exposed, or even inflamed and infected, and cause one of those extremely irritating little sores known as a "hangnail." diseases and disturbances of the skin their chief causes. skin troubles are of two main kinds according to their cause: _internal_, due to the irritation of waste-poisons, or toxins, in the blood; and _external_, from direct injury or irritation of the skin from without. the latter are often due to the wearing of too tight or too heavy clothing, or the failure properly to wash, cleanse, and ventilate the skin. some of the lesser disturbances come from the chafing of collars, wristlets, and belts, and are, of course, relieved by loosening the clothing or substituting soft, comfortable cotton for rasping flannels. others come from the use of too strong soaps, or the too frequent use of hot water, or too vigorous scrubbing of the skin, and these can be relieved by the avoidance of their cause. sunburn and freckles and how to cure them. upon the hands and face, sunburn and freckles may occur from exposure to the weather. they are not caused necessarily by exposure to direct sunlight; as the bright light and the cold air out of doors, also, will produce this irritating effect upon the skin. the best way to cure sunburn is to bathe in cool water, take a night's rest, then go out the next day, and the day after, and take another dose of exposure, keeping this up until your face is hardened to stand a reasonable amount of sun. if you are in proper condition, neither your face nor your hands will sunburn uncomfortably. if they do, except under extreme exposure, it is a sign that you have not been living out of doors enough. the various face-washes and creams and dusting powders which are used for the relief of sunburn, while they may, if mild enough, make the face feel somewhat more comfortable for a little time, owe most of their virtues to the fact that they are generally used at bedtime and then get the credit for the cure which nature works while you are asleep. if you should buy them, and keep them on your dressing-table unopened, where you could see them before you went to bed, you would in nine cases out of ten be just as much better in the morning as if you had used them. the only harm done by freckles is to your vanity. they and sunburn both, in fact, are protective actions on nature's part, filling the skin with coloring matter, or _pigment_, so as to protect it, and the tissues below, from the irritating effects of the strong rays of light. a like deposit of pigment, in greater amounts, in the skins of races who live in or near the tropics, gives rise to the characteristic coloring of the black, brown, and yellow races. the pigment, or coloring matter, is of exactly the same kind in all, from the negro to the white. the brown race having a little less of it than the negro, the yellow race a little less yet, and the white least of all, though there is some of it in even the whitest of skins. real skin diseases. most of the serious and lasting diseases of the skin are caused by the attack of germs. perfect cleanliness and ventilation are the best protection against them all; but if you should be unfortunate enough to catch one of these diseases, your doctor will be able to give you the mild germicide or antiseptic that will kill the particular germ that may have lodged upon your skin. the commonest form of inflammation of the skin is called _eczema_, and eight-tenths of all eczemas are due to some mild germ, and can be cured by the appropriate poison for it. other diseases, particularly of the scalp, such as _ringworm_ and _dandruff_, are due to other forms of vegetable germs, and may be cured by their proper poisons; while others, such as the so-called "prairie itch" (_scabies_), and lice in the hair, are due to the presence of tiny animal _parasites_. the hookworm. another disease which enters through the skin is the now famous _hookworm_, or blood-sucking parasite, which has been found to be so common in tropical regions and in our southern states. this parasite has the curious habit of attaching itself by hooks surrounding its mouth (which gave it its name), to the lining of the human intestine, particularly its upper third. there it swings, and lives by sucking the blood of its victim. when the worm has once attached itself in the intestine, it may live for from five to fifteen years. all this time it is constantly laying eggs; and these eggs, which are so tiny that they have to be put under a microscope to be seen, pass out in the feces; and if they are not deposited in a proper water closet, or deep vault, but scattered about upon the surface of the soil, the eggs quickly hatch into tiny, little wriggling worms called _larvæ_, which are still scarcely large enough to be seen with the naked eye. these larvæ live in the soil; and, when it is wet and muddy, they get up between the toes of boys and girls who are going barefoot, burrow their way in through the skin, and produce a severe itching inflammation of the skin of the feet, known as "ground-itch," "toe-itch" or "dew-itch." when they have worked their way through the skin, they bore on into a blood vessel, are carried to the heart, pumped by the heart into the lungs, and there again work their way out of the blood vessels into the bronchial, or air tubes, crawl up these through the windpipe and voice organ into the throat, are swallowed into the stomach, and from there pass on into the upper intestine to attach themselves for their blood-sucking life. if they are sufficiently numerous, their victim becomes thin, weak, and bloodless, with pale, puffy skin, and shortness of breath; he is easily tired on the least exertion, and ready to fall a victim to any disease, like tuberculosis, pneumonia, or typhoid, that may happen to attack him. their spread can be absolutely prevented either by the strict use of toilets or deep vaults, thus preventing the deposit of feces anywhere upon the surface of the ground; or by the constant wearing of shoes or sandals, thus preventing the larvæ from attacking the feet and working their way through the skin and body into the intestine. fortunately, the disease is as curable as it is common, and two doses of a proper germicide, with a day in bed, and a laxative, will promptly cure it except in the worst cases. the rashes of measles, scarlet fever, etc. many of the infectious fevers, such as measles, scarlet fever, chicken-pox, and smallpox, are attended by rashes, or _eruptions_, upon the surface of the skin, due to a special gathering or accumulation of the particular germs causing each disease, just under the skin. when the skin sheds, or flakes off, after the illness, the germs are shed in the scales and float, or are carried about, and thus spread the disease to others. these rashes or eruptions are not dangerous in themselves, though often very uncomfortable, but help us to recognize the disease; they probably show us the sort of thing that is going on in the deeper parts of the body. if you imagine that your throat and bronchial tubes and lungs are peppered as full of the disease spots as your skin is, in measles and in scarlet fever, you will readily understand why your throat is so sore and why you have so much tickling and coughing. the health of the scalp and hair. the scalp, being covered by hair, does not perspire so freely as the rest of the skin of the body; but a considerable amount of oily waste matter is poured out on it, and the surface of its skin scales off in exactly the same way as does the rest of the body. if this accumulation of tiny scales and grease is not properly brushed out, it forms an excellent seed-bed for some of the milder kinds of germs that attack the skin; and a scurfy, itchy condition of the scalp is set up, known as dandruff. the best way to keep the scalp clean of these accumulations of greasy scales is by vigorous and regular brushing with a moderately stiff, but flexible, bristle brush. wire brushes should not be used, as the wires scratch and irritate the delicate scalp and do more harm than good. if you watch a groom brushing and currying the coat of a thoroughbred horse, you will get a fair idea of hew you ought to treat your own scalp at least twice a day, night and morning. if this currying of the hair be thoroughly done, and the head washed with soap and hot water about once a week for short hair and twice a month for long hair, most of the dangers of dandruff and of other infections of the scalp will be avoided. one thing to be remembered is, don't brush too hard or too deep. there is an old saying and a good one, "you can't brush the scalp too little, or the hair too much." wetting the hair for the purpose of "slicking" it or combing it, is about as bad a thing as could be done; for the moisture sets up a sort of rancid fermentation in the natural oil of the scalp, giving the well-known sour smell to hair that is combed instead of brushed, and furnishing a splendid soil for germs and bugs of all sorts to breed in. there is no objection to boys' and men's wetting their hair in cold water as often as they wish, provided that they rub it thoroughly dry afterward and give it a brisk currying with the brush. hair oils and greases of all sorts are sanitary nuisances, and mere half-civilized and lazy substitutes for proper brushing and washing. there is no drug known to medicine which will cause hair to grow, or make it thicker or curlier. all "hair tonics" claiming to do this are frauds. corns, calluses, and warts. our skin not only made our hair, teeth, and nails, but still retains in every part a trace of its nail-making powers, so that under pressure or irritation, it can thicken up into a heavy leather-like substance which we call _callus_. this is naturally and healthfully present in the soles of the feet and the palms of the hands. savage, or barbarous, races who wear no shoes get the skin of their soles thickened into a regular human leather, almost half an inch thick, and as tough as rawhide. a somewhat similar condition develops in the palms of the hands of those who work hard with spades, axes, or other tools. any good process carried to excess becomes bad, and this is true of this power of callus formation in the skin; for parts of it which are under constant pressure, like the surface of the toes inside the shoe, and particularly of the outside toes, the little and the big toe, develop under that pressure patches of thickened, horny skin, which we call _corns_. these patches start to grow into cone-shaped projections or buttons; but being prevented from growing outward by the pressure of the shoe, they turn upon themselves and burrow into the skin itself, and we get the well-known ingrowing corn. if there is anything in the human body which we ought to be thoroughly ashamed of, it is corns; for they are caused by our own vanity, and nothing else, in cramping our feet into shoes one or two sizes too small for them. there are a number of things that can be done to relieve the discomfort of the corn, but the only sure way is to remove its cause, namely, the tight shoe. under other kinds of irritation, the skin has the power of growing curious little button-like buds, or projections, which we call _warts_. these are commonest in childhood, and generally disappear at about twelve or fifteen years of age, when we no longer delight in dirt, and glory in mud pies. they can be produced upon the hands of grown men and women by irritating fluids and substances, such as wet sugar in the case of bakers and confectioners, and various color-stains in dye works. they seldom last for more than a few months, and usually narrow at their base and drop off, when the particular irritation that caused them ceases. on this account it is seldom worth while to try to remove them by burning with acids or cutting them off; and it is best not to pick at, or irritate, or scratch them too much. chapter xvii the plumbing and sewering of the body the wastes of the body. almost everything that the body does in the process of living means the breaking down, or burning, of food; and produces, like every other kind of burning, two kinds of waste--"smoke" and "ashes." the carbon dioxid "smoke," as we have already learned, is carried in the blood to the lungs, where it passes off in the breath. the solid part of our body waste, or the "ashes," is of two kinds--that which can be melted in water, or is, as we say, _soluble_; and that which cannot be melted in water, or is _insoluble_. the insoluble part of our solid body waste goes into the feces and is thus disposed of. the soluble part of the body waste goes by a somewhat more roundabout route. with the carbon dioxid it is poured by the body cells into the veins, carried to the heart, and pumped through the lungs, where the carbon dioxid is thrown off. going back to the heart it is pumped all over the body, part of it going through a very large artery to the liver, part through two large arteries to the kidneys, part to the skin, and the rest all over the remainder of the body. the blood goes completely round the body-circuit from the heart to the fingers and toes, and back again to the heart, in less than forty-five seconds. practically every drop of blood in the body will be pumped through the liver, the kidneys, and the skin, about once every half minute, so that they get plenty of chance to purify it thoroughly when they are working properly. this sounds rather complicated; but is interesting, because it shows how much of a "mind of their own" the different organs and stuffs in our bodies have, or what, in scientific language, we call "power of selection." the skin glands pick out of the blood those waste substances which they are able to get rid of. the kidneys pick out another class of waste substances, which they are best able to deal with; while the liver which is the most important of all, attacks almost every kind of waste brought to it by the blood, and prepares it for disposal by the intestines, skin, and kidneys. the liver. the liver has a size to match its importance. it is the largest and heaviest gland, or organ, in the body, and weighs about three pounds, a little more than the brain. it buds off from the food tube just below the stomach, so that its waste tube, the _bile duct_--about the size of a goose quill--opens into the upper part of the intestine. the main work of the liver is to receive the blood from all over the body and to act upon its waste substances, burning them up so that they can be taken up, and got rid of, by the glands of the skin and the kidneys. in the process it very frequently changes these waste substances from poisonous into harmless forms; and even when disease germs get into the body and infect it, the poisons, or toxins, which they pour into the blood are carried to the liver and there usually burned up, or turned into harmless substances. the liver is, therefore, to be regarded as a great _poison filter_ for the entire body. so long as it can deal with the poisons as fast as they are formed, either by the body itself, or in the food, or by disease germs, the body is safe and will remain healthy. but if the poisons come faster than the liver can deal with them, as, for instance, when we have eaten tainted meat or spoiled fruit, or have drunk alcohol, they begin to poison our nerves and muscles, and we become, as we say, "bilious." our head aches, our tongue becomes coated, we have a bad taste in the mouth, we lose our appetite and feel stupid, dull, and feverish. such waste materials as the liver cannot burn down so that the kidneys and skin can handle them, it pours out through its duct into the intestine as the bile. the bile is a yellowish-brown fluid, which assists the pancreatic juice in the digestion of the food, and helps to dissolve the fats eaten, but is chiefly a waste product. it turns green when it has been acted upon by acids, or exposed to the air. so that the bile which you throw up when you are very sick at your stomach, is green because it has been acted upon by your gastric juice. as you will remember, the blood which comes from the stomach and bowels is carried by the portal vein to the liver first and, through that, to the heart, instead of going directly to the heart, as all the other impure blood in the body does. this is owing, in part, to the fact that this blood, being full of substances freshly taken or made from the food, is very likely to contain poisons; indeed, as a matter of fact, blood taken from these veins on its way to the liver, and injected directly into the blood vessels of an animal, acts like a mild poison. in part, however, this blood goes first to the liver, because the liver, besides being a great blood purifier, is a "blood-maker" in the sense that it changes raw food-stuffs in the blood from the intestines into forms which are more suitable for use by the brain, the muscles, and the other tissues of the body. some of the sugars, for instance, the liver turns into a kind of animal starch (_glycogen_), which it stores away in its own cells. it also turns both sugars and proteins in the portal blood into fat, part of which it pours into the blood, and part of which it stores away also in its own cells. thus the liver owes its great size partly to the large amount of blood-purifying, filtering, and poison-destroying work which it has to do, and partly to its acting as a storehouse of starch and fat, which the body can readily draw upon as it needs them. [illustration: outline diagram showing general plan and position of body-machinery] as all poisons formed in, or entering, the body are brought to the liver for destruction, it is in an extremely exposed position, and very liable to break down under the attack of these poisons, whether of infectious diseases, or chloroform, or alcohol, or those formed by putrefaction in the stomach and intestines. this is why those who have lived long in the tropics and suffered from malaria, dysentery, and other infectious diseases, and those who drink too much alcohol, or have chronic indigestion, or dyspepsia, are likely to have swollen and inflamed livers. the gall bladder. the liver has on its under side a little pear-shaped pouch called the _gall bladder_, in which the bile is stored before it is poured into the bowel. if this becomes inflamed by disease germs, or their poisons, in the blood, little hard masses will form inside it, usually about the size of a grain of corn, known as _gall stones_. so long as they stay in the gall bladder, they give little trouble, but if they start to pass out through the narrow bile duct into the intestine, they cause severe attacks of pain, known as "gall-stone colic," and, by blocking up the duct, may dam up the flow of the bile, force it back into the blood again, and stain all our tissues, including our skin and our eyes, yellow; and then we say we are _jaundiced_. jaundice may also be caused by colds or other mild infections which attack the liver and bile ducts and clog the proper flow of the bile. the kidneys. the kidneys are another form of blood-filter, which deal chiefly with waste stuffs in the blood left from the proteins, or meats, of our food--meat, fish, milk, cheese, bread, peas, beans, etc. these waste-stuffs, called _urea_ and _urates_, are formed in the liver and brought in the blood to the kidneys. these lie on either side of the backbone, opposite the small of the back, their lower ends being level with the highest point of the hip-bones, nearly six inches higher than they are usually supposed to be. when you think you have a "pain across the kidneys," it is usually a pain in the muscles of the back much lower down, and has nothing to do with the kidneys at all. a very large artery carries the blood from the aorta to each side of the kidney, and a large vein carries the purified blood back to the vena cava and heart. two smaller tubes about the size of a crow quill, the waste pipes of the kidneys (the _ureters_), carry the water containing urea and other waste substances strained out by the kidneys and called urine, down into a large pouch, the _bladder,_ to be stored there until it can be got rid of. [illustration: the urinary system _k_, kidneys; _u_, ureters; _b_, bladder; _a_, artery; _v_, vein.] the kidneys then are big filter-glands. they, like the lungs, are made up of a mesh, or network, of thousands of tiny tubes of two kinds, one set of tubes being blood vessels, and the other set the tiny branches of the kidney tubes which finally run together to form the ureters. the urine filters through from the spongy mesh of blood tubes (capillaries) into the kidney tubes and is poured out through the ureters. it is very important that the urine should be discharged as fast as it fills the bladder, that is, about once every three hours during the day. nothing should be allowed to interfere with this; and whenever nature tells you that the bladder is full, it should be emptied promptly, or the poisons which nature is trying to get rid of in the urine may get back into the blood and cause serious trouble. diseases of the kidneys. naturally, the kidneys, working all the time and pouring out, as they do every day, from three to four pints of the liquid waste called urine, are subject to numerous diseases and disturbances. one of the common causes of these is failure to keep the skin thoroughly clean and healthy, as perspiration is of somewhat the same character as the urine; and if it be checked, it throws an extra amount of work upon the kidneys. another most important thing to keep the kidneys working well is to drink plenty of water, at least six or eight glasses a day, as well as to eat plenty of fresh green vegetables and fresh fruits, which, as we have seen, are eighty per cent water. remember, we are a walking aquarium, and all our cells must be kept flooded with and soaked in water in order to be healthy. if the blood becomes overloaded with poisons, so much work may be thrown upon the kidneys that they will become inflamed and diseased and cannot form the urine properly; and then poisons accumulate in the system and finally produce serious illness and even death. it was at one time believed that eating too much of certain kinds of foods, particularly those that leave much nitrogenous waste in the body, such as meat and fish, could produce a diseased condition of the kidneys, known as bright's disease; but we have found that the larger part of such cases are due to the attack of the germs of infectious diseases, particularly scarlet and typhoid fevers, tuberculosis, and colds. the popular impression that colds from wet feet or long drives in winter may "settle in the kidneys" is wrong, except in so far as those colds are caused by infectious germs. another cause of disturbance and permanent damage to the kidneys is the habitual use of alcohol. even though this may be taken in only moderate amounts, the constant soaking of the tissues with even small amounts of alcohol may be most harmful to the kidneys, as well as to the liver. chapter xviii the muscles importance of the muscles. it wouldn't be of much use to smell food, if we couldn't pick it up and bite it after we had reached it; or to see danger, if we were not able to move away from it. every animal that lives, moves; and every movement, whether of the entire body from one place to another, or of parts of the body changing their relations to one another, or altering their shape, is carried out by an elastic, self-moving body-stuff, which we call _muscle_. all the work that we do, whether in earning our living, or catching our food, or chewing it, or swallowing it and driving it through our food tube, or pumping the blood through our arteries, or drawing air into our lungs, is done by muscles. hence, a very large part of the body has to be made of muscles. in fact, our muscles, put together, weigh almost as much as all the other stuffs in the body, making over forty per cent of our weight. how the muscles act. the commonest form of muscle that we see is the red, lean meat of beef, mutton, or pork; and this will give us a good idea of how our own muscles look. all muscles, whatever their size or shape, are made up of little spindle-shaped or strap-shaped cells, or wriggling "body-cells" arranged in bands or strings. the size of a given muscle depends upon the number of cells that it contains. the astonishing variety of movements which muscles can make is due to the fact that they have the power when stirred up, or stimulated, of changing their shape. as most of the muscle substance is arranged in bands, this change of shape on the part of the tiny cells that make up the band means that the band grows thicker and at the same time shorter,--just as a stretched rubber band does when it slackens,--so that it pulls nearer together the bones or other structures to which it is fastened at each end by fibrous cords called _tendons_, or sinews. this shortening of the muscle band is known as _contraction_. when you wish, for instance, to lift your hand toward your face, you unconsciously send a message from your brain down the nerve cables in your spinal cord, out through the nerve-wires of your neck and shoulder, to the big _biceps_ muscle on the front of your upper arm. this muscle then contracts, or shortens, and pulls up the forearm and hand, by bending the elbow joint. just in proportion as the muscle becomes shorter, it becomes thicker in the middle; and this you can readily prove by grasping it lightly with your fingers when it contracts, and feeling it bulge.[ ] the food tube is surrounded with muscles, as you will remember, for moving the food along it, or churning it. these internal muscles, requiring only the presence of food to cause them to act, and not needing attention on the part of the brain or the will, are known as the _involuntary_ ("without the will") muscles. the great group of the _voluntary_, or bone-moving muscles, which move "with the will" and are under our direct control, may be divided roughly into two divisions--those that move the trunk, or body proper, and run, for the most part, lengthwise of it; and those that move the limbs. on the body, they may be divided into two great sheets--one running up the front, and the other up the back. when those running up the front of the body contract, they naturally bend the back, and pull the head and shoulders forward and downward. or, as when you spring up and catch the branch of a tree or a horizontal bar with your hands, these same muscles will pull the lower part of the body and legs upward, so that you can climb into the tree. the largest and thickest bands of these front body muscles are found over the abdomen, or stomach, where you can feel them thicken and harden when you bend your body forward and pull with your arms, as in hauling on a rope. by their pressure upon the intestines, they give the bowels valuable support, assist in their movements, and help the circulation of the blood through them; so that it is of considerable importance to keep this entire group of muscles well toned up by exercises, such as swinging your arms back over your head, and then down between your legs; bending the head and shoulders backward and forward; swinging the legs up over the body, either when hanging from a bar or lying on your back. proper exercising and toning up of these muscles will often cure constipation and dyspepsia, by their influence upon the bowels and stomach, and also keep one from taking on fat around the waist too rapidly. on the back of the body, the muscle-sheet has grown into great, thick ropes of muscle on each side of the backbone, which you can feel hardening and softening in the small of the back, when you stoop down or lift weights. these are the muscles that hold the body erect, and keep the back straight when you stand, and are the largest and hardest working group of muscles in the body. every minute that you sit, or stand, they are at work; and that is why they so often get tired out, and ache, and you say you have "a backache." they have to work harder to keep you erect or upright when you are standing perfectly still than when you walk or run, so that standing perfectly still is the hardest work you can do. next to standing still, the hardest thing is to sit still, as you probably have found out. if it were not for these great muscles of the back and abdomen, we should double up like a jack-knife, either forward or backward, when we tried to stand up. it is not our skeleton that keeps us stiff or erect, but our muscles. [illustration: the muscle-sheet showing how the muscles, overlapping and interlocking, give shape to the body.] if you want to keep straight and erect, and thus have a good carriage, you must keep these great body muscles well trained and exercised by swinging movements, such as bending the back forward, standing with your feet apart and then swinging your head and shoulders down and between your legs; or, with your heels together, swinging your hands down till the fingers touch the ground; or by the different exercises that either bend your back, or hold it stiff and erect. swinging from a bar, rowing, digging with a spade, chopping or sawing wood, dancing, rope-skipping, ball-playing, hop-scotch, and wrestling, all develop these muscles finely and are good for both boys and girls. other strands of these muscles branch out to fasten themselves to the shoulder blades and shoulders, where they help to draw the arm back as for a blow, pull the shoulders into position when you stand upright, or, when you have leaned forward and grasped something with the hand, help to pull up the arm and lift it from the ground. these muscles are quite important in holding the shoulders back and giving a good shape to the chest and good carriage of the upper part of the body and head. they are called into play in all exercises like striking, batting, tennis-playing, ball-throwing, swinging, shoveling, swimming, as well as in pulling, in lifting weights, in swinging an axe or handling a broom. [illustration: use of muscles in bowling showing _a_ thickening of flexors on front of arm, as forearm is swung forward, and _b_ thickening of extensors on back of arm, as forearm is swung backward.] the muscles of the limbs are almost as numerous as those of the trunk of the body, and even more complex. most of them, on both arms and legs, are in two great groups--one known as the "benders," or _flexors,_ which, when they shorten, bend the limb; and the other, the "straighteners," or _extensors_, which straighten or extend it. on the front of the arm, for instance, we have the large biceps ("two-headed") muscle, which runs from the shoulder to the bone of the forearm just below the elbow and, when it shortens, bends the elbow and lifts the arm toward the body. on the back of the upper arm is the _triceps_ ("three-headed") muscle, which is fastened at its lower end to a big spur of bone, the "point" of the elbow; when it shortens, acting lever fashion, it straightens or _extends_ the arm. if this is done quickly, the fist is swung outward with force enough to strike quite a sharp blow, though, as you know, if you wish to hit really hard, you have to strike with the weight and muscles of the full arm and the body behind it, or, as we say, "from the shoulder." [illustration: use of muscles in football showing _a_ thickening of flexors on front of thigh and leg, as foot is swung forward; and _b_ thickening of extensors on back of thigh and leg, as leg is swung backward.] [illustration: patella and muscle _p_, patella (knee cap); _m_, muscle; _l_, ligament; _t_, tendon.] in the lower limbs, the muscles are larger because they have heavier work to do, supporting and moving the whole weight of the body; but they are simpler in their arrangement since they have not such a variety of movements to carry out. the principal muscle in the thigh is the great muscle running down the front of the thigh, and fastening to the upper border of the _patella_, or knee cap. this muscle, when it shortens, straightens or extends the limb, or lifts the foot from the ground and swings it forward as in walking, or raises the knee up toward the body when we are sitting or lying down. you can easily tell how much it is used in walking by remembering how stiff and sore it gets when you have taken an unusually long tramp, particularly if there has been much hill-climbing in it. on the back of the thigh, runs another great group of muscles, which bend or flex the limb when they shorten. when the knee is bent, you can feel their tendons, or sinews, stand out as hard cords beneath the knee; hence, this group is called the _ham-string_ muscles.[ ] how the muscles are fed. our muscles are not only the largest, but the "livest" part of our bodies. their contractions and movements are caused by their tiny "explosions" (like the chugging of an automobile, except that we can't hear them); and in this way they burn up the largest part of the food-fuel which we eat--mostly in the form of sugar. when they have burned up their surplus food-fuel, they call for more; and when this demand has been telegraphed to the brain, we say we are hungry, and that exercise has given us an appetite. while the muscles are at work, they demand that large supplies of fresh fuel shall be brought to them through the blood vessels; and this makes the heart beat harder and faster, and improves the circulation. as they burn up this fuel, they form smoke and ashes, or waste materials, which must be got rid of--the fluid part by perspiration from the surface of the skin, and through the kidneys, and the gas, or "smoke," through the lungs. this is the reason why, during exercise, we breathe faster and deeper than at other times, and why our skin begins first to glow and then to perspire. if these waste-materials form in the muscles faster than the blood can wash them out, they poison the muscle-cells and we begin to feel tired, or fatigued. this is why our muscle-cells are often so stiff and sore next morning after a long tramp, or a hard day's work, or a football game. a hot bath or a good rub-down takes the soreness out of the muscles by helping them to get these poisonous wastes out of their cells. thus when we play or run or work, we are not only exercising our muscles and making them gain strength and skill, but we are stirring up, or stimulating, almost every part of our body to more vigorous and healthful action. indeed, as our muscles alone, of all our body stuffs, are under the control of the will, our only means of deliberately improving our appetites, or strengthening our hearts or circulation, or invigorating our lungs, or causing a large part of our brains and minds to grow and develop, is through muscular exercise. this is why nature has taken care to make us all so exceedingly fond of play, games, and sports of all sorts, in the open air, when we are young; and, as we grow older, to enjoy working hard and fighting and "hustling," as we say; and that is the reason, also, why we are now making muscular exercise such an important part of education. footnotes: [ ] the muscle does not get any bigger when it contracts, as was at one time supposed; if you were to plunge it into a bath of water, and then cause it to contract, you would find that it did not raise the level of the water, showing that it was of exactly the same size as before, having lost as much in length as it gained in thickness. [ ] in the leg below the knee, and in the forearm, we have two groups of "benders" or _flexors_, and "straighteners" or _extensors_, as in the upper arm and leg, only slenderer and more numerous. they taper down into cord-like tendons at the wrist and ankle to fasten and to pull the hands and feet "open" and "shut," just as do the strings in the legs and arms of a puppet or mechanical doll, or the sinews in the foot of a chicken. chapter xix the stiffening rods of the body-machine what bones are. the bones are not the solid foundation and framework upon which the body is built, as they are usually described. they are simply a framework of rods and plates which "petrified," or turned into spongy limestone after the body was built, to make it firmer and stiffen it for movement. all the animals below the fishes, such as worms, sea-anemones, oysters, clams, and insects, get along very well without any bones at all; and when we are born, our bones, which haven't fully "set" yet, are still gristly and soft. the cores of the limbs, as they begin to stiffen, first turn into gristle, or cartilage, and later into bone; indeed, many of our bones remain gristle in parts until we are fifteen or sixteen years of age. this is why children's bones, being softer and more flexible than those of grown-up people, are not so liable to break or snap across when they fall or tumble about; and why, too, they are more easily warped or bent out of shape through lack of proper muscular exercise and proper food. bones are strips of soft body-stuff soaked with lime and hardened, like bricklayer's mortar, or concrete.[ ] when you know the shape of the body, you know the bones; for they simply form a shell over the head and run like cores, or piths, down the centre of the back, and down each joint of the limbs. in turning into spongy limestone, or animal concrete, they have become one of the deadest tissues in the body. they are tools of the muscles, the levers by which the muscles move the limbs and body about; they never do anything of their own accord. on account of their lifelessness and lack of vitality, they are rather easily attacked by disease, or broken by a blow or fall. there are such a large number of bones (two hundred and six, all told), and they resist decay and last so much longer after death than any other parts of the body, that they fill our museums and text-books of anatomy, form most of our fossils, and have thus given us rather an exaggerated idea of their importance during life. [illustration: the human skeleton] the frame-work of the body. just look at any part of the body and imagine that it has a bony core of about the same general shape as itself, and you can reason out all the bones of the skeleton. to begin at the top, the _skull_ is a box of strong, plate-like bones, which have hardened to protect the brain as it grew; and the shape of its upper, or brain, part is exactly that of the head, as you can easily feel by laying your hands upon it. then come bony shells, or sockets, for the eyes and nose; and, below these, two heavy half-circles of bone, like the jaws of a steel trap, to carry the teeth. the thickness of the lower jaw and the size and squareness of the angle where it bends upward to be hinged to the skull, below the ear, are what give the appearance of squareness and determination to the faces of strong, vigorous men or women. if we want to imply that a person has a feeble will, or weak character, we say he has a "weak jaw." the skull rests upon the top of the backbone, or _spinal column_, which, instead of being one long solid bone, is made up of a number of pieces, or sections, known as _vertebræ_. each one of these vertebræ has a ring, or arch, upon its back. these, running one after the other, form a jointed, bony tube to protect the _spinal cord_, or main nerve-cable of the body, which runs through it. [illustration: the spinal column _v_, vertebra; _c_, cartilage protecting spinal cord; _a_, point of articulation on the right side.] although the backbone can bend forward or backward, or twist from side to side a little, by the little pieces of bone of which it is built up gliding and turning upon one another, it is really very stiff and rigid, so as to protect the spinal cord and prevent its being stretched or pinched. most of the movements which we call bending the spine are really movements of other joints which connect the body or head with it. when we bend our necks, for instance, we hardly bend the backbone at all, as most of the movement is made in the joint at the top of it, between it and the skull. similarly, when we bend our backs, we really bend our backbones very little; for most of the movement comes at the hip joints, between the thighs and the hip bones. each of the limbs has a single, long, rounded bone in the upper part, known in the arm as the _humerus_, and two bones in the lower part. these last are known as the _radius_ and _ulna_ (the "funny bone") in the forearm, and the _tibia_ and _fibula_ in the leg. the shoulder-joint is made by the rounded head of the humerus fitting into the shallow cup of the _scapula_, or shoulder-blade. it is shallower than the hip joint to allow it freer movement; but this makes it weaker and much more easily dislocated, or put out of joint,--the most so, in fact, of any joint in the body. [illustration: a ball-and-socket joint hip joint.] [illustration: a hinge joint knee joint, with the knee cap removed] the hip joints are deep, strong, cup-shaped sockets upon each side of the hip bones, or _pelvis_, into which fit the heads of the _femurs_ or thigh bones. when the hip joint does become dislocated, it is very hard to put back again, on account of its depth and the heavy muscles surrounding it. it is quite subject to the attack of tuberculosis, or "hip-joint disease." [illustration: lengthwise section of bone] the _joints_, or points at which the bones join one another, look rather complicated, but they are really as simple as the bones themselves. each joint has practically made itself by the two bones' rubbing against each other, until finally their ends became moulded to each other, and formed the ball-and-socket, or the hinge, according to whichever the movements of the "bend" required. the ends, or heads, of the bones which form a joint are covered with a smooth, shining coating of _cartilage_, or gristle, so that they glide easily over each other. [illustration: cross section of bone] around each joint has grown up a strong sheath of tough, fibrous tissue to hold the bones together; and, inside this, between the heads of the bones, is a very delicate little bag, or pouch, containing a few drops of smooth, slippery fluid (_synovial fluid_) to lubricate the movements of the joint. this is sometimes called the "joint oil," though it is not really oil. bones are covered with a tough skin, or membrane (_periosteum_). they are hardest and most solid on their surfaces, and hollow, or spongy, inside. the long bones of the limbs are hollow, and the cavity is filled with a delicate fat called _marrow_--just as an elderberry stem or willow-twig is filled with pith. this tubular shape makes them as strong as if they were solid, and much lighter.[ ] the short, square, and flattened bones of the body, such as those of the wrist, the skull, and the hips, instead of being hollow inside are spongy; and the spaces in the bone-sponge are filled with a soft tissue called the _red marrow_ in which new red and white corpuscles for the blood are born, to take the place of those which die and go to pieces. footnotes: [ ] you can easily prove that a bone is made up of living tissue soaked and stiffened with lime, by putting it into a jar filled with weak acid. this will gradually dissolve and melt out the lime salts, and then you will find that the bone has lost three-fourths of its weight and that what remains of it is so soft and flexible that it can be bent, or even tied into a knot. [ ] the hollow spaces in the bones of birds, however, are filled with air, which makes them lighter for flying. chapter xx our telephone exchange and its cables the brain. we are exceedingly proud of our brain and inclined to regard it as the most important part of our body. so it is, in a sense; for it is the part which, through its connecting wires, called the _nerves_, ties together all the widely separated organs and regions in our body, and helps them to work in harmony with one another. we speak of it as the master and controller of the body; but this is only partially true. the brain is not so much the president of our cell republic as a great central telephone exchange, where messages from all over the body are received, sifted, and transmitted in more or less modified form, to other parts of the body. three-fourths of the work of the brain consists in acting as "middle-man," or transmitter, of messages from one part of the body to another. in fact, the brain is far more the servant of the body than its ruler; and depends for its food supply, its protection, its health, and its very life, upon the rest of the body. the best way to keep the brain clear and vigorous is to keep the muscles of the stomach, the liver, the heart, and the entire body in good health. what the brain does. the brain is the very wonderful organ with which we do what we are pleased to call our thinking, and also a number of other more important things of which we are not conscious at all. it is a large organ, weighing nearly three pounds when full grown. in shape it is like an oval loaf of bread split lengthwise by a great groove down the centre, and with a curiously wrinkled or folded surface. the two halves of the brain, called _hemispheres_ (though more nearly the shape of a coffee-bean), are alike; and each one, by some curious twist, or freak, of nature, receives messages from, and controls, the opposite half of the body--the right half controlling the left side of the body, while the left half controls the right side of the body. thus an injury or a hemorrhage on the left side of the brain will produce paralysis of the right side, which is the side on which a stroke of paralysis most commonly occurs. all the nerve fibres in each half or hemisphere of the upper brain run downward and inward like the sticks of a fan, to meet in a strap-like band, or stalk, which connects it with the base of the brain and the spinal cord. a very small amount of damage at this central part, or base, of the brain will produce a very large amount of paralysis. we may have large pieces of the bones of the skull driven into the outer surface of the brain, or considerable masses of our upper brain removed, or destroyed by tumors or disease, without very serious injury. but any disease or injury which falls upon the base of the brain, where these stalks run and big nerve-knots (_ganglia_) lie, will cause very serious damage, and often death. the whole upper brain is a department of superintendence, which has grown up from the lower brain to receive messages, compare them with each other, and with the records of previous messages which it has stored up, thus giving us the powers which we call memory, judgment, and thought. unfortunately, however, long and carefully as we have studied the brain, we really know little about the way in which it carries out these most important processes of memory, of judgment, and of thought, or even of the particular parts of it in which each of these is carried out. [illustration: the nervous system diagram to show brain, spinal cord, and larger nerves.] no part of the brain, for instance, seems to be specially devoted to, or concerned in, memory or reason or imagination, still less to any of the emotions, such as anger, joy, jealousy or fear; so all those systems which pretend to tell anything about our mental powers and our dispositions by feeling the shapes of our heads, or the bumps on them, are pure nonsense. the most important and highest part of the brain is its surface, a thin layer of gray nerve-stuff, often spoken of as the _gray matter_ (the _cortex_, or "bark"), which is thrown into curious folds, or wrinkles, called _convolutions_. this gray matter is found in the parts of the nervous system where the most important and delicate work is done. the rest of the nervous system is made up of what is called white matter, from its lighter color; and this is chiefly mere bundles of telephone wires carrying messages from one piece of gray matter to another, or to the muscles. we also know that a certain rather small strip of the upper brain-surface, or cortex, about the size of two fingers, running upward and backward from just above the ear, controls the movements of the different parts of the body. one little patch of it for the hand, another for the wrist, another for the arm, another for the shoulder, another for the foot, and so on. we can even pick out the little patch which controls so small a part of the body as the thumb or the eyelids. so when we have a tumor of the brain or an injury to the skull in this region, we can tell, by noticing what groups of muscles are paralyzed, almost exactly where that injury or tumor is. then we can drill a hole in the skull directly over it and remove the tumor, lift up the splinter of bone, or tie the ruptured blood vessel. three other patches, or areas, running along the side of the brain, each of them about two inches across, are known to be the centres for smell, hearing, and sight, that for sight lying furthest back. damage to one of these areas will make the individual more or less completely blind, or deaf, or deprived of the sense of smell, as the case may be. at the lower part of the area which controls the muscles of the different parts of the body, above and a little in front of the tip of the ear, lies a very important centre, which controls the movements of the tongue and lips, and is known as the _speech centre_. if this should be injured or destroyed, the power of speech is entirely lost. this, curiously enough, lies upon the left side of the brain, and is the only one-sided centre in the body. why this is so is somewhat puzzling, except that as speech is made up both of sound and of gesture, and our gestures are usually made with the right hand, it is not unreasonable to suppose that the speech centre should have grown up on that side of the brain which controls the right hand, which is, as you remember, the left hemisphere. what makes this more probable is that in persons who are "left-handed," the speech centre lies upon the opposite or _right_ side of the brain. so it is waste of time and does more harm than good to try to "break" any child of left-handedness. the spinal cord. running downward from the base of the brain, like the stalk of a flower, is a great bundle of nerve-fibres, the central cable of our body telephone system, the spinal cord. this, you will remember, runs through a bony tube formed by the arches of the successive vertebrae; and as it runs down the body, like every other cable it gives off and receives branches connecting it with the different parts of the body through which it passes. these branches are given off in pairs, and run out through openings between the little sections of bone, or vertebrae, of which the spinal column is made up. they are called the _spinal nerves_, and each pair supplies the part of the body which lies near the place where it comes out of the cord. the spinal nerves contain nerve wires of two sorts--the inward, or _sensory_, and the outward, or _motor_, nerves. the sensory, or ingoing, nerves come from the muscles and the skin and bring messages of heat and cold, of touch and pressure, of pain and comfort, to the spinal cord and brain. the outward, or motor, nerves running in the same bundle go to the muscles and end in curious little plates on the surface of the tiny muscle fibres, and carry messages from the spinal cord and brain, telling the muscles when and how to contract. as the spinal cord runs down the body, it becomes gradually smaller, as more and more branches are given off, until finally, just below the small of the back and opposite the hip bones, it breaks up by dividing into a number of large branches which go to supply the hips and lower limbs. while most of the spinal cord is made up of bundles of white fibres, carrying messages from the body to the brain, its central portion, or core, is made of gray matter. the reason for this is that many of the simpler messages from the surface of the body and the movements that they require are attended to by this gray matter, or ganglia, of the spinal cord without troubling the brain at all. for instance, if you were sound asleep, and somebody were to tickle the sole of your bare foot very gently, the nerves of the skin would carry the message to the gray matter of the spinal cord, and it would promptly order the muscles of the leg to contract, and your foot would be drawn away from the tickling finger, without your brain taking any part in the matter, though, if you had been awake, you would of course have known what was going on. this sort of reply to a stimulus, or "stirring up," without our knowing anything about it, is known as a _reflex_ movement. not only are many of these reflexes carried out without any help from the will, or brain, but they are so prompt and powerful that the brain, or will, can hardly stop them if it tries, as, for instance, in the case of tickling the feet. you can, if you make up your mind to it, prevent yourself from either wriggling, pulling your foot away, or giggling, when the sole of your foot is tickled; but if you happen to be at all "ticklish," it will take all the determination you have to do it, and some children are utterly unable to resist this impulse to squirm when tickled. this extraordinary power of your reflexes has developed because only the promptest possible response, by jerking your hand away or jumping, will be quick enough to save your life in some accidents or emergencies, when it would take entirely too long to telephone up to the brain and get its decision before jumping. when you are badly frightened, you often jump first and discover that you are frightened afterwards; and this jump, under certain circumstances, may save your life. on the other hand, like all instinctive or impulsive movements, it may get you into more trouble than if you had kept still. as you will see by the picture, the spinal nerves, which are given off from the cord in the lower part of the neck and between the shoulder blades, are gathered together into a great loose bundle to form the long nerve-wires needed to supply the shoulders and arms. those given off from the small of the back just above the hips also run together to form, first a network and then a big single nerve-cord, called the _sciatic_ nerve, which many of you have probably heard of from the frightfully painful disease due to an inflammation of it, called _sciatica_. it is the largest nerve-cord in the body, running down the middle of the back of the thigh to supply the muscles of two-thirds of the leg.[ ] the substance of both the spinal cord and the brain is made up of millions of delicate, tiny cells, called _neurons_, most of which, with very long branches, are arranged in chains for carrying messages, forming the white matter; while the others lie in groups, or ganglia, for sorting and deciding upon messages, forming the gray matter. just at the top of the spinal cord, where it passes into the skull and joins with the brain, it swells out into a sort of knob, about the size of a queen olive or the head of a gold-headed cane, which is known as the _medulla_, or "pith." this is the most vital single part of the entire brain and nervous system; and the smallest direct injury to it will produce instant death, partly because all the messages which pass between the brain and the body have to go through it, and partly because in it are situated the centres which control breathing and the beat of the heart, and another quite important but less vital centre,--that for swallowing. how messages are received and sent. now to learn how smoothly and beautifully this nerve telephone system of ours works, and how simple it really is, although it has such a large number of lines and so many telephones on each line, and such a large central exchange, let us see how it deals with a message from the outside world. suppose you are running barefoot and step on a thorn. instantly the tiny nerve bulbs in the skin of the sole of your foot are stimulated, or set in vibration, and they send these vibrations up the sciatic nerve, into and up the whole length of the spinal cord, through the medulla, which switches them over to the other side of the brain up through the _brain stalk_, and out to the part of the surface (cortex) of the brain which controls the movements of the foot. all this takes only a fraction of a second, but it is not until the message reaches the brain-surface that you feel pain. if you were to cut the sciatic nerve, or even tie a string tightly around it, you could prick or burn the sole of your foot as much as you pleased, and you would not feel any pain at all. as soon as the surface of the brain has recognized the pain and where it comes from, it promptly sends a return message back down the same cable, though by different nerve-wires, to the muscles of the foot and leg, saying, "jerk that foot away!" as a matter of fact, this message will arrive too late, for the centres in the spinal cord will already have attended to this part of the matter, often almost before you know that you are hurt. however, there is plenty of other work for the brain to do; and its next step, quicker than you can think, is to wake up a dozen muscles all over the body with the order, "sit down!" and you promptly sit down. at the same time, the brain "central" has ordered the muscles of your arms and hands to reach down and pick up the foot, partly to protect it from any further scratch, and partly to pull the thorn out of it. next it rushes a hurry call to the muscles controlling your lungs and throat, and says, "howl!" and you howl accordingly. another jab at the switchboard, and the eyes are called up and ordered to weep, while at the same time the muscles of the trunk of your body are set in rhythmic movement by another message, and you rock yourself backward and forward. this weeping and rocking yourself backward and forward and nursing your foot seem rather foolish,--indeed you have perhaps often been told that they are both foolish and babyish,--but, as you say, you "can't help it," and there is a good reason for it. the howl is a call for help; and if the hurt were due to the bite of a wolf or a bear, or the cut had gone deep enough to open an artery, this dreadfully unmusical noise might be the means of saving your life; while the rocking backward and forward and jerking yourself about would also send a message that you needed help, supposing you were so badly hurt that you couldn't call out, to anyone who happened to be within sight of you. so that it isn't entirely babyish and foolish to howl and squirm about when you are hurt--though it is manly to keep both within reasonable limits. if the message about the thorn had been brought by your eyes,--in other words, if you had seen it before you stepped on it,--then a similar but much simpler and less painful reflex would have been carried out. the image of the thorn would fall on the _retina_ of the eye and through its _optic nerve_ the message would be flashed to the brain: "there is something slim and sharp in the path,--looks like a thorn." when this message reached the brain, and not till then, would you see the thorn, just as in the case of the pain message from the foot. then the brain would take charge of the situation just as before, flashing a hasty message to the muscles of the legs, saying, "jump!" while its message to the throat and lungs, instead of "yell," would be merely, "say, 'goodness!' or 'whew!'" and you would say it and run on. if the thing in the grass, instead of a thorn, happened to be a snake, and you heard it rustle, then the warning message would come through your ears to the brain, and you would jump just the same; though, as it is not so easy to tell by a hearing message exactly where the sound is coming from, you might possibly jump in the wrong direction and land on top of the danger. this is the way in which you see, hear, and form ideas of things. your eye telegraphs to the brain the colors; your ear, the sounds; and your nose, the smells of the particular object; and then your brain puts these all together and compares them with its records of things that it has seen before, which looked, or sounded, or smelt like that, and decides what it is; and you say you _see_ an apple, or you _hear_ a rooster crow, or you _smell_ pies baking. remember that, strange as it may seem, you don't see an orange, for instance, but only a circular patch of yellowness, which, when you had seen it before, and felt of it with your hand, you found to be associated with a feeling of roundness and solidness; and when you lifted it toward your nose, with the well-known smell of orange-peel; so you called it an orange. if the yellow patch were hard, instead of elastic, to the touch, and didn't have any aromatic smell when you brought it up to your nose, you would probably say it was a gourd, or an apple, or perhaps a yellow croquet ball. this is the way in which, we say, our senses may "deceive" us, and is one of the reasons why three different people who have seen something happen will often differ so much in their accounts of it. it is not so much that our senses deceive us, but that we draw the wrong conclusions from the sights, sounds, and smells that they report to our brains, usually from being in too great a hurry and not looking carefully enough, or not waiting to check up what we _see_ by touching, hearing, or tasting the thing that we look at. this message-and-answer system runs all through our body. for instance, if we run fast, then the muscle cells in our legs burn up a good deal of sugar-fuel, and throw the waste gas, or smoke, into the blood. this is pumped by the heart all over the body, in a few seconds. when this carbon dioxid reaches the breathing centre in the medulla, it stirs it up to send promptly a message to the lungs to breathe faster and deeper, while, at the same time, it calls upon the circulation centre close to it, to stir up the heart and make it beat harder and faster, so as to give the muscles more blood to work with. if some poisonous or very irritating food is swallowed, as soon as it begins to hurt the cells lining the stomach, these promptly telegraph to the vomiting centre in the brain, we begin to feel "sick at the stomach," the brain sends the necessary directions to the great muscles of the abdomen and the diaphragm, they squeeze down upon the stomach, and its contents are promptly pumped back up the gullet and out through the mouth, thus throwing up the poisons. and so on all over the body--every tiniest region or organ in the body, every square inch of the skin, has its special wire connecting it with the great telephone exchange, enabling it to report danger, and to call for help or assistance the moment it needs it. footnotes: [ ] to give you an idea of what real things nerve-trunks are, this sciatic nerve is as large as a small clothes-line, or, more accurately, as a carpenter's lead pencil, and so strong that when the surgeon cuts down upon it and stretches it to cure a very bad case of sciatica, he can lift the lower half of the body clear of the table by it. this strength, of course, is not due to the nerve-fibres and cells themselves but to the tough, fibrous sheath, or covering, with which all the nerves that run outside of the brain and spinal cord are covered and coated. the spinal cord, though it is between one-half and three-fourths of an inch across, or about the size of an ordinary blackboard pointer, has little or none of this fibrous tissue in it, and is very soft and delicate, easily torn when its bony case is broken; hence its old name, the _spinal marrow_, from its apparent resemblance to the marrow, or soft fat, in the hollow of a bone. chapter xxi the hygiene of bones, nerves, and muscles how to get and keep a good figure erect position is the result of vigorous health. naturally and properly, an erect, graceful figure and a good carriage have always been keenly desired; and much attention has been paid to the best means of acquiring them; as we say, we try to "get the habit" of carrying ourselves straight and well. but it must be remembered that an erect figure and a good carriage are the results of health and vigor, rather than the cause of them. stooping, round shoulders, sitting "all hunched up," or a shuffling gait, are owing partly to bad habits, or "slouchiness," but chiefly to weak muscles and a badly-fed nervous system, often due to a poor digestion and a weak circulation. if a child is not healthy and vigorous, then no amount of drilling or reminders to "sit straight" and "stand erect" will make him do so. it is of great importance that the child should take an erect and correct position for reading and writing, and while sitting at his desk; and that the desk and the seat should fit him. but it is more important that he should not sit at his desk in a stuffy room long enough to be harmed by a cramped position. there are few children who will "hump over" at their desks, if the muscles of their backs and necks are strong and vigorous, and their brains well ventilated. nor will many of them bore their noses into their books, or sprawl all over their copy books when they write, unless the light is poor, or they have some defect of the eyes which has not been corrected by proper glasses. a bad position or a bad carriage in a child is a sign of ill health, and should be treated by the removal of its cause. curvatures--their cause and cure. there are various forms of curvatures, or bendings, of the spine which are supposed to be owing to faulty positions of sitting or of carrying the body. there is wide difference of opinions as to their cause; but this all are agreed on, that they practically never occur in sturdy, well-grown, active children; and the way that they are now corrected is by careful systems of balancing, muscular exercise, open-air life, and abundant feeding, instead of using steel braces, or jackets, or schoolroom drills. [illustration: the position of the body is an index to its health note the pupil in the second row who evidently needs eye glasses.] much the same is true of other deformities and defects of the body, as, for instance, round shoulders, or "flat-foot," or even such serious ones as "club-foot" and "bow-legs." nearly all these are caused by the weakness or wrong action of some muscle, or groups of muscles. if this be long continued or neglected, the bones--which, you will remember, were made by the muscles in the first place--will be warped out of shape. when this has occurred, it is often necessary to bring back the limb, or foot, into a nearly straight position by mechanical or surgical means; but we now largely depend upon muscular exercises combined with rubbing and massage with the hand, and on building up the general vigor of the entire body, so that the muscles will pull the limb or the backbone back into proper position. take care of the muscles, and the bones will take care of themselves! make the body strong, vigorous, and happy, and it will "hold" and "carry" itself. our feet the living arches of the foot. one of the most important things to look after, if we wish to have an erect carriage and a swift, graceful gait, is the shape and vigor of the feet. each foot consists of two springy, living arches of bone and sinew, which are also used as levers, one running lengthwise from the heel to the ball of the toes, and the other crosswise at the instep. these arches are built largely of bones, but are given that springy, elastic curve on which their health and comfort depend, and are kept in proper shape and position, solely by the action of muscles--those of the lower part of the leg and calf. [illustration: imprint of ( ) arched foot and ( ) flat foot the absence of impression on the inner border of the normal footprint at _a_ is due to the elevation of the foot by the longitudinal arch. the other arch lies across the foot in front of this.--after schmidt.] the purpose of these arches is to "give," or spring, like carriage springs, and thus break the shock of each step and cause the body to "ride" easily and comfortably. in order that a spring may "give," it must expand, or spread. far the commonest and most serious cause of a poor, easily tired gait and a bad carriage is tight shoes, which, by being too short, or too narrow, or both, prevent the arches of the foot from "giving" and expanding. not only does this produce corns, bunions, and lame feet, but it makes both standing and walking painful and feeble, and destroys the balance of the entire body, causing the back to ache, the shoulders to droop forward, and the neck muscles to tire themselves out trying to pull the head back so as to keep the face and eyes erect. thus one soon tires, and never really enjoys walking. if this disturbance of balance is increased by high heels, thrust forward under the middle of the foot, the result is very bad. [illustration: the result of wearing a fashionable shoe ( ) a foot that has never worn a shoe (from a photograph); ( ) a foot so cramped and bent as to prevent firmness of step and gait.] our shoes, an important factor in health. few more ingenious instruments of crippling and torture have ever been invented than fashionable tight shoes with high heels. kipling never said a shrewder or truer thing than when he made mulvaney, the old irish drill-sergeant, tell the new recruit, "remimber, me son, a soljer on the marrch is no betther than his feet!" and this applies largely to the march of life as well. every shoe should be at least three-quarters of an inch longer, and from half to three-quarters of an inch wider, than the foot at rest, to allow proper expansion of these great "carriage-spring" arches. if children run free in the open air, either barefoot, or with light, loose, well-ventilated shoes, or sandals, they will have little trouble, not only with bunions, corns, "flat-foot," or lameness, but also with their backs, their gait, and their carriage. easily half of our backaches, and inability to walk far or run fast in later life, to say nothing of over-fatness and dyspepsia, are caused by tight shoes. sleep and rest why we need rest. a most important element in a life of healthful exercise, study, and play is rest. even when we are hard at work, we need frequent breathing spells and changes of occupation and amusement to keep one part of our muscles, or our brains, from poisoning itself. but after a time, in even the strongest and toughest of us, there comes a period when no change of occupation, no mere sitting still, will rest us; we begin to feel drowsy and want to go to sleep. this means partly that the fatigue poisons, in spite of fresh air and change, have piled up faster than we can burn them, so that we need sleep to restore the body. all day long we are making more carbon dioxid than the oxygen we breathe in can take care of; while we sleep, the situation is reversed--the oxygen is gaining on the carbon dioxid. this is why the air in our bedrooms ought to be kept especially pure and fresh. but the need goes deeper than this: sleeping and waking are simply parts of the great rhythm in which all life beats--a period of work followed by a period of rest. continuous, never-ceasing activity for any living thing quickly means death. while externally the body appears to be at rest, the processes of growth and upbuilding probably go on more rapidly when we are asleep than when we are awake. the benefits of exercise are made permanent and built into the body during the sleep that follows it. the more rapidly young animals are growing, the more hours out of the twenty-four they spend in sleep. when you sleep, you are not stopping all the useful activities of your body and mind, you are simply giving some of the most useful and most important of them a chance to work. the only likeness between sleep and death is that in both the body is quiet and the eyes are closed. really we are never more alive and growing than when asleep. it is of the utmost importance that young children especially have all the sleep they need, and that is precisely all that they can be induced to take. the best rule for you, then, to follow, is to go to bed when you feel sleepy, and to get up when you wake rested. every child under twelve should have at least ten hours of sleep, and every grown person eight, or better still, nine hours. time spent in sound, refreshing sleep, is time well spent. if you cannot sleep well, it is a signal that something is wrong with your health, or your habits--a danger signal of great importance, which should be attended to at once. the best and only safe sleep-producer is exercise in the open air. disorders of muscles and bones the muscles and bones have few diseases. considering how complex it is, and the never-ceasing strain upon it, this moving apparatus of ours, the nerve-bone-muscle-machine, is surprisingly free from disease. the muscles, though they form nearly half our bulk, have scarcely a single disease peculiar to them, or chiefly beginning in them, unless fatigue and its consequences might be so regarded. they may become weakened and wasted by either lack or excess of exercise, by under-feeding, or by loss of sleep; but most of their disturbances are due to poisons which have got into the blood pumped through them, or to paralysis or other injuries to the nerves that supply them. the muscles of an arm, for instance, which has been lashed to a splint, or shut tightly in a cast for a long time, waste away and shrink until the arm becomes, as we say, "just skin and bone"; and the same thing will happen if the nerve supplying a muscle, or a limb, is cut or paralyzed. the bones have more diseases than the muscles, but really comparatively few, considering their great number and size, and the constant strain to which they are subjected in supporting the body, and driving it forward and doing its work under the handling and leverage of the muscles. most of their diseases are, like those of the muscles, the after-effects of general diseases, particularly the infections and fevers, which begin elsewhere in the body; and the best treatment of such bone diseases is the cure and removal of the disease that caused them. [illustration: callus formed around a fracture an aluminum splint holds the parts of the bone together.] repair of broken bones. if bones are broken by a fall, or blow, they display a remarkable power of repair. the "skin" covering them (periosteum) pours out a quantity of living lime-cement, or animal-mortar, around the two broken ends, which solders them together, much as a plumber will make a joint between the ends of two pipes. this repair substance is called _callus_. the most remarkable thing about the process is that, when it has held the two broken ends together long enough for them to "knit" firmly--that is, to connect their blood vessels and marrow cavities properly--this handful of lime-cement, which has piled up around the break, gradually melts away and disappears; so that, if the ends of the bone have been brought accurately together, you can hardly tell where the break was, except by a slight ridge or thickening. troubles of the nervous system the nervous system is not easily damaged. the nervous system is subject to a good many more diseases than are either the muscles or the bones; but, considering how complex it is, it is not nearly so easily damaged or thrown out of balance as we usually imagine, and has astonishing powers of repair. instead of being one of the first parts of the body to be attacked by a disease, such as an infection or a fever, it is one of the very last to feel the effects of disease, except in the sense that it often gives early that invaluable danger signal, pain. headache. next after fatigue the most valuable danger signal given us by our nerves is that commonest of all pains, _headache_. indeed, it is not too much to say that headache is the most useful pain in the world. it has little to do with the condition of the brain, but occurs in the head chiefly because the nerves of the head and face are the most sensitive of all those in the body, and the first ones, therefore, to "cry out" when hurt. headache has been described as the cry of a poisoned or starved or over-worked nerve, and is simply nature's signal that something is going wrong. toxins, or poisons, formed anywhere in the body, from any cause, get into the blood, are carried to the sensitive nerves of the head and face, and irritate them so that they ache. it is foolish to try to do anything to the head itself for the relief of headache, although cold cloths, or a hot-water bottle, may be soothing in mild cases. the thing to do is to clear the poison out of the blood, and the only way is to find what has caused it. nearly all the things that cause headache do so by poisoning the blood. a very common cause of headache, for instance, is getting over-tired, especially if at the same time you do not get enough sleep; and, as you already know, tiredness, or fatigue, is a form of self-poisoning. another very common cause of headache is bad air--sitting or sleeping in hot, stuffy rooms with the windows shut tight. if you do this, not only are you not getting oxygen enough into your blood to burn up the waste poisons that your own cells are making all the time, but also you are breathing in the waste poisons from other people's lungs, and the germs that are always in bad air. another very common cause of headache is _eye-strain_. whenever you find that, when you try to read, the letters begin to dance before your eyes, and your head soon begins to ache, it is a sign that you need to have your eyes examined and perhaps a pair of glasses fitted to enable you to see properly. constipation and disturbances of digestion also very often cause headache by poisoning the blood; and, as you know, the first sign of a bad cold, or the beginning of a fever, or other illness, will often be a bad headache. in short, a headache always means that something is going wrong; and the thing to do is to set to work at once to see if you can find out what has caused it, and then to remove the cause. if you cannot find out the cause, then go to a doctor and ask him to tell you what it is, and what to do to get rid of it. above all things, don't swallow a dose of some kind of headache medicine, and go on with your work, or your bad habits of eating, or using your eyes; because, even though it may relieve the pain, it doesn't do anything whatever to remove the cause and leaves you just as badly off as you were before you took it. besides, most of these headache medicines, which for a time will relieve the pain of a headache, are narcotics, or pain-deadeners; and in more than very moderate doses they are poisons, and often dangerous ones. those in commonest use, known as the "coal tar" remedies, because the chemists make them out of coal tar,[ ] are likely to have a weakening effect upon the heart; and, while not very dangerous in small doses, they are very bad things to get into the habit of using. the exaggerated claims of patent medicines. the same thing must be said of the habit of dosing yourself every time you feel a pain or an ache, with some sort of medicine, whether obtained at some previous time from a doctor, or bought at a drug store. a large majority of the medicines that are most widely advertised to cure all sorts of pains and aches contain some form of narcotic--most commonly either alcohol or opium. the reason for this is that no one medicine can possibly be a cure for all sorts of diseases; and the only kind of medicine that will make almost every one who takes it feel a little bit better for the time being is a narcotic, because it has the power of deadening the nerves to pain or discomfort. careful analyses by boards of health and government chemists of a great number of advertised medicines have shown that three-fourths of the so-called tonics and "bitters" and "bracers" of all sorts contain alcohol--some of them in such large amounts as to be stronger and more intoxicating than whiskey. the same investigations have found that a large majority of the "colic cures," "pain relievers," nearly all the "soothing syrups" and "teething syrups," and most of the cough mixtures, cough cures, and consumption cures contain opium, often in quite dangerous amounts. the widely-advertised medicines and remedies guaranteed to cure all sorts of diseases in a very short time are almost certain to be one of two things: either out-and-out frauds, costing about four cents a bottle and selling for fifty cents or a dollar, or else dangerous poisons. all patent pain relievers are safe things to let entirely alone. another risk in taking medicines wholesale, especially those that are known as patent medicines, is that you never can be quite sure what you are taking, as their composition is usually kept a strict secret. it may happen to be something very good for your disease, it may be entirely useless, and it may be something very harmful. there is no one drug, or medicine, known to the medical profession, that will cure more than one or two diseases, or relieve more than four or five disturbed and uncomfortable conditions. as you not only do not know what you are taking, but are not always quite sure what is the matter with you, the chances of your getting the right remedy for your disease are not much more than one in a hundred. if it isn't the right thing, you are certainly wasting your money, and may be doing yourself a serious injury. we should not pour drugs of which we know little into a body of which we know less. doctors give scarcely a fourth as much medicine now as they did fifty years ago. the best cures are food, exercise, sleep, and fresh air. the effects of disease. in the case of nearly all infectious diseases, the effects on the nervous system are among the last to appear, and may not occur until weeks, months, or even years after the main fever or attack of sickness. this is one of the reasons why, when they do occur, they are often hard to cure; the whole system has become saturated with the poisons before they reach the nerves at all. so it happens that the idea has grown up that nervous diseases are very hard to cure. when, however, we know that two-thirds of them are a late result of some of the preventable infectious diseases and fevers, we can realize that it is perfectly possible to prevent them, and that prevention is the best cure. the poisons that attack the brain and nervous system may be formed in the body by disease germs or brought in from without, as are alcohol, tobacco, lead, or arsenic. even such mild infections as measles, scarlet fever, and influenza may poison certain nerves supplying the muscles of an arm or a leg, causing temporary paralysis, or even permanent laming; or they may attack the nerve of sight or of hearing and produce blindness or deafness. a great many of the cases of paralysis and insanity are caused by alcohol. alcohol in excess may attack the nerves supplying the arms and legs, producing severe pain and partial paralysis. it may also, after long-continued use, affect the cells of the brain itself, producing the horrible condition known as delirium tremens--a form of acute insanity with distressing delusions, in which the patient imagines that he sees rats, snakes, and other reptiles and vermin crawling over him, or in his room. even in those who never use it to such excess as this, or indeed in those who may never become intoxicated, the long-continued use of alcohol may produce a slow poisoning and general breaking-down of the whole nervous system, causing in time the hand to tremble, the eye to become bleared and dim, the gait weak and unsteady, the memory uncertain, and the judgment poor. are nervous diseases increasing? the direct use of the brain and nervous system has much less to do with the production of its diseases or even its serious disturbances than is usually believed. most of these, as we have seen, are due either to the poisons of disease or alcohol, or to the fatigue-poisons, or other poisons, produced in the stomach, the liver, the muscles, or other parts of the body. the worst results of brain-work are due to the extent to which it deprives us of proper exercise and fresh air. good, vigorous mental activity,--hard brain work, in fact,--when you are in good condition, is, if not overdone, as healthful and almost as invigorating as physical exercise or hearty play. we often hear it said that the rush and hurry of our modern strenuous life is increasing the number of mental diseases and nervous breakdowns. but there is no evidence that the strain of civilization upon our brains and nervous systems is damaging them, or that either nervous diseases or insanity are more frequent now than they used to be one hundred or five hundred years ago. in fact, all the evidence that we have points in exactly the opposite direction; for, as we have seen, most of these brain and nerve diseases are due to infectious diseases, bad food, and bad living conditions generally, all of which the progress of modern civilization is rapidly lessening and preventing. we are collecting our insane in modern hospitals and comfortable homes, instead of letting them wander in rags about the country, and this makes them live longer and seem more numerous. but the poorest and least highly civilized classes and races have much more insanity among them than those who live under more favorable conditions. footnotes: [ ] some of these coal-tar remedies are _acetanilid_, and _antipyrin_, and _phenacetin_. chapter xxii exercise and growth fatigue as a danger signal. the chief use of exercise in childhood, whether of body or mind, is to make us grow; but it can do this only by being kept within limits. within these limits it will increase the vigor of the heart, expand the lungs, clear the brain, deepen sleep, and improve the appetite. beyond these limits it stunts the body, dulls the brain, overstrains the heart, and spoils the appetite. how are we going to tell when these limits are being reached? nature has provided a danger signal--fatigue, or "tiredness." fatigue is due, not to complete exhaustion, but to poisoning of the muscle, or nerve, by its own waste substances. if the fatigue is general, or "all over," it is from these waste substances piling up in the blood faster than the lungs, skin, and kidneys can get rid of them. in other words, fatigue is a form of self-poisoning. we can see how it is that exercise, which, up to the point of fatigue, is both healthful and improving, when carried on after we are tired, becomes just the opposite. fatigue is nature's signal, "enough for this time!" that is why all methods of training for building up strength and skill, both of mind and muscle, forbid exercising beyond well-marked fatigue. if you yourself stop at this point in exercising, you will find, the next time you try that particular exercise, that you can go a little further before fatigue is felt; the third time, a little further yet; and so, by degrees, you can build up both your body and brain to the fullest development of which they are capable. in muscular training, a series of light, quick movements, none of which are fatiguing, repeated fifteen, twenty, or a hundred times, will do much more to build up muscle and increase strength, than three or four violent, heaving strains that tax all your strength. real athletes and skilled trainers, for instance, use half-or three-quarter-pound dumb-bells and one-or two-pound indian clubs, instead of the five-pound dumb-bells and ten-pound clubs with which would-be athletes delight to decorate their rooms. a thoroughbred race-horse is trained on the same principle: he is never allowed to gallop until tired, or to put out his full speed before he is well grown. in fact, the best methods of all forms of exercising and training always stop just short of fatigue. education and study ought to be planned on the same principle. exercise of either our muscles or our minds after they have begun to poison themselves through fatigue never does them any good, even if it does not do them serious harm; and, where the exercise is for the sake of building us up and developing our powers, it is best to stop for a little while, or change the task, as soon as we begin to feel distinctly tired, and then to try it again when we are rested. [illustration: a trained body ellery h. clark, all-around athletic champion of america, , .] this is one of the secrets of the healthfulness and value of play and games for children, and for older persons as well. when you get tired, you can stop and rest; and then start in again when you feel rested--that is to say, when your heart has washed the poisons out of your muscles and nerves. in fact, if you will notice, you will find that nearly all play and games are arranged on this plan--a period of activity followed by a period of rest. some games have regular "innings," with alternate activity and rest for the players; or each player takes his turn at doing the hard work; or the players are constantly changing from one thing to another--for instance, throwing or striking the ball one minute; running to first base the next; and standing on base the next. every muscle, every sense, every part of you is exercised at once, or in rapid succession, and no part has time to become seriously fatigued; so that you can play hard all the afternoon and never once be uncomfortably tired, though your muscles have done a tremendous lot of work, measured in foot-pounds or "boy-power," in that time. the good school imitates nature in this respect. the recitation periods are short, and recesses frequent; a heavy subject is followed by a lighter one; songs, drawing, calisthenics, and marching are mixed in with the lessons, so as to give every part of the mind and body plenty to do, and yet not over-tire any part. all-round training from work and play. every game that is worth playing, every kind of work that accomplishes anything worth while, trains and develops not merely the muscles and the heart, but the sight, hearing, touch, and sense of balance, and the powers of judgment, memory, and reason, as well. if you are healthy, you know that you don't need to be told to play, or even how, or what, to play; for you would rather play than eat. you have as strong and natural an appetite for play as you have for food when you are hungry, or for water when you are thirsty, or for sleep when you are tired. it is just as right to follow the one instinct as the others, though any one may be carried to extremes. some of the most important part of your training and fitting for life is given by plays and games. not only do they put you in better condition to study and enjoy your work in school, but they also teach you many valuable lessons as well. our favorite national game, base-ball, for instance, not only develops the muscles of your arms and shoulders in throwing the ball and in striking and catching it, and your lungs and heart in rushing to catch a fly or in running the bases, but also develops quickness of sight and hearing,--requires, as we say, "a good eye" for distance,--makes you learn to calculate something of the speed at which a ball is coming toward you or flying up into the air, requires you to judge correctly how far it is to the next base and how few seconds it will take to get there and whether you or the baseman can get there first. more important yet, like all team games, it teaches you to work with others, to obey orders promptly, to give up your own way and do, not what you like best, but what will help the team most; to keep your temper, to bend every energy to win, but to play fair. it also teaches you that you must begin at the beginning, take the lowest place, and gradually work yourself up; and that only by hard work and patience and determination can you make yourself worth anything to the team, to say nothing of becoming a "star" player. if you will just go at your studies the way you do at base-ball, you will make a success of them. make up your mind to gain a little at a time, to learn something new every day, and you will be astonished how your knowledge will mount up at the end of the year. when you first start in a new study, it looks, as you say, "like greek" to you. you feel quite sure that you never will be able to understand those hard words or solve those problems "clear over in the back of the book." but remember how you started in on the diamond as a "green player," with fumbling fingers that missed half the balls thrown to you, with soft hands that stung every time you tried to stop a "hot" ball; how you ducked and flinched when a fast ball came at you, and how you fumbled half your flies and, even when you fielded them, were likely to send them in six feet over the baseman's head. but by quietly sticking to it--watching how the good players did it, and playing an hour or two every day during the season--you gradually _grew_ into the game, until, almost without knowing how it happened, you had trained your muscles, your nerve cells, and your brain and found yourself a good batsman and a sure catcher. [illustration: tug of war good for muscle and will.] so it will be in your school work. just stick quietly to it, taking your work a lesson at a time; give yourself plenty of sleep and plenty of fresh air, and eat plenty of good food three times a day, and your mind will grow in strength and skill as gradually, as naturally, and as happily as your body does. every season of the year has its special games suited to the weather and the condition of the ground. if you take pride in playing all of them in their turn, hard and thoroughly, and making as good a record in them as you can, you will find that it will not only keep you healthy and make you grow, but will help you in your school work as well, by keeping your wits bright and your head clear. there is a fine group of running games, for instance, such as prisoner's base, or dare base, hide-and-seek, or i spy, and the different kinds of tag,--fox-and-geese, duck-on-rock,--which are not only capital exercise for leg muscles, lungs, and heart, but fine training in quickness of sight, quickness and accuracy of judgment, and quickness of ear in catching the slightest rustle on either side, or behind you, so that you can rush back to the base, or "home," first. then with the winter comes skating, with hockey and prisoner's base on the ice, and coasting and sledding and snow-balling, to say nothing of forts and snowmen. you should try to be out of doors as many hours a day in the winter-time as in the summer, so far as possible. if you play and romp hard, you will find that you don't mind the cold at all, and that, instead of taking more colds and chills, you will have fewer of these than you had when you cooped yourself up indoors beside the warm stove. [illustration: the giant stride a good exercise for all the muscles.] it is just as important for girls to play all these games as it is for boys; and girls enjoy them just as much and can play them almost, if not quite, as well, if they are only allowed to begin when they are small and do just as they please. there is no reason whatever why a girl should not be just as quick of eye and ear, and as fast on the run, and as well able to throw or catch or bat a ball, as a boy. up to fifteen years of age boys and girls alike ought to be dressed in clothes that will allow them to play easily and vigorously at any good game that happens to be in season. girls like base-ball as well as boys do, if they are only shown how to play it. in summer, of course, the whole wide world outdoors turns into one great playground; and it is largely because we turn out into this playground that we have so much less sickness, and so many fewer cases of the serious diseases like tuberculosis, pneumonia, and rheumatism in summer than in winter. boys and girls ought to know how to swim and how to handle a boat before they are twelve years old; for these are not only excellent forms of exercise and most healthful and enjoyable amusements in themselves, but they may be the means of saving lives--one's own life or the lives of others. as a form of exercise and education combined, nothing is better than walks in the country or, where this is impossible, in parks and public gardens. an acquaintance with trees, flowers, plants, birds, and wild animals, is one of the greatest sources of enjoyment and good health that any one can have all his life through. last, but not by any means least, comes that delightful combination of work and play known as gardening, and the lighter forms of farming. every child naturally delights in having a little patch of ground of his own in which he can dig and rake and weed and plant seeds and watch the plants grow. in our large cities, where most of the houses have not sufficient space about them to allow children to have gardens of their own at home, land is being bought near school-houses and laid out as school gardens, and the work done in them is counted as part of the school work. indeed, so important is this work considered as a part of school education, that some large cities are actually building their schools out in the open country, so that they can have plenty of space for playgrounds and gardens and shops, and carrying the children from the central parts of the city out to them by trolley or train in the morning and back at night. [illustration: school gardening] wherever you happen to live, you should engage in healthy happy, vigorous play in the open air at least two to four hours a day all the year round. if you live in a town, while it will not be quite so easy to reach the woods and the fields and the swimming holes and the skating ponds, yet you will have a large number of playmates of your own age, and have good opportunity to play the games calling for half a dozen or more players; and there will be plenty of vacant lots and open spaces, or little-traveled streets, in which to play base-ball and foot-ball and prisoner's base and tag. and although you may not be within reach of the best zoological garden ever made,--a barnyard,--yet you can make occasional trips to the city "zoo," or the botanical gardens, or to parks. healthful methods of study. in the growth and training of the highest, most valuable, and most wonderful part of the body--the brain--the same methods followed in our outdoor games will give the best results. we do not create intelligence by study, nor manufacture a brain for ourselves, in school. we simply develop and strengthen and improve the brains and the mental power that we were born with. [illustration: a wasted chance for public health a large area in the residence section of a city, now used as a dump, from which dust and disease can spread. it could easily be cleared and used for children's gardens, or a playground or athletic field.] our minds grow as our bodies do, by healthful exercise--little at a time, with plenty of rest and change of occupation between the periods of work. that is why our school studies are arranged as they are: instead of one subject being studied all the morning, or all day, four or five subjects are studied for twenty or thirty minutes each, and a change is made to another before our minds become over-tired and begin poisoning themselves with fatigue toxins. a subject that is rather hard for us is followed by one that is easier; and the hardest subjects in the course are usually taken up early in the morning session, or after recess, or early in the afternoon, when we are well-rested and feeling fresh and ready for work. we should try to keep our bodies and our brains and our sight and hearing in the very best possible condition for our work, so as to come up to each task that we have to master keen and fresh and clear-headed, rather than to take pride in spending so many hours a day studying in a half-tired, half-hearted, listless kind of way. you will find that you will be able to master a lesson and see through a problem in half the time if you get plenty of sleep in a room with the windows open, play a great deal out-of-doors, and do not hurry through your meals for either school or play. [illustration: an obstacle race] study just as you play ball when you are trying to make a place on the team. bend every energy that you have to that one thing, and forget everything else, until you have finished it. you can do more work in fifteen minutes in this way than you can in forty minutes of sitting and looking out of the window and wondering how much longer the study period is to last, and what the next chapter is about in the story that you are reading at home, or what you are going to wear to the party next week. keep yourself in good condition, and then buckle down to your work as if that were the only thing there was in the world for the time being, and you will be surprised to find, not only how much more easily and quickly you will do your work, but how much better you will remember it afterwards. do not set out to accomplish too much at a time; but when you undertake a task, don't let go until you have finished it. if you will train yourself in this way, you will soon find that it will seldom take you longer to master a lesson than it will to recite it. it is becoming more and more the custom in the best schools to plan to do all the school work in school hours, alternating periods of recitation and play with periods of study, so that no school-books need be taken home at night. this cannot always be done; but it is well to come as near to it as possible, in order, first, to learn to do work quickly and thoroughly and to drop it when it is finished, and, secondly, to give time to playing and resting and forming the priceless habit of reading. you will leave school some day, but you may still be a student in the great university of books; and the pleasure of widening your knowledge and kindling your imagination will never fail you or pall on you as long as you live. an evening spent with newspapers and magazines, with books of travel and adventure, with good stories and poetry, with enjoyable and sensible parlor games such as authors, checkers, chess, charades, and with music and singing, will help you more with your lessons next day than two hours of listless yawning over text-books. [illustration: the high jump like the obstacle race, the high jump cultivates determination as well as muscle.] if you take your school work in this spirit, you will find that you will enjoy it quite as well as any other form of exercise--even play itself. the harder and more intelligently you play, the better you will be able to work in the schoolroom; and the harder and more intelligently you study, the more you will enjoy your play. chapter xxiii the lookout department why the eyes, ears, and nose are near the mouth. if you had no eyes, ears, or nose, you might just as well be dead; and you soon would be, if you had no one to feed you and guide you about and take care of you. naturally, all three of these scouts and spies of the body, which warn us of danger and guide us to food and shelter, are near the mouth, at the head-end of the body. the nose by means of which we smell food, to see whether it is sweet and good or not, is directly above the mouth; the eyes are above and on each side, like the lamps of an automobile, but swinging in sockets like search-lights; while the ears are a couple of inches behind, on each side of us, for catching from the sea of air the waves that we call sound. you could almost guess what each of these is for, just by looking at it. the nose and the ears are open and hollow because air must pass into them in order to bring us odors or sounds; while the eyes are solid, somewhat like big glass marbles, to receive light--because light can go right through anything that is transparent. eyes, ears, and nose all began on the surface, and sank gradually into the head, so as to be surrounded and protected, leaving just opening enough at the surface to allow smells, light-rays, and sound-waves to enter; and all of them have at their bottom, or deepest part, a sensitive patch of surface, which catches the light, or the smells, or the sounds, and sends them by a special nerve to the brain. these three sets of organs have gradually and slowly grown into the shape in which we now find them, in order to do the particular kind of smelling, seeing, and hearing that will be most useful to us. every kind of animal has a slightly different shape and arrangement of eye, of ear, and of nose to fit his particular "business"; but in all animals they are built upon the same simple, general plan. the nose how the nose is made. the nose began as a pair of little puckers, or dimples, just above the mouth, containing cells that were particularly good smellers, in order to test the food before it was eaten. all smells rise, so these cells were right on the spot for their particular "business." the original way of breathing, before the nose-dimples or pits opened through into the throat, was through the mouth; and that is one reason why it is so easy to fall into the bad habit of mouth-breathing whenever the nose gets blocked by _adenoids_ or _catarrh_. some creatures--fishes, for instance,--breathe through their mouths entirely; if you watch one in an aquarium or a clear stream, you will easily see that it is going "gulp, gulp, gulp" constantly. the saying "to drink like a fish" is a slander upon an innocent creature; for what it is really doing is breathing, not drinking. even a frog, which has nostrils opening into its throat, still has to swallow its air in gulps, as you can see by watching its throat when it is sitting quietly. and, strange as it may seem, if you prop its mouth open, it will suffocate, because it can no longer gulp down air.[ ] our noses are nine-tenths for breathing, and only about one-tenth for smelling; so that by far the greater part of the nose is built on breathing lines. but the smelling part of it, though small, is very important, because it now has to decide, not merely upon the goodness or badness of the food, but also upon the purity or foulness of the air we breathe. the _nostrils_ lie, as you can see, side by side, separated from each other by a thin, straight plate of gristle and bone known as the _septum_. this should be perfectly straight and flat; but very often when the nose does not grow properly in childhood, it becomes crumpled upon itself, or bulged over to one side or the other, and so blocks up one of the nostrils. this is a very common cause of catarrh, and requires, for its cure, a slight operation, a cutting away of the bulging or projecting part of the septum. the rims of the openings of the nose, known as the _wings_, have little muscles fastened to them which pull them upward and backward, thus widening the air openings or, as we say, dilating the nostrils. if you will watch any one who has been running fast, or a horse that has been galloping, you will see that his nostrils enlarge with every breath; and these same movements occur in sick people who are suffering from disease of the lungs or the heart, which makes it difficult for them to get breath enough. each nostril opens into a short and rather narrow, but high, passage, known as the _nasal passage_, through which the air pours into the back of the throat, or _pharynx_, and so down into the windpipe and lungs. instead of having smooth walls, however, the passage is divided into three almost separate tubes, by little shelves of bone that stick out from the outer wall. these are covered with thick coils of tiny blood vessels, through which hot blood is being constantly pumped, like steam through the coils of a radiator, so that the air, as it is being drawn into the lungs, is warmed and moistened. the passage is lined with a soft, moist "skin," called mucous membrane, very much like that which lines the stomach and bowels, except that it is covered with tiny little microscopic hairs, called _cilia_, and that its glands pour out a thin, sticky _mucus_, instead of a digestive juice. this thick network of blood vessels just under the thin mucous "skin" is easily scratched into or broken, and then we have "nose-bleed." the purpose of this mucus is to catch and hold, just as flypaper catches flies, all specks of dust, lint, or germs that may be floating in the air we breathe, and to keep them from going on into the lungs. as these are caught upon the lining of the nose, they are washed down by the flow of mucus or wafted by the movement of the tiny hairs back into the throat, and swallowed into the stomach, where they are digested. or, if they are very irritating, they are blown out of the nostrils, or sneezed out, and in that way got rid of. if the dust is too irritating, or the air is foul and contains disease germs, these set up an inflammation in the nose, and we "catch cold," as we say. if we keep on breathing bad or dusty air, the walls of the nasal passages become permanently thickened and swollen; the mucus, instead of being thin and clear, becomes thick and sticky and yellowish, and we have a catarrh. catarrh is the result of a succession of neglected "bad colds," caused, not by fresh, cold air, but by hot, stuffy, foul air containing dust and germs. the best and only sure way to avoid catarrh is by breathing nothing but fresh, pure air, day and night, keeping your skin clean and vigorous by cool bathing every day, and taking plenty of play in the open air. so perfect is this heating, warming, and dust-cleansing apparatus in the nose, that by the time quite cold air has passed through the nostrils, and got down into the back of the throat, it has been warmed almost to the temperature of the body, or blood-heat, and has been moistened and purified of three-fourths of its dust or disease germs. when you go out of doors on a cold, frosty morning, your nose is very likely to block up, because so much hot blood is pumped into these little steam-coils of blood vessels, in order to warm the air properly, that they swell until they almost block up the nostrils. the sense of smell. the lower three-fourths of the nasal passages have nothing whatever to do with the sense of smell; this is found only in the highest, or third, division of the passages, right up under the root of the nose, where odors can readily rise to it. here can be found a little patch of mucous membrane of a deep yellowish color, which is very sensitive to smells, and from which a number of tiny little nerve twigs run up to form the nerve of smell (_olfactory nerve_), which goes directly to the brain. the position of the smell area at the highest and narrowest part of the nose passage explains why when you have a very bad cold, you almost lose your sense of smell; the lining of the lower part of the nose has become so inflamed and swollen as to block up the way to the highest part where the smelling is done. [illustration: adenoids a section through the nose and mouth: _a_, adenoid growth; _p_, soft palate; _t_, right tonsil.] adenoids. if colds are neglected and allowed to run on, the inflammation spreads through the nose back into the upper part of the throat, or pharynx. here it attacks a spongy group of glands, like a third tonsil, which swells up until it almost blocks up the nose and makes you breathe through your mouth. these swollen glands are called adenoids, and cause not only mouth-breathing, but deafness, loss of appetite, indigestion, headache, and a stupid, tired condition; so that children that are _mouth-breathers_ are often two or more grades behind in school, poor students, and even stunted and undersized. you can often tell them at sight by their open mouths and vacant, stupid look. a very simple and harmless scraping operation will remove these adenoids entirely, and what a wonderful improvement the mouth-breather will make! he will often catch up two grades, and gain two inches in height and ten pounds in weight within a year. [illustration: mouth-breathers note how swollen the face is under the eyes and how tired and dull the whole expression.] adenoids not only cause deafness by blocking up the tube (_eustachian_) that runs from the throat to the ear,--the tube through which the air passes when your ear "goes pop,"--but are also the commonest cause of ear-ache and gatherings in the ear, which may burst the drum. the tongue the tongue is not used chiefly for tasting. if you will notice the next time that you have a bad cold, you will find that you have almost lost your sense of taste, as well as of smell, so that everything tastes "flat" to you. this illustrates what scientists have known for a long time, but which seems very hard to believe, that two-thirds of what we call taste is really smell. if you carefully block up your nostrils with cotton or wax, so that no air can possibly reach the smell region at the top of them, and blindfold your eyes, and have some one cut a raw potato, an apple, and a raw onion into little pieces of the same size and shape, and put them into your mouth one after the other, you will find that it is difficult to tell which is which. the only tastes that are really perceived in the mouth are bitter, sweet, sour, and salty; and even these are perceived quite as much by the roof and back of the mouth, especially the soft palate, as they are by the tongue. all the delicate flavors of our food, such as those of coffee or of roast meat or of freshly baked bread, are really smells. the tongue, which is usually described as the organ of taste, is really a sort of fingerless hand grown up from the floor of the mouth--to help suck in or lap up water or milk, push the food in between the teeth for chewing, and, when it has been chewed, roll it into a ball and push it backward down the throat. it is not even the chief organ of speech; for people who have had their tongues removed on account of cancer, or some other disease, can talk fairly well, although not so clearly as with the whole tongue. the tongue is simply a "tongue-shaped" bundle of muscles, covered with a thick, tough skin of mucous membrane, dotted all over with little knob-like processes called _papillæ_, which are of various shapes, but of no particular utility, except to roughen the surface of the tongue and give it a good grip on the food. if the mucous "skin" covering the tongue does not shed off properly, the dead cells on its surface become thickened and whitish, and the germs of the mouth begin to breed and grow in them, forming a sort of mat over the surface. then we say that the tongue is badly coated. this coating is in part due to unhealthy conditions of the stomach and bowels, and in part to lack of proper cleaning of the mouth and teeth. the sense of taste can usually be trusted. since the nose and the tongue have had about five million years' experience in picking out what is good and refusing what is bad, their judgment is pretty reliable, and their opinion entitled to the greatest respect. as a general thing, those things that taste good are wholesome and nutritious; the finest and most enjoyable flavors known are those of our commonest and most wholesome foods, such as good bread, fresh butter, roast meats, apples, cheese, sugar, fruit, etc.; while, on the other hand, those things that taste bad or bitter or salty or sour, or that we have to learn to like, like beer or pickles or strong cheese or tea or coffee, are more often unwholesome or have little nutritive value. very few real foods taste bad when we first try them. if we used our noses to test every piece of food that went into our mouths, and refused to eat it if it "smelt bad," we should avoid many an attack of indigestion and ptomaine poisoning. it is really a great pity that it is not considered polite to "sniff" at the table. the eye how the eye is made. next in importance after the smell and the taste of our food comes the appearance of it; hence, our need of eyes to help us in choosing what to eat, as well as how to avoid the dangers about us. the eyes began as little sensitive spots on the surface of the head. like the nose pits, as they became more sensitive, they too sank in beneath the surface; but with this difference, that, instead of remaining open, the rims or edges of the eye-pit grew together and became transparent, forming a cover, or eye-glass, which became the clear part of the eye, called the _cornea_. at the same time, the little sensitive spot at the bottom of the eye-pit spread out into the shape of the bottom of a cup, called the _retina_; and then the hollow of that cup between the retina and the cornea filled up with a clear, soft, animal jelly called the _vitreous humor_, and we have the eye as it is in our heads to-day. the sensitive retina, spreading out, as it does, to form the back of the eyeball, is the nerve-coat of the eye; and from its centre a thick round bundle of nerve fibres, known as the _optic nerve_, runs back to the brain. [illustration: the apparatus of vision a cross-section diagram, showing eye and optic nerve, the bones forming the orbit or socket, and the front lobes of the brain.] the bones of the head, grown out in a ring in order to protect the eyes, are called the _orbit_ or _socket_. to protect the delicate glass (cornea) of the eye, there are two folds of skin, one above and one below, known as the eyelids. the eyelids carry a row of extra long hairs at their edges, called the eyelashes, and a number of little glands, somewhat like those of the stomach, to pour out a fluid, which makes the lids glide smoothly over the eyeball and keeps them from sticking together. underneath the upper lid a number of these glands become gathered together and "grow in," after the fashion of the salivary glands, to form a larger gland about the size of a small almond, which pours out large amounts of this fluid as tears. it is called the tear gland (_lachrymal_ gland). whenever a cinder or a grain of sand or a tiny insect or any other irritating thing gets into the eye, this gland pours out a flood of tears, which washes the intruder down into the inner corner of the eye where it can be wiped out; or, if it be small enough, carries it down through a little tube in the edge of each eyelid, through a little passage known as the _nasal_, or _tear, duct_, into the nose. so, if you get anything into your eye, much the best and safest thing to do is to hold the lids half shut, but as loose, or relaxed, as possible, and allow the tears to wash the speck of dust down into the inner corner of the eye. if you squeeze down too hard with the lids, and particularly if you rub the eye, you will be very likely to scratch the cornea with the speck of dust or sand, or, if the speck be sharp-edged, to drive it right into the cornea and give yourself a great deal of unnecessary pain and trouble, or even seriously damage the eye. if the cinder or dust doesn't wash down quickly, pull the upper lid gently away from the eyeball by the lashes and hold it there a minute or so, when often the cinder will drop or wash out. as the light rays cannot be bent, or drawn into the eyes as smells can into the nostrils, it is necessary that the eyes should be able to roll about so as to turn in different directions; and so nature has made them round, or globular, attaching to their outer coat or shell (the _sclerotic_ coat) little bands of muscle, each of which pulls the eyeball in its particular direction. there are four straight bands--one for each point of the compass: one fastened to the upper surface of the eye to roll it upward; another to the lower to roll it downward; another to the outer to roll it outward; and another to the inner side to roll it inward for near vision.[ ] there is another reason for the rounded shape of the eye--that it may act as a lens in condensing the rays of light. in order that we may see things clearly, the rays of light must be brought to a focus upon or close to the retina, at the back of the eye; and our eyes are so shaped that they form a lens of proper thickness, or strength, to do this. you can see how this is done with an ordinary magnifying glass, or burning-glass. the little sharply lighted and heated point to which the light-rays can be brought is the focus of the lens, and the distance it lies behind the lens is called the focal distance. the thicker the lens, or burning-glass, is in the middle, the shorter its focal distance, and the more strongly it will magnify. a healthy, or normal, eye is of just such shape and "bulge" that rays of light entering the eye are brought to a focus on, or close to, the retina at the back of the eyeball. some people, however, are unfortunately born with eyes that are too small and flat, or do not "bulge" enough; and then the rays of light are focused behind the retina instead of upon it, and the image is blurred. this is known as "long sight" (_hyperopia_), and can be corrected by putting in front of the eyes lenses of glass, called spectacles, which bulge sufficiently to bring the rays to focus on the retina. an eye that is too large and round and bulging brings the rays to a focus in front of the retina, and this also blurs the image. this form of poor sight is called "short sight" (_myopia_), and can be relieved by putting in front of the eye a glass that is concave, or thinnest in the middle and thickest at the edges, in the right proportions to focus the image where it belongs, right on the retina. this kind of glass is sometimes called a "minifying" glass, from the fact that it makes objects seen through it look smaller. it is also called a "minus" glass, while the magnifying glass is called a "plus" glass. the shape of the glasses or spectacles prescribed for an eye is just the opposite of that of the eye. if the eye is too flat (_long-sighted_), you put on a bulging, or convex, glass; and if the eye is too bulging (_short-sighted_), a hollow, or concave, glass. other eyes are irregularly shaped in front and bulge more in one direction than another, like an orange. this defect is called _astigmatism_ and is very troublesome, making it hard to fit the eye with glasses, as the glasses have to be ground irregular in shape. [illustration: a school eye-test a normal eye should be able to read the smaller type easily at a distance of twenty feet.] we have just seen how the eye deals with rays of light coming from a distance, which are practically parallel. when, however, books or other objects are brought near the eye, the rays of light coming from them do not remain parallel, but begin to spread apart, or diverge; and a stronger lens is required to bring them to a focus upon the retina. to provide for this, there is in the middle of the eyeball a firm, elastic, little globular body about the size and shape of a lemon-drop, called the _crystalline lens_. around this is a ring of muscle, which is so arranged that when it contracts it causes the lens to change its shape and become more bulging, or thicker in the middle. this makes the eyeball a "stronger" lens so that the rays of light can be brought to a focus upon the retina. this action is known as _accommodation_, or adjustment; and you can sometimes feel it going on in your own eye, as when you pick up a book or a piece of sewing and bring it up quickly, close to the eye, in order to see clearly. if this little muscle is worked too hard, as when we try to read in a bad light, it becomes tired and we get what is called "eye-strain"; and if the strain be kept up too long, it will give us headache and may even make us sick at the stomach. the commonest cases of eye-strain are in eyes that are too flat (_hyperopic_) where this little muscle has to "bulge" the lens enough to make good the defect and bring the rays to a focus. this, however, of course keeps it on a constant strain; and the eye is continually giving out, and its owner suffering from headache, neuralgia, dyspepsia, sleeplessness, and other forms of nervous trouble, until the proper lens or spectacle is fitted.[ ] a surface as delicate and sensitive to light as the retina, would, of course, be damaged by too bright a glare; so in the front of the eye, just behind the cornea, a curtain has grown up, with an opening or "peep-hole" in its centre, which can be enlarged or made smaller by little muscles. this opening is the _pupil_; the curtain, which is colored so as to shut out the rays of light, is known as the _iris_, for the quaint, but rather picturesque, reason that _iris_ in greek means "rainbow," and this part of the eye may be any one of its colors. [illustration: disinfecting a baby's eyes at birth] it is the iris which, according to the amount of coloring matter (pigment) in it, makes the eye, as we say, blue, gray, green, brown, or black. blue eyes have the least; black, the most.[ ] the care of the eyes. the most dangerous diseases of the eye are caused by infectious germs, which get into them either from the outside, as in dust, or by touching them with dirty fingers; or through the blood, as in measles, smallpox, tuberculosis, and rheumatism. the more completely we can prevent these diseases, the less blindness we shall have in the nation. about one-sixth of all cases of blindness in our asylums is caused by a germ that gets into babies' eyes at birth, but can be done away with by proper washing and cleansing of the eyes. the ear structure of the ear. next after sight, hearing is our most important sense; without it, speaking, and consequently reading and writing, would be impossible. man learned to speak by hearing the sounds made by other people and things, and then by listening to his own voice and practicing until he could imitate them. children who are unfortunate enough to be born _deaf_ also become _dumb_, not because there is anything the matter with their voice organs, but simply because, as they cannot hear the sounds they make, they do not form them by practice into words and sentences. by proper training, deaf mutes can now be taught to speak, though their voices sound flat and "tinny," like a phonograph. as in the nose and the eye, the important part of the ear is the nerve spot that can "feel" the air waves that we call sound, just as the retina "feels" light. it is from this sensitive spot that the _auditory nerve_ carries the sound to the brain. this spot has grown into quite an elaborate structure, buried, for safety, deeply in the bones of the skull, close to the base of the brain. it is made up of a long row of tiny little nerve rods, laid side by side like the keys of a piano, only there are about three thousand of them. each one of these is supposed to respond, or vibrate, to a particular tone, or sound. this keyboard, from the fact that, to save space, it is coiled upon itself like a sea-shell, instead of running straight, is called the _cochlea_ (greek for "snail-shell"); it is also called, because it is the deepest, or innermost, part of the hearing apparatus, the _internal ear_. just as the retina has a lens and a vitreous humor in front of it to act upon the light, so the internal ear has an apparatus in front of it to act upon the sound waves. this is called the _drum_ (_tympanum_). it consists of a fold of thin, delicate skin stretched tightly across the bottom of the outer ear canal, as parchment is stretched across the head of a drum. if you should take a hand-mirror--best a hollow, or concave, one--and throw a bright ray of light deep into some one's ear, you would be able, after a little trying, to see this drum-skin stretched across the bottom of it and about an inch and a quarter in from the surface of the head. [illustration: the apparatus of hearing a cross-section diagram from the outer ear to the lobes of the brain.] when the sound waves go into the ear canal and strike upon this tiny drum, which is about two-thirds the size of a silver dime and really more like a tambourine or the disk of a telephone or phonograph than a drum, they start it thrilling, or vibrating, just as a guitar string vibrates when you thrum it. these little vibrations are carried across the hollow behind the drum by a chain of tiny bones, known as the _ear-bones_ (called from their shapes, the _hammer_, the _anvil_, and the _stirrup_), and passed on to the keyboard of the cochlea. here comes in one of the most curious things about this ingenious hearing-apparatus. this little hollow behind the drum-skin has to be kept full of air in order to let the drum vibrate properly, and this is arranged for by a little tube (the eustachian tube) which runs down from the bottom of it and opens into the back of the throat just behind the nasal passages, and above the soft palate. when you blow your nose very hard, you will sometimes feel one of your ears go "pop"; and that means that you have blown a bubble of air out through this tube into your drum cavity. if your nose and throat become inflamed, then the mouth of this little tube may become blocked up; the drum can no longer thrill, or vibrate, properly; and, for the time being, you are deaf. this tube is of great importance, because nearly all the diseases that attack the ear start in at the throat and travel up the tube until they reach the drum cavity. this is why one so often has earache after an attack of the grip or after a bad cold. the drum cavity, with its chain of bones and its tube down to the throat, is called, from its position, the _middle ear_. the _outer_, or _external, ear_, though far the largest of the three parts, and quite imposing in appearance, is really of little use or importance. it is simply a sort of receiving trumpet for catching sounds, with a very wide and curiously curved and crumpled mouth, or bell. the large, expanded mouth of the trumpet, called the _concha_ ("conch shell"), was at one time capable of being "pricked up" and turned in the direction of sounds, just as horses' or dogs' ears are now; and in our own ears there are still for this purpose three pairs of tiny unused muscles running from them to the side of the head. but the concha is now motionless and almost useless, except for its beauty; and it is very troublesome to wash. the care of the ear. the tube of the trumpet leading down from the surface of the ear to the drum is lined with skin; and this skin is supplied with glands, which pour out a sticky, yellowish fluid called _ear wax_, which catches the bits of dust or insects that get into the ear and, flowing slowly outward, carries them with it. if it is let alone, it will keep the ear canal clean and healthy; but some people imagine that, because it looks yellowish, it must be dirt; and consequently, from mistaken ideas of cleanliness, they work at it with the end of the finger, the corner of a towel, or even with a hairpin, an ear-spoon, or an ear-pick, and in this way stop the proper flow of the wax and make it dry and block up the ear. remember, you should not wash too deeply into your ears; (as the old german proverb puts it, "never pick your ear with anything smaller than your elbow"). and if you don't, you will seldom have trouble with wax in the ear. scarcely one case of deafness in a hundred is caused by wax. when your ear does become blocked up with wax, it is best to go to a doctor and let him syringe it out. picking at it, or even syringing too hard, may do serious damage to the ear. if an earache is neglected, the inflammation may spread into some air-cells in the bony lump behind the ear (the _mastoid_) and thus cause _mastoid disease_, which may spread to, and attack, the brain if not cured by a surgical operation. our spirit-levels the sixth sense. though we usually speak of having five senses,--sight, smell, hearing, touch, and taste,--we really have also a sixth--the sense of direction, or of balance. the "machine" of this sense is comparatively simple, being made up of three tiny curved tubes, which, from their shape, are called the _semi-circular canals_. these are buried in the same bone of the skull as the internal ear, and so close to it that they were at one time described as part of it. these little canals are three in number, one for each of the dimensions--length, breadth, and thickness,--so that whichever way the head or body is moved,--backward and forward, up and down, or from side to side,--the fluid with which they are filled will change its level in one of them, just as the "bead" does in the carpenter's spirit-level that you can find in any tool shop. the delicate nerve twigs that run out into the fluid in these tiny canals are gathered together into a bundle, or nerve-cable, which runs back to the part of the brain known as the _cerebellum_ or hind-brain, which has most to do with controlling the balance and movements of our bodies. it is the disturbance set up in these spirit-level canals by the pitching and rolling of a ship, which makes us seasick. neither the stomach, nor anything that we may have eaten, has anything to do with it. in the same way we sometimes become sick and dizzy from swinging too long or too high, or from riding on the cars. footnotes: [ ] to show in how many different ways nature may carry out the same purpose, the smelling organs in insects, lobsters, and crabs are on the ends and sides of tiny feelers, which they wave about; and the eyes in lobsters, crawfish, and snails, are on the ends of stalks, which they thrust about in all directions as a burglar handles a bull's-eye lantern. snakes "hear," or catch the sound-waves, with their flickering, forked tongues; and grasshoppers and locusts have "ear-drums" on the sides of their chests. [ ] these are called the _recti_ or "straight" muscles, upper, lower, inner, and outer, according to their position. then, to roll the eye round and round, there are two little muscles, one above and one below, which run "crosswise" of the orbit, called the upper and lower _oblique_ muscles. [ ] the retina is chiefly made up of a great number of fine little nerve cells called, from their shape, the _rods_ and _cones_. these are kept soaked in a colored fluid called the _retinal purple_, which changes under the influence of light, somewhat in the same way that the film on a photographic plate does, thus forming pictures, which are translated by the rods and cones and telegraphed along the fibres of the optic nerve to the brain. naturally, all parts of the retina are not equally sensitive to light; its centre, which is directly opposite the pupil of the eye, is far the most so, while those around the rim of the cup are dull. this is why, when you are looking, say at some one's face across the room, only the face and a few inches around it are seen perfectly clear and sharp, while the rest of the room is seen only vaguely. [ ] as the inside of the eye is dark, or comparatively so, the pupil, or little opening in the centre of the iris, looks black, and was at one time supposed to be a solid body instead of a hole. you can easily watch the pupil changing in size, according to the brightness of the light, from a mere pin-point in very bright sunlight or gaslight, up to the size of the butt-end of a lead pencil in the dark or in a dim light. this change in size is very simply but ingeniously carried out by two sets of tiny muscles. one set of these muscles runs in a ring right around the pupil; and when they shorten, the opening is contracted or narrowed. the other set runs outward through the iris like the spokes of a wheel; and when they shorten, they pull the pupil open. if anyone has had "drops" (_atropin_) put into his eyes in order to have them fitted with glasses, he will know what a disagreeably dazzling thing it is to have the pupil permanently enlarged, so that it cannot _contract_ in a bright light. chapter xxiv the speech organs the voice, a waste product. it is one of the most curious things in this body of ours that what we regard as its most wonderful power and gift, the voice, is, in one sense, a waste product. so ingenious is nature that she has actually made that marvelous musical instrument--the human voice--with its range, its flexibility, and its powers of expression, out of spent breath, or used-up air, which has done its work in the lungs and is being driven off to get rid of it. it is like using the waste from a kitchen sink to turn a mill. the organs that make the human voice were never built for that purpose in the first place. unlike the eye and the ear, nature built no special organ for the voice alone, but simply utilized the windpipe and lung-bellows, the swallowing parts of the food passage (tongue, lips, and palate) and the nose, for that purpose, long after they had taken their own particular shapes for their own special ends. the important point about this is that a good voice requires not merely a large and well-developed "music box" in the windpipe, but good lungs, a well-shaped healthy throat, properly arched jaws,--which mean good, sound teeth,--clear and healthy nasal passages, and a flexible elastic tongue. of course, the blood and the nerves supplying all these structures must be in good condition, as well. so practically, a good voice requires that the whole body should be healthy; and whatever we do to improve the condition of our nose, our teeth, our throat, our lungs, our digestion, and our circulation will help to improve the possibilities of our voice. there are, of course, many exceptions; but you will generally find that great singers have not only splendid lungs and large vocal cords, but good hearts, vigorous constitutions, and bodies above the average in both stature and strength. how the voice is produced. the chief parts of the breathing machine that nature has made over for talking purposes are the windpipe, or air tube, and the muscles in its walls. in the neck, about three inches above the collar bone, four or five of the rings of cartilage, or gristle,--which, you remember, give stiffening to the windpipe,--have grown together and enlarged to form a voice box, or _larynx_. [illustration: the vocal cords looked at from above: position _a_, in quiet inspiration; _b_, in singing a low tone; _c_, in singing a high tone.] the upper edge of this voice box forms the projection in the front of the throat known by the rather absurd name of the "adam's apple." this grows larger in proportion to the heaviness of the sounds to be made, and hence is larger in men than in women and boys. when the boy's voice box begins to grow to the man's in shape and size, his voice is likely to "break"; for it is changing from the high, clear boy's voice to the heavy, deep voice of the man. inside of this voice box, one of the rings of muscle that run around the windpipe has stretched into a pair of straight, elastic bands, or strings, one on each side of the air pipe, known as the _vocal cords_, or voice bands. these are so arranged that they can be stretched and relaxed by little muscles; and, when thrown into vibration by the air rushing through the voice box, they produce the sounds that we call talking or singing. the more tightly they are stretched, the higher and shriller are the tones they produce; and the more they are slackened, or relaxed, the deeper and more rumbling are the tones. this is why, when you try to sing a high note, you can feel something tightening and straining in your throat, until finally you can stretch it no tighter, and your voice "breaks," as you say, into a scream or cry. all musical instruments that have strings, are played, or produce their sounds, upon this same principle. the thinner and shorter the string, or the more tightly it is stretched, the higher the note; the heavier and longer the string, the lower the note. but no musical instrument ever yet invented can equal the human voice in the music of its tones, in its range, in the different variety and quality of tones it can produce, and in its wonderful power of expression. the human voice is a combination of reed organ, pipe organ, trumpet, and violin; and can produce in its tiny music box--only about two inches long by one inch wide--all the tones and qualities of tones that can be produced on all these instruments, except that it cannot go quite so high or so low. all the musical instruments in the world, from the penny whistle to the grand piano, are but poor imitations of the human music box. the bellows, of course, of the human pipe organ are the lungs; while the tongue furnishes the stops; and the throat, mouth, and nose, the resonance, or sounding, chambers. just as a violin, or guitar, has two main parts,--a string, which vibrates and makes the sound; and a box, or hollow body, which catches that sound and enlarges it and gives it sweetness and vibration and quality,--so the human voice has two similar parts--the vocal bands, which make the sound; and a sound box, or rather series of three resonance boxes,--the throat, the mouth, and the nasal passages,--which enlarge and soften it and improve its quality. you would naturally think that the strings, or cords, were the most important part both of the voice and of a musical instrument; and in one sense they are, as it could make no noise at all without them. but in another sense, far more important are the sounding boxes, or resonance chambers. the whole quality and value, for instance, of a stradivarius[ ] violin, which will make it readily bring ten thousand dollars in the open market, are due to the skill with which the body, or sound box, was made; the quality of the wood used; and, odd as it may seem, even the varnish used on it--the strings are the same as on any five-dollar fiddle. this is almost equally true of the human voice. while its size, or volume, is determined by the voice box and vocal bands, and its power largely by the lungs and chest, its musical quality, its color, and its expression are given almost entirely by the throat, mouth (including the lips), and nose. the proper management of these parts is two-thirds of voice training, and all these are largely under our control. how a good voice may be developed. if the nasal passages, for instance, are blocked by a bad cold or a catarrh or adenoids, then nearly half the body of your violin is blocked up and deadened; half your resonance chamber is destroyed, and the voice sounds flat and dead and nasal. if, on the other hand, your throat be swollen, or blocked, as by enlarged tonsils or chronic sore throat, then this part of the resonance chamber is muffled and spoiled, and your voice will be either entirely gone or hoarse; though perhaps by driving it very hard you may be able to make a clear tone. if you have an attack of inflammation or cold further down, and the vocal bands swell, or the mucous membrane lining the voice box becomes inflamed and thickened, then the voice is lost entirely, just as the tone of a violin would be if a wet cloth were thrown across the strings. but disturbances in the voice box, or larynx, cause only a very small percentage of husky, poor, or unmusical voices. a far commoner cause, indeed probably the commonest single cause of a poor, squeaky, or drawling, unmusical voice is careless and improper management of the mouth and lips. in the first place, you can easily show that such marked differences in sound as those of the different vowels are all produced by the mouth and lips. if you will prepare to say the vowels--_a, e, i, o, u_--aloud, and begin with _a_, and then hold your mouth and lips firmly in the same position, you will find that all the other vowels also come out as _a_. if, on the other hand, you begin with your mouth and lips in the rounded and somewhat thrust-out position necessary to say _o_, and try to repeat the rest of the vowels, you will find that you cannot say them at all, but only different forms of _o_. when you have convinced yourself of this, repeat the vowels loudly and clearly without stopping to think about the position of the mouth, and notice how your lips, the tip and base of your tongue, and your soft palate and throat all change their positions for each successive vowel. if you will try to sing the scale, beginning with a comfortable note about the middle of your voice range, and letting your mouth take the shape for that note unconsciously, you will find that, as you sing up the scale, you change the shape of your mouth, lips, and tongue at every note, thrusting the lips and mouth further forward as if to whistle, narrowing the opening and closing up the back of your throat for the high notes. on the other hand, as you sing down, you tend to open the mouth and lips more widely, to drop the bottom of your mouth--that is, the base of your tongue--toward your throat, and your chin down toward your chest. again you will find, just as in the case of the different vowels, that you can sing any tone clearly and musically after putting the mouth in precisely the shape that best fits that tone; and learning how to do this is a most important part of vocal training. what we call words are simply breath sounds and voice-box sounds chopped into convenient lengths by the movements of the tongue and lips and throat. so when we come to the question of clear and pleasant speaking, or, as we term it, _articulation_, the lips and tongue have almost everything to do with making the difference between a clear, musical, and refined enunciation, which is so easy to understand that it is a pleasure to listen to it, and a slurred, drawling, squeaky, nasal kind of speech, which is as hard to understand as it is unpleasant to listen to. few of us can ever hope to develop a really great singing voice; but anyone who will take the pains can acquire a clear, distinct, and pleasing speaking voice; and perhaps half of us can learn to sing fairly well. but to do this, we must first have good, healthy, well-developed lungs and elastic chest walls, which can come only from plenty of vigorous exercise in the open air, combined with good food and well-ventilated rooms. we must have a healthy stomach, which will not fill up with gas and keep our diaphragms from going down and enlarging our chests properly; we must have clear nasal passages, good teeth, well-shaped mouths and flexible lips, which we are willing to use vigorously in articulating, or cutting up our voice sounds; and we must have good hearing and a well-trained ear. in short, the best way to get a clear, strong, pleasant voice is to have a vigorous, well-grown, healthy body. footnotes: [ ] a famous violin-maker who lived about years ago in cremona, italy. fifty thousand dollars has been asked for an unusually choice "strad." chapter xxv the teeth, the ivory keepers of the gate why the teeth are important. the teeth are a very important part of our body and deserve far more attention and better care than they usually get. they are the first and most active part of our digestive system, cutting up and grinding foods that the stomach would be unable to melt without their help. in all animals except those that have horns or fists, the teeth are their most important weapons of attack and defense. so important are they in all animals, including ourselves, and so closely do they fit their different methods of food-getting and of attack and defense, that when scientists wish to decide what class, or group, a particular animal belongs to, they look first and longest at its teeth. the shape and position of the teeth literally make the lower half of the face and give it half its expression. a properly grown and developed set of teeth not only is necessary to health and comfort, but helps greatly to make the face and expression attractive or unattractive. few faces with bright eyes, clear skin, and white, regular, well-kept teeth are unpleasing to look at. beauty and health are closely related, and we ought to try to have both. in fact, nine times out of ten, what we call beauty is the outward and visible sign of inward health. the healthier you are, the handsomer you'll be. it is particularly important to understand the natural growth and proper care of the teeth because there are few organs in the body for which we are able to do so much by direct personal attention. our stomachs, our livers, and our kidneys, for instance, are entirely out of sight, and more or less out of reach; but our teeth are both easily got at and in full view; and, to a large degree, upon the care that we give them while they are young, will depend not only their regularity and whiteness, but also the length of their life and the vigor and comfort of our digestion all our lives. [illustration: teeth--a question of care] the first thing to be remembered about the teeth is that, hard and shiny and different from almost everything else in the body as they look, they are simply a part of the skin lining the mouth, hardened and shaped for their special work of biting and chewing. much of the care needed to prevent decay should be given, not to the teeth themselves directly, but to the gums and the mucous membrane of the whole mouth. the gums and the mouth literally _grew_ the teeth in the first place; and when they become diseased, they secrete acids which slowly eat away the crowns and roots of the teeth. their diseases come chiefly from irritation by decaying scraps of food, or from the blocking of the nose so that air is breathed in through the mouth, drying and cracking the soft mucous membrane. after the acids from the diseased gums have attacked the teeth, the poisons of the germs that breed in the warmth and moisture of the mouth cause the teeth to decay. eight times out of ten, if you take care of the gums the teeth will take care of themselves. structure of the teeth. the upper half of the tooth, which pushes through and stands up above the jaw and the gum, we call the _crown_; and this is the portion that is covered with _enamel_, or "living glass." the body of the tooth under the enamel is formed of a hard kind of bone called _dentine_. the lower half of the tooth, which still is buried in the jaw, we call the _root_. wrenching the lower or root part of the tooth loose from its socket in the jaw is what hurts so when a tooth is pulled. the crown of the tooth is hollow, and this hollow is filled with a soft, sensitive pulp, in which we feel toothache. tiny blood vessels and nerve-twigs run up from the jaw to supply this pulp through canals in the roots of the tooth. [illustration: a tooth (lengthwise section.) _e_, enamel; _d_, dentine; _p_, pulp cavity; _c_, cement; _b_, blood vessels; _n_, nerve.] kinds of teeth. if you look at your own teeth in a mirror, the first thing that strikes you is your broad, white, shiny front teeth, four above and four below, shaped like the blade of a rather blunt chisel. their shape tells what they are used for. like chisels, they cut, or bite, the food into appropriate sizes and lengths for chewing between the back teeth; and from this use they are called the _incisors_, or "cutters." from having been used for so many generations upon the kind of food we live on, they have grown broader than the _canines_, the teeth next to them, and almost as long. the canines are of a cone-like shape, although it is a pretty blunt cone, or peg. those in the upper jaw lie almost directly under the centre of each eye, and are called the "eye-teeth"; though their proper name, from the fact that they are the most prominent teeth in the dog, is the canine teeth. these are our oldest and least changed teeth; and as you might guess from their shape, like a heavy, blunt spear-head, were originally the fighting and tearing teeth, and still have the longest and heaviest roots of any teeth in our jaws. if you slip your finger up under your upper lip, you can feel the great ridge of this root, standing out from the surface of the gum. lastly, looking farther back into our mouths, we see behind our canines a long row of broad, flat-topped, square-looking teeth, which fill up the largest part of our jaws. again their shape tells what they are used for. they are not sharp enough to cut with, or pointed enough to tear with, but are just suited for crushing and grinding into a pulp, between their broad, flat tops, any food that may be placed between them; and from this grinding they are called the _molars_, or "mill" teeth. if you will look closely at the back ones, you will see that each of them has four corners, or _cusps_, with a cross-shaped, sunken furrow in the centre, where they come together. after they have been used in grinding food for some years and rubbing against each other, these little corner projections become worn away, and their tops become almost flat. those in the upper jaw have three roots, and those in the lower jaw have two, so that they are solidly anchored for their heavy, grinding work. the first two molars in each jaw, behind the canines, are smaller than the others and made up of only two pieces instead of four, and hence are called the _bicuspids_, or "two-cusped" teeth. as we are what the scientists call an omnivorous, or "all-devouring," animal, able to eat and live upon practically every kind of food that any animal on earth can deal with,--animal and vegetable, soft and hard, wet and dry; fruits, nuts, crabs, roots, seaweeds, insects, anything that we can get our teeth into,--we have kept in working condition some of every kind of teeth possessed by any living animal; and the most important rule for keeping our teeth in health is to give all these kinds something to do. just as in other animals the teeth appear when needed, and grow into the shape required, so they grow in our own mouths when they are wanted, and of the size and shape required at the time. we are born without any teeth at all; and it is only when we begin to need a little solid food added to our milk diet,--when we are about seven months old,--that our first teeth appear; and these are incisors, first of all in the lower jaw. then, at average intervals of about three months, the other incisors and the canines appear and, last of all, the molars, so that at about two years of age we have a complete set of twenty teeth. these are called the _milk teeth_. most animals (_mammals_) have formed the habit of growing two sets of teeth--a smaller, slighter set for use during the first few months or years of life, and a larger, heavier set to come in and take their place after the jaws have grown to somewhat more nearly their permanent size. in our mouths, at about seven years of age, a larger, heavier tooth pushes up behind the last milk tooth,--called the "seventh year molar,"--the milk teeth begin to loosen and fall out, and their places are taken by other new teeth budding up out of the jaw just as the first set did. these take a still longer time to grow, so that the last four of the full set of thirty-two do not come through the gums until somewhere between our eighteenth and twentieth years. these last four teeth, for the rather absurd reason that they do not appear until we are old enough to be wise, are known as the "wisdom teeth." instead of being, as one might expect, the hardest and longest-lived of all our teeth, they are the smallest and worst built of our molars and among the first of our permanent teeth to break down and disappear. not only so, but our jaws are so much shorter than they were in the days when man fought with his teeth and knew nothing about cooking and had no tools or utensils with which to grind and prepare his food, that there is scarcely room in them for these last teeth to come through. they often cause a great deal of pain in the process, and may even break through at the side of the jaw and cause abscesses and other troubles. [illustration: the replacing of the milk teeth the "second teeth" are shown fully formed in the gums, ready to push out the milk teeth. the wisdom teeth, which appear later, cannot be shown at this stage.--after gray.] care of the teeth. the most important thing for the health of any organ in the body is to give it plenty of exercise, and this is especially true of our teeth. this exercise can be secured by thoroughly chewing, or _masticating_, all our food, of whatever sort, especially breads, biscuits, and cereals. thorough chewing not only gives valuable exercise to the teeth, but, by grinding up these foods thoroughly, makes them easier for the stomach to digest; and, by mixing them well with the saliva, enables it to change the starch into sugar. meats, fish, eggs, cheese, etc., do not need to be mixed with the saliva, nor to be ground so fine for easy digestion in the stomach, and hence do not require such thorough chewing, though it is better to make a rule of chewing all food well. we can exercise our teeth also by eating plenty of foods that require a good deal of chewing, especially the crusts of bread, and vegetables such as corn, celery, lettuce, nuts, parched grains, and popcorn. it is most important to keep the nasal passages clear and free, and the teeth sound and regular by proper dental attention, so that the jaws will grow properly, and each tooth will strike squarely against its fellow in the opposite jaw, and both jaws fit snugly and closely to each other, making the bite firm and clean, and the grinding close and vigorous. if we are mouth-breathers, our jaws will grow out of shape, so that our teeth are crowded and irregular and do not meet each other properly in chewing. pressure upon the roots of the teeth, from meeting their fellows of the opposite jaw in firm, vigorous mastication, is one of the most important means of keeping them sound and healthy. whenever a tooth becomes idle and useless, from failing to meet its fellow tooth in the jaw above or below properly, or from having no fellow tooth to meet, it is very likely to begin to decay. the next important thing in keeping the teeth healthy is to keep them thoroughly clean. the greatest enemies of our teeth are the acids that form in the scraps of food that are left between them after eating. meats are not so dangerous in this regard as starches and sugars, because the fluids resulting from their decay are alkaline instead of acid; but it is best to keep the teeth clear of scraps of all kinds. this can best be done by the moderate and gentle use of a quill, or _rolled_ wooden tooth-pick, followed by a thorough brushing after each meal with a rather stiff, firm brush. then use floss-silk, or linen or rubber threads to "saw" out such pieces as have lodged between the teeth. this brushing should be given, not merely to the teeth, but to the entire surface of the gums as well; for, as we have seen, it is the gums that make or spoil the health of the teeth, and they, like all other parts of the body, require plenty of exercise and pressure in order to keep them healthy. in the early days of man, when he had no knives and gnawed his meat directly off the bones, and when he cracked nuts and ground all his grain with his teeth, the gums got an abundance of pressure and friction and were kept firm and healthy and red; but now that we take out the bones of the meat and stew or hash it, have all our grain ground, and strip off all the husks of our vegetables and skins of our fruits, though we have made our food much more digestible, we have robbed our gums of a great deal of valuable friction and exercise. the most practical way to make up for this is by vigorous massage and scrubbing with a tooth-brush for five minutes at least three times a day. it will hurt and even make the gums bleed at first; but you will be surprised how quickly they will get used to it, so that it will become positively enjoyable. [illustration: a tooth-brush drill a school in which the children are taught the importance of using the tooth brush, are supplied with brushes at cost, and required to report both on their care of their teeth and on the condition of the brushes.] it is good to use some cleansing alkaline powder upon the brush. the old-fashioned precipitated chalk, which makes the bulk of most tooth powders, is very good; but an equally good and much cheaper and simpler one is ordinary baking soda, or saleratus, though this will make the gums smart a little at first. any powder that contains pumice-stone, cuttle-fish bone, charcoal, or gritty substances of any sort, as many unfortunately do, is injurious, because these scratch the enamel of the teeth and give the acids in the mouth a chink through which they may begin to attack the softer dentine underneath the "glaze" of enamel. antiseptic powders and washes, while widely advertised, are not of much practical value, except for temporary use when you have an abscess in your gums, or your teeth are in very bad condition. it is almost impossible to get them strong enough to have any real effect in checking putrefaction of the food or diseases of the gums, without making them too irritating or poisonous. if you keep the gums and teeth well brushed and healthy, you will need no antiseptics. not only should the teeth be kept thoroughly clean and sweet for their own sake, but also for the sake of the stomach and the health of the blood and the whole body. the mouth, being continually moist and warm and full of chinks and pockets, furnishes an ideal breeding ground for all kinds of germs; and the average, uncleansed human mouth will be found to contain regularly more than thirty different species of germs, each numbering its millions! among them may sometimes be found the germs of serious diseases such as pneumonia, diphtheria, and blood-poisoning, just waiting, as it were, their opportunity to attack the body. in fact, a dirty, neglected mouth is one of the commonest causes of disease. chapter xxvi infections, and how to avoid them what causes disease. the commonest and most dangerous accident that is likely to happen to you is to catch some disease. fortunately, however, this is an accident that is as preventable as it is common. indeed, if everybody would help the board of health in its fight against the spread of the common "catchable" diseases, these diseases could soon be wiped out of existence. every one of them is due to dirt of some sort; and absolute cleanness would do away with them altogether. diseases that are "catching," or will spread from one person to another, are called _infections_; and all of them, as might be supposed from their power of spreading, are due to tiny living particles, called _germs_--so tiny that they cannot be seen except under a powerful microscope. nine-tenths of these disease germs are little plants of the same class as the moulds that grow upon cheese or stale bread, and are called bacteria, or bacilli. the different kinds of bacteria, or bacilli, are usually named after the diseases they produce, or else after the scientists who discovered them. for instance, the germ that causes typhoid fever is called the _bacillus typhosus_; that which causes tuberculosis is called the bacillus tuberculosis; while the germ of diphtheria known as the _klebs-loeffler bacillus_, after the two men who discovered it. a few kinds of disease germs belong to the animal kingdom, though all germs are so tiny that you would have to have a very powerful microscope to tell the difference between the animal germs and the bacilli, or little plants. most of these animal germs are called _protozoa_ and cause diseases found in, or near, the tropics, like malaria and the terrible "sleeping sickness" of africa. smallpox, yellow fever, and hydrophobia--the disease that results from the bite of a mad dog--are also probably due to animal germs. so far as prevention is concerned, however, it makes practically little difference whether infectious diseases are due to an animal or a vegetable germ, or to one bacillus or another. they all have two things in common: they can be spread only by the touch of an infected person, and "touch" includes breath,--indeed "by touch" is the meaning of both infectious and contagious; and they can all be prevented by the strictest cleanness, or killed by various poisons known as germicides ("germ-killers"), or disinfectants. most of these germicides are, unfortunately, poisonous to us as well; for, as you will remember, our bodies are made up of masses of tiny animal cells, not unlike the animal germs. most of the germicides, therefore, have to be used against germs while they are outside of our bodies. scripture says that "a man's foes shall be they of his own household," and this is true of disease germs. they grow and flourish--and, so far as history tells us, the diseases they cause seem to have started--only where people are crowded together in huts or houses, breathing one another's breaths and one another's perspiration, and drinking one another's waste substances in the well water. this fact has, however, its encouraging side; for, since this habit of crowding together, which we call civilization, or "citification," has caused and keeps causing these diseases, it can also cure them and prevent their spread if all the people will fight them in dead earnest. no amount of money, or of time, that a town or a county can spend in stamping out these infectious diseases would be wasted. indeed, every penny of it would be a good investment; for, taken together, they cause at least half, and probably nearly two-thirds, of all deaths. not only so, but most of the so-called chronic diseases of the heart, kidneys, lungs, bones, and brain are due to the after-effects of their toxins, or poisons. how disease germs grow and spread. but perhaps you will ask, "if these bacteria and protozoa are so tiny that we have to use a microscope, and one of the most powerful made, in order even to see them, how is it that they can overrun our whole body and produce such dangerous fevers and so many deaths?" the answer is simply, "because there are so many millions of them; and because they breed, or multiply, at such a tremendously rapid rate." when one of these little bacilli breeds, it doesn't take time to form buds and flowers and seeds, like other plants, or even the trouble to lay eggs like an insect or a bird, but simply stretches itself out a little longer, pinches itself in two, and makes of each half a new bacillus. this is known as _fission_ or "splitting," and is of interest because this is the way in which the little cells that make up our own bodies increase in number; as, for instance, when a muscle is growing and enlarging under exercise, or when more of the white blood cells are needed to fight some disease. remember that we and the disease germs are both cells; and that, if they are numbered by millions, we are by billions; and that we are made up of far the older and the tougher cells of the two. except in a few of the most virulent and deadly of fevers, like the famous "black death," or _bubonic plague_, and lock-jaw, or _tetanus_, ninety-five times out of a hundred when disease germs get into our bodies, it is our bodies that eat up the germs instead of the germs our bodies. keep away from disease germs all that you reasonably and possibly can; but don't forget that the best protection against infectious diseases, in the long run, is a strong, vigorous, healthy body that can literally "eat them alive." grow that kind of body, keep it perfectly clean inside and out, and you have little need to fear fevers, or indeed any other kind of disease; for you will live until you are old enough to die--and then you'll want to, just as you want to go to sleep when you are tired. remember that this fight against the fevers is a winning fight, this study of disease germs a cheering and encouraging one, because it will end in our conquering them, not merely nine times out of ten, but ninety-nine times out of a hundred. we are not making this fight just to escape death; what we are fighting for is to live out a full, useful, and happy life. and we already have five chances to one of gaining this, and the chances are improving every year; for science has already raised the average length of life from barely twenty years to over forty. broadly speaking, if you will keep away from every one whom you know to have an infectious disease; wash your hands always before you eat, or put anything into your mouth; keep your fingers, pencils, pennies, and pins out of your mouth,--where they _don't_ belong; live and play in the open air as much as possible and keep your windows well open day and night, you will avoid nine-tenths of the risks from germs and the dangers that they bring in their wake. children's diseases. we have already studied two of the greatest and most dangerous diseases, and the way to conquer them--tuberculosis, or consumption, in the chapter on the lungs; and typhoid fever, in the chapter on our drink. one of the next most important groups of "catching" diseases--important because, though very mild, they are so exceedingly common,--is that known as the "diseases of childhood," or "diseases of infancy" because they are most likely to occur in childhood. so common are they that you know their names almost as well as you know your own--measles, mumps, whooping cough, scarlet fever, and chicken-pox. though they are in no way related to one another, so far as we know (indeed, the precise germs that cause two of them--measles and scarlet fever--have not yet positively been determined), yet they can be practically taken together, because they are all spread in much the same way, they all begin with much the same sort of sneezing and inflammation of the nose and throat, they can all be prevented by the same means, and, if properly taken care of, they result in complete recovery ninety-five times out of a hundred. [illustration: the winning fight statistics for the population of the old city of new york. the chart shows a decrease from out of every , in - to out of every , in . this is due very largely to the careful methods of prevention enforced by the board of health, especially the inspection of milk.] any child who has sneezing, running at the nose or eyes, sore throat, or cough, especially with headache or backache, a flushed face and feverishness, ought to be kept at home from school and placed in a well-ventilated, well-lighted room by himself for a day or two, until it can be seen whether he has one of these children's diseases, or only a common cold. if it turns out to be measles, scarlet fever, or whooping cough, he should then be kept entirely away from other children in a separate room, or, where that is impossible, in a special hospital or ward for the purpose; he should be kept in bed and given such remedies as the doctor may advise. then no one else will catch the disease from him; and within from two to five weeks, he will be well again. the most important thing is not to let him get up and begin to run about, or expose himself, too soon; five times as many deaths are caused by taking cold, or becoming over-tired, or by injudicious eating, during recovery after measles, scarlet fever, and whooping cough, as by the disease itself. this one caution will serve two purposes; for, as a sick child's breath, and the scales from his skin, and what he coughs out from his mouth and nose are full of germs, and will give the disease to other children from two to four weeks after the fever has left him, he ought to be kept by himself--"in quarantine," as we say--for this length of time, which is just about the period needed to protect him from the dangers of relapse or taking cold. boards of health fix this period of quarantine by law and put a colored placard on the house to warn others of the danger of infection. [illustration: death-rate from measles note that, after the quarantining of measles in , the death-rate dropped at once. statistics for the old city of new york.] colds and sore throats. a milder and even more common kind of infection is that known as common colds. these, as shown by their name, were once supposed to be due to exposure to cold air, or drafts, or to becoming wet or chilled. but, while a few of them are so caused, at least eight, and probably nine, out of ten are due to germs caught from somebody else. they are never caught in the open air and very seldom in cold, pure fresh air of any sort, but almost always in the hot, foul, stuffy, twice-breathed air of bedrooms, schoolrooms, churches, theatres, halls, sleeping cars, etc. the colds, for instance, that you catch when traveling, are usually due not to drafts or damp sheets, but to the crop of cold germs left behind by the last victim. you have probably known of colds that have run through a family or a school or a shop. it is well worth trying to keep away from the infection of colds, because not only is their coughing and sore throat and hoarseness and running at the nose very disagreeable and uncomfortable, but they may cause almost as many different kinds of serious troubles in heart, kidneys, and nervous system as any of the other infections. in fact, they probably cause more than any other, because they are at least ten times as common and frequent. for instance, many cases of rheumatism, or rheumatic fever, come after attacks in the nose and throat, which cannot be distinguished from a common cold or ordinary tonsilitis. indeed, it is more than probable that one of the ten or a dozen different germs that may get into your nose or throat and give you a cold, is the germ that causes rheumatism. at all events, it would be fairly safe to say, "no colds, no rheumatism." whenever you have a cold, keep away from everybody that you possibly can and stay at home from school or business for a day or two. you will do no good to yourself or others, working in that condition; and you may infect a dozen others. if you find anyone in your class or room or shop, sneezing or coughing or running at the nose, report him to your teacher or foreman; and if he won't send him home, keep away from him as much as possible. diphtheria. another common and serious disease, until quite recently very fatal, is diphtheria. this is caused by getting into your mouth or nose the germs from another case of the disease. this disease also is most likely to occur in childhood, though it may attack a person of any age, and is always serious. it may be prevented from spreading by keeping children who have it shut up in rooms, or wards, by themselves and keeping all other children away from them, or from their nurses or those who have anything to do with them. up to about thirty years ago, it was one of the deadliest and most terrible diseases that we had anything to do with. we knew absolutely nothing that would cure it, or even check its course; and nearly half of the children attacked by it died. about that time, however, two scientists, klebs and loeffler, discovered that, by taking some of the membrane, or tough growth that forms in the throat in this disease, and by rubbing it over a plate of gelatin jelly, they could grow on that gelatin a particular kind of germ. this germ, or bacillus, they then put into the throats of guinea pigs, and found that it would give them diphtheria. this is the way disease germs are discovered, or, as we say, identified; but of course this did not give at once any remedy for the disease. scientists soon found, however, that, if a very small number of these bacilli were put into a guinea pig's throat, it would have diphtheria, but in a very mild form. if, when it had recovered, it was again infected, it would stand a much larger dose of the bacilli without harm. this made them suspect that some substance had been formed in the guinea-pig's blood that killed the bacillus or worked against its toxin, or poison; and soon, to their delight, they succeeded in finding this substance, which they called _antitoxin_ (meaning "against poison"). then came the idea that if they could only get enough of this antitoxin, and inject it into the blood of a child who had diphtheria, it might cure the disease. a guinea pig is such a tiny animal that the amount of antitoxin which it could form would be far too small to cure a man, or even a child. so larger animals were taken; and it was finally found that the largest and strongest of our domestic animals, the horse, would, if the diphtheria germs were injected into its blood, make such large amounts of antitoxin that merely by drawing a quart or two of the blood--and closing up the vein again--enough antitoxin could be got to cure fifty or a hundred children of diphtheria. this treatment has not the slightest harmful effect upon the horse. the pain of injecting is only like sticking a pin through the skin, while the pain of bleeding is no greater than cutting your finger. there are now at our great manufacturing laboratories whole stables full of horses, for the production of this wonderful remedy. [illustration: death-rate from diphtheria and croup statistics from the city of new york. antitoxin was used largely from - , during which time there was a steady decrease (from % to %) in the death-rate. after the board of health took up the matter, furnishing antitoxin without cost, the death-rate continued to decrease to less than % of the total number of cases, in .] with this remedy, our entire feeling toward diphtheria is changed. instead of dreading it above all things, we know now, from hundreds of thousands of cures, that, if a case is seen on the first day of the disease, and this antitoxin injected with a hypodermic needle, it is almost certain that the patient will recover; not more than two or three cases out of a hundred will fail. if the case is seen and treated on the second day, all but four or five out of a hundred will recover; and if on the third day, all but ten. in fact, the average death rate of diphtheria has been cut down now from forty-five per cent to about six per cent. we now have antitoxins, or _vaccines_, for blood-poisoning; for typhoid fever; for one of the forms of rheumatism; for boils; for the terrible _cerebro-spinal meningitis_, or "spotted fever"; and for tetanus, or lock-jaw. and every year there are one or two other diseases added to the list of those that have been conquered in this way. none of these vaccines is so powerful, or so certain in its effects, as the diphtheria antitoxin. but they are very helpful already; and some of them, particularly the typhoid vaccine, are of great value in preventing the attack of the disease, as small doses of it given to persons who have been exposed to the infection, or are obliged to drink infected water, as in traveling or in war, very greatly lessen their chances of catching the disease. vaccination, the great cure for smallpox. another valuable means of preventing disease by means of its germs is by putting very small doses of the germs into a patient's body, so that they will give him a very mild attack of the disease, and cause the production in his blood of such large amounts of antitoxin that he will no longer be liable to an attack of the violent, or dangerous, form of the disease. vaccines, for this purpose, usually consist either of a very small number of the disease germs, or of a group of them, which have been made to grow upon a very poor soil or have been chilled or heated so as to destroy their vitality or kill them outright. when these dead, or half-dead, bacilli are injected into the system, they stir up the body to produce promptly large amounts of its antitoxin. in some cases the reaction is so prompt and so vigorous that the antitoxin is produced almost without any discomfort, or disturbance, and the patient scarcely knows anything about it. in others there will be a slight degree of feverishness, with perhaps a little headache, and a few days, or hours, of discomfort. when this has passed, then the individual is protected against that disease for a period varying from a few months to as long as seven or eight years, or even for life. the best-known and oldest illustration of the use of these vaccines is that of _smallpox_. a little more than a hundred years ago, an english country doctor by the name of jenner discovered that the cows in his district suffered from a disease accompanied by irritation upon their skins and udders, which was known as "cowpox." the dairymaids who milked these cows caught this disease, which was exceedingly mild and was all over within four or five days; but after that the maids would not take smallpox, or, as we say, were immune against it. smallpox at that time was as common as measles is now. nearly one-fourth of the whole population of europe was pock-marked, and over half the inmates in the blind asylums had been made blind by smallpox. so common was it that it was quite customary to take the infectious matter from the pocks upon the skin of a mild case and inoculate children with it, so as to give them the disease in mild form and thus protect them against a severe, or fatal, attack; just as in country districts, a few years ago, some parents would expose their children to measles when it happened to be a mild form, so as to "have it over with." it occurred to dr. jenner that if this inoculation with cowpox would protect these milkmaids, it would be an infinitely safer thing to use to protect children than even the mildest known form of inoculation. so he tried it upon two or three of his child patients, after explaining the situation to their parents, and was perfectly delighted when, a few months afterward, these children happened to be exposed to a severe case of smallpox and entirely escaped catching the disease. this was the beginning of what we now call _vaccination_. the germ of cowpox, which is believed to be either the cow or horse variety of human smallpox, is cultivated upon healthy calves. the matter formed upon their skin is collected with the greatest care; and this is rubbed, or scraped, into the arm of the child. it is a perfectly safe and harmless cure; and although it has been done millions of times, never has there been more than one death from it in , cases. in a little over a hundred years it has reduced smallpox from the commonest and most fatal of all diseases to one of the rarest. but in every country in the world into which vaccination has not been introduced, smallpox rages as commonly and as fatally as ever. for instance, between and in russia, where a large share of the people are unvaccinated, , deaths occurred from smallpox; in spain, where the same condition exists, , . in germany, on the other hand, where vaccination is practically universal, there were in the same period only deaths-- / as many as in russia; and in england, only a slightly greater number. another illustration, which comes closer home, is that of the philippine islands. before they were annexed by the united states, vaccination was rare, and thousands of deaths from smallpox occurred every year. in , after the people had been thoroughly vaccinated, there was not a single death from this cause in the whole of the islands. [illustration: bill of health no outgoing ship may "clear the port" without a bill of health, signed by the collector of customs and the naval officer of the port.] this discovery of jenner's was most fortunate; for vaccination remains until this day absolutely the only remedy of any value whatever that we possess against smallpox. quarantine, inoculation, improvement of living and sanitary conditions, the use of drugs and medicines of all sorts other than vaccination, have no effect whatever upon either the spread or the fatality of the disease. the author, when state health officer of oregon, saw the disease break out in a highly-civilized, well-fed, well-housed community, and kill eleven out of thirty-three people attacked, just as it would have done in the "dark ages." not one of the cases that died had been vaccinated; and, with but one exception (and in this the proof of vaccination was imperfect), every vaccinated case recovered. vaccination will usually protect for from five to ten years; then it is advisable to be re-vaccinated, and in six to eight years more, another vaccination should be attempted. this third vaccination will usually not "take," for the reason that two successful vaccinations will usually protect for life. unexpected as it may seem, vaccination is not only a preventive of smallpox, but a cure for it. the reason being that _vaccinia_, the disease resulting from successful vaccination, being far milder than smallpox, runs its course more quickly,--taking only two days to develop,--while smallpox requires anywhere from seven to twenty days to develop after the patient has been infected, or exposed. so, if anyone who has been exposed to smallpox is vaccinated any time within a week after exposure, the vaccine will take hold first, and the patient will have either simple vaccinia, with its trifling headache and fever, or else a very mild form of smallpox. some persons object to having children deliberately infected with even the mildest sort of disease; but this is infinitely better than to allow, as was the case before vaccination, from one-fourth to one-fifth of them to be killed, twenty-five per cent of them to be pock-marked, and ten per cent of them to be blinded by this terrible disease. so far as any after-effects of vaccination are concerned, careful investigation of hundreds of thousands of cases has clearly shown that it is not so dangerous as a common cold in the head. infantile paralysis. another disease that has been unpleasantly famous of late is also caused and spread by a germ. this is a form of laming or crippling of certain muscles in childhood known as _infantile paralysis_. it is not a common disease, though during the last two years there has been an epidemic of it in the united states, especially in new york and massachusetts. the only things of importance for you to know about it are that it begins, like the other infections, with headache, fever, and usually with "snuffles" or slight sore throat, or an attack of indigestion; and that its germ is probably spread by being sneezed or coughed into the air from the noses and throats of the children who have it, and breathed in by well children. the best known preventive of serious results from this disease is the same as in the rest of infectious diseases, namely, rest in bed, away from all other children, which at the same time stops the spread of it. it furnishes one more reason why all children having the "snuffles" and sore throat with fever and headache should be kept away from school and promptly put to bed and kept there until they are better. the reason why the disease produces paralysis is that its germs specially attack the spinal cord, so as to destroy the roots of the nerves going to the muscles. unless the harm done to the spinal cord is very severe, other muscles of the arm or the leg can very often be trained to take the place and to do the work of the paralyzed muscles, so that while the limb will not be so strong as before, it will still be quite useful. malaria. practically the only disease due to animal germs, which is sufficiently common in temperate or even subtropical regions to be of interest to us, is _malaria_, better known perhaps as _ague_, or "chills-and-fever." this disease has always been associated with swamps and damp marshy places and the fogs and mists that rise from them; indeed its name, _mal-aria_, is simply the italian words for "bad air." it is commonest in country districts as compared with towns, in the south as compared with the north, and on the frontier, and usually almost disappears when all the ponds and swamps in a district are drained and turned into cultivated land or meadows. about four hundred years ago, the spanish conquerors of america were fortunate enough to discover that the natives of peru had a bitter, reddish bark, which, when powdered or made into a strong tea, would cure ague. this, known first as "peruvian bark," was introduced into europe by the intelligent and far-sighted spanish countess of chincon; and, as she richly deserved, her name became attached to it--first softened to "cinchona" and later hardened to the now famous "quinine." but for this drug, the settlement of much of america would have been impossible. the climate of the whole of the mississippi valley and of the south would have been fatal to white men without its aid. [illustration: germs of malaria (greatly magnified) these germs are animal germs and are in the red blood corpuscles, feeding on them.] but although we knew that we could both break up and prevent malaria by doses of quinine large enough to make the head ring, we knew nothing about the cause--save that it was always associated with swamps and marshy places--until about forty years ago a french army surgeon, laveran, discovered in the red corpuscles of the blood of malaria patients, a little animal germ, which has since borne his name. this, being an animal germ, naturally would not grow or live like a plant-germ and must have been carried into the human body by the bite of some other animal. the only animals that bite us often enough to transmit such a disease are insects of different sorts; and, as biting insects are commonly found flying around swamps, suspicion very quickly settled upon the mosquito. [illustration: culex position on the wall.--after berkeley.] by a brilliant series of investigations by french, italian, english, and american scientists, the malaria germ was discovered in the body of the mosquito, and was transmitted by its bite to birds and animals. then a score or more of eager students and doctors in different parts of the world offered themselves for experiment--allowed themselves to be bitten by infected mosquitoes, and within ten days developed malaria. at first sight, this discovery was not very encouraging; for to exterminate mosquitoes appeared to be as hopeful a task as to sweep back the atlantic tides with a broom. but luckily it was soon found that the common piping, or singing, mosquito (called from his voice _culex pipiens_) could not carry the disease, but only one rather rare kind of mosquito (the _anopheles_), which is found only one-fiftieth as commonly as the ordinary mosquito. it was further found that these malaria-bearing mosquitoes could breed only in small puddles, or pools, that were either permanent or present six months out of the year, and that did not communicate with, or drain into, any stream through which fish could enter them. fish are a deadly enemy of the mosquito and devour him in the stage between the egg and the growth of his wings, when he lives in water as a little whitish worm, such as you may have seen wriggling in a rain-barrel. [illustration: anopheles position on the wall.--after berkeley.] it was found that by hunting out a dozen or twenty little pools of this sort in the neighborhood of a town full of malaria, and filling them up, or draining them, or pouring kerosene over the surface of the water, the spread of the malaria in the town could be stopped and wiped out absolutely. this has been accomplished even in such frightfully malarial districts as the panama canal zone, and the west coast of africa, whose famous "jungle fever" has prevented white men from getting a foothold upon it for fifteen hundred years. since the young mosquitoes, in the form of wrigglers, or _larvæ_, cannot grow except in still water, draining the pools kills them; and, as they must come to the surface of the water to breathe, pouring crude petroleum over the water--the oil floating on the surface and making a film--chokes them. the common garden mosquito, while not dangerous, is decidedly a nuisance and can be exterminated in the same way--by draining the swamps and pools, or by flooding them with crude petroleum,--or by draining swamps or pools into fresh-water ponds and then putting minnows or other fish into these ponds. there is no reason why any community calling itself civilized should submit to be tormented by mosquitoes if it will spend the few hundred, or the thousand, dollars necessary to wipe them out. it is prophesied that the use of quinine will soon become as rare as it is now common, because malaria will be wiped out by the prevention of the mosquito. disinfectants. so far we have been considering how to attack the germs after they have got into our bodies, or to prevent them from spreading from one patient to another; but there is still another way in which they may be attacked, and that is by killing, or poisoning them, outside the body. this process is generally known as _disinfection_, and is carried out either by baking, boiling, or steaming, or by the use of strongly poisonous fluids or gases, known as _disinfectants_. while fortunately none of these disease germs can breed, or reproduce their kind, outside the human body, and while comparatively few of them live very long outside the human body, they may, if mixed with food or caught upon clothing, hangings, walls, or floors, remain in a sort of torpid, but still infectious, condition for weeks or even months. consequently, it has become the custom to take all the bedding, clothing, carpets, curtains, etc., that have touched a patient suffering from a contagious disease, or have been in the room with him, and also any books that he may have handled, any pens or pencils that he may have used, and either destroy them, or bake, boil, or fumigate them with some strong germicidal, or disinfectant, vapor. [illustration: oiling a breeding ground of mosquitoes the photograph shows work done in the panama canal zone. the swamp has already been drained by ditches, and the work of destroying the larvæ is being completed by the use of oil.] this is usually done by closing up tightly the sick-room, putting into it all clothing, bedding, pictures, books, hangings, and other articles used during the illness (except wash-goods, which, of course, can be sterilized by thorough boiling; and dishes and table utensils, which also can be scalded and boiled); draping the carpet over chairs so as to expose it on all sides, opening closets and drawers, and then filling the room full of some strong germ-destroying fumes. one of the best disinfectants, and the one now most commonly used by boards of health for this purpose, is _formaldehyde_--a pungent, irritating gas, which is an exceedingly powerful germ-destroyer. this, for convenience in handling is usually dissolved, or forced into water, which takes up about half its bulk; and the solution is then known as _formalin_. when formalin is poured into an open dish, it rapidly evaporates, or gives up its gas; and, if it be gently heated, this will be thrown off in such quantities as to completely fill the room and penetrate every crevice of it, and every fold of the clothing or hangings. one pound, or pint, of formalin will furnish vapor enough to disinfect a room eight feet square and eight feet high, so the amount for a given room can thus be calculated. the formalin vapor will attack germs much more vigorously and certainly if it be mixed with water vapor, or steam; so it is usually best either to boil a large kettle of water in the room for half an hour or more, so as to fill the air with steam, before putting in the formalin, or to use a combination evaporator with a lamp underneath it, which will give off both formalin and steam. this, if lighted and placed on a dish in the centre of a wash-tub or a large dishpan, with two or three inches of water in the bottom of it, can be put into the room and left burning until it goes out of its own accord. another very good method is to take a pan, or basin, with the required amount of formalin (not more than an inch or two inches deep) in the bottom of it, get everything ready with doors and windows fastened tight and strips of paper pasted across the cracks, pour quickly over the formalin some permanganate of potash (about a quarter of a pound to each pound of formalin), and then bolt for the door as quickly as possible to avoid suffocation. the resulting boiling up, or effervescence, will throw off quantities of formaldehyde gas so quickly as to drive it into every cranny and completely through clothing, bedding, etc. the room should be left closed up tightly for from twelve to thirty-six hours, when it can be opened--only be careful how you go into it, first sniffing two or three times to be sure that all the gas has leaked out, or holding your breath till you can get the windows open; and in a few hours the room will be ready for use again. another older and much less expensive disinfectant for this purpose is common _sulphur_. from one to three pounds of this, according to the size of the room, is burned by a specially prepared lamp in a pan placed in the centre of a dishpan of water, and the vapor thus made is a very powerful disinfectant. this, however, is a very poisonous and suffocating gas (as you will remember if you have ever strangled on the fumes of an old-fashioned sulphur match) and, compared with formalin, is nearly five times as poisonous to human beings, or animals, and not half so much so to the germs. where formalin cannot be secured, sulphur is very effective; but its only merit compared with formalin is that it is cheaper, and more destructive to animal parasites and vermin such as bugs, cockroaches, mice, rats, etc., when these happen to be present. formalin has the additional advantage of not tarnishing metal surfaces, as sulphur does. it is a good thing for every household and every schoolroom to have a bottle of formalin on hand, so that you may sniff the vapor of it into your nostrils and throat if you think you have been exposed to a cold, or other infectious disease, or make a solution with which to wash your hands, handkerchiefs, pencils, etc., after touching any dirt likely to contain infection. half a teaspoonful in a bowl of water is enough for this. a saucerful of it placed in an air-tight box, or cabinet, will make a disinfecting chamber in which pencils, books, etc., can be placed over night; and a teaspoonful of it in a quart of water will make an actively germ-destroying solution, which can be used to soak clothing, clean out bedroom utensils, or pour down sinks, toilets, or drains. it is a good thing also to pour a few teaspoonfuls occasionally on the floor of the closets in which your shoes, trousers, dresses, and other outdoor clothing are kept, as these are quite likely to be contaminated by germs from the dust and dirt of the streets. formalin is one of the best and safest general disinfectants to use. its advantages are, that it is nearly ten times as powerful a germicide as carbolic acid, or even corrosive sublimate, so that it may be used in a solution so weak as to be practically non-poisonous to human beings. it is so violently irritating to lips, tongue, and nostrils as to make it almost impossible for even a child to swallow it, while the amount that would be absorbed if taken into the mouth and spit out again would be practically harmless, so far as danger to life is concerned, though it would blister the lips and tongue. bacteria, our best friends. while, naturally, the bacteria that do us harm by producing disease are the ones that have attracted our keenest attention and that we talk about most, it must never be forgotten that they form only a very, very small part of the total number of bacteria, or germs. these tiny little germs swarm everywhere; and the mere fact that we find bacteria in any place, or in any substance, is no proof whatever that we are in danger of catching some disease there. all our farm and garden soil, for instance, is full of bacteria that not only are harmless, but give that soil all its richness, or fertility. if you were to take a shovelful of rich garden earth and bake it in an oven, so as to destroy absolutely all bacteria in it, you would have spoiled it so that seeds would scarcely grow in it, and it would not produce a good crop of anything. these little bacteria, sometimes called the soil-bacteria, or bacteria of decay, swarm in all kinds of dead vegetable and animal matter, such as leaves, roots, fruits, bodies of animals, fishes, and insects, and cause them to decay or break down and melt away. in doing this they produce waste substances, particularly those that contain ammonia, or nitrates, or some other form of nitrogen, which are necessary for the growth of plants or crops. this is why soil can be made richer by scattering over it and plowing into it manure, waste from slaughter houses, or any other kind of decaying animal or vegetable matter. this is promptly attacked by the bacteria of the soil and turned into these easily soluble plant foods. the roots of the plants grown in the soil could no more take this food directly from dead leaves or manure than you could live on sawdust or cocoanut matting. so, if it were not for these bacteria, or lower plants, there could be no higher, or green, plants. as animals live either upon these green plants, such as grass and grains, or upon the flesh of other animals that live upon plants, we can see that without the bacteria there would be no animal life, not even man. no bacteria, no higher life. it would be safe to say that, out of every million bacteria in existence, at least , are not only not harmful but helpful to us. one large group of bacteria produces the well-known souring of milk; and while this in itself is not especially desirable, yet the milk is still wholesome and practically harmless, and its sourness prevents the growth of a large number of other bacteria whose growth would quickly make it dangerous and poisonous. many races living in hot countries deliberately sour all the milk directly after milking, by putting sour milk into it, because, when soured, it will keep fairly wholesome for several days, while if not soured it would entirely spoil and become unusable within twenty-four hours. another group of bacteria, which float about in the air almost everywhere, are the yeasts, which we harness to our use for the very wholesome and healthful process of bread-making. millions upon millions of bacteria of different sorts live and grow naturally in our stomachs and intestines; and while they are probably of no special advantage to us, yet at the same time the majority of them are practically, within reasonable limits--not to exceed a few billions or so--harmless. insect pests. one kind of "dirt" that should be avoided with special care is insects of all sorts. no one needs to be told to try to keep a house, or a room, clear of fleas, bed-bugs, or lice; indeed to have these creatures about is considered a mortal disgrace. not only is their bite very unpleasant, but they may convey a variety of diseases, including plague and blood poisonings of various sorts. but there is another insect pest far commoner and far more dangerous than either fleas or bed-bugs, whose presence we should feel equally ashamed of; and that is the common house fly. this filthy little insect breeds in, and feeds upon, filth, manure, garbage, and dirt of all sorts, and then comes and crawls over our food, falls into our milk, wipes his feet on our sugar and cake, crawls over the baby's face, and makes a general nuisance of himself. take almost any fly that you can catch, let him crawl over a culture plate of gelatin, put that gelatin away in a warm place, and you will find a perfect flower-garden of germs growing up all over it, following the pattern made by the tracks of his dirty feet. in this garden will be found not "silver bells and cockle shells and pretty maids all in a row," but a choice mixture of typhoid bacilli, pus germs, the germs of putrefaction, tubercle bacilli, and the little seeds which, if planted in our own bodies, would blossom as pneumonia or diphtheria. [illustration: an educational fly poster] the fly is an unmitigated nuisance and should be wiped out. no half-way measures should be considered. fortunately, this is perfectly possible; for his presence is our own fault and nothing else, as he can lay his eggs and hatch only in piles of dirt and filth found about our own houses, barns, and outbuildings. he is not a wild insect but a domestic one and is practically never found more than a few hundred yards away from some house or barnyard. his favorite place for breeding is in piles of stable manure, especially horse manure; but neglected garbage cans, refuse heaps, piles of dirt and sweepings, decaying matter of all sorts, which are allowed to remain for more than ten days or two weeks at a time, will give him the breeding grounds that he needs. [illustration: a breeding place of flies and filth] it takes him about two weeks to hatch and get away from these breeding places; so that if everything of this sort is cleaned up carefully once a week, or if, where manure heaps and garbage dumps have to remain for longer periods, they are sprinkled with arsenic, kerosene, corrosive sublimate, chloride of lime, or carbolic acid, he will perish and disappear as surely as grass will if you wash away the soil in which it grows. the presence of a fly means a dirty house or a dirty yard somewhere, and to discover a fly in your house should be considered a disgrace. until people are aroused to the need of such cleanliness as will make flies disappear entirely, in most places it will be necessary, as warm weather approaches, to screen all doors and windows, and particularly all boxes, pantries, or refrigerators in which food is kept. if you cannot afford screens, use fly paper. these are all, however, only half-way measures and will give only partial relief. the best prevention of flies is absolute cleanliness. no dirt, no flies. dust, a source of danger. dust is an easily recognized form of dirt. it is dangerous in itself and nearly always contains germs of one sort or another mixed in with it. shops and factories whose processes make much dust are usually very unhealthy for the workers, who are likely to show a high death-rate from consumption. dust should be fought and avoided in every possible way. city streets should have good modern pavements,--preferably asphalt or some crude petroleum, or sawmill-waste, "crust," or coating,--which will not make any dust, and which can be washed down every night with a hose. in smaller towns where there is no pavement, dust may be prevented by regular sprinklings during the summer, preferably with some form of crude oil. two or three full sprinklings of this will keep down the dust for the greater part of the summer. if these measures are properly carried out, they will prevent most of the dust that accumulates in houses, as nearly all of this blows in through the windows or is carried in on shoes or skirts. when this has once floated in and settled down upon the walls, furniture, or carpets, be very careful how you disturb it; for, as long as it lies there, it will do you no harm, however untidy it may look. the broom and the feather duster and the dry cloth do almost as much harm as they do good; for while they may remove two-thirds of the dust from a room, they drive the other third right into your nose and throat, where the germs it contains can do the most possible harm. dusting should always be done with a damp cloth; sweeping, with a damp cloth tied over a broom; and, wherever possible, a carpet sweeper, or, better still, a vacuum cleaner, should be used instead of a broom. carpets, window curtains, and any hangings that catch dust should be abolished--rugs that can be rolled up and taken out of doors to be shaken and beaten should be used instead; and too many pieces of bric-à-brac and ornaments should be avoided. all surfaces of walls, ceilings, and floors should be made as smooth and hard and free from angles, ledges, and projecting lines as possible. the colds usually caught by members of the family during "spring cleaning" are usually due to the swarms of germs stirred up from their peaceful resting places. let those sleeping germs lie, until you can devise some means of removing them without brushing, or whisking, them straight into your nostrils. chapter xxvii accidents and emergencies ordinarily, accidents are not serious. accidents will happen--even in the best regulated families! while taking all reasonable care to avoid them, it is not best to worry too anxiously about the possibility of accidents; for a nervous, fearful state of mind is almost as likely to give rise to them as is a reckless and indifferent one. fortunately, most accidents, especially with growing boys and girls, are comparatively trifling in their results, and to a considerable extent must simply be reckoned as part of the price that has to be paid for experience, self-control, and skill. to have keen senses, vigorous and elastic muscles, and a clear head, is better protection against accidents than too much caution; it is also the best kind of insurance that can be taken out against their proving serious. the real problem is not so much to avoid accidents as to be ready to meet them promptly, skillfully, and with good judgment when they occur, as they inevitably will. as the old masters of swordsmanship used to teach, "attack is the best defense." luckily, healthy children are as quick as a cat and as tough as sole-leather--if they weren't, the race would have been wiped out centuries ago. children in their play, on errands, going to and from school, and in excursions through the woods and the fields, run, of course, a great many risks. but in spite of all these dangers, the number of children killed, or even seriously injured, in these "natural" accidents, is not half of one per cent of those who die from disease or bad air or poor food or overwork. another cheering thing about accidents is that ninety-nine out of every hundred of them are not serious; and if you are only wise enough to know what to do--and still more what not to do--in taking care of them, you can recover from them safely and quickly. the bodies of healthy children have an astonishing power of repairing themselves. their bones are not so brittle as those of "grown-ups"; and even when one of them is broken, if properly splinted and dressed, it will heal up in a little more than half the time required by the adult. and wounds and scratches and bruises, _if kept perfectly clean_, will heal very rapidly. probably the commonest of all accidents are cuts and scratches. so common is it for us to "bark" our knuckles, or our shins, or scratch ourselves on nails and splinters and drive pins into ourselves, or let our pocket knives slip and cut our fingers, that, if the human skin had not the most wonderful power of repairing itself,--not merely closing up the cut or the scratch, but making the place "as good as new,"--we should be seamed and lined all over our hands, arms, faces, and limbs like a city map, or scarred and pitted like a tattooed man, before we were fifteen years old. but of course, as you know, the vast majority of cuts and scratches and tears heal perfectly. they hurt when they happen; and they burn, or smart, for a few hours, or hurt, if bumped, for a few days afterward; but they heal soon and are forgotten. on the other hand, some cuts and scratches will fester and throb and turn to "matter" (_pus_) and even give you fever and headache and blood poisoning. what makes the difference? it is never the size, or depth, of the scratch or cut itself, but simply _the dirt that gets into it afterward_. if a cut, or scratch, no matter how deep or ragged, be made with a clean knife-blade or sliver and kept clean afterward, it will never "matter" (_suppurate_) or cause blood poisoning. so if you know how to keep dirt out of cuts and scratches, you know how to prevent ninety-nine per cent of all the dangers and damage that may come from this sort of accident. not more than one cut or scratch in a thousand is deep enough to go down to an artery, so as to cause dangerous bleeding, or to injure an important nerve trunk. so, though no one would by any means advise you to be reckless about getting cut and scratched, yet it is better and safer to run some risk of cuts and scratches in healthy play when young, and learn how to keep them clean, than to grow up pale and flabby-muscled and cowardly. how to prevent infection in wounds. it is not just dirt that is dangerous,--although dirt of any sort is a bad thing to get into wounds and should be kept out in every possible way,--but dirt that contains those little vegetable bacteria that we call germs. the dirt most likely to contain these germs--called pus germs, because they cause pus, or "matter" in a wound--is dirt containing decaying animal or vegetable substances (particularly horse manure, which may contain the tetanus, or lock-jaw germ) and the discharges from wounds, or anything that has come near decayed meat or unhealthy gums or noses or teeth. this is why a cut or scratch made by a knife that has been used for cutting meat, or by a dirty finger-nail, or by the claw of a cat, or by the tooth of a rat, is often likely to fester and "run." animals like rats and dogs and cats often feed upon badly decayed meat; and hence their teeth, or claws, are quite likely to be smeared with the germs that cause decay, and these will make trouble if they get into a wound. fortunately, the care of a cut or scratch is very simple and practically the same in all cases. just make the wound thoroughly clean and keep it so until it is healed. for a slight clean cut or scratch, a good cleanser is pure water. hold the hand or foot under the faucet or pump, and let the cool water wash it out thoroughly. if you are sure that the thing you cut it with was clean, let the blood dry on the cut and form a scab over it. if the wound is large, or there is any danger of the water of the well, or tap, having sewage in it (see chapter ix), it is better to boil the water before using it. unless the blood is spurting in jerks from a cut artery, or bleeding very freely indeed, it is better to let the wound bleed, as this helps to wash out any dirt or germs that have got into it. when the bleeding has stopped, do not put on sticking plaster, because this keeps out the air and keeps in the sweat of the skin surrounding the wound, which is not healthful for the wound, and may also contain some weak pus germs. if the wound is small, the old-fashioned clean white rag that has been boiled and washed is as good as anything that can be used for a dressing. tear off a narrow strip from one to two inches wide and as many feet long, according to the position of the wound, roll it round the finger or limb three or four times, and then take a turn round the wrist or nearest joint, to keep the bandage from slipping off. if the wound be likely to keep on oozing blood, put on first a thickness of surgeon's cotton, or prepared cotton-batting, an ounce of which can be purchased for ten cents at any drugstore. this is an excellent dressing, because it not only sucks up, or absorbs any oozing from the wound, but is a perfect filter-protection against germs of all sorts from the outside. ninety-nine simple wounds out of a hundred dressed in this way will heal promptly and safely without danger of pus, or "matter." if the wound happens to have been made with a knife or tool that you are not absolutely sure was perfectly clean, or if the wound gets manure or road-dirt or other filth rubbed into it, then it is best to go at once to a doctor and let him give it a thorough _antiseptic_ dressing, which consists of cleaning it out thoroughly with strong remedies, called antiseptics,--which kill the germs, but do not injure living tissues,--and then putting on a germ-proof dressing as before. this is one of the "stitches in time" which will save not only nine, but ninety-nine. if you have a wound with dirt in it, and cannot reach a doctor, one of the best and safest antiseptics to use is _peroxide of hydrogen_. this is non-poisonous, and can be poured right into the wound. it will smart and foam, but will clean out and kill most of the germs that are there. another safe antiseptic is pure alcohol. it is a good thing to have a bottle of one of these in the medicine-closet, or in your "war-bag" when camping out. a package of surgeon's cotton and two or three rolled bandages of old cotton, linen, or gauze also should be on hand. dog-bites, rat-bites, or cat-bites should always be dressed by a doctor, or made thoroughly antiseptic, mainly on account of the germs that swarm round the roots of the teeth of these animals, and also because treatment of this sort will prevent _hydrophobia_--although this danger is a rare and remote one, not more than a few score of deaths from mad-dog bites occurring in the whole united states in a year. the wonderful progress made by surgery within the last twenty or thirty years has been almost entirely due to two things: first, the discovery of chloroform and ether, which will put patients to sleep, so that they do not feel the pain of even the severest and longest operation; and, second, but even more important, keeping germs of all kinds out of the wound before, during, and after the operation. that sounds simple, but it really takes an immense amount of trouble and pains in the way of baking the dressings; boiling the instruments, and scrubbing with soap, alcohol, hot water, and two or three kinds of antiseptics, or germ-killers, the hands of the surgeon and of the nurse and the body of the patient. how enormous a difference this keeping of the germs out of the wound has made may be gathered from the fact that, while in earlier days, before lister showed us how to avoid this danger, surgeons used to lose seventy-five per cent of their amputations of the thigh, from pus infection, or blood poisoning, now they can perform a hundred operations of this sort and not lose a single case. we can open into the skull and remove tumors from the brain; open into the chest and remove bullets from the lungs, and even from the heart itself; operate in fact upon any part, or any organ, of the body with almost perfect safety and wonderful success. whereas, before, two-thirds of the patients so operated upon would die, probably of blood poisoning. how to treat bruises. bruises are best treated either by holding the injured part under the faucet, or pump, if convenient, or by plunging it into very hot water and holding it there for ten or twelve minutes. then if the bruise still continues to throb or ache, wrap it up lightly with a bandage of soft, loose cotton or linen cloth, and pour over it a lotion of water containing about one-fourth alcohol until the bandage is soaked, moistening it again as fast as it dries. this is also a useful treatment for wounds that have been made by a fall, or by something blunt and heavy, so that there is bruising as well as cutting. most of the household applications for wounds or bruises, such as arnica, camphor, witch-hazel, etc., owe their virtues to the five or ten per cent of alcohol they contain, which, by evaporating, cools the wound and relieves inflammation, kills germs and so acts as an antiseptic, and cleans the wound and the skin around it very thoroughly and effectively. bruises of all sorts, however, unless very severe, are much safer than cuts or scratches, because they do not break the skin, and consequently no germs can get into the tissues of the blood. our skin, as you remember, is one of the most wonderful water-proof, germ-proof, hot-and-cold-proof coatings in the world; and as long as it remains unbroken, none but a few of the most virulent disease-germs can get through it into the body. boils and carbuncles, their cause and their cure. boils and carbuncles are almost the only instances in which pus germs can get into the body without some actual cut, tear, or breaking of the skin. they come always from other boils or ulcers or discharging wounds and are caused by the pus germs in these either being rubbed into the skin until it is almost chafed through, or else being driven down into the mouth of one of the hair follicles, or "pores." here they proceed to grow and form a little gathering, which soon turns to pus; and this stretches the skin and presses upon the sensitive nerves in it so as to cause much pain. the best way to treat them in the beginning is to give a thorough scrubbing with hot water and soap, and then to drop right over the point, or "head," of the gathering two or three drops of a strong antiseptic, like formalin or peroxide or carbolic acid. if this does not check them, then they had better be opened up freely with a sharp knife that has been held in boiling water, or a needle that has been held in a flame until it is red hot and allowed to cool. then pour peroxide into the opening, put on a light dressing, and keep soaked with alcohol and water, as for a bruise. this evaporating dressing is far superior to the dirty, sticky, germ-breeding poultice. if this does not clear it up within twenty-four hours, go to a doctor and have him treat it antiseptically. how to stop bleeding. if a cut should go deep enough to reach an artery the size of a knitting needle, or larger, then the blood will spurt out in jets. there is then some danger of so much blood being lost as to weaken one. our blood, however, has a wonderful power of clotting, or clogging, round the mouth of the cut artery, so that the risk of bleeding to death, except from quite a large artery, like that of the thigh, or the armpit, is not very great. for a wound in the hand or foot, that spurts in this way, it will usually be sufficient to grasp the arm firmly above the wrist or the elbow, or the ankle, as the case may be, with the thumb over the artery, or even to press directly over the wound, until the bleeding stops and the blood is thus given a chance to clot. if the wound is small and deep, like that made by the stab of a knife, or the slip of a chisel, then firm pressure directly over the wound itself with a thumb, or both thumbs, will usually be sufficient to stop the bleeding. [illustration: a tourniquet a stone laid above the cut under the bandage will help to increase the pressure at this point.] should, however, the spurting be from an artery like that of the pulse, or from that at the bend of the elbow or the knee, then the best thing to do is to tie quickly a handkerchief or strip of tough cloth loosely around the limb above the wound and, slipping a short stick or bar into the loop, twist upon it, as shown in the picture, until the blood ceases to flow from the wound. it is much better to use a handkerchief or piece of cloth than a cord, because the latter may cut into and damage the tissues, when drawn as tight as is needed to stop the circulation. it is not best to allow a bandage twisted tight enough to stop the circulation--called a _tourniquet_--to remain tight for more than half an hour at a time, as this may give rise to very dangerous congestion, or serious "blood starvation" of the tissues below it. it should be gently untwisted every half hour until the arm, or limb, below it reddens up again, and then, if the spurting begins, should be tightened as before. there is, however, a good chance that if the cut artery is not too large, the blood will have clotted firmly enough in this time to stop the bleeding; though the tourniquet had better be left on the arm, ready to be tightened at a moment's notice, until the doctor comes. the treatment of burns. burns require more careful treatment on account of the wide surface of the skin usually destroyed. the layer of the skin that is most alive and most active in the process of repair is the outer layer (the epithelial, or epidermis). a burn, or scald, if at all severe, is likely to destroy almost the entire thickness of this, over its whole extent. this gives both a wide surface for the absorption of pus germs and a long delay in "skinning over," or healing. as the same heat that made the burn has usually destroyed any germs that may be present, it is not necessary to wash or clean a burn, like a wound, unless dirt has been rubbed or sprinkled into it after it has been made. the first thing to be done is to coat it over so as to shut out the air; and this, for a slight burn, can be very well done by dusting it over with baking soda or clean flour or with one of the many dusting, or talc, powders on the market, containing boracic acid, or by laying over the burn a clean cloth soaked in perfectly clean olive oil or vaseline. if the oil or vaseline is not perfectly clean, put it on the top of a stove and heat it thoroughly before using. dress with soft, clean cotton rag or lint as before, keeping wet with the alcohol lotion (one part of alcohol to eight of water) if there be much pain, or throbbing. if the burn is deep or the pain at all severe, it is best to call in a doctor, as bad burns are not only agonizingly painful, but also very dangerous on account of the wide, raw surface that they leave open to entrance of pus germs for days and even weeks. until a doctor can be secured, coat it over with some non-irritating powder or oil, as for lighter burns, or hold it in warm water to exclude the air. do not try to clean a burn. you only increase the pain of it and probably add to the risk of infection. if your clothing ever catches fire, wrap yourself up at once in a blanket or rug to smother the flame. remember that running will supply more air to the flame and cause it to do more damage. if you have nothing at hand in which to wrap yourself, lie down on the floor, or ground, and roll over and over until you have smothered the flame. what should be done in the case of broken bones, or fractures. broken bones, or fractures, as they are called, are more serious, but fortunately not very common. they should, of course, always be treated by a doctor, to prevent shortening of the limb, or to prevent the bones from growing together at an angle, or in a bad position, so as to interfere with the use of it. where a doctor cannot readily be had, or the patient has to be taken to him,--as, for instance, where the accident occurs out in the woods,--take two light pieces of board, or two bundles of straight twigs, or two pieces of heavy paper folded fifteen or twenty times--two folded newspapers, for instance--and, wrapping them in cloth or paper, place one on each side of the broken limb, at the same time gently pulling it straight. then take strips of cloth, or bandage, and bind these splints gently, but firmly and snugly, the length of the limb, so that it cannot be bent in such a way as to make the ends of the bone grate against each other. the patient can then be lifted, or carried, with comparative comfort. most fractures, or broken bones, in children or young boys or girls, heal very rapidly; and if the limb be properly straightened and splinted by competent hands, it will be practically as good and as strong as before the accident. sprains. sprains are twists or wrenches, of a joint, not severe enough to "put it out," or dislocate it, or to break a bone. a mild sprain is a very trifling affair, but a severe one is exceedingly painful and very slow in healing. the best home treatment for sprains is to hold the injured joint under a stream of cold water for ten or fifteen minutes and then to bandage it firmly and thoroughly, but gently, with a long "figure-of-eight" bandage, wound many times, and to keep this moist with an alcohol lotion. then keep the limb at rest. if the cold water does not relieve the pain, plunge the joint into water as hot as you can comfortably bear it and keep it there for ten or fifteen minutes, adding fresh hot water to keep up the temperature; then bandage as before. if the pain should not go down under either of these treatments within six or eight, certainly within ten or twelve, hours, it is far wisest to call a doctor, because severe sprains very often mean the tearing of some important tendon or ligament, and the partial fracture of one of the bones of the joint. unless these conditions are promptly corrected, you may be laid up for weeks, and even months, and left with a permanently damaged--that is, stiffened--joint. you will often hear it said that a sprain is harder to heal than a fracture; but that kind of sprain usually includes a fracture of some small portion of a bone, which has escaped notice and proper treatment. if the sprain is mild, so that it does not pain you when at rest, then the bandage should be removed every day, and the joint gently rubbed and massaged, and the bandage replaced again. should there be any one in reach who understands massage, a thorough massaging right after the accident is quite helpful; but no amateur had better attempt it, as unskilled rubbing and stretching are likely to do more harm than good. what to do in case of poisoning. poisoning is, fortunately, a rare accident; and the best thing to be done first is practically the same, no matter what poison--whether arsenic, corrosive sublimate, or carbolic acid--has been swallowed. this is to dilute the poison by filling the stomach with warm water and then to bring about vomiting as quickly as possible. this can usually be done by adding a tablespoonful of mustard to each glass of warm water drunk. if this cannot be had, or does not act within a few minutes, then thrusting the finger as far down the throat as it will go, and moving it about so as to tickle the throat, will usually start gagging; or a long feather may be dipped in oil and used in the same way. it is also a good thing to add milk or white of egg or soap to the water, or to mix a little oil or plaster scraped off the wall with it, as these tend to combine with the poison and prevent its being absorbed. if the poison happens to be an acid, like vitriol, then add a tablespoonful or more of baking soda to the hot water; if an alkali, like lye or ammonia, give half a glass of weak vinegar. the main thing, however, is to set up vomiting as quickly as possible. [illustration: poison ivy it may be distinguished from woodbine by its _leaves in groups of three_ (not five), _glossy_ and _smooth-edged_ (not dull and saw-toothed); its _berries greenish-white_ (not blue).] another rather frequent and most disagreeable accident, which may happen to you when out in the woods, is poisoning by poison ivy. this is due to the leaves or twigs of a plant, which many of you probably know by sight, touching your hands or face. if you do not happen to know what poison ivy looks like, you had better get some one who knows to point out the shrub to you the next time you go into the woods, and then you should try to keep as far away from it as possible. it is sometimes called poison oak, but both these names are incorrect, as the shrub is really a kind of sumac. it takes its different names because it has the curious habit of either climbing like a vine, when it is called "ivy," or growing erect like a bush, or shrub, when it is called "oak." all sorts of absurd stories are told about the leaves of the shrub being so poisonous that it is not safe to go within ten feet of it, when the dew is on it, or to walk past it when the wind is blowing from it toward you. but these are pretty nearly pure superstitions, because it has been found that the substance in the leaves or bark of the shrub which poisons the skin is an oil, which is _non-volatile_, that is to say, will not give off any vapors to the air and, of course, cannot be dissolved in dew or other watery moisture. you must actually touch the leaves in order to be poisoned; but, unfortunately, this is only too easy to do without knowing it when you are scrambling through the woods or hunting for flowers or picking berries. the remedy for poison ivy is a very simple one, and within the reach of anybody, and is as effective as it is simple. this is a thorough scrubbing of the part poisoned, just as soon as it begins to itch, with a nail-brush and soap and hot water. this makes the skin glow for a little while, but it washes out all the burning and irritating oil and, if used promptly, will usually stop the trouble then and there. it is a good idea if you know that you have touched poison ivy, or even if you have been scrambling about actively in woods or patches of brush where you know that the ivy is common, to give your hands a good washing and scrubbing with sand or mud, if there is no soap at hand, in the first stream or pool that you come to. this will usually wash off the oil before it has had time to get through the natural protective coating of the skin. snake-bite is one of the rarest of all accidents and not one-fiftieth as dangerous as usually believed. not more than one person in twenty bitten by a large rattlesnake will die, and only about two in a hundred bitten by small rattlers or by copperheads. the average poisonous snake of north america cannot kill anything larger than a rabbit, and any medium-sized dog can kill a rattlesnake with perfect safety. our horror-stricken dread of snakes is chiefly superstition. of those who die after being bitten by north american snakes, at least half die of acute alcoholic poisoning from the whiskey poured down their throats in pints; and another fourth, from gangrene due to too tight bandaging of the limb to prevent the poison from getting into the circulation, or from pus infections of the wound from cutting it with a dirty knife. alcohol is as great a delusion and fraud in snake-bite as in everything else; instead of being an antidote, it increases the poisoning by its depressing effect on the heart. if you should be bitten, throw a bandage round the limb, above the bite, and tighten as for a cut artery. then make with a clean knife two free cuts, about half or three-quarters of an inch deep, through the puncture, one lengthwise and the other crosswise of the limb, and let it bleed freely. then throw one or, if there be room, two or three other bandages round the limb, three or four inches apart, and tighten gently so as to close the surface veins by the pressure, without shutting off the flow in the arteries. after thirty or forty minutes loosen the first bandage to the same tightness and leave it so unless the heart weakens or faintness is felt, in which case tighten again. if this be done, there isn't one chance in a hundred of any serious result. how to avoid drowning. in case of falling into the water, the chief thing to do is to try to keep calm and to _keep your hands below your chin_. if you do this and keep paddling, you will swim naturally, just as a puppy or a kitten would, even if you have never learned to swim. it is, however, pretty hard to remember this when you go splash! into the water. everyone should learn to swim before he is twelve years old; and then in at least nine times out of ten, he will be safe if he fall overboard. remember that, if you keep your mouth shut and your hands going below your chin, you can keep floating after a fashion, for some time; and in that time the chances are that help will reach you. if you can reach a log or apiece of board or the side of a boat, just cling quietly to that with one hand, and keep paddling with the other. even if you can get hold of only quite a small limb or pole or piece of a box, by holding one hand on that and paddling with the other and kicking your feet, you will be able to keep floating a long time unless the water be ice cold. if you can manage to keep both your feet splashing on top of the water and both hands going, you can swim several hundred yards. [illustration: pressing out the air in the lungs. allowing the lungs to fill themselves. the new method of artificial breathing devised by a celebrated physiologist, professor schaefer of edinburgh, and now being adopted by life-saving stations and crews everywhere.] you may sometime be called upon to save another person from drowning. in such a case, as in every emergency, a cool head is the chief thing. make up your mind just what you are going to do before you do _anything_,--then do it _quickly_! if no one is near enough to hear your shouts for help, and no boat is at hand, if possible throw, or push, to the one in the water a plank or board or something that will float, and he will instinctively grasp it. if you are thrown into the water with a person that can't swim, grasp his collar or hair, and hold him at arm's length, to prevent his dragging you under, until help arrives, or until you can tow him to safety. boys and girls, after they have learned to swim, may well practice rescuing each other, so as to be prepared for such accidents. artificial breathing. the best way to revive a person who has been under water and is apparently drowned, is to turn him right over upon his chest on the ground, or other level surface, turning the face to one side so that the nose and mouth will be clear of the ground. then, kneeling astride of the legs, as shown in the picture, place both hands on the small of the back and throw your weight forward, so as to press out the air in the lungs. count three, then swing backward, lifting the hands, and allow the lungs to fill themselves with air for three seconds, then again plunge forward and force the air out of the lungs and again lift your weight and allow the air to flow in for three seconds. keep up this swinging backward and forward about ten or twelve times a minute. this is the newest and by far the most effective way--in fact the only real way--of keeping up artificial breathing. it is very, very seldom that any one can be revived after he has been under water for more than five minutes,--indeed, after three minutes,--but this method will save all who can possibly be saved. so perfect a substitute for breathing is it that if any one of you will lie down in this position upon his face, and allow some one else to press up and down on the small of his back after this fashion, ten or twelve times a minute, he will find that, without making any effort of his own to breathe, this pumping will draw enough air into his lungs to keep him quite comfortable for half an hour. don't waste any time trying to pour the water out of the lungs. as a matter of fact there is very little there, in drowned people. don't waste any time in undressing, or warming or rubbing the hands or feet to start the circulation. get this pendulum pump going and the air blowing in and out of the lungs, and if there is any chance of saving life this will do it; then you can warm and dry and rub the patient at your leisure after he has begun to breathe. questions and exercises chapters i and ii . look up in a dictionary the words physiology and hygiene. what does each mean? if you can, find the derivation of each. . why should everyone learn about the human body? . how is the "man-motor" like an "auto"? compare the fuel of each. . from what source do all the fuels get their force or energy? . how do plants get their fuel, or food? . what is meant in saying that man takes his food at second, or third, hand? . why do we need a mouth? . does a plant have a mouth? where? . draw a diagram showing how the food is carried into and throughout the body. . describe the parts of the food tube through which it goes. . tell how the body-motor uses bread as a fuel. how is its form changed before it can be used? . what are the salivary glands for? what work is done by their juice? . what other juices help to melt the bread? . which foods need the most chewing? . how is the food carried down the food tube? . what is the appendix? explain how it sometimes causes trouble. . how can you tell the difference between colic and appendicitis? . on which side is the appendix located? . in what parts of the food tube are (_a_) starch, (_b_) meats, (_c_) fat digested? . what causes constipation? how may it be avoided? . is drinking water at meals hurtful? if so, how? chapter iii . if we call the body an engine, what is the fuel? what is the smoke? what are the ashes? . why and how far can we rely upon our natural desires and appetites for food? . how should we choose our foods? . name two serious faults that foods may have. . why do we need a variety of foods? . what is meant by the term "fuel value of food"? . how can we roughly tell to which class a food belongs or what its fuel value is? . why should animal and vegetable foods be used together? chapter iv . name and describe our most common meats. . when is pork a valuable food? . why do we digest it slowly? . why should we eat fish only once or twice a week? . what food-stuffs are found in milk? . name some vegetables which contain protein food. . in planning a week's diet, how often would you use these vegetables, and why? . what is our greatest danger in eating meat? . why is it dangerous to eat highly seasoned stews or hashes? . should cheese be eaten in large amounts at a time? why? . describe the care taken at a good dairy. . why is this necessary? . why is dirty milk less nourishing than clean milk? chapter v . explain the name "starch-sugars." to which class of fuel-food might we say that they belong? . why are they cheaper than meat? . why must these foods be ground and cooked? . which is the better food, white or brown bread? why? . could we live on starch-foods alone? what is the reason of this? . in what foods do we find nitrogen? in what, carbon? . what is a "complete food"? name some. . why must the starchy foods be changed in the body into sugar, or glucose? . name three ways by which bread is made "light." . what is yeast? . how is bread made? . why should it be thoroughly baked? . what causes bread to become sour? . name other important starchy foods. . is sugar a valuable food? why? . in what plants do we find it? chapter vi . why are fats slow of digestion? . if they are so valuable as "coal foods," why do we not eat more of them at a meal? . give some reasons for carrying fats as food supply on long voyages and expeditions. . in what forms are they best carried? . what makes up the emergency field-ration of the german army, and why? . what is the most valuable single fat, and why? . name other fats in common use and describe their effects on digestion. . state the food values of bacon. . why should nuts be eaten in moderate quantity only? . how do nuts compare in cost (_a_) with other proteins? (_b_) with other fats? . what is the peanut? . why is it hard to digest? . what digestive juices "melt" fats? . what is oleomargarine and how does it compare with butter? chapter vii . what is the necessity of fruits and vegetables in our dietary? why especially in summer? . give some idea of the food value of fruits as compared with bread and meat. . name the most wholesome and useful fruits. . what is the food value of bananas? why is it very important that they be eaten in moderation only? . what does (_a_) boiling and (_b_) drying do to fruits? . why seal the jars of preserved fruits? . why can you not eat as much jam, at one time, as raw fruit? . what disease is caused by scarcity of fresh vegetables or fruits? . name some of the common vegetables and give their fuel values. . why do we need with our meals the lighter green vegetables, although they have little nutritive value? . what vegetables contain starch, what sugar, and what digestible protein? . in what form is most of the nitrogen of vegetables? chapter viii . what changes occur in food when it is cooked? describe some of the changes. . what are the advantages of cooking meats and vegetables? . why is it necessary that food should taste good? . what has cooking to do with the cost of food? . why is time well spent in cooking food? . describe the different methods of cooking food and tell advantages of each. . in what ways can you help make the table attractive and preserve health? . in what ways may food be made less digestible and wholesome by cooking? . in what way can fried food be made digestible? . what is the supposed economy of boiling? . write out a good menu for each meal of the day. chapter ix . why is water necessary in the body? . how does the body take in water other than by drinking it? . why is this water sure to be pure? . why is drinking water likely to be impure? . where and when is water perfectly pure? . what are our chief sources of water-supply? . what is a well? a spring? a reservoir? . which source of water-supply is safest? . what are the dangers of well water? . how can they be avoided? . what are the dangers of river water? . what is a filter and how does it work? . what makes water rise in a spring or an artesian well? . how may water suspected of being unhealthful be made safe to drink? . how is sewage disposed of? . how can it be kept out of the drinking water? . why does it pay cities to spend large sums to secure pure water? . how can a reservoir be protected? . what are the risks of house filters? . how do bacteria help us in keeping our water-supply pure? . does your city or town have a central source of water-supply? where is it? . visit the waterworks of your city or town and describe to the class how the water is obtained, how prepared for use, and how distributed to buildings. chapter x . how can you prove that beverages are not real foods? . what is tea? what is coffee? what are chocolate and cocoa? . why are tea and coffee, if stewed, bad for the digestion? . why is it better for you to let these drinks alone? . how is alcohol made? . how is wine made? beer? cider? whiskey? . when does fermentation stop, and for what reason? . what is the difference between whiskey and brandy? why are these the most harmful of these drinks? . explain the effect of alcohol on the digestion. . does it increase the warmth of the body? . does it increase our working power? . how is it that at first people thought that alcohol was helpful, when really it was not? . what is the effect of alcohol on the nervous system? . can the man who drinks alcohol tell how, or to what extent, it is injuring him? . is alcohol a food or a medicine? . how does alcohol usually affect the mind and character? . why is smoking a foolish habit? . why is it harmful for boys? . what is nicotine? . what proof have we that smoking stunts growth? . how is it likely to hinder a boy's career? chapter xi . where does the real "eating" take place in the body? . how is the food carried to these parts? . what does the name "artery" mean? . what are veins? . if you examine blood under a microscope, what will you find in it? . what are the uses of these two kinds of little bodies (corpuscles)? . explain the process of inflammation. . draw a diagram or rough picture showing the route of the blood through the heart and body. mark the vena cava and the portal vein. . what are the capillaries, and what does the name mean? . why do the veins have valves? . explain how the different parts of the heart act, while they are pumping and receiving the blood. . how many strokes of the heart-pump are there per minute in a man? a woman? a child? . which part of the heart has the thickest muscle and why? . where are the strongest valves? . what blood vessels carry the blood to and from the lungs? . what blood vessel carries the blood from the heart over the body? . when you press your hand to the left side of your chest, what movement do you feel? . where is the best place to feel the pulse? why? . which are generally nearer the surface, arteries or veins? are they near each other? . why does the heart beat faster when you run? chapter xii . why is it bad for you to study or exercise while you are eating, or right after eating? . how does overwork, or over-training, affect the heart? . what kind of play or exercise strengthens it? . how does good food help it? . what is the best way to avoid heart diseases, rheumatism, consumption, and pneumonia? . how does outdoor air help heart-action? . how do alcohol and tobacco injure the blood system and heart? . why is alcohol particularly bad for underfed and overworked people? . at what two points is the blood system most likely to give way? . what may cause this breakage, or leakage? . what "catching" diseases often cause organic disease of the heart? . why should heavy muscular work or strain be avoided after an attack of one of these diseases? . how may valvular heart trouble be remedied? . in what way are the nerve and blood systems connected? . what signal have we that we are beginning to over-exercise the heart? . what do we mean by "tobacco heart"? . tell how to take care of the heart. chapter xiii . how long can an animal live without eating? . how long can an animal live without breathing? . why is your body like a sponge? . what are cells? . how do they get their food? . how many kinds of waste come from the body cells? . how is each kind carried away from the body? . what does the blood carry from the lungs to the body cells? . why does it not carry air? . what process keeps your body warm? . what happens if the body cannot get oxygen? . how are the human lungs formed? . what is the windpipe? what are the bronchi? . draw a picture of the lung-tree showing how the tubes branch. . what is at the end of each tiny branch? . how do the windpipe and the esophagus differ in form? . why is the windpipe stiff? . in what four ways is the air you breathe out different from that which you took in? . why does lime-water become milky when you breathe into it? . when you run, why do you breathe more quickly? why does your heart beat faster? . how can you improve your "wind"? . in fever, why do you breathe more rapidly? . how do the ribs and muscles help in breathing? chapter xiv . why is "caged air" dangerous? . how is outdoor air kept clean and pure? . what is air made of? . in what ways do people poison the air? . how do plants help to clean the air? . what is the best way to ventilate a room? why? . why do you have recess? . how does impure air make children look and feel? . why is an open fire not the best means of heating and ventilating? . see if the room you are now in is properly ventilated. why, or why not? . what are disease germs? . why is dusty air unwholesome? . what is the safest way to clean a room? . name three groups of disease germs that float in the air. . name three ways in which you can protect yourself against these germs. . what is a cold? . what is the best way to cure a cold? . how can you prevent colds? . what causes consumption (tuberculosis of the lungs)? . does the tubercle bacillus attack other parts of the body? . why should a consumptive hold a cloth before his face when coughing? . why should his sputum be burned? . why should he go to a camp or sanatorium? give two reasons. . about how much money could this country afford to spend in fighting consumption? why? . why need we no longer dread it as people did twenty-five years ago? . what methods are used in curing the disease? . what methods are used for preventing it? . give two reasons why spitting should be prohibited. . what will fresh-air and sunlight do to the disease germs in the dust? . what do we know about the germs of pneumonia? . do those who use alcohol stand a good chance in fighting pneumonia? . how may pneumonia be prevented? chapter xv . why is the skin so important? . name some of the things that it does. . how many layers has it? describe each. . what glands are found in the skin? . what is sweat, or perspiration, and from what does it come? . why should clothing be porous? . why should clothing be frequently washed? . describe a hair gland and its muscles. . describe the process of "nail-making." . is there any process like this among the lower animals? . why do we need nails? . what causes the white crescent on the nail? . explain how the skin is a heat regulator. . what is the "normal temperature" of the body? . how does perspiring affect the heat of the body? . what are the "nerve buds" or "bulbs"? . name four things that they do. chapter xvi . what are the uses of the skin to the rest of the body? . in what two ways does the skin clean itself? . what should we specially avoid in washing or scrubbing the skin? . what are the characteristics of a good soap? . what are the dangers of a poor soap? . what are the advantages of cold water in bathing? . how often should hot baths be taken and why? . on what parts of the body should soap be most freely used? . what is the best way of keeping the hair and scalp healthy? . why is this important? . why should hair tonics be let alone? . what causes dandruff? . how should the nails be trimmed and cleaned? . what should be done to the nail-fold? . why is dirt under the nails sodangerous? . what qualities should a good garment possess as to shape, fit, and texture? . what are the advantages and disadvantages of wool? . what are the advantages and disadvantages of cotton? . why are furs unwholesome? . what is the best possible material for an undergarment? . what are some of the causes of diseases of the skin? . what is the cause of sunburn and freckles? . what makes a good complexion? . what is a corn? what causes it? chapter xvii . name four processes that take place in the living body. . what two kinds of waste do these processes cause? . what is the name of the "body smoke"? . how is the body smoke carried away? . what do the terms "soluble" and "insoluble" waste mean? . how does the insoluble waste leave the body? . by what path does the soluble waste leave the body? . how many times in an hour is all the blood in the body pumped through the liver, kidneys, and skin? , why is this done? . why is the blood from the food tube sent to the liver directly, instead of by way of the heart? . why is the liver such a large organ? . what does the liver do to the blood? . what is the bile duct? . what is the bile? . what is the gall bladder? . what do the terms "bilious" and "jaundiced" mean? . what effect does alcohol have upon the liver? chapter xviii . what is muscle? how much of your body weight is made up of the muscles? . what two kinds of muscles are there? . how do muscles change in shape? . what do we mean by voluntary and involuntary muscles, and how do they differ in form and location? . describe the way in which the body muscles are arranged. what kind of actions do they perform? . what exercise is good for the muscles over the abdomen? for the muscles of the back? . what muscles are we using when we "bat" or "serve" in ball and tennis? . how do the muscles of the limbs act for you? . where are the biceps and triceps muscles? explain their use. . what are tendons? what is their use (function)? . how is your arm fastened to your body? . describe the arrangement of the muscles in the lower limb. why are they larger than the arm-muscles? . how does exercising the muscles give you an appetite? what else does it do? . why do you naturally love to play? . why is muscular exercise in the open air important in education? chapter xix . what are the bones? . make a rough sketch of the human skeleton. . in what sense are the bones the tools of the muscles? . how are the bones of the skull arranged? . give two functions (uses) of the spinal column (back bone). . what bones and tendons do you use when you stand on tip-toe? . how are the limbs fastened to the body and back bone? . why is the collar-bone more likely to be broken than some of the other bones? . how are the joints formed? . what is cartilage? . how does it help in making the two kinds of joints we find in the body? . is there any arrangement for oiling the joints? if so, what is it? . when you soak a bone in weak acid, what happens? what does this prove? . what causes disease or deformity of the bones? chapter xx . why do we need a system of nerves? . what do we mean by motor nerves? by sensory nerves? . how is the central system like a telephone office? . what does the word ganglion mean to you? . what are the ganglions (ganglia) for? . is the brain a ganglion? . give a rough idea of the structure of the brain, and name its parts or divisions. . what does each one of these divisions do? . what is the result of injury to any one of these parts? give an instance. . where do we find the gray matter in the nervous system? . what is the white matter and what does it do? . when the thumb is paralyzed, what do we know about the brain? . where in the body do we really smell, hear, and see? . what do we know about the speech centre? . draw a picture of the spinal cord and its branches. . of what use are the ganglia (gray matter) in the spinal cord? give an example. . why is it that some children can't help wriggling when tickled? . why is the medulla such an important part of the nervous system? . when you touch a hot lamp chimney, what happens in your nervous system? . suppose you had seen some tempting fruit, what would have happened in your nervous system and in your digestive system? . what does the brain do with the messages from the eyes, ears, and nose? . how does the message-and-answer system protect the body? . how does it help us to gain knowledge? . why is it that when two people look at the same thing at the same time they may have very different ideas of what it is? chapter xxi . describe the arches of the feet and tell what they are for. . describe the kind of shoe you ought to wear. . do you grow while asleep? . how much sleep do you need? . are there many diseases of the muscles and bones? . how does nature repair a broken bone? . what causes most of the diseases of bones? . what is a slouching gait due to? . what is the cause of headache? . how should headache be regarded and treated? . what are the dangers of taking patent or unknown medicines? . what do most patent medicines contain? . are the nerves resistant to disease, or specially subject to its attack? . what causes many of the diseases of the nerves? . name some poisons that injure the nerves. . how may diphtheria affect the nerves? . what does alcohol do to the nervous system? . does our modern method of life tend to cause or to cure nervous diseases and insanity? why? chapter xxii . how much of the body will muscular exercise develop? . why should exercise and play be in the open air? . what is fatigue and what does it mean? . name some games that are good exercise for the body and tell why they are so. . why do marching and singing and drawing alternating with your other lessons, help you to grow? . is playing a waste of time? why? . how much exercise a day does a grown man or woman need? . how should this exercise be taken? . what senses and powers does base-ball develop? . in what respects is your progress in school work like your progress in learning to play games well? . what are good games for girls? . why have we less sickness in summer than in winter? . why is gardening a valuable occupation? . when should we do our hardest studying? . what is the best and most successful way to study? . how can you make school work as enjoyable as play? . what are your duties to-day? plan the best way to do them so that you can also take exercise and rest and time for meals. write this plan in the form of a day's programme. chapter xxiii . what is the "lookout department" of the body, and how is the work of this department distributed among the members? . describe the inside structure of the nose. . in what sense is the nose like a radiator? . what are the cilia for? . how does the nose dispose of dust and lint? . what causes catarrh and colds? . where is the sense of smell located? . when you have a cold, why do you often lose your sense of smell? of taste? . how do you tell the difference in flavor between an apple and an onion? . what does the tongue do? . what are the only tastes perceived in the mouth? . what does a coated tongue mean? . is the sense of taste a safe guide in choosing foods? why? . what are adenoids? what trouble do they cause? how can they be cured? . how does the eye help to choose food? . name and describe the parts of the face around the eye. . of what use is each? . how does the tear gland act? . what is the retina? the pupil? the iris? what is each for? . what do we mean by bringing the rays of light to a focus? how can you illustrate this by a burning glass? . when do eyes need glasses? . how can the eye change the form of its lens for near and for far sight? what is this action called? . why do children born deaf become dumb? . where do we find the key-board of hearing? why do we call it the cochlea? . draw a picture showing the position of the drum, "hammer," "anvil," "stirrup," and cochlea. . what has happened in your inner ear when something in your ear goes "pop"? . why does a cold sometimes make you deaf? . why do we have wax in the outer ear? what is the german proverb about cleaning the ear? . what is our "sixth sense"? where do we find its organ located? what is it like? chapter xxiv . how is the voice a waste product? . what are the conditions required to make a good voice? . are great singers usually strong? why? . how was the windpipe made into the voice box? . describe the vocal bands or cords. . how do they act in making voice sounds? when we breathe? . how do catarrh and adenoids affect the voice? . how is the voice box like a violin? . what part of the violin has most to do with the quality of the sound? how does this apply to the human voice? . what do the throat, the mouth, and the nose have to do with voice training? . what is one of the commonest causes of a poor voice? . how can you prove this? . what are spoken words? . how is a good, clear, distinct voice of value? . how can you build up a strong, clear, useful voice? chapter xxv . give four reasons why the teeth are important. . to take proper care of the teeth, what other parts of the mouth need attention? . draw a picture of a tooth and label the crown, the enamel, the root, the pulp. . name the different teeth, making diagrams of the upper and lower jaws and tell how each kind of tooth is used. . compare your own teeth with those of a dog, a sheep, and a squirrel and explain the difference in use. . in what order did your teeth appear in your mouth? . what are the milk-teeth? . how many teeth have you? have any been pulled? . will you have any more later? . name three things to be remembered in exercising the teeth. . what is the best method to keep the teeth and gums clean? . why are "gritty" tooth-powders bad for the teeth? . are antiseptics good for them? . why are dirty teeth a very common cause of disease in the body? . (exercise) write a letter to your teacher telling how you have been taking care of your teeth in the past, and how you purpose to do it in the future. chapter xxvi . how may "catching" diseases be prevented? . what are disease germs, and how are they named? . how do disease germs grow? . why should patients with the "diseases of childhood" be placed in quarantine. . what causes a cold? how should you take care of one? why keep away from other people? . when and how did we find that diphtheria was due to germs? . explain how "antitoxin" prevents it. . how much has the death rate in diphtheria been lowered? . name the diseases for which we now have vaccines and antitoxins. how do we grow them? . tell the story about dr. jenner and the milkmaids. . what good has his discovery done? . explain why vaccination will cure as well as prevent smallpox. . what is quinine, and where does it get its name? . who discovered the germ of malaria? is it a plant or an animal? . what do we know about the connection between mosquitoes and malaria? . what is a quick way of killing the mosquito? . how does draining fields prevent malaria? why is malaria not so common now as in pioneer days? . why do we need disinfectants? name some, and describe how they are used. . what is the best one in most cases? why? in what ways may it be used? . how do the bacteria of the soil "feed" the green plants? . explain why a crop of clover will enrich the soil. what other plants also do the same thing? . name some other harmless bacteria. . why ought one to wash the hands before eating? . is it possible to kill all house flies? why ought we to try to? how can it be done? . what do we find in dust? . what good does it do to sprinkle streets? . what is the best way to clean house? chapter xxvii . what is the best insurance against accidents? . why do most cuts and scratches heal quickly, while some others do not? . what kind of dirt is dangerous to wounds? . if your knife should slip and cut you, how ought you to take care of the cut? . if you know the knife is dirty, what is the proper treatment? . is "sticking-plaster" good for a wound? why not? . why does absorbent cotton make a good dressing? . give two reasons why doctors can perform surgical operations now much more safely than some years ago. . why must surgeons and nurses keep themselves and their patients perfectly clean? . what difference has this cleanliness made in the saving of life? . what is the treatment for bruises? why are they not so dangerous as cuts? . what are boils and carbuncles? . how do we clean and heal them? . where blood comes in spurts from a cut, what does this mean? . how does the blood itself protect us against infection in wounds? . if the wound is very deep, how can you check the bleeding? . why should the tight bandage be slightly loosened in half an hour after it has been applied? . why is it that we do not need to clean a burn? . why is it wise to keep the air from a burn? how may it be done? . why must the dressings be perfectly clean? . why do we need a doctor in the case of a broken bone? . if you can't get a doctor, what is to be done? . what is a sprain? tell how to bathe and bandage it. . in the case of swallowing poison, why should one drink warm water? . what else should be done? . what should be given when lye has been swallowed? . what is the important thing to remember in any such case? . if you fall into deep water, what four things should you remember? . explain carefully just how to revive a person who has been under water. . what is the main purpose of this method? glossary of important terms used in the book [transcriber's note: in the following section vowels are transcribed as: [)vowel] with breve [=vowel] with macron [.vowel] with dot above] i. relating to the body as a whole ab'do men (or [)a]b d[=o]'m[)e]n). the cavity of the trunk immediately below the diaphragm. car'ti lage. tough, elastic tissue, generally more or less fibrous; called also gristle (gr[)i]s'l). cell. the simplest form of living matter, with power to grow, develop, reproduce itself, and, with others of its kind, build up a living fabric. di'a phragm (d[=i]'[.a] fr[)a]m). the muscular membrane that separates the thorax from the abdomen. duct. a tube through which fluid from a gland is conveyed. fa tigue' (f[.a] t[=e]g'). a condition in which the body cells are worn out faster than they are built up, so that waste matter accumulates in the body and poisons it. germ. the simplest form of life, from which a living organism develops. gland. a part, or organ, that has the power of making a secretion, peculiar to itself. a gland may be a simple pocket, or follicle, as is an oil gland of the skin, or it may be an aggregate of such glands, as is the liver. or'gan. any part, or member, that has some specific function, or duty, by which some one of the body's activities is carried on; for example, the eye is the organ of vision, the liver is one of the organs of digestion. tho'rax. the cavity of the trunk immediately above the diaphragm. tis'sue (t[)i]sh'[=u]). a fabric, or texture, composed of cells and cell-products of one kind; as, for example, nervous tissue, muscular tissue, fatty tissue. se cre'tion. a substance made from the blood, the special character of which depends upon the kind of gland that makes, or secretes, it. ii. relating to the digestive system al i men'ta ry ca nal'. the food tube, or digestive tube, extending from lips and nose to the end of the rectum, with its various branches and attachments. bile. a yellow, bitter, alkaline liquid secreted by the liver, and especially valuable in the digestion of fats; sometimes called gall. co'lon. the large intestine. di ges'tion. the process in the body by which food is changed to the form in which it can pass from the alimentary canal to the blood vessels and lymphatics. di ges'tive sys'tem. the alimentary canal with all its branches and appendages; that is, all the organs that directly take part in the process of digestion. e soph'a gus. the tube through which food and drink pass from the pharynx to the stomach; called also the gul'let. gall blad'der. the bile bladder; the sac, or reservoir, lying on the under side of the liver, in which the bile is received from the liver, and in which it is retained until discharged through the gall duct into the small intestine. gas'tric juice. the digestive liquid secreted by the glands of the stomach (pep'tic glands); it contains pepsin, acid, and ferments; called also peptic juice. in tes'tine. the last part of the alimentary canal, extending from the pylorus. its length is five or six times that of the body. the greater part of its length is called the small intestine in distinction from the remaining part, which, though much shorter, is larger in diameter, and is called the large intestine or co'lon. the intestine as a whole is sometimes called the bow'el. liv'er. the large gland that secretes bile and is active in changing or killing harmful substances; located in the upper part of the abdominal cavity, on the right side, and folds over on the pyloric end of the stomach. lym phat'ics. small transparent tubes running through the various tissues, and containing a colorless fluid somewhat thinner than blood, called lymph. this fluid is composed of the leakage from the arteries and of wastes from the tissues, which are being carried to a larger lymph duct to be emptied into one of the larger veins. the lymphatics in the wall of the intestine take up some of the digested food from the cells and pass it on through the lymph glands of the abdomen to the lymph duct which empties into a vein near the heart. mas ti ca'tion. the process of grinding, or chewing, food in the mouth. mes'en ter y. the tissue (part of the peritoneum) which is attached to the intestine and, for a few inches, to the spinal column, to hold the coils of the intestine in place. mu'cous mem'brane. the lining membrane, or tissue, of the entire alimentary canal. it is very complex in structure, has different characteristics in different areas, and contains nerves, blood vessels, lymphatics, and in various parts special structures such as glands. it secretes mucous. it is continuous with the outside skin of the body, as may be seen at the lips. pan'cre as. the gland that secretes the pancreatic juice; located in the abdominal cavity near the stomach. pan cre at'ic juice. an alkaline digestive juice poured by the pancreas into the small intestine; especially valuable in the digestion of starches, fats, and proteins. per i to ne'um. the membrane lining the abdominal cavity and enfolding its organs. phar'ynx. the passage between the nasal passages and the esophagus: the throat. py lor'us. ( ) the opening from the stomach into the small intestine. ( ) the fold of mucous membrane, containing muscle fibres, that helps to regulate the passage of food through the pyloric opening. sa li'va. the digestive secretion in the mouth, consisting of the secretion of the salivary glands and the secretion of the mucous membrane of the mouth. stom'ach. the pouch-like enlargement of the alimentary canal, lying in the upper part of the abdominal cavity, and slightly to the left, between the esophagus and the small intestine. iii. relating to food and drink ac'id ([)a]s'[)i]d). a substance (usually sour tasting) that has, among other properties, the power of combining with an alkali in such a way that both substances lose their peculiar characteristics and form a salt. al'co hol. a colorless liquid formed by the fermentation of starch-sugars or certain other substances, which is highly inflammable and burns without smoke or waste; it is a stimulant and an antiseptic. al'ka li. a substance that has, among other properties, the power of neutralizing acids and forming salts with them. (see acid.) car'bo hy'drates. plant or animal substances composed of carbon, hydrogen, and oxygen. (called also starch-sugars.) chlo'ro phyll. the green coloring matter of plants, formed by the action of sunlight on the plant cells. it is a necessary part of the plant's digestive system, since without it the plant could not break up the carbon dioxid of the air into the carbon which it uses in preparing its starch food, and the oxygen which it gives off as waste. fer men ta'tion. a chemical change in plant or animal substance, produced usually by the action of bacteria, in the process of which the substance is broken up (decomposed), and new substances are formed. nar cot'ic. any substance that blunts the senses, or the body's sensibility to pain or discomfort. ni'tro gen. a tasteless, odorless, colorless gas, forming nearly four-fifths of the earth's atmosphere; and constituting a necessary part of every plant and animal tissue. pro'te ins. foods containing a large amount of nitrogen; such as meat, fish, milk, egg, peas, beans. iv. relating to the blood and the circulatory system a or'ta. the main artery of the body; it leads out from the left ventricle of the heart, carrying arterialized blood (blood that has been acted upon by oxygen) to all parts of the body except the lungs. ar'te ries. the blood vessels and their branches that carry blood from the heart to all parts of the body. the pul'mon a ry artery carries impure (ve'nous) blood to the lungs. au'ri cles (ô'r[)i] klz). the two chambers of the heart that receive blood from the veins. cap'il la ries. the minute blood vessels which form a network between the ends of the arteries and the beginnings of the veins. cir cu la'tion. the passage of the blood from the heart into the arteries, and from them through the capillaries into the veins, and through the veins back into the heart. cor'pus cles (cor'p[)u]s'lz). minute jelly-like disks or cells. these are of two kinds, red and white, the red (the oxygen carriers) being about times as many as the white, and giving the blood its color. heart. a muscle-sac located in the thorax between the lungs, its lower point, or a'pex, being tilted somewhat to the left; the centre and force-pump of the circulatory system. ox i da'tion. combining with oxygen. ox'y gen. a colorless, odorless, tasteless gas, which forms about one-fifth of the earth's atmosphere. it is found in all animal and vegetable tissues. when it combines with other substances, a certain amount of heat is produced; and if the process is sufficiently rapid, a flame is seen. pulse. the regularly recurring enlargement of an artery, caused by the increased blood flow following each contraction of the ventricle of the heart. veins. the blood vessels and their branches through which blood flows from all parts of the body back to the heart. all the veins except the pulmonary veins carry impure (venous) blood; the pulmonary veins carry arterialized (oxidated) blood from the lungs. ve'na ca'va. either of the two large veins discharging into the right auricle of the heart. por'tal vein. the large, short vein that drains the liver and adjacent parts. ven'tri cles. the two chambers of the heart that receive blood from the auricles and force it into the arteries. v. relating to the respiratory system and organs of excretion al ve'o li ([)a]l v[=e]'o l[=i]). (plural of _alveolus_). air cells. the cells, or cavities, that line the air passages and air sacs at the ends of the bronchial tubes. breath. air taken in or sent out in respiration; that breathed out containing carbon dioxid, watery vapor, and various impurities. bron'chi (br[)o]n'k[=i]). (plural of _bronchus_). the two main branches of the trachea. these branch into numerous smaller branches, called the bron'chi al tubes. car'bon di ox'id. a gas formed of carbon and oxygen; colorless and odorless; has a somewhat acid taste, and is used for aerating soda water and other beverages; is present naturally in mineral and spring waters. it is present largely in the fissures of the earth and makes the choke-damp of mines. called also car bon'ic acid. ep i glot'tis. the valve-like cover that prevents food and drink from entering the larynx. ex cre'tion. a waste substance thrown out, or rejected, from the system; for example, carbon dioxid, sweat, ur'ine, the fe'ces. lar'ynx. the enlargement of the windpipe, near its upper end, across which are stretched the vocal cords. lungs. two spongy organs in the thorax, entered by the bronchi with their bronchial tubes; they contain in the walls of their air cells the capillaries through which the blood passes from the branches of the pulmonary artery to the branches of the pulmonary veins. rec'tum. the lowest and last section of the alimentary canal, being the discharge pipe of the large intestine, and excreting the solid wastes in the form of the feces. res pi ra'tion. breathing; the action of the body by which carbon dioxid is given off from the blood and a corresponding amount of oxygen is absorbed into the blood. skin. the continuous outer covering of the body, in the deeper layer (der'ma) of which are located the sweat glands, which secrete sweat (a watery, oily substance containing impurities from the blood) and excrete it through the sweat ducts and their openings (pores) in the surface of the skin. tra'che a (or tr[=a] ch[=e]' [.a]). the windpipe between the larynx and the bronchi. u'ri na ry system. the organs concerned in the secretion and discharge of urine: the kid'neys (two glands in the abdominal cavity, back of the peritoneum, which receive wastes from the blood, and excrete them as urine), the u re'ters (ducts through which the urine flows from the kidneys to the bladder), the blad'der (an elastic muscle-sac in which the urine is retained until discharged from the body). vi. relating to the nervous and motor systems brain. the soft mass of nerve tissue filling the upper cavity of the skull. its cellular tissue is gray, and its fibrous tissue white. with the spinal cord it controls all the sensory and motor activities of the body. cer e bel'lum. the part of the brain lying below the hind part of the cerebrum. cer'e brum. the upper or fore part of the brain; it is divided by a deep fissure into two hemispheres, its cor'tex (surface) lies in many con vo lu'tions (folds), and its fibres run down into the spinal cord. in this part of the brain are the centres, or controlling nerve cells, of the senses and most of our conscious activities. gang'li a (g[)a]ng'l[)i] [.a]). (plural of _ganglion_). nerve knots, or groupings of nerve cells, forming an enlargement in the course of a nerve. me dul'la. a portion of the brain forming an enlargement at the top of the spinal cord and being continuous with it; the channel between the brain and the other parts of the nervous system. muscle (mus'l). a kind of animal tissue that consists of fibres that have the power of contracting when properly stimulated. a bundle of muscle fibres, called a muscle, is usually attached to the part to be moved by a ten'don, or sinew. muscles causing bones to bend are termed flex'ors; those causing them to straighten, ex ten'sors. the movements of muscles may be voluntary (controlled by the will), or involuntary (made without conscious exercise of the will). nerve. a fibre of nerve tissue, or a bundle of such fibres, connecting nerve ganglia with each other or with some terminal nerve organ. nerves running inward toward the spinal cord and the brain are called sen'so ry nerves; those from the brain and spinal cord outward, mo'tor nerves. nerv'ous system. the nerve centres with the sensory and motor nerves and the organs of sense. neu'rons. the cells of the spinal cord and the brain. re'flex. a simple action of the nervous system, in which a stimulus is carried along sensory nerves to a nerve centre, and from which an answering stimulus is sent along motor nerves to call into play the activity of some organ, without consciousness, or without direct effort of the will. spi'nal cord. the soft nerve tissue that extends from the medulla almost to the end of the spinal column, being encased by it. it controls most of the reflex actions of the body. stim'u lus. anything that starts an activity in the tissues on which it acts; for example, light is a stimulus to the nerve tissues of the eye. index abdomen, . accommodation, . acetanilid, _note_. acid, as an antidote, ; butyric, ; carbonic, ; explained, ; in changing starch, ; in leavening, , ; in fruits, , , ; in starch-sugars, ; in digestive juices, _note_; in mouth, , ; lactic, . "adam's apple," . adenoids, , , , . ague. _see_ malaria. air, circulation of free, , ; composition of, ; indoor currents of, - ; per person, ; pure and impure, - . alcohol, a medicine, , ; an antiseptic, , , ; a narcotic, , , ; a toxin, ; decreasing use of, - ; effect of, on character, ; in beverages, , ; in patent medicines, ; not a food, , ; physical effects of, - , - , , , , , ; source of, , . aldehydes, . ale, . alimentary canal, , ; digestion in, - . _see also_ gullet, intestine. alkali, as an antidote, ; as medicine, , ; explained, ; digestive juices, _note_; in leavening, , ; in meat, ; in soap, . alveoli, . ameba, white corpuscles compared to, , . amherst, experiments with smokers at, . ammonia from decay, , . animals and plants contrasted, - . anopheles, . antidotes. _see_ poisoning. antipyrin, _note_. antiseptics, use of, - . antitoxins, - . anvil, . aorta, , , , , , . apex of heart, . apoplexy, . appendicitis, . appendix vermiformis, . appetite, from exercise, ; juice, . appetites, explained, . apples, fermented, ; food value of, ; fuel value of, . aqueduct, . arrack, . arteries, bleeding from, - ; defined, , ; function of, ; position of, ; red blood in, ; stiffening of, ; _also_, , , . artery, pulmonary, ; radial, . articulation, of bones, ; of sounds, . artois, wells of, . astigmatism, . athletics, , , . atropin, _note_. auricle, , , . bacilli, cultivation of, ; explained, - , ; method of naming, ; multiplication of, . _see also_ bacteria _and_ germs. backache, . backbone. _see_ spinal column. bacon, fuel value of, , , . bacteria, explained, ; harmless, ; in feces, ; in food, ; in milk, - ; in small intestine, ; of disease, , ; of soil, , , , , , , ; of yeast, . _see also_ bacilli _and_ germs. bakeries, , . baking-powders, , . banana, , . barley, in making beer and ale, . bathing, need of, ; preventive of colds, ; right and wrong, - . beans, . beef-tea, , . beer, . _see also_ alcohol. beets, , . berries, , . beverages, - . _see also_ alcohol. biceps, , . bile, _note_, , , , ; duct, , . biliousness, , . "black bread," . "black death," . bladder, . _see also_ gall bladder. bleeding. _see_ wounds. blood, alkaline quality of, _note_; anemic, , ; arterial, ; circulation of, - , , ; color of, , , , , ; composition of, , ; heat, ; impure, ; poisoning, , , ; purifying of, ; result of food, . blood vessels, , . _see also_ arteries, capillaries, veins. board of health, and infections, , ; control of water supply, , , ; examination, ; milk inspection, , , , . boils, , . bolus, . bones, composition and growth of; , ; disorders of, , , , ; fractures of, ; kinds of, - ; number of, ; structure of, ; tuberculosis of, . bowel. _see_ intestine. brain, - ; development of, . brandy, , . bread, baking, , ; crust of, ; fuel value of, ; kinds and values of, , , ; leavening, - ; souring of, , . breakfast foods, . breathing, control of, ; need of continuous, ; operation of, ; rate of, ; variations in, , . bright's disease, . bronchi, . bronchial tubes, . bruises, . brushes, hair, - ; nail, ; skin, . bubonic plague, . burns, , . butter, , - . cabbage, , , . caffein, . callus, , , . candy, , . capillaries, , , , , , , , . carbohydrates, , , , . _see also_ starch-sugars. carbon, . carbonates, . carbon dioxid, in air, , ; in blood, ; in body cells, ; in breath, ; in lungs, , ; in spring water, , ; in yeast, . carbuncles, . carrots, . cartilage, , , . casein, , , . catarrh, , , . cathartic, . cecum, . celery, , . cells, , , , , , , ; eating done by, , , , ; of liver, ; of lungs, ; of muscles, , , ; of skin, , ; waste from, , ; water , . cereals, . _see also_ breakfast foods _and_ oatmeal. cerebellum, . cheese, . chemical change, . chickenpox, . children's diseases, - ; from dirty milk, . china, wearing nails long in, . chincon, countess of, . chloral, . chloroform, , . chlorophyll, . choking, cause of, . cider, . cigarette habit, , . cinchona. _see_ quinine. circulation, blood vessels of skin and, ; color an index to, ; control of, ; rate of, . clothing, - . _also_ , . coal-tar remedies, _note_. cocci, ; of pneumonia, , . cochlea, . cocoa, , - . coffee, , , , - . colds, , - , , , - . colic, . colon, , . complexion, , , . concha, . cones, _note_. constipation, , , . consumption, , , - . _see also_ tuberculosis. contraction, . convolutions, . cooking, - . corn, , . cornea, , , . corns, , . corpuscles, malaria germs in red, ; red, , , ; renewal of, ; white, , . cortex, , . cowpox, , . crystalline lens, . cucumbers, , , . culex pipiens, . dandruff, . dentine, . derma, . dextrin, . diaphragm, , , . diarrhea, , , . _see also_ children's diseases. digestion, by body cells, , ; by liver, ; food route in, ; in intestines, - ; in mouth, - ; in stomach, - ; juices aiding, - , - ; preparatory, . digestive system, - . diphtheria, - ; germs of, , . disease, causes of, - ; effects of, ; germs of, _note_, - , , ; growth and spread of, - ; hip-joint, . diseases, children's, - ; nervous, , ; occupation, , . disinfectants, , , - , . disinfection, ; methods of, - ; of wounds, - . dispensaries, tuberculosis, . drafts, , . drainage, extent of wells, ; of sewage, - ; of swamps, , . drink, - . _see also_ alcohol, beverages, water, etc. drowning, treatment for partial, - . duct of a gland, development of, _note_. dust, , , , , . dysentery, . _see also_ diarrhea. dyspepsia, , , , . ear, care of, , ; development of, , , ; structure of, - . eczema, , . effervescence, , , . egg, digestion of, , . enamel, . energy in food and fuel, , . england, smallpox in, , . epidermis, . epiglottis, . epithelial cells, , . eruptions, . esophagus, . _see also_ gullet. ether, . ethers, . eustachian tube, . exercise, - ; appetite and, ; heart and, - , , , ; muscles and, , , , . _also_ , , , , . extensors, . eyes, care of, ; development of, , , ; structure of, - . eye-strain, . fat, - ; fuel value of, , , ; in digestion, , , ; in liver, , ; in milk, , . fatigue, - . feces, , , , . femur, . fermentation, . fever, - ; effect of, on heart, ; in consumption, . fibula, . filters, domestic, ; nature's, , , , , ; of waterworks, , . fish, fuel value of, ; wastes from, . fission of a bacillus, . flexors, . flies, - . food, absorption of, - ; appetizing, - ; as fuel, - , , , ; changed into blood, ; cleanliness of, ; "coal," , , - ; digestion of, - ; in blood, - ; irritating, , , ; "kindling," , , - ; "paper," , , , - ; preservation of, , ; sunlight in, - ; variety in, - ; water in, . food tube. _see_ alimentary canal. foot, - . formaldehyde, - . formalin, - . fractures, , . freckles, . fruits, composition of, , , ; fuel value of, , ; in diet, - ; tainted, . furs, as clothing, . gall bladder, . gall stones, . games, - . ganglia, , , . gardening, , , . gas, illuminating, ; sewer, . _see also_ carbon dioxid, carbonic acid. gastric juice, . gelatin, in veal, ; for bacteria culture, , . german proverb, . germany, smallpox in, ; typhoid in, _note_. germicides. _see_ disinfectants. germs, _note_, . _see also_ bacilli, bacteria, cocci, disinfection, disease. glands, development of, , _note_; hair, , ; lachrymal, ; lymph, ; of ear, ; of intestine, - ; of stomach, , ; of throat, ; oil, ; parotid, ; salivary, , ; sublingual, _note_; submaxillary, _note_; sweat, , . glucose, . gluten, , , , . glycogen, . "goose-skin," . gout, . gray matter, , . gristle. _see_ cartilage. gullet, , , , , , , . habit, regularity of physical, . hair, , , _and note_; care of, , , ; diseases of, and scalp, , . ham, , . hammer, . "ham-string" muscle, . hang nail, . headache, - , . heart, alcohol and, , , ; beat, , , , , , - ; blood vessels connecting with, , ; care of, ; disease of, - ; exercise and, - , , ; function of, ; nerves and, - ; repairing power of, , ; structure and action of, - , , ; tea and coffee and, . heart-burn, . heat of body, normal, ; radiation of, - . heating, , . hemispheres, . hives, . hookworm, - . humerus, . humus, risks to water from, , . hydrophobia, , . hygiene, - . hyperopia, , . influenza. . _see also_ colds. insanity, , . insect pests, - . instincts, , . intestine, absorption in, , - ; digestion in, , - , ; effect of fibrous foods on, , ; hookworm in, ; muscles supporting, . iris, . jaundice, . jenner, dr., - . "joint oil." _see_ synovial fluid. joints, , ; injury to, , . kidneys, , , - . _see also_ wastes. kipling quoted, . klebs-loeffler bacillus, , . knee cap. _see_ patella. lactose, . lard, , . larynx, - . laveran, . leavening, - . legumin, . leprosy, . lettuce, , . lime, carbon dioxid and, ; in body, , , ; in water, . "lime-juicers," _note_. liver, - ; development of, _note_; function of, , ; juice of, , ; position of, ; vein entering, ; weight of, . _see also_ wastes. lungs, - ; capillaries in, ; function of, ; diseases of, , - . _see also_ wastes. lymphatics, . malaria, , - . maltose, . marrow, ; "spinal," _note_. mastication, , . mastoid, . measles, , , , . meat, digestion of, , ; fuel value of, - , ; tainted, , , . wastes from, . medulla, , . meningitis, cerebro-spinal, ; tubercular, . mesentery, . microbes. _see_ bacteria. milk, bacteria in, , - , , ; digestion of, , ; fuel value of, - ; inspection of, , , , ; stations, , . mosquitoes, , . mouth, , , ; in speaking and singing, - ; infection from, ; breathing, , , , . mucous membrane, , , , , , . mucus, . mumps, . muscles, - ; and nerves, - ; controlling hair, ; disorders of, , , , ; exercise of, - ; in breathing, . _see also_ , , , , , , . myopia, . myosin, . nails, - . _see also_ , , . narcotics, , , , . nerves, and heart, - ; and muscles, , - ; auditory, ; optic, ; sciatic, , , ; sensory and motor, ; spinal, , . nervous system, - ; alcohol and, - , ; development of, ; disorders of, - ; effects of disease on, ; eyes and, ; fatigue and, - ; tobacco and, , . nettle-rash. _see_ hives. neurons, . nicotine, . nitrogen, as food, , , , , , _note_; in air, ; in soil, . nose, , - , - . nuts, , . oatmeal, , , . ohio river, pollution of, _note_. oil, in killing larvæ, , , . oleomargarine, , . onions, , . opium, , . _see also_ narcotics. orbit, . oxidation, - . oxygen, gas jets and, ; in blood, , - , ; in water, . ozone. _see_ oxygen. palate, . panama, malaria in, . pancreas, _note_, . pancreatic juice, _note_, , , . papillae, . paralysis, , ; infantile, . parasites, animal, in the skin, - . parsnips, . patella, . patent medicines, , . peaches, . peanuts, . pears, . peas, . pelvis, . pemmican, . pepsin, , . peptic juice, _note_, , . periosteum, , . peritoneum, . peroxide of hydrogen, . perspiration. _see_ sweat. pharynx, , , . phenacetin, _note_. philippine islands, smallpox in, . physiology, - . pigment, . pneumonia, , ; coccus of, ; effects of, on heart, . poisoning, treatments for, - . poison ivy, , . portal vein, , . post mortem, . potatoes, , , , , , , , . privy vault, dangers from, , , , . proteins, , ; changed by liver, ; in food, , , , , ; wastes from, . protozoa, , . ptomaines, . ptyalin, . pulse, , , . pupil, . pylorus, . quarantine, , . quinine, . radius, . reading, position in, . recti, . rectum, , . reflex, , . reservoirs, - ; _also_, , , _note_. respiration, artificial, , . retina, , , , . rheumatism, , , , . ribs, . rice, fermented, ; fuel value of, . ringworm, . rods, _note_. russia, smallpox in, . rye, . saké, . saliva, - , , . salts, ; from deep soil, ; in vegetables, , , ; in water, , , ; laxative, _note_, . scabies, . scapula, . scarlet fever, , , , , . school, gardens, , ; luncheons, ; physician, , ; recesses, . sclerotic coat, . scrofula, . scurvy, . seaver, dr., experiments with smokers, . selection, power of, . semi-circular canals, , . sense, of hearing, ; of pain, , ; of sight, ; of smell, ; of taste, - ; of temperature, ; of touch, , _and note_; sixth--of direction or balance, , . senses and ideas, , . septum, . shoes, , , . skeleton, , . skin, - ; accidents to, - , ; brushes, ; diseases of, , , , , , , . _see also_ wastes. skull, . sleep, , . smallpox, , - . smoking. _see_ tobacco. snake-bite, . soaps, , , , . socket. _see_ orbit. soda water, , . soup, , . spinal column, , ; curvatures of, ; tuberculosis of, . spinal cord, , - , . spitting, , . sprains, , . sputum, infection from, , , . starch, as fuel, , , ; compared with sugar, ; digestion of, , , , , , ; in foods, , , , , - , , , , ; teeth and, . starch-sugars, , , . state control of health, . sterilizing, . stirrup, . stomach, , - ; and nervous system, . _see also_ - , , _note_, , . stradivarius, . strawberries, , , . study, how to, , . sugar, digested starch, , , , , , ; fuel value of, , , , , ; in digestion, ; in foods, , , , , - ; teeth and, . sulphur, as a disinfectant, ; in cabbage, ; in water, . sulphuric acid, . sunburn, . sweat, _note_, , , , - , . synovial fluid, . tannin, , . tattooing, . tea, , , - . teeth, , - ; care of, - ; infection from, , . temperance, - . _see also_ alcohol. tendons, , , , . tetanus, , . thein, . theobromin, . thigh, , . thirst, . tibia, . tissues, . _see also_ cells. tobacco, - ; and heart, , ; and nervous system, . tomatoes, , . tongue, , , , , . tonsil, . tourniquet, . toxins, . trachea, . _see also_ windpipe. triceps, . trypsin, . tubercle bacillus, , ; toxin of, . tuberculin test, . tuberculosis, deaths from, ; effects of, , ; expense of, , ; kinds of, - , ; prevention and cure of, - , ; symptoms of, , . turner, . turnips, . tympanum, , , . typhoid, bacillus of, , ; effect of, on heart, ; from milk, , ; from water, - ; in germany, . _see also_ , . ulna, . urates, . urea, , . ureters, . urinary system, . urine, _note_, , , . vaccination, - . vaccine. _see_ antitoxin. vaccinia, . vacuum, process, of cleaning, , ; of milking, . valves, of heart and veins, - ; disease of heart, , - . vegetables, fuel value of, , , , , , , ; in diet, - , , ; salts in, , ; water in, , . veins, denned, ; function of, - ; position of, . _see also_ , . vena cava, in, , , , , , . ventilation, diseases from poor, ; methods of, - ; need of, - . ventricle, , , , . vertebrae, . vitreous humor, . vitriol. _see_ sulphuric acid. vocal cords, - . voice, - . warts, . wastes, disposal of, - , , ; in the body, , , , . water, body's need of, - , ; boiled, , ; carbon dioxid in, , ; filtration of, , , , , , ; in food, , ; marsh, ; minerals in, , , ; natural purifiers of, , - , , ; rain, ; sources of impurities in, - ; supply , - ; when and how to drink, , . water-brash, . wells, artesian, - , ; dangers to, - , , ; permanent, . wheat, , ; fermented, ; food value of, ; whole, . whiskey, , . _see also_ alcohol, beverages. white matter, , . white swelling, . whooping cough, , . windpipe, - , , . wine, . _see also_ alcohol. wings, . wounds, treatment of, - . yale. _see_ seaver. yeast, as leavening, - ; in making alcohol, , , . yellow fever, . medical experts. investigation of insanity by juries. read before the santa clara medical society, september , . _by w. s. thorne, m. d._ san jose: "the pioneer" print, commercial bank building. . medical experts. _mr. president and gentlemen of the santa clara medical society:_ in the almost infinite variety of human affairs there are possibly none more complex than those which are involved in adjusting the legal relations of the insane. and, certainly, no duty which the medical man is called to perform so tries his patience or tests his knowledge and his experience as the character of medical witness in judicial investigations. the points to which i particularly desire to call your attention to-night are the following, to-wit: first.--the present uncertain position occupied by medical experts in california courts. second.--the provision in our civil code which enables a person, who has been declared insane before a commission of lunacy, to demand a judicial investigation before a jury. my own limited capacity, mr. president, and the presence here to-night of older and more experienced members of the profession admonish me that my theme is ill-chosen, and whilst i feel that my effort is properly prefaced by an apology, i am likewise impressed with the conviction, that it is my duty and privilege to raise my voice, feeble though it be, against abuses which are alike derogatory to our profession and an injustice to society. it is a confession no less mortifying than true, that medical experts, in california courts, have no legal rights, and their testimony elicits neither respectable consideration nor carries with it authoritative weight. i assume these premises to be true, and if there is a medical man within the sound of my voice, whose experience as a legal expert in this state has been more fortunate, i shall unhesitatingly pronounce his case anomalous. admitting then my hypothesis, let us inquire, if so we may, wherein lie the evils of which we speak and if possible their remedy. any person holding a diploma from a reputable school of medicine and engaged in the active practice of his profession, is in law an expert. in this capacity he may be summoned at any moment to testify to questions of fact, hypothetical or theoretical. the questions thus propounded to the medical witness are frequently complex in their nature, involve a wide range of inquiry, and necessitate on his part a just discrimination, extensive knowledge and large experience. again, medical science is ever varying; it may be likened to an uncertain stream that shifts its banks--restless and aggressive, the land-marks change, but the river's course is ever onward. principles like the rocks left in its ancient bed, alone remain to mark its passage and reveal its work; accepted truths of to-day may be _un_truths to-morrow. errors have been enunciated by philosophers, have been sanctified by the church, and promulgated by priests, but have finally been overtaken by this same resistless stream of progress, and by it have been swept out of the world. even so to-day our science is changing its foundation stones. insanity is but just emerging from a complex labyrinth of metaphysical obscurities, and has taken its place in pathology as a physical disease. physiological chemistry has scarcely conned its alphabet, and its unknown literature, pregnant with marvelous truths has yet to unfold its treasures to us. equally unexplored is the vast field embraced in the ætiology of diseases, the character of morbid germs and their mode of entry into the economy. organic chemistry is filling our libraries with its new facts and experiments. the imperative demand therefore of the medical expert is constant study. the exigencies of the position require, in justice to the profession, a thorough acquaintance with all that is old, and an equal familiarity with all that is new. the range of judicial inquiry often embraces the entire field of medical and surgical knowledge, as well as all their collateral branches. no obsolete theory, no unborn or possible fact is too remote for searching investigation. hypothetical questions, ingeniously framed, which include complex and unusual possibilities or specious probabilities, invite the attention, and tax the knowledge, the memory and the judgment of the expert. again, medical men are frequently summoned as experts by opposing counsel, between whom there is known to exist personal animosities or professional jealousies. the usual result is anticipated by the legal gentlemen. the doctors contradict each other; the lawyers are delighted, the jury puzzled, and the court is disgusted with medical testimony. an advocate will not infrequently subpoena his medical friends to testify in a given case. testimony thus elicited is of necessity biased by the personal influence of the attorney and the _ex-parte_ statements of facts derived from the same source. the medical witness is thus led by a piece of legal _finesse_ to rebut the evidence of the experts on the other side, which he would have unhesitatingly endorsed in the consulting room. the doctor has perhaps satisfied a little ambitious egotism--he has assisted the attorney to win his cause; but he has done so at the sacrifice of personal dignity, professional unity, and the respect of both court and jury. _biased_ expert testimony is a shame and a disgrace to our profession. it is infinitely baser and more ignoble than rank perjury, for perjury is often the child of fear, of hate, of avarice; but what language shall be found adequate to characterize a student of science, enlightened by education and refined by gentle associations, who can so far forget his duty to himself and society as to prostitute his knowledge to so ignoble a purpose? again, medical men, after graduation, are prone to neglect the systematic reading of new books and journals. their reading is desultory, and as the increasing demand of professional duties press them for time, they come to rely more and more upon their own experience, with an overweening confidence as to its entire accuracy. now, no sane man doubts the value of _individual experience_. as well might you deny the value of a single dollar because it is only one. "i have been in practice twenty years," exclaims a neighbor, "and i speak from experience; i am right!" true to the extent of that one experience for twenty years; but suppose twenty other observers, who have systematically recorded their experience for the same length of time--who are at least your equals in the profession and vastly your superiors in their opportunities for observation--should have met with results adverse to your own, would you not pause ere you ventured to assert the accuracy of your knowledge under oath in a public tribunal? the experience of one man, though of incalculable value, is as naught to establish the truth or falsity of a principle; observations must be numerous and widespread, least the inductions therefrom lead to erroneous conclusions. the most successful ovariotomist is he who has never lost a case, but can it be truly said that he who has had but a single case, and saved it, is the man? i will here venture the belief that the medical man whose testimony will carry with it the greatest weight, will be he, who, in addition to his own experience, can supplement it by the accumulated experience of many others, whatever be _his_ age or however limited _his_ experience. an eminent lawyer once remarked in my presence: "you doctors make bad witnesses. when asked by counsel, questions which no man can answer, why don't you confess your inability to do so?" i have often seen a medical witness floundering through an attempted definition of insanity--of mind and its relations to matter. herbert spencer begins his chapter on mind by declaring that we do not know, and probably never shall know, anything concerning mind. it is in nowise derogatory, therefore, to our intelligence, to admit the same unwelcome truth. to recapitulate, then, the causes, as i understand them, of the merited discredit attending expert testimony in medico-judicial inquiries, are: _first_--a diploma and active practice constituting the only legal requirement for that position. _second_--inequality of professional acquirements; an inequality, i may remark, resulting from a difference of industrious habits in the later years of professional life. _third_--inharmony among professional men. these, i am persuaded, are the proximate causes of the ridicule and contempt with which medical testimony is at present received in california courts. the remedies for the evil may be briefly stated to consist in: _first_--a united profession, determined to elevate the standard of medical education. _second_--the formation of local medical societies for the interchange of ideas and harmonious intercourse, and the promotion of mutual improvement in medical and collateral science. _third_--the establishment in the medical department of the university of california of a chair of state medicine for the benefit of those who desire to fit themselves for service in medico-legal investigations. in concluding this part of my subject i would venture to enjoin upon the medical witness that he should enter the court room as he would approach the bedside, a calm intelligence, untramelled by fear or prejudice, instigated by no ignoble purpose and inspired only with the desire to elucidate such questions as are propounded for his consideration, in a manner that shall accord with advanced science and the views of the most enlightened of his profession. the ancient injunction, "thou shall not muzzle the ox that treadeth out the corn," appears to be pretty generally observed towards all kinds of animals, the world over, with the exception of medical experts, who do an amount of public treading at a rate of compensation inferior to that accorded to the time of a first-class shoemaker. with your permission i will relate an example illustrating the truth of this statement. a murder has been committed; the defense set up insanity, and a judicial investigation is had, to determine the _mental_ condition of the accused; six experts are summoned to assist in the trial; they are detained three days and a half; a bill for expert service is rendered the county, endorsed by the district judge and the district attorney, for an amount below the actual loss that each had sustained by absence from his practice, and the munificent sum allowed by the county for three and a half days service is fifteen dollars a piece. the legal obligations on the part of the expert to respond to the summons of the court is inexorable; but there is no corresponding obligation of the county to remunerate the expert beyond common witness fees of two dollars per diem. it would seem that the five dollars allowed in the case under consideration was a mere gratuity; and counsel on careful investigation have advised the experts that they can not recover the full amount of their claims. such, gentlemen, is the anomalous position of medical witnesses before the courts. now, mr. president, a physician's time is practically his capital, his stock in trade, if you please. is not, therefore, this exercise of judicial authority, in effect, the appropriation of private property to public uses without just compensation? if the courts of this county have the right to compel my attendance, as an expert, three days and a half at the rate of four dollars and twenty-eight cents per diem, it would have an equal right to extend that attendance to fifty days, or a year, at the rate of $ , . . now if my income be $ , per month, the county of santa clara has the legal right to appropriate to public uses $ , . of my money, my only redress being to supplicate the legislature to restore, as a charity, what is mine by right. the principle by which medical experts are forced to attend in courts of law is manifestly _unjust_, and demands immediate alteration by our next legislature. the forced attendance of medical experts in courts of justice at a rate of compensation arbitrarily fixed, or withheld, is an abuse of power that finds no excuse in justice or necessity. the citizen is thus virtually deprived of an inalienable right, for the security of which our forefathers yielded up their fortunes and their lives. let the medical profession of the state of california see to it that the next legislature pass an act empowering district judges to allow extra compensation to medical experts summoned in criminal cases. the same provision can be made for the compensation of medical experts by the legislature as provided in section of the civil code for the payment of short-hand reporters in criminal cases, which is as follows, to-wit: "in criminal cases, where the testimony has been taken down upon the order of the court, the compensation of the reporter must be fixed by the court, and paid out of the treasury of the county in which the case is tried, upon the order of, the court." i now pass to the second part of my subject, relating to the trial of persons accused of insanity. section of the "code of civil procedure" of the state of california declares that "a person of unsound mind may be placed in an asylum for such persons, upon the order of the county judge of the county in which he resides, as follows: first--the judge must be satisfied by the oath of two respectable physicians that such person is of unsound mind, and unfit to be at large. second--before granting the order the judge must examine the person himself, or if that be impracticable, cause him to be examined by an impartial person. third--after the order is granted, the person alleged to be of unsound mind, his or her husband or wife, or relative to the third degree may demand an investigation before a jury, which must be conducted in all respects as under an inquisition of lunacy." section declares "that any person who has been declared insane, or the guardian, or any relative of such person, within the third degree, or any friend, may apply by petition to the probate judge of the county in which he was declared insane, to have the fact of his restoration to capacity judicially determined. the petition shall be verified, and shall state such person is then sane. upon receiving the petition the judge must appoint a day for hearing, and, if the petitioner request it, shall order an investigation before a jury, which shall be summoned and impaneled in the same manner as juries are summoned and impaneled in other cases in the probate court. on trial the guardian or relative of the petitioner, and, in the discretion of the judge, any other person may contest the right of the petitioner to the relief demanded. if it be found that the petitioner be of sound mind and capable of taking care of himself and his property, his restoration to capacity shall be adjudged, and the guardianship of such person, if such person be not a minor, shall cease." such, mr. president, are the latest enactments in this state respecting the examination and trial of persons alleged to be insane. the provisions to which i desire to direct your attention are those parts of sections and , which enable the person who has been adjudged insane, or any person within the discretion of the court, the husband or wife, the guardian, or any relative to the third degree, to petition the probate judge to order an investigation by a jury. sir, i will premise my remarks on these provisions of our civil code by the enunciation of the following theorem: that if the provisions of our code, relative to trial by jury of persons alleged to be insane, were hereafter to be applied in all cases, there would be no more commitments to our insane asylums in future, except raving maniacs, and the present inmates of those institutions, once restored to liberty, could never again be returned to them. let us see if the facts will prove the theorem. about the year , one a. b., an intemperate and wealthy citizen of this county, was thought to be insane, and a guardian was appointed to take charge of his estate. at the solicitation of friends he was placed as a pay patient in st. mary's hospital, in san francisco. he remained there several months. when it became impracticable to retain him longer in that institution he was brought to san jose. not long after this event he was examined before a commission of lunacy, consisting of the county judge and two physicians. he was pronounced insane by this commission and was ordered to be taken to the asylum at stockton. at the suggestion of his wife he was released after a few weeks confinement in that institution, but was not discharged as cured. he returned to his home, and soon after made application to the probate judge for the discharge of the guardian upon the ground that he was competent to manage his own affairs. a lengthy trial was had and a large number of medical witnesses were called, who testified that the plaintiff was insane. the application to remove the guardian was denied. a few days subsequent to this event the new law, (section , civil code,) went into effect which allows a person who has been adjudged insane to have his restoration to sanity determined by a jury. a jury was impaneled and by consent of all parties a (sham) verdict was rendered declaring him sane. about this time he made a deed of one-half of his property to his wife, in trust. soon after this instrument was made, his conduct became so ungovernable, and as his family alleged, dangerous, that they made application to the county judge to have him examined with a view of committing him to an asylum. the examination was had before the county judge and two physicians, sitting as a court. the trial was lengthy and occupied several days. a large number of medical and lay witnesses were examined, and the result of the inquiry was a declaration of insanity, and the order that the accused be taken to stockton. a short time before this trial took place, this gentleman made and executed a second deed of one-half of the remaining property, to his wife. immediately after he had been declared insane by the last commission, and before he was taken to stockton, a jury was demanded to determine the fact of his restoration to sanity. this trial was contested by the family, and a large number of medical witnesses were called, including his family physician and the superintendent of the asylum at stockton. the testimony of the medical witnesses was unanimously in favor of his insanity. numerous witnesses, among the laity, however, were not wanting whose opinions flatly contradicted those of learned gentlemen, and the jury returned a verdict of sanity. a few months subsequent to the latter decision, this unfortunate gentleman began an action in the district court to have the second deed to his wife set aside, upon the ground that he was insane at the time of executing it. the judgment of the court was, that the deed be set aside upon the grounds as alleged in the complaint. mr. president, we behold the transformation of the caterpillar into the butterfly and we marvel at the mysterious process of designing nature; but what a sluggard is nature when compared to the law! the law can metamorphose a human intellect from health to frenzy and from frenzy to health by the exercise of its resistless fiat. we read of the arabian knights and of aladdin's lamp, but the fantastic evolutions of this legal romance surpass them all. the same individual in the short space of two years, without apparent change in his mental state, so far as could be determined by physicians or friends, is thrice pronounced insane by as many commissions of lunacy, twice sane by two different juries and once insane by a district judge, in order to annul a deed that was executed just prior to the verdict of a jury that declared him sane and therefore responsible for his acts. from the fantastic inconsistency of the foregoing decisions, a disinterested person might be led to infer, that of all the _dramatis personæ_ of this legal farce, the chief actor is the least liable to the imputation of insanity. it is instructive to remark that the learned judges who presided, had all, either separately, or in connection with a commission of lunacy, pronounced in favor of insanity--an opinion which was fully concurred in by medical men. but the efforts of learned and eloquent counsel, aided by public prejudice, mawkish sentiment, and the ignoring by the jury of all the expert testimony, determined the verdict as stated. i will not weary you with further details respecting jury verdicts in questions of mental capacity. they are so thoroughly farcical, that our judges do not hesitate to advise the friends to drop all proceedings when a jury is demanded. i will illustrate the statement by a few examples. it had long been apparent to the friends of d. v. that his mind was unsound. some time since he became violent, loquacious, and obscenely _erotic_. he declared he was in frequent correspondence with the emperor of germany and his first chancellor; that he owned large and valuable properties in this city, in which it was known that he had not the remotest interest; that he was the most extraordinary intellect the world had ever produced; that he represented in his own person, several different individuals, and other like absurdities. he was finally arrested for indecent exposure of person and taken to the county jail. whilst confined in this place, his wild incoherence and absurd statements convinced the most inexperienced observers that he was laboring under marked aberration of mind. a commission of lunacy was finally ordered, and the expediency of placing him in an asylum was unanimously determined. the patient disagreed with this decision, and demanded an examination before a jury. a jury was not impaneled; the necessity was kindly obviated by a friend of the accused, a lumber dealer, who gratuitously informed the judge that the man was not insane, because, forsooth, he could play a better game at cards than himself. it was not deemed necessary to further invoke the popular wisdom in this case, and the man was discharged. ten years ago j. t., a wholesale merchant, was attacked with a nervous disorder which his physicians pronounced _spinal sclerosis_. epileptic seizures came on subsequently. his mental powers became manifestly impaired, and he was ordered to the country. he became a patient of mine, and i attended him for several years. he would have attacks of a week's duration, during which he would never sleep. these attacks were accompanied by frequent epileptic fits and _clonic_ convulsion of certain muscles. the condition of his mind at such times was wild in the extreme. he finally became violent towards his family, and unmanageable. his condition was generally that of exaltation. he was usually happy; always gaining victories over his enemies, of whom he had no lack. although poor, he would talk of investments in real estate, and foreign travel. he would rise at midnight and order his attendant to take down the pictures from the walls; insisted that his wife was tired of him and conspired with others to poison him; call for his meals to be served in the street, and would discharge his servant for imaginary insults or neglect. his general conversation was always childish and often incoherent. his faithful wife long struggled in her misfortune. at last, wan and pale, this feeble woman, bleached with the vigil of ten long years, sought relief from the burden she could no longer bear, at the hands of the law. when, at at last, he threatened her with violence, and spurned her, this wife, all trembling, and with many tears, prayed that, in charity to both herself and him, this husband should be placed in an asylum, and a commission was ordered to inquire into his mental state. during the examination he was assisted by counsel. the medical witnesses thought him insane, and the two physicians did sign, or were willing to sign, the commitment. the judge did not make the order, for it was stated that if made, a jury would be demanded. the wife had no means to defray such expenses, with the certainty of final defeat. the man was discharged. section of the civil code was again an economy to the state. the law had thrust a madman back upon that hearthstone, where death was soon to lay its unwelcome tribute, and where the lament of a widow would soon mingle with the wail of her posthumous babe. mr. president, these are facts. to some of you they are known. the man i speak of is a dangerous lunatic, with whom neither you nor i would sleep beneath the same roof. the law said to that poor wife, you shall take this madman back to your hearth, or i will place you on the witness-stand; i will impugn your motives; i will insinuate a diabolical conspiracy; i will hint at poison; i will wring drops of agony from your pale brow; i will invade the sacred precincts of your domestic temple with court and jury; i will place your demented husband upon the witness-stand, that he may publicly accuse you, under the solemnity of an oath, of conspiracy, of infidelity, of debauchery, and the poisoned draught. all this will i do, in order that the legal fraternity may thrive; that justice may be defeated, and that the absurd and idiotic provisions of that crazy code, number , may be fulfilled. it is needless to multiply examples of this character. a skillful advocate, before a jury, can set at liberty the most dangerous lunatic in the state. why is this? why should not a jury composed of twelve impartial citizens, sworn to render a verdict in accordance with the evidence adduced before them, with medical experts to give opinions and testify as to matters of fact, with a learned judge to expound the law--why, i would ask, should not a court so constituted, present the very best and most perfect type of a tribunal to investigate those complex questions which arise concerning insanity? learned jurists have said, and still assert, that any person, of common sense and common experience, is as competent to judge between a sound mind and a mind diseased as the physician or alienist. sir, this doctrine is repugnant to reason and common sense. as well might they claim that the same persons could as unerringly discriminate between health and disease in some other part of the nervous system--in the retina, the spinal cord, or the medulla-oblongata. the doctrine is utterly false, false in theory and false in fact. if any person, indifferently selected, is as competent as the medical man to judge of what symptoms indicate a diseased brain or nervous system, the same individual, under like circumstances, should be able to determine the symptoms of cholera, scarlatina, measles, or the symptoms of certain poisons. if the assumption of legal gentlemen be true, i would propose that in certain cases of doubtful diagnosis, a jury be empaneled to determine the real character of the disease. i deny the fact that jurymen selected from the laity are competent judges of the symptoms that indicate mental diseases. they are disqualified because: first--they lack the special study and experience by which alone they could comprehend and rightly interpret what they must see and hear. second--_juries do not render verdicts in accordance with the evidence._ it is, i believe, one of the esteemed privileges of juries to render verdicts utterly at variance with the testimony. third--in trials of this character, juries are exposed to the eloquent wiles of counsel, who dwell with telling effect upon the probable persecution of the defendant; the loss of name and reputation an asylum would entail upon him; conspiracy of family or others from criminal motives, and the hardship of isolation and confinement; finally, the introduction of a mass of testimony by interrogations somewhat as follows: question--do you know the defendant? q.--how long have you known him? q.--did you always consider him a sane man? q.--have you often seen and talked with him of late? q.--do you perceive any difference in his mental condition now and when you first knew him? q.--do you consider him insane at the present time? the answers to such questions, generally in favor of the defendant, will outweigh the opinion of the mightiest expert in the land, in the opinion of the jury. yet the witness is not even asked if he has ever seen a case of insanity, if he were ever in an asylum, or whether he has any practical or theoretical knowledge of insanity or insane men. his recent relations with the accused may have been confined to mere daily salutations, or so cursory as to furnish no useful information as to mental health. the position of the accused also, is one that naturally excites in the minds of the jury the deepest sympathy. they can not, and will not, understand why a poor fellow who sleeps little, talks strangely, and facetiously styles himself general jackson, should be sent away to an asylum, deprived of all that makes life dear to them. they do not believe the man insane; their sympathies forbid so hard a verdict. insanity is not a contract, a will or a deed. it is not a question of law; it is a question of fact. a fact often difficult to reach; a fact so closely related with physiological and metaphysical facts, so interwoven with the subtile threads of human intelligence, so artful in alluding apprehension, so dangerous in its results, that its judicial investigation can never be safely entrusted to those deficient in knowledge and experience. the custom of conducting these inquiries before juries, and in public places, should be discontinued. the exhibition of these god-stricken people and their mental deformities as a public spectacle, is a relic of barbarian inhumanity. charity would fain cover them with the mantel of privacy. the practice of allowing loquacious attorneys to harangue the court, to brow-beat the medical witness and vex him with impertinence, to sneer at and gibe an expert whilst he elucidates some difficult point to a stupid jury, that has been raised by a yet more stupid attorney, is too despicable for respectful comment. what would you think of the proposition, mr. president, to employ attorneys at law in a court composed of mathematicians? the question for investigation being one pertaining to their science. the very questionable utility of attorneys at law, under any circumstances, would not be found available in such a court. neither ought they to find place in a court convened for the solution of a problem quite as technical and far more abstruse. a question of physical disease involving nerve centers. i will here venture the opinion that the day is not far distant, when investigations involving insanity only, will be more expeditiously and justly determined without the assistance of either lawyers or juries. lawyers tell us sir, that the merchant, the artisan, the laborer and the men who till the soil are as competent and intelligent judges of mental phenomena as the physician. let us examine, therefore, a few of the possible advantages which a medical man might possess over the laity in these investigations. the life study of the physician is man; man in his entirety, man as an animal, man as a rational entity, man in relation to himself, and man in relation to his physical surroundings--air, earth, water, organic and inorganic nature. as physicians we behold man in embryo; we often hold in the palm of our hands the germ that had been quickened into a living soul. we subject it to optical glasses and study its physical mysteries. we watch it at every period of its intra-uterine life. we bring it ripe for a more exalted stage of activity into this breathing world. we study its growth and mark its development. we foster and protect it, until we behold the structure complete--a living man. we observe this being in health, and we minister to him in disease. we look into his eyes, that we may read the temper and pressure of his brain. we scan the optic discs, that we may measure the blood currents and detect unhealthful changes in the sensorium itself. we regard the face and note the emotions that sweep over it. we read upon its pallid surface the signs of agony, peace, fear, love, hope, despair, death. we read a history in the drooping of a lid, the compressed lip, the pinched nostril, or the tremor of a muscle. we feel the heart throb; we interrogate its action, we interpret its sounds. we place our ears upon the chest and tell you of life's breathing tide. we ask the blood its heat, and it records the answer. we bid the stomach, liver, kidneys, to bear us witness, and they respond at our bidding. as we behold the growth of mind with the body, so do we witness their decay. we study psychology in its various relations to physical disease. we see it infinitely manifested as physical decay encroaches upon its citadel. we study mental phenomena as the earliest precursor of physical death. we observe, study and interpret, mental phenomena as a most important aid to physical diagnosis. we begin this study in our student days, and we never cease this careful observation of mental phenomena. it yields to the medical man a full measure of practical benefits in the treatment of human maladies. the physician's life, then, is chiefly devoted to the special study of physical disease and mental manifestations in relation thereto. will the jurist, yet assert that the man whose life is spent in the manufacture of shoes, the production of wheat, and the growth of four-footed beasts, is as competent to estimate the value and interpret the symptoms of diseased nerve centres as he, whose life has been spent in their special study? this assertion of legal gentlemen is too absurd for argument. i will remark, by way of a possible explanation for this curious belief, that the most learned alienists of this age declare that in general, the lawyers and jurists are as ignorant of insanity as the laity itself. this statement accords with my own experience. the special study which they direct to the investigation of a particular case, in which they are acting as partisans, tends neither to enlarge their views nor enlighten their understanding upon the subject. it certainly would do so, if they could persue the investigation with that careful and impartial spirit of inquiry that alone leads to knowledge. erroneous tests of insanity have been incorporated into works of law, and these dogmas have become a part of the judicial mind. practically ignorant of nervous disorders and the physiological knowledge necessary to comprehend them, and unused to contact with the insane, what wonder is it that the judicial ideas of insanity are as crude as the antiquated law which inspired them. the study of the mind is the study of the human body. he who declares that mind is a function of the brain alone, asserts an untenable theory. every organ in the body ministers directly or indirectly to the manifestations of mind. _mens sana in corpore sano_ is an axiom. every organ in the body is connected by direct continuity of nervous structure with the brain. the mind, as a separate entity, exists only in the imaginations of men. it can only be studied in relation to its corelative matter, the body. he who most perfectly comprehends the latter must, of necessity, learn much of the former; and it is the special province of the physician to study both. as he is the custodian of the diseased body, so, likewise, is he the ablest minister to the mind diseased. physicians should be both judges and jury in questions involving mental derangement. our present commission of lunacy is a sufficient guarantee of honest, intelligent and just decision. if any particular doubts arise, more experts can be summoned; and should there still be doubts, it is ever safe and practicable to delay proceedings whilst the accused is kept under observation. the provisions of sections and of our civil code, respecting the examination of persons alleged to be insane, before juries and assisted by counsel, should be repealed. such an act would meet the approval of every legal gentleman and jurist whose opinion i have been able to obtain at this time. in common justice to medical men, whose time and knowledge are so indispensable in medico-judicial investigations, a provision should be made for their extra compensation, similar to that in section respecting short-hand reporters in criminal cases. thanking you, mr. president and gentlemen, for your respectful attention, i will close, with the hope that the profession of the state will lend its generous efforts to correct our present system of expert service, and the trial by jury of person held to be insane. [illustration: decoration] the untroubled mind by herbert j. hall, m.d. boston and new york houghton mifflin company the riverside press cambridge copyright, , by herbert j. hall all rights reserved _published may _ preface a very wise physician has said that "every illness has two parts--what it is, and what the patient thinks about it." what the patient thinks about it is often more important and more troublesome than the real disease. what the patient thinks of life, what life means to him is also of great importance and may be the bar that shuts out all real health and happiness. the following pages are devoted to certain ideals of life which i would like to give to my patients, the long-time patients who have especially fallen to my lot. they are not all here, the steps to health and happiness. the reader may even be annoyed and baffled by my indirectness and unwillingness to be specific. that i cannot help--it is a personal peculiarity; i cannot ask any one to live by rule, because i do not believe that rules are binding and final. there must be character behind the rule and then the rule is unnecessary. all that i have written has doubtless been presented before, in better ways, by wiser men, but i believe that each writer may expect to find his small public, his own particular public who can understand and profit by his teachings, having partly or wholly failed with the others. for that reason i am encouraged to write upon a subject usually shunned by medical men, being assured of at least a small company of friendly readers. i am grateful to a number of friends and patients who have read the manuscript of the following chapters. these reviewers have been frank and kind and very helpful. i am particularly indebted to dr. richard c. cabot, who has given me much valuable assistance. contents i. the untroubled mind ii. religio medici iii. thought and work iv. idleness v. rules of the game vi. the nervous temperament vii. self-control viii. the lighter touch ix. regrets and forebodings x. the virtues xi. the cure by faith i the untroubled mind canst thou not minister to a mind diseas'd, pluck from the memory a rooted sorrow, raze out the written troubles of the brain, and with some sweet oblivious antidote cleanse the stuff'd bosom of that perilous stuff which weighs upon the heart? macbeth. when a man tells me he never worries, i am inclined to think that he is either deceiving himself or trying to deceive me. the great roots of worry are conscience, fear, and regret. undoubtedly we ought to be conscientious and we ought to fear and regret evil. but if it is to be better than an impediment and a harm, our worry must be largely unconscious, and intuitive. the moment we become conscious of worry we are undone. fortunately, or unfortunately, we cannot leave conscience to its own devices unless our lives are big enough and fine enough to warrant such a course. the remedy for the mental unrest, which is in itself an illness, lies not in an enlightened knowledge of the harmfulness and ineffectiveness of worry, not even in the acquirement of an unconscious conscience, but in the living of a life so full and good that worry cannot find place in it. that idea of worry and conscience, that definition of serenity, simplifies life immensely. to overcome worry by substituting development and growth need never be dull work. to know life in its farther reaches, life in its better applications, is the final remedy--the great undertaking--_it is life_. we must warn ourselves, not infrequently, that the larger life is to be pursued for its own glorious self and not for the sake of peace. peace may come, a peace so sure that death itself cannot shake it, but we must not expect all our affairs to run smoothly. as a matter of fact they may run badly enough; we shall have our ups and downs, we shall sin and repent, and sin again, but if in the end we live according to our best intuitions, we shall be justified, and we need not worry about the outcome. to put it another way, if we would have the untroubled mind, we must transfer our conscientious efforts from the small details of life--from the worry and fret of common things--into another and a higher atmosphere. we must transfigure common life, dignify it and ennoble it; then, although the old causes of worry may continue, we shall have gained a stature that will make us unconscious masters of the little troubles and in a great degree equal to the larger requirements. life will be easier, not because we make less effort, but because we are working from another and a better level. if such a change, and it would be a change for most of us, could come about instantly, in a flash of revelation, that would be ideal, but it would not be life. we must return again and again to the old uninspired state wherein we struggle conscientiously with perverse details. i would not minimize the importance and value of this struggle; only the sooner it changes its level the better for every one concerned. large serenity must, finally, be earned through the toughening of moral fibre that comes in dealing squarely with perplexing details. some of this struggle must always be going on, but serener life will come when we begin to concern ourselves with larger factors. how are we to live the larger life? partly through uninspired struggle and through the brave meeting of adversity, but partly, also, in a way that may be described as "out of hand," by intuition, by exercise of the quality of mind that sees visions and grasps truths beyond the realms of common thought. i am more and more impressed with the necessity of inspiration in life if we are to be strong and serene, and so finally escape the pitfalls of worry and conscience. by inspirations i do not mean belief in any system or creed. it is not a stated belief that we need to begin with; that may come in time. we need first to find in life, or at least in nature, an essential beauty that makes its own true, inevitable response within us. we must learn to love life so deeply that we feel its tremendous significance, until we find in the sea and the sky the evidence of an overbrooding spirit too great to be understood, but not too great to satisfy the soul. this is a sort of mother religion--the matrix from which all sects and creeds are born. its existence in us dignifies us and makes simple, purposeful, and receptive living almost inevitable. we may not know why we are living according to the dictates of our inspiration, but we shall live so and that is the important consideration. if i urge the acquirement of a religious conception that we may cure the intolerable distress of worry, i do what i have already warned against. it is so easy to make this mistake that i have virtually made it on the same page with my warning. we have no right to seek so great a thing as religious experience that we may be relieved of suffering. better go on with pain and distress than cheapen religion by making it a remedy. we must seek it for its own sake, or rather, we must not seek it at all, lest, like a dream, it elude us, or change into something else, less holy. nevertheless, it is true that if we will but look with open, unprejudiced eyes, again and again, upon the sunrise or the stars above us, we shall become conscious of a presence greater and more beautiful than our minds can think. in the experience of that vision strength and peace will come to us unbidden. we shall find our lives raised, as by an unseen force, above the warfare of conscience and worry. we shall begin to know the meaning of serenity and of that priceless, if not wholly to be acquired, possession, the untroubled mind. i am aware that i shall be misunderstood and perhaps ridiculed by my colleagues when i attempt to discuss religion in any way. theology is a field in which i have had no training, but that is the very reason why i dare write of it. i do not even assume that there is a god in the traditional sense. the idea is too great to be made concrete and literal. no single fact of nature can be fully understood by our finite minds. but i do feel vaguely that the laws that compass us, and make our lives possible, point always on--"beyond the realms of time and space"--toward the existence of a mighty overruling spirit. if this is a cold and inadequate conception of god, it is at least one that can be held by any man without compromise. the modern mind is apt to fail of religious understanding and support, because of the arbitrary interpretations of religion which are presented for our acceptance. it is what men say about religion, rather than religion itself, that repels us. let us think it out for ourselves. if we are open to a simple, even primitive, conception of god, we may still repudiate the creeds and doctrines, but we are likely to become more tolerant of those who find them true and good. we shall be likely in time to find the religion of christ understandable and acceptable--warm and quick with life. the man who ungrudgingly opens his heart to the god of nature will be religious in the simplest possible sense. he may worry because of the things he cannot altogether understand, and because he falls so far short of the implied ideal. but he will have enlarged his life so much that the common worries will find little room--he will be too full of the joy of living to spend much conscious thought in worry. such a man will realize that he cannot afford to spend his time and strength in regretting his past mistakes. there is too much in the future. what he does in the future, not what he has failed to do in the past, will determine the quality of his life. he knows this, and the knowledge sends him into that future with courage and with strength. finally, in some indefinable way, character will become more important to him than physical health even. illness is half compensated when a man realizes that it is not what he accomplishes in the world, but what he _is_ that really counts, which puts him in touch with the creative forces of god and raises him out of the aimless and ordinary into a life of inspiration and joy. ii religio medici at all events, it is certain that if any medical man had come to middlemarch with the reputation of having definite religious views, of being given to prayer and of otherwise showing an active piety, there would have been a general presumption against his medical skill. george eliot. when a medically educated man talks and writes of religion and of god, he is rightly enough questioned by his brothers--who are too busy with the hard work of practice to be concerned with anything but material problems. to me the word "god" is symbolic of the power which created and which maintains the universe. the sunrise and the stars of heaven give me some idea of his majesty, the warmth and tenderness of human love give me some idea of his divine love. that is all i know, but it is enough to make life glow; it is enough to inspire the most intense devotion to any good cause; it is enough to make me bear suffering with some degree of patience; and it is enough, finally, to give me some confidence and courage even in the face of the great mystery of death. why this or another conception of god should produce such a profound result upon any one, i do not know, except that in some obscure way it connects the individual with the divine plan, and does not leave him outside in despair and loneliness. however that may be, it will be conceded that a religious conception of some kind does much toward justifying life, toward making it strong and livable, and so has directly to do with certain important problems of illness and health. the most practical medical man will admit that any illness is made lighter and more likely to recover in the presence of hope and serenity in the mind of the patient. naturally the great bulk of medical practice calls for no handling other than that of the straight medical sort. a man comes in with a crushed finger, a girl with anæmia--the way is clear. it is only in deeper, more intricate departments of medicine that we altogether fail. the bacteriologist and the pathologist have no use for mental treatment, in their departments. but when we come to the case of the nervously broken-down school teacher, or the worn-out telegrapher, that is another matter. years may elapse before work can be resumed--years of dependence and anxiety. here, a new view of life is often more useful than drugs, a view that accepts the situation reasonably after a while, that does not grope blindly and impatiently for a cure, but finds in life an inspiration that makes it good in spite of necessary suffering and limitations. often enough we cannot promise a cure, but we must be prepared to give something better. a great deal of the fatigue and unhappiness of the world is due to the fact that we do not go deep enough in our justification for work or play, or for any experience, happy or sad. there is a good deal of a void after we have said, "art for art's sake," or "play for the joy of playing," or even after we have said, "i am working for the sake of my family, or for some one who needs my help." that is not enough; and whether we realize it or not, the lack of deeper justification is at the bottom of a restlessness and uncertainty which we might not be willing to acknowledge, but which nevertheless is very real. i am not satisfied when some moralist says, "be good and you will be happy." the kind of happiness that comes from a perfunctory goodness is a thing which i cannot understand, and which i certainly do not want. if i work and play and serve and employ, making up the fabric of a busy life, if i attain a very real happiness, i am tormented by the desire to know why i am doing it, and i am not satisfied with the answer i usually get. the patient may not be cured when he is relieved of his anæmia, or when his emaciation has given place to the plumpness and suppleness and physical strength that we call health. the man whom we look upon as well, and who has never known physical illness, is not well in the larger sense until he knows why he is working, why he is living, why he is filling his life with activity. in spite of the elasticity and spring of the world's interests, there must come often, and with a kind of fatal insistence, the deep demand for a cause, for a justification. if there is not an adequate significance behind it, life, with all its courage and accomplishment, seems but a sorry thing, so full of pathos, even in its brightest moments, so shadowed with a sense of loss and of finality that the bravest heart may well fail and the truest courage relax, supported only by the assurance that this way lies happiness or that right is right. what is this knowledge that the world is seeking, but can never find? what is this final justification? if we seek it in its completeness, we are doomed always to be ill and unsatisfied. if we are willing to look only a little way into the great question, if we are willing to accept a little for the whole, content because it is manifestly part of the final knowledge, and because we know that final knowledge rests with god alone, we shall understand enough to save us from much sorrow and painful incompleteness. there is, in the infinitely varied and beautiful world of nature, and in the hearts of men, so much of beauty and truth that it is a wonder we do not all realize that these things of common life may be in us and for us the daily and hourly expression of the infinite being we call god. we do not see god, but we do feel and know so much that we may fairly believe to be of god that we do not need to see him face to face. it is something more than imagination to feel that it is the life of god in our lives, so often unrecognized or ignored, that prompts us to all the greatness and the inspiration and the accomplishment of the world. if we could know more clearly the joy of such a conception, we should dry up at its source much of the unhappiness which is, in a deep and subtle way, at the bottom of many a nervous illness and many a wretched existence. the happiness which is found in the recognition of kinship with god, through the common things of life, in the experiences which are so significant that they could not spring from a lesser source, the happiness which is not sought, but which is the inevitable result of such recognition--this experience goes a long way toward making life worth living. if we do have this conception of life, then some of the old, old questions that have vexed so many dwellers upon the earth will no longer be a source of unhappiness or of illness of mind or body. the question of immortality, for instance, which has made us afraid to die, will no longer be a question--we shall not need to answer it, in the presence of god, in our lives and in the world about us. we shall be content finally to accept whatever is in store for us--so it be the will of god. we may even look for something better than mere immortality, something more divine than our gross conception of eternal life. this is a religion that i believe medical men may teach without hesitation whenever the need shall arise. i know well enough that many a blunt if kindly man cannot bring himself to say these words, even if he believes them, but i do think that in some measure they point the way to what may wisely be taught. there is a practice of medicine--the common practice--that is concerned with the body only, and with its chemical and mechanical reactions. we can have nothing but respect and admiration for the men who go on year after year in the eager pursuit of this calling. we know that such a work is necessary, that it is just as important as the educational practice of which i write. we know that without the physical side medicine would fail of its usefulness and that disease and death would reap far richer harvests: i only wish the two naturally related aspects of our dealing with patients might not be so completely separated that they lose sight of each other. as a matter of fact, both elements are necessary to our human welfare. if medicine devotes itself altogether to the cure and prevention of physical disease, it will miss half of its possibilities. it is equally true that if we forget the physical necessities in our zeal for spiritual hygiene, we shall get and deserve complete and humiliating failure. many men will say, "why mix the two? why not let the preachers and the philosophers preach and the doctors follow their own ways?" for the most part this may have to be the arrangement, but the doctor who can see and treat the spiritual needs of his patient will always be more likely to cure in the best sense than the doctor who sees only half of the picture. on the other hand, the philosopher is likely to be a comparatively poor doctor, because he knows nothing of medicine, and so can see only the other half of the picture. there is much to be said for the religion of medicine if it can be kept free from cant, if it can be simple and rational enough to be available for the whole world. iii thought and work i wish i had a trade!--it would animate my arms and tranquilize my brain. senancour. "doe ye nexte thynge."--_old english proverb_. since our minds are so constantly filled with anxiety, there would seem to be at least one sure way to be rid of it--to stop thinking. a great many people believe that the mind will become less effective, that life will become dull and purposeless, unless they are constantly thinking and planning and arranging their affairs. i believe that the mind may easily and wisely be free from conscious thought a good deal of the time, and that the greatest progress and development in mind often comes when the thinker is virtually at rest, when his mind is to all intents and purposes blank. the busy, unconscious mind does its best work in the serenity of an atmosphere which does not interfere and confuse. it is true that the greatest conceptions do not come to the untrained and undisciplined mind. but do we want great conceptions all the time? there is a technical training for the mind which is, of course, necessary for special accomplishments, but this is quite another matter. even this kind of thought must not obtrude too much, lest we become conscious of our mental processes and so end in confusion. one of the greatest benefits of work with the hands, or of objective and constructive work with the mind, is that it saves us from unending hours of thinking. work should, of course, find its fullest justification as an expression of faith. if we have ever so dim a vision of a greater significance in life, of its close relationship to infinite things, we become thereby conscious of the need of service, of the need of work. it is the easy, natural expression of our faith, the inevitable result of a spiritual contact with the great working forces of the world. it is work above all else that saves us from the disasters of conflicting thought. a few years ago a young man came to me, suffering from too much thinking. he had just been graduated from college and his head was full of confused ideas and emotions. he was also very tired, having overworked in his preparation for examinations, and because he had not taken the best care of his body. the symptoms he complained of were sleeplessness and worry, together with the inevitable indigestion and headache. of course, as a physician, i went over the bodily functions carefully, and studied, as far as i might, into the organic conditions. i could find no evidence of physical disease. i did not say, "there is nothing the matter with you"; for the man was sick. i told him that he was tired, that he had thought too much, that he was too much concerned about himself, and that as a result of all this his bodily functions were temporarily upset. he thought he ought to worry about himself, because otherwise he would not be trying to get well. i explained to him that this mistaken obligation was the common reason for worry, and that in this case, at least, it was quite unnecessary and even harmful for him to go on thinking about himself. that helped a little, but not nearly enough, because when a man has overworked, when he has begun to worry, and when his various bodily functions show results of worry, no reasoning, no explanations, can wholly relieve him. i said to this young man, "in spite of your discomforts, in spite of your depression and concern in regard to yourself, you will get well if you will stop thinking about the matter altogether. you must be first convinced that it is best for you to stop thinking, that no harm or violence can result, and then you must be helped in this direction by going to work with your hands--that will be life and progress, it will lead you to health." fortunately i had had some experience with nervous illness, and i knew that unless i managed for this man the character and extent of his work, he would not only fail in it, but of its object, and so become more confused and discouraged. i knew the troubled mind, in this instance, might find its solace and its relief in work, but that i must choose the work carefully to suit the individual, and i must see that the nervously fatigued body was not pushed too hard. in the town where i live is a blacksmith shop, presided over by a genial old man who has been a blacksmith since he was a boy, and in whose hands iron is like clay. i took my patient down to the smithy and said, "here is a young man whom i want to put to work. he will pay for the chance. i want you first to teach him to make hand-wrought nails." this was a good deal of a joke to the smith and to the patient, but they saw that i was in earnest and agreed to go ahead. we got together the proper tools and proceeded to make nails, a job which is really not very difficult. after an hour's work, i called off my patient, much to his disgust, for he was just beginning to be interested. but i knew that if he were to keep on until fatigue should come, the whole matter would end in trouble. so the next day, with some new overalls and a leather apron added to the equipment, we proceeded to another hour's work. we went on this way for three or four days, before the time was increased. the interest of the patient was always fresh, he was eager for more, and he did not taste the dregs of fatigue. yet he did get the wholesome exercise, and he did get the strong turning of the mind from its worry and concern. of course, the rest of the day was taken care of in one way or another, but the work was the central feature. in a week, we were at it two hours a day, in three weeks, four hours, and in a month, five hours. he had made a handsome display of hand-wrought nails, a superior line of pokers and shovels for fireplaces, together with a number of very respectable andirons. on each of these larger pieces of handiwork my patient had stamped his initials with a little steel die that was made for him. each piece was his own, each piece was the product of his own versatility and his own strength. his pride and pleasure in this work were very great, and well they might be, for it is a fine thing to have learned to handle so intractable a material as iron. but in handling the iron patiently and consistently until he could do it without too much conscious thinking, and so without effort, he had also learned to handle himself naturally, more simply and easily. as a matter of fact, the illness which had brought this boy to me was pretty nearly cured by his blacksmithing, because it was an illness of the mind and of the nerves, and not of the body, although the body had suffered in its turn. that young man, instead of becoming a nervous invalid as he might have done, is now working steadily in partnership with his father, in business in the city. i had found him a very interesting patient, full of originality and not at all the tedious and boresome person he might have been had i listened day after day, week after week to the recital of his ills. i was willing to listen,--i did listen,--but i also gave him a new trend of life, which pretty soon made his complaints sound hollow and then disappear. of course, the problem is not always so simple as this, and we must often deal with complexities of body and mind requiring prolonged investigation and treatment. i cite this case because it shows clearly that relief from some forms of nervous illness can come when we stop thinking, when we stop analyzing, and then back up our position with prescribed work. there may be some nervous invalids who read these lines who will say, "but i have tried so many times to work and have failed." unfortunately, such failure must often occur unless we can proceed with care and with understanding. but the principle remains true, although it must be modified in an infinite variety to meet the changing conditions of individuals. i see a great many people who are conscientiously trying to get well from nervous exhaustion. they almost inevitably try too hard. they think and worry too much about it, and so exhaust themselves the more. this is the greater pity because it is the honest and the conscientious people who make the greatest effort. it is very hard for them to realize that they must stop thinking, stop trying, and if possible get to work before they can accomplish their end. we shall have to repeat to them over and over again that they must stop thinking the matter out, because the thing they are attempting to overcome is too subtle to be met in that way. so, if they are fortunate, they may rid themselves of the vagueness and uncertainty of life, until all the multitude of details which go to make up life lose their desultoriness and their lack of meaning, and they may find themselves no longer the subjects of physical or nervous exhaustion. iv idleness o ye! who have your eyeballs vex'd and tir'd, feast them upon the wideness of the sea. keats. extreme busyness, whether at school or college, kirk or market, is a symptom of deficient vitality; and a faculty for idleness implies a catholic appetite and a strong sense of personal identity. stevenson. it is an unfortunate fact that very few people are able to be idle successfully. i think it is not so much because we misuse idleness as because we misinterpret it that the long days become increasingly demoralizing. i would ask no one to accept a forced idleness without objection or regret. such an acceptance would imply a lack of spirit, to say the least. but idleness and rest are not incompatible; neither are idleness and service, nor idleness and contentment. if we can look upon rest as a preparation for service, if we can make it serve us in the opportunity it gives for quiet growth and legitimate enjoyment, then it is fully justified and it may offer advantages and opportunity of the best. the chief trouble with idleness is that it so often means introspection, worry, and impatience, especially to those conscientious souls who would fain be about their business. i have for a long time been accustomed to combat the worry and fret of necessary idleness--not by forbidding it, not by advising struggle and fight against it, but by insisting that the best way to get rid of it is to leave it alone, to accept it. when we do this there may come a kind of fallow time in which the mind enriches and refreshes itself beyond our conception. i would rather my patient who must rest for a long time would give up all thought of method, would give up all idea of making his mind follow any particular line of thought or absence of thought. i know that the mind which has been under conscious control a good deal of the time is apt to rebel at this freedom and to indulge in all kinds of alarming extravagances. i am sure, however, that the best way to meet these demands for conscious control is to be careless of them, to be willing to experience these extravagances and inconsistencies without fear, in the belief that finally will come a quiet and peace which will be all that we can ask. the peace of mind that is unguided, in the conscious and literal sense, is a thing which too few of us know. mr. arnold bennett, in his little book, "how to live on twenty-four hours a day," teaches that we should leave no time unused in our lives; that we should accomplish a great deal more and be infinitely more effective and progressive if we devoted our minds to the definite working-out of necessary problems whenever those times occur in which we are apt to be desultory. i wish here to make a plea for desultoriness and for an idleness which goes even beyond the idleness of the man who reads the newspaper and forgets what he has read. it seems to me better, whether we are sick or well, to allow long periods in our lives when we think only casually. to the good old adage, "work while you work and play while you play," we might well add, "rest while you rest," lest in the end you should be unable successfully either to work or play. a man is not necessarily condemned to tortures of mind because he must rest for a week or a month or a year. i know that there must be anxious times, especially when idleness means dependence, and when it brings hardship to those who need our help. but the invalid must not try constantly to puzzle the matter out. if we do not make ourselves sick with worry, we shall be able sometime to approach active life with sufficient frankness and force. it is the constant effort of the poor, tired mind to solve its problems that not only fails of its object, but plunges the invalid deeper into discouragement and misunderstanding. how cruel this is, and how unfortunate that it should come more commonly to those who try the hardest to overcome their handicaps, to throw off the yoke of idleness and to be well. when you have tried your best to get back to your work and have failed, when you have done this not once but many times, it is inevitable that misunderstanding should creep in, inevitable that you should question very deeply and doubt not infrequently. yet the chances are that one of the reasons for your failure is that you have tried too hard, that you have not known how to rest. when you have learned how to rest, when you have learned to put off thinking and planning until the mind becomes fresh and clear, when you are in a fair way to know the joy of idleness and the peace of rest, you are a great deal more likely to get back to efficiency and to find your way along the great paths of activity into the world of life. it is not so much the idleness, then, as the attempt to overcome its irksomeness, that makes this condition painful. the invalid in bed is in a trap, to be tormented by his thoughts unless he knows the meaning of successful idleness. this knowledge may come to him by such strategy as i have suggested--by giving up the struggle against worry and fret; but peace will come surely, steadily, "with healing in its wings," when the mind is changed altogether, when life becomes free because of a growth and development that finds significance even in idleness, that sees the world with wise and patient eyes. in a way it does not matter, your physical condition or mine, if our "eyes have seen the glory" that deifies life and makes even its waste places beautiful. what is that view from your window as you lie in your bed? a bit of the sea, if you are fortunate, a corner of garden, surely, the top of an elm tree against the blue. what is it but the revelations of a god in the world? there is enough that is sad and unhappy, but over all are these simple, ineffable things. if the garden is an expression of god in the world, then the world and life are no longer meaningless. even idleness becomes in some degree bearable because it is a part of a significant world. unfortunately, the idleness of disability often means pain, the wear and tear of physical or nervous suffering. that is another matter. we cannot meet it fully with any philosophy. my patients very often beg to know the best way to bear pain, how they may overcome the attacks of "nerves" that are harder to bear than pain. to such a question i can only say that the time to bear pain is before and after. live in such a way in the times of comparative comfort that the attacks are less likely to appear and easier to bear when they do come. after the pain or the "nervous" attack is over, that is the time to prevent the worst features of another. forget the distress; live simply and happily in spite of the memory, and you will have done all that the patient himself can do to ward off or to make tolerable the next occasion of suffering. pain itself--pure physical pain--is a matter for the physician's judgment. it is his business to seek out the causes and apply the remedy. v rules of the game it is not growing like a tree in bulk, doth make man better be. ben jonson. it is a good thing to have a sound body, better to have a sane mind, but neither is to be compared to that aggregate of virile and decent qualities which we call character. theodore roosevelt. the only effective remedy against inexorable necessity is to yield to it. petrarch. when i go about among my patients, most of them, as it happens, "nervously" sick, i sometimes stop to consider why it is they are ill. i know that some are so because of physical weakness over which they have no control, that some are suffering from the effects of carelessness, some from wilfulness, and more from simple ignorance of the rules of the game. there are so many rules that no one will ever know them all, but it seems that we live in a world of laws, and that if we transgress those laws by ever so little, we must suffer equally, whether our transgression is a mistake or not, and whether we happen to be saints or sinners. there are laws also which have to do with the recovery of poise and balance when these have been lost. these laws are less well observed and understood than those which determine our downfall. the more gross illnesses, from accident, contagion, and malignancy, we need not consider here, but only those intangible injuries that disable people who are relatively sound in the physical sense. it is true that nervous troubles may cause physical complications and that physical disease very often coexists with nervous illness, but it is better for us now to make an artificial separation. just what happens in the human economy when a "nervous breakdown" comes, nobody seems to know, but mind and body coöperate to make the patient miserable and helpless. it may be nature's way of holding us up and preventing further injury. the hold-up is severe, usually, and becomes in itself a thing to be managed. the rules we have wittingly or unwittingly broken are often unknown to us, but they exist in the all-wise providence, and we may guess by our own suffering how far we have overstepped them. if a man runs into a door in the dark, we know all about that,--the case is simple,--but if he runs overtime at his office and hastens to be rich with the result of a nervous dyspepsia--that is a mystery. here is a girl who "came out" last year. she was apparently strong and her mother was ambitious for her social progress. that meant four nights a week for several months at dances and dinners, getting home at  a.m. or later. it was gay and delightful while it lasted, but it could not last, and the girl went to pieces suddenly; her back gave out because it was not strong enough to stand the dancing and the long-continued physical strain. the nerves gave out because she did not give her faculties time to rest, and perhaps because of a love affair that supervened. the result was a year of invalidism, and then, because the rules of recovery were not understood, several years more of convalescence. such common rules should be well enough understood, but they are broken everywhere by the wisest people. the common case of the broken-down school teacher is more unfortunate. this tragedy and others like it are more often, i believe, due to unwise choice of profession in the first place. the women's colleges are turning out hundreds of young women every year who naturally consider teaching as the field most appropriate and available. probably only a very small proportion of these girls are strong enough physically or nervously to meet the growing demands of the schools. they may do well for a time, some of them unusually well, for it is the sensitive, high-strung organism that is appreciative and effective. after a while the worry and fret of the requirements and the constant nag of the schoolroom have their effect upon those who are foredoomed to failure in that particular field. the plight of such young women is particularly hard, for they are usually dependent upon their work. it is, after all, not so much the things we do as the way we do them, and what we think about them, that accomplishes nervous harm. strangely enough, the sense of effort and the feeling of our own inadequacy damage the nervous system quite as much as the actual physical effort. the attempt to catch up with life and with affairs that go on too fast for us is a frequent and harmful deflection from the rules of the game. few of us avoid it. life comes at us and goes by very fast. tasks multiply and we are inadequate, responsibilities increase before we are ready. they bring fatigue and confusion. we cannot shirk and be true. having done all you reasonably can, stop, whatever may be the consequences. that is a rule i would enforce if i could. to do more is to drag and fail, so defeating the end of your efforts. if it turns out that you are not fit for the job you have undertaken, give it up and find another, or modify that one until it comes within your capacity. it takes courage to do this--more courage sometimes than is needed to make us stick to the thing we are doing. rarely, however, will it be necessary for us to give up if we will undertake and consider for the day only such part of our task as we are able to perform. the trouble is that we look at our work or our responsibility all in one piece, and it crushes us. if we cannot arrange our lives so that we may meet their obligations a little at a time, then we must admit failure and try again, on what may seem a lower plane. that is what i consider the brave thing to do. i would honor the factory superintendent, who, finding himself unequal to his position, should choose to work at the bench where he could succeed perfectly. the habit of uncertainty in thought and action, bred, as it sometimes is, from a lack of faith in man and in god, is, nevertheless, a thing to be dealt with sometimes by itself. not infrequently it is a petty habit that can be corrected by the exercise of a little will power. i believe it is better to decide wrong a great many times--doing it quickly--than to come to a right decision after weakly vacillating. as a matter of fact, we may trust our decisions to be fair and true if our life's ideals are beautiful and true. we may improve our indecisions a great deal by mastering their unhappy details, but we shall not finally overcome them until life rings true and until all our acts and thoughts become the solid and inevitable expression of a healthy growing regard for the best in life, a call to right living that is no mean dictum of policy, but which is renewed every morning as the sun comes out of the sea. however inconsequential the habit of indecision may seem, it is really one of the most disabling of bad habits. its continuance contributes largely to the sum of nervous exhaustion. whatever its origin, whether it stands in the relation of cause or effect, it is an indulgence that insidiously takes the snap and sparkle out of life and leaves us for the time being colorless and weak. next to uncertainty, an uninspired certainty is wrecking to the best of human prospects. the man whose one idea is of making himself and his family materially comfortable, or even rich, may not be coming to nervous prostration, but he is courting a moral prostration that will deny him all the real riches of life and that will in the end reward him with a troubled mind, a great, unsatisfied longing, unless, to be sure, he is too smug and satisfied to long for anything. the larger life leads us inevitably away from ourselves, away from the super-requirements of our families. it demands of them and of ourselves an unselfishness that is born of a love that finds its expression in the service of god. and what is the service of god if it is not such an entering into the divine purposes and spirit that we become with god re-creators in the world--working factors in the higher evolution of humanity? while we live we shall get and save, we shall use and spend, we shall serve the needs of those dependent upon us, but we shall not line the family nest so softly that our children become powerless. we shall not confine our charities to the specified channels, where our names will be praised and our credit increased. we shall give and serve in secret places with our hearts in our deeds. then we may possess the untroubled mind, a treasure too rich to be computed. we shall not have it for the seeking; it may exist in the midst of what men may call privations and sorrows; but it will exist in a very large sense and it will be ours. the so-called hard-headed business man who never allows himself to be taken advantage of, whose dealings are always strict and uncompromising, is very apt to be a particularly miserable invalid when he is ill. i cannot argue in favor of business laxity,--i know the imperative need of exactness and finality,--but i do believe that if we are to possess the untroubled mind we must make our lives larger than the field of dollars and cents. the charity that develops in us will make us truly generous and free from the reaction of hardness. it is a great temptation to go on multiplying the rules of the game. there are so many sensible and necessary pieces of advice which we all need to have emphasized. that is the course we must try to avoid. the child needs to be told, arbitrarily for a while, what is right, and what is wrong, that he must do this, and he must not do that. the time comes, however, when the growing instinct toward right living is the thing to foster--not the details of life which will inevitably take care of themselves if the underlying principle is made right. it must be the ideal of moral teaching to make clear and pure the source of action. then the stream will be clear and pure. such a stream will purify itself and neutralize the dangerous inflow along its banks. it is true that great harm may come from the polluted inflows, but they will be less and less harmful as the increasing current from the good source flows down. we shall have to look well to our habits lest serious ills befall, but that must never be the main concern or we shall find ourselves living very narrow and labored lives; we shall find that we are failing to observe one of the most important rules of the game. vi the nervous temperament beyond the ugly actual, lo, on every side, imagination's limitless domain. browning. he that too much refines his delicacy will always endanger his quiet. samuel johnson. the great refinement of many poetical gentlemen has rendered them practically unfit for the jostling and ugliness of life. stevenson. it has been my fortune as a physician to deal much with the so-called nervous temperament. i have come both to fear and to love it. it is the essence of all that is bright, imaginative, and fine, but it is as unstable as water. those who possess it must suffer--it is their lot to feel deeply, and very often to be misunderstood by their more practical friends. all their lives these people will shed tears of joy, and more tears of sorrow. i would like to write of their joy, of the perfect satisfaction, the true happiness that comes in creating new and beautiful things, of the deep pleasure they have in the appreciation of good work in others. but with the instinct of a dog trained for a certain kind of hunting i find myself turning to the misfortunes and the ills. the very keenness of perception makes painful anything short of perfection. what will such people do in our clanging streets? what of those fine ears tuned to the most exquisite appreciation of sweet sound? what of that refinement of hearing that detects the least departure from the rhythm and pitch in complex orchestral music? and must they bear the crash of steel on stone, the infernal clatter of traffic? well, yes,--as a matter of fact--they must, at least for a good many years to come, until advancing civilization eliminates the city noise. but it is not always great noises that disturb and distract. there is a story told of a woman who became so sensitive to noise that she had her house made sound-proof: there were thick carpets and softly closing doors; everything was padded. the house was set back from a quiet street, but that street was strewn with tanbark to check the sound of carriages. surely here was bliss for the sensitive soul. i need not tell the rest of the story, how absolutely necessary noises became intolerable, and the poor woman ended by keeping a man on the place to catch and silence the tree toads and crickets. there is nothing to excuse the careless and unnecessary noises of the world--we shall dispose of them finally as we are disposing of flamboyant signboards and typhoid flies. but meanwhile, and always, for that matter, the sensitive soul must learn to adjust itself to circumstances and conditions. this adjustment may in itself become a fine art. it is really the art by which the painter excludes the commonplace and irrelevant from his landscape. sometimes we have to do this consciously; for the most part, it should be a natural, unconscious selection. i am sure it is unwise to attempt at any time the dulling of the appreciative sense for the sake of peace and comfort. love and understanding of the beautiful and true is too rare and fine a thing to be lost or diminished under any circumstances. the cure, as i see it, is to be found in the cultivation of the faculty that finds some good in everything and everybody. this is the saving grace--it takes great bulks of the commonplace and distils from the mass a few drops of precious essence; it finds in the unscholarly and the imperfect, rare traces of good; it sees in man, any man, the image of god, to be justified and made evident only in the sublimity of death, perhaps, but usually to be developed in life. the nervous person is often morose and unsocial--perhaps because he is not understood, perhaps because he falls so short of his own ideals. often he does not find kindred spirits anywhere. i do not think we should drive such a man into conditions that hurt, but i do believe that if he is truly artistic, and not a snob, he may lead himself into a larger social life without too much sacrifice. the sensitive, high-strung spirit that does not give of its own best qualities to the world of its acquaintance, that does not express itself in some concrete way, is always in danger of harm. such a spirit turned in upon itself is a consuming fire. the spirit will burn a long time and suffer much if it does not use its heat to warm and comfort the world of need. real illness makes the nervous temperament a much more formidable difficulty--all the sensitive faculties are more sensitive--irritability becomes an obsession and idleness a terror. the nervous temperament under irritation is very prone to become selfish--and very likely to hide behind this selfishness, calling it temperament. the man who flies into a passion when he is disturbed, or who spends his days in torment from the noises of the street; the woman of high attainment who has retired into herself, who is moody and unresponsive,--these unfortunates have virtually built a wall about their lives, a wall which shuts out the world of life and happiness. from the walls of this prison the sounds of discord and annoyance are thrown back upon the prisoner intensified and multiplied. the wall is real enough in its effect, but will cease to exist when the prisoner begins to go outside, when he begins to realize his selfishness and his mistake. then the noises and the irritations will be lost in the wider world that is open to him. after all, it is only through unselfish service in the world of men that this broadening can come. there is no lack of opportunity for service. perhaps the simplest and most available form of service is charity,--the big, professional kind, of course,--and beyond that the greater field of intimate and personal charity. i know a girl of talent and ability--herself a nervous invalid--sick and helpless for the lack of a little money which would give her a chance to get well. i do not mean money for luxuries, for foolish indulgences, but money to buy opportunity--money that would lift her out of the heavy morass of poverty and give her a chance. she falls outside the beaten path of charity. she is not reached by the usual philanthropies. i also know plenty of people who could help that girl without great sacrifice. they will not do it because they give money to the regular charities--they will not do it because sometimes generosity has been abused. so they miss the chance of broadening and developing their own lives. i know well enough that objective interest can rarely be forced--it must usually come the other way about--through the broadening of life which makes it inevitable. sometimes i wish i could force that kind of development, that kind of charity. sometimes i long to take the rich neurasthenic and make him help his brother, make him develop a new art that shall save people from sorrow and loss. we are all together in this world, and all kin; to recognize it and to serve the needs of the unfortunate as we would serve our own children is the remedy for many ills. it is the new art, the final and greatest of all artistic achievements; it warms our hearts and opens our lives to all that is wholesome and good. this is one of the crises in which my theory of "inspiration first" may fail. here the charity may have to come first, may have to be insisted upon before there can be any inspiration or any further joy in life. it is not always charity in the usual sense that is required; sometimes the charity that gives something besides money is best. but charity in any good sense means self-forgetfulness, and that is a long way on the road to nervous health. give of yourself, give of your substance, and you will cease to be troubled with the penalties of selfishness. then take the next step--that gives not because life has come back, but because the world has become larger and warmer and happier. when the giver gives of his sympathy and of his means because he wants to,--not because he has to do so,--he will begin to know what i mean when i say it is better to have the inspiration first. vii self-control he only earns his freedom and existence who daily conquers them anew. goethe. a good many writers on self-control and kindred subjects insist that we shall conscientiously and consciously govern our mental lives. they say, "you must get up in the morning with determination to be cheerful." they insist that in spite of annoyance or trouble you shall keep a smiling face, and affirm to yourself over and over again the denial of annoyance. i do not like this kind of self-control. i wish i could admire it and approve it, but i find i cannot because it seems to me self-conscious and superficial. it is better than nothing and unquestionably adds greatly to the sum of human happiness. but i do not think we ought to be cheerful if we are consumed with trouble and sorrow. the fact is we ought not to be for long beyond a natural cheerfulness that comes from the deepest possible sources. while we are sad, let us be so, simply and naturally; but we must pray that the light may come to us in our sorrow, that we may be able soon and naturally to put aside the signs of mourning. the person who thinks little of his own attitude of mind is more likely to be well controlled and to radiate happiness than one who must continually prompt himself to worthy thoughts. the man whose heart is great with understanding of the sorrow and pathos of life is far more apt to be brave and fine in his own trouble than one who must look to a motto or a formula for consolation and advice. deep in the lives of those who permanently triumph over sorrow there is an abiding peace and joy. such peace cannot come even from ample experience in the material world. despair comes from that experience sometimes, unless the heart is open to the vital spirit that lies beyond all material things, that creates and renews life and that makes it indescribably beautiful and significant. experience of material things is only the beginning. in it and through it we may have experience of the wider life that surrounds the material. our hearts must be opened to the courage that comes unbidden when we feel ourselves to be working, growing parts of the universe of god. then we shall have no more sorrow and no more joy in the pitiful sense of the earth, but rather an exaltation which shall make us masters of these and of ourselves. we shall have a sympathy and charity that shall need no promptings, but that flow from us spontaneously into the world of suffering and need. beethoven was of a sour temper, according to all accounts, but he wrote his symphonies in the midst of tribulations under which few men would have worked at all. when we have felt something of the spirit that makes work inevitable, it will be as though we had heard the eternal harmonies. we shall write our symphonies, build our bridges, or do our lesser tasks with dauntless purpose, even though the possessions that men count dear are taken from us. suppose we can do very little because of some infirmity: if that little has in it the larger inspiration, it will be enough to make life full and fine. the joy of a wider life is not obtainable in its completeness; it is only through a lifetime of service and experience that we can approach it. that is the proof of its divine origin--its unattainableness. "god keep you from the she wolf and from your heart's deepest desire," is an old saying of the rumanians. if we fully obtain our desires, we prove their unworthiness. does any one suppose that beethoven attained his whole heart's desire in his music? he might have done so had he been a lesser man. he was not a cheerful companion. that is unfortunate, and shows that he failed in complete inspiration and in the ordinary kind of self-control. he was at least sincere, and that helped not a little to make him what he was. i would almost rather a man would be morose and sincere than cheerful from a sense of duty. our knowledge of the greater things of life must always be substantiated and worked out into realities of service, or else we shall be weak and ineffective. the charity that balks at giving, reacts upon a man and deadens him. i am always insisting that we must not live and serve through a sense of duty, but that we must find the inspiration first. it is better to give ourselves to service not for the sake of finding god, but because we have found him and because our souls have grown in the finding until we cannot help giving. if we have grown to such a stature we shall be able to meet sorrow and loss bravely and simply. we shall feel for ourselves and for others in their troubles as forbes robertson did when he wrote to his friend who had met with a great loss: "i pray that you may never, never, never get over this sorrow, but through it, into it, into the very heart of god." all this is very unworldly, no doubt, and yet i will venture the assertion that such a standard and such a method will come nearer to the mark of successful and well-controlled living than the most carefully planned campaign of duty. if we plan to make life fine, if we say, in effect, "i will be good and cheerful, no matter what happens," we are beginning at the wrong end. we may be able to work back from our mottoes to real living, but the chances are we shall stop somewhere by the way, too confused and uncertain to go on. self-control, at its best, is not a conscious thing. it is not well that we should try to be good, but that we should so dignify our lives with the spirit of good that evil becomes well-nigh impossible to us. viii the lighter touch heart not so heavy as mine, wending late home, as it passed my window whistled itself a tune. emily dickinson. i have never seen good come from frightening worriers. it is no doubt wise to speak the truth, but it seems to me a mistake to say in public print or in private advice that worry leads to tragedies of the worst sort. no matter how hopeful we may be in our later teaching about the possibilities of overcoming worry, the really serious worrier will pounce upon the original tragic statement and apply it with terrible insistence to his own case. i would not minimize the seriousness of worry, but i am convinced that we can rarely overcome it by direct voluntary effort. it does not go until we forget it, and we do not forget it if we are always trying consciously to overcome it. we worriers must go about our business--other business than that of worry. life is serious--alas, too serious--and full enough of pathos. we cannot joke about its troubles; they are real. but, at least, we need not magnify them. why should we act as though everything depended upon our efforts, even the changing seasons and the blowing winds? no doubt we are responsible for our own acts and thoughts and for the welfare of those who depend upon us. the trouble is we take unnecessary responsibilities so seriously that we overreach ourselves and defeat our own good ends. i would make my little world more blessedly careless--with an _abandon_ that loves life too much to spoil it with worry. i would cherish so great a desire for my child's good that i could not scold and bear down upon him for every little fault, making him a worrier too, but, instead, i would guide him along the right path with pleasant words and brave encouragement. the condemnation of faults is rarely constructive. we had better say to the worriers, "here is life; no matter what unfortunate things you may have said or done, you must put all evil behind you and live--simply, bravely, well." the greater the evil, the greater the need of forgetting. not flippantly, but reverently, leave your misdeeds in a limbo where they may not rise to haunt you. this great thing you may do, not with the idea of evading or escaping consequences, but so that past evil may be turned into present and future good. the criminal himself is coming to be treated this way. he is no longer eternally reminded of his crime. he is taken out into the sunshine and air and is given a shovel to dig with. a wonderful thing is that shovel. with it he may bury the past and raise up a happier, better future. we must care so much to expiate our sins that we are willing to neglect them and live righteously. that is true repentance, constructive repentance. we cannot suddenly change our mental outlook and become happy when grief has borne us down. "for the broken heart silence and shade,"--that is fair and right. i would say to those who are unhappy, "do not try to be happy, you cannot force it; but let peace come to you out of the great world of beauty that calmly surrounds our human suffering, and that speaks to us quietly of god." genuine laughter is not forced, but we may let it come back into our lives if we know that it is right for it to come. we have all about us instances of the effectiveness of the lighter touch as applied to serious matters. the life of the busy surgeon is a good example. he may be, and usually is, brimming with sympathy, but if he were to feel too deeply for all his patients, he would soon fail and die. he goes about his work. he puts through a half-dozen operations in a way that would send cold shivers down the back of the uninitiated. and yet he is accurate and sure as a machine. if he were to take each case upon his mind in a heavy, consequential way, if he were to give deep concern to each ligature he ties, and if he were to be constantly afraid of causing pain, he would be a poor surgeon. his work, instead of being clean and sharp, would suffer from over-conscientiousness. he might never finish an operation for fear his patient would bleed to death. such a man may be the reverse of flippant, and yet he may actually enjoy his somber work. cruel, bloodthirsty? not at all. these men--the great surgeons--are as tender as children. but they love their work, they really care very deeply for their patients. the successful ones have the lighter touch and they have no time for worry. sometimes we wish to arouse the public conscience. do the long columns of figures, the impressive statistics, wake men to activity? it is rather the keen, bright thrust of the satirist that saves the day. once in a new england town meeting there was a movement for a much-needed new schoolhouse. by the installation of skylights in the attic the old building had been made to accommodate the overflow of pupils. the serious speakers in favor of the new building had left the audience cold, when a young man arose and said he had been up into the attic and had seen the wonderful skylights that were supposed to meet the needs of the children. "i have seen them," he said; "we used to call them scuttles when i was a boy." a hundred thousand dollars was voted for the new schoolhouse. there is a natural gayety in most of us which helps more than we realize to keep us sound. the pity is that when responsibilities come and hardships come, we repress our lighter selves sternly, as though such repression were a duty. better let us guard the springs of happiness very, very jealously. the whistling boy in the dark street does more than cheer himself on the way. he actually protects himself from evil, and brings courage not only to himself, but to those who hear him. i do not hold for false cheerfulness that is sometimes affected, but a brave show of courage in a forlorn hope will sometimes win the day. it is infinitely more likely to win than a too serious realization of the danger of defeat. the show of courage is often not a pretense at all, but victory itself. the need of the world is very great and its human destiny is in our hands. half of those who could help to right the wrongs are asleep or too selfishly immersed in their own affairs. we need more helpers like my friend of the skylights. most of us are far too serious. the slumberers will slumber on, and the worriers will worry, the serious people will go ponderously about until some one shows them how ridiculous they are and how pitiful. ix regrets and forebodings regret avails little--still less remorse--the one keeps alive the old offense, the other creates new offenses. goethe. the unrepentant sinner walks abroad. unfortunately for us moralists he seems to be having a very good time. we must not condone him, though he may be a very lovable person; neither must we altogether condemn him, for he may be repentant in the very best way of all ways, the way that forgets much and leaves behind more, because life is so fine that it must not be spoiled, and because progress is in every way better than retrospection. the fact is, that repentance is too often the fear of punishment, and such fear is, to say the least, unmanly. i would rather be a lovable sinner than one of the people who repent because they cannot bear to think of the consequences. knowledge and fear of consequences undoubtedly keep a great many young people from the so-called sins of ignorance. but there must be something behind knowledge and fear of consequences to stop the youth of spirit from doing what he is inclined to do. over and over again we must go back to the appreciation of life's dignity and beauty--to the consciousness of the spirit of god behind and in the world if we are to find a balance and a character that will "deliver us from evil." when we have found this consciousness--when we live it and breathe it, we shall be far less apt to sin, and when we have sinned, as we all must in the course of our blundering lives, we shall not waste our time in regret or in the fear of consequences. if the god we dream of is as great as the sea, or as beautiful as a tree, we need not fear him. he will be tender, and just at the same time. he will be as forgiving as he is strong. the best we can do, then, is to leave our sins in the hand of god and go our way, sadder and wiser, maybe, but not regretting too much, not fearing any more. there is a new idea in medicine--the development of which has been one of the most striking achievements of modern times--the idea of psychanalysis as taught and advocated by freud in germany. the plan is to study the subconscious mind of the nervous patient by means of hypnotism, to assist the patient to recall all the mental experiences of his past,--even his very early childhood,--and in this way to make clear the origin of the misconceptions and the unfortunate impressions which have presumably exerted their influence through the years. the new system includes, also, the interpretation of dreams, their effect upon the conscious life and their influence upon the mentality. very wonderful results are reported from the pursuit of this method. many a badly warped and twisted life has been straightened out and renewed when the searchlight has revealed the hidden influences that have been at work and which have made trouble. the repression of conscious or unconscious feelings can no doubt change the whole mental life. we should have the greatest respect for the men who are doing this work. it requires, i am told, an almost unbelievable amount of patience and time to accomplish the analysis. no doubt the adult judgment of childish follies is a direct means of disposing of their harmful influence in life, the surest way of losing the conscious or unconscious regrets that sadden many lives. there are probably many cases of disturbed and troubled mind that can be cured in this way only. the method does not appeal to me because i am so strongly inclined to take people as they are, to urge a forgetfulness that does not really forget, but which goes on bravely to the development of life. this development cannot proceed without the understanding that life may be made so beautiful that sins and failures are lost in progress. some of us may need the subtle analysis of our lives to make clear the points where we went astray in our thoughts and ideas, but many of us, fortunately, are able to take ourselves for better or for worse, sins and all. most of us ought to do that, for the most part, if we are to progress and live. sometimes the revelations of evils we know not of result in complications rather than simplification, as in the case of a boy who wrote to me and said that since he had learned of his early sins he had made sure that he could never be well. instead of going into further analysis with him, i assured him that, while it was undoubtedly his duty to regret all the evil of his life, it was a still greater duty to go on and live the rest of it well, and that he could do so if he would open his eyes to the possibilities of unselfish service. i am very much inclined to preach against self-analysis and the almost inevitable regret and despair that accompany it. one of my patients decided some time ago that her life was wasted, that she had accomplished nothing. it was true that she had not the endurance to meet the usual demands of social or even family life, and that for long periods she had to give up altogether. but it happened that she had the gift of musical understanding, that she had studied hard in younger days. with a little urging the gift was made to grow again and to serve not only the patient's own needs, but to bring very great pleasure to every one who listened to her playing. that rare, true ability was worth everything, and she came to realize it in time. the gift of musical expression is a very great thing, and i succeeded in making this woman understand that she should be happy in that ability even if nothing else should be possible. often enough nothing that can compare with music exists, and life seems wholly barren. rather cold comfort it seems at first to assure a person who is helpless that character is the greatest thing in the world, but that is the final truth. the most limited and helpless life may glow with it and be richer than imagination can believe. it is never time to regret--and never time to despair. the less analysis the better. when it comes to character, live, grow, and get a deeper and deeper understanding of life--of life that is near to god and so capable of wrong only as we turn away from him. "do not say things; what you are stands over you and thunders so, i cannot hear what you say to the contrary." we shall do well not to forget that, whatever failures or mistakes we have made, there is infinite possibility ahead of us, that character is the greatest thing in the world, and that most good character has been built upon mistakes and failures. i believe there is no sin which may not make up the fabric of its own forgiveness in the living of a free, self-sacrificing life. i know of no bodily ill nor handicap which we may not eventually rise above and beyond by means of brave spiritual progress. the body may fail us, but the spirit reaches on and into the great world of god. x the virtues the virtues hide their vanquished fires within that whiter flame-- till conscience grows irrelevant and duty but a name. frederick lawrence knowles. in most books i have read on "nerves" and similar subjects, advice is given, encouragement is given, but the necessity for patience is not made clear. patience is typical of all the other virtues. many a man has followed the best of advice for a time, and has become discouraged because the promised results did not materialize. it is disappointing, surely, to have lived upon a diet for months only to find that you still have dyspepsia, or to have followed certain rules of morality with great precision and enthusiasm without obtaining the untroubled mind. we are accustomed to see results in the material world and naturally expect them everywhere. the trouble is we do not always recognize improvements when we see them, and we insist upon certain preconceived changes as a result of our endeavors. the physician is apt rashly to promise definite physical accomplishments in a given time. he is courting disappointment and distrust when he does so. we all want to get relief from our symptoms, and we are inclined to insist upon a particular kind of relief so strongly that we fail to appreciate the possibilities of another and a better relief which may be at hand. the going astray in this particular is sometimes very unfortunate. i have known a man to rush frantically from one doctor to another, trying to obtain relief for a particular pain or discomfort, unwilling to rest long enough to find out that the trouble would have disappeared naturally if he had taken the advice of the first physician, to live without impatience and within his limitations. the human body is a very complex organism, and sometimes pain and distress are better not relieved, since they may be the expression of some deeper maladjustment which must first be straightened out. this is also true of the mind--in which the unhappy proddings of conscience had better not be cured by anodynes or by evasion unless we are prepared to go deeply enough to make them disappear spontaneously. we must sometimes insist upon patience, though it should exist as a matter of course--patience with ourselves and with others. the physician who demands and secures the greatest degree of patience from his clients is the most successful practitioner, for no life can go on successfully without patience. if patience can be spontaneous,--the natural result of a broadening outlook,--then it will be permanent and serviceable; the other kind, that exists by extreme effort, may do for a while, but it is a poor makeshift. i always feel like apologizing when i ask a man or a woman to be tolerant or charitable or generous or, for that matter, to practice any of the ordinary virtues. sound living should spring unbidden from the very joy of life; it should need no justification and certainly no urging. but unfortunately, as the world now stands, there are men and groups of men who do not see the light. there is a wide contagion of selfishness and short-sightedness among the well-to-do, and a necessary federation of protection and selfishness among the poor. the practical needs of life, artificial as they are among the rich, and terribly insistent as they are among the poor, blind us to larger considerations. if all matters of welfare, public or private, could be treated unselfishly, how quickly we should be rid of some of the great evils that afflict the race. i am inclined to think that much of the goodness of people does come in that way, unconsciously, naturally, as the light flows from the sun. yet i suppose that in our present order, and until, through the years, the better time arrives, we must very often ask ourselves and others to be good and to be charitable, just because it is right, or worse still because it is good policy. a man grows better, more human, more intelligent, as he practices the virtues. he is safer, no doubt, and the world is better. it is even true that, by the constant practice of virtues, he may come finally to espouse goodness and become thoroughly good. that is the hopeful thing about it and the reason why we may consistently ask or demand the routine practice of the virtues. but let us hold up all the time in our teaching and in our lives the other course, the development of the inspiration that includes all virtues and that makes all our way easy and plain in a world where confusion reigns, because men are going at the problem of right living the wrong way around. the practice of good living will never be easy in its details, but if it is sure in its inspiration there will be no question of the final triumph. we shall have to fight blindly sometimes and with all the strength and persistence of animals at bay. we shall fail sometimes, too, and that is not always the worst thing that can happen. it is the glory of life that we shall slowly triumph over ourselves and the world. it is the glory of life that out of sore trouble, in the midst of poverty and human injustice, may rise, spontaneous and serene, the spirit of self-sacrifice, the unconquerable spirit of service that does not question, that expresses the divine tenderness in terms of human love. through the times of darkness and doubt which must inevitably come, there will be for those who cherish such a vision, and who come back to it again and again, no utter darkness, no trouble that wholly crushes, no loss that wholly destroys. if we could not understand it before, it will slowly dawn upon us that the life of christ exemplified all these things. charity, kindliness, service, patience,--all these things which have seemed so hard will become in our lives, as in his, the substance and expression of our faith. the great human virtues will become easy and natural, the untroubled mind, or as much of it as is good to possess, will be ours, not because we have escaped trouble, but because we have disarmed it, have welcomed it even, so long as it has served to strengthen and ennoble our lives. xi the cure by faith the healing of his seamless dress is by our beds of pain-- we touch him in life's throng and press, and we are whole again. whittier. i cannot finish my little book of ideals without writing some things that are in my mind about cure by faith or by prayer. it is a subject that i approach with hesitation because of the danger of misunderstanding. no subject is more difficult and none is more important for the invalid to understand. we hear a great deal about the wonderful cures of christian science or of similar agencies, and we all know of people who have been restored to usefulness by such means. has the healing of christ again become possible on earth? no one would be more eager to accept it and acknowledge it than the physician if it were really so. but careful investigation always reveals the fact that the wonderful cures are not of the body but of the mind. it is easy enough to say that a cancer or tuberculosis has been cured by faith, and apparently easy for many people to believe it, but alas, the proof is wanting. the christian scientist, honest and sincere as he may be, is not qualified to say what is true disease and what is not. what looks like diseased tissue recovers, but medical men know that it could not have been diseased in the most serious sense, and that the prayer for recovery could have had nothing to do with the cure, save in a very indirect way. the man who discards medicine for philosophy or religion is courting unnecessary suffering and even death. the worst part of it is that he may induce some one else to make the same mistake with similar results. in writing this opinion i am in no way denying the great significance and value of faith nor of the prayerful and trustful mind. if it cannot cure actual physical disease, faith can accomplish veritable miracles of healing in the mind of the patient. no thoughtful or honest medical man will deny it. nor will most medical men deny that the course of almost any physical illness may be modified by faith and prayer. i am almost saying that there is no known medicine of such potency. every bodily function is the better for the conquering spirit that transcends the earth and finds its necessary expression in prayer. there really need be no issue or disagreement between medicine and faith cure. at its best, one is not more wonderful than the other, and both aim to accomplish the same end--the relief of human suffering. when the two are merged, as some day they will be, we shall be surprised to discover how alike they are. christian science is rightly scorned by medical men because it is unscientific, because it makes absurd and untenable claims outside its own field, and because it has not as yet investigated that field in the scientific spirit. when proper study and investigation have been made it will be found that faith cure, not in its present state, but in some future development, will have an immense field of usefulness. it will be worthy of as much respect in that field as medicine proper in its own sphere. as a matter of fact both medicine and faith cure are miraculous in a very real sense, as both depend for efficiency now and always upon the same great laws which may be fairly called divine. what is the discovery that the serum of a horse will under certain circumstances cure diphtheria? does it not mean that man is tapping sources of power far beyond his understanding? is man responsible save as the agent? did he produce the complex animal chemistry that makes this cure possible? did man make the horse, or the laws that control the physiology and pathology of that animal? here, then, is faith cure in its largest and best sense. the biologist may not be willing to admit it, but his faith in these great laws of god have made possible the cure of a dread disease. here, as in all matters of pure religion, it is what men say and write, not the fact itself, that makes all the misunderstanding; we make our judgments and conceive our prejudices from mere surface considerations. call life what you will,--leave out the symbolic word "god" altogether,--the facts remain. the true scientific spirit must reverence and adore the power that lies behind creation. it is as inconsistent for the bacteriologist to be an unbeliever as it is for the christian scientist to deny the value of bacteriology. medicine is infinitely farther advanced than christian science, and yet christian science has grasped some truth that the natural scientist has stupidly missed. when an obsession is thrown off and courage substituted for fear, we witness as important a "cure" as can be shown to the credit of surgery. if the christian scientists and the other faith-curers were only less superficial and less narrow in their explanation of the facts, if they would condescend to study the diseases they treat, they would be entitled to, and would receive, more respect and consideration. the cure and prevention of disease through the agency of man are evidently part of the divine plan. our eagerness to advance along the lines of investigation and practice is but that divine plan in action. the truly scientific spirit will neglect no possible curative agent. when scientific men ridicule prayer, they are thinking not of the real thing which is above all possible criticism, but of the feeble and often pathetic groping for the real thing. we ask in our prayers for impossible blessings that would invert the laws of god and change the face of nature--very well, we must be prepared for disappointment. the attitude of prayer may, indeed, transform our own lives and make possible for us experiences that would otherwise have been impossible. but our pathetic demands--we shall never know how forlorn and weak they are. prayer is the opening of the heart to the being we call god--it is most natural and reasonable. if we pray in our weakness and blindness for what we may not have, there is, nevertheless, a wonderful re-creative effect within us. the comfort and peace of such communion is beyond all else healing and restoring in its influence upon the troubled and anxious mind of man. the poet or the scientist who bows in adoration before the glory of god revealed in nature, prays in effect to that god and his soul is refreshed and renewed. the poor wretch who stands blindfolded before the firing squad, waiting the word that ends the life of a military spy, is near enough to god--and the whispered prayer upon his lips is cure for the wounds that take his life. the best kind of prayer seeks not and asks not for physical relief or benefit, but opens the heart to its maker, and so receives the cure of peace that is a greater miracle than any yet wrought by man. under the influence of that cure the sick are well and the dead are alive again. with the courage and spirit of such a cure in our lives, we shall inevitably do our utmost to relieve, by any good means, the physical suffering of the world. we shall follow the laws of nature. we shall study them with the utmost care. we shall take nothing for granted, since by less careful steps we shall miss the divine law and so go astray. the science of healing will become no chance and irrational thing. we shall use all the natural means to relieve and prevent suffering--there will be no scoring of one set of doctors by another because all will have one purpose. but more to the point than that, men will discover that health in its largest sense consists in living devout and prayerful lives whereunto shall be revealed in good time all that our finite minds can know and use. there will be no suffering of the body in the old and pitiful sense, for we shall be so much alive that disease and death can no longer claim us. the end [illustration: happy homes are happier if the "new home"] terms to suit eve the new home sewing machine co chas. e. naylor, manager. market st. (history building), san francisco health, happiness, and longevity. health without medicine, happiness without money, the result, longevity. by l. p. mccarty, author of the annual statistician and economist, san francisco, cal. san francisco: carson & co., post street. health happiness and longevity. entered according to act of congress in the year , by l. p. mccarty, in the office of the librarian of congress at washington, d. c. price, in flexible covers, $. price, in paper covers, . address, l. p. mccarty, cal. st., s. f., cal. or the book trade generally. carson & co., wholesale agents, post st., san francisco, cal. preface. = ... "to know that which before us lies in daily life is the prime wisdom. what is more is fume, or emptiness, or fond impertinence, and renders us, in things that most concern, unpractic'd, unprepar'd, and still to seek." --_milton's adam to angel._= experience is honored. this book is the result of experience. man is interested in what pertains to health. we are positive that the ideas herein set forth are healthful. our profession is not that of a doctor of chemical medicines. we have no hobby to ride or patent panacea to advertise, but desire to express, in plain, forcible, truthful language, the methods by which mankind can practically achieve health, happiness and longevity. these go together. why should they not? related, dependent upon each other, the great objects of human life, the culmination of all physical and worldly pleasure are contained in them. whether you are the perfect embodiment of a business man or the ideal disciple of a certain profession, you cannot possibly reach the highest or even most lucrative grades of your calling without health, happiness, and their logical consequence, longevity. they will prove trusty lieutenants. without them the battle of life will draw to a close in retreat and end in defeat. to assert that the average man can enjoy health without medicine, happiness without even money, and longevity too, is a broad and sweeping declaration. in fact, we expect to have opposition from those who have not tried the formula laid down in the following pages. to _keep_ yourself in health without medicine is what we intend to convey; and we assert that but little or no medicine is necessary to reach that condition. to have happiness without any money (in the present condition of society) is not what we claim, but that more happiness can be extracted from a competency than by more or less. to live to good old age means with us to years, to increase with future generations, when order, regularity, sobriety, cleanliness, and love for the whole human family, shall be paramount in the political, moral, and intellectual world. the author is living on thirty years of made land. in other words, according to medical diagnosis, he should have _died_ thirty years ago! hence he desires to put before the unhealthy, unhappy, and short-lived human race the result of his experience of half a century. having battled with a score of diseases, a number of which were claimed to be absolutely incurable--having freed himself entirely of them all--having been completely restored to health and happiness, he honestly believes that he has a convincing right to be heard. you can now prove for yourself. part i. chapter i. "health is the vital principle of bliss, and exercise of health." _health_, _happiness_, and _longevity_. what a talisman is here! in them is the magic that can rule all men. no seal, figure, character, engraven on a sympathetic stone, can equal their single or combined influence. say to your fellow-man, "if you follow my direction i will confer upon you health, happiness, and longevity," and you will receive his lasting gratitude. he will always be your friend. money is potent, but these qualities are, as it were, omnipotent. money alone cannot bring them; they alone can make wealth. this work is _not_ a _philosophical_ treatise, difficult to read and more so to comprehend. its ideas are simple, the result of long _experience_ and _observation_. its propositions are easily demonstrated. then, my reader, do not think you are perusing the hobbies of a crank, the fantasies of a dreamer, and the preachings of him who does not practice. the world has been so flooded with worthless productions of such characters that we fear we must combat severe _prejudice_. will you lay that aside? if so we will not only interest but instruct you. agreeing with our premises and conclusions, you will certainly reap some benefit; not agreeing, you will be tempted to further investigation, which will inevitably prove the strength of our position. this book was not written at one sitting or many, but it is the culmination of several _years' preparation_. while the first part is the result of thorough reasoning and experience, the second is a collection of the best modern data on prominent diseases and their remedies, with our own annotations. both sections represent thoughtful and painstaking labor. even if you are so bold as to maintain that you possess health, happiness, and are sure of longevity, we believe you cannot fail to find practical, valuable truths in these pages. whether you are an editor, merchant, lawyer, doctor, minister, or day-laborer, we hope at least to entertain you. are we right? read and judge. from the mythological times of _Æsculapius_ down to the present day, votaries of medical science have been compounding, diagnosing, and prescribing for helpless, suffering humanity. for many ages this condition may have been a necessity, but in the light of our present civilization, sound common sense is the best physician. that _doctors_ cannot be trusted to be right in every instance or even in a majority of them is shown by practical experiments. they certainly are well proved to be an inharmonious crowd by the experience of a _boston globe_ reporter, who recently called upon ten regular physicians on the same day, and described his symptoms in exactly the same language to each. he received ten prescriptions, of which no two were alike, and a majority were utterly inconsistent each with the other. _nellie bly_, the famous lady writer of the new york _world_, had a cold and went to over fifty of the city's leading physicians, in october, , asking them to prescribe for her. they did, and among the collection there were no two alike, and many diametrically opposite in nature and effect! in a lecture recently delivered before the cooper medical college, san francisco, cal., on the subject of "quacks and quackery," by prof. l. c. lane, the speaker said: "every good thing in the world has been counterfeited, and in these advanced times the work is so well done that it takes an expert to detect the true from the false. everything is now more or less adulterated, especially the food we consume. the three great professions also of theology, law, and medicine, have been and are grossly counterfeited, especially the latter, which opens up the widest field for imposture." as the above quotations, without an explanation, might convey the idea to the reader that the author considers that doctors, dentists, and specialists are no longer a necessity, i will say, under the present state of society, they are not only indispensable, but absolutely a necessity. when you are ill, and do not know what is the matter with you, or if you know the nature of your ailments, and do not know a remedy, seek a first-class physician; take his advice in every particular until he either cures you or you are convinced he cannot. i am not a prophet, nor the son of one, but i will venture an opinion that before the close of the next century, the position of the minister, teacher, and physician will be filled by one and the same person. the teacher _then_ will fill the most exalted position on the earth. he will not only instruct how to navigate the air without collision, but how not to catch cold at , feet elevation in your shirt sleeves, and _who_ and _what_ is _god_. his school-house will sit upon the most elevated spot in his district, with light reflected from all four sides; it will be at least fifty feet from the floor of his school-room to the ceiling; and in place of a steeple, there will be a dome, containing a -inch refractor telescope, and with the extra timber not used for a _steeple_, the seats will be made more comfortable, and pure filtered water will be supplied for the pupils to drink. it is granted that the majority of mankind appreciate health, desire happiness, and expect longevity. with this as an incentive, why not strive to win the prize? do not depend on the doctor, do not think some drug must be applied or imbibed for every ill; there are other methods. perhaps we can aid you to the true enjoyment of life if you will _impartially_ weigh our _argument_. here is an _editor_ suffering from nervousness. he consults a physician, who hands him an opiate so that he can sleep. better if he had given up all thought of his paper and battles of words, on leaving his office, and allowed his throbbing, weary brain a deserving rest. then the cells of this brainy tissue would cease to be gorged with blood, and sleep would positively follow. again, there is a _clergyman_ every sunday beseeching his flock to obey the commandments of the _bible_; while every day, through carelessness, he is breaking the laws of health. if an _all-wise being_ gave us our bodies as homes of our souls, did he not mean that we should promote the happiness of the soul by providing for it a healthy residence? what logic and strength exist in a religion that does not countenance such philosophy? the majority of mankind admire a well-developed _physique_. the minister wishes and prays to influence the masses of men. can he reach them effectively, can he point to himself as an example, can he sway them by any reasoning or eloquence, when he himself has a husky voice, a pallid face, and a weakened figure? indeed, the cowled, decrepit monk could lead the world in the darkness of the middle ages; but in the brightness of the nineteenth century his scepter is powerless. _health_, _happiness_ and _longevity_ seem to be all that is required for mortal man. they are the foundation, the superstructure, and the apex respectively of the great _pyramid_ of life. who would desire more than the possession of perfect health, the realization of happiness, the achievement of ripe old age, retaining all the pleasurable attributes of perfected manhood, experiencing all these until called upon to surrender this present house of clay for a more advanced state, whatever that may be? such degrees of soundness, felicity, and age, which we have mentioned, are within the reach of all who desire them, if they will observe the rules implied in the following terms, arranged in the order of their importance: regularity, cleanliness, temperance (or moderation), morality, and self-control. it is safe to state the proposition that there is not one in a thousand of those induced to peruse this humble effort, who will not claim to possess one or more of the foregoing virtues, while a fair minority will urge that they are characterized by all of them. that your _egoism_ may not get the better of you in the start and bias you before reading my talk, i will frankly say that there is hardly a person living to-day who is either regular, cleanly, temperate, moral, or self-controlled. it is a fact that some have made fair efforts in those lines of action, but we shall attempt to prove that not any have perfected themselves in a single attribute above mentioned. with us, regularity, cleanliness, temperance, morality, and self-control are so interlaced as to become synonymous terms, the perfection of any one of which means the consummation of all, while their master could laugh at sorrow, pain, and even death, for through long years they would pass his door and forget to knock. just in proportion as we approximate these virtues, correspondingly will our _lives_ be prolonged and our _happiness_ intensified. _fear_ will not prostrate us because "death rides on every passing breeze, he lurks in every flower." as modifying the foregoing partially, let us understand, however, that it is possible to have health and longevity to a wonderful degree without cleanliness, temperance, morality, and self-control, on one vital consideration. that is, the _continual_ exercise of _regularity_. here we have the corner-stone of the whole structure of health, the cardinal first law. but can we be happy without the generous employment of _all_ these virtues? obviously and fortunately, we cannot. _health_ is also the chief _desideratum_ to happiness. as disease creeps through the physical frame, as aches and pains increase and torment our bodies, our _doubts_ supplant _faith_ in the _source_ of all goodness. after a quarter of a century's constant devotion, in sackcloth and ashes, as it were, attempting to free the body from the shackles of pulmonary consumption, and growing gradually worse during the whole period, the majority of devotees, we think, would begin to inquire, "are our prayers lacking sincerity? or is the source of goodness at this time otherwise occupied? or may it not be that this for which i ask, i must seek by personal action?" we will try this self-helping method; if success comes, we will return to the same altar with a more exalted idea of a higher source. cleansed of our maladies, we will have a clearer perception of who and what is god. chapter ii. "there is naught like universal co-operation to promote universal achievement." _individuals_ may seek and obtain health through the agencies already, and to be, suggested. to keep in health, their _neighbors_ must be induced or compelled to adopt the same course. this is not an absolute law, but manifestly is very essential. supposing your own house, sidewalk, alley, or yard, are comparatively immaculate, it will be impossible to live without constant danger and exposure if your friend (or enemy in this sense) has an untidy house, a dirty sidewalk, and a filthy yard, in your proximity. then how encouraging to note that health is as contagious as disease. it even spreads with greater rapidity. health is gladly welcomed; disease is shunned like a deadly poison. all over the world past and contemporary history proves that, once started, health spreads at a rate that disease cannot follow. what will surely result? healthful communities will make healthful municipalities; healthful municipalities will end in commonwealths and nations of like character. the whole earth will be leavened. from a record of years as the average _duration_ of human life, the thermometer of universal progress will point to the threescore and ten, or years. if you were induced to smile at the close of the last sentence, it shows that you are not lost to all sense of appreciation--but quietly put on your sober cap for a moment and read a few facts on _vital statistics_. the average length of life up to twenty years ago was years, now it has reached about . years. this has not been caused by the _whole_ world becoming more healthful--indeed, some portions of the earth, including sections of the united states, have retrograded, and the former limit of _mortality_ has been lowered--but by the health of a number of _organizations_, _sects_, and individuals who have increased their standards of regularity, cleanliness, temperance, morality, and self-control. thus the average rate of mortality has been raised nearly %. an interesting fact which is new to the majority of persons is this, that the whole sect of _friends_, or _quakers_, live an average of years per individual. in the thirty-two years from to they raised the average six years, or about one year in five. with this ratio, which is itself increasing, the plurality of quakers will be centenarians in less than two hundred years--in half that time if assisted by the world at large. by the foregoing it will be seen that the whole organization of friends live % longer than the general age allotted to mankind, which includes them to make up the universal rate. another noticeable feature in connection with the quakers' life is this, the deaths among them average in every thousand; in the general population, per thousand; while the amount given to charities per inhabitant in that sect is $ . , and in the total population the average is $ . . why this difference in longevity to so marked a degree? the _prohibitionist_ will give this reason, that the friends dissipate less; the religionists will say they are more truthful, more godly. while each of the aforementioned reasons have a healthful tendency, there is a more scientific conclusion, for it is a well-known fact that there are thousands of cases of longevity of men and women who lack every moral principle, and dissipate all their lives. the _scientist_ comes to our rescue. he tells us that the quaker's life is prolonged by his methodical way of living, evenness of temperament, wearing the same weight of clothing, allowing nothing to furrow the brow, regularity of sleeping, drinking, exercising, and eating. he takes no food or drink into his stomach above ° or below ° fahr. _boiling_ hot soup and frozen _ice-cream_ are unknown in a quaker family. this might convey the idea that ice-cream is foresworn by them. not entirely so. they use the same good judgment in that as in every other indulgence, allowing the cream to rise in temperature from ° to ° above the freezing point, to soft consistency, before it is taken into the stomach. dr. ufflemann, a german physician of authority, draws some important conclusions from his own experiments and those of others. the rules laid down are briefly:-- . that, in general, a temperature of food which approaches that of the blood is most healthful. . for quenching the thirst the best temperature is from ° fahr. to ° fahr. americans prefer about °. . the gulping down of ice-water or hot coffee, etc., means eventually a stomach damnation. . the use of very hot and cold substances, following or alternating, is injurious to the teeth. . ingestion of cold food and drinks lessens the bodily temperature, whether it be normal or febrile. . cold food and drinks increase the tendency to cough, by causing, reflexly, a congestion of the bronchial vessels. hence persons with bronchial disease ought not to indulge in cold drinks. the habits of indulgence in alcoholic drinks, tobacco, opium, and other narcotics or stimulants, have less to do than is generally supposed with longevity, but much to do with happiness, while their abuse or irregularity determines all for health, happiness, and longevity combined. temperance men and moralists will take issue with me, and undertake to prove that any quantity, no matter how small, of either alcohol, tobacco, or opium will shorten life; but the facts will not sustain the assertion. it is the irregularity with which the body is treated, either by outward application or bathing, in eating, sleeping, or excess in all vices. for health, a regular gratification in the full list of vices is better than having no vices--such as are so termed by the world--and being irregular in everything else. while i do not believe in practising any form of vice, yet the man who takes six drinks of alcoholic spirits in reasonable quantities at fixed intervals each day, smokes six cigars--two after each meal--chews three ounces of tobacco with the same punctuality every day, eats his meals slowly and at stated periods, sleeps from - / to hours per night between the same hours, will outlive the man who neither smokes, chews, or drinks, but does eat and sleep irregularly, and lies awake all night hating his neighbor for his immoralities. he gets thin and haggard, followed by all the weaknesses to which his system is heir; while the other man, with his evenness of nature, habits, and dissipations, enjoys health, becomes fat, and lives to the proverbial good old age. here, then, my reader, we have the explanation why a man may live through _dissipation_ all his life, and then die only by accident at or years of age. a beggar, miser, or hermit may by degrees contract the habit of filthiness, non-bathing, scantiness of food and improper clothing, with such regularity that he will outlive all his friends and relatives, and be chronicled at his death as one of the _centenarians_. as an interesting fact, we state that in a beggar, aged , in perth, hungary, tried to commit suicide by throwing himself into the danube because he was no longer able to support his father and mother, who were and years old respectively! _poisons_ may be taken in infinitesimal doses for a while, then increasing by degrees until _twenty_ grains of morphia or strychnia may be taken at a single dose without immediate injury. there is at least one case of positive record in colusa county, of this state. in closing this chapter we wish to call attention to a reasonable result of true system, or regularity. here is a _convict_ in the state prison. before he was incarcerated his health was imperfect, and he wore a sallow, dejected look; but behold him after six months of strict penitentiary discipline; he is a well man, fat and sleek--no longer a semi-invalid. there are exceptions, but they are due to melancholy generally. a _soldier_ after he enlists, unless he is exposed to the constant privations of protracted war, throws off most defects in his physique. you must know the cause; it is the compulsory regulation of diet and clothing. cleanliness and regularity are forced upon them, showing it to be just what they needed. chapter iii. "let health my nerves and finer fibers brace." the possession of health, happiness, and longevity requires _not_ so much a general literary and _scientific education_, as a _practical knowledge_ of one's own self. the latter will far outweigh the other. in many ways, however, will these qualities be improved by the former. a person must know what is regularity, cleanliness, and temperance, or moderation. by the use of these effective auxiliaries, i have freed myself of so many maladies within the last thirty years that the average medical devotee will laugh in derision and question my trustworthiness. for the first _eleven_ years of my life i had _seven_ years of wasting sickness. of these, _five_ were spent in bed. at the age of i left a clerkship in new york city to come to california, _via_ cape horn. _consumption_ was strongly seated on my lungs. in addition to this dangerous affliction i had bronchitis, catarrh, constipation, piles, periodical rheumatism, cataracts on my eyes, corns on my feet, and fever and ague from one to three months every year. surely i was in a position to sympathize with _job_, but impatient, rather than patient like the biblical hero. i set myself towards absolute health. before i had been in this state two years, i gained the mastery of the lung and throat troubles; but while assisting in putting in a flume in feather river, below oroville, in , i ruptured myself so that for twenty-five years i wore a truss. now i am entirely rid of the aforementioned list of ailments, including hernia. the detail of how i treated each of the maladies might not interest the reader, and is too long a story to relate in this work. the principal things done in each case, however, will be chronicled under their proper heads in the second part of this work. see index. i do not now smoke, chew, nor drink intoxicants; the latter i did to a limited degree, and the former to excess, for a number of years, up to the close of . on the st day of december of that year--the day i smoked my _last cigar_--i bought _twenty-five_ cigars and smoked _twenty-three_ of them. my cigar bill that year averaged $ . per day, and ran as high as $ . . having dissipated, and had nearly every form of disease, i speak from my own thorough experience and not from that of anyone else. why should not my story, then, have a beneficial influence? if any man knows how he can improve the welfare of his fellows, it is his duty to spread the information. true it is that many of the _quasi reformers_, or informers, are cranks or dreamers; but we wish the fact distinctly understood and appreciated that we come not under that category. we raise no false standard; we send forth no untried hypothesis. there is a man in a new england state who annually lectures on agriculture, writes special and general articles for the country papers on the most improved methods of farming, appears before legislative committees as a successful tiller of the soil. but, alas! what superficiality is contained in this man's brain. his house is a barn, his garden a chicken-yard, his orchard a forest, and his meadow a pasture. there are like phantasmagoric geniuses interested in the health question. we simply say, trust them not. shun them and their advice as you would the presence and enticings of a bunco steerer. but you will get impatient to learn in what consists cleanliness, regularity, and temperance if i do not proceed. indeed, i think i can hear some of you say, "i neither chew, drink, smoke, eat irregularly, or miss my stipulated number of hours in bed; yet i have all manner of aches and pains, and many lingering maladies." if such be the case, you do not understand the true principle and its practical application of _cleanliness_. a word here in regard to bathing. there is no doubt we all should bathe at least once a day. it should be done either at retiring or rising. if a warm or hot bath, at night; if cold or sponge bath, in the morning. of course, if a person is not accustomed to a cold sponge bath, or is quite nervous, he must not attempt it too strongly at first. commence and advance by gradation. almost anything can be done to which an individual is unaccustomed if regular steps are taken towards the end, and not one leap. whether it be beneficial or destructive, invigorating or poisoning, gradation will accomplish the end. madame patti, who always has been obliged to take the greatest care of herself, gives this warning, which may not be out of place: "take plenty of exercise, take it in the open air, take it alone, and breathe with the mouth closed. live on simple food; all the fruit and rare beef you want, very little pastry, a glass of claret for dinner, coffee in moderation, but never a sip of beer, because it thickens the voice and stupefies the senses. keep regular hours for work, meals, rest, and recreation, and never under any circumstances indulge in the fashionable habit of eating late suppers. if you want to preserve the beauty of face, and the priceless beauty of youth, keep well, keep clean, keep erect, and keep cool." without being didactic, let me detail to you a few things you should and should not do; and all of which i carry out to the letter:-- adopt some style of _clothing_ so that even if you change the color the _weight_ will be about the _same_. wear no overcoat, overshoes, nor gloves; in their place wear a sufficiently heavy suit when it is warm, so as to have enough on when it is cold. by wearing a _chest protector_ fore and aft of the lungs, made of chamois and flannel, over the under-garment and under the shirt, you will never take cold through your lungs. have good, thick-soled _boots_--and always of the same thickness--and you will not take cold through your feet. have a _hat_ always of the same weight, and that should be light, with ventilators in the top or sides. if you do not wear your hat at the lunch table, or in your place of business, you will not catch cold in your head. a large list of accessories accompany the above:-- never sit at your desk or home fireside with the same coat which you use on the street. in its place have one per cent lighter for such occasions and positions. never _sleep_ in your _under-garments_, nor in any other clothing that you carry during the day. the reason is strong and obvious. your covering in the course of the day receives all the perspiration and surface deposit of the skin, which amounts to considerable in sixteen hours. this must have a chance to escape or be absorbed by the air. the amount is only increased by wearing the same garments at night. have a good warm _night-shirt_, and a clean one at least every week. do not sleep in a room without having the windows down from the top to some extent. if there be six, lower three of them. if you sleep with a companion and do not know anything about _animal magnetism_, find out through someone who does know. ascertain which of you is more positive, and govern yourself accordingly. i find best results for me in sleeping with my head north, and on the west side of a negative companion. this principle of magnetism is too little observed. yet it applies to all persons at all times. naturally some individuals are more magnetic than others, that is, more positive. usually, if not always, the more masculine, swarthy, is the more positive, while the light-haired and eyed are negative. sleep invariably with your head towards the north if you are positive, towards the west if you are negative, but never in any case towards the east or south. these conclusions are based wholly on scientific reasons, and anyone who understands physics will see the cogency of our statements. as a preventative against anything that has once been in my stomach rising and remaining on the tongue, i use a piece of ordinary _whalebone_ to curry it every morning, from end to end. this will tend to purify the breath, sweeten the mouth, and aid mastication. my _tooth brush_, after using, is so thoroughly _cleansed_ and dried that anyone acquainted with the facts would hardly believe it had been used. there are millions of particles of dust, atoms, _microbes_, or any other name you may use, that collect upon your person and clothing hourly. if your garments be tattered and torn, or patched and glazed, this will not shorten your life or lessen your appetite; but i assure you, if you will use up a -cent whisk-broom twice a year, in brushing yourself from head to foot before each meal, there will be less to fall upon your food, and thus find its way to your stomach, and your days will be prolonged in exact ratio. chapter iv. "on life's vast ocean diversely we sail, reason the card, but passion is the gale." there are more diseases contracted, more unhappiness created during life, and early decay occasioned, by _politeness_ and _pride_ than by whisky and tobacco combined. total-abstinence advocates will assert that drink kills more than all other causes. what would they think if we should say, if he is a reformed drinker, that it was out of pure politeness that he quaffed his first glass. politeness is the cause of disease in many ways, of which the following are a few:-- a friend--only in name--will stop you in the first corner of the street and insist on telling you a good(?) joke about brown, smith, or jones. he takes you by the lapels of the coat, holds you to windward for twenty minutes in a breeze blowing twenty-five miles an hour, although this lays you up with a cold for a week, and thus plants the first seeds of consumption. you will be too polite to tell him that your health will not permit you to be so exposed. as a remedy for this class of attacks, if a man insists on saying anything more than "how do you do" or "good-bye," i should invite him into the nearest hall-way or around the corner to leeward, entirely out of the draft. if this does not seem feasible, i would bid him "good-day." another case of excessive politeness is when a gentleman or lady continues chatting ten minutes in the _hall_ after he or she _must =go= immediately_. then at the door after they have walked out, you, in dressing-gown and slippers, stand on the cold marble step in a driving fog for twenty minutes more, to hear the latest gossip--too polite to slam the door in their faces, or excuse it as an accident. but the politeness that kills faster than any other is that of the consumptive, bronchially-affected, or catarrhal patient. he will sit at the table, or in company, and, out of pure politeness, swallow the _mucus_ and other impurities that arise in his throat--too polite to use a cuspidor or excuse himself by withdrawing to another room or the open air, and clear his throat. a great many people are accustomed to _expectorate_ into their _handkerchiefs_. this is a baneful practice. just as soon as that gets dry which they have thrown up from their lungs, innumerable microbes of deadly effect escape and do extensive harm. avoid this habit and use the cuspidor or step out-of-doors. it is not unreasonable to believe that per cent of all the consumptives would recover if they would, by care and cleanliness, see that no particle of mucus once away from the lungs should ever go back down the throat, and observe other points regarding apparel and cleanliness mentioned in the first part of this work. we have already devoted some space to what we should and should not do. all that, however, is but a small part of a life which will continually experience health, happiness, and longevity. we trust you do not simply read these statements not intending to test their value. it is not unlikely that many of you from your course or line of business will find it eminently difficult to absolutely follow our instructions. be that as it may, come as approximately as you can, and there will positively result an improvement in your physical condition, a progression in your happiness, and a realization of longevity. the remainder of this chapter will be occupied by a program, or rather set of _formula_ of what is necessary to aid you in _keeping well_, living long and happily. keep your _bowels_ open and regular in action. this you can do, if irregular or _constipated_, by taking a few drops of water in your right hand every morning and rubbing the bowels in a circular motion from right to left, until a friction is produced and the moisture gone. from six to ten separate passages of the hand over the bowels is usually sufficient, and the object will be accomplished. each day this is repeated; in a very short time you will be all right in this particular, and will not require even this effective medicine. you must be aware that a score of maladies are kept at bay by the regularity of the bowels. this fact cannot be too strongly impressed on mankind in general. it is very seldom indeed that you come upon a man who is well with a bad digestive apparatus; but, again, he who possesses a strong stomach and is moderate and regular in eating is almost invariably characterized with a vigorous constitution. disease finds no place to locate upon or in him. there is no doubt the american people eat too fast, and that is why so many die so soon. the system is worn out when it should be ready to do its best work. if all the men and women in this country would eat % slower they would live % longer. of this we have no doubt--nor do you, reader. sleep eight hours every night, between the same hours, as nearly as possible, in a room well ventilated from the top of the window. if your room is small you will require more _ventilation_ than if it is large; in this case use more clothing on the bed. if possible have a bowl or basin of water uncovered in the room, but the next morning do not either drink or wash your face in the water that has stood exposed all night. to drink it is slow suicide; to wash in it is unhealthy. in the morning scrape the tongue with a strip of whalebone, as before mentioned; brush the teeth with a good stiff clean tooth-brush, up and down, but not across; note this latter proposition, there is reason for it. by perpendicular brushing the bristles or hairs get in between the teeth, where much sediment is left, and the gums are not made sore. this is the best method also to prevent tartar forming. _gargle_ the throat with clean water three or four times; then, if you have it at hand, drink about three swallows of cool filtered water; if not near go thirsty until it is. never take a drink of water, whether you be sick or well, without first gargling the throat with at least one swallow and spitting it out. do you think _filtering_ of reservoir or general city water is necessary? if not, then make a microscopic examination, and any skepticism will be entirely removed. it is a prominent fact in science to-day that almost all diseases and troubles are started or promulgated by microbes and bacilli. there are often enough of these in one swallow of water to poison a whole family. then take a moist towel and apply it to every part of your body; follow this with a vigorous rubbing with a dry towel. a sponge bath is recommended by many physicians. this is all right for the first time, but from that on the sponge begins to get foul, not from necessity, but because not one person in fifty will wash and thoroughly _dry_ the _sponge_. in any other case it is a disease breeder. perforated with so many cells and passages, intricate and numberless, it is not surprising that it should be the residence of much that is dangerous. during the time of your bath you should close the windows of your room to exclude the cold draughts--in any part of the country where the atmosphere moves over two miles per hour--but not the sun. after this lower or raise your window to the height or level of the eyes, and proceed to enjoy a breathing exercise. this is done by first exhausting all the air from the lungs through the mouth, then inhale, slowly, through the nasal organs to the full capacity of the lungs. do this _three_ times or more each morning. if your lungs are not too weak, tap with your fingers on your chest while it is inflated. this will tend to develop your capacity of breathing wonderfully. the gentle percussion thus effected is quite exhilarating. practice yourself also in _holding_ your _breath_ for a prolonged interval, but always draw in air through your nostrils; they strain out all impurities. you are now ready for your breakfast; but, perhaps you say, i am a workingman and have not the time. to such i would reply: i go through all these duties in _one_ hour's time, and if belated i accomplish it in _forty minutes_. if i have to take a train at a. m., i see that i am called at a. m., at least, and enjoy my regular time for _toilet_. i would advise those of you who think you have not time, to go to bed that much earlier. even if you are to travel, by using my method of preparation you will not experience that tired, disagreeable, restless feeling that will otherwise come. you all know how intensely that feeling acts to destroy all your pleasure until the day is half over and it is worn away. employ common-sense ways and you will be as fresh at as at o'clock. your lips will not be blue, your skin cold, your teeth unclean, your mouth dry, your eyes red, and your whole self out of sorts as it were. chapter v. "of right choice food are his meals, i ween." now as to what you should eat, what you should not eat, and how you should eat. this is perhaps the greatest problem for a man to solve. a man with a bad digestive apparatus is practically an invalid. we have no hesitation in saying that there is as much bodily injury done by over and careless eating among people commonly called temperate as among those who drink alcoholic liquors to a large extent. if you would preserve your vital strength and capabilities for a happy, long period, mind your diet. don't rest too much on the insane idea that you have a _stomach_ of _iron_ and that you can digest shingle nails. you are not a species of the genus ostrich, or goat. then if you really do possess organs that can take care of all kinds of food, their splendid power should not be destroyed or even weakened by improper indulgence. the mightiest engine is soon as valueless as old iron if it is continually exerted to its greatest velocity. if inanimate mechanism cannot stand a permanent strain surely bodily flesh would be quickly disabled. some foods are particularly muscle formers, others produce fat, and still others brain and nerve, while most of the common articles of diet combine these uses in varying degrees. but the question to cover our entire physical needs requires to be broadened into this: what combination of food will best nourish the body? even then the answer must be modified to suit individual cases, for the digestive power differs greatly in different persons. moreover, there is an interdependence between the different bodily organs and tissues, so that the body must be built up as a whole. if one part lacks the whole suffers, and if one part is overfed the others will be underfed. thus a person who becomes unduly fat loses in muscular fiber, either in quantity or quality. one who overfeeds the brain loses in muscular strength. so, too, muscular development may be carried to such excess as to impoverish the brain, and also to reduce the fat of the body below what is necessary both as surplus food laid up for emergencies, and as a protection against sudden changes of temperature. the best food for producing muscle, therefore, must, while being duly appetizing, contain a large per cent of nitrates for the muscles, of phosphates for the brain and nerves, and of carbonates for the fat. of nitrates, beans stand at per cent, then peas at , cabbage and salmon at , oats at , eggs and veal at , and beef at . of phosphates, salmon stands first at , then codfish at , beef and eggs at , beans and veal at , and cabbage, peas, and oats at . of carbonates, butter stands at the head at , rice at , corn and rye at , wheat at , oats at , peas at , beans at , and cabbage at . fresh codfish fried in fat or served with butter gravy about equals beef in all respects, and so do eggs fried in fat. but we must add:-- the mere eating of food cannot make muscle. the muscles must be called into vigorous daily exercise, yet without overdoing. excessive eating is weakening, and must be avoided. it is the amount digested and assimilated that tells, not the quantity taken into the stomach. all the laws of health must be steadily observed. we are in favor of a diet that excludes meat entirely; and once a day should be the excess of those who indulge in the flesh-eating luxury. a suspicion that there is a difference between merely getting food down into the stomach and its digestion, is abroad, and that a peach, an orange, an apple, a spoonful of flour, or something similar, which is digested, is really better for a man than a beefsteak, which simply passes through the alimentary canal. see "food" for further consideration of vegetarianism. for _breakfast_ have any of the numerous preparations of _mush_, such as oatmeal, cracked wheat, and germea, every other day some kind of fish; of the miscellaneous, potatoes baked or boiled, eggs poached, boiled, or omelette, and natural fruit; of drinks, water, filtered or boiled, and not below ° fahr., milk, pure and sweet but not cream, cocoa, chocolate, tea, or coffee. these are good and beneficial in the order they are placed. the following from the n. y. _medical record_ is invaluable information:-- "stimulants (drink most healthful).--milk heated to much above degrees fahrenheit loses for a time a degree of its sweetness and density. no one who, fatigued by over-exertion of body or mind, has ever experienced the reviving influence of a tumbler of this beverage, heated as warm as it can be sipped, will willingly forego a resort to it because of its being rendered somewhat less acceptable to the palate. the promptness with which its cordial influence is felt is indeed surprising. some portion of it seems to be digested and appropriated almost immediately, and many who now fancy they need alcoholic stimulants when exhausted by fatigue will find in this simple draught an equivalent that will be abundantly satisfying and far more enduring in its effects. there is many an ignorant overworked woman who fancies she could not keep up without her beer; she mistakes its momentary exhilaration for strength, and applies the whip instead of nourishment to her poor, exhausted frame. any honest, intelligent physician will tell her that there is more real strength and nourishment in a slice of bread than in a quart of beer; but if she loves stimulants it would be a very useless piece of information. it is claimed that some of the lady clerks in our own city, and those too who are employed in respectable business houses, are in the habit of ordering ale or beer at the restaurants. they probably claim that they are 'tired,' and no one who sees their faithful devotion to customers all day will doubt their assertions. but they should not mistake beer for a blessing or stimulus for strength. a careful examination of statistics will prove that men and women who do not drink can endure more hardships, and do more work, and live longer, than those less temperate." if you must eat meat for breakfast, have your _steak rare_, mutton chops well done; if fish, always well done; and if each are fried, use butter, not lard--the same applies to everything else that has to be fried. all meats are sweeter and more healthful broiled than fried. of bread, for health, natural _graham_ comes first; and, in order of nutrition, corn, corn and wheat mixed, rye, and wheat. they should be taken cold and at least twenty-four hours after baking. if the midday meal is a lunch, all dishes should be cold. it can be made up largely from dishes left over from the morning meal, such as cold cracked wheat with milk, natural fruit; add nuts, sauces, jellies, and prepared fruit. if _dinner_ is taken at noon instead of lunch at that hour, any one of the score of vegetable soups are first in value; all other kinds are secondary; let there be from three to six kinds of vegetables cooked; any of the drinks mentioned for breakfast may be used, but none of them iced; cold bread, and no pastry unless an open pie with unshortened undercrust. an excellent morsel for _dyspeptics_ is _sea biscuit_ dipped in cold water and then placed in a hot oven from three to five minutes. if meat is to be a portion of this meal, you can have beef, mutton, or venison, roasted or broiled, the former rare, and the two latter well done. provided dinner is enjoyed at the close of the day, it should occur before : p. m.; if at midday, then the lunch meal can be renamed supper, and can be partaken of as late as or p. m. let there be no eating two meals for sundays and holidays, and three for other days, or indulging in them at later hours in the morning and earlier in the evening; for this irregularity will detriment more than many kinds of improper food. do not eat _fresh pork_, for this and every other kind of swine flesh is an abomination. eat no _kidney_, _liver_, or _tripe_; deal sparingly with _fowl_ and all the bird family. outside impure water and uncleanliness, there can be but one cause for _skin diseases_, eczema, boils, and the dread leprosy, which is the eating of pork, kidney, liver, duck, etc. if the lion indiscriminately kills and eats all kinds of flesh, and thereby is made ferocious, if the lamb is rendered passive and inoffensive by grasses and grains, then what the swine or different domestic fowls eat must have something to do with the make-up of the flesh of their bodies. the hog is the most filthy animal of that nature, while chicken and duck are the most so in the line of fowls used by man for food. it is offensive but true that they will not only _eat_ but relish both their own and man's _excrement_. we cannot use space foolishly, if we show plainly why pork should be abandoned. did you ever stop to think on what most _swine_ live? _swill_ is the most common term for it. anything and everything that is the refuse of a boarding-house will they eagerly devour. give them _rotten_ apples and potatoes, full of innumerable microbes, and they will relish the repast. place them in a dung heap--they will root, and eat much of what they find. now all meat, all flesh and tissue, is made from what an animal or person eats--if he doesn't eat he grows thin and starves. then the hog's flesh is made from elements derived from swill, decayed substances, and everything either cooked, uncooked, or even digested, that man is through with or has cast off. you who eat pork relish that which once you have refused to eat--only in another form. can you enjoy this meat when you consider all this? surely its use means bad health and contamination. skin diseases and _poor complexions_ are found almost entirely among those who live on these improper foods. again, even if you feed swine on clean corn, milk, and water, we ascertain by careful experiment and examination that pork is most susceptible to bacteria of almost any meat. better boycott it altogether. _leprosy_ and skin troubles are found largely among pork-eating people--such as the inhabitants of the hawaiian islands, where there are lepers. on the other hand, jews, who everywhere are marked with clear skins, avoid pork. in constantinople there are lepers, in crete upwards of , , and quantities in the islands of eastern mediterranean sea, and , in norway. these places are all characterized by the great amount of pork, and duck too, that they consume. other things not good for _invalids_, and will make strong persons invalids, are: fried potatoes, hot cakes, warm bread, pound cake, green cucumbers, and rich pie-crust. eat only those things that will excite the salivary glands to assist digestion. the walls, not the center of the alimentary canal, need attention. have your _soup cool_ enough so that it will not cause tears in your eyes when you swallow--same with your coffee, tea, and other warm drinks; take no _ice drinks_; if you are used to having water only with your meals, drink it warm with sugar and milk, and _not hot_. if you are obliged to live in a second-class boarding-house or restaurant, and are obliged to take one of three meals each day at such a place, insist on having a _napkin_. use it first to wipe your glass for water, then follow by polishing every utensil set before you for use at your meal. if note is taken of the napkin before and after each meal, you will be able by a mathematical calculation to tell just how much _real estate_ did not belong to you. how you should eat: begin with one swallow of cool water. eat slowly; take full minutes for a hurried meal, and minutes when you have the time. if you eat beefsteak, have it rare; if mutton chops, have them well done; if _fish_, well done and brown; if potatoes, first choice, baked; second, boiled; third, stewed or mashed. never eat decayed vegetables or fruit; have them fresh or do without them. at table, see that the conversation is pleasant and mirthful. should any of the younger members of the family insist, at each meal, in changing this order of things, cause them for a short season to sit at a separate table in the kitchen, until this sort of disease--for disease it is--may be cured. nothing retards digestion, brings dyspepsia, or creates neuralgia, to such extent as a sullen disposition. we will end this chapter with a remarkably bright paraphrase on the ten commandments, which we recently ran across:-- the ten health commandments. " . thou shalt have no other food than at meal-time. " . thou shalt not make unto thee any pies, or put into pastry the likeness of anything that is in the heavens above or in the waters under the earth. thou shalt not fall to eating it or trying to digest it. for the dyspepsia will be visited upon the children to the third and fourth generation of them that eat pie; and long life and vigor upon those that live prudently and keep the laws of health. " . remember thy bread to bake it well; for he will not be kept sound that eateth his bread as dough. " . thou shalt not indulge sorrow or borrow anxiety in vain. " . six days shalt thou wash and keep thyself clean, and the seventh thou shalt take a great bath; thou, and thy son, and thy daughter, and thy man-servant, and thy maid-servant, and the stranger that is within thy gates. for in six days man sweats and gathers filth and bacteria enough for disease; wherefore the lord has blessed the bath-tub and hallowed it. " . remember thy sitting-room and bed-chamber to keep them ventilated, that thy days may be long in the land which the lord thy god giveth thee. " . thou shalt not eat hot biscuit. " . thou shalt not eat thy meat fried. " . thou shalt not swallow thy food unchewed, or highly spiced, or just before hard work, or just after it. " . thou shalt not keep late hours in thy neighbor's house, nor with thy neighbor's wife, nor his man-servant, nor his maid-servant, nor his cards, nor his glass, nor with anything that is thy neighbor's."--_new england farmer._ with the use of the foregoing as a guide, and ordinary judgment in the affairs with your fellow-men, life will run smoothly, happiness will follow, and a long life be the result. chapter vi. "let the jewel of happiness poise in the setting of health." if you are a reader of this work to find out a cure for consumption, catarrh, bronchitis, constipation, hemorrhoids or piles, hernia or rupture, rheumatism, fever and ague, cataracts on the eyes, warts on the hands, corns on the feet, and how to abstain from drink and tobacco in all injurious forms, we will try and not disappoint you. under the head of each disease above named, see index and second part. we offer you a remedy. all of these troubles i have had (and a score not mentioned), of the entire list of which _=i=_ am now _free completely_. in short, the whole number of diseases that beset the human family can be cured by care, cleanliness, regularity, fresh air, cold water used internally, and by compress, proper clothing, right food, regular exercise, an even disposition, a clear conscience, intelligent and agreeable associates, and a reasonable amount of time. it took me years, of which i spent ascertaining the way. if someone could have informed me, as this book does you, i would have enjoyed full health _twenty-five_ years earlier than i did. anyone observing the rules i have recounted can restore a broken-down _constitution_ in less than years--yes, even if one foot is already in the grave! soon you will begin to lift it out, and it will be a long period before you will take that step again. i do not exaggerate when i state that i had _both feet_ in the grave. fortunately, however, my head was above-ground, and i began to reason how to get the rest of myself away. the secret was discovered, the causes set to work, and finally the end achieved. to use another figure, my coffin had many nails already driven in it when i secured a clincher, pulled them all out, and then split up the old wooden hulk to make fires with which to start the steam of my new energies. all of my _time_ is _employed_. i do some sort of laborious work every day to start my blood coursing vigorously, and open the pores of my skin. by a proper adjustment of my under-clothing, i prevent a cold, and am always ready with a good appetite when meal-time comes. i have never studied _anatomy_, _medicine_, or _surgery_, know but little about the niceties of the english language, but i have studied the materia medica of myself, and am aware of just what is beneficial and what is injurious for me. there is a duty each individual owes to his fellow-man, each municipal corporation to its citizens, and each state and general government to those over whom they preside. every individual should strive to see how much distress he can relieve during his short stay on this earth; how few thorns he has to place in the pathway of others, and how many drops of oil he can pour on the disturbed waters of the ocean of life. _accidents_ that are _preventable_, caused by carelessness, laziness, and ignorance, cost more money, suffering, and life than viciousness and incendiarism, in the ratio of to . every man who builds a mill, manufactory, or a business block, makes his own rate of insurance. a slight variation in the construction of a building, the omission of certain details, the wrong location of hazardous machinery or materials, or the neglect of cleanliness and order, may very seriously affect the _fire hazard_, and consequently the _rate_ of insurance which must necessarily attach to the property. the _fire losses_ in the united states amount to $ , , per annum, and the great mass of this enormous loss is chargeable to bad construction of buildings, the lack of necessary apparatus for extinguishing fires, and carelessness in the management of property. the _unavoidable_ losses are few in number; the _avoidable_, many. insurance companies _restore no value_, _repair no loss_; they can only _distribute_ the loss throughout the community. careless, ignorant, annihilative, is the term to be applied to % of the fire losses. the destruction of life by accidents, where immediate death follows, in the united states is large; but, in comparison with those that assist in shortening life, they are about in the ratio of to . only such persons as have undoubted _integrity_, coupled with order, cleanliness, and carefulness should be allowed to insure their property, and this should be restricted by law. a certain sect in our population that now have to be charged from to % more for insurance than other people, should be stricken from the list of the insured, until they have by personal action abolished this difference in risk. when the time comes that only such persons as attend to all the details of cleanliness and prevention of the loss of property and health can be insured, the cost will be reduced %. until we are willing, or educated up to that point, to protect our neighbors' lives and property as if they were ours, we must expect to pay this % more for everything we have, use, drink, eat, and wear. longevity will be restricted in the same proportion. hundreds of accidents would be prevented by proper care. throwing foolishly the match, cigar, cigarette, etc., any and everywhere, causes great loss of property, and often life; the unthinking eat oranges and _bananas_ in the _street_ and cast underfoot the rinds and skins to cause the next moment the _dislocation_ of a limb, or broken skull. over accidents have occurred in this city alone during the last years, occasioned by some sort of vegetable or fruit refuse lying upon the pavements; fatal results, though not all immediate, happened to persons, and a number were maimed for life. broken bottles and glass thrown into the street and on the sidewalks bring about at times frightful accidents to both man and beast; and if a correct report could be had from each livery-man and teamster in this regard, it would startle the most inhuman of our race. the _tax-payer_ has a tendency to be selfish when he is really doing himself severe injury. it is a case of reflex action. in passing along a thoroughfare he sees a banana skin lying on the sidewalk. he cannot possibly stop or trouble himself to push it into the gutter. almost immediately another man comes along, steps on the skin, slips, breaks his leg, and is carried to the hospital. he remains there a month, supported by the city, that is, by money paid by the same tax-payer. in this manner, and other ways, can every man act, both selfishly or unselfishly. if selfish in passing this by, it is sure to come back on him a hundred-fold to the original trouble required. his unselfishness will consist in saving his fellow-men from danger by removing the cause. indeed, he will be selfish if he casts it off for the sake of decreasing his taxation, but such selfish unselfishness will be gladly excused. _garbage_ thrown out of back doors or under neighbors' steps creates contagion, and in time the thoughtless individuals fall a prey to their own carelessness. three out of every five men and five out of every hundred women are ruptured as a result of their own or somebody else's recklessness. on the top of nearly every house in the section where _artesian_ water is used, there is a _tank_ to receive water for various purposes about each dwelling; much of this is employed for drinking and culinary uses. without any attempt at a sensation, we pronounce this box or _tank_ a _death trap!_ there is not a clean one in this whole great city, that has an outside exposure, and out of every are reeking with filth. having had occasion to investigate several i am convinced that they average alike. if so, there are at least tons of concentrated filth playing the part of filters in the tanks of this city alone at this writing! and there is every reason to believe that this city is as clean as the average. provided this is so, there is enough of such refuse in the united states to dam the mississippi river many times and build a levee across lake erie. health officers may keep their own tanks clean in the future, but if individuals desire health and abolition of the need of health boards, let them keep their own tanks, back yards, streets, and pavements neat. municipal corporations should prevent by _law_ the throwing of any kind of rubbish into the streets, and make it a misdemeanor for the proprietors allowing any of their mercantile houses, work-shops, or residences to be found filthy, and there are thousands of them in this city. to avoid accidents, every man, woman, and child should be compelled to pass to their right on the street. every person in every city not having a legitimate vocation in the eyes of the law, nor an income from property or money in the bank, should, if criminally inclined, be sent to the house of correction. if poor and willing to work, they ought to be put to work in the public streets and in the parks, to beautify them, for the benefit of the frugal classes. no begging should be allowed, under penalty of imprisonment. that a city may escape being overrun by country tramps, their entrance should be quarantined. to stop contagion, public _crematories_ should be established and cremation of the human and animal bodies be compulsory. if the principal church and secret organizations will now change their rituals so as to permit of the incineration of the bodies of their deceased members, the world will have advanced years before the close of this century and the average duration of life at that date will have increased from . to years. it is needful that the false sentiment regarding the disposition of our dead should undergo a complete revolution. there could probably be no better aid to this end than a general investigation of the mortuary records of the towns and cities of the globe, by proper officials, the facts and discoveries of whom should be given all possible publicity. an hundred or so years ago this was not so much a matter of importance as now, with a greater and increasing density of population, by virtue of which a great portion of the habitable earth is fast becoming a mass of putrifying corruption, that will involve at no distant time the world in pestilence, woe, and desolation. the recent official return on the condition of the london cemeteries is, or should be, sufficient to cause all reasonable persons to cry out for the crematory. in brompton cemetery, with an area of twenty-eight and three-fourths of an acre, there have been buried in less than fifty years one hundred and fifty-five thousand bodies. in tower hamlets cemetery, with twelve acres less, in about the same time, the number is two hundred and forty-seven thousand. when it is remembered how perfectly unfitted the soil of these districts is for burial purposes, together with the means so largely employed for preventing speedy decomposition, one may readily imagine the danger that menaces those above this still-increasing mass of sub-pollution. multiply the condition of the london suburbs by several hundred thousand more, and then ponder the product! talk about sanitary regulations, when our public health laws are violated thus, and the air and water poisoned as a result of the superstitious custom of body burial! when pestilence stalks abroad, it is said to be planetary influence or divine wrath! the following from the springfield _republican_ will indicate the current of public opinion:-- "that the custom of burying the dead is bound to be superseded by more scientific and economical methods, especially in the centers of population, may be seen in the reanimation of the old scheme of desiccation by new york capitalists. these men are not yet ready to accept cremation. their project is to build mausoleums as substitutes for cemeteries, where the body will be subjected to the absorbent action of currents of pure, dry air, which will prevent decomposition, and, by thoroughly exhausting the body of moisture and gases, carry away all germs of disease. these air currents, thus laden, will then pass through furnaces, where all noxious elements will be destroyed. the lifeless form will be reduced in weight about two-thirds and nearly one-half in size. resting in a sepulcher, it may then be preserved for an indefinite period. as explained in detail, with particulars of the beauty of the buildings thrown in, this scheme has advantages compared with the undesirable method in vogue, though it is less thorough and simple than cremation. a promoter of the enterprise in speaking of the desiccated body says that 'although shrunken, still, with the semblance of life, it is an object that the eye of affection can look upon without a shock, and the sanitarian can think of without a shudder.' in essence, however, the scheme is simply a concession to a public, not yet educated to the idea of cremation. while appropriating enough of the latter system to solve the question of public health, it caters to the human sentimentalities in preserving at half size the dead form. upon these sentiments, summed up as the 'instinct of humanity,' the promoters of the new system base their hopes of profit. besides advancing in its favor all the arguments used for cremation, its friends add that in the desiccating process no danger can exist of suspended animation escaping notice." public _fountains_ should be established in every other block of cities or towns having over , inhabitants, with best-devised filters known, so that both man and beast could enjoy pure water to drink, free for the taking. during epidemics it should be not only compulsory in municipalities to have water filtered in each house before drinking, but it should be boiled. every house ought to have a filter. if you cannot afford a $ one, you can secure one for cents. chapter vii. "vice is a monster of so frightful mien, as to be hated, needs but to be seen; yet seen too oft, familiar with her face, we first endure, then pity, then embrace." "but evil is wrought by want of thought as well as by want of heart." the following extract from the report of the grand jury of this city, given publicity december , , is self-explanatory:-- "some of the dives and variety theaters are the nurseries of vice and crime, where drunkenness is encouraged, our youth demoralized, the unwary roped in and robbed, and crimes committed which the authorities are unable to prevent or discover. there is, of course, a broad distinction to be noted between those places of public resort where the demand for distilled, fermented, and malt liquors is supplied in a legitimate manner, and the entertainment provided, if any, is not of an objectionable character, and those places where salacious performances are presented as an attraction, and lewd women, under the guise of waitresses to serve liquors, pursue a shameful vocation. these evils may be partly remedied if respectable citizens will refuse to rent their property for such uses, and also refuse to assist in obtaining licenses whereby such headquarters for drunkenness, lewdness, and crime are in a measure entrenched behind existing general laws. "the so-called 'social evil' is aggressive on our thoroughfares, and should be restrained by the authorities within narrower limits." but we add our interpretation and our suggestions for these twin evils which stalk up and down the earth and apparently defy control. the _minister_ treats lightly upon the liquor traffic, in many instances because certain of his church members either sell it at wholesale, retail, or furnish the barley, corn, grapes, hops, or rent to the man who does. the _editors_ of all newspapers of general circulation must treat the subject likewise, for fear of his advertising patrons. his readers are never taken into account, for the simple reason that circulation alone does not pay newspapers issued daily, and very few that are issued weekly. it will be seen by the above report that the grand jurymen too have _vital_ interests at stake. in order to keep their respective businesses from being boycotted by their fellow-merchants, they handle the subject with soft gloves, as if it were eggs, and the "social evil" by this same jury is done up in _nineteen_ words. but they have indicated a great deal in those few words, namely, that such an evil _does exist_--something the different _church_ organizations have _refused_ to acknowledge. high license, with personal responsibility for results, under a sufficient bond, will in time remedy the liquor traffic. the _social evil_ should be licensed, and under the perfect control of the police--and not the police under its control, as seems to be the case in this city. are they not under pay to look the other way? its boundaries should be exact, isolated, and under the direct supervision of the health department. is there any justice in demanding a license of a milliner, or on any other mercantile pursuit that a female may see fit to adopt, while , of these questionable women go untaxed, because you do not _dare_ to acknowledge that their calling _exists?_ to ask the question is to answer it--no!! let no one think that in any way whatever we would seem to unduly countenance, or in the least encourage, this evil. but we do believe in recognizing absolute facts. they cannot be overlooked. it is surprising that, amidst all this widespread discussion of intemperance, no more has been said on this _social problem_. as long as men are mortal, this condition of relations will exist--it has existed through all time--but it is possible to limit it, to heavily license it, and keep it within proper bounds. then by all means should churches and various kinds of societies exert their influence to the legal recognition of the true status, and benefit the general condition of mankind. boards of supervisors, aldermen, etc., are clothed with power to accomplish the ends suggested, if they are only backed by public sentiment. if the _catholic church_ organization alone will inaugurate a general agitation over the country, as they have already indicated and begun in their convention at baltimore, on the liquor traffic, they will either break it up or put it under control; for % of this business is carried on by their following. public _urinals_ are greater necessities than public fountains in cities and large towns. the alarming increase of _diabetes_ and kidney troubles in cities during the last few years, while remaining normal, or actually decreasing in the rural districts, has led to the belief that the prolonged detention of the urine is the principal, and, in most cases, the only cause of this terrible malady. the foregoing facts recapitulated exhibit a few of the ills of mankind that are in the power of municipal officials to alleviate. the duties of the general government cover all of the above, and include the _prevention_ of all _criminals_ and _paupers_ of every nation from _landing_ on our shores; the compulsory education of all citizens old and young--as it is cheaper to educate than to punish criminals; to furnish employment upon all useful and needed public works for the worthy, willing poor, and cause to be distributed with equity to the deserving, all the earnings of the criminal institutions of the country, over and above their actual expenses. it will not be out of place to complete this chapter with a few words on the necessity of giving man and beast _one day_ in seven to _rest_. _sunday_ seems to be the preferable one, but to compel the observance of one particular day in each week for all classes and sects would be tyrannical. the majority of religious societies employ sunday for worship and rest, but, throwing aside the moral and religious bearing, every human being would be healthier, happier, and live longer, if he rested one day in the week. we all live too fast. though we enjoy laziness at times, yet we are too anxious to get riches or fame earlier than we ought or can. a man may work so mightily that he will be very wealthy at instead of , but he will die at instead of . better prolong life by reserving forces for the future. chapter viii. "for a man's house is his castle." after individual cleanliness and regularity, erect your next _house_ in which you intend to live, or that you expect to rent to another, or remodel your present residence, to correspond with the following:-- sanitary house.--it should stand facing the sun, on dry soil, in a wide, clean, amply-sewered, substantially-paved street, over a deep, thoroughly ventilated and lighted cellar. the floor of the cellar should be cemented, the walls and ceilings plastered and thickly whitewashed with lime every year, that the house may not act as a chimney to draw up into its chambers micro-organisms from the earth. if your lot is situated so that you cannot face your house either east or south, construct the rooms in such a way that your parlors and sleeping apartments will receive the sun at least hours during the day. all windows should extend from floor to ceiling, adjusted to let down from the top, and in position to secure as much as possible of the through currents of air. the outside walls, if of wood or brick, should be kept thickly painted, not to shut out penetrating air, but for the sake of dryness. all inside walls should be plastered smooth, painted, and, however unaesthetic, varnished. mantels should be of marble, plate, iron, or, if wood, plain, and, whether natural, painted, or stained, varnished. interior wood-work, including floors, should all show plain surfaces and be likewise treated. no paper on the walls, no carpets on the floors, but movable rugs, which can be shaken daily in the open air--not at doors or out of windows, where dust is blown back into rooms--should cover the floors. white linen shades, which will soon show the necessity of washing, should protect the windows. all furniture should be plain, with cane seats, without upholstery. mattresses should be covered with oiled silk. blankets, sheets, and spreads--no comforts or quilts--should constitute the bedding. of plumbing there should be as little as is necessary, and all there is must be exposed. the inhabited rooms should be heated only with open fires, the cellar and halls by radiated heat, or, better, by a hot-air furnace, which shall take its fresh air from above the top of the house and not from the cellar itself or the surface of the earth, where micro-organisms most abound. let there be no annual house cleaning, but keep it clean all the time, and have it gone through thoroughly at least four times per year. of course a corner lot is always preferable, but how often it is supposed that the benefit consists alone in a commanding position, in a chance for architectural display, when the greatest boon is the increased opportunity for sunlight. the atmosphere of a room where the sun never shines is never agreeable or healthful. science has taught us that the sun is the source of all life. it will effect more than tons of disinfectants and chemicals to purge and sweeten the air of a house. let the building be exposed to the south, and keep shade trees from checking the sun too much. verandas and broad piazzas often do as much harm as they give pleasure--especially if they are all covered with vines. be more careful about plumbing than people are wont to be. do not practice economy by trying to cut down _plumbing_ bills. when a contractor agrees to erect a house, either withhold this part from him or see that he employs the most skilled labor. ventilation cannot be slighted, for upon it health greatly depends. if you can in any way afford it, use _incandescent electric light_ instead of gas or oil. the reason is a powerful one. an ordinary _gas_ jet destroys as much pure air and oxygen as five men--a good-sized _oil lamp_ equal to three men. add to this the heat that comes from such methods, and we see the strong advantage of the incandescent electric light. this vitiates no air, gives off no perceptible heat. though there are stories that electric lights injure the eyes, from careful observation we find that it hurts the eyes of the majority no more than any artificial light. the _sanitary news_ urges people not to paper or paint the interior walls of houses. arsenical poisons are used in coloring wall paper. mold collects in flour paste used in fastening paper to walls, absorbing moisture and germs of disease. glue also disintegrates, so that any friction removes small particles, to which germs attach and float in the air. undecorated walls, ugly as they are, the _news_ insists are the only healthy ones to live within. dr. cushing, of this city, thus ends his lecture on "healthful houses":-- "the essentials then of good house building are, first, a dry soil, a good foundation, exposure to the sun, and, next, good plumbing by reputable men at whatever cost necessary for first-class work, warming and ventilating by open grates rather than by steam heaters and stoves, clean floors and clean walls; and now, if there be no decomposition of animal or vegetable matter allowed in the immediate vicinity of the house, we shall have done the best that the present state of science will permit toward making our houses healthful." the hotel del monte is the only perfectly clean hotel in america. it is located at monterey, cal., not over a quarter of a mile from the ocean. the prevailing winds are from the sea and would naturally blow over the sands towards the house. now the cause of dirt has virtually been killed by the planting of trees, brush, and by the laying of asphaltum walks and sod-ground drives on this windward side. the only dirt is that which is brought there by travelers--this is easily kept down. the moral is here: if possible prevent dust and dirt by stopping the cause. chapter ix. "let this great maxim be my virtue's guide." as we are hastily reading books and papers we continually come across maxims, epigrams, and short, pithy sayings that attract us. we wish we could not only remember them, but also often put them in practice, but they slip our mind and actions almost immediately. from time to time the author has collected fruit from the vast field of health of its kindred subjects, and placed the best of them in this book for the reader's careful consideration. among the multitude of "don'ts" for politeness are the following for health alone:-- "don't endeavor to rest the mind by absolute inactivity; let it seek its rest in work in other channels, and thus rest the tired part of the brain. "don't delude yourself into the belief that you are an exception as far as sleep is concerned; the normal average of sleep is eight hours. "don't allow your servants to put meat and vegetables in the same compartments of the refrigerator. "don't keep the parlor dark unless you value your carpet more than your and your children's health. "don't forget that moral defects are as often the cause as they are the effects of physical faults. "don't direct special mental or physical energies to more than eight hours' work in each day. "don't neglect to have your dentist examine your teeth at least every three months. "don't read, write, or do any delicate work unless receiving the light from the left side. "don't pamper the appetite with such variety of food that may lead to excess. "don't read in street-cars or other jolting vehicles. "don't eat or drink hot and cold things immediately in succession. "don't pick the teeth with pins or any other hard substance. "don't sleep in a room provided with stationary washstands. "don't neglect any opportunity to insure a variety of food." there are many things we should _never_ do. among them are:-- "never go to bed with cold or damp feet. "never lean with the back upon anything that is cold. "never begin a journey until the breakfast has been eaten. "never take warm drinks and then immediately go out in the cold. "never ride in an open carriage or near the window of a car for a moment after exercise; it is dangerous to health or even life. "never omit regular bathing, for unless the skin is in regular condition the cold will close the pores and favor congestion or other diseases. "never stand still in cold weather, especially after having taken a slight degree of exercise." perhaps among the following you may find succinctly stated what will be of eminent value:-- "focus your brain as you would a burning-glass. butter enough for a slice won't do for a whole loaf. "keep empty-headed between times. mental furniture should be very select. useless lumber in the upper story is worse than a pocketful of oyster shells. leave your facts on your book shelves, where you can find them when wanted. a walking encyclopedia cannot work for want of room to turn round in his own head. "don't tax your memory. make a memorandum, and put it in your pocket. every unnecessary thought is a waste of effective force. "don't believe that muscular exercise contracts head work. brain and muscle are bung-hole and spigot of the same barrel. it is poor economy to keep both running. "pin your faith to the genius of hard work. it is the safest, most reliable, and most manageable sort of genius. "amuse yourself. this is the first principle of good hard work. and the second is like unto it. "don't work too much. it is quantity, not quality, that kills. therefore, work only in the day-time. night was made for sleep. and loaf on sunday. six days' work earns the right to go a-fishing, or to church, or to any harmless diversion, on the seventh. "go to work promptly, but slowly. a late, hurried start keeps you out of breath all day trying to catch up. "when you stop work forget it. it spoils brains to simmer after a hard boil. "feed regularly, largely, and slowly. lose no meal; approach it respectfully and give it gratefully. no more can be got out of a man than is put into him. "sleep one-third of your whole life. how i hate the moralist who croaks over time wasted in sleep. besides, sleep is, on the whole, the most satisfactory mode of existence." misconceivements.--"there are a number of mistakes made even by wise people while passing through life. prominent among them is the idea that you must labor when you are not in a fit condition to do so; to think that the more a person eats the healthier and stronger he will become; to go to bed at midnight and rise at daybreak, and imagine that every hour taken from sleep is an hour gained; to imagine that, if a little work or exercise is good, violent and prolonged exercise is better; to conclude that the smallest room in the house is large enough to sleep in; to eat as if you had only a moment to finish a meal in, or to eat without any appetite, or to continue after it has been satisfied, merely to please the taste; to believe that children can do as much work as grown people, and that the more hours they study the more they learn; to imagine that whatever remedy causes one to feel immediately better (as alcoholic stimulants) is good for the system, without regard to the after-effects; to take off proper clothing out of season because you have become heated; to sleep exposed to a direct draught; to think any nostrum or patent medicine is a specific for all the diseases flesh is heir to." weariness.--"a tramp knows what it is to be leg-weary, a farm laborer to be body-weary, a literary man to be brain-weary, and a sorrowing man to be soul-weary. the sick are often weary of life itself. weariness is generally a physiological 'ebb-tide,' which time and patience will convert into a 'flow'. it is never well to whip or spur a worn-out horse, except in the direst straits. if he mends his pace in obedience to the stimulus, every step is a drop drawn from his life-blood. idleness is not one of the faults of the present age; weariness is one of the commonest experiences. the checks that many a man draws on his physiological resources are innumerable; and, as these resources are strictly limited, like any other ordinary banking account, it is very easy to bring about a balance on the wrong side. adequate rest is one kind of repayment to the bank, sound sleep is another, regular eating and good digestion another. one day's holiday in the week and one or two months in the year for those who work exceptionally hard usually bring the credit balance to a highly favorable condition; and thus with care and management physiological solvency is secured and maintained." "what produces death.--someone says that few men die of age. almost all persons die of disappointment, personal, mental, or bodily toil, or accident. the passions kill men sometimes even suddenly. the common expression, 'choked with passion,' has little exaggeration in it, for even though not suddenly fatal, strong passions shorten life. strong-bodied men often die young; weak men live longer than the strong, for the strong use their strength and the weak have none to use. the latter take care of themselves, the former do not. as it is with the body, so it is with the mind and temper. the strong are apt to break, or, like the candle, run; the weak burn out. the inferior animals, which live temperate lives, have generally their prescribed term of years. the horse lives years, the ox or , the lion about , the hog or , the rabbit , the guinea-pig or . the numbers all bear proportion to the time the animal takes to grow to its full size. but man, of all animals, is one that seldom comes up to the average. he ought to live a hundred years, according to the physiological law, for five times are ; but instead of that he scarcely reaches an average of four times the growing period. the reason is obvious--man is not only the most irregular and most intemperate, but the most laborious and hard-working of all animals. he is always the most irritable of all animals, and there is reason to believe, though we cannot tell what an animal secretly feels, that more than any other animal man cherishes wrath to keep it warm, and consumes himself with the fire of his own reflections." provided you have babies in your family go through the following and see if you can't train your child so it shall be among the last seventeen mentioned:-- "take your pencil and follow me, while we figure on what will happen to the , , of babies that will have been born in the last , , seconds. "i believe that is about the average--'one every time the clock ticks.' "one year hence, if statistics don't belie us, we will have lost , of these little 'prides of the household.' "a year later , more will be keeping company with those that have gone before. "at the end of the third year we find that , more have dropped by the wayside. "the fourth year they have become rugged little darlings, not nearly so susceptible to infantile diseases, only , having succumbed to the rigors imposed by the master. "by the time they have arrived at the age of twelve years but a paltry few hundred leave the track each year. "after threescore years have come and gone we find less trouble in counting the army with which we started in the fall of . "of the , , with which we began our count, but , remain; , have gone the way of all the world, and the remaining few have forgotten that they ever existed. at the end of eighty, or, taking our mode of reckoning, by the year a. d., there are still , gray-haired, shaky old grannies and grandfathers, toothless, hairless, and happy. "in the year our , , babies with which we started in will have dwindled to an insignificant helpless old wrecks, 'stranded on the shores of time.' "in all but seventeen have left this mundane sphere forever, while the last remaining wreck will probably, in seeming thoughtlessness, watch the sands filter through the hour-glass of time, and die in the year at the age of one hundred and eight. "what a bounteous supply of food for reflection!" "laughter as a health promoter.--in his 'problem of health,' dr. greene says that there is not the remotest corner or little inlet of the minute blood-vessels of the human body that does not feel some wavelet from the convulsions occasioned by good hearty laughter. the life principle, or the central man, is shaken to its innermost depths, sending new tides of life and strength to the surface, thus materially tending to insure good health to the persons who indulge therein. the blood moves more rapidly and conveys a different impression to all the organs of the body, as it visits them on that particular mystic journey when the man is laughing, from what it does at other times. for this reason every good hearty laugh in which a person indulges tends to lengthen his life, conveying, as it does, new and distinct stimulus to the vital forces." chapter x. "while bright-eyed science watches round." a scientific investigation into the nature and causes of consumption proves the immediate causes, apart from hereditary, to be dampness of houses and localities. of races, the negroes seem most liable, and the jews the most exempt. a french scientist has found that inhalation of air containing a small amount of _hydrofluoric acid_ gas has a remarkably good effect on _consumption_. in england good results were obtained by inspiration of air mixed with _ozone_. that the disease results chiefly from inactivity of the lungs is the statement of a physician who maintains that the cure of the disease is a mechanical question. the international tuberculosis congress lately held at paris admits that tuberculosis is contagious, can be transmitted from man to animals, and _vice versa_, and is the same in men, women, and cattle. diseased milk is the most frequent agent of transmission, and with this meat, particularly lightly cooked, as food. predisposing causes are sedentary life, overwork, mental anxiety, insufficient nourishment, in general, anything calculated to lower the vitality. the congress has discovered no remedy, only palliatives for tuberculosis. catarrhs, bronchitis, and other throat troubles have a tendency to develop into pleurisy or consumption when neglected. _typhoid fever_ never affects the atmosphere, but it does affect water, milk, ice, and meat. the eggs of a parasite from dogs, and hence more or less infecting all waters to which dogs have access, appear to have an unequaled facility of passage to all parts of the human system. as for _surgical operations_, in a german paper are particulars of a case in which the eye of a man was thrust out of its socket by a parasite cyst in the rear, discovered by surgical exploration and extracted. from a -year old boy an injured kidney was removed successfully and the patient recovered. the bridge of the nose was completely restored by using the breast-bone of a chicken and stretching the flesh of the old nose over it. even the part of a destroyed nerve of the arm was restored by the substitution of a part of a sound nerve from an amputated limb, so that the continuity was restored and sensation returned in hours! prematurely-born children are kept in an artificial mother, which consists of a glass case warmed by bowls of water. a new opiate has been discovered called the sulsonal. it produces sleep in nervous people and those affected with heart disease, but not in healthy subjects. the idea that sufferers from heart disease should avoid physical exertion has been dispelled by a noted physiologist who has successfully employed regulated exercise. brown-séquard has brought out his great vital fluid. he is reported as saying: "i never made use of the word 'elixir,' still less of the words 'elixir of life.' these are all expressions or inventions of sensational newspapers. if quacks or ignorant men in america have killed people, as stated by the new york papers, they would have avoided committing those murders had they paid the least attention to the most elementary rules as regards the subcutaneous injection of animal substances. injections of animal matter have no danger, as a rule, unless the substances begin to be decomposed. when this condition of things exists, no good can be obtained, and there is grave danger of inflammation, abscesses, and even death." "professor brown-séquard is reported to have lately informed the french academy of sciences that, by condensing the watery vapor coming from the human lungs, he obtained a poisonous liquid capable of producing almost immediate death. the poison is an alkaloid (organic), and not a microbe or series of microbes. he injected this liquid under the skin of a rabbit and the effect was speedily mortal without convulsions. dr. séquard said it was fully proved that respired air contains a volatile element far more dangerous than the carbonic acid which is one of its constituents, and that the human breath contains a highly poisonous agent. this startling fact should be borne in mind by the occupants of crowded horse-cars and ill-ventilated apartments." "a very curious geographical distribution of certain virtues and vices has been mooted by a scientist. intemperance is mostly found above latitude °, amatory aberrations south of the forty-fifth, financial extravagance in large seaports, industrial thrift, in pastoral highland regions." "advance in hygienic clothing.--the new cellular clothing now coming into use in england is said to be a success. it is woven out of the same materials as the common weaves of cloth, being simply, as its name indicates, closely woven into cells, the network of which is covered over with a thin fluff. its porous quality allows the slow passing of the outside and inside air, giving time for the outside air to become of the same temperature as the body, obviating all danger of catching colds, and allowing vapors constantly exhaled by the body to pass off, thus contributing toward health and cleanliness. the common objection to cotton clothing--that it is productive of chills and colds--is removed if woven in this manner, and the invention can certainly be said to be strictly in accordance with hygienic and scientific principles." the annual death rate, in , for the principal cities of the world, per , inhabitants, was: san francisco, cleveland, stockholm, ; bristol, dresden, ; chicago, cincinnati, edinburgh, london, turin, ; berlin, baltimore, brussels, buffalo, liverpool, philadelphia, pittsburg, ; brooklyn, st. louis, tokyo, ; amsterdam, christiana, paris, washington, ; glasgow, ; copenhagen, ; bombay, boston, new orleans, pesth, venice, vienna, ; breslau, calcutta, manchester, new york, prague, rotterdam, ; dublin, ; rome, ; hamburg, munich, ; trieste, ; buda pesth, st. petersburg, ; alexandria, ; madras, ; and cairo, . the death rate among the poor and rich respectively varies much. in paris the death rate per , inhabitants between and years in easy circumstances was . against . among the poor. in london are some districts of the wealthy classes where the rate was . against in the slums. the mean age at death among the gentry was years, while among the workers it was - / years. it was found that only % of the children of the upper classes died in their first year against % in the general population of liverpool and % in the slums of that city. deaths from consumption were nearly one-fourth of all deaths among the poor, and only one-eighteenth among the rich. the above facts and figures cannot fail to set every intelligent person who reads them to thinking of this great health problem. happiness. chapter xi. happiness. "the learned is happy nature to explore, the fool is happy that he knows no more." happiness is defined by webster as an agreeable feeling or condition of the soul arising from good of any kind; the possession of those circumstances or that state of being which is attended with enjoyment; the state of being happy; felicity; blessedness: bliss; joyful satisfaction. _happiness_ is generic and applied to almost every kind of enjoyment except that of the animal appetites; _felicity_ is a more formal word, and is used more sparingly in the same general sense, but with elevated associations; _blessedness_ is applied to the most refined enjoyment arising from the purest social, benevolent, and religious affections; _bliss_ denotes still more exalted delight, and is applied more appropriately to the joy anticipated in heaven. happiness is only comparative, and we drink it in, in the exact ratio of our understanding to interpret the justice of the divinity within us. the first pre-requisite is_ wisdom_, the second is like unto it, _more wisdom_, and the third sufficient understanding to know that it is wisdom. "it is easy enough to be pleasant, when life flows by like a song, but the man worth while is one who will smile when everything goes dead wrong. for the test of the heart is trouble, and it always comes with the years, and the smile that is worth the praises of earth is the smile that shines through tears. "it is easy enough to be prudent when nothing tempts you to stray, when without or within no voice of sin is luring your soul away. but it's only a negative virtue until it is tried by fire, and the life that is worth the honor of earth is the one that resists desire. "by the cynic, the sad, the fallen, who had no strength for the strife, the world's highway is cumbered to-day, they make up the item of life, but the virtue that conquers passion, and the sorrow that hides in a smile, it is these that are worth the homage of earth, for we find them but once in a while." --_ella wheeler wilcox._ we possess none of the attributes save in a degree only, any one of which can be intensified, brightened, or benefited by our thoughts and actions. the shortest road to happiness, after having cleansed your body, actions, and thoughts, is to "do all the good you can, in all the ways you can, to all living creatures you can, just as long as you can." the more unselfish you become, the less you think of personal comfort, and the more pleasure you take in the comforts of others, the deeper and broader will the fountains of your own happiness become. there is no class of people who have equal happiness or bliss pictured upon their countenances to those who practice and teach the universal brotherhood of man without regard to race, creed, sex, caste, or color. happiness is like manna. it is to be "gathered in grains and enjoyed every day; it will not keep; it cannot be accumulated; nor need we go out of ourselves nor into remote places to gather it, since it is rained down from heaven at our very doors, or, rather, within them." george macdonald says: "a man must not choose his neighbor; he must take the neighbor that god sends him. in him, whoever he be, lies hidden or revealed a beautiful brother. any rough-hewn semblance of humanity will at length be enough to move the man to reverence and affection." and there is a still more extensive love, urges charles mackay:-- "you love your fellow-creatures? so do i,-- but underneath the wide paternal sky are there no fellow-creatures in your ken that you can love except your fellow-men? are not the grass, the flowers, the trees, the birds, the faithful beasts, true-hearted, without words, your fellows also, howsoever small? he's the best lover who can love them all." there are certain principles that lead to positive happiness. one of these is the avoiding of mistakes. "what have been termed 'the fourteen mistakes of life' are given as follows: it is a great mistake to set up our own standard of right and wrong and judge people accordingly; to measure the enjoyment of others by our own; to expect uniformity of opinion in this world; to look for judgment and experience in youth; to endeavor to mould all dispositions alike; not to yield to immaterial trifles; to look for perfection in our own actions; to worry ourselves and others with what cannot be remedied; not to alleviate all that needs alleviation as far as lies in our power; not to make allowances for the infirmities of others; to consider everything impossible that we cannot perform; to believe only what our finite minds can grasp; to expect to be able to understand everything. the greatest of mistakes is to live for time alone when any moment may launch us into eternity." ignorance is a state of happiness that many fairly intellectual people cite as well worthy of emulation; but those who assert it have not understood, or attempted to fathom, how shallow is this lake of knownothingness called "ignorance." only a slight ripple can be seen on the bosom of a shallow lake during the most fearful storm, yet but a slight zephyr is needed to show the white caps upon the grand old ocean, and at the least provocation of a storm "see how she causes the continents to tremble, showing her great depth and majesty." if in the presence of this happy, ignorant personage, we place the most beautiful piece of statuary or painting, or produce the most startling of shakespeare's plays, with the best living talent, or have the most gifted vocalist sing the most difficult _aria_, or have a panorama of the pyramid jeezeh, eiffel tower, washington monument, philadelphia city hall, cologne cathedral, all actual size, and such of nature's grandest views as the yosemite fall, and father of the forest, we would look upon this happy individual and listen in breathless silence for his opinion. well, what of it? what is to prevent it? would be the reply. but note the difference even in a cultured child; see the gentle cheek turn from pale pink to livid carmine, the heart pant, the bosom heave, and the whole form, for the time being, feel itself suspended in the air. to the above picture, add cultured, ripe old age, and the enjoyment, ecstasy, and pure happiness that would follow could only be measured by the difference between where _we_ stand and the _end_ of space! prerequisites in the begetting of wisdom are, first, you must be regular in everything you do, act, or think. this will give you health. second, you must be regular, cleanly, temperate, and moral. this will start you on the road to happiness. third, in addition to the first and second propositions, you must exercise self-control in all its aspects if you would have health, be happy, and live to excessive old age, before the culmination of which you will possess wisdom of no ordinary character. let the legend that "man's inhumanity to man makes countless thousands mourn," cease, and in its place have, "the universal brotherhood of man removes the shackles of inhumanity, replacing them by bands of love." this will elevate the trend of human thought, and every zephyr of human intellect will gather and multiply until a cyclone of happiness envelopes the earth; like love it will seem but a soothing breeze to the human heart, so gentle will fall its benign influences. this brings us to the point where every person is led to look to each of the four points of the compass and there exclaim, "who or what is god?" this is the first thing upon which intelligent beings should render a decision; mankind can only approximate happiness until they have settled in their own mind this point. it is not imperative that your decision should cover _all_ the truth or the _only_ truth in regard to deity, but it should preclude all doubt on the part of the person so deciding. there is just as much inconsistency in the statement that we know who and what is god in his physical proportions, just where he or it resides, and just what relation it or he holds toward the human monad, man, as there is in the assertion, "there is no god." there is no harm, however, in asserting our belief in _one_ god, the trinity, or a great first cause. if we believe it and shape our lives accordingly, true light will be given sufficient to satisfy each searcher after the truth; and he or they will advance to some other belief just when it is necessary. the exultant methodist receives his light in one form, and the quiet quaker in another. the devout catholic represents still another type of ritualistic form, and the wisdom religionist (theosophist) seems to get his from nature, and finds some good in everything. with the , other different kinds of faith, there should be no complaint on our part of a variety from which to choose. we offer not as anything new, but as something possibly forgotten, the following formulæ for obtaining happiness, _viz._: ( ) the carrying out in our lives and actions the golden rule; ( ) total unselfishness as regards self; ( ) trying to excel all others in doing what the world calls _good_; ( ) condemning no one until we have heard both sides of the question in dispute; ( ) having the same tender compassion for all the lower animals that you exercise towards the human family; ( ) following out consistently some religious belief, and, until you are convinced of a better one, defending it; ( ) above all other things, having charity for every person's short-comings and belief. add to these a few intrinsic principles: ( ) happiness is no other than soundness and perfection of mind; ( ) there are two ways of being happy--we may either diminish our wants or augment our means--either will do, the result is the same; and it is for each man to decide for himself, and do that which happens to be the easiest; ( ) happiness is a road-side flower growing on the highways of usefulness; ( ) carry the radiance of your soul in your face; let the world have the benefit of it; ( ) learn the lesson embodied in this little poem:-- the two workers. "two workers in one field toiled on from day to day, both had the same hard labor, both had the same small pay; with the same blue sky above, the same green grass below, one soul was full of love, the other full of woe. "one leaped up with the light, with the soaring of the lark; one felt it ever night, for his soul was ever dark. one heart was hard as stone, one heart was ever gay; one worked with many a groan, one whistled all the day. "one had a flower-clad cot beside a merry mill; wife and children near the spot made it sweeter, fairer still. one a wretched hovel had, full of discord, dirt, and din, no wonder he seemed mad, wife and children starved within. "still they worked in the same field, toiled on from day to day, both had the same hard labor, both had the same small pay; but they worked not with one will: the reason let me tell-- lo! the one drank at the still, and the other at the well." ( ) embody in your lives the better idea of this poem, "where do you live," by josephine pollard:-- "i knew a man, and his name was horner, who used to live on grumble corner: grumble corner, in cross-patch town, and he was never seen without a frown. he grumbled at this; he grumbled at that; he growled at the dog; he growled at the cat; he grumbled at morning; he grumbled at night; and to grumble and growl were his chief delight. "he grumbled so much at his wife that she began to grumble as well as he; and all the children, wherever they went, reflected their parents' discontent. if the sky was dark and betokened rain, then mr. horner was sure to complain; and, if there was never a cloud about, he'd grumble because of a threatened drought. "his meals were never to suit his taste; he grumbled at having to eat in haste; the bread was poor, or the meat was tough, or else he hadn't had half enough. no matter how hard his wife might try to please her husband, with scornful eye he'd look around, and then, with a scowl at something or other, begin to growl. "one day, as i loitered about the street, my old acquaintance i chanced to meet, whose face was without the look of care and the ugly frown which it used to wear. 'i may be mistaken, perhaps,' i said, as, after saluting, i turned my head; 'but it is, and it isn't, the mr. horner who lived for so long on grumble corner!' "i met him next day; and i met him again, in melting weather, and pouring rain, when stocks were up and when stocks were down; but a smile somehow had replaced the frown. it puzzled me much; and so one day i seized his hand in a friendly way, and said: 'mr. horner, i'd like to know what can have happened to change you so?' "he laughed a laugh that was good to hear, for it told of a conscience calm and clear, and he said, with none of the old-time drawl, 'why, i've changed my residence, that is all!' 'changed your residence?' 'yes,' said horner, 'it wasn't healthy on grumble corner, and so i moved; 'twas a change complete; and you'll find me now on thanksgiving street!' "now, every day as i move along the streets so filled with the busy throng, i watch each face and can always tell where men and women and children dwell; and many a discontented mourner is spending his days on grumble corner, sour and sad, whom i long to entreat to take a house on thanksgiving street." chapter xii. "gold can gild a rotten stick and dirt sully an ingot." aids to morality.--"many imagine that the only ways in which public and private morality can be improved," says the philadelphia _ledger_, "are those definite and direct methods which appeal at once to the conscience and the heart. preaching and teaching, persuading and warning, exhorting and encouraging, are instrumentalities worthy of all honor, and those whose abilities qualify them for such tasks should receive every possible stimulus to exert them in so noble a cause. but it is a great mistake to suppose that these are the only means to promote morality. every truly civilizing influence is also a reforming one. by this we do not mean that miscalled civilization which multiplies wants, and increases luxury and develops refinement in a few, at the expense of the many, but that advancement of mind and of knowledge, which is forever disclosing better methods of living and diffusing them among the whole people. dr. howard crosby, president of the society for the prevention of crime, in new york, and who has had wide opportunities of observing the condition of morality in that city, has recently declared that the moral condition of new york has vastly improved during the past few years, and that fifty years ago, although there was far less of the foreign element than there is now, a low condition of morality existed that would not be tolerated at the present time. what is true of new york in this respect is equally true of our other cities, and if there be any pessimist who points to the well-known corruptions and vices which still exist as a refutation of this statement, we would remind him that the very fact that such things are now brought to the light, discussed, and condemned, is a proof that they are on the decline. when a community is deeply sunk in immorality, little or no comment is made on the fact. when we come to seek into the causes of this improvement, we shall find that among the most prominent are the practical results of scientific progress and the civilizing tendencies of the age. there is no question that dirt, disease, and darkness are prevalent sources of vice and crime, and whatever influences are brought to bear against them will also press heavily against immorality. the increasing value set upon health, as shown alike in sanitary laws and regulations and in the greater willingness manifested by the community to understand and adopt hygienic modes of life, is beyond dispute. the improvements in house building and drainage; the introduction of water, pure and plentiful; the freer admission of fresh air; the better systems of ventilation; the brilliant lighting up of our city streets--all contribute to the prevention of crime and to the spread of a higher type of morality, while increasing the health, peace, and comfort of the community. and when to all these we add the better and wider education given to the rising generation than was thought possible fifty years ago, we shall find abundant reason for the moral advancement which has been made. there are some persons who feel quite powerless to help on the cause of reform, or to improve the moral character of a single individual, because they have no gift for influencing men by direct appeal. they have, perhaps, tried and failed, and so, although they would like to do some good in the world, they are hopeless of any success. let such take courage as they remember how many indirect, yet most effectual, methods there are of accomplishing this end. let them look over the multitudes of civilizing agencies that are silently working in the interests of morality, and attach themselves to such as most heartily engage their interest. every intelligent individual must be in sympathy with some of them; and it is just there that his services are needed and will be most valuable. nor let him make the mistake of supposing that he is thus working upon a lower or inferior plane. it is in works of benevolence and reform, just as in all other kinds of work--that which a man can do best is the very best thing for him to do. so, if one man is interested in sanitary schemes and another in evening schools; if one is anxious for free libraries and another for free parks; if one can help to secure good roads and clean streets and another can aid in protecting children or dumb animals from ill-treatment, let each be assured that in such exertions he is doing his share in promoting morality and in elevating character as surely and as effectually as those whose peculiar province it is to teach or to preach, to admonish or to advise." if the butcher's trade begets in him, the butcher, a disposition to use the knife more indiscriminately, and causes him to look upon the taking of life indifferently and unconcernedly, so that in a majority of the states he is disqualified from sitting upon a murderer's jury, there then must be something not only in the associations we keep but in the business we follow. the average lawyer tries by every known means to clear his client. in % of the cases handled by % of the attorneys their clients are guilty and they know it. they do not break the law of their state or country simply because the laws in the main are made to screen the evil-doers and not the honest citizen. but how they can do this and affiliate with any one of the , different faiths, or attend their church organizations or services sincerely, is more than we can surmise. in contrast, however, we must mention an isolated case that has reached us well authenticated. a very prominent and able lawyer of new york city, who had the reputation of never losing a case, was accosted by a well-known offender of the law on trial for felony before the court of oyer and terminer. the attorney invited the would-be client into his private office and had him state his case. he finished, and the lawyer remarked, "you are guilty." "well, i know that," replied the culprit, "that is why i want your services--you never lose a case." "sir," said the lawyer, "you have come to the wrong office. i have never failed in any case before the courts; i account for it from the fact that i have never espoused a cause where i knew the client was guilty. knowing i was right, i have thrown my whole soul into it, and won." gossip.--there is a vast deal of unhappiness in this world caused by gossip. dr. j. g. holland presents helpful ideas in the following:-- "what is the cure for gossip?--simply culture. there is a great deal of gossip that has no malignity in it. good-natured people talk about their neighbors because they have nothing else to talk about. as we write, there comes to us the picture of a family of young ladies. we have seen them at home, we have met them in galleries of art, we have caught glimpses of them going from a book store or library with a fresh volume in their hands. when we meet them they are full of what they have seen and read. they are brimming with questions. one topic of conversation is dropped only to give place to another in which they are interested. we have left them after a delightful hour, stimulated and refreshed, and during the whole hour not a neighbor's garment was soiled by so much as a touch. they had something to talk about. they knew something, and wanted to know more. they could listen as well as they could talk. to speak freely of a neighbor's doings and belongings would have seemed an impertinence to them, and, of course, an impropriety. they had no temptation to gossip, because the doings of their neighbors formed a subject very much less interesting than those which grew out of their knowledge and their culture. "and this tells the whole story. the confirmed gossip is always either malicious or ignorant. the one variety needs a change of heart and the other a change of pasture. gossip is always a personal confession either of malice or imbecility, and the young should not only shun it, but, by most thorough culture, relieve themselves from all temptation to indulge in it. it is a low, frivolous, and, too often, a dirty business. there are neighborhoods in which it rages like a pest. churches are split in pieces by it. neighbors are made enemies by it for life. in many persons it degenerates into a chronic disease, which is practically incurable. let the young cure it while they may." married life.--as the family is the center about which all life revolves, it is absolutely essential to have happy relations there. husbands too often neglect their wives and homes. "women are lonely," says mrs. annie jenness. "they miss their husbands. what amount of companionship exists between the american woman and the man? he starts for his office as soon as his breakfast is hurriedly swallowed. he does not come home at the lunch hour. he is barely in season for a late dinner. very possibly he belongs to a club and has an engagement as soon as dinner is done. "if not that, his head is in bank or counting-house, and he studies the stock quotations in the night's paper, and counts, as against a possible rise of wheat, the day's gossip, with which his wife is overflowing, very small potatoes. they have callers, or they go to opera or theater. it may easily happen that they do not spend ten minutes in conversation with each other during the day. american men are always in a hurry. they seem to live for the sole purpose of catching trains. they have no time to amuse or be amused. "the conditions of modern life separate them from women. the lives of men grow more and more simple--business comprehends the whole. the lives of women grow more and more complex--everything which is not business is given over to them. a man past the romantic epoch, who honestly enjoys talking with women, is not an average mortal. the every-day sort of man takes pains to be detained somewhere until all the guests have departed from his wife's o'clock tea. the couple live in different worlds. the world is now discussing why marriage is a failure, if it is? then consider this collection of reasons:-- "when either of the parties marry for money. "when the lord of creation pays more for cigars than his better half does for hosiery, boots, and bonnets. "when one of the parties engages in a business that is not approved by the other. "when both parties persist in arguing over a subject upon which they never have and never can think alike. "when neither husband nor wife takes a vacation. "when the vacations are taken by one side of the house only. "when a man attempts to tell his wife what style of bonnet she must wear. "when a man's christmas presents to his wife consist of boot-jacks, shirts, and gloves for himself. "when the watchword is, 'each for himself.' "when dinner is not ready at dinner-time. "when 'he' snores his loudest while 'she' kindles the fire. "when 'father' takes half of the pie and leaves the other half for the one that made it and her eight children. "when the children are given the neck and back of the chicken. "when children are obliged to clamor for their rights. "when the money that should go for a book goes for what only one side of the house knows anything about. "when there is too much latch-key. "when politeness, fine manners, and kindly attentions are reserved for company or visits abroad." chapter xiii. "the greatest friend of truth is time." what we inherit from the past. the world moves only through the constant accumulation and conservation of force--the force of mind. we are not capable of conceiving the immense wastage of this force from year to year and from century to century. if we produce a great inventor we are ignorantly proud of him. we wonder at him as if he were a miracle. a great thinker in mechanics, in art, in science, in letters, astonishes as if he were a prodigy, when he is really only an approach to what all men have the right to be, to what all men may become when the right mind has applied to it the right compelling power of suggestion from the force of other minds. as surely as the plant is involved in its seed, so surely is all the progress of the future involved in the thought of the past, recorded in books as far as it is possible to record it at all. the telephone, the telegraph, the phonograph, the steam-engine, the power loom--every result of the application of mind in the subjection of matter--existed in the minds of men and was recorded in books years before the thought gave suggestion to the mind which applied it practically. back of the mind of the great thinker in poetry, in statesmanship, in science, in mechanics, is the conserved force of the minds preceding him. but what does it all avail if it is wasted? we may have now a thousand edisons, fultons, morses and maurys, inert and practically useless because of force unapplied that might set them in motion to make the lives of millions, born and unborn, easier and happier. we have poets, statesmen, scientists, and inventors as unknown and unproductive as the worms which change them into productive forms of matter in country church-yards, where some gray finds them and touches us with a sense of their loss to us without suggesting the remedy. what remedy is there if it is not this of making the suggested possibility of the past the endeavor of the present and the achievement of the future? how is that possible, if we regard our capable men as miracles, when our own incapacity to understand is the only miracle when we leave the great possibilities of mind in unnumbered "thousands to die with the matter of their bodies? charity builds a small-pox hospital and men bless it--rightly. it benefits its hundreds and its thousands. the same benevolence, operating under the force of the conserved energy of mind, discovers vaccination, and so benefits millions and tens of millions for ages after the small-pox hospital is back in the clay from which its bricks were burned. there is here no parallel possible between the results achieved--those of the one hand so immensely exceed those of the other. the whole problem of the present and future is to bring the accumulated force of suggestion from the past to bear on the given point--on the mind of the living man, capable in possibility, and failing to achieve only for lack of stimulus--of force, of power--as a steam-engine is incapable without force applied from without. and as it is the last shovel of coal that sets the engine to work, so the mind, prepared for the final suggestion that is to give it its highest usefulness, will remain inert if the suggestion fails it. these suggestions may come from nature or directly from other minds, but in the main they come from the force of mind preserved in books. can there be any greater, any more capable benevolence, than that which gives this force its widest possible application? a million dollars may endow a hospital for a century. half as much in an endowment making a library free may bring pressure to bear on some brain, that, as a result, will save more suffering for the human race than has been saved by vaccination." longevity. chapter xiv. longevity. "tell me not in mournful numbers, life is but an empty dream, for the soul is dead that slumbers, and things are not what they seem." how long shall a man live? that depends entirely upon the _liver!_--_punch._ if you have read with care the preceding chapters of this work, and paused between the lines to reflect, you will not now have to be retold our panacea for a long life. by this we mean the usually allotted three-score and ten, or also the years given as the limit in genesis, rd and th chapters. these ages, however, are not common in any country or age. there are many instances of years, but not enough to be called common, while it is the "survival of the fittest" that reach years. in the united states only . % of population are above years and probably not more than - / % are over years. norway has the best record, with % of the population above the age of . japan has , , people over years, but only of these are over , and alone has reached the age of years. probably the oldest human being living in the united states at this writing is the old indian named gabriel, residing at or near castroville, cal., miles south of san francisco. he has an authentic history of years, and he is believed to be over years old. but for real characteristic longevity, we must visit the mountain fastnesses of thibet, in asia, where live a number of specimens of the human family that have a recorded history back to the latter part of the th century. we have previously told you that by regularity alone man may reach the age of years. now we intend to treat more the possibilities of how long it is possible for mankind to retain all their mental faculties and enjoy sufficient vital force to battle with the world for a livelihood. we are led to believe, like dr. wm. a. hammond, a prominent physician of new york city "that there is no physiological reason at the present day why man should die." (further on we give more of the doctor's theory.) just so long, however, as there are no paid teachers to show how not to get sick, how to keep the physique and mind from tiring, the heart from growing weary and discontented, just so long will the average of life remain under years and the grave-yards continue to be populated. there are hundreds of reasons why this or that clan or sect live longer than the other sect or clan, but what we wish to convey is that none of them live out all their days. for instance, in comparison with other nations not mentioned, the german can drink more beer, the frenchman more wine, the russian more pure spirits, the englishman more brandy, and the american more whisky, before harm is perceptible, likewise the chinese can smoke more opium and the russian a stronger cigarette, and more of them, before harm is apparent to others. no matter what an individual's creed, color, or nationality, if he be intelligent and clearly endowed with the five known senses, he does know that any narcotic, no matter of what nature, even if it is as mild as steeped tea leaves and as odorless as pure water, is a detriment to some one of the senses. as each sense is dulled, the others must sympathize with it; so it will not require an instrument to measure to the . part of an inch, or to a single vibration of the violet ray, to test the degree of injury that the human structure received for each variation from the path of perfection. if perfection of climate is sought, perfect sanitation obtained, regularity, cleanliness, uprightness, temperance, and self-control practiced, if the bodily waste is supplied with nature's fruits, grains, vegetables, and herbs, if drinking is done at nature's fountain for thirst, life will be prolonged to see the light in more than one century. finally, add to that, if self is forgotten, and only the comfort of others remembered and regarded, life may be indefinitely prolonged. m. chevreul, the eminent french scientist, died april , , aged years. "on the st day of august, , he attained the age of years, and was still in vigorous health, and with all his faculties unimpaired. the occasion 'was celebrated by the students of paris, among whom he is a great favorite, and by the french people generally, with enthusiasm.' the paris _journal illustre_ seized upon the opportunity to interview him in a manner that is described as marking 'an era in this line of journalistic enterprise. not only were his words taken down _verbatim_, but his various attitudes while speaking were photographed by the instantaneous process, and engraved,' twelve illustrations being given in the interview. m. chevreul is an important figure in the scientific world, and the interview contains many useful lessons in hygiene and philosophy, not the least of which is described by his interviewer as an exposition of the 'chemical secret of longevity.' in a condensed form, it is as follows: he regards longevity as a great blessing, and declares that the method by which it may be secured is easy to learn; but i think that with many people it would be difficult to follow. he laid down the proposition that the larger proportion of the human race die of disease and not of old age. now, he finds that while we should especially guard against drawing general conclusions from particular cases, yet it is nevertheless true that the study of particular cases may and should conduct us to general precepts. it is necessary for each one to study his personal aptitudes, and conform to them with a constant firmness. every _régimé_ is personal, and 'i cannot too much insist upon this essential point, that what is suitable for one may not be for another. it is, then, important for each one to note well what is adapted to his own constitution. thus, i have the same aversion to fish as to fermented liquors, especially to wine, also a distaste for a large number of vegetables, and i could never drink milk. shall i conclude, then, that fish, that the vegetables which i do not relish, and milk, are not nutritive?--certainly not; for i judge by a general rule and not by my own idiosyncrasies. coffee and chocolate agree with me; the latter is especially nutritive, and gives me an appetite for food. it is for me an aperient. shall i conclude from this that chocolate would give everybody an appetite?' "he maintains a barometric exactness and regularity in all the habits of his daily life,--eats at fixed hours, takes his time, and leaves the table with some appetite for more. he says he remembers the words of the wise man, 'the stomach has slain more men than war,' and that the spartans proscribed those citizens who were too fat. "i use little salt or spices, and but little coffee, and i flee as from a pest from all those excitants of which i feel no need, and from all tobacco and alcoholics in whatever form they may present themselves.' "he divides his day, the morning to exact science, the middle of the day to philosophy, and the evening to music and poetry. 'but above all, no discussion at the table. one should only eat with a calm spirit. let the dining-room remain the dining-room, and never be turned into a room for argument. discussion while eating is a cushion of needles in the stomach.'" dr. felix l. oswald has made the following brilliant conclusions in the "curiosities of longevity:"-- "among the centenarians of all nations and all times, a significant plurality were either rustics, or city dwellers addicted to outdoor pursuits. centenarians are remarkably frequent among the bailiff-ridden boors of southern russia, and the five oldest persons of modern times were care-worn if not abjectly poor villagers: peter czartan, who died in a hamlet near belgrade, , in his _hundred and eighty-fifth year_; the russian beggar kamartzik, a native of polotzk, who reached an age of one hundred and sixty-three years, and died in consequence of an accident; the fisherman jenkins, who, in spite of life-long penury, lived at least a century and a half (the estimate of his neighbors varying from one hundred and fifty-eight to one hundred and sixty-nine years); the negress truxo, who died in slavery on the plantation of a tucuman physician, in her hundred and seventy-fifth year; and the day-laborer, thomas parr, who attained the pretty-well-authenticated age of one hundred and fifty-two years, and who died a few weeks after his removal from country air and indigence to comfort and city quarters. if dietetic restrictions tend to prolong human life, the rule would seem to be chiefly confirmed by its exceptions. the children of israel are apt to ascribe their certainly remarkable longevity to the mosaic interdict of hogs' flesh.... "john h. brown, m. d., the berwick Æsculapius, enumerates a long list of patients who had postponed their funeral by following his plan of systematic hygiene--the plan, namely, of 'toning down' plethora by bleeding and cathartics, and of 'toning up' debility by means of beef and brandy. but sixteen hundred years ago the philosopher lucian called attention to the exceptional longevity of the pythagorean ascetics, whose religious by-laws enjoined total abstinence from wine and all sorts of animal food. the naturalist brehm describes the robust physique of a soudan chieftain who, at the reputed age of one hundred and six years, could hurl a stone with force sufficient to kill a jackal at a distance of fifty yards, and thought nothing of starving for a week or two if his foragers happened to return empty-handed. but the same traveler mentions that his swarthy nestor now and then compensated such fasts by barbecues lasting from ten to twenty-four hours, and including a _mélange_ of marrow-fat and pepper-grass, besides dozens of hard-boiled crane's eggs, jerboa stew, and deep draughts of clarified butter. long fasts certainly enhance the vigor of the digestive organs, but the net result of repeating such experiments seems rather difficult to reconcile with the experience of luigi cornaro, the venetian reformer, who managed to outlive all his cousins and schoolmates, and ascribed his success to the mathematical regularity of his bill of fare, which, during the last sixty years of his self-denying existence, had been limited to twelve ounces of solid food and fourteen ounces of fluids--wine chiefly, a beverage which the soudanese emir would have rejected with a snort of virtuous horror. dr. virchow, though by no means an advocate of total abstinence, admits that the longevity of the semitic desert-dwellers can be explained only by their caution in the use of stimulants--a virtue which in their case would, indeed, appear to offset an unusual number of circumstantial disadvantages--thirst, fiery suns, and fiery passions being decidedly unpropitious to length of life. "and here, at last, we may strike a bit of _terra firma_ in the quicksands of speculative hygiene. 'take a hundred different animals,' says the sanitarian schrodt, and you will find them to prefer a hundred different sorts of solid food, but they all drink milk in infancy, and afterward water; and considering the infinite variety of comestibles a healthy human stomach contrives to digest, we might very well agree to deserve that privilege by limiting the variety of our beverages.' instinct certainly abhors the first taste of alcoholic liquors, and statistics prove that in all climes and among all nations the disease-resisting power of the human organism is diminished by the habitual use of toxic stimulants. mohammed, buddha, and zoroaster agree on that point, and the esoteric teachings of pythagoras may have qualified his rather fanciful objections to grape-juice by the practical hope of longevity. a complete list of infallible prescriptions for the prolongation of human life would fill a voluminous book, and would include some decidedly curious specifics. 'to what do you ascribe your hale old age?' the emperor augustus asked a centenarian whom he found wrestling in the _palæstra_ and bandying jokes with the young athletes. '_intus mulso, foris oleo_,' said the old fellow--'oil for the skin and mead [water and honey] for the inner man.' cardanus suggests that old age might be indefinitely postponed by a semi-fluid diet warmed (like mothers' milk) to the exact temperature of the human system and voltaire accuses his rival maupertuis of having hoped to attain a similar result by varnishing his hide with a sort of resinous paint (_un poix résineux_) that would prevent the vital strength from evaporating by exhalation. robert burton recommends 'oil of unaphar and dormouse fat;' paracelsus, rectified spirits of alcohol; horace, olives and marsh-mallows. dr. zimmerman, the medical adviser of frederick the great, sums up the 'art of longevity' in the following words: 'temperate habits, outdoor exercise, and steady industry, sweetened by occasional festivals.'" "the increasing longevity of man is attracting considerable attention from collectors of statistics, and some curious facts are being elicited. according to the last census, per cent of the people who died between and had outlived the traditional three-score years and ten, whereas of the deaths between and , only . per cent were of persons of that age. in , . per cent of the deaths were of children under one year of age; in , the proportion was . , showing a smaller percentage of deaths among adults. the average length of life in england years ago was only twenty years. in france the average length of life, under louis xviii., was twenty-eight years. actuaries are figuring that within the past half-century the average length of life has greatly increased." "a study of this subject is impeded by the tendency of almost everyone to generalize from individual examples within his own observation. this is almost sure to be misleading, because no one's acquaintance is so large that it embraces factors enough to base a theory on. people say that life is longer than it used to be, because palmerston rode to hounds at , and peter cooper and the emperor william were intellectually vigorous at over . they forget that marino faliero was over when he concocted his plot, and that the blind dodge dandolo was when he took constantinople. every age has produced a few long-lived men, and here and there a centenarian." "the question of importance is not whether this age is yielding more centenarians than former ages, but whether, on the average, the age of man is longer than it was, and if so, how much longer? the grounds for an increased longevity--better doctors and more of them, better drainage, more wholesome food, wiser habits, and better facilities for securing change of air--justify the belief that life is lengthening, to what degree it is hard to say. m. flourens, who had made a life study of the subject, said that every man ought to live to be a hundred, if he took care of himself." "in a number of the _popular science monthly_ is an article by clement milton hammond on the prolongation of human life that is interesting both in the way of being readable and as based on returns as to an unusually large number of persons above eighty years of age. the facts were obtained by sending out , blanks to be filled. they were sent through new england only and were intended to cover personal history and hereditary influence. over , of the blanks were filled out and returned. they show that less than per cent remained unmarried through life, the unmarried women being three times as numerous as the unmarried men. the average number of children was five. five out of six of the old people had light complexions, blue or gray eyes, and abundant brown hair. the men were generally tall and ranged in weight from to pounds, with a few of pounds, and the women of medium size, weighing from to pounds, with some exceptional cases up to pounds. the men were generally bony and muscular, and the women the opposite. at the time of record the hair was generally thick, the teeth poor or entirely gone, the skin only slightly wrinkled. generally their habits of eating and sleeping have been conspicuously regular. they have as a rule adhered to one occupation through life, and of the , men were farmers. few have used alcoholic drink stronger than cider. a large majority of the men used tobacco. the average age of the parents and grandparents of the persons reported on was about sixty-five. the average time of sleep was about eight hours." dr. maurice advances some staunch ideas on old age:-- "do poor people live longer than the affluent? there are so many more poor in the world than there are rich that we can be sure of finding more poor old people. probably excessive wealth is a burden sure to exhaust its possessor in the care of it. our millionaires, however, are men for the most part who began poor and were possessed of tenacious vitality, that is, with a grip on other things as strong as on the money bags. professor humphrey's 'report on age of persons' gives us persons, of both sexes, of whom about half were poor and the rest at least in good circumstances, per cent only being possessed of wealth. the real truth seems to be that poverty, with an iron constitution and sound nerves, is most likely to produce an instance of extreme age; but the possession of the comforts and amenities of life produces by far the best average of ages. the average age of the middle classes has always surpassed that of others; but at present sanitation forces on the poor so many provisions against disease that they are saved from their former high death-rate, and brought quite near the privately better-bred and furnished class. "there has certainly been long sustained, in proverbs and otherwise, a conviction that early rising and early retiring have much to do with prolonged vitality. franklin insisted on it vigorously. lord mansfield, also, held it to be an important item in his sustained vigor to near ninety. i am inclined to believe that the estimate is not erroneous. we are far more the creatures of habit than we generally allow. at certain moments we become regularly hungry, regularly sleepy, and so with all other functions. it is wise beyond doubt to recognize this fact and never break our habits, that is, our useful habits. but beyond this, there are certain habits dependent on cosmical causes, such as movements of the sun. our natural rest would seem to be properly conformed, in the main, to the appearance and disappearance of daylight. "but after we have fairly and fully considered the subject, there remains the one fact that idleness will end life sooner than any other cause. the hour that any person retires from any and all occupation he is sure to drop into decadence. the mind is very sure to begin to lose its clearness when it is withdrawn from regular exercise. both brain and muscular power lapse with lack of activity. the custom of working excessively till sixty-five or seventy, and then withdrawing from business, is wrong at both ends. we crowd life at the beginning, and let its functioning grow torpid at the close. much is lost to age by our modern methods of locomotion. great walkers are scarce; there is almost a total lack of horse-back exercise. carriage-riding over smooth roads in no way compensates." perhaps there is nothing that prolongs life more than genial, hearty _laughter_. william matthews says "that there is not a remote corner or little inlet of the minute blood-vessels of the human body that does not feel some wavelet from the great convulsion caused by hearty laughter shaking the central man. not only does the blood move more quickly than it is wont, but its chemical or electric condition is distinctly modified, and it conveys a different impression to the organs of the body, as it visits them on that particular mystic journey when the man laughs, from what it does at other times. a genial, hearty laugh, therefore, prolongs life, by conveying a distinct and additional stimulus to the vital forces. best of all, it has no remorse in it. it leaves no sting, except in the sides, and that goes off. cicero thought so highly of it that he complained bitterly at one time that his fellow-citizens had all forgotten to laugh: _civem mehercule non puto esse qui his temporibus ridere possit_. titus, the roman emperor, thought he had lost a day if he had passed it without laughing. what a world would this be without laughter! to what a dreary, dismal complexion should we all come at last, were all fun and cachination expurged from our solemn and scientific planet! care would soon overwhelm us; the heart would corrode; the river of life would be like the lake of the dismal swamp; we should begin our career with a sigh, and end it with a groan; while cadaverous faces, and words to the tune of 'the dead march in saul,' would make up the whole interlude of our existence." "hume, the historian, in examining a french manuscript containing accounts of some private disbursements of king edward ii. of england, found, among others, one item of a crown paid to somebody for making the king laugh. could one conceive of a wiser investment? perhaps by paying one crown edward saved another. 'the most utterly lost of all days,' says chamfort, 'is that on which you have not once laughed.' even that grimmest and most saturnine of men, who, though he made others roar with merriment, was never known to smile, and who died 'in a rage, like a poisoned rat in a hole'--dean swift--has called laughter 'the most innocent of all diuretics.' yet the philosopher of concord, r. w. emerson, is reported as having said in a lecture: 'laughter is to be avoided. lord chesterfield said that after he had come to the years of understanding he never laughed.' lord chesterfield would have had far more influence if, instead of repressing every inclination to laugh, he had now and then given his ribs a holiday--nay, if he had even roared outright; for it would have disabused the public of the notion that he never obeyed a natural impulse, but that everything he said and did was prestudied--done by square, rule, and compass. as it was, though he was confessedly the politest, best-bred, most insinuating man at court, yet he was regularly and invariably out-flanked and out-maneuvered by sir robert walpole, who had the heartiest laugh in the kingdom, and by the duke of newcastle, who had the worst manners in the world. in commending laughter, we mean genuine laughter, not a make-believe, not the artificial or falsetto laugh of fashionable society, nor, again, the mere smile of acquiescent politeness, or the crackling of thorns under a pot, or the curl of the lips that indicates in the laughter a belief in his fancied superiority. still less do we mean the hollow, mocking laugh of the cynic. the laughter which we would commend as healthful is not bitter, but kindly, genial, and sympathetic." no physiological reason for death.--"dr. william a. hammond, a prominent physician of new york, who has written several medical treatises, and was some years ago surgeon-general of the united states army, has recently set forth his belief that there is no physiological reason at the present day why man should die. he maintains that people die through the ignorance of the laws which govern their existence, and from their inability, or indisposition, to attend to those laws with which they are acquainted. now, as the business of medical men has ostensibly been for the last four thousand years to prolong human life, and as dr. hammond affirms that there is no good reason why people should die, the wonder is why men of his school have not drawn up some formula by which they could live on for three or four thousand years, at least. there has always been a vague impression that the knowledge of the preservation of human life had been lost, and that in some favored era of the world's history that knowledge would be recovered. "if there is such a thing as a hidden law of life, which, when discovered and asserted, will arrest physical decay and prevent death, except by accident, doctor hammond, and all who hold to his doctrine, ought to lose no time in making it known. this medical authority reasons that, as the human body is constantly dying and constantly renewing its particles, this law of displacement and renewal ought to be perpetual, and that when it is discovered just what substances are best fitted to maintain this equipoise, as it were, there should be no giving out of the physical powers. "'the food that man takes into his stomach,' says doctor hammond, 'ought to be of such quantity and quality as would exactly repair the losses which, through the action of the several organs, his body is to undergo. if it is excessive in either of these directions, or if it is deficient, disease of some kind will certainly be the result. if he knew enough to be able to adjust his daily food to the expected daily requirements of his system, disease could never ensue through the exhaustion of any one of his vital organs. a large majority of the morbid affections to which he is subject are due to a lack of this knowledge. "'now, suppose that he is exactly right in his calculations, and that the food taken is neither too great nor too little, but exactly compensates the anticipated losses, the death of each cell in the brain, or the heart, or the muscles, etc., will be followed by the birth of a new cell, which will take its place and assume its functions. gout, rheumatism, liver and kidney diseases, heart affections, softening and other destructive disorders of the brain, the various morbid conditions to which the digestive organs are subject, would be impossible except through the action of some external force, such as the swallowing of sulphuric acid, or a blow on the head, or a stab with a knife, which would come clearly within the class of accidents, and of course many of these would be avoidable.' "dr. hammond's theory supposes that the time will come when the individual will have learned the uttermost thing about the laws of life, and when he will conform so strictly to these laws that he will have nothing more to learn in regard to the best way of living. it may require ages for this progress, but when it is attained, and the race is set free from all morbific influences, physical death would be impossible. the summary of his points is that 'people die from ignorance of the laws of life; and from willfulness in not obeying the laws they know.' that may be a part of the truth which is very near the surface. but the other demonstration is not quite so clear as could be wished--that there can be any such thing as an eternity of physical life, even if all the laws touching that life were known and every one of them obeyed." part ii chapter i. diseases and remedies; how to prevent most maladies and cure ills possessed. note.--if the reader is in haste to know what will cure this or that trouble, before perusing the pages of this entire pamphlet, such as cramp, colic, indigestion, constipation, headache, etc., the index found in the back part of this work will give immediate reference, and the prescriptions instant relief. if you are cured thereby of any of the many maladies that beset the human family, remember that it is only temporary; for to be cured of any disease permanently requires the removal of the cause. one of the objects of this book is to convey that information. the great disparity between the actions and teachings of many of our principal writers must be apparent to every reader of books, pamphlets, and editorials, upon the subject of health and its allies, happiness and longevity. many of the leading exponents of temperance have periodical spells of drunkenness, and some drink all the time. the prominent articles written upon the subject of sanitary matters and cleanliness, are generally by the editor whose office is the scene of disorder, the floor covered with tobacco quids, old rubbish and dust, and the corners filled with cobwebs. the writer upon the subject of poverty and the wrongs of the poor, has his headquarters fitted up in the most magnificent style;--he never knew what it was to want for a meal, nor did he ever darken the door of real poverty. the missionary advocate soliciting funds for the heathen and down-trodden poor of foreign lands, more than likely never crossed the borders of his own state, certainly has not taken a stroll through the dark lanes and alleys, or climbed the dingy stairways of the tenement houses of his own city. if he had done so, a more effective appeal would have gone up for the suffering poor and spiritually blind of the principal unsanitary municipalities of his own country. the physician with a bad cough and broken-down constitution is still prescribing for consumptives and patients with all manner of aches and pains, of which his own body is a perfect index. and the minister who has not yet lost all his hatred for "that other sect," and occasionally assists in persecuting it, is still teaching the doctrine of the meek and lowly nazarene. having experienced a large number of diseases and their successful remedies, we have for several years been collecting the most reliable data and testimony on many--in short most--of mankind's bodily ills. in this second part we present them for your benefit. there are about , remedies mentioned in the th edition of the "united states dispensatory," by reference to which it will be seen that each affliction to which flesh is heir must be more than well drugged. it is the fault of the community at large that the necessity of such a work exists. there is no demand for any form of disease even with the improper state of society as it is to-day. extreme old age and a limited number of accidents are all that can be necessary to record. the following is an admirable article from the st. louis _globe democrat_, which is quite pertinent. "sanitation and sanity.--the general subject of sanitation now covers our architecture and our home life; our sewerage and disposition of waste; our personal cleanliness and contact in all social relations; our food and drink, both as to quality and kind; quarantine and other preventives against contagion and infection; the purification of streams, and the cleansing of the air of smoke and foul vapors; in fact, the whole subject of health or wholeness. * * * a national board of health was as unthought of as was an atlantic cable in . but the fact that great epidemics were liable to invade us, and did invade us, led to a system of quarantine and to enforced vaccination. but the regulation by law of our social manners, so far as they bore on public health, was not undertaken to any extent until within the past decade. * * * indeed, public sentiment is as yet so uninformed that thorough laws in the case could not be enacted or enforced. there is not a stream in the united states that can be kept entirely free from pollution. the sanitary value of this is not understood by even the intelligent populace. the drainage of swamps is neglected in the neighborhood of our larger cities." "st. louis has tolerated inside her limits pools that have made fevers of a malarious sort, with spinal meningitis, as common as croup. chicago has acres of rotting vegetable matter inside the corporation every autumn. the inroads of yellow fever have always been invited by the unsanitary condition of southern towns. the reports of surgeon-general hamilton, last summer, showed that the pest found its first welcome in a town where sewerage was wholly neglected, and tons of rotting sawdust and refuse filled the heated air with fever conditions. "the discovery of the germ origin of diphtheria and of the typhoid forms of fever, has led to great changes in thousands of households. our houses are constructed with far more attention to ventilation and proper heating. we shall finally get rid of drunkenness and intemperance of other sorts, on sanitary grounds mainly. alcohol has been considered as at least valuable in moderation. it has been looked upon as a medicine. that its value as a stimulant hangs on the previous abuse of health is now understood, and its value purely as a very temporary bridging of weakness alone is conceded. that the drink habit is in any sense, however moderate, of sanitary value, is disproved. few doctors prescribe any form of alcohol for habitual use. the saloon is unsanitary in all its effects. the temperance issue rests at that point. animals to which spirits have been given in their food digest nearly one-half less than other animals of the kind. the nutrition of the human body demands the abolition of stimulants and narcotics. the saloon will go ultimately as a nuisance to health. we have not yet reached a condition when public morals can rest on any other basis than health. it is doubtful if there can be a higher basis. what is unwholesome is wrong; what is promotive of health and completeness for the individual and for the community is right. "sanity is dependent on sanitary living. they both are derived etymologically from _sanitus_, and that from _sanus_, the latin for sound or whole. insanity has come to have the limited meaning of unsoundness of brain. * * * insanity is on the increase in the united states, but not more so than nervous disorders in general. this indicates a tendency to a break-down of the national type of organism, and cannot be considered with indifference. the fact exists as a consequence of the overwork and high pressure of modern life, but in this country is at its maximum, because, for several generations, we have been at white heat, subjecting a continent to our domestic purposes. "the vast unfolding of means of wealth has also acted as a stimulant, compared to which alcohol is insignificant. our lunatic asylums multiply, but are all full. the percentage of failure is greatest in california, where speculation has been most intense. it is impossible to avoid the problem. how shall we reverse this tendency, and begin the construction of an american type of full, robust, conservative, and reserved energy? the underlying problem of all problems is to secure a constitution. a nation that lives and works in such a manner as to grow weaker in brain endurance and nerve power, and yet so lives that the demands on brain and nerves are increased, is doomed. the intensity of modern life is something we cannot reverse. we must adapt ourselves to it by securing larger and more systematic means of recuperation. brain-workers must learn to use the first half of the day for work, and sacredly give the last half to rest and play. night must be given back entirely to sleep. withal it is clear that we must understand the close relation between sanity and sanitation. our people can no longer eat and drink as grossly as our fathers did. the stomach gets not half the time it formerly did for digestion. it must, therefore, be delivered of half its toil. the introduction of stoves and modern conveniences must be accompanied by more rational ventilation. active brains require a vast and regular supply of oxygen. it is not for the lungs alone that we need pure air, but for the brain. this is specifically an american problem, the readjustment of society, so that the mind shall be relieved of strain and consequent enfeeblement." individual, municipal, and national cleanliness by enactment of law are among the first steps that should be taken. the churches and schools should teach it as a prerequisite before godliness, or education in general; then with perfect ventilation, sanitation, and regularity of all the virtues, there will be no vices, and godliness and education will be contagious, just as though they were real diseases. the first thing to undertake if you are desirous of freeing yourself of any disease, ache, or pain, is to stop the cause. act on the same principle you would if you had a barrel that had leaked its contents and you desired to refill it,--first stop the leak. it is absolutely necessary that you study _cause_ as well as _effect_, if you would know yourself. the secret of sound health.--"half the secret of life," says _macmillan's magazine_, "we are persuaded, is to know when we are grown old; and it is the half most hardly learned. it is more hardly learned, moreover, in the matter of exercise than in the matter of diet. there is no advice so commonly given to the ailing man of middle age as the advice to take more exercise, and there is perhaps none which leads him into so many pitfalls. this is particularly the case with the brain workers. the man who labors his brain must spare his body. he cannot burn the candle at both ends, and the attempt to do so will almost inevitably result in his lighting it in the middle to boot. most men who use their brains much soon learn for themselves that the sense of physical exaltation, the glow of exuberant health which comes from a body strung to its full powers by continuous and severe exercise, is not favorable to study. the exercise such men need is the exercise that rests, not that which tires. they need to wash their brains with the fresh air of heaven, to bring into gentle play the muscles that have been lying idle while the head worked. nor is it only to this class of laboring humanity that the advice to take exercise needs reservations. the time of violent delights soon passes, and the effort to protract it beyond its natural span is as dangerous as it is ridiculous. some men, through nature or the accident of fortune, will, of course, be able to keep touch of it longer than others; but when once the touch has been lost, the struggle to regain it can add but sorrow to the labor. of this our doctor makes a cardinal point; but, pertinent as his warning may be to the old, for whom, indeed, he has primarily compounded his _elixir vitæ_, it is yet more pertinent to men of middle age, and probably it is more necessary. it is in the latter period that most of the mischief is done. the old are commonly resigned to their lot; but few men will consent without a struggle to own that they are no longer young. all things are not good to all men, and all things are not always good to the same man. the man who confines his studies within one unchanging groove will hardly find his intellectual condition so light and nimble, so free of play, so capable of giving and receiving, as he who varies them according to his mood, for the mind needs rest and recreation no less than the body; it is not well to keep either always at high pressure. one fixed, unswerving system of diet, without regard to needs and seasons, or even to fancy, is not wise. the great secret of existence after all is to be the master and not the slave of both mind and body, and that is best done by giving both free rein within certain limits, which, as the old sages were universally agreed, each man must discover for himself. happy are the words of addison, and happily quoted: "a continual anxiety for life vitiates all the relishes of it, and casts a gloom over the whole face of nature, as it is impossible that we should take delight in anything that we are every moment afraid of losing. "one of the best methods of avoiding that pitiful anxiety is to learn within what limits we may safely indulge our desire for change, and then freely indulge it within them." chapter ii. we shall now take up a practical list of subjects, arranged in alphabetical order. without any attempt at egotism, we claim that there are few nontechnical books extant that contain a superior selection of preventatives and remedies. read carefully and judge for yourself. there are very few common or occasional afflictions which are not considered to some extent. why always seek a doctor when you seem to be somewhat off your physical equilibrium? you will generally at each visit spend more money than this book will cost. learn to provide against constant medical attention. =accidents.=--in sudden emergencies, either of accident or sickness, the first great requisite is presence of mind. be calm. endeavor, if possible, to grasp the situation, and do what is to be done promptly and quietly, until the arrival of the physician. all hurried and distracted motions, and all exciting noises, confuse the attendants and needlessly alarm the sufferer. in many cases, the course of immediate action is suggested by the circumstances; but where you do not know what aid to render, it is best to do nothing, except to make the patient as comfortable, for the time being, as possible. for all ordinary emergencies, ample directions are:-- " . always look in the direction in which you are moving. " . never leave a car, or other public vehicle, when it is in motion. " . never put your head or arms out of a vehicle when it is in motion. " . if a horse runs away with you, remain in the vehicle rather than risk the danger of jumping from it. " . in thunder-storms keep away from trees, metallic substances, doors, and windows. the lower part of a house is the safer. " . never play with fire-arms. always keep them beyond the reach of children. " . avoid charcoal fumes; they are deadly when confined in a close room. " . illuminating gas; be sure to turn it off. _never blow it out._ " . when gas can be smelt in an apartment always air the room well before striking a match or bringing a light. " . when very cold, move quickly. if any part of the body is frozen, rub it with snow, and keep from the fire. " . change wet clothing as soon as possible. " . carefully avoid exposure to night air, in malarial districts. " . if necessary to go into an old vault or well, first introduce a burning candle. if the light burns low and finally goes out, carbonic acid gas is present and the place is unsafe to enter. unslaked lime will absorb the gas and purify the air. " . avoid walking on railroad tracks and icy sidewalks. " . when awake, very young children should never be left alone. " . do not go, with loose hair or flowing garments, near dangerous machinery. " . never touch gunpowder after dark. " . never fondle a strange dog. " . never light a fire with kerosene. " . fill and trim your lamps in the day-time. never trim or fill a lighted lamp. " . keep matches in a closed metallic box. " . have your horses rough-shod as soon as the ground freezes. " . when feeling dizzy or seasick, lie down. " . do not close the damper of your stove too early. better waste coal than run the risk of suffocation by gas. " . when climbing a ladder, look up and not down. " . in railroad traveling take the center of the car, and the middle car of the train, for safety. " . eat only pure food, drink only pure liquids, think only pure thoughts, and keep your blood pure. " . in going through dry woods or over prairies do not smoke or cast matches about carelessly. there should be laws against this often wanton destruction of property. " . look out for spontaneous ignition of oily rags, oil-painted canvas rolled up, wet iron filings. " . in entering mines not used, always try for gas before venturing into them. " . do not be careless in any way whatever in connection with fire. the losses in the united states, in , by fires as a result of carelessness amounted to nearly $ , , , while in san francisco for the same year we find that fully % of the losses can be attributed to the same source." =alcohol.=--felix l. oswald, m.d., gives some very good ideas in _good health_ on the alcoholic habit. "'reform,' says an able political writer, 'is ever unpopular. all wrongs lie in the consent of the wronged, and what with the fierce support of those who thrive on the abuse, and the dull, heavy, ignorant conservatism of the masses, * * * it is a sad delusion to suppose that the cause is won when the argument is made.' an unquestionable preponderance of power, they argue, favors the side of the liquor venders, and in this world, at least, always finds a way to assert itself as right. the last link of that syllogism, however, is a rule with occasional exceptions. no unqualified evil has ever succeeded in maintaining its supremacy, and the evils of the alcohol vice are offset by no benefits. alcohol has been called 'negative food,' because its physiological influence torpifies the functional energy of the digestive organs, and thus, for a time, renders the toper insensible to the cravings of hunger. the same effect, however, can be produced by a stunning blow, and we might as well claim that the interests of political economy could be promoted by a fierce war, because a knock-down stroke with the butt-end of a musket is apt to lessen the appetite of the afflicted soldier. no real benefit can result from the lethargizing effect of a poison dose, the retardation of the digestive functions being in every case a morbid and abnormal process, avenging its repetition by the fatty degeneration of the tissues and the impoverished condition of the blood. * * * during the horrible flood which a few months ago devastated the two richest provinces of the chinese empire, a number of vile marauders eked out an existence by fishing out wreckage and plundering floating corpses. the idea of mentioning the profits of these wretches as a compensating offset to the horrors of a public calamity would justly consign its propounder to the custody of a lunatic commission. yet, by an exactly analogous line of argument, many of our political economists continue to defend the legal sanction of the liquor traffic. nay, it might be seriously questioned if the total loss (by fire or water) of a billion bushels of grain would not be financially and morally preferable to their conversion into a life-blighting poison. according to the statistics of the treasury department, the alcohol drinkers of the united states (representing hardly one-fifth of the alcoholized nations of christendom) spent during the last ten years a yearly average of $ , , for whisky, $ , , for other distilled liquors, $ , , for wine, and $ , , for ale and beer; together, $ , , a year. that enormous sum has been far worse than wasted. it has been invested in the purchase of disease. it has been devoted to the development of idiocy, crime, and pauperism. it has turned blessings into a concentration of curses. the general recognition of these facts will seal the doom of the liquor traffic." dr. c. e. spitka expresses some results of science investigating strong drinks:-- "alcoholism among the ancients was therefore mainly or exclusively known in its acute phases, the drunken frenzy in which alexander the great killed clitus being a familiar example. with the introduction of tobacco and playing cards, the saloon, the cellar-dive, and the bar-room usurped the place formerly held by the inn. the enlargement of cities deprived their inhabitants of rustic sports, and led to their seeking in other and more dangerous channels an escape from mental and physical strain, and a variation of routine monotony. it is generally conceded by those medical writers who are unshackled by prejudice that a certain amount of alcohol can be ingested with perfect impunity. that amount has been accurately determined by dujardin-beaumetz in the course of experiments made in the abattoirs of paris. transferring the result of his experiments to the human species, he concluded that a man weighing pounds could take the equivalent of two ounces of alcohol a day for years without injury to any organ of the body. but when the amount taken daily exceeds the toleration-point, prolonged abuse is followed by results which are as sinister as they are insidious. in the dead-house of the philadelphia hospital, formad found that, of chronic alcoholists, nearly per cent had fatty degeneration of the liver, per cent had congestion or a dropsical state of the brain, the same proportion an inflamed or degenerated stomach, while not quite per cent had normal kidneys. of children of drunken fathers observed by voisin, were idiots, confirmed epileptics, suffered from a congenital spinal disease, and the remainder died in early life with convulsions. of children similarly descended, cited by dagonet, died in the same way. of such births recorded in alsace-lorraine, were still-born and died of convulsive disorders shortly after birth. one drunken father had still-born children in succession; another lost of by convulsions. it is not alone as a direct result of inebriety that a defective nervous system is thus transmitted. even in his sober intervals, he whose nervous system has been shattered by alcohol is liable to have a degenerate or diseased offspring. of children recorded as born under these circumstances, voisin found epileptic and idiotic. as if to prove beyond the possibility of a doubt that such degeneracy is due to the alcoholism of the parent, and to that alone, two french investigators, mairet and combemale, performed a series of experiments on dogs, by which they showed that the same result which the chronic inebriate is accused of producing in his offspring, through selfish indulgence, can be produced at will in the offspring of lower animals by compulsory induction of the same vice in them." an english investigation, just completed, puts in tangible form the effect of the use of alcohol, from observations covering , cases in all walks of life. this report shows that, with men over twenty-five, the intemperate use of alcohol cuts off ten years from life, those who never drink to excess, or use no liquor, living, on the average, ten years longer than those who do. indulgence, if carried to excess, doubles diseases of the liver, quadruples those of the kidneys, and greatly increases the number of deaths from pneumonia, pleurisy, and epilepsy. it is not often appreciated how many people die annually from the effects of strong drink. dr. norman kerr, an eminent physician of england, believing the statement of temperance people to be extravagant, that , people die annually from the effects of strong drink, began as early as a personal inquiry, in connection with several medical men and experts, expecting to quickly disprove the same. according to their deductions, the latest estimates of deaths of adults annually caused through intemperance is, in great britain, , ; in france, , ; in the united states, , --or nearly a half million each year in three countries aggregating a population of , , . _excessive beer drinking._--in the earlier part of our work we endeavored to impress on our readers the necessity of regularity and the avoidance of excesses. the last week of in new york city saw two prominent brewers buried, and two others of the guild were near death. none of them were, or are, over forty-seven years old. kidney and heart disease were the causes of death in the case of the first two. similar ailments have marked the other two gentlemen for the grave. the question arises, was it beer or champagne that caused these diseases? in this connection the statement a physician of bellevue hospital once made is not amiss. these are his words: "the worst cases of alcoholic ailments coming under our observation are those resulting from excessive beer drinking." in appearance the beer drinker may be the picture of health; but in reality he is most incapable of resisting disease. a slight injury, a severe cold, or a shock to the body or mind, will commonly provoke acute disease, ending fatally. compared with other inebriates who use different kinds of alcohol, he is more incurable and more generally diseased. it is our observation that beer drinking in this country produces the very lowest kind of inebriety, closely allied to criminal insanity. the most dangerous class of ruffians in our large cities are beer drinkers. intellectually, a stupor amounting almost to paralysis arrests the reason, changing all the higher faculties into a mere animalism, sensual, selfish, sluggish, varied only with paroxysms of anger, senseless and brutal. that men are the sex most addicted to stimulating but injurious habits is sadly growing less true, and women are finding recourse too often to poisonous invigorators. if one-half of what the doctors are saying all over the country is true, there may soon be a greater need of a temperance reform among the women than there ever has been among the men. strong drink, however, is not the monster by which the women may be enslaved, but a strong and poisonous drug equally baneful in its effect. this drug is antipyrine. it is a white powder, slightly bitter, and soluble in water. until about a year ago it was prescribed for fevers only, but a french medical college recommended it for headaches and other pains and disorders, and in this way it has gained its grasp on so many thoughtless and nervous women. in chicago and many other places it is said that the habit is gaining with alarming rapidity, for the women take it for every ill, and cannot believe that its soothing effect can have any evil result until the habit is thoroughly fixed upon them. it produces different results under different circumstances, and, like many other preparations, varies according to the size of the dose. in large doses it has been known to produce complete relaxation, and at the same time a loss of reflex action, and death. in moderate or tonic doses it often produces convulsions. its effect as a stimulant seems to be very much like that of quinine, and the physicians say that they do not understand why it should get the hold on women that it does. the latest female vice is intoxication by naphtha. it is not drank. the fumes of it are simply inhaled, inducing, so the inebriates say, a particularly agreeable exhilaration. _remedies of alcoholism._--without much doubt, the best way to affect a cure is to regularly reduce one's amount of liquor each day until the system can do without it. a systematic decrease can always be carried through if the will power will back it. we add also some ideas that have been advanced by good judges: "to dispel as quickly as possible the effects of intoxicants, one of the most effectual remedies is a small dose of sal volatile, or volatile salts, in a wine-glass of water--repeating the dose in half an hour. a dish of cold broth may answer the same purpose. the most speedy way, however, of effecting a cure, is by taking an emetic, following it with the sal volatile and water half an hour after." the russian physician and publicist portugaloff declares that strychnine in subcutaneous injections is an immediate and infallible remedy for drunkenness. the craving of the inebriate for drink is changed into positive aversion in a day, and after a treatment of eight or ten days the patient may be discharged. even should the appetite return months afterward, the first attempt to resume drinking will produce such painful and nauseating sensations that the person will turn away from the liquor in disgust. the strychnine is administered by dissolving one grain in two hundred drops of water, and injecting five drops of the solution every twenty-four hours. dr. portugaloff recommends the establishment of inebriate dispensaries in connection with police stations. =appetite=.--happy is the man who always possesses a good appetite; unhappy is he who does not have this precious boon. the lack of it results largely from failure of exercise and the excessive use of condiments. in the first place, try to take an invigorating bath with a wet towel and rub hard. if you cannot endure even that, use a dry towel on the body until the friction brings the blood to the surface of the skin. then give the mouth a careful cleansing by rinsing and tooth-brush. when you sit at the table, do so with a cheerful mood, eat slowly, partake sparingly of condiments, using salt mostly, and vinegar for an acid. preface your meals with a walk long enough to get up a circulation, if it is dinner or supper hour, but do not tire yourself, and be sure to rest the last fifteen minutes before eating. =asphyxiation.=--a practical man, conversant with cases in which asphyxiation resulted from inhaling carbonic acid gas, gives some valuable hints for their recovery by simple remedies always at hand. fresh air to restore consciousness is the first important step. then he gave apples, apple juice, or vinegar, to neutralize the gas and remove it from the stomach by eructations. eggs broken into vinegar mixed and swallowed made a very effective drink. after removing the gas from the stomach, the patient was further relieved by a cup of strong, hot coffee, which speedily restored him to normal vigor. on two similar occasions, where a physician was called, he administered injections of carbonate of ammonia, and the man was ill for eight or ten days from the effects of the medicine. a little common sense is often better than physic. =bathing.=--we have already treated this subject to some extent, but we recommend the careful reading of dr. c. h. steele's ideas, part of which we embody here; also some other worthy opinions on this matter, of great importance to health. "the use of water in the treatment of diseases dates back to remote antiquity. savages resort to the surf and sweat-bath, and hindoos and mohammedans bathe because their religion commands them to do so. references to the bath may be found scattered throughout the literature of greece, and in rome the magnificent buildings and lavish expenditure devoted to the public bath show it in the highest stage of perfection it has ever attained." "it is only within a few years past that the domestic bath has been accepted as a necessity. no home in england is complete without a bath-room, and no englishman deems himself well unless he bathes daily. the speaker said that a thermometer, whose use should be understood, should be permanently attached to every bath-tub. "_physiological action of the bath._--in considering the physiological action of the bath, it is first to be accepted that water of a temperature below that of the body abstracts heat from the skin, which abstraction continues indefinitely, only for a time checked by the renewed activity of the heat centers. in a bath the temperature of which is from ° to °, the body may remain indefinitely without any loss or gain of temperature, but after the bath a cooling takes place, owing to increased perspirations. if the water is between ° and °, there is, after the first shock, a positive rise in the temperature of the body. sixty-five degrees, and lower, may be borne for a long time." "nature adapts herself to the cold bath by a rapid stimulation of heat production. all the muscles, nerves, and organs of the body are brought into heightened activity, and thus it is that to the healthy individual the cold bath is invigorating. but nature has her limits, and the bath must be discontinued while this tonic effect is felt, for the heat centers become fatigued and give rise to a chill which may continue for days afterward. "the greatest agency in bathing is the stimulation of perspiration, and this depends upon the relative dryness of the surrounding air. thus, in the dry vapor, or turkish bath, a person will easily endure °, and lose four pounds per hour by perspiration. it is this rapid evaporation from the skin that keeps the body cool. a person may stand for some time in an oven, beside a roasting rib of beef. but in the steam or russian bath the perspiration is retarded, and a temperature of ° is hardly bearable. a temperature of ° may induce a rise in the temperature of the mouth to ° or even °, which is seldom reached in a raging fever. hence, there is an element of danger in the russian bath--a danger to sudden death similar to sunstroke. this danger is much more pronounced in the hot-water bath when perspiration ceases altogether, and the supply of heat from the interior to the skin is excessive. the temperature of bathing water should not exceed °, and this hot bath should not be endured more than fifteen minutes. even then it is likely to be followed by depression and weakness." "the circulation being quickened, the cold bath acts as a good blood purifier, washing away the poisons of the body through the channels of the veins. in case of persons troubled with an excess of fat, the bath must be accompanied by massage, banting, and a liberal indulgence in outdoor exercise. in the hot bath there is this same waste of tissue, but no tonic effects, and it is invariably accompanied with loss of energy and vitality. but the action of the bath upon the skin is no less beneficial than upon the interior of the body. it favors the excretory action of the skin, thus purifying it. the millions of dead scales, kept to the skin by the clothing, and the cementing effect of the oil, are washed away, thus relieving the skin, which is the great sewerage system of the body. the work of the lungs and kidneys is thus lessened, and the danger of consumption and bright's disease, which may be caused by uncleanness, reduced." "_effects of sea bathing._--sea bathing is much more tonic than all other kinds, and the reason is simple. the salt has a slightly irritating effect on the skin, which is very beneficial. besides, sea bathing is always accompanied by the best of exercise, by relaxation and freedom from the ordinary cares of life, by a change of climate and scene. the beating of the waves against the body also has an exhilarating effect. the bath in the sea should be taken about three hours after breakfast. there are three stages experienced in the cold bath--first, that of depression; second, the tonic stage; and third, the giving out of the heat-producing powers. this is the same as the one stage of the hot bath, and is always to be avoided as highly injurious. "nevertheless, the hot bath has its value. its power to cool the body is admitted, and it is used with effect in cases inflammation induced by cold. the cold foot-bath is recommended as a positive cure for cold feet." "the practice among modern women of taking hot baths is endangering the health of the race. in a hot bath there is at first a feeling of oppression and violent throbbing of the head, followed by prostration, a highly feverish condition, and a relaxation of the entire system. in case of any organic disease of the heart or consumption, this bath must be carefully shunned. the hot bath belongs alone to the province of the physician. the cold bath, on the other hand, aside from its tonic effects, renders the body less sensitive to changes of temperature, and in this climate is, hence, especially valuable as a protection against catching cold. this bath is from ° to °, and should be taken in the morning before breakfast." "=bleeding.=--a sudden and profuse flow of blood is cause for alarm. first, decide whether the blood comes from an artery or a vein. if from a vein, the blood is dark, and oozes or flows evenly; if from an artery, it is bright red, and spurts in jets. in the former case, the bleeding may generally be stopped by binding on a hard pad. in case of a ruptured artery, the flow of blood may be checked by tying a twisted handkerchief, a cord, or strap, _between the wound and the heart_. if the hand is cut, raise the arm above the head and bind it tightly. in _wounds of the throat_, _arm-pit_, or _groin_, caused by cuts, and in case of any deep wound, thrust the thumb and finger into the bottom of the wound and pinch up the part from which the blood comes, directing the pressure against the flow. _in cuts of the lips_, compress the lips between the thumb and finger nearer the angle of the mouth than the cut itself. in _scalp wounds_, make direct pressure against the bones of the skull with the fingers, or, better, by means of a compress or bandage." "_nosebleed._--full-blooded persons who are afflicted with headache and dizziness are most subject to nosebleed. in such cases, the bleeding should be regarded as a relief to an overcharged system, and should not be too suddenly stopped. to stop the bleeding, keep the patient's arms elevated, apply cold water or ice to the base of the brain, or inject vinegar or alum water up the nostrils with a syringe. a thick piece of wrapping paper, placed between the upper lip and gum, and firmly pressed, will usually arrest the flow. it acts by compressing the arteries which supply the sneiderian membrane. try plugging with cotton, or a strip of soft muslin, gently pushed up the nostrils, thus causing the blood to clot about the plug. if these remedies fail, the case should have the attention of a physician." =brain worry.=--"after a good spell of hard work, the brain worker is often tormented by finding it difficult, all at once, to turn off the steam. his work-day thoughts will intrude themselves in spite of every effort to keep them out. thackeray generally succeeded in exorcising the creatures he had been calling into existence, by the simple expedient of turning over the leaves of a dictionary. a great lawyer was in the habit, in similar circumstances, of plunging into a cold bath, and averred that a person never took out of cold water the same ideas that he took into it. perhaps the best mental corrective of this condition is to employ the mind for a short time in a direction most contrasted to that in which it has been overworked. during excessive labor of the brain, there is an increased flow of blood to the working organ. if this condition of distention is long continued, the vessels are apt to lose the power of contracting when mental activity is diminished. hence arises the impossibility of fulfilling the physical conditions of sleep, the most important of which is the diminution of the flow of blood to the brain. it is certain enough that the continued deprivation of any considerable part of the normal amount of sleep will be seriously detrimental to health. dr. hammond, in his work on sleep, mentions the case of a literary man in america who for nearly a year restricted his rest to four hours a day, and frequently less. at the end of that time, the overtasking of his mental powers was manifested in a curious way. he told the physician that, though still able to maintain a connected line of reasoning, he found that as soon as he attempted to record his ideas on paper, the composition turned out to be simply a tissue of arrant nonsense. when in the act of writing, his thoughts flowed so rapidly that he was not conscious of the disconnected nature of what he was writing, but as soon as he stopped to read it over, he was aware how completely he had misrepresented his conceptions." =breathing.=--in each respiration an adult inhales one pint of air. a man respires to times a minute, or , times a day; a child, to times a minute. while standing, the adult respiration is ; while lying, . the superficial surface of the lungs, _i. e._, of their alveolar spaces, is square yards. the amount of air inspired in hours is about , gallons. two-thirds of the oxygen absorbed in hours is absorbed during the night hours, from p.m. to a.m. three-fifths of the total carbonic acid is thrown off in the day-time. the pulmonary surface gives off about fluidounces of water daily in the state of vapor. the heart sends through the lungs gallons of blood hourly, or , gallons daily. the duration of inspiration is five-twelfths, of expiration seven-twelfths, of the whole respiratory act; but during sleep, inspiration occupies ten-twelfths of the respiratory period. there are two good rules to follow given by william blaikie:-- " . to hold the body erect, whether standing, sitting, or walking, and breathe deeply. this habit gives the lungs and digestive organs free play. more oxygen is taken into the blood, and the food is more readily digested and assimilated. . to fill the lungs full at frequent intervals, holding the air in the chest as long as is comfortable. this practice will soon improve a disturbed circulation." =bright's disease.=--bright's disease is a disorder of the kidneys which causes those organs to secrete albumen in the urine, while they fail to extract from the blood the urea, or effete matter, which they should take up from that fluid. urea in the blood operates as a poison, and when accumulated in large quantities, produces drowsiness, convulsions, and apoplexy. intemperance is a fruitful source of bright's disease, because excessive drinking tends peculiarly to the degeneration of the kidneys. the best remedy we know, or have ever seen tested, is bethesda water, from waukesha springs, wis. it should be natural, without gas; a quart per day will not be too much for an adult. =bruises.=--if the skin is not broken, the best thing for a bruise, or black and blue spot, as they are often termed, is a piece of pure copper. it should be thin enough to shape with the fingers just the curvature or angle of the portion of the body bruised. in applying it, be very gentle at first, for if it be a finger nail you desire to preserve, on first application it will give you quite a severe shock, but by relieving it every second or two, inside of minutes the pain will cease, and no black spot will follow. if the skin be broken, and the blood has ceased to flow, and you desire to use this remedy, first paste a piece of unprinted newspaper over the broken part, and then proceed as above; but in no case ever place a piece of copper on a broken part of the skin without the above precaution. =burns=.--a correspondent of the philadelphia _record_ vouches for the wonderful efficacy of the common cat-tail as a remedy for burns. he says: "take the down, and with just enough lard to hold it together, make a plaster and lay upon any burn, and it soothes and heals so soon that it seems a miracle. put upon a fresh burn, and in less than half an hour the smart is gone; if it is an old burn, the healing will commence in twenty-four hours. 'cat-tail' is also the indian remedy for scrofulous sores or ulcers. age does not destroy its healing virtues. it can be laid away and kept for years without losing any of its remedial properties." burns should be bathed with alcohol or turpentine and afterwards with lime-water and sweet-oil, but never with cold water. soft soap or apple butter are equally excellent for burns. =cancer.=--it is well proved that cancer cannot be successfully removed by use of the knife. surgeon john mcfarlane, of glasgow, mentions the cutting out of _eighty-six_ cancers without effecting a _single cure_. for those who are troubled we would say that there have been and there are remedies with permanent effects. the writer knows of a female physician in this city who has been very successful in achieving lasting cures in numerous authenticated instances. =chewing gum and other substances.=--regular chewing outside of meal hours of any substance is injurious. it unnecessarily excites the salivary glands, the strength of which should be reserved for eating. do not chew the ends of your finger nails. little pieces of the nails may be swallowed, which at some time--possibly quite remote--may cause you great pain, and even death. this has occurred. it has also been found by opticians and doctors that hardly anything will affect the eyes harmfully quicker than gum-chewing. =cholera.=--dr. gamaleia, of odessa, claims to have discovered a prophylactic against cholera, and hopes to win the prize of $ , offered for such a cure. he calls his specific chemical vaccine, and has tried it efficaciously on apes, guinea-pigs, and pigeons. this is obtained by the successive passages of cholera virus through the blood of animals. after each of these passages, the virus becomes stronger, and is finally injected into the patient. a cure which was very effective when the cholera struck america is called the "sun cholera medicine." it is also an excellent remedy for colic, and diarrhea, etc. take equal parts of tincture of cayenne pepper, tincture of opium, tincture of rhubarb, essence of peppermint, and spirits of camphor. mix well. dose: to drops in a little cold water, according to age and violence of symptoms, repeated every fifteen minutes or twenty, until relief is obtained. our own _infallible_ remedy for cholera, cholera morbus, cramps, colic, and diarrhea, is:-- tincture of opium, drachms. " " cayenne pepper, drachms. " " ginger, drachms. " " camphor, drachms. dose: teaspoonful in a gill of cool water for an adult; repeat with half a teaspoonful in minutes if not relieved. for a child years old / the above dose, and in proportion up to an adult. =cleanliness.=--the english upper classes are clean, but cleanliness of any high degree is a modern virtue among them. it is an invention of the nineteenth century. men and women born at the close of the eighteenth century did as french people do to-day; they took a warm bath occasionally for cleanliness, and they took shower-baths when they were prescribed by the physician for health, and they bathed in summer seas for pleasure, but they did not wash themselves all over every morning. however, the new custom took deep root in england, because it became one of the signs of class. it was adopted as one of the habits of a gentleman. don't take your pocket-handkerchief to dust off your shoes and the next moment wipe your face and eyes with it; don't carry your _own sheets_ with you on a trip and then sit in the smoking-car for miles for enjoyment; anything added to white castile soap as scenting matter is no improvement and in most cases is detrimental. we have taken this subject up so carefully in "bathing" and in the first part that we will say no more here. =cold feet.=--the best prescription for cold or tired feet is to carefully envelop each toe and foot with blank newspaper before encasing the same with sock. first have the feet perfectly dry and warm, then they will remain so all day, if properly protected with easy-fitting, strong boots or shoes. barbers do this to prevent their feet scalding and heating; stage drivers use this method, and hundreds attest its efficacy. many people, especially women and children, suffer the whole winter through with cold feet. this is mainly due to the fact that they wear their shoes too tight. unless the toes have perfect freedom, the blood cannot circulate properly. people who wear rubbers the whole winter through, generally suffer with their feet. rubbers make them very tender by overheating and causing them to perspire. they should be removed as soon as one enters the house. they draw the feet, keep them hot and wet with perspiration--then as soon as one goes again into the air the feet are chilled. =colds.=--don't have any fear of night air. that is an unfounded superstition. keep your windows open. you will sleep better and the next day you will not catch cold. take a good hot lemonade just before retiring; in the morning, immediately on getting out of bed, take a cold bath and rub hard until you are in a perfect glow. too much coddling is unquestionably one of the most common causes of catarrh. one who is inured to hardships is able to endure exposure without injury, while one unaccustomed to like experience quickly succumbs. air-tight houses, close and unventilated, overheated rooms, even the quantity of clothing required, are active causes, preventing development of hardihood. as a result, colds and catarrh are universal maladies among civilized people. says a writer in _woman's work_: "without dwelling on the nature and causes of colds, or on what physicians call the pathology of these disorders, i will say that a low or even starvation diet for a few days, with the free drinking of warm, mildly stimulating teas, is better for a cold than any drug or combination of drugs. if with this a warm bath or a hot foot-bath is taken, little more will be needed. nine cases in ten of colds can be broken up in this early stage by a hot foot or rather leg-bath, keeping the bath as hot as it can be borne, until perspiration arises. after the bath drink a half pint of hot lemonade and go to bed." _a good cough remedy._--the following is from a doctor connected with an institution with many children: "there is nothing more irritable to a cough than a cough. for some time i had been so fully assured of this that i determined, for one minute at least, to lessen the number of coughs heard in a certain ward in a hospital of the institution. by the promise of rewards and punishments, i succeeded in inducing them to simply hold their breath when tempted to cough, and in a little while i was myself surprised to see how some of the children entirely recovered from their disease. constant coughing is precisely like scratching a wound on the outside of the body. so long as it is done the wound will not heal. let a person when tempted to cough draw a long breath and hold it until it warms and soothes every air-cell, and some benefit will soon be received from this process. the nitrogen which is thus refined acts as an anodyne to the mucous membrane, allaying the desire to cough and giving the throat and lungs a chance to heal. at the same time a suitable medicine will aid nature in her effort to recuperate." =constipation.=--regularity in the hour of going to stool and the avoidance of highly-seasoned food are preventatives. see "constipation," first part, per index, for a cure. =consumption.=--"what changes has the acceptance of the germ theory made in measures for the prevention and treatment of consumption?" is the title of an essay by dr. charles v. chapin, of providence, to whom was awarded a premium of $ by the trustees of the fisk fund. in this essay dr. chapin has given an admirable _résumé_ of all that has been written about consumption from the time of hippocrates to the present day. after a careful examination of the literature of the subject, he thinks that we are justified in the conclusion that the acceptance of the germ theory has made no direct or important addition either to the hygiene or medicinal treatment of consumption. he thinks, however, that it should have great influence. it tells us plainly what we ought to do. we simply do not obey its behests. the germ theory--now no longer a theory in the case of tubercular consumption--tells us that we have to do with a contagious disease. now there is no theoretical reason why a purely contagious disease like tuberculosis cannot be exterminated. if we can prevent the spread of contagion at all, we can prevent it entirely. the enormous value of preventive measures, isolation, disinfection, and quarantine, is well illustrated in history of cholera, typhus fever, and yellow fever in the united states. by keeping out the virus of these diseases, or destroying it when it had gained access to our shores, we have for a number of years been remarkably free from these diseases, and it is certain that if these precautions had not been taken we should have suffered severely. for obvious reasons, the suppression of tuberculosis is not so easy a matter as the suppression of cholera or yellow fever. neither is the suppression of scarlet fever or small-pox as easy. yet whenever the public has been educated to a correct appreciation of the contagious nature of scarlet fever, the number of cases has diminished very much. even in small-pox, with its virulent contagion, it is possible, by means of isolation and disinfection, to check its spread even among an unvaccinated population, as has been illustrated many times of late in the anti-vaccination city of leicester, england. we must now put tuberculosis among these diseases, and, though its theoretical suppression is simple its actual extermination is a very difficult problem. it lies largely with the medical profession how long tubercular disease shall decimate the human race. the physicians are the educators of the people in these matters. when the doctor shall teach that tuberculosis is contagious, the people will believe, and will govern themselves accordingly. in combating contagious diseases the preventive measures taken often give discouraging results. this will be particularly so in tubercular disease. half-way measures secure less than half-way results, and these alienate the support of those who only indifferently believe in contagion and the importance of precautionary measures. efficient means of suppression are radical, and bear hard on the individual; they are not complied with, and they produce violent opposition. yet, difficult as it may be, the medical profession should take aggressive action against this disease. we have no right to wait for the discovery of a specific, or the gradual evolution of a phthisis-proof race. we must take the world as we find it, full of men and women predisposed to tubercular phthisis, and with no idea of its contagious nature. what can we do about it? . teach the people the true nature of the tuberculosis, that no one ever has tubercular consumption unless the tubercle bacilli find their way into their lungs. . teach them, also, that, even if it finds its way there, it will not grow unless the conditions are right. teach fathers and mothers how to rear healthy boys and girls. tell them what to eat and what to wear, to exercise, to breathe fresh air. this alone would exterminate phthisis. . the contagion must be destroyed. fortunately, in this disease there is no need of isolation. disinfection is enough. the consumptive patient gives off the poison only in the sputum, or perchance the other excreta, if the disease extend beyond the lungs. the virus is not given off from these while moist. we must therefore disinfect all sputum at once with mercuric bi-chloride. cloths must be used instead of handkerchiefs, and then burned, or, if the latter are used, they should be often changed, and immediately put in a bi-chloride solution and boiled. bed-linen should be treated in the same way. frequent disinfection of the entire person, and fumigation of the apartment, would be safe additions to the preventive measures. . persons who have a marked predisposition to the disease had best not come in close contact with the phthisical. children should never have tuberculous nurses, wet or dry. in the case of consumptives very great attention should be paid to ventilation, and to the alimentation both of the patient and the attendants. such measures, if rigidly carried out, would be of enormous service in preventing this disease. but with the increasing prevalence of tuberculosis among domestic animals, something more is imperatively demanded. active measures should be taken to free the country from animal tuberculosis. there are some ideas which it is well to observe:-- . flies may carry the virus if they are allowed to frequent cuspidors into which consumptives have expectorated. clean these out often. do not permit the patient to spit into a handkerchief and then let it lie around to dry. the dust arising may inoculate some person prone to consumption. . be careful about the meat you eat. it can and does convey tuberculosis. investigations have been made showing that as high as % of a herd to be slaughtered in new york city had tuberculosis. milk may be also infected and often is. . have an abundance of flowers around. they invariably are helpful. . constant and regular singing with proper care and not tiring is excellent for consumptive lungs, which should be done in well-ventilated rooms. . be out in the open air as much as possible, and breathe through the nose entirely. continually exercise the lungs by drawing in long breaths. . if possible try fumes of hydrofluoric acid. in glass factories if workmen are rendered consumptive by stooping over the grinding machinery, they usually find great benefit by being allowed to work in the room with the glass etchers, where so much hydrofluoric acid is employed. . buttermilk is well recommended. . consumptive and bronchial troubles in women are often due to irregularity of dress about the throat and lungs. there is danger from wearing _décolléte_ costumes. so regular have we been in our habits that the throwing off of a -oz. neck-tie for half an hour in the open air will give us a cold with the thermometer at % fahr. the ocean cure is well set forth in the following, which represents the advantages of a long sea voyage:-- . perfect rest and quiet, and complete removal from and change of ordinary occupation and way of life; a very thorough change of scene, and perfect and enforced rest from both mental and physical labor. . the life in the open air and the great amount of sunshine to be enjoyed; it is quite possible, under favorable circumstances, to pass fifteen hours daily in the open air; and whenever it is possible the traveler by sea is certain to endeavor to escape from the close and sometimes unpleasant atmosphere of a small cabin, into the pure air to be found on deck. . the great purity of the air at sea, and its entire freedom from organic dust and other impurities. in this respect it has an advantage over the air of an open country, for the latter is apt to contain the pollen of grasses and other plants, which, in some persons, excites hay fever and asthma. the air of the cabins may, of course, be contaminated, but the air of the open sea is probably the purest to be found anywhere. . the presence in the sea air of a large amount of ozone, as well as particles of saline matter, more particularly in stormy weather, from the sea spray, and these may exercise a beneficial effect in certain throat and pulmonary affections on the respiratory mucous membrane. . the great equability of the temperature at sea. this refers chiefly to the daily variations, which rarely exceed four or five degrees fahr. it must be noted that in a long sea voyage very considerable variations of temperature are encountered, and in a swift steamer the transitions are somewhat sudden. . the great humidity of the atmosphere and the high barometric pressure, which are considered to exercise a useful sedative influence on certain constitutions. it is said that the temperature of the body averages one degree fahr. less on account of this sedative effect. the exhilarating and tonic effect of rapid motion through the air; for by the continuous progress of the ship the sea breezes are constantly blowing over it, and the passengers are borne through the rapidly-moving air without any exertion of their own. the influence of these currents of air on the surface of the body is, no doubt, important, acting as a stimulant and a tonic, increasing evaporation from the skin, and imparting tone to the superficial blood-vessels. we now give our own cure, which we claim is of great value, at least it is worth trying, for it cured the author of consumption of twenty years' standing in one year. this disease can be cured by "cold packing" the lungs and throat, and following the rules in general for health stated in the first part of this work. you must understand a cold compress or pack, otherwise you are likely to increase the malady and hasten your death. some persons cannot warm one ounce of cold water in twenty-four hours. such we advise to go very slowly. first adopt the formulæ for cleanliness and regularity already given. then when a little more blood is infused through the system and hence more heat exists, commence the cold pack. use simply a moistened cambric handkerchief, placed upon the lungs; envelop with at least two thicknesses of linen and one of flannel; wrap up warm and go to bed. do not attempt to cold pack any part of your body and then expose it to a moving atmosphere. after one week you can increase the moisture of the pack at least %. then add to the thickness and moisture % each week, as long as you can succeed in warming it and causing it to sweat that portion of the body packed. if you should wake up in the night and find the pack dry, remove the portion previously moistened and retain only the dry covering, viz., the linen and flannel. in the morning, before arising, thoroughly rub the lungs with a dry linen towel. this, then, is all that is necessary to get rid of this incurable (?) disease, if you will only follow the rules already given for health, happiness, and longevity. =convulsions, fits.=--when a child has a convulsion, or what is commonly called "a fit," attention should be given to the urinary secretion at once. if there is suppression of urine, the child should be put into a warm bath and made to sweat as speedily as possible. in many cases in which children die from a succession of convulsions, the real cause of death is suppression of urine (a fact which is probably not so generally known as it should be), so that the child really dies of poisoning through the retention of the urinary secretion. when a child is subject to attacks of this character, care should be taken to dress it warmly in flannels, so as to keep up a degree of perspiration most of the time, and hot baths should be administered frequently. give a glass of bethesda water from three to four times a day, and the disease will disappear. =corns and bunions= are caused by tight, ill-fitting boots and shoes. the way of preventing them is, therefore, manifest. thrusting the toe into a lemon, to be kept on over night, will make the removal of a corn easy. two or three applications will suffice for the worst cases. soft corns may be relieved by dissolving a piece of ammonia, the size of three peas, in an ounce of water, and applying the solution as hot as can be borne. it is beneficial to place blank newspaper between the toes. that will keep them from scalding, and hence softening, so that corns will easily form. we have already referred to this paper method for cold feet. paper is a non-conductor and thus has the proper effect. =croup=.--the following prescription, to be used as a gargle, is not only excellent for croup, but will _absolutely_ keep anyone from choking to death from phlegm in the throat, no matter what the cause, so long as they have any portion of a lung left. it consists of the yolks of two eggs thoroughly beaten, in half a pint of good cider vinegar, adding two tablespoonfuls of honey. i have known two different patients, given up by their physicians, to rally in thirty minutes under the above treatment, and finally get well. =diabetes.=--a prominent french physician advocates a coffee remedy. after having continued to use the remedy for upward of a third of a century in many hundreds of cases, he again appeals to the profession to give it a trial in those cases of liver and kidney troubles which have resisted all other treatment. his habit is to place twenty-five grammes, or about three drachms, of the green berries (he prefers a mixture of three parts of mocha with one part each of martinique and isle de bourbon coffee) in a tumbler of cold water, and let them infuse over night. the infusion, after straining or filtering, is to be taken on an empty stomach the first thing after getting up in the morning. he cites many cases of renal and hepatic colics, diabetes, migraine, etc., which, although rebellious to all other treatments for years, soon yielded to the green coffee infusion. it is worth a trial at any rate. bethesda water from the wakeshaw springs, in wisconsin, will cure three out of every five cases of diabetes and help the other two. drink it as you would any good water. =diphtheria.=--diphtheria is a malignant and very infectious disease. it may often be communicated by a kiss, a touch of the hand, or by drinking out of the same cup with the sick person. the mildest case should be carefully isolated. in the family this may sometimes be done by removing the patient to an upper room, which can be well ventilated by means of windows and an open fire. the contagion of diphtheria is not carried far by the atmosphere; hence, by strict attention to cleanliness and ventilation, it may be quite possible to isolate a case even under the family roof. the disease is characterized by soreness of the throat, pain in swallowing, apoplectic, epileptic, hysterical, or the result of poisoning. put a cork between the patient's teeth, that the tongue may not be bitten. loosen the clothing, have plenty of fresh air, and do not restrain the movements of the patient, except to prevent injury or bruising. rub the temples with cologne or spirits, and, as soon as the patient can swallow, give a little cold brandy and water. dr. w. a. scott, of iowa, where, in the latter part of , diphtheria raged, found a valuable and effective remedy for this dread disease. the recipe can be filled at any drug store, and used by any person without danger:-- take ten grains of permanganate of potassium and mix with one ounce of cold water. as soon as dissolved, it must be applied with a rag or sponge mop or swab to the whitish places in the tonsils, and other parts that have the diphtheria membrane on them. do this very gently, but thoroughly, every three hours until better; then every six hours until well. it does not give pain, but is rather nauseous to the taste. if the tongue is coated white, mix one drachm of hyposulphite of soda and five drops oil of sassafras in four ounces of syrup made of sugar and hot water, and give a teaspoonful every to hours, as needed, when awake. if the tongue is not coated white, i mix drops of tincture of phytolacca in four ounces of cold water and give a teaspoonful every to hours, as needed, when awake. (the phytolacca is the common poke-root of the south, and as it loses its strength by drying and age, the tincture should be from the fresh root, or it is worthless.) it is well to apply a little sweet-oil or cosmoline to the outside of the throat to protect from the action of the air, as the patient must be protected from all danger of getting chilled. in the beginning of the disease, in mild cases, the above solution of permanganate of potassium is all i use, and all that is needed, as the disease is local at first, but rapidly affects the whole system when seated. in the stinking form of diphtheria this solution soon destroys all smell, and in every case destroys the diphtheria membrane without leaving any bad effect. m. roulin, of france, has successfully treated cases of diphtheria with carbolic acid as an antiseptic. nasal douches, consisting of three teaspoonfuls of the crude acid in a quart of water, were employed every hour by means of the ordinary irrigator. tonics were given internally. dr. deriker, of st. petersburg, who is the head physician of the children's hospital, and has treated no less than , cases of diphtheria, and tried all remedies, both internal and external, has found the following a certain cure for the disease: as soon as the white spots appear on the tonsils he gives a laxative, usually senna tea. when the purgative effect has ceased, he gives cold drinks acidulated with lemons, limes, or hydrochloric acid, and every two hours a gargle composed of lime-water and milk. hot milk was also given as a drink, and the throat well rubbed with spirits of turpentine. the academy of medicine in france offered a large sum of money for a successful cure for diphtheria, and this is said to have been it. equal parts of liquid tar and turpentine are put in an iron pan and burned in the patient's room. the dense resinous smoke gives immediate relief. the fibrinous matter soon becomes detached and is coughed up. =clothing.=--there are some very important principles in regard to dress:-- . if you desire health, do not wear a belt. . avoid tight lacing. some of the most beautiful women, including actresses, are giving up this injurious practice. . do not wear, especially in summer, the constant black, even if in mourning. if you do someone may be mourning you too. . use woolens almost entirely for clothing--always for under-clothing. . have shoes that fit and give the feet an abundance of room, and not high heeled, but thick soled. . wear sufficiently heavy woolen under-garments so that you will not be obliged to resort continually to overcoats. . in summer, use light outer garments--white flannels and cheviots are excellent. the most important function of under-garments.--it is a great mistake to suppose that the material of which a garment is made is the most important consideration in selecting warm under-clothing. the way in which the fabric is prepared and manufactured is of more vital importance as regards heat or coldness of the body than the actual material. a light garment with large meshes is more effective against cold than a close, heavy one. whatever an under-vest may be made of, its real value as a protector from cold depends upon its ability to inclose within its meshes a certain quantity of air. this is indeed the most important function of under-garments, viz., to encircle the whole body with an envelope of warm air, and a vestment that does not keep a continual layer of warm air next to the skin is of very little use. we advise the discarding of cotton shirts altogether and wearing only those of flannel. the best material for an under-vest, where the shirt worn is flannel, is silk, but by reason of high cost it is within the reach of a comparatively few only. hence woolen under-vests must be selected. they should be large and never tight-fitting, for there must be room for the air to circulate freely beneath them. good taste suggests that the outside shirt be of white flannel, and that also must be large. nearly all those which are on sale in stores have collars, but for a small sum added to the price the dealer will make the necessary changes so that a linen collar may be worn. with such under-clothing a man is very well protected against sudden changes of weather, and is much less liable to take cold than he would be with a cotton shirt on. now, as to chest protectors. if a man is subject to colds during the winter he should wear a chest-protector. in order for him to get the full benefit of it it should fit him quite snugly at the neck and extend front and back to the belt. dressed in flannels, as we have recommended, with his chest well covered by a protector, he will be as well fortified against cold as under-clothing of a healthful sort can make him. =dropsy.=--it is not generally known that the silk on an ear of green corn is a powerful and efficient remedy for dropsy, for bladder troubles and diseases of the kidneys. in the louisville _medical news_ we find an account of the medical properties of corn-silk and the cures that have been effected by its use. the way to use it is to take two double-handfuls of fresh corn-silk and boil in two gallons of water until but a gallon remains. add sugar to make a syrup. drink a tumblerful of this thrice daily, and it will relieve dropsy by increasing the flow of urine. other diseases of the bladder and kidneys are benefited by the remedy, which is prompt, efficient, and grateful to the stomach. the treatment can be continued for months without danger or inconvenience. bethesda water is just as good, but both together are better. =dyspepsia.=--this trouble is often the result of decomposition of the food before it is digested. unless this is remedied death will ultimately follow. a good remedy is this: thoroughly brown some whole grain wheat, grind it in an ordinary clean coffee-mill; eat of nothing else for the two last meals of the day; carefully masticate it and eat sparingly for a few days, after that _ad libitum_; in ten days you will be well, if all other suggestions regarding cleanliness are followed. =ears=.--sapolini of milan has described a method of his which he states has been successfully employed in cases of deafness of old age. it consists in mopping the membrana tympani with a weak oleaginous solution of phosphorus. he claims that the treatment diminishes the opacity of the membrane, increases the circulation, and improves the hearing. a writer in a medical journal says: "beware of too much quinine. it will produce a congestion of the ear and irritation of the auditory nerve. the common habit of taking quinine for neuralgia and other ailments without consulting a doctor is altogether reprehensible, and may lead to very serious results. many cases of deafness are produced by overdoses and long-continued use of this drug." aprysexie is the name dr. guye, of amsterdam, chooses for inattentiveness, and he quite singularly finds that the nose is a cause of it. a dull boy became quick to learn after certain tumors had been taken from the nose, and a man who had been troubled with vertigo and buzzing in the ears for twelve years found mental labor easy after a like operation. in a third case a medical student was similarly relieved. dr. guye supposes that these nasal troubles affect the brain by preventing the cerebral lymph from circulating freely. =elixir brown-sequard.=--the way brown-sequard uses this medicine is entirely successful. do not think because others have failed that the principle is wrong. most experimenters, first, are not careful in getting perfectly healthy specimens of animals from whose vitals the elixir is made, while, secondly, they expose the liquid and allow it to become filled or impregnated with microbes and various foreign elements. the process of administration is thus described:-- the syringe punctures the cuticle, or scarf-skin, and the cutis, or true skin, and then enters the subcutaneous or cellular tissue which covers the muscles, or flesh. through all the tissues of the body run the lymphatics, which convey the injected matter to the lymph channels, these in turn to the veins, and thence throughout the system. a half ounce of the fluid will be distributed in from one to three hours. sometimes the subject might feel the stimulus very quickly, and in some cases hours might elapse before any effect was felt. the human system is able to absorb almost an unlimited amount of this liquid, if administered properly and if pure. =epidemics.=--the history of severe plagues is remarkable. the first great pestilence in a comparatively civilized nation was the one at athens about b. c. on account of being shut up by the spartans in their crowded city the athenians had this terrible experience. it carried off thousands--nearly two-thirds of the population. in the reign of the emperor justinian no less than , , inhabitants died in thirty years from a pestilence that swept from persia to gaul. later, in the fourteenth century, the plague of beautiful florence in italy killed , people in six months. in - london was a vast pest-house and during september of the weekly death rate reached the number of , . in america the sunny south has witnessed the blasting effects of yellow fever during the last fifteen years. in , florida had , deaths, and new orleans , from yellow fever. fully % of those attacked succumbed. in the same year , people died of it at memphis. the last important run of this epidemic was in , at jacksonville and decatur. there the deaths averaged % of those attacked. the duration of the infection stages of various diseases is thus given by dr. t. f. pearse, an english physician: measles, from the d day of the disease for weeks; small-pox, from the st day for weeks; scarlet fever, from the th day for weeks; mumps, from the d day for weeks; diphtheria, from the st day for weeks. the incubation periods, or intervals occurring between exposure to infection and the first symptoms, are as follows: whooping-cough, days; mumps, days; measles, days; small-pox, days; scarlet fever, days; diphtheria, days. scarlet fever is at its minimum from january to may, and at its maximum in october and november. diphtheria is more evenly distributed through the year, and is most dangerous a little later than scarlet fever. measles and whooping-cough seem to be somewhat aggravated by cold weather, but are most fatal in may and june. hot weather is adverse to small-pox, and favorable to disorders of the bowels, particularly in children. the difference between measles and small-pox.--at the outset of a popular eruption it is often difficult to decide whether the case is one of measles or of small-pox. m. grisol's method of diagnosis is as follows (_medical times_): "if, upon stretching a portion of the skin, the papule becomes impalpable to the touch, the eruption is caused by measles; if, on the contrary, the papule is still felt when the skin is drawn out, the eruption is the result of small-pox." =erysipelas.=--it has long been known that an attack of erysipelas exerts a remarkable influence upon other diseases, and the attempt has been made to cure more serious maladies by deliberately inoculating the patient with the virus of erysipelas. in a recent case in norway, the growth of a cancer was greatly retarded by this means, and life was probably prolonged a few weeks or even months, though no cure was effected. =exercise.=--ben. hogan, the reformed pugilist, has advanced some practical ideas:-- "in every city there are thousands of rich men and women who are ready to commit suicide because of ill-health. 'what is wealth without health?' they say. 'nothing,' i should say; but i do say that, while every man cannot amass wealth, every man can secure good health. i know a man who owns a fine horse. he employs two men to take care of that horse and keep him in condition. he is exercised, sponged, and blanketed daily. does the owner himself have a man to take care of him?--no. he possibly bathes once a week. he arises at o'clock in the morning, throws his breakfast down without masticating it, and madly rushes off to his business. at noon he rushes into a restaurant and eats his dinner in five minutes. on he goes, hiring men to look after the health of his horse, but never stops to think of his own body and its needs. "a man cannot digest his food unless he eats carefully. a meal should never be eaten in less than one hour. gladstone says he bites each piece of meat he puts into his mouth twenty times before he swallows it, and that isn't too often. the men of to-day who throw their food into their stomach are physical wrecks in fifteen years. the american doctor studies medicine when he should study nature; instead of trying to prevent disease, they try to cure. there are many people who do not take a bath in two years and they prematurely die from poisoning. the poison that accumulates under the first layer of skin breeds disease and sooner or later must come death. "there are thousands of people dying of consumption who haven't sense enough to know that they can throw it off. no man who is lazy can become healthy, for the best way to bring health is by physical development. i have seen thousands of young men apparently on the verge of the grave grow strong by following this daily routine: when you get up in the morning rub yourself with a rough towel until the blood is in circulation, and then take a cold bath. never take a cold bath without getting the blood in circulation, for it is dangerous. after the bath rub the flesh for three-quarters of an hour. then take a cup of tea and eat some toast, and start out for a half hour's walk. don't plod slowly along the streets, but walk as rapidly as your legs will carry you. when you return you are ready for breakfast. eat rice, mutton chops, and toast, and drink tea. if you are a business man you are ready for business, but if you are training for an athlete you will again start upon the walk and keep it up all day. a man under training is required to walk at least forty miles every day. when he returns from his walk he is put under blankets until he has cooled, and then again put in the bath-tub. he is taken out and rubbed or manipulated. then he is ready for dinner. the athlete or pugilist would be required to eat raw ham or raw steak without salt or pepper. pugilists are not allowed to use pepper, because it heats the blood. for men who are not undergoing training for pugilists i would advise a dinner on rare beef, rice, and other vegetables cooked dry." =eyes.=--a writer in _cassell's magazine_ gives the following rules for the use and care of the eyes:-- " . sit erect in your chair when reading, and as erect when writing as possible. if you bend downward you not only gorge the eyes with blood, but the brain as well, and both suffer. the same rule should apply to the use of the microscope. get one that will enable you to look at things horizontally, not always vertically. " . have a reading-lamp for night use. n. b.--in reading the light should be on the book or paper and the eyes in the shade. if you have no reading-lamp, turn your back to the light and you may read without danger to your eyes. " . hold the book at your focus; if that begins to get far away use spectacles. " . avoid reading by the flickering light of the fire. " . avoid straining the eyes by reading in the gloaming. " . reading in bed is injurious as a rule. it must be admitted, however, that in cases of sleeplessness, when the mind is inclined to ramble over a thousand thoughts a minute, reading steadies the thoughts and conduces to sleep. " . do not read much in a railway carriage. i myself always do, however, only in a good light, and i invariably carry a good reading-lamp to hang on behind me. thousands of people would travel by night rather than by day if the companies could only see their way to the exclusive use of the electric light. " . authors should have black-ruled paper instead of blue, and should never strain the eyes by reading too fine types. " . the bedroom blinds should be red or gray, and the head of the bed should be toward the window. " . those ladies who not only write but sew should not attempt the black seam by night. " . when you come to an age that suggests the wearing of spectacles, let no false modesty prevent you from getting a pair. if you have only one eye, an eye-glass will do; otherwise it is folly. " . go to the wisest and best optician you know of and state your wants and your case plainly, and be assured you will be properly fitted. " . remember that bad spectacles are most injurious to the eyes, and that good and well-chosen ones are a decided luxury. " . get a pair for reading with, and if necessary a long-distance pair for use outdoors." further rules are:-- avoid all sudden changes between light and darkness. never begin to read, write, or sew for several minutes after coming from darkness to a bright light. never read by twilight or moonlight, or on dark, cloudy days. when reading, it is best to let the light fall from above obliquely over the left shoulder. do not use the eye-sight by light so scant that it requires an effort to discriminate. the moment you are instinctively prompted to rub your eyes that moment stop using them. if the eyelids are glued together on waking up do not forcibly open them, but apply saliva with the finger. it is the speediest diluent in the world; then wash your eyes and face in warm water. in the selection of books or pamphlets see that the paper is of a slight orange tint; this shade is the most pleasant for the eye to look upon. the following is recommended as an efficient means of removing particles from the eye: make a loop by doubling a horse hair; raise the lid of the eye in which is the foreign particle; slip the loop over it, and placing the lid in contact with the eyeball, withdraw the loop, and the particle will be drawn out with it. an old locomotive engineer gives the following as an infallible method to eradicate any foreign substance from the eye, viz., close the eyes, and rub gently from right to left with a circular motion the well eye. =food.=--of all the fruits we are blest with, the peach is the most digestible. there is nothing more palatable, wholesome, and medicinal than good, ripe peaches. they should be ripe but not overripe and half rotten; and of this kind they may make a part of either meal, or be eaten between meals; but it is better to make them a part of the regular meals, says _hall's journal of health_, a medical authority. it is a mistaken idea that no fruit should be eaten at breakfast. it would be far better if our people would eat less bacon and grease at breakfast and more fruit. in the morning there is an arid state of the secretions, and nothing is so well calculated to correct this as cooling, subacid fruits, such as peaches, apples, etc. the apple is one of the best of fruits. baked or stewed apples will generally agree with the most delicate stomach, and are an excellent medicine in many cases of sickness. green or half-ripe apples stewed and sweetened are pleasant to the taste, cooling, nourishing, and laxative, far superior, in many cases, to the abominable doses of salts and oil usually given in fever and other diseases. raw apples and dried apples stewed are better for constipation than liver pills. oranges are very acceptable to most stomachs, having all the advantages of the acid alluded to; but the orange juice alone should be taken, rejecting the pulp. the same may be said of lemonade, pomegranates, and all that class. lemonade is the best drink in fevers, and when thickened with sugar is better than syrup of squills and other nauseants in many cases of cough. tomatoes act on the liver and bowels, and are much more pleasant and safe than blue mass and "liver regulators." the juice should be used alone, rejecting the skins. the small-seeded fruits, such as blackberries, figs, raspberries, currants, and strawberries, may be classed among the best foods and medicines. the sugar in them is nutritious, the acid is cooling and purifying, and the seeds are laxative. we would be much the gainers if we would look more to our orchards and gardens for our medicines and less to our drug stores. to cure fever or act on the kidneys no febrifuge or diuretic is superior to water-melon, which may, with very few exceptions, be taken in sickness and health in almost unlimited quantities, not only without injury but with positive benefit. but in using them the water or juice should be taken, excluding the pulp, and the melon should be ripe and fresh, but not overripe and stale. while, undeniably, a mixed diet is the best for man, there is a mistaken notion, which prevails to a great extent, that meat should largely enter into the same. as a consequence, much more is eaten than is needed or can properly be disposed of in the system. never eat meat oftener than once a day, and very sparingly in summer. men of sedentary habits might with safety for several days at a time during that season live on vegetables, fruits, milk, breadstuffs, and foods of like character, which are easy of digestion. for those who have good reason to believe that their "kidneys are weak," a diet largely made up of meat is ill-advised. those organs are intimately concerned in its disposal in the system, and hence are overtasked if it is taken in too great a quantity. _reasons why a strictly vegetable diet is to be preferred to animal food._--the food which is most enjoyed, says a writer in _longman's magazine_, is the food we call bread and fruit. in my long medical career, i have rarely known an instance in which a child has not preferred fruit to animal food. i have been many times called upon to treat children for stomachic disorders induced by pressing upon them animal to the exclusion of fruit diet, and have seen the best results occur from the practice of reverting to the use of fruit in the dietary. i say it without the least prejudice, as a lesson learned from simple experience, that the most natural diet for the young, after the natural milk diet, is fruit and whole-meal bread, with milk and water for drink. the desire for this same mode of sustenance is often continued into after years, as if the resort to flesh were a forced and artificial feeding, which required long and persistent habit to establish as a permanency as a part of the system of every-day life. how strongly this preference taste for fruit over animal food prevails is shown by the simple fact of the retention of those foods in the mouth. fruit is retained, to be tasted and relished. animal food, to use a common phrase, is "bolted." there is a natural desire to retain the delicious fruit for full mastication; there is no such desire, except in the trained gormand, for the retention of animal substance. one further fact which i have observed--and that too often to discard it--as a fact of great moment, is that when a person of mature years has for a time given up voluntarily the use of animal food in favor of vegetable, the sense of repugnance to animal food is soon so markedly developed that a return to it is overcome with the utmost difficulty. neither is this a mere fancy or fad peculiar to sensitive men or oversentimental women. i have been surprised to see it manifested in men who are the very reverse of sentimental, and who were, in fact, quite ashamed to admit themselves guilty of any such weakness. i have heard those who have gone over from a mixed diet of animal and vegetable food to a poor vegetable diet speak of feeling low under the new system, and declare that they must needs give it up in consequence; but i have found even these (without exception) declare that they infinitely preferred the simpler, purer, and, as it seemed to them, more natural food plucked from the prime source of food, untainted by its passage through another animal body. there are thirty vegetarian restaurants in london, and a vegetarian hotel is the latest move in the right direction. the time required to digest different kinds of food:-- hours. roasted pork . salt beef (boil'd) . veal (boiled) . boiled hens . roasted mutton . boiled beef . roasted beef . raw oysters . roasted turkey . boiled milk . boiled codfish . venison steak . trout (broiled) . tripe . pig's feet . eggs (hard boil'd) . to . eggs (soft boil'd) . the above is taken from beaumont's "experiments on digestion." dalton comments on these observations as follows: "these results would not always be precisely the same for different persons, since there are variations in this respect according to age and temperament. thus, in most instances, mutton would probably be equally digestible with beef, or perhaps more so; and milk, which in some persons is easily digested, in others is disposed of with considerable difficulty. but as a general rule, the comparative digestibility of different substances is no doubt correctly expressed by the above list." _to ascertain pure milk._--take an extra quart of milk any day from your milkman and put it in a glass jar, an ordinary fruit-jar will do; set it away and await results. the proportion of cream on top shows the richness of the milk. let it alone until it turns to clabber, and if there is any water in it, it will appear between the cream and the clabber. after fermentation sets in, the water will sink to the bottom. if there has been no water put into the milk, none will show. by trying milk from different milkmen, you can readily see which is the best. we will add under food that eggs should be kept in oak or porcelain receptacles, not in pine boxes, as they partake of the odor of the pine. =freckles.=--a young lady of st. louis says: "i accidentally discovered a sovereign remedy a couple of years ago, which costs next to nothing. one day the plumber shut our water off, and i could get none in which to wash my face. i was fearfully soiled, and, looking out of the window just then, i saw a friend approaching to call on me. glancing about me, i noticed half a water-melon from which the meat had been removed some time before. it was partly filled with juice, and i hastily washed my face in it. the result was so soothing that i repeatedly washed my face in that manner. judge of my astonishment a few days later on seeing that there was not a freckle left on my face." =gargle.=--an excellent gargle for general use is:-- chloras potass., ounces. tannin, drachms. dissolve one teaspoonful in half a pint of water, which will keep for several days. for bronchial trouble or bleeding at the lungs, gargle the throat often; but for general cleanliness, gargle a little every morning; for catarrh, not only gargle but snuff some up the nose. =hair.=--to prevent hair from falling out, headache, neuralgia, brain fever, etc., the hair should be worn comparatively short by both sexes, washed and dried every day. to preserve the hair this is a good recipe: take a teaspoonful of dried sage; boil it in a quart of water for twenty minutes. strain it off and add a piece of borax the size of an english walnut; pulverize the borax. put the sage tea, when cold, into a quart bottle; add the borax; shake well together and put in a cool place. brush the hair thoroughly and rub and wash well on the head with the hand; then, after a good hard rubbing, brush the hair well before a fire, so that it will become perfectly dry. never use a fine-tooth comb, as it irritates the skin, and consequently inflames the roots of the hair. =headache.=--the causes are: "overstudy, overwork in-doors, neglect of the bath, want of fresh air in bedrooms, nervousness, however induced; want of abundant skin-exciting exercise, the excitement inseparable from a fashionable life, neglect of the ordinary rules that conduce to health, overindulgence in food, especially of a stimulating character, weakness or debility of body, however produced (this can only be remedied by proper nutriment), work or study in-doors, carried on in an unnatural or cramped position of the body. literary men and women ought to do most of their work at a standing desk, lying down now and then to ease the brain and heart, and permit ideas to flow. they should work out-of-doors in fine weather--with their feet resting on a board, not on the earth--and under canvas in wet weather. it is surprising the good this simple advice, if followed, can effect. =health beverages.=--lemons make the best beverage. they are very healthy and good, not only for allaying the thirst, but will cure a multitude of disorders. the juice of the lemon contains citric acid. acids, as a rule, decrease the acid secretion of the body and increase the alkaline. citric acid, which is the acid of lemons and oranges, for instance, will diminish the secretions of gastric juice, but increases very materially the secretion of saliva. the very thought of a lemon is sufficient to make the mouth water. thirst in fevers is not always due to lack of water in the blood. it may be due in part to a lack of the secretion of the saliva. when the mouth is parched and dry, the acid will increase the saliva. when acid is given for the relief of dyspepsia it should be taken before eating. lemon juice drank before meals will be found very advantageous as a preventive of heart-burn. _drinks for the voice._--tea, coffee, and cocoa are three admissible drinks, but none in excess. for the voice cocoa is the most beneficial. it should never be made too strong, and those cocoas are the best that have been deprived of their oil. a cup of thin cocoa, just warm, is more to be recommended between the exertions of singing than any alcoholic beverage. tea must not be taken too strong, nor when it has drawn too long, for tea then becomes acid, and has a bad influence on the mucous membrane that lines the throat. there is always a dry sensation after having taken a cup of tea that has been allowed to draw too long. a vocalist had better do without sugar in tea and only take milk with it. =hernia or rupture.=--a swelling suddenly appearing in the abdomen, and especially in the groin, may be recognized as a rupture, particularly if it puffs out, or grows larger when the patient breathes or coughs violently. if, for any reason, the services of a physician cannot be immediately secured, the patient should lie down on his back, draw up his knees, and, while he breathes gently, rest his fingers upon the rupture, and press it in all directions. in most cases the hernia will slip back when thus treated. then apply a bandage to hold the bowels in place long enough for the person to have a truss fitted to him. during this period the bowels should be kept regular. the author of this book was cured of rupture of the right groin completely. though having worn trusses of different patterns for years, the one that effected a permanent remedy was an electric elastic truss, invented by dr. a. t. sherwood, stockton street, this city. this is no advertisement, but wishing to help others who are afflicted, we are of the opinion that it will cure four out of every five cases that exist, provided the patient will pursue a careful course otherwise. my treatment required less than months. =hiccoughing.=--sweet-flag (calamus) is claimed to be an agent that will relieve and stop persistent hiccough in almost any case. chew a small piece of the root. =hydrophobia.=--rabies, the madness produced by the bite of mad animals, is often apprehended when there is no danger. in case the supposed mad creature has been killed, an important means of information is lost. if possible, the animal should be secured and closely watched. if he does not show signs of rabies, the bitten person need have no fear; but, in any case, when one has been bitten, the wound should be washed with hot water, sucked, by some person whose mouth is free from sores, and then thoroughly cauterized with pure nitric acid or concentrated liquor of ammonia. the patient's strength should be sustained by stimulants, and medical attendance should be secured as soon as possible. drs. valentine mott and a. f. baldwin, of the carnegie laboratory; are prepared to inoculate hydrophobia patients according to the pasteur system. the first patient was the seven-year-old son of dr. newell, of jersey city. dr. mott inoculated himself to prove the harmlessness of the method for a healthy man. it has been discovered recently that the juice of the maguey plant is a certain remedy for hydrophobia. =influenza (la grippe).=--the first symptoms of the disease are sudden faintness, a chill, and marked prostration, succeeded by headache and a general feeling of malaria, followed by acute coryza, pharyngitis, and slight laryngitis, winding up with bronchitis. examination shows that the patients are about as sick as persons with a bad cold. the duration of the attack is from to days and upward. an application of parts turpentine to of sweet-oil placed on the chest over the lungs, and then inhale the steam from steeped eucalyptus leaves, is the best remedy we know. =insomnia.=--the next time a sufferer finds himself awake, say or o'clock in the morning, instead of merely trying to banish the painful thought and repeating numbers, according to habit, let him revert at once to the dream which was the cause of his awakening, and try to go on with it. sleep will come soon. it is stated on good authority that this experiment, oft repeated, has never been known to fail. a correspondent of the _lancet_ gives the following method of self-asphyxiation as an effectual remedy for insomnia in his own case: after taking a deep inspiration, he holds his breath till discomfort is felt, then repeats the process a second and third time. as a rule this is enough to procure sleep. a slight degree of asphyxia is thus relied on as a soporific agent. =leprosy.=--an interesting report by the hawaiian board of health is in our hands; incomplete statistics give the number of lepers in the several islands of the hawaiian group on january , , as . a statement of the leper population at leper settlement at molokai for the biennial period ending march , , is . the report says: "accurate statistics as to the number of lepers still at large in the various communities of this country cannot be obtained." it is estimated from the best data obtainable, that there were lepers at large on the islands on march , . the report says: "the rations furnished each leper at the leper settlement on molokai are abundant for the support of any adult hawaiian." one of the embarrassing questions the board is called upon to decide is, how many of the non-leper friends and relatives of the afflicted ones shall be allowed to go and live with them at the leper settlement as helpers, or _kokuas_, the number of applicants being in excess of the demand. the great obstacle to be overcome in carrying out the law of segregation consists in the fact that the hawaiians do not appreciate and refuse to be convinced that leprosy is a communicable disease. it is with them as if devotion to a fatal sentimentality had bid defiance to every instinct of self-preservation. marriages between leprous and non-leprous individuals are freely contracted, and the intimacies are not prevented by the fact of potent evidences of the disease. "if this race is ever to be rescued from the slough into which it is sinking, the fatal lethargy that stupefies them must be dispelled, the instinct of self-preservation must be awakened, and it must be written upon their hearts, as with the point of a diamond, that to voluntarily contaminate one's self with leprosy is a crime. in spite of a number of claims to the contrary, we believe it safe to say that no one has been able to prove, to the satisfaction of the medical profession, who very rightly demand full proof in such cases, that a single unmistakable case of this disease has been definitely cured." says the report: "it is necessary always to bear in mind that the symptoms of leprosy, like those of some other diseases, have a way of receding or entirely disappearing for a time, only to show themselves again when least expected." government physicians generally attribute the causes which are checking the increase of the hawaiian population to be leprosy; also the indolent and easy nature of the natives, which causes them to rest content, provided they can obtain the bare necessities of life. they are content to sit idle while their places are being filled with chinese, and their lands are gradually passing from their possession. this apathy causes them to degenerate, both mentally and physically, and thus leads to the smallness of families and the general extinction of the race. the following description of how this terrible disease develops and affects the patient is taken from the hankow (china) medical mission report: "leprosy is common. it chiefly affects men who work in the field; we have met with it in brothers; it is occasionally met with in women. the age varies from ten to fifty years. often the first symptom complained of is some localized anæsthesia--which is sometimes quite accidentally discovered--in the feet, hands, or face, which are the parts that are most commonly affected. the sensory nerves are first affected, and sensation as a rule absent partially or completely. the anæsthesia is followed by want of free use of affected parts; the circulation is also impaired in those parts; the hair on the eyebrows falls out. a peculiar punched-out-looking ulcer, with a very fetid discharge, is often met in the feet; sometimes, but not so often, in the hands. as the disease advances, which it does very slowly--it often apparently remains stationary for years--the face broadens, becomes square, glazed, irregular and nodular; nodules are also found in the mucous membrane of the lips and in the nerves; perspiration is absent; the natural expression of the face is completely changed; the patient looks old and sad. as the disease further advances, the toes and fingers drop off, and by and by part of the limb. the general health is never affected. treatment is not very satisfactory; symptoms seem to be controlled for a time, but never cured." =lockjaw.=--professor renzi, of naples, records several cases of tetanus successfully treated by absolute rest. the method advocated is as follows: the patient's ears are closed with wax, after which he is placed in a perfectly dark room, far from any noise. he is made to understand that safety lies in perfect rest. the room is carpeted heavily in order to relieve the noise of stepping about. the nurse enters every quarter of an hour with a well-shaded lantern, using more the sense of touch than sight to find the bed. liquid food (milk, eggs in beef tea, and water) is carefully given, so that mastication is not necessary. constipation is not interfered with. mild doses of belladonna or secale are given to relieve pain. this treatment does not shorten the disease, but under it the paroxysms grow milder, and finally cease. numerous physicians attest to the value of this treatment. =marriage.=--the _medical record_ says the unpopularity of marriage in england continues unabated, and last year was the first in recent times in which, while the price of wheat fell, the marriage rate remained stationary. it is now . per , . the decline in the popularity of matrimony is greatest with those who have already had some experience of wedded life. between and the marriage rate fell per cent for bachelors and spinsters, per cent for widowers, per cent for widows. another interesting fact is that the births have now reached the lowest rate recorded since civil registration began. in the rate was . per , ; it is now . . this is very satisfactory, and it is also notable that the illegitimate birth-rate has declined, the proportion, . per cent, being the lowest yet registered. the worst feature in the registrar-general's returns, however, is the fact that the male births had fallen in proportion to the female; in the last ten years , boys were born for every , girls, and last year the male preponderance had dropped by , and is now standing at , to , . m. huth has recently published a valuable book on consanguinity. there is no lack of instances of enforced consanguinity, in the matter of marriage, in isolated communities, according to m. huth, to disprove the assumption that physical degeneration is likely to result from the practice. an investigation into a number of unions between uncles and nieces, nephews and aunts, and cousins in the first and second degree, gives an average of children rather above than below the general average, though this is attributed to some extent to the comparatively early age at which such unions are generally contracted. breeders inform us that the results are markedly in favor of consanguineous unions between healthy, well-bred animals. unions between men or animals of widely different varieties, on the other hand, have a decidedly injurious effect on the offspring, and beyond a certain limit are almost absolutely sterile. mulattoes and the half-breeds of india and america are striking examples of the deterioration to which such racial disparity gives rise. the great point to bear in mind is that the union of individuals with the same morbid tendencies intensifies the taint, and that, too, quite irrespective of any consanguinity. the moral, according to the author, is that the reasons which have led to the prohibition of marriages within certain degrees of relationship are social, and not physiological. =malaria (chills and fever).=--mr. w. s. green, editor of the _weekly colusa sun_, of this state, has made careful investigations on the malaria question. we quote from his issue of may , :-- "_irrigation and malaria._--at the irrigation convention held at riverside in march, ' , a paper by w. s. green was read on the subject of 'irrigation on health.' the writer took a new departure, and combated notions held for ages; that is, he held that however much the received notions of malaria might hold good as to other climates, they were not correct when applied to california, where the air was in motion pretty much all the while. mr. green received the highest indorsement of his ideas, and they have come to be accepted as correct. his statement of facts has been verified by almost all observing men. "_to the pres. of the irrigation convention, riverside, cal._-- "having taken great interest in the problem of irrigation for twenty years and over, i had intended to be present at your meeting, but at this date i find it will be impossible. if a man possesses a mite of knowledge or an idea on this great subject, it is his duty to give his co-workers the benefit of it. "during a residence of thirty-four years in the sacramento valley, i have had time and opportunity to observe and to study its sanitary conditions, and these observations bear directly, i think, on the subject of the effect of irrigation on the health of a country. i am led by these observations to reject almost _in toto_ the long-accepted theory of infection by malaria from the atmosphere, that is, so far as it pertains to california. i will not consume your time with a technical dissertation, but will state some facts as briefly as possible, and in plain, homely phrase. "when i saw people living all along the margins of the tules, where in summer the water became hot and stale and full of decaying vegetation, and hundreds of forms of animal life, and yet remain entirely free from malarial influence, i began to think there was some mistake in the accepted theory. i do not pretend to say that all the people living along the tule margins were or are healthy. all who occupy some places seem to be attacked by chills, while the occupants of places close by are never so attacked. health is the rule. i saw that all these people, those on the healthy and those on the sickly places, must breathe the same air, coming to them from the same hot, stagnant water and decaying vegetation, and i concluded that malaria was not in the air. but i investigated further. "there are clay, or, as some call them, hardpan banks to the upper sacramento river, which are from a quarter of a mile to a mile apart. the river, for some very indefinite number of centuries, has vibrated between these banks--washing in on one side and filling in on the other. there is, then, an old or clay formation and a newer or alluvial formation; of course, there is alluvium on top of the clay, but this is not to our purpose. when i first saw the valley in , this new land, some of it as high as the old, was covered with pea vines, blackberry vines, and a dense undergrowth generally, while the other grew wild oats and was usually as open as our wheat-fields. i began to notice that those people who built their houses and _dug their wells_ on a newer formation generally had chills, while the others, as a rule, had not. sometimes these sickly and healthy places would be but a few feet apart. they breathed the same air, but they _did not drink the same water_. i began to conclude that these people, both along the river and around the margins of the tules, drank the germ of disease and did not breathe it, and i continued my observations. "the town of colusa is built upon the old, or clay formation, and the people are entirely free from the so-called malarial influence. they are almost entirely free from chills, typhoid fevers, diphtheria, etc., but just at the lower end of the town there is evidence that the river at one time ran almost at right angles with its present course, and while the land is just as high, and very large oaks grew upon it, showing the formation to be very old--the span of human life taken as a measure--yet in digging and boring wells, as well as by the indigenous growth, the very great difference in the age of the formation was apparent. upon this new formation an extension to the town was located, and among other buildings the county hospital was placed there. the patients and employes of the hospital all had chills for several years, until the physician-in-charge, dr. w. h. belton, noticed that the people generally who used water from wells on this newly-made land had chills, while the others had not, and caused pipes from the town waterworks, into which river water was pumped, to be laid to the hospital. there was an _immediate_ change. at the commencement of the use of river water, there were some forty persons in the hospital, all with chills, but since the building has been almost entirely free from it. there could be no more conclusive evidence that these people _drank_ the germ of the disease and _did not breathe it_. "it is claimed that after a wet season there is more malaria in the air, and that hence people are more subject to disease. i have investigated this, and my observations, extended over a number of years, have convinced me that the water in the wells is simply raised to a newer stratum, one not thoroughly washed, as it were, and that people drink the germ of disease, and do not breathe it. "my conclusions are, therefore, that irrigation will tend to bring on malarial disorders, as it raises the water in wells to a newer stratum of earth, but no further. when we irrigate so as to produce this effect we must _go down_ after pure drinking water, or bring it to our houses in pipes. the effect of disorders thus brought about is easily remedied. "i do not wish to be understood as maintaining that there may be no such thing as poison in the atmosphere. in some localities, where the air is not in motion every day, as it is here, the air, like standing water, may become stagnant. i know of some hotels in this valley totally void of drainage, and where the accumulated filth of a quarter of a century stands in the yards in cess-pools. in some countries this would kill ninety out of a hundred people who would stop in them a week, but here we feel no inconvenience from it, except in so far that the water may become impregnated. air in motion, like water in motion, purifies itself, and hence i have come to the rejection of the theory of malaria in the air." of our own remedies we feel very proud because they are sure to kill chills and fever. there are two:-- _first:_ take the proportions of one ( ) of sulphur to two ( ) of gin, or fluidounces of gin to of sulphur. let it stand overnight. for an adult take one teaspoonful of this mixture in a little water from to minutes before the attack. remain in bed in a room warmed to ° fahr., for from to hours. this has not been known to fail. _second:_ this requires much care and judgment. take a whole nutmeg finely grated, and its equal quantity of pulverized alum, thoroughly mix them, and take at one dose; the _time_ to take it has everything to do with its effect. it must be taken between and minutes before the shake is due to come on. go to bed immediately, using double the usual amount of bedclothes, remain there from - / to hours, and both chills and fever will permanently depart. if the medicine is taken too soon (say minutes before the shake), the attack will be more severe; if taken immediately after the shake it will increase the fever; in either case the dose will have to be repeated to effect a cure. this latter treatment completely cured the author. =nervousness and worry.=--one meets few unworried people. most faces bear lines of care. men go anxious to their day's duties, rush through the hours with feverish speed, and bring hot brain and tumultuous pulse home at night for restless, unrefreshing sleep. this is not only a most unsatisfactory, but is also a most costly, mode of living. the other night the train lost two hours in running less than a hundred miles. "we have a hot box," was the polite conductor's reply to some impatient passengers who begged to know the cause of the long delays at stations. this hot-box trouble is not altogether unknown in human life. there are many people who move swiftly enough and with sufficient energy, but who grow feverish and are thus impeded in their progress. a great many failures in life must be charged to worrying. when a man worries he is impeded in several ways. for one thing he loses his head. he cannot think clearly. his brain is feverish, and will not act at its best. his mind becomes confused, and his decisions are not to be depended upon. the result is that a worried man never does his work as well as he should do it, or as he could do it if he were free from worry. he is apt to make mistakes. marks of feverishness are sure to be seen somewhere in whatever he does. remedy: keep cool, think three times before you act once. =obesity and thinness.=--to increase the weight; eat, to the extent of satisfying a natural appetite, of fat meats, butter, cream, milk, cocoa, chocolate, bread, potatoes, peas, parsnips, carrots, beets, farinaceous food, or indian corn, rice, tapioca, sago, corn-starch, pastry, custards, oatmeal, sugar, sweet wines, and ale. avoid acids. exercise as little as possible, sleep all you can, and don't worry or fret. to reduce the weight: eat, to the extent of satisfying a natural appetite, of lean meat, poultry, game, eggs, milk moderately, green vegetables, turnips, succulent fruits, tea or coffee. drink lime juice, lemonade, and acid drinks. avoid fat, butter, cream, sugar, pastry, rice, sago, tapioca, corn-starch, potatoes, carrots, beets, parsnips, and sweet wines. exercise freely. =piles.=--when piles become painful, whether they protrude or not, the patient should take a warm hip-bath and remain in until the pain ceases, extra precaution being taken for cleanliness, using pure white castile soap with the hip-bath. a careful diet of farinaceous and other easily-digested food, and regularity in going to stool, will suffice to cure the majority of cases. if the piles are bleeding, apply a salve of opium and nut-gall; if itching, a drop of oil of cade will give relief. linseed oil, applied to the piles, is said to be an effective remedy. in severe cases of piles great relief is afforded by the use of suppositories made after the following formula: grains sulphate morphina, grains extract belladonna, scruple tannin. the above mixed with a sufficient quantity of cocoa butter to make twelve suppositories of one-half ounce each; one to be used every night on retiring. =poisons.=--poisons may be classified under two distinct heads--_mineral_ and _vegetable_. _mineral poisons_ are irritating and corrosive in their action. they produce a metallic taste in the mouth, burning pains in the throat, stomach, and bowels, and, often, violent retching and bloody vomiting, purging, cramps, cold sweats, and great depression. _vegetable poisons_ are chiefly narcotics, and many of them are as virulent as any in the mineral kingdom. they cause giddiness, drowsiness, stupor, insensibility or delirium, and oppressed breathing. _general directions._--first and instantly dilute the poison with large draughts of warm water, either clear, or, if the particular poison is known, containing the proper antidote. this will usually cause vomiting, which is to be desired. if vomiting does not soon occur, excite it. protect as much as possible the lining membrane of the stomach and bowels from contact with the poison by large and frequent doses of sweet-oil, mucilage of gum arabic, flaxseed tea, milk, etc. melted cosmoline, vaseline, butter, or lard will serve for this purpose. keep up the temperature by means of warm blankets, hot bottles, etc.; and if there are marked evidences of sinking, such as a failure of the pulse, or very feeble, gasping respiration, give a little stimulus, preferably by injection into the bowels. in the case of an adult, a tablespoonful of brandy, whisky or gin, with an equal quantity of water, may be administered in this manner every five or ten minutes, until reaction sets in--that is, until the face regains its color, the pulse becomes stronger, and the breathing natural. a general antidote for all cases of poisoning, where the nature of the poison is unknown, is a mixture of carbonate of magnesia, powdered charcoal, and hydrated sesquioxide of iron, equal parts, in water. poisons--mineral. _acids.--muriatic_ (spirit of salt), _nitric_ (aqua fortis), _sulphuric_ (oil of vitriol), _oxalic_, _nitro-muriatic_, etc. nitric and sulphuric acids are sometimes used for the removal of warts; oxalic acid is often employed for taking out iron or ink stains; muriatic and nitro-muriatic acids are frequently prescribed medicinally. as soon as a poisonous dose has been swallowed, seek for something which will neutralize the acid. powdered chalk, whiting, magnesia, or lime scraped from a wall and stirred in water, may be given in any of these cases. for sulphuric or muriatic acid also administer soap-suds, sweet milk, common soap cut into small pieces, baking or washing soda, or saleratus, giving these latter in very small quantities at a time, so as not to produce dangerous distension of the stomach, from the evolution of gas. in the case of sulphuric acid, water must not be used freely at first, at least not unless it contains some antidote, as the heat produced, when this acid and water are mixed, is sufficient of itself to cause serious damage. _ammonia, and other alkalies (caustic potash, soda or lime)._--antidotes: vinegar, lemon juice, or a weak solution of tartaric acid, to be followed immediately with sweet-oil or mucilage of gum arabic, and an emetic. also give an injection of boiled starch. pain may be relieved with laudanum, in doses of ten to fifteen drops, as the paroxysms occur. _antimony (butter of antimony, tartar emetic)._--encourage vomiting. the antidotes are milk, tea, tannic acid. _arsenic, ratsbane, paris green, cobalt, and all arsenical preparations used as rat poisons._--give the whites of five or six eggs, beaten in half a pint of water; or, flour and water, barley water, flaxseed tea, or magnesia. also administer an emetic of five grains of sulphate of copper (blue vitriol), or fifteen grains of sulphate of zinc (white vitriol), ipecac, or mustard and water. after the vomiting, give hydrated sesquioxide of iron in tablespoon doses, every fifteen minutes, until danger is past. this is the best-known antidote for arsenic, and should be procured fresh from the drug store if possible. _chloral, chloroform, ether._--cold water should be sprinkled over the face and applied to the head. if breathing is suspended, treat the patient for artificial respiration. the use of electricity is recommended. _corrosive sublimate_ (bedbug poison), _calomel_ (mercury).--the whites of three or four eggs, beaten in water, should be given without delay. if eggs are not at hand, flour or thin starch gruel, mucilage of gum arabic, or milk, will answer. an emetic should be taken immediately after the antidote has been administered. _iodine_ (used for external application).--if it has been swallowed, give a paste of starch, or flour and water. _lead, salts of (sugar of lead, lead paint)._--after an emetic, administer as much epsom salt, or glauber's salt, as the patient can drink. then give large quantities of milk and whites of eggs. _lunar caustic, nitrate of silver._--give a large teaspoonful of common salt, in a glass of water. repeat the dose every ten minutes for an hour. then give a dose of castor-oil, and let the patient drink freely of flaxseed tea, barley water, or sweet milk. _muriates of tin and zinc._--these poisons are sometimes found in canned goods--fruits, vegetables, fish, and meats. they cause nausea, vomiting, sudden failure of the vital forces, and sometimes cramps and convulsions. milk, the whites of eggs, strong tea, or tincture of peruvian bark, should be given. after the violent symptoms have subsided, the patient should drink freely of flaxseed tea or barley water. _phosphorus, matches._--give large quantities of warm water containing calcined magnesia, chalk, or whiting. _prussic acid._--liquor of ammonia, in doses of ten drops to a tablespoonful of water, should be given every fifteen minutes, until the patient is out of danger. also apply smelling salts to the nose, dash cold water in the face, and give stimulants. _verdigris._--give sugar, milk, and whites of eggs in large quantities, then strong tea, but no acids of any kind. poisons--vegetable. _aconite._--induce free vomiting, then give brandy or whisky every half hour until the dangerous symptoms are allayed. _alcohol, spirits._--give half a teaspoonful of aromatic spirits of ammonia in sweetened water every half hour. bromide of potassa, in doses of fifteen to thirty grains, every two or three hours, will also be found useful. _cocaine_ is the alkaloid of the coca plant of south american origin. it is generally employed in the form of muriate of cocaine and principally used as a local anæsthetic. it should only be used under the direction of a physician. it may occasion dangerous effects even in doses usually deemed safe. when it has been taken internally, the proper antidote is a powerful emetic followed by stimulants--such as liquor and spirits of ammonia--administered internally. when it has been used to a dangerous extent externally, give whisky or brandy and ammonia. _laudanum, opium, paregoric, morphia, belladonna, hyoscyamus, stramonium, and conium._--an emetic of mustard and water, twenty grains of sulphate of zinc (white vitriol), or thirty grains of powdered ipecac, should be given. strong coffee, brandy, or whisky should then be administered in large quantities, and the patient walked around the room. slapping, pinching, dashing cold water in the face, and even whipping, may be necessary to keep the patient awake. _strychnine (nux vomica)._--give an emetic of a solution of sulphate of zinc (white vitriol), or a strong infusion of tobacco; or inject into the bowels bromide of potassium, thirty grains, and the extract of coca, one-half ounce. during the spasms, the patient should breathe chloroform or ether from a saturated cloth held to the nose and mouth. _toadstools (false mushrooms) and other poisonous plants and seeds, such as are liable to be picked up and eaten by children._--empty the stomach at once by an emetic you have at hand. coffee poisoning occurs mostly with well-to-do people--those who are overfed. tea poisoning comes to hard-working, half-starved women. the symptoms of coffee poisoning are want of appetite, sleeplessness, and nervous tremblings, with various indications of indigestion and torpor of liver. tea poisoning requires rest and nourishment; but the victim of coffee excess usually needs to unload his system by exercise on a low diet. _antipyrine._--dr. t. e. smith, of cincinnati, had his whole right side paralyzed by a ten-grain dose of antipyrine. the dose is an ordinary one. this powerful drug is much resorted to by grippe victims. =removal of foreign substances.=--considering the frequency with which foreign bodies are swallowed, especially by children, the best treatment to employ in such cases should be generally known. a variety of such methods have been advocated, but just now the so-called "potato cure" appears to be the most popular. one physician not long ago reported that he had successfully applied it with the best results in three cases. one was that of a -year-old boy, who swallowed a small weight; another that of a girl, years old, who had swallowed a nail; and the remaining one that of a woman who had swallowed a set of teeth. he fed the patients for three days on nothing but potatoes. this treatment is a method in vogue among the pickpockets of london, who, swallowing their booty, live on potatoes until the stolen articles have passed down and out of the body. =rheumatism.=--those who have a tendency to that disease should "take a stitch" now and free their systems from all injurious retained matter. they should live abstemiously, exercise freely, keep the skin active by frequent bathing, the bowels open with fruits, and drink water in large quantities. water dissolves and washes waste matter out of the system; it is therefore an absolute essential where there is any impairment in the action of the kidneys, bowels, or skin. he who applies this simple treatment, and takes proper care of himself otherwise, may feel quite secure from attacks of rheumatism. "practical medicine" suggests: "make a concentrated emulsion of black soap, grammes; add thereto or grammes of turpentine, and shake the whole vigorously until a beautiful creamy emulsion is obtained. for a bath take half of this mixture, which possesses an agreeable pine odor. after remaining in the bath a quarter of an hour, the patient should get into bed, when a prickling sensation, not disagreeable, however, is felt over the entire body; then, after a nap, he awakens with marked diminution of rheumatic pains." flour of sulphur dusted into the soles of the shoes and stockings is said to be a perfect preventive. the exciting causes of rheumatism are cold or wet applied to the body when in a state of heat, exposure to cold winds, remaining long in wet clothes, sleeping in a damp bed, or blood-poisoning. acute attacks of rheumatism should be treated by painting the affected part with tincture of iodine. =seasickness.=--experts claim that seasickness can be regulated by a system of breathing. one must sit still and time the breathing to the upward and downward motion of the boat. as the boat falls there should be a full expiration, and as the boat rises start on an inspiration ending just as the boat begins to drop. =sleep.=--the "home maker" says: "up to the fifteenth year most young people require ten hours, and till the twentieth year, nine hours. after that age everyone finds out how much he or she requires, though, as a general rule, at least six to eight hours are necessary. eight hours' sleep will prevent more nervous derangements in women than any medicine can cure. during growth there must be ample sleep if the brain is to develop to its full extent, and the more nervous, excitable, or precocious a child is, the longer sleep should it get if its intellectual progress is not to come to a premature standstill, or its life be cut short at an early age." a doctor of prominence says: "there is no doubt in my mind but the belief that human beings should sleep with their bodies lying north and south has its foundation in true scientific facts. each human system has two magnetic poles--one positive and one negative. now, it is true that some persons have the positive pole in the head and the negative pole in the feet, and _vice versa_. in order that the person sleeping should be in perfect harmony with the magnetic phenomena of the earth, the head, if it possesses the positive pole, should lie to the south, or if the feet possess the positive pole the head should lie to the north. the positive pole should always lie opposite to the magnetic center of the continent and thus maintain a magnetic equilibrium. the positive pole of the person draws one way, but the magnetic pole of the earth draws the other way and forces the blood toward the feet, affects the iron in the system, tones up the nerves, and makes sleep refreshing and invigorating. but if the person sleeps the wrong way and fails to become magnetically _en rapport_ with the earth, he will then probably be too magnetic, and he will have a fever resulting from the magnetic forces working too fast, or he will not be magnetic enough, and the great strain will cause a feeling of lassitude, sleep will not be refreshing, and in the morning he will have no more energy than there is in a cake of soap. some persons may scoff at these ideas, but the greatest scientific men of the world have studied the subject. only recently the french academy of science made experiments upon the body of a guillotined man, which go to prove that each human system is in itself an electric battery, one electrode being represented by the head, the other by the feet. the body was taken immediately after death and placed on a pivot, to move as it might. after some vacillation the head portion turned toward the north, the body then remaining stationary. one of the professors turned it half way around, but it soon regained its original position, and the same result was repeatedly obtained, until organic movement finally ceased." =small-pox and vaccination.=--notwithstanding existing prejudices, statistics prove the great usefulness of vaccination. in small-pox epidemics, of those persons attacked who have not been vaccinated, one case in four is fatal; while of those who have been vaccinated, the death rate is not one in four hundred and fifty. in cities, it is important that every infant should be vaccinated before it is six months old. in the country, the operation may be deferred until the infant is a year old. care should be taken to have the virus fresh and from the cow. the taking of virus from a child, or an adult, should never be allowed, as constitutional diseases are often transmitted in that way. vaccination is performed by making a small incision in the skin and introducing the virus on the point of a lancet or needle. on the third day, if the desired result has been attained, a small red spot may be seen. this increases in size, becomes elevated, and, by the sixth day, is filled with a clear, yellow liquid. about the eighth day, the pustule is fully formed, when symptoms of small-pox are usually felt,--headache, shivering, loss of appetite, etc. these symptoms subside in a day or two; the fluid in the pustule dries up, and a scab forms, which remains about two weeks and then disappears, leaving a scar. the affected part should be protected by a loose bandage, and all scratching or rubbing prevented. the theory in regard to vaccination is that the disease in a mild form takes hold of the system, and either completely or partially destroys the liability to contract the same disease in the future. if the destruction is only partial, it can be made total by future vaccinations. all authorities agree that it is necessary to revaccinate frequently--just as often, in fact, as the system shows itself in readiness to take the vaccinations. then as often as once in five or seven years vaccination should be repeated in order to obtain complete immunity from small-pox. =superstitions.=--numerous are the dangerous superstitions about marriage. for instance, the bride must not try on her wedding gown, or ill-luck will follow. she must not look in the glass after she is fully dressed and ready for the ceremony. she must not enter her new home by stepping over the threshold, but must be carried over it by one of her relatives. a piece of the bride's cake must be broken over her head as soon as she is safely on the other side. it is very unlucky for her to be in a happy state on her wedding-day. she must be as dolorous as possible, violent fits of weeping being especially beneficial. it is a good idea for the brides-maids to throw away as many pins as possible on the wedding-day, as this will hasten marriage. the bride should throw away her slipper in leaving the wedding feast, and she who catches it will be the first married. the month of may is generally conceded to be the most unfortunate for marriages. the lucky months are january, april, august, october, and november. january is especially lucky. lovers should carefully avoid passing a sharp or pointed instrument from one to the other. such things tend to cause quarrels. the wedding should be put off by all means if a cat sneezes on the eve of the wedding-day. it should never take place if the cat is black. to sweep dust over a girl's feet or legs will be certain to make an old maid of her. should the younger sister of a family marry first, the older sisters will be condemned to lasting celibacy unless they dance at her wedding in their stocking-feet. the wedding-ring of the mother is an infallible cure for eruptions on the skin of the child. the ring must be rubbed three times around each sore. cure is certain. the virtue of the dew that glitters and sparkles in every leaf and flower of a may morning has been recognized from the earliest times. if a young girl wishes to obtain and preserve a glorious complexion she should venture out of a may morning and wash her face in this dew. to spit in the hand before undertaking anything, whether in love, war, or business, will not fail to bring luck. if you are out fishing, do not step over your rod, or you will catch no more fish than did simple simon in his mother's pail. of births, it may be said in general that a crying child will grow up to be a great and useful man. this omen is not very clearly settled, however, and is often given the other way. some seer far back in the ages discovered the following: born on monday, fair in the face; born on tuesday, full of god's grace; born on wednesday, sour and sad; born on thursday, merry and glad; born on friday, worthily given; born on saturday, work for your living; born on sunday, you will never know want. to recall a person after they have left the house is bad luck. to go back for something forgotten is also bad luck, unless you sit down before going out again. if, when you sit before the fire, a live coal jumps out, it is a sign that you are to have good luck, especially in money matters. to wash in water another has washed in is not only bad sanitarily, but also superstitiously. he who makes many crumbs at the table will never have any money to spare. it is flying in the face of fortune to sweep dust out of the front door or to allow it to be swept out. in so doing you are sweeping out your good luck. to count one's gains brings luck, but to find money is the worst possible luck. the -leaved clover once found, should be treasured, as every school-child knows and believes. it brings luck of every description. eve attempted to carry a -leaved shamrock of precious stone from paradise with her, but it fell and shattered at her feet. think of the disaster thus entailed upon the human race! to see the moon over the left shoulder is as unlucky as to hold the four of clubs at cards. but the new moon seen over the right shoulder, or straight in front, portends fortune as smiling as her own bright rays. one should be careful in writing a letter not to cross out a word in it. to do so means that any request you may have made in the letter will not be granted. it is very unlucky to dry a letter before the fire, instead of allowing it to dry slowly and naturally. but unluckiest of all is to drop the letter on the floor after finishing it. birth, marriage, and death are the three most important events in every life. death, being the most dreadful, comes in for the largest share. one of the best ways given us of avoiding it when mortal sickness is upon us is to allow the report to be circulated that you are already dead. the chances are strongly in favor of getting well. especially is this so if friends begin to arrange for the funeral. a sure sign of early death is for a person to scatter the leaves of a red rose upon the ground. it is extremely hazardous to an infant's life to pare its nails before it is a year old. they should be bitten off. some superstitions of my early life which i still remember are:-- . turning a loaf of bread upside down creates family quarrels. . allowing anyone to pass between you and your companion evil and death to follow. . breaking a mirror, death in the family. . having your hair cut on sunday, forgetfulness. . beginning an undertaking on friday, ill luck. . sitting at table or in company when just are present, a death of one of their number before the year is done. . presenting a sharp instrument or edge-tool to anyone, ill luck to ensue. . putting on any garment inside out, unless you retain it until the sun goes down, bad luck to come. . spilling salt, unless some is thrown into the fire or over the left shoulder, misfortune. during my life i have done everything in the above list that is claimed should not be done, that fell in my way to do, and still live and prosper, although born on friday, and being one of a family of children. =snake bites.=--tie a string or ligature hard around the injured limb and above the bitten place; suck the wound, so as to extract the poison, but be careful to see that the person who performs the sucking has no open sore in his mouth; wash with warm water and apply caustics, such as carbolic acid or concentrated liquor of ammonia; give five to ten grains of carbonate of ammonia, in water, every hour, and stimulate the patient with whisky or brandy; rub the limbs with pieces of flannel dipped in hot whisky or diluted alcohol. medical attendance should be secured as soon as possible. =tape-worm.=--recently attention has been called to cocoanuts as a vermifuge. professor paresi, of athens, when he was in abyssinia, happened to discover that ordinary cocoanut possesses vermifuge qualities in a high degree. he took, one day, a quantity of the juice and pulp, and shortly afterward felt some gastric disturbance, which, however, passed off in a few hours. subsequently he had diarrhea, and was surprised to find that there had been expelled a complete tape-worm, head and all, quite dead. after returning to athens he made a number of observations which were most satisfactory, the tape-worm being always passed and quite dead. he orders the milk and pulp of one cocoanut to be taken early in the morning, fasting, no purgative or confinement to the house being required. =teeth.=--for toothache rub a little essential oil on the face, at the hinge of the jaw, on the side that aches. =tobacco.=--probably no subject in our book can interest the majority of persons more than this great question of the use of tobacco. we have a collection of opinions from the best authorities:-- the _medical news_ published a paper by dr. wm. l. dudley, professor of chemistry in the vanderbilt university, giving the results of recent careful analytical experiments made by him in his laboratory with the smoke of an ordinary cigarette. mice were used upon which to employ his tests. it is not needful that we should give the professor's description of his _modus operandi_ by means of air-tubes, an aspirator, a glass jar, etc., the results of his experimentation being the chief object of interest in which the reader is concerned. suffice it to say, then, that in each of his several chemical tests by the gradual combustion of a single cigarette, the mouse that was the recipient of the resultant smoke died in the course of the operation, being literally poisoned to death by inhaling the carbonic oxide evolved from the "noxious weed." the blood of the dead creature being subjected to spectroscopic examination, it was found that the veinous fluid had been so completely altered and vitiated that death was the inevitable effect. the tests were thoroughly scientific and conclusive. the fact was demonstrated, beyond the chance of doubt or question, that carbonic oxide is the chief constituent of cigarette smoke, if not all tobacco smoke, and that its inhalation into the air-passage and lungs must of necessity be exceedingly deleterious, as much so to men and boys as to mice. cases of poisoning due to meat which seemed thoroughly wholesome have sometimes occurred and have remained unexplained. in the _revue d' hygiene_, m. bourrier, inspector of meat for the city of paris, makes a suggestion. he described his experiments with meat impregnated with tobacco smoke. some thin slices of beef were exposed for a considerable time to the fumes of tobacco, and afterward offered to a dog which had been deprived of food for twelve hours. the dog, after smelling the meat, refused to eat it. some of the meat was then cut into small pieces and concealed within bread. this the dog ate with avidity, but in twenty minutes commenced to display the most distressing symptoms, and soon died in great agony. all sorts of meat, both raw and cooked, some grilled, roasted, and boiled, were exposed in tobacco smoke and then given to animals, and in all cases produced symptoms of acute poisoning. even the process of boiling could not extract from the meat the nicotine poison. grease and similar substances have facilities of absorption in proportion with their fineness and fluidity. fresh-killed meat is more readily impregnated, and stands in order of susceptibility as follows--pork, veal, rabbit, poultry, beef, mutton, horse. a simple experiment which will show how injurious is cigarette smoke inhaled may be easily performed by means of a handkerchief: after taking a mouthful of smoke, put the handkerchief tightly over the lips and blow the smoke through it. you will find a dark brown stain on it. if the smoke is inhaled, and then blown through the handkerchief, there is very little stain, if any; consequently all that nicotine must remain in the lungs. _an ex-smoker's advice._--a young man who, not long ago, was an inveterate smoker, but who was recently induced to "swear off," came to me and talked in this strain: "i have been doing some figuring lately, and the result astonishes me. when i was smoking my hardest my average was eight cigars a day. sometimes it would run over eight and sometimes under; but eight was about the all-round figure. i rarely bought my cigars by the box, and as i indulged in straight -cent goods, cents a day was what my smoking cost me. this, with cents added for cigars that i gave away and lost shaking dice, make a total of about $ . a week that i now save. it is just nine weeks and three days since i swore off, and by saturday i shall have $ in the bank, without an effort on my part save that required to control an unnecessary appetite. i must also regard as an asset the superabundance of animal spirits i enjoy as a direct result of my abstinence from a habit that everybody knows is weakening, when indulged in to excess. smoke yourself, do you? well, try my scheme. swear off and put your cigar money in the bank. you might need it some day, even if you are a newspaper man." the new york _medical journal_ contains a convincing article on tobacco: "tobacco contains an acrid, dark brown oil, an alkaloid, nicotine, and another substance called nicotianine, in which exists its odorous and volatile principles. when tobacco is burned a new set of substances is produced, some of which are less harmful than the nicotine, and are more agreeable in effect, and much of the acrid oil--a substance quite as irritating and poisonous as nicotine--is carried off. these fire-produced substances are called, from their origin, the 'pyridine series.' by great heat the more aromatic and less-harmful members of the series are produced, but the more poisonous compounds are generated by the slow combustion of damp tobacco. this oil which is liberated by combustion is bad both in flavor and in effect, and it is better, even for the immediate pleasure of the smoker, that it should be excluded altogether from his mouth and air passages. "smoking in a stub of a pipe is particularly injurious, for the reason that in it the oil is stored in a condensed form, and the smoke is therefore highly charged with the oil. sucking or chewing the stub of a cigar that one is smoking is a serious mistake, because the nicotine in the unburned tobacco dissolves freely in the saliva, and is absorbed. 'chewing' is, on this account, the most injurious form of the tobacco habit, and the use of a cigar holder is an improvement on the custom of holding the cigar between the teeth. cigarettes are responsible for a great amount of mischief, not because the smoke from the paper has any particularly evil effect, but because smokers--and they are often boys or very young men--are apt to use them continuously, or at frequent intervals, believing that their power for evil is insignificant. thus the nerves are under the constant influence of the drug, and much injury to the system results. moreover, the cigarette smoker uses a very considerable amount of tobacco during the course of a day. 'dipping' and 'snuffing' are semi-barbarities which need not be discussed. not much effect is obtained from the use of the drug in these varieties of the habit. "nicotine is one of the most powerful of the 'nerve poisons' known. its virulence is compared to that of prussic acid. if birds be made to inhale its vapor in amounts too small to be measured, they are almost instantly killed. it seems to destroy life, not by attacking a few, but of all the functions essential to it, beginning at the center, the heart. a significant indication of this is that there is no substance known which can counteract its effects; the system either succumbs or survives. its depressing action on the heart is by far the most noticeable and noteworthy symptom of nicotine poisoning. the frequent existence of what is known 'tobacco heart' in men whose health is in no other respect disturbed is due to this fact." "a youth of eighteen at bayshire, l. i., has become insane from the excessive use of cigarettes." those who can use tobacco without immediate injury will have all the pleasant effects reversed and will suffer from the symptoms of poisoning if they exceed the limits of tolerance. these symptoms are: . the heart's action becomes more rapid when tobacco is used. . palpitation, pain, or unusual sensations in the heart. . there is no appetite in the morning, the tongue is coated, delicate flavors are not appreciated, and acid dyspepsia occurs after eating. . soreness of the mouth and throat, or nasal catarrh appears, and becomes very troublesome. . the eyesight becomes poor, but improves when the habit is abandoned. . a desire, often a craving, for liquor or some other stimulant is experienced. "in an experimental observation of thirty-eight boys of all classes of society, and of average health, who had been using tobacco for periods ranging from two months to two years, twenty-seven showed severe injury to the constitution and insufficient growth; thirty-two showed the existence of irregularity of the heart's action, disordered stomachs, cough, and a craving for alcohol; thirteen had intermittency of the pulse, and one had consumption. after they had abandoned the use of tobacco, within six months one-half were free from all their former symptoms, and the remainder had recovered by the end of the year." _pasteur recommends camphor smoking._--in an interview with m. pasteur, he was asked whether he considered la grippe occasioned by bacteria? the professor smiled sardonically and shrugged his shoulders, but said nothing. on being asked what he considered the best remedy for the malady, he remarked: "let men and women both quit smoking tobacco and smoke camphor instead, and they will probably escape the pest."--_paris special._ the _bulletin_ of this city has a good article on insanity and the cigarette. ten or twelve boys have within a short time been committed to the insane asylum at napa whose insanity has been traced directly to the smoking of cigarettes. the number who by reason of the same indulgence have brought on a degree of imbecility that may ultimately land them in the asylum or in the penitentiary cannot be reduced to an exact estimate. but having occasion recently to make some inquiry about a number of boys who had figured in the records of the criminal courts, it was found that a majority of them were habitual smokers of cigarettes. the connection between cigarette smoking, mental imbecility, idiocy, and crime has recently attracted more than usual attention. no boy or young man can smoke a cigarette without being harmed thereby. one of the reasons ascribed for the lunacy of several boys was that the cigarettes were made up of the vilest stuff. they contained a narcotic beyond that usually found in pure tobacco. this is supposed to be some of the cheaper forms of opium. but, whatever it may be, it is making imbeciles and idiots of many boys, and criminals of some of them. in a number of instances where boys have been sent to the asylum, it was found that after a short period, the cigarette and all other forms of dissipation having been cut off, the patients rapidly improved, and after a few months' detention they were sent home. the evil does not end here. if a boy becomes an inveterate cigarette smoker, the chances are greatly against any reformation. some friend may take him in hand and show him the danger in season. the larger number will keep right on. of this number it is doubtful if ten per cent will ever come to anything. and even these will accomplish far less than if they had never weakened their mental powers by this vile indulgence. the crazy boys who bring up in the asylum are only the few wretched examples of the cigarette mania. other examples are constantly found in the criminal courts. the moral sense has been utterly lost, or so weakened that there is no clear distinction between right and wrong. every boy who smokes a cigarette has started to go to the bad. just where he will bring up--whether in the insane asylum, in the criminal courts, or in a condition of such hopeless moral and mental imbecility that friends must support him, or the almshouse must finally give him shelter, is one of the questions that time will settle for him. but if any better record is to be made for him, the boy and the cigarette must have a prompt and final separation. the boston _herald_ states: "it is said that turkish tobacco contains prussic acid, and that havana tobacco has another alkalide called collidine, of which one-twentieth of a drop will kill a frog, with symptoms of paralysis. the half-liquid matter that accumulates in the bowl of a pipe will kill a small animal in three-drop doses. a few drops of nicotine inserted under the conjunctiva of an animal will kill at once. eight drops will kill a horse, with frightful general convulsions. it has been observed that the living systems quickly become tolerant of tobacco poison--"an animal that is thrown into convulsions by half a drop one day will require twice as much the next day, and so in four or five days four or five times as much." the following is suggestive: no student who smokes can obtain a scholarship at dartmouth college, hanover, n. h. it is a new rule of the faculty. as the purchase of the breweries of the united states has been commenced by the capitalists of the eastern continent, i trust they will extend their purchases to the distilleries and tobacco warehouses and plantations on this continent, especially of the united states; its financiers being shrewd will the sooner observe the advancement of intelligent progress in the line of thought, and change their investments from breweries, distilleries, and cigarette and tobacco manufactories, to the sinking of artesian wells and the invention of some improved water-filter. =tonsillitis, quinsy,= _black tongue, or ulcerated sore throat._-- prescription. solution chlorate of potash ( in ) ounces tincture muriate of iron drachms tannic acid grains tincture of capsicum drachm add glycerine to make ounces shake well before using. dilute in equal parts of water, and gargle every half hour in a severe case for the first three hours. after that every two or three hours. the above is invaluable and unfailing in case of quinsy. =vital statistics.=--statisticians are bringing out some curious facts with regard to the birth and death-rates of the leading nations of the world. unfortunately, our tables are not as accurate as those collected in the european states. abroad there is a careful record of marriages, births, and deaths. these are collected by us without any thoroughness, save only when a census is being taken. in england and wales it has been found that the birth-rate is . and the death-rate is . per , persons. in sweden the birth-rate is . , against a death-rate of . . in the german empire, birth-rate . and death-rate . . austria, . birth-rate, . death-rate. the official returns state that our annual birth-rate is and death-rate , but clearly our birth-rate is much larger, as we are growing in numbers faster than any people on earth. our increase is fully , , since the last census was taken in . our colored population have a higher birth-rate than have the southern whites. among the latter it is . , while for the colored it is . . although the death-rate of the blacks is quite large, still they are increasing relatively faster than the white. it is also a curious fact that more colored females are born than whites, but taking blacks and whites together the births of the males exceed those of the females. the report of the california state board of health for the month of april, , contains the following: reports from different localities, with an estimated population of , , give a mortality of , which is a percentage of . per , in the month, or an annual mortality of . , which is the lowest annual percentage at which we have yet arrived, indicating a remarkably good condition of the public health throughout the state. =voice.=--a question in connection with the training of the voice is to be discussed, viz., when it should be commenced. with regard to the question, says a distinguished scientist, "i am strongly of opinion that training can hardly be begun too early. of course, the kind and amount of practice that are necessary in the adult would be monstrous in a young child, but there is no reason why, even at the age of six or seven, the right method of voice production should not be taught. singing, like every other art, is chiefly learned by imitation, and it seems a pity to lose the advantage of those precious early years when that faculty is most highly developed. there is no fear of injuring the larynx or straining the voice by elementary instruction of this kind; on the contrary, it is habitual faulty vocalization which is pernicious." there are three essential elements in voice production: first, the air blast, or motive power; second, the vibrating reed, or tone-producing apparatus; third, the sounding-board, or re-inforcing cavities. these, to parody a well-worn physiological metaphor, are the three legs of the tripod of voice. defect in or mismanagement of any one of them is fatal to the musical efficiency of the vocal instrument. the air supplied by the lungs is moulded into sound by the innumerable little fingers of the muscles which move the vocal cords, and their training largely moulds the tone and volume of voice. much of the lung and throat troubles existing can be traced to the ignorance of vocal teachers and parental indulgence in allowing the voice to be strained beyond its register. to know a teacher that understands the proper treatment of the vocal organs, from one that does not--judge them by their pupils; if a pupil has an impaired throat, and there is no improvement after six lessons, change teachers. every vocal teacher can instruct in the rudiments of music, but only _one_ in _fifty_ knows anything about the voice. =warts.=--a drop of cinnamon oil on each wart daily, continued for a fortnight, will usually remove them. the most successful remedy we have ever tried is to have the wart saturated three times a week for three weeks with the saliva of a person of _positive_ magnetism, not a member of the family. there is a scientific reason for it not here explained, _but try it_. =water.=--if a small quantity of oxalic acid added to water produces a white precipitate, lime is contained in the water. tincture of galls added to the water which contains iron will yield a black precipitate. water which causes a bright piece of steel to turn yellow, when dipped into it, contains copper. sulphuric acid, dropped into water and turning it black, shows that the water contains vegetable and animal matter. for detecting sewage contamination, fill a clean pint bottle three-fourths full of the water to be tested; add a teaspoonful of granulated sugar; cork the bottle, and set it in a warm place for two days; if the contents of the bottle become cloudy or muddy, the water is unfit for domestic use. half an ounce of the neutral solution of bisulphate of alumina added to gallons of water will precipitate the organic matter therein contained; the water may be then used freely for drinking purposes. to remove the odor from cistern water, suspend in the water a bag containing a peck of charcoal. according to dr. leuf, when water is taken into the full or partly full stomach, it does not mingle with the food, as we are taught, but passes along quickly between the food and lesser curvative toward the pylorus, through which it passes into the intestines. the secretion of mucus by the lining membrane is constant, and during the night a considerable amount accumulates in the stomach; some of its liquid portion is absorbed, and that which remains is thick and tenacious. if food is taken into the stomach when in this condition it becomes coated with this mucus, and the secretion of the gastric juice and its action are delayed. these facts show the value of a goblet of water before breakfast. this washes out the tenacious mucus and stimulates the gastric glands to secretion. in old and feeble persons water should not be taken cold, but it may be with great advantage taken warm or hot. this removal of the accumulated mucus from the stomach is probably one of the reasons why taking soup at the beginning of a meal has been found so beneficial. there is no remedy of such general application, and none so easily obtainable, as water, and yet nine persons in ten will pass it by in emergency to seek for something of less efficacy. there are but few cases of illness where water should not occupy the highest place as a remedial agent. a strip of flannel or a napkin wrung out of hot water and applied round the neck of a child that has croup will usually bring relief in ten minutes. a towel folded several times and quickly wrung out of hot water and applied over the seat of the pain in toothache or neuralgia will generally afford prompt relief. this treatment in colic works like magic. a physician writes: "we have known cases that have resisted other treatments for hours yield to this in ten minutes. there is nothing that will so promptly cut short congestion of the lungs, sore throat, or rheumatism as hot water when applied promptly and thoroughly. pieces of cotton batting dipped in hot water and kept applied to sores and new cuts, bruises, and sprains, is the treatment adopted in many hospitals. sprained ankle has been cured in an hour by showering it with water poured from a few feet. tepid water acts promptly as an emetic, and hot water taken freely half an hour before bed-time is the best cathartic in the case of constipation, while it has a most soothing effect on the stomach and bowels. this treatment continued for a few months, with proper attention to diet, will alleviate any case of dyspepsia. =water pollution remedy.=--according to dr. s. s. kilvington, the mississippi river received during the past year , tons of garbage and offal, , tons of night-soil, and , dead animals from only eight cities; the ohio , tons of garbage, , tons of night-soil, and , dead animals from five cities; and the missouri , tons of garbage, , tons of night-soil, and , dead animals from four cities. doctor kilvington urges the cremation of most of the refuse, and out of health officials consulted by him favored the plan. =whooping-cough.=--mr. w. a. stedman, superintendent of the rochester gas works, gives his opinion:-- "the fumes of the substance used to purify gas are generally recognized as a specific for this disease. "the composition used for purifying gas is composed of wood shavings, iron filings, lime, and sometimes copperas. this substance cleanses the gas of the ammonia and sulphur it contains. if a child with the whooping-cough is allowed to breathe the fumes of the purifier after it becomes foul, immediate relief will be experienced. the fumes of the lime after it has been taken out are particularly beneficial. the lime, after it is taken out, begins to heat and throws off fumes strongly impregnated with ammonia. after breathing these fumes for a short time the cough seems to loosen, and two of these visits will generally cure the most obstinate case. "in newport one winter, when i was superintendent of the gas works there, there was an epidemic of whooping-cough, and i treated over cases, with the happiest results. i had so many patients that i was forced to put benches in the purifying-room. once in awhile there are people affected with whooping-cough to whom this gas treatment gives no relief, but they are the exception rather than the rule. in nearly every instance it gives immediate relief and effects a positive cure. i know of many physicians who send all their whooping-cough patients straightway to the gas works. i know that it is a sure cure from personal experience, and we would be happy to extend the courtesies of our purifying-room to any person who is suffering from the disease." =yellow fever.=--the yellow fever is one of the varied forms of the typhus, the name being derived front the hue of the victim, while the spanish call it _vomito negro_--the black vomit--from one of its symptoms. its home is tropical africa and tropical america, but it is never found in india and china, hot as the climate may be. the cause of this difference, however, has never been explained. its greatest prevalence is on the sea-coast or banks of navigable rivers. its ordinary duration of attack is from to hours. the yellow tinge first appears in the eye and then spreads over the face, gradually reaching the extremities and often becoming dark brown. the rate of mortality varies in a striking degree, for in some places one-third of the cases prove fatal, while in others the mortality reaches two-thirds, and then at other times it has not exceeded three per cent. treatment varies more in this disease than in any other, which is a proof that thus far it has baffled the best practitioners. like all other forms of pestilence, it not only walketh in darkness but destroyeth at noonday. the disease itself is not as dangerous as typhoid fever when properly handled. it is a continuous fever, lasting hours. the premonitory symptoms are a pain in the back of the head and in the loins, followed by a slight chill. the pulse and temperature then rise rapidly, the former attaining usually about beats to the minute, and the latter degrees in a few hours. on the second day the pulse begins to drop and continues to do so slowly until the normal is reached, while the temperature remains steady, and this peculiarity is the one pathognomonic symptom of the disease, as ascertained by experts who have studied many epidemics. toward the third day the temperature is often up to . this is a grave symptom, and unless it can speedily be reduced, "black vomit" or gastric hemorrhage appears, or the kidneys refuse to act on account of acute inflammation and destruction of tissue. the famous black vomit is not fatal in more than per cent of cases well treated, but when albumen appears in the urine death almost inevitably follows. nursing is everything. the treatment of the disease is wholly expectant. a hot mustard foot-bath and a large dose of castor-oil are preliminaries. after this nothing is given but orange-leaf tea, to promote perspiration, and sometimes a little extract of jaborandi. champagne in small quantities is found to be the best preventive of black vomit, and dry cupping and blisters are resorted to in case of a tendency to kidney trouble. the nurse does more than the doctor in yellow fever to effect a cure, and in new orleans nearly all the black "mammies" are experts in handling the disease, which undoubtedly accounts for the very low mortality in that city's epidemics. to watch the patient, be quick to start a fire if a north wind comes to chill the air, to keep the clothing adjusted, see that no talking is allowed, and be familiar with the symptoms forerunning black vomit or kidney trouble, and know how to treat them promptly--these are necessaries in nursing yellow fever, and in these the darkey women of new orleans are more familiar than are the doctors in other towns. on the third day after the attack, when the fever heat subsides, the patient is left in a weak and horribly nervous condition, and for many hours is subject to immediate relapse upon the slightest provocation. then it is that the tolling of a bell, the sudden shock of a cannon fired by silly authorities, the slightest indigestion or exposure to cold or excitement, will do murder. the stomach is left raw, and for many days only milk, gruel, and crackers are given, doled out in miserly quantity. supplemental. the following important items do not appear under their regular alphabetical heading, but are none the less efficacious. =blindness.=--_a simple remedy that often will prevent this dreadful misfortune._--it is distressing to learn that out of the , persons blind from their birth in this country, who owe their loss of sight to inflammation of the eyes, at least two-thirds might now have been in the enjoyment of their sight but for the ignorance or neglect of their earliest guardians. it seems that the remedies for the infantile inflammation which causes blindness are both many and simple. thus, says the london _figaro_, it cannot be too widely made known that the eyes of the newly-born child, if inflamed, should be washed with pure warm water, and that then a single drop of a per cent solution of nitrate of silver should be instilled into each with a drop-tube. in germany midwives are enjoined to adopt the above remedial treatment, under oath, and since this has been done the decrease in the number of blind children has been most appreciable. _increase of blindness._--dr. lucien howe says blindness has increased in the state of new york during the past five years thirteen times as fast as the population; and the state charities commissioners state that the excess in the increase of the insane in the state over the increase in the population for the last nine years has been forty-four per cent. these figures are most startling, especially when it is considered that the modes of treating the eyes and brain are supposed to have been so much improved of late years.--_ex._ =hiccough.=--_a mechanical cure._--procure a glass of water and pour a little of it down the patient's throat. while he is drinking the water he should press a finger on the orifice of each ear. by this method you open the glottis, and in five seconds the thing is done. should you by any chance meet with an obstinate case, you may rest assured that the throat and ears were not closed at one and the same time; either the water was swallowed before the ears were thoroughly stopped, or the water was not sufficient to fill the throat. another precaution is to keep the chin well up. this cure was obtained by the writer from an old indian medical officer who had experimented for some years to discover a method of relieving the terrible stage of hiccoughing in yellow fever, and this cure was the outcome.--_pharmaceutical journal._ =hydrophobia.=--dr. bokai, a professor at the klausenburg university, hungary, claims to have discovered an absolutely certain remedy for hydrophobia and for destroying the virus at the seat of the bite. the remedy consists of a solution of chlorine, bromine, sulphuric acid, and permanganate of potash, with oil of eucalyptus. the above was received in the united states as a press dispatch, from vienna, february , . =intemperance.=--"we believe," says the canada _health journal_, "that there is no better direct remedy for intemperance than strict vegetarianism. sir charles napier tried a vegetable diet as a cure for intemperance in twenty-seven cases, and the cure was effected in every case, the time varying from thirty-six days to twelve months." =la grippe.=--_how to prevent it._--a boston physician has a novel preventive of the influenza, which has been named la grippe. he orders a small quantity of the flour of sulphur to be put in an envelope and worn in the bottom of shoes. "only this and nothing more." patients who complied with the conditions laid down, escaped the influenza. this particular physician evidently has some knowledge of human nature. if he had told his patients, in a general way, to keep their feet warm, they would have paid no attention to his directions. but there was an odor of a drug store in the sulphur prescription, and they followed it. perhaps that was the easiest way to keep the feet warm. =teeth.=--_extraction painless._--by spraying the region of the external ear with ether, drs. henoque and fridel, of paris, render the dental nerves insensible, and extract teeth without pain or general anæsthesia. index. accidents, percentage of, preventable, - prevention of, - advice of an ex-smoker, aids to morality, philadelphia _ledger_, alcohol, treatise by dr. felix oswald on, , alcoholic habit, - alcoholism, remedy for, reviewed by dr. spitka, , animal and human lives compared, antipyrine, female intoxicant, paralysis caused by, appetite, how to improve an, artery, ruptured, treatment of a, asphyxiation, remedy for, attorney, the most conscientious, , babies, mortality out of , , , bathing, dr. steele's ideas of, , - beer-drinking excessive, beggar centenarians, bethesda water, benefits of, , , , bites of snakes, remedy for, black tongue, prescription for, bleeding, treatment and cure for, blindness, a simple remedy for, increase of, in state of n. y., boston _globe_ reporter, experience of a, brain-workers, time to rest for, brain worry, panacea for, breakfast, _menu_ for, breathing, healthful mode of, , breweries, english purchasers of, bright's disease, remedy for, brown sequard's vital elixir, , bruises, specific for, bunions and corns, preventive for, burns, remedies for, butchers' trade, effect of, cancer not cured by surgery, catholics and liquor evil, cemeteries of london, pollution of the, , chevreul, m., health at years, chewing-gum, injurious effect of, , chills and fever, w. s. green on, - cholera, remedies for, church and society duties, cigar dissipation, cigarette-smoking, insanity results from, cleanliness, hints on, , of teeth, tongue, and throat, clothing, importunities about, - hygienic advance in, cold and tired feet, how to prevent, colds, cure for, - commandments, the ten health, constipation, remedies for, , , consumption, causes and palliatives, dr. chapin's treatise on, treatment of, - consumptives' pride unhealthful, convulsions (fits), treatment of, corns and bunions, preventive and cure of, cough remedy, whooping, cure for, crematories will stop contagion, - crime, prevention of, dr. crosby, - croup, instantaneous relief of, dartmouth college, no student smoker at, deafness, prevention and cure of, , death, how produced, , no physiological reason for, - death-rate, of poor and rich, , of principal cities, deity, belief in, a necessity, , del monte hotel, model for cleanliness, diabetes, treatment and remedies for, digestion, time required for, dinner _menu_, , diphtheria, dr. deriker's prescription, dr. roulin's ", dr. scott's ", notes on, and treatment of, - diseases and their remedies, - individual experience with, , disparity between actions and teachings, dissipators long-lived, why?, dives and variety theaters, grand jury's report, doctors and dentists a necessity, , drinks for the voice, dropsy, treatment for, dyspepsia, treatment and remedy for, ears, care of the, eat, how you should, , eat, what you should, " " " " not, editor's opinion of evil, eggs, how best to preserve, electric light, incandescent, best, elixir, brown sequard's, , employment necessary for health, epidemics, history of, - erysipelas, facts regarding, esculapius, , evil, editor's opinions of, ministers' ", exercise, ben hogan's opinion of, , ex-smoker's advice, eye-glasses, when to use, eye, surgical operation on the, eyes, care of the, - faith in the source of goodness, feet, cold and tired, how remedied, fever, yellow, treatment of, , filtered water a necessity, ,, filters indispensable, fire losses in u. s., how to avoid, fits (convulsions), treatment of, food, carbonates of, for each meal, - most wholesome, - nitrates of, phosphates of, sinew producing, temperature most healthful for, foreign substances, removal of, forgotten lore remembered, - fountains, public, a necessity for, freckles, how to remove, friends or quakers, average life of, garbage creates contagion, gargle for throat troubles, general government, duties of the, germ theory, discovery of the, god, clearer perception of, who and what is, , gossip, by dr. j. g. holland, remedy for, , grand jury's report, of s. f., cal, , hair, treatment to preserve the, _hall's journal of health_ on food, hammond, dr., death not imperative, - happiness, - formula for, happiness, not found in ignorance, headache, causes and remedies for, health, - beverages, chief desideratum, - commandments, ten, contagious as disease, happiness and longevity, - how to keep in, , - laughter a promoter of, maxims, - officers' attention, , requirements of, - healthful houses, by dr. cushing, hemorrhoids, remedy for, hermit centenarians, hernia or rupture, cure for, hiccough, remedies for, , high license, liquor remedy, hotel del monte, model for cleanliness, house decorations, _sanitary news_, sanitary, model for, - human and animal lives compared, life prolonged, professor hammond, hydrophobia, drs. mott and baldwin on, remedies for, , , hygiene, systematic, dr. j. h. brown, - hygienic clothing, ignorance is not happiness, , incandescent light the best, individual duties, influenza (la grippe), remedy for, insanity and the cigarette, _bulletin_, insomnia, relief for, insurance, persons not eligible, intemperance, cures for, , deaths caused by, intemperate men, age of, invalids should not eat, what?, irrigation and malaria, by w. s. green, - kidney surgical operation, successful, la grippe (influenza), remedy for, pasteur's cure for, prevention of, lane, prof. l. c., on quackery, laughter, a health promoter, lawyer, the most conscientious, , lawyer's profession, influence exerted by, lepers of hawaii, number of, pork eaters are, leprosy, statistics regarding, - life being prolonged, reason for, life-table of , souls, , vitiated by anxiety for, light, electric, incandescent, best, liquor remedy, high license, liquors consumed in u. s., value of, lockjaw, successful treatment of, london cemeteries, condition of, - longevity, - by dr. maurice, - curiosities of, dr. oswald, , possible without virtues, , statistics regarding, _longman's magazine_ on vegetable diet, love, those deserving, luncheon, _menu_, , macdonald, geo., neighbor of, mackay, chas., on love's subjects, malaria and irrigation, by w. s. green, - chills and fever, cures for, new theory by w. s. green on, - maladies and ills cured, - man, oldest, marriage, facts regarding, , , physical degeneration, m. huth on, married life, is it a failure?, , maxims for health, - measles contrasted with small-pox, meats, how best prepared, kind and quality of, men, oldest, microbes and bacilli in water, milk, purity, how ascertained, minister, teacher, and physician, minister's opinion of evil, misconceivements, , miser centenarians, mistakes of life, morality, aids to, municipalities, duties of, naphtha, a female intoxicant, , nelly bly's experience with doctors, nervousness and worry, nicotine in tobacco, deadly poison, , nose-bleed, remedy for, obesity and thinness, treatment for, oldest man living in u. s. in , patti's formula for health, physician, minister, and teacher, piles, remedy for, poem, "deserving love," by chas. mackay, heart's test, by ella w. wilcox, milton's "adam to angel", "the two workers", "where do you live?" by josephine pollard, - poisons and antidotes, - mineral, - taken with impunity, vegetable, politeness, health interfering, pork, disease producing, unfit for food, practical knowledge, health begetting, prevention of accidents, - prohibitionist's reason for longevity, public fountains a necessity, urinals " ", quaker's life prolonged, why? or friends, average life of, quinsy, etc., prescription for, regularity, first consideration is, religionist's reason for long life, religious perceptions, remedies for alcoholism, diseases, - supplemental list, , rest, one day in seven necessary, rheumatism, prevention and cure of, , rupture or hernia, cure for, sanitation and sanity, sanitary house building, - scientific education, practical knowledge, scientist's reasons for longevity, sea-bathing, effects of, seasickness, how to prevent, selfishness excusable in tax-payer, , sleep, hours required, , - position of body during, small-pox and vaccination, contrasted with measles, smoking, evil effects of, - pasteur's substitute, camphor, snake-bites, remedy for, social evil, grand jury's report of, , society and church duties, sound health, secret of, spectacles, when to use, stimulants, most healthful, strychnine taken with impunity, substances, foreign, removal of, sulsonal, a new opiate, sunday, or one day, for rest, superstitions of the world, - supplemental list of remedies, , tanks for water, death-traps, tape-worms, cure for, tax-payer, selfishness excusable in the, , teacher, minister, and physician, teeth, painless extraction of, treatment of the, , ten health commandments, temperament, by ella wheeler wilcox, , temperance not necessary to longevity, temperature for food and drinks, thinness and obesity, treatment for, tobacco habit, dr. dudley on, experiments regarding, authorities on, - tonsillitis, etc., prescription for, toothache, remedy for, typhoid fever, substances affected by, ulcerated sore throat, remedy for, under-garments, important function of, - urinals, public, a necessity, vaccination and small-pox, vegetable diet, why preferred, , vegetarian restaurants in london, virtues, rank of the, vital statistics, , , principal cities, voice, drinks for the, essential elements in the, treatment of the, , warts, remedies for, water, detection of impurities in, - filtration of, - pollution remedy, when to drink, water-tanks, uncleanly, weariness, different phases of, treatment for, what we inherit, - "where do you live?" by josephine pollard, whooping-cough, positive cure for, , wilcox, ella wheeler, on temperament, , wisdom, prerequisites for, "workers, the two", worry and nervousness, yellow fever, statistics and treatment of, , adjusting spectacles _to suit the various conditions of sight a specialty. no other optician has or can get such facilities as are found at this establishment, because the instruments used for measuring the strength of the eye are my own invention and patent, and the only ones ever invented that will give the exact amount of imperfection in one's sight._ [illustration: l.a. berteling scientific the only reliable optician kearny st. ] my own invented instruments are the very best ever made for measuring defective sight. i value my reputation. my own discovered method is the only accurate one by which to determine imperfections of the eye i guarantee satisfaction. _berteling's inventions:_ _demonstrative ophthalmoscope_, _compound optometer_, _eyeglasses_, _refraction ophthalmoscope_, _simple optometer_, _charts_, _centralizing prisometer_, _myopic scale_, _objective._ my success has been due to the merits of my work. the annual statistician and economist, [illustration: by l. p. mccarty.] published between march and june of each year. _price, in cloth_ _$ . _ _ " " leather_ _$ . _ the above work has been published annually since (fourteen volumes). the set makes a most complete encyclopædia of the events and discoveries in art, science and literature the world over during those and previous years. the work has become a recognized authority on all statistical matters throughout the world. complete sets of the above work may be had of the undersigned on reasonable terms. send for circular giving full particulars. address, samuel carson & co., booksellers, post street, san francisco, cal. a home industry. _the pioneer and only printing ink manufactory on the pacific coast._ e. j. shattuck & co., manufacturers of printing and lithographic inks, printers' rollers and composition. commercial st., and clay st., san francisco, cal. * * * * * the paper used in this book was furnished by * * * * * * * * the graham paper company, of st. louis. san francisco office, commercial street. _w. g. richardson, pacific coast manager._ * * * * * "copperine," the new type metal. the only perfect amalgam of tin, copper, antimony and lead. we call the special attention of printers to our new type metal, copperine which is the result of years of experiments. all of our type is now made of this new amalgam, and it is warranted to have better lasting qualities than any other type made in the united states, and with publishers who use perfecting presses and stereotype their forms, copperine type will soon be the favorite, as it will stand the stereotype process better than any type now in use. palmer & rey, portland, or. san francisco, cal. galveston, tex. pure water! pure water! the best water filter in the world is the [illustration] "gate city." the filtering medium is a natural stone, mined from the earth. it is unlike any other stone. impurities never penetrate it! it does not absorb and become foul. no metal in these filters to poison the water. "i have in use one of these filters. it gives perfect satisfaction; it is the best i have seen."--l. p. mccarty, san francisco, cal. send for catalogue. address, wiester & company, new montgomery st., _san francisco, cal._ manuf's and dealers in useful inventions. * * * * * [illustration: bethesda] pure, refreshing and health-giving water. so delicately proportioned in mineral qualities by nature as to make it agreeable and wholesome in health, and in cases of diabetes and bright's disease, or any disease affecting the kidneys, more benefit will be derived from it in hours than from any medicine known to science in three months. l. cahen & son, general agts. pacific coast, sacramento st., san francisco. pacific electric belt and truss company. [illustration: pacific electric pad truss in position ] rupture positively cured. a new invention. rupture in all forms successfully retained and cured. no interference with business. no surgical operation. no discomfort. absolutely safe. consultations free. satisfaction guaranteed. "i was cured of hernia of years' standing by the above-named truss."--l. p. mccarty. * * * * * holbrook's electric catarrh cure. one bottle positively cures the worst case; prompt, agreeable, convenient, effective. price, one dollar per bottle; sent by mail on receipt of price, and if not satisfactory the money refunded. * * * * * [illustration: duplex galvanic belt _for lady or gentleman_ ] the best in the world. the duplex galvanic belts, for the cure of general debility, nervous prostration, rheumatism, paralysis, constipation, and those troubles peculiar to ladies. call and read letters from all parts of the country, attesting their wonderful curative powers. * * * * * we also manufacture dr. sheerwood's electric abdominal supporters, for ladies. these garments are a boon to expectant mothers, during the period of gestation, and for the speedy cure of all ovarian and womb troubles, the perfect correcting of all cases of deranged menstruation, etc., etc. * * * * * send for descriptive catalogue, with hundreds of testimonials, free on application. address, pacific electric belt and truss co., stockton street, _san francisco, cal._ remington standard [illustration: type writer.] for fifteen years the standard, and constantly improving. the embodiment of all most valuable type-writer improvements of recent years, and excels all machines in speed, durability, and ease of manipulation. g. g. wickson & co., and front st., s. f., cal. * * * * * annual statistician and economist, _reviewed by the_ "argonaut," of s. f., april , . "mccarty's 'annual statistician.'--the fourteenth edition of 'the annual statistician and economist,' prepared by l. p. mccarty, has just been issued, bringing the record up to the fifth day of april, . this work deservedly ranks among the foremost statistical publications of the world, and is the most useful and valuable to californians, inasmuch as it treats most fully of local topic, as do macmillan's 'year book' of english affairs, the 'american almanac' of united states and new york affairs, etc. it is by no means a local publication, however; it summarizes the history of mankind--in war, politics, religion, education, science, and material progress--in wonderfully brief space, and it is so systematically arranged that, by table of contents or index, one may find almost any desired information on the widest possible range of knowledge at a moment's notice. it is arranged in four divisions: the united states, the political and military history of the union, the _personnel_ of the government, the distribution of population, and statistics of production, of illiteracy, of immigration, of export and import, etc.; the world, in which the other political divisions of the globe are similarly analyzed, though not so minutely; the practical, giving tables of mensuration, rapid methods of calculation, value of coins, and other facts about material things; and, the miscellany, in which are crowded what information could not well be included in the other chapters. as the 'annual statistician' is issued between march and june each year, it can summarize the reports of officials and other important sources of information which are not available for similar publications which appear soon after the end of the year, and to indicate the compiler's assiduity in his task, it may be mentioned that a leaf has been inserted in the present volume supplementing the record of events with a list of 'principal occurrences while binding,' including february and march. published by l. p. mccarty, san francisco; for sale by the book sellers; price, per cloth, $ . ; black leather, $ . ." waterhouse & lester, importers and dealers in hardwood lumber, carriage and wagon material, wheels, bodies, gears, axles, springs, tire steel, and carriage and wagon tops. pacific coast agents for crown shaft anti-rattlers and "always there" lubricant. to beale street, san francisco, cal. * * * * * gold, silver and nickel plating. [illustration] every description of metal goods, plated tableware, and all kinds of house goods repaired and plated equal to new. silver plated amalgam plates, for saving gold in quartz and placer mining. san francisco plating works, and mission street, san francisco, cal. _e. g. denniston, prop._ * * * * * [illustration] pacific --' saw manfg. co. saws of every description on hand and made to order. & fremont street, san francisco, cal. * * * * * duncan, and garcin & son's timber jacks; h. royer's lace leather; planing knives; curriers' knives. agents for c. b. paul's files. beamish custom-made shirts. importer and manufacturer of gents' furnishing goods, underwear, gloves, handkerchiefs, collars, etc. nucleus building, cor. market & third sts., _san francisco, california_. * * * * * bookkeeping, shorthand, type-writing, telegraphy, _penmanship, english branches, etc._ [illustration: pacific business college, post st. san francisco. ] individual instruction. no vacations. ladies admitted to all departments. _life scholarship, full business course,--$ ._ send for circular. t. a. robinson, m. a., president. * * * * * [illustration] a splendid stock of common sense shoes kept constantly on hand, superior goods only, at bedrock prices, at kast's, & market st., s. f. branch: broadway, oakland. the pacific mutual life insurance company of california, _ california st., san francisco_. geo. a. moore, president. geo. w. beaver, vice-pres. thos. bennet, supt. j. n. patton, secretary. s. m. marks, asst. sec. h. f. band, asst. supt. life and accident insurance. organized . assets, $ , , . paid on policy-holders' acct., $ , , . policy contracts unsurpassed. claims paid on presentation of satisfactory proof's. for policy holders the best legal organization. * * * * * w. w. montague & co. mantels, grates, tiles. brass, bronze, steel, and iron fire place trimmings. _warm air, hot water, and steam_ heating apparatus for warming churches, halls, school-houses, dwellings and public buildings. wrought steel ranges. -- market street, san francisco. * * * * * sherman, clay & co. importers, manuf's and jobbers. pianos. weber, estey, emerson, sold on installments at cash prices. guitars. c. f. martin, h. l. mason. fairbanks & cole banjos. bohman mandolines. organs. estey, story & clark, manufacturers of church pipe organs. band instruments. strings, accordions, and musical merchandise. sheet music, music books, etc., etc. corner kearny and sutter sts. san francisco, cal. [illustration: bird's-eye view of the celebrated hotel del monte, monterey, california.] transcriber's notes: page add missing period. ... its greatest velocity. if inanimate ... page add missing period. ... and beef at . page correct spelling: celler to cellar. ... not from the cellar itself or ... page correct spelling: unesthetic to unaesthetic. ... and, however unaesthetic, varnished. page correct spelling: succintly to succinctly. ... may find succinctly stated ... page correct spelling: shakspere's to shakespeare's. ... startling of shakespeare's plays, ... page change comma to period. ... of sanitary value, is disproved. few doctors ... page correct spelling: quaniny to quantity. ...with a sufficient quantity of cocoa ... page correct typo: in-instantly to instantly. page correct spelling: conjuctiva to conjunctiva. ... under the conjunctiva of an ... page correct spelling: tonsilitis to tonsillitis. =tonsillitis, quinsy,= page correct spelling: tonsilitis to tonsillitis. tonsillis, etc., ... a guide to health by mahatma gandhi _translated from the hindi_ by a. rama iyer, m.a. [illustration] s. ganesan., publisher, triplicane ... madras, s.e. contents page translator's note vii introduction part i: general chap. i. the meaning of health chap. ii. the human body chap. iii. air chap. iv. water chap. v. food chap. vi. how much and how many times should we eat? chap. vii. exercise chap. viii. dress chap. ix. sexual relations part ii: some simple treatments chap. i. air treatment chap. ii. water cure chap. iii. the use of earth chap. iv. fever and its cures chap. v. constipation, dysentery, etc. chap. vi. contagious diseases small-pox chap. vii. other contagious diseases chap. viii. maternity and child-birth chap. ix. care of child chap. x. accidents--drowning chap. xi. do --burns and scalds chap. xii. do --snake bite chap. xiii. do --scorpion-sting, etc. chap. xiv. conclusion translator's note in these days when the name of mahatma gandhi is identified with the momentous question of non-co-operation, it may come with a shock of surprise to most readers to be told that he is something of an authority on matters of health and disease as well. very few of us perhaps are aware that he is the author of quite an original little health-book in gujarati. those who think of him as a dreamy idealist or an unpractical visionary, with his head always in the clouds, will certainly be undeceived when they read this book replete from cover to cover with _practical_ observations on the most _practical_ question of health. his views are of course radically different from the ordinary views that find expression in the pages of such books; in many cases, indeed, his doctrines must be pronounced revolutionary, and will doubtless be regarded by a certain class of readers as wholly impracticable. even the most revolutionary of his doctrines, however, are based, not on the shifting quicksands of mere theory, but on the solid foundation of deep study, backed up by personal experience of nearly thirty years. he himself recognises that many of his views will hardly be accepted by the ordinary reader, but he has felt himself impelled by a stern sense of duty to give publicity to his convictions formed after so much of study and experience. some at least however, of those who read his book cannot help being profoundly influenced by it. such, at any rate, has been the case with me; and i have ventured to translate the book into english in the hope that others may also be benefitted likewise. i should perhaps explain that i am not a student of gujarati, the language of the original. i have used instead one of the two hindi versions of the book. i should also point out that i have not attempted a literal or close translation, but only _a very free rendering_ into english. in some cases, whole passages have been omitted; and occasionally only the general sense of a passage has been given. it is hoped, however, that, in no single instance has there been a _misinterpretation_ of the original words. i am aware that many errors might have crept in, as the translation had to be done in a hurry, and there was hardly anytime for revision. i hope to make a thorough revision of the book, in case a second edition is called for. national college, } trichinopoly, } a. rama iyer. july . } introduction for more than twenty years past i have been paying special attention to the question of health. while in england, i had to make my own arrangements for food and drink, and i can say, therefore, that my experience is quite reliable. i have arrived at certain definite conclusions from that experience, and i now set them down for the benefit of my readers. as the familiar saying goes, 'prevention is better than cure.' it is far easier and safer to prevent illness by the observance of the laws of health than to set about curing the illness which has been brought on by our own ignorance and carelessness. hence it is the duty of all thoughtful men to understand aright the laws of health, and the object of the following pages is to give an account of these laws. we shall also consider the best methods of cure for some of the most common diseases. as milton says, the mind can make a hell of heaven or a heaven of hell. so heaven is not somewhere above the clouds, and hell somewhere underneath the earth! we have this same idea expressed in the sanskrit saying, _mana êva manushayanâm kâranam bandha mokshayoh_--man's captivity or freedom is dependant on the state of his mind. from this it follows that whether a man is healthy or unhealthy depends on himself. illness is the result not only of our actions but also of our thoughts. as has been said by a famous doctor, more people die for fear of diseases like small-pox, cholera and plague than out of those diseases themselves. ignorance is one of the root-causes of disease. very often we get bewildered at the most ordinary diseases out of sheer ignorance, and in our anxiety to get better, we simply make matters worse. our ignorance of the most elementary laws of health leads us to adopt wrong remedies or drives us into the hands of the veriest quacks. how strange (and yet how true) it is that we know much less about things near at hand than things at a distance. we know hardly anything of our own village, but we can give by rote the names of the rivers and mountains of england! we take so much trouble to learn the names of the stars in the sky, while we hardly think it worth while to know the things that are in our own homes! we never care a jot for the splendid pageantry of nature before our very eyes, while we are so anxious to witness the puerile mummeries of the theatre! and in the same way, we are not ashamed to be ignorant of the structure of our body, of the way in which the bones and muscles, grow, how the blood circulates and is rendered impure, how we are affected by evil thoughts and passions, how our mind travels over illimitable spaces and times while the body is at rest, and so on. there is nothing so closely connected with us as our body, but there is also nothing perhaps of which our ignorance is so profound, or our indifference so complete. it is the duty of every one of us to get over this indifference. everyone should regard it as his bounden duty to know something of the fundamental facts concerning his body. this kind of instruction should indeed be made compulsory in our schools. at present, we know not how to deal with the most ordinary scalds and wounds; we are helpless if a thorn runs into our foot; we are beside ourselves with fright and dismay if we are bitten by an ordinary snake! indeed, if we consider the depth of our ignorance in such matters, we shall have to hang down our heads in shame. to assert that the average man cannot be expected to know these things is simply absurd. the following pages are intended for such as are willing to learn. i do not pretend that the facts mentioned by me have not been said before. but my readers will find here in a nutshell the substance of several books on the subject. i have arrived at my conclusions after studying these books, and after a series of careful experiments. moreover, those who are new to this subject will also be saved the risk of being confounded by the conflicting views held by writers of such books. one writer says for instance, that hot water is to be used under certain circumstances, while another writer says that, exactly under the same circumstances, cold water is to be used. conflicting views of this kind have been carefully considered by me, so that my readers may rest assured of the reliability of my own views. we have got into the habit of calling in a doctor for the most trivial diseases. where there is no regular doctor available, we take the advice of mere quacks. we labour under the fatal delusion that no disease can be cured without medicine. this has been responsible for more mischief to mankind than any other evil. it is of course, necessary that our diseases should be cured, but they cannot be cured _by medicines_. not only are medicines merely useless, but at times even positively harmful. for a diseased man to take drugs and medicines would be as foolish as to try to cover up the filth that has accumulated in the inside of the house. the more we cover up the filth, the more rapidly does putrefaction go on. the same is the case with the human body. illness or disease is only nature's warning that filth has accumulated in some portion or other of the body; and it would surely be the part of wisdom to allow nature to remove the filth, instead of covering it up by the help of medicines. those who take medicines are really rendering the task of nature doubly difficult. it is, on the other hand, quite easy for us to help nature in her task by remembering certain elementary principles,--by fasting, for instance, so that the filth may not accumulate all the more, and by vigorous exercise in the open air, so that some of the filth may escape in the form of perspiration. and the one thing that is supremely necessary is to keep our minds strictly under control. we find from experience that, when once a bottle of medicine gets itself introduced into a home, it never thinks of going out, but only goes on drawing other bottles in its train. we come across numberless human beings who are afflicted by some disease or other all through their lives in spite of their pathetic devotion to medicines. they are to-day under the treatment of this doctor, to-morrow of that. they spend all their life in a futile search after a doctor who will cure them for good. as the late justice stephen (who was for some time in india) said, it is really astonishing that drugs of which so little is known should be applied by doctors to bodies of which they know still less! some of the greatest doctors of the west themselves have now come to hold this view. sir astley cooper, for instance, admits that the 'science' of medicine is mostly mere guess-work; dr. baker and dr. frank hold that more people die of medicines than of diseases; and dr. masongood even goes to the extent of saying that more men have fallen victims to medicine than to war, famine and pestilence combined! it is also a matter of experience that diseases increase in proportion to the increase in the number of doctors in a place. the demand for drugs has become so widespread that even the meanest papers are sure of getting advertisements of quack medicines, if of nothing else. in a recent book on the patent medicines we are told that the fruit-salts and syrups, for which we pay from rs. to rs. , cost to their manufacturers only from a quarter of an anna to one anna! no wonder, then, that their compositions should be so scrupulously kept a secret. we will, therefore, assure our readers that there is absolutely no necessity for them to seek the aid of doctors. to those, however, who may not be willing to boycott doctors and medicines altogether, we will say, "as far as possible, possess your souls in patience, and do not trouble the doctors. in case you are forced at length to call in the aid of a doctor, be sure to get a good man; then, follow his directions strictly, and do not call in another doctor, unless by his own advice. but remember, above all, that the curing of your disease does not rest ultimately in the hands of any doctor." m. k. gandhi. a guide to health chapter i the meaning of health ordinarily that man is considered healthy who eats well and moves about, and does not resort to a doctor. but a little thought will convince us that this idea is wrong. there are many cases of men being diseased, in spite of their eating well and freely moving about. they are under the delusion that they are healthy, simply because they are too indifferent to _think_ about the matter. in fact, perfectly healthy men hardly exist anywhere over this wide world. as has been well said, only that man can be said to be really healthy, who has a sound mind in a sound body. the relation between the body and the mind is so intimate that, if either of them got out of order, the whole system would suffer. let us take the analogy of the rose-flower. its colour stands to its fragrance in the same way as the body to the mind or the soul. no one regards an artificial paper-flower as a sufficient substitute for the natural flower, for the obvious reason that the fragrance, which forms the essence of the flower, cannot be reproduced. so too, we instinctively honour the man of a pure mind and a noble character in preference to the man who is merely physically strong. of course, the body and the soul are both essential, but the latter is far more important than the former. no man whose character is not pure can be said to be really healthy. the body which contains a diseased mind can never be anything but diseased. hence it follows that a pure character is the foundation of health in the real sense of the term; and we may say that all evil thoughts and evil passions are but different forms of disease. thus considered, we may conclude that that man alone is perfectly healthy whose body is well formed, whose teeth as well as eyes and ears are in good condition, whose nose is free from dirty matter, whose skin exudes perspiration freely and without any bad smell, whose mouth is also free from bad smells, whose hands and legs perform their duty properly, who is neither too fat nor too thin, and whose mind and senses are constantly under his control. as has already been said, it is very hard to gain such health, but it is harder still to retain it, when once it has been acquired. the chief reason why we are not truly healthy is that our parents were not. an eminent writer has said that, if the parents are _in perfectly good condition_ their children would certainly be superior to them in all respects. a _perfectly healthy_ man has no reason to fear death; our terrible fear of death shows that we are far from being so healthy. it is, however, the clear duty of all of us to strive for perfect health. we will, therefore, proceed to consider in the following pages how such health can be attained, and how, when once attained, it can also be retained for ever. chapter ii the human body the world is compounded of the five elements,--earth, water, air, fire, and ether. so too is our body. it is a sort of miniature world. hence the body stands in need of all the elements in due proportion,--pure earth, pure water, pure fire or sunlight, pure air, and open space. when any one of these falls short of its due proportion, illness is caused in the body. the body is made up of skin and bone, as well as flesh and blood. the bones constitute the frame-work of the body; but for them we could not stand erect and move about. they protect the softer parts of the body. thus the skull gives protection to the brain, while the ribs protect the heart and the lungs. doctors have counted bones in the human body. the outside of the bones is hard, but the inside is soft and hollow. where there is a joint between two bones, there is a coating of marrow, which may be regarded as a soft bone. the teeth, too, are to be counted among the bones. when we feel the flesh at some points, we find it to be tough and elastic. this part of the flesh is known as the muscle. it is the muscles that enable us to fold and unfold our arms, to move our jaws, and to close our eyes. it is by means of the muscles, again, that our organs of perception do their work. it is beyond the province of this book to give a detailed account of the structure of the body; nor has the present writer enough knowledge to give such an account. we will, therefore, content ourselves with just as much information as is essential for our present purpose. the most important portion of the body is the stomach. if the stomach ceases to work even for a single moment, the whole body would collapse. the work of the stomach is to digest the food, and so to provide nourishment to the body. its relation to the body is the same as that of the steam engine to the railway train. the gastric juice which is produced in the stomach helps the assimilation of nutritious elements in the food, the refuse being sent out by way of the intestines in the form of urine and fæces. on the left side of the abdominal cavity is the spleen, while to the right of the stomach is the liver, whose function is the purification of the blood and the secretion of the bile, which is so useful for digestion. in the hollow space enclosed by the ribs are situated the heart and the lungs. the heart is between the two lungs, but more to the left than the right. there are on the whole bones in the chest; the action of the heart can be felt between the fifth and the sixth rib. the lungs are connected with the windpipe. the air which we inhale is taken into the lungs through the windpipe, and the blood is purified by it. it is of the utmost importance to breathe through the nose, instead of through the mouth. on the circulation of the blood depend all activities of the body. it is the blood that provides nourishment to the body. it extracts the nutritious elements out of the food, and ejects the refuse through the intestines, and so keeps the body warm. the blood is incessantly circulating all over the body, along the veins and the arteries. the beatings of the pulse are due to the circulation of the blood. the pulse of a normal adult man beats some times a minute. the pulses of children beat faster, while those of old men are slower. the chief agency for keeping the blood pure is the air. when the blood returns to the lungs after one complete round over the body, it is impure and contains poisonous elements. the oxygen of the air which we inhale purifies this blood and is assimilated into it, while the nitrogen absorbs the poisonous matter and is breathed out. this process goes on incessantly. as the air has a very important function to perform in the body, we shall devote a separate chapter to a detailed consideration of the same. chapter iii air of the three things that are indispensable for the subsistence of man,--namely, air, water, and food--the first is the most important. hence it is that god has created it in such large quantities as to make it available to all of us for nothing. modern civilisation, however, has rendered even fresh air somewhat costly, for, in order to breathe fresh air, we have to go out of towns, and this means expense. the residents of bombay, for instance, distinctly improve in health in the air of matheran or, still better, of the malabar hills; but they cannot go to these places without money. hence, in these days, it would be hardly true to say that we get fresh air _gratis_, as we used to in the old days. but, whether fresh air is available _gratis_ or not, it is undeniable that we cannot get on without it. we have already seen that the blood circulates over the body, returns to the lungs, and after being purified, starts on its round again. we breathe out the impure air, and take in oxygen from the outside, which purifies the blood. this process of inspiration and expiration goes on for ever, and on it depends man's life. when drowned in water we die, because, then we are unable to let out the impure air in the body and take in pure air from outside. the divers go down into the water in what is known as a diving bell, and they take in fresh air through a tube which leads to the top. hence it is that they are able to remain under water for a long time. it has been ascertained by experiments that no man can live without air for as long as five minutes. we often hear of the death of little children, when they are held so close to the bosom by ignorant mothers as to make it impossible for them to breathe. we should all be as much against the breathing of impure air as we are against the drinking of dirty water and the eating of dirty food; but the air we breathe is, as a rule, far more impure than the water we drink or the food we eat. we are all worshippers of concrete objects; those things that can be seen and felt are regarded by us as of far greater importance than those which are invisible and intangible. since air belongs to this latter class of objects, we fail to realise the evil wrought by the impure air that we breathe. we would think twice before eating the leavings of another man's food, or drinking out of a cup polluted by another man's lips. even those who have not the least sense of shame or repugnance would never eat another man's vomit, or drink the water which has been spat out by him; even those who are dying of hunger and thirst would refuse to do it. but, alas, how few of us realise that the air we inhale is so often the impure and poisonous air which has been exhaled by others, and which is surely no less objectionable than a man's vomit! how strange that men should sit and sleep together for hours in closed rooms, and go on inhaling the deadly air exhaled by themselves and their companions! how fortunate for man that air should be so light and diffusive, and capable of penetrating the smallest holes! even when the doors and windows are closed, there is generally some little space between the walls and the roof, through which some air from outside manages to get in, so that the inmates of the room have not to breathe exclusively poisoned air. the air that we exhale mixes with the air outside, and is rendered pure again by an automatic process that is always going on in nature. now we are able to understand why so many men and women should be weak and diseased. _there can be absolutely no doubt that impure air is the root-cause of disease in ninety-nine cases out of every hundred._ it follows that the best way of avoiding disease is to live and work in the open air. no doctor can compete with fresh air in this matter. consumption is caused by the decay of the lungs, due to the inhaling of impure air, just as a steam engine which is filled with bad coal gets out of order. hence doctors say that the easiest and the most effective treatment for a consumptive patient is to keep him in fresh air for all the hours of the day. it is, of course, essential to know how we can keep the air pure. in fact, every child should be taught the value of fresh air, as soon as it is able to understand anything. if my readers would take the trouble to learn the simple facts about the air and would put their knowledge into practice, while teaching their children also to do the same. i shall feel immensely gratified. our latrines are perhaps most responsible for rendering the air impure. very few people realise the serious harm done by dirty latrines. even dogs and cats make with their claws something like a pit wherein to deposit their fæces, and then cover it up with some earth. where there are no lavatories of the modern approved types, we should also do likewise. there should be kept ashes or dry earth in a tin can or an earthen vessel inside the latrine, and whoever goes into the latrine should, on coming out, cover the fæces well with the ash or the earth, as the case may be. if this is done there would be no bad smell, and the flies too will not settle on it and transmit the filth. anybody whose sense of smell has not been wholly blunted, or who has not grown thoroughly accustomed to foul smells will know how noxious is the smell that emanates from all filthy matter which is allowed to lie open to the weather. our gorge rises at the very thought of fæces being mixed with our food, but we go on inhaling the air which has been polluted by such foul smell, forgetting the fact that the one is just as bad as the other, except that, while the former is visible, the latter is not. we should see that our latrines are kept thoroughly neat and clean. we abhor the idea of our cleaning the latrines ourselves, but what we should really abhor is the idea of making use of dirty latrines. what is the harm in ourselves removing the filth which has been expelled from inside our own body, and which we are not ashamed to have removed by others? there is absolutely no reason why we should not ourselves learn the work of scavenging and teach it to our children as well. the filthy matter should be removed, and thrown into a pit two feet deep, and then covered up with a thick layer of earth. if we go to some open place, we should dig a small pit with our hands or feet, and then cover it up, after the bowels have been evacuated. we also make the air impure by making water at all places indiscriminately. this dirty habit should be given up altogether. if there is no place specially set apart for the purpose, we should go to some dry ground away from the house, and should also cover up the urine with earth. the filth should not be cast into very deep pits, for, in that case, it would be beyond the reach of sun's heat, and would also pollute the water flowing underneath the earth. the habit of spitting indiscriminately on the verandahs, court yards, and such like places is also very bad. the spittle, especially of consumptives, is very dangerous. the poisonous germs in it rise into the air, and, being inhaled by others, lead to a spread of the disease. we should keep a spittoon inside the house, and if we have to spit when out on the road we should spit where there is dry dust, so that the spittle may be absorbed into the dust and cause no harm. doctors hold that the consumptive should spit into a spittoon with some disinfectant in it: for, even if he spits on dry ground, the germs in his spittle manage to rise and spread into the air along with the dust. but, in any case, there can be no doubt that the habit of spitting wherever we please is dirty as well as dangerous. some people throw where they like cooked food and other articles, which decay and render the air impure. if all such rubbish be put underground, the air would not be made impure, and good manure, too could be obtained. in fact, no kind of decaying matter should be allowed to lie exposed to the air. it is so easy for us to take this necessary precaution, if only we are in earnest about it. now we have seen how our own bad habits render the air impure, and what we can do to keep it pure. next we shall consider how to inhale the air. as already mentioned in the last chapter, the air is to be inhaled through the nose, and not through the mouth. there are, however, very few persons who know how to breathe correctly. many people are in the pernicious habit of inhaling through the mouth. if very cold air is inhaled through the mouth, we catch cold and sore throat. further, if we inhale through the mouth, the particles of dust in the air go into the lungs and cause great mischief. in london, for instance, in november, the smoke which issues from the chimneys of great factories mixes with the dense fog, producing a kind of yellow mixture. this contains tiny particles of soot, which can be detected in the spittle of a man who inhales through the mouth. to escape this, many women (who have not learnt to breathe through the nose alone) put on a special kind of veil over their faces, which act as sieves. if these veils are closely examined, particles of dust can be detected in them. but god has given to all of us a sieve of this kind inside the nose. the air which is inhaled through the nostrils is sifted before it reaches the lungs, and is also warmed in the process. so all men should learn to breathe through the nose alone. and this is not at all difficult, if we remember to keep our mouth firmly shut at all times, except when we are talking. those who have got into the habit of keeping their mouth open should sleep with a bandage round the mouth, which would force them to breathe through the nose. they should also take some twenty long respirations in the open air, both in the morning and in the evening. in fact, all men can practise this simple exercise and see for themselves how rapidly their chest deepens. if the chest be measured at the beginning of the practice, and again after an interval of two months, it will be seen how much it has expanded in this short period. after learning how to inhale the air, we should cultivate the habit of breathing fresh air, day in and day out. we are generally in the most pernicious habit of keeping confined to the house or the office throughout the day, and sleeping in narrow rooms at night, with all doors and windows shut. as far as possible, we should remain in the open air at all times. we should at least _sleep_ on the verandah or in the open air. those who cannot do this should at least keep the doors and windows of the room fully open at all times. the air is our food for all the twenty-four hours of the day. why, then, should we be afraid of it? it is a most foolish idea that we catch cold by inhaling the cool breeze of the morning. of course, those people who have spoiled their lungs by the evil habit of sleeping within closed doors are likely to catch cold, if they change their habit all on a sudden. but even they should not be afraid of cold, for this cold can be speedily got rid of. now-a-days, in europe, the houses for consumptives are being built in such a way that they may get fresh air at all times. we know what terrible havoc is wrought in india by epidemics. we should remember that these epidemics are due to our habit of defiling the air, and of inhaling this poisonous air. we should understand that even the most delicate people will be benefitted by systematically inhaling fresh air. if we cultivate the habit of keeping the air pure and of breathing only fresh air, we can save ourselves from many a terrible disease. sleeping with the face uncovered is as essential as sleeping in fresh air. many of our people are in the habit of sleeping with the face covered, which means that they have to inhale the poisonous air which has been exhaled by themselves. fortunately however, some of the air from outside does find its way through the interstices of the cloth, else they should die of suffocation. but the small quantity of air that gains entrance in this way is altogether inadequate. if we are suffering from cold, we may cover the head with a piece of cloth, or put on a night-cap, but the nose should be kept exposed _under all circumstances_. air and light are so intimately connected with each other that it is as well to speak a few words here on the value of light. light is as indispensable to life as air itself. hence it is that hell is represented as completely dark. where light cannot penetrate, the air can never be pure. if we enter a dark cellar, we can distinctly perceive the smell of the foul air. the fact that we cannot see in the dark shows that god has intended us to live and move in the light. and nature has given us just as much darkness as we require in the night. yet, many people are in the habit of sitting or sleeping in underground cellars, devoid of air and light, even in the hottest summer! those who thus deprive themselves of air and light are always weak and haggard. now-a-days, there are many doctors in europe who cure their patients by means of air-bath and sun-bath alone. thousands of diseased persons have been cured by mere exposure to the air and to the sunlight. we should keep all doors and windows in our houses always open, in order to allow the free entrance of air and light. some readers may ask why, if air and light are so indispensable, those who live and work in cellars are not visibly affected. those who have thought well over the matter would never put this question. our aim should be to attain the maximum of health by all legitimate means; _we should not be content merely to live anyhow_. it has been indubitably established that insufficient air and light give rise to disease. dwellers in towns are, as a rule, more delicate than those in the country, for they get less air and light than the latter. air and light, then, are absolutely indispensable to health, and every one should remember all that we have said on the matter, and act up to it to the best of his ability. chapter iv water as has been already pointed out, air is the most indispensable to our subsistence, while water comes next in order. man cannot live for more than a few minutes without air, but he can live for a few days without water. and in the absence of other food, he can subsist on water alone for many days. there is more than % of water in the composition of our food-stuffs, as in that of the human body. even though water is so indispensable, we take hardly any pains to keep it pure. epidemics are as much the outcome of our indifference to the quality of the water we drink, as of the air we breathe. the drinking of dirty water very often produces also the disease of the stone. water may be impure in either of two ways,--by issuing from dirty places, or by being defiled by us. where the water issues from dirty places, we should not drink it at all; nor do we generally drink it. but we do not shrink from drinking the water which has been defiled by ourselves. river-water, for instance, is regarded as quite good for drinking, although we throw into it all sorts of rubbish, and also use it for washing purposes. we should make it a rule never to drink the water in which people bathe. the upper portion of a river should be set apart for drinking water, the lower being reserved for bathing and washing purposes. where there is no such arrangement, it is a good practice to dig in the sand, and take drinking water therefrom. this water is very pure, since it has been filtered by passage through the sand. it is generally risky to drink well-water, for unless it is well protected, the dirty water at the top would trickle down into the well, and render the water impure. further, birds and insects often fall into the water and die; sometimes birds build their nests inside the wells; and the dirt from the feet of those who draw water from the well is also washed down into the water. for all these reasons, we should be particularly careful in drinking well-water. water kept in tubs is also very often impure. if it should be pure, the tubs should be washed clean at frequent intervals, and should be kept covered; we should also see that the tank or well from which the water is taken is kept in good condition. very few people, however, take such precautions to keep the water pure. hence the best way of removing the impurities of the water is to boil it well, and, after cooling it, filter it carefully into another vessel through a thick and clean piece of cloth. our duty, however, does not end with this. we should realise that we owe a duty to our fellowmen in this matter. we should see to it that we do absolutely nothing to defile the water which is used for drinking by the public. we should scrupulously refrain from bathing or washing in the water which is reserved for drinking; we should never answer the calls of nature near the banks of a river, nor cremate the dead bodies there and throw the ashes after cremation into the water. in spite of all the care that we may take, we find it so difficult to keep water perfectly pure. it may have, for instance, salt dissolved in it, or bits of grass and other decaying matter. rain water is, of course, the purest, but, before it reaches us, it generally becomes impure by the absorption of the floating matter in the atmosphere. perfectly pure water has a most beneficial effect on the system; hence doctors administer distilled water to their patients. those who are suffering from constipation are appreciably benefitted by the use of distilled water. many people do not know that water is of two kinds, _soft_ and _hard_. hard water is water in which some kind of salt has been dissolved. hence, soap does not readily lather in it, and food cannot be easily boiled in it. its taste is brackish, while soft water tastes sweet. it is much safer to drink soft water, although some people hold that hard water is better by virtue of the presence of nutritious matter dissolved therein. rain water is the best kind of soft water, and is therefore, the best for drinking purposes. hard water, if boiled and kept over the fire for some half an hour, is rendered soft. then it may be filtered and drunk. the question is often asked, "when should one drink water, and how much?" the only safe answer to this is this: one should drink water only when one feels thirsty, and even then only just enough to quench the thirst. there is no harm in drinking water during the meals or immediately afterwards. of course, we should not wash the food down with water. if the food refuses to go down of itself, it means that either it has not been well prepared or the stomach is not in need of it. ordinarily, there is no need to drink water; and indeed, there _should_ be none. as already mentioned, there is a large percentage of water in our ordinary articles of food, and we also add water in cooking them. why then should we feel thirsty? those people whose diet is free from such articles as chillies and onions which create an artificial thirst, have rarely any need to drink water. those who feel unaccountably thirsty must be suffering from some disease or other. we may be tempted to drink any kind of water that we come across, simply because we see some people doing it with impunity. the reply to this has already been given in connection with air. our blood has in itself the power of destroying many of the poisonous elements that enter into it, but it has to be renewed and purified, just as the sharp edge of a sword has to be mended when it has been once employed in action. hence, if we go on drinking impure water, we should not be surprised to find our blood thoroughly poisoned in the end. chapter v food it is impossible to lay down hard and fast rules in the matter of food. what sort of food should we eat, how much of it should be eaten, and at what times,--these are questions on which doctors differ a great deal. the ways of men are so diverse, that the very same food shows different effects on different individuals. although, however, it is impossible to say conclusively what sort of food we should eat, it is the clear duty of every individual to bestow serious thought on the matter. needless to say, the body cannot subsist without food. we undergo all sorts of sufferings and privations for the sake of food. but, at the same time, it is indisputable that . % of men and women in the world eat merely to please the palate. they never pause to think of the after-effects at the time of eating. many people take purgatives and digestive pills or powders in order to be able to eat thoroughly well. then there are some people who, after eating to the utmost of their capacity, vomit out all that they have eaten, and proceed to eat the same stuffs once more! some people, indeed, eat so sumptuously that, for two or three days together, they do not feel hungry at all. in some cases, men have even been known to have died of over-eating. i say all this from my own experience. when i think of my old days, i am tempted to laugh at many things, and cannot help being ashamed of some things. in those days i used to have tea in the morning, breakfast two or three hours afterwards, dinner at one o'clock, tea again at p.m., and supper between and ! my condition at that time was most pitiable. there was a great deal of superfluous fat on my body, and bottles of medicine were always at hand. in order to be able to eat well, i used to take purgatives very often, as well as some tonic or other. in those days, i had not a _third_ of my present capacity for work, in spite of the fact that i was then in the prime of youth. such a life is surely pitiable, and if we consider the matter seriously, we must also admit it to be mean, sinful and thoroughly contemptible. man is not born to eat, nor should he live to eat. his true function is to know and serve his maker; but, since the body is essential to this service, we have perforce to eat. even atheists will admit that we should eat merely to preserve our health, and not more than is needed for this purpose. turn to the birds and beasts, and what do you find? they never eat merely to please the palate, they never go on eating till their inside is full to overflowing. on the other hand, they eat only to appease their hunger, and even then only just as much as will appease their hunger. they take the food provided by nature, and do not cook their food. can it be that man alone is created to worship the palate? can it be that he alone is destined to be eternally suffering from disease? those animals that live a natural life of freedom never once die of hunger. among them there are no distinctions of rich and poor,--of those who eat many times a day, and those who do not get even one meal in the day. these abnormalities are found only among us human beings,--and yet we regard ourselves as superior to the animal creation! surely those who spend their days in the worship of their stomach are worse than the birds and beasts. a calm reflection will show that all sins like lying, cheating and stealing are ultimately due to our subjection to the palate. he who is able to control the palate, will easily be able to control the other senses. if we tell lies, or commit theft or adultery, we are looked down upon by society, but, strangely enough, no odium attaches to those who slavishly pander to the palate! it would seem as though this were not a question of morality at all! the fact is that even the best of us are slaves to the palate. no one has yet adequately emphasised the numberless evils that arise from our habit of pandering to the palate. all civilised people would boycott the company of liars, thieves, and adulterers; but they go on eating beyond all limits, and never regard it as a sin at all. pandering to the palate is not regarded by us as a sin, since all of us are guilty of it, just as dacoity is not regarded as a crime in a village of dacoits; but what is worse, we pride ourselves on it! on occasions of marriage and other festivities, we regard it as a sacred duty to worship the palate; even in times of funeral, we are not ashamed of doing it. has a guest come? we must gorge him with sweetmeats. if, from time to time, we do not give feasts to our friends and relations, or do not partake of the feasts given by them, we must become objects of contempt. if, having invited our friends to eat with us, we fail to cram them with rich stuffs, we must be regarded as miserly. on holidays, of course, we must have specially rich food prepared! indeed, what is really a great sin has come to be looked upon as a sign of wisdom! we have sedulously cultivated such false notions in the matter of eating that we never realise our slavishness and our beastliness. how can we save ourselves from this terrible state? let us view the question from another standpoint. we find it invariably the case in the world that nature herself has provided for all creatures, whether man or beast, or bird or insect, just enough food for their sustenance. this is an eternal law of nature. in the kingdom of nature, none goes to sleep, none forgets to do his duty, and none shows a tendency to laziness. all the work is done to perfection, and punctually to the minute. if we remember to order our lives strictly in accordance with the immutable and eternal laws of nature, we shall find that there are no more deaths by starvation anywhere over the wide world. since nature always provides just enough food to feed all created beings, it follows that he who takes to himself more than his normal share of food, is depriving another of his legitimate share. is it not a fact, that, in the kitchens of emperors and kings, of all rich men, in general, much more food is prepared than is required to feed them and all their dependents? that is to say, they snatch so much food from the share of the poor. is it, then, any wonder that the poor should die of starvation? if this is true (and this fact has been admitted by the most thoughtful men) it must necessarily follow that all the food that we eat beyond our immediate need is food filched from the stomachs of the poor. and to the extent to which we eat merely with a view to pleasing the palate must our health necessarily suffer. after this preliminary discussion, we can proceed to consider what kind of food is best for us. before, however, we decide the question of the ideal food for us, we have to consider what kinds of food are injurious to health, and to be avoided. under the term "food", we include all the things that are taken into the body through the mouth,--including _wine_, _bhang_ and _opium_, _tobacco_, _tea_, _coffee and cocoa_, _spices_ and _condiments_. i am convinced that all these articles have to be completely eschewed, having been led to this conviction partly from my own experience, and partly from the experiences of others. wine, bhang and opium have been condemned by all the religions of the world, although the number of total abstainers is so limited. drink has brought about the ruin of whole families. the drunkard forfeits his sanity; he has even been known to forget the distinction between mother, wife and daughter. his life becomes a mere burden to him. even men of sound sense become helpless automatons when they take to drink; even when not actually under its influence, their minds are too impotent to do any work. some people say that wine is harmless when used as medicine, but even european doctors have begun to give up this view in many cases. some partisans of drink argue that, if wine can be used as medicine with impunity, it can also be used as drink. but many poisons are employed as medicines; do we ever dream of employing them as food? it is quite possible that, in some diseases, wine may do some good, but even then, no sensible, or thoughtful man should consent to use it _even as medicine_, under any circumstances. as for opium, it is no less injurious than wine, and is to be equally eschewed. have we not seen a mighty nation like the chinese falling under the deadly spell of opium, and rendering itself incapable of maintaining its independence? have we not seen the _jagirdars_ of our own land forfeiting their _jagirs_ under the same fatal influence? so powerful is the spell that has been woven over the minds of men by tobacco that it will take an age to break it. young and old have equally come under this fatal spell. even the best men do not shrink from the use of tobacco. its use, indeed, has become a matter of course with us, and is spreading wider and wider every day. very few people are aware of the many tricks employed by the cigarette-manufacturers to bring us more and more under its influence. they sprinkle opium or some perfumed acid on the tobacco, so that we may find it all the more difficult to extricate ourselves from its clutches. they spend thousands of pounds in advertisements. many european firms dealing in cigars keep their own presses, have their own cinemas, institute lotteries, and give away prizes, and, in short, spend money like water to achieve their end. even women have now begun to smoke. and poems have been composed on tobacco, extolling it as the great friend of the poor! the evils of smoking are too numerous to mention. the habitual smoker becomes such a bond slave to it that he knows no sense of shame or compunction; he proceeds to emit the foul fumes even in the houses of strangers! it is also a matter of common experience that smokers are often tempted to commit all sorts of crimes. children steal money from their parents' purses; and even the prisoners in gaols manage to steal cigarettes and keep them carefully concealed. the smoker will get on without food, but he cannot dispense with his smoke! soldiers on the field of battle have been known to lose all capacity for fighting for failure of the indispensable cigarette at the critical moment. the late count leo tolstoi of russia tells us the following story. a certain man once took it into his head, for some reason, to murder his wife. he actually drew the knife and was about to do the deed, when he felt some compunction, and gave it up. then he sat down to smoke and his wits being turned under the influence of tobacco, he rose once more and actually committed the murder. tolstoi held the view that the poison of tobacco is more subtle and irresistible, and hence far more dangerous, than that of wine. then the money that is spent on cigars and cigarettes by individuals is frightfully large. i have myself come across instances of cigars consuming as much as rs. a month for one man! smoking also leads to an appreciable reduction of digestive powers. the smoker feels no appetite for food, and in order to give it some flavour, spices and condiments have to be freely used. his breath stinks, and, in some cases, blisters are formed on his face, and the gums and teeth turn black in colour. many also fall a prey to terrible diseases. the fumes of tobacco befoul the air around, and public health suffers in consequence. i cannot understand how those who condemn drink can have the temerity to defend smoking. the man who does not eschew tobacco in all its forms can never be perfectly healthy, nor can he be a man of pure and blameless character. i must say that tea, coffee and cocoa are equally injurious to health, although i know that very few are likely to agree with me. there is a kind of poison in all of them; and, in the case of tea and coffee, if milk and sugar were not added, there would be absolutely no nutritious element in them. by means of repeated and varied experiments it has been established that there is nothing at all in these articles which is capable of improving the blood. until a few years ago, we used to drink tea and coffee only on special occasions, but to-day they have become universally indispensable. things have come to such a pass that even sickly persons often use them as substitutes for nourishing food! fortunately for us, the costliness of cocoa has prevented its spread to the same extent as tea and coffee, although, in the homes of the rich, it is quite liberally used. that all these three articles are poisonous can be seen from the fact that those who once take to them can never afterwards get on without them. in the old days, i myself used to feel a distinct sense of weariness or langour if i did not get my tea punctually at the usual hour. once some women and children had gathered together at a certain celebration. the executive committee had resolved against providing tea to the visitors. the women, however, that had assembled there, were in the habit of taking tea at o'clock every evening. the authorities were informed that, if these women were not given their usual tea, they would be too ill to move about, and, needless to say, they had to cancel their original resolution! but some slight delay in the preparation of the tea led to a regular uproar, and the commotion subsided only after the women had had their cup of tea! i can vouch for the authenticity of this incident. in another instance, a certain woman had lost all her digestive powers under the influence of tea, and had become a prey to chronic headaches; but from the moment that she gave up tea her health began steadily to improve. a doctor of the battersea municipality in england has declared, after careful investigation, that the brain-tissues of thousands of women in his district have been diseased from excessive use of tea. i have myself come across many instances of health being ruined by tea. coffee does some good against _kapha_ (phlegm) and _vatha_ ('wind'), but at the same time it weakens the body by destroying the vital fluid, and by making the blood as thin as water. to those people who advocate coffee on the ground that it is beneficial against "phlegm" and "wind", we would recommend the juice of ginger as even better for the purpose. and, on the other hand, let us remember that the evil effects of coffee are too serious to be counter-balanced by its good. when the blood and the vital fluid are poisoned by a stuff, can there be any hesitation in giving it up altogether? cocoa is fully as harmful as coffee, and it contains a poison which deadens the perceptions of the skin. those people who recognise the validity of moral considerations in these matters should remember that tea, coffee and cocoa are prepared mostly by labourers under indenture, which is only a fine name for slavery. if we saw with our own eyes the oppressive treatment that is meted out to the labourers in cocoa plantations, we should never again make use of the stuff. indeed, if we enquire minutely into the methods of preparation of all our articles of food, we shall have to give up % of them! a harmless and healthy substitute for coffee (tea or cocoa) can be prepared as follows. even habitual coffee-drinkers will be unable to perceive any difference in taste between coffee and this substitute. good and well-sifted wheat is put into a frying-pan over the fire and well fried, until it has turned completely red, and begun to grow dark in colour. then it is powdered just like coffee. a spoon of the powder is then put into a cup, and boiling water poured on to it. preferably keep the thing over the fire for a minute, and add milk and sugar, if necessary, and you get a delicious drink, which is much cheaper and healthier than coffee. those who want to save themselves the trouble of preparing this powder may get their supply from the _satyagraha ashram, ahmedabad_. from the point of view of diet, the whole mankind may be divided into _three_ broad divisions. ( ) the first class, which is the largest, consists of those who, whether by preference or out of necessity, live on an exclusive vegetable diet. under this division come the best part of india, a large portion of europe, and china and japan. the staple diet of the italians is macaroni, of the irish potato, of the scotch oatmeal, and of the chinese and japanese rice. ( ) the second class consists of those who live on a mixed diet. under this class come most of the people of england, the richer classes of china and japan, the richer mussalmans of india, as well as those rich hindus who have no religious scruples about taking meat. ( ) to the third class belong the uncivilised peoples of the frigid zones, who live on an exclusive meat diet. these are not very numerous, and they also introduce a vegetable element into their diet, wherever they come in contact with the civilised races of europe. man, then, can live on three kinds of diet; but it is our duty to consider which of these is the healthiest for us. an examination of the structure of the human body leads to the conclusion that man is intended by nature to live on a vegetable diet. there is the closest affinity between the organs of the human body and those of the fruit-eating animals. the monkey, for instance, is so similar to man in shape and structure, and it is a fruit-eating animal. its teeth and stomach are just like the teeth and stomach of man. from this we may infer that man is intended to live on roots and fruits, and not on meat. scientists have found out by experiments that fruits have in them all the elements that are required for man's sustenance. the plantain, the orange, the date, the grape, the apple, the almond, the walnut, the groundnut, the cocoanut,--all these fruits contain a large percentage of nutritious elements. these scientists even hold that there is no need for man to cook his food. they argue that he should be able to subsist very well on food cooked by the sun's warmth, even as all the lower animals are able to do; and they say that the most nutritious elements in the food are destroyed in the process of cooking, and that those things that cannot be eaten uncooked could not have been intended for our food by nature. if this view be correct, it follows that we are at present wasting a lot of our precious time in the cooking of our food. if we could live on uncooked food alone, we should be saving so much time and energy, as well as money, all of which may be utilised for more useful purposes. some people will doubtless say that it is idle and foolish to speculate on the possibility of men taking to uncooked food, since there is absolutely no hope of their ever doing it. but we are not considering at present what people will or will not do, but only what they _ought_ to do. it is only when we know what the ideal kind of diet is that we shall be able more and more to approximate our actual to the ideal. when we say that a fruit-diet is the best, we do not, of course, expect all men to take to it straightway. we only mean that, _if_ they should take to this diet, it would be the best thing for them. there are many men in england who have tried a pure fruit-diet, and who have recorded the results of their experience. they were people who took to this diet, not out of religious scruples, but simply out of considerations of health. a german doctor has written a bulky volume on the subject, and established the value of a fruit-diet by many arguments and evidences. he has cured many diseases by a fruit-diet combined with open-air life. he goes so far as to say that the people of any country can find all the elements of nutrition in the fruits of their own land. it may not be out of place to record my own experience in this connection. for the last six months i have been living exclusively on fruits--rejecting even milk and curd. my present dietary consists of plantain, groundnut and olive oil, with some sour fruit like the lime. i cannot say that my experiment has been altogether a success, but a period of six months is all too short to arrive at any definite conclusions on such a vital matter as a complete change of diet. this, however, i can say, that, during this period, i have been able to keep well where others have been attacked by disease, and my physical as well as mental powers are now greater than before. i may not be able to lift heavy loads, but i can now do hard labour for a much longer time without fatigue. i can also do more mental work, and with better persistence and resoluteness. i have tried a fruit-diet on many sickly people, invariably with great advantage. i shall describe these experiences in the section on diseases. here i will only say that my own experience, as well as my study of the subject, has confirmed me in the conviction that a fruit-diet is the best for us. as i have already confessed, i do not think for a moment that people will take to a fruit-diet as soon as they read this. it may even be that all that i have written has no effect at all on a single reader, but i believe it to be my bounden duty to set down what i hold to be the right thing to the best of my light. if however, anybody does wish to try a fruit-diet, he should proceed rather cautiously in order to obtain the best results. he should carefully go through all the chapters of this book, and fully grasp the fundamental principles, before he proceeds to do anything in practice. my request to my readers is that they should reserve their final judgments until they have read through all that i have got to say. a vegetable diet is the best after a fruit-diet. under this term we include all kinds of pot-herbs and cereals, as well as milk. vegetables are not as nutritious as fruits, since they lose part of their efficacy in the process of cooking. we cannot, however, eat uncooked vegetables. we will now proceed to consider which vegetables are the best for us. wheat is the best of all the cereals. man can live on wheat alone, for in it we have in due proportion all the elements of nutrition. many kinds of edibles can be made of wheat, and they can all be easily digested. the ready-made foods for children that are sold by chemists are also made partly of wheat. millet and maize belong to the same genus, and cakes and loaves can also be made out of them, but they are inferior to wheat in their food-value. we will now consider the best form in which wheat may be taken. the white "mill flour" that is sold in our bazars is quite useless; it contains no nutriment at all. an english doctor tells us that a dog which was fed solely on this flour died, while other dogs which were fed on better flour remained quite healthy. there is a great demand for loaves made of this flour, since men eat merely to satisfy their palate, and are rarely moved by considerations of health. these loaves are devoid of taste and nutriment, as well as of softness. they become so hard that they cannot be broken by the hand. _the best form of flour is that which is made of well-sifted wheat in the grind-mill at home._ this flour should be used without further sifting. loaves made of it are quite sweet to the taste, as well as quite soft. it also lasts for a longer time than the "mill flour", since it is far more nutritious, and may be used in smaller quantities. the loaf sold in the bazars is thoroughly useless. it may be quite white and attractive in appearance, but it is invariably adulterated. the worst of it is that it is made by fermentation. many persons have testified from experience that fermented dough is harmful to health. further, these loaves being made by besmearing the oven with fat, they are objectionable to hindu as well as mussalman sentiment. to fill the stomach with these bazar loaves instead of preparing good loaves at home is at best a sign of indolence. another and an easier way of taking wheat is this. wheat is ground into coarse grain, which is then well cooked and mixed with milk and sugar. this gives a very delicious and healthy kind of food. rice is quite useless as a food. indeed, it is doubtful if men can subsist upon mere rice, to the exclusion of such nutritious articles as _dhall_, _ghee_ and milk. this is not the case with wheat, for man can retain his strength by living on mere wheat boiled in water. we eat the pot-herbs mainly for their taste. as they have laxative powers, they help to purify the blood up to a limit. yet they are but varieties of grass, and very hard to digest. those who partake too much of them have flabby bodies; they suffer very often from indigestion, and go about in search of digestive pills and powders. hence, if we take them at all, we should do so in moderation. all the many varieties of pulse are very heavy, and hard of digestion. their merit is that those who eat them do not suffer from hunger for a long time; but they also lead to indigestion in most cases. those who do hard labour may be able to digest them, and derive some good out of them. but we who lead a sedentary life should be very chary of eating them. dr. haig, a celebrated writer in england, tells us, on the basis of repeated experiments, that the pulses are injurious to health, since they generate a kind of acid in the system, which leads to several diseases, and a premature old age. his arguments need not be given here, but my own experience goes to confirm his view. those, however, who are unable or unwilling to eschew the pulses altogether, should use them with great caution. almost everywhere in india, the spices and condiments are freely used, as nowhere else in the whole world. even the african negroes dislike the taste of our _masala_, and refuse to eat food mixed with it. and if the whites eat _masala_, their stomach gets out of order, and pimples also appear on their faces, as i have found from my own experience. the fact is that _masala_ is by no means savoury in itself, but we have so long been accustomed to its use that its flavour appeals to us. but, as has been already explained, it is wrong to eat anything for its mere taste. how comes it, then, that _masala_ is so freely eaten by us? admittedly, in order to help the digestion, and to be able to eat more. pepper, mustard, coriander and other condiments have the power of artificially helping the digestion, and generating a sort of artificial hunger. but it would be wrong to to infer from this that all the food has been thoroughly digested, and assimilated into the system. those who take too much of _masala_ are often found to suffer from anaemia, and even from diarrhea. i know a man who even died in the prime of youth out of too much eating of pepper. hence it is quite necessary to eschew all condiments altogether. what has been said of _masala_ applies also to salt. most people would be scandalised at this suggestion, but it is a fact established by experience. there is a school in england who even hold the view that salt is more harmful than most condiments. as there is enough of salt in the composition of the vegetables we use, we need not put any extra salt into them. nature herself has provided just as much salt as is required for the upkeep of our health. all the extra salt that we use is quite superfluous; all of it goes out of the body again in the form of perspiration, or in other ways, and no portion of it seems to have any useful function to perform in the body. one writer even holds that salt poisons the blood. he says that those who use no salt at all have their blood so pure that they are not affected even by snake-bite. we do not know if this is a fact or not, but this much we know from experience, that, in several diseases like piles and asthama, the disuse of salt at once produces appreciably beneficial results. and, on the other hand, i have not come across a single instance of a man being any the worse for not using salt. i myself left off the use of salt two years ago, and i have not only not suffered by it, but have even been benefitted in some respects. i have not now to drink as much water as before, and am more brisk and energetic. the reason for my disuse of salt was a very strange one: for it was occasioned by the illness of somebody else! the person whose illness led to it did not get worse after that, but remained in the same condition; and it is my faith that, if only the diseased person himself had given up the use of salt, he would have recovered completely. those who give up salt will also have to give up vegetables and _dhall_. this is a very hard thing to do, as i have found from many tests. i am convinced that vegetables and _dhall_ cannot be properly digested without salt. this does not, of course, mean that salt improves the digestion, but it only _appears_ to do so, just as pepper does, although ultimately it leads to evil consequences. of course, the man who entirely gives up the use of salt may feel out of sorts for a few days; but, if he keeps up his spirits, he is bound to be immensely benefitted in the long run. i make bold to regard even milk as one of the articles to be eschewed! this i do on the strength of my own experience which, however, need not be described here in detail. the popular idea of the value of milk is a pure superstition, but it is so deep-rooted that it is futile to think of removing it. as i have said more than once, i do not cherish the hope that my readers will accept all my views; i do not even believe that all those who accept them in theory will adopt them in practice. nevertheless, i think it my duty to speak out what i believe to be the truth, leaving my readers to form their own judgments. many doctors hold the view that milk gives rise to a kind of fever, and many books have been written in support of this view. the disease bearing germs that live in the air rapidly gain an entrance into the milk, and render it poisonous, so that it is very difficult to keep milk in a state of perfect purity. in africa elaborate rules have been laid down for the conduct of the dairies, saying how the milk should be boiled and preserved, how the vessels should be kept clean, and so on. when so much pains have to be taken in this matter, it is certainly to be considered how far it is worth while to employ milk as an article of food. moreover, the purity or otherwise of the milk depends upon the cow's food, and the state of its health. doctors have testified to the fact that those who drink the milk of consumptive cows fall a prey to consumption themselves. it is very rare to come across a cow that is perfectly healthy. that is to say, perfectly pure milk is very hard to obtain, since it is tainted at its very source. everybody knows that a child that sucks the breast of its mother contracts any disease that she might be suffering from. and often when a little child is ill, medicine is administered to its mother, so that its effect might reach the child through the milk of her breast. just in the same way, the health of the man who drinks the milk of a cow will be the same as that of the cow itself. when the use of milk is fraught with so much danger, would it not be the part of wisdom to eschew it altogether, especially when there are excellent substitutes? olive oil, for instance serves this purpose to some extent; and sweet almond is a most efficient substitute. the almond is first soaked in hot water, and its husk removed. then it is well crushed, and mixed thoroughly well with water. this gives a drink which contains all the good properties of milk, and is at the same time free from its evil effects. now let us consider this question from the point of view of natural law. the calf drinks its mother's milk only until its teeth have grown; and it begins to eat as soon as it has its teeth. clearly, this is also what man is intended to do. nature does not intend us to go on drinking milk after we have ceased to be infants. we should learn to live on fruits like the apple and the almond, or on wheat _roti_, after we have our teeth. although this is not the place to consider the saving in money that might be effected by giving up milk, it is certainly a point to be kept in mind. nor is there any need for any of the articles produced from milk. the sourness of lime is quite a good substitute for that of buttermilk; and as for _ghee_, thousands of indians manage with oil even now. a careful examination of the structure of the human body shows that meat is not the natural food of man. dr. haig and dr. kingsford have very clearly demonstrated the evil effects of meat on the body of man. they have shown that meat generates just the same kind of acid in the body as the pulses. it leads to the decay of the teeth, as well as to rheumatism; it also gives rise to evil passions like anger, which, as we have already seen, are but forms of disease. to sum up, then, we find that those who live on fruits alone are very rare, but it is quite easy to live on a combination of fruits, wheat and olive oil, and it is also eminently conducive to sound health. the plantain comes easy first among the fruits; but the date, the grape, the plum and the orange, to name only a few, are all quite nourishing, and may be taken along with the _roti_. the _roti_ does not suffer in taste by being besmeared with olive oil. this diet dispenses with salt, pepper, milk and sugar, and is quite simple and cheap. it is, of course, foolish to eat sugar for its own sake. too much sweetmeat weakens the teeth, and injures the health. excellent edibles can be made of wheat and the fruits, and a combination of health and taste secured. the next question to consider is how much food should be taken, and how many times a day. but, as this is a subject of vital importance, we will devote a separate chapter to it. chapter vi how much and how many times should we eat? there is a great divergence of opinion among doctors as to the quantity of food that we should take. one doctor holds that we should eat to the utmost of our capacity, and he has calculated the quantities of different kinds of food that we can take. another holds the view that the food of labourers should differ in quantity as well as in quality from that of persons engaged in mental work, while a third doctor contends that the prince and the peasant should eat exactly the same quantity of food. this much, however, will be generally admitted, that the weak cannot eat just as much as the strong. in the same way, a woman eats less than a man, and children and old men eat less than young men. one writer goes so far as to say that, if only we would masticate our food thoroughly well, so that every particle of it is mixed with the saliva, then we should not have to eat more than five or ten tolas of food. this he says on the basis of numberless experiments, and his book has been sold in thousands. all this shows that it is futile to think of prescribing the quantity of food for men. most doctors admit that % of human beings eat more than is needed. indeed, this is a fact of everyday experience, and does not require to be proclaimed by any doctor. there is no fear at all of men ruining their health by eating _too little_; and the great need is for a reduction in the quantity of food that we generally take. as said above, it is of the utmost importance to masticate the food thoroughly well. by so doing, we shall be able to extract the maximum of nutriment from the minimum of food. experienced persons point out that the fæces of a man whose food is wholesome, and who does not eat too much, will be small in quantity, quite solid and smooth, dark in colour, and free from all foul smell. the man who does not have such fæces should understand that he has eaten too much of unwholesome food, and has failed to masticate it well. also, if a man does not get sleep at night, or if his sleep be troubled by dreams, and if his tongue be dirty in the morning, he should know that he has been guilty of excessive eating. and if he has to get up several times at night to make water, it means that he has taken too much liquid food at night. by these and other tests, every man can arrive at the exact quantity of food that is needed for him. many men suffer from foul breath, which shows that their food has not been well digested. in many cases, again, too much eating gives rise to pimples on the face, and in the nose; and many people suffer from wind in the stomach. the root of all these troubles is, to put it plainly, that we have converted our stomach into a latrine, and we carry this latrine about with us. when we consider the matter in a sober light, we cannot help feeling an unmixed contempt for ourselves. if we want to avoid the sin of over-eating, we should take a vow never to have anything to do with feasts of all kinds. of course, we should feed those who come to us as guests, but only so as not to violate the laws of health. do we ever think of inviting our friends to clean their teeth with us, or to take a glass of water? is not eating as strictly a matter of health as these things? why, then, should we make so much fuss about it? we have become such gluttons by habit that our tongues are ever craving for abnormal sensations. hence we think it a sacred duty to cram our guests with rich food, and we cherish the hope that they will do likewise for us, when their turn comes! if, an hour after eating, we ask a clean-bodied friend to smell our mouth, and if he should tell us his exact feelings, we should have to hide our heads in utter shame! but some people are so shameless that they take purgatives soon after eating, that they might be able to eat still more or they even vomit out what they have eaten in order to sit down again to the feast at once! since even the best of us are more or less guilty of over-eating, our wise forefathers have prescribed frequent fasts as a religious duty. indeed, merely from the point of view of health, it will be highly beneficial to fast at least once a fortnight. many pious hindus take only one meal a day during the rainy season. this is a practice based upon the soundest hygienic principles. for, when the air is damp and the sky cloudy, the digestive organs are weaker than usual, and hence there should be a reduction in the quantity of food. and now we will consider how may meals we may take in the day. numberless people in india are content with only two meals. those who do hard labour take three meals, but a system of four meals has arisen after the invention of english medicines! of late, several societies have been formed in england and in america in order to exhort the people to take only two meals a day. they say that we should not take a breakfast early in the morning, since our sleep itself serves the purpose of the breakfast. as soon as we get up in the morning we should prepare to work rather than to eat. we should take our meal only after working for three hours. those who hold these views take only two meals a day, and do not even take tea in the interval. an experienced doctor by name deway has written an excellent book on fasting, in which he has shown the benefits of dispensing with the breakfast. i can also say from my experience that there is absolutely no need to eat more than twice, for a man who has passed the period of youth, and whose body has attained its fullest growth. chapter vii exercise exercise is as much of a vital necessity for man as air, water and food, in the sense that no man who does not take exercise regularly, can be perfectly healthy. by "exercise" we do not mean merely walking, or games like hockey, football, and cricket; we include under the term all physical and mental activity. exercise, even as food, is as essential to the mind as to the body. the mind is much weakened by want of exercise as the body, and a feeble mind is, indeed, a form of disease. an athlete, for instance, who is an expert in wrestling, cannot be regarded as a really _healthy_ man, unless his mind is equally efficient. as already explained, "a sound mind in a sound body" alone constitutes true health. which, then, are those exercises which keep the body and the mind equally efficient? indeed, nature has so arranged it that we can be engaged in physical as well as mental work at the same time. the vast majority of men on earth live by field-labour. the farmer has to do strenuous bodily exercise at any cost, for he has to work for or hours, or sometimes even more, in order to earn his bread and clothing. and efficient labour is impossible unless the mind is also in good condition. he has to attend to all the many details of cultivation; he must have a good knowledge of soils and seasons, and perhaps also of the movements of the sun, the moon, and the stars. even the ablest men will be beaten by the farmer in these matters. he knows the state of his immediate surroundings thoroughly well, he can find the directions by looking at the stars in the night, and tell a great many things from the ways of birds and beasts. he knows, for instance, that rain is about to fall when a particular class of birds gather together, and begin to make noise. he knows as much of the earth and the sky as is necessary for his work. as he has to bring up his children, he must know something of _dharma sastra_. since he lives under the broad open sky, he easily realises the greatness of god. of course, all men cannot be farmers, nor is this book written for them. we have however, described the life of the farmer, as we are convinced that it is the _natural life_ for man. to the extent to which we deviate from these natural conditions must we suffer in health. from the farmer's life we learn that we should work for at least hours a day, and it should involve mental work as well. merchants and others leading a sedentary life have indeed, to do some mental work, but their work is too one-sided and too inadequate to be called _exercise_. for such people the wise men of the west have devised games like cricket and football, and such minor games as are played at parties and festive gatherings. as for mental work the reading of such books as involve no mental strain is prescribed. no doubt these games do give exercise to the body, but it is a question if they are equally beneficial to the mind. how many of the best players of football and cricket are men of superior mental powers? what have we seen of the mental equipment of those indian princes who have earned a distinction as players? on the other hand, how many of the ablest men care to play these games? we can affirm from our experience that there are very few players among those who are gifted with great mental powers. the people of england are extremely fond of games, but their own poet, kipling, speaks very disparagingly of the mental capacity of the players. here in india, however, we have chosen quite a different path! our men do arduous mental work, but give little or no exercise to the body. their bodies are enfeebled by excessive mental strain, and they fall a prey to serious diseases; and just when the world expects to benefit by their work, they bid it eternal farewell! our work should be neither exclusively physical nor exclusively mental, nor such as ministers merely to the pleasure of the moment. the ideal kind of exercise is that which gives vigour to the body as well as to the mind; only such exercise can keep a man truly healthy, and such a man is the farmer. but what shall he do who is no farmer? the exercise which games like the cricket give is too inadequate, and something else has to be devised. the best thing for ordinary men would be to keep a small garden near the house, and work in it for a few hours every day. some may ask, "what can we do if the house we live in be not our own?" this is a foolish question to ask, for, whoever may be the owner of the house, he cannot object to his ground being improved by digging and cultivation. and we shall have the satisfaction of feeling that we have helped to keep somebody else's ground neat and clean. those who do not find time for such exercise or who may not like it, may resort to walking, which is the next best exercise. truly has this been described as the queen of all exercises. the main reason why our _sadhus_ and _fakirs_ are strong as a class is that they go about from one end of the country to the other only on foot. thoreau, the great american writer, has said many remarkable things on walking as an exercise. he says that the writings of those who keep indoors and never go out into the open air, will be as weak as their bodies. referring to his own experience, he says that all his best works were written when he was walking the most. he was such an inveterate walker that four or five hours a day was quite an ordinary thing with him! our passion for exercise should become so strong that we cannot bring ourselves to dispense with it on any account. we hardly realise how weak and futile is our mental work when unaccompanied by hard physical exercise. walking gives movement to every portion of the body, and ensures vigorous circulation of the blood; for, when we walk fast, fresh air is inhaled into the lungs. then there is the inestimable joy that natural objects give us, the joy that comes from a contemplation of the beauties of nature. it is, of course, useless to walk along lanes and streets, or to take the same path every day. we should go out into the fields and forests where we can have a taste of nature. walking a mile or two is no walking at all; at least ten or twelve miles are necessary for exercise. those who cannot walk so much every day can at least do so on sundays. once a man who was suffering from indigestion went to the doctor to take medicine. he was advised to walk a little every day, but he pleaded that he was too weak to walk at all. then the doctor took him into his carriage for a drive. on the way he deliberately dropped his whip, and the sick man, out of courtesy, got down to take it. the doctor, however, drove on without waiting for him, and the poor man had to trudge behind the carriage. when the doctor was satisfied that he had walked long enough, he took him into the carriage again, and explained that it was a device adopted to make him walk. as the man had begun to feel hungry by this time, he realised the value of the doctor's advice, and forgot the affair of the whip. he then went home and had a hearty meal. let those who are suffering from indigestion and kindred diseases try for themselves, and they will at once realise the value of walking as an exercise. chapter viii dress dress is also a matter of health to a certain extent. european ladies, for instance, have such queer notions of beauty that their dress is contrived with a view to straitening the waist and the feet, which, in its turn, leads to several diseases. the feet of chinese women are deliberately straitened to such an extent that they are smaller even than the feet of our little children, and, as a result, their health is injured. these two instances show how the health may be affected by the nature of the dress. but the choice of our dress does not rest always in our hands, for we have perforce to adopt the manners of our elders. the chief object of dress has been forgotten, and it has come to be regarded as indicative of a man's religion, country, race and profession. in this state of things, it is very difficult to discuss the question of dress strictly from the point of view of health, but such a discussion must necessarily do us good. under the term dress, we include all such things as boots and shoes, as well as jewellery and the like. what is the chief object of dress? man in his primitive state had no dress at all; he went about naked, and exposing almost the whole body. his skin was firm and strong, he was able to stand sun and shower, and never once suffered from cold and kindred ailments. as has already been explained, we inhale the air not only through the nostrils, but also through the numberless pores of the skin. so when we cover the body with clothing, we are preventing this natural function of the skin. but when the people of the colder countries grew more and more indolent, they began to feel the need to cover their bodies. they were no longer able to stand the cold, and the use of dress came into being, until at length it came to be looked upon not merely as a necessity, but as an ornament. subsequently it has also come to be regarded as an indication of country, race etc. in fact, nature herself has provided an excellent covering for us in our skin. the idea that the body looks unseemly in undress is absurd, for the very best pictures are those that display the naked body. when we cover up the most ordinary parts of our body, it is as though we felt ashamed of them in their natural condition, and as though we found fault with nature's own arrangement. we think it a duty to go on multiplying the trappings and ornaments for our body, as we grow richer and richer. we 'adorn' our body in all sorts of hideous ways, and pride ourselves on our handsomeness! if our eyes were not blinded by foolish habit, we should see that the body looks most handsome only in its nakedness, as it enjoys its best health only in that condition. dress, indeed, detracts from the natural beauty of the body. but, not content with dress alone, man began to wear jewels also. this is mere madness, for it is hard to understand how these jewels can add an iota to the body's natural beauty. but women have gone beyond all bounds of sense or decency in this matter. they are not ashamed to wear anklets which are so heavy that they can hardly lift their feet, or to pierce their nose and ears hideously for putting on rings, or to stud their wrists and fingers with rings and bracelets of several kinds. these ornaments only serve to help the accumulation of dirt in the body; there is indeed no limit to the dirt on the nose and ears. we mistake this filthiness for beauty, and throw money away to secure it; and we do not even shrink from putting our lives at the mercy of thieves. there is no limit to the pains we take to satisfy the silly notions of vanity that we have so sedulously cultivated. women, indeed, have become so infatuated that they are not prepared to remove the ear-ring even if the ears are diseased; even if the hand is swollen and suffering from frightful pain, they would not remove the bracelets; and they are unwilling to remove the ring from a swollen finger, since they imagine that their beauty would suffer by so doing! a thorough reform in dress is by no means an easy matter, but it is surely possible for all of us to renounce our jewels and all superfluous clothing. we may keep some few things for the sake of convention, and throw off all the rest. those who are free from the superstition that dress is an ornament can surely effect many changes in their dress, and keep themselves in good health. now-a-days the notion has gained ground that european dress is necessary for maintaining our decency and prestige! this is not the place to discuss this question in detail. here it will be enough to point out that, although the dress of europeans might be good enough for the cold countries of europe, it is hopelessly unsuited to india. indian dress, alone, can be good for indians, whether they be hindu or musalman. our dress being loose and open, air is not shut out; and being white for the most part, it does not absorb the heat. black dress feels hot, since all the sun's rays are absorbed into it, and, in its turn, into the body. the practice of covering the head with the turban has become quite common with us. nevertheless we should try to keep the head bare as far as possible. to grow the hair, and to dress it by combing and brushing, parting in the middle and so on, is nothing short of barbarous. dust and dirt, as well as nits and lice, accumulate in the hair, and if a boil were to arise on the head, it cannot be properly treated. especially for those who use a turban, it would be stupid to grow the hair. the feet also are common agents of disease. the feet of those who wear boots and shoes grow dirty, and begin to exude a lot of stinking perspiration. so great is the stink that those who are sensitive to smells will hardly be able to stand by the side of one who is removing his shoes and socks. our common names for the shoe speak of it as the "protector of the feet" and the "enemy of the thorn" showing that shoes should be worn only when we have to walk along a thorny path, or over very cold or hot ground, and that only the soles should be covered, and not the entire feet. and this purpose is served excellently well by the _sandal_. some people who are accustomed to the use of shoes often suffer from headaches, of pain in the feet, or weakness of the body. let them try the experiment of walking with bare feet, and then they will at once find out the benefit of keeping the feet bare, and free from sweat by exposure to the air. chapter ix sexual relations i would specially request those who have carefully read through the book so far to read through this chapter with even greater care, and ponder well over its subject-matter. there are still several more chapters to be written, and they will, of course, be found useful in their own way. but not one of them is nearly as important as this. as i have already said, there is not a single matter mentioned in this book which is not based on my personal experience, or which i do not believe to be strictly true. many are the keys to health, and they are all quite essential; but the one thing needful, above all others, is _brahmacharya_. of course, pure air, pure water, and wholesome food do contribute to health. but how can we be healthy if we expend all the health that we acquire? how can we help being paupers if we spend all the money that we earn? there can be no doubt that men and women can never be virile or strong unless they observe true _brahmacharya_. what do we mean by _brahmacharya_? we mean by it that men and women should refrain from enjoying each other. that is to say, they should not touch each other with a carnal thought, they should not think of it even in their dreams. their mutual glances should be free from all suggestion of carnality. the hidden strength that god has given us should be conserved by rigid self-discipline, and transmitted into energy and power,--not merely of body, but also of mind and soul. but what is the spectacle that we actually see around us? men and women, old and young, without exception, are seen entangled in the coils of sensuality. blinded by lust, they lose all sense of right and wrong. i have myself seen even boys and girls behaving like mad men under its fatal influence. i too have behaved likewise under similar influences, and it could not well be otherwise. for the sake of a momentary pleasure, we sacrifice in an instant all the stock of vitality that we have accumulated. the infatuation over, we find ourselves in a miserable condition. the next morning, we feel hopelessly weak and tired, and the mind refuses to do its work. then, we try to remedy the mischief by taking all sorts of 'nervine tonics' and put ourselves under the doctor's mercy for repairing the waste, and for recovering the capacity for enjoyment. so the days pass and the years, until at length old age comes upon us, and finds us utterly emasculated in body and in mind. but the law of nature is just the reverse of this. the older we grow, the keener should grow our intellect also; the longer we live, the greater should be our capacity to transmit the fruits of our accumulated experience to our fellowmen. and such is indeed the case with those who have been true _brahmacharies_. they know no fear of death, and they do not forget good even in the hour of death; nor do they indulge in vain complaints. they die with a smile on their lips, and boldly face the day of judgment. they are the true men and women; and of them alone can it be said that they have conserved their health. we hardly realise the fact that incontinence is the root-cause of all the vanity, anger, fear and jealousy in the world. if our mind is not under our control, if we behave once or more every day more foolishly than even little children, what sins may we not commit consciously or unconsciously? how can we pause to think of the consequences of our actions, however vile or sinful they may be? but you may ask, "who has ever seen a true _brahmachary_ in this sense? if all men should turn _brahmacharies_, would not humanity be extinct, and the whole world go to rack and ruin?" we will leave aside the religious aspect of this question, and discuss it simply from the secular point of view. to my mind, these questions only bespeak our weakness and our cowardliness. we have not the strength of will to observe _brahmacharya_, and, therefore, set about finding pretexts for evading our duty. the race of true _brahmacharies_ is by no means extinct; but, if they were to be had merely for the asking, of what value would _brahmacharya_ be? thousands of hardy labourers have to go and dig deep into the bowels of the earth in search of diamonds, and at length they get perhaps merely a handful of them out of heaps and heaps of rock. how much greater, then, should be the labour involved in the discovery of the infinitely more precious diamond of a _brahmachary_? if the observance of _brahmacharya_ should mean the ruin of the world, why should we regret it? are we god that we should be so anxious about its future? he who created it will surely see to its preservation. it is none of our business to enquire if other people practise _brahmacharya_ or not. when we turn merchant or lawyer or doctor, do we ever pause to consider what the fate of the world would be if all men were to do likewise? the true _brahmachary_ will, in the long run, discover for himself answers to such questions. but how can men engrossed by the cares of the material world put these ideas into practice? what shall the married people do? what shall they do who have children? and what shall be done by those people who cannot control their lust? the best solution for all such difficulties has already been given. we should keep this ideal constantly before us, and try to approximate to it more and more to the utmost of our capacity. when little children are taught to write the letters of the alphabet, we show them the perfect shapes of the letters, and they try to reproduce them as best they can. just in the same way, if we steadily work up to the ideal of _brahmacharya_, we may ultimately succeed in realising it. what if we have married already? the law of nature is that _brahmacharya_ may be broken only when the husband and wife feel a strong desire for a child. those who, remembering this law, violate _brahmacharya_ once in four or five years cannot be said to be slaves to lust, nor can they appreciably lose their stock of vitality. but, alas, how rare are those men and women who yield to the sexual craving merely for the sake of an offspring! the vast majority, who may be numbered in thousands, turn to sexual enjoyment merely to satisfy their carnal passion, with the result that children are born to them quite against their will. in the madness of sexual passion, we give no thought to the consequences of our acts. in this respect, men are even more to blame than women. the man is blinded so much by his lust that he never cares to remember that his wife is weak and incapable of rearing a child. in the west indeed, people have trespassed even against the claims of common decency. they indulge in sexual pleasures, and devise measures in order to evade the responsibilities of parenthood. many books have been written on this subject, and a regular trade is being carried on in providing the means of preventing conception. we are as yet free from this sin, but we do not shrink from imposing the heavy burden of maternity on our women, and we are not concerned even to find that our children are weak, impotent and imbecile. every time we get children, we bless providence, and so seek to hide from ourselves the wickedness of our acts. should we not rather deem it a sign of god's anger to have children who are weak, sensual, crippled and impotent? is it a matter for joy that mere boys and girls should have children? is it not rather a curse of god? we all know that the premature fruit of a too young plant weakens the parent, and so we try all means of delaying the appearance of fruit. but we sing hymns of praise and thanks-giving to god when a child is born of a boy-father and a girl-mother! could anything be more dreadful? do we think that the world is going to be saved by the countless swarms of such impotent children endlessly multiplying in india or elsewhere in the world? verily we are, in this respect, far worse than even the lower animals; for, the bull and the cow are brought together solely with the object of having a calf. man and woman should regard it as sacred duty to keep apart from the moment of conception up to the time when the child has ceased to suck its mother's breast. but we go on in our merry fashion blissfully forgetful of this sacred obligation. this incurable disease enfeebles our mind and leads us to an early grave, after making us drag a miserable existence for a short while. married people should understand the true function of marriage, and should not violate the law of _brahmacharya_ except with a view to having a child for the continuation of the race. but this is so difficult under our present conditions of life. our diet, our ways of life, our common talk, and our environments are all equally calculated to rouse and keep alive our sensual appetite; and sensuality is like a poison, eating into our vitals. some people may doubt the possibility of our being able to free ourselves from this bondage. this book is written not for those who go about with such doubtings of heart, but only for those who are really in earnest, and who have the courage to take active steps for their improvement. those who are quite content with their present abject condition may even be offended to read all this; but i hope this will be of some service to those who are heartily disgusted with their own miserable existence. from all that has been said, it follows that those who are still unmarried should try to remain so; but, if they cannot help marrying, they should do so as late as possible. young men, for instance, should take a vow to remain unmarried till the age of or . we shall not explain here all the benefits other than physical that result from this; but those who want to enjoy them can do so for themselves. my request to those parents who may read these pages is that they should not tie a mill-stone round the necks of their sons by marrying them in their teens. they should look also to the welfare of their sons, and not only to their own interests. they should throw aside all silly notions of caste-pride or 'respectability', and cease to indulge in such heartless practices. let them, rather, if they are true well-wishers of their children, look to their physical, mental and moral improvements. what greater disservice can they do to their sons than compelling them to enter upon a married life, with all its tremendous responsibilities and cares, even while they are mere boys? then again, the true laws of health demand that the man that loses his wife, as well as the woman that loses her husband, should remain single ever after. there is a difference of opinion among doctors as to whether young men and women need ever let their vital fluid escape, some answering the question in the affirmative, others in the negative. but this cannot justify our taking advantage of it for sensual enjoyment. i can affirm, without the slightest hesitation, from my own experience as well as that of others, that sexual enjoyment is not only not necessary for the preservation of health, but is positively detrimental to it. all the strength of body and mind that has taken long to acquire, is lost altogether by the escape of the vital fluid, and it takes a long time to regain this lost strength, and even then there is no saying that it can be thoroughly recovered. a broken vessel may be made to do its work after mending, but it can never be anything but a broken vessel. as has already been pointed out, the preservation of our vitality is impossible without pure air, pure water, pure and wholesome food, as well as pure thoughts. so vital indeed is the relation between our health and the life that we lead that we can never be perfectly healthy unless we lead a clean life. the earnest man who, forgetting the errors of the past, begins to live a life of purity will be able to reap the fruit of it straightway. those who have practised true _brahmacharya_ even for a short period will have seen how their body and mind improve steadily in strength and power, and they will not, at any cost, be willing to part with this treasure. i have myself been guilty of lapses even after having fully understood the value of _brahmacharya_, and have, of course, paid dearly for it. i am filled with shame and remorse when i think of the terrible contrast between my condition before and after these lapses. but from the errors of the past i have now learnt to preserve this treasure in tact, and i fully hope, with god's grace, to continue to preserve it in the future; for i have in my own person, witnessed the inestimable benefits of _brahmacharya_. i was married early in life, and had become the father of children as a mere youth. when, at length, i awoke to the reality of my situation, i found myself sunk in the lowest depths of degradation. i shall consider myself amply rewarded for writing these pages if at least a single reader is able to take warning from my failings and experiences, and to profit thereby. many people have told me (and i also believe it) that i am full of energy and enthusiasm, and that my mind is by so means weak; some even accuse me of rashness. there is disease in my body as well as in my mind; nevertheless, when compared with my friends, i may call myself perfectly healthy and strong. if even after twenty years of sensual enjoyment, i have been able to reach this state, how much better should i have been if only i had kept myself pure during those twenty years as well? it is my full conviction that, if only i had lived a life of _brahmacharya_ all through, my energy and enthusiasm would have been a thousandfold greater and i should have been able to devote them all to the furtherance of my country's cause as of my own. if this can be affirmed of an ordinary man like myself, how much more wonderful must be the gain in power,--physical, mental, as well as moral--that unbroken _brahmacharya_ can bring to us! when so strict is the law of _brahmacharya_, what shall we say of those guilty of the unpardonable sin of illegitimate sexual enjoyment? the evil that arises from adultery and prostitution is a vital question of religion and morality and cannot be fully dealt with in a treatise on health. here we are only concerned to point out how thousands who are guilty of these sins are afflicted by syphilis and other unmentionable diseases. the inflexible decree of providence happily condemns these wretches to a life of unmitigated suffering. their short span of life is spent in abject bondage to quacks in a futile quest after a remedy that will rid them of their suffering. if there were no adultery at all, there would be no work for at least % of doctors. so inextricably indeed has venereal disease caught mankind in its clutches that even the best doctors have been forced to admit that, so long as adultery and prostitution continue, there is no hope for the human race. the medicines for these diseases are so poisonous that, although they may appear to have done some good for the time being, they give rise to other and still more terrible diseases which are handed down from generation to generation. in concluding this chapter, we will briefly point out how married people can preserve their _brahmacharya_ intact. it is not enough to observe the laws of health as regards air, water and food. the man should altogether cease to sleep in privacy with his wife. little reflection is needed to show that the only possible motive for privacy between man and wife is the desire for sexual enjoyment. they should sleep apart at night, and be incessantly engaged in good works during the day. they should read such books as fill them with noble thoughts and meditate over the lives of great men, and live in the constant realisation of the fact that sensual enjoyment is the root of all disease. whenever they feel a prompting for enjoyment, they should bathe in cold water, so that the heat of passion may be cooled down, and be refined into the energy of virtuous activity. this is a hard thing to do, but we have been born into this world that we might wrestle with difficulties and temptations, and conquer them; and he who has not the will to do it can never enjoy the supreme blessing of true health. part ii some simple treatments chapter i air-treatment we have now done with the discussion of the foundations of health, as well as the means of its preservation. if all men and women were to obey all the laws of health, and practice strict brahmacharya, there would be no need at all for the chapters which follow, for such men and women would then be free from all ailments, whether of the body or of the mind. but where can such men and women be found? where are they who have not been afflicted by disease? the more strictly, however, we observe the laws which have been explained in this book, the more shall we be free from disease. but when diseases do attack us, it is our duty to deal with them properly, and the following chapters are intended to show how to do it. pure air, which is so essential to the preservation of health, is also essential to the cure of diseases. if, for instance, a man who is suffering from gout is treated with air heated by steam, he perspires profusely, and his joints are eased. this kind of vapour-treatment is known as "turkish bath." if a man who is suffering from high fever is stripped naked, and made to sleep in the open air, there is an immediate fall in the temperature, and he feels a distinct relief. and if, when he feels cold, he is wrapped in a blanket, he perspires at once, and the fever ceases. but what we generally do is just the reverse of this. even if the patient is willing to remain in the open air, we close all the doors and windows of the room in which he lies, and cover his whole body (including the head and ears) with blankets, with the result that he is frightened, and is rendered still weaker. if the fever is the outcome of too much heat, the sort of air-treatment described above is perfectly harmless, and its effect can be instantly felt. of course, care should be taken that the patient does not begin to shiver in the open air. if he cannot remain naked, he may well be covered with blankets. change of air is an effective remedy for latent fever and other diseases. the common practice of taking a change of air is only an application of the principle of air-treatment. we often change our residence in the belief that a house constantly infested by disease is the resort of evil spirits. this is a mere delusion, for the real "evil spirits" in such cases are the foul air inside the house. a change of residence ensures a change of air, and with it the cure of the diseases brought on by it. indeed, so vital is the relation between health and air that the good or evil effects of even a slight change are instantaneously felt. for a change of air the rich can afford to go to distant places, but even the poor can go from one village to another, or at least from one house to another. even a change of room in the same house often brings great relief to a sick man. but, of course, care should be taken to see that the change of air is really for the better. thus, for instance, a disease that has been brought on by damp air cannot be cured by a change to a damper locality. it is because sufficient attention is not paid to simple precautions like this that a change of air is often so ineffectual. this chapter has been devoted to some simple instances of the application of air to the treatment of disease, while the chapter on air in part i of this book contains a general consideration of the value of pure air to health. hence i would request my readers to read these two chapters side by side. chapter ii water-cure since air is invisible, we cannot perceive the wonderful way in which it does its work. but the work of water and its curative effects can be easily seen and understood. all people know something of the use of steam as a curative agent. we often employ it in cases of fever, and very often severe headaches can be cured only by its application. in cases of rheumatic pain in the joints, rapid relief is obtained by the use of steam followed by a cold bath. boils and ulcers not cured by simple dressing with ointments can be completely healed by the application of steam. in case of extreme fatigue, a steam-bath or a hot-water bath immediately followed by a cold bath will be found very effective. so too, in cases of sleeplessness, instant relief is often obtained by sleeping in the open air after a steam-bath followed by a cold bath. hot water can always be used as a substitute for steam. when there is severe pain in the stomach, instant relief is obtained by warming with a bottle filled with boiling water placed over a thick cloth wrapped round the waist. whenever there is a desire to vomit, it can be done by drinking plenty of hot water. those who are suffering from constipation often derive great benefit by drinking a glass of hot water either at bedtime or soon after rising and cleaning the teeth in the morning. sir gordon spring attributed his excellent health to the practice of drinking a glass of hot water every day before going to bed and after getting up in the morning. the bowels of many people move only after taking tea in the morning, and they foolishly suppose that it is the tea which has produced this effect. but, as a matter of fact, tea only does harm, and it is really the hot water in the tea that moves the bowels. a special kind of cot is often used for steam-baths, but it is not quite essential. a spirit or kerosine oil stove, or a wood or coal fire, should be kept burning under an ordinary cane chair. over the fire should be placed a vessel of water with the mouth covered; and over the chair a sheet or blanket is so spread that it may hang down in the front and protect the patient from the heat of the fire. then the patient should be seated in the chair and wrapped round with sheets or blankets. then the vessel should be uncovered, so that the patient may be exposed to the steam issuing from it. our common practice of covering the head also of the patient is a needless precaution. the heat of the steam presses through the body right up to the head, and gives rise to profuse perspiration on the face. if the patient is too weak to sit up, he may be made to lie down on a cot with interstices, taking care to see that none of the steam escapes. of course, care should also be taken to see that the patient's clothes or the blankets used do not catch fire; and due consideration should be paid to the state of the patient's health, as an inconsiderate application of steam is fraught with danger. the patient, indeed, feels weak after a steam bath, but this weakness does not last long. too frequent use of steam, however, enfeebles the constitution, and it is of the highest importance to apply steam with due deliberation. steam may also be applied to any single part of the body; in cases of headache, for instance, there is no need to expose the whole body to the steam. the head should be held just over a narrow-mouthed jar of boiling water, and wrapped round with a cloth. then the steam should be inhaled through the nose so that it may ascend into the head. if the nasal passage is blocked, it will also be opened by this process. likewise, if there be inflamation in any part of the body, it alone need be exposed to the steam. very few realise the curative value of cold water, in spite of the fact that it is even more valuable in this respect than hot water, and can be made use of by even the weakest persons. in fever, small-pox, and skin-diseases, the application of a sheet dipped in cold water is very beneficial, and often produces startling results; and anybody may try it without the least risk. dizziness or delirium can be instantly relieved by tying round the head a cloth dipped in melted ice. people suffering from constipation often derive great benefit by tying round the stomach for some time a piece of cloth dipped in melted ice. involuntary seminal discharges can also be often prevented by the same means. bleeding in any part of the body may be stopped by the application of a bandage dipped in ice-cold water. bleeding from the nose is stopped by pouring cold water over the head. nasal diseases, cold and headache, may be cured by drawing pure cold water up the nose. the water may be drawn through one nostril and discharged through the other, or drawn through both nostrils and discharged through the mouth. there is no harm in the water going even into the stomach provided the nostrils are clean. and indeed, this is the best way to keep the nostrils clean. those who are unable to draw the water up the nostrils may use a syringe, but after a few attempts, it can be done quite easily. all should learn to do this, since it is very simple, and at the same time a most effective remedy against headaches, bad smells in the nose, as well as dirty accumulations in the nasal passage. many people are afraid of taking an enema, and some even think that the body is weakened by it; but such fears are baseless. there is no more effective means of producing an instant evacuation of the bowels. it has proved effective in many diseases where all other remedies have been futile; it thoroughly cleans the bowels, and prevents the accumulation of poisonous matter. if those who suffer from rheumatic complaints or indigestion or pains caused by an unhealthy condition of the bowels take an enema of lbs. of water, they would see how instantaneous is its effect. one writer on this subject says that once he was suffering from chronic indigestion and, all remedies proving futile; he had grown emaciated, but the application of the enema at once restored him his appetite, and altogether cured him of his complaint in a few days. even ailments like jaundice can be cured by the application of the enema. if the enema has to be frequently employed, cold water should be used, for the repeated use of hot water is likely to enfeeble the constitution. dr. louis kuhne of germany has, after repeated experiments, arrived at the conclusion that water-cure is the best for all diseases. his books on this subject are so popular that they are now available in almost all the languages of the world, including those of india. he contends that the abdomen is the seat of all diseases. when there is too much heat in the abdomen, it manifests itself in the form of fever, rheumatism, eruptions on the body, and the like. the efficacy of water-cure had, indeed, been recognised by several people long before kuhne, but it was he who, for the first time, pointed out the common origin of all diseases. his views need not be accepted by us in their entirety, but it is an undoubted fact that his principles and methods have proved effective in many diseases. to give only one instance out of many that have come within my experience, in a bad case of rheumatism, a thorough cure was effected by kuhne's system, after all other remedies had been tried, and had proved utterly ineffectual. dr. kuhne holds that the heat in the abdomen abates by the application of cold water, and has, therefore, prescribed the bathing of the abdomen and the surrounding parts with thoroughly cold water. and for the greater convenience of bathing, he has devised a special kind of tin bath. this, however, is not quite indispensable; the tin tubs of an oval shape and of different sizes to suit people of different heights, available in our bazaars, will do equally well. the tub should be filled three-fourths with cold water, and the patient should seat himself in it in such a fashion that his feet and the upper part of the body remain outside the water, and the rest of the body up to the hips inside it. the feet may preferably be placed on a low foot-stool. the patient should sit in the water quite naked, but, if he feels cold, the feet and the upper part of the body should be covered with a blanket. if a shirt is worn, it should be kept entirely outside the water. the bath should be taken in a room where there is plenty of fresh air and light. the patient should then slowly rub (or cause to be rubbed) the abdomen with a small rough towel from to minutes or more. the effect is instantly felt in most cases. in cases of rheumatism, the wind in the stomach escapes in the form of eructations and the like, and in cases of fever, the thermometre falls by one or two degrees. the bowels are readily cleaned by this process; fatigue disappears; sleeplessness is removed, and extreme drowsiness gives place to vigour. this contrariness of result is more apparent than real; for want of sleep, and the excess of it, are both brought on by the same cause. so too, dysentery and constipation, which are both the outcome of indigestion, are cured by this method. piles of long standing can also be got rid of by this bath, with proper regulation of diet. those who are troubled by the necessity for constant spitting should at once resort to this treatment for a cure. by its means the weak can become strong; and even chronic rheumatism has been cured by it. it is also an effective remedy for haemorrhages, headaches, and blood-poisoning. kuhne prescribes it as an invaluable remedy even for diseases like the cancer. a pregnant woman who takes to it regularly will have an easy child-birth. in short, all persons, without distinction of age or sex, can take to it with advantage. there is another kind of bath, known as the "wet-sheet-pack", which is an unfailing remedy for various diseases. this bath is taken in the following manner. a table or chair is placed in the open air, big enough to allow of the patient lying on it at full length. on it are spread (hanging on either side) some four blankets, less or more according to the state of the weather. over them are spread two white thick sheets well dipped in cold water, and a pillow is placed under the blankets at one end. then the patient is stripped naked (with the exception of a small waist-cloth, if he so wishes), and made to lie down on the sheets, with his hands placed in the arm-pits. then the sheets and blankets are, one after another, wrapped round his body, taking care that the parts hanging under the feet are well tucked in so as to cover them. if the patient is exposed to the sun, a wet cloth is put over his head and face, keeping the nose always open. at first the patient will experience some shivering, but this will soon give place to an agreeably warm sensation. he can lie in this position from minutes to an hour or more. after a time he begins to perspire, or at times falls asleep. soon after coming out of the sheets he should bathe in cold-water. this is an excellent remedy for small-pox and fever, and skin-diseases like the itch, the ringworm, and pimples and blotches. even the worst forms of chicken-pox and small-pox are completely cured by this process. people can easily learn to take the "wet-sheet-pack" themselves, and to apply it to others, and can thus see for themselves its wonderful effect. as the whole dirt of the body sticks to the sheets in the process of taking this bath, they ought not to be used again without being well washed in boiling water. needless to say, the full benefit of these baths cannot be derived unless the rules already mentioned as to diet, exercise and the like are strictly observed. if a rheumatic patient, for instance, were to take to kuhne's bath or to the "wet-sheet-pack," while eating unwholesome food, living in impure air, and neglecting his exercise, how can he possibly derive any good out of it? it is only when accompanied by strict observance of all the laws of health that water-cure can be of any effect; and when so employed, its effects are sure and immediate. chapter iii the use of earth we will now proceed to describe the curative properties of earth, which are, in some cases, even more remarkable than those of water. that earth should have such properties need not cause us any surprise, for our own body is compounded of the earthly element. indeed, we do make use of earth as a purifying agent. we wash the ground with earth to remove bad smells, we put it over decaying matter to prevent the pollution of the air, we wash our hands with it, and even employ it to clean the private parts. yogis besmear their bodies with it; some people use it as a cure for boils and ulcers; and dead bodies are buried in the earth so that they may not vitiate the atmosphere. all this shows that earth has many valuable properties as a purifying and curative agent. just as dr. kuhne has devoted special attention to the subject of water-cure, another german doctor has made a special study of earth and its properties. he goes so far as to say that it can be used with success in the treatment of even the most complicated diseases. he says that once in a case of snake-bite, where everybody else had given up the man for dead, he restored him to life by causing him to be covered up with earth for some time. there is no reason to doubt the veracity of this report. it is well known that great heat is generated in the body by burying it in the earth; and although we cannot explain how exactly the effect is produced, it is undeniable that earth does possess the property of absorbing the poison. indeed, every case of snake-bite may not be cured in this way; but it should certainly be tried in every case. and i can say from my own experience that, in cases of scorpion-sting and the like, the use of mud is particularly beneficial. i have myself tried with success the following forms of earth-cure. constipation, dysentery, and chronic stomach-ache have been cured by the use of a mud-poultice over the abdomen for two or three days. instant relief has been obtained in cases of headache by applying a mud-bandage round the head. sore eye has also been cured by the same method; hurts of all kinds, whether accompanied by inflammation or not, have been healed likewise. in the old days i could not keep well without a regular use of eno's fruit-salt and the like. but, since , when i learnt the value of earth-cure, i have had not a single occasion to use them. a mud-poultice over the abdomen and the head, gives distinct relief in a state of high fever. skin-diseases like the itch, the ringworm, and boils, have been cured with the use of mud, though no doubt ulcers from which pus issues are not so easily cured. burns and scalds are likewise healed by mud, which also prevents inflammation. piles, too, are cured by the same treatment. when the hands and feet become red and swollen owing to frost, mud is an unfailing remedy, and pain in the joints is also relieved by it. from these and other experiments in mud-cure, i have come to the conclusion that earth is an invaluable element in the domestic treatment of diseases. all kinds of earth are not, of course, equally beneficial. dry earth dug out from a clean spot has been found the most effective. it should not be too sticky. mud which is midway between sand and clay is the best. it should, of course, be free from cow-dung and other rubbish. it should be well sifted in a fine sieve, and then soaked in cold water to the consistency of well-kneaded dough before use. then it should be tied up in a piece of clean, unstarched cloth, and used in the form of a thick poultice. the poultice should be removed before the mud begins to dry up; ordinarily it will last from two to three hours. mud once used should never be used again, but a cloth once used can be used again, after being well washed, provided it is free from blood and other dirty matter. if the poultice has to be applied to the abdomen, it should first be covered over with a warm cloth. everybody should keep a tinful of earth ready for use, so as not to have to hunt for it whenever an occasion arises for its use. otherwise, much precious time may be wasted in cases (as of scorpion-sting) where delay would be dangerous. chapter iv fever and its cure we now pass on to consider some particular diseases and the means of curing them. and first, fever. we generally apply the term "fever" to a condition of heat in the body, but english doctors have distinguished many varieties of this disease, each with its own system of treatment. but, following the common practice and the principles elaborated in these chapters, we may say that all fevers can be cured in one and the same manner. i have tried this single treatment for all varieties from simple fever up to bubonic plague, with invariably satisfactory results. in , there was a severe outbreak of plague among the indians in south africa. it was so severe that, out of persons that were affected, as many as died within the space of hours; and of the remaining two, who were removed to the hospital, only one survived, and that one was the man to whom was applied the mud-poultice. we cannot, of course, conclude from this that it was the mud-poultice that saved him, but, in any case, it is undeniable that it did him no harm. they were both suffering from high fever brought on by inflammation of the lungs, and had been rendered unconscious. the man on whom was tried the mud-poultice was so bad that he was spitting blood, and i afterwards learnt from the doctor that he had been insufficiently fed on milk alone. as most fevers are caused by disorders of the bowels, the very first thing to do is to starve the patient. it is a mere superstition that a weak man will get weaker by starving. as we have already seen, only that portion of our food is really useful which is assimilated into the blood, and the remainder only clogs the bowels. in fever the digestive organs are very weak, the tongue gets coated, and the lips are hard and dry. if any food is given to the patient in this condition, it will remain undigested and aid the fever. starving the patient gives his digestive organs time to perform their work; hence the need to starve him for a day or two. at the same time, he should take at least two baths every day according to the kuhne's system. if he is too weak or ill to bathe, a mud-poultice should be applied to his abdomen. if the head aches or feels too hot, a poultice should also be applied to the head. the patient should, as far as possible, be placed in the open air, and should be well covered. at meal-time, he should be given the juice of lime, well filtered and mixed with cold or boiling water, and if possible, without any sugar. this has a very beneficial effect, and should alone be given if the patient's teeth can bear its sourness. afterwards, he may be given a half or the whole of a plantain, well mixed with a spoon of olive oil, mixed with a spoon of lime juice. if he feels thirsty, he should be given water boiled and cooled, or the juice of lime,--never unboiled water. his clothes should be as few as possible, and should be frequently changed. even persons suffering from typhoid and the like diseases have been completely cured by this simple treatment, and are enjoying perfect health at present. a seeming cure may also be effected by quinine, but it really brings other diseases in its train. even in malarial fever, in which quinine is supposed to be most effective, i have rarely seen it bring permanent relief; on the other hand, i have actually seen several cases of malarial patients being permanently cured by the treatment described above. many people subsist on milk alone during fever, but my experience is that it really does harm in the initial stages, as it is hard to digest. if milk has to be given, it is best given in the form of "wheat-coffee",[ ] or with a small quantity of rice-flour well boiled in water; but in extreme forms of fever, it ought not to be given at all. in such a condition, the juice of lime may always be given with great success. as soon as the tongue gets clean, plantain may be included in the diet, and given in the form described above. if there be constipation, a hot-water enema with borax should be applied in preference to purgatives, after which a diet of olive oil will serve to keep the bowels free. [ ] part ii, chap. iv chapter v constipation, dysentery, gripes and piles it may at first sight appear strange to have four different ailments put together in this chapter, but, as a matter of fact, they are all so closely connected, and may be cured more or less in the same way. when the stomach gets clogged by undigested matter, it leads to one or other of these diseases, according to the varying constitutions of individuals. in some it produces constipation. the bowels do not move, or move only partly, and there is great straining at stools, until it results in bleeding, or at times in the discharge of mucus, or piles. in others, it leads to diarrhea, which often ends in dysentery. in others again, it may give rise to gripes, accompanied by pain in the stomach and the discharge of mucus. in all these cases, the patient loses his appetite, his body gets pale and weak, his tongue gets coated, and his breath foul. many also suffer from headache and other complaints. constipation, indeed, is so common that hundreds of pills and powders have been invented to cure it. the chief function of such patent medicines as mother siegel's syrup and eno's fruit-salt is to relieve constipation, and hence thousands of people go in for them in the vain hope of being cured for good. any _vaid_ or _hakim_ will tell you that constipation and the like are the result of indigestion, and that the best way to cure them is to remove the causes of indigestion; but the more candid among them will confess that they are forced to manufacture pills and powders, since the patients are not really prepared to renounce their bad habits, but at the same time want to get cured. indeed the present-day advertisments of such medicines go to the extent of promising to those that would buy them that they need observe no directions as to diet and the like, but may eat and drink whatever they like. but my readers need not be told that this is a mere string of lies. all purgatives are invariably injurious to health. even the mildest of them, even if they relieve the constipation, give rise to other forms of disease. if they should do any good at all, the patient should thoroughly change his ways of life, so as not to have to turn to purgatives again; otherwise, there can be no doubt that they must give rise to new diseases, even supposing that they serve to get rid of the old. the very first thing to do in cases of constipation and the like is to reduce the quantity of food, especially such heavy things as ghee, sugar and cream of milk. of course, he should eschew altogether wine, tobacco, bhang, tea, coffee, cocoa, and loaves made of "mill flour." the diet should consist for the most part of fresh fruits with olive oil. the patient should be made to starve for hours before treatment begins. during this time and after, mud-poultices should be applied to the abdomen during sleep; and, as has been already said, one or two "kuhne baths" should also be taken. the patient should be made to walk for at least two hours every day. i have myself seen severe cases of constipation, dysentery, piles and gripes effectively cured by this simple treatment. piles may not, of course, completely disappear, but they will certainly cease to give trouble. the sufferer from gripes should take special care not to take any food except lime-juice in hot water, so long as there is discharge of blood or mucus. if there is excessive griping pain in the stomach, it can be cured by warming with a bottle of hot water or a piece of well-heated brick. needless to say, the patient should live constantly in the open air. fruits like the french plum, the raisin, the orange and the grape, are particularly useful in constipation. this does not, of course, mean that these fruits may be eaten even where there is no hunger. they ought not to be eaten at all in cases of gripes accompanied by a bad taste in the mouth. chapter vi contagious diseases: small-pox now we will proceed to deal with the treatment of contagious diseases. they have a common origin, but, since small-pox is by far the most important of them, we will give a separate chapter to it, dealing with the rest in another chapter. we are all terribly afraid of the small-pox, and have very crude notions about it. we in india even worship it as a deity. in fact it is caused, just like other diseases, by the blood getting impure owing to some disorder of the bowels; and the poison that accumulates in the system is expelled in the form of small-pox. if this view is correct, then there is absolutely no need to be afraid of small-pox. if it were really a contagious disease, everyone should catch it by merely touching the patient; but this is not always the case. hence there is really no harm in touching the patient, provided we take some essential precautions in doing so. we cannot, of course, assert that small-pox is never transmitted by touch, for those that are physically in a condition favourable to its transmission will catch it. this is why, in a locality where small-pox has appeared, many people are found attacked by it at the same time. this has given rise to the superstition that it is a contagious disease, and hence to the attempt to mislead the people into the belief that vaccination is an effective means of preventing it. the process of vaccination consists in injecting into the skin the liquid that is obtained by applying the discharge from the body of a small-pox patient to the udder of a cow. the original theory was that a single vaccination would suffice to keep a man immune from this disease for life; but, when it was found that even vaccinated persons were attacked by the disease, a new theory came into being that the vaccination should be renewed after a certain period, and to-day it has become the rule for all persons--whether already vaccinated or not--to get themselves vaccinated whenever small-pox rages as an epidemic in any locality, so that it is no uncommon thing to come across people who have been vaccinated five or six times, or even more. vaccination is a barbarous practice, and it is one of the most fatal of all the delusions current in our time, not to be found even among the so-called savage races of the world. its supporters are not content with its adoption by those who have no objection to it, but seek to impose it with the aid of penal laws and rigorous punishments on all people alike. the practice of vaccination is not very old, dating as it does only from a.d. but, during this comparatively short period that has elapsed, millions have fallen a prey to the delusion that those who get themselves vaccinated are safe from the attack of small-pox. no one can say that small-pox will necessarily attack those who have not been vaccinated; for many cases have been observed of unvaccinated people being free from its attack. from the fact that some people who are not vaccinated do get the disease, we cannot, of course, conclude that they would have been immune if only they had got themselves vaccinated. moreover, vaccination is a very dirty process, for the serum which is introduced into the human body includes not only that of the cow, but also of the actual small-pox patient. an average man would even vomit at the mere sight of this stuff. if the hand happens to touch it, it is always washed with soap. the mere suggestion of tasting it fills us with indignation and disgust. but how few of those who get themselves vaccinated realise that they are in effect eating this filthy stuff! most people know that, in several diseases, medicines and liquid food are injected into the blood, and that they are assimilated into the system more rapidly than if they were taken through the mouth. the only difference, in fact, between injection and the ordinary process of eating through the mouth is that the assimilation in the former case is instantaneous, while that in the latter is slow. and yet we do not shrink from getting ourselves vaccinated! as has been well said, cowards die a living death, and our craze for vaccination is solely due to the fear of death or disfigurement by small-pox. i cannot also help feeling that vaccination is a violation of the dictates of religion and morality. the drinking of the blood of even dead animals is looked upon with horror even by habitual meat-eaters. yet, what is vaccination but the taking in of the poisoned blood of an innocent living animal? better far were it for god-fearing men that they should a thousand times become the victims of small-pox and even die a terrible death than that they should be guilty of such an act of sacrilege. several of the most thoughtful men in england have laboriously investigated the manifold evils of vaccination, and an anti-vaccination society has also been formed there. the members of this society have declared open war against vaccination, and many have even gone to gaol for this cause. their objections to vaccination are briefly as follows: ( ) the preparation of the vaccine from the udder of cows or calves entails untold suffering on thousands of innocent creatures, and this cannot possibly be justified by any gains resulting from vaccination. ( ) vaccination, instead of doing good, works considerable mischief by giving rise to many new diseases. even its advocates cannot deny that, after its introduction, many new diseases have come into being. ( ) the vaccine that is prepared from the blood of a small-pox patient is likely to contain and transmit the germs of all the several diseases that he may be suffering from. ( ) there is no guarantee that small-pox will not attack the vaccinated. dr. jenner, the inventor of vaccination, originally supposed that perfect immunity could be secured by a single injection on a single arm; but when it was found to fail, it was asserted that vaccination on both the arms would serve the purpose; and when even this proved ineffectual, it came to be held that both the arms should be vaccinated at more than one place, and that it should also be renewed once in seven years. finally, the period of immunity has further been reduced to three years! all this clearly shows that doctors themselves have no definite views on the matter. the truth is, as we have already said, that there is no saying that small-pox will not attack the vaccinated, or that all cases of immunity must needs be due to vaccination. ( ) the vaccine is a filthy substance, and it is foolish to expect that one kind of filth can be removed by another. by these and similar arguments, this society has already produced a large volume of public opinion against vaccination. in a certain town, for instance, a large proportion of the people refuse to be vaccinated, and yet statistics prove that they are singularly free from disease. the fact of the matter is that it is only the self-interest of doctors that stands in the way of the abolition of this inhuman practice, for the fear of losing the large incomes that they at present derive from this source blinds them to the countless evils which it brings. there are, however, a few doctors who recognise these evils, and who are determined opponents of vaccination. those who are conscientious objectors to vaccination should, of course, have the courage to face all penalties or persecutions to which they may be subjected by law, and stand alone, if need be, against the whole world, in defence of their conviction. those who object to it merely on the grounds of health should acquire a complete mastery of the subject, and should be able to convince others of the correctness of their views, and convert them into adopting those views in practice. but those who have neither definite views on the subject nor courage enough to stand up for their convictions should no doubt obey the laws of the state, and shape their conduct in deference to the opinions and practices of the world around them. those who object to vaccination should observe all the more strictly the laws of health already explained; for the strict observance of these laws ensures in the system those vital forces which counteract all disease germs, and is, therefore, the best protection against small-pox as well as other diseases. if, while objecting to the introduction of the poisonous vaccine into the system, they surrendered themselves to the still more fatal poison of sensuality, they would undoubtedly forfeit their right to ask the world to accept their views on the matter. when small-pox has actually appeared, the best treatment is the "wet-sheet-pack", which should be applied three times a day. it relieves the fever, and the sores heal rapidly. there is no need at all to apply oils or ointments on the sores. if possible, a mud-poultice should be applied in one or two places. the diet should consist of rice, and light fresh fruits, all rich fruits like date and almond being avoided. normally the sores should begin to heal under the "wet-sheet-pack" in less than a week; if they do not, it means that the poison in the system has not been completely expelled. instead of looking upon small-pox as a terrible disease, we should regard it as one of nature's best expedients for getting rid of the accumulated poison in the body, and the restoration of normal health. after an attack of small-pox, the patient remains weak for sometime, and in some cases even suffers from other ailments. but this is due not to the small-pox itself; but to the wrong remedies employed to cure it. thus, the use of quinine in fever often results in deafness, and even leads to the extreme form of it known as "quininism". so too, the employment of mercury in venereal diseases leads to many new forms of disease. then again, too frequent use of purgatives in constipation brings on ailments like the piles. the only sound system of treatment is that which attempts to remove the root-causes of disease by a strict observance of the fundamental laws of health. even the costly _bhasmas_ which are supposed to be unfailing remedies for such diseases are in effect highly injurious; for, although they may seem to do some good, they excite the evil passions, and ultimately ruin the health. after the vesicles on the body have given place to scabs, olive oil should be constantly applied, and the patient bathed every day. then the scabs rapidly fall off, and even the pocks soon disappear, the skin recovering its normal colour and freshness. chapter vii other contagious diseases we do not dread chicken-pox so much as its elder sister, since it is not so fatal, and does not cause disfigurement and the like. it is, however, exactly the same as small-pox in other respects, and should therefore be dealt with in the same way. bubonic plague is a terrible disease, and has accounted for the death of millions of our people since the year , when it first made its real entry into our land. the doctors, in spite of all their investigations, have not yet been able to invent a sure remedy for it. now-a-days the practice of inoculation has come into vogue, and the belief has gained ground that an attack of plague may be obviated by it. but inoculation for plague is as bad and as sinful as vaccination for small-pox. although no sure remedy has been devised for this disease, we will venture to suggest the following treatment to those who have full faith in providence, and who are not afraid of death. ( ) the "wet-sheet-pack" should be applied as soon as the first symptoms of fever appear. ( ) a thick mud-poultice should be applied to the bubo. ( ) the patient should be completely starved. ( ) if he feels thirsty, he should be given lime-juice in cold water. ( ) he should be made to lie in the open air. ( ) there should not be more than one attendant by the side of the patient. we can confidently assert that, if plague can be cured by any treatment at all, it can be cured by this. though the exact origin and causes of plague are yet unknown, it is undoubted that rats have something to do with its communication. we should, therefore, take all precautions, in a plague-infected area, to prevent the approach of rats in our dwellings; if we cannot get rid of them, we should vacate the house. the best remedy to prevent an attack of plague is, of course, to follow strictly the laws of health,--to live in the open air, to eat plain wholesome food and in moderation, to take good exercise, to keep the house neat and clean, to avoid all evil habits, and, in short, lead a life of utter simplicity and purity. even in normal times our lives should be such, but, in times of plague and other epidemics, we should be doubly careful. pneumonic plague is an even more dangerous form of this disease. its attack is sudden and almost invariably fatal. the patient has very high fever, feels extreme difficulty in breathing, and in most cases, is rendered unconscious. this form of plague broke out in johannesburg in , and as has been already said,[ ] only one man escaped alive out of the who were attacked. the treatment for this disease is just the same as that for bubonic plague, with this difference that the poultice should be applied in this case to both sides of the chest. if there be no time to try the "wet-sheet-pack", a thin poultice of mud should be applied to the head. needless to say, here as in other cases, prevention is better than cure. [ ] part i, chap. v we are terribly afraid of cholera, as of plague, but in fact, it is much less fatal. here the "wet-sheet-pack", however, is of no effect, but the mud-poultice should be applied to the stomach, and where there is a tingling sensation, the affected part should be warmed with a bottle filled with warm water. the feet should be rubbed with mustard-oil, and the patient should be starved. care should be taken to see that he does not get alarmed. if the motions are too frequent, the patient should not be repeatedly taken out of bed, but a flat shallow vessel should be placed underneath to receive the stools. if these precautions are taken in due time, there is little fear of danger. this disease generally breaks out in the hot season, when we generally eat all sorts of unripe and over-ripe fruits in immoderate quantities and in addition to our ordinary food. the water also that we drink during this season is often dirty, as the quantity of it in wells and tanks is small, and we take no trouble to boil or filter it. then again, the stools of the patients being allowed to lie exposed, the germs of the disease are communicated through the air. indeed, when we consider how little heed we pay to these most elementary facts and principles, we can only wonder that we are not more often attacked by these terrible diseases. during the prevalence of cholera, we should eat light food in moderation. we should breathe plenty of fresh air; and the water that we drink should always be thoroughly boiled, and filtered with a thick clean piece of cloth. the stools of the patient should be covered up with a thick layer of earth. indeed, even in normal times, we should invariably cover up the stools with ashes or loose earth. if we do so, there would be much less danger of the spread of disease. even the lower animals like the cat take this precaution, but we are worse than they in this respect. it should also be thoroughly impressed on the minds of persons suffering from contagious diseases, as well as those around them, that they should, under no circumstances, give way to panic, for fear always paralyses the nerves and increases the danger of fatality. chapter viii maternity and child-birth our object in the foregoing chapters has been to point out the unity of origin and treatment of some of the more common diseases. we are, indeed, fully aware that those who are the constant victims of disease, and who are constantly oppressed by the fear of death, will still continue to put themselves at the mercy of doctors, in spite of all that we might say against it. we venture to think, however, that there would be at least a few who are willing to cure themselves of their diseases by purely natural processes, so as to save themselves from all further attacks; and such persons would surely find it worth while to follow the simple directions we have given. before concluding this book, we will also give a few hints on maternity and the care of the child, as well as some common accidents. in the lower orders of the animal creation, the pangs of child-birth are altogether unknown. the same should really be the case with perfectly healthy women. in fact, most women in the country regard child-birth as quite an ordinary matter; they continue to do their normal work till almost the last moment, and experience hardly any pain at the time of delivery. women employed in labour have also been known to be able very often to return to work almost immediately after child-birth. how comes it, then, that women in towns and cities have to endure so much pain and suffering at the time of child-birth? and why is it that they have to receive special treatment before and after the delivery? the answer is simple and obvious. the women in towns have to lead an unnatural life. their food, their costume, their mode of life, in general, offend against the natural laws of healthy living. further, besides becoming pregnant at a premature age, they are the sad victims of men's lust even after pregnancy, as well as immediately after child-birth, so that conception again takes place at too short an interval. this is the state of utter misery and wretchedness in which lakhs of our young girls and women find themselves in our country to-day. to my mind, life under such conditions is little removed from the tortures of hell. so long as men continue to behave so monstrously, there can be no hope of happiness for our women. many men put the blame on the women's shoulders; but it is none of our business here to weigh the relative guilt of man and woman in this matter. we are only concerned to recognise the existence of the evil, and to point out its cure. let all married people realise, once for all, that, so long as sexual enjoyment at a premature age, as well as during pregnancy and soon after child-birth, does not cease to exist in our land, an easy and painless child-birth must remain a wild dream. women silently endure the pangs of child-birth, as well as the subsequent period of confinement, under the wrong notion that they are inevitable, but they fail to see how their own ignorance and weakness of will make their children grow weaker and droop from day to day. it is the clear duty of every man and woman to try to avert this calamity at any cost. if even a single man and woman should do their duty in this matter, to that extent it would mean the elevation of the world. and this is clearly a matter in which no man need or should wait for another's example. it follows, then, that the very first duty of the husband is wholly to abstain from all sexual intercourse with the wife from the moment of conception. and great is the responsibility that rests on the wife during the nine months that follow. she should be made to realise that the character of the child to be born will depend entirely on her life and conduct during this sacred period. if she fills her mind with love for all things that are good and noble, the child will also manifest the same disposition; if, on the other hand, she gives way to anger and other evil passions, her child will necessarily inherit the same. hence in these nine months, she should engage herself constantly in good works, free her mind from all fear and worry, give no room for any evil thoughts or feelings, keep out all untruth from her life, and waste not a moment in idle talk or deed. the child that is born of such a mother,--how can it help being noble and strong? the pregnant woman should, of course, keep her body as pure as her mind. she should breathe plenty of fresh air, and eat only so much of plain and wholesome food as she can easily digest. if she attends to all the directions already given in the matter of diet etc., she would have no need at all to seek the aid of doctors. if she suffers from constipation, the proportion of olive oil in the diet should be increased; and in cases of nausea or vomitting, she should take juice of lime in water without sugar. all spices and condiments should be scrupulously avoided. the yearning for various new things that attends a woman in pregnancy may be restrained by the use of "kuhne baths". this is also useful in increasing her strength and vitality, and in easing the pangs of child-birth. it is also necessary to steel her mind against such yearnings by nipping in the bud each desire as it comes. the parents should be constantly mindful of the welfare of the child in the womb. it is also the husband's duty during this period to refrain from all wranglings with his wife, and to conduct himself in such a way as to make her cheerful and happy. she should be relieved of the heavier duties of household management, and made to walk for some time every day in fresh air. and on no account should she be given any drugs or medicines during the period. chapter ix care of the child we do not propose in this chapter to describe the duties of a midwife or wet nurse, but only to point out how the child should be cared for after birth. those who have read the foregoing chapters need not be told how injurious it is to keep the mother during the period of confinement in a dark and ill-ventilated closet and to make her lie on a dirty bed with a fire underneath. these practices, however time-honoured they may be, are nevertheless fraught with dangerous consequences. no doubt, during the cold season, the mother should be kept warm, but this is best done by using good blankets. if the apartment is too cold and a fire has to be kept, it must be lighted outside and only brought in when all the smoke has disappeared, and even then it should not be kept under the cot on which she lies. warmth may also be given by keeping bottles of hot water on the bed. all the clothes and sheets should be thoroughly cleansed after child-birth, and before being used again. as the health of the child will depend entirely on that of the mother, special attention must be paid to her diet and mode of living. if she is fed on wheat, with plenty of good fruits like the plantain, and olive oil she would feel warm and strong, and have plenty of milk. olive oil gives aperient properties to the mother's milk, and thus serves to keep the child free from constipation. if the child is unwell, attention must be turned to the state of the mother's health. administering drugs to the child is as good as murdering it, for the child with its delicate constitution, easily succumbs to their poisonous effects. hence the medicine should be administered to the mother, so that its beneficial properties may be transmitted to the child through her milk. if the child suffers, as it often does, from cough or loose bowels, there is no cause for alarm; we should wait for a day or so, and try to get at the root of the trouble, and then remove it. making fuss over it and falling into a panic only makes matters worse. the child should invariably be bathed in tepid water. its clothing should be as little as possible; for a few months it is best to have none at all. the child should be laid on a thin soft white sheet and covered with a warm cloth. this will obviate the need for the use of shirts, prevent the clothes from getting dirty, and make the child hardy and strong. a fine piece of cloth folded into four should be placed over the navel-string, and kept in position by a band over it. the practice of tying a thread to the navel-string and hanging it round the neck is highly injurious. the navel-band should be kept loose. if the part round the navel be moist, fine well-sifted flour may be gently applied over it. as long as the supply of the mother's milk is sufficient, the child should be fed exclusively on it; but, when it gets insufficient, fried wheat well powdered, and mixed with hot water and a little of jaggery, may be used as a substitute with quite good results. half a plantain well mashed and mixed with half a spoonful of olive oil is also particularly beneficial. if cow's milk has to be given, it should at first be mixed with water in the proportion of three to one, and then heated until it just begins to boil, when a little of pure jaggery should also be added. the use of sugar instead of jaggery is harmful. the child should gradually be accustomed to a fruit-diet, so that its blood may be kept pure from the very beginning, and it may grow manly and bright. those mothers who begin to feed their children on things like rice, vegetables and _dhall_, as soon as or even before its teeth have appeared, are doing them infinite harm. needless to say, coffee and tea should be strictly eschewed. when the child has grown big enough to walk, it may be clothed with _kurta_ and the like, but its feet should still be kept bare, so that it may be free to roam about at will. the use of shoes prevents the free circulation of blood and the development of hardy feet and legs. dressing the child in silk or lace cloths, with cap and coat, and ornaments, is a barbarous practice. our attempt to enhance by such ridiculous means the beauty that nature has given, only bespeaks our vanity and ignorance. we should always remember that the education of the child really begins from its very birth, and is best given by the parents themselves. the use of threats and punishments, and the practice of gorging the children with food, are an outrage on the principles of true education. as the old saying has it, "like parent, like child"; hence the example and practice of the parents necessarily shape the conduct and character of the children. if they are weaklings, their children also grow up weak and delicate; if they talk clearly and distinctly, so too will the children; but if they talk with a lisp, the children will also learn to do so. if they use foul language, or are addicted to bad habits, the children necessarily imitate them, and develop into bad characters. in fact, there is no field of human activity in which the child does not imitate the example of its parents. we see, then, how heavy is the responsibility that rests on the shoulders of parents. the very first duty of a man is to give such education to his children as will make them honest and truthful, and an ornament to the society in which they live. in the animal and vegetable kingdoms, the offspring invariably takes after the parent. man alone has violated this law of nature. it is only among men that we see such incongruities as vicious children being born to virtuous parents, or sickly ones to the healthy. this is due to the fact that we thoughtlessly become parents when we are not mature enough to assume the responsibilities of that position. it is the solemn duty of all virtuous parents to train their children in noble ways. this requires that both the father and the mother should themselves have received a sound education. where the parents lack such education and are aware of their imperfections, it is their duty to entrust their children to the care of proper guardians. it is foolish to expect that a high character can be developed in the children by merely sending them to school. where the training given at school is inconsistent with that given at home, there can be no hope of improvement for the child. as already pointed out, the true education of the child begins from the very moment of its birth. the rudiments of knowledge are imbibed almost in the course of play. this, indeed, was the ancient tradition; the practice of sending children to school is a growth of yesterday. if only the parents would do their duty by their children, there would be no limit to the possibilities of their advancement. but, in fact, we make playthings of our children. we deck their persons with fine clothes and jewels, we gorge them with sweetmeats, and spoil them from their very infancy by fondlings and caresses. we let them go unchecked on their way in our false affection for them. being ourselves miserly, sensuous, dishonest, slothful and uncleanly, is it to be wondered at that our children should follow in our foot steps, and turn out weak and vicious, selfish and slothful, sensuous and immoral? let all thoughtful parents ponder well over these matters; for on them depends the future of our land. chapter x some accidents: drowning we will now turn our attention to some of the more common accidents, and the methods of dealing with them. a knowledge of these things is essential to everybody, so that timely help may be rendered, and the loss of many precious lives averted. even children should be taught to deal with these cases, as in that way they are the more likely to grow up kind and thoughtful citizens. and first we will deal with drowning. as man cannot live without air for more than minutes at the most, little life generally remains in a drowning man taken out of water. immediate steps should, therefore, be taken to bring him back to life. two things have specially to be done for these,--artificial respiration, and the application of warmth. we should not forget that very often such 'first aid' has to be rendered by the side of tanks and rivers, where all the needed materials are not easily available, and such aid can be most effectual only when there are at least two or three men on the spot. the first-aider should also possess the qualities of resourcefulness, patience, and briskness; if he himself loses his presence of mind, he can do nothing. so too, if the attendants begin to discuss methods, or quarrel over details, there is no hope for the man. the best one in the party should lead, and the others should implicitly follow his directions. as soon as the man is taken out of water, his wet clothes should be removed, and his body wiped dry. then he should be made to lie on his face, with his hands under the head. then, with our hand on his chest, we should remove from his mouth the water and dirt that might have got in. at this time his tongue would come out of his mouth, when it should be caught hold of with a kerchief, and held till consciousness returns. then he should at once be turned over, with the head and the chest a little raised above the feet. then one of the attendants should kneel by his head, and slowly spread out and straighten his arms on either side. by this means his ribs will be raised, and the air outside can enter into his body; then his hands should be quickly brought back and folded on his chest, so that the chest may contract and the air be expelled. in addition to this, hot and cold water should be taken in the hands and poured on his chest. if a fire can be lighted or procured, the man should be warmed with it. then all the available clothes should be wrapped round his body, which should be thoroughly rubbed for warmth. all this should be tried for a long time without losing hope. in some cases, such methods have to be applied for several hours on end before breathing is restored. as soon as signs of consciousness appear, some hot drink should be administered. the juice of lime in hot water, or decoction of cloves, pepper, and the bark of the bay-tree, will be found specially effective. the smell of tobacco may also prove useful. people should not be allowed to crowd round the patient, and obstruct the free passage of air. the signs of death in such cases are the following. the complete cessation of breathing and the beating of heart and lungs, as indicated by a piece of peacock-feather held near the nose remaining quite steady, or a mirror held near the mouth being undimmed by the moisture in the breath; the eyes remaining fixed and half-open, with heavy eye-lids; the jaws getting fixed; the fingers getting crooked; the tongue protruding between the teeth; the mouth getting frothy; nose getting red; the whole body turning pale. if all these signs simultaneously appear, we may conclude that the man is dead. in some rare cases, life may still remain even when all these signs are present. the only conclusive test of death is the setting in of decomposition. hence the patient should never be given up for lost, until after a long and patient application of remedial measures. chapter xi some accidents--(_contd._) burns and scalds very often when a man's clothes catch fire, we get into a panic, and, instead of helping the injured, make matters worse by our ignorance. it is our duty, therefore, to know exactly what to do in such cases. the person whose clothes have caught fire should not lose his presence of mind. if the fire is only at one edge of the cloth, it should at once be squeezed out with the hands; but if it has spread over the whole cloth or a large portion of it, the man should at once lie down and roll on the floor. if a thick cloth like a carpet be available, it should at once be wrapped round his body; and if water is at hand, it should also be poured over it. as soon as the fire has been put out, we should find out if there are burns in any part of the body. the cloth would generally stick to the body where there are burns, in which case it should not be forcibly torn off, but gently snipped off with a pair of scissors, leaving the affected parts undisturbed, and taking care to see that the skin does not come off. immediately after this, poultices of pure mud should be applied to all these places, and kept in position by bandages. this will instantly relieve the burning, and ease the patient's suffering. the poultices may as well be applied over the portions of the cloth which stick on to the body. they should be renewed as soon as they begin to get dry; there is no reason to fear the touch of cold water. where this sort of first aid has not been rendered, the following directions will be found very useful. fresh plantain leaves well smeared with olive or sweet oil should be applied over the burns. if plantain leaves are not available, pieces of cloth may be used. a mixture of linseed oil and lime-water in equal proportions may also be applied with great advantage. the portions of cloth which adhere to the burns may be easily removed by moistening them with a mixture of tepid milk and water. the first bandage of oil should be removed after two days, and afterwards fresh bandages applied every day. if blisters have formed on the burnt surface, they should be pricked, but the skin need not necessarily be removed. if the skin has simply got red by the burn, there is no more effective remedy than the application of a mud poultice. if the fingers have been burnt, care should be taken, when the poultice is applied, that they do not touch against one another. this same treatment may be applied in cases of acid-burns, and scalds of every description. chapter xii some accidents--(_contd._) snake-bite there is no limit to the superstitions current among us in regard to snakes. from time immemorial we have cultivated a terrible fear of the snake; we even dread the very mention of its name. the hindus worship the serpent, and have set apart a day in the year (_nagapanchami_) for that purpose. they suppose that the earth is supported by the great serpent sesha. god vishnu is called _seshasayee_, as he is supposed to sleep on the serpent-god; and god siva is supposed to have a garland of serpents round his neck! we say that such and such a thing cannot be described even by the thousand-tongued adisesha, implying our belief in the snake's knowledge and discretion. the serpent karkotaka is said to have bitten king nala and deformed him, so that he might not suffer any harm in the course of his wanderings. such conceptions are also to be met with among the christian nations of the west. in english a man is very often described to be as wise and cunning as a serpent. and in the bible, satan is said to have assumed the shape of a serpent in order to tempt eve. the real reason for the popular dread of snakes is obvious. if the snake's poison should spread over the whole body, death must necessarily ensue; and since the idea of death is so dreadful to us, we dread the very name of a snake. hence, our worship of the snake is really based on our fear. if the snake were a little creature, it would hardly be worshipped by us; but since it is a big creature, and a strangely fascinating one, it has come to be deified and worshipped. the western scientists of to-day hold that the snake is merely a creature of instinct, and it should be destroyed forthwith wherever found. from the official statistics, we gather that not less than , persons die every year in india of snake-bite alone. the destruction of every venomous snake is rewarded by the state, but it is really a question if the country has benefitted by it in any way. we find from experience that a snake never bites wantonly, but only as a retaliatory measure when it is molested in any way. does this not bespeak its discretion, or at the least its innocence? the attempt to rid hindustan, or any portion thereof, of snakes is as ridiculous and futile as trying to wrestle with the air. it may be possible to prevent snakes coming to a particular place by a systematic process of extermination, but this can never be done on a large scale. in a vast country like india, it would be an altogether foolish enterprise to try to avoid snake-bites by wholesale destruction of the snakes. let us never forget that the serpents have been created by the same god who created us and all other creatures. god's ways are inscrutable, but we may rest assured that he did not create animals like the lion and the tiger, the serpent and the scorpion, in order to bring about the destruction of the human race. if the serpents were to meet in council and conclude that man has been created by god for their destruction, seeing that he generally destroys a snake wherever found, should we approve of their conclusion? surely not. in the same way, we are wrong in regarding the serpent as a natural enemy of man. the great st. francis of asissi, who used to roam about the forests, was not hurt by the serpents or the wild beasts, but they even lived on terms of intimacy with him. so too, thousands of _yogis_ and _fakirs_ live in the forests of hindustan, amidst lions and tigers and serpents, but we never hear of their meeting death at the hands of these animals. it might, however, be contended that they must certainly be meeting their death in the forests, but that we do not hear of it, as we live so far away. granted; but we cannot deny that the number of _yogis_ that live in the forests is nothing in comparison with that of the serpents and wild beasts, so that, if these animals were really the natural enemies of man, the whole race of _yogis_ and other dwellers in the forests should become very rapidly extinct, especially since they have no weapons with which to defend themselves against their attacks. but they have by no means become extinct, and we may conclude, therefore, that they have been allowed to live unmolested in the forests by the serpents and wild beasts. in fact, i have implicit faith in the doctrine that, so long as man is not inimical to the other creatures, they will not be inimical to him. love is the greatest of the attributes of man. without it the worship of god would be an empty nothing. it is, in short, the root of all religion whatsoever. besides, why should we not regard the cruelty of the serpents and the wild beasts as merely the product and reflection of man's own nature? are we any the less murderous than they? are not our tongues as venomous as the serpent's fangs? do we not prey upon our innocent brethren much in the same way as lions and leopards? all scriptures proclaim that, when man becomes absolutely harmless, all the other animals will begin to live on terms of intimacy with him. when feuds and conflicts as fierce as that between the lion and the lamb are going on within our own breasts, is it any wonder that such things should go on in the external world? for, we are but the reflection of the world around us; all the features of the external world are found reflected in the inner world of our mind. when we change our nature, the world around should also inevitably change. do we not find that the world assumes a totally different aspect to those individual men and women who change their own nature by strenuous self-discipline? this is the great mystery of god's creation as well as the great secret of true happiness. our happiness or otherwise rests entirely upon what we are; we have no need to depend on other people at all in this matter. our excuse for writing at such length on snake-bite is this. rather than merely prescribe cure for snake-bite, we thought it as well to go a little more deeply into the matter, and point out the best way of getting rid of our foolish fears. if even a single reader were to adopt in practice the principles we have been discussing, we shall consider our effort amply rewarded. moreover, our object in writing these pages is not merely to give the generally accepted hygienic principles, but to go to the root of the matter, and deal with the most fundamental principles of health. modern investigations have also shown that the man who is perfectly healthy, whose blood has not been tainted by excess of heat, and whose food is wholesome and _satvic_, is not immediately affected by the poison of the snake, but that, on the other hand, its effect is instantaneous as well as fatal on the man whose blood has been tainted by drink or unwholesome food. one doctor goes so far as to say that the blood of the man who eschews salt and the like, and lives exclusively on a fruit-diet, remains so pure that no kind of poison can have any effect on him. i have not had enough experience myself to say how far this is true. the man whose diet has been free from salt and the like for only one or two years cannot be said to have attained this stage of perfect immunity, for the blood which has been tainted and poisoned by bad practices continued for years cannot be brought back to its normal state of purity in the short period of a year or two. it has further been scientifically demonstrated that a man under the influence of fear or anger is much more and much sooner, affected by poison than when in the normal condition. everybody knows how fear and anger make the pulse and the heart beat faster than the normal rate, and the quicker the flow of blood in the veins, the greater the heat generated. but the heat generated by evil passions is not healthy, but extremely harmful. anger is, indeed, nothing but a variety of fever. hence the best antidote against snake-bite is to use pure and _satvic_ food in moderation, to rid our minds of all evil passions like anger and fear, to refrain from giving way to panic, to retain perfect confidence in the saving power of a pure and godly life, and to remain self-possessed in the full faith that we are ever in god's hands, and that the span of life which he has allotted to us can on no account be curtailed or exceeded. dr. fitz-seaman, the director of the port elizabeth museum, who has devoted a large portion of his life to the study of snakes, their varieties and their habits, and who is a great authority on snake-bite and its cure, has told us, as a result of his numerous experiments, that the majority of the so-called deaths by snake-bite are really caused by fear and the wrong remedies applied by quacks. we should remember that all snakes are not venomous, and that even the bite of all venomous snakes is not immediately fatal either. moreover, the snakes do not always get an opportunity of injecting their venom into the body of their victim. we should not, therefore, give way to panic even when we are bitten by a venomous serpent, especially since very simple remedies are available, which can be applied by ourselves without any aid from others. the part of the body immediately above the point at which the snake has bitten should be tied round with tight bandage, which should be further strengthened by means of strong pencils or pieces of wood, so that the poison may not ascend through the veins. then the wound should be cut half an inch deep with the fine point of a knife, so that the poisoned blood may freely flow, and the hollow should be filled with the dark-red powder sold in the bazaars and known as potassium permanganate. if this is not available, the blood issuing from the wound should be well sucked and spat out, by the patient himself or by somebody else, until all the poison has been removed. of course, no man who has a wound on the lips or the tongue should be allowed to suck this poisoned blood. this treatment should be applied within minutes of the accident,--that is to say, before the poison has had time to ascend and diffuse through the body. as already mentioned, the german doctor who has specialised in mud-cure, claims to have cured snake-bite by burying the patient under fresh earth. although i have not tried the use of mud in snake-bites, i have unbounded faith in its efficacy from my experience in other cases. after the application of potassium permanganate (or the sucking out of the blood, in the alternative,) a poultice of mud half an inch in thickness, and big enough to cover the whole region around and above the affected part, should be applied. there should be kept in every home a quantity of well-sifted and powdered mud in a tin ready for use. it should be so kept as to be exposed to light and air, and free from dampness. suitable bandages of cloth should also be kept so as to be within reach when needed. these will be found useful not only in snake-bite, but in numberless other cases as well. if the patient has lost consciousness, or if respiration seems to have ceased, the process of artificial respiration already described in connection with drowning should be resorted to. hot water, or preferably a decoction of cloves and the bark of the bay-tree, is very useful for recovering consciousness. the patient should be kept in the open air, but if his body seems to have taken cold, bottles of hot water should be employed, or a piece of flannel dipped in hot water and wrung out should be rubbed over the body, to produce warmth. chapter xiii some accidents--(_contd._) scorpion-sting our familiar expression, "may god never give any man the pain of scorpion-sting", shows how keen that pain is. in fact, this pain is even sharper than that of snake-bite, but we do not dread it so much, since it is much less fatal. indeed, as dr. moor has said, the man whose blood is perfectly pure has little to fear from the sting of a scorpion. the treatment for scorpion-sting is very simple. the affected part should be cut into with a sharp-pointed knife, and the blood that issues from it slightly sucked out. a small bandage tied tightly above this portion would prevent the spread of the poison, while a poultice of mud would give immediate relief to the pain. some writers advise us to tie a thick bandage of cloth over the affected part, wetted with a mixture of vinegar and water in equal proportions, or to keep the region around it immersed in salt water. but the poultice of mud is certainly the most effective remedy of all, as may be personally tested by those who may have the misfortune to be stung by scorpions. the poultice should be as thick as possible; even two seers of mud would not be too much for the purpose. if the finger be stung, for instance, the poultice should extend up to the elbow. if the hand be kept immersed for sometime in wet mud in a pretty large vessel, it would give instant relief to the pain. the stings of the centipede and other animals should be dealt with exactly as that of the scorpion. chapter xiv conclusion i have now said all that i had intended to say on the subject of health. and now, before finally taking leave of my readers, i will say a word or two on my object in writing these pages. one question which i have asked myself again and again, in the course of writing this book, is why i of all persons should write it. is there any justification at all for one like me, who am no doctor, and whose knowledge of the matters dealt with in these pages must be necessarily imperfect, attempting to write a book of this kind? my defence is this. the "science" of medicine is itself based upon imperfect knowledge, most of it being mere quackery. but this book, at any rate, has been prompted by the purest of motives. the attempt is here made not so much to show how to cure diseases as to point out the means of preventing them. and a little reflection will show that the prevention of disease is a comparatively simple matter, not requiring much specialist knowledge, although it is by no means an easy thing to put these principles into practice. our object has been to show the unity of origin and treatment of all diseases, so that all people may learn to treat their diseases themselves when they do arise, as they often do, in spite of great care in the observance of the laws of health. but, after all, why is good health so essential, so anxiously to be sought for? our ordinary conduct would seem to indicate that we attach little value to health. if health is to be sought for in order that we might indulge in luxury and pleasure, or pride ourselves over our body and regard it as an end in itself, then indeed it would be far better that we should have bodies tainted with bad blood, by fat, and the like. all religions agree in regarding the human body as an abode of god. our body has been given to us on the understanding that we should render devoted service to god with its aid. it is our duty to keep it pure and unstained from within as well as from without, so as to render it back to the giver, when the time comes for it, in the state of purity in which we got it. if we fulfil the terms of the contract to god's satisfaction, he will surely reward us, and make us heirs to immortality. the bodies of all created beings have been gifted with the same senses, and the same capacity for seeing, hearing, smelling and the like; but the human body is supreme among them all, and hence we call it a "_chintamani_," or a giver of all good. man alone can worship god with knowledge and understanding. where devotion to god is void of understanding, there can be no true salvation, and without salvation there can be no true happiness. the body can be of real service only when we realise it to be a temple of god and make use of it for god's worship; otherwise it is no better than a filthy vessel of bones, flesh and blood, and the air and water issuing from it are worse than poison. the things that come out of the body through the pores and other passages are so filthy that we cannot touch them or even think of them without disgust; and it requires very great effort to keep them tolerably clean. is it not most disgraceful that, for the sake of this body, we should stoop to falsehood and deceit, licentious practices and even worse? is it not equally shameful that, for the sake of these vices, we should be so anxious to preserve this fragile frame of ours at any cost? this is the truth of the matter in regard to our body; for the very things which are the best or the most useful have inherent in them capabilities of a corresponding mischief. otherwise, we should hardly be able to appreciate them at their true worth. the light of the sun, which is the source of our life, and without which we cannot live for an hour, is also capable of burning all things to ashes. so too, a king may do infinite good to his subjects, or be the source of untold mischief. indeed, the body may be a good servant, but, when it becomes a master, its powers of evil are unlimited. there is an incessant struggle going on within us between our soul and satan for the control of our body. if the soul gains the ascendancy, the body becomes a most potent instrument of good; but, if the devil is victorious in the struggle, it becomes a hot-bed of vice. hell itself would be preferable to the body which is the slave of vice, which is constantly filled with decaying matter and which emits filthy odours, whose hands and feet are employed in unworthy deeds, whose tongue is employed in eating things that ought not to be eaten or in uttering language that ought not to be uttered, whose eyes are employed in seeing things that ought not to be seen, whose ears are employed in the hearing of things that ought not to be heard, and whose nose is employed in the smelling of things that ought not to be smelt. but, while hell is never mistaken for heaven by anybody, our body which is rendered worse than hell by ourselves is, strangely enough, regarded by us as almost heavenly! so monstrous is our vanity, and so pitiful our pride, in this matter! those who make use of a palace as a latrine, or vice versa, must certainly reap the fruit of their folly. so too, if, while our body is really in the devil's hands, we should fancy that we are enjoying true health, we shall have only ourselves to thank for the terrible consequences that are sure to follow. to conclude, then our attempt in these pages has been to teach the great truth that perfect health can be attained only by living in obedience to the laws of god, and defying the power of satan. true happiness is impossible without true health, and true health is impossible without a rigid control of the palate. all the other senses will automatically come under our control when the palate has been brought under control. and he who has conquered his senses has really conquered the whole world, and he becomes a part of god. we cannot realise rama by reading the ramayana, or krishna by reading the gita, or god by reading the koran, or christ by reading the bible; the only means of realising them is by developing a pure and noble character. character is based on virtuous action, and virtuous action is grounded on truth. truth, then, is the source and foundation of all things that are good and great. hence, a fearless and unflinching pursuit of the ideal of truth and righteousness is the key-note of true health as of all else. and if we have succeeded (in however feeble a measure) in bringing this grand fact home to our reader, our object in writing these pages would have been amply fulfilled. --finis-- _errata_ _page_ _line_ _for_ _read_ _êvam_ _êva_ beings being _kapah_ _kapha_ had begun begun detial detail admire pride surley surely would should fus pus according according to sriget siegel wick brick vaccinations vaccination difference deference patients patient passion passions and end piece pair superstitious superstitions , god god vareity a variety godly godly is are brid bird that omit some none the huxley press, g. t. madras. ======================================================================== ganesan's new publications the failure of european civilisation by s. e. stokes with foreword by c. f. andrews. re. - . in this book mr. stokes shows how european civilisation by its prejudices of colour and race has miserably failed to satisfy the laws of true progress and needs of the modern world, and warns india of destroying her unique culture by falling a prey to white imperialism. national self-realisation by s. e. stokes re. - . students of current indian politics and workers for swaraj will find in this publication a very useful discussion of india's ultimate goal and the methods of attaining it. the author though an american is well known as a sincere friend of the oppressed and to use the words of mahatma gandhi "mr. stokes is a convinced non-co-operator and a congressman. i think i am right in saying that he has come to it by slow degrees. no indian is giving such battle to the government as mr. stokes. he has veritably become the guide, philosopher and friend of the hillmen". essays: political and national by s. e. stokes rs. . this collection of essays is intended to stimulate thought on some of the important problems that india has to solve in the field of education, religion and other aspects of national life. the truth about india by h. m. hyndman as. . this small book gives the main facts about india's plight under alien domination in a boldly frank and appealing manner. the pages breathe throughout the true englishman's inextinguishable fire of freedom and righteous indignation at oppression and exploitation of weak nations. the author exposes the methods by which british domination was established in india and discusses the political and economic effects of such rule, uttering grave words of warning against the final nemesis. the book deserves to be widely read and translated in the various vernaculars as a very necessary corrective to the distorted version of british indian history taught in our schools. post box no. , triplicane, madras s.e. ======================================================================== transcriber's notes: obvious errors in spelling and punctuation have been silently corrected. similarly errors listed in the errata at the end have also been corrected. movement--the houses in portsburgh--the popular idea of the method of burke and hare--origin of the words "burker" and "burking."_ such were the resurrectionist times in scotland, and such the crimes committed by burke and hare, and their english imitators. now-a-days it may seem strange that events like these were possible in a country professing a civilizing christianity, but no one with a knowledge of the depths to which humanity can descend will deny that even in our much boasted time, with all our social advancement, men could be found who would dare to put their consciences under the burden of such terrible iniquities, were the other circumstances and necessities still the same. there was little wonder that the public sense of security was alarmed, that the heart of the nation was touched, at the shocking disclosures made at each successive trial, and at the daily actions of men who seemed to be safe from the law. we have seen how the people of scotland felt under the constant robbing of their churchyards; how they were awe-struck at the mysterious disappearance from among them of some unfortunate, whose whereabouts was never found out; and how they rose in righteous anger when the mystery was cleared up in the high court of justiciary. the wonder, indeed, is that considering the reverential regard for the dead which has always characterised them, that they bore the terrible pillage of their golgothas so long; and that when the end came they did not work more mischief than they did. but the times, hard as they were at the best, and suffering under such a shocking blemish, were productive of real and lasting good to the nation, socially, scientifically, and even spiritually. for a long time after the execution of burke and the flight of his accomplices, the houses in wester portsburgh were objects of horror and detestation; and having acquired a ghastly interest from the horrible crimes of which they were the scene, were among the best visited places in edinburgh, until at last they were knocked down as eyesores to the community, and as perpetuating a series of crimes which were too deeply impressed on human memory to be easily forgotten. but the tradition clung long to the district, and even to this day the locality is pointed out to the stranger as being notable. the interest taken in these buildings and their internal arrangement was so great, that paintings of them on canvas were taken through the country, and shown at village fairs and markets. but an annoying and reprehensible practice arose out of the actions of burke and hare, which while certainly not so serious, was not without its dangerous element. this was a habit which many young men dropped into of attempting to put pieces of sticking-plaster over the mouths of unsuspicious passengers on the streets. most commonly this prank was played upon girls, many of whom were almost out of their wits, and who would not venture out of the door at nights. this practice obtained not only in edinburgh but also in glasgow and the other large towns in scotland, and though examples were made by the miscreants being apprehended and punished by the police magistrates, it became after a time such an intolerable nuisance, that the strictest measures had to be taken for its repression. one case of this kind in glasgow created an extraordinary commotion. a servant girl was attacked in the street, and a sticking-plaster of so strong an adhesive nature was placed over her mouth that it could not be removed without taking a great portion of the skin of her face with it. there was little wonder that the _glasgow chronicle_, in a comment on the occurrence, said that the "wretches who can behave thus at any time, and more especially in the present state of public feeling, are a disgrace to society." but it is curious to note how this silly imitation of the method of burke and hare came to be regarded as the actual mode in which these men had performed their manifold murders. the fact that so many terrible crimes had been committed by them kept a firm hold on the mind of the people, but, gradually, the method, which had been made so public through the medium of the newspapers, was forgotten, and the impression as gradually gained ground that slipping up to their intended victims on the streets, burke and his accomplice gave them their quietus by skilfully placing a piece of sticking-plaster over their mouths. of course the preceding narrative, and the confessions of the condemned criminal, show that it was far otherwise, but the impression, amounting latterly to an absolute belief, became so fixed that even yet it still holds sway, though certainly in a less degree now than a generation ago. allusion has already been made to the remarkably strong hold the whole plot took upon the minds of the scottish people, and to the fact that it has exercised an influence on the inner life of the scottish mind down to the present. this is generally acknowledged, but perhaps a better idea of the original character of the impression made by the discoveries of may be gained when the great events and movements going on all around at and after the time are taken into consideration. in the year the country was agitated not only by stirring news from the continent, where armies were marching to and fro, and there was a tendency to a general european conflagration, but also by the catholic emancipation movement, and parliamentary reform. every one knows the interest the people of scotland took in these matters, and especially in the reform bill, and how many suffered on the scaffold for over boldness in the struggle. these were events that might have absorbed all the attention the people could spare from their daily toil for the sustenance of life; but yet the burke and hare tragedies were always to be heard repeated by some fireside, and the tales of the resurrectionists were rehearsed to willing listeners. such great events affected the rights of the people as citizens of the empire, as freemen in the state; but the violation of churchyards, the murder of poor human beings for the sale of their bodies, touched the heart, it related to the home-life of the man, independent of his citizenship. it was the same with the other great political movements of the early half of the century. the stories went from mouth to mouth, from father to son, from nurse to child, and the horrid memory of the foulest series of murders on the criminal calendar of scotland was kept fresh, young minds grew up in fear of a terrible unknown something of which the preceding generation had had a full realization, a something which happily was impossible, but which exercised a baneful and dwarfing influence all the same. the old bogles of superstitious times were thrown aside, the stern realities of human criminality were used in their stead. many still remember their youthful impressions and shudder. it is well that these influences are losing their power, but it would be unfortunate if the lessons taught by these awful times were forgotten by the country. happily, however, the resurrectionist times were not without their good elements as well as their bad. had such events not taken place two things would have been evident--first, that up to that time anatomical study and research had made little progress; and second, that the study would have continued in a state of stagnation under restrictions discreditable to the country and its rulers. but quite another state of matters existed and do exist. the scientific ardour which from an early period of its history had characterised the medical faculty in scotland, and particularly in edinburgh, may be said to have created the necessity for resurrectionists or body-snatchers, and the fact that the research so needful to the happiness and comfort of humanity was being conducted under such unfortunate auspices, and debasing restrictions, gradually awoke the community to a sense of what they owed to themselves and to those whose ultimate object was the general good. the churchyards were being robbed of their silent tenants, the poor were being surreptitiously bribed to part with the bodies of their dead relatives, and even the streets were being laid under contribution for their living wanderers. the exigencies of science had created a necessary evil; the natural and even justifiable prejudices of the nation, outraged and grieved, were against the seeking of a remedy. but the evil became so great, its worst and latest development was so shocking, that some steps had to be taken, even at the expense of human sentiment, to put matters on a right and proper footing. men could not live without doctors who were thoroughly trained and experienced in all the intricacies and mysteries of the human frame; these doctors could not gain their experience without "subjects," and "subjects" they must have by some means or other. not, certainly, that the profession approved of murder to obtain their ends, but the result showed that the men upon whom the profession mainly depended had resorted to that terrible act to supply their patrons. the only feasible course open, therefore, was that made lawful by the anatomy act of , which put upon a legal basis the purchase of bodies from relatives under certain wise and not too irksome conditions. it has been seen that notwithstanding the unhappy state of matters then existing, and the terrible scourge under which the country had so long suffered, there was a strong feeling against the passage of that measure; but on the other hand an interesting testimony was given in its favour when many of the highest in the land, amongst them the duke of sussex, the youngest son of king george iii., and uncle of queen victoria, gave directions that if necessary their bodies should after death be anatomised. the science of anatomy, therefore, for the first time in its existence, made rapid progress, the art of healing and alleviating disease became more perfect, and although there is much still to be desired, research is unfettered, and the possibility of discoveries valuable to humanity are increased. it is curious, however, that in the last few years of these baneful restrictions, extraordinary results accrued from the researches of anatomists, and, strange though it may seem, the science was really put upon a scientific basis it had never occupied before. but there was still another effect of the resurrectionist movement, and that was that it had a widening tendency on the religious beliefs of the people. the old idea is well expressed in the ballad written in , and quoted in an early chapter in this volume, when the unknown author says:-- "methink i hear the latter trumpet sound, when emptie graves into this place is found, of young and old, which is most strange to me, what kind of resurrection this should be." the people preferred to think of a resurrection which would in one respect and to a certain extent be comprehensible to them. they thought they could understand the dead rising from the grave if their bodies were placed intact in the sepulchre, but they deemed that a body dissected and cut into pieces, probably portions buried in different places, was unlikely to be under the influence of the last call. in this they distrusted god in the belief of a doctrine which above all required a distinct act of faith in his almighty power. their ideas, however, were widened, and they came to see that if it were possible for the great father of the human race to wake the dead on the judgment day when their dust lay peacefully beside the village church, it was also possible for him to call them to him though their particles lay far apart. there is one other point which must not be omitted in a work of this kind. the transactions in the west port of edinburgh, in , gave new words with a peculiar significance to the english language. a "burker" was unknown before the crimes of william burke were made public; "burking" was an undiscovered art until he discovered it. this in itself is another testimony to the effect the crimes chronicled in this book had upon the minds of the men and women of the period. many other words similarly derived have had a brief popularity, and dropped into oblivion, to be only hunted up by the philological antiquary, but these have retained their significance, and, by their aptitude to many actions in all phases of life, have attained to a classical position in the language to which their usefulness, rather than their origin, entitle them. [illustration: mrs. hare and child (from a sketch taken in court)] appendix appendix. the case against torrence and waldie. at page twenty-four _ante_ a brief note is given of the case against torrence and waldie for the murder of a boy for the purpose of disposing of his body to the surgeons. the account there given is founded upon a brief jotting in the _edinburgh evening courant_, and, as the case is one of considerable interest, the following more lengthy record is taken from the _scots magazine_ for :-- "helen torrence, residenter, and jean waldie, wife of a stabler's servant in edinburgh, were tried, at the instance of the king's advocate, before the court of justiciary, for stealing and murdering john dallas, a boy of about eight or nine years of age, son of john dallas, chairman in edinburgh. the indictment bears, that in november last the pannels frequently promised two or three surgeon-apprentices to procure them a subject; that they pretended that they were to sit up with a dead child, and after the coffining, slip something else into the coffin, and secrete the body; but said afterwards that they were disappointed in this, the parent refusing to consent; that on the rd of december, janet johnston, mother to the deceased, having come to torrence's house, was desired by her to sit down; that waldie, who was then with torrence, soon left them, on pretence of being ill with the colic, and went up stairs to her own house, which was immediately above that of torrence; that thereafter, on hearing a knock upon the floor above, torrence went up stairs to waldie, staid a short while with her, then returned to janet johnstone, and invited her to drink a pint of ale in a neighbouring house, which invitation she accepted of; that after they had drunk one pint of ale, torrence offered another; that this second pint being brought in, torrence went out of the ale-house; that then both or either of the pannels went to the house of the above-mentioned john dallas, chairman, stole away the poor innocent boy in the absence of its parents, and murdered it; that waldie immediately after went and informed the surgeon apprentices that torrence and she had now found a subject, desiring them to carry it instantly away; that on this the apprentices came to waldie's house, and found the dead body stretched on a chest; that having asked what they should give for the subject? would not two shillings be enough? both pannels declared they had been at more expense about it than that sum; but that upon their giving torrence tenpence to buy a dram, she and waldie accepted of the two shillings in part payment; that, at the desire of the apprentices, torrence carried the body in her apron to one of their rooms, for which she received sixpence more; and that when the pannels were apprehended, some of the facts were confessed by them, by torrence before one of the bailies of edinburgh, and by waldie before the lord provost; waldie in particular, having confessed that torrence told her, that should this boy die, he would be a good one for the doctors; that, at torrence's desire, she frequently went to see how the boy was; that thereafter, torrence having asked her how he was? and she having answered, that he continued much in the same way, torrence replied that it would be better to take him away alive, for he would be dead before he could be brought to her house; that accordingly, after the boy's mother had seen waldie upstairs to her own house, rd december, torrence came and told her that she and the mother were then drinking a pint of ale, and that it would be a proper time for waldie to go for the boy; that waldie accordingly went, found the boy looking over a window, took him up in her arms, and carried him directly to her own house, whither she was immediately followed by torrence; that, before torrence came in, waldie had given the boy a drink of ale, but it would scarce go over, and he died six minutes thereafter; and that waldie, at torrence's desire, went for the surgeons, and sold the dead body to them, as above. on missing their child, the parents made inquiry for him. in about four days, the body was found in a place of the town little frequented, but with evident marks of having been in the surgeons' hands. the parents were thereupon taken up, and likewise the pannels. the pannels were examined, the parents set at liberty, and the pannels kept in prison. their trial came off on the rd february. after debates, the lords found the libel relevant to infer the pains of law. a proof was taken on the same day. among the witnesses were the boy's parents, and the surgeons' apprentices. next day the jury returned the following verdict:--'found, that the pannels are both guilty, art and part, of stealing john dallas, a living child, and son of john dallas, chairman in edinburgh, from his father's house, at the time and in the manner libelled; and of carrying him to the house of jean waldie, one of the pannels; and soon thereafter, on the evening of the day libelled, of selling and delivering his body, then dead, to some surgeons and students of physic.' counsel were heard on the import of this verdict on the sixth, when all defences were over-ruled. both pannels were sentenced to be hanged in the grassmarket of edinburgh, on the th march. they were executed accordingly. waldie, in her last speech, says, that torrence prevailed on her, when much intoxicated, to go and carry the child alive from its mother's house; that she carried it in her gown-tail to her own house; that when she arrived at home, she found the child was dead, having, as she believed, been smothered in her coats in carrying it off; that it really died in her hands; that she acknowledges her sentence to be just. torrence declines saying anything about the crime." on page of maclaurin's _remarkable cases_, under date february , , there is a short account of the pleadings at the trial. the following is a note of the matter contained there, with the exception of the finding of the jury, which has already been given:-- _his majesty's advocate against helen torrence and jean waldie._ "they were indicted for stealing and murdering john dallas, a boy about eight or nine years of age, son of john dallas, chairman, in edinburgh, on the rd december, . "the counsel for the prisoners represented, that however the actual murder might be relevant to infer the pains of death, yet the stealing of the child could only infer an arbitrary punishment. and as to the selling of the dead body, it was no crime at all. "_ans._--though the stealing the child when alive, when disjoined from the selling of it when dead, might not go so far; yet, when taken together, they were undoubtedly relevant to infer a capital punishment. "the court pronounced the usual interlocutor." an interview with burke in prison. the following appeared in the _caledonian mercury_ early in the month of january, :-- "the information from which the following article is drawn up we have received from a most respectable quarter, and its perfect correctness in all respects may be confidently relied on. in truth, it is as nearly as possible a strict report, rather than the substance, of what passed at an interview with burke, in the course of which the unhappy man appears to have opened his mind without reserve, and to have given a distinct and explicit answer to every question which was put to him relative to his connection with the late murders. "after some conversation of a religious nature, in the course of which burke stated that, while in ireland, his mind was under the influence of religious impressions, and that he was accustomed to read his catechism and prayer-book, and to attend to his duties. he was asked, 'how comes it then that you, who, by your own account, were once under the influence of religious impressions, ever formed the idea of such dreadful atrocities, of such cold-blooded, systematic murders as you admit you have been engaged in--how came such a conception to enter your mind?' to this burke replied, 'that he did not exactly know; but that becoming addicted to drink, living in open adultery, and associating continually with the most abandoned characters, he gradually became hardened and desperate; gave up attending chapel or any place of religious worship, shunned the face of the priest, and being constantly familiar with every species of wickedness, he at length grew indifferent as to what he did, and was ready to commit any crime.' "he was then asked how long he had been engaged in this murderous traffic, to which he answered, 'from christmas, , till the murder of the woman docherty in october last.' 'how many persons have you murdered, or been concerned in murdering, during the time? were they in all?' 'not so many; not so many, i assure you.' 'how many?' he answered the question, but the answer was, for a reason perfectly satisfactory, not communicated to us, and reserved for a different quarter. "'had you any accomplices?' 'none but hare. we always took care when we were going to commit a murder that no one else should be present; that no one could swear he saw the deed done. the women might suspect what we were about, but we always put them out of the way when we were going to do it. they never saw us commit any of the murders. one of the murders was done in broggan's house while he was out, but before he returned the thing was finished and the body put into a box. broggan evidently suspected something, for he appeared much agitated, and entreated us to take away the box, which we accordingly did. but he was not in any way concerned in it.' "'you have already told me that you were engaged in these atrocities from christmas, , till the end of october, . were you associated with hare during all that time?' 'yes, we began with selling to dr. ---- the body of a woman who had died a natural death in hare's house. we got ten pounds for it. after this we began the murders, and all the rest of the bodies that we sold to him were murdered.' "'in what place were these murders generally committed?' 'they were mostly committed in hare's house, which was very convenient for the purpose, as it consisted of a room and kitchen. daft jamie was murdered there. the story told of this murder is incorrect. hare began the struggle with him, and they fell and rolled together on the floor; then i went to hare's assistance, and we at length finished him, though with much difficulty. i committed one murder in the country by myself. it was in last harvest. all the rest were done in conjunction with hare.' "'by what means were these fearful atrocities perpetrated?' 'by suffocation. we made the persons drunk, and then suffocated them by holding the nostrils and mouth and getting on the body. sometimes i held the mouth and nose, while hare went upon the body; and sometimes hare held the mouth and nose, while i placed myself on the body. hare has perjured himself by what he said at the trial about the murder of docherty. he did not sit by while i did it, as he says. he was on the body assisting me with all his might, while i held the nostrils and mouth with one hand, choked her under the throat with the other. we sometimes used a pillow, but did not in this case.' "'now, burke, answer me this question:--were you tutored and instructed, or did you receive hints from any one as to the mode of committing murder?' 'no, except from hare. we often spoke about it, and we agreed that suffocation was the best way. hare said so, and i agreed with him. we generally did it by suffocation.' "'did you receive any encouragement to commit or persevere in committing these atrocities?' 'yes; we were frequently told by paterson that he would take as many bodies as we could get for him. when we got one he always told us to get more. there was commonly another person with him of the name of ----. they generally pressed us to get more bodies for them.' "'to whom were the bodies so murdered sold?' 'to dr. ----. we took the bodies to his rooms in ---- ----, and then went to his house to receive the money for them. sometimes he paid us himself; sometimes we were paid by his assistants. no questions were ever asked as to the mode in which we had come by the bodies. we had nothing to do but to leave a body at the rooms, and go and get money.' "'did you ever, upon any occasion, sell a body or bodies to any other lecturer in this place?' 'never. we knew no other.' "'you have been a resurrectionist (as it is called) i understand?' 'no. neither hare nor myself ever got a body from a churchyard. all we sold were murdered, save the first one, which was that of the woman who died a natural death in hare's house. we began with that: our crimes then commenced. the victims we selected were generally elderly persons; they could be more easily disposed of than persons in the vigour of health.' "such are the disclosures which this wretched man has made, under circumstances which can scarcely fail to give them weight with the public. before a question were put to him concerning the crimes he had been engaged in, he was solemnly reminded of the duty incumbent upon him, situated as he is, to banish from his mind every feeling of animosity towards hare, on account of the evidence which the latter gave at the trial; he was told that a dying man, covered with guilt, and without hope except in the infinite mercy of almighty god, through our blessed redeemer the lord jesus christ, he, who stood so much in need of forgiveness, must prepare himself to seek it by forgiving from his heart all who had done him wrong; and he was emphatically adjured to speak the truth, and nothing but the truth, without any attempt either to palliate his own iniquities, or to implicate hare more deeply than the facts warranted. thus admonished, and thus warned, he answered the several interrogations in the terms above stated; declaring at the same time, upon the word of a dying man, that everything he had said was true, and that he had in no respect exaggerated or extenuated anything, either from a desire to inculpate hare, or to spare anyone else." the confessions of bishop and williams, the london "burkers." the following are the confessions of bishop and williams, the london "burkers," an account of whose case is given in chapter xli. they were emitted in presence of the under-sheriff on the th of december, , the day before their execution:-- "i, john bishop, do hereby declare and confess, that the boy supposed to be the italian boy was a lincolnshire boy. i and williams took him to my house about half-past ten o'clock on the thursday night, the rd of november, from the bell, in smithfield. he walked home with us. williams promised to give him some work. williams went with him from the bell to the old bailey watering-house, whilst i went to the fortune of war. williams came from the old bailey watering-house to the fortune of war for me, leaving the boy standing at the corner of the court by the watering-house at the old bailey. i went directly with williams to the boy, and we walked then all three to nova scotia gardens, taking a pint of stout at a public-house near holloway lane, shoreditch, on our way, of which we gave the boy a part. we only stayed just to drink it, and walked on to my house, where we arrived about eleven o'clock. my wife and children and mrs. williams were not gone to bed, so we put him in the privy, and told him to wait there for us. williams went in and told them to go to bed, and i stayed in the garden. williams came out directly, and we both walked out of the garden a little way, to give time for the family getting to bed: we returned in about ten minutes or a quarter of an hour, and listened outside the window to ascertain whether the family were gone to bed. all was quiet, and we then went to the boy in the privy, and took him into the house; we lighted a candle, and gave the boy some bread and cheese, and, after he had eaten, we gave him a cup full of rum, with about half a small phial of laudanum in it. (i had bought the rum the same evening at the three tuns, in smithfield, and the laudanum also in small quantities at different shops). there was no water or other liquid put in the cup with the rum and laudanum. the boy drank the contents of the cup directly in two draughts, and afterwards a little beer. in about ten minutes he fell asleep on the chair on which he sat, and i removed him from the chair to the floor, and laid him on his side. we then went out and left him there. we had a quartern of gin and a pint of beer at the feathers, near shoreditch church, and then went home again, having been away from the boy about twenty minutes. we found him asleep as we had left him. we took him directly, asleep and insensible, into the garden, and tied a cord to his feet to enable us to put him up by, and i then took him in my arms, and let him slide from them headlong into the well in the garden, whilst williams held the cord to prevent the body going altogether too low in the well. he was nearly wholly in the water in the well, his feet just above the surface. williams fastened the other end of the cord round the paling, to prevent the body getting beyond our reach. the boy struggled a little with his arms and his legs in the water; the water bubbled for a minute. we waited till these symptoms were past, and then went in, and afterwards i think we went out, and walked down shoreditch to occupy the time, and in about three-quarters of an hour we returned and took him out of the well, by pulling him by the cord attached to his feet. we undressed him in the paved yard, rolled his clothes up, and buried them where they were found by the witness who produced them. we carried the boy into the wash-house, laid him on the floor, and covered him over with a bag. we left him there, and went and had some coffee in old street road, and then (a little before two on the morning of friday) went back to my house. we immediately doubled the body up, and put it into a box, which we corded so that nobody might open it to see what was in it; and then went again and had some more coffee in the same place in old street road, where we stayed a little while, and then went home to bed--both in the same house, and to our own beds as usual; we slept till about ten o'clock on friday morning, when we got up, took breakfast together with the family, and then went both of us to smithfield, to the fortune of war--we had something to eat and drink there. in about half-an-hour may came in--i knew may--but had not seen him for about a fortnight before,--he had some rum with me at the bar, williams remaining in the tap-room. [the condemned man then described the movements of himself and williams, and may during that day, in course of which they were principally occupied in visiting public houses, though they called upon two lecturers on anatomy and offered them the body, but were refused.] at the fortune of war we drank something again, and then (about six o'clock) we all three went in the chariot to nova scotia gardens; we went into the wash-house, where i uncorded the trunk, and shewed may the body. he asked, "how are the teeth?" i said i had not looked at them. williams went and fetched a brad-awl from the house, and may took it and forced the teeth out; it is the constant practice to take the teeth out first, because, if the body be lost, the teeth are saved; after the teeth were taken out, we put the body in a bag, and took it to the chariot; may and i carried the body, and williams got first into the coach, and then assisted in pulling the body in...." [the rest of this part of the confession is simply a record of "having something to drink," and visiting lecturers, who refused to purchase the body. it concludes with an account of the apprehension of the men at st. bartholomew's hospital, with the body in their possession.] in an addition to this confession of the murder of the boy, bishop made this further statement:-- "i declare that this statement is all true, and that it contains all the facts so far as i can recollect. may knew nothing of the murder, and i do not believe he suspected that i had got the body except in the usual way, and after the death of it. i always told him i got it from the ground, and he never knew to the contrary until i confessed to mr. williams [a clergyman] since the trial. i have known may as a body-snatcher for four or five years, but i do not believe he ever obtained a body except in the common course of men in the calling--by stealing from the graves. i also confess that i and williams were concerned in the murder of a female--whom i believe to have been since discovered as fanny pigburn--on or about the th of october last. i and williams saw her sitting about eleven or twelve o'clock at night on the step of a door in shoreditch, near the church. she had a child four or five years old on her lap. i asked her why she was sitting there. she said she had no home to go to, for her landlord had turned her out into the street. i told her that she might go home with us, and sit by the fire all night. she said she would go with us, and she walked with us to my house, in nova scotia gardens, carrying her child with her. when we got there we found the family abed, and we took the woman in and lighted a fire, by which we all sat down together. i went out for beer, and we all took beer and rum (i had brought the rum from smithfield in my pocket); the woman and her child laid down on some dirty linen on the floor, and i and williams went to bed. about six o'clock next morning i and williams told her to go away, and to meet us at the london apprentice in old-street road, at one o'clock. this was before our families were up. she met us again at one o'clock at the london apprentice, without her child. we gave her some half-pence and beer, and desired her to meet us again at ten o'clock at night at the same place. after this we bought rum and laudanum at different places, and at ten o'clock we met the woman again at the london apprentice, she had no child with her. we drank three pints of beer between us there, and stayed there about an hour. we would have stayed there longer, but an old man came in whom the woman said she knew, and she said she did not like him to see her there with any body; we therefore all went out; it rained hard, and we took shelter under a door-way in the hackney road for about an hour. we then walked to nova scotia gardens, and williams and i led her into no. , an empty house adjoining my house. we had no light. williams stepped into the garden with the rum and laudanum, which i had handed to him; he there mixed them together in a half-pint bottle, and came into the house to me and the woman, and gave her the bottle to drink; she drank the whole at two or three draughts; there was a quartern of rum, and about half a phial of laudanum; she sat down the step between two rooms in the house, and went off to sleep in about ten minutes. she was falling back; i caught her to save her fall, and she laid back on the floor. then williams and i went to a public-house, got something to drink, and in about half-an-hour came back to the woman; we took her cloak off, tied a cord to her feet, carried her to a well in the garden and thrust her into it headlong; she struggled very little afterwards, and the water bubbled a little at the top. we fastened the end to the pailings to prevent her going down beyond our reach, and left her and took a walk to shoreditch and back, in about half-an-hour; we left the woman in the well for this length of time, that the rum and laudanum might run out of the body at the mouth. on our return, we took her out of the well, cut her clothes off, put them down the privy of the empty house, carried the body into the wash-house of my own house, where we doubled it up and put it into a hair-box, which we corded and left there. we did not go to bed, but went to shields' [a street porter] house in eagle street, red lion square, and called him up; this was between four and five o'clock in the morning. we went with shields to a public-house near the sessions-house, clerkenwell, and had some gin, and from thence to my house, where we went in and stayed a little while, to wait the change of the police. i told shields he was to carry that trunk to st. thomas's hospital. he asked if there was a woman in the house who could walk alongside of him, so that people might not take any notice. williams called his wife up, and asked her to walk with shields, and to carry the hat-box which he gave her to carry. there was nothing in it, but it was tied up as if there were. we then put the box with the body on shields' head, and went to the hospital, shields and mrs. williams walking on one side of the street, and i and williams on the other. at st. thomas's hospital i saw mr. south's footman, and sent him up stairs to mr. south to ask if he wanted a subject. the footman brought me word that his master wanted one, but could not give an answer till the next day, as he had not time to look at it. during this interview, shields, williams, and his wife, were waiting at a public-house. i then went alone to mr. appleton, at mr. grainger's [anatomical theatre], and agreed to sell it to him for eight guineas, and afterwards i fetched it from st. thomas's hospital, and took it to mr. appleton, who paid me £ then, and the rest on the following monday. after receiving the £ , i went to shields and williams and his wife, at the public-house, when i paid shields s. for his trouble, and we then all went to the flower pot in bishopsgate, where we had something to drink, and then went home. i never saw the woman's child after the first time before mentioned. she said she had left the child with a person she had taken some of her things to, before her landlord took her goods. the woman murdered did not tell us her name; she said her age was thirty-five, i think, and that her husband, before he died, was a cabinetmaker. she was thin, rather tall, and very much marked with the small-pox. i also confess the murder of a boy who told us his name was cunningham. it was a fortnight after the murder of the woman. i and williams found him sleeping about eleven or twelve o'clock at night, on friday, the st of october, as i think, under the pig-boards in the pig market in smithfield. williams woke him, and asked him to come along with him (williams), and the boy walked with williams and me to my house in nova scotia gardens. we took him into my house, and gave him some warm beer, sweetened with sugar, with rum and laudanum in it. he drank two or three cups full, and then fell asleep in a little chair belonging to one of my children. we laid him on the floor and went out for a little while, and got something to drink and then returned, carried the boy to the well, and threw him into it, in the same way as we served the other boy and the woman. he died instantly in the well, and we left him there a little while, to give time for the mixture we had given him to run out of the body. we then took the body from the well, took off the clothes in the garden, and buried them there. the body we carried into the wash-house, and put it into the same box, and left it there till the next evening, when we got a porter to carry it with us to st. bartholomew's hospital, where i sold it to mr. smith for eight guineas. this boy was about ten or eleven years old, said his mother lived in kent street, and that he had not been home for a twelvemonth and better. i solemnly declare that these were all the murders in which i have been concerned, or that i know anything of; that i and williams were alone concerned in these, and that no other person whatever knew anything about either of them, and that i do not know whether there are others who practise the same mode of obtaining bodies for sale. i know nothing of any italian boy, and was never concerned in or knew of the murder of such a boy.... until the transactions before set forth, i never was concerned in obtaining a subject by the destruction of the living. i have followed the course of obtaining a livelihood as a body-snatcher for twelve years, and have obtained and sold, i think, from to bodies; but i declare, before god, that they were all obtained after death, and that, with the above exceptions, i am ignorant of any murder for that or any other purpose." williams, whose proper name was thomas head, confirmed the confession given above as altogether true. songs and ballads. _the following songs and ballads were published at the time the news of the west port tragedies was agitating the people of scotland. they are rude and unpoetical for the most part, but they are fairly representative of a very extensive class, in which the feelings of the common people are not unfaithfully mirrored._ rhymes _on reading the trial of william burke and helen m'dougal, for murder, th december, ._ an expostulation. "_thou can'st not say i did it!!!_" ah!--can'st thou, with cold indifference see the hand of execration point to thee? can'st thou, unmov'd, bear a whole nation's cry, to cleanse thyself from the polluted sty of burke, and hare, and all that fiendish crew, who, for mere gain, their fellow-mortals slew, and sold to thee, as thou hast not denied, such bodies as by students were descried ne'er to have been interred, nay, bore, some say, strong marks of life, by violence reft away? and thou didst not attempt the truth to find, though oft it must have flash'd across thy mind; but with a reckless carelessness, receiv'd whate'er was brought,[ ] and any lie believ'd, told by the gang, whose very forms do show they would not tell thee aught thou did'st not know, or should'st have known, if true thy science says, that marks of death by _murder_ any ways may well be seen, when the dissecting knife opens all the sure and secret seats of life.[ ] art thou a scotsman ----? then haste to prove that patriotic feelings can thy bosom move; haste to wipe out the stain thy country shares, while such a stigma fair edina bears. art thou a son of science? quickly, then, show she does not make brutes of _lect'ring_ men. art thou a father? then thy child may plead, to cleanse thyself from this unholy deed. art thou a husband? ask thine honest wife, if 'twere not better to descend in life, than traffic with the basest, vilest band, and thus for ---- soon's the deed is plann'd; a ready market keep--and hide away an _old tea-box_; that's all which you can say. art thou a christian? think'st thou this avails with him on high, who, with unerring scales, weighs all the thoughts, and words, and deeds of men, and searches through, ev'n the soul's inmost _ken_? if this dread argument will not prevail, nought can thy cold obdurate heart assail. yes, time mispent, and surely worse than vain, 'tis to attempt to rouse, by my poor strain, the proud rich man, hedg'd round by many a friend, whose voice th' applause of hundred youths attend. if his own conscience will not wake and cry, assert thine innocence, reply, reply, to all the accusations lately rais'd 'gainst thy fair fame, till ev'n ---- has gaz'd, and gaz'd in vain to see thee ---- come forth, arm'd with thy ---- thy ---- and thy ---- * * * * _cetera desunt._ [ ] _vide_ the evidence produced on the trial of burke, &c. it has been told as a fact, that this gang carried off to ---- one of their slaughtered victims in such a hurry, that the body actually _groaned_ in the box on the porter's back. no doubt the half-strangled being would be dead enough after a night in the ---- cellar.--_original note._ [ ] the ---- is understood to be profoundly skilled in anatomy; consequently, it is one of the bitterest satires that can be uttered against the utility of the science, to say that he was _ignorant_ that the bodies supplied by burke and his gang had come to their death by violence.--_original note._ william burke. o burke, cruel man, how detested thy name is! thy dark deeds of blood are a stain on our times. o savage, relentless, forever infamous, long, long will the world remember thy crimes. thrice ten human beings, weep all you who hear it, were caught in his snares and caught in his den, the shades of thy victims may elude thy vile spirit, o burke, cruel monster, thou basest of men. the weary, the old, and the way-faring stranger, were woo'd by his kindness and led to his door, but little knew they that the path led to danger, o little knew they that their wanderings were o'er. little knew they that the beams of the morning, to wake them to brightness, would shine all in vain, and little their friend knew, who watched their returning, that they were ne'er more to return back again. o gather the bones of the murdered together, and give them a grave in some home of the dead, that their poor weeping friends with sad hearts may go thither, and shed tears of sorrow above their cold bed. ye great men of learning, ye friends of dissection, who travell'd through blood to the temple of gain, and bright human life for your hateful inspection, o give the poor friends the white bones of the slain. but woe to the riches and skill thus obtained, woe to the wretch that would injure the dead, and woe to his portion whose fingers are stained with the red drops of life that he cruelly shed. tho' burke has been doom'd to expire on the gallows, the vilest that ever dishonoured the tree, yet some may survive him whose hearts are as callous, o, who wall be safe if the tigers be free. let none e'er reside in the crime marked dwellings, for ever disgraced by burke and by hare, may the cold damp of horror lie dark in their ceilings, and their pale ghastly walls still be dismal and bare. let their guilt and their gloom speak of nothing but terror, some dark deeds of blood to the stranger declare, and ages to come ever mark them with horror, for the ghosts of the murdered will still gather there. elegaic lines written on the tragical murder of poor daft jamie. attendance give, whilst i relate how poor daft jamie met his fate; 'twill make your hair stand on your head, as i unfold the horrid deed;-- that hellish monster, william burke, like reynard sneaking on the lurk, coy-duck'd his prey into his den, and then the woeful work began;-- "come, jamie, drink a glass wi' me, and i'll gang wi' ye in a wee, to seek yer mither i' the toun-- come drink, man, drink, an' sit ye doun." "nae, i'll no' drink wi' ye the nou, for if i div 'twill make me fou;" "tush, man, a wee will do ye guid, 'twill cheer yer heart, and warm yer bluid." at last he took the fatal glass, not dreaming what would come to pass; when once he drank, he wanted more-- till drunk he fell upon the floor. "now," said th' assassin, "now we may seize on him as our lawful prey." "wait, wait," said hare, "ye greedy ass; he's yet too strong--let's tak' a glass." like some unguarded gem he lies-- the vulture wants to seize his prize; nor does he dream he's in his power, till it has seized him to devour. the ruffian dogs,--the hellish pair,-- the villain burke,--the meagre hare,-- impatient were their prize to win, so to their smothering pranks begin:-- burke cast himself on jamie's face, and clasp'd him in his foul embrace; but jamie waking in surprise, writhed in an agony to rise. at last, with nerves unstrung before, he threw the monster on the floor; and though alarm'd, and weaken'd too, he would have soon o'ercome the foe; but help was near--for it burke cried, and soon his friend was at his side; hare tripp'd up jamie's heels, and o'er he fell, alas! to rise no more! now both these blood-hounds him engage, as hungry tygers fill'd with rage, nor did they handle axe or knife, to take away daft jamie's life. no sooner done, than in a chest they cramm'd this lately-welcom'd guest, and bore him into surgeons' square-- a subject fresh--a victim rare! and soon he's on the table laid, expos'd to the dissecting blade; but where his members now may lay is not for me--or you--to say. but this i'll say--some thoughts _did_ rise, it fill'd the students with surprise, that so short time did intervene since jamie on the streets was seen. but though his body is destroy'd, his soul can never be decoy'd from that celestial state of rest, where he, i trust, is with the bless'd. mrs. wilson's lamentation on hearing of the cruel murder of her son. why didst thou wander from my side, my joy, my treasure, and my pride? though others little thought of thee, though wert a treasure dear to me. i little thought when thee i left, so soon of thee to be bereft; or that when after me you sought you would by ruffian men be caught. thy playful manners fill'd with joy the aged sire and sportive boy; of real joy you had enough, when you could give or take a snuff. the tricks you play'd with childish art, bound you the closer to my heart; thy kindness to thy mother prov'd how dearly she by thee was lov'd. what horrid monsters were these men who lur'd thee to their fatal den; that den, whose deeds as yet untold, were done for sake of sordid gold. but they alone were not to blame; for when these dauntless monsters came with human creatures scarcely cold, the doctors took them, we were told. nor did they leave the doctors door without an order to bring more! but justice stern aloud doth cry-- "let all who wink at murder die!" and justice shall to me be done, on all who murder'd my poor son;-- i'll make appeal to britain's king, that one and all of them may swing. but that will not restore my son, or remedy the mischief done; he murder'd is--no peace i have, i shall go mourning to my grave. daft jamie. the following is a chap-book version of the ballad quoted at pp. - . o! dark was the midnight when hare fled away, not a star in the sky gave him one cheering ray, but still now and then, would the blue lightnings glare, and some strange cries assail'd him, like shrieks of despair. over vale, over hill, i will watch thee for ill; i will haunt all thy wanderings and follow thee still. but, lo! as the savage ran down the wild glen, for no place did he fear like the dwellings of men, where the heath lay before him all dismal and bare, the ghost of daft jamie appeared to him there. over vale, &c. i am come, said the shade, from the land of the dead, though there is for jamie no grass covered bed, yet i'm come to remind you of deeds that are past, and to tell you that justice will find you at last. over vale, &c. o! hare, thou hast been a dark demon of blood, but vengeance shall chase thee o'er field and o'er flood; though you fly away from the dwellings of men, the shades of thy victims shall rise in thy den. over vale, &c. when night falls on the world, o! how can you sleep, in your dreams do you ne'er see my poor mother weep? sadly she wept; but, o! long shall she mourn, e'er poor wandering jamie from the grave shall return. over vale, &c. from the grave, did i say, and though calm is the bed where slumber is dreamless, the home of the dead, where friends may lament, there sorrow may be, yet no grave rises as green as the world for me. over vale, &c. o! hare, go to shelter thy fugutive head, in some land that is not of the living or dead; for the living against thee may justly combine, and the dead must despise such a spirit as thine. over vale, &c. o! hare fly away, but this world cannot be the place of abode to a demon like thee, there is gall in your heart--poison is in your breath, and the glare of your eyes is as fearful as death. over vale, &c. when the blue lightnings flash'd through the glen, and it shone, and there rose a wild cry, and there heaved a deep groan, as the ghost of the innocent boy disappear'd, but his shrieks down the glen, in the night breeze were heard. over vale, &c. the resurrectionists. in no. xxix of _the emmet_, an old glasgow periodical, published on saturday, th october, , is the following:-- "_the_ resurrectionists, _a tale_ (in blind alek verse) _humbly inscribed to the editor of the 'glasgow chronicle.' printed for john smith, , gallowgate._ "original. "this _elegant_ poem was put into our hands as we were going to press, so we must be excused for passing it over more slightly than such a performance _deserves_. in fact we have only room for a single extract. it opens as follows, in a style which leaves lewis, and ratcliffe, and all our writers on the horrible, far in the rear. john starke himself, with his 'thesaurus of horror,' never penned anything so deliciously frightful. 'twas a cold winter night, and dark _was_ the clouds, and the dead men lay quietly still in their shrouds; the worms revelled sweetly their eyeholes among,-- it was a rout night, and there was a great throng: some fed upon brains, others fed upon liver, had we e'er such a feast, all cried out, o! no, never. "we suspect our readers will think we have given them enough of this feast; if they pant for more of it, let them turn to the work itself. more disgusting trash never emanated from the press. blind alek is a milton compared with the blockhead who would sit down and pen such a mass of loathesomeness.... lord preserve us from this imitator of blind alek. 'some heads replete with strange bombastic stuff, think words when rhym'd poetical enough.'" the lament. "whoso sheddeth man's blood, by man shall his blood be shed."--genesis, ix. . "bloody and deceitful men shall not live out half their days."--psalm, lv. . "depart from me therefore, ye bloody men."--psalm, cxxxix. . "now thou son of man, wilt thou judge, wilt thou judge the bloody city?"--ezekiel, xxii. . "the voice of thy brother's blood crieth unto me from the ground."--genesis, iv. . o woe for bonny scotland, for murder is abroad, and we must flee for refuge, to an avenging god. for we have seen that law alone, can do us little _gude_, as it has let three demons loose, to work _mair_ deeds of _blude_. ye bloody fiends, ye hellish fiends, dare ye here yet be seen, with the mark of blood upon your brows, and murder in your _een_! o woe for my _ain_ scotland, for thou art now the land, chosen for such deeds of darkness, as man before ne'er plann'd. alas for mary paterson, cut off in her young days, wi' a' her sins upon her, and in her wicked ways; while steep'd in drunk stupidity, and overcome by sleep, on his devoted victim burke took the dreadful leap. and alas for the old woman, entic'd to revelry, under the mask of country kindness, by a judas for his fee; that he might sell her body, when he had done the deed, and with the price of human blood, his _loathsome_ carcass feed. o'hon for poor _daft_ jamie, whom we shall miss away, in his own happy _idiocy_, _sae gude-natur'd_ and gay! o! who shall cheer the mother for the want of her poor boy, by's simpleness the more endear'd to her--her only joy. but our all-gracious maker will surely soon look down, on this detested murder with his all-powerful frown! * * * * in search of his dear mother, burke found him wand'ring then, and for to see his parent, was lur'd to hare's dread den; where he was ply'd with liquor, (and all by coaxings prest), till he was quite o'erpow'red, and laid him down to rest. the two fell fiends they watch'd then, until he soundly slept, then hare upon his destin'd prey with murderous purpose crept. and having fastened on him, hare strove his life to take; which recall'd his long lost reason, and did his senses wake. he shook the butcher from him, and seeing no help there, he fought with all the frenzy of madness and despair. his cowardly assassin, did crouch beneath his blows, and called on burke his comrade to give the murderous close. they two, conjoin'd together, depriv'd him of his life; but not before he left them marks of the desperate strife. in his tremendous struggle, though weaken'd much by drink, he showed how men do fight for life, when on death's dreadful brink. his body, it is said, (if true, let those who bought beware) was sold to an anatomist; and some one did declare, when it lay on his table for the dissecting knife, that it was poor _daft_ jamie, whom he saw strong in life but yesterday; and more 'twas strange as all knew passing well, he was a stout and hearty youth, the rest i may not tell; but loudly it's been whisper'd, that damning marks of strife show'd clear that death by violence had _twin'd_ him of his life. 'tis told, that then the body was laid in spirits strong, to remove all such suspicions, and hide the cruel wrong. if so! o righteous heaven, to thee we look for aid; nor will thy kindling anger be longer much delay'd! thou art the _poor's_ avenger, the _idiot's_ only guard, the _childless_ mother's helper, the good man's high reward. to thee then we are looking, to appease the cry of blood which runs throughout our city, like a portentous flood! and we do hold thy promise, we shall not look in vain; for whoso sheddeth man's blood, he surely shall be slain! the end. the university of chicago science series _editorial committee_ eliakim hastings moore, _chairman_ john merle coulter robert andrews millikan the university of chicago science series, established by the trustees of the university, owes its origin to a feeling that there should be a medium of publication occupying a position between the technical journals with their short articles and the elaborate treatises which attempt to cover several or all aspects of a wide field. the volumes of the series will differ from the discussions generally appearing in technical journals in that they will present the complete results of an experiment or series of investigations which previously have appeared only in scattered articles, if published at all. on the other hand, they will differ from detailed treatises by confining themselves to specific problems of current interest, and in presenting the subject in as summary a manner and with as little technical detail as is consistent with sound method. food poisoning the university of chicago press chicago, illinois +agents+ the baker & taylor company new york the cunningham, curtiss & welch company los angeles the cambridge university press london and edinburgh the maruzen-kabushiki-kaisha tokyo, osaka, kyoto, fukuosa, sendai the mission book company shanghai food poisoning _by_ edwin oakes jordan _chairman of the department of hygiene and bacteriology the university of chicago_ [illustration: emblem] the university of chicago press chicago, illinois copyright by the university of chicago all rights reserved published may composed and printed by the university of chicago press chicago, illinois, u.s.a. contents chapter page i. introduction the extent of food poisoning various kinds of food poisoning the articles of food most commonly connected with food poisoning ii. sensitization to protein foods iii. poisonous plants and animals poisonous plants poisonous animals iv. mineral or organic poisons added to food arsenic antimony lead tin copper various coloring substances food preservatives food substitutes v. food-borne pathogenic bacteria typhoid food infection asiatic cholera tuberculosis various milk-borne infections possible infection with _b. proteus_ vi. food-borne pathogenic bacteria (_continued_) paratyphoid infection typical paratyphoid outbreaks general characters of paratyphoid infection toxin production sources of infection means of prevention vii. animal parasites trichiniasis teniasis uncinariasis other parasites viii. poisonous products formed in food by bacteria and other micro-organisms ergotism botulism symptoms anatomical lesions bacteriology epidemiology prevention and treatment other bacterial poisons spoiled and decomposed food ix. poisoning of obscure or unknown nature milksickness or trembles deficiency diseases beriberi pellagra lathyrism favism scurvy rachitis the foods most commonly poisonous index chapter i introduction how frequently food poisoning occurs is not definitely known. everybody is aware that certain articles of food are now and again held responsible for more or less severe "attacks of indigestion" or other physiological disturbances that have followed their consumption, but in many cases the evidence for assuming a causal connection is of the slightest. that convenient refuge from etiological uncertainty, "ptomain poisoning," is a diagnosis that unquestionably has been made to cover a great variety of diverse conditions, from appendicitis and the pain caused by gallstones to the simple abdominal distention resulting from reckless gorging. no doubt can be entertained, however, that intestinal and other disorders due to particular articles of food occur much more frequently than they are recorded. there are few persons who have not experienced gastro-intestinal attacks of moderate severity which could be reasonably attributed to something eaten shortly before. it is often possible to specify with a fair degree of certainty the offending food. the great majority of such attacks are of a mild character, are quickly recovered from, and are never heard of beyond the immediate family circle. only when the attack is more serious than the average or when a large number of persons are affected simultaneously does knowledge of the occurrence become more widely spread. a small proportion of food-poisoning cases receives notice in the public press and a still smaller proportion is reported in the medical journals. very few indeed are ever completely investigated as to their origin. although most attacks of food poisoning are usually of a slight and apparently temporary nature, it does not follow that they are to be considered negligible or of trivial importance from the standpoint of public health. the human organism is always more or less weakened by such attacks, many of them, as we shall see, genuine infections; and, as is known to be the case with many infectious diseases, some permanent injurious impression may be left on the body of the affected individual. under certain conditions it is possible that degenerative changes are initiated or accelerated in the kidneys or blood vessels by the acute poisoning which is manifested for a short time in even the milder cases. in yet greater degree these changes may follow those insidious forms of food poisoning due to the frequent ingestion of small quantities of mineral or organic poisons, which in each dose may cause little or no measurable physiological change, but whose cumulative effect may be vicious. in view of the grave situation evidenced by the increase in the degenerative diseases affecting early middle life in the united states,[ ] the extent, causes, and means of prevention of food poisoning seem pressing subjects for investigation. the extent of food poisoning since cases of food poisoning, "ptomain poisoning," and the like are not required by law to be reported, public health authorities in general possess no information respecting their occurrence. very indirect and imperfect indications of the prevalence of certain kinds of food poisoning are afforded by casual press reports. such as they are, these accounts are the only available material. tables i and ii summarize data i have gathered through a press-clipping bureau and other sources during the period october, , to october, . they serve to show at least the universality and complexity of the problem. the group and family outbreaks together involved , persons. while it is not probable that all the instances reported as due to food poisoning can properly be so considered, there is no doubt that the number recorded in the tables falls far short of the actual occurrences. in the past few years the writer has investigated several large food-poisoning outbreaks which have never been reported in the press nor received public notice in any way. there is reason to think that the majority of cases escape notice. probably several thousand outbreaks of food poisoning in families and larger groups, affecting at least , - , persons, occur in the united states in the course of a year. the assignment of causes indicated in table i is of limited value. the tendency to incriminate canned food is here manifest. proper investigation of the origin of an outbreak is so rarely carried out that the articles of food ordinarily accused are selected rather as the result of popular prejudice and tradition than of any careful inquiry. table i food poisoning in the united states, october, , to october, ================================================================= assigned cause | group | | |and family|individual| | outbreaks| cases | total -----------------------------------+----------+----------+------- meat | | | canned fish | | | canned vegetables | | | ice cream | | | fish, oysters | | | cheese | | | sausage and canned meat | | | milk | | | mushrooms | | | fruit | | | vegetables | | | fowl | | | salad | | | contact of food or drink with metal| | | miscellaneous | | | -----------------------------------+----------+----------+------- | | | no cause assigned | | | -----------------------------------+----------+----------+------- | | | , ----------------------------------------------------------------- table ii seasonal distribution of food poisoning cases, - (group, family, and individual) ========================================== january | ||may | ||september| february| ||june | ||october | march | ||july | ||november | april | ||august| ||december | ------------------------------------------ there is no very striking seasonal incidence apparent in the figures here gathered (table ii). the warmer months seem to have a slight preponderance of cases, but general conclusions from such data are hardly warranted. various kinds of food poisoning cases of poisoning by articles of food may be distinguished as: ( ) those caused by some injurious constituent in the food itself, and ( ) those caused by a peculiar condition of the individual consuming the food, by virtue of which essentially wholesome food substances are capable of producing physiological disturbance in certain individuals. the latter group includes persons, apparently normal in other respects, who are more or less injuriously affected by some particular article of diet, such as eggs or milk, which is eaten with impunity by all normal individuals. this is the so-called food sensitization or food allergy. food poisoning, as more commonly understood, is due to the composition, contents, or contamination of the food itself. it is not within the scope of this book to consider any of those cases in which definite poisonous substances are added to food with criminal intent. the term food poisoning is here taken to include the occasional cases of poisoning from organic poisons present in normal animal or plant tissues, the more or less injurious consequences following the consumption of food into which formed mineral or organic poisons have been introduced by accident or with intent to improve appearances or keeping quality, the cases of infection due to the swallowing of bacteria and other parasites which infest or contaminate certain foods, and the poisoning due to deleterious substances produced in food by the growth of bacteria, molds, and similar organisms. as already pointed out, little is known about the relative frequency of occurrence of these different causes or the extent to which they are separately and collectively operative. the articles of food most commonly connected with food poisoning in addition to the definitely poisonous plants or animals, certain everyday articles of food have been frequently associated with the more serious outbreaks of food poisoning. meat in particular has been implicated so often that the term meat poisoning is used about as commonly as the term food poisoning in general discussions of this subject. certain it is that the great majority of the best-studied and most severe outbreaks of food poisoning have been attributed on good grounds to the use of meat or meat products. other animal foods, and especially milk and its derivatives, cheese and ice-cream, have likewise been held responsible for extensive and notable outbreaks. perhaps the most significant feature of food poisoning attacks is the frequency with which they have been traced to the use of raw or imperfectly cooked food. the probable interpretation of this fact will be discussed in the later chapters. especially have the use of uncooked milk, either by itself or mixed with other food substances, and the eating of raw sausage brought in their train symptoms of poisoning in a disproportionately large number of cases. canned goods of various sorts have likewise been repeatedly accused of causing injurious effects, but the evidence adduced is not always convincing. the actual degree of danger from this source is far from being determined. the national canners association publishes in the annual report of the secretary a brief list of "libels on the industry" or instances in which canned foods of various sorts were regarded as the cause of illness. the report contains fifty-one cases of this character, none of which was considered by the investigator of the association to be based on sound evidence. a still more searching investigation of all such cases would seem to be desirable, not with a view to incriminating or exculpating any particular product, but simply for the purpose of ascertaining and placing on record all the facts. footnotes: [ ] tables a and b show that the "expectation of life" for adults of forty years and over is shorter in new york city now than it was thirty years ago (table a), and that this increase in the death-rate in the higher-age groups is manifested in recent years in a wide area in this country (table b). this increased mortality is due chiefly to diseases of the heart, arteries, and kidneys, and to cancer. table a[ a] approximate life table, trienna - and - , based on new york city statistics ================================================== |expectation|expectation| gain (+) or | of life, | of life, |loss (-) in years ages | - | - | of expectancy --------+-----------+-----------+----------------- under | . | . | + . | . | . | + . | . | . | + . | . | . | + . | . | . | + . | . | . | + . | . | . | + . | . | . | + . | . | . | - . | . | . | - . | . | . | - . | . | . | - . | . | . | - . | . | . | - . | . | . | - . | . | . | - . | . | . | - . | . | . | - . balance | | | + . | | | - . | | |----------------- | | | + . -------------------------------------------------- table b[ b] comparison of mortality of males and females, by age groups. death-rates per , population (registration states as constituted in ) ============================================================ ages | males |percentage | females |percentage |-----------|increase or|-----------|increase or | | | decrease | | | decrease ------------+-----+-----+-----------+----------------------- under | . | . | - . | . | . | - . - | . | . | - . | . | . | - . - | . | . | - . | . | . | - . - | . | . | - . | . | . | - . - | . | . | - . | . | . | - . - | . | . | - . | . | . | - . - | . | . | - . | . | . | - . - | . | . | + . | . | . | - . - | . | . | + . | . | . | + . - | . | . | + . | . | . | + . and over| . | . | + . | . | . | + . all ages | . | . | - . | . | . | - . ------------------------------------------------------------ [ a] _monthly bull., dept. of health, city of new york_, iii ( ), . [ b] dublin, _amer. jour. public health_, iii ( ), . chapter ii sensitization to protein foods the first introduction under the skin of a guinea-pig of a minute quantity of egg-white or other apparently harmless protein substance is itself without visible injurious effect, but if this is followed by a second injection of the same substance after an interval of about ten days, the animal will die in a few minutes with symptoms of violent poisoning. whatever be the physiological explanation of the remarkable change that thus results from the incorporation of foreign protein into the body, there can be no doubt that the phenomenon known as protein sensitization or anaphylaxis is relatively common.[ ] sensitization to proteins came to light in the first instance through the study of therapeutic sera, and has been found to have unexpectedly wide bearings. it is now known that not only the rash and other symptoms which sometimes follow the administration of horse serum containing diphtheria antitoxin, but the reaction to tuberculin and similar accompaniments of bacterial infection, are probably to be explained on the principle of anaphylactic change. the sensitiveness of certain individuals to the pollen of particular plants (hay fever) is also regarded as a typical instance of anaphylaxis, accompanied as it is by asthma and other characteristic manifestations of the anaphylactic condition. among the reactions usually classed as anaphylactic are the occasional cases of sensitivity to particular food substances. it is a familiar fact that certain foods that can be eaten with impunity by most persons prove more or less acutely poisonous for others. strawberries and some other fruits and some kinds of shellfish are among the articles of food more commonly implicated. unpleasant reactions to the use of eggs and of cow's milk are also noted. the severity of the attacks may vary from a slight rash to violent gastro-intestinal, circulatory, and nervous disturbances. coues[ ] has described a rather typical case in a child twenty-one months old and apparently healthy except for some eczema. when the child was slightly over a year old egg-white was given to it, and nausea and vomiting immediately followed. about eight months later another feeding with egg-white was followed by sneezing and all the symptoms of an acute coryza. extensive urticaria covering most of the body also appeared, and the eyelids became edematous. the temperature remained normal and there was no marked prostration. the symptoms of such attacks vary considerably in different individuals, but usually include pronounced urticaria along with nausea, vomiting, and diarrhea. the rapidity with which the symptoms appear after eating is highly characteristic. schloss[ ] has reported a case of an eight-year-old boy who evinced marked sensitiveness to eggs, almonds, and oatmeal. experiments in this instance showed that a reaction was produced only by the proteins of these several foods, and that extracts and preparations free from protein were entirely inert. it was further found that by injection of the patient's blood serum guinea-pigs could be passively sensitized against the substances in question, thus showing the condition to be one of real anaphylaxis. idiosyncrasy to cow's milk which is observed sometimes in infants is an anaphylactic phenomenon.[ ] the substitution of goat's milk for cow's milk has been followed by favorable results in such cases. in very troublesome cases of protein idiosyncrasy a method of treatment based on animal experimentation has been advocated. this consists in the production of a condition of "anti-anaphylaxis" by systematic feeding of minute doses of the specific protein substance concerned.[ ] s. r. miller[ ] describes the case of a child in whom a constitutional reaction followed the administration of one teaspoonful of a mixture composed of one pint of water plus one drop of egg-white, while a like amount of albumen diluted with one quart of water was tolerated perfectly. "commencing with the dilution which failed to produce a reaction, the child was given gradually increasing amounts of solutions of increasing strength. the dosage was always one teaspoonful given three times during the day; the result has been that, in a period of about three months, the child has been desensitized to such an extent that one dram of pure egg-white is now taken with impunity." many other instances of anaphylaxis to egg albumen are on record.[ ] in some of these cases the amount of the specific protein that suffices to produce the reaction is exceedingly small. one physician writes of a patient who "was unable to take the smallest amount of egg in any form. if a spoon was used to beat eggs and then to stir his coffee, he became very much nauseated and vomited violently."[ ] the dependence of many cases of "asthma" upon particular foods is an established fact. various skin rashes and eruptions are likewise associated with sensitization to certain foods.[ ] mcbride and schorer[ ] consider that each particular kind of food (as tomatoes or cereals) produces a constant and characteristic set of symptoms. possibly certain definitely characterized skin diseases are due to this form of food poisoning. blackfan[ ] found that of forty-three patients without eczema only one showed any evidence of susceptibility to protein by cutaneous and intracutaneous tests, while of twenty-seven patients with eczema twenty-two gave evidence of susceptibility to proteins. footnotes: [ ] general agreement respecting the true physiological and chemical nature of anaphylactic phenomena has not yet been reached. for a discussion of the theories of anaphylaxis, see in hans zinsser, _infection and resistance_ (new york, ), chaps. xv-xviii; also doerr, "allergie und anaphylaxis," in kolle and wassermann, _handbuch_, d edition, , ii, . [ ] _boston med. and surg. jour._, clxvii ( ), . [ ] _amer. jour. obstet._ (new york), lxv ( ), . [ ] f. b. talbot, _boston med. and surg. jour._, clxxv ( ), . [ ] see, for example, schloss, _loc. cit._ [ ] _johns hopkins hosp. bull._, xxv ( ), . [ ] see, for example, k. koessler, _ill. med. jour._, xxiii ( ), ; bronfenbrenner, andrews, and scott, _jour. amer. med. assoc._, lxiv ( ), ; f. b. talbot, _boston med. and surg. jour._, clxxi ( ), . [ ] _jour. amer. med. assoc._, lxv ( ), . [ ] strickler and goldberg, _jour. amer. med. assoc._, lxvi ( ), . [ ] _jour. cutaneous dis._, xxxiv ( ), . [ ] _amer. jour. dis. of children_, xi ( ), . chapter iii poisonous plants and animals some normal plant and animal tissues contain substances poisonous to man and are occasionally eaten by mistake for wholesome foods. poisonous plants poisonous plants have sometimes figured conspicuously in human affairs. every reader of ancient history knows how socrates "drank the hemlock," and how crafty imperial murderers were likely to substitute poisonous mushrooms for edible ones in the dishes prepared for guests who were out of favor. in our own times the eating of poisonous plants is generally an accident, and poisoning from this cause occurs chiefly among the young and the ignorant. according to chesnut[ ] there are , leaf-bearing plants included in heller's _catalogue of north american plants_, and of these nearly five hundred, in one way or another, have been alleged to be poisonous. some of these are relatively rare or for other reasons are not likely to be eaten by man or beast; others contain a poison only in some particular part, or are poisonous only at certain seasons of the year; in some the poison is not dangerous when taken by the mouth, but only when brought in contact with the skin or injected beneath the skin or into the circulation. there are great differences in individual susceptibility to some of these plant poisons. one familiar plant, the so-called poison-ivy, is not harmful for many people even when handled recklessly; it can be eaten with impunity by most domestic animals. the actual number of poisonous plants likely to be inadvertently eaten by human beings is not large. chesnut[ ] has enumerated about thirty important poisonous plants occurring in the united states, and some of these are not known to be poisonous except for domestic animals.[ ] many of the cases of reported poisoning in man belong to the class of exceedingly rare accidents and are without much significance in the present discussion. such are the use of the leaves of the american false hellebore (_veratrum viride_) in mistake for those of the marsh-marigold[ ], the use of the fruit pulp of the kentucky coffee tree (_gymnocladus dioica_) in mistake for that of the honey-locust[ ], the accidental employment of daffodil bulbs for food, and the confusion by children of the young shoots of the broad-leaf laurel (_kalmia latifolia_) with the wintergreen.[ ] one of the most serious instances of poisoning of this sort is that from the use of the spindle-shaped roots of the deadly water hemlock (_cicuta maculata_) allied to the more famous but no more deadly poison hemlock. these underground portions of the plant are sometimes exposed to view by washing out or freezing, and are mistaken by children for horseradish, artichokes, parsnips, and other edible roots. poisoning with water hemlock undoubtedly occurs more frequently than shown by any record. eight cases and two deaths from this cause are known to have occurred in one year in the state of new jersey alone. [illustration: fig. .--_conium maculatum._ the fresh juice of _conium maculatum_ was used in the preparation of the famous hemlock potion which was employed by the greeks in putting their criminals to death. (from _applied and economic botany_, by courtesy of professor kraemer [after holm].)] an instance of food poisoning to be included under this head is the outbreak in hamburg and some thirty other german cities in due to the use of a poisonous vegetable fat in preparing a commercial butter substitute.[ ] in the attempt to cheapen as far as possible the preparation of margarin various plant oils have been added by the manufacturers. in the hamburg outbreak, in which over two hundred cases of illness occurred, poisoning was apparently due to substitution of so-called maratti-oil, derived from a tropical plant (_hydrocarpus_). this fat is said to be identical with oil of cardamom, and its toxic character in the amounts used in the margarin was proved by animal experiment. increasing economic pressure for cheap foods may lead to the recurrence of such accidents unless proper precautions are used in testing out new fats and other untried substances intended for use in the preparation of food substances.[ ] [illustration: fig. .--_cicuta maculata_ (water hemlock); _a_, upper part of stem with leaves and compound umbels; _b_, base of stem and thick tuberous roots; _c_, cross-section of stem; _d_, flower; _e_, fruit; _f_, fruit in longitudinal section; _g_, cross-section of a mericarp. (from _applied and economic botany_, by courtesy of professor kraemer [after holm].)] investigators from the new york city health department have found that certain cases of alleged "ptomain poisoning" were really due to "sour-grass soup."[ ] this soup is prepared from the leaves of a species of sorrel rich in oxalic acid. in one restaurant it was found that the soup contained as much as ten grains of oxalic acid per pint! [illustration: fig. .--fly amanita (poisonous). (_amanita muscaria_ l.) (after marshall, _the mushroom book_, by courtesy of doubleday, page & company.)] by far the best-known example of that form of poisoning which results from confounding poisonous with edible foods is that due to poisonous mushrooms.[ ] there is reason to believe that mushroom (or "toadstool") intoxication in the united states has occurred with greater frequency of late years, partly on account of the generally increasing use of mushrooms as food and the consequently greater liability to mistake, and partly on account of the growth of immigration from the mushroom-eating communities of southern europe. many instances have come to light in which immigrants have mistaken poisonous varieties in this country for edible ones with which they were familiar at home. in the vicinity of new york city there were twenty-two deaths from mushroom poisoning in one ten-day period (september, ) following heavy rains. the "fly _amanita_"[ ] (_amanita muscaria_) in this country has been apparently often mistaken for the european variety of "royal _amanita_" (_a. caesaria_).[ ] such a mistake seems to have been the cause of death of the count de vecchi in washington, d.c., in . the count, an attaché of the italian legation, a cultivated gentleman of nearly sixty years of age, considered something of an expert upon mycology, purchased, near one of the markets in washington, a quantity of fungi recognized by him as an edible mushroom. the plants were collected in virginia about seven miles from the city of washington. the following sunday morning the count and his physician, a warm personal friend, breakfasted together upon these mushrooms, commenting upon their agreeable and even delicious flavor. breakfast was concluded at half after eight and within fifteen minutes the count felt symptoms of serious illness. so rapid was the onset that by nine o'clock he was found prostrate on his bed, oppressed by the sense of impending doom. he rapidly developed blindness, trismus, difficulty in swallowing, and shortly lost consciousness. terrific convulsions then supervened, so violent in character as to break the bed upon which he was placed. despite rigorous treatment and the administration of morphine and atropine, the count never recovered consciousness and died on the day following the accident. the count's physician on returning to his office was also attacked, dizziness and ocular symptoms warning him of the nature of the trouble. energetic treatment with apomorphine and atropine was at once instituted by his colleagues and for a period of five hours he lay in a state of coma with occasional periods of lucidity. the grave symptoms were ameliorated and recovery set in somewhere near seven o'clock in the evening. his convalescence was uneventful, his restoration to health complete, and he is, i believe, still living. on this instance the count probably identified the fungi as _caesaria_ or _aurantiaca_. from the symptoms and termination the species eaten must have been _muscaria_. _a. muscaria_ contains an alkaloidal substance which has a characteristic effect upon the nerve centers and to which the name muscarin and the provisional chemical formula c{ }h{ }no{ } has been given. the drug atropin is a more or less perfect physiological antidote for muscarin and has been administered with success in cases of muscarin poisoning. it is said that the peasants in the caucasus are in the habit of preparing from the fly _amanita_ a beverage which they use for producing orgies of intoxication. deaths are stated to occur frequently from excessive use of this beverage.[ ] the deadly _amanita_ or death-cup (_a. phalloides_) is probably responsible for the majority of cases of mushroom poisoning. ford estimates that from twelve to fifteen deaths occur annually in this country from this species alone. this fungus is usually eaten through sheer ignorance by persons who have gathered and eaten whatever they chanced to find in the woods. a few of these poisonous mushrooms mixed with edible varieties may be sufficient to cause the death of a family. ford thus describes the symptoms of poisoning with _a. phalloides_: following the consumption of the fungi there is a period of six to fifteen hours during which no symptoms of poisoning are shown by the victims. this corresponds to the period of incubation of other intoxications or infections. the first sign of trouble is sudden pain of the greatest intensity localized in the abdomen, accompanied by vomiting, thirst, and choleraic diarrhoea with mucous and bloody stools. the latter symptom is by no means constant. the pain continues in paroxysms often so severe as to cause the peculiar hippocratic facies, _la face vultueuse_ of the french, and though sometimes ameliorated in character, it usually recurs with greater severity. the patients rapidly lose strength and flesh, their complexion assuming a peculiar yellow tone. after three to four days in children and six to eight in adults the victims sink into a profound coma from which they cannot be roused and death soon ends the fearful and useless tragedy. convulsions rarely if ever occur and when present indicate, i am inclined to believe, a mixed intoxication, specimens of _amanita muscaria_ being eaten with the _phalloides_. the majority of individuals poisoned by the "deadly amanita" die, the mortality varying from to per cent in various accidents, but recovery is not impossible when small amounts of the fungus are eaten, especially if the stomach be very promptly emptied, either naturally or artificially. a number of other closely related species of _amanita_ (e.g., _a. verna_, the "destroying angel," probably a small form of _a. phalloides_) have a poisonous action similar to that of _a. phalloides_. all are different from muscarin. [illustration: fig. .--death-cup; destroying angel (_amanita phalloides_ fries); reduced; natural size: cap, - / inches; stem, - / inches. (after marshall, _the mushroom book_, by courtesy of doubleday, page & company.)] the character of the poison was first carefully investigated by kobert, who showed that the _amanita_ extract has the power of laking or dissolving out the coloring matter from red blood corpuscles. this hemolytic action is so powerful that it is exerted upon the red cells of ox blood even in a dilution of : , . ford[ ] has since shown that in addition to the hemolytic substance another substance much more toxic is present in this species of _amanita_ and he concludes that the poisonous effect of the fungus is primarily due to the latter ("_amanita_ toxin"). the juice of the cooked _amanita_ is devoid of hemolytic power, but is poisonous for animals in small doses, a fact that agrees with the observation that these mushrooms, after cooking, remain intensely poisonous for man. extensive fatty degeneration in liver, kidney, and heart muscle is produced by the true _amanita_ toxin. in the baltimore cases studied by clark, marshall, and rowntree[ ] the kidney rather than the liver was the seat of the most interesting functional changes. these authors conclude that the nervous and mental symptoms, instead of being due to some peculiar "neurotoxin," are probably uremic in character. no successful method of treatment is known. an antibody for the hemolysin has been produced, but an antitoxin for the other poisonous substance seems to be formed in very small amount. attempts to immunize small animals with _amanita_ toxin succeed only to a limited degree.[ ] poisonous animals while the muscles or internal organs of many animals are not palatable on account of unpleasant flavor or toughness, there do not seem to be many instances in which normal animal tissues are poisonous when eaten. as pointed out elsewhere (chapter vi), the majority of outbreaks of meat and fish poisoning must be attributed to the presence of pathogenic bacteria or to poisons formed after the death of the animal. this has been found especially true of many of the outbreaks of poisoning ascribed to oysters and other shellfish; in most, if not all, cases the inculpated mollusks have been derived from water polluted with human wastes and are either infected or partially decomposed. in some animals, however, notably certain fish, the living and healthy organs are definitely poisonous. the family of tetrodontidae (puffers, balloon-fish, globe-fish) comprises a number of poisonous species, including the famous japanese _fugu_, which has many hundred deaths scored against it and has been often used to effect suicide. poisonous varieties of fish seem more abundant in tropical waters than in temperate, but this is possibly because of the more general and indiscriminate use of fish as food in such localities as the japanese and south sea islands. it is known that some cool-water fish are poisonous. the flesh of the greenland shark possesses poisonous qualities for dogs and produces a kind of intoxication in these animals.[ ] much uncertainty exists respecting the conditions under which the various forms of fish poisoning occur. one type is believed to be associated with the spawning season, and to be caused by a poison present in the reproductive tissues. the roe of the european barbel is said to cause frequent poisoning, not usually of a serious sort. the flesh or roe of the sturgeon, pike, and other fish is also stated to be poisonous during the spawning season. some fish are said to be poisonous only when they have fed on certain marine plants.[ ] there is little definite knowledge about the poisons concerned. they are certainly not uniform in nature. the _fugu_ poison produces cholera-like symptoms, convulsions, and paralysis. it is not destroyed by boiling. the effect of the greenland shark flesh on dogs is described as being "like alcohol." it is said that dogs fed with gradually increasing amounts of the poisonous shark's flesh become to some degree immune. different symptoms are described in other fish poisoning cases.[ ] footnotes: [ ] _science_, xv ( ), . [ ] _u.s. dept. of agric., div. of botany, bull. _, . [ ] among the plants that seem to be most commonly implicated in the poisoning of stock are the larkspur (_delphinium._ _u.s. dept. of agric., bull. _, september , ), the water hemlock (_cicuta maculata_) and others of the same genus, the lupines (_u.s. dept. of agric., bull. _, ), some of the laurels (_kalmia_), and the death _camas_ or _zygadenus_ (_u.s. dept. of agric., bull. _, ). the famous loco-weed of the western united states (_u.s. dept. of agric., bull. _, ) is less certainly to be held responsible for all the ills ascribed to it (h. t. marshall, _johns hopkins hosp. bull._, xxv [ ], ). [ ] chesnut, _u.s. dept. of agric., div. of botany, bull. _, , p. . [ ] _ibid._, p. . [ ] _ibid._, p. . the seeds of the castor-oil bean, which contain a very powerful poison (ricin) allied to the bacterial toxins, have been known to cause the death of children who ate the seeds given them to play with. [ ] mayer, _deutsche viertelj. f. öffentl. ges._, xlv ( ), . [ ] cf. an instance of palmolin poisoning, _centralbl. f. bakt._, i, ref., lxii ( ), . [ ] _weekly bull., n.y. dept. of health_, september , . [ ] seventy-three species of mushrooms known or suspected to be poisonous are enumerated in a bulletin of the united states department of agriculture, patterson and charles ("mushrooms and other common fungi," _bull. _, ). this bulletin contains descriptions and excellent illustrations of many edible and of the commoner poisonous species. [ ] used in some places as a fly poison. [ ] ford, _science_, xxx ( ), . [ ] another species of mushroom occurring in this country and commonly regarded as edible (_panaeolus papilionaceus_) has on occasion shown marked intoxicating properties (a. e. verrill, _science_, xl ( ), ). [ ] _jour. infect. dis._, iii ( ), . [ ] _jour. amer. med. assoc._, lxiv ( ), . [ ] w. w. ford, "plant poisons and their antibodies," _centralbl. f. bakt._, i abt., ref., lviii ( ), and , with full bibliography. [ ] a. h. clark, _science_, xli ( ), . [ ] see w. m. kerr, _u.s. nav., monthly bull._, vi ( ), . [ ] _ibid._ chapter iv mineral or organic poisons added to food well-known mineral or organic poisons--"chemical poisons"--sometimes find their way into food, being either introduced accidentally in the process of manufacture or preparation, or being added deliberately with intent to improve the appearance or keeping qualities of the food. arsenic so powerful a poison as arsenic has been occasionally introduced into food by stupidity or carelessness. arsenic has been found by english authorities to be generally present in food materials dried or roasted with gases arising from the combustion of coal, and in materials treated with sulphuric acid during the process of preparation. in both cases the source is the same: the iron pyrites, practically always arsenical, contained in the coal or used in making the sulphuric acid. a celebrated epidemic of "peripheral neuritis" in the english midlands in was traced to the presence of dangerous quantities of arsenic in beer. about six thousand persons were affected in this outbreak and there were some seventy deaths. the beer coming from the suspected breweries had all been manufactured with the use of brewing sugars obtained from a single source, and these sugars were found to have been impregnated with arsenic by the sulphuric acid used in their preparation, some specimens of the acid containing as much as . per cent of arsenic.[ ] the use of glucose, not only in beer, but as an admixture or adulterant in jams, syrups, candies, and the like, is open to serious objection unless the glucose is known to have been prepared with sulphuric acid freed from arsenical impurity. in fact, the use of any food material prepared by the aid of sulphuric acid is permissible only in case arsenic-free acid is employed.[ ] antimony the cheaper grades of enameled cooking utensils in use in this country contain antimony, and this is dissolved out in noteworthy amounts in cooking various foods.[ ] the rubber nipples used for infants' milk bottles also sometimes contain antimony.[ ] although the poisonous qualities of antimony are well known, there is little information about the toxic effect of repeated very minute doses. recognized instances of chronic antimony poisoning are very rare. further investigation is needed. lead the well-known poisonousness of lead and its compounds prevents, as a rule, the deliberate addition of lead salts to food substances, although it is true that lead chromate is sometimes used for imparting a yellow color to candy and decorating sugars.[ ] foods that are wrapped in foil, however, such as chocolate and soft cheese, contain traces of lead, as do the contents of preserve jars with metallic caps and the "soft drinks" vended in bottles with patent metal stoppers. occasional ingestion of minute quantities of lead is probably a matter of little physiological importance, but since lead is a cumulative poison, frequent taking into the body of even very small amounts entails danger. severe lead poisoning has been known to result from the habitual use of acid beverages contained in bottles with lead stoppers. investigations made to determine the possible danger of poisoning from lead taken up from glazed and earthenware cooking utensils indicate that injury from this source is unlikely. the enameled ware in common use in this country is lead-free. objection on the ground of possible contamination has been raised to the use of solder for sealing food cans. such objections have less weight than formerly owing to changes in the construction of the container, so that any contact of solder with the food is now minimized and to a large extent done away with altogether. in consequence of the fact that many natural waters attack lead, the use of lead service pipes for wells, cisterns, and public water supplies has given rise to numerous outbreaks of lead poisoning. it is now generally recognized that water intended for drinking purposes should not be drawn through lead pipes. a special liability to take lead into the stomach exists in persons working at the painters' trade and other occupations involving contact with lead and its salts. it has been shown that the eating of food handled with paint-smeared hands brings about the ingestion of considerable quantities of lead and, when long continued, results in lead poisoning. the risk of contaminating food with lead in this way can be greatly lessened by thorough cleansing of the hands with soap and hot water before eating.[ ] tin special interest has attached to the possibility of tin poisoning on account of the widespread use of canned foods.[ ] it is established chemically that tin is attacked, not only by acid fruits and berries, but by some vegetables having only a slightly acid reaction. more tin is found in the drained solids than in the liquor, and the metal is largely in an insoluble form.[ ] it has been the general opinion based on experiments by lehmann[ ] and others that the amounts of tin ordinarily present in canned foods "are undeserving of serious notice," and this view has found expression in the leading textbooks on hygiene.[ ] certainly there has not been any noticeable amount of tin poisoning observed coincident with the enormous increase in the use of canned foods. an instance of poisoning by canned asparagus observed by friedmann,[ ] however, is attributed by him to the tin content, and this view is rendered probable by the negative result of his bacteriological and serological examinations. canned asparagus apparently contains an unusually large amount of soluble tin compounds.[ ] there seems some ground for the assumption that certain individuals are especially susceptible to small quantities of tin and that the relative infrequency of such cases as that cited by friedmann can be best explained in this way. lacquered or "enamel-lined" cans are being used to an increasing extent for fruits and vegetables that are especially likely to attack tin.[ ] intentional addition of tin salts to food substances does not appear to be common, although protochloride of tin is said sometimes to be added to molasses for the purpose of reducing the color. the chlorides are regarded as more definitely poisonous than other compounds of tin, and for this and other reasons the practice is undesirable. sanitarians insist that chemical substances likely to be irritating to the human tissues in assimilation or elimination should not be employed in food. each new irritant, even in small quantity, may add to the burden of organs already weakened by age or previous harsh treatment. copper danger is popularly supposed to attend the cooking and especially the long standing of certain foods in copper vessels on account of the verdigris or copper acetate that is sometimes formed, but professor long, of the referee board of consulting scientific experts,[ ] points out that this substance is far less toxic than it was once imagined to be, and he considers it likely that the cases of illness attributed to "verdigris poisoning" reported in the older literature should have been explained in some other way. the use of copper sulphate for imparting a green color to certain vegetables, such as peas, beans, and asparagus, is a relatively modern practice, having been started in france about . since the natural green of vegetables is in part destroyed or altered by heat, restoration of the color has appealed to the color sense of some consumers. it must be admitted that this aesthetic gratification is fraught with some degree of danger to health. the experiments by long show that copper is absorbed and retained in certain tissues, and that even small amounts ingested at brief intervals may have a deleterious action. he concludes that the use of copper salts for coloring foods must be considered as highly objectionable. the united states government now prohibits the importation of foods colored with copper and also the interstate trade in these substances. various coloring substances copper sulphate is but one of a host of chemical substances applied to various foods for the purpose of altering the color which the foods would otherwise possess. in some cases perhaps it may be the general opinion that by special treatment the attractiveness of a food product is increased, as when dark-colored flour is bleached white with nitrogen peroxide, but in many instances the modification of color is based on preposterously artificial standards. the use of poisonous aniline dyes for staining candies all the colors of the rainbow must be defended, if at all, on aesthetic rather than on sanitary grounds. some coloring matters in common use, such as the annatto, universally employed in coloring butter, are believed to be without harmful effect, but others are to be viewed with suspicion, and still others, like copper sulphate, are unquestionably dangerous. the whole practice of food coloration at its best involves waste and may entail serious danger to health. broadly speaking, all modification of the natural color of foodstuffs is based on an idle convention and should be prohibited in the interest of the public welfare. bleached flour, stained butter, dyed jelly and ice-cream are no whit more desirable as foods than the natural untreated substances; in fact, they are essentially less desirable. if the whole process of food coloration were known to the public, artificially colored foods would not be especially appetizing. economically the practice is singularly futile. the artificial whitening of flour with the highly poisonous nitrogen peroxide seems hardly worth the extra tax of fifty cents to a dollar a barrel. such bleaching with a poisonous gas certainly does not improve the nutritive or digestive qualities of flour; it may be insidiously injurious. the solution of the problem of food coloration seems to lie in a policy of educational enlightenment which shall make natural foods appear more desirable than those sold under false colors. custom, however, buttressed by skilful advertising, offers a difficult barrier to reform in this field. food preservatives it is not only legitimate, but in every way most desirable, to keep food over from a season of superabundance to a season of scarcity. from time immemorial food has been preserved by drying, smoking, or salting, and, in modern times, by refrigeration and by heat (canning). these latter methods have come to play a large part in the food habits of civilized communities. since food spoils because of microbic action, all methods of preservation are based upon the destruction of the microbes or the restraint of their growth by various physical and chemical agencies. the use of certain chemical preservatives such as strong sugar and salt solutions, saltpeter brines, and acid pickles has long been known and countenanced. in recent times the employment of chemical preservatives has acquired a new aspect through the increasing tendency of manufacturers to add to food products antiseptic chemicals in wide variety and of dubious physiological effect. it is not so easy and simple as it might appear to declare that no substance that is poisonous shall be added to food. the scientific conception of a poison is one involving the amount as well as the kind of substance. common salt itself is poisonous in large doses, but, as everyone knows, small amounts are not only not injurious, but absolutely necessary to health. well-known and very powerful protoplasmic poisons such as strychnine and quinine are frequently administered in minute doses for medicinal purposes, without causing serious results. how complicated the question of using food preservatives really is appears in the case of smoked meats and fish, which owe their keeping qualities to the creosote and other substances with which they are impregnated by the smoke. although these substances are much more highly poisonous than chemical preservatives like benzoic acid, over which much concern has been expressed, but little if any objection has been made to the use of smoked foods. the use of benzoic acid (benzoate of soda) as a food preservative illustrates several phases of the controversy. observations by wiley in upon so-called "poison squads" were thought by him to indicate that benzoate of soda administered with food led to "a very serious disturbance of the metabolic functions, attended with injury to digestion and health." on the other hand, the experiments of the referee board of scientific experts ( ), conducted with at least equal care and thoroughness, were considered to warrant the conclusions that: ( ) sodium benzoate in small doses (under five-tenths of a gram per day) mixed with the food is without deleterious or poisonous action and is not injurious to health. ( ) sodium benzoate in large doses (up to four grams per day) mixed with the food has not been found to exert any deleterious effect on the general health, nor to act as a poison in the general acceptance of the term. in some directions there were slight modifications in certain physiological processes, the exact significance of which modification is not known. ( ) the admixture of sodium benzoate with food in small or large doses has not been found to injuriously affect or impair the quality or nutritive value of such food. still later experiments under the auspices of the german government ( ) showed that in the case of dogs and rabbits relatively large doses of benzoic acid (corresponding to sixty to one hundred grams per day for a man weighing one hundred and fifty pounds) were necessary in order to produce demonstrable effects of any kind. this finding may be considered to confirm in a general way the finding of the referee board that four grams per day is harmless. probably the evidence respecting the effect of benzoic acids and the benzoates when used as food preservatives constitutes as favorable a case as can be made out at the present time for the employment of any chemical substance. benzoic acid is present in noteworthy amounts in many fruits and berries, especially cranberries, and its presence in these natural foods has never been connected with any injurious action. in point of fact, substances present in many ordinary foodstuffs are converted within the human body first into benzoic acid and then into hippuric acid. folin's masterly summing up is worth quoting: we know that the human organism is prepared to take care of and render harmless those small quantities of benzoic acid and benzoic acid compounds which occur in food products or which are formed within the body; we know how this is accomplished and are reasonably sure as to the particular organ which does it. we also know that the mechanism by means of which the poisonous benzoic acid is converted into the harmless hippuric acid is an extremely efficient one, and that it is capable of taking care of relatively enormous quantities of benzoic acid. in this case, as in a great many others, the normal animal organism is abundantly capable of performing the function which it must regularly perform in order to survive. from this point of view it can be argued, and it has been argued with considerable force, that the human organism is abundantly capable of rendering harmless reasonable amounts of benzoic acid or benzoate which are added for purposes of preservation to certain articles of our food. in my opinion this point of view is going to prevail, and the strife will resolve itself into a controversy over how much benzoic acid shall be permitted to go into our daily food. but we ought to be exceedingly cautious about accepting any definite figure, certainly any large figure, as representing the permissible amount of added benzoic acid in our food. the very fact that we are in possession of an efficient process for converting poisonous benzoic acid into harmless hippuric acid indicates that there is a necessity for doing so. it suggests that even the small quantities of benzoic acid which we get with unadulterated food, or produce within ourselves, might be deleterious to health except for the saving hippuric acid forming process. and because that "factor of safety" is a large one with respect to the normal benzoic acid content of our food it does not follow that we can encroach on it with perfect impunity. what the effect of a general, regular encroachment on it would be cannot be determined by a few relatively short feeding experiments. it is known that while certain chemicals may be taken in substantial quantities for a month or a year without producing demonstrably injurious effects, nevertheless the continued use of the same substances, even in smaller quantities, will eventually undermine the health. perhaps the final solution of the benzoic acid problem could be best obtained directly from the people at large. if they were to consume benzoic acid as knowingly as they consume, for example, sodic carbonate in soda biscuits, or caffeine and theobromine in coffee and tea, it would not require more than a decade or two before we should have a well-defined and well-founded public opinion on the subject, at least in the medical profession.[ ] with respect to other familiar and more or less poisonous substances used to preserve foods, defense of their harmlessness is far more difficult. formaldehyde, salicylic acid, sulphurous acid, and sulphite are compounds definitely poisonous in relatively small amounts, their injurious action in minute successive doses in animal experiments is quite marked, and their use in human food products practically without justification. boric acid and borax are perhaps on a slightly different footing, but are never present in natural foods, and there is no good evidence that their long-continued ingestion in small doses is without injurious effect. it must not be forgotten that all such substances owe their preservative or antiseptic power to the poisonous effect they have upon bacterial protoplasm. it is fair to assume that, in general, bacterial protoplasm is no more easily injured than human protoplasm, and this raises at once the propriety of bringing into repeated contact with human tissues substances likely to produce injury even if such injury is slight and recovery from it is ordinarily easy. in every case the burden of proof should be properly placed on those who advocate the addition of bacterial-restraining substances to food intended for human consumption. it is for them to show that substances powerful enough to hold in check the development of bacteria are yet unable to interfere seriously with the life-processes of the cells of the human body. when this view of the situation is taken, not only the chemical substances mentioned previously fall under some suspicion, but also certain household preservatives long sanctioned by custom. spices such as cinnamon, oil of cloves, and the like are, so far as we know, as likely to have an injurious physiological effect when taken in small recurring quantities as are some of the "chemical" preservatives whose use is debarred by law. the chemicals deposited by wood smoke in meat are of a particularly objectionable nature, and their continuous ingestion may quite conceivably lead to serious injury. one fact persistently comes to the front in any comprehensive study of the food-preservative question, namely, the need of further experiment and observation. we do not at present know what effect is produced in human beings of different ages and varying degrees of strength by the _long-continued_ consumption of food preserved with particular chemicals. there is, i think, only one way to get at the facts with regard to the various chemicals which have been used for the preservation of foods, and that is by trying them and keeping track of the results. to try them properly, on a sufficiently extensive scale and for a sufficiently long time, is, however, more of a task than can be undertaken by private investigators; for it is only by their continuous use for many years under competent supervision and control that we can hope to attain adequate information for final conclusions. work of this sort should be done and could very well be done at large government institutions, as, for example, among certain classes of prison inmates. i do not know how many life prisoners or long-term prisoners may be available, but there must be an abundance of them. they would make better subjects than students on whom to try out a substance like boric acid. this, not because they are prisoners whose fate or health is of comparatively little consequence, but because they represent a body of persons whose mode of life is essentially uniform and whose health record could easily be kept for a long period of years. i am well aware that this suggestion will impress many persons as heartless and brutal, but such an experiment would be a mild and humane one when compared with the unrecorded boric acid experiments which have been made by manufacturers on all kinds and conditions of people. prisoners are unfortunate in not being able to render any useful service to society. probably not a few would be willing to co-operate in prolonged feeding experiments, similar to the short ones conducted by dr. wiley and by the referee board. acceptable reward in the way of well-prepared food of sufficient variety would attract volunteers. if additional inducement were necessary, shortened term of service would probably appeal to many. and in the face of the fact that every civilized country is prepared to sacrifice thousands of its most virile citizens for the honor of its flag (and its foreign trade), the sentiment against endangering the health of a handful of men in the interest of all mankind is not particularly intelligent.[ ] until such information is forthcoming we do well to err on the side of caution. the desirability of adopting this attitude is especially borne in upon us by the facts already instanced (pp. - ) concerning the increased death-rates in the higher-age groups in this country. for aught we now know to the contrary, the relatively high death-rates from degenerative changes in the kidneys, blood vessels, and other organs may be in part caused by the use of irritating chemical substances in food. although no one chemical by itself and in the quantities in which it is commonly present in food can perhaps be reasonably accused of producing serious and permanent injury, yet when to its effect is superadded the effect of still other poisonous ingredients in spiced, smoked, and preserved foods of all kinds the total burden laid upon the excretory and other organs may be distinctly too great. there can be no escape from the conclusion that the more extensive and widespread the use of preservatives in food the greater the likelihood of injurious consequences to the public health. the use of spoiled or decomposed food falls under the same head. it cannot be assumed that the irritating substances produced in food by certain kinds of decomposition can be continually consumed with impunity. we do not even know whether these decomposition products may not be more fundamentally injurious than preservatives that might be added to prevent decomposition! so far as our present knowledge indicates, therefore, effort should be directed ( ) to the purveying of food as far as possible in a fresh condition; ( ) to the avoidance of chemical preservatives of all kinds except those unequivocally demonstrated to be harmless. the methods of preserving food by drying, by refrigeration, and by heating and sealing are justified by experience as well as on theoretical grounds, and the same statement can be made regarding the use of salt and sugar solutions. but the use of sulphites in sausage and chopped meat, the addition of formaldehyde to milk, and of boric acid or sodium fluoride to butter are practices altogether objectionable from the standpoint of public health. the remedy is obvious and has been frequently suggested--namely, laws prohibiting the addition of any chemical to food except in certain definitely specified cases. the presumption then would be--as in truth it is--that such chemicals are more or less dangerous, and proof of innocuousness must be brought forward before any one substance can be listed as an exception to the general rule. such laws would include not only the use of chemicals or preservatives, but the employment of substances to "improve the appearance" of foodstuffs. as already pointed out, the childish practice of artificially coloring foods involves waste and sometimes danger. it rests on no deep-seated human need; food that is natural and untampered with may be made the fashion just as easily as the color and cut of clothing are altered by the fashion-monger. the incorporation of any chemical substance into food for preservative or cosmetic purposes could wisely be subject to a general prohibition, and the necessary list of exceptions (substances such as sugar and salt) should be passed on by a national board of experts or by some authoritative organization like the american public health association. food substitutes on grounds of economy or convenience familiar and natural articles of food are sometimes replaced or supplemented by artificial chemical products, or by substances whose food value is not so definitely established. i need refer only briefly to those notorious instances of adulteration in which chicory is added to coffee, or ground olive stones to pepper, or glucose to candy. on hygienic grounds alone some such practices are not open to criticism, however fraudulent they may be from the standpoint of public morals. it might be argued with some plausibility that chicory is not so likely to harm the human organism as caffeine and that sprinklings of ground cocoanut shell are more wholesome than pepper. but there is another group of cases in which the artificial substitute is strictly objectionable. the use of the coal-tar product saccharin for sweetening purposes is an example. this substance, whose sweetening power is five hundred times as great as that of cane sugar, has no nutritive value in the quantities in which it would be consumed, and in not very large quantities (over . gram per day) is likely to induce disturbance of digestion. as a substitute for sugar in ordinary foodstuffs it is undesirable.[ ] the use of cheap chemically prepared flavors such as "fruit ethers" in "soft drinks," fruit syrups, and the like in place of the more expensive natural fruit extracts affords another well-known instance of substitution. probably more important hygienically is the production of "foam" in "soda water" by saponin, a substance known to be injurious for red blood corpuscles. among the many other familiar examples of food substitution, sophistication, and adulteration there are some of demonstrable hygienic disadvantage and others whose chief demerit lies in simple deception. of practically all it may be said that they are indefensible from the standpoint of public policy since they are based on the intent to make foodstuffs appear other than what they really are. it is the opinion of some who have closely followed the course of food adulteration that, while the amount of general sophistication--legally permissible and otherwise--has greatly increased in recent years, the proportion of really injurious adulteration has fallen off. be that as it may, it is plain that the opportunity for wholesale experimentation with new substances should not be allowed to rest without control in the hands of manufacturers and dealers largely impelled by commercial motives. so long as the motive of gain is allowed free scope, so long will a small minority of unscrupulous persons add cheap, inferior, and sometimes dangerous ingredients to foodstuffs. the net of restriction must be drawn tighter and tighter. the motives leading to the tampering with food fall mainly under three heads: ( ) a desire to preserve food from spoiling or deterioration; ( ) a puerile fancy--often skilfully fostered for mercenary reasons--for a conventional appearance, as for polished rice, bleached flour, and grass-green peas; and ( ) intent to make the less valuable appear more valuable--deliberate fraud. only the first-named motive can claim any legitimate justification, and its gratification by the use of chemical preservatives is surrounded with hygienic difficulties and uncertainty, as already set forth. from the unbiased view of human physiology the dangers of slow poisoning from chemically treated foods must be regarded as no less real because they are insidious and not easily traced. footnotes: [ ] e. s. reynolds, _lancet_, i ( ), . [ ] the sulphuric acid used in making glucose in the united states is authoritatively declared to be absolutely free from arsenic (report of hearing before illinois state food standard commission, june - , ; see _amer. food jour._, july, , p. ). [ ] e. w. miller, _jour. home economics_, viii ( ), . [ ] phelps and stevenson, _hyg. lab., u.s. public health service, bull. _, , p. . [ ] harrington and richardson, _manual of practical hygiene_, th ed., p. . [ ] see alice hamilton, "hygiene of the painters' trade," _u.s. bureau of labor statistics, bull. _, . [ ] in the value of foods canned in the united states amounted to about $ , , (_u.s. dept. of agric., bull. _, ). [ ] w. d. bigelow, _amer. food jour._, xi ( ), . [ ] _arch. f. hyg._, xlv ( ), ; _ibid._, lxiii ( ), . [ ] see, e.g., harrington and richardson, _practical hygiene_, th ed., p. . [ ] _ztschr. f. hyg._, lxxv-lxxvi ( - ), . [ ] bigelow, _loc. cit._ [ ] a. w. bitting, _u.s. dept. of agric., bull. _, . [ ] _u.s. dept. of agric., report _, . [ ] folin, _preservatives and other chemicals in foods_ (harvard university press, ), p. . [ ] folin, _op. cit._, p. . [ ] see _u.s. dept. of agric., report _, . chapter v food-borne pathogenic bacteria many cases of so-called food poisoning are due to the presence of pathogenic bacteria in the food. in some instances, as in the typical meat poisoning epidemics, symptoms develop so soon after eating that the particular food involved is immediately suspected and laid hands on. in other cases the guilty article of food is difficult to trace. certain cases of tuberculosis are undoubtedly caused by swallowing tubercle bacilli in the food, but the precise source and date of infection can be rarely, if ever, certainly established. the presence of pathogenic bacteria in food is usually due either to the contamination of the food by infected human beings during the process of preparation or serving, or to an infection of the animal from which the food is derived. the relative importance of these two factors is quite different in the various infections. typhoid food infection the typhoid bacillus does not attack any of the domestic animals; consequently all food-borne typhoid is caused more or less directly by human contamination. a remarkable instance of typhoid infection due to food was reported in in hanford, california, where ninety-three typhoid cases were caused by eating spanish spaghetti served at a public dinner.[ ] investigation showed that this dish was prepared by a woman typhoid-carrier who was harboring living typhoid bacilli at the time she mixed the sauce for the spaghetti before baking. further laboratory experiments indicated that the ordinary baking temperature at which the spaghetti was cooked was not only not sufficient to sterilize the food, but afforded a favorable opportunity for the bacteria in the interior of the mass to multiply. the infection of the food was consequently heavy and involved a very large proportion ( per cent) of those present at the dinner. merited celebrity attaches to the exploits of the typhoid-carrier, mary malloy, who, in pursuing her career as cook in and about new york city, is known to have caused at least seven typhoid outbreaks in various families in which she worked and one extensive hospital epidemic. similar cases of typhoid food infection by employees in restaurants and public institutions are by no means uncommon, and show the necessity of protecting food from contamination during the whole process of preparation and serving. acting on this principle, the department of health of new york city has inaugurated a comprehensive examination of the cooks and waiters (approximately , ) employed in the public restaurants and dining-rooms in that city. results have been obtained in the discovery of typhoid-carriers and of cases of communicable disease that amply justify this procedure as an important measure for protecting the community against the dissemination of infection. some foods by their origin are exposed more than others to typhoid contamination. such vegetables as lettuce, celery, radishes, and watercress, which are commonly eaten without cooking, are more likely to convey typhoid than peas, beans, and potatoes. a typhoid outbreak apparently due to watercress has been reported from philadelphia.[ ] at a wedding breakfast to forty-three guests on june , , watercress sandwiches were served, and subsequent inquiry showed that nineteen of the guests partook of these sandwiches. eighteen of this number became ill with typhoid fever within a month, the illness developing in most cases after the guests had scattered to their summer homes. those who did not eat watercress sandwiches were not affected. typhoid infection by uncooked celery has also been reported.[ ] the practice of using human excreta as fertilizer in truck gardens is sometimes responsible for a dangerous contamination of the soil, which is communicated to the growing plants and persists for a long time.[ ] even scrupulous washing of vegetables is not sufficient to render them bacterially clean. in the future the danger to the community from this source is likely to become increasingly serious unless the growing use of this method of soil enrichment is definitely checked. in an increasing number of typhoid cases in south philadelphia led to an investigation by the state health department.[ ] this disclosed the fact that the majority of the cases were clustered in and about three public markets. these are all curb markets--fruits, vegetables, pastry, clothing, and miscellaneous merchandise of every description are dumped on push-carts and pavements without regard for any sanitary precautions. the patrons of these markets handle and pick over the exposed foodstuffs, thus giving every opportunity for the transmission of disease.... the greatest number of cases occurred in the immediate vicinity of the christian street market. this market is largely patronized by the inhabitants of the section known as "little italy." the patrons of the south street market are principally hebrews, while the seventh street market is patronized in the main by hebrews and poles. the following conclusion was reached regarding the particularly large number of cases among persons of one nationality: our inspectors have found that the different methods used by the italians and hebrews in the preparation of their food are responsible for the larger number of cases being found in the vicinity of the christian street market in little italy. it is the custom of the italians to eat many of the fruits and vegetables raw, while the hebrews cook the greater portion of their food. it is presumably due to this custom that the members of the italian colony have suffered to a greater extent than the other residents of the district. a bacterial examination of various kinds of vegetables obtained from push-carts and curb markets led to the finding of the typhoid bacillus upon some of the celery. it would naturally be difficult to determine in such cases whether the typhoid bacilli were derived from infected soil in which the celery was grown or whether the contamination occurred through improper handling. bread, when marketed unwrapped, is subject to contamination from flies and from uncleanly handling. katherine howell[ ] has shown that unwrapped loaves of bread sold in chicago were more or less thickly smeared with bacteria and were coated on the average with a much larger number than wrapped loaves. in some cases typhoid fever has been directly traced to bread. hinton[ ] has recorded the occurrence of seven typhoid cases in the elgin (illinois) state hospital, which were apparently due to a typhoid-carrier whose duty it was as attendant to slice the bread before serving. when this typhoid-bearing attendant was transferred to another department where she handled no uncooked food, cases of typhoid ceased to appear.[ ] food such as milk that is not only eaten customarily without cooking, but is also suitable for the growth of typhoid bacilli, needs to be particularly safeguarded. it is noteworthy that the compulsory pasteurization of milk in new york, chicago, and other large american cities has been accompanied by a great diminution in the prevalence of typhoid fever. until recent years milk-borne typhoid in the united states has been common and hundreds of typhoid epidemics have been traced to this source. [illustration: fig. .--bacteria left by fly passing over gelatin plate. (by courtesy of doubleday, page & company.)] one food animal, the oyster, frequently eaten raw, has been connected on good evidence with certain typhoid outbreaks.[ ] the number of well-established oyster typhoid epidemics is not great, however, and the danger from this source has sometimes been exaggerated. the source of oyster contamination is in sewage pollution either of the shellfish beds or of the brackish water in which the oyster is sometimes placed to "fatten" before it is marketed. state and federal supervision of the oyster industry in the united states in recent years has largely done away with the taking of oysters from infected waters, and although oysters--and clams and mussels as well--must be steadily safeguarded against sewage contamination, the actual occurrence of oyster infection at the present time is believed to be relatively rare. probably the most effective method of preventing typhoid food infection is to investigate every case of typhoid fever and trace it, so far as practicable, to its origin. in this way typhoid-carriers may be discovered and other foci of infection brought to light. carriers, once found, may be given proper advice and warned that they constitute a danger to others; the complete control of typhoid-carriers who are not disposed to act as advised is a difficult problem and one not yet solved by public health authorities. asiatic cholera with asiatic cholera, just as with typhoid fever, domestic animals are not susceptible to the disease, all cases of infection having a direct human origin. drinking-water is the usual vehicle of cholera infection, and even in countries where the disease is endemic, food-borne outbreaks of this disease are far less common than those of typhoid fever. occasional instances of asiatic cholera due to milk supply and to contaminated fruits or lettuce are on record, but these are exceptional and cannot be regarded as exemplifying a common mode of spread of this disease. the extent, however, to which dwellers in tropical countries--and indeed in all lands--are at the mercy of their household helpers is illustrated by the following experience of the english bacteriologist, hankin. "i have seen," he says, "a cook cooling a jelly by standing it in a small irrigation ditch that ran in front of his cookhouse. the water running in this drain came from a well in which i had detected the cholera microbe. he cleaned a spoon by dipping it in the drain and rubbing it with his fingers; then he used it to stir the jelly."[ ] tuberculosis animal experiments have shown that both meat and milk derived from tuberculous cattle are capable of conveying infection. the precise degree of danger to human beings from the use of these foods under modern conditions is still in dispute. since the tubercle bacillus of bovine origin differs from the tubercle bacillus of human origin in certain well-defined particulars, it is possible by careful study to distinguish the human infections caused by the bovine bacillus from those caused by the so-called human tubercle bacillus. additional comparative investigations are needed in this field, and these may enable us to estimate eventually more fully than is possible at present the extent of human tuberculous infection derived from bovine sources. meat is a less likely source of infection than milk, chiefly because it is rarely eaten without cooking. opinion regarding the actual frequency of the transmission of tuberculosis by means of the meat of tuberculous cattle has been widely at variance in the past, and must even now be based on indirect evidence. there is no well-established instance of human infection from the use of the flesh of tuberculous cattle. the significance of this fact, however, is diminished by the observation that tubercle bacilli can pass through the intestinal wall without leaving any trace of their passage and can make their way to the lungs or to other distant organs where they find opportunity for growth. this, together with the long period which usually elapses between the actual occurrence of infection and the discovery of the existence of infection, makes the difficulty of securing valid evidence peculiarly great. opposed to any very frequent occurrence of meat-borne tuberculosis are the facts that the tubercle bacillus is not commonly or abundantly present in the masses of muscle usually marketed as "meat," that the tubercle germ itself is not a spore-bearer and is killed by ordinary cooking, and that the reported cases of the finding of tubercle bacilli of bovine origin in adults over sixteen years of age are extremely rare. this latter fact is perhaps the strongest evidence indicating that tuberculous meat infection, although theoretically possible, is at least not of common occurrence. most of the commissions and official agencies that have considered the precautions to be taken against possible tuberculous meat infection are agreed that the entire carcass of an animal should be condemned when the tuberculous lesions are generalized or when the lesions are extensive in one or both body cavities as well as when the lesions are "multiple, acute, and actively progressive." any organ showing evidence of tuberculous lesions is obviously not to be passed as food. on the other hand, it is considered that portions of properly inspected animals may be put on the market if the tuberculous lesion is local and limited and the main part of the body is unaffected; in such cases contamination of the meat in dressing must be avoided. it is the general belief that when such precautionary measures are taken the danger of tuberculous infection through properly cooked meat is so slight as to be negligible. milk is a much more likely vehicle than meat for the transmission of tuberculosis. freshly drawn raw milk from tuberculous cattle may contain enormous numbers of tubercle bacilli, especially if the udder is diseased. contamination of milk by the manure of tuberculous cows can also occur. observers in england, germany, france, and the united states have found tubercle bacilli in varying numbers in market milk, and have proved that such milk is infectious for laboratory animals. although, as pointed out with reference to meat infection, the difficulties of tracing any particular case of tuberculosis to its source are very great, there are a number of instances on record in which the circumstantial evidence strongly indicates that milk was the vehicle of infection. especially convincing are the observations on the relative frequency of infection with bovine and human tubercle bacilli at different ages as shown in the following tabulation:[ ] ==================================================================== |adults sixteen|children five to|children under | years old | sixteen years | five years | and over | old | --------------------+--------------+----------------+-------------- human tubercle | | | bacilli found | | | bovine tubercle | | | bacilli found | | | ------------------------------------------------------------------- the large proportion of bovine tubercle bacillus infections in children stands in all probability in causal relation to the relatively extensive use of raw milk in the child's dietary. the proper pasteurization of milk affords a safe and reasonably satisfactory means of preventing tuberculous infection from this source. the general introduction of the pasteurizing process in most american cities has ample justification from the standpoint of the prevention of infection. various milk-borne infections the facts related in the foregoing pages indicate that of all foods milk is the most likely to convey disease germs into the human body. this is partly due to the fact that milk is sometimes obtained from diseased animals, and partly to the fact that unless great care is taken it may readily become contaminated during the process of collection and transportation; if milk is once seeded with dangerous bacteria these can multiply in the excellent culture medium it affords. it is also partly because milk is commonly taken into the alimentary tract without being cooked. for these reasons the amount of illness traceable to raw milk far exceeds that ascribable to any other food. there are several infections that may be communicated by milk, but are rarely if ever due to other foodstuffs. diphtheria and scarlet fever are perhaps the best known of these. both diseases have been repeatedly traced to the use of particular milk supplies, although various forms of individual contact also play a large rôle in their dissemination. milk-borne scarlet fever and diphtheria seem to be generally, if not always, due to the direct contamination of the milk from human sources. it is considered possible, however, by some investigators that the cow may sometimes become infected from human sources with the virus of scarlet fever or diphtheria and may herself occasionally contribute directly to the infection of the milk. a serious milk-borne disease, which has lately been conspicuous in boston, chicago, baltimore, and other american cities under the name of "septic sore throat" or "streptococcus sore throat," originates apparently in some cases from infection of the udder of the cow by an infected milker; in other cases the milk has seemingly been directly infected by a human "carrier." the specific germ is thought to have been isolated and its connection with the disease demonstrated in the laboratory. this disease, like diphtheria and scarlet fever, is sometimes due to contact. it is not known to be caused by any food except milk. foot-and-mouth disease of cattle is transmissible to man through the milk of infected cattle, but this infection in man is not very common or as a rule very serious. so far as known, it is not communicated to man in any other way except through the use of uncooked milk. such cases of infection or "poisoning" by milk may be prevented, as already stated, by the exclusive use of heated milk. the possible occurrence of nutritional disturbances (e.g., scurvy) in a small proportion of the children fed on pasteurized or boiled milk is considered by many physicians to be easily remedied and to possess much less practical importance than the avoidance of infection. possible infection with b. proteus one widely distributed organism known as _bacillus proteus_ has been several times held responsible for food poisoning outbreaks, but it is not yet certain how far this accusation is justified. _b. proteus_ is related to _b. coli_, but most varieties do not ferment lactose and are much more actively proteolytic than the latter organism, as shown by their ability to liquefy gelatin and casein. like _b. coli_, they form indol and ferment dextrose with gas production. varieties of _b. proteus_ are found widely distributed in decomposing organic matter of all sorts. the evidence upon which this bacillus is regarded as the cause of food poisoning is not altogether convincing. the outbreak described by pfuhl[ ] is typical. eighty-one soldiers in a garrison at hanover were suddenly attacked with acute gastro-enteritis four to twelve hours after eating sausage meat. the meat was found to contain _b. proteus_ in large numbers, although it was prepared with ordinary care and was entirely normal in appearance, taste, and smell. rats and mice fed with the sausage became ill and _b. proteus_ was isolated from the blood and internal organs. but these animals sometimes die when fed with quite normal meat, and _b. proteus_ and other common intestinal bacteria are often isolated from the body after death. _b. proteus_, in fact, is found in many animal foods and in the apparently normal human intestine. like _b. coli_, it frequently invades the internal organs after or shortly before death. finding _b. proteus_ in food or in the internal organs does not therefore constitute definite proof of any causal relationship. the evidence attributing other outbreaks to infection with _b. proteus_ is similarly inconclusive. it is equally uncertain whether the production of a poison in food by this species can in any degree be held responsible for meat poisoning. _b. proteus_ is common enough in decomposing food material and under certain circumstances is known to generate substances that are toxic for man. it is possibly true that toxic substances are produced in the early stages of decomposition by this organism. in the opinion of mandel[ ] and others, if any injurious effect at all is to be attributed to _b. proteus_, it is in the nature of an intoxication and not an infection (see chapter viii). so far as the existing evidence goes, the question of the responsibility of this organism for food poisoning is still an open one. footnotes: [ ] sawyer, _jour. amer. med. assoc._, lxiii ( ), . [ ] _eng. news_, lxx ( ), . [ ] morse, _report of state board of health of mass._, , p. . [ ] r. h. creel, _reprint from public health reports, no. _, washington, . [ ] _health bull. no. , pennsylvania state department of health_, december, . [ ] _amer. jour. public health_, ii ( ), . [ ] _institution quarterly_, iii ( ), . [ ] see also a similar instance reported by lumsden, _hyg. lab., u.s. public health and marine hosp. service, bull. _, p. . [ ] for a discussion of the oyster question see g. w. fuller, _jour. of franklin institute_, august, ; _n.y. city dept. of health, monthly bull._, november, , and may, ; h. s. cumming, _u.s. public health service, pub. health bull. _, march, . [ ] _lancet_, ii ( ), . [ ] park and krumwiede, _jour. med. research_, n.s., xviii ( ), . [ ] _ztschr. f. hyg._, xxxv ( ), . [ ] _centralbl. f. bakt._, i, orig., lxvi ( ), . chapter vi food-borne pathogenic bacteria (_continued_) paratyphoid infection the most characteristic examples of "food poisoning," popularly speaking, are those in which the symptoms appear shortly after eating and in which gastro-intestinal disturbances predominate. in the typical group-outbreaks of this sort all grades of severity are manifested, but as a rule recovery takes place. the great majority of such cases that have been investigated by modern bacteriological methods show the presence of bacilli belonging to the so-called paratyphoid group (_b. paratyphosus_ or _b. enteritidis_). especially is it true of meat poisoning epidemics that paratyphoid bacilli are found in causal relation with them. hübener[ ] enumerates forty-two meat poisoning outbreaks in germany in which bacilli of this group were shown to be implicated, and savage[ ] gives a list of twenty-seven similar outbreaks in great britain. in the united states relatively few outbreaks of this character have been placed on record, but it cannot be assumed that this is due to their rarity, since no adequate investigation of food poisoning cases is generally carried out in our american communities. _typical paratyphoid outbreaks._--kaensche[ ] describes an outbreak at breslau involving over eighty persons in which chopped beef was apparently the bearer of infection. the animal from which the meat came had been ill with severe diarrhea and high fever and was slaughtered as an emergency measure (_notgeschlachtet_). on examination a pathological condition of the liver and other organs was noted by a veterinarian who declared the meat unfit for use and ordered it destroyed. it was, however, stolen, carried secretly to breslau, and portions of it were distributed to different sausage-makers, who sold it for the most part as hamburger steak (_hackfleisch_). the meat itself presented nothing abnormal in color, odor, or consistency. nevertheless, illness followed in some cases after the use of very small portions. with some of those affected the symptoms were very severe, but there were no deaths. bacilli of the _bacillus enteritidis_ type were isolated from the meat. a large and unusually severe outbreak reported by mcweeney[ ] occurred in november, , among the inmates of an industrial school for girls at limerick, ireland. there were cases with deaths out of the total number of pupils. the brunt of the attack fell on the first or senior class comprising girls between the ages of thirteen and seventeen. out of girls belonging to this class who partook of beef stew for dinner sickened, and of these died. one of the two who were not affected ate the gravy and potatoes but not the beef. some of the implicated beef was also eaten as cold meat by girls in some of the other classes, and also caused illness. part of the meat had been eaten previously without producing any ill effects. "the escape of those who partook of portions of the same carcass on october and [five days earlier] may be accounted for either by unequal distribution of the virus, or by thorough cooking which destroyed it. some of the infective material must, however, have escaped the roasting of the th, and, multiplying rapidly, have rendered the whole piece intensely toxic and infective during the five days that elapsed before the fatal tuesday when it was finally consumed." the animal from which the fore quarter of the beef was taken had been privately slaughtered by a local butcher. no reliable information could be obtained about the condition of the calf at, or slightly prior to, slaughter. the meat, however, was sold at so low a price that it was evidently not regarded as of prime quality. in this outbreak the agglutination reactions of the blood of the patients and the characteristics of the bacilli isolated showed the infection to be due to a typical strain of _bacillus enteritidis_. an epidemic of food poisoning occurred in july, , at and near westerly, rhode island.[ ] the outbreak was characterized by the usual symptoms of acute gastro-enteritis, and followed the eating of pie which was obtained at a restaurant in westerly. all the circumstances of the outbreak showed that a particular batch of pies was responsible. about sixty persons were made seriously ill and four died. there was no unusual taste or odor to the pies to excite suspicion. the symptoms followed the eating of various kinds of pie: custard, squash, lemon, chocolate, apple, etc., that had been made with the same pie-crust mixture. _bacillus paratyphosus_ b was isolated from samples of pie that were examined. no definite clue was obtained as to the exact source of infection of the pie mixture. it is possible that the pie became infected in the restaurant through the agency of a paratyphoid-carrier, but since there had been no change in the personnel of the restaurant for several months, this explanation is largely conjectural. possibly some ingredient of animal origin was primarily infected. _general characters of paratyphoid infection._--the symptoms of paratyphoid food infection are varied. as a rule the first signs of trouble appear within six to twelve hours after eating, but sometimes they may come on within half an hour, or they may not appear until after twenty-four to forty-eight hours. gastro-intestinal irritation is practically always present, and may take the form of a mild "indigestion" or slight diarrhea or may be of great severity accompanied with agonizing abdominal pain. fever is usual, but is generally not very high. recovery may occur quickly, so that within two or three days the patient regains his normal state, or it may be very slow, so that the effects of the attack linger for weeks or months. investigators have noted the occurrence of at least two clinical types of paratyphoid infection, the commoner gastro-intestinal type just described and a second type resembling typhoid fever very closely, and occasionally not to be distinguished from it except by careful bacterial examination. it is not yet clear how these two clinical varieties are related to the amount and nature of the infecting food material. no difference in the type of paratyphoid bacillus has been observed to be associated with the difference in clinical manifestation. possibly the amount of toxin present in the food eaten as well as the number of bacilli may exercise some influence. the individual idiosyncrasy of the patient doubtless plays a part. while there is still some uncertainty about particular features of paratyphoid infection, a few significant facts have been clearly established: ( ) certain articles of diet are much more commonly associated than others with this type of food poisoning. the majority of recorded outbreaks are connected with the use of meat, milk, fish, and other protein foods. vegetables and cereals have been less commonly implicated, fruits rarely. ( ) in many, though not all, of the cases of paratyphoid meat poisoning it has been demonstrated that the meat concerned has been derived from an animal slaughtered while ailing (_notgeschlachtet_, to use the expressive german term). there seems reason to believe that in such an animal, "killed to save its life," the specific paratyphoid germ is present as an infection before death. milk also has caused paratyphoid poisoning and in certain of these cases has been found to be derived from a cow suffering from enteritis or some other disorder. ( ) there is evidence that originally wholesome food may become infected with paratyphoid bacilli during the process of preparation or serving in precisely the same way that it may become infected with typhoid bacilli; the handling of the food by a paratyphoid-carrier is commonly responsible for this. in a few instances the disease is passed on from case to case, but this mode of infection seems exceedingly rare and is not nearly so frequent as "contact" infection in typhoid. ( ) the majority of paratyphoid outbreaks are associated with the use of uncooked or partly cooked food. a selective action is often manifested, those persons who have eaten the incriminated food substance raw or imperfectly cooked being most seriously affected, while those who have partaken of the same food after cooking remain exempt. [illustration: fig. .--_bacillus enteritidis_, gärtner; pure culture; van ermengem preparation. (kolle and wassermann.)] the discovery of the connection of paratyphoid bacilli with meat poisoning dates from the investigation by gärtner,[ ] in , of a meat poisoning outbreak in frankenhausen, a small town in germany. this epidemic was traced to the use of meat from a cow that was slaughtered because she was ill with a severe enteritis. fifty-eight persons were affected in varying grades of severity; the attack resulted fatally in one young workman who ate about eight hundred grams of raw meat. gärtner isolated from the spleen of the fatal case and also from the flesh and intestines of the cow a bacillus to which he gave the name _b. enteritidis_. inoculation experiments showed it to be pathogenic for a number of animal species. bacilli with similar characters have since been isolated in a number of other meat poisoning epidemics in germany, belgium, france, and england. one well-studied instance of food poisoning due to the paratyphoid bacillus has been reported in the united states.[ ] the bacteria of the paratyphoid group are closely related to the true typhoid bacillus, but differ from the latter organism in being able to ferment glucose with gas production. they are more highly pathogenic for the lower animals than is the typhoid bacillus, but apparently somewhat less pathogenic for man. most types of paratyphoid bacilli found in food poisoning produce more or less rapidly a considerable amount of alkali, and, if they are inoculated into milk containing a few drops of litmus, the milk after a time becomes a deep blue color. several distinct varieties of paratyphoid bacilli have been discovered. the main differences shown by these varieties are agglutinative differences. that is, the blood serum of an animal that has been inoculated with a particular culture or strain will agglutinate that strain and also other strains isolated from certain other meat poisoning epidemics, but will not agglutinate certain culturally similar paratyphoid bacteria found in connection with yet other outbreaks. except in this single matter of agglutination reaction, no constant distinction between these varieties has been demonstrated. the clinical features of the infections produced in man and in the higher animals by the different varieties seem to be very similar if not identical. the bacillus discovered by gärtner (_loc. cit._) and known as _b. enteritidis_ or gärtner's bacillus is commonly taken as the type of one of the agglutinative varieties. bacilli with all the characters of gärtner's bacillus have been found in meat poisoning epidemics in various places in belgium and germany. mayer[ ] has compiled a list of forty-eight food poisoning outbreaks occurring between and and attributed to _b. enteritidis_ gärtner. these outbreaks comprised approximately two thousand cases and twenty deaths. in twenty-three of the forty-eight outbreaks the meat was derived from animals known to be ill at the time, or shortly before, they were slaughtered. sausage and chopped meat of undetermined origin were responsible for eleven of the remaining twenty-five outbreaks. two of the _b. enteritidis_ outbreaks were attributed to _vanille pudding_; one, to potato salad. in other food poisoning outbreaks a bacillus is found which is culturally similar to the gärtner bacillus, but refuses to agglutinate with the gärtner bacillus serum. its cultural and agglutination reactions are almost, if not quite, identical with those of the bacilli found in human cases of paratyphoid fever which have no known connection with food poisoning. mayer[ ] gives a list of seventy-seven outbreaks of food poisoning ( - ) in which organisms variously designated as "_b. paratyphosus_ b" or as "_b. suipestifer_" were held to be responsible. the total number of cases (two thousand) and deaths (twenty) is about the same as ascribed to _b. enteritidis_. according to mayer's tabulation meat from animals definitely known to be ailing is less commonly implicated in this type (ten in seventy-seven) than in _b. enteritidis_ outbreaks (twenty-three in forty-eight). sausage and chopped meat of unknown origin, however, were connected with eighteen outbreaks. the bacillus named _b. suipestifer_ was formerly believed to be the cause of hog cholera, but it is now thought to be merely a secondary invader in this disease; it is identical with the bacillus called _b. paratyphosus_ b in its cultural and to a large extent in its agglutinative behavior, but is regarded by some investigators as separable from the latter on the basis of particularly delicate discriminatory tests. bainbridge, savage, and other english investigators consider indeed that the true food poisoning cases should be ascribed to _b. suipestifer_ and would restrict the term _b. paratyphosus_ to those bacteria causing "an illness clinically indistinguishable from typhoid fever." german investigators, on the other hand, regard _b. suipestifer_ and _b. paratyphosus_ b as identical. my own investigations[ ] indicate that there is a real distinction between these two types. bearing directly on this question is the discussion concerning the distribution of the food poisoning bacilli in nature. most investigators in germany, where the majority of food poisoning outbreaks have occurred, or at least have been bacteriologically studied, are of the opinion that _b. suipestifer_ (the same in their opinion as _b. paratyphosus_ b) is much more widely distributed than _b. enteritidis_ and that it occurs, especially in certain regions, as in the southern part of the german empire, quite commonly in the intestinal tract of healthy human beings. such paratyphoid-carriers, it is supposed, may contaminate food through handling or preparation just as typhoid-carriers are known to do. a number of outbreaks in which contamination of food during preparation is thought to have occurred have been reported by jacobitz and kayser[ ] (vermicelli), reinhold[ ] (fish), and others. reinhold notes that in one outbreak several persons who had nursed those who were ill became ill themselves, indicating possible contact infection. in another outbreak also reported by reinhold it was observed that those who partook of the infected food, in this case dried codfish, on the first day were not so severely affected as those who ate what was left over on the second day. a bacillus belonging to the paratyphoid group was isolated from the stools of patients, but not from the dried codfish. these facts were interpreted as signifying that the fish had become infected in the process of preparation and that the bacilli multiplied in the food while it was standing. there seems no doubt that certain cases of paratyphoid food poisoning are caused by contamination of the food during preparation and are, sometimes at least, due to infection by human carriers. the bacilli in such cases are usually (according to many german investigators) or always (according to most english bacteriologists) of the _b. suipestifer_ type. other cases are due to pathogenic bacteria derived from diseased animals, and these bacteria are often, possibly always, of a slightly different character (_b. enteritidis_ gärtner). it is still unsettled whether both types of food poisoning bacteria are always associated with disease processes of man or animals, or whether they are organisms of wide distribution which may at times acquire pathogenic properties. in certain regions, as in north germany and england, such bacteria are rarely, if ever, found except in connection with definite cases of disease. in parts of southwest germany, on the other hand, they are said to occur with extraordinary frequency in the intestines of healthy men and animals. savage[ ] believes that there is some confusion on this subject owing to the existence of saprophytic bacteria which he calls "paragaertner" forms and which bear a close resemblance to the "true" gärtner bacilli. they can be distinguished from the latter only by an extended series of tests. the bacilli of this group show remarkable variability, and in the opinion of some investigators "mutations" sometimes occur which lead to the transformation of one type into another.[ ] in spite of the present uncertainty regarding the relationship and significance of the varieties observed, a few facts emerge plainly from the confusion: ( ) the majority of meat poisoning outbreaks that have been bacterially studied in recent years have been traceable to one or another member of this group and not to "ptomain poisoning." ( ) bacteria of the _paratyphoid enteritidis_ group that are culturally alike but agglutinatively dissimilar can, when taken in with the food, give rise to identical clinical symptoms in man. ( ) food poisoning bacteria of this group, when derived directly from diseased animals, seem more likely to be of the gärtner type (_b. enteritidis_) than of the _b. suipestifer_ type. _toxin production._--the problem of the production of toxin by the bacteria of this group and the possible relation of the toxin to food poisoning has been much discussed. broth cultures in which the living bacilli have been destroyed by heat or from which they have been removed by filtration contain a soluble poison. when this germ-free broth is injected into mice, guinea-pigs, or rabbits, the animals die from the effects. practically nothing is known about the nature of the poisonous substances concerned, except that they are heat-resistant. they are probably not to be classed with the so-called true toxins generated by the diphtheria and tetanus bacilli, since there is no evidence that they give rise to antibodies when injected into susceptible animals. in the opinion of some investigators the formation of these toxic bodies by the _paratyphoid-enteritidis_ bacilli in meat and other protein foodstuffs is responsible for certain outbreaks and also for some of the phenomena of food poisoning, the rapid development of symptoms being regarded as due to the ingested poisons, whereas the later manifestations are considered those of a true infection. opposed to this view is the fact that well-cooked food has proved distinctly less liable to cause food poisoning than raw or imperfectly cooked food. a large proportion of the recorded meat poisoning outbreaks are significantly due to sausages made from raw meat and to meat pies, puddings, and jellies. this is most likely because the heat used in cooking such foods is insufficient to produce germicidal results. in milk-borne epidemics also it is noteworthy that the users of raw milk are the ones affected. for example, respecting an extensive _b. enteritidis_ outbreak in and about newcastle, england, it is stated: in no instance was a person who had used only boiled milk known to have been affected. thus in one family, consisting of husband, wife, and wife's mother, the two women drank a small quantity of raw milk from the farm, at the most a tumblerful, and both were taken ill about twelve hours later. the husband, on the other hand, habitually drank a pint a day, but always boiled. he followed his usual custom on this occasion, and was unaffected.[ ] when in addition it is taken into consideration that the ordinary roasting or broiling of a piece of meat is often not sufficient to produce a germicidal temperature throughout, the argument that a heat-resistant toxin is present in such cases is not conclusive. it must be remembered also that in some outbreaks those persons consuming raw or partly cooked meat have been affected while at the same time others eating well-cooked meat from the same animal have remained exempt; this would seem to indicate the destruction of living bacilli by heat, since the toxic substances formed by these organisms are heat-resistant. the view that a definite infection occurs, is favored, too, by the fact that the blood-serum of affected persons so frequently has an agglutinative action upon the paratyphoid bacillus. this would not be the case if the symptoms were due to toxic substances alone. altogether the rôle of toxins formed by _b. enteritidis_ and its allies in food outside the body cannot be said to be established. the available evidence points to infection as the main, if not the sole, way in which the bacilli of this group are harmful. _sources of infection._--the main sources of _enteritidis-suipestifer_ infection are: ( ) diseased domestic animals, the infected flesh or milk of which is used for food; ( ) infection of food by human carriers during the process of preparation or serving. to these may be added a third possibility: ( ) contamination of food with bacteria of this group which are inhabitants of the normal animal intestine. considering these in order: . diseased animals: the majority of the meat poisoning outbreaks are caused by meat derived from pigs or cattle. table iii gives the figures for a number of british[ ] and german[ ] epidemics. table iii[ ] ==================================================================== | | | belonging to | b. enteritidis | b. suipestifer | this group but | | |undifferentiated |--------------------+--------------------+---------------- |british|german|total|british|german|total| british ---------+-------+------+-----+-------+------+-----+---------------- pig | | | | | | | ox or cow| | | | | | | calf | | | | | | | horse | | | | | | | ... chickens | | | | | | | ... -------------------------------------------------------------------- occasional outbreaks have also been attributed to infection through eating rabbit, sheep, goose, fish, shrimp, and oysters. especially noteworthy is the relative rarity of infection from the meat of the sheep. more definite information is needed respecting the pathological conditions caused by these bacteria in animals and the relation of such conditions to subsequent human infection. a rather remarkable problem is presented by the relation of _b. suipestifer_ to hog cholera. this bacillus, although not now considered the causal agent of hog cholera, is very commonly associated with the disease as an accessory or secondary invader, and is frequently found in the internal organs of swine after death. it might be supposed that in regions where hog cholera is prevalent human infections would be more common than in other districts, but this seems not to be the case. no connection has ever been demonstrated between outbreaks of hog cholera--in which _b. suipestifer_ is known to be abundantly distributed--and so-called _b. suipestifer_ infections in man. suppurative processes in cattle, and especially in calves, have given rise to poisoning from the use of the meat or milk of the infected animals. it has been often demonstrated that bacteria of the _enteritidis-suipestifer_ group are associated with inflammation of the udder in cows and with a variety of septicemic conditions in cattle and other domestic animals as well as with manifestations of intestinal disturbances ("calf diarrhea," etc.).[ ] the frequency with which poisoning has occurred through the use of the meat of "emergency-slaughtered" animals has been already mentioned. k. f. meyer[ ] has reported an instance of accidental infection in a laboratory worker caused by handling a bottle of sterilized milk that had been artificially contaminated with a pure culture of _b. enteritidis_ for experimental purposes. the strain responsible for the infection had been isolated from the heart blood of a calf that had succumbed to infectious diarrhea. . human contamination: in a certain number of paratyphoid food infections there is some evidence that the food was originally derived from a healthy animal and became infected from human sources during the process of preparation. in addition to the instances already mentioned (reinhold _et al._, p. ) the wareham (england, ) epidemic[ ] was considered by the investigators to be due to infection of meat pies by a cook who was later proved to be a carrier of paratyphoid bacilli. the evidence in this case, however, is not altogether conclusive. söderbaum[ ] mentions a milk-borne paratyphoid epidemic occurring in kristiania which was ascribed to infection of the milk by a woman milker. sacquépée and bellot[ ] report an interesting paratyphoid outbreak involving nineteen out of two hundred and fifty men in a military corps. the patients fell ill on different dates between june and june . it was found that an assistant cook who had been in the kitchen for several months had been attacked a little before the epidemic explosion by some slight malady which was not definitely diagnosed. he had been admitted to the hospital and was discharged convalescent. the cook, on being recalled and quarantined, stated that some days before june he was indisposed with headache and anorexia. he had nevertheless continued his service in the kitchen.... _b. paratyphosus_ b (_b. suipestifer_) was repeatedly found in his stools in august, september, and october.... in all probability, therefore, the outbreak was due to food contaminated by a paratyphoid-carrier who had passed through an abortive attack of the fever.[ ] bainbridge and dudfield[ ] describe an outbreak of acute gastro-enteritis occurring in a boarding-house; it was found that no one article of food had been eaten by all the persons affected, and there were other reasons for supposing the outbreak to be due to miscellaneous food contamination by a servant who was a carrier. there is, therefore, ground for believing that occasional contamination of food may be brought about by bacteria of this group derived from human sources. it is not clear, however, how frequent this source of infection is, compared to infection originating in diseased animals. it must be admitted, too, that english investigators are disposed to look upon outbreaks similar to those just described as infections with _b. paratyphosus_ b, an organism which they would distinguish from the "true" food poisoning bacilli, _b. enteritidis_ and _b. suipestifer_. . miscellaneous contaminations: some investigators, especially certain german writers, regard the bacilli of the paratyphoid group as so widely distributed in nature that any attempt to control the spread of infection is like fighting windmills. according to this view the bacilli occur commonly in our everyday surroundings and thence make their way rather frequently into a variety of foodstuffs. various german investigators have reported the presence of paratyphoid bacilli in the intestinal contents of apparently normal swine, cattle, rats, and mice and more rarely of other animals, in water and ice, in german sausage and chopped meat, and in the bodies of apparently healthy men. to what extent their alleged ubiquity is due to mistaken bacterial identification, as claimed by some english investigators, remains to be proved. there is no doubt that in some quarters exaggerated notions have prevailed respecting a wide distribution of the true paratyphoid bacteria. savage and others believe that the hypothesis that food poisoning outbreaks are derived from ordinary fecal infection of food is quite unfounded. it is pointed out that there is good evidence of the frequent occurrence of intestinal bacteria in such food as sausages and chopped meat, and that consequently, if paratyphoid infections could occur through ordinary contamination with intestinal bacteria not connected with any specific animal infection, food poisoning outbreaks should be exceedingly common instead of--as is the case--comparatively rare. at the present time even those who maintain that these bacilli are of common occurrence admit that their abundance is more marked in some regions than in others. southwest germany, for example, seems to harbor paratyphoid bacilli in relatively large numbers. possibly local differences in distribution may account for the discrepancies in the published findings of german and british investigators. a special case is presented by the relation of these bacilli to rats and mice. among the large number of bacteria of the paratyphoid group is the so-called danysz bacillus, an organism quite pathogenic for rodents, and now and again used in various forms as a "rat virus" for purposes of rodent extermination. several outbreaks of food poisoning in man have been attributed on more or less cogent evidence to food contamination by one of these viruses either directly by accident, as in the case described by shibayama,[ ] in which cakes prepared for rats were eaten by men, or indirectly through food contaminated by mice or rats that had been infected with the virus.[ ] the use of such viruses has not proved of very great practical value in the destruction of rodents, and is open to serious sanitary objections, since the animals after apparent recovery can continue to carry the bacilli of the virus and to distribute them on or near food substances. it seems possible that rats and mice may become infected with certain bacteria of this group without human intervention, and that these infected animals may be the means of contaminating foodstuffs and so causing outbreaks of food poisoning. proof of the frequency with which this actually occurs is naturally difficult to obtain. there is no escape from the conclusion that in any given case of food poisoning the exact source of infection is often largely conjectural. even when suspicion falls strongly on a particular article of food, it may not be possible to establish beyond a reasonable doubt whether the material (meat or milk) came from a diseased animal or whether it was infected from other sources (man or other animals) at some stage during the process of preparation and serving. the most definitely attested cases yet put on record are those in which it is possible to trace the infection to food derived from an ailing animal. _means of prevention._--the most obvious and probably the most important method of preventing infection with paratyphoid bacilli is the adoption of a system of inspection which will exclude from the market as far as possible material from infected animals. to be most effective such inspection must be directed to examination of the living animal. the milk or the meat from diseased animals may give no visible sign of abnormality. in the ghent outbreak of the slaughter-house inspector, a veterinary surgeon, was so firmly convinced that the meat which he had passed could have had no connection with the outbreak, that he ate several pieces to demonstrate its wholesomeness. the experiment had a tragic ending, as the inspector was shortly attacked with severe choleraic symptoms and died five days later, paratyphoid bacilli being found at the autopsy. müller[ ] also has described a case in which paratyphoid bacilli were found in meat that had given rise to a meat poisoning outbreak although the meat was normal in appearance and the organs of the animal showed no evidence of disease to the naked eye. it is evident that inspection of the live animal will often reveal evidence of disease which might be missed in the ordinary examination of slaughter-house products. although inspection of cows used for milking and of food animals before slaughter is highly important, it does not constitute an absolute protection. emphasis must be repeatedly laid on the fact that meat, and especially milk that is derived from seemingly healthy animals, may nevertheless contain paratyphoid bacilli. to meet this difficulty in part the direct bacterial examination of the carcasses of slaughtered food animals has been proposed, but this seems hardly practicable as a general measure. in spite of all precautions taken at the time of slaughtering it seems probable that occasionally paratyphoid-infected meat will pass the first line of defense and be placed on the market. this danger, which is probably not a very grave one under a reasonably good system of inspection of live animals, may be met by thoroughly cooking all foods of animal origin. it is worth noting that some of the internal organs, as the liver and kidneys, are more likely to contain bacteria than the masses of muscle commonly eaten as "meat." sausages, from their composition and mode of preparation, and chopped meat ("hamburger steak") are also to be treated with especial care. consumption of such foods as raw sausage or diseased goose liver (paté de foie gras) involves a relatively high risk. it is true of paratyphoid infection as of most other forms of food poisoning that thorough cooking of food greatly diminishes the likelihood of trouble. whatever be the precise degree of danger from food infection by healthy paratyphoid-carriers (man or domestic animals), it is obvious that general measures of care and cleanliness will be more or less of a safeguard. as with typhoid fever so all outbreaks of paratyphoid should be thoroughly investigated in order that the sources of infection may be found and eliminated. the possible connection of rats and mice with these outbreaks should furnish an additional incentive to lessen the number of such vermin as well as to adopt measures of protecting food against their visits. footnotes: [ ] _fleischvergiftungen u. paratyphusinfektionen_ (jena, ). [ ] _rept. to local govt. board_, n.s. no. (london, ). [ ] _zeit. f. hyg._, xxii ( ), . [ ] _brit. med. jour._, i ( ), . [ ] bernstein and fish, _jour. amer. med. assoc._, lxvi ( ), . [ ] _breslau aerztl. ztschr._, x ( ), . [ ] bernstein and fish, _jour. amer. med. assoc._, lxvi ( ), . [ ] _deutsche viertelj. f. öffentl. ges._, xlv ( ), - . [ ] _op. cit._, pp. - . [ ] _jour. infect. dis._, xx ( ), . [ ] _centralbl. f. bakt._, i orig., liii ( ), . [ ] _cor.-bl. f. schweiz. aerzte_, xlii ( ), and . [ ] _jour. hyg._, xii ( ), . [ ] see sobernheim and seligmann, _centralbl. f. bakt._, ref., beilage, l ( ), . [ ] _report med. officer of health_ (newcastle-upon-tyne, ). [ ] compiled from savage, _report of local gov't board_, . [ ] mayer, _deutsche viertelj. f. öffentl. ges._, xlv ( ), . [ ] it must be noted that origin of the food from a diseased animal was not definitely proved in all the cases cited. some of these cases should possibly be classed under human contamination ( ). [ ] although not directly connected with the question of food poisoning, it is of interest to note that certain diseases of birds have been traced to infection with members of this group of bacteria. in a few cases, as in several epidemics among parrots in paris and elsewhere, the infection has been communicated to man by contact. [ ] _jour. infect. dis._, xix ( ), . [ ] r. trommsdorff, l. rajchman, and a. e. porter, _jour. hyg._, xi ( ), . [ ] _hygiea_, lxxv ( ), . [ ] _progrès méd._, d series, xxvi ( ), . [ ] ledingham and arkwright, _the carrier problem in infectious diseases_, pp. - . [ ] _jour. hyg._, xi ( ), . [ ] _münch. med. wchnschr._, liv ( ), . [ ] see, for example, h. langer and thomann, _deutsche med. wchnschr._, xl ( ), . [ ] _ztschr. f. infektionsk. ... d. haustiere_, viii ( ), . chapter vii animal parasites not only pathogenic bacteria but certain kinds of animal parasites sometimes enter the human body in or upon articles of food. one of the most important of these is the parasite causing trichiniasis. trichiniasis trichiniasis or trichinosis is a disease characterized by fever, muscular pains, an enormous increase in the eosinophil blood corpuscles, and other more or less well-defined symptoms; at the onset it is sometimes mistaken by physicians for typhoid fever. the responsible parasite is a roundworm (_trichinella spiralis_, formerly known as _trichina_) which is swallowed while in its encysted larval stage in raw or imperfectly cooked pork.[ ] the cysts or envelopes in which the parasites live are dissolved by the digestive fluids and the young larvae which are liberated develop in the small intestine to the adult worm, usually within two days. the young embryos, which are produced in great numbers by the mature worms, gain entrance to the lymph channels and blood stream, and after about ten days begin to invade the muscles--a procedure which gives rise to many of the most characteristic symptoms of the infection. it is estimated that in severe cases as many as fifty million embryos may enter the circulation. the parasites finally quiet down and become encysted in the muscle tissue and the symptoms, as a rule, gradually subside. ingestion of a large number of parasites at one time often results fatally, the mortality from trichiniasis being on the average somewhat over per cent and rising in some outbreaks to a much higher figure ( per cent). on the other hand, many infections are so light as to pass unnoticed. williams[ ] found _trichinella_ embryos present in . per cent of the bodies of persons dying from other causes. such findings are considered to indicate that occasional slight _trichinella_ infections even in the united states are quite common. this might indeed be expected from the frequent occurrence of infection in swine, about per cent of these animals being found to harbor the parasite. [illustration: fig. .--trichinae encysted in intercostal muscle of pig. (about Ã� .) (after neumann and mayer.)] the specific symptoms (such as the muscular pain) of trichiniasis may be due in part to mechanical damage of the muscle tissue, but it is also probable that they are partly due to toxic products exuded by the worms and partly to the introduction of alien protein material--the protein of the worm--into the tissues. secondary bacterial infection is also a possibility, but there is little evidence to prove that this is an important factor in most cases of trichiniasis. the various stages observed in the progress of the disease are plainly connected with the different phases of the worm's development--the initial localization in the intestines, the invasion of the muscles, and the final encystment. swine become infected with this parasite by eating scraps of infected meat, or the offal of their own kind, or by eating infected rats. the rat, through its cannibalistic propensities, becomes infected frequently, and is one of the chief factors in the wide dissemination of the disease. human infection is practically accidental and self-limited; biologically speaking, man as a host does not enter into the calculations of the parasite. treatment of established trichiniasis infection is palliative, not truly remedial. the parasites, once inside the body, cannot be materially affected by the administration of any drug. while cure of trichiniasis is thus difficult, if not impossible, prevention is very simple. the thorough cooking of all food is sufficient to preclude infection. this relatively simple means of destroying the larvae is a more certain as well as less expensive method of preventing infection than is the laborious microscopic examination of the tissues of every slaughtered hog. in germany between and over per cent of , cases of trichinosis that were investigated were traced to meat that had been microscopically examined and passed as free from trichinae.[ ] on the other hand, thorough cooking removes all possibility of danger. teniasis various tapeworm or cestode infections are contracted by eating meat containing the parasite. particular species of tapeworm usually infest the flesh of specific hosts, as _tenia saginata_ in the beef and _tenia solium_ in the hog. the dwarf tapeworm, _hymenolepis nana_, develops in rats, and the human infections with this parasite occasionally observed are probably caused by contamination of food by these animals. [illustration: fig. .--_cysticercus cellulosae_ in pig's tongue. (after neumann and mayer.)] sometimes the existence of the tapeworm in man is restricted to the alimentary tract and the symptoms vary from trivial to severe, but sometimes (_tenia solium_) the larval stage of the tapeworm invades the tissues and becomes encysted in various organs (brain, eye, etc.), where, as in the case of cerebral infection, it may result fatally. the encysted larva of _tenia solium_ was at one time regarded as an independent animal species and named _cysticercus cellulosae_. the condition known as "measly pork" is produced by the occurrence of this encysted parasite. so-called hydatid disease is due to the cystic growth produced by the larva of a species of tapeworm (_echinococcus_) inhabiting the intestine of the dog. human infection may be caused by contaminated food as well as more directly by hands soiled with petting infected dogs. several varieties of tapeworms infesting fish, especially certain fresh-water species, may be introduced into the human body in raw or partly cooked fish. methods for the prevention of tapeworm infection include the destruction of the larvae by heat--that is, the thorough cooking of all meat and fish--and the minimization of close contact with those animals, such as the dog and cat, that are likely to harbor parasites. cleanliness in the preparation and serving of food, and attention to hand-washing before meals, and especially after touching pet animals, are necessary corollaries. uncinariasis hookworm infection (uncinariasis, ankylostomiasis) is commonly caused by infection through the skin of the feet, but the possibility of mouth infection cannot be disregarded, and in regions where hookworm disease exists methods of guarding against food contamination should be practiced, as well as other precautions. billings and hickey[ ] believe that hookworm disease is contracted by unconscious coprophagy (from raw vegetables) much more frequently than is generally supposed. other parasites a number of other parasitic worms (e.g., _strongyloides_, _ascaris_ or eelworm, and _oxyuria_ or pinworm) may conceivably enter the human body in contaminated food, and while, as in hookworm disease, other modes of infection are probably more important, the liability to occasional infection by uncooked food must not be overlooked. [illustration: fig. .--_lamblia intestinalis._ (after neumann and mayer.)] various forms of dysentery or diarrhea have been attributed to infection with _giardia (lamblia) intestinalis_. observations made by fantham and porter[ ] upon cases contracted in gallipoli and flanders have given support to this view. strains of this parasite of human origin have been shown to be pathogenic for mice and kittens. it is considered possible that these animals may act as reservoirs of infection and spread the disease by contamination of human food. footnotes: [ ] the consumption of raw sausage made with pig meat is particularly likely to give rise to trichiniasis. [ ] _jour. med. research_, vi ( ), . [ ] edelmann, mohler, and eichhorn, _meat hygiene_, , p. . [ ] _jour. amer. med. assoc._, lxvii ( ), . [ ] _brit. med. jour._, ii ( ), . chapter viii poisonous products formed in food by bacteria and other micro-organisms in close relation to the cases of infection with animal or plant parasites which have been discussed, there are certain well-established instances of poisoning by substances that have been generated in food while it is still outside of the body. this is the common type of food poisoning in popular estimation, but in point of fact the proved cases of this class are much less frequent than the instances of true infection with bacteria of the _paratyphoid-enteritidis_ group (chapter vi). thus far the best-known examples of poisoning by the products of micro-organisms are botulism and ergotism. ergotism ergotism or ergot poisoning is due to the use of rye that has become diseased through the attack of a fungus, _claviceps purpurea_. it occurred frequently in the middle ages when in times of famine the ergot or spurred rye (o.fr. _argot_, "a cock's spur") was often used in default of better food. in limoges in it is said that forty thousand persons perished from this cause. improvement in the facilities for transportation of food into regions where crops have failed, and the use of special methods for separating the diseased grain from the wholesome have greatly reduced the prevalence of ergotism. in western europe poisoning from this cause has practically ceased, although hirsch recorded some twenty-eight outbreaks in the nineteenth century; in parts of russia the disease is said still to occur in years of bad harvest.[ ] the poison ergot itself has long been used as a drug in obstetrics, but its composition is complex and is still not completely understood. several constituents of ergot have been extracted, and these have been shown to possess different physiological effects.[ ] the symptoms observed in the outbreaks of ergotism of mediaeval times are not wholly reproduced experimentally by the drug and are thought to have been in part due to the semi-starvation engendered by the use of rye from which the nutritious portions had been largely removed by the growth of the fungus. botulism the best established case of poisoning by means of bacterial products taken in with the food is the serious malady known somewhat inappropriately as botulism (botulus, sausage).[ ] this kind of food poisoning, which has a characteristic set of symptoms, seems to have been first recognized and described in by the german poet and medical writer justinus kerner. in two articles ( - ) he enumerates cases with deaths occurring in württemberg between and and apparently in most cases connected with the use of insufficiently smoked sausage. mayer[ ] tabulates about additional cases observed in various parts of germany down to the end of , the total mortality in the cases being about per cent. in france botulism is said to be very rare.[ ] in great britain savage[ ] declares that he has been unable to trace the occurrence of a single outbreak. in the united states several instances of botulism poisoning are on record (sheppard,[ ] , cases, deaths, canned pork and beans; peck,[ ] , cases, deaths; wilbur and ophüls,[ ] , canned string beans, cases, death; frost,[ ] , cases, deaths). professor stiles[ ] has given a graphic description of his own attack of probable botulism due in all likelihood to minced chicken. [illustration: fig. .--_claviceps purpurea:_ , ergot on rye-grass; , ergot on rye; , section of a portion of the conidial form of fruit, Ã� ; , a sclerotium or ergot; , head of ascigerous form of fruit; , an ascus, Ã� ; , a single spore, Ã� . (after massee, _plant diseases_, by courtesy of the macmillan company.)] _symptoms._--the description of a case seen by wilbur and ophüls,[ ] is so typical that it may be cited: girl, aged , tuesday evening, nov. , , ate the dinner including the canned string beans of the light green color together with a little rare roast beef. the following day she felt perfectly normal except that at : in the evening the eyes felt strained after some sewing. thursday morning, thirty-six hours after the meal, when the patient awoke, the eyes were out of focus, appetite was not good, and she felt very tired. at night she had still no appetite, was nauseated, and vomited the noon meal apparently undigested. friday morning, two and one-half days after the meal, the eyes were worse, objects being seen double on quick movement, and it was noticed that they had a tendency to be crossed. a peculiar mistiness of vision was also complained of. she was in bed until late in the afternoon, when she visited dr. black. she had had some disturbance in swallowing previous to this time and stated that it felt as if "something came up from below" that interfered with deglutition. the fourth day she remained in bed, was much constipated, and noticed a marked decrease in the amount of urine voided. there was at no time pain except for occasional mild abdominal cramps, no headache, subnormal temperature, and a normal pulse. the fourth and fifth days the breathing became difficult at times and swallowing was almost impossible. the patient complained of a dry throat with annoying thirst. the sixth day there were periods of a sense of suffocation with a vague feeling of unrest and as if there might be difficulty in getting the next breath. the upper lids had begun to droop. the voice was nasal. when the attempt was made to swallow liquids they passed back through the nose. the patient felt markedly weak. physical examination at this time showed ptosis of both upper eyelids, dilatation of the right pupil, sluggish reaction to light of both pupils, apparent paralysis of the internal rectus of the left eye, normal retina, inability to raise the head, control apparently having been lost of the muscles of the neck, inability to swallow, absence of taste. the tongue was heavily coated and the throat was covered with a viscid whitish mucus clinging to the mucous membrane. the soft palate could be raised but was sluggish, particularly on the right side. the exudate on the right tonsil was so marked that it resembled somewhat a diphtheritic membrane. the seventh day there was some change in the condition; occasional periods occurred when swallowing was more effective, and there was less tendency to strangle. on the eleventh day there was some improvement of the eyes, still strangling on swallowing, sensation of taste was keener, and the general condition improved. the twelfth day the patient was able to move her head, but was unable to lift it except when she took hold of the braids of her hair, and pulled the head forward. the eyes could be opened slightly, speech was less nasal and more distinct, and improvement in swallowing was marked. at the end of two weeks the patient was able to take soft diet freely, and at four weeks she was up in a chair for a couple of hours complaining only of general weakness and inability to use her eyes. at the end of five weeks she was able to leave the hospital and return to her home and later to resume her regular work. in all cases the nervous system is strikingly affected in this form of food poisoning. dizziness, double vision, difficulty in chewing and swallowing, and other symptoms of nervous involvement occur with varying intensity and may persist for a long time after the first signs of the attack. temperature, pulse, and respiration remain practically normal. in contrast with the traditional type of food poisoning gastro-intestinal symptoms may be slight or altogether lacking. freedom from abdominal pain is usually noted; diarrhea is the exception and constipation the rule; vomiting sometimes occurs, but may be absent. in the cases described by sheppard there was "an entire absence of the usual gastro-intestinal symptoms from first to last, no pain or sensory disturbance and no elevation of temperature." the visual disturbances are very characteristic. stiles relates his own experiences as follows: vertigo and nystagmus developed [a few hours after eating] in a startling degree, the car [in which he was being taken to his house] seemed to be ascending an endless spiral, the stars made circles in the sky, and the houses by the wayside reeled. the lighted doorway of my house seemed to approach and surround me as i was carried in. my bed for the moment presented itself as a vertical surface which i could not conceive to be a resting place.... whenever i opened my eyes on this day [the next day] the impression of gyration of the room was appalling.... to turn my head even very slowly from one side to the other brought an accession of the overpowering giddiness.... [eight days after the beginning of the attack]. the nystagmus now became limited to momentary onsets, but in its place i became aware of a peculiar diplopia. the image of one retina was not merely displaced from the position of its fellow but was tilted about degrees from parallel.... this fantastic diplopia gradually gave place to the familiar variety and this occurred less and less often as my convalescence proceeded. from [this date] my recovery pursued a course which was dishearteningly slow but free from any setbacks. among the persistent symptoms were ... the visual difficulties mentioned. the left pupil was usually smaller than the right and i thought i detected a slight failure to relax accommodation with the left eye. reading was difficult for several weeks and the ability to write, as requiring closer fixation, was still longer in returning. in the cases reported by sheppard visual symptoms were the initial signs of trouble, double vision, mistiness, and inability to hit the mark in shooting being the first complaint. the time elapsing between eating the implicated food and the onset of the earliest symptoms is usually between twelve and forty-eight hours, but may be much less. in stiles's case the interval was apparently less than three hours. _anatomical lesions._--in fatal cases no characteristic gross changes are observed in the various organs. it has been stated by some writers that microscopic degenerative changes occur in the ganglion cells, involving especially the so-called nissl granules, but in the carefully studied case reported by ophüls[ ] the nissl granules were quite normal in size, arrangement, and staining qualities. there was, in fact, no evidence to substantiate the hypothesis of a specific action of the toxin on the nerve-cells. on the other hand, ophüls found numerous hemorrhages in the brain-stem and multiple thromboses in both the arteries and veins. he holds, consequently, that the indications of severe disturbances of brain circulation associated with hemorrhages and thrombosis in medulla and pons are sufficient to explain the symptoms of botulism poisoning without having recourse to the assumption that the poison has a specific action on certain ganglion cells. _bacteriology._--the cause of botulism poisoning was discovered by van ermengem to be the toxin produced by a bacillus which he named _b. botulinus_. this organism was isolated from portions of a ham that had caused fifty cases of poisoning ( ) at ellezelles (belgium), and also from the spleen and gastric contents of one of the three fatal cases. the bacillus grows only in the absence of oxygen (strict anaërobe), stains by gram's method, forms terminal spores, and develops best at °c. unlike most bacteria dangerous to man, it appears unable to grow in the human body, and its injurious effect is limited to the action of the toxin produced in foodstuffs outside the body. botulism is an intoxication--not an infection. the fact that the bacillus can grow in nature only when the free oxygen supply is cut off explains in part at least the relatively rare occurrence of botulism since all the conditions necessary for the production of the botulism toxin do not commonly concur. next to nothing is known as to how widely _b. botulinus_ is distributed. except in connection with the cases of poisoning it has been reported but once in nature.[ ] the botulism poison is a true bacterial toxin, chemically unstable, destroyed by heating at °c. for minutes, capable of provoking violent symptoms in minute doses, and possessing the property characteristic of all true toxins of generating an antitoxin when injected in small, non-fatal doses into the bodies of susceptible animals. in animal experiments the toxin formed by _b. botulinus_ has been found capable of reproducing the typical clinical picture of this form of food poisoning. symptoms of paralysis are produced in rabbits, guinea-pigs, and other animals by the injection of so small a dose as . c.c. of a filtered broth culture. [illustration: fig. .--_bacillus botulinus_ with spores. pure culture on sugar-gelatin. van ermengem preparation. (kolle and wassermann.)] _epidemiology._--the conditions under which _b. botulinus_ occurs and is given opportunities for multiplying are not completely known. it is possible that there are localities where this bacillus is particularly abundant in the soil or in the intestinal contents of swine or other domestic animals, but on the whole it seems more probable that the organism is widely distributed, but that it does not often find suitable conditions for entrance into, and multiplication in, human food. practically all the reported cases of botulism have been caused by food which has been given some sort of preliminary treatment, as smoking, pickling, or canning, then allowed to stand for a time, and _eaten before cooking_. since both the bacillus, including the spore stage, and its toxin are destroyed by relatively slight heating, it is clear that a rather unusual set of factors must co-operate in order that botulism poisoning shall take place. these are evidently: ( ) the presence of the bacilli in sufficient numbers in a suitable foodstuff; ( ) the initial preparation of the food by a method that does not destroy the _b. botulinus_--inadequate smoking, too weak brine,[ ] or insufficient cooking; ( ) the holding of this inadequately preserved food for a sufficient length of time under the right conditions of temperature and lack of oxygen; ( ) the use of this food, in which conditions have conspired to favor the production of toxin by _b. botulinus_, without final adequate cooking. it seems as reasonable to suppose that the infrequency with which these several factors coincide is responsible for the relative uncommonness of botulism as to suppose it due to the rarity of the specific bacillus. in the belgian outbreak studied by van ermengem the poisonous ham had lain at the bottom of a cask of brine (anaërobic conditions) while the other ham of the same animal lay on top of it but was not covered with brine, and was eaten without producing any poisonous effect. in this instance the presence or absence of favorable conditions for anaërobic growth seemed to be the decisive factor. _prevention and treatment._--the food in which _b. botulinus_ has grown does not seem to be altered in a way that necessarily arouses suspicion. in the case described by römer the incriminated ham showed bluish-gray areas from which _b. botulinus_ could be isolated, but this condition does not seem to have attracted attention before the poisoning occurred and was an observation made only after the event. so far as can be learned the meat that has caused botulism has always come from perfectly sound animals. in some cases the accused article of food is said to have had a rancid or acrid taste (due to butyric acid?), but there is nothing definitely characteristic about this, as the majority of anaërobes produce butyric acid. if, as in the darmstadt[ ] and stanford university[ ] epidemics, the food (canned beans) is served with salad dressing, a sour taste might pass without notice or even add to the relish. in the instance reported by sheppard the canned beans were good in appearance, taste, and smell. the obvious precaution to take against poisoning of this sort is first the use of adequate methods of food preservation. to judge from the recorded outbreaks, domestically prepared vegetables and meats are more likely to give rise to botulism than those prepared commercially on a large scale. the general use of steam under pressure in the large canning factories affords a high degree of protection against the anaërobic bacteria and their resistant spores. whatever the method of treatment, all canned or preserved food having an unnatural appearance, taste, or odor should be rejected. reheating of all prepared foods immediately before use is an additional safeguard. foods, such as salads, composed wholly or in part of uncooked materials should not be allowed to stand overnight before being served. if symptoms of botulism, such as visual disturbances, become manifest, the stomach should be emptied with a stomach pump, cathartics administered, and strychnine and other stimulants given as required. since one of the noteworthy features of this disease is the paralysis of the intestinal tract by the toxin absorbed, the guilty food may lie for a long time in the stomach (cf. stiles, _loc. cit._). consequently, measures to empty the stomach should be taken even if the patient does not come under observation until several days after the poisonous food has been eaten. an antitoxic serum has been prepared at the koch institute in berlin. this serum has given successful results in animal experimentation, but has not been used, so far as i can learn, in any human outbreak. it is not available at any point in this country. other bacterial poisons the interesting case reported by barber[ ] shows that there are other possibilities of food poisoning by formed bacterial poisons. acute attacks of gastro-enteritis were produced in several individuals by the use of milk containing a poisonous substance elaborated by a white staphylococcus. this staphylococcus occurred in almost pure culture in the udder of the cow from which the milk was derived. the milk when used fresh was harmless and the poison was generated in effective quantities only when the milk stood some hours at room temperature before being used. the symptoms were similar to those usually ascribed to "ptomain poisoning." spoiled and decomposed food there is a general belief that food is unwholesome whenever the evidence of the senses shows it to be more or less decomposed. this opinion finds expression in civilized countries in many legal enactments forbidding traffic in decomposed meats, vegetables, and fruits. there is unfortunately lack of evidence as to what kinds or degree of visible decomposition are most dangerous. in fact, some foods of high nutrient value, notably cheeses, are eaten only after somewhat extensive decomposition processes (termed ripening) have taken place. the characteristic flavors or aromas of the various hard and soft cheeses are due to the substances formed by certain species of molds and bacteria and are just as properly to be regarded as decomposition products as the unpleasant stenches generated by decomposing eggs or meat. indeed, some of the decomposition products formed in the ripening of brie, camembert, or limburger are similar to, if not identical with, those which are associated with spoiled foods. sour milk, again, is recommended and commonly used as a food or beverage for persons in delicate health, and yet sour milk contains many millions of bacteria and their decomposition products. some of the bacteria commonly concerned in the natural souring of milk are closely related to pathogenic types. the partial decomposition of meats and game birds is often considered to be advantageous rather than otherwise. even eggs, a food whose "freshness" is marred for most persons by the initial stages of decomposition, are ripened in various ways by the chinese and eaten as a delicacy after the lapse of months or years. the preserved ducks' eggs known as pidan are stored for months in a pasty mixture of tea, lime, salt, and wood ashes. "they are very different from fresh eggs. the somewhat darkened shell has numerous dark green dots on the inner membrane. both the white and yolk are coagulated; the white is brown, more or less like coffee jelly...."[ ] increase of ammoniacal nitrogen has taken place to an extraordinary degree in these eggs, indicating much decomposition of the egg protein. the ammoniacal nitrogen in pidan is considerably higher than in the eggs known by egg candlers as black rots. it is evident, therefore, that bacterial growth in substances used as food is not necessarily injurious and may in some cases increase the palatability of food without destroying its wholesomeness. little or nothing is known about the correlation of visible signs of decomposition with the presence of poisonous products, and it is at present impossible to say at what point in the process of decomposition a food becomes unfit to use owing to the accumulation of poisonous substances within it. there seems to be no connection between the natural repugnance to the use of a food and its unwholesomeness. under ordinary conditions the nauseous character of very stale eggs is proverbial, and yet few nitrogenous foods have so clear a health record as eggs or have been so infrequently connected with food poisoning outbreaks. it might seem tempting to conclude on the basis of the available evidence that spoiled or decomposed foods possess poisonous qualities only when certain specific bacteria, like the _b. botulinus_ already discussed, have accidentally invaded them and formed definite and specific poisons. but we have no right to assume that the everyday decomposition products of the banal bacteria are in all cases without injurious effects. even though no sharply defined acute form of poisoning may be laid at their door, it does not follow that an irritating or perhaps slightly toxic action of the ordinary decomposition products is altogether absent. our present knowledge of the nature and degree of danger to be apprehended from the use of spoiled food is imperfect and unsatisfactory. that fact, however, does not release us from the obligation to continue measures of protection based even to a limited extent on experience. footnotes: [ ] another species of _claviceps_ (_c. paspali_) which attacks the seeds of a wild grass is believed to be responsible for certain outbreaks of poisoning among cattle and horses (_science_, xliii [ ], ). [ ] barger (_jour. chem. soc._, xcv [ ], ) has shown that parahydroxyphenylethylamine is present in ergot and is in some degree responsible for the physiological action of the drug. [ ] although some of the early outbreaks were traced to the use of sausage, particularly in württemberg, the proportion of recent botulism poisoning attributed to this food is no greater than of sausage-conveyed infections with the paratyphoid bacillus (chap. vi), and a number of the most completely studied outbreaks of botulism have been traced to ham, beans, and other foods. [ ] _deutsche viertelj. f. öffentl. ges._, xlv ( ), . [ ] e. sacquépée, _progrès méd._, xxvi ( ), . [ ] _report to local govt. board on bacterial food poisoning and food inspection_, n.s. no. , , p. . [ ] _southern cal. pract._, xxii ( ), . [ ] _ibid._, xxv ( ), . [ ] _arch. of int. med._, xiv ( ), . [ ] _amer. med._, x ( ), . [ ] _jour. amer. med. assoc._, lxi ( ), . [ ] _loc. cit._ [ ] _loc. cit._ [ ] in the feces of a healthy pig (kempner and pollock, _deutsche med. wchnschr._, xxiii [ ], ). [ ] _b. botulinus_ does not develop in media containing over per cent of salt and should not be able to grow in meat properly covered in brine made with per cent of salt (römer, _centralbl. f. bakt._, xxvii [ ], ). [ ] g. landmann, _hyg. rundschau_, xiv ( ), . [ ] wilbur and ophüls, _arch. of int. med._, xiv ( ), . [ ] _phil. jour. of science_, ix ( ), b , p. . [ ] k. blunt and c. c. wang, _jour. biol. chem._, xxviii ( ), . chapter ix poisoning of obscure or unknown nature while many and diverse causes of food poisoning have been discussed in the foregoing pages, there remain certain affections definitely connected with food that are still of obscure or doubtful causation. milksickness or trembles this disease, common to man and some of the higher animals, is characterized by a definite symptom-complex, the salient features being excessive vomiting and obstinate constipation accompanied usually by a subnormal temperature. many cases result fatally. at the present time it is known to occur only rarely in some of the southern and central western states in this country, but during the period of pioneer settlement it was quite common in districts that are now seldom affected. a great many references to milksickness are found in the writings of the early travelers and physicians in the middle west, one observer predicting that "some of the fairest portions of the west in consequence of the prevalence of this loathsome disease must ever remain an uninhabitable waste unless the cause and remedy can be discovered." in certain regions it is estimated that "nearly one-fourth of the pioneers and early settlers died of this disease." the mother of abraham lincoln fell a victim to this malady in in southern indiana. the disease appears to be usually contracted in the first instance by grazing cattle or sheep that have access to particular tracts of land; "milksickness" pastures are, as a rule, well known locally for their dangerous qualities. milksickness is communicated to man through the medium of raw milk, or butter and possibly of meat. although some of the earlier observers make the statement that the disease is self-propagating and can be passed on without limit from one animal to another, later experiments cast doubt on this view.[ ] many different theories have been advanced to account for the origin of the disease. the belief that mineral poisons such as arsenic or copper might be taken up by grazing animals and eliminated in the milk finds no justification either in analytical or in clinical data. many plants, known or suspected to be poisonous, have been accused of furnishing the substance that imparts the poisonous quality to the milk of animals suffering from trembles, but there is no agreement as to the responsible species. feeding experiments with suspected plants have in no case given unambiguous results. while some facts have been supposed to indicate that living micro-organisms are the cause of milksickness, other facts are opposed to this view, and the most recent experiments in this direction did not lead to conclusive results.[ ] the true cause of milksickness is at present quite unknown. deficiency diseases although diseased conditions due to the absence rather than the presence of certain constituents in the food are not perhaps to be properly classed as food poisoning, they may be mentioned here to illustrate the complexity of the food problem. at least one disease,--pellagra--is attributed by some observers to the presence of an injurious substance or micro-organism in the food, and by others to the absence of certain ingredients necessary to the proper maintenance of life. _beriberi._--one of the best established instances of a disease due to a one-sided or defective diet is beriberi. this affection is prevalent among those peoples subsisting chiefly or wholly on a diet of rice prepared in a certain way. as a matter of trade convention milled white rice has long been considered superior to the unpolished grain. the process of polishing rice by machinery removes the red husk or pericarp of the grain, and a diet based almost exclusively on polished rice causes this well-marked disease--beriberi--which was for long regarded as of an infectious nature.[ ] it has been shown that if the husks are restored to the polished grain and the mixture used as food the disease fails to develop. experiments upon chickens and pigeons show that an exclusive diet of white rice causes in these animals a disease (polyneuritis of fowls) similar to beriberi, which likewise can be arrested or prevented by a change in diet. from such observations the conclusion has been drawn that in the pericarp of the rice grain there are certain substances essential to the maintenance of health and that their withdrawal from the diet leads to nutritional disturbances. the name "vitamin" has been given to these substances, but little is known about their chemical or physiological nature. in a varied diet vitamins are presumably present in a variety of foodstuffs, but if the diet is greatly restricted, some apparently trivial treatment of the food may result in their elimination. it is uncertain how many and how various the substances are that have been classed by some writers under the designation vitamin. at least two "determinants" are thought to be concerned in the nutrition of growth, a fat-soluble and a water-soluble substance.[ ] _pellagra_ is one of the diseases attributed to an unbalanced diet,[ ] and it has been suggested that the increased use of highly milled maize and wheat flour from which vitamins are absent may be responsible for the extension of this malady in recent years. other observers, while admitting that a faulty diet may predispose to pellagra as to tuberculosis and other diseases, do not assent to the view that it is the primary factor.[ ] _lathyrism._--the name lathyrism has been given to a disease supposed to be connected with the use of the pulse and the chick pea. nervous symptoms are conspicuous and sometimes severe, although the affection is of a milder type than pellagra. the disease is said to be associated with the exclusive or almost exclusive use of leguminous food and with generally miserable conditions of living. it is yet uncertain whether lathyrism is a deficiency disease like beriberi and possibly pellagra, or whether it is due to a mixture of foreign and poisonous seeds with the particular legumes consumed, or whether under certain conditions the legumes themselves may contain poisonous substances generated by some unknown fungus growths. _favism_ (from _fava_, "bean") is an acute febrile anemia with jaundice and hemoglobinuria which occurs in italy and has been attributed to the use of beans as food or even to smelling the blossom of the bean plant.[ ] a marked individual predisposition to the malady is said to exist. although the symptoms are very severe and seem to point to an acute poisoning, no toxic substance has been isolated from the implicated beans. it has been suggested by some that bacterial infection, and by others that a fungous growth on the bean, is responsible, but no evidence has been brought forward to support either assumption. _scurvy_ in some forms is undoubtedly connected with the lack of certain necessary components of a normal diet. the development of scurvy on shipboard in the absence of fresh milk, fresh vegetables, fruit juice, and the like is a fact long familiar. guinea-pigs fed on milk, raw and heated, and on milk and grain have developed typical symptoms of scurvy.[ ] on the other hand, a form of experimental scurvy has been produced in guinea-pigs and rabbits kept on an ordinary diet of green vegetables, hay, and oats by the intravenous injection of certain streptococci.[ ] the relative share of diet and infection in the production of human scurvy is consequently regarded by some investigators as uncertain. _rachitis_ or rickets is a pathological condition in some way connected with a protracted disturbance of digestion which in turn leads to faulty calcium metabolism. it does not seem probable that rickets is caused by too little calcium in the food, but rather by the inability of the bone tissue to utilize the calcium brought to it in the body fluids. experiments upon the causation of the disease have not given uniform results, and it does not seem possible at present to place responsibility for this condition upon any particular form of diet, such as deficiency of fat or excess of carbohydrates or protein. it appears to be true that the prolonged use of any food leading to nutritional disturbance causes an inability on the part of the bone cells to take up calcium salts in the normal manner. while there are many obscure points with regard to the origin of both scurvy and rickets, there is no doubt that some dietary shortcoming lies at their base, and that they can be cured or altogether avoided by maintenance of suitable nutritional conditions. the foods most commonly poisonous certain articles of food figure with special frequency in the reports of food poisoning outbreaks. it is not clear in all cases why this special liability to inflict injury exists. for an example, vanilla ice-cream and vanilla puddings have been so often implicated that some investigators have not hesitated to ascribe a poisonous quality to the vanilla itself. but there is no good evidence that this is the case, and it has been suggested that the reducing action of the vanilla favors the growth of anaërobic bacteria which produce poisonous substances, an explanation highly conjectural. the conspicuous frequency with which the consumption of raw meat provokes food poisoning has already been set forth and in large part explained by the occasional derivation of meat from animals infected with parasites harmful to man. the even greater culpability of raw milk is due to the fact that milk is not only, like meat, sometimes obtained from an infected animal, but that it is a particularly good culture medium for bacteria, and in the process of collection or distribution may become infected through the agency of a human carrier. foods such as ice-cream that are prepared with milk are also often connected with food poisoning. it seems probable that illness caused by ice-cream is much more commonly due to bacterial infection than to poisoning with metals or flavoring extracts. the responsibility of these latter substances is entirely problematic. cases of cheese poisoning, which apparently are relatively numerous, are of quite obscure causation. whether such poisoning is due more commonly to some original contamination of the milk, or to an invasion of the cheese by pathogenic bacteria in the course of preparation, or to the formation of toxic substances by bacteria or molds during the process of ripening which the cheese undergoes, is left uncertain in the majority of cases. shellfish poisoning from eating oysters, mussels, or clams is unquestionably caused in some instances by sewage contamination of the water from which the bivalves are taken, and in such cases bacilli of the typhoid or paratyphoid groups are commonly concerned. it is a disputed question whether certain recorded outbreaks of mussel poisoning have been due to bacterial infection or whether sometimes healthy or diseased mussels taken from unpolluted water contain a poisonous substance. in a similar way it is uncertain whether a certain marine snail (_murex bradatus_), sometimes used for food, contains under certain conditions a substance naturally poisonous for man, or whether it is poisonous only when it is infected or when toxigenic bacteria have grown in it. potato poisoning has been attributed in some cases to bacterial decomposition of potatoes by proteus bacilli; in other cases, to a poisonous alkaloid, solanin, said to be present in excessive amounts in diseased and in sprouting potatoes. it is noteworthy that many instances of potato poisoning have been connected with the use of potato salad which had stood for some time after being mixed, so that the possibility of infection with the paratyphoid bacillus or other pathogenic organisms cannot be excluded. that solanin is ever really responsible for potato poisoning is considered doubtful by many investigators. these examples are sufficient to show that in a considerable proportion of cases of alleged food poisoning there is a large measure of uncertainty about the real source of trouble. although the trend of opinion has been in the direction of an increased recognition of the share of certain bacteria, especially those of the paratyphoid group, there is an important residue of unexplained food poisoning that needs further skilled investigation. it is one of the objects of this book to point out this need and to draw attention to the numerous problems that await settlement. the first step is the regular and thorough investigation of every food poisoning outbreak. footnotes: [ ] jordan and harris, _jour. infect. dis._, vi ( ), . [ ] _ibid._ [ ] e. b. vedder, _jour. amer. med. assoc._, lxvii ( ), . [ ] mccollum and davis, _jour. biol. chem._, xxiii ( ), . [ ] goldberger, _jour. amer. med. assoc._, lxvi ( ), . [ ] macneal, _jour. amer. med. assoc._, lxvi ( ), ; jobling, _jour. infect. dis._, xviii ( ), . [ ] gasbarrini, _policlinico_, november , ; abstract, _jour. amer. med. assoc._, lxv ( ), . [ ] holst and frölich, _jour. hyg._, vii ( ), ; moore and jackson, _jour. amer. med. assoc._, lxvii ( ), . [ ] jackson and moody, _jour. infect. dis._, xix ( ), . index a acid pickles, adulteration, food, agglutination, , , alkaloid, allergy, food, almonds, _amanita_: _aurantiaca_, ; _caesaria_, , ; _muscaria_, , , , ; _phalloides_, , , ; _verna_, "_amanita_ toxin," , anaphylaxis, , , aniline dyes, animal parasites, animals, , , , , , , , , , , , , , , ; emergency-slaughtered, , , , , ankylostomiasis, annatto, "anti-anaphylaxis," antimony, antiseptic chemicals, , antitoxin, ; diphtheria, appendicitis, arsenic, , arteries, artichokes, _ascaris_, asiatic cholera, asparagus, , asthma, , atropin, b bacillus: _botulinus_, - ; _coli_, ; danysz, ; _diphtheriae_, ; _enteritidis_, , , , , , , , , , , , , , ; _enteritidis-suipestifer_, , ; _paratyphoid-enteritidis_, , , ; _paratyphosus_, , ; _paratyphosus_ b, , , , , ; _proteus_, , , , ; _suipestifer_, , , , , , , , ; tetanus, ; tubercle, , , , ; typhoid, - , , bacteria: food-borne, , ; pathogenic, , bacterial products, balloon-fish, barbel, beans, , , , , , , beef stew, beer, , benzoate of soda, benzoic acid, , , beriberi, berries, , birds, game, biscuits, soda, blood vessels, , borax, boric acid, , , botulism, ; anatomical lesions, ; bacteriology, ; cases, ; epidemiology, ; prevention and treatment, ; symptoms, bread, , butter, , , , butyric acid, c caffeine, , cakes, "calf diarrhea," candies, , , , canned foods, , , , , , , canning, , cap, metallic, cardamom, oil of, carriers, ; paratyphoid, , , , , , , ; typhoid, , , , cases of: botulism, , listed by mayer, , in u.s., - ; dysentery, ; food sensitization, , , ; milksickness, ; mushroom poisoning, , , ; plant poisoning, ; poisoning from asparagus, ; trichiniasis, , ; tuberculosis, cat, cathartics, cattle, , , , , , , , , , , , , , celery, , , cereals, , cestode infection, cheese, , , , , chemicals, antiseptic, , chicken, , chick pea, chicory, chocolate, cholera microbe, chopped beef, _cicuta maculata_, , , cinnamon, clams, , _claviceps_: _paspali_, ; _purpurea_, , codfish, coffee, , coffee-tree, coloring, artificial, coloring substances, _conium maculatum_, "contact infection," , cook, , , , , copper, , copper: acetate, ; salts, ; sulphate, , cranberries, creosote, _cysticercus cellulosae_, , d daffodil bulbs, danysz bacillus, death camas, death-cup, , death-rates, , , , _delphinium_, diarrhea, diet, defective, , , , diphtheria, diseases: deficiency, ; degenerative, ; milk-borne, ; skin, dog, , drying, , dyes, aniline, dysentery, e _echinococcus_, eczema, , eelworm, eggs, , , , , , egg-white, , , , epidemics. _see_ outbreaks ergot, ergotism, - "expectation of life," extracts, flavoring, f favism, fish, , , , , , , , flies, flour, , , "fly _amanita_," , , fly poison, food: adulteration, ; allergy, ; coloration, ; intoxication, , , ; preservatives, ; substitutes, , foods: canned, , , , , , , ; cooked, , , , , , , , , , , , ; decomposed, , ; most commonly poisonous, ; protein, sensitization to, ; smoked, , ; spoiled, , ; uncooked, , , , , , , , , , , , foot-and-mouth disease, formaldehyde, , fowl, fruits, , , , , , , , , , "fruit ethers," fruit syrups, _fugu_, fungus, g gallstones, game birds, gastro-enteritis, , , , _giardia (lamblia) intestinalis_, globe-fish, glucose, , goose, ; liver, grain, , grass, wild, _gymnocladus dioica_, h _hackfleisch_, ham, , , , hamburger steak, , hay, hay fever, heart, , heating, hellebore, hemlock, , ; poison, ; water, , , hippuric acid, , hog cholera, , honey-locust, hookworm infection, horse, , horseradish, hydatid disease, _hydrocarpus_, _hymenolepis nana_, i ice, ice cream, , , , , infection: accidental, ; asiatic cholera, ; _bacillus proteus_(?), ; bacterial poisons, , ; carrier, , , , , , , , , , , , ; cestode, ; _giardia (lamblia) intestinalis_, ; hookworm, ; laboratory, ; milk-borne, ; parasitic, ; paratyphoid, ; scurvy, ; secondary bacterial, ; soil, ; tapeworm, ; tuberculous meat, ; tuberculous milk, ; typhoid food, intoxication, food, , , iron pyrites, j jams, japanese _fugu_, jars, preserve, jelly, , k _kalmia latifolia_, kidneys, , , , , kittens, l larkspur, lathyrism, laurel, lead, lead: chromate, ; foil, ; pipes, ; salts, legumes, lettuce, , liver, , ; goose, loco-weed, lupines, m maize, maratti-oil, margarin, marsh-marigold, mary malloy, "measly pork," meat, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ; jellies, ; pies, , ; puddings, meat inspection, , metals, , mice, , , , , milk, , , , , , , , , , , , , , , , , , , , , , , , milksickness, - molasses, _murex bradatus_, muscarin, mushrooms, , , - mussels, , "mutations," n neuritis, "neurotoxin," nipples, rubber, nissl granules, nitrogen peroxide, o oatmeal, oats, oil of cardamom, ; of cloves, olive stones, outbreaks due to: beans, darmstadt, , stanford university, ; beef, breslau, ; beef stew, limerick, ; beer, england, ; bread, elgin, ; codfish, ; diseased animals, ; ergot, limoges, ; gastro-enteritis carrier, ; group and family in u.s., , ; ham, ellezelles, ; human contamination, ; list of, by: hirsch, , hübener, , mayer, , savage, ; margarin, hamburg, ; meat, , ; frankenhausen, , ghent, ; meat pies, wareham, ; milk, ; kristiania, , newcastle, ; miscellaneous contaminations, ; mushrooms, new york city, ; oysters, ; paratyphoid carrier, ; pie, westerly, ; potato salad, ; public markets, south philadelphia, ; rat virus, ; sausage, , hanover, , württemberg, ; "sour grass soup," new york city, ; spaghetti, hanford, ; typhoid carrier, new york city, ; _vanille pudding_, ; vermicelli, ; watercress, philadelphia, ; water hemlock, new jersey, oxalic acid, _oxyuria_, oysters, , , , , , , p palmolin, _panaeolus papilionaceus_, "paragaertner" forms, parasites, , paratyphoid fever, - ; carriers, , , , , , , ; diseased animals, , ; gastro-intestinal, ; general characters of, ; human contamination, ; means of prevention, ; miscellaneous contaminations, ; sources of infection, ; symptoms, ; toxin production, ; typhoid-like, ; typical outbreaks, parrots, parsnips, pasteurization, , pastry, paté de foie gras, peas, , , pellagra, , pepper, pericarp of rice, peripheral neuritis, pickling, pidan, pie, pigs, pike, pinworm, plant oils, plants, , - , , poisons: bacterial, ; chemical, ; mineral, ; organic, ; protoplasmic, poisoning by: aniline dyes, ; animals, ; antimony, ; arsenic, ; asiatic cholera infection, ; _bacillus proteus_(?) infection, ; botulism intoxication, ; coloring substances, ; copper, ; defective diet: beriberi, , favism, , lathyrism, , pellagra, , rickets, , scurvy, ; egg-white, ; ergot, ; fish, ; food preservatives, ; food substitutes, ; lead, ; milk-borne infections: diphtheria, , foot-and-mouth disease, ; milksickness, ; scarlet fever, , and septic sore throat, ; mushrooms, ; parasites, animal: teniasis, , trichiniasis, , other, ; paratyphoid infection, ; plants, ; shellfish, ; tin, ; tuberculosis infection, ; typhoid infection, poisoning, food: articles of food most commonly connected with, ; effects of, ; extent of, ; frequency of, ; kinds of, ; means of prevention, ; obscure, ; outbreaks of, in united states, , , ; reports of, , , ; scope of book, ; seasonal incidence of, ; unknown, poison-ivy, "poison squads," pollen, polyneuritis of fowls, pork, pork and beans, potatoes, , potato salad, preservatives: chemical, ; food, ; household, proteins, , , , , , protochloride of tin, "ptomain poisoning," , , , , puffers, pulse, pyrites, iron, q quinine, r rabbit, rachitis, radishes, rash, , rats, , , , , , "rat virus," refrigeration, , rice, , ricin, rickets, ripening, roundworm, "royal _amanita_," rye, s saccharin, salad, , , ; dressing, salicylic acid, salt, , , salt solution, , salting, saltpeter brines, sandwiches, saponin, sausage, , , , , , , , , , , scarlet fever, scurvy, , sensitization, food, , "septic sore throat," serum, antitoxic, ; blood, , , , ; therapeutic, shark, sheep, , shellfish, , , shrimp, smoking, , , snail, "soda water," sodic carbonate, sodium benzoate, sodium fluoride, "soft drinks," , soil, infected, , solanin, solder, sorrel, "sour grass soup," sour milk, spaghetti, spices, staphylococcus, stoppers, patent metal, strawberries, "streptococcus sore throat," _strongyloides_, strychnine, , sturgeon, substances, coloring, substitutes, food, , sugar, , , , sugar solution, , sulphite, , sulphurous acid, , , swine, , , , , symptoms: cholera-like, , ; circulatory, ; coma, ; constipation, , , ; convulsions, , , ; coryza, ; diarrhea, , , , ; difficulty in swallowing, ; digestive, , , ; dizziness, , ; eyelids, edematous, ; febrile anemia, ; fever, , ; gastro-intestinal, , , , , ; hemoglobinuria, ; jaundice, ; mental, ; nausea, , , ; nervous, , , , ; pain: abdominal, , , , muscular, , ; paralysis, , ; rapidity of appearance of, , , , , ; rash, , ; sneezing, ; temperature, subnormal, , ; thirst, , ; trismus, ; visual, , , , , , ; vomiting, , , , , , syrups, , t tapeworm, , tea, _tenia saginata_, teniasis, _tenia solium_, tetrodontidae, theobromine, tin, - tin salts, "toadstools," tomatoes, toxin, trembles, trichina, _trichinella spiralis_, , trichiniasis, trichinosis, tuberculin, tuberculosis, , typhoid fever: - , , ; carriers, , , , ; milk-borne, u uncinariasis, urticaria, utensils, cooking, , , v vanilla: ; ice cream, ; pudding, , vegetables, , , , , , , , , , , , _veratrum viride_, "verdigris poisoning," vermicelli, "vitamin," , w water, , , watercress, , wintergreen, z _zygadenus_, transcriber's notes: passages in italics are indicated by _underscore_. passages in fracture style are indicated by +fracture+. this book contains chemical formula on page : c{ }h{ }no{ } the numbers in brackets should be read as subscripts. illustrations have been moved from the middle of a paragraph to the closest paragraph break. the punctuation in the index was inconsistent, all semi-colons in listings for page numbers have been changed into commas, they are not specially mentioned/marked in the list of changes. subentries are in general separated by semi-colons, these have been added or changed from other punctuation marks silently. sub-subentries are in general separated by commas, these have been added or changed from other punctuation marks silently. atropin and atropine have been retained in both versions in this project. table a in footnote [ ] contains a potential mathematical error, the nd column (expectation of life - ), row (ages) shows the value . , it should be . to add up correctly in the th column (gain or loss). the original value ( . ) has been retained. footnote [ ] "also doerr, "allergie und anaphylaxis," in kolle" is cited often as "also doerr, "allergie und anaphylaxie," in kolle". it has been retained in the version printed in the book for authenticity reasons. margarin (pages and ) is in general spelled margarine, it has been retained in this book for reasons of authenticity. maratti-oil (pages and ) is in general known as moratti-oil, it has been retained in this book for reasons of authenticity. hydrocarpus (pages and ) is in general known as hydnocarpus, it has been retained in this book for reasons of authenticity. amanita caesaria (pages , , and ) is also known as amanita caesarea but retained for this project in the first form. muscarin (pages , , , and ) is in general spelled muscarine, it has been retained in this book for reasons of authenticity. zygadenus (pages and ) is in general known as zigadenus, it has been retained in this book for reasons of authenticity. the typhoid carrier in new york mary mallon (aka typhoid mary) mentioned on page as well as on page is spelled in this book as mary malloy, the original of the book has been retained. other than the corrections listed below, printer's inconsistencies in spelling, punctuation, hyphenation, and ligature usage have been retained. the following misprints have been corrected: added to +. in table b footnote [ ], second to last value in th column. changed "la face vulteuse" into "la face vultueuse" page changed "paneolus papilionaceus" into "panaeolus papilionaceus" page the italic mark-up for "xlv" in "f. öffentl. ges., xlv" has been removed, footnote [ ] changed "r. trommsdorff, l. rajchmann, and a. e. porter," into "r. trommsdorff, l. rajchman, and a. e. porter," footnote [ ] changed "paneolus papilionaceus" into "panaeolus papilionaceus" page generously made available by the internet archive/american libraries.) the diary of a resurrectionist [illustration: "the dissecting room." by rowlandson. the figure standing up above the rest is william hunter; his brother john is on his right-hand side, and matthew baillie is the next figure to william hunter on the left; cruikshank is seated at the extreme left of the picture, and hewson is working on the eye of the subject on the middle table.] the diary of a resurrectionist - to which are added an account of _the resurrection men in london_ and a short history of the passing of the anatomy act by james blake bailey, b.a. librarian of the royal college of surgeons of england _london_ swan sonnenschein & co., lim. paternoster square introduction the "diary of a resurrectionist" here reprinted is only of a fragmentary character. it is, however, unique in being an actual record of the doings of one gang of the resurrection-men in london. many persons have expressed a wish that so interesting a document should be published; permission having been obtained to print the diary, an endeavour has been made to gratify this wish. to make the reprint more interesting, and to explain some of the allusions in the diary, an account of the resurrection-men in london, and a short history of the events which preceded the passing of the anatomy act, have been prepared. the great crimes of burke and hare drew especial attention to body-snatching in edinburgh, and consequently there have been published ample accounts of the resurrection-men in scotland.[ ] for this reason, edinburgh has been omitted from the present work. as to the genuineness of the diary there can be no doubt. it was presented to the royal college of surgeons of england by the late sir thomas longmore. in his early days, sir thomas was dresser to bransby cooper, and assisted him in writing the _life of sir astley cooper_. at the suggestion of lord abinger, it was decided to introduce an account of the resurrection-men into the book. the information for this was partly obtained by mr. longmore from personal communication with some of the resurrection-men, who were then living in london. one of these handed over portions of a diary he had kept during his resurrectionist days. this was preserved for some years at netley, and was afterwards presented to the college, as stated above. a few extracts from the diary were printed in the _life of sir astley cooper_. the information respecting the resurrection-men is very scattered; the two most useful works for getting up this subject are the _life of astley cooper_ before mentioned, and the _report of the committee on anatomy_ published in . most of the detailed information has to be sought for in the newspapers of the period. the accounts there given are, however, generally of such an exaggerated character that it is often very difficult to arrive at the truth. when any fresh scandal had given prominence to the doings of the resurrection-men, the newspapers saw "burking" in every trivial case of assault. if a child were lost, the paragraph announcing the fact was headed, "another supposed case of burking." reports of the most ridiculous character were duly chronicled as facts by the newspapers of the day. sometimes over a hundred bodies were supposed to have been found in some building, and it was expected that several persons of eminence would be named in the subsequent proceedings. search in the papers nearly always fails to find any further mention of the case. in reading these accounts it must be remembered that "burking" did not always mean killing a person for the purpose of selling the body, but it referred to the mode adopted by burke and hare in killing their victims, viz., suffocation. elizabeth ross is called a "burker," and may be found so described in haydn's _dictionary of dates_. she murdered an old woman named catherine walsh, but in the report of her trial there is no evidence of her having attempted to sell the body. the broadside here printed is an excellent example of this exaggeration. the facts are so circumstantial, that it appears as though there could be no mistake. enquiry at edinburgh, however, shows that no such case occurred. mr. a. d. veitch, of the justiciary office, has very kindly made search, and can find no record of wilson's supposed crimes. had the statements in the broadside been true, there is no doubt that this case would have been referred to in books on medical jurisprudence. poisoning by inhalation of arsenic is rare, and wilson's would have been a leading case. there would also have been great opportunities for studying _post mortem_ appearances, as it is stated that three bodies were found in wilson's possession. search through the chief books on the subject has failed in finding any reference whatever to this case. "burking by means of snuff. "_the following account is of so serious a nature that no one can be too cautious how they receive snuff from strangers._ "it appears that, on monday se'nnight, a man, named john wilson, was apprehended at edinburgh on a charge of burking a number of persons by introducing arsenic into snuff kept by him. he had long excited the suspicion of the police of that place, but so deep-laid were his diabolical schemes that he eluded their vigilance for a considerable time, until monday last. when, on the moors, on that day, between lauder and dalkeith, practising his dreadful trade, it appears that the victim of wilson's villainy was a poor man travelling over the moor, whom he accosted, and offered a pinch of snuff. he took it, and it had the desired effect. the next individual whom he accosted was a labouring-man breaking stones, who was asked the number of miles to edinburgh; when answered, he then offered his snuff-box to the labourer, which was refused, alleging that he never used any. wilson urged him again, which excited the man's suspicions, but he took the snuff, and wrapped it up in paper, and carried it to a chemist at dalkeith, who analysed it, when it proved to be mixed with arsenic. the police were then informed of wilson's villainies, who went in pursuit of him, and after a search of him for several days was at length apprehended at a place three miles from edinburgh, driving rapidly in a vehicle like a hearse, which, on examination, contained three dead bodies. they were recognised from their dresses to be an elderly man, and his wife and son, who were seen travelling towards lauder the day before. "wilson was immediately ironed and conveyed to edinburgh, and a sheriff's inquest was held on the bodies. after an investigation of nearly two hours a verdict of wilful murder was returned against john wilson, who was fully committed to the calton gaol to take his trial at the ensuing sessions. "wilson is described as a desperate character, and of ferocious countenance. he is supposed to have been two or three years in this abominable practice, and to have realised a considerable sum in the course of that time. his career is now stopped, and that justice and doom which overtook a burke and a hare are his last and only portion. "lines on the occasion. of burke and of hare we have heard much about, yet burking's a trade that was lately found out-- their plans of despatching were wicked indeed, 't was thought of all others that theirs did exceed; but the scheme first invented of burking by snuff, may yet be prevented by taking the huff, for if strangers invite you to take of their dust, decline their kind offers--refuse them you must; and would you be safe, and keep from all evil, shun them as pests as you'd shun the d----l; by these means you'll live, avoiding all strife, shunning snuff takers all the days of your life. "_printed for the publishers by t. kay._" the difficulty of getting reliable information is increased by the incomplete nature of most of the newspaper records. in many cases there is an account of a preliminary examination of some of the men who were arrested for body-stealing. the report states that they were remanded, but further search fails to find any subsequent notice of the case. it is often impossible to fix who the men were who thus got into trouble, as they nearly always gave false names: unless they were too well-known to the police who arrested them, they invariably did this. for the photographs, from which the illustrations of the house at crail are taken, the writer is indebted to the kindness of prof. chiene, of edinburgh. the diary of a resurrectionist chapter i. the complaint as to the scarcity of bodies for dissection is as old as the history of anatomy itself. great respect for the body of the dead has characterised mankind in nearly all ages; _post mortem_ dissection was looked upon as a great indignity by the relatives of the deceased, and every precaution was taken to prevent its occurrence. it would be beyond the scope of the present work to attempt a history of anatomical teaching; as will be pointed out later on, the resurrection-men did not come into existence until the early part of the eighteenth century. in great britain the study of medicine and surgery was much hampered at this date by the scarcity of opportunities by which the student might get a practical acquaintance with the anatomy of the human body. a knowledge of anatomy was insisted upon by the corporation of surgeons, as each student had to produce a certificate of having attended at least two courses of dissection. it is unnecessary to point out the wisdom of this condition in the case of men who were to go out into the world as surgeons, and, consequently, to have the lives of their fellow-men in their hands. the attendance on the two courses of dissection could be evaded, and this was frequently done. the apothecaries' hall had no such restriction, and, consequently, many men went thither and received a qualification to practise, although they were quite unacquainted with human anatomy. the work of such 'prentice hands one trembles to think of; whatever experience these men did gain was obtained after they began to practise, and so must have been at the expense of their patients, who were generally those of the poorer class in life. it was pointed out by mr. guthrie, that in the then state of the law a surgeon might be punished in one court for want of skill, and in another court the same individual might also be punished for trying to obtain that skill. before the anatomy committee, in , sir astley cooper narrated the case of a young man who was rejected at the college of surgeons on account of his ignorance of the parts of the body; it was found, on enquiry, that he was a most diligent student, and that his ignorance arose entirely from his being unable to procure that which was necessary for carrying on this part of his education. when bodies were obtained for dissection it was generally by surreptitious means; the newly-made grave was too often the source from whence the supply was obtained. at first there was no direct trade or traffic in subjects by men who devoted all their efforts to this mode of obtaining a livelihood. the students supplied their own wants as they arose. mr. g. s. patterson told the committee that at st. george's hospital the students had to exhume bodies for their own use. in the _diary of a late physician_ samuel warren has given us a chapter on this subject, which he calls "grave doings," and which is probably founded on fact. the object in the expedition here recorded was, however, rather to obtain a valuable pathological specimen, than to get a body for dissection. writers of fiction have made use of body-snatching, and have given a gruesome turn to their stories by making the body, when uncovered, turn out to be that of a relation or friend of some one of the party engaged in the exhumation. such a tale is recorded in the _monthly magazine_ for april, ; there a sailor is pressed into the service of some students who were anxious to obtain a body. the subject was safely brought home, and, on being taken from the sack, turned out to be the sweetheart of the sailor, who had just returned from sea, and, not having heard of his girl's decease, was on his way to greet her after a long absence from home. truth and fiction often agree. there is a case on record of a child who had died of scrofula, and whose body was brought to st. thomas' hospital by holliss, a well-known resurrectionist. the body was at once recognised by one of the students as that of his sister's child; on this being made known to the authorities at the hospital, the corpse was immediately buried before any dissection had taken place. in vols. and of the _medical times_ there is a series of articles, entitled "the confessions of jasper muddle, dissecting-room porter." these papers are signed "rocket," but were written by albert smith.[ ] one of the articles contains an account of a handsome young lady who came to the dissecting-room late at night, and begged for the body of a murderer executed the previous day, which was then being injected, ready for lecture purposes. in the _tale of two cities_, dickens has given us a good study of a resurrection-man in the person of mr. cruncher. moir in _mansie wauch_, lytton in _lucretia_, mrs. crowe in _light and darkness_, and miss sergeant in _dr. endicott's experiment_, have also used the body-snatcher in fiction. as long as the barber surgeons kept to their right of the exclusive teaching of anatomy, there was small need of bodies for dissection. this right the company jealously guarded. on st may, , the following entry occurs in the records, "here was john deane and appoynted to brynge in his fyne x{li} for havinge an anathomye in his howse contrary to an order in that behalf between this and mydsomer next."[ ] as late as this rule was put in force against no less a man than william cheselden. the entry in the books of the company runs as follows, "at a court of assistants of the company of barbers and surgeons, held on the th march, . our master acquainting the court that mr. william cheselden, a member of this company, did frequently procure the dead bodies of malefactors from the place of execution and dissect the same at his own house, as well during the company's publick lectures as at other times without the leave of the governors and contrary to the company's by law in that behalf. by which means it became more difficult for the beadles to bring away the companies bodies and likewise drew away the members of this company and others from the public dissections and lectures at the hall. the said mr. cheselden was, therefore, called in. but having submitted himself to the pleasure of the court with a promise never to dissect at the same as the company had their lecture at the hall, nor without leave of the governors for the time being, the said mr. cheselden was excused for what had passed with a reproof for the same pronounced by the master at the desire of the court."[ ] by the act henry viii., xxii., cap. , provision was made for the company of barbers and surgeons to have the bodies of malefactors for the purpose of dissection. this part of the act was as follows: "and further be it enacted by thauctoritie aforesayd, that the sayd maysters or governours of the mistery and comminaltie of barbours and surgeons of londo & their successours yerely for ever after their sad discrecions at their free liberte and pleasure shal and maie have and take without cõtradiction foure persons condempned adjudged and put to deathe for feloni by the due order of the kynges lawe of thys realme for anatomies with out any further sute or labour to be made to the kynges highnes his heyres or successors for the same. and to make incision of the same deade bodies or otherwyse to order the same after their said discrecions at their pleasure for their further and better knowlage instruction in sight learnyng & experience in the sayd scyence or facultie of surgery." the "foure bodies" could not always be obtained without difficulty; despite the precautions of the company private anatomy was, to a certain extent, carried on, and the bodies of malefactors had a market value. the following entries from the _annals of the barber surgeons_ are illustrative of this: " th march, .[ ] it is ordered that william cave, one of the beadles of this company, do make inquiry who the persons were that carryed away the last body from tyburne, and that such persons be indicted for the same. " th october, . richard russell, one of the persons who stands indicted for carrying away the last publick body applying himself to this court and offering to be evidence against the rest of the persons concerned it is ordered that the clerk do apply himself to her majesty's attorney generall for a noli p'sequi as to the said russell in order to make him an evidence upon the s{d} indictment and particularly ag{st} one samuell waters whom the court did likewise order to be indicted for the said fact." often there were riots caused by the beadles of the company going to tyburn for the bodies of murderers. this rioting was carried to such an extent that it was found necessary to apply for soldiers to protect the beadles. " th may, . ordered that the clerk go to the secretary at war for a guard in order to gett the next body [from tyburn.]" the dissection of these bodies was made known by public advertisement. the following is from the _daily advertiser_ of january th, : "notice is hereby given that there being a publick body at barbers and surgeons hall, the demonstrations of anatomy and the operations of surgery will be at the hall this evening and to-morrow at six o'clock precisely in the amphitheatre." in it was ordered that bodies of murderers executed in london and middlesex should be conveyed to the hall of the surgeons company to be dissected and anatomized, and any attempt to rescue such bodies was made felony. in the barbers and surgeons, who from , until that date, had formed one company, separated, and the latter were incorporated under the title of "the masters, governors, and commonalty of the art and science of surgery." to the surgeons naturally fell the duty of dissecting the bodies of the malefactors handed over for that purpose. the building of the surgeons' company was in the old bailey; there was, therefore, no difficulty in removing the bodies from newgate. in the company came to a premature end through an improperly constituted court having been held. it was attempted to put matters right by a bill in parliament, but there was so much opposition from those persons who were practising without the diploma of the corporation, that the bill, after passing safely through the commons, was thrown out by the lords. in the following year attempts were made to come to terms with the opponents of the bill, and finally it was agreed to petition for a charter from the crown to establish a royal college of surgeons in london. these negotiations were successfully carried out in , and the old corporation having disposed of their old bailey property to the city authorities, the college took possession of a house in lincoln's inn fields, the site of part of the present building. during the debate in the house of lords on the bill just mentioned, the bishop of bangor, who had charge of the measure, sent for the clerk of the company, and informed him that a strong opposition was expected to the bill, on account of the inconvenience that would arise from the bodies of murderers being conveyed through the streets from newgate to lincoln's inn fields. to remedy this a clause was proposed, giving the college permission to have a place near to newgate, where the part of the sentence which related to the dissection of the bodies might be carried out. that this difficulty of moving the bodies was not a fancied one, the following extract from "alderman macaulay's diary" will show: "dec. , . francis dunn and will. arnold were yesterday executed for murder and the first malefactors conveyed to the new surgeons' hall in the lincoln's inn fields. they were conveyed in a cart, their heads supported by tea chests for the public to see: i think contrary to all decency and the laws of humanity in a country like this. i hope it will not be repeated."[ ] just at this date the corporation were removing from their old premises to lincoln's inn fields; the last court in the old bailey was held on october th, , and the first at lincoln's inn fields on january th, . in july, , it was reported to the court that mr. chandler, one of their members, "had in the most polite and ready manner offered his stable for the reception of the bodies of the two murderers who were executed last month." the thanks of the court were voted to mr. chandler "for his polite attention to the company upon that occasion." after the bill had been lost in the lords, the following resolution was passed by the court in november, : "resolved that in order to evince the sincerity of the court to remove all reasonable objections to the present situation in lincoln's inn fields the clerk be directed, with proper assistance, to look for a temporary dissecting-room at a place in or near the old bailey until a permanent one near the place of execution can be established." in june, , a warehouse was taken in castle street, cow cross, west smithfield, for eighteen months, as, owing to the labours of taking over the hunterian collection, there had been no time for obtaining a permanent place. a house in duke street, west smithfield, was afterwards leased for the purpose, and arrangements were made for pass, the beadle, to reside there. this landed the college in a small expense, as in the beadle was elected constable of the ward of farringdon, and the council had to pay a fine of £ in place of his serving the office. at the expiration of the lease of the duke street house, so great an increase of rent was demanded that the college gave up the premises, and took a newly-built house in hosier lane, on a lease for twenty-one years. here the dissections were carried on until the passing of the anatomy act, when the college had no longer to share with the hangman the duty of carrying out the sentence on murderers who were condemned to be hanged and anatomized. the bodies were not really dissected by the college authorities; a sufficient incision was made to satisfy the requirements of the act, and the body was then handed over to one of the teachers of anatomy. the following is a copy of an order authorizing the secretary of the college to give up a body: "ordered. "that the body of mary whittenbach executed this day at the old bailey for murder be delivered (after the necessary dissection by the college) to mr. joseph henry green. "william blizard "wm. norris "anth{y} carlisle. "royal college of surgeons "_ th day of sept. _ "to mr. belfour, secy. to the college." there is in the library of the royal college of surgeons of england a series of drawings of the heads of murderers, made by the two clifts, father and son, when the bodies were brought to the college for dissection. these drawings include bishop and williams (see p. ),[ ] and bellingham, who was executed in for the murder of mr. perceval in the lobby of the house of commons. earl ferrers, who suffered the extreme penalty of the law in for the murder of his steward, was taken to surgeons' hall, where an incision was made in the body; instead of being further dissected it was given over to the relatives for burial. at the execution of bishop and williams the sheriffs of london felt that some means should be taken to show gratitude to mr. partridge, and the other officials of king's college, for the way they had brought the murderers to justice. the following letter was therefore addressed to the college of surgeons: "justice hall, "_dec. , ._ "_to the governors and directors of the college of surgeons._ "it is our particular desire and we do ask that it may be thought but a reasonable request that the bodies of the malefactors executed in the front of newgate this morning should be sent to king's college--by the vigilance of whose surgical establishment these offenders were detected and ultimately brought to justice, we shall therefore feel obliged by your handing over these bodies to the king's college. "we are, with great respect, "your mo. ob. servts., "j. cowan } } _sheriffs_." "john pirie} the body of bishop was given to mr. partridge, and that of williams went to mr. guthrie at the little windmill street school of anatomy. the following account of the reception of one of the bodies is by mr. t. madden stone, for many years an official at the college. it was printed in a series of articles, entitled "echoes from the college of surgeons."[ ] "the executions generally took place at eight o'clock on mondays, and the 'cut down,' as it is called, at nine, although there was no cutting at all, as the rope, with a large knot at the end, was simply passed through a thick and strong ring, with a screw, which firmly held the rope in its place, and when all was over, calcraft, _alias_ 'jack ketch,' would make his appearance on the scaffold, and by simply turning the screw, the body would fall down. at once it would be placed in one of those large carts with collapsible sides, only to be seen in the neighbourhood of the docks, and then preceded by the city marshal in his cocked hat, and, in fact, all his war paint, with calcraft and his assistant in the cart, the procession would make its way to hosier lane, west smithfield, in the front drawing room of which were assembled sir william blizard, president of the royal college of surgeons, and members of the court desirous of being present, with messrs. clift (senior and junior), belfour, and myself. on extraordinary occasions visitors were admitted by special favour. the bodies would then be stripped, and the clothes removed by calcraft as his valuable perquisites, which, with the fatal rope, were afterwards exhibited to the morbidly curious, at so much per head, at some favoured public-house. it was the duty of the city marshal to be present to see the body 'anatomised,' as the act of parliament had it. a crucial incision in the chest was enough to satisfy the important city functionary above referred to, and he would soon beat a hasty retreat, on his gaily-decked charger, to report the due execution of his duty. these experiments concluded, the body would be stitched up, and pearson, an old museum attendant, would remove it in a light cart to the hospital, to which it was intended to present it for dissection." * * * * * these bodies of murderers were the only ones which could be legally used for dissection; it is therefore obvious that the number was quite insufficient for the wants of the metropolitan schools, and the teachers were thus forced to obtain a supply from other sources. it was strongly urged, but urged in vain, that the whole difficulty would disappear if a short act were passed, doing away with the dissection of murderers, and enacting that the bodies of all unknown persons who died in workhouses or hospitals, without friends, should be handed over, under proper control, to the different teachers of anatomy. that these would be sufficient was afterwards made clear by the committee on anatomy.[ ] in their report it is stated that the returns obtained from of the parishes situate in london, westminster, and southwark, or their immediate vicinity, showed that out of persons who died in the workhouses of these parishes in the year , were buried at the parish expense, and that of these about were not attended to their graves by any relations. the number of bodies obtained from this source would have exceeded those supplied by the resurrection-men, and would have been adequate for the wants of the london schools. the newspapers of the day contain many proposed solutions of the difficulty. one correspondent gravely suggested that as prostitutes had, by their bodies during life, been engaged in corrupting mankind, it was only right that after death those bodies should be handed over to be dissected for the public good. another correspondent proposed that all bodies of suicides should be used for dissection, and that all those persons who came to their death by duelling, prize-fighting, or drunkenness, should be handed over to the surgeons for a similar purpose. mr. dermott, the proprietor of the gerrard street, or little windmill street, school of medicine, proposed a scheme by which a fund was to be raised by grants from government, and from the college of surgeons, and by voluntary contributions from the nobility and gentry. this fund was to be invested in the names of "opulent and respectable men," not more than one-third of whom were to be members of the medical profession. it was proposed to expend the interest on this fund in paying a sum not exceeding seven pounds to those persons who were willing to contract for the sale of their bodies for dissection. registers were to be kept of all such persons, and the committee were to have the power of claiming the body six hours after death. mr. dermott also suggested that all medical men should leave their own bodies to be used for anatomical teaching. it is hardly necessary to point out the absurdity of the first part of this scheme; the committee, after paying their seven pounds, would have had no control over the subsequent movements of the persons whose bodies they had thus purchased, and it was hardly to be expected that friends of the deceased would send notice to the committee that the body was ready for them. both parts of the scheme would have required an act of parliament, as executors were not bound to give up a corpse, even though instructions had been left that it was a person's wish that his body should be used for anatomical purposes. many such bequests have been made, and in some instances the desire of the testator has been carried into effect. to try to do away with some of the prejudices against dissection, jeremy bentham left his body for this purpose; the dissection was duly carried out at the webb street school, and at the request of dr. southwood smith, mr. grainger delivered the following oration over the body on june th, : "gentlemen,--in presenting myself before you this day, at the request of my friend and colleague, dr. southwood smith, i can assure you i do so strongly impressed with the high importance of the duty i have undertaken, and the responsibility i have thus assumed. gentlemen, it is no ordinary occasion on which we are assembled. we are here collected to carry into execution the last wishes of one whose mortal career, prolonged far beyond the usual limits of man's existence, has been devoted with almost unexampled energy and perseverance to the establishment of those great moral and political truths, on which the happiness and the enlightenment of the human race are founded. ill would it become me, however, to dwell on the genius, the philanthropy, or the integrity of the illustrious deceased. his eulogium has already been eloquently pronounced by one more fitted to do justice to such an undertaking than the humble individual who now addresses you. it would be more suitable to the object of the present meeting that i should consider in what manner the intentions of the late mr. bentham, regarding the disposition of his remains, can best be carried into effect. but before i do this, it may be proper to inform some of my auditors what those intentions were. this great man was an ardent admirer of the science of medicine, and his penetrating mind was not slow in perceiving that the safe and successful practice of the healing art entirely rests on a thorough knowledge of the natural structure and functions of the human body. he also perceived that there was but one method of obtaining such knowledge, viz., dissection. in proceeding to inquire how it came to happen that in a country like england, justly proud of those numerous institutions in which science is so successfully cultivated, so little encouragement, or more correctly speaking, so much opposition, was offered to the advancement of so indispensable a branch of knowledge, mr. bentham discovered that this repugnance to dissection sprang from a feeling strongly implanted in the human breast--a feeling of reverence towards the dead. far be it from me to condemn such a sentiment, for it has its source in some of the purest principles of our nature. but if it can be shown that an undue indulgence in this feeling produces incalculable mischief in society, it becomes the duty of all who are interested in the happiness of mankind to oppose the progress of such injurious opinions. mr. bentham, impressed with this idea, and thinking it unjust that the humbler classes of the community should alone be called upon to sacrifice those feelings which are cherished alike by the rich and poor, determined to devote his own body to the public good. he knew that this determination would inflict pain on many of his dearest friends. an example of this character, emanating from a person so talented, so influential, and so esteemed, is calculated to operate a most beneficial effect on the public mind, and i cannot refrain from considering the dissection of the body now before us as an important era in the progress of anatomy, as it is one of the first that in this country has been employed for the purposes of science, under the direct sanction of the individual expressed during his lifetime; he also knew that obstacles would probably be offered to its fulfilment, but with an indifference to personal feeling rarely witnessed, he took effectual means to carry his resolution into effect. and thus, gentlemen, did the last act of this illustrious man's existence accord with that leading principle of his well-spent life--the desire to promote the universal happiness and welfare of mankind." bentham's skeleton, clothed in his usual attire, is now in university college, london. messenger monsey, the eccentric physician to the chelsea hospital, was exceedingly anxious that his body should be examined after death. he obtained a promise from mr. forster, of union court, that he would perform this service for him. so anxious was monsey for the _post mortem_ to be carried out, that in may, , he wrote to cruikshank, the anatomist, as follows: "mr. foster (_sic_) a surgeon in union court, broad street, has been so good as to promise to open my carcass and see what is the matter with my heart, arteries, kidnies, &c. he is gone to norwich and may not return before i am [dead]. will you be so good as to let me send it to you, or if he comes will you like to be present at the dissection. i am now very ill and hardly see to scrawl this & feel as if i should live two days, the sooner the better. i am, tho' unknown to you "your respectfull humble servant "messr. monsey." monsey lived until december th, ; his wishes were duly carried out by mr. forster, at guy's hospital, in the presence of the students. ninety-nine gentlemen of dublin signed a document, in which the wish was expressed that their bodies, instead of being interred, should be devoted by their surviving friends "to the more rational, benevolent, and honourable purpose of explaining the structure, functions and diseases of the human being." a mr. boys, who died in , wished to be made into "essential salts" for the use of his female friends. in a letter to dr. campbell, written four years before his death, he asks: "are you now disposed (without burking) to accomplish my wish, when my breath or spirit shall have ceased to animate my carcase, to perform the operation of vitrifying my bones, and sublimating the rest, thereby cheating the devil of his due, according to the ideas of some devotees among christians? and, that i may not offend the delicate olfactory nerves of my female friends with a mass of putridity, if it be possible, let me rather fill a few little bottles of essential salts therefrom, and revive their drooping spirits. it may be irksome to you to superintend the business, but, perhaps, you have knowledge of some rising genius or geniuses who may be glad of a subject without paying for it. let them slash and cut, and divide, as best please 'em." the following account, taken from a newspaper of , shows that untoward events sometimes followed a request of this kind. a journeyman tailor died at the _black prince_, in chandos street, and directed, in his will, that his body should be opened in the presence of mr. wood, the landlord. this instruction was carried out. the paragraph goes on to say that the dissection was scarcely concluded "when the landlord, a stranger to such exhibitions, was seized with sickness and vomiting; and, on reaching the bar, was prevailed upon by his wife to take a glass of brandy and water; in a few minutes he was obliged to be carried to bed, never to rise again; on friday last, the third day from the attack, he died in a state of delirium, not from contagion, or a predisposition to disease, but solely from the impression made upon his mind by the anatomical performance, which, he observed, exceeded in horror any thing he had ever beheld." it was not an uncommon thing for persons to try to put into effect part of dermott's plan, by offering to leave their bodies for anatomical purposes, on the condition that they were paid a certain sum down. this was generally only a swindling dodge, and one by which the teachers were not to be caught, as they could have no hold on the persons whose bodies they purchased, nor could they compel the friends to give them up after death. the following letter, preserved amongst sir astley cooper's papers, and now forming part of the stone collection at the royal college of surgeons of england, is a specimen: "sir,--i have been informed you are in the habit of purchasing bodys and allowing the person a sum weekly; knowing a poor woman that is desirous of doing so, i have taken the liberty of calling to know the truth. "i remain, your humble servant." [ ] on the back sir astley has written, "the _truth_ is that you deserve to be hanged for such an unfeeling offer. a. c." the idea at the present day has not died out; quite recently a man called at the college of surgeons, and offered to sell his body for a cash payment. it is a fairly common experience of curators of pathological museums to have similar offers from persons suffering from a rare disease, or a curious deformity. [illustration: mortsafe in greyfriars churchyard, edinburgh.] chapter ii. as has been stated in the previous chapter, there was no need of the resurrection-men, so long as the teaching of anatomy was confined to the company of barbers and surgeons. it has also been pointed out that, as late as , cheselden was reprimanded for having anatomical demonstrations at his private house. soon after this date, however, began the establishment of private schools. mr. nourse, of st. bartholomew's, was one of the first to deliver public lectures at his own house. after a time this probably became inconvenient, as we find his advertisement, in , worded thus: "anatomy. "designing to have no more lectures at my own house, i think it proper to advertise that i shall begin a course of anatomy, chirurgical operations and bandages on monday, the th of nov., at st. bartholomew's hospital. "edw. nourse, assistant surgeon and lithotomist to the said hospital." percivall pott, who was apprenticed to nourse, followed his master's example, and lectured on surgery. in we find dr. fr. nicholls advertising thus: "on wednesday, the nd of february, at the house below the bull head, in lincoln's inn fields, at five in the evening, will begin a course of anatomy and physiology, introductory to the study and practice of physick in all its branches by fr. nicholls, m.d. n.b. a compendium referring to the several matters, explain'd in these lectures, is sold by john clarke, under the royal exchange, and f. woodward, at the half moon, within temple bar, booksellers." the following is the advertisement of cæsar hawkins, from a newspaper of : "in pall mall court, in pall mall. on thursday, the th of february next, will begin a course of anatomy, with the principal operations in surgery and their suitable bandages, by cæsar hawkins, surgeon to st. george's hospital." joshua brookes' advertisement, in , ran as follows: "theatre of anatomy, blenheim street, great marlborough street. "the summer course of lectures on anatomy, physiology, and surgery, will be commenced on monday, the th of june, at seven o'clock in the morning. by mr. brookes.--anatomical converzationes will be held weekly, when the different subjects treated of will be discussed familiarly, and the students' views forwarded. to these none but pupils can be admitted. spacious apartments, thoroughly ventilated, and replete with every convenience, will be open at five o'clock in the morning, for the purposes of dissecting and injecting, when mr. brookes attends to direct the students and demonstrate the various parts as they appear on dissection. "the inconveniences usually attending anatomical investigations, are counteracted by an antiseptic process. pupils may be accommodated in the house. gentlemen established in practice, desirous of renewing their anatomical knowledge, may be accommodated with an apartment to dissect in privately." a very interesting account of the old anatomical schools, by mr. d'arcy power, will be found in the _british medical journal_, , vol. , p. . the paper is entitled "the rise and fall of the private medical schools in london." it has been reprinted, with other articles, in a pamphlet, entitled _the medical institutions of london_. in great britain, as no licence was required for opening an anatomical school, there was no limit to their number; there was also no regular legal supply of subjects, except the bodies of murderers, executed in london and the county of middlesex, which came to the schools through the college of surgeons. in paris a licence had to be obtained before opening an anatomical school, and bodies were regularly supplied to the licensed places. with the rise and competition of the medical schools in london, the difficulty of getting an adequate number of bodies increased. the absolute necessity of having a good supply for the use of students, so as to prevent them from going off to rival schools, caused the teachers to offer large prices, and thus made it worth while for men to devote themselves entirely to obtaining bodies for this purpose. at first the trade was carried on by a very few men, and without any public scandal, but the inducements mentioned above enticed others into the business; these were of the lowest class, often professed thieves, and the fights and disputes of these men, one with the other, in churchyards, often made really more scandal than the actual stealing of the bodies. it was stated by the police in that the number of persons who, in london, lived regularly on the profits of exhumation, did not exceed ten; but there were, in addition to these, about two hundred who were occasionally employed. these latter individuals were thieves of the lowest grade, and the most desperate and abandoned class of the community. the men worked generally in gangs, and would do anything to spoil the success of their opponents in the business. if a body were bought by one of the teachers from an outside source, the regular men would sometimes break into the dissecting-room and cut the body in such a manner as to make it useless for anatomical purposes. if this could not be done, they would give information to the police that a stolen body was lying in a certain dissecting-room. joshua brookes, the proprietor of the blenheim street, or great marlborough street, school, was a victim in this way; a body, for which he had paid guineas, was taken away from his school through information of this kind, and the police officer who carried out the business was, as a reward for his efforts, presented with a silver staff, purchased by public subscription. brookes seems to have got on very badly with the resurrection-men; at one time, because he refused five guineas as a douceur at the beginning of the session, two dead bodies, in a high state of decomposition, were dropped at night close to his school by the men whom he had thus offended; one of these bodies was placed at the poland street end of great marlborough street, and the other at the end of blenheim street. two young ladies stumbled over one of these bodies, and at once raised such a commotion that, had it not been for the prompt assistance of sir robert baker and the police, brookes would have fared very badly at the hands of the mob which soon collected. the fact of his house being near to the marlborough police court, on more than one occasion saved brookes from the popular fury. a subject was brought to him one day in a sack, and paid for at once; soon after it was discovered that the occupant of the sack was alive. this was not a case of attempted murder; the "subject" was a confederate of those from whom he had been purchased, and had, in all probability, been thus introduced to the premises for purposes of burglary. the competition of the schools had risen to such a height in the demand for bodies, that brookes stated that for a subject, which would have cost two guineas in his student days, he had paid as much as sixteen guineas. nor was the cost of the body the only expense to the teacher. at the beginning of each session he was waited upon by the resurrection-men, who offered to supply him regularly with bodies at a fixed price, on the condition that a douceur was paid down at once. the teachers were powerless in the matter, and had either to accede to the offered terms, or to lose their students through not having a sufficient supply of subjects. the scarcity of bodies was most keenly felt at the beginning of the session; the resurrection-men knew that they could command their own terms, and would not supply any subjects until the teachers had conceded all their demands. this was felt to be bad for the students, and dr. james somerville, who was assistant to brodie at the great windmill street school, in giving evidence before the committee on anatomy, said that "the pupils not being able to proceed for a certain time lose their ardour, and get into habits of idleness." at the end of the session the resurrection-men again waited on the proprietors of the schools, and demanded "finishing money." in some papers relating to sir astley cooper, which were referred to in a letter published in the _medical times_, , vol. , p. , we read: "may th, , paid hollis, vaughan, and llewellyn, finishing money, £ s. d. , june th, paid murphy, wildes, & naples, finishing money £ s. d." the cost of the bodies in this way to the teachers was more than they could charge to the students, and the deficiency thus created was made up by increased fees for the lectures. the expenses, moreover, did not end here. if one of the resurrection-men was unfortunate enough to get a term of imprisonment, the teacher had to partly keep the man's wife and family whilst he was serving his sentence. a solatium was also expected on his release from gaol. mr. r. d. grainger spent £ in this way for one man, and several guineas in keeping the family of another resurrectionist whilst the latter was in gaol. sir astley cooper is known to have spent large sums of money for a similar purpose. the following may be cited as examples: "january th, , paid mr. cock to pay mr. south half the expenses of bailing vaughan from yarmouth and going down £ s. d. , may th, paid vaughan's wife s. paid vaughan for twenty-six weeks' confinement at s. per week, £ s. d." if any independence were shown by the teachers, and the demands of the men resisted, victory generally fell to the lot of the resurrectionists. a teacher, perhaps, would refuse to pay the exorbitant demands, and would employ other men to obtain bodies for him. these were then watched by the regular gang, and information to the police was laid against them on every occasion. the bodies obtained by the irregular men were often taken from them by those who considered they had a monopoly in the business; these subjects were then hacked and cut about so as to make them quite useless for anatomical purposes. so the supply at this particular school would be very short, and great indignation would arise amongst the students, who had paid their fees, and therefore demanded an adequate number of bodies for dissection. the teacher was thus obliged to give way, and to accede to the demands of the regular gang. the teachers formed themselves into an anatomical club for their own protection; by this means it was hoped to regulate the price to be paid for bodies, by agreement amongst the members of the club not to give more than a certain amount. this agreement does not seem, according to mr. south, to have been very faithfully kept, and so, with new schools springing up and giving rise to still greater competition, the teachers were as much as ever in the hands of the resurrection-men. it must not be supposed that all the bodies which were supplied to the schools were exhumed. many of them were stolen or obtained by false pretences before burial. glennon, the police officer, who has been before mentioned in connection with joshua brookes, told the committee that he had recovered between fifty and a hundred bodies for persons who had had their houses broken open, and bodies stolen from them whilst in the coffin awaiting burial. the following case, tried at the london sessions in , is an example of this: "london adjourned sessions. "tuesday.--body-snatching.--a well-known pilferer of graves, named clarke, was tried upon an indictment, charging him with having stolen the body of a dead child, aged about four years, which had been under the care of a nurse named mary hopkins. the facts which came out in evidence are as follows: the deceased was the daughter of a woman of the town, residing in shire lane, and had been kept at the nurse's lodging, which was in the same neighbourhood. she died on a friday, and clarke, whose ears were described as 'quick to the toll of the passing bell,' paid the nurse a visit the next morning, under pretence of hiring a cellar under the house. he took occasion to notice the poor woman's son; said it was a pity to see the boy idle, and that he should have immediate employment, and called again with evidences of still stronger interest in favour of the family. 'by the way,' said he, 'i understand you have had a death lately.' 'yes, sir,' said the nurse, 'a poor little girl is departed.' 'poor little dear,' cried the snatcher, 'i should like to look at the little innocent.' he was forthwith led into the front parlour, where the body lay in a coffin, and observing that its position was favourable to his intention, he sympathized with the nurse, and said, 'we must all come to this sooner or later,' and then he went to get a half-pint of summut to comfort them. the nurse disposed of a glass, which presently set her in a profound sleep, and when she awoke the body of the babe was gone. it appeared that the snatcher, after having quitted the house, as if for good, returned, and opening the parlour-window hooked out with a stick the corpse of the child, and went off with it towards a market that is open at all hours, near bridgewater square. however, a police officer, who knew his trade, laid hands upon him, telling him he was wanted. the snatcher then threw down the child and took to his heels, but was apprehended and lodged in the compter. the nurse proved the identity of the body. upon her cross-examination, by mr. payne, she stated that the mother had not been to see the deceased for four or five days before the death. the jury returned a verdict of guilty, but some of them audibly spoke of recommending the prisoner to mercy, but made no appendage to that effect. the recorder sentenced the prisoner to be imprisoned for the space of six calendar months." sometimes these stolen bodies were claimed after payment had been made to the resurrection-men, but before any dissection had taken place. the following refers to guy's hospital: "returned to vestry clerk of newington, by order of the treasurer, one male and two females, purchased of page, &c., on the th, who had broken open the dead-house to obtain them." bodies of suicides, and of those who had met with an accidental death, were frequently stolen whilst they were awaiting the coroner's inquest. often in these cases the body-thieves, after selling the subject to a teacher of anatomy, secretly gave information to the police where the missing body might be found. it was then seized by the police, and, after the inquest, handed over to those who claimed to be relatives; these supposed relatives were frequently confederates of the thieves, and by them the body was at once taken off and again sold to another teacher. * * * * * the following case is from a newspaper of : "suicide and the body stolen.--tuesday evening last a young woman of respectable and interesting appearance was observed for some time parading the banks of the surrey canal, camberwell, in a melancholy mood, and at length she plunged into the water; on which a man rushed in after her and dived several times, but failed in recovering the body, which was not found till the following morning, when it was taken to the albany arms, near the canal, for the coroner's inquest, which was to have taken place on thursday. on the landlord proceeding to the shed on wednesday morning, where the body had been deposited, he discovered, that in the course of the night, it had been broken open, and the corpse of the female stolen away. he instantly repaired to the police office, union street, and gave information of the circumstance to the magistrates, who gave orders that immediate inquiry should be made at mr. brookes's, where the body has since been discovered and given up. the poor woman was unclaimed, and the verdict of the coroner's jury was 'found drowned.'" a favourite trick, in the carrying out of which a woman was generally necessary, was that of claiming the bodies of friendless persons who died in workhouses, or similar institutions. immediately it was found out that such an one was dead a man and woman, decently clad in mourning, in great grief, and often in tears, called at the workhouse to take away the body of their dear departed relative. if the trick proved successful, as it often did, the body was taken straight off to one of the schools and sold. the parish authorities, probably, were not over particular about giving up the body, if the deceased were a stranger, as by this means they saved the cost of burial. subjects, too, were obtained from cheap undertakers, who kept the bodies of the poor until the time for burial. the coffin was weighted so as to conceal the fraud, and the mockery of reading the burial service over it was gone through in the presence of the unsuspecting relatives. that some bodies were obtained by murder there can be no doubt. the exposure caused by the trials of burke and hare in edinburgh, and bishop and williams in london, proves this. the facts previously stated, however, go very far to exonerate the anatomists from the false charge (freely made at the time) of their being privy to these murders. it has been frequently stated that signs of murder could be easily seen, and that the fact of the body being fresh, and there being no evidence of its having been interred, ought to have at once suggested foul play, and to have caused the teacher to communicate with the police. but it must be remembered that the murders were generally very artfully contrived by suffocation, so as to leave no outward signs of ill-treatment. it was also no uncommon thing, for the reasons just given, to receive at the schools bodies in quite a fresh state, which had evidently never received sepulture. an account of the _post mortem_ on the italian boy, for whose murder bishop and williams were hanged,[ ] has been preserved by mr. clarke.[ ] the examination of the body was carried out by mr. wetherfield, of southampton street. there were also present mr. mayo, lecturer on anatomy at king's college; mr. partridge, his demonstrator; mr. beaman, parish surgeon; and his assistant, mr. d. edwards, and mr. clarke. the boy's teeth had been removed and sold to a dentist, but beyond this there were no external marks of violence on any part of the body. the internal organs were carefully examined, but no trace of injury or poison could be found. mr. mayo, who had a peculiar way of standing very upright with his hands in his breeches' pockets, said, with a kind of lisp he had, "by jove! the boy died a nathral death." mr. partridge and mr. beaman, however, suggested that the spine had not been examined, and after a consultation it was decided to do this. it was then found that one or more of the upper cervical vertebræ were fractured. "by jove!" said mr. mayo, "this boy was murthered." the conviction of bishop and williams was due, in a very great measure, to mr. partridge and mr. beaman. at the present day it is well-nigh impossible to understand the relations between men of honour and education, such as the teachers of anatomy were, and the ruffians who carried on this ghastly trade. it must, however, be borne in mind that, until the passing of the anatomy act in , there was no provision for supplying the means by which the student might be taught this necessary part of his professional education; the only way in which teachers could get material for giving instruction was by dealing with the resurrection-men. it would have been quite impossible for the resurrection-men to have obtained the number of bodies they frequently did, had they not been able to bribe the custodians of the different burial-grounds. sometimes they met with a difficulty in the shape of a keeper newly appointed to replace one who had been dismissed for being privy to these depredations. in most instances this was soon overcome; if, at the outset, the custodian could not be bribed, he could generally be induced to drink, and then, whilst he was in a state of intoxication, the body which the resurrection-men wished to obtain could be easily removed. after this first step there was generally very little difficulty in the future. sometimes, too, the grave-diggers not only gave information to the resurrectionists, but acted as principals themselves. in benson's _remarkable trials_ is recorded the case of john holmes, peter williams, and esther donaldson. holmes was grave-digger at st. george's, bloomsbury; williams was his assistant, and donaldson was charged as an accomplice. they were prosecuted before sir john hawkins at the guildhall, westminster, in december, , for stealing the body of mrs. jane sainsbury, who died in the previous october, and was buried in the st. george's burial-ground. holmes and williams were sentenced to six months' imprisonment, and to be whipped on their bare backs from the end of kingsgate street, holborn, to dyot street, st. giles. the sentence, says benson, was duly carried out amidst crowds of well-satisfied and approving spectators. the woman donaldson was acquitted. the ranks of the resurrection-men were largely recruited from the keepers of burial-grounds. when these men had lost their situations for connivance at the stealing of bodies, they naturally joined their old associates, and became part of the regular gang. the bribery of the custodians will account for the large number of bodies often obtained in one night. had there been the slightest vigilance on the part of the authorities, it would have been absolutely impossible for the resurrection-men to have spent the time necessary for their work without detection. the amount of time required for the work depended greatly on the soil. one man told bransby cooper that he had taken two bodies from separate graves of considerable depth, and had restored the coffins and the earth to their former positions in an hour and a half. another man said that he had completed the exhumation of a body in a quarter of an hour; but in this instance the grave was extremely shallow, and the earth loose and without stones. if much gravel had to be dug through, the resurrection-men had a peculiar way of using their spades, so that the gravel was thrown out of the grave quite noiselessly. on thursday, february th, , the diary tells us that large bodies and one small one were obtained from st. pancras. no doubt this was simplified by the custom of burying several paupers in one grave. to obtain these it was necessary to dig all the earth out, so that each coffin could be dealt with; the men generally worked very soon after a funeral, and so the earth was much more easily moved than it would have been if they had been obliged to dig through undisturbed ground. when only one body was to be had, a small opening was dug down to the head of the coffin, which was then broken open, and the body was pulled up with a rope, fastened either round the neck or under the armpits. in a memoir of thomas wakley, the founder of _the lancet_,[ ] the following account of the _modus operandi_ of the resurrection-men is given: "in the case of a neat, or not quite new grave, the ingenuity of the resurrectionist came into play. several feet--fifteen or twenty--away from the head or foot of the grave, he would remove a square of turf, about eighteen or twenty inches in diameter. this he would carefully put by, and then commence to mine. most pauper graves were of the same depth, and, if the sepulchre was that of a person of importance, the depth of the grave could be pretty well estimated by the nature of the soil thrown up. taking a five-foot grave, the coffin lid would be about four feet from the surface. a rough slanting tunnel, some five yards long, would, therefore, have to be constructed, so as to impinge exactly on the coffin head. this being at last struck (no very simple task), the coffin was lugged up by hooks to the surface, or, preferably, the end of the coffin was wrenched off with hooks while still in the shelter of the tunnel, and the scalp or feet of the corpse secured through the open end, and the body pulled out, leaving the coffin almost intact and unmoved. "the body once obtained, the narrow shaft was easily filled up and the sod of turf accurately replaced. the friends of the deceased, seeing that the earth _over_ his grave was not disturbed, would flatter themselves that the body had escaped the resurrectionist; but they seldom noticed the neatly-placed square of turf, some feet away." a somewhat similar account is given in the _memorials of john flint south_.[ ] this method is also referred to by bransby cooper,[ ] who states that it was told him by one "who fancied he had found out their secret, but had, no doubt, been deceived by some of them purposely." bransby cooper also says that he asked one of the principal resurrection-men as to the feasibility of this method, and the man showed him several objections to it, and stated that "it would never do." this statement was made after the resurrection-days were over, when there could be no advantage in keeping the true plan secret. it must be remembered that there were some amateur body-snatchers, and that it was not at all unlikely that the regular men would tell to them a plan as full of difficulties as that quoted above. to make the tunnel as described, would be impossible, and it is somewhat difficult to see how grappling-irons were fastened to the coffin; a man could hardly get down a tunnel in. in diameter and feet in length to do this; if he did succeed, his difficulties in returning must have been still greater. to pull a body out of the head or foot of a coffin, as described, is an impossibility. no allowance is made, either, in digging the tunnel for obstacles, in the shape of intervening graves or grave-stones. as regards the evidence on the surface of a grave having been disturbed, it would be greater in one opened in this manner than if the recently-disturbed earth had been again dug out. it would be impossible to get back into the tunnel all the earth dug out in the course of its construction, and this loose earth would at once attract attention. generally, bodies were removed before the graves were finally tidied up, so that it was difficult to notice a fresh disturbance. the writer of the diary was a cemetery-keeper when he first began his resurrection proceedings; his _modus operandi_, in some cases, was to take the body out of the coffin, and place it in a sack, before he began to fill in the grave. then, as he gradually threw the earth in, he kept pulling the sack to the surface, so that when his work of filling in was completed, he had the sack close to the top of the grave. he had then only to wait until night, when he was able, under cover of the darkness, to remove the body without fear of detection. when the resurrection-men had been successful in their night's work, they were glad to find a temporary shelter for the bodies, as near at hand as possible. this was generally an out-house belonging to one of the schools which they regularly supplied; the men were permitted to place the bodies there for the night, and to fetch them away the next day. this explains some of the entries in the diary, such as "took the whole to ----," and the next day, "removed the whole from ----." before removing any of the bodies, the men would find out exactly where they were wanted, and so would save much risk of being arrested with the bodies in their possession. if the following broadside could be believed, the resurrection-men sometimes performed a valuable service to those who had been buried-- "miraculous circumstance: "_being a full and particular account of john macintire, who was buried alive, in edinburgh, on the th day of april, , while in a trance, and who was taken up by the resurrection-men, and sold to the doctors to be dissected, with a full account of the many strange and wonderful things which he saw and felt while he was in that state, the whole being taken from his own words._ "i had been some time ill of a low and lingering fever. my strength gradually wasted, and i could see by the doctor that i had nothing to hope. one day, towards evening, i was seized with strange and indescribable quiverings. i saw around my bed, innumerable strange faces; they were bright and visionary, and without bodies. there was light and solemnity, and i tried to move, but could not; i could recollect, with perfectness, but the power of motion had departed. i heard the sound of weeping at my pillow, and the voice of the nurse say, 'he is dead.' i cannot describe what i felt at these words. i exerted my utmost power to stir myself, but i could not move even an eyelid. my father drew his hand over my face and closed my eyelids. the world was then darkened, but i could still hear, and feel and suffer. for three days a number of friends called to see me. i heard them in low accents speak of what i was, and more than one touched me with his finger. the coffin was then procured, and i was laid in it. i felt the coffin lifted and borne away. i heard and felt it placed in the hearse; it halted, and the coffin was taken out. i felt myself carried on the shoulders of men; i heard the cords of the coffin moved. i felt it swing as dependent by them. it was lowered and rested upon the bottom of the grave. dreadful was the effort i then made to exert the power of action, but my whole frame was immovable. the sound of the rattling mould as it covered me, was far more tremendous than thunder. this also ceased, and all was silent. this is death, thought i, and soon the worms will be crawling about my flesh. in the contemplation of this hideous thought, i heard a low sound in the earth over me, and i fancied that the worms and reptiles were coming. the sound continued to grow louder and nearer. can it be possible, thought i, that my friends suspect that they have buried me too soon? the hope was truly like bursting through the gloom of death. the sound ceased. they dragged me out of the coffin by the head, and carried me swiftly away. when borne to some distance, i was thrown down like a clod, and by the interchange of one or two brief sentences, i discovered that i was in the hands of two of those robbers, who live by plundering the grave, and selling the bodies of parents, and children, and friends. being rudely stripped of my shroud, i was placed naked on a table. in a short time i heard by the bustle in the room that the doctors and students were assembling. when all was ready the demonstrator took his knife, and pierced my bosom. i felt a dreadful crackling, as it were, throughout my whole frame; a convulsive shudder instantly followed, and a shriek of horror rose from all present. the ice of death was broken up; my trance was ended. the utmost exertions were made to restore me, and in the course of an hour i was in full possession of all my faculties. "stephenson, printer, gateshead." * * * * * it was quite necessary for the committee on anatomy to adopt some means to protect the resurrection-men who gave evidence before it; this was done by suppressing their names, and using letters of the alphabet to distinguish the witnesses one from another. popular feeling was so bitter against these men that they were often severely handled by the mob. sometimes the mob made a mistake, and the innocent suffered for the guilty. in a coach containing an empty coffin was being drawn along the streets of edinburgh; the people, suspecting that it was intended to convey a body, taken from some churchyard, seized the coach; it was with great difficulty that the police rescued the driver from the fury of the mob. the coach they could not save; it was taken through the streets, thrown over a mound, and smashed; the people then kindled a fire with the fragments, and danced round it. it turned out that the coffin was intended to convey to his house, in edinburgh, the body of a physician who had died in the country. on another occasion two american gentlemen, who were looking at the abbey of linlithgow after nightfall, were mistaken for resurrection-men, and assaulted by the mob. one of the witnesses, called "a. b.," but who was probably ben crouch himself, stated that twenty-three in four nights was the greatest number he had ever obtained. he added, "when i go to work, i like to get those of poor people buried from the workhouses, because instead of working for one subject, you may get three or four. i do not think, during the time i have been in the habit of working for the schools, i got half a dozen of wealthier people." another witness, who is called "c. d.," but who was, without doubt, the writer of the diary, stated that, "according to my book," in and the number of bodies disposed of in england was adults and small; but the same year were sent to edinburgh, and the gang had in hand, which were never used at all. in - , adults were disposed of in the regular session, and in the summer, in addition to smalls. in the report of the committee in , it was pointed out that, at that time, there were over students attending the schools of anatomy in london, but of these not more than actually worked at dissection. the number of subjects annually available for instruction amounted to between and , or rather less than one for each student. the average price of an adult body was stated to be £ s. d. it may be here explained that a "small" was a body under three feet long; these were sold at so much per inch and were generally classified as "large small," "small," and "foetus." the earnings of the resurrection-men may be gathered from the above entry. to take the year - , the receipts for bodies alone come to guineas; this is exclusive of "smalls," and probably also of the teeth, in which these men did a large trade. teeth, in those days, were very valuable; the amounts received by some of the men for teeth only will be dealt with in the chapter containing biographical notices of some of the principal london resurrection-men. it may be here mentioned that on one occasion murphy obtained the entry to a vault belonging to a meeting-house, on the pretence of selecting a burial-place for his wife. whilst in there he managed to slip back some bolts, so that he could easily gain an entrance at another time; this he did at night, and got possession of teeth by which he made £ . from the statements of the teachers it is most likely that £ s. d. is under the average price paid for bodies. it must be remembered, too, that this amount does not include the retaining-fee paid at the beginning of the session, nor the "finishing-money" which was demanded at its close. the guineas spoken of above would be divided amongst six or seven persons, and this, for men in their position, was a large income. the biographical notes of the chief workers in this horrible trade will show that some few of them did save money. taking them, however, as a whole, they were a dissolute and ruffianly gang; reference to the diary proves their drunken habits, and there is more than one entry to show that they were often in pecuniary difficulties; so much so that on one occasion they were obliged to have recourse to mordecai, the jew. it was quite useless for those who had just buried a relative or friend to depend either upon the custodian of the burial-ground, or upon the watch, to see that the newly-made grave was not violated. the resurrection-men often met with a guard, instituted by the friends of the deceased, who would take it in turns to watch by the grave-side through the whole night; these friends were frequently armed, and were not afraid to use their arms if the resurrection-men gave them an opportunity. as a rule the body-snatchers made off when they found a guard in the cemetery; it was to their interest not to create a riot, and if they were strong enough to drive off the watchers, the latter could soon raise a tumult, whereby the bodily safety of the thieves would be endangered. matters did not always pass off so peaceably, particularly in ireland, as the following extract from an irish newspaper for shows: "desperate engagement with body-snatchers.--the remains of the late edward barrett, esq., having been interred in glasnevin churchyard on the th of last month (january), persons were appointed to remain in the churchyard all night, to protect the corpse from 'the sack 'em-up gentlemen,' and it seems the precaution was not unnecessary, for, on saturday night last, some of the gentry made their appearance, but soon decamped on finding they were likely to be opposed. nothing daunted, however, they returned on tuesday morning with augmented force, and well armed. about ten minutes after two o'clock three or four of them were observed standing on the wall of the churchyard, while several others were endeavouring to get on it also. the party in the churchyard warned them off, and were replied to by a discharge from fire-arms. this brought on a general engagement; the sack 'em-up gentlemen fired from behind the churchyard wall, by which they were defended, while their opponents on the watch fired from behind the tomb-stones. upwards of to shots were fired. one of the assailants was shot--he was seen to fall; his body was carried off by his companions. some of them are supposed to have been severely wounded, as a great quantity of blood was observed outside the churchyard wall, notwithstanding the ground was covered with snow. during the firing, which continued for upwards of a quarter of an hour, the church bell was rung by one of the watchmen, which, with the discharge from the fire-arms, collected several of the townspeople and the police to the spot--several of the former, notwithstanding the severity of the weather, in nearly a state of nakedness; but the assailants were by this time defeated, and effected their retreat. several of the head-stones bear evident marks of the conflict, being struck with the balls, &c." [illustration: mortsafe in greyfriars churchyard, edinburgh.] most of the disgraceful riots which took place in the burial-grounds, were not between resurrection-men and friends guarding a grave, but between two gangs of body-snatchers. in cases of this kind one gang would do all in its power to bring its rival into disrepute; the stronger party, after driving the weaker one away, would put the burial-ground into a most disgraceful state, and then give information against their opponents. besides watching, many other devices were tried to prevent the depredations of the resurrection-men; spring guns were set in many of the cemeteries, but these were often rendered harmless. if the men intended going to a certain grave at night, late in the afternoon a woman, in deep mourning, would walk round the part of the cemetery in which the grave was situated, and contrive to detach the wires from the guns. loose stones were placed on the walls of the grave-yard, so as to make scaling the walls almost an impossibility; this was useless when the custodian had a house with a window looking into the burial-place. if entrance could not be obtained in this way, there was generally some other house through which the men could gain admission to the grave-yard. mort-safes, or strong iron guards, were placed over newly-made graves for protection; some of these can be seen at the present day in the greyfriars churchyard, edinburgh (see illustrations). [illustration: mortsafe in greyfriars churchyard, edinburgh.] iron coffins were also used by some persons to protect their friends from the resurrectionist. the following interesting advertisement appeared in _wooler's british gazette_ for october th, : "many hundred dead bodies will be dragged from their wooden coffins this winter, for the anatomical lectures (which have just commenced), the articulators, and for those who deal in the dead for the supply of the country practitioner and the scotch schools. the question of the right to inter in iron is now decided. lord chief justice abbott declared he wished they might be generally used; justice bailey declared that if the ecclesiastical court was to grant a suit for a fee, they, the court of king's bench, would grant a prohibition, knowing it had no such right. sir william scott, now lord stowell, decided and directed the interment without any extra fee, as this question was raised by an undertaker; those undertakers who have iron coffins must divide the profits of the funeral with edward lillie bridgman. ten guineas reward will be paid on the conviction of any parish officer demanding an extra fee, whereby i shall lose the sale of a coffin. the violation of the sanctity of the grave is said to be needful, for the instruction of the medical pupil, but let each one about to inter a mother, husband, child, or friend, say shall i devote this object of my affection to such a purpose; if not, the only safe coffin is bridgman's patent wrought-iron one, charged the same price as a wooden one, and is a superior substitute for lead. edward lillie bridgman, , fish street hill, and goswell street road, performs funerals in any part of the kingdom, and by attention to moderate charges insures the recommendation of those who employ him. twenty-five private grounds within the bills of mortality receive them; dues from seven shillings to one guinea. patent cast-iron tombs and tablets, superior to stone." the advertisement is headed by a rough cut, showing the coffin[ ] and the iron clamps by which it was fastened. there was another maker of patent coffins, who is mentioned by southey in his ballad called _the surgeon's warning_. the ballad represents the fear of a dying surgeon, lest his apprentices should serve him after death as he, during his life, has served many other persons: "and my 'prentices will surely come and carve me bone from bone, and i, who have rifled the dead man's grave, shall never rest in my own. "bury me in lead when i am dead, my brethren, i entreat, and see the coffin weigh'd i beg, lest the plumber should be a cheat. "and let it be solder'd closely down strong as strong can be, i implore, and put it in a patent coffin that i may rise no more. "if they carry me off in the patent coffin their labour will be in vain, let the undertaker see it bought of the maker, who lives in st. martin's lane." [illustration] all the surgeon's wishes were duly carried out as regards his coffin; money was also given to watchers to keep guard every night over the grave. the "'prentices," however, were able easily to buy the watchers, and so "they burst the patent coffin first, and then cut through the lead, and they laugh'd aloud when they saw the shroud, because they had got at the dead. "and they allow'd the sexton the shroud and they put the coffin back, and nose and knees they then did squeeze, the surgeon in a sack. * * * * "so they carried the sack pick-a-back, and they carved him bone from bone, but what became of the surgeon's soul, was never to mortal known." the following extract from a scotch paper shows the alarm felt for the safety of the newly-buried: "resurrection-men.--curiosity drew together a crowd of people on monday, at dundee, to witness the funeral of a child, which was consigned to the grave in a novel manner. the father, in terror of the resurrection-men, had caused a small box, inclosing some deathful apparatus, communicating by means of wires, with the four corners, to be fastened on the top of the coffin. immediately before it was lowered into the earth, a large quantity of gunpowder was poured into the box, and the hidden machinery put into a state of readiness for execution. the common opinion was, that if any one attempted to raise the body he would be blown up. the sexton seemed to dread an immediate explosion, for he started back in alarm after throwing in the first shovelful of earth." friends and relatives often placed objects on the newly-made grave, such as a flower or an oyster-shell, so that they might be able to tell if the earth had been disturbed. these objects were generally carefully noted by the resurrection-men, and were put back in their exact places after the body had been removed and the grave re-filled. in some burial-grounds, houses were built in which the bodies could be kept until they were putrid, and therefore useless to the resurrection-men. such a house is still standing in the burial-ground at crail.[ ] [illustration: house at crail (described on page ). over the door is the following inscription: "erected for securing the dead. ann. dom. mdcccxxvi."] [illustration: house at crail (described on page ). over the door is the following inscription: "erected for securing the dead. ann. dom. mdcccxxvi."] as a rule, the resurrection-men were able not only to supply the london schools from the grave-yards in and around the metropolis, but also to send bodies to some of the provincial schools; the diary shows that even edinburgh received some of the proceeds of the work of this london gang. if, however, from increased vigilance or other causes, the supply of bodies ran short in london, recourse was had to the provinces. a case occurred some seventy years ago at yarmouth. a man died, and was buried in st. nicholas churchyard. not long after, his wife died also. on the husband's grave being opened, it was discovered that the man's body had been removed; this led to a panic amongst people in yarmouth who had recently buried friends in that churchyard. many graves were opened, and, in a large number of instances, were found to have been violated. this led to a regular watch being established over newly-made graves in the churchyard. it was the custom of the resurrection-men, when they had bodies to send from the country to london, to forward them so that they should, in outward appearance, correspond with the class of goods exported from the place where the bodies had been obtained. if the goods usually came to london in crates, crates were used by the body-snatchers; if ordinary packing-cases, then the bodies were enclosed in like receptacles. the proceeds of the exhumations at yarmouth were probably packed in barrels, and came through billingsgate. in three casks, labelled "bitter salts," were taken down to george's dock at liverpool, to be shipped on board the _latona_, bound for leith; a full description of this transaction was printed as a broadside, of which the following is a copy: "resurrectionists at liverpool. "discovery of human bodies, in casks, about to be shipped from liverpool for edinburgh, on monday last, october , . "yesterday afternoon, a carter took down one of our quays three casks, to be shipped on board the carron company's vessel, the _latona_, addressed to 'mr. g. ironson, edinburgh.' the casks remained on the quay all night, and this morning, previous to their being put on board, a horrible stench was experienced by the mate of the _latona_ and other persons, whose duty it was to ship them. this caused some suspicion that their contents did not agree with their superscription, which was 'bitter salts,' and which the shipping note described they contained. the mate communicated his suspicions to the agent of the carron company, and that gentleman very promptly communicated the circumstances to the police. socket, a constable, was sent to the quay, and he caused the casks to be opened, when eleven dead bodies were found therein, salted and pickled. the casks were detained, and george leech, the cart-man, readily went with the officer to the cellar whence he carted them, which was situated under the school of dr. mcgowan, at the back of his house in hope street; the cellar was padlocked, but, by the aid of a crow-bar, boughey, a police officer, succeeded in forcing an entrance, and, on searching therein, he found casks, all containing human bodies, salted as the others were, and three sacks, each containing a dead body. he also found a syringe, of that description used for injecting hot wax into the veins and arteries of the dead bodies used for anatomization; he also found a variety of smock-frocks, jackets, and trowsers, which, no doubt, were generally used by the resurrectionists to disguise themselves. in this cellar were found twenty-two dead bodies, pickled and fresh, and in the casks on the quay, eleven, making in the whole thirty-three. the carter described the persons who employed him as of very respectable appearance, but he did not know the names of any of them. "information of the above circumstances was speedily communicated to his worship, the mayor, who sent for dr. mcgowan. this gentleman is a reverend divine, and teacher of languages; he attended the mayor immediately, and, in answer to the questions put to him, we understand he said, that he let his cellar in january last to a person named henderson, who, he understood, carried on the oil trade, and that he knew nothing about any dead bodies being there. george leech deposed that he plies for hire as a carter (the cart belongs to his brother); yesterday afternoon, between three and four o'clock, a tall, stout man asked him the charge of carting three casks from hope street to george's dock passage; he replied, s. they then went to hope street, where the witness found two other men getting the first cask out of a cellar under dr. mcgowan's schoolroom, and witness assisted to get two other casks out of the cellar; the three were then put into his cart, and the men who employed him gave him a shipping note, describing the casks as containing 'bitter salts,' and told him to be careful in laying them down upon the quay, and that they were to be forwarded to edinburgh by the _latona_. "mr. thomas wm. dawes, surgeon, of st. paul's square, deposed that he had examined the bodies, by the direction of the coroner. in one cask he had found the bodies of two women and one man; in another, two women and two men; in the third, three men and one woman, and in the other casks and sacks he found (_sic_) bodies, viz., nine men, five boys, and three girls; the bodies were all in a perfect state; those in the casks appeared to have been dead six or seven days, and three men found in the sacks appeared to have been dead only three or four days. in each of the casks was a large quantity of salt. there were no external marks of violence, but there was a thread tied round the toes of one of the women, which is usual for some families to do immediately after death. witness had no reason but to believe that they had died in a natural way, and he had no doubt the bodies had all been disinterred. the season for lectures on anatomy is about to commence in the capital of scotland. "the police were ordered to be upon the alert to discover the persons who had been engaged in this transaction, but as yet nothing further has been ascertained. the bodies, by the direction of the coroner, were buried this morning in the parish cemetery, in casks, as they were found. "it is not yet ascertained whence these bodies have been brought, but it is supposed that the liverpool workhouse cemetery has been the principal sufferer. some of them are so putrid, that it is extremely dangerous to handle them. boag, printer." * * * * * the statements in this broadside are quite true, and agree with the account which is to be found in the _liverpool mercury_ for october th, . henderson, who was a greenock man, and the principal in this business, escaped, and could not be brought to justice; but a man named james donaldson, who was a party to the transaction, was made to pay a fine of £ , and was sent to kirkdale gaol for twelve months. from ireland very many bodies were exported, chiefly to edinburgh; a better price could be obtained there than in dublin, and the consequence was that the irish schools were often very badly supplied with subjects. in dublin there were several ancient burial-grounds, all badly protected; the poor were all buried in one part, and, as their friends were generally unable to afford watchers, their bodies fell an easy prey to the resurrection-men. in january, , the detection of a body about to be exported caused a tumult in the streets of dublin, and led to the murder of a man named luke redmond, a porter at the college of surgeons.[ ] the body-snatchers in dublin seem to have done more damage than the men engaged in a like occupation in london; they were not content with taking the bodies, but, in addition, they broke the tomb-stones, and played general havoc in the grave-yards. according to the following cutting from the _universal spectator and weekly journal_, may th, (printed in _notes and queries_, th ser. i. ), bodies were sometimes taken for other than dissection purposes. "john loftas, the grave digger, committed to prison for robbing of dead corpse, has confess'd to the plunder of above fifty, not only of their coffins and burial cloaths, but of their fat, where bodies afforded any, which he retail'd at a high price to certain people, who, it is believed, will be call'd upon on account thereof. since this discovery several persons have had their friends dug up, who were found quite naked, and some mangled in so horrible a manner as could scarcely be suppos'd to be done by a human creature." southey also refers to this in the poem before quoted, where he makes the surgeon say in his lamentation, "i have made candles of infants' fat." chapter iii. it is well-nigh impossible to read of all these misdoings and not to ask why the government did not step in and put a stop to them? it was urged by many that a short act should be passed, making the violation of a grave a penal offence, as it was in france. there was a general agreement that anatomical education was absolutely necessary for medical men, and that this education was an impossibility without a supply of subjects; yet there was a great reluctance to interfere by legislation. the home secretary told a deputation that there was no difficulty in drawing up an effective bill; the great obstacle was the prejudice of the people against any bill; this impediment, he added, had not been trifling. by no class of men was legislation more earnestly asked for than by the teachers of anatomy; to them the system then in vogue was not only degrading, but it meant absolute ruin. there was at that time no property in a dead body, and a prosecution for felony could not take place unless some portion of the grave-clothes or coffin could be proved to have been stolen with the body. the resurrection-men were well aware of this fact, and generally took precaution to keep themselves out of the meshes of the law. there had been some successful prosecutions like that of holmes and williams before mentioned, but magistrates would not always convict. in this question first came before the court of king's bench in the case of rex _v._ lynn. the indictment charged the prisoner with entering a certain burial-ground, and taking a coffin out of the earth, and removing a body, which he had taken from the coffin, and carrying it away, for the purpose of dissecting it. for the defence the following passage from lord coke was quoted: "it is to be observed that in every sepulchre that hath a monument two things are to be considered, viz., the monument, and the sepulture or burial of the dead: the burial of the cadaver is _nullius in bonis_, and belongs to ecclesiastical cognizance; but as to the monument, action is given at the common law for defacing thereof." the only act of parliament which was said to bear on the subject was that of jac. i., c. , which made it felony to steal bodies for purposes of witchcraft. the court, however, held in this case of rex _v._ lynn that to take a body from a burial-ground was an offence at common law, and _contra bonos mores_. in the judgment it was stated that as the defendant might have committed the crime through ignorance, no person having been before punished for this offence, the court only fined him five marks. the reference here, to no one having been previously punished for a like offence, refers only to the superior courts, as there had been convictions at the police courts and the old bailey. despite this decision of the court, prosecutions were very seldom undertaken, although southwood smith[ ] states that there had been fourteen convictions in england during the year . in examination before the committee on anatomy, in , mr. twyford, one of the magistrates at worship street police court, stated that he had not had more than six cases in as many years. the following account of proceedings at hatton garden police court, in , will show the difficulty of getting a conviction. in this case there seems to have been no one to identify the bodies. it is very improbable that in a case of this sort the authorities of burial-grounds would come forward to give evidence, and so confess their own negligence. "hatton garden. "t. light, w. arnot, and ---- spelling, were brought up on wednesday. it appeared that the prisoners were going up holborn about half-past four o'clock on tuesday afternoon, with a horse and cart; they were observed by two officers, who, knowing the prisoners to be resurrection-men, stopped the horse and cart, and, after a hard contest, succeeded in securing the prisoners. they then examined the contents of the cart, and found it contained seven dead bodies of men and women; one of the bodies was headless, but how it came to be so remains as yet to be cleared up. they were packed up in bags and baskets. the prisoners were followed by an immense crowd to hatton garden office, whence they were committed to prison, and the bodies deposited in the lock-up house. the cart was hired at battle bridge. some of the officers were sent to make enquiry at the different burying-grounds. the office was crowded with men and women, who had some of their relatives buried on sunday last, to see if they could recognize any of the bodies. they were brought up again on thursday, and discharged." in the case of rex _v._ cundick was tried at kingston assizes, _coram_ graham.[ ] this was an indictment for misdemeanour. a man named edward lee was executed in the parish of st. mary, newington; george cundick was employed by the keeper of the gaol to bury the body of lee, and for this he was paid. instead of burying the corpse, he sold it for dissection, or, in the words of the indictment, he "for the sake of wicked lucre and gain did take and carry away the said body, and did sell and dispose of the same for the purpose of being dissected, cut in pieces, mangled, and destroyed, to the great scandal and disgrace of religion, decency, and morality, in contempt of our lord the king, and his laws, to the evil example of all other persons in like cases offending." the evidence showed plainly that cundick had had possession of the body, and that he had received the burial fees. on the friends of lee wishing to see the corpse, cundick declared that it was already buried; but several days after this he clandestinely went through the ceremony of burying a coffin filled with rubbish. it was also proved that cundick had been seen to remove a heavy package from his house at night, and that the body of lee had been identified in a dissecting-room. the defence was, in the first place, that the indictment was bad "as a perfect anomaly in the history of criminal pleading." in the second place, if the indictment were good, it was unsupported by evidence. it was argued by counsel that the only evidence before the court was that the body was not buried, and that it was found at a dissecting-room. without the production of the owner of the dissecting-room, and the proof that he had bought the body from cundick, the jury could not be asked to give a verdict against the defendant. the judge, however, over-ruled these objections, and the jury found the prisoner guilty. these trials and verdicts made it still more difficult than before to get subjects for dissection, as even men of the resurrectionist class hesitated to run the risk of getting the punishment, which now the superior courts had upheld. those who did run this risk very naturally expected a price proportionate to the danger, and so the cost of subjects was still more increased. but to surgeons, and to teachers of anatomy, by far the most important trial of all was that of john davies and others, of warrington, for obtaining the body of jane fairclough, which had been taken from the chapel-yard belonging to the baptists, at high cliff, appleton, cheshire, in october, . this case was tried at lancaster assizes, march th, . the defendants were john davies (a medical student at the warrington dispensary), edward hall (a surgeon and apothecary in practice at warrington), william blundell (an apprentice to a stationer in the same town), and richard box. thomas ashton was also included in the indictment, but no evidence was offered against him. there were fourteen counts in the indictment, ten charging the defendants with conspiracy, and four charging them with unlawfully procuring and receiving the body of jane fairclough. it appears, from the report of the trial, that davies called on dr. moss, one of the physicians to the dispensary, and obtained permission to use a building in his garden for the purpose of dissecting a subject which he had purchased. mr. hall, on behalf of davies, paid four guineas to the men who brought the body to a cellar in warrington, but he knew nothing more of the transaction; from the cellar the body was removed to dr. moss' premises by blundell and another man, and was received by davies and a servant of dr. moss. information of the exhumation seems to have quickly got about. the funeral was on a friday; on the monday following the grave was undisturbed, but on tuesday the soil was spread about, and an examination of the grave showed that the corpse had been removed. the body was identified at dr. moss' house, and was taken away before any dissection had been performed on it. in charging the jury, mr. baron hullock said that, as conspiracy was an offence of serious magnitude, they should be satisfied, before finding a verdict of guilty on the former part of the indictment, that the conduct of the defendants was the result of previous concert.... if any of the defendants were in possession of the body under circumstances which must have apprized them that it was improperly disinterred, the jury would find them guilty of the latter part of the charge. the only bodies legally liable to dissection in this country were those of persons executed for murder. however necessary it might be, for the purposes of humanity and science, that these things should be done, yet, as long as the law remained as it was at present, the disinterment of bodies for dissection was an offence liable to punishment. the jury found all the defendants not guilty of the charge of conspiracy, but they pronounced davies and blundell guilty of possession of the body, with knowledge of the illegal disinterment. the defendants were brought up for judgment in london in may, . mr. justice bayley, in passing sentence, said that "there were degrees of guilt, and in this case the defendants were not the most criminal parties." he sentenced davies to a fine of £ , and blundell to a fine of £ . it will be noted that in this trial there is no charge against anyone for violating the grave, or stealing the body. the fines were inflicted on davies and blundell for having the body in their possession, knowing it to have been disinterred. this decision, therefore, as before stated, was of the utmost importance to teachers of anatomy, as they were clearly liable to punishment for all the subjects supplied to them by the resurrectionists. the teachers knew well the sources from which the bodies were obtained, and were only driven to get them in the way they did through there being no regular supply of subjects from a legitimate source. the feeling that legislation on this subject was absolutely necessary, was more keenly felt than ever, and the teachers did all they could to get a change in the laws. many pamphlets were issued from the press, urging this duty upon parliament; it was pointed out that if a supply of bodies could be regularly obtained in a legal way, the trade of the resurrectionist would at once cease. there were many who doubted this, but subsequent events proved the statement to be strictly accurate. [illustration: _surgical operations, or a new method of obtaining subjects._] it was very strongly urged that the act of geo. ii., which ordered the bodies of all murderers executed in london and middlesex to be anatomized by the surgeons' company, ought to be repealed. no doubt this provision much increased the dislike of the poor to any regulations by which the bodies of their friends might be given up for dissection after death. it was felt that dissection by the surgeons was part of the sentence passed on a murderer, and therefore carried with it shame and disgrace. to make provision by law, therefore, for the dissection of the bodies of any other class of persons was, not unnaturally, distasteful, in that it partly put them in the same position as murderers. the answer to the desire for the repeal of this obnoxious clause was that nothing must be done to weaken the law; it was stated that to withdraw the part of the sentence which related to dissection would rob the punishment of its prohibitive effect. it is somewhat difficult to understand the argument; surely if the risk of suffering the extreme penalty of the law would not keep a man from crime, the extra chance of being dissected after death could hardly be expected to do so. as sir henry halford said, "i certainly think that while that law remains they [the public] will connect the crime of murder with the practice of dissection; an order to be dissected, and a permission to be dissected, seem to be too slight a distinction." another objection to the dissection of murderers came from the teachers. they stated that when the body of a notorious criminal was lying at either of the anatomical schools, the proprietor was pestered by persons of a morbid turn of mind for permission to view the body. this difficulty was also felt by the college of surgeons, and in consequence a placard was hung up outside the place where the dissections were made, giving notice that no person could be admitted, unless accompanied by a member of the court of assistants. to make dissection less distasteful to the general public, and to show the advantages of anatomy, some endeavours were made to explain the structure of the human body to non-professional persons. in ireland sir philip crampton lectured with open doors, and gave demonstrations in anatomy to poor people. these persons, he tells us, became interested in the subject, and often brought him bodies for dissection. a newspaper cutting of shows that this was also tried in london. a surgeon called in the overseers and churchwardens of st. clement danes, and gave a demonstration on a body, explaining its construction, and the use of the internal organs. "by this means," says the paragraph, "he so fully absorbed the self-interest of his audience as to extinguish the pre-conceived notions of horror and disgust attached to the idea of a spectacle of this description. the enlightened governors of the parish assented to the _post mortem_ examination of the body of every unclaimed pauper, an enquiry into whose case might appear conducive to the interests of medical science." it has been already pointed out that, to try to overcome the repugnance to dissection, some persons left specific instructions that their bodies should be used for this purpose. the representations of the teachers were so far successful, that in a select committee was appointed by the house of commons "to enquire into the manner of obtaining subjects for dissection in the schools of anatomy, and into the state of the law affecting the persons employed in obtaining and dissecting bodies." amongst those who gave evidence before the committee were the principal teachers of anatomy, and three of the resurrection-men. the tone of the report was decidedly in sympathy with the teachers, but it strongly condemned the way in which they were compelled to obtain bodies for dissection. after showing how badly off english students were for opportunities of learning anatomy, as compared with those of foreign countries, and pointing out that those students who really wished to master their art were compelled to go abroad, the report proceeds: "these disadvantages affecting the teachers are such, that except in the most frequented schools, attached to the greater hospitals, few have been able to continue teaching with profit, and some private teachers have been compelled to give up their schools. to the evils enumerated it may be added, that it is distressing to men of good education and character to be compelled to resort, for their means of teaching, to a constant infraction of the laws of their country, and to be made dependent, for their professional existence, on the mercenary caprices of the most abandoned class in the community." in march, , mr. warburton obtained leave to introduce into the house of commons "a bill for preventing the unlawful disinterment of human bodies, and for regulating schools of anatomy." in this bill it was enacted that persons found guilty of disinterring any human body from any churchyard, burial-ground or vault, or assisting at any such disinterment, should be imprisoned for a term not exceeding six months for the first offence, and two years for the second offence. seven commissioners were to be appointed; the majority of these were not to be either physicians, surgeons, or apothecaries. all unclaimed bodies of persons dying in workhouses or hospitals, were, seventy-two hours after death, to be given over for purposes of dissection; but if within this specified time a relative appeared and requested that the body might not be used for anatomical purposes, such request was to be granted. another proposed change in the law was that a person might legally bequeath his body for dissection; in such cases the executors, administrators, or next-of-kin had the option of carrying out the wishes of the testator, or declining to do so, as they thought fit. a heavy penalty was laid on persons who were found carrying on human anatomy in an unlicensed building, and it was made an offence to move a body from one place to another, without a licence for so doing. all bodies used for dissection were to be buried; the penalty for failing to do this was fifty pounds. one great blot on this bill was the neglecting to repeal the clause which ordered the bodies of murderers to be given up for dissection. as pointed out on page , this was one of the great reasons which made dissection so hateful to the poor. during the debate, a motion was made by sir r. inglis "to repeal so much of the act geo. iv. cap. , as empowers judges to order the bodies of murderers to be given over for dissection." this, however, was lost, eight members only voting for the amendment, and forty against. there was strong opposition to the bill outside the house. some of the private teachers were very uneasy as regarded the effect of the bill on themselves. the measure spoke of "recognized teachers" and "hospital schools," and all those who were to be entitled to the benefits of the act were to have licences from one of the medical corporations. the proprietors of the smaller schools felt that this would result in their extinction, and that the teaching would all pass to the large schools. in the country, too, there was strong opposition to the bill, as practitioners there felt that they were excluded from any benefit. the _lancet_, always ready in those days with a nickname, dubbed the measure "a bill for preventing country surgeons from studying anatomy." the college of surgeons also petitioned against the bill. the council felt that the appointment of commissioners, who were to have complete control over all schools and places of dissection, would greatly interfere with the privileges of the college. it was pointed out to the house of commons that the establishment of a board, such as that proposed by the bill, was virtually placing the whole profession of surgery under the control of commissioners, not one of whom need be a member of the profession, and the majority of whom must not be so. another fault of the bill was that it did not apply to ireland. a large supply of bodies was regularly sent from that country to england and scotland, and it was felt that to exclude ireland from the provisions of the bill, was simply increasing the temptation for bodies to be still more largely exported therefrom. it was also argued that the bill would tell hardly against the poor, as they would refuse to go into workhouses or hospitals if they thought that their bodies would be dissected after death. for this objection there was no foundation, and mr. peel pointed out, in the debate on the third reading, that "it was the poor who would really be benefited by the measure. the rich could always command good advice, whilst the poor had a strong interest in the general extension of anatomical science." the bill passed the commons, but was lost in the lords. in , lord calthorpe was to have again introduced the bill into the upper house, but the intention was abandoned on account of the threatened dissolution of parliament. as the _lancet_ expressed it, "dissolution has so many horrors, that a discussion on the _subject_ at the present time would be by no means agreeable." public feeling was now very strong in favour of some law to prevent the wholesale spoliation of graves, which was going on practically unchecked. but, as has happened frequently in legislation, the absolute necessity for a change in the law was brought within the range of practical politics by a crime of a most diabolical character, one which, in this country, created a sensation equal to that raised in scotland by the atrocities of burke and hare in edinburgh. on november th, , two men, named bishop and may, called at the dissecting-room at king's college, and asked hill, the porter, if he "wanted anything." on being interrogated as to what they had to dispose of, may replied, "a boy of fourteen." for this body they asked guineas, but ultimately agreed to bring it in for guineas. they went off, and returned in the afternoon with another man named williams, _alias_ head, and a porter named shields, the latter of whom carried the body in a hamper. the appearance of the subject excited hill's suspicion of foul play, and he at once communicated with mr. partridge, the demonstrator of anatomy. a further examination of the body by mr. partridge confirmed the porter's suspicions.[ ] to delay the men, so that the police might be communicated with, mr. partridge produced a £ note, and said that he could not pay until he had changed it. soon after, the police officers appeared upon the scene, and the men were given into custody. at the coroner's inquest a verdict of "wilful murder against some person or persons unknown" was brought in, the jury adding that there was strong suspicion against bishop and williams. the prisoners were not allowed to go free, but were kept in custody. bishop, williams, and may were tried at the old bailey, december, . the evidence given against them showed that they had tried to sell the body at guy's hospital; being refused there, they tried mr. grainger, at his anatomical theatre, but with no success. then they tried king's, where their crime was detected. the body was proved to be that of an italian boy, named carlo ferrari, who obtained his living by showing white mice. the boy's teeth had been extracted, and it was proved that they had been sold by one of the prisoners to mr. mills, a dentist, for twelve shillings. the jury found all three prisoners guilty, and they were sentenced to death. from the subsequent confessions of bishop and williams, it was shown that they had enticed the boy to their dwelling in nova scotia gardens; there they drugged him with opium, and then let his body into a well, where they kept it until he was suffocated. to the last the prisoners declared that the deceased was not the italian boy, but a lad from lincolnshire. they seem to have had great difficulty in disposing of the body, as bishop, in his confession, said that, before taking it to guy's, they had tried mr. tuson and mr. carpue, both in vain. bishop and williams confessed, also, to the murder of a woman named fanny pigburn, and a boy, whose name was supposed to be cunningham. both of these bodies they sold for dissection. may was respited, and was sentenced to transportation for life. on hearing of his respite, may went into a fit, and for some time his life was despaired of; he, however, partially recovered, but his feeble state of health was aggravated by the annoyance he received from the other convicts on board the hulks. he died on board the _grampus_ in . may can hardly be described as even a minor poet, if the following verse, written whilst in prison, may be taken as a fair sample of his compositions: "james may is doomed to die, and is condemned most innocently; the god above, he knows the same, and will send a mitigation for his pain." at the execution of bishop and williams, there was a scene of the most tremendous excitement. by some mistake, three chains hung from the gallows; one was taken away as soon as the error was noticed, and this was recognized by the crowd as a sign that may had been reprieved. the _weekly dispatch_ sold upwards of , copies of the number which contained the confessions of the murderers. many persons were injured in the crowd, and the _dispatch_ states that those who were hurt were attended to "by mr. birkett, the dresser to mr. vincent, who had been in attendance [at st. bartholomew's hospital] to receive any accident that might be brought in." bishop was the son of a carrier between london and highgate, and on the death of his father he succeeded to the business. this he soon sold, and became an informer. he got mixed up with some of the resurrection-men, and then regularly took to the occupation. williams, _alias_ head, was bishop's brother-in-law, and was a well-known member of the resurrection-gang. in the _weekly dispatch_ for december th, , the following curious information respecting williams appeared: "excise court.--yesterday. "the king _v._ thomas head, _alias_ williams, the murderer.--the court was occupied during a great part of the morning in hearing the evidence in the case of head, _alias_ williams (who was hung with bishop) for carrying on an illicit trade in the manufacture of glass. it appeared that the deceased was a _cribb man_, or regular porter, to private glass blowers. there were found on the premises at no. , nova scotia gardens (the scene of the late murders), a regular furnace, and all the necessary apparatus for the manufacture of glass, which trade it appears was carried on to a very considerable extent on the premises. alexander m'knight, an officer of excise, deposed that on the th of august last, he went to no. , nova scotia gardens, and made a seizure of cwt. of manufactured glass, cwt. of cullet, and cwt. of iron, articles used in the manufacture of glass. in about half-an-hour afterwards he saw williams come out of bishop's yard; williams spoke to witness, and called him by an opprobrious name for having made the seizure. judgment 'abated,' the goods to be returned to the excise office to be condemned." may had been brought up as a butcher, but this trade he gave up, and became possessed of a horse and cart with which he was supposed to ply for hire. the real business of the vehicle, however, seems to have been to convey bodies from place to place for the resurrectionists. shields, the porter to the gang, had been watchman and grave-digger at the roman catholic chapel in moorfields, so that he was most useful to the other resurrectionists in giving information, and in granting facilities for the removal of bodies. no evidence was offered against him in connection with the murder of the italian boy. soon after the trial he attempted to get work as a porter in covent garden market, but on his being recognized by those working there, a shout of "burker!" was raised, and shields narrowly escaped with his life, and took refuge in the police office. [illustration: john head, _alias_ thomas williams. john bishop. executed december , . from drawings by w. h. clift, made directly after the execution.] this one incident as regards shields gives an idea of the public feeling towards the resurrection-men, and that feeling was quite as bitter towards the anatomists. it was therefore absolutely necessary that some determined steps should be taken as regards legislation. in december, , mr. warburton again introduced a bill into the house of commons; it passed safely through both houses, and became law on august st, . by this new act the secretary of state for the home department in great britain, and the chief secretary in ireland, were empowered to grant licences for anatomical purposes to any person lawfully qualified to practise medicine, to any professor or teacher of anatomy, and to students attending any school of medicine, on an application signed by two justices of the peace, who could certify that the applicant intended to carry on the practice of anatomy. it was enacted that executors, or other persons having lawful possession of a body (provided they were not undertakers, or persons to whom the body had been handed over for purposes of interment), might give it up for dissection unless the deceased had expressed a wish during his life that his body should not be so used, or unless a known relative objected to the body being given up. if a person had expressed a wish to be dissected, this wish was to be carried out unless the relatives raised any objection. no body might be moved for anatomical purposes until forty-eight hours after death, nor until the expiration of a twenty-four hours' notice to the inspector of anatomy; a proper death certificate had also to be signed by the medical attendant before the body could be moved. provision was made for the decent removal of all bodies, and for their burial in consecrated ground, or in some public burial-ground in use for persons of that religious persuasion to which the person, whose body was so removed, belonged. a certificate of the interment was to be sent to the inspector within six weeks after the day on which the body was received. no licensed person was to be liable to any prosecution, penalty, forfeiture, or punishment for having a body in his possession for anatomical purposes according to the provisions of the act. perhaps the most important clause was that which did away with the dissection of the bodies of murderers. this was done by section xvi., which ran as follows: "and whereas an act was passed in the ninth year of the reign of his late majesty, for consolidating and amending the statutes in england relative to offences against the person, by which latter act it is enacted, that the body of every person convicted of murder shall, after execution, either be dissected or hung in chains, as to the court which tried the offender shall deem meet; and that the sentence to be pronounced by the court shall express that the body of the offender shall be dissected or hung in chains, whichever of the two the court shall order. be it enacted, that so much of the said last-recited act as authorizes the court, if it shall see fit, to direct that the body of a person convicted of murder shall after execution, be dissected, be and the same is hereby repealed: and that in every case of conviction of any prisoner for murder, the court before which such prisoner shall have been tried shall direct such prisoner either to be hung in chains or buried within the precincts of the prison in which such prisoner shall have been confined after conviction, as to such court shall deem meet; and that the sentence to be pronounced by the court shall express that the body of such prisoner shall be hung in chains, or buried within the precincts of the prison, whichever of the two the court shall order." three inspectors were appointed to carry out the provisions of the act. the first inspectors were dr. j. c. somerville, for england; dr. craigie, of edinburgh, for scotland; and sir james murray, of dublin, for ireland. there was no provision for punishing persons found violating graves; it had been already decided that this was an offence at common law; and presumably the framers of the act had, at last, sufficient faith in their measure to believe that it would put an end to the proceedings of the resurrection-men. if that were so, they were not disappointed. after the passing of the act the resurrection-man, as such, drops out of history; his occupation was gone, and one of the most nefarious trades that the world has ever seen came completely to an end. public feeling against these men did not all at once subside; this strongly militated against their getting employment, and some of them moved to other quarters, where they lived under assumed names. in looking back it is impossible not to regret that parliament was so slow to believe that legislation in the direction of the anatomy act would do away with the evils of the resurrection-men. this fact was urged upon them by the teachers; but popular feeling was so dead against the anatomists, who were thought to be responsible for even the worst crimes of the resurrection-men, that parliament seemed to fear to do anything which favoured the teachers, although the great disadvantages under which they suffered were thoroughly well known. perhaps the best tribute to the success of the act, is the very small alterations which have been made in it between and the present day. a glance at the regulations in force in foreign countries for the supply of bodies, at the time of the passing of the anatomy act, shows that when a fair provision was made by law for the supply of bodies, the resurrection-men were unknown. the great advantages of the student on the continent, as compared with his brethren in england, were thus pointed out to the committee by mr. [afterwards sir] william lawrence: "i see many medical persons from france, germany, and italy, and have found, from my intercourse with them, that anatomy is much more successfully cultivated in those countries than in england; at the same time i know, from their numerous valuable publications on anatomy, that they are far before us in this science; we have no original standard works at all worthy of the present state of knowledge." it was also shown that this fact was chiefly the result of the greater opportunities for getting subjects abroad, and that teachers found that those english students who had been to foreign schools were the best informed. * * * * * before the revolution in france the hospitals of paris were supported by voluntary contributions, and each had separate funds and boards of management, similar to the hospitals in london at the present day. at the revolution these boards were consolidated, and one administrative body was formed. this "administration des hôpitaux, hospices et secours à domicile de paris," carried into effect the law passed by the legislative assembly, that the bodies of all those persons who died in hospitals, which were unclaimed within twenty-four hours after death, should be given up for anatomical purposes. the distribution from the hospitals to the medical schools was systematically carried out, generally at night. by art. of the penal code, the punishment for violation of a place of sepulture was imprisonment for a term varying from three months to a year, and a fine of from to francs. the result of these regulations was that exhumation for anatomical purposes was quite unknown. * * * * * in germany the bodies of persons who died in prisons, or penitentiaries, and those of suicides, were given up for dissection, unless the friends of the deceased cared to pay a certain sum to the funds of the school; in this case the body was handed over to the friends. other sources of supply were the bodies of those persons who died without leaving sufficient to pay the cost of burial, poor people who had been supported at the public cost, all persons executed, and public women. although these regulations were not rigorously carried out, there was an ample supply of bodies for anatomical purposes, and the resurrection-men were unknown. * * * * * in austria, if the medical attendant thought necessary, a _post mortem_ was made on all patients who died in hospital, but only unclaimed bodies were used for dissection; these were given up to the teachers forty-eight hours after death. in vienna the supply came from the general hospital; this was sufficient for all purposes, and there was no recourse to exhumation. * * * * * the supply in italy came from a source similar to that of the other countries named. the rule was that all bodies of persons who died in hospital were given up for dissection if required; but, by paying the cost of the funeral, friends could, if they wished, take away the body. this, however, was seldom done. there was generally a sufficient supply of bodies; but, if this ran short, the subjects were obtained from "the deposit" of poor people who died and were buried at the public cost. in every parish church in italy there was a chamber in which all the dead bodies of the poor were deposited during the day-time, after the religious ceremonies had been performed over them in the church; at night these bodies were removed either to the dissecting-room or to the burial-fields, outside the town. body-snatching was quite unknown. * * * * * there was an ample supply of bodies in portugal from similar sources. mortality was very high amongst infants, who were put into _roda_, or foundling cradles; the bodies of these children could be obtained without any difficulty. in portugal the resurrection-man did not exist. * * * * * in holland there was no lack of material for teaching anatomy, and for students to learn operative surgery on the dead body. the dissecting school at leyden was supplied from the civil hospitals at amsterdam. there was no prejudice against dissection in holland; in all the principal towns lectures on anatomy were publicly given, and dissected subjects were exhibited. here, again, exhumation was not necessary, and was unknown. * * * * * in the united states the laws relating to anatomy varied very considerably in the different states; there was no regular supply for the schools, and, consequently, subjects had to be obtained by the aid of resurrection-men. in philadelphia and baltimore, the two great medical schools of the united states in those days, the supply of bodies was obtained almost entirely from the "potter's field," the burial-place of the poorest classes. this exhumation was carried on by an understanding with the authorities that the men employed by the schools in this work should not be interfered with. dissection in the united states was, as in this country, looked upon with great aversion; this was, no doubt, mainly owing to the fact that the bodies used for this purpose were obtained from the graves. chapter iv. the diary of a resurrectionist is written on leaves, but is, unfortunately, imperfect. the first entry is november th, , and the last december th, . there are no entries in may, june, and july; during these months there would be little demand for subjects, as the sessions of the anatomical schools ran from october to may. besides this, the light nights would interfere with the work of the men. the entry under the date february th refers to this: "the moon at the full, could not go." the state of the moon was of great importance to these men in their work; the writer of the diary has on one of the pages copied out the "rules for finding the moon on any given day," and has set out the epact for and . there is no clue in the diary itself as to the name of the writer, and, unfortunately, sir thomas longmore[ ] was quite unable to remember the name of the individual from whom he received it. feeling was very strong against the men who had been engaged in the resurrection business, and therefore, when information was required from them, every effort was made to keep their names secret. as late as , when the _life of sir astley cooper_ was published, the name of this man was carefully concealed, though most of the other members of the gang were freely spoken of under their full names. bransby cooper[ ] quotes a written statement made by this man to the effect that he was in maidstone gaol in october, . enquiry at the gaol has, however, failed to find any mention of him; the original document is not forthcoming, and it is very probable that there is a mistake as regards the date. in this statement he is called josh. n----, and bransby cooper speaks of him as n. there is a letter on "body-snatchers" in the _medical times_, , vol. i. p. , signed, "your old correspondent"; the writer of the letter was, in all probability, mr. t. madden stone, who had been a correspondent of the journal in question from the time of its foundation. mr. stone had a valuable collection of papers and autographs, and his letter is really a reprint of a paper in his possession relating to payments made to the resurrection-men. in it occurs the following passage: "n.b., sir astley cooper great friend to naples." mr. stone presented a large number of papers and letters to the royal college of surgeons, but this particular one is not in the collection. it is curious that bransby cooper makes no special mention of naples in his book, although he gives an account of all the other men with whom sir astley had any dealings. he gives a long notice of "n.," and mentions that he wrote the diary from which quotations are made; this is the document now under consideration. the witness "c. d.," who was examined before the committee on anatomy in , was, in all probability, naples; he gave statistics to show the number of bodies obtained, and stated that the figures were taken "from my book." the letters "c. d." are not given as initials; the three resurrection-men who gave evidence were distinguished as "a. b.," "c. d.," and "f. g." the testimony was probably given on the condition that no names were revealed, and, therefore, definite information cannot be obtained as to "c. d.'s" real name from the house of commons. on one page of the diary is written "miss naples." this does not prove much, as the names of several other females are mentioned; not, however, in any connection with the business. the entries look as though the writer had amused himself by scribbling them down, and then crossing them out again. "miss naples" is the only one not crossed through. it is known that the man described as n---- by bransby cooper was on board the _excellent_ in the action off cape st. vincent. in the muster-book of the _excellent_ for josh. naples is down as an a.b.: he is there stated to have been born at deptford, and to have been years of age in . this seems conclusively to prove that naples was the man who wrote the diary. the men who composed the gang at the time the diary was written are, in that document, nearly always spoken of by their christian names. their names are ben [crouch], bill [harnett], jack [harnett], daniel,[ ] butler, tom [light], and holliss. this gang, whose doings are recorded in the diary, was the chief one in the metropolis in the early part of the present century. the account, therefore, of the proceedings of these men gives a good idea of the work of the body-snatchers in general. honour amongst thieves was not the motto of the resurrection-men; they seem to have been ever ready to sell or cheat their comrades, if a favourable opportunity presented itself. for the accompanying biographical notes of the men mentioned in the diary the writer is indebted chiefly to the account given of them by bransby cooper.[ ] ben crouch, the leader of the gang, was the son of a carpenter, who worked at guy's hospital. he was a tall, powerful, athletic man, with coarse features, marked with the small-pox, and was well known as a prize-fighter. he used to dress in very good clothes, and wore a profusion of gold rings, and had a large bunch of seals dangling at his fob. he was tried for stealing cloth from watling street, but was able to successfully prove an _alibi_. bransby cooper states that crouch was seldom drunk, but when he was in that state he was most abusive and domineering; the diary shows him in more than one of these attacks. he was sharp enough to be always sober on settling-up nights, and so had a distinct advantage over his comrades; by this means he generally managed to get more than his proper share of the proceeds of their horrible work. about he gave up the resurrection business, and occupied himself chiefly in dealing in teeth; in this he was joined by jack harnett. they obtained licences as sutlers, so that they might be allowed as camp-followers, both in france and spain. a large supply of teeth was thus obtained by them, their plan being to draw the sound teeth of as many dead men as possible on the night after a battle. they did not limit their attention to teeth, but made large sums of money by stealing valuables from the persons of those who had fallen in battle--proceedings which were even more brutal than their former resurrectionist practices. with the money he had thus made, crouch built a large hotel at margate, which at first looked like being a paying concern. the nature of his former occupation, however, leaked out, and ruined his business; he then parted with the property at a great sacrifice. subsequently he became very poor, and, whilst harnett was away in france, crouch appropriated some of his property; for this he was sentenced to twelve months' imprisonment. after this he lived in london, in great poverty, and was ultimately found dead in the top room of a public-house near tower hill. it is very probable that at one time he made money by lending to the medical students. in his "confessions of a dissecting-room porter," before alluded to, albert smith says, "i beg you will look at your watches, if you have not already lent them to uncle crouch." * * * * * bill harnett was a favourite with astley cooper and henry cline. with the exception of a fondness for gin, he seems to have been a more respectable man than one would have expected to find in such company. he was very obliging, and could generally be trusted to carry out his promises. bransby cooper states that bill harnett and "n." objected to crouch, and often worked against him; in the diary they will be all found working together, though there is recorded at least one "row" with crouch. bill harnett was a good boxer, and fought ben crouch at wimbledon; he had previously received an injury to his jaw, and crouch hit him a severe blow on this part, which decided the fight in crouch's favour. harnett died in st. thomas' hospital of consumption. like southey's "surgeon," he had a great horror of being dissected, and on his death-bed he obtained a promise from mr. joseph henry green that his body should not be opened. * * * * * jack harnett was a nephew of bill; he is described as a stout, red-haired, ill-looking fellow, uncouth in his address and manner of speech. like his partner, crouch, he seems to have been fond of display in the matter of jewellery. but, unlike crouch, he did not lose the money he had made, and at his death left nearly £ , to his family. * * * * * butler was originally a porter in the dissecting-room at st. thomas'. bransby cooper describes him as "a short, stout, good-tempered man, with a laughing eye and sancho-panza sort of expression." he was a clever articulator, and dealt largely in bones and teeth. afterwards he set up as a dentist in liverpool; but his dissolute habits were his ruin, and he was obliged to fly from his creditors. butler was sentenced to death for robbing the edinburgh mail, but his execution was postponed. during this delay he obtained the skeleton of a horse, and articulated it in the prison. the austrian archdukes john and lewis were at that time in this kingdom, and, on visiting the prison in edinburgh, were shown this skeleton; they were so pleased with the man's handiwork that they obtained his pardon from the prince regent. after his release, butler was never heard of again by any of his old comrades or employers. * * * * * tom light is not mentioned by bransby cooper by name; he gives an account of a resurrection-man whom he calls "l----," but whether this notice refers to light or not cannot be definitely determined. in all probability l---- and light are identical; cooper speaks of the former as being so unreliable that his comrades could never trust him. tom light seems to have had a happy knack of escaping justice; on p. will be found an account of his being acquitted, even when taken with the bodies in his possession. he does not seem to have worked regularly with crouch's gang; at hatton garden police court he appeared as t. light, _alias_ john jones, _alias_ thomas knight, in october, , and it was stated against him that he had lately been convicted at the middlesex sessions of stealing dead bodies for dissection, but he had evaded standing his trial, in consequence of which the bench issued a warrant against him. the particular charge on which he was now brought before the magistrates was that, with patrick harnell,[ ] one of his bail, he had been found in the act of stealing three dead bodies from the parish burial-ground of st. pancras, or st. giles, which were separated only by a wall. the men were apprehended by the horse patrol of the hampstead and highgate district. there was some difficulty in carrying on the case, as, until it was determined from which burial-ground the bodies had been taken, it could not be said which parish was the real prosecutor. light attempted to escape, but was secured. the newspaper adds, "and, from the frequency of such offences, strong indignation was excited in the neighbourhood, from whence a crowd attended at the office." * * * * * holliss was originally a sexton, and, like so many of his class, came into the pay of the resurrectionists; at last his demands became so exorbitant that the resurrection-men refused to pay him, and informed his employers of what had been taking place. he was at once dismissed, and, having no other means of livelihood, he joined the resurrection-men. he saved money, and afterwards purchased a hackney coach, which he himself drove. like most of his companions, holliss came to a bad end. harnett, the younger, had been to france, and had brought away with him a large number of teeth, which he valued at £ ; these he entrusted to his daughter, who left them in a hackney carriage. the driver found the teeth, and, not knowing how to dispose of them, consulted his friend, holliss. holliss offered £ for the teeth, and promised an extra sum if they sold well. harnett had made known his loss to holliss, so that he knew perfectly well to whom the teeth belonged. thinking that he could make more money by selling them privately than by trusting to a reward from harnett, he began to dispose of the teeth to dentists. harnett made enquiries of some of his customers as to whether they had lately been offered teeth for sale, and was shown some lately purchased from holliss; these he was able to identify. holliss was at once given into custody, and was tried at croydon; he escaped transportation through a flaw in the indictment. whilst he was in gaol awaiting his trial, harnett seized holliss' house and all his household furniture for a debt of £ . holliss was afterwards mixed up in a horse-stealing case, and ultimately died in great poverty and wretchedness. * * * * * "n." or joseph naples, the writer of the diary, is described by bransby cooper as "a civil and well conducted man, slight in person, with a pleasing expression of countenance, and of respectful manners." he was the son of a respectable stationer and bookbinder, and in early life went as a sailor into the king's service. he was for some time on board the _excellent_, and served in that vessel in the engagement off cape st. vincent.[ ] then he returned to england, and, having spent all his prize-money, went on a vessel cruising about the channel. from this he ran away and came back to london; here he obtained a situation as grave-digger to the spa fields burial-ground. a man named white enticed naples into the resurrectionist business; this soon caused him to lose his situation. white was stopped by the patrols, and a body was found in his possession. he managed to escape, but it was proved that the body had been taken from spa fields, and naples was sentenced to two years' imprisonment. he escaped, with another prisoner, from the house of correction by making an opening through a skylight in the roof, and afterwards scaling the outer walls of the prison by means of a rope. he was retaken through information given against him by crouch, and it was only by the mediation of sir astley cooper with the secretary of state that naples escaped additional punishment. in the list of prisoners written out by himself, and printed by bransby cooper (_life_, vol. . p. ), naples thus describes himself: "jos{h}. n----[ ] 'resurgam hommo,' for trial." the writing and spelling in the diary show him to have been a man of superior education to most of his class. he continued in the resurrectionist business up to the time of the passing of the anatomy act, when he was taken on as a servant in the dissecting-room of st. thomas' hospital. * * * * * there is considerable difficulty in identifying many of the burial-grounds from which bodies are said in the diary to have been stolen. many of these were private, and the name mentioned is probably either that of the proprietor or of the care-taker. no doubt, too, some of the names are slang terms which are quite forgotten at the present day.[ ] [illustration: facsimile of page of diary.] the diary [the spelling of the diary has been preserved in the reprint, but as there is no attempt at punctuation in the original, stops have here been added to make some of the entries more intelligible. the writer's capital letters, too, have not been strictly followed in the reprint.] november. _thursday th._ at night went out and got , jack & me hospital crib,[ ] benj{n}, danl & bill to harpers,[ ] jack & me big gates,[ ] sold taunton d{o} s{t} thomas's. _friday th._ at night went out and got , jack, ben & me got , bethnall green, bill & dan{l}. bartholo{w}. crib opened;[ ] whole at barth{w}. _saturday th._ at night went and got bunhill row, sold to mr. cline, s{t}. thomas's hospital. remarks, &c., december, . _sunday st._ we all look{d}. out,[ ] at home all night. _monday nd._ met at s{t}. thomas's, got paid for the adults & settled; met and settled with mordecei,[ ] made him up £ s. d. and receipt of all demands. at home all night. _tuesday rd._ went to look out and brought the shovils from barthol{w}., met early in the evening at mr. vickers,[ ] did not go out that night, butler and me came home intoxsicated. _wednesday th._ at night went out and got , whole[ ] went to green[ ] and got , black crib , bunner[ ] fields . _thursday th._ the whole at home all night. _friday th._ removed from barthol. to carpue.[ ] at night went out and got , dan{l}. at home all night. back s{t}. lukes & big gates: went barthol. frampton[ ] s{t}. thomas's, wilson.[ ] _saturday th._ at night went out & got at bunhill row. s{t}. thomas's, brookes.[ ] _sunday th._ at home all night. _monday th._ at night went out and got at bethnall green. _tuesday th._ intoxsicated all day: at night went out & got bunhill row. jack all most buried. _wednesday th._ tom & bill and me removed[ ] from s{t}. barthol{w}., wilson, brookes, bell[ ]; in the evening got harps,[ ] went to s{t}. thomas', at home all night. _thursday th._ i went up to brookes and wilson, afterwards me bill and daniel went to bethnall green, got ; jack, ben went got large & large small back s{t}. luke's,[ ] came home, afterwards met again & went to bunhill row got , of them with ----[ ] named mary rolph, aged , died {th} dec. . _friday th._ at home all day & night. _saturday th._ went to bartholomew took{d}. two brookes: pack{d} and sent them to edinborough, came home to ben{n}., settled £ s. - / d. each man, came home, got up at me jack & bill went to bunhill row and got . ben & daniel staid at home. _sunday th._ at home all day, got up at a.m. the whole party went to harps, got , went to s{t}. thomas's. _monday th._ at home all day & night ill. _tuesday th._ at home all day & do. night. _wednesday th._ at home all day & do. night. remember me when far away [this line is written in the same way as the names mentioned on p. .] _thursday th._ went to bartholomew, at home all night. _friday th_. went to s{t}. thomas's, came home and went to the play, came home: at a.m. got up and went to the hospital crib got large. _saturday st._ went to s{t}. thomas's sent to mr. taunton,[ ] to edinburgh, s{t}. thomas's took of the above this week, came home and stopt at home all night. _sunday nd._ went and look'd out, at o'clock, got up, party went to harps got large and small, the whole went to barth{m}. _monday rd._ went for orders to wilson and brookes, met bill, brought one to carpue, sent him back to bring from barthol{w}. for brookes, for bell, ben{n} and jack got small at harpers. _tuesday th._ at twelve at midnight a party went to wygate got small, came back and got large at newington, came home then settled at ben{n}, each man's share £ s. d., at home all night. _wednesday th._ at home all day and night. _thursday th._ at home all day and night. _friday th._ went to look out, came home met ben and dan{l} at o'clock, went to harps, got large and took it to jack's house, jack, bill and tom not with us, geting drunk. _saturday th._ at o'clock in the morning got up, with the whole party to guy's and s{t}. thomas's crib, got took them to s{t}. thomas's. came home and met at thomas's again, pack{d}. up for edinbro, took one over to guys. _sunday th._ at home all day and night. _monday th._ butler and dan{l}, took large to framton, large small to hornig. _tuesday st._ met at the harty choak,[ ] had dispute about the horse. remarks, &c., january, . _wednesday st._ got up at in the morning, the whole party went to guys and s{t}. thomas', got adults, from guy's and from s{t}. thomas', took them to s{t}. thomas', came home and met again, took one of the above to guy's, settled for the horse £ . at home all night. miss naples.[ ] _thursday nd._ went down to s{t}. thomas's, got paid £ for one adult open d{o} not. came home, met by agreement at s{t}. thomas's, did not go out, bill not there, came home again, at home all night. _friday rd._ went to s{t}. thomas's, took the foetus to the london, rec{d}. s. d. came back to s{t}. thomas's rec{d}. £ s. d., went home, met by agreement, went to the green got , jack, ben{n} and me; dan{l}. and bill at home, took the above to barthol{w}. at home all night. _saturday th._ met at bartholo{w}., they took of the above, sent to edinburgh, went to brookes, carpue and wilson for orders, came back, at home all night. _sunday th._ at home all day. met at , whole went to newin.[ ] got . jack and me took them to wilson, came home, met at , got & small at harps, afterwards went to the big gates, got adults, left dan{l}. at home, took the whole to bartho{m}. _monday th._ went to barth{w}., took to the london, jack & tom to harnige, d{o} to s{t}. thomas's. came home, in all night. _tuesday th._ at home all day, tom removed from the borough to bartholom{w}. fetched £ ., from there took to mr. wilson, d{o} to brookes. _wednesday th._ at a.m. got up, the party went to harps, got adults and small, took to s{t}. thomas's, came home went to mr. wilson & brookes, dan{l}. got paid £ from mr. wilson i rec{d}. from mr. brookes, came over to the borough, sold small for £ , rec{d}. £ for adult, at home all night. _thursday th._ went down to s{t}. thomas's, got paid £ , adults: at home all night. _friday th._ met at s{t}. thomas's, settled each man's share £ , things[ ] on hand. _saturday th._ at a.m. got up & went to the hospital crib, got adults, met at barthol{w}., packed up for the country, sold at s{t}. thomas's: at home all night. _sunday th._ at home all day, at p.m. met & the whole went to wygate, got adults & small, afterwards went to the green, got large & large small,[ ] took them to barthol{w}. _monday th._ took of the above to mr. brookes & large & small to mr. bell, foetus to mr. carpue, small to mr. framton, large small to mr. cline. met at , the party went to newington, adults. took them to s{t}. thomas's. _tuesday th._ at a.m. got up, ben{n}., bill & me went to s{t}. luke's, adults; jack, dan{l}. big gates, large & small, took them to barthol{w}., came home & went to s{t}. thomas's, afterwards went to the other end of the town for orders. at home all night. _wednesday th._ went to s{t}. thomas's, came back, pack'd up large & small for edinburgh. at home all night. _thursday th._ the party met at the hartichoak. settled the above, each man's share £ s. - / d. at home all night. _friday th._ went & look out: came home met at , party except dan{l}., went to the hospital crib & got , was stopt by the patrols, butler, horse & cart were taken. _saturday th._ went to the white horse, butler bailed: at home all night. _sunday th._ went & look'd out, at home all night, could not get the horse out of the stable. _monday th._ at home all day & night, butler & jack got drunk. _tuesday st._ look'd out, jack & butler drunk as before, hindred us of going out. at home. _wednesday nd._ at o'clock in the morning got up, bill & me went to the hospital crib and for mr. cooper's[ ] lectures, had a dispute with the party, at home all night. ben got drunk. _thursday rd._ met at at night, went to wygate, got large and small, went to the green got large. dan{l}, not with us. _friday th._ met at at night. met the patrols. got one hospital crib and at bermondsey, took them to barthol{w}., sent to the country. _saturday th._ met at bartholomew. took to mr. carpue; s{t}. barthol{w}. took : at home all night. _sunday th._ went to big gates to look out, came home, at home all night. _monday th._ at o'clock in the morning got up, met the party except dan{l}., went to the big gates, got took them to barthol{w}., afterwards met, took to mr. cline, to mr. wilson, came home. tom & bill got drunk, did not go out. _tuesday th._ went to barthol{w}., could not sell, came back to the borough & came home, at home all night. _wednesday th._ went to bartho{w}. brought remaining to s{t}. thomas's, at home all night. _thursday th._ went to s{t}. thomas's, at home all night. _friday st._ went to look out, at night went out, got guys & thomas's, same night harps small: same night the cart broke down, took to guys. remarks, &c., feb., . _saturday st._ went to barthol{w}., did not settle, at home all night. _sunday nd._ went to look out, met at in the evening, went to the green, got large & small and foetus. same night went to wygate large & small. took them to bartholomew. _monday rd._ went to bartholomew, at home all night. _tuesday th._ met at bartholomew, settled each man's share £ s. d., met at night, went to guy's got adults. took them to bartholomew: at home all night. _wednesday th._ went to barthol{w}. met at night. got at newington. _thursday th._ went to st. thomas's: at home all night. _friday th._ met together me & butler went to newington, thing bad.[ ] jack & bill went to goswell st.[ ] got . came home met again. danl. bill & me went to st. johns got adults. ben{n} and jack went to flemish[ ] got nothing, took st. thomas's. _saturday th._ went to st. thomas's, at home all night. _sunday th._ went to look out, at home all night. _monday th._ met. went to st. james's. got large & small, took them to barthol{w}. _tuesday th._ went to barthol{w}. moved the things. at home all night. _wednesday th._ went to look out, met at night, went to st. olives. got adults and do bermondsey, took them to st. thomas's. _thursday th._ met at st. thomas's. at home all night. _friday th._ met by appointment, me & jack went to big gate got , the rest went to st. luke's got , took them to barthol{w}. _saturday th._ met at barthol{w}. at home all night. _sunday th._ went to look out, at home all night. _monday th._ met & went to wiegate. got large & small. took them to st. thomas's. _tuesday th._ met at st. thomas's. took over to guy's. came home & settled each man's share £ s. d. on hand open'd large, small & foetus not paid, at home all night. _wednesday th._ at home all day sick. john harnet and butler got drunk, at home all night. _thursday th._ met and went to pancress[ ] got large & small took them to barthol{w}. _friday st._ met at barthol{w}. sold part, came home. met at a.m. went to st. thomas's crib. got large, met the patrols, took to st. thomas's and to barthol{w}. _saturday nd._ met at barthol{w}. sent into the country, distributed the rest about town. at home all night. _sunday rd._ at home all day and night. _monday th._ bill jack tom and ben{n} with nat ure getting drunk oblige to come home in a coach which prevented us going out to harps. _tuesday th._ at home all day, at night met at jack to go to harps. the moon at the full, could not go.[ ] _wednesday th._ went to look out. could not go out jack and tom got drunk. ben{n}. taken very ill. _thursday th._ went to st. thomas's, sold the extremities. at night tom & bill got drunk at the rockingham arms, at home all night. _friday th._ met at jacks got large small and foetus, harps. took them to the london. _saturday th._ met at st. thomas's at home all night. march . _sunday st._ met & went to the big gates got . took them to st. thomas's, not settled. _monday nd._ met at mr. vickers, jack & tom went to the fight, at home all night. _tuesday rd._ went to st. thomas's, at night went to pencress got adults, small and foetus. _wednesday th._ met at jack's & settled, at home all night. _thursday th._ went to st. thomas's; at night early, went out & got st. thomas's crib: at home all night. _friday th._ went to look out big gates green, at night got big gates. _saturday th._ at home all day and night. _sunday th._ met at night, jack, tom & dan{l}. went to harps got large, bill and me went to the big gates, miss{d}.[ ] _monday th._ at home all day and night. _tuesday th._ went to st. thomas's & settled. _wednesday th._ went to the big gates to look out, at night the party went to the above place and again miss{d}., all got drunk. _thursday th._ at home all day & night. _friday th._ went to look out, met at night and went to wiegate got large, also went to the green got large took them bartholomew. _saturday th._ met at barthol. sent to edinburgh, mr. wilson , brookes , barthol. . settled each man's share £ . on hand.[ ] _sunday th._ went to look out, at night went to st. john's, got large and large small, burnt. took the large to wilson, small to st. thomas's. paid hollis £ at the order of miss kay. _monday th._ at home all day went to harps got large and large small, small, and foetus, took large to st. thomas's, large to guy's, large small to mr. frampton and small to mr. taunton. mr. frampton called at in the evening. _tuesday th._ went to the borough: at night met at in the evening, went to the flemish, jack, ben{n}. & myself. got adults, bill not with us, took the above to st. thomas's. big gate for time is very well. _wednesday th._ went to the big gates to look out. came home, at home all night which was a very bad thing for us as we wanted some money to pay our debts to several persons who were importunate. _thursday th._ met at jack and settled each man's share £ : at in the evening went to the meeting crib[ ], large and small, afterwards went to the big gates got large took them to barth{w}. _friday th._ went to st. thomas's, at home all night. _saturday st._ jack and tom got large small, frampton taunton. rec{d}. for the above £ d{o}. £ : at home all night. _sunday nd._ went to the green, at home all night. _monday rd._ at home all night. _tuesday th._ d{o}. _wednesday th._ went to pancress got adult, took them to bartholomew. _thursday th._ went to look out, jack got large small. d{o}. frampton £ d{o}. mr. taunton £ . _friday th._ went to look out, at home all night. _saturday th._ jack got large small for mr. cline £ , at home all night. _sunday th._ went to the green; at home all night. _monday th._ at home all day & night. _tuesday st._ went to pancress got adults ben bill & me. dan'l jack and tom went to harps, missed. _wednesday_ april _ st._ party went to the green got adults; being the st of april the man left us a new hat.[ ] _thursday nd._ went bill & me to the big gates adults and small, jack, ben and dan'l got adults, harps. _friday rd._ went to look out and distribute the above, met at jack's at night, ben being drunk disappoint'd the party. _saturday th._ met and settled £ s. d. each man's share £ s. d., at home all night. _sunday th._ went to look out met at jack's at , not coming home in time did not go out. [_no date put._] tom & me went to olives,[ ] did not succeed. [at this point the diary leaves off abruptly: the entries from friday th to saturday th are in a different handwriting from the rest of the ms.] [ , august] _friday th._ went to look out hollis & myself could not find bill, went to st johns, then to white chappell returned at night, went to white chappel did not succeed, came back went to st. johns, the other party had got the adult, coming back with the ladder, bill got taken unto the watchhouse,[ ] with the ladder, came home. _saturday th._ canines shillings: went to union hall[ ] bill got clear the party went to bartholomew. at night went to w{e}. chappel got adults, one small, took to barthol{m}. & small to st. thomas's. horse & cart. _sunday th._ at home all day & night, wortley came concerning horse & cart. _monday th._ went to st. tho{s}. got paid for adult £ s. d. went to barthol{m}. got paid £ . s. d. row'd with ben did not settle each man had £ s. d, left with hollis £ s. d. for expences, at home all night. _tuesday th._ had information crouch had cut the subjects[ ] went to st. thom{s}, had not cut them, barthol{m}. they had, went to differ{t}. parts of the town for orders, settled our expence & what we had rec{d}. each man's share £ s. - / d. one adult st thom{s}. london d{o} unpaid / d{o} barthol{n}. unpaid; at night went to hoxton, large yellow jaundice sold at brooks. _wednesday th._ went to look out, at night went to barthol{m}. crib. cut off the extremitys took to barthol{m}.--rec{d}. £ s. d. _thursday th._ went to st thomas's crib could not succeed came back to the white horse, bill got arrested,[ ] millard[ ] pd. the debt i got drunk would not go out, bill & hollis went to weigate got adult male, took to the boro, rec{d}. £ s. d. _friday th._ went to barthol swagg{d}. the extra{s}[ ] to st. thos. at night went to weigate got male took them to brooks dan -- --[ ] rec{d}. £ _saturday th._ went to different places, at night went to panc{s}.[ ] miss{d}. rec{d}. £ _sunday th._ went to look out, at night went to harp's got adult male took to wilson small d{o}, took to bartho{w}: a porter carried the large. hollis did not go in. _monday th._ went & got paid for the above, small fetched three guineas, at night went to connell{s}. got adult m.[ ] dan{l}, carried to st tho{s}. hollis did not go in, rec{d}. £ . _tuesday th._ went to different places, at night went to the play. rec{d}. £ . _wednesday th._ went as above at night flemish ad{t}. male, took to st thomas's got paid; likewise head, millard gave £ for it. _thursday th._ as above, at night went to flemish adult male, took to st tho{s}. rec{d} £ . _friday st._ went to different places, settled our quarrell by agreeing with mr. stanley[ ] to bring in a subject for lecture, removed the above from st. thom{s} at night, went to harp's got adult m. underneath took to st. thos{s}. _saturday nd._ went to look out me & hollis, bill staid in the boro, got paid £ for the above a very queer one, received but two guineas for the one at barth{l}. would not do for lecture, sett{d}. each man's share £ s. d., at night the party went to weigate, the thing bad. _sunday rd._ went to look out at different places. holliss met with ben at st. george's agreed to meet at lamberts with the seperate partys: met, look{d} at each other nothing transpired concerning the business, our party went to harp's could not get in the private[ ] door being shut, came home. _monday th._ our party went to barthol{m}. met with ben and daniel partly agreed me & ben went in the cart to different places to look out coming back by charing cross met the jews[ ] drag touted till dark and lost scent came home did not go out that night. _tuesday th._ understood the jew had brought a male to barthol{m}. met by appointment at the above place, had a row, came home after looking out, met by agreement at p.m. (crouch having over slept himself two hours) went to st j{ns} work{d}. three places only got two adults m. and f. on account of not having time, took the above to mr frampton. _wednesday th._ seperated to look out. holliss got paid in part £ from mr. f. i took from the above £ . the party met at night, ben bill & tom light went to st geo{s} got adults m. & f. took willson m. & f. barthol{m} me jack and hollis went to isl{n}. could not succeed the dogs flew at us, afterwards went to pancr{s} found a watch[ ] planted, came home. _thursday th._ went to look out, hollis got paid the remainder at frampton £ . met at night at st. thos.--very light could not go out (came home). _friday th._ seperated to look out, brought the f. from barthol{n}. to st. thomas, having not settled took from hollis £ , afterwards met at st. thos. & went to st. jns, ben not with us work'd two holes one bad, drew the c.{ns}[ ] & took the above to st. thos. _saturday th._ met at st thos. could not get p{d} for either. borrowed £ of jack, at home all night. _sunday th._ went to look out, at night went to h. got two large m{s}. went to st thos. removed to wilson, adult came from st jns. _monday st._ went to look out ---- ---- ----[ ] old small £ got p{d} one do wilson's at night met except bill went to conn{n} got adults m. & f. took to barthol{m}. one small do. september. _tuesday st._ went to barthol{m} got paid for adults £ , at night met, me and light went to connelly got adults m. and one large size small f., jack bill & hollis went to weigate, got large & small, took the above to frampton m. & d{o}. f. large & small to st thos. small to wilson. _wednesday nd._ went to the london hollis got canines £ , bill got paid for large m. £ . i rec{d}. £ for large size small, bill rec{d}. £ for the f. that come from st george small came wiegate went to wilson. rec{d}. £ for large small came from wiegate, went to st thomas' not sold being putrid: at night the party met & divided, me & hollis went to harp's work{d}. the thing, proved to be bad, jack bill & tom{s}. light went to westminster october. _monday th._ went to look out at different places, at night party went to lamb{h} got adults and small took the whole to the borough. mr. cline took the about [above], adults £ from lamb{h}. & small from d{o} £ . _tuesday th._ at night did not go out. _wednesday th._ went to look out jack & ben had a row at the white horse: did not go out. _thursday th._ party went to see the fight did not go out. _friday th._ went to look out at different places. at night went to st. olave, got adults m. & f. m. was opened took them to st. thomas's; again met, i got drunk, i miss{d}. going with the party. they seperated, part went to lambeth got adult f. they missed, one took that to the boro the others (except ben who was getting drunk) went to connolly got adult f., took that to bartholomew, & removed the other same place. _saturday th._ met at barthol{m}. mr. stanley took three of the above f. £ one adult m. being opened £ d, left one on hand, came home, in all night [the above entry finishes a page: the back of this page is occupied by a table for finding the moon's age on any given day: this was most useful to the resurrection-men, as they could not work undisturbed on moonlight nights.] _sunday th._ went to look out at night the whole party went to the black (jack with us for the first time going out) got three ad{t}. m., then to connolly two ad{t}. m. & f. took the whole to st. thos. came home. _monday th._ went to st. thos. cline had taken the above, went to lamb{h}. in the evening met by appointment, at home, drew up an account but did not settle jack & bill not being present and others having over drawn met again at twelve, the whole excepting butler went to lambeth got ad{ts}. small, took of the above & small to wilson do carpue, do brooks, came home. _tuesday th._ went to barthol{m}. me ben jack & butler could not find the others, myself came to the boro sold small that was on hand for £ . came home afterwards went to tomlight[ ] understood he had rec{d}. the money got £ from him, came home, at home all night _wednesday th._ went to lamb{h}. look out, at home all night on account of ben getting out of the way, did not go out, had a dispute at hollis's house child's dance. _thursday th._ went to look out, came home went to the play, afterward met at the white horse, the party excepting ben had a row with hollis; seperated me, light & butler went lam{b}. adts, jack, bill & mr. hollis went to connelly adults, also went to st. geo{e}. adts. on account of the boy deceiving us at lamb{h}. lost the above at st. geo{e}. ben[ ] went to france. _friday th._ met and went wiegate got three adults f. m. took to barthol{m}. jack & tom brought the cart, came home. _saturday th._ met at barthol{w}. rec{d}. £ went to lamb{h}. p{d}. the man £ came home, at home all night. _sunday th._ went to look out, nothing done, at home all night. _monday th._ went to lamb{h}. got adult m. [opened another whole but bad with the small pox][ ] took the above m. to barth{m}. came home, butler not with us. _tuesday th._ went to barthol{w}. bill had got p{d}. for the above male i borrowed of him £ , went to lamb{h}. came home at night met at the white [horse] hollis myself jack & tom light, bill not with us could not find his clothes[ ]: went to lamb{h}. two adults m. took to barthol{w}. butler again not with us came home. _wednesday st._ went to barthol{m} got p{d}. the above adt. gave light & hollis s. d. gave jack £ kept £ myself, came home, but hollis & light went to the hospital crib got adult male took to st thos. shared the money betwixt them: likewise pound for a small, at home all night. _thursday nd._ went to look out, followed a black[ ] from tower hill, came home and met at w{e}. horse, the party except butler went to lamb{h}. got adults m. f. (left one behind us) small & foetus, took them to the boro. november . _monday th._ the party went to tottenham got adults, wilson . abernethy . on hand _tuesday th._ at home. _wednesday th._ at home. _thursday th._ met with hutton at smithfield, bill me & ben went to st t{s} got ad. jack remained with hutton, the party went barthol{m}. c{b}. got ad. the whole abernethy. gave one to hutton for information. _friday th._ butler got drunk in the morning, the party except him met at barthol{m}. me jack & ben went to st t{s}. got adt. sent bill again after tom to bring the cart, took them to barthol{m}. me jack & ben went to blue lion got adt. sent bill to bring tom with the cart, took that to barthol{m}. came over the water got adt. guys c{b}. & at tho{s}. crib. pack up for edinbro on the saturday: settled our money at home all night. _sunday nd._ look{d}. out at st t{s}. b.--l{n}[ ]--and tott{n} at home all night. _monday rd._ met at barth{m}. went to st t{s}. got took them to wilson, bill took ad. to frampton. _tuesday th._ went & mov{d}. one of the above to carpue, got p{d}. came home met at jack at , bill not at home, did not go out till morning. jack sold the canines to mr. thomson for guineas. _wednesday th._ met at jack at p.m. butler & myself went to the b. l{n}. got adt. jack, ben & bill went panc{s}. got adt. & small, took them to barthol{w}. removed to cline, got sets of can{s}.[ ] _thursday th._ met at barthol{m}, me & jack went to tottenh{m}. got adt. ben & bill went to st ths. d{o} large came home me & jack got tottenh{m} bill & ben large small. _friday th._ met at plough, went to st t{s}. adt. small. met the man with the lanthorn[ ]: took them barthol{m}. went to golden lane adt. small gave jack hutton £ as a share, took to the above place. _saturday th._ met at barthol. disposed of the above except adt. opened, small, sent three to edinboro. drew up our account, came home met at jack, did not settle, at home all night. _sunday th._ went look out at blue l{n}. &c did not go out jack bill & tom drunk the reason as ben said for not going out. _monday th._ settled our account up to sat{y}. on hand adt. op{d}. & small three; met at barthol{n}. me bill & jack hutton went to b. lyon got adt. got up at four in the morning tuesday, butler bill & me brought the above to st thos'. december, . _tuesday st._ met at tottenham court road had a dispute in st. ts crib. came home did not do anything. came to the rockingham arms, got drunk _wednesday nd._ met at vickers rectify{d}. our last account, the party sent out me & ben to st thos. c{b}. got adt., bill & jack guys crib adt but one of them opd. butler look out for us, took them to st. thos. came home met at st thos., me & jack went to tott{m}. got adts ben & bill got ad/ s/ f/ . at pancrass took totten{m} to wilson, pan{s}. to barthol.[ ] _thursday rd._ met at wind{ll}. st. disposed of of the above to wilson, went to barthol{w}. came home for the night. _friday th._ met at vickers pack{d}. up one for shute, afterwards went to st thos. got adt. took them to barth{m}. left ben & jack hutton to pack up for edinbro, afterwards jack me & bill went to tott{m}. got adt. took them to barthol{m}. _saturday th._ remain'd at barth{m}. packing up for edinboro, sent to the wharf for the above place, at home all night. _the following list contains some of the chief sources of information on the history of the resurrectionists._ smith, southwood. "use of the dead to the living." _westminster review_, ii., , p. . this was afterwards reprinted as a pamphlet. one of the editions was issued with the title of _body-snatching_. mackenzie, w. _an appeal to the public and to the legislature, on the necessity of affording dead bodies to the schools of anatomy by legislative enactment_. vo. glasgow, . green, joseph henry. _a letter to sir astley cooper, on certain proceedings connected with the establishment of an anatomical surgical school at guy's hospital_. vo. london, . "on the pleasures of body-snatching." _monthly mag._, iii., , p. . _report from the select committee [house of commons] on anatomy_. fol., london, . this is, perhaps, the best source of information respecting the resurrectionists. many important documents are printed in this volume, in addition to the evidence and the report. "importance of dissection in anatomy." _westminster review_, x., , p. . _an address to the members of both houses of parliament, on the legislative measures necessary for providing an adequate supply of human bodies for the purpose of anatomical instruction. [by a friend of science and of man.]_ vo. bath. n.d. the debates in the houses of parliament on the anatomy bills will be found in _hansard_. there is also much information in the pages of the _lancet_ for the period during which the bills were before parliament. mr. wakley, the editor, took a great interest in the question, and wrote many vigorous articles, pointing out defects in the bills whilst they were under discussion. "supply of subjects for anatomy." _london mag._, xxiii., , p. . article in _blackwood_ for march, , by "christopher north," on "robert knox." _the trial of bishop, williams, and may, at the old bailey, december nd, , for the murder of the italian boy_. vo. london, . there were many reports of this trial published, both as broadsides and as pamphlets. "regulation of anatomy." _westminster review_, xvi., , p. . "obstructions to science of anatomy." _monthly review_, cxxvii., , p. . hanson, n. _a letter addressed to the government and the royal college of surgeons, founded on the diabolical and horrible practice of burking; setting forth the necessity of placing anatomical schools on a different footing_. vo. london, . guthrie, g. j. _remarks on the anatomy bill now before parliament, in a letter addressed to the right hon. the lord althorp_. vo. london, . _an act for regulating schools of anatomy_ ( and guil. iv. cap. ). fol. london, . dermott, g. d. _a lecture introductory to a course of lectures on anatomy, physiology, and surgery, delivered at the school of medicine and surgery, gerrard street, soho_. vo. london, . cooper, bransby b. _the life of sir astley cooper_. vols. vo. london, . "the resurrectionists." _chambers' journal_, xxxix., , p. . "body-snatching and burking." _once a week_, x., , p. . "burke and hare." _all the year round_, xvii., , p. . lonsdale, h. _a sketch of the life and writings of robert knox, the anatomist_. vo. london, . "body-snatchers." _every saturday_, ix., , p. . feltoe, c. l. _memorials of john flint south_. mo. london, . macgregor, george. _the history of burke and hare, and of the resurrectionist times_. vo. glasgow, . there is a large mass of literature relating to burke and hare and their trial and execution: this is well summed up in mr. macgregor's book. cameron, sir c. a. _history of the royal college of surgeons in ireland, and of the irish schools of medicine_. vo. dublin, . index abernethy (john), body sold to, . advertisements of lectures on anatomy, - . america, supply of bodies in, . anatomical schools, establishment of, . history of, by d'arcy power, referred to, . anatomists, charges against, of receiving murdered bodies, . fined for teaching, . form an anatomical club, . anatomy, committee on, appointment of, . evidence before, . report of, . referred to, vii. inspectors of, appointed, . knowledge of, necessary for surgeons, . lectures on, advertisements of, - . teaching of, confined to company of barbers and surgeons, . anatomy act, passing and provisions of, - . anatomy bill, , introduction of, . opposition to, . arnold (will.), execution of, . arnot (w.) at hatton garden, for body-snatching, . arsenic, poisoning by, ix. "artichoke" public-house, mentioned. see diary, _passim_. austria, supply of bodies in, . austrian archdukes obtain butler's release, . barber-surgeons. see company of barbers and surgeons. beaman, _post mortem_ of the italian boy, . bell, sir charles, body sold to, . bellingham, drawing of head of, referred to, . bentham, jeremy, left his body for dissection, . oration by mr. grainger over his body, . bermondsey, bodies obtained from. see diary, _passim_. bethnal green, bodies obtained from. see diary, _passim_. bibliography of subject, . big gates, bodies obtained from. see diary, _passim_. bishop and williams, arrest and trial of, . disposal of bodies of, . drawings of heads of, . execution of, . "black," a, . black crib, . "blue lion" public-house. see diary, _passim_. blundell (william), trial of, at warrington, . bodies, difficulties of obtaining, . dissection of, in public, . fatal effect of, . for dissection supplied by students, . left for anatomical purposes, - . offered for dissection after death, . possession of stolen, decided to be felony, . prices of, . raised by competition of different schools, . scarcity of, . stolen by resurrectionists from houses, . from dead-house at guy's hospital, . whilst awaiting coroner's inquest, . supply of, in foreign countries, . from provinces, . from workhouses, . suggestions in newspapers, . see also _country_; _edinburgh_. temporary shelter for, . of malefactors given to company of barbers and surgeons, . difficulty of obtaining from tyburn, . of murderers to be given up to surgeons' company, . dissected at college of surgeons, . account of proceedings at dissection, by t. m. stone, . conveyed through streets, . dissection of, an obstacle to passing the anatomy act, . boys (mr.) wishes his body to be made into "essential salts," . bridgman's patent coffin, . illustration of, . brookes (joshua), advertisement of lectures, . badly treated by resurrection-men, . bodies sold to. see diary, _passim_. bunhill row, bodies obtained from. see diary, _passim_. burial-grounds, custodians of, bribed by resurrectionists, . precautions for watching, . protection of, . burke and hare, referred to, v., viii. burking, by means of snuff, ix. meaning of, viii. panic from fear of, vii. butler, biographical notice of, . see also diary, _passim_. cameron (sir c.) history of royal college of surgeons in ireland, referred to, . carpue (j. c.), caricature of, . mentioned in diary, . refuses to buy body of italian boy, . chandler (george), provides building for dissecting murderers, . chapman (israel), jew resurrectionist, . cheselden (william) summoned before court of barber-surgeons for teaching anatomy, . chiene (prof.), referred to, xii. clarke (--), imprisoned for stealing body of child, . clarke (j. f.), on post mortem of the italian boy, . clift (w. and w. h.). drawings of heads of murderers, . cline (h.), mentioned in diary, . coffins, bridgman's patent, . illustrations of, . mentioned by southey, . coke (lord), on property in a dead body, . committee on anatomy. see _anatomy_. company of barbers and surgeons to have bodies of malefactors, . advertisement of dissection, . anatomical teaching by, . connolly, mentioned in diary. see diary, _passim_. cooper (sir astley), evidence before anatomy committee, . payments to resurrectionists, , . purchase of bodies, , . life of. see _cooper (b. b.)_. cooper (bransby b.), life of sir astley cooper, referred to, vi., vii., . notices of resurrectionists, . corporation of surgeons, required knowledge of anatomy in students, . to have bodies of murderers, . end of, . country, bodies sent to, , , . craigie (dr.), inspector of anatomy, . crail, house for securing the dead, . crouch (ben), biographical notice of, . see also diary, _passim_. crowe (mrs.). _light and darkness_, resurrection-man in, . cundick (george). see rex _v._ cundick. deane (john), fined for teaching anatomy, . dermott (g. d.), proposal by, for raising fund to purchase bodies, . _diary of a resurrectionist_, description and authorship of, . _fac-simile_ of page of, . history of, v. reprinted, . dickens (charles). mr. cruncher in _tale of two cities_, . dissection. see _bodies_. dublin, burial-grounds of, . dundee, protection of grave at, . dunn (francis), execution of, . edinburgh, bodies sent to, , , , , , . greyfriars churchyard, mortsafes in, . illustrations of, , , . edwards (d.). _post mortem_ of the italian boy, . fairclough (jane), prosecution of davies and others for stealing her body, . fat, graves rifled for, . ferrari (carlo), murder of, . _post mortem_ of, . ferrers (earl), execution of, . fiction, body-snatchers in, . finishing money, . flemish, the, bodies obtained from. see diary, _passim_. forster (mr.), _post mortem_ on messenger monsey, . frampton (dr.), bodies sold to. see diary, _passim_. france, supply of bodies in, . germany, supply of bodies in, . glasnevin churchyard, riot in, . glennon, the police officer, presented with silver staff, . recovered stolen bodies, . goswell street, bodies obtained from, . grainger (r. d.), payments to resurrection-men, . oration over body of jeremy bentham, . refuses to buy body of italian boy, . graves, protection of, , , . see also _burial-grounds_. green churchyard, . guthrie, referred to, . guy's hospital, bodies stolen from dead-house, . mentioned in diary. see diary, _passim_. hall (edward), trial of, at warrington, . harnell (p.), a resurrectionist, . harnett (bill), biographical notice of, . see also diary, _passim_. harnett (jack), biographical notice of, . see also diary, _passim_. harnige. see hornig. harpers. see diary, _passim_. hawkins (cæsar), advertisement of lectures, . head. see _bishop and williams_. henderson, of greenock, punished for shipping bodies from liverpool, . hill, porter at king's college, . holland, supply of bodies in, . holliss, biographical notice of, . holmes (mrs. basil). _burial-grounds of london_, quoted, , . holmes (john) and peter williams, convicted of robbery from grave, . hornig, or harnige, mentioned in diary, , . hullock (baron), summing up in trial of davies and others, . hutton (jack) mentioned. see diary, _passim_. inspectors of anatomy, appointment, . ireland, supply of bodies from, . iron coffin, . illustration of, . italian boy, the. see _ferrari (carlo)_. italy, supply of bodies in, . lambert, mentioned in diary, . _lancet_, the, and the anatomy bill, . large small, meaning of, . law relating to body-snatching, . lawrence (sir w.), on anatomical teaching abroad, . lee (edward), execution, &c., of, . light (tom), biographical notice of, . at hatton garden, for body-snatching, . see also diary, _passim_. lincoln's inn fields, bodies of murderers conveyed to, . liverpool, bodies shipped as "bitter salts," . london hospital, mentioned in diary. see diary, _passim_. longmore (sir thomas), obtained diary, and presented it to royal college of surgeons, vi., . lynn. see rex _v._ lynn. lytton (lord). _lucretia_, resurrection-man in, . macaulay, alderman, extract from diary of, . macintire (john) buried alive, and rescued by resurrection-men, . may (james), arrest and trial of, . respite and death of, . verse by, . biographical notice of, . mayo (h.), _post mortem_ of the italian boy, . millard (w.), account of, , . mills (mr.), buys teeth of italian boy, . moir (d. m.). _mansie wauch_, refers to body-snatching, . monsey (messenger), _post mortem_ on, . moon, full, interfered with resurrectionists, . mordecai, the jew, , . mortsafes in greyfriars churchyard, edinburgh, . illustrations of, , , . moss (dr.) of warrington, . "muddle (jasper), confessions of" (by albert smith), . murderers, dissection of, agitation against, . repealed, . drawings of heads of, . murphy, stealing teeth, . murray (sir james), inspector of anatomy, . naples (joseph), biographical notice of, . method of working, . writer of diary, . newington, bodies obtained from. see diary, _passim_. nicholls (fr.), advertisement of lectures, . nourse (edward), advertisement of lectures, . paris, supply of bodies in, . partridge (richard), arrest of bishop and williams, . body of bishop given to, . _post mortem_ of the italian boy, . patrick, a resurrectionist, . patterson (g. s.) referred to, . pigburn (fanny), murder of, by bishop and williams, . "plough" public-house, . portugal, supply of bodies in, . pott (percivall), lectures on surgery, . power (d'arcy), history of anatomical schools, referred to, . see _south (j. f.)_. prosecutions for body-snatching, . provincial schools, supply of, . redmond, luke, murder of, . resurrectionists, biographical notices of, . cost of keeping families of, whilst the men were in gaol, . damage done to subjects purchased from rivals, , . demand finishing money, . earnings of, , . end of, . first appearance of, . in fiction, . _modus operandi_ of, . as described in _memoir_ of thomas wakley, . improbability of this method, . _modus operandi_ of naples, . number of bodies obtained by, , . origin of, . popular feeling against, , . sources of information respecting, vii. see also _diary, prosecutions_. rex _v._ cundick, . rex _v._ lynn, . "rockingham arms" public-house. see diary, _passim_. rolph (mary), body of, exhumed, . ross, elizabeth, the "burker," viii. rowlandson's "dissecting-room." _frontispiece_. royal college of surgeons, examinations of, . foundation of, . obliged to dissect bodies of murderers, , . opposition to bill of, on account of distance of new building from newgate, . proceedings for obtaining premises near newgate, . st. bartholomew's hospital, mentioned. see diary, _passim_. st. george's, bloomsbury, robbery from graveyard of, . see also diary, _passim_. st. james', bodies obtained from. see diary, _passim_. st. john's, bodies obtained from. see diary, _passim_. st. luke's burial-ground, bodies obtained from. see diary, _passim_. st. olave and st. john, southwark, burial-ground, . st. pancras, bodies obtained from. see diary, _passim_. st. thomas', charterhouse, . st. thomas' hospital, mentioned. see diary, _passim_. sergeant, miss, _dr. endicott's experiment_, refers to body-snatching, . sheriffs of london, letter from, as to bodies of bishop and williams, . shields, porter to bishop and williams, . smalls, meaning of, . smith (albert), "confessions of jasper muddle, dissecting-room porter," , . society of apothecaries, did not require attendance at dissection, . somerville (james c.), effects on students of want of subjects, . inspector of anatomy, . south (j. f.) and d'arcy power, memorials of the craft of surgery, quoted, . southey (r.), _the surgeon's warning_, , . spelling (--), at hatton garden for body-snatching, . stanley (e.), bodies sold to. see diary, _passim_. stone (t. madden), account of dissection at college of surgeons, . letter on body-snatchers, . students, knowledge of anatomy necessary for. see _anatomy_. subjects for dissection. see _bodies_. taunton (mr.), bodies sold to. see diary, _passim_. teeth, trade in, by resurrectionists, , . tottenham, bodies obtained from. see diary, _passim_. trance, man buried during, and rescued by resurrection-men, . trials for body-snatching. see _prosecutions_. tuson, refuses to buy body of italian boy, . twyford (mr.), statement as to number of prosecutions at worship st., . tyburn, bodies taken from, . ure (nat.), mentioned, . veitch (a. d.), on wilson's supposed burking, viii. vickers (mr.), mentioned in diary, _passim_. walsh, catherine, murder of, viii. warburton's act. see _anatomy bill_ and _anatomy act_. warren (samuel), _diary of a late physician_, quoted, . warrington, prosecution of john davies and others at, . wetherfield (mr.), _post mortem_ of the italian boy, . "white horse" public-house. see diary, _passim_. whitechapel, bodies obtained from. see diary, _passim_. williams, and illicit trade in glass, . see also _bishop and williams_. williams (peter). see holmes (john). wilson (james), bodies sold to. see diary, _passim_. wilson (john), "burking by means of snuff," ix. wood (mr.), death of, from seeing a body dissected, . workhouses, number of deaths in, . wortley, mentioned in diary, . wygate or wiegate, bodies obtained from. see diary, _passim_. yarmouth, body-snatching at, . young (sidney), _annals of the barber-surgeons_, quoted, , . _plymouth: w. brendon and son, printers._ footnotes: [ ] see _sketch of the life of robert knox_, by henry lonsdale (london, ); and _the history of burke and hare and of the resurrectionist times_, by george macgregor (glasgow, ). [ ] it may be interesting to mention that albert smith's remuneration for these papers was five shillings per page of three columns. [ ] _annals of the barber surgeons_, by sidney young, p. . [ ] south and d'arcy power, _memorials of the craft of surgery_, p. , _note_. [ ] young, _loc. cit._ p. . [ ] _academy_, vol. vi. p. , . [ ] for the portraits of bishop and williams see p. . [ ] _hospital gazette_, from sep. , , to march , . [ ] this committee was appointed by the house of commons in , to take evidence and report on the necessity of obtaining bodies for anatomical purposes. the work of the committee is referred to at greater length on p. . [ ] the letter has no signature. [ ] see also p. . [ ] _autobiographical recollections of the medical profession_, p. . [ ] _lancet_, , vol. i. p. . [ ] _memorials of john flint south_, by c. t. feltoe, , p. . [ ] _life of sir astley cooper_, vol. i. p. . [ ] see illustration. [ ] see two following illustrations. [ ] cameron, _history of roy. coll. surgeons in ireland_, p. . [ ] _use of the dead to the living._ [ ] _d. and r. nisi prius repts._ i. . [ ] see also page . [ ] see page vi. [ ] _life of sir astley cooper_, vol. i. p. . [ ] cannot find out his surname. [ ] _loc. cit._ vol. i. _passim_. [ ] b. cooper gives an account of a resurrectionist under the name of "patrick"; this is probably the man referred to. the name is harnell in the _sun_ for october th, ; it may, perhaps, be a misprint for harnett; two men of this name have already been spoken of. [ ] see also p. . [ ] the name is suppressed in the printed copy. [ ] since the above was written, mrs. basil holmes' interesting volume on _the burial grounds of london_ has been published. reference to this book confirms the statement above made. mrs. holmes' account is very carefully done, and the list of the old burial-grounds is probably as complete as it can be, but no light is thrown upon any of the difficult names used in the diary. [ ] slang for a burial-ground. [ ] harper is probably the name of the keeper of a burial-ground. [ ] this occurs often in the diary, and was evidently a favourite place for meeting. it was, doubtless, the entrance to some burial-ground, but there is no evidence by which the place can be definitely determined. [ ] _i.e._ a body which had had a post mortem performed on it was obtained from the burial-ground attached to st. bartholomew's hospital. [ ] watched to see what funerals were taking place during the day. [ ] probably michael mordecai, who kept an old curiosity-shop in new alley, and was a noted receiver. [ ] probably the landlord of a public-house. [ ] _i.e._ all the gang. [ ] the "green churchyard" was an addition to the churchyard of st. giles, cripplegate. "green churchyard" is a name which we find repeated in other parishes; for instance, it was given to the higher portion of st. james', piccadilly, and to the little piece by st. bartholomew the great, approached through the present south transept. holmes, _loc. cit._ it is impossible to say which of these is here meant. [ ] bunhill. [ ] j. c. carpue, the founder of the dean street anatomical school. [ ] dr. frampton, of the london hospital. [ ] james wilson, of the great windmill street school. [ ] joshua brookes, founder of the blenheim street, or great marlborough street, anatomical school: for references to brookes, see index. [ ] see page . [ ] sir charles bell, of great windmill street school. [ ] abbreviation for harpers. see p. . [ ] either st. luke's church or st. luke's hospital in old street. [ ] words so crossed out that they cannot be deciphered; in all probability it originally read "with their ---- throat cut." [ ] john taunton, founder of the city of london truss society, a demonstrator at guy's hospital under cline, and at this time principal lecturer to the london anatomical society. [ ] artichoke public-house. [ ] see page . [ ] newington. [ ] slang term for bodies. [ ] see page . [ ] afterwards sir astley cooper. [ ] body putrid, and therefore of no use for anatomical purposes. [ ] probably church of st. thomas, charterhouse. [ ] the burial-ground for the parishes of st. olave and st. john, southwark; it was taken by the "greenwich railway company": part of the approach to the "flemish" now forms the approach to london bridge station. [ ] this is, of course, not the st. pancras church in the euston road, but the old parish church situated on the north side of the road leading from king's cross to kentish town. [ ] see page . [ ] failed to get a body. [ ] bodies unsold. [ ] probably a burial-ground attached to a meeting-house. [ ] the diary is torn at the margin in this place: the word "left" is probably correct, but who "the man" was cannot be determined. [ ] st. olave's. [ ] probably from information given to the police by the other party who "had got the adult." [ ] the police court in union street, southwark; it was removed in . [ ] _i.e._ had spoiled them for anatomical purposes; very likely to be done out of spite, as on the previous day they had "row'd with ben," _i.e._ crouch; see page . [ ] evidently for debt. [ ] millard was superintendent of the dissecting-room at st. thomas'; he was an avaricious man, and lost this situation through dealing in bodies. his plan was to take them in at the hospital from the resurrection-men, and then to sell them at an advanced price in edinburgh unknown to the men who supplied him, and to the teachers at the hospital. millard was popular with the pupils, and, after his dismissal, they persuaded him to take an eating-house in the neighbourhood of st. thomas'. as there was money to be made in the "resurrection" traffic, he did not abandon his connection with the body-snatchers. this came to be known, and created a strong prejudice against him; so much so that his legitimate business fell off to such an extent as to make it necessary for him to relinquish it altogether. then he took entirely to the resurrection business, and was sentenced to three months' imprisonment for taking a body from the burial-ground attached to the london hospital. he appealed against the sentence, and found bail. then he brought an action against the magistrate at lambeth for false imprisonment; this was set aside, and millard was sent back to cold bath fields to complete his sentence. he tried hard to get sir astley cooper to solicit a pardon for him, but without avail. this so preyed on his mind that he threatened sir astley with bodily injury. ultimately millard quite lost his reason, and died in gaol. in his widow published a pamphlet entitled, "an account of the circumstances attending the imprisonment and death of the late william millard, formerly superintendent of the theatre of anatomy of st. thomas' hospital, southwark." the pamphlet states that millard had notice to leave st. thomas' because it was found that he was supplying mr. grainger with bodies, and that sir astley cooper was determined to put an end to the school which grainger had established. the publication is of a very abusive character; the surgeon of the gaol, mr. wakley, of the _lancet_, and the authorities at the hospital, all come in for severe censure. the whole tone of the pamphlet is so exaggerated that it is impossible to tell whether there is any truth in mrs. millard's grievances. [ ] extremities. [ ] these words are illegible. [ ] st. pancras. [ ] male. [ ] mr. edward stanley, surgeon to st. bartholomew's hospital. [ ] private door into the burial-ground, probably generally left unlocked for them by the custodian; for some special reason it was closed on this particular night. [ ] in all probability israel chapman, a jew, who was in the resurrection trade; the object of following was to try and prevent his doing any business. (see page .) the next entry shows that the jew had sold a body at st. bartholomew's; there was "a row" at this, and, no doubt, "the regular men" had to be pacified. [ ] placed there by friends of the deceased, in all probability. [ ] opened two graves; one body too decomposed to bring away, so they drew the canine teeth and sold them. [ ] words crossed out and illegible in the ms. [ ] tom light. [ ] see also p. . [ ] the words in brackets are crossed out in the ms. [ ] _i.e._ the clothes specially used for resurrection work; they would naturally be clay-stained, and if worn during the day would betray their owner's occupation. [ ] probably slang for a funeral. [ ] blue lion. [ ] canine teeth. [ ] the watchman. [ ] _i.e._ got adults, small, and foetus from st. pancras: these were taken to s. bartholomew's: the four from tottenham went to mr. wilson. transcriber's notes: passages in italics are indicated by _underscore_. superscripted letters are shown in {brackets}. the following misprints have been corrected: "where" corrected to "were" (page xii) "how tax" corrected to "hot wax" (page ) other than the corrections listed above, printer's inconsistencies in spelling, punctuation, and hyphenation usage have been retained. generously made available by internet archive (https://archive.org) note: project gutenberg also has an html version of this file which includes the original illustration. see -h.htm or -h.zip: (http://www.gutenberg.org/files/ / -h/ -h.htm) or (http://www.gutenberg.org/files/ / -h.zip) images of the original pages are available through internet archive. see https://archive.org/details/sanitaryevolutio jeph transcriber's note: text enclosed by underscores is in italics (_italics_). small capitals have been transcribed as all capitals. a more extensive transcriber's note can be found at the end of this text. the sanitary evolution of london by henry jephson, l.c.c. author of "the platform: its rise and progress" "the discovery of the laws of public health, the determination of the conditions of cleanliness, manners, water supply, food, exercise, isolation, medicine, most favourable to life in one city, in one country, is a boon to every city, to every country, for all can profit by the experience of one." g. graham, registrar-general, . a. wessels company publishers brooklyn, n. y. mcmvii dedicated to the london county council by one of its members the author , cornwall gardens, s.w. contents map _facing page_ page chapter i chapter ii ( - ) chapter iii ( - ) chapter iv ( - ) chapter v ( - ) chapter vi ( - ) chapter vii ( - ) index [illustration: sketch map of local districts in london. reference to names of parishes and districts numbered on the map. . clerkenwell. . holborn. . st. giles'. . strand. . st. martin-in-the-fields. . whitechapel. . st. james', westminster. . westminster. . st. saviour's, southwark. . st. olave's, southwark. . st. george the martyr, southwark.] the sanitary evolution of london chapter i the health of the people of a country stands foremost in the rank of national considerations. upon their health depends their physical strength and energy, upon it their mental vigour, their individual happiness, and, in a great degree, their moral character. upon it, moreover, depends the productivity of their labour, and the material prosperity and commercial success of their country. ultimately, upon it depends the very existence of the nation and of the empire. the united kingdom can claim no exemption from this general principle; rather, indeed, is it one which, in the present period of our history, affects us more vitally than it has ever done before, and in a more crucial manner than it does many other nations. the more imperative is it, therefore, that every effort should be made to raise the health of our people to the highest attainable level, and to maintain it at the loftiest possible standard. the subject is so vast and complicated that it is impossible, within reasonable limits, to treat more than a portion of it at a time. london, the great metropolis, the capital of the empire itself, constitutes, by the number of its inhabitants, so large a portion of the united kingdom, that the health of its people is a very material factor in that of the kingdom. it has a population greater than either scotland or ireland, greater than any of our colonies, except canada and australasia, greater than that of many foreign states--"the greatest aggregate of human beings that has ever existed in the history of the world in the same area of space." and, in a measure too, it is typical of other of our great cities. a narrative of the sanitary history and conditions of life of the people of london, therefore, would be a material contribution to the consideration of the general subject in its national aspect, whilst it cannot but be of special interest to those more immediately concerned in the amelioration of the existing condition of the masses of the people of the great capital. such a narrative is attempted in the following pages. it is, in the main, based upon the experiences, and inferences, and conclusions, of men who, more than any others, were in a position closely to observe the circumstances in which the people lived, their sanitary condition, and the causes leading thereto and influencing the same. it includes the principal measures from time to time passed by the legislature to create local governing authorities in sanitary matters--the various measures designed and enacted to improve the condition of the people--and the administration of those measures by the local authorities charged with their administration. it is a narrative, in fact, of the sanitary--and, therefore, to a great extent of the social--evolution of this great city. it is doubtful how long a time would have elapsed before the condition of the people came into real prominence had it not been for the oft-recurring invasions of the country by epidemic disease of the most dreaded and fatal forms. ever-present diseases, disastrous and devastating though they were, did not strike the imagination or appeal to the fears of the public as did the sudden onslaught of an awe-inspiring disease such as cholera. an epidemic of that dreaded disease swept over london in , and there were over , cases and nearly , deaths in the districts then considered as metropolitan--the population of those districts being close upon , , . for the moment, the dread of it stimulated the people, and such governing authorities as there were, to inspection, and cleansings, and purifications, and to plans for vigorous sanitary reform; but the instant the cholera departed the good resolutions died down, and the plans disappeared likewise. there were, however, some persons upon whom this visitation made more abiding impression; and they, struck by the waste of human life, by the frequent recurrence of epidemics which swept away thousands upon thousands of victims, and distressed by the perpetual prevalence and even more deadly destructiveness of various other diseases among the people, bethought themselves of investigating the actual existing facts, and the causes of them--so far at least as london, their own city, was concerned. and then slowly the curtain began to be raised on the appalling drama of human life in london, and dimly to be revealed the circumstances in which the great masses of the working and labouring classes of the great metropolis lived, moved, and came to the inevitable end, and the conditions and surroundings of their existence. the slowness with which england as a nation awoke to the idea that the public health was a matter of any concern whatever is most strange and remarkable. it seems now so obvious a fact that one marvels that it did not at all times secure for itself recognition and acknowledgment. but men and women were growing up amidst the existing surroundings, foul and unwholesome though those were, and some, at least, were visibly living to old age; population was increasing at an unprecedented rate; wealth was multiplying and accumulating; the nation was reaching greater heights of power and fame. what, then, was there, what could there be wrong with the existing state of affairs? real social evils, however, sooner or later, force themselves into prominence. for long they may be ignored, or treated with indifference by the governing classes; for long they may be endured by the victims in suffering and silence; but ultimately they compel recognition, and have to be investigated and grappled with, and, if possible, remedied. the real beginning of such investigations was not until near the close of the fourth decade of the nineteenth century. information then for the first time was collected, of necessity very limited in extent, crude in form, and of moderate accuracy, but none the less illuminating in its character--information from which one can piece together in a hazy sort of way a general impression of the condition of the working and poorer classes in london at that period. foremost among the diseases which worked unceasing and deadly havoc among the people was fever. by its wide and constant prevalence and great fatality, it was the first upon which attention became fixed. the returns which were collected as regarded it related to twenty metropolitan unions or parishes, and in them only to the pauper population, some , in number. but they showed that in the single year of , out of those , persons, , , or very nearly one-fifth, had been attacked by fever, and nearly , had died.[ ] being limited to the technically pauper population this information related only to one section of the community; but it nevertheless afforded the means of forming a rough estimate of the amount of fever among the community as a whole. and another fact also at once became apparent, namely, that certain parts of london were more specially and persistently haunted or infested by fever than others. in whitechapel, holborn, lambeth, and numerous other parishes or districts, fever of the very worst forms was always prevalent--"typhus, and the fevers which proceed from the malaria of filth." the sanitary condition of those districts was fearful, every sanitary abomination being rampant therein, whilst certain localities in them were so bad that "it would be utterly impossible for any description to convey to the mind an adequate conception of their state." and most marvellous and deplorable of all was the fact that this fearful condition of things was allowed, not merely to continue, but to flourish without any attempt being made to remedy, or even to mitigate, some of the inevitable and most disastrous consequences. as regarded the districts in which the wealthier classes resided, systematic efforts had been made on a considerable scale to widen the streets, to remove obstructions to the circulation of free currents of air, and to improve the drainage--an acknowledgment and appreciation of the fact that these things did deleteriously affect people's health. but nothing whatever had been attempted to improve the condition of the districts inhabited by the poor. those districts were not given a thought to, though in them annually thousands and tens of thousands of victims suffered or died from diseases which were preventable. reports such as these attracted some degree of attention, and awakened a demand for further information, and in the house of commons appointed a select committee to inquire as to the health, not only of london, but of the large towns throughout the country. their report[ ] enlarged upon the evils previously in part portrayed, and emphasised them. "your committee," they wrote, "would pause, from the sad statements they have been obliged to make, to observe that it is painful to contemplate in the midst of what appears an opulent, spirited, and flourishing community, such a vast multitude of our poorer fellow-subjects, the instruments by whose hands these riches were created, condemned for no fault of their own to the evils so justly complained of, and placed in situations where it is almost impracticable for them to preserve health or decency of deportment, or to keep themselves and their children from moral and physical contamination. to require them to be clean, sober, cheerful, contented under such circumstances would be a vain and unreasonable expectation. there is no building act to enforce the dwellings of these workmen being properly constructed; no drainage act to enforce their being properly drained; no general or local regulation to enforce the commonest provisions for cleanliness and comfort." lurid as were the details thus made public of the condition in which the vast masses of the people in london were living, neither parliament nor the government took any action beyond ordering successive inquiries by poor law commissioners, or committees of the house of commons, or royal commissions. before one of these commissions[ ] the following striking evidence was given--evidence which it might reasonably be expected would have moved any government to immediate action:-- "every day's experience convinces me," deposed the witness,[ ] "that a very large proportion of these evils is capable of being removed; that if proper attention were paid to sanitary measures, the mortality of these districts would be most materially diminished, perhaps in some places one-third, and in others even a half. * * * * * "the poorer classes in these neglected localities and dwellings are exposed to causes of disease and death which are peculiar to them; the operation of these peculiar causes is steady, unceasing, sure; and the result is the same as if twenty or thirty thousand of these people were annually taken out of their wretched dwellings and put to death--the actual fact being that they are allowed to remain in them and die. i am now speaking of what silently but surely takes place every year in the metropolis alone." but the government took no action--beyond a building act which did little as regarded the housing of the people. no local bodies took action, and years were to pass before either government or parliament stirred in the matter. in dealing historically with matters relating to london as a whole, it is to be remembered that for a long time there had been practically two londons--that defined and described as the "city," and the rest of london--that which had no recognised boundaries, no vestige of corporate existence, and which can best be described by the word "metropolis." the "city" was virtually the centre of london--the centre of its wealth, its industry, its geographical extent--a precisely defined area of some acres, or about one square mile in extent, and originally surrounded by walls. its boundaries had been fixed at an early period of our history, and had never been extended or enlarged. so densely was it covered with houses at the beginning of the nineteenth century, and so fully peopled, that there was practically no room for more, either of houses or people; and from then to the middle of that century its population was stationary--being close upon , at each of those periods. apart altogether from political influences, there were in the "city" powerful economic forces at work which profoundly affected the condition and circumstances of the people, not only of the "city," but of london. these, which were by no means so evident at one time, became more and more pronounced as time went on. all through the earlier part of the nineteenth century england was attaining to world pre-eminence by her commerce, her manufactures, and her wealth. the end of the great war with france saw her with a firm grip of all the commercial markets of the world. her merchants pushed their trade in every quarter of the globe--her ships enjoyed almost a monopoly of the carrying trade of the world. in this progress to greatness london took the foremost part, and became the greatest port and trade emporium of the kingdom, a great manufacturing city, and the financial centre of the world's trade. it was upon this commerce that the prosperity and glory of london were built: it was by this commerce that the great bulk of the people gained their livelihood, and that a broad highway was opened to comfort, to opulence, and power. and so the commercial spirit--the spirit of acquiring and accumulating wealth--got ever greater possession of london. that spirit had long been a great motive power in london; it became more and more so as the century wore on, until almost everything was subordinated to it. that indisputable fact must constantly be borne in mind as one reviews the sanitary and social condition of the people of london at and since that time. other constant factors there were, also exercising vast influence--the constant factors of human passions and human failings--but widespread as were their effects, they were second to the all-powerful, the all-impelling motive and unceasing desire--commercial prosperity and success. synchronous with the rise in importance of the port of london, and with its trade and business assuming ever huger volume and variety, a noteworthy transformation took place. the "city," by the very necessities of its enormous business, became gradually more and more a city of offices and marts, of warehouses and factories, of markets and exchanges, and houses long used as residences were pulled down, and larger and loftier ones erected in their place for business purposes. in some places, moreover, ground was entirely cleared of houses for the construction of docks, or for the erection of great railway termini. how marked were the effects of these changes is evidenced by the fact that from , inhabited houses in the "city" in , the number had sunk to , in . the explanation was the simple economic one, that land in the "city" yielded a much larger income when let for business than for residential purposes. offices and warehouses were absolutely essential in the "city" for business. what did it matter if people had to look for a residence in some other place? london was large. they could easily find room. and the process, without control of any sort or kind, and wholly unimpeded by legislation or governmental regulation, went on quite naturally--entailing though it did consequences of the very gravest character, then quite unthought of, or, if thought of, ignored or regarded as immaterial. this then was, at that time, and still is, one of the great, if not indeed the greatest of the economic forces at work which has unceasingly dominated the housing of the people not only in the "city," but in the metropolis outside and surrounding the "city," and, in dominating their housing, powerfully affected also their sanitary and social condition. the "city" was in the enjoyment of a powerful local governing body--namely, the lord mayor and corporation, or common council, elected annually by the ratepayers; and numerous acts of parliament and royal charters had conferred sundry municipal powers upon them. for that important branch of civic requirements--the regulation of the thoroughfares and the construction of houses and buildings--they had certain powers. the vastly more important sphere of civic welfare--namely, the matters affecting the sanitary condition of the inhabitants--was delegated by the corporation to a body called the commissioners of sewers, annually elected by the common council out of their own body, some ninety in number. and these commissioners had, in effect, authority in the city, directly or indirectly, over nearly every one of the physical conditions which were likely to affect the health or comfort of its inhabitants. they could also appoint a medical officer of health to inform and advise them upon public health matters, and inspectors to enforce the laws and regulations. the "city" was thus in happy possession of a powerful local authority, and a large system of local government. and it stood in stately isolated grandeur, proud of, and satisfied with, its dignity, and privileges, and wealth; glorying in its own importance and splendour; content with its own system of government, and its powers for administering its municipal affairs, and indifferent to the existence of the greater london which had grown up around it, and which was ever becoming greater. greater indeed. the population of the "city" in was , ; that of the metropolis not far short of , , . the number of inhabited houses in the "city" was hundreds short of , . in the metropolis it was over , . the "city" was acres in extent: what in was regarded as the metropolis was about , acres in extent. and here, with no visible boundary of separation between them, were what were still "parishes," but what were in reality great towns; not merely merged or rapidly merging into each other, but already merged into one great metropolis. some of them even had a greater population than the "city" itself. st. pancras, for instance, with , persons; st. marylebone with , , and lambeth with , . of that greater london--or, in effect, of london itself--there is a complicated and tangled story to tell. long before the middle of the nineteenth century had been reached, the time had passed when the "city" could contain the trade, and commerce, and manufactures, and business, which had grown up. they had overflowed into london outside the walls, and just as in the "city" the great economic forces produced certain definite changes in the circumstances and sanitary condition of the people living therein, so, in the greater london, the commercial spirit radiating gradually outwards, produced precisely similar results, only on a far wider scale, and with more potent effect. trade, and commerce, and wealth, and population, were increasing by leaps and bounds; and like the rings which year by year are added to the trunk of a tree, so year by year, decade by decade, london--the metropolis--spread out, and grew, and grew. from something under one million of inhabitants in , the population increased to nearly two and a half millions in , partly by natural increase, due to the number of those who were born being greater than of those who died, partly by immigration from the country. this was london, in the large sense of the title--london, the great metropolis which had never received recognition by the law as one great entity, and whose boundaries had never been fixed, either by enactment, charter, or custom.[ ] dependent as is the public health, or sanitary and social condition of the people, upon the circumstances in which they find themselves placed, and the economic forces which are constantly at work moulding those circumstances, it is in as great a degree dependent on the system of local government in existence at the time, upon the scope and efficacy of the laws entrusted to the local authorities to administer, and upon the administration of those laws by those authorities. as for local government--unlike the "city"--this greater london was without form and almost void. with the exception of the poor law authority--the boards of guardians--whose sphere of duty was distinctly limited, there was, outside the boundaries of the "city," not even the framework of a system of such government; and the confusion and chaos became ever greater as years went on and london grew. there was no authority so important as to have any extended area for municipal purposes under its control and management except certain bodies, five in number, entitled "commissioners of sewers," charged with duties in connection with the sewerage of their districts. in some parishes some of the affairs of the parish were managed by the parishioners in open vestry assembled, at which assembly churchwardens, overseers of the poor, and surveyors of highways were appointed to carry out certain limited classes of work. in others, the parishioners elected a select vestry to do the work of the parish. but for many of the vitally important municipal affairs there were no authorities at all. as the non-city and out-districts became more thickly peopled, and streets and houses increased in number, the inconvenience of there being practically no local government at all made itself felt. in some cases, the owners of the estates which were being so rapidly absorbed into london and being built upon, applied to parliament for powers to regulate those estates. in other cases, persons with interests in a special locality associated themselves together and obtained a private act of parliament giving them authority, under the name of commissioners or trustees, to tax and in a very limited way to govern a particular district or group of streets forming part of a parish. thus it happened that a large number of petty bodies of all sorts and kinds came into existence. any district, however small, was suffered to obtain a local act of parliament for the purpose of managing some of its affairs, and this, too, without any reference to the interests of the immediate neighbours, or of the metropolis as a whole. most of the limited and somewhat primitive powers possessed by them were derived from an act passed in ,[ ] and related to the paving of streets and the prevention of nuisances therein. some of these bodies were authorised to appoint surveyors or inspectors; also "scavengers, rakers, or cleaners" to carry away filth from streets and houses, but the exercise of such powers was, of course, purely optional. indeed, there were scarcely any two parishes in london governed alike. what the exact number of these various petty authorities was is unknown. of paving boards alone, it is said that about the middle of the last century there were no less than eighty-four in the metropolis--nineteen of them being in one parish. the lighting of the parish of lambeth was under the charge of nine local trusts. the affairs of st. mary, newington, were under the control of thirteen boards or trusts, in addition to two turnpike trusts.[ ] in westminster:-- "the court of burgesses and the vestry retained general jurisdiction over the whole parish for certain purposes; but the numerous local acts so effectually subdivided the control and distributed it among boards, commissioners, trustees, committees, and other independent bodies, that uniformity, efficiency, and economy in local administration had become impossible."[ ] there were authorities exclusively for paving; authorities for street improvements; authorities for lighting; even authorities for a bridge across the river. in the course of years, several hundred such bodies had been created, without any relation one to the other, and without any central controlling authority, good, bad, or indifferent, by as many acts of parliament. they were mostly self-elected, or elected for life, or both; and were wholly irresponsible to the ratepayers, or indeed to any one else; nor were their proceedings in any way open to the public. many of them had large staffs of well paid officials; and there were perpetual conflicts of jurisdiction between them, and an absolute want of anything approaching to municipal administration. it has been roughly stated--roughly because there are no reliable figures--that there were about three hundred such bodies in london--"jostling, jarring, unscientific, cumbrous, and costly"--the very nature of many of them being "as little known to the rest of the community as that of the powers of darkness." add to these numerous, clashing, and incompetent authorities, various great public companies or corporations--the water companies, and gas companies, and dock companies, each with its own special rights--which were far more favourably and generously regarded by parliament than were the rights of the public, and one has fairly enumerated the local governing bodies then existing in london. in fact, in no parish of the great metropolis of london was there a local authority possessed of powers to deal in its own area with the multitudinous affairs affecting the health and well-being of the people. nor was there in the metropolis any central authority--no single body, representative or even otherwise--to attend to the great branches of municipal administration which affected and concerned the metropolis as a whole, and which could only be dealt with efficiently by the metropolis being treated as a whole. the consequences to the inhabitants of london of the absence of any efficient form of local government were dire in character, terrible in extent, and unceasing in operation. the higher grades of society suffered in some degree, as disease, begotten in filth and nurtured in poverty, often invaded with disastrous consequences the homes of the well-to-do; but it was by the great mass of the industrial classes and the poorer people that the terrible burden of insanitation had to be borne, and upon them that it fell with the deadliest effect. the non-existence of a central authority, or of any capable local authorities whose function it would have been to protect them from the causes of disease, had resulted in an insanitary condition which year after year entailed the waste of thousands upon thousands of lives. and the people, in the cruel circumstances of their position, were absolutely powerless to help themselves, and had no possible means of escape from the ever-present, all-surrounding danger. the first absolute necessity of any sanitation whatever is the getting rid by deportation or destruction of all the filth daily made or left by man or beast, for such filth or refuse breeds all manner of disease, from the mildest up to the very worst types and sorts, and promptly becomes not only noxious to health, but fatal to life. the more rapidly and thoroughly, therefore, this riddance is effected, the better is it in every way for the general health of the public. so far as the metropolis was concerned, this necessity had for generation after generation been very lightly regarded; and when at last it so forced itself upon public notice that it could no longer be ignored, the measures taken were wholly inadequate and ineffective. what system there was in london as to the disposal of sewage throughout the earlier half of last century was based upon a statute dating so far back as henry viii.'s reign, amended by another in william and mary's reign. under these statutes certain bodies had been constituted by the crown as commissioners of sewers for certain portions of london, and charged with the duty of providing sewers and drains in their respective districts, and maintaining the same in proper working order. but what might have been good enough for london in the sixteenth or seventeenth centuries was certainly not adequate in the nineteenth, when london had extended her borders in every direction, and her population had reached almost two and a half millions. successive parliaments had not troubled themselves about such a matter; and this neglect, which now appears almost incredible, was typical of the habitual attitude of the governing classes to the sanitary requirements of the masses of the population of the metropolis. in the eighteen hundred and forties, five such bodies of commissioners were in existence in london, each with a separate portion of the metropolis under its charge and exercising an independent sway in its own district; and when we collect the best testimony of that time as to their work and that of their predecessors, we have the clearest demonstration of their glaring incapacity, and of the utter inadequacy and inefficiency of the sewerage in their respective districts. many miles of sewers had, it is true, in process of time been constructed, and did exist, but much of the work had been so misdone that the cure was little better than the disease. a river is always a great temptation to persons to get rid of things they want to get rid of, particularly when the things are nasty and otherwise not easily disposed of. londoners only followed the general practice when they constructed their sewers so that they discharged their contents direct into the thames. the majority of these sewers emptied themselves only at the time of low water; for as the tide rose the outlets of the sewers were closed, and the sewage was dammed back and became stagnant. when the tide had receded sufficiently to afford a vent for the pent-up sewage, it flowed out and deposited itself along the banks of the river, evolving gases of a foul and offensive character. and then the sewage was not only carried up the river by the rising tide, but it was brought back again into the heart of the metropolis, there to mix with each day's fresh supply of sewage; the result being that "the portion of the river within the metropolitan district became scarcely less impure and offensive than the foulest of the sewers themselves." this was bad enough, but there were miles of sewers which, through defects of construction or disrepair, did not even carry off the sewage from the houses and streets to the river, but had become "similar to elongated cesspools," and, as such, actual sources and creators of disease. incredible almost were the stupidities perpetrated by these commissioners in regard to the construction of the sewers. at even so late a date as no survey had been made of the metropolis for the purposes of drainage; there was a different level in each of the districts, and no attempt was made to conform the works of the several districts to one general plan. large sewers were made to discharge into smaller sewers. some were higher than the cesspools which they were supposed to drain, whilst others had been so constructed that to be of any use the sewage would have had to flow uphill! it might reasonably have been expected that in the nineteenth century, at least, the twenty parishes which formed the district of the westminster commissioners of sewers would have been equal to producing an enlightened and capable body as commissioners, but the westminster court of sewers was certainly not such. even their own chief surveyor, in , stigmatised it as a body "totally incompetent to manage the great and important works committed to their care and control." upon it were builders, surveyors, architects, and district surveyors--a class of persons whose opinions "might certainly be biassed with relation to particular lines of drains and sewers." of another of the courts--namely, the finsbury court of sewers--one of the commission had been outlawed; another was a bankrupt. it was stated at the time that "jobbery and favouritism and incompetence were rampant," and that the system was "radically wrong and rotten to the core." certain it is that these bodies failed completely to cope with the requirements of the time. london was spreading out in all directions, and the increase of houses and population was very rapid. practically no effort, however--certainly no adequate effort--was made by the various bodies of commissioners to provide these new and growing districts with the means of getting rid of their sewage. and then, inasmuch as the sewage had somehow or other to be got rid of, and some substitute for sewers devised, the surface drains, and millstreams, and ditches were appropriated to use and converted into open sewers or "stagnant ponds of pestilential sewage." london was "seamed with open ditches." according to contemporary reports there were in lambeth numerous open ditches of the most horrible description. bermondsey was intersected by ditches of a similar character, and abounded with fever nests. rotherhithe was the same. hackney brook, formerly "a pure stream," had become "a foul open sewer."[ ] in st. saviour's union the sewers were in a dreadful condition ... "the receptacle of all kinds of refuse, such as putrid fish, dead dogs, cats, &c. greenwich was not drained or sewered." what certainly was conclusively demonstrated was that the existence of several bodies of commissioners, each with a district to itself, presented an insuperable obstacle to any general system of sewerage for greater london; and that one capable central authority was the first essential of an adequate and efficient system for london as a whole. thus, then, in this first essential of all sanitation--one might say of civilisation--no adequate provision was made by parliament for the safety of the metropolis; whilst as to other essentials of sanitation, there were no laws for the prevention of the perpetration of every sanitary iniquity; and such authorities as there were failed absolutely to use even the few powers they possessed. the defective and inefficient sewerage of the metropolis precluded the possibility of any proper system of house drainage, for there being few sewers there were few drains, and consequently instead of drains from the houses to the sewers there were cesspools under almost every house. at the census of there were over , houses in the metropolis. it was known, then, that most houses had a cesspool under them, and that a large number had two, three, or four under them. some of them were so huge that the only name considered adequate to describe them was "cess-lake." in many districts even the houses in which the better classes lived had neither drain nor sewer--nothing but cesspools; and many of the very best portions of the west end were "literally honeycombed" with them. and so jealous was the law as regarded the rights of private property that so late as owners were not to be interfered with as regarded even their cesspools, no matter how great the nuisance might be to their neighbours, no matter how dangerous to the community at large. indeed, the commissioners of sewers had no power to compel landlords or house-owners to make drains into the sewers, and of their own motion the landlords would take no action. in the lower part of westminster the commissioners of sewers had actually carried sewers along some of the streets, but they found "very little desire on the part of the landlords" to use them. "so long as the owners get their rent they do not care about drainage.... the landlords will not move; their property pays them very well; they will not put themselves to any expense; they are satisfied with it as it stands." strange level of satisfaction! when one reads the following evidence given two years later before the metropolitan sewers commission:-- "there are hundreds, i may say thousands, of houses in this metropolis which have _no drainage whatever_, and the greater part of them have stinking, overflowing cesspools. and there are also hundreds of streets, courts, and alleys, that have no sewers; and how the drainage and filth is cleared away, and how the poor miserable inhabitants live in such places it is hard to tell. "in pursuance of my duties, from time to time, i have visited very many places where filth was lying scattered about the rooms, vaults, cellars, areas, and yards, so thick, and so deep, that it was hardly possible to move for it. i have also seen in such places human beings living and sleeping in sunk rooms with filth from overflowing cesspools exuding through and running down the walls and over the floors.... the effects of the stench, effluvia, and poisonous gases constantly evolving from these foul accumulations were apparent in the haggard, wan, and swarthy countenances, and enfeebled limbs, of the poor creatures whom i found residing over and amongst these dens of pollution and wretchedness."[ ] and this witness was unable to refrain from passing a verdict upon what he had seen:-- "to allow such a state of things to exist is a blot upon this scientific and enlightened age, an age, too, teeming with so much wealth, refinement, and benevolence. morality, and the whole economy of domestic existence, is outraged and deranged by so much suffering and misery. let not, therefore, the morality, the health, the comfort of thousands of our fellow creatures in this metropolis be in the hands of those who care not about these things, but let good and wholesome laws be enacted to compel houses to be kept in a cleanly and healthy condition." there were, it was said, "a formidable host of difficulties" as regarded the execution of improved works of house drainage. there was the opposition of the proprietors on the ground of expense; there were the provisions of the act of parliament,[ ] which were so intricate as to be almost unintelligible and unworkable; there was the want of a proper outfall for the sewage; and the want of a supply of water to wash away the filth--a possible explanation for the existing state of abomination, but certainly not a justification for the prolonged inaction of successive parliaments and governments in allowing affairs to reach so frightful a pass, and for dooming the people to a condition of things which it was entirely beyond their power to remedy even as regarded the single house they inhabited. just as everything connected with sewerage and drainage was so placidly neglected, and so fearfully bad, so also was it as regarded another matter of even more vital necessity, namely, the supply of water to the inhabitants of london for drinking, or for domestic, trade, or sanitary purposes. "water is essential as an article of food. water is necessary to personal cleanliness. water is essential to external cleansing, whether of houses, streets, closets, or sewers." manifestly, the supply of water was not a matter which the individual in a large community such as london could in any way make provision for by his own independent effort. and yet there was no public body in london, central or local, representative or otherwise, charged with the duty of securing to the people even the minimum quantity necessary for life. early in the seventeenth century the new river company was formed for the supply of water to london. and as years went on parliament evidently considered it fulfilled its obligations in this respect by making over to sundry private companies the right of supplying to the citizens of london this vital requirement, or, as it has been termed, this "life-blood of cities"; and parliament had done this without even taking any guarantee or security for a proper distribution to the people, or for the purity of the water, or the sufficiency of its supply. practically, a generous parliament had bestowed as a free gift upon these water companies the valuable monopoly, so far as london was concerned, of this necessity of life. although by the middle of the nineteenth century there was no portion of the metropolis into which the mains and pipes of some of the companies had not been carried, yet, as the companies were under no compulsion to supply it to all houses, large numbers of houses, and particularly those of the poorer classes, received no supply. indeed, in many parts of london there were whole streets in which not a single house had water laid on to the premises. in the district supplied by the new river company, containing about , persons, about one-third of the population were unsupplied; and in the very much smaller area of the southwark company's district about , persons had no supply. even in it was computed that , houses in london, inhabited by , persons, were unsupplied with water. a very large proportion of the people could only obtain water from stand-pipes erected in the courts or places, and that only at intermittent periods, and for a very short time in the day; sometimes, indeed, only on alternate days, and not at all on sunday. "to these pipes," wrote a contemporary, "the inhabitants have to run, leaving their occupation, and collecting their share of this indispensable commodity in vessels of whatever kind might be at hand. the water is then kept in the close, ill-ventilated tenements they occupy until it is required for use."[ ] the quality of the water which was supplied by the companies left much to be desired. that supplied by the new river company was, as a rule, fairly good in quality; but that supplied by the other companies was very much the reverse. financial profit being their first and principal consideration, they got it from where it was obtainable at least capital outlay or cost, regardless of purity or impurity; and almost without exception took it from the thames--"the great sewer of london"--took it, too, from precisely the places where the river was foulest and most contaminated by sewage and other filth; and as there were no filtering beds in which it could have been to some extent purified before its distribution to householders, its composition can best be imagined. looking at the great river even now in its purified state, as it sweeps under westminster bridge, any one would shudder at the idea of being compelled to drink its water in its muddy and unfiltered state, and of one's health and life being dependent on the supply from such a source. how infinitely more repugnant it must have been when the river was "the great sewer" of the metropolis. the great shortage of company-supplied water compelled large numbers of people to have recourse to the pumps which still existed in considerable numbers in many parts of london, the water from which was drawn from shallow wells. the water of these "slaughter wells," as they have been termed, appears to have combined all the worst features of water, and to have contained all the ingredients most dangerous to health. "if," wrote a medical officer of health some years later, "the soil through which the rain passes be composed of the refuse of centuries, if it be riddled with cesspools and the remains of cesspools, with leaky gas-pipes and porous sewers, if it has been the depository of the dead for generation after generation, the soil so polluted cannot yield water of any degree of purity."[ ] as all these "ifs" were grim actualities, the water of such wells was revolting in its impurity and deadly in its composition. of clerkenwell it was indeed stated positively that "the shallow-well water of the parish received the drainage water of highgate cemetery, of numerous burial grounds, and of the innumerable cesspools in the district." on the south side of the river the water in most of the shallow wells was tidal--from the thames, which is a sufficient description of the quality thereof--and where people did not live close enough to the river to draw water from it for their daily wants, they took it from these tidal wells. vile as it was, it had to be used in default of any better. where such wells were not available, the water for all household consumption was taken from tidal ditches which were to all intents and purposes only open sewers. a contemporary report gives a graphic picture of this form of supply[ ]:-- "in jacob's island (in bermondsey) may be seen at any time of the day women dipping water, with pails attached by ropes to the backs of the houses, from a foul, foetid ditch, its banks coated with a compound of mud and filth, and with offal and carrion--the water to be used for every purpose, culinary ones not excepted." an adequate supply of wholesome water has for very long been recognised as of primary sanitary importance to all populations, but with a densely crowded town population the need of care as to the quality of the supplies is peculiarly urgent. and yet, through the indifference of successive governments, the people of the great metropolis of london were most inadequately supplied with water, and what water was supplied to the great mass of them, or was available for them, was of the foulest and most dangerous description. the inadequacy of supply not alone put a constant premium upon dirt and uncleanliness, both in house and person, but it intensified the evils of the existing sewers and drains, as without water efficient drainage was impossible. and the horrible impurity of the water affected disastrously and continuously the health of the great mass of the people. many dire lessons, costing thousands upon thousands of lives, were needed before it was borne in on the government of the country that the arrangements regarding the supply of water for the people of london required radical amendment. much of the health of a city depends upon the width of its thoroughfares, the free circulation of air in its streets and around its buildings, and the sound and sanitary construction of its houses. in every one of these respects all the central parts of london were remarkably defective. the great metropolis had grown, and had been permitted to grow, mostly at haphazard. large parks and open spaces there were in the richer and more well-to-do parts, and some handsome thoroughfares; but "there were districts in london through which no great thoroughfares passed, and which were wholly occupied by a dense population composed of the lowest class of persons, who, being entirely secluded from the observation and influence of better educated neighbours, exhibited a state of moral degradation deeply to be deplored."[ ] parliament had taken some interest as to the width of the streets, and had shown some anxiety for improvements in them. hence, much local and general legislation was from time to time directed to control the erection of buildings beyond the regular lines of buildings. thus the metropolitan paving act, , contained stringent provisions as to projections which might obstruct the circulation of air and light, or be inconvenient or incommodious to passengers along carriage or foot ways in certain parts of the metropolis. in the act for consolidating the metropolis turnpike trusts, also, contained certain restrictive provisions, but these were rendered futile by the construction put upon its terms by the magistrates. again, in , further enactments were made by the metropolitan building act to restrain projections from buildings; but after a short administration of its provisions it was found that shops built on the gardens in front of the houses, or on the forecourts of areas, did not come within the terms of the act. and so the act, in that very important respect, was useless. the action of parliament had been mainly prompted by the necessity for increased facilities of communication, and by the desire to safeguard house property from destruction by fire; whilst the most important of all aspects of the housing of the people--namely, the sanitary aspect--received no consideration, and was completely ignored as a thing of no consequence. but whatever the motive of action by parliament, the ensuing legislation was in the main inoperative or ineffective. the resolution of landowners to secure the highest prices for their property, and the determination of builders, once they got possession of any land, to utilise every inch of it for building, and so to make the utmost money they could out of it, defeated the somewhat loosely drawn enactments. means of evading the legislative provisions were promptly discovered, and, in despite of legislation, builders, architects, and surveyors of the metropolis were unrestrained in their encroachments upon areas and forecourts--at times even were successful in breaking the existing lines of buildings in metropolitan streets or roads by encroachments which were only discovered too late to be prevented. nor was there anything to prevent houses being built on uncovered spaces at the backs of existing buildings, thus taking up whatever air-space had been left between the previous buildings. hence, great blocks of ground absolutely covered with buildings, back to back, side to side, any way so long as a building could by any ingenuity be fitted in. hence the culs-de-sac, the small and stifling courts and alleys. nor were there any regulations forbidding certain kinds of buildings which would be injurious to the health of their inhabitants. hence the mean and flimsy and insanitary houses which were being erected in the outer circle of the metropolis, and which wrought havoc with the health and lives of the people. hence, too, the erection, on areas and forecourts, of buildings which narrowed the streets, diminished the air-spaces and means of ventilation, and destroyed the appearance of the localities. and once up they had come to stay; for years were to pass before the legislature created any effective means for securing their amelioration, and for generations they were permitted to exercise their evil and deadly sway over the people, and to scatter broadcast throughout the community the seeds of disease and death. the then existing actual state of the case was summed up by dr. southwood smith in his evidence before the select committee of the house of commons in :-- "at present no more regard is paid in the construction of houses to the health of the inhabitants than is paid to the health of pigs in making sties for them. in point of fact there is not so much attention paid to it." legislation against some of the evils which had already reached huge proportions, and which, as london grew, were spreading and developing, was not alone ineffective, but earlier legislation, in one notorious act, had been the direct incentive to, and cause of evils. this was the act which imposed a tax upon windows.[ ] in effect this act said to the builder, "plan your houses with as few openings as possible. let every house be ill-ventilated by shutting out the light and air, and as a reward for your ingenuity you shall be subject to a less amount of taxation."[ ] the builder acted upon this counsel, and the tax operated as a premium upon the omission from a building of every window which could by any device be spared; with the result that passages, closets, cellars, and roofs--the very places where mephitic vapours were most apt to lodge--were left almost entirely without ventilation.[ ] in effect, the window duties compelled multitudes to live and breathe in darkened rooms and poisoned air, and with a rapidly increasing population the evils resulting therefrom were being steadily intensified. admirable was the comment passed upon the tax in :-- "health is the capital of the working man, and nothing can justify a tax affecting the health of the people, and especially of the labouring community, whose bodily health and strength constitute their wealth, and, oftentimes, their only possession. it is a tax upon light and air, a tax more vicious in principle and more injurious in its practical consequences than a tax upon food." not until was the tax abandoned, but its evil consequences, wrought in stone and embodied in bricks and mortar, endured many a long year after. the existing laws or regulations as to building were wholly inadequate to secure healthy houses. and there was no public authority with power to compel attention to the internal condition of houses so as to prevent their continuance in such a filthy and unwholesome state as to endanger the health of the public. there was no power to compel house owners to make drains and carry them to the common sewer where it existed. no persons were appointed to carry into effect such communication. no persons were authorised to make inspection and to report upon these matters. the poor, or, indeed, the working classes generally, were powerless to alter or amend the construction of the dwellings in which they were compelled to reside, still less to alter their surroundings. any improvement in the condition of their dwellings could only be by voluntary action on the part of the landlords, or of interference by government to compel that measure of justice to the poor, and of economy to the ratepayers. parliament failed to interfere with any effect; and as to the landlords or house-owners, their interest ran all the other way. few persons of large capital built houses as a speculation, or had anything to do with them. many, however, who were desirous of making the highest possible interest on their money acquired either freehold or leasehold land, and built cheap and ill-constructed houses upon it without the least regard to the health of the future inmates. and the small landlords were often the most unscrupulous with regard to the condition of the houses they let, and exacted the highest rents. inasmuch as this freedom as regarded house construction had been going on almost from time immemorial, it was not only the newly-built houses which were bad. earlier built houses had rapidly fallen into disrepair and semi-ruin, and were steadily going from bad to worse, and becoming ever less and less suitable for human dwellings. the following description[ ] of parts of st. giles' and spitalfields shows what, under a state of freedom as to building, had been attained to in , and is typical of what so extensively prevailed in the central parts of london:-- "those districts are composed almost entirely of small courts, very small and very narrow, the access to them being only under gateways; in many cases they have been larger courts originally, and afterwards built in again with houses back to back, without any outlet behind, and only consisting of two rooms, and almost a ladder for a staircase; and those houses are occupied by an immense number of inhabitants; they are all as dark as possible, and as filthy as it is possible for any place to be, arising from want of air and light." here is another description--that of "christopher court," a cul-de-sac in whitechapel--given, in , by dr. allison, one of the surgeons of the union:-- "this was one of the dirtiest places which human beings ever visited--the horrible stench which polluted the place seemed to be closed in hermetically among the people; not a breath of fresh air reached them--all was abominable." it is needless to multiply instances. there is a dreadful unanimity of testimony from all parts of london as to the miserable character and condition of the houses in which in the middle of the nineteenth century the industrial and the lower classes were forced to live; the deficiency or total absence of drainage, the universal filth and abomination of every kind, the fearful overcrowding, the ravages of every type of disease, and the absolute misery in which masses struggled for existence. the density of houses upon an area has long been recognised as one of the great contributing causes to the ill-health of a community, but when coupled with the overcrowding of human beings in those houses, the combined results are always disastrous in the extreme. overcrowding had been a long-standing evil in london; had existed far back in history. as london had grown, the evil had grown; and about the middle of the last century it was immeasurably greater than ever before, and its disastrous consequences were on a vastly larger scale. the great economic forces which resulted, in certain districts of london, in the destruction of houses and great clearances of ground, had largely reduced the available accommodation for dwellings, and the expelled inhabitants, chained to the locality by the fact of their livelihood being dependent upon their residence being close by, were forced to invade the yet remaining places in the neighbourhood suited to their means. as the circle of possible habitations contracted, while the numbers seeking accommodation therein increased, a larger population was crowded into an ever-diminishing number of houses. it was also a most unfortunate but apparently inevitable consequence that once a beginning was made to improve some of the streets and thoroughfares of london, and to substitute in any district a better class of houses and shops for those actually existing, the improvements necessarily involved increased overcrowding in that particular locality and in those adjoining it. but so it was. thus, in the eighteen hundred and forties a new street--new oxford street--was formed. it was driven through "a hive of human beings, a locality overflowing with human life." evidence given before the commission in described the results:-- "the effect has been to lessen the population of my neighbourhood by about , people, and therefore to improve it at the expense of other parts of london. some have gone to the streets leading to drury lane, some to st. luke's, whitechapel, but more to st. marylebone and st. pancras. the vestries of st. marylebone and st. pancras disliked this very much. places in the two latter parishes which were before bad enough are now intolerable, owing to the number of poor who formerly lived in st. giles'." and a year or so later, from across the river, came the complaint from lambeth that "owing to the number of houses pulled down in westminster and other places, there had been a great influx of irish and other labourers which necessarily caused a great overcrowding of the miserable domiciles already overfull." this lambeth complaint is specially interesting, as it refers to another great cause of overcrowding--the constant immigration into london of labourers and poor people in search of work or food. owing to the ever increasing and urgent demand for house accommodation for the working and poorer classes, it became a very remunerative proceeding for the occupier of a house to sub-let it in portions to separate families or individuals, and the practice gradually extended to and absorbed streets hitherto belonging to the better class. the owner of a property let his whole house to a tenant; this tenant, seeing an easy way of making money, sub-let the rooms in it in twos or threes, or even separately, at a very profitable rate to individual tenants. nor did the sub-letting end here, for these tenants let off even the sides or corners of their room or rooms to individuals or families who were unable to bear the expense of a whole room. and so the house sank at once into being a "tenement house"--that prolific source of the very worst evils, sanitary, physical, and moral, to those who inhabited them. even the underground kitchens and cellars, which were never intended for human habitation, were let to tenants, and thus turned to financial profit.[ ] it mattered not that they were without air or ventilation, or even light; it mattered not that they were damp, or sometimes even inundated with the overflow of cesspools; it mattered not that they were inhabited contrary to the provisions of section of the building act of , for that section was of no operative effect whatever. it is true that "overseers" were to report to the "official referees," who were to give notice to and inform the owners and occupiers of such dwellings as to the consequences of disobeying the statute, and the "district surveyor" was to carry out the directions of the referees. but nothing was ever done--overseers, district surveyors, and referees, all neglected their duties. overcrowding was usually at its worst in one-room tenements, and in an immense number of cases in the metropolis one room served for a family of the working or of the labouring classes. it was their bedroom, their kitchen, their wash-house, their sitting-room, their eating-room, and, when they did not follow any occupation elsewhere, it was their workroom and their shop. in this one room they were born, and lived, and slept, and died amidst the other inmates. and still worse, in innumerable cases, more than one family lived in one room. when this one room was in a badly drained, damp, ill-constructed, and unventilated house, reeking with a polluted atmosphere, and that house was in a narrow and hemmed-in, unventilated "court" or "place" or "alley"--as an immense number of them were--the maximum of evil consequences was attained. the evils of overcrowding cannot be summed up in a phrase, nor be realised by the description, however graphic, of instance upon instance. the consequences to the individual living in an overcrowded room or dwelling were always disastrous, and, through the disastrous consequences to great masses of individuals, the whole community was affected in varying degree. physically, mentally, and morally, the overcrowded people suffered. not a disease, not a human ill which flesh is heir to, but was nurtured and rendered more potent in the human hothouse of the overcrowded room; and the ensuing ill-health and diseases not alone doubled the death rate, but increased from ten to twenty-fold, at least, the number of victims of disease of one sort or another--diseases dealing rapid death, or slowly but surely sapping human strength and vitality. in the report of the london fever hospital for a certain overcrowded room in the neighbourhood was described--a room which was filled to excess every night, sometimes from to men being in it; a room feet long, feet wide, and feet high. from that one room alone no fewer than persons affected with fever were received into the hospital in the course of the year.[ ] one, whose very close experience of the conditions of life and circumstances of the poorer classes of london at the time of the cholera epidemic of - entitled him to speak with special authority on the subject, thus summed up his views and conclusions:-- "the members of the medical profession, in the presence of these physical evils, when they are, as so often happens, concentrated, find their science all but powerless; the minister of religion turns from these densely crowded and foul localities almost without hope; whilst the administrators of the law, especially the chaplains and governors of prisons, see that crime of every complexion is most rife where material degradation is most profound."[ ] and he quoted from the report of the governors of the houses of correction at coldbath fields and westminster the following passage:-- "the crowning cause of crime in the metropolis is, in my opinion, to be found in the shocking state of the habitations of the poor, their confined and foetid localities, and the consequent necessity for consigning children to the streets for requisite air and exercise. these causes combine to produce a state of frightful demoralisation. the absence of cleanliness, of decency, of all decorum--the disregard of any needful separation of the sexes--the polluting language and the scenes of profligacy hourly occurring, all tend to foster idleness and vicious abandonment. here i beg emphatically to record my conviction that this constitutes the _monster mischief_." and then he himself adds:-- "if to considerations like these regarding the moral and religious aspect of this great question, be added those suggested by the indescribable physical sufferings inflicted on the labouring classes by the existing state of the public health in the metropolis, the conviction must of necessity follow, that the time is come when efforts in some degree commensurate with these great and pervading evils can no longer with safety be deferred."[ ] this opinion was expressed three years after the royal commissioners of had said in their report:-- "there appears to be no available (legal) means for the immediate prevention of overcrowding; all we can do is to point it out as a source of evil to be dealt with hereafter." one gets a clue to the unceasing insanitary condition of the greater part of london and to the inhuman conduct of so many tenement house-owners when one realises that there was no legal punishment whatever for the perpetration and perpetuation of the insanitary abominations, no matter how noxious or dangerous they were, nor how rapidly or directly they led to disease or death. an order to abate a nuisance (which usually was not obeyed) appears to have been the only penalty, and it was only obtainable at great trouble and after great delays; and, even if obtained and the nuisance abated, there was nothing to prevent the offender at once starting the nuisance again. offences of the most heinous description--amounting morally to deliberate murder--were perpetrated with absolute impunity. houses which were scarcely ever free from fever cases were allowed to continue year after year levying their heavy death tax from the unfortunate inhabitants. in whitechapel one house, inhabited by twelve or fourteen families, was mentioned as scarcely free from fever cases for as many years. "it is also a fearful fact that in almost every instance where patients die from fever, or are removed to the hospital or workhouse, their rooms are let as soon as possible to new tenants, and no precautions used, or warning given; and in some houses, perfect hotbeds of fever probably, where a patient dies or is removed, the first new-comer is put into the sick man's bed." sanitary improvement was almost a hopeless task. there was a dead weight of opposition to it in the ignorance and recklessness and indifference of the poorer classes, the very hopelessness of being able to improve their condition. and there was an active and bitter opposition from those house-owners or lessees who for their own financial profit exploited the poorer classes. "there is one house in spitalfields," said dr. lynch, "which has been the constant habitation of fever for fifteen years. i have enforced upon the landlord the necessity of cleansing and lime-washing it, but it has never been done!!... there are many landlords with whom nothing but immediate interest has any effect."[ ] the favourite principle that an englishman's house was his castle was used as a defence against any suggestion that the malpractices committed therein should be curbed. others argued, "i am entitled to do what i like with my own." "we everywhere find people ready to declare in respect to every evil: there is not any law that could compel its removal, the place complained of being private property." all sorts of far-fetched and strained arguments were devised by them in the efforts to evade responsibility for the infamous condition of their property, and to defend and justify inaction. fortunately some voices began to be raised as to the persons upon whom both equitably and morally the responsibility lay of improving the condition of things. "i would suggest," said a voice in , "the idea of the landlords of many of the wretched filthy tenements being held responsible for their being tenantable, healthy, and cleanly." and the commissioners in reported:-- "there are some points on which the public safety demands the exercise of a power on the part of a public authority to compel attention to the internal condition of houses so as to prevent their continuance in such a filthy and unwholesome state as to endanger the health of the public." and they recommended that:-- "on complaint of the parish, medical, or other authorised officer, that any house or premises are in such a filthy and unwholesome state as to endanger the health of the public, the local authority have power to require the landlord to cleanse it properly without delay." but ideas or recommendations were alike ignored by the government and parliament, and several years were to pass before any legislation was attempted which would make owners responsible for their misdeeds in matters affecting the public health, and would subject them to penalties for their misconduct. there were many other causes contributing largely to the insanitary condition of the people of the metropolis, prominent, if not most deleterious, amongst them being the widely-prevalent practice of interring the dead in the already overcrowded churchyards or burial grounds in the midst of the most densely populated districts of london--a practice resulting in "the slaughter of the living by the dead." burial grounds long since utilised to their utmost for the disposal of the dead were utilised over and over again for graves which could only be dug in the débris of human remains, until the soil reeked with human decomposition; the surrounding atmosphere was polluted by the horrible process, and they became monstrous foci of infection. how extensive this evil was may be realised from figures given by mr. chadwick in a report to the government:-- "in the metropolis, on spaces of ground which do not exceed acres, closely surrounded by the abodes of the living, layer upon layer, each consisting of a population numerically equivalent to a large army of , adults, and nearly , youths and children, is every year imperfectly interred. within the period of the existence of the present generation upwards of a million of dead must have been interred in those same spaces." and he asserted that:-- "the emanations from human remains are of a nature to produce fatal disease, and to depress the general health of whoever is exposed to them; and interments in the vaults of churches, or in graveyards surrounded by inhabited houses, contribute to the mass of atmospheric and other impurities by which the general health and average duration of life of the inhabitants is diminished." too horribly gruesome and revolting are the descriptions of these graveyards--places where the dead were, so to speak, shovelled in as the filth of the streets is into scavengers' carts, and which "gave forth the mephitical effluvia of death"; such a one as that in russell court, off drury lane, where the whole ground, which by constant burials had been raised several feet, was "a mass of corruption" which polluted the air the living had to breathe, and poisoned the well water which in default of other they often had to drink. or those in rotherhithe, where "the interments were so numerous that the half-decomposed organic matter was often thrown up to make way for fresh graves, exposing sights disgusting, and emitting foul effluvia." the master hand of dickens has given a more vivid picture of one of these places than any to be found in parliamentary blue books:-- "a hemmed-in churchyard, pestiferous and obscene, whence malignant diseases are communicated to the bodies of our dear brothers and sisters who have not departed.... into a beastly scrap of ground, which a turk would reject as a savage abomination, and a caffre would shudder at, they bring our dear brother here departed to receive christian burial. with houses looking on on every side, save where a reeking little tunnel of a court gives access to the iron gate--with every villainy of life in action close on death, and every poisonous element of death in action close on life--here they lower our dear brother down a foot or two; here sow him in corruption, to be raised in corruption; an avenging ghost at many a sick bedside; a shameful testimony to future ages, how civilisation and barbarism walked this boastful island together." interments in the vaults of the churches--then a common practice--were also a fruitful source of sickness and death. it mattered not whether or not the bodies were hermetically closed in leaden coffins, for "sooner or later every corpse buried in the vault of a church spreads the products of decomposition through the air which is breathed, as readily as if it had never been enclosed"; thus adding to the contamination of the atmosphere. the death-roll from this horrible condition of things cannot be gauged, but those most conversant with the matter were firmly convinced that it was the direct cause of fevers, and of all kinds of sickness among the people. pollution of the atmosphere which people had to breathe, and upon the purity of which the public health in varying degree depended, was caused also by various businesses and processes of manufacture grouped together under the name of "noxious trades," such as bone-boilers, india-rubber manufacturers, gut-scrapers, manure manufacturers, slaughterers of cattle, and many others. in [ ] a description had been given of a street in shoreditch which shows to what extent this evil had attained:-- "it is impossible to believe, passing through this main street, that so great a number of pigsties, bone-boileries, dog-and-cat's meat manufactories, and tallow-melting establishments, on a large scale ... should exist in a densely-crowded and closely-built locality. the noxious trades and occupations which so greatly abound here exerted a most deleterious influence upon the health of the inhabitants." parliament, in , had enacted with regard to several of these that it should not be lawful for any person to establish any such business at a less distance than feet from the public way, or than feet from any dwelling-house; and that it should not be lawful to erect a dwelling-house within feet of such businesses. but these legislative restraints were utterly inadequate as any sort of check upon the evil; for, even if a nuisance were abated, there was no law to prevent its repetition, and so the evil promptly re-appeared. the stenches did not limit their sphere of action by feet, but distributed their abominations over large areas; and the manufacturers cared not what nuisances they subjected people to, nor how far the horrid smells were wafted by the winds, so long as they themselves could carry on a profitable business. and the intentions of parliament were wholly frustrated by the district surveyors, who were charged with the enforcement of the act, and who wholly failed in their duty. as for slaughter houses, until any person could start one who pleased, and practically where he pleased, subject only to the shadowy restriction of the common law as to doing anything which might be considered a nuisance. and so these numerous and various abominations, mixed with the impurity of the atmosphere caused by the masses of smoke emitted from the chimneys of factories and private houses, and with the sickening smell from the thames, spread sickness and death throughout great portions of the metropolis, and were one of the great causes of its insanitary condition. chapter i, part ii previous to the fifth decade of the last century it was only very rarely that the prevalence of disease, or any subject connected with the health of the community, received recognition by parliament. in the medical society of london, in a petition to parliament, called attention to the increase of smallpox, and to its preventability by vaccination, and to the imperfect means of vaccination throughout the country. the mortality from this--"one of the greatest pests that ever afflicted humanity"[ ]--was very great. in one city in the south of england no less than persons had died of it in one year. in london in upwards of , had died of it. and parliament, after an unusual amount of discussion, passed an act[ ] for extending the practice of vaccination, and enacted that boards of guardians might contract with their medical officers or other medical practitioners "for the vaccination of all persons resident in their union or parish." and at the same time "inoculation" or "otherwise producing smallpox" was made penal--to the extent of one month's imprisonment. in there was a sudden display of parliamentary energy in health matters. the total want of baths and wash-houses for the poorer classes of the people in the towns was brought under the notice of the legislature, and, as it was deemed "desirable for the health, comfort, and welfare of the inhabitants of towns, &c., to encourage the establishment therein of baths, wash-houses, and open bathing places," an act was passed giving power to the parochial authorities to establish such institutions and to borrow money for the purpose.[ ] their provision would have tended to an increased degree of cleanliness among the people, and consequently an improved sanitary condition, but it was long before many of these institutions were established, the local authorities being slow in availing themselves of the facilities thus offered, and this piece of legislation--like every other of the sort--being purely permissive or facilitatory. and in the same year parliament so far awakened to the fact that certain causes of disease were removable, that in a preamble to an act[ ] it acknowledged that it was "highly expedient for the purposes of preserving the health of her majesty's subjects that better provision should be made for the removal of certain nuisances likely to promote or increase disease." the better provision made by the act did not amount to much. there were two forms of insanitary evil to be combated: one the chronic insanitary condition of the masses of the people, the other the invasion of the country by some exceptional or unusual epidemic disease. as to the former, authority was given to certain public officers, on receipt of a certificate of two medical men, to complain of the existence of certain nuisances. the justices before whom the case was heard might order the abatement of the nuisance; and if the order were not obeyed, the parties complaining might enter upon the necessary cleansing of such dwelling, and the cost of the same might be imposed on the owner or occupier. in london, the power of complaint was vested in the officers of those petty local bodies which have already been described, and, in their default, in the boards of guardians. ludicrous, truly, was the idea that the countless thousands of nuisances existing in london could be remedied, or even temporarily abated, by so cumbrous, dilatory, and complicated a procedure as the complaint of an individual backed by the certificate (which would have to be paid for) of two doctors to the officer of a more or less hostile and self-interested local body, who might or might not bring the complaint before the justices, whose decision, even if it were in favour of the complainant, could only effect a reform so far as the precise nuisance complained of was concerned, and that only temporarily, for were the nuisance renewed the whole procedure would have to be gone through again. yet this was the "better provision" propounded and enacted by parliament in for the regeneration of the sanitary condition of the great masses of the people of london. nor was it even intended to be permanently available, for the act was only to be in force for two years. the dreadful nemesis for such dense inappreciation by parliament of its obligations to the community was, unfortunately, soon to fall heavily upon the unhappy people of the metropolis. thousands of miles away in hindoostan, asiatic cholera of a deadly type had been playing havoc with the people of the country. thence it was slowly but steadily moving westward; so much so that the desirability of making some preparations for defence against its invasion of england became apparent; and in a royal commission was appointed to "inquire whether any, and what, special means might be requisite for the improvement of the health of the metropolis, with regard more especially to the better house, street, and land drainage, ... the better supply of water for domestic use, &c., &c., &c." one important conclusion was at once forced upon the commissioners, namely, that the great and vital task of making adequate provision for the sewerage of london could not be accomplished so long as it was entrusted to several bodies, each with a district of its own. "everything," they said, "pointed to the necessity of operations being superintended by one competent body"; and they declared that it was expedient that a commission for the entire drainage of the whole of the metropolis should be appointed with a special view to such measures, and with aid to carry them out. this report was followed in the ensuing year ( ) by an act of parliament[ ] abolishing the various commissions of sewers (except those of the city), and creating in their stead one executive body whose members were to be appointed by the crown. wide powers were given to this central body: among them that no house was to be built or re-built without proper drains, and without proper sanitary conveniences, and that if houses built before the passing of the act were not properly drained, the commissioners might order the work to be done. the metropolitan commissioners of sewers were duly appointed, and they divided the area over which they had jurisdiction into seven separate sub-districts, with a commission for each. the creation of this body constitutes a great landmark in the sanitary evolution of london, for it was the first recognition by parliament of the great principle of the unity of london; of the necessity--at least so far as regarded one matter--for one central governing authority for the numerous populations, and bodies, and districts which were becoming welded together into one mighty town and one vast community. it is true, the recognition extended only to this one matter, and that the central board was to be a board nominated by the crown, and without any vestige of representation upon it, but none the less it was a forward step towards a sounder and wiser system of government than that which had hitherto prevailed. that the new body failed to prove equal to the task imposed upon it was due as well to the constituent members thereof as to the imperfections of the machinery devised by the act. its failure, however, in no way controverted the soundness of the great principle thus, for the first time, recognised by parliament. the evidence given before the royal commissioners brought into view the enormous area of filth and limitless insanitation in london: it displayed some of the principal sources of the excessive amount of disease and premature mortality; and to some extent it elucidated the principles and demonstrated the practicability of large measures of prevention. and it also disclosed the regrettable fact that since the epidemic of cholera in there had been little or no improvement in the sanitary condition of many parts of the metropolis--indeed, in most parts of it the evils were wider spread and acuter in form, whilst, owing to the increase of population, the numbers affected were vastly larger. all the while the commissioners were sitting, the evil seeds of insanitation were producing a tremendous crop, and events actually occurring at the moment emphasised the crying need for some means of grappling with the intolerable existing evils. the whole class of zymotic diseases--diseases which constitute the true gauge of the healthiness or unhealthiness of a community--received a rapid and immense development.[ ] from , deaths from such diseases in , the number increased to , in ; and in this latter year the metropolis was visited by two epidemics which rendered the mortality of the last quarter of the year higher than that of any other quarter of any year since the new system of registration of deaths had been commenced.[ ] typhus fever produced fourfold its ordinary mortality--other diseases showed a similar increase--and towards the end of november influenza broke out and spread so suddenly and to such an extent that within five or six weeks it attacked no less than , persons out of , , --the then population of london. altogether the excess of mortality in over was very close upon , persons. the attitude of parliament and of successive governments about this period, as regarded the insanitary condition of the masses of the inhabitants of london, is now almost incomprehensible. the plea of ignorance cannot be urged in exculpation, for their own blue books and official returns were there to inform them. moreover, the existence of similar evils throughout the country, where they were on a very much smaller scale, was recognised both by the government and parliament. lord morpeth, a member of the cabinet, speaking in in the house of commons, said[ ]:-- "it is far from any temporary evil, any transient visitant, against which our legislation is now called upon to provide. it is the abiding host of disease, the endemic and not the epidemic pestilence, the permanent overhanging mist of infection, the annual slaughter doubling in its ravages our bloodiest fields of conflict, that we are now summoned to grapple with." yet they resolutely shut their eyes to the huge mass of misery and fearful waste of life which was going on at their very doors, and all around them. this was proved beyond controversy by their action in . in that year the government introduced into parliament a measure which was, in effect, a comprehensive sanitary code, and which, if duly enforced, was capable of conferring vast benefit on the community at large. describing the provisions of the bill, lord morpeth said:-- "it will be imperative upon the local administrative bodies to hold meetings for the transaction of business; to appoint a surveyor; to appoint an inspector of nuisances; to make public sewers; to substitute sufficient sewers in case old ones be discontinued; to require owners or occupiers to provide house-drains; to cleanse and water streets; to appoint or contract with scavengers to cleanse, cover, or fill up offensive ditches; ... to provide sufficient supply of water for drainage, public and private, and for domestic use. "the permissive powers to be granted to the local administrative bodies ... include the power to make house-drains upon default of owner or occupier, to make bye-laws with respect to the removal of filth, to whitewash and purify houses after notice ... to require that certain furnaces be made to consume their own smoke ... to provide places for public recreation, to purchase and maintain waterworks." the bill, which was duly passed and became an act, in fact provided means for coping with many of the sorest dangers, it curbed some of the powers for evil which so many persons had such little scruple in exercising; it provided methods for bringing to punishment at least some of the evil-doers who hitherto had gone scot free; and it held out some prospects of the diminution of the huge death rate and still huger sick rate. though a somewhat similar bill, introduced in , and which was withdrawn, had included the metropolis, this act did not apply to the metropolis. its application was limited to the rest of england and wales. london--the capital of the kingdom--was, it was said, "reserved for a separate bill." "the separate bill," however, did not make its appearance. the subtle, all-pervading influence of vested rights was too powerful for any such reform to be attempted.[ ] and so, the government and parliament, deliberately excluding the metropolis from this beneficial legislation, left untouched the centre and main emporium of disease, and left the people of london exposed on all sides to the merciless onslaught of the direst diseases which can afflict mankind. cholera, however, the only power able to awe the government, was now so close at hand that some special provision had to be devised for the protection of the public health. parliament, this time not excluding the metropolis, re-enacted the trumpery "nuisance removal and diseases prevention act" of , with some slight enlargements, and one important addition, namely, authority for the appointment by the privy council of a general board of health, which might issue directions and regulations for the prevention of epidemic and contagious disease. upon this slender thread londoners were left dependent for such measures as might afford them some protection against the impending epidemic. no other help was at hand. nor was there much time for help to be organised or preparations made, for cholera had reached egypt and constantinople, and by june, , had crept forward to st. petersburg. isolated suspicious cases occurred in london in the summer of ,[ ] then an undoubted case in southwark on the nd of september, and then more undoubted cases, and the disease had secured a footing. as the winter approached it died down and ceased, having carried off some victims. the privy council had appointed a general board of health, and early in november the board issued regulations directing the guardians to take the necessary measures for the cleansing of houses, the abatement of nuisances, and generally for the removal of all matters injurious to health. to direct is one thing, to get obeyed is another, and with some few exceptions, these directions were disregarded. partly, the fault was parliament's. the act, by naming various local authorities, had created a divided power, and consequently a divided responsibility, which resulted in inaction, neglect, delay, and loss of life; and though the general board of health might require the boards of guardians and other local bodies to put the regulations into force, they had no power to compel them to do so, and in default of such power the general board of health was almost helpless. the cessation of the disease proved to be only temporary. scarcely was entered on than the epidemic broke out again, steadily gathering momentum as the summer went on. in bethnal green there was an outbreak in the night--sudden and panic-striking--"consternation and alarm were spread abroad--the hurried passing and re-passing of messengers, and the wailing of relatives, filled the streets with confusion and woe, and impressed all with a deep sense of awful calamity." and the epidemic spread and spread until in one week in september ( ) the deaths from it amounted to , .[ ] were the full facts known, the mortality was doubtless far higher. and then the epidemic began rapidly to abate, and by the end of the year had ceased, having slain some , victims.[ ] numerous and important were the lessons inculcated by this disastrous epidemic. it afforded the most definite evidence that had yet been obtained of the influence upon health of local conditions and pre-disposing causes. it showed that in the most violent and extensive outbreaks of the pestilence its virulence was invariably confined to circumscribed localities. it showed that the habitat of cholera and the habitat of fever were one and the same. deaths from cholera took place in the very same streets, and houses, and rooms, which had been again and again visited by fever; and rooms were pointed out where some of the poor people had recovered from fever in the spring to fall victims to cholera in the summer. as it was tersely summed up by one of the most active and capable medical officers of the board of health:-- "we find but one cause of so much sickness, suffering and death--the prolific parent of all this diversified offspring--'filth.' "it is in filth, in decomposing organic matter, that the main causes of epidemic diseases are to be sought out--filthy alleys, filthy houses, filthy air, filthy water, and filthy persons." what the general board of health could do, it did, as was indeed to be expected from such sanitary enthusiasts as lord ashley, dr. southwood smith, and mr. edwin chadwick, but the local authorities were dilatory, lukewarm, or actually hostile, and their proceedings, where anything was done, were altogether inadequate for insuring those prompt, comprehensive, and vigorous measures so urgently demanded in the presence of a great and destructive epidemic such as malignant cholera. the system of house-to-house visitation was essential for the discovery and checking of the disease, but, wrote the board, "nothing effective was done or attempted in the metropolis. we repeatedly and earnestly urged upon the boards of guardians the importance to the saving of life of making immediate arrangements for special measures of prevention, but our representations were made in vain. "the local authorities could not be induced to carry into effect the preventive measures we proposed." several unions and parishes, among whom were some of the most wealthy and populous, positively refused to comply with the directions of the board. in the case of bethnal green, just described, the board issued a "special order." but even under these urgent circumstances "the board of guardians appointed no medical officer for five days, they provided no nurses, they established no hospital, they opened no dispensary, they appointed one inspector of nuisances instead of two, and they made no provision for extensive and effectual lime-washing." the explanation of the inaction and hostility of the local authorities lay in the fact that the various measures prescribed by the act interfered with private interests, and especially with interests which were largely represented on the boards of guardians. among the members of those boards there was often "an antagonistic power" at work which prevented proper attention being paid to the sanitary condition of the localities of the poor. in many instances, owners of small houses and cottage property, to which class of dwellings the provisions of the act more particularly applied, were themselves members of such boards, and when this was not the case, they exerted an influence not the less powerful because it was indirect. this interest often conspired to impede efficient sanitary measures.[ ] local interests also operated, the apprehension being that if active and really efficient measures were adopted the trade of the neighbourhood would suffer. in one instance--an instructive one--where the epidemic had extensively prevailed among the poor, its existence was denied, and house-visitation resisted, till, after considerable delay and loss of life, a number of shopkeepers were attacked by the disease, and _then_, all opposition ceased. the evidence of the unfitness of the local authorities charged with the administration of the act for the duties imposed upon them was overwhelming. the unfortunate position was accentuated and intensified by the fact that the general board of health had no power either of compelling the local authorities to do their duty or of itself acting in default of their neglect; and the absence of this first essential of effective administration hampered and crippled its action. the board summed up its experience of this great visitation of - :-- "the evidence shows that where combined sanitary arrangements have been carried into effect the outbreak of the pestilence has been sometimes averted; that where not prevented, its course has been gradually arrested. "that where material improvements have been made in the condition of the dwellings of the labouring classes, there has been an entire exemption from the disease, and where minor improvements were made, the attacks have been less severe and less extensive. "that with reference to the measure of prevention, the immunity from the disease has been in proportion to the extent to which those measures have been carried into effect systematically and promptly." by the end of the year the epidemic was practically over. and then the usual thing took place. it is described a few months later by dr. grainger, who wrote:-- "in many of the most densely populated districts the inspectors of nuisances have been dismissed, the cleansing operations have been relaxed, and there is too much reason to apprehend that the courts and alleys will lapse back again into their accustomed filth, ... that houses proved by the evidence of medical officers, inspectors, and local authorities to be unfit for human habitation will long continue to remain 'pest-houses,' spreading disease around; and that, in the midst of these tolerated and accumulated evils, the industrious classes will continue as heretofore to be decimated by fever, or, should it again break out, by cholera."[ ] chapter i, part iii the "city" of london, though constituting territorially and by population but a small portion of the metropolis, affords much matter of deep interest in connection with the sanitary evolution of london, totally apart from those great economic forces emanating from it which have dominated the whole of london life. the "city" differed mainly, as has already been pointed out, from "greater london" in that it had a real and active governing body for its local affairs, and that that body was possessed of considerable powers for dealing with the sanitary condition and requirements of its inhabitants. that those sanitary powers were annually delegated to a body entitled the commissioners of sewers in no way diminished its sanitary authority or weakened its efficiency, for that body was practically a committee of its own, and had authority, directly or indirectly, over nearly every one of the physical conditions which were likely to affect the health or comfort of its inhabitants. the "city" differed also in that it was able to obtain from the government and parliament powers which neither government nor parliament would grant to "greater london." it differed too in that from onwards it was in beneficial enjoyment of the services of a medical officer of health. but in many respects the "city" was a microcosm of the metropolis; and though possessed of a local government, yet was it cursed with evils which were the terrible legacy left it by the ignorance, indifference, neglect, incapacity, or cupidity, of previous generations. the graphic reports of its medical officer of health--dr. john simon--have left us a most vivid and valuable contemporary picture of the sanitary condition and surroundings of the people living in the favoured area about the middle of the last century, and they disclose, in no hesitating manner, the desperate evils prevalent therein. the thames, "with the immeasurable filth" which polluted it, and its acres of mud banks saturated with the reeking sewage of an immense population, vitiated the atmosphere of the city, just as it did that of other parts of london. but sewers there were in the city, of one sort or another, over forty miles of them, and some of the filth of the city was carried away, at least into the river. house drainage into the sewers was, however, either lamentably deficient or non-existent, and cesspools abounded--abounded so freely that "parts of the city might be described as having a cesspool-city excavated beneath it." "it requires," reported dr. simon to his employers, "little medical knowledge to understand that animals will scarcely thrive in an atmosphere of their own decomposing excrements; yet such, strictly and literally speaking, is the air which a very large proportion of the inhabitants of the city are condemned to breathe.... in some instances, where the basement storey of a house is tenanted, the cesspool lies, perhaps merely boarded over, close beneath the feet of a family of human beings whom it surrounds uninterruptedly, whether they wake or sleep, with its foetid pollution and poison." for such evils, and such a state of things, he said, house drainage, with effective water supply, were the remedies which could alone avail; and it was only in the session of that the authority to secure and enforce these remedies was vested by the legislature in any public body whatsoever. the city was fortunately included, but the metropolis, with its two and a half millions of inhabitants, was unfortunately not. the unrestricted supply of water, he pointed out, was the first essential of decency, of comfort, and of health; no civilisation of the poorer classes could exist without it; and any limitation to its use in the metropolis was a barrier which must maintain thousands in a state of the most unwholesome filth and degradation. even in the city, however, the supply of water was but "a fraction of what it should have been, and thousands of the population inhabited houses which had no supply of it." nor was what was supplied by the water companies much to boast of. "the waters were conducted from their sources in open channels; they received in a large measure the surface-washing, the drainage, and even the sewage of the country through which they passed; they derived casual impurities from bathers and barges, and on their arrival were, after a short subsidence in reservoirs, distributed without filtration to the public." in some cases the scanty distribution was from a stand-pipe in a court or alley, for a very short time of the day. in other cases the water was delivered into butts or cisterns. their condition is thus described:-- "in inspecting the courts and alleys of the 'city,'" he wrote, "one constantly sees butts, for the reception of water, either public or in the open yards of houses, or sometimes in their cellars; and these butts, dirty, mouldering, and coverless; receiving soot and all other impurities from the air; absorbing stench from the adjacent cesspool; inviting filth from insects, vermin, sparrows, cats, and children; their contents often augmented through a rain-water pipe by the washings of the roof, and every hour becoming fustier and more offensive. nothing can be less like what water should be than the fluid obtained under such circumstances." it is interesting to observe that the evils of the system of water supply by private companies were, even in the "city," so manifest that dr. simon expressed his opinion that the only satisfactory solution of the difficulty in connection therewith was the acquisition by the public authority of the control of the supply, and he urged the adoption of the principle of what is now denounced by some people as "municipal trading." in every practical sense the sale of water in london was a monopoly. "the individual customer," wrote dr. simon, "who is dissatisfied with his bargain can go to no other market; and however legitimate may be his claim to be supplied with this prime necessary of life at its cheapest rate, in the most efficient manner, and of the best possible quality, your honourable court (the commissioners of sewers) hitherto possesses no power to enforce it." in the public health act of the principle had been recognised by parliament so far as towns in the country were concerned--local boards of health being authorised to provide their district with such a supply of water as might be proper or sufficient, or to contract for such a supply. he urged that the city should obtain a similar power. "all the advantages which could possibly be gained by competition, together with many benefits which no competition could ensure, would thus be realised to the population under your charge." but that solution of the difficulty was more than half a century in advance of its accomplishment so far as either the "city" or "greater london" was concerned. as to the atmosphere in the "city," there seems to have been no limit to the pollutions thereof, all of which were injurious to the health of the public. numerous noxious and offensive trades were carried on in the most crowded places. directly and indirectly, slaughtering of animals in the "city" was prejudicial to the health of the population, and exercised a most injurious influence upon the district. the number of slaughter-houses registered and tolerated in the "city" in amounted to , and of these, in cases, the slaughtering was carried out in the vaults and cellars.[ ] and there were very many noxious and offensive trades in close dependence upon "the original nuisance" of the slaughter-house, and round about it, "the concomitant and still more grievous nuisances of gut-spinning, tripe-dressing, bone-boiling, tallow-melting, paunch-cooking, &c., &c." certain it is that offensive businesses of these and other sorts were carried on by their owners with an absolute disregard to the comfort or health of the public. the matter was a difficult one to deal with, as any severe restrictions might destroy the trade or manufacture and take away from the people the employment which gave them the means of earning a livelihood. furthermore, such restrictions were usually resented as an infraction of personal liberty. dr. simon forcibly and conclusively answered this contention. "it might," he wrote, "be an infraction of personal liberty to interfere with a proprietor's right to make offensive smells within the limits of his own tenement, and for his own separate inhalation, but surely it is a still greater infraction of personal liberty when the proprietor, entitled as he is to but the joint use of an atmosphere which is the common property of his neighbourhood, assumes what is equivalent to a sole possession of it, and claims the right of diffusing through it some nauseous effluvium which others, equally with himself, are thus obliged to inhale." some improvement in this respect was rendered possible by the act of , which enacted that whatever trade or business might occasion noxious or offensive effluvia, or otherwise annoy the inhabitants of its neighbourhood, "shall" be required to employ the best known means for preventing or counteracting such annoyance. but the remedy scarcely appears to have been availed of or enforced, and "greater london" was, as usual, excluded from the act. another more constant pollution of the air was that resulting from intramural burial. "overcrowding" in the "city" was not limited to the living; it extended even to the dead, and though the dead themselves had passed beyond any further possible harm from it, yet their overcrowding affected disastrously those they had left behind. here the evils already described as existing in "greater london" existed also in acute form. two thousand bodies or more were interred each year actually within the "city" area, and the burial grounds were densely packed. and "in all the larger parochial burying grounds, and in most others, the soil was saturated with animal matter undergoing slow decomposition." and the vaults beneath the churches were "in many instances similarly overloaded with materials of putrefaction, and the atmosphere which should have been kept pure and without admixture for the living, was hourly tainted with the foetid emanations of the dead...." in dr. simon's words:-- "close beneath the feet of those who attend the services of their church there often lies an almost solid pile of decomposing human remains, heaped as high as the vaulting will permit, and generally but very partially coffined." the metropolitan burials act of effected a great improvement in this respect by putting a term to the indefinite perpetuation of this horrible evil. it gave the secretary of state power to prohibit further intramural burials, and it gave the "city," and other local authorities, the power to establish burial places beyond the boundaries of the metropolis. but, even when thus stopped, years had to elapse before the condition of intramural burial grounds and vaults would cease to vitiate the air around them.[ ] the atmosphere of the "city," the air which people breathed, was thus vitiated in varying degrees of intensity by numerous and various abominations--the polluted thames, defective sewerage and drainage, offensive trades, intramural interments. as regards the houses in which the people lived, these were crammed together--packed as closely together as builders' ingenuity could pack them--many of them combining every defect that houses could have, and so situated that ventilation was an impossibility. "in very many parts of the city you find a number of courts, probably with very narrow inlets, diverging from the open street in such close succession that their backs adjoin, with no intermediate space whatsoever. consequently each row of houses has but a single row of windows facing the confined court, and thus there is no possibility of ventilation, either through the court generally or through the houses which compose it.... houses so constructed as to be as perfectly a cul-de-sac out of the court as the court is a cul-de-sac out of the street."[ ] and the climax of insanitary conditions was reached when these densely-packed houses were overcrowded by human beings. the process of converting dwelling-houses into warehouses, or business offices, or for trade or manufactures was in full swing--a constant force--and so the number of houses for people to live in became ever fewer. and the "tenement houses," in which the great bulk of the working classes lived, became more and more crowded; houses wherein "each holding or tenement, though very often consisting but of a single small room, receives its inmates without available restriction as to their sex or number, and without registration of the accommodation requisite for cleanliness, decency, and health." the census of had shown an increase of over , in the population of the "city," and a diminution of nearly houses. "probably," wrote dr. simon, "for the most part it represents the continued influx of a poor population into localities undesirable for residence, and implies that habitations previously unwholesome by their overcrowdedness are now still more densely thronged by a squalid and sickly population.... "it is no uncommon thing, in a room twelve feet square or less, to find three or four families styed together (perhaps with infectious disease among them), filling the same space night and day--men, women, and children, in the promiscuous intercourse of cattle. of these inmates it is nearly superfluous to observe that in all offices of nature they are gregarious and public; that every instinct of personal or sexual decency is stifled; that every nakedness of life is uncovered there.... who can wonder at what becomes, physically and morally, of infants begotten and born in these bestial crowds?..." of overcrowding or "pestilential heaping of human beings," this matter of "infinite importance," he wrote:-- "while it maintains physical filth that is indescribable, while it perpetuates fever and the allied disorders, while it creates mortality enough to mask the results of all your sanitary progress, its moral consequences are too dreadful to be detailed." pursuing his masterly analysis of the sanitary condition of the people in the "city" and its causes, he wrote:-- "last and not least among the influences prejudicial to health in the city, as elsewhere, must be reckoned the social condition of the working classes.... often in discussion of sanitary subjects before your honourable court, the filthy, or slovenly, or improvident, or destructive, or intemperate, or dishonest habits of these classes are cited as an explanation of the inefficiency of measures designed for their advantage. it is constantly urged that to bring improved domestic arrangements within the reach of such persons is a waste and a folly. "it is unquestionable that in houses containing all the sanitary evils enumerated--undrained and waterless, and unventilated--there do dwell whole hordes of persons who struggle so little in self-defence against that which surrounds them that they may be considered almost indifferent to its existence, or almost acclimated to endure its continuance. "it is too true that among the lower classes there are swarms of men and women who have yet to learn that human beings should dwell differently from cattle--swarms to whom personal cleanliness is utterly unknown; swarms by whom delicacy and decency in their social relations are quite unconceived. "my sphere of duty lies within the city boundary. "i studiously refrain from instituting comparisons with other metropolitan localities. * * * * * "i feel the deepest conviction that no sanitary system can be adequate to the requirements of the time, or can cure those radical evils which infest the under framework of society, unless the importance be distinctly recognised and the duty manfully undertaken of improving the social condition of the poor.... "who can wonder that the laws of society should at times be forgotten by those whom the eye of society habitually overlooks, and whom the heart of society often appears to discard? "to my duty it alone belongs, in such respects, to tell you where disease ravages the people under your charge, and wherefore; but while i lift the curtain to show you this--a curtain which propriety may gladly leave unraised--you cannot but see that side by side with pestilence there stalks a deadlier presence, blighting the moral existence of a rising population, rendering their hearts hopeless, their acts ruffianly and incestuous, and scattering, while society averts her eyes, the retributive seeds of increase for crime, turbulence, and pauperism." and what was the physical result of this state of living? "in some spots in the city you would see houses, courts, and streets, where the habitual proportion of deaths is far beyond the heaviest pestilence rate known for any metropolitan district aggregately--localities where the habitual rate of death is more appalling than any such averages can enable you to conceive. "among their dense population it is rare to see any other appearance than that of squalid sickness and misery, and the children who are reproduced with the fertility of a rabbit warren perish in early infancy. "the diseases of these localities are well marked. scrofula more or less completely blights all that are born ... often prolonging itself as a hereditary curse in the misbegotten offspring of those who, under such unnatural conditions, attain to maturity and procreation. "typhus prevails as a habitual pestilence. "the death rate during the last five years has been at the rate of about twenty-four per , per annum. "the city of london appears peculiarly fatal to infant life. "of the , persons who died within your jurisdiction in the five years - to - , nearly three-eighths died in the first five years of life." to his employers he mostly appeals. he hopes that the statements in his reports may suffice to convince them of the necessity which exists in the "city" of london for some effectual and permanent sanitary organisation. "for the metropolis generally there is hitherto no sanitary law such as you possess for your territory." he pointed out that-- "inspection of the most constant, most searching, most intelligent, and most trustworthy kind is that in which the provisional management of our said affairs must essentially consist. * * * * * "the committee was given power by the act for the amendment or removal of houses presenting aggravated structural faults. "wherever your medical officer of health may certify to you that any house or building is permanently unwholesome and unfit for human habitation, you are empowered to require of the owner (or in his neglect yourselves to undertake) the execution of whatever works may be requisite for rendering the house habitable with security to life." and he urged that:-- "the principle might be distinctly recognised that the city will not tolerate within its municipal jurisdiction the continuance of houses absolutely incompatible with healthy habitation. "here terminates my statement of the powers now vested in you for the maintenance of the public health. "authority so complete for this noble purpose has never before been delegated to any municipal body in the country. "if the deliberate promises of science be not an empty delusion, it is practicable to reduce human mortality within your jurisdiction to nearly the half of the present prevalence." the most valuable and weighty of all his conclusions was that affixing the responsibility for the existing mass of insanitation and consequent misery. with a courage worthy of all admiration he did not hesitate, regardless of the consequences to himself, to fix the responsibility and blame where they were due. "the fact is that, except against wilful violence, life is very little cared for by the law." of parliament he wrote:-- "fragments of legislation there are, indeed, in all directions; enough to establish precedents, enough to testify some half-conscious possession of a principle; but for usefulness little beyond this. the statutes tell that now and then there has reached to high places the wail of physical suffering. they tell that our law makers, to the tether of a very scanty knowledge, have, not unwillingly, moved to the redress of some clamorous wrong.... but ... their insufficiencies constitute a national scandal, ... something not far removed from a national sin.... "the landlord must be held responsible for the decent and wholesome condition of his property, and for such conduct of his tenants as will maintain that condition." the clear, precise, and unqualified enunciation of such a principle must have given a shock to many of the members of the governing authority of the "city," and excited their wrath, the more especially as it was so absolutely sound and true. "the death of a child by smallpox," he went on to say, "would in most instances call for a verdict of 'homicide by omission' against the parent who had neglected daily opportunities of giving it immunity from that disease by the simple process of vaccination; the death of an adult by typhus would commonly justify still stronger condemnation (though with more difficulty of fixing and proportioning the particular responsibility) against those who ignore the duties of property, and who knowingly let for the occupation of the poor dwellings unfit even for brute tenants, dwellings absolutely incompatible with health." and then he proceeds to explain and justify and enlarge upon his assertion of the responsibility of the landlord. "there are forty-five miles of sewerage in your jurisdiction, ready to receive the streams of private drainage, and leaving the owners of house property no excuse for the non-performance of necessary works.... but ... the intentions of your court, and the industry of its officers, have been in great measure frustrated by the passive resistance of landlords. delays and subterfuges have been had recourse to in order to avoid compliance with the injunctions of the commission." in his evidence before the royal commission of - he said:-- "the poorer house property of the city is very often in the hands of wealthy people who have only the most general notion of its whereabouts, have perhaps never visited the place for which they receive rent, and in short know their property only through their agents. "instances have come to my knowledge of the very worst description of property being thus held ignorantly and carelessly by wealthy persons. often for years we can get at no representative of the property other than the agent or collector who receives the weekly rent for some anonymous employer." in his third report to the commissioners of sewers he wrote:-- "it is easy to foresee the numerous obstacles which interested persons will set before you to delay the accomplishment of your great task. "when your orders are addressed to some owner of objectionable property--of some property which is a constant source of nuisance, or disease, or death; when you would force one person to refrain from tainting the general atmosphere with results of an offensive occupation; when you would oblige another to see that his tenantry are better housed than cattle, and that, while he takes rent for lodging, he shall not give fever as an equivalent--amid these proceedings you will be reminded of the 'rights of property' and of 'an englishman's inviolable claim to do as he will with his own.' "permit me to remind you that your law makes full recognition of these principles and that the cases in which sophistical appeal will often be made to them are exactly those which are most completely condemned by a full and fair application of the principles adverted to. with private affairs you interfere only when they become of public import, with private liberty only when it becomes a public encroachment. the factory chimney that eclipses the light of heaven with unbroken clouds of smoke, the melting house that nauseates an entire parish, the slaughter-house that forms round itself a circle of dangerous disease--these surely are not private but _public_ affairs. "and how much more justly may the neighbour appeal to you against each such nuisance as an interference with his privacy; against the smoke, the stink, the fever that bursts through each inlet of his dwelling, intrudes on him at every hour, disturbs the enjoyment and shortens the duration of his life. and for the rights of property--they are not only pecuniary. life, too, is a great property, and your act (of ) asserts its rights." "the landlord of some overthronged lodging-house complains that to reduce the number of his tenantry, to lay on water, to erect privies, or to execute some other indispensable sanitary work, would diminish his rental--in the spirit of your act it is held a sufficient reply that human life is at stake--and that a landlord in his dealings with the ignorant and indefensive poor cannot be suffered to estimate them at the value of cattle, to associate them in worse than bestial habits, or let to them for hire at however moderate a rent the certain occasions of suffering and death." "seeing the punctuality with which weekly visitation is made for the collection of rents in these wretched dwellings it would not be unreasonable to insist on some regulations for the clean and wholesome condition of his premises, water supply, and scavenging, &c." such a regulation would "render it indispensable to the landlord of such holdings to promote cleanly and decent habits among his tenants--even to obtain security for their good behaviour." the picture thus presented of the sanitary condition of the people residing in the "city" about the middle of the last century is--it must be acknowledged--a terrible one; but it rests upon unimpeachable testimony. the very grave and serious conclusion, however, follows from it--that if the evils were thus terrible in the "city," with a comparatively small population, only a little more than a twentieth of that of the metropolis, and where there was a local government with wide powers for dealing with matters affecting the public health--how infinitely more serious was the condition of things in the "greater london" with its huge population, and where there was practically no local government, and no punitive law for insanitary misdoings and crimes. in some degree, the evils the people suffered under were of their own making, though many excuses can be urged in extenuation. in some degree, too, the people were unquestionably the victims of circumstances. but in the main, they were the victims of other people's iniquities. it was those circumstances which the government should have altered, or, at any rate, have endeavoured to control or modify--it was the unlimited power to do evil that the government should have checked and curbed; but "greater london" was virtually left outside the pale of remedial legislative treatment by parliament. chapter i, part iv the great cholera epidemic of - had deeply stirred public feeling in london. it had destroyed , people (and diarrhoea, its satellite, had destroyed many thousands more), and it had been "accompanied by an amount of sickness and physical misery beyond computation." but even all its horrors, and all the proofs it afforded of the desperately insanitary condition of the masses in the metropolis, were not sufficient to induce the government to depart from its policy of neglect, or to wring from parliament measures which would lay the basis for the alleviation of the sufferings of the working population of the metropolis, or which would remove even a small part of the evils which fell so heavily upon those least able to sustain them, and least able to remove them. the health of london was becoming worse every year. the number of persons dying from preventable disease had been steadily increasing. one gleam of hope there was, however. an increasing number of persons were becoming interested in the health of the people, and were awakening to the gravity of the subject, and to the public discredit and inhuman scandal of the existing condition of things--an awakening of interest which, in february, , reached to the extent of a public meeting. the bishop of london presided, and the meeting was rendered the more remarkable by speeches from lord ashley, then actively pressing sanitary and social questions forward, and by charles dickens. lord ashley said:-- "the condition of the metropolis, in a sanitary point of view, was not only perilous to those who resided in it, but it was an absolute disgrace to the century in which they lived. it was a disgrace to their high-sounding professions of civilisation and morality. they were surrounded by every noxious influence--they were exposed to every deadly pestilence.... the water they drank, the air they breathed, the surface they walked on, and the ground beneath the surface, all were tainted and rife with the seeds of disease and death.... "let them look at another abomination--the existence of putrefying corpses in graveyards and in vaults amidst the habitations of the living--an abomination discountenanced by all the civilisation of modern days, as it was by that of the ancient days--the practice of intramural interments. "could anything be worse than the graveyards of the metropolis? under a surface of ground not amounting to acres there had been interred within thirty years in the metropolis far more than , , human beings. what must be the condition of the atmosphere affected by the exhalations from that surface?... "and what were the financial and social consequences of allowing such a state of things to exist? "at least one-third of the pauperism of the country arose from the defective sanitary condition of large multitudes of the people...." charles dickens said:-- "the object of the resolution he was proposing was to bring the metropolis within the provisions of the public health act, most absurdly and monstrously excluded from its operation.... infancy was made stunted, ugly, and full of pain; maturity made old; and old age imbecile. "he knew of many places in london unsurpassed in the accumulated horrors of their long neglect by the dirtiest old spots in the dirtiest old towns under the worst old governments in europe. "the principal objectors to the improvements proposed were divided into two classes. "the first consisted of the owners of small tenements, men who pushed themselves to the front of boards of guardians and parish vestries, and were clamorous about the rating of their property; the other class was composed of gentlemen, more independent and less selfish, who had a weak leaning towards self-government. the first class generally proceeded upon the supposition that the compulsory improvement of their property when exceedingly defective would be very expensive.... "no one," he went on to say, "who had any knowledge of the poor could fail to be deeply affected by their patience and their sympathy with one another--by the beautiful alacrity with which they helped each other in toil, in the day of suffering, in the hour of death. "it hardly ever happened that any case of extreme protracted destitution found its way into the public prints without our reading at the same time of some ragged samaritan sharing his last loaf or spending his last penny to relieve the poor miserable in the room upstairs or in the cellar underground. it was to develop in the poor people the virtue which nothing could eradicate, to raise them in the social scale as they should be raised, to lift them from a condition into which they did not allow their beast to sink, ... to cleanse the foul air for the passage of christianity and education throughout the land, that the meeting was assembled. the object of their assembly was simply to help to set that right which was wrong before god and before man." the realisation of this object, noble as it was, was not easily attainable. the vicar of st. martin-in-the-fields said that "the difficulty of legislation in these matters was to hit the medium between the rights of property and the rights of humanity." he might have added, with truth, that the difficulty had so far been met by sacrificing the rights of humanity to the rights of property. lord ashley had pointed out that they "had to contend with ignorance, indifference, selfishness, and interest;" or as lord robert grosvenor more vigorously expressed it, in a phrase which should live in history as giving the key to the mystery of the slow sanitary evolution of this great city, they had to contend against "vested interests in filth and dirt." one thing was already absolutely clear, that it was hopeless to expect anything from the spontaneous action of land-owners or house-owners. "they knew it was quite impossible," said the bishop of chichester, "to bring the owners of even one small court or alley, much less the owners or occupiers of any large district, to concur in any measure for the general good of their particular locality." the fact was that nothing but the imperative directions of the law would secure the removal of evils or curtail the practice of infamous abuses--and even when the law was enacted for their remedy, nothing but its rigorous enforcement with adequate penalties would make it effective. as the result of the meeting, a deputation waited on lord john russell, the then prime minister. his reply was not encouraging. "in this city," he said, "there is very naturally and properly great jealousy of any interference either with local rights or individual will and freedom from control." that great jealousy proved to be so powerful that nothing was attempted by the government except an abortive effort to deal with the loathsome and insanitary evils of intramural interments where vested interests were neither powerful nor loud voiced. the act was so defective that it never came into operation, and two more years elapsed before the government again essayed to deal with the subject. and in the meanwhile that most horrible evil was permitted to work its will upon the dwellers in the metropolis. to the enthusiasm of an individual, and not of the government, was due the first effective attempt to grapple with one of the widespread, deep-seated evils which were working such havoc among the people. the most disastrous and vicious forms of overcrowding were at the time to be found in the so-called common lodging houses--the sink of insanitary abominations. these were the temporary and casual abodes of the dregs of london humanity--of the tramps, and the unfortunates, and the mendicants and criminals, male and female--when they could afford the penny or pence to pay for their night's lodging. in most cases these houses were low brothels and hotbeds of crime and moral degeneracy, their foul and filthy condition making them great sources and propagators of contagious and loathsome diseases. in the "city" the authorities had power to regulate and control them. not so, however, in the metropolis. there, no one had any authority in the matter, nor was there any authority for any one to have. lord ashley, truly discerning that the one and only way of dealing with this evil was by regulation and constraint, introduced a bill[ ] and actually carried it through parliament, and two years later got another act[ ] embodying amendments which made it more effective. what the common lodging house owner or keeper--anxious to secure the utmost profits from his property and regardless of all consequences to others--would not do, he was, by those acts, made to do. the houses which he devoted to this purpose, solely for his own profit, were placed under the control and inspection of the police, and had to be registered as "common lodging houses." overcrowding in them was checked by restricting the number of inmates who might be in each room; regulations (confirmed by a secretary of state) were made, and steadily enforced, for the separation of the sexes; for the proper cleansing of the houses; and for compelling the keeper to give immediate notice of fever or any contagious or infectious disease occurring therein. the accumulation of refuse was to be prevented, and provision had to be made for adequate sanitary accommodation, for better drainage, and for sufficient water supply. a very brief experience showed that great practical benefits resulted from thus regulating these houses, and the amount of sickness and mortality in them became astonishingly small, considering the character of their inmates and the localities where they were situated; and inasmuch as the number of such houses was nearly , , and the population in them about , , the benefit was a really substantial one. how obstinate and pertinacious was the opposition of house-owners, or middlemen, to regulation and supervision of any kind is illustrated by a case reported by the assistant police commissioner.[ ] the owner of certain premises in st. giles' had been often applied to, without success, to remedy some gross sanitary defects therein which had resulted in the loss of life by fever. brought to bay at last, at the police court, and ordered to remedy the evil, he said that he was willing to do all in his power to abate the nuisance ... but, "he thought he ought not to be dictated to as to the way his property was to be managed." his words embodied the predominant spirit of the time. "there are," wrote the assistant police commissioner in commenting upon this case, "owners of property whom nothing but the strong arm of the law can move." unfortunately the act did not go far enough. single rooms occupied by families did not come within its scope. they constituted an enormous proportion of the habitations of the people, and they were allowed to continue the prolific cause of sanitary evils and of physical and moral degradation. limited in its scope though the act was, it afforded nevertheless one great object lesson--the lesson which since that time has been consistently preached by all who had actual experience as regarded the sanitary condition of the people of london--the lesson that the worst of the sanitary and social evils could only be effectually grappled with, on the one side by the supervision and regulation and constant inspection of the houses in which the poorer classes lived, and upon the other side by insistent compulsion of house-owners to maintain a certain standard of sanitation and cleanliness in those houses. that, however, was a course which parliament for many years did not think it desirable to adopt, and which, when adopted in a tentative and half-hearted sort of way, suffered the usual fate of sanitary legislation--that of being neglected, opposed, evaded, or thwarted by land-owners, house-owners, middlemen, and by hostile local authorities. lord ashley also originated and succeeded in the same session in obtaining from parliament another act of notable interest, namely, "the labouring classes lodging houses act,"[ ] which aimed at increasing the quantity of houses for working men by facilitating the establishment of well-ordered houses for such persons. it gave power to vestries to adopt the act, and thereafter to purchase or lease land, and to erect houses thereon for the working classes, and to borrow money on the security of the rates for this purpose. in advocating his plan in the house of commons he enforced the importance of the reform. he said:-- "until the domiciliary condition of the working classes were christianised (he could use no less forcible a term) all hope of moral or social improvement was utterly vain. though not the sole, it was one of the prime sources of the evils that beset their condition; it generated disease, ruined whole families by the intemperance it promoted, cut off or crippled thousands in the vigour of life, and filled the workhouses with widows and orphans."[ ] he specially mentioned one of the objections urged to this proposal for the construction of better houses--an objection which since then has invariably found expression when any amelioration of the housing of the working classes has been proposed to be done by a public authority. "it was said those matters ought to be left to private speculation. he should much object to that. private speculation was very much confined to the construction of the smallest houses, and of the lowest possible description, because it was out of these the most inordinate profits could be made. private speculation was almost entirely in that direction." he might have added that "private speculation" had hitherto had a completely free field in the sphere of housing, with all the evil results visible before them, and that it had aggravated and intensified the evil instead of removing or mitigating it. the debate in parliament was interesting, as it drew from the home secretary an expression of the government view of the situation. "after all," said sir g. grey, "it was not to the government, it was rather to the efforts of individuals, and associations of individuals, that they must look for real and general improvement among the great body of the people. all that the government could do was to remove obstacles in the way, and to present facilities by modifications of the law more useful than direct legislation."[ ] an "association of individuals" had already been formed--"the society for improving the condition of the labouring classes"--and work of this class had to the extent of over £ , been carried out by it. the new piles of buildings erected were eagerly availed of by people of the working classes, and in a sanitary point of view they at once demonstrated their very satisfactory immunity from disease. the act, however, being a voluntary or adoptive act, was not likely to be adopted and put into force by those by whom a certain amount of financial liability might be incurred as the result. as a matter of fact it never was put in force by any vestry, and it remained a dead letter. it was memorable, however, as embodying for the first time in legislation the idea that the housing of the people was a public matter with which a public authority might properly concern itself, even to the extent of competing with private enterprise, and pledging the rates as security. the supply of water to london, both as regarded quality and quantity, had, since the epidemic of - , been engaging the attention of committees of parliament, the belief that the epidemic of cholera had been increased and propagated by the filthy and impure water having given an impetus to the demand for ameliorative measures. in an act[ ] was passed by which the companies taking their water from the thames were required to remove their intakes to some place above teddington lock, where the tide would not affect it, and the sewage of london would not be intermixed with it. this was a considerable step in the right direction, for though the river above teddington lock received the sewage of many large towns and villages, it was at least free from contamination by the sewage and filth of the metropolis. other improvements were also enacted. reservoirs within a certain distance of st. paul's cathedral were to be covered in, and all water intended for domestic use was to be filtered before being supplied to the consumer; and provision was also made for a constant supply of water by every company within five years after the passing of the act. but the companies were given five years within which to effect the removal of the intake from the foulest parts of the river to above tidal reach--and thus for a wholly unnecessary term the cause which had wrought such havoc among the people was permitted to continue its disastrous effects. chapter i, part v the epidemic of cholera in had failed to produce any lasting effect upon the local authorities or the public opinion of london, and the nemesis of renewed neglect and indifference was once again to fall upon the metropolis. cholera had kept hovering about. in a number of suspicious cases occurred in various districts. in suspicion passed into certainty, and the disease assumed the form of an epidemic--as many as deaths from it occurring in the first week in november. then it died down. in the following year it again appeared in more severe epidemic form over the whole of the metropolis. on one day--september th--there were deaths from it. the climax was reached in the second week in september (almost the identical date on which the epidemic of occasioned the highest mortality) and there were , deaths from it.[ ] in that one month , persons died from it, and from july st to december th, when it at last disappeared, there was a total mortality from cholera alone of , persons. every conclusion which had been arrived at as regards the disease during the previous epidemics was confirmed by this third great epidemic, and many previous theories passed into the region of proved facts. cholera was once more proved to be a filth disease, and in the main confined to filthy localities. the more defective and abominable the methods of drainage, the larger the number of victims. the filthier and more contaminated the water supplied for drinking and household purposes, the more numerous the cases, and the more virulent the disease. this was demonstrated beyond further question. the mortality on the south side of the thames was above threefold what it was on the north side; and both as regarded water supply and drainage, south london was in a worse sanitary state than north london. the water consumed by the population there was generally worse than that on the north. lying lower, too, the drainage had less chance of being conveyed away, and in the miles upon miles of open sewer ditches it was left to rot and putrefy in close propinquity to the houses and to poison the air. and the most remarkable proof was afforded by the effects of the consumption of water taken from different sources. in both the lambeth and the southwark water companies pumped the water they supplied to their customers from the very foulest part of the thames--near hungerford bridge--with equally disastrous results. in the course of the following years the lambeth company removed its source of supply to a part of the river above teddington lock--the southwark company, however, went on as before. in the epidemic of the inhabitants of houses supplied with the water by the latter company suffered eight times as much as those supplied by the better water of the lambeth company, whilst the number of persons who died in the houses where the impure was drunk was three and a half times greater than that in the houses where the purer water was supplied. of all the conclusions arrived at by those who had been engaged in combating the disease during this epidemic, the most important was that where cholera had become localised it was connected with obvious removable causes, and was in fact a preventable disease. most unfortunately, and reprehensibly, many of those who could have done most to prevent it failed signally to take action. once more, and this time in an accentuated degree, the widespread prevalence of the disease, and the frightful mortality, were distinctly due to the inertia, laxity, or deliberate neglect of those local authorities who by law were charged with the duty of cleansing localities and removing some of the causes of disease. the general board of health, of which sir benjamin hall was president, did all that it could do. medical inspectors were appointed by it to visit all the parishes most severely affected; and the fullest and minutest instructions were issued to the boards of guardians as to the course they should pursue, and the action they should take. but several of the boards of guardians took no notice of the instructions sent them; others sent unsatisfactory replies. in not one of the parishes in which the epidemic was most fatal was the preventive machinery, sanitary and medical, organised in accordance with the instructions; and although some parishes did more than others, yet, speaking generally, the administration of the sanitary and medical relief measures by the boards of guardians was inefficient in character and extent, except in some of the larger and more healthy parishes where they were least wanted.[ ] at rotherhithe, the guardians declined to proceed with the removal of nuisances as entailing a useless expense. at deptford, where cholera was at the worst, no inspector of nuisances was appointed, even for the emergency. nor did greenwich, where it was also bad, appoint one. in bethnal green, where memories ought to have been bitter, the authorities practically did nothing, although promising almost everything. in lambeth, the parish was left without any adequate protection against the epidemic; and it was only after urgent remonstrances by the medical inspector, and after his threatening to place himself in communication with the coroner in any cases of death occurring in localities where the proper cleansing measures had not been carried out, that he succeeded in obtaining the adoption of measures even to a limited extent.[ ] in clerkenwell, the guardians utterly disregarded the recommendations of the board of health, and from the first there was an openly expressed determination not in any way to be interfered with by the board. and the disastrous state of affairs was, that the nuisances, &c., removal acts gave the board of health no power to enforce upon the guardians the execution of the regulations made. the whole sanitary administration--so far as any existed in london--was in a state of chaos, and the various local authorities were able, with absolute impunity to themselves, to ignore and even defy the general board of health. of these authorities, as has been already said, there was a multiplicity, and it was no infrequent occurrence to find the administrative authority of some of them in the hands of parties directly interested in the continuance of the existing state of matters, evil though those were. in fact, the "vested interests in filth and dirt" were a power in local administration in "greater london," and the practical result was that the great majority of the population of the metropolis were left without any protection against the ravages of epidemic or other preventable diseases. the indifference of parliament, moreover, had left london without any effective or systematic sanitary supervision; and in no part of it, except the "city," was there any officer conversant with the effect of local influences on the health of the population, or who could advise as to the sanitary measures which should be adopted. the board of health having had it brought home to them that, with their limited powers, they were unable to introduce order into this chaos, or to enforce even the most elementary precautions against the spread of the disease, their president addressed a letter on the th of january, , to lord palmerston, the then home secretary (and a few weeks later the prime minister), in which he set forth the exact state of affairs as ascertained by his own observation and by the experience of some of the best and most well-informed medical men in london. in this letter he summarised the main causes of the insanitary condition in which the people of london were forced to live. he wrote:-- "the evidence on the localising conditions of cholera given in the report of dr. sutherland points to the following as among the more prominent of the removable causes of zymotic disease. "open ditches as sewers. want of sewers. badly constructed sewers accumulating deposits and generating sewer gases. "the pollution of the atmosphere in streets and within houses from untrapped drains, from sewer ventilating openings in streets, and from cesspools, whereby the air was contaminated and the sub-soil saturated with filth. "want of house drainage. "the absence of any organised daily system of cleansing, and the consequent retention of house refuse in or near dwellings. "bad water, badly distributed. unwholesome trades. unwholesome vapours exhaled from the thames. cellar habitations. "neighbourhoods, the houses of which are closely packed together with narrow overcrowded streets, alleys and courts so constructed as to prevent ventilation. houses structurally defective, filthy, unventilated, and overcrowded--absolutely unfit for human habitation." and several others which need not be here enumerated. "lastly, and applying to all these--multiplicity of local authorities, and the want of sufficient powers in such authorities to deal with these evils." "great as these evils are in london," he wrote, "... there is not one among them that cannot be remedied if proper steps be taken. "the first and most obvious necessity in the metropolis is to sweep away the existing chaos of local jurisdiction." included in that chaos were two boards with great powers of taxation over which the ratepayers had no control.[ ] one of them consisted of the persons appointed under the metropolitan building act of , who, at a cost of £ , a year, entirely neglected their work. the other, the commissioners of sewers, who had demonstrated their utter incapacity, the cost of whose establishment was "something extraordinary," and who in the five years of their existence had only attempted one great work--"the victoria sewer"--which cost a large sum, and which not many years after fell to ruins. the great epidemic of cholera, its attendant panic, its gruesome accompaniments, its revelation of the actual condition of the masses, and of the rottenness of the local authorities, and the growing outcry against the iniquity of such a state of things in a civilised and christian country, brought matters to a head. the state of the thames had also become a greater danger than ever to the community, and a more unbearable nuisance. as described by _the lancet_ in july, :-- "the waters are swollen with the feculence of the myriads of living beings that dwell upon the banks, and with the waste of every manufacture that is too foul for utilisation. wheresoever we go, whatsoever we eat or drink within the circle of london, we find tainted with the thames.... no one having eyes, nose, or taste, can look upon the thames and not be convinced that its waters are, year by year, and day by day, getting fouler and more pestilential.... the abominations, the corruptions we pour into the thames, are not, as some falsely say, carried away into the sea. the sea rejects the loathsome tribute, and heaves it back again with every flow. here, in the heart of the doomed city, it accumulates and destroys." and the government, compelled at last by the force of events to take some steps for the better sanitary government of the metropolis, and for remedying some of the evils the people suffered under, decided on taking action. acknowledging the necessity for giving local government to "greater london"--the "city" of course already had its own--it proposed the creation of a central authority which should deal with certain matters affecting london as a whole, and local authorities which should deal with local affairs affecting their own localities. and, in , a group of measures giving effect to these views, and containing also what amounted to a sanitary code similar to that in the public health act already for years in force in england, was passed by parliament. those most important measures marked the end of one great period in the sanitary history of this great metropolis. of that period it is to be said that there is none in the history of london in which less regard was shown for the condition of the great mass of the inhabitants of the metropolis; no period when the spirit of commercialism recked so little of the physical condition and circumstances of those upon whom, after all, it depended; no period when the rights of property were so untrammelled by any consideration for the welfare of human flesh and blood; no period when private individuals not alone so strained, for their own advantage or aggrandisement, the utmost rights the law allowed them, but far exceeded those rights, and too often successfully filched from the public that to which the law gave them no right. never had there been a time in which the rights of property had been more insisted upon and exercised. never a time in which land-owners, house-owners, and builders did as freely as they liked with their own, regardless of the injury or damage inflicted upon others; nor in which manufacturers carried on, without interference, trades for their own benefit, which were not merely offensive, but actually death-dealing to their neighbours. and throughout this period the people in their daily lives and circumstances were absolutely unprotected by any public authority, or by any local governing body. there was no one to help them to contend against the extremest exercise of real or even assumed rights. in this period london, the metropolis, had grown up, and had not merely been permitted by the government and the legislature to grow up practically without government, guidance, supervision, or restraint, but it had been absolutely denied any system of local government, and so been denied all provision for the sanitary needs of the community. in a large and liberal measure of municipal self-government was given to all the cities and towns and municipalities large and small of england and wales--many of them not a tithe so populous as the great parishes of london--and a governing body, elected by the ratepayers, and with almost all the essential powers of local government, was instituted in each. but the municipal corporations act expressly excluded the great towns which surrounded the walls of the "city" and which constituted the metropolis, and the law continued to recognise them only as rural parishes. twelve years later, namely in , the towns improvement act was passed, by which towns of much smaller size were given facilities for obtaining considerable powers of local government. by it general sanitary provisions were framed, which, with the sanction of parliament, might be applied in any town for the management by the local authorities of the supply of water, of drainage, of the paving, cleansing, and lighting of the streets, and the prevention of fires; and for the regulation of buildings, of slaughter-houses, of public baths, and of the interment of the dead. but even this more limited but still liberal system of local government was not extended to london, and once more the metropolis was excluded. the "city" did not wish to extend its own borders, and the authorities of the "city" viewed with dislike the idea of the creation at their very gates of local bodies which might develop into formidable rivals. and so "greater london" was left by successive governments and by parliament to scramble along as best she could, and to suffer. and just as there was no local government so were there practically no laws safeguarding the sanitary condition of the people except the temporary and imperfect ones provided by the nuisances removal and diseases prevention acts of , and such very limited protection as the common law afforded. the public health act of --a sanitary code in itself--was an act for england and wales alone. the benefits it conferred were refused to london; and, as a consequence, the masses of her people were doomed to continue in circumstances of the utmost misery; year by year tens of thousands of her citizens were sent to an unnecessarily early death, and ten times their number were made to undergo diseases which even then were recognised as preventable. and all the time that she was thus left without a local government, without any permanent sanitary laws, other forces were at work inflicting ever-widening evil, and intensifying already existing evils. the population had increased by leaps and bounds, and the increasing trade of london had brought great numbers of workmen to the metropolis. the necessity for offices and warehouses had led to the substitution of such houses for houses previously used as residences. and so the growing population was forced to herd ever closer together, houses were packed thicker and thicker, and, in the central districts, every available spot of ground was built upon. and the overcrowding of human beings in those houses, and all the attendant ills, increased countless-fold. and the result was unparalleled, indescribable, unspeakable misery of the industrial and working classes, and of the lower and poorer orders. not merely years, but generations of neglect and indifference on the part of the governing classes had multiplied and intensified in london every evil to which the poorer classes of a nation are liable. for long the great process of social and economic change at work in "greater london," and all that it entailed, was let go its own way--a way which, in default of the regulation and the alleviation a government should have given it, was beset with creakings and groanings like those of some badly constructed piece of machinery; only instead of machinery, inanimate and insensitive, they were the groanings, the agonies, of suffering thousands and tens of thousands of sick and perishing people, sinking annually into the abyss. all through the earlier half of the nineteenth century, in fact, london, the great metropolis, was left to evolve itself so far as regarded the public health and sanitary condition of the people. the tremendous import of such deliberate inaction by parliament, and by successive governments, is even now only partly comprehended. but the nemesis has been truly a terrible one. the injury wrought was in many ways irreparable, and we are still reaping the crop of evil sown by such seed--are still far from the end of the appalling consequences such a disastrous policy has entailed. footnotes: [ ] see parliamentary papers, - , vol. xxviii. and p.p. , vol. xx. p. , dr. s. smith. [ ] . p.p., vol. xi. p. . [ ] commission for inquiring into the state of large towns and populous districts, . [ ] dr. southwood smith, p.p. , vol. xviii. [ ] royal commission, - , p. xii. [ ] the metropolitan paving act, george iii. cap. . [ ] see report of vestry, - . [ ] see special report of the vestry, , p. . [ ] report of commission of . [ ] j. phillips, p. , metropolitan sewers commission, . [ ] see p.p. - , vol. liii. p. , &c. [ ] report of medical officer of health for clerkenwell, . [ ] see report of medical officer of health for st. giles'. [ ] report of general board of health, . [ ] report of select committee of the house of commons, p.p. , vol. xxviii. [ ] george iii. cap. . [ ] an opening only a foot square cost an additional s. d. tax per annum. [ ] , commissioners on state of towns. evidence of w. e. hickson, p. . [ ] select committee, . evidence of j. pennethorne, p. . [ ] p.p. , vol. xlv. p. . in part of the parish of st. marylebone only there were , underground or cellar dwellings. [ ] see hansard, vol. cxv. (lord ashley's speech). [ ] p.p. , vol. xxi. p. (dr. grainger). [ ] p.p. , vol. xxi. [ ] dr. t. lynch, medical officer of west london union (holborn). [ ] p.p. - , vol. xxi. [ ] hansard, , vol. liii. p. . [ ] and vic. cap. . [ ] expenses to be charged upon borough fund, and receipts to be paid into same. [ ] and vic. cap. . [ ] and vic. cap. . [ ] p.p. , vol. xxi. p. . [ ] metropolitan sanitary commission, , nd report. [ ] hansard, , vol. xcvi. p. . [ ] "vested rights in crowded houses, deadly stenches, putrid water, foggy courts, and cesspools." see "health by act of parliament," _household words_, , vol. i. [ ] p.p. , vol. xxi. p. . [ ] p.p. , vol. xxi. p. . [ ] in london in - (population , , ), the attacks were , , the deaths were , . - (population , , ), the attacks were about , , the deaths about , , so that in the last epidemic the deaths were more numerous than the attacks in - , whilst the attacks were more than double. [ ] dr. grainger, p.p. - , vol. xxi. [ ] p.p. , vol. xxi. p. . [ ] this was rendered illegal by the amended city sewers act of . [ ] see p.p. - , vol. x., general report of medical council. [ ] simon, st report, . [ ] and vic. cap. . [ ] and vic. cap. . [ ] p.p. , vol. xxxv. p. . [ ] and vic. cap. , . [ ] see hansard, , vol. cxv. [ ] ibid. [ ] "the metropolis water act, ," and vic. cap. . [ ] see p.p. , vol. xlv. p. . [ ] see p.p. - , vol. xlv., reports of general board of health. [ ] ibid. [ ] see speech of sir b. hall in in house of commons, hansard, vol. cxxxvii. p. . chapter ii - the act "for the better local management of the metropolis"[ ] which was passed by parliament in was the turning point in the sanitary history and evolution of london. it put a term to the chaos of local government in "greater london" and swept away the three hundred trumpery and petty existing local governing bodies. it created a legally recognisable metropolis by defining its component parts and boundaries. it established a definite system of local representative government in that metropolis for the administration of its local affairs. it conferred upon the new authorities not only the powers vaguely possessed and imperfectly, if at all, acted on by their predecessors, but a considerable number of new ones. it laid the basis of an organisation for the sanitary supervision of the inhabitants of each parish of greater london. and with the object of making provision for the effective treatment of some of the numerous matters affecting london as a whole--matters of a general and not of a local character--with which smaller local authorities could not possibly deal, and with the further object of securing a certain uniformity of administration by the new local authorities, it founded a central governing body for the metropolis. simultaneously parliament passed a new "nuisances removal act for england"[ ] which was made applicable to london, and which, coupled with the health provisions in the metropolis local management act, bestowed upon the metropolis a sort of code of sanitary laws in some degree similar to those enjoyed by other parts of england. and also an act[ ] making stricter provisions as to the construction of buildings in the metropolis. though three acts were thus passed, they formed but separate parts of one general plan of reform. some little detail must be gone into as regards the system of local government thus initiated. for government in purely local matters--in each of the twenty-three largest parishes, definite vestries, as distinguished from parishioners meeting in open vestry, were constituted, the members thereof being elected by the householders of the respective parishes rated to the relief of the poor. the total number of members on any vestry was not to exceed one hundred and twenty, and each year one-third of them were to retire, and an election to be held to fill their places. and as there were many parishes so small that to have constituted them separate local governing authorities would have perpetuated all the evils of small areas of local government, these small parishes were grouped together into "districts" of a fairly large size, for each of which--some fourteen in number--there was to be a governing body entitled "the board of works for the ---- district," the members thereof being elected, not directly by the electors, but by the smaller vestries constituting the district. these new local governing bodies were thus representative bodies, the vestries elected directly by the ratepayers, the district boards indirectly elected; but both were constituted "the sanitary authority" for their respective areas, both were charged with the administration of local affairs, and so the term "vestry" and the "district board" may be taken as synonymous. the central body which was constituted for dealing with matters affecting london as a whole was named "the metropolitan board of works." it was not directly elected by the ratepayers of london, but was elected by the aforesaid local authorities and by the "city." it consisted of forty-five members. three were elected by "the mayor, aldermen, and commons of the city of london in common council assembled." each of the six largest vestries elected two of their members to it; the other vestries one each, and the district boards of works elected the remainder. it was thus representative of the whole of london--city and metropolis included. each year one-third of the members were to retire, and one-third to be elected in their place. this central board was charged with many important duties affecting london as a whole. foremost amongst them was the first essential of any sanitary well-being--the improvement of the sewerage and drainage of london. this new body superseded the commissioners of sewers, and was specially charged with the task of designing and carrying out "a system of sewerage which should prevent all or any part of the sewage within the metropolis from passing into the river thames in or near the metropolis: and also make all such other sewers and works as they may from time to time think necessary for the effectual sewerage and drainage of the metropolis." it was also given general control over the sewage works, and power to make orders for controlling vestries and district boards in the construction of sewers in their respective parishes. furthermore it was given power to make, widen, or improve, any streets or roads in the metropolis for facilitating the traffic, and certain powers of prohibiting the erection of buildings beyond the regular line of buildings. it was given power, too, to make bye-laws--for regulating the plans, level, and width, &c., of new streets and roads; for the plans and level of sites for building; for the cleansing of drains, and their communication with sewers; for the emptying, closing, and filling up of cesspools; for the removal of refuse, and generally, for carrying into effect the purposes of the act--all which bye-laws were to be enforced by the vestries and district boards. thus it was given large powers to deal with many of the matters which most affected the public health. but in some other such matters--essential for the effectiveness of the whole scheme--it was left strangely helpless. it was given no power to appoint a medical officer of health for the metropolis to advise it as to matters affecting the health of london as a whole; or to appoint inspectors of nuisances to ascertain information upon sanitary matters and to carry out various sanitary duties. but, gravest and most deleterious defect of all, no authority was conferred upon the board to compel any negligent or recalcitrant local authorities to carry out the duties imposed upon them by parliament or by bye-laws of the board. those authorities might with absolute impunity neglect to carry out even the imperative directions of parliament as embodied in the act, and thus what parliament emphatically enacted "shall" be done might be left undone, with the most disastrous consequences to the public health, not merely of the particular parish, but to the great community of london. the omission of some such provision made the vestries practically independent bodies, and arbiters as to the administration or non-administration of various important provisions of existing or future acts of parliament, and afforded them the opportunity, so freely and widely availed of, of not performing duties against their own opinions or interests. as regarded these newly created local authorities--the "vestries" and the "district boards of works"--the powers and duties conferred upon them were extensive. all the powers and duties of the previous local authorities as regarded paving, lighting, watering, and cleansing, or improving any parish, were transferred to them. the sewers, other than the main sewers, were vested in them, with the contingent duty of maintaining, repairing, and cleansing them, and they were given power to put sewers in every street. also, they were given power, under certain circumstances, to compel owners of houses, "whether built before or after the commencement of this act," to construct drains into the common sewer. furthermore, no house was to be built without drains constructed to the satisfaction of the vestry, or without sufficient sanitary conveniences, and they were directed to cause open ditches, sewers, and drains of an offensive nature, or likely to be prejudicial to health, to be cleansed, filled up, and covered. and they were required to appoint scavengers to collect the dirt and rubbish, or to contract for its removal. and each of the authorities was to appoint one or more medical officers of health, whose duty it should be to inspect and report periodically upon the sanitary condition of the parish or district, and who would act as medical adviser to the vestry in all matters relating to the public health, and was also to appoint one or more inspectors of nuisances to report as to the existence of nuisances or disease, and perform various other duties in connection with the sanitary condition of the parish. provision was also made for the prevention of the sale of food unfit for human consumption. the sanitary inspector "might at all reasonable times inspect and examine any carcase, meat, poultry, game, flesh, fish, fruit, vegetables, corn, bread, or flour exposed for sale," and in case the same appeared to him to be unfit for such food it might be seized, and the magistrate might order it to be destroyed, and the person to whom it belonged, or in whose custody it was found, should on conviction be liable to a penalty of £ . by "the nuisances removal act for england" the word "nuisances" was so defined as to include any accumulation or deposit which was injurious to health, "any premises in such a state as to be injurious to health, any pool, ditch, water-course, cesspool, drain, or ashpit, &c., so foul as to be a nuisance or injurious to health." the right to give notice to the sanitary authority of the existence of a nuisance was extended, and the process was facilitated. notice might be given to the sanitary authorities by the person aggrieved, by the sanitary inspector, or by a constable, or by two inhabitant householders of the parish; and certain powers of entry were given to the local authority or their officer. the justices who heard the case might require the person offending to provide sufficient sanitary accommodation, means of drainage, or ventilation, to abate the nuisance, or to whitewash, disinfect, or purify the premises which were a nuisance, and could inflict a fine for contravention of the order of abatement; and, if the nuisance proved to exist were such as, in their judgment, to render a house unfit for human habitation, they were given authority even to prohibit the using thereof until it was rendered fit. furthermore, as regarded certain noxious trades, including slaughter-houses and manufactories causing effluvia, which were certified by the medical officer of health to be a nuisance, or injurious to the health of the inhabitants of the neighbourhood, the owner or occupier of the premises might be proceeded against, and, on conviction, fined. against the monster evil of "overcrowding" parliament made an attempt to legislate specifically, thus formally recognising the necessity for dealing with it. "whenever the medical officer of health shall certify to the local authority that any house is so overcrowded as to be dangerous or prejudicial to the inhabitants, and the inhabitants shall consist of more than one family, the local authority shall cause proceedings to be taken before the justices to abate such overcrowding, and the justices shall thereupon make such order as they may think fit, and the person permitting such overcrowding shall forfeit a sum not exceeding forty shillings." and an effort was also made to curtail the practice of living in underground rooms and cellars by defining what such a room or cellar was, and making liable to a penalty "whoever let, occupied, or knowingly suffered to be occupied, any room or cellar contrary to the act."[ ] as money was essential for the working of the acts, over and above that for which rates could be levied, power was given both to the metropolitan board of works and to the vestries and district boards of works to borrow money on the security of the rates, and repayable by instalments, "provided always that no money should be so borrowed by vestries or district boards without the previous sanction in writing of the said metropolitan board." there were to be auditors of the accounts of the local authorities, who were to be annually elected at the same time and in the same manner as members of the vestry. finally, each vestry and district board of works was to make to the metropolitan board of works an annual report of its proceedings, including a report from the medical officer of health; and the metropolitan board was to make an annual report of its proceedings, and present a copy to one of her majesty's secretaries of state. the third of these acts, "the metropolitan building act, ," amended the existing laws relating to buildings in the metropolis, and laid down an elaborate code for the regulation and supervision of all new buildings. most of this code related to the structure--the thickness of walls, &c., &c.--and had primarily in view the security of the house from destruction by fire. only a few sections in the act related to the infinitely more important matter of adequate provision for the health of the inhabitants, and those dealt with it in the most niggardly way. a minimum of one hundred square feet was laid down as satisfying the requirements of open space for air and ventilation around a dwelling; a minimum of seven feet in height was held to satisfy the requirements of any room in a house. and the supervision of every building, and every work done in or upon any building, was entrusted to the "district surveyors"--officials taken over by the metropolitan board from the previous body, appointed under the building act of , which had distinguished itself by its incapacity. these acts practically laid down the framework of the machinery of the sanitary government of london, and struck the first real blow at the roots of the insanitary condition of the metropolis. the callous indifference and inaction of generations had left not a mere augean stable to be cleansed, but a great city over square miles in extent and containing two and a half millions of people, and the new authorities, when they came into existence, had not only to meet the daily needs of a vast existing population, but to make good the neglect of centuries, and to build up a sound and effective working system of sanitary administration. the task lying before them was one of enormous proportions, for on them rested the responsibility of effecting the sanitary redemption of the millions of the metropolis--as well as the infinitely greater duty of safeguarding future generations from similar sufferings and wrongs. it was, moreover, a task of almost superhuman difficulty, for arrayed against reform and amelioration were the powerful forces of "vested rights in filth and dirt." and adding to the difficulty was the huge inert mass of ignorance, and poverty, and helplessness of masses of the people. one principle contained in these acts was of pre-eminent consequence--namely, the responsibility of "ownership." hitherto owners had effectually escaped all responsibility as regarded the sanitary state of their property, and had dealt with their property exactly as they pleased, and regardless of the consequences to any one but themselves. parliament now formally recognised and definitely laid down the principle that the "owner" was the person responsible for the insanitary condition of his property; and in addition declared that individuals would not in future be allowed to deal with their property in such a manner as to cause injury to the public health. but declaration of principles was one thing--their enforcement was another. unfortunately, those who were charged with their enforcement were too often the persons directly interested in resisting reform, and in very many instances, where even a partial enforcement of these principles was attempted, the action was resented and vigorously resisted. the metropolis local management act came into force on january , , and the central authority--the metropolitan board of works--and the local authorities--vestries and district boards--having been duly elected, entered upon their duties. the first and most urgent work which the metropolitan board was charged to carry out was the main drainage of the metropolis, and at the outset, the new board directed its efforts almost exclusively to the highly technical task of devising and considering and adopting plans for the construction of a great system of sewerage which should intercept the flow of sewage into the thames, and should convey it by other means to a safe distance below london, whence it might flow into the sea. any plan had, however, to be approved by the chief commissioner of works. to him the board submitted three plans, but none of them received such approval, and the matter was at a deadlock until , when an act was passed removing the veto of the chief commissioner of works, and at the same time giving the metropolitan board power to raise a loan of £ , , , which up to that time it had no power to do. within a week from the passing of that act, the board determined on a plan, and began arrangements for carrying it out. the plan adopted was to intercept all the sewage flowing into the thames within the area of the metropolis, and to convey it by sewers to a distance, and to discharge it into the river at such a condition of tide as should take it still further out, so as not to return and become a nuisance to the metropolis. the proposed interception on the north side was by three main sewers, discharging at barking--the upper, the middle, and the lower, with branches; on the south side, by two main sewers, discharging at crossness. as the result of the act there had been transferred to the board miles of main sewers on the north side of the thames with outlets into the river, and miles on the south side with outlets. a considerable number of these were offensive open sewers, others were defective in design and construction, whilst all required reconstruction to make them effective, and to fit them for connection with the new system. the central authority had thus a heavy task before it, and one which it would take years to perform. the local authorities, with simpler duties to perform, were able to get quicker to work. they appointed "surveyors" in each parish to look after the multifarious duties in connection with the paving, lighting, and cleansing of the streets, with scavenging, and the removal of house and trade refuse, and with the construction and maintenance of local sewers and drains. in a sort of way some of this work had been done by the previous petty authorities; parts of it, therefore, were more or less familiar, and so not wholly new. but wholly new, and of very great importance, were the appointments which the new local authorities had to make for their districts of a medical officer of health, and of one or more inspectors of nuisances to help him. the duties of the medical officer of health were carefully prescribed by the act. he was to inspect and report periodically upon the sanitary condition of the parish; to ascertain the existence of diseases increasing the rate of mortality; to point out the existence of any causes likely to originate or maintain such diseases, as well as to suggest the most efficacious mode of checking and preventing their spread, and various other important sanitary duties. these appointments were duly made, and some appointments also of inspectors of nuisances. herein was involved the clear recognition of another principle of the utmost consequence--that of inspection--a principle very naturally held in abhorrence by all sanitary misdoers. it had previously been put spasmodically into operation, and with the best effects, on the occasions when asiatic cholera was approaching or raging in the country, but when the panic had subsided it was promptly dropped, and every one was practically left free to commit any sanitary enormity with impunity. henceforth, however, there would be the contingency of being found out for breaches of sanitary laws, and the eye of the law would, at least theoretically, be upon sanitary law breakers. the majority of the medical officers of health entered energetically on their work, and thenceforward a constant light was thrown upon the sanitary condition of various parts of the metropolis by men who lived in the closest and most unceasing contact with the devastating evils afflicting the masses of the people. all were not equally efficient or energetic--all were not equally communicative--but the reports of many of them are full of interesting facts, of acute and instructive comment, and of wise counsel; and though holding office at the pleasure of their employers, many of these officers were courageously independent and outspoken in their criticism and advice.[ ] unfortunately, the reports had practically no circulation beyond the members of the bodies to whom they were made, if even they were read by them, and the recommendations made therein were too often absolutely ignored by those bodies, or, for reasons of self-interest, opposed. to us now, however, these reports are of the greatest value, being in many respects the most valuable official records existing on the subject. we learn from them, better than we do from any other source, as regards the various parishes of london, the nature, and in some measure the extent of the evils which existed, and the causes of those evils; we find in them opinions expressed and reiterated as to the best way of remedying those evils, and accounts of the results of the efforts made to remove or cure those evils. the reports set forth facts demonstrating the appalling misery which the great masses of the people of the metropolis endured; the loathsome foulness in which vast numbers of them habitually lived, and were allowed to live; the dreadful hardships they had to suffer; the fearful moral and physical contamination they underwent; the terrible death-roll--in great part preventable--and the ten or twenty-fold larger roll of victims of preventable illnesses and epidemics, with the consequent poverty which sickness entailed. we can bit by bit piece together from these reports a realistic picture of the sanitary condition of london as a whole during the successive periods of the latter half of the nineteenth century, and we can discern the action of the silent, steady, and irresistible economic forces which unintermittently dominated that condition. north and south in the metropolis, east and west, it was all the same, varying only in intensity, in extent, and, in some degree, in form; a harrowing and almost incredible story. and the remarkable concurrence of testimony from men acting independently of each other, and resident in wholly different parts of london, justifies the fullest confidence in statements uniformly harmonious. the metropolis is so large a place, with such marked differences between its component parts, differences in situation, and physical characteristics, and degree of development--differences in wealth and poverty, and in the occupations of their inhabitants--that the attempt to trace any special branch of its history is beset with the greatest difficulties. especially is this the case when the subject treated of is so complex and comprehensive as that of the public health. it is manifest that all parts of the metropolis cannot be described simultaneously--whilst to go "seriatim" into the history of the public health in each separate locality would, by the very weight of detail, fail to convey an impression of the subject as a whole. the same objections apply to a "seriatim" historic treatment of the different branches of the public health. moreover, the action of the central authority has also to be described in its proper place. and, still more important, the action of parliament, and the principal acts of parliament relating to matters affecting the public health, either directly or administratively. how then can the subject be best treated with the object of presenting the main facts of the sanitary evolution of london, and deducing from them the lessons of experience and guidance for the future? probably by a sort of compromise between these two methods--taking groups of districts instead of separate districts--and groups of matters pertaining to the public health, instead of separate subjects--and, furthermore, dealing with the whole subject in certain definite periods. groups of parishes have already, for certain health purposes, been classified into central, eastern, northern, western, and southern. that classification can be adhered to here. and inasmuch as almost the only reliable statistics as to many matters relating to the public health are those afforded every decade by the census, the narrative can best be treated by taking decennial periods, and utilising the reliable information of the census for the deduction of conclusions which on any other basis might be unsound. this method, then, though in many respects imperfect, is adopted as probably the best for tracing the sanitary evolution of the great metropolis. foremost among the central group, but standing by itself, and in the main outside the scope of the legislation, was the "city." to the description of its condition already given nothing need be added beyond the statement of the fact that the great economic forces at work therein were displaying their results in the "city" itself in very striking manner. under their potent influence the population there had begun to rapidly decline. in it had been , . in it had come down to , . the number of inhabited houses was likewise rapidly declining. in there had been , ; in there were , . under the irresistible demands for greater business and trading accommodation, the inhabited houses there were being rapidly converted to the more profitable purpose of business offices, or warehouses. as the number of business premises and shops increased in a locality, so did the better-to-do residents leave it, and migrate to pleasanter or more healthy localities. some of the houses thus vacated became promptly tenanted by numerous families of a lower, or even the lowest classes; until they too were converted to business purposes, and their inhabitants once more turned adrift to seek other habitation. some of these people secured in the neighbouring parishes residence in one or part of one of those jerry-built and insanitary constructions which land-owners and builders were erecting as rapidly as possible upon any unbuilt ground which they owned, or which they could lay hands upon--the majority contented themselves with squeezing somehow into tenement houses already overcrowded. it cannot be too constantly borne in mind that this was one of the great forces in unceasing action in the metropolis, extending its sphere of action step by step, and stage by stage, and that as years went on, the various districts of the metropolis were, one and all, in varying degree, subject to the accompaniments and consequences of its different stages of growth. and the transition was further aggravated by the natural increase of population, and by another great force--the unceasing flow of immigrants into the metropolis, the majority in search of work, others of food given by charitable people, or of any other chance good thing or adventure that might turn up. and so, on january , , the new local authorities of the metropolis began their great task. and about forty medical officers of health began to examine into and inspect their respective districts, and to inform or advise their respective authorities. what did these men find when they got well into their work? what opinions did they form as to the fearful facts with which they were promptly brought face to face, and the great social problems with which they were confronted? and what did they and their employers, the vestries and district boards, do to carry out the legislation which parliament had at last enacted? the first impression of one of them was that the possessor of the office of medical officer of health[ ] could never become popular, "his functions bringing him into constant collision with the apparent interests of many influential persons;"--in other words, with vested interests. others took a less personal and wider view of their duties. thus one of them[ ] wrote:-- "we have to remodel an old system--a system on which has been for centuries engrafted by slow degrees all the undesirable elements we now wish to eradicate." another[ ] was impressed by the vast amount to be done even in his own parish:-- "from what i daily witness, i make bold to state that this vestry has a herculean task to perform to abate all the nuisances of rotherhithe; nuisances which have grown uninterrupted for ages, and have become inveterate customs with many." if it was a herculean task in one parish, and that a small one, what was the task for the whole of the metropolis? another,[ ] after a few years' experience of the working of the act, summed up the actual position--the very kernel of the case--when he wrote:-- "the working of the metropolis management act might often be characterised as a war of the community against individuals for the public good." and that is what, undoubtedly, it amounted to. hitherto the "individuals" had had their own way unchallenged and unchecked, and countless thousands of the community had been sent to their doom. now, in a sort of way, it was to be a war--a very just and necessary, and on the part of the community a bloodless war--to enforce upon land-owners, and house-owners and house-middlemen, obedience to the principle that "property has its duties as well as its rights," and that those individual rights should not be exercised--as they had hitherto so cruelly been--to the mortal injury of vast numbers of the community. and there was yet another aspect of their work being a war. it was war against disease and filth, and all the causes of insanitation, and against the consequent human suffering and misery, and degradation, in some of the very worst forms. that, unfortunately, was a never-endable war. great successes might be won--complete and final victory never. the central group of parishes and districts outside the "city"--and lying to the north and west of the "city," consisted of st. luke, clerkenwell, holborn, st. giles', the strand, and st. martin-in-the-fields, with a population of close upon , --about one-ninth of that of the metropolis. already in four of these, under the influence of the economic forces already described, the population was decreasing. every portion of this central group was densely populated, and it contained two of the most crowded of all the areas of the metropolis--the strand, which stood highest, and st. luke's, which had "the questionable distinction" of being the second most densely populated parish. in st. giles', which was "amongst the oldest, most densely peopled, and most deteriorated portions of london," the population in "did not appear capable of further increase, the district being incapable of expansion either by packing closer or by the addition of new houses." the eastern group consisted of the parishes or districts of shoreditch, whitechapel, bethnal green, mile-end-old-town, st. george-in-the-east, limehouse, and poplar. in whitechapel the population was stationary; in all the others increasing. the northern group of parishes and districts consisted of hackney, islington, st. pancras, st. marylebone, and hampstead. in every one of these the population was on the increase, slightly in st. marylebone, very rapidly in most of them, notably so in st. pancras and islington. the western group consisted of westminster, st. james', st. george (hanover square), paddington, kensington, fulham, and chelsea. in st. james' the population was decreasing (having reached its apogee in ); in westminster it was slightly increasing; in all the others rapidly increasing. the southern group, with a population roughly of about , , consisted of the whole of that portion of the metropolis which was situate on the south side of the river. beginning on the west, there was wandsworth (which included battersea), then lambeth, camberwell, lewisham, with woolwich and plumstead on the extreme east, then greenwich, rotherhithe, bermondsey, st. mary, newington, st. george-the-martyr, southwark, st. saviour, southwark, and st. olave, in southwark. many of these were still mostly country. the various parishes and districts of the metropolis differed remarkably in their rate of increase of population. in all, the number of births was in excess of the number of deaths, but as this excess in no way accounted for the increase in many of them, the rest of the increase could only be accounted for by immigration--immigration either from other parishes or from outside london. and as it was with population so it was with the houses in which the people dwelt. in most of the central parts of london, houses crowded every available scrap of land, squares and open spaces being few and far between. where there should have been streets of good width, there were narrow lanes of houses; where there should have been thoroughfares, there were cul-de-sacs; where there should have been space for through currents of air and for light, there were brick walls stopping both light and air. figures giving so many houses to the acre convey little actual idea of the density of houses. far more suggestive is such a statement as that made by the medical officer of health in limehouse ( ) that: "there would be no difficulty in marking out courts and alleys where the problem would seem to have been with the originators, how to enable the greatest number of people to live in the smallest amount of space." or the description of st. giles',[ ] where, "exclusive of mews, there may be counted on the map upwards of seventy streets, courts, and alleys, in which there is no thoroughfare, or which are approached by passages under houses." nor is it a matter of surprise that this state of things should have come about, when hitherto there had been practically no check whatever upon building. "it is to be regretted," wrote the medical officer of health for mile-end-old-town about his own district ( ), "that the great increase in the number of habitations should have been allowed to take place without some municipal direction, or some supervision competent to supply its place; the general salubrity of the district would certainly have been better secured.... but every owner of a piece of ground has had the opportunity of making the most of it for his own advantage and in real opposition to the public good." in nearly all the non-central parts of london houses were increasing rapidly. "bricklayers are spreading the webs and meshes of houses with such fearful rapidity in every direction that people are being gradually confined within narrow prisons only open at the top for the admission of what would be air if it were not smoke. "suburban open spaces are being entombed in brick and mortar mausoleums for the suffocation as well as for the accommodation of an increasing populace."[ ] thus in islington there were , houses in , and , in ; in kensington , in , and , in . but what evoked comment was, that the evils of one sort or another connected with the crowding of houses together were being perpetuated. "not only is it to be deplored," wrote the medical officer of health for whitechapel, "that the houses in most of the poor neighbourhoods are already too closely packed together, but the evil is increasing: for wherever there is a vacant spot of ground, more houses are built, thereby still further diminishing the healthiness of those already existing" ( - ). from hampstead--still but little built on--came a complaint of "the tendency among builders to cover the new ground as thickly and at as little cost as practicable." in wandsworth "houses were erected and new streets formed without due regard to sanitary requirements, and in situations where good drainage seems impossible." in fulham, "cottages out of number were constructed in the excavations of old brick fields with the soft refuse of bricks, habitations run in swamps and quagmires, and their foundations three parts of the year sopped with surface water." efficient sewerage was so manifestly the basis of all wise sanitation that the want of sewers, and the abominable condition of those which existed, were general subjects of complaint. the strand boasted of being "one of the best sewered districts in the metropolis," which, however, was not saying much for it. and in st. giles' the sewerage was stated to be good, and "much above the average of the town." but such reports were quite exceptional. in hackney, the principal sewer was the former hackney brook, which, from the increase of the population, and the drainage from other sewers, houses, cemeteries, and cattle-market, had become a foul open ditch--with very trifling exception wholly uncovered--and "emitting pestiferous noxious effluvia." in st. marylebone, the sewers, themselves insufficient for the requirements of a growing population ( ), were, in many cases, so shallow as to cause rather than remove evil, for in certain places they flooded the basements, and in more than one house was witnessed the curious spectacle of the daily use of pumps to remove the foul liquids, as in leaking ships. in paddington ( - ), "the principles of good town drainage were completely ignored. the sewers were those which had been constructed at intervals, previous to , in a piecemeal and unsatisfactory manner, as the thoroughfares were formed, without any regard to the requirements of the adjoining streets." the general direction of these sewers was "extremely defective. numbers of them have a fall towards the summit or highest level of the street through which they pass; the bottoms are very irregular, running up and down and forming successions of hills and hollows." in fulham, there existed scarcely the trace of a main sewer, open sewers and filthy ditches, conveying some part of the sewage to the river, the rest remaining in the cesspools. in hammersmith, not only were sewers and ditches in a most fearful state of nuisance, but there was also "a morass of several acres in extent, having no outlet, which received the sewage from a large area, the noxious emanations from which must be regarded as highly detrimental to health." on the south side of the river matters were still worse. the greater number of the southern districts were situate nearly on the same level as high-water mark, if not indeed below it, and they differed from the other districts of london in their marshy character, their low level, and in the want of proper drainage dependent on that low level. the whole district suffered under the effects of a tide-locked, pent-up system of sewerage. in greenwich, a very large number of streets were without main sewers. in st. mary, newington, "the great fact meeting us at every turn has been the large number of streets without main sewers therein." rotherhithe, which lay from four to seven feet below high water, was exceptionally bad. the largest portion of the parish had no drainage whatever. there were about fifteen miles of open ditches which had been converted into open sewers, called in some official documents "stygian pools," and serving "the double debt to pay of watercourse and cesspool." among the ditches "one of the foulest in the whole neighbourhood of london" was the king's mills stream, about one and a half miles long, which had not been cleansed for ten years. the sewer in paradise row was "in reality not a sewer," but "an elongated cesspool a mile in length," and during twenty hours daily it was waterlogged. the very boundary line of the parish for a long distance was "a wide, filthy, black, open sewer." in part consequent on the lack of sewers, house drainage was either non-existent or fearfully defective. in every part of the metropolis the evil was evident. in clerkenwell the "drainage was either none or very imperfect. numberless houses do not drain into the sewers." in st. martin-in-the-fields, "in the old streets and courts the drainage was the same as it was when the houses were built, some as far back as the reign of elizabeth, and many in that of charles i." in st. george-in-the-east ( ), "it is astonishing how few houses have availed themselves of the sewers." in paddington, "the condition of the house-drains is far worse than that of the sewers. they include every possible variety of geometrical construction, from a circle to a square. some have fallen in; others are choked with filth." in lewisham ( - ), "in several places there are reported to be nuisances of the usual character ... cesspools, no water, &c.--stinking ditches filled with sewage which can get no further--every abomination, and people apparently doing what they pleased as regards getting rid of their filth." nor was it only in the poorer parts of london that the house-drainage was bad. in st. james' (westminster) the medical officer of health wrote ( ):-- "for the last two or three years the worst cases of neglected drainage have not been in houses inhabited by the poor, but in those inhabited by the wealthier classes of the community. it is to me frequently a matter of great astonishment to find how regardless those classes are, whose circumstances can command every comfort of life, of the sources of disease and death. this is not only seen in neglect of attention to drainage, but also in the neglect of ventilation." nor was care being taken to provide drainage even to houses which were in course of erection. the medical officer of health for hackney, which was a growing district, reported ( - ):-- "building operations have recently been carried on with considerable activity, numerous new streets have been laid out and built on.... unfortunately there have not been, and there are not at the present time, any means whereby the construction of proper drainage works could be enforced before the erection of buildings along the line of new streets, and the consequence has been that, to avoid the heavy cost of constructing effective sewers, the drainage works have been almost everywhere but very imperfectly carried out, and in many cases not even a brick has been laid for these purposes." the internal condition of the houses was very bad. in clerkenwell, where there were over , houses, many of them were "quite unfit for human habitation"; not more than one-third were "in a satisfactory state." in bethnal green there were "disease-inviting houses"; in whitechapel, such was the bad condition of many of the , houses which were inspected, that "they ought to be condemned as unfit for human habitation." in st. george-in-the-east, "the sanitary condition of the dwelling-houses is deplorable." lambeth contained a greater number of inhabited houses than any other parish in the metropolis--nearly , . the medical officer of health, after the very limited inquiry possible within the first year of work, reported the unwholesome condition of , of them. from figures such as these--and they related to only a tiny fragment of the whole--one can get some measure of the way the sanitary condition of the houses throughout london had been neglected, and the indifference of the owners to the condition of the premises they let. mention has been made of the vast number of cesspools which existed in london before the passing of the metropolis local management act. the investigations of the various medical officers of health soon demonstrated that the previous estimates of their prevalence, and of the disastrous consequences they entailed, had been in no way exaggerated. their disastrous results were at once recognised. the medical officer of health for whitechapel, in his report for , wrote:-- "i must now direct your attention to the most important subject, in a sanitary point of view, which can be brought before you. i allude to the existence of _cesspools_, more especially such as are situated either in the cellars of inhabited houses, or in the small backyards, which are surrounded by the walls of houses filled with lodgers.... "no cesspool ought to be allowed to exist in london, for wherever there is a cesspool, the ground in its vicinity is completely saturated with the foul and putrefying liquid contents, the stench from which is continually rising up and infecting the air which is breathed by the people, and in some instances poisoning the water which is drawn from the public pumps.... "i am thoroughly convinced by the result of experience, that the existence of cesspools and overcrowding are the chief causes of ill-health." and the medical officer of health for camberwell wrote:-- "... of all the abominations which disgrace and pollute the dwellings of the poor, the imperfect, rarely emptied, and overflowing cesspools are by far the worst ... they not merely poison the atmosphere without, but pour their emanations constantly, silently, deadly, into the interior of the houses themselves." upon the quality and supply of the water which was essential for the life of the people, and upon which their health, and cleanliness, and sanitation absolutely depended, the information supplied by the medical officers of health as to their respective districts brings home, far more than any general descriptions do, the full import and actualities of the great evils endured by the people, and the disastrous consequences entailed upon them. as to the water from the surface and tidal wells, which large numbers of them used and consumed, the opinion, though expressed in various terms, was unanimous. from shoreditch ( ), the medical officer of health wrote: "i have hardly ever exposed a sample of town spring water to the heat of a summer day for some hours without observing it to become putrid." in st. giles' ( - ), "the water of the wells was not deemed good enough (on analysis) for watering the roads." in st. marylebone " public wells supplied water which was for the most part offensive to taste and smell." in kensington ( ) "all the well waters of the parish were foul." in rotherhithe ( ), "the water from the tidal well smelt as if it had recently been dipped from a sewer." the medical officer of health for lambeth declared ( ) that "the shallow well waters of london combined the worst features--they represent the drainage of a great manure bed." the people were driven to the use of the water from these wells owing to the deficient and intermittent supply of water by the various water companies--water supplied for less than an hour a day by one single stand-pipe in a court containing hundreds of people--water supplied only every second and third day, and none on sundays, the day of all others on which it was most wanted; and the house-owners had provided no cisterns or reservoirs of proper capacity, and the vestries had not compelled the house-owners to do so. in some parishes hundreds of houses had no supply at all. in some houses which had a supply the tenants were deliberately deprived thereof by the water companies, because the house-owner had not paid the water-rate. the defective supply had the disastrous effect of putting a constant premium upon dirt--dirt of person, of room, of houses, and their surroundings. and such drains and sewers as there were, were insufficiently flushed. time after time the consequential evils were pointed out, and water companies and house-owners were vigorously censured. but the censure had little practical effect. the great inconveniences and evils, however, evoked the expression of opinion that the duty of supplying water to the community ought to be in the hands of the community. even in it had been pointed out that:-- "water is as indispensable for many purposes as air is for life itself, and its supply ought not to be allowed to depend on the cupidity or caprice of landlords or water companies." and the metropolitan sanitary association had enunciated the principle:-- "that inasmuch as water is a prime necessity of life, attainable in large cities by combined effort only, and not to be denied to any without injury to all, its supply should not be dependent on commercial enterprise, but be provided at the expense of the community for the common benefit." and the medical officer of health for st. george-in-the east wrote in :-- "the water supply of your parish is in the hands of a joint stock company, called the east london water company, and is managed by persons who represent solely the interest of the shareholders, whose only anxiety is of course the dividends--the consumers are not represented at all. this appears to me to be a strange anomaly, a false position, and a monstrous inconsistency--as great as if the sewerage of london were committed to a joint stock company. but so it is, and however great the danger, the vestry has _no available_ remedy whatever in its hands." the principle had been conceded by parliament so far as england was concerned--the large cities and even small towns having been authorised to undertake the supply of water; but london, the capital, was denied the power to do so--the duty was given to private companies, and the population of london was left to undergo untold sufferings. the quality of the water supplied by most of the water companies after the intakes had been removed to above teddington lock, and the filtration thereof before distribution for domestic use had been made compulsory, was considerably improved. but the filthy and dangerous character of the receptacles provided in many houses for it undid much of the good which would have come from the improvement in quality. the description given by one of the medical officers of health was in the main true:-- "there is disease and death in the tanks, wells, and water-butts." thus, in the great primary necessities of the public health--efficient sewerage and drainage, decent houses, good ventilation, pure air, a pure and ample water supply--the general conditions were almost inconceivably bad. these evil conditions, however, were far from constituting the whole of those under which the people of london suffered. over and above them all was one which compelled the attention of the medical officers of health the moment they had entered on their duties--"the gigantic evil," "the monster evil" of overcrowding. not the mere crowding of houses together, evil though that was, but the overcrowding of people in those houses, and still worse, the overcrowding of the rooms of those houses by human beings. in every part of the metropolis there was overcrowding; worst in the centre, and the parts nearest the centre of london, but existing in the outer districts where houses still were comparatively few and population small. centre, east, north, west, south, there was overcrowding, differing only in extent and acuteness of form. "soon after i was appointed as sanitary adviser to your board," wrote the medical officer of health for holborn ( - ), "i found, dwelling in houses which were undrained, waterless, and unventilated, whole hordes of persons who struggled so little in self-defence that they seemed to be indifferent to the sanitary evils by which they were surrounded. "it is too true that among these classes there were swarms of men and women who had yet to learn that human beings should dwell differently from cattle, swarms to whom personal cleanliness was utterly unknown, swarms by whom delicacy and decency in their social relations were quite unconceived...." he mentions some instances too horrible to quote, and says: "such were instances that came within my own knowledge of the manner and of the degree in which persons may relapse into habits worse than those of savage life, when their domestic condition is neglected, and when they are suffered by overcrowding to habituate themselves to the lowest depths of physical obscenity and degradation." in st. luke "the houses swarmed with their human tenants." in bethnal green "our crowded streets and courts are becoming more crowded." in st. pancras "in many houses the overcrowding is very great, each room being occupied by a family." in islington, so overcrowded were some of the houses that the medical officer of health had met with as little as , , , down to cubic feet of air available for each occupant of a room. in rotherhithe "almost all the houses were overcrowded with inmates." in westminster, the medical officer of health gave (in ) fifty examples of overcrowding in his district. in one house, in a room feet long by wide, and feet high, there were adults and children; and in a lower room in the same house, feet long by wide, and high, there were adults and children. there are no statistics whatever showing even approximately the number of cases at that time in which a single room was occupied by a family, but it is certain that vast numbers of families had to be content with that limited accommodation. nor was that even the worst--for, in very many cases, more families than one lived in a single room, or the single family took in one or more lodgers. life under such circumstances must have been, and was, awful. the medical officer of health for st. giles' wrote:-- "the houses whose rooms are occupied by single families were last year in a condition of squalor and overcrowding which it is difficult to conceive surpassed.... "in lincoln and orange courts, the most glaring violation of the laws of health and of the requirements of civilised life was found. for instance, there are several small rooms in the backyards of church lane.... each of the rooms measures about feet by , and between and feet high. each of them serves a family for sleeping, cooking, and all domestic needs. "... the air of these rooms was unbearable to a visitor, and to open the window was only to exchange one foul emanation for another." and the medical officer of health for clerkenwell wrote ( ):-- "in thousands of instances in this district, living, cooking, sleeping, and dying ... all go on in one room.... "if a poor man gets married he is pretty sure to have a large family of children, and at the present rate of mortality several will die of zymotic disease. "hence, when a death occurs, the living and the dead must be together in the same room; the living must eat, drink, and sleep beside a decomposing corpse, and this in usually a small, ill-ventilated room, overheated by a fire required for cooking, and already filled with the foul emanations from the bodies of the living and their impure clothes. "this is an everyday occurrence in clerkenwell, and constitutes a formidable evil." so great was the pressure for accommodation of some sort or kind, that even the cellars and kitchens in the basements of the houses were occupied as dwelling-places and overcrowded. in st. james', "the worst feature of the overcrowding was the very common practice of residence in cellars or kitchens. in the majority of cases the places are quite unfit for human residence. "... a cellar in st. giles'," wrote the medical officer of health for that district in , "has been the by-word for centuries to express a wretched habitation unworthy of humanity. "dating from the time of charles i., the underground dwellings of our district attained the acme of their miserable notoriety from the pen and pencil of fielding and hogarth. "... the building act of contained stringent clauses against the use of such rooms unless they possessed requisites of area and ventilation, such as were out of the question in the cellars of st. giles'. "the metropolis management act ( ) repeated the prohibition of , and in defence of the public health the board have lately put this statute in force. this has been done without compromise. as separate habitations for occupation by human beings at night 'a cellar in st. giles'' is no longer to exist." this was written in , but in the following year he wrote:-- "the profit derived from letting the basement of these houses as dwelling-rooms was too strong a temptation for their owners, and many of the kitchens were let again as soon as the inspector had reported them emptied." in the strand ( ) underground rooms and kitchens were inhabited "notwithstanding that district surveyors are numerous, and that the metropolitan building act is in operation." in westminster, "an examination of various portions of the parishes shows that large numbers of the poor occupy premises whereby they are not only deprived of the required quantity of air, but being situated below the level of the street, the ventilation is insufficient, the rooms generally damp, and when closed for the night the atmosphere is perfectly insufferable--mostly kitchens and cellars, evidently never intended to be used as sleeping rooms" ( - ). the causes of the dreadful overcrowding which existed so extensively were many and deep-seated--springing from the very roots of the social and economic system. and they were of great force and widespread in effect. the cause to which the various authorities and medical officers of health directly attributed it was the one immediately before their eyes--namely, the pulling down of houses which hitherto had afforded shelter, of a sort, to the people. as the medical officer of health for st. olave, southwark, said ( - ):-- "to effect street improvements--to build warehouses, or for some other purpose--the habitations of the working classes are broken up without any provision being made for them elsewhere. they are therefore driven by necessity to crowd into other houses in the same neighbourhood perhaps already overcrowded." an actual illustration was the case reported by the medical officer of health for limehouse:-- "the london dock company have, for the purpose of enlarging and improving their docks, pulled down not less than houses in the parish of shadwell, the homes of not fewer than , persons of the poorer classes. "... the neighbouring parishes are now suffering from an augmentation of their already overcrowded population." the district board of st. saviour, southwark, stated that the evil of overcrowding "can scarcely be exaggerated, whether it be regarded in a physical, mental, or moral aspect." the principal of the causes are:-- "( ) the arbitrary power exercised by railway companies in ejecting the labouring classes from their homes without any obligation to provide for their domestic convenience. "( ) the existing law of (poor law) removal, any break in the three years' residence in the parish rendering them liable to removal to other distant parishes." the latter had, however, most probably, but very small effect. a great cause was that described by the medical officer of health for shoreditch:-- "there is a constant and rapid flow of population into shoreditch. it is in this circumstance that i see one of the most alarming dangers to the health of the district. "the area does not enlarge, and yet year after year dense crowds of human beings are packed and squeezed into that limited area. the growth of the population has far outstripped the growth of the house accommodation. "the immense majority of the immigrants are precisely of that class which most largely increases the dangers of disease by thickening the population. you are largely burdened with the pauperism of other and wealthier districts. the burden is doubly grievous; for it taxes your property, your labour, and gives strength to the elements of disease amongst you. "it is probable that there is no spot in london more crowded with life than many places in holywell or st. leonard's. "typhus--a disease more terrible than cholera--has made itself at home in the parish." and the medical officer of health for fulham wrote ( ):-- "... the daily necessities of the labourer's family draw so heavily on his earnings as to leave only a very small sum for the payment of rent, and hence the most limited house accommodation is sought for and endured...." the most powerful cause of all, however, was, undoubtedly, the overpowering instinct of self-preservation, or, in other words, the need of working, no matter under what conditions, for the only means of obtaining food for themselves and their families. that, as a rule, necessitated their being near the work to be done--and rather than lose that work any conceivable hardship or abomination would be put up with. another of the great causes of overcrowding was high rent. "it must not be imagined," wrote the medical officer of health for the strand ( ), "that this system of overcrowding is altogether a direct consequence of a state of poverty. it certainly does not appear to be so, for among the metropolitan districts the strand ranks seventh in order of wealth. "the overcrowding seems to be partly a result of the high rental which the houses and rooms of many parts of the district--so peculiarly well situate for business purposes--command, and partly of the 'middleman' system, in which so many of the houses in the occupation of the poorer residents are let. "the 'middleman' system, which obtains so largely in this metropolis, in the letting of houses of the kind referred to, is ruinous in its action upon the working classes. the rent paid for a single room often exceeds a sixth or fifth of the total income of the family...." in a case in bow street police court it was given in evidence that , church lane, st. giles', was rented of the owner for £ a year--that the rents recovered from the sub-tenants were £ s.--and the rents received by these sub-tenants from lodgers £ per annum.[ ] overcrowding was not confined to the sleeping places of the people, for the same causes which cramped the available space for people at night, cramped also the space for very many of them during the day when they were away from their so-called homes. of the overcrowding in factories and workshops, where so many of the working classes spent their days, and of the insanitary conditions in which they there worked, no mention is made in these earlier reports of the medical officers of health, not because there were not any, but because the inspection or regulation of factories and workshops did not come within the sphere of their duties. evidence in plenty there is on this branch of the subject in later years from those who could speak with authority in the matter, and it will be referred to hereafter, and that the state of things then described is equally applicable to this period is an inference so legitimate as to be tantamount to a certainty. that the bad conditions under which the workers worked were a great contributing factor in the insanitary condition of the people is a fact as to which there can be no question. mention is made, however, of the overcrowding which existed in another large section of the community--namely, the overcrowding of children in some of the schools. the medical officer of health for whitechapel reported that there was much overcrowding, and in his report for gave some instances of it in his district:-- , _charlotte street_.--in a room feet high, wide, long: children and mistress = cubic feet each. , _charlotte street_.--matters still worse; the room was underground; feet wide, long; about feet high; children and mistress = cubic feet each. , _gorelston street_.-- cubic feet; children and mistress = cubic feet each. in such cases the atmosphere must have been a rapid poison to those breathing it. there was another powerful contributory cause to the general insanitation of london, namely, the defilement of the atmosphere which people had to breathe. as one of the medical officers of health said some years later:-- "we should remember that the air we breathe is as much our food as the solids we eat and the liquids we drink, and as much care should be taken that it is free from adulteration." london was already the greatest manufacturing city in the world, and the great volumes of smoke proceeding from the numerous factories undoubtedly deteriorated the quality of the air. but it was the noxious vapours proceeding from the various processes of manufacture classified as "noxious trades" which rendered the atmosphere in many parts of london dangerous to health. many were the descriptions given of the almost intolerable evils. thus the medical officer of health for rotherhithe reported in :-- "in the mile length of rotherhithe street there are no less than nine factories for the fabrication of patent manure, that is to say, nine sources of foetid gases. the process gives out a stench which has occasioned headache, nausea, vomiting, cough, &c. many complaints have been made by the inhabitants." from st. mary, newington, "the terrible effluvium of bone-boiling is freely transmitted over the district." some manufacture in a yard in clerkenwell ( - ), which had existed until lately, was "one of the most abominable, exceeding anything that the imagination could picture." and in every parish or district of london there were slaughter-houses. "there are too many slaughter-houses in crowded districts," wrote the medical officer of health for st. pancras ( - ). "it is impossible that slaughtering of animals can be carried on amongst a dense population without proving more or less injurious to the public health. "this it does in several ways--by occasioning the escape of effluvia from decomposing animal refuse into the air and along the drains, and by the numerous trades to which it gives rise in the neighbourhood which are offensive and noxious, such as gut-spinning, tallow-melting, bladder-blowing, and paunch-cleansing." even in the strand district there were ( )-- "nuisances arising from various branches of industry, the slaughtering of sheep and calves in the back-yards, and even in the cellars and kitchens, and the keeping of cows in the basements under private dwelling-houses, conditions which continue to exist in the most crowded parts of this district, and should on no account be permitted in such a district:" whilst in westminster "pig-keeping existed to a very considerable extent." in some of the outer parishes the "foetid emanations" caused in the process of brickmaking added to the general impurity of the air. there were many other local causes of impurity of the atmosphere, some even caused by the sanitary authorities themselves. thus the more thorough scavenging and removal of the filth of streets and houses, vitally necessary as that was, resulted in the accumulation of great heaps of filth in crowded centres. thus the medical officer of health for fulham reported that:-- "the collection of dust heaps, and dust contractors' depôts, constitute a most injurious and offensive nuisance--enormous quantities of animal and vegetable matter are heaped together, from which the most noxious effluvia constantly arise." and the medical officer of health for rotherhithe pointed out ( ) that:-- "it is little use causing our own dust to be carted away if rotherhithe is to become the receptacle of all the ashes and offal of a large neighbouring parish (bermondsey). on a piece of land near the viaduct there stands an immense heap of house refuse, covering an acre of ground at least, and forming quite an artificial hillock, the level of the surface having been raised - feet. the bulk of the heap is composed of ashes with a due admixture of putrefying vegetable matter and fish." a little later he reports it as - / acres in extent, averaging feet high, in one place as high as feet. how to deal with these noxious or offensive trades was felt by some of the medical officers of health to be a great difficulty. "we have the health of the community on the one hand," wrote the medical officer of health for lambeth; "the great manufacturing interests on the other.... we have all a common right to an unpolluted atmosphere, and it is our bounden duty to withstand any encroachments on that right. the personal aggrandisement of the manufacturer must not be achieved by the spoliation of the property, the comforts, and the lives of his poorer neighbours.... "but the manufacturing interest is not a thing to be trifled with. destroy the manufactures of lambeth, and you starve its population. there are nuisances of more benefit than of injury to the community," and he rather deprecated "a crusade against those interests, the untrammelled prosecution of which has raised this country to its present proud pre-eminence." some of the medical officers of health expressed decided views on the subject ( ):-- "those who follow unwholesome trades led on by the thirst of gain," reported one medical officer of health, "have no right to poison a neighbourhood and swell its mortality." the medical officer of health for the strand wrote ( ):-- "... the protection of the public health which has been committed to your charge is, beyond doubt, of infinitely more importance than, and should far outweigh the interests of, private individuals how numerous soever they should be." the nuisances removal act, , had given the local authority power on the certificate of the medical officer of health to take proceedings against an offender, and had provided the means for inflicting a penalty. and in some instances it was used, for the medical officer of health for hackney reported:-- "several proprietors of noxious trades having omitted to adopt the best practicable means for preventing injury to health, in some cases legal proceedings were taken against them." the medical officer of health for whitechapel declared there was no desire on his part to use the powers of the act to the oppression of any individual or to insist upon the adoption of such arbitrary and stringent measures as shall drive wealthy manufacturers from the district. "all that is necessary to be insisted upon is that the business be so conducted that the health and comfort of the inhabitants shall not be injured." but whether it was from the unwillingness of the local authorities to prosecute, or the difficulties of enforcing the law, the nuisances continued to the great detriment of the health of the people. and over and above this combination of nuisances, there was the abominable smell from the river. that still was an evil. "rotherhithe," wrote the medical officer of health, in july, , "in common with all other metropolitan riverside parishes, has suffered considerable inconvenience during the last month from the stenches arising from the filthy state of the thames water. perhaps in the annals of mankind such a thing was never before known, as that the whole stream of a large river for a distance of seven or eight miles should be in a state of putrid fermentation. the cause is the hot weather acting upon the ninety millions of gallons of sewage which discharge themselves daily into the thames. and by sewage must be understood not merely house and land drainage, but also drainage from bone-boilers, soap-boilers, chemical works, breweries, and gas factories--the last the most filthy of all.... it is quite impossible to calculate the consequences of such a moving mass of decomposition as the river at present offers to our senses." as one sums up all these disastrous influences, or rather, these evil powers, unceasing in their work, by night and by day--in the overcrowded dwelling and the street--with their victims unable to escape, one realises somewhat the conditions under which great masses of the people of london were living. the result was a fearful mortality--an awful waste of human life. "death," wrote one of the medical officers of health, "finds easy victims in filthy habits, overcrowded rooms, impure air, and insufficient and ineffective water supply." the consequences were inevitable. "wherever there are crowded apartments, imperfect or no drainage, offensive cesspools, dung-heaps resting against houses or close to inhabited rooms--wherever ventilation is impeded by the narrowness of courts and alleys, and wherever the inhabitants living under these unfavourable circumstances lose their self-respect, pay no regard to personal cleanliness, and consider a state of filth and offensiveness as their natural lot--there we find zymotic diseases in full force and frequency. those attacked do not simply recover or die. i shall not be exaggerating when i say that all recovering from these complaints are permanently injured."[ ] it is impossible to apportion the respective shares which these various causes of insanitation had in bringing about these dire results, but overcrowding was undoubtedly one of the principal. as to its disastrous effects the medical officers of health were of one opinion. there was no single exception to the strong-voiced insistence upon this fact. "the main cause," wrote the medical officer of health for the strand ( ), "to which we must attribute the high mortality is the close packing and overcrowding which exists throughout the district.... overcrowding and disease mutually act and react upon each other. "there is one circumstance of general prevalence throughout the district which, so to speak, almost paralyses these efforts of sanitary improvement--overcrowding--the overcrowding of parts of it with courts and alleys, the overcrowding of these courts and alleys with houses, the overcrowding of these houses with human beings" ( ). "the overcrowding of dwellings," wrote another,[ ] "is one of the most frequent sources of sickness and decay at all ages." "perhaps," wrote a third,[ ] "there is no single influence to which a human being is exposed more prejudicial to his health than overcrowding in rooms the air of which cannot be perpetually and rapidly changed." "no axiom," wrote another,[ ] "can be more positive than the connection of epidemic diseases with defects of drainage and ventilation ... the overcrowded localities being especially scourged by disease." the consequences were not confined to epidemic disease; other fatal diseases were begotten by it. "all medical writers," wrote the medical officer of health for st. james' ( ), "are agreed that impure air from want of ventilation is the most potent of all causes of consumption." not merely directly did overcrowding bring about fatal results. indirectly it also led thither. it was recognised as a cause of intemperance and of the evils, moral as well as physical, which ensued from intemperance. "men whose nervous systems became depressed, and the tone of their system generally lowered, became the subjects of a continued craving for stimulants."[ ] dr. simon, medical officer of the general board of health, wrote:-- "in an atmosphere which forbids the breath to be drawn freely, which maintains habitual ill-health and depresses all the natural spring and buoyancy of life, who can wonder that frequent recourse is had to stimulants?" the evils were disastrous enough for the adult population, but they fell with more dire effect upon infants and young children. "conditions more or less injurious to health gradually impair the matured energies and slowly undermine the fully developed constitution of the adult; but the self-same conditions, exerting their baneful influence on the infant or young child, nip the tender plant in the bud and speedily destroy its young life."[ ] throughout the whole of the metropolis the infantile mortality--that is, of children under five years of age--was very great: almost without exception it was close upon, or over, per cent. of all the deaths in the various parishes or districts. in clerkenwell the infantile mortality, which was "nearly one-half of all the deaths," was characterised as "enormous"; but in shoreditch it was actually one-half, being per cent. ( ); in bethnal green it was over one-half, being per cent. ( ); in st. george-in-the-east it was - / per cent.--or, to put it otherwise, of , deaths in the year, were of children under five. in poplar it was more than half. in islington, in , nearly half. in st. saviour, southwark, per cent. in - , "a waste of life which appears almost incredible." in limehouse (in ) of , deaths were under five. the medical officer of health wrote:-- "it is when such wretched offspring, ill-nourished, ill-clothed, and in every way neglected, become exposed to the depressing influences of an impure atmosphere that they sicken, and such children when they sicken they die.... when the habitation of such children is an overcrowded, dilapidated tenement in some close, ill-ventilated court or alley, furnished with an undrained closet, surrounded by untrapped drains, and festering heaps of filth, we find ourselves astonished, not that so many die, but that so many survive." in some special places the mortality was still higher. thus the medical officer of health for kensington reports in :-- "in some places the mortality among infants under five years of age was at the enormous rate of · per cent. of the total deaths. "one of the most deplorable spots, not only in kensington, but in the whole metropolis, is the potteries at nottingdale. it occupies about or acres, and contains about , inhabitants ... the general death-rate varies from - per , per annum. of these deaths, the very large proportion of · per cent. are under five years of age." the medical officer of health for whitechapel (in ), after reporting that the total mortality under five years in the whitechapel district is about per cent., wrote:-- "how to overcome this frightful and apparently increasing amount of mortality of the young is a problem well worthy the attentive consideration of every citizen. the time may be far distant before this problem is solved; nevertheless it is my duty to chronicle facts, and although i may not be able to suggest a remedy to meet this evil, still the knowledge that so large an amount of infant mortality does exist in our district--i may say, at our very doors--will perhaps rouse the attention of the philanthropist, the man of science, and the man of leisure, to investigate its cause, and endeavour to mitigate it." once more it must be called to mind that this mortality was not the whole of the evil, for it was indicative of widespread infantile sickness and disease among those who escaped the death penalty--sickness and disease impairing the health and strength of thousands upon thousands of the juvenile population. the facts set forth by many of the medical officers of health must have enlightened many of the new local authorities as to the nature and extent of the work which it had now become their duty to perform, and the grave problems for which they were expected to find the best solution. the earlier annual reports of many of the vestries and district boards were poverty-stricken in the extreme, and were mostly confined to bald and uninforming tables of receipts and expenditure, which practically threw but little light upon the condition of their parishes. the vestry of st. mary, newington, evidently anxious to prevent disappointment as to immediate results from its action, stated that:-- "in consequence of the previous want of adequate sanitary powers in the local authorities of this and other suburban parishes, so great an extent of sanitary improvement was required when the vestry came into operation, that it was impossible the whole could be dealt with at once, at the same time acting with consideration for those who have to bear the effects of many years' neglect of those sanitary duties which are now found to be so essential." lambeth vestry expressed its desire to discover-- "in what manner a prompt and beneficial execution of the provisions of the act can be secured without creating any serious increase in local taxation." one of the vestries, indeed, gave the quaint explanation that one of the things which somewhat retarded sanitary improvement was "the novelty of applying compulsory powers to landlords." the desirability of securing parks and places of recreation for the people was one of the matters which first appealed to some of the vestries and district boards, and memorials were addressed to the metropolitan board urging the importance of their putting in force the powers conferred on them for the purchase of land for such purposes. others directed their attention to the promotion in a small way of improvements in their parishes by widening streets and roads, and preserving open spaces--towards which, in some cases, they received a contribution from the central authority. a good deal of paving was done, and better measures taken for scavenging the streets and courts, and for the removal of refuse and dirt of all sorts. to local sewerage, as distinct from main sewerage, they also gave attention, and in designs for miles of new sewers were sent in to the metropolitan board for approval, and £ , borrowed for the purpose; and in the following year for miles of new sewers, and loans for £ , . a fair amount of drainage work was also carried out--thousands of cesspools were filled in and drains made. also a certain amount of inspection, with the disclosure of an enormous amount of insanitation. thus, in the strand district in --where houses were inspected--in , or per cent. of these, works had to be done to remedy sanitary defects. in the following year , houses were inspected, and in , sanitary defects were found. in poplar, of , houses which were visited, required sanitary improvement. in paddington , houses were inspected; in over , works had to be executed to put them in sanitary order; figures which showed that, roughly speaking, two out of every three houses were sanitarily defective. "the last year," wrote the medical officer of health for hackney ( )--where , houses had been connected with the sewers--"has been a year of drainage." parliament having enacted that the "owner" was responsible for the state of his property, this work had to be done at the expense of the owners; but how many decades had passed in which "owners" had spent nothing on the property, and had been receiving large rents; and how many cases of sickness and death had occurred in their houses, the result of the insanitary condition in which they had been allowed to fall, and in which they were allowed to continue. in holborn such works cost the owners about £ , in , and in lambeth about £ , . but the work thus chronicled touched little more than the fringe of the matter. most of the local authorities had, out of a spirit of economy, or for some other reason, appointed only one inspector of nuisances; yet in nearly every one of their parishes there were thousands of houses--in greenwich , , in st. marylebone , , in lambeth , --and years would have had to elapse before the solitary inspector could have completed even one round of inspection and got the houses he inspected put in order; whilst the others would inevitably have been existing in, or falling into, a state of insanitation. for years, therefore, the most vile disease-begetting nuisances might not merely exist throughout the parish, but work endless evil without any interference, as indeed they did. some of the vestries put forward their economy as a claim for praise. thus, the wandsworth board said that "a due and careful regard to economy had characterised all their proceedings," and the vestry of st. mary newington said, in , that it had carried out its operations out of current income and had incurred no debt. the medical officers of health held their offices at the pleasure of the vestries, and, therefore, if they valued their position, had to be cautious in their criticisms of the management of the affairs of the parishes. but their reports convey that the work which ought to have been done was not being done as rapidly as they wished. "i wish i could induce the vestry to insist more upon having the poorer dwellings cleansed and lime-whited." and again, "the vestry has the power to restrict the operation of underground rooms, yet it has not moved in this important matter."[ ] the medical officer of health for st. giles' ( ) referred to the-- "indisposition of the board to do works and charge the owners"; and, referring to a special case, he wrote, "it becomes your duty to do something to prevent the production of disease among the neighbours." the medical officer of health for st. pancras wrote in - :-- "in many houses the overcrowding is very great. there is a clause under the nuisances removal act by which the vestry is called on to take proceedings before a magistrate to abate overcrowding, if it is certified to be such as to endanger health. no prosecutions have been taken under this clause." and again in :-- "very little has been done in this parish to abate over-crowding--extreme cases have been proceeded against. no systematic efforts have been made in this direction." and the medical officer of health for hampstead wrote ( ):-- "nothing short of constant vigilance and inspection can keep the dwellings and premises of the people in a tolerably healthy state. i am not sure that your board is blameless in some of these respects--an amiable, though weak, reluctance to act severely to any." and in he pleaded for the appointment of an inspector of nuisances, which, however, he did not get. the local authorities had their difficulties in dealing with many of these matters, even when they were disposed or anxious to do so, owing to-- "the imperfection of the powers conferred on them by the legislature, and to the great and stubborn apathy of a poor population." and the medical officer of health for st. james' ( ) attributed blame to the public generally:-- "one of the greatest barriers to the practical efficiency of sanitary arrangements is the ignorance and carelessness of the public. it is frequently seen that where infectious illness occurs, little or no attention is paid to its infective character, and an unscrupulous intercourse is carried on between the members of infected families, not only amongst themselves, but amongst their neighbours, and thus these diseases are propagated in spite of every warning and precaution." "i regret," wrote the medical officer of health for whitechapel, "that the powers of your board are not at present sufficient to compel the owners of small house property to provide an adequate supply of water for their tenants." the medical officer of health for westminster wrote:-- "few of the objects of sanitary improvement can be fairly attained without intrenching upon private interests to an extent which would appear harsh and oppressive. one great obstacle consists in the habits of a great portion of the poor--generally deficient in cleanliness or order; they consider any endeavour to improve their dwelling as an interference, and throw every obstacle in the way. on the other hand, a large number are most grateful for what has been effected." but in many matters the local authorities would not take action. in only four parishes or districts in london had public baths and wash-houses been established under the act of , though where they were in existence "the benefits were immense by promoting habits of cleanliness." in poplar in - nearly , men, and , women, and children availed themselves of the baths. in st. pancras ( - ) the laundry department, erected by the "society for establishing public baths and wash-houses," was of great value in affording the poor housewife an opportunity of washing and drying her linen away from her one room, in which the family had to live night and day. "i have frequently seen a small room of this kind with from four to eight or even ten inmates rendered doubly unhealthy by these laundry operations, which produce a damp and almost malarious atmosphere." the medical officer of health for lambeth had pleaded for such an establishment in his district, but "the idea of erecting them seems quite abandoned by the vestry." "i know nothing more objectionable in a sanitary point of view than the washing of foul clothes in the dwellings of the poor, and still worse the drying of them in courts and rooms already deficient of free circulation of air and light." nothing, however, was done. but inaction far greater in gravity and infinitely more reprehensible was that relating to the housing of the people. the medical officer of health for whitechapel drew attention, in his report of , to their power in this respect:-- "docks, railways, warehouses, &c., &c., must be constructed for the increase of the trade of this great metropolis, but our construction of them ought not to prevent us from providing better habitations for the working classes whose labours effect these improvements; more especially as it is in the power of parishes by virtue of an act of parliament to encourage the establishment of lodging-houses for the labouring classes."[ ] not one single vestry or district board ever attempted to deal with the evils of bad housing and overcrowding by putting into operation the provisions of this act. the occasional statement in the report of a medical officer of health as to what was actually done in his parish, by showing what might have been done in any other one, brings into strong relief the incapacity or deliberate inaction of the local authorities of other parishes. thus, in some parishes the medical officers of health endeavoured to effect some diminution of overcrowding--for instance, the medical officer of health for islington reported that-- "in several instances the owners of dwelling-houses had been summoned for permitting the overcrowding of their houses; and the magistrate had fined the offenders." and the medical officer of health for holborn in the same year wrote:-- "your board has already done much to ameliorate the condition of this class of society (the poor and overcrowded) by compelling the owners to cleanse, drain, and ventilate their dwellings; to close cellars, to provide proper water supply, sanitary accommodation, and in many cases had abated overcrowding." but few of the vestries followed, or attempted to follow, these examples, and in many of the most vital matters a deliberate inactivity was the prevailing characteristic of the vestries and district boards. "in several vestries resolutions were actually moved with the view of averting the construction of sewers. it was thought by many persons of influence to be better to live in the midst of overflowing cesspools than to add to the defilement of the thames."[ ] the medical officers of health did not confine themselves to merely reporting what was annually done to ameliorate the existing state of affairs. as was their duty, they made numerous and frequent suggestions to their authorities as to what it was best to do. and some of them, going further than this, sometimes endeavoured to inspire the members of the vestries and district boards with a sense of the gravity of their work, and with lofty views of their duty. occasionally, even, they did not hesitate to censure their employers for inaction or lethargy. the medical officer of health for the strand wrote ( ):-- "to pave streets, and to water roads, to drain houses or even to construct sewers, however necessary these works may be, are among the least important of the duties which devolve upon you. but to improve the social condition of the poorer classes, to check the spread of disease, and to prolong the term of human life, while they are works of a high and ennobling character, are yet duties involving the gravest responsibility. should less care be bestowed upon our fellow creatures than is daily afforded the lower animals? at the present moment the condition of many of the working classes is degraded in the extreme." the medical officer of health for st. saviour, southwark, wrote ( ):-- "in all our efforts at sanitary improvement we are chiefly dealing with persons who in most instances have not the power of helping themselves, and who until of late have had no source to which they might apply for aid in rendering their dwellings clean and wholesome." the medical officer of health in st. pancras wrote:-- "all who have made themselves acquainted with the condition of many of the poor of london will agree with me when i say that before their moral or religious state is likely to be remedied, their physical condition must be improved, and their houses made more comfortable. on you devolves, to a great extent, the solemn responsibility for carrying out the preparatory work." the medical officer of health for st. martin-in-the-fields wrote to his vestry in : "to permit such grievous evils as are to be seen in the worst localities of this great city is a contradiction to the teaching of christianity ... such outrages on humanity as many of the abodes of the poor are permitted to remain. "it is unholy, it is unchristian, that people should herd together in such dens; and so long as such dwellings are allowed to be occupied our assumed religion must be a pretence and a sham...." and thus, the medical officer of health for bethnal green:-- "to open out avenues through our cul-de-sac courts, to promote the sanitary condition of every house, to arrest by thorough drainage and removal of refuse the elimination of aerial poison, are the great duties that we have day by day to do. though the task before us be great, the objects in view are immeasurably greater--to exalt the standard of life, to economise rates, and above all to decrease the sum of misery, disease, and death.... to supply the arm strong to labour, to substitute productive for unproductive citizens, to decrease the death-roll of the young, and to protract life beyond the present span, these are the tasks that sanitary science imposes on us." the medical officer of health for clerkenwell pointed out that-- "the poorer classes have not the means of remedying the defective sanitary conditions under which they are living. but the vestry has this power." the medical officer of health for st. pancras made a calculation that nearly , deaths in the parish in were due to causes which might have been prevented by sanitary improvements. "to every death we may safely assume more than thirty cases of illness. this gives us , cases of preventable disease in the year." "you will see," wrote the medical officer of health for st. james' ( ), "that by diminishing death and disease, you are diminishing poverty and want.... the sanitary question lies at the root of all others. it is a national one and a religious one. it is true that in the exercise of your powers you will often be met by the assertion of the rights of property, but the right of life stands before the right of property, and it is this recognition of the sacredness of human life that lies at the foundation of sanitary legislation." the medical officer of health for whitechapel wrote:-- "i have in this report, as in duty bound, spoken plainly; if in the opinion of some members of the board too plainly, my apology is--the deep sense i entertain of the importance of sanitary progress; for upon the success that shall attend the labours of those engaged in this most sacred cause depends the improvement of the social, moral, and intellectual condition of the people." and the medical officer of health for st. giles' made this pathetic appeal for action:-- "while you are listening to the remainder of this report, i trust you will hold in your mind how many lives are being sacrificed every month to deficiencies in sanitary arrangements." it is only here and there in the earlier reports of the medical officers of health that specific mention is made of intemperance, but every reference to the subject showed how largely "drink" affected the sanitary condition of the people and intensified and complicated the evil conditions in which the people were placed, and rendered any amelioration, physical, moral, or religious, infinitely more difficult. it was becoming more and more generally recognised that a very large proportion of the deaths and of disease were preventable. "any skilled eye glancing over the mortality tables will observe that a considerable number of deaths might have been prevented." "we are now to a great extent aware," wrote the medical officer of health for st. saviour's ( ), "of the physical conditions on which the lives of individuals and communities depend." the medical officer of health for fulham wrote in :-- "sanitary science and experience have full clearly proved to us how great an extent the prevention of disease and its extension rests with us." but against contagion and infection no precautions whatever were taken, and so disease was sown broadcast throughout the community, and death followed. as to suggested remedies and action there was a chorus of absolute unanimity upon some points:-- "the principal cause of the extent of zymotic disease," wrote the medical officer of health for mile-end-old-town, in , "is the defective state of the habitations of the poorer classes. the remedy for the evil is only to be secured by a systematic house visitation. "... without a general house inspection it is impossible to secure the proper entry to and use of the expensive sewers which have been and are being constructed. "having done so much for the streets, pavements, and drains, the improvements will lose half their salutary effect if the interior of the dwellings are not placed in a corresponding condition of wholesome cleanliness." "it is," wrote the medical officer of health for whitechapel, "to the interior of the houses that our attention must be directed, for it is here that the source of disease is usually found.... an habitual and detailed inspection of the houses occupied by the poorer classes is therefore essential." a house-to-house visitation was, indeed, the first essential. by no other means could the actual condition of the abodes of the people be ascertained, and the breeding places of disease be discovered, cleared out, and rendered innocuous. and as there was a never ceasing tendency on the part of the poorer classes to sink into a condition of uncleanliness, and on the part of their abodes to fall into dilapidation, or, as it was expressed, "a pertinacity for dirt," so was constant inspection and supervision of vital necessity for the maintenance of any improvements made. "there are," wrote the medical officer of health for st. pancras ( ), "many parts of the parish densely crowded. some of the people have become so used to filth, they appear to prefer it to cleanliness; at any rate, they have not the energy to get rid of it and improve their condition. such houses--perfect hotbeds of infectious diseases--ought to be visited two or three times a year...." the medical officers of health had one valuable object lesson before them in the common lodging-houses, which, regulated and inspected by the police under the acts passed by parliament, had shown that even the very worst conditions of life could be ameliorated, and that the very lowest and most miserable classes of society were not beyond improvement. "the chief points which are regulated by the authorities (the police) are cleanliness, drainage and water supply, the separation of the sexes, and the prevention of overcrowding. the testimony of all who are acquainted with the dwellings of the poor is concurrent as to the immense sanitary advantages gained by the provisions of the common lodging houses act, and the results had been to improve in a marked degree the health, habits, and morals of the persons using these places."[ ] "the cleanliness, comfort, and ventilation of the licensed rooms in common lodging-houses offer a very marked contrast to those which are unlicensed."[ ] to more than one of these officers the idea occurred that similar benefits would follow if tenement houses were similarly inspected. "i believe considerable good might be accomplished by a legislative enactment placing every house let out in weekly tenements to more than one family under similar regulations to those affecting common lodging-houses, and rendering landlords liable for permitting overcrowding to exist upon their property." the success of the common lodging-houses was due to the enforcement upon the owner of the first essentials of sanitation in the house he let to occupants, and to the regular "inspection" of his house to secure that those essentials were maintained in a state of efficiency. but it was just these two things that were most held in abhorrence by the majority of tenement-house owners in london. the medical officer of health for the strand, after describing the overcrowding of tenement-houses, wrote ( ):-- "no remedy it is feared will be found until all houses of the class alluded to, the rooms of which are let out as separate tenancies, shall be compulsorily _registered_ under the supervision of the local authority of the district in which they are situate, as fit for the accommodation of a certain number of persons, and no more." "this suggestion will doubtless excite the sneers of the ignorant, the fears of the weak, and the ridicule of the selfish, coupled with the usual expressions about interference with the liberty of the subject; but the upright and unprejudiced will not fail to perceive that it is the liberty and the health of the working classes, forming, as they do, so large a proportion of the mass of the people which it is sought to protect from the tyrannical and grasping covetousness of an avaricious few who care little whether the health of the working man be destroyed, or whether his children be reared up in such a way that disease and vice must almost necessarily result, provided they succeed in obtaining for themselves an additional percentage upon their investment." and the following year he again forcibly adverted to the subject. "when it is borne in mind that in some of the small courts in this district there are packed together as many persons as almost equal in number the soldiers congregated in a commodious barracks, is the high death-rate a matter of surprise? but what can be done? the authorities, general or local, cannot surely be expected to provide suitable dwellings for the people! undoubtedly they cannot; but it is incumbent upon these authorities, in the interest of the well-being of all classes of the community, to place a prohibitive limit in regard of overcrowding upon the class of houses the rooms of which are let out as separate tenements, which would, without hardship upon their occupants, speedily produce the desired effect. such a condition, practically speaking, already exists in regard of most of the public institutions of this country in which large numbers of persons reside; such a condition is enacted by law in regard of our emigrant ships: such a condition is enforced by act of parliament in regard of common lodging houses: and in all these instances the principle works well. is it reasonable, then, that in relation to the influence of over-crowding upon health and life, less care should be taken of the people who occupy the densely populated districts of our great towns and cities than is already provided by law for the inmates of our common lodging houses, or for the paupers admitted into our workhouses, or for the emigrants who leave our shores? surely the injustice cannot but be apparent." other suggestions were also made. the medical officer of health for whitechapel wrote ( ):-- "if the public is to enjoy health, and a freedom from the ravages of epidemic disease, a stop must be put to the present scheme of erecting houses in crowded situations; for although the rights of property are to be respected, yet, in my opinion, such rights are of secondary consideration when compared with the public health and the increased burdens which must be borne by the ratepayers to support those whose sickness is occasioned by the unhealthiness of the localities where they reside." several urged the vigorous enforcement of the existing law. to the vestry of lambeth the medical officer of health wrote in his report in :-- "you must proceed actively against those who have raised the value of their possessions by ignoring the value of human life, who wilfully multiply disease by neglect of their pestiferous property." the medical officer of health for hackney wrote ( ):-- "i feel assured that it cannot be too widely known that individuals will not be allowed to deal with their property in such a manner as to cause injury to the public health. for although individual liberty has long been the boast of england, yet there is a point beyond which it cannot be tolerated with safety; and private good should always be made to give way to the public welfare." the greater the light thrown upon the sanitary condition of the people of london, the clearer became the fact that the principal blame therefor rested upon the house-owner, lessee, or middleman, or as parliament defined him, "the owner." many of the medical officers of health were outspoken and unhesitating in their opinion as to the responsibility of the house-owner for the existing condition of the dwellings of the people. "the enemies of the poorer classes," wrote the medical officer of health for clerkenwell, "are the landlords, who know well that proper lodgings for the really poor do not exist. they know also that if they buy at a cheap rate any old premises not fit for a pig-sty and let them cheaply they will be sure to find tenants." if it was not the real owner of the house, it was the middleman or person or persons between the owner and the tenant. rents were high in most parts of london where there was urgent demand for accommodation, and "the yearly rental is unfortunately in many cases still further increased by the 'middleman system'; many of the houses being rented by an individual who sub-lets them in separate rooms as weekly tenancies, and this at an increase of per cent. (strand ):-- "and thus it is that health and life are daily sacrificed at the shrine of gain." what sort of property some of them held, and the condition in which they allowed it to remain, whilst they drew their "gain" from it, is graphically illustrated by the medical officer of health in st. olave's, southwark ( ). he thus described the houses in three small courts:-- "the whole of these houses are held by one person, and it is impossible to imagine any state much worse than the condition of everything connected with their drainage, &c. "here, within a small area, are thirty-nine houses, all having open foul privies, cesspools all filled, and many overflowing. the yards are foul, dirty, damp, and wretchedly paved with small, loose, broken bricks--most of them are daily filled with the overflowing of the drains and cesspools, the drains are all untrapped, and scarcely a house has a proper receptacle for water; they are mostly broken, dilapidated, uncovered tubs, placed close to the cesspools, so as to absorb the foul gases emanating from them. the effluvium on entering any of these places is abominable, and greatly complained of.... "these three courts are thickly inhabited." in the following month he reported nineteen houses in two streets very much the same as above. in the next month twenty more--in the month after, thirty more. he might almost have had the general description printed, with blanks for filling up the number of such houses and where situated. if it had not been for the new acts passed in , this condition of things would doubtless have continued indefinitely. that condition had been reached under absence of inspection, or regulation, and freedom on the part of the owner to do as he liked; and had no laws been enacted to terminate it, no change would ever have been effected. and when efforts were made by the local authorities to remedy similar places, strong opposition was met with. thus in hackney ( - ):-- " nuisances have been rooted out. in very many cases prosecutions have been ordered by the board. they were almost invariably opposed by the offenders, generally people of substance, with the advantage of able legal aid, in the most pertinacious and resolute manner...." the novelty of enforcing upon the owners the improvements deemed necessary naturally raised in the minds of some of the medical officers of health the question as to the justice of such a proceeding. those who discussed it were clear upon the point. thus the medical officer of health for shoreditch ( - ) wrote:-- "the question of putting houses into a condition fit for habitation has two bearings. it is, _first_, a question between the landlords and the tenants, whose health is sacrificed by neglect. it is, in the next place, a question between the landlords and the ratepayers. "if the landlords neglect to make the necessary outlay in improving their property, the expense of maintaining that property in its unhealthy condition is thrown upon the ratepayers, for these have to bear the burden of supporting the sick and the destitute." and the medical officer of health for clerkenwell:-- "at present the poor rates are raised by the parish having to pay the expenses of afflicted poor persons, whose misery has in most instances arisen from defective sanitary arrangements, the remedying of which ought to have been effected at the expense of the landlords, who derive their substance from the miseries of the poor." and the medical officer of health for st. george's, hanover square:-- "i am compelled to say that the number of dingy and dilapidated houses is a proof either that the owners of house property do not exercise sufficient control over their tenants, or that they themselves are grievously neglectful of their duties to their tenants and to society at large. the health of the parish should not be allowed to suffer through the default of either landlord or tenant.... here there need be no scruple about interference with private property. "no man is allowed to sell poisonous food, and none should be allowed to sell poisonous lodgings, more especially as the effects of poisonous food are confined to the persons who eat it--the effects of unwholesome apartments may be diseases that may be spread." on the equity of compelling the owners to put their houses in order, there are many insisters. "it is but right," wrote the medical officer of health for fulham ( ), "that those who have hitherto fed their own resources by impoverishing others, should now in their turn make good the damage." the medical officer of health for poplar ( ), wrote:-- "while on the one hand we must not proceed in a reckless manner so to burden property as to render it entirely unproductive, yet on the other we cannot allow the labouring man, whose health is the only property he can call his own, to live in unwholesome places to the destruction of that capital, by which alone he is enabled to support himself and family." and the medical officer of health for mile-end-old-town ( ):-- "... to charge such property (viz., in bad condition and heavily encumbered) with the costs of thorough repair, would leave the owners in some instances, i am fully aware, destitute, but life is more sacred, and possesses higher rights than property, and it cannot be just to inflict or continue a public injury while endeavouring to spare and sympathise with the inconvenience of an individual." that the evil state of the dwellings of the poorer classes entailed a charge upon the public was also pointed out by the medical officer of health for bethnal green, who, referring to the miserable homes in the parish, wrote:-- "from the cradle to the grave their inmates are a direct charge upon our funds." happily the law was beginning to be enforced, and beginning to create a little alarm among some house-owners. "as landlords are now aware that their property will be visited in rotation by the inspector, the necessary alterations and improvements are frequently effected by them in anticipation."[ ] others did the necessary work when ordered to do it by the sanitary authority. others, however, not until legal proceedings were taken, and they were ordered by the magistrate to do it--and even then some would not obey the magistrate's order, and the work had to be done by the sanitary authority, and the cost thereof levied from the owner. one case was recorded by the medical officer of health for st. giles', in - , in which the authority of the law was more strongly asserted. "while speaking of the resistance met with in enforcing sanitary requirements, it may be here mentioned that the extreme step of imprisoning the owner of a certain house has been had recourse to for his obstinate refusal to comply with a magistrate's order." that disease and sickness among the people entailed a great loss and heavy burden upon the community appears scarcely to have received any recognition up to this, and yet it was a truth of far-reaching importance. that individuals suffered was of course clear, but that the community did was by no means realised. several of the medical officers of health promptly discerned how true it was, and in their earlier reports dwelt upon it, pointing out the effects, and emphasising their great importance. "it cannot be too often impressed upon our minds," wrote one, "that sickness among the poor is the great cause of pressure upon the rates; and everything that will tend to diminish the number of sick will be so much saved to the ratepayers."[ ] "the greater the amount of disease," wrote another, "the larger the proportion of pauperism." "of the causes of pauperism, none are so common as disease and death," wrote another. indeed, a little consideration must have demonstrated its truth. difficult as it was for the individual in health to earn a livelihood--when sickness fell upon him there was the instant and complete cessation of his wages, and there were expenses incurred by his sickness. if he recovered, there had been a long disablement from work, and a heavy loss. if, however, he died, the community suffered by the loss of his productive labour, and, where the victim was the breadwinner of a family, his widow and children but too commonly became a charge upon the rates. "high mortality in a district," wrote the medical officer of health for clerkenwell ( ), "especially among the poor who are the principal sufferers, does not relate simply to the dead; the living are also deeply concerned. every death in a poor family causes an interruption to the ordinary remunerative labour, and produces expenses which have to be paid out of scanty wages. hence the living suffer from want; the parish funds must be appealed to; families become parentless, and next comes crime." the medical officer of health for whitechapel ( ) wrote:-- "in the course of time the public will learn that sickness, with its concomitant evils, viz., the loss of wages, the calls upon clubs and friendly societies, the increased amount of charitable contributions, a heavier poor rate, &c., entails more expense upon the community than would be required to carry out sanitary improvements in widening streets, converting the culs-de-sac into thoroughfares, and in erecting more commodious houses for the poor." and the medical officer of health for the strand wrote:-- "of every death which occurs in this district over and above the ordinary rate of mortality, the number of _cases of illness in excess_ must be a high multiple. and during every attack of severe illness the patient, whatever his position in life may be, must be maintained--if wealthy, at his own expense, if poor, at that of the community at large. and in the latter case, the community at large must thus suffer a direct loss. _health is money_, as much as time is money, and sooner or later sickness must be paid for out of the common fund...." and the medical officer of health for shoreditch ( ) wrote:-- "to communities as well as to individuals there is nothing so expensive, so fatal to prosperity, as sickness. to a productive and labouring community, health is the chief estate.... a community is but a system of individuals--if one portion of that system be disabled by sickness, every other portion will feel the blow; the whole community will be taxed to support that part which is rendered incapable of supporting itself. it is then a plain matter of self-interest, as well as of solemn obligation, to exercise the most vigilant care in preserving to the poor their only worldly possession, their health and capacity for self-support." nor did the danger to the great community of london, from the prevalence of sickness in any particular district, appear to have received the faintest recognition. and yet, in the matter of health, and protection from infection, all classes from the highest to the lowest had equal interest; for disease commencing or raging in one district is not long in spreading to other districts. the medical officer of health for chelsea ( - ) wrote:-- "it cannot need any argument to prove that diseases of an epidemic or infectious nature cannot be arrested in their progress by the imaginary line drawn around the boundaries of the parish--that the smoke from the furnaces in lambeth and vauxhall must be wafted across the thames and influence the health of the inhabitants of chelsea, if not kept in check, and that evils of minor importance in pimlico, on one side, and kensington on the other, may be quite as prejudicial to the health of the neighbours residing on this side of the boundary as to those among whom they are generated." that any one locality had a duty to its neighbours, still less to london as a whole, as well as to the people of its own area, was beyond the range of the ideas of the vestries and district boards. indeed, if their sense of duty did not induce them to look after and safeguard the people for whose sanitary condition they were immediately responsible, how could it be expected of them to be influenced by considerations as to those residing outside their area, and residing many miles away. and yet, by the very condition of things, this greater responsibility did exist. but the great fact that in the vital matter of the public health london was one great community, the various parts thereof being indissolubly welded together into one great whole, had not as yet apparently dawned upon the minds of the newly-created local authorities; nor, indeed, had parliament even realised it, for it had left the forty and more of those authorities full freedom to scatter disease of the deadliest type from one end of london to the other, and to imperil the lives of london's inhabitants. the reports of one of the medical officers of health give such an exceptionally complete and vivid description of the condition of the parish to which he had been appointed, and in which he worked, that a series of extracts from them are given. the parish was the parish of st. george-the-martyr in southwark, on the south side of the river, just opposite the city; "low-lying and flat, and about half a foot below trinity high-water mark," with an area of acres, and a population of about , persons, and the medical officer of health was dr. william rendle, who speaks of himself as "an old parish surgeon." "if a loose drain conducts stenches into a man's house instead of out of it, if the concentrated filthiness of a gully is blown into a front door or window, if a house often visited with fever has not been cleansed or whitewashed for many years, if there is no water but putrid water filled with disgusting living creatures, and no butt except a rotten one, not even the most enthusiastic lover of things as they are can find fault with us if we try to alter these things for the better.... "let us picture to ourselves the man of the alley come home from work. "the house is filthy, the look of it is dingy and repulsive, the air is close and depressing; he is thirsty: the water-butt, decayed and lined with disgusting green vegetation, stands open nigh a drain, and foul liquids which cannot run off are about it, tainting it with an unwholesome and unpleasant taste; the refuse heap with decaying vegetable matter is near, and the dilapidated privy and cesspool send up heavy, poisonous, and depressing gases. such are the homes, may i say, of thousands in this parish?" he contrasts the public-house with that, and says: "the surprise is not so much that one man here and there reels home drunk and a savage, as that for every such a one there are not twenty. gentlemen of the vestry who have seen these things can bear me witness that i do not exaggerate. this is no fancied statement.... "this parish has always been remarkable for its deathly pre-eminence. hitherto there has been no sufficient law. after this we shall stand without excuse.... "... who is to say, when the question is improvement, as to where we shall stop? no doubt there is a question of more or less rapid progress, so as to hurt existing interests as little as may be.... "our intrusive visits, as some would call them, into filthy and diseased houses, benevolent as they are, on behalf of those who cannot always help themselves, have example even in the most remote times and from the highest authority. the ancient authority was more imperative, and made it more a matter of conscience. in the ancient jewish law it was ordained 'that he that owneth the house shall himself come and tell the priest, saying: "it seemeth to me there is, as it were, a plague in the house."' the priest was then to command the emptying it, so that "all in the house be not made unclean." he was then to cause it to be scraped within and about, and finally he was to pronounce when the house was clean, and might be again inhabited. "the priest was, you perceive, the medical officer of health under the jewish law, and this text of leviticus is the th section of the diseases prevention act.... "from what i see of the parish we cannot without inconveniently close packing hold many more.[ ] "the growth of our parish is not from births alone; some persons of course immigrate from other parts of england, but the greater part come from ireland, bringing with them disease and poverty.... "i am afraid that the poor of other parishes are forced upon us. we increase in poverty, and, paradoxical as it looks, the poorer we get the more we shall have to pay. "there are now from - , cases of illness per year attended by the poor-law surgeons. "our poor work at the waterside, in the city, and at the docks; their productive labour helps to pay the rates of other parishes, but in difficulty and sickness they live and lean upon us. "now as to _overcrowding:--_ in lewisham there are persons to an acre. " camberwell " " " " " rotherhithe " " " " " all london " " " " " newington " " " " while we have " " " and in one of the parts of the parish " " " "our parish is now almost completely built over. "in , out of , deaths (or one half) were under years. "in bermondsey, out of . "our parish and bermondsey are quite ahead (of others) in this unenviable race towards death." "the contents of our sewers can only be discharged hours each tide-- hours each day--the remaining hours daily they are reservoirs of stagnant sewage." "we are sadly deficient in sewers. at least courts, alleys, and back streets are entirely without drainage.... some of our sewers have remarkably little incline. that in friar street, a most important one, is so level from bean street to suffolk street that it has a most curious quality for a sewer, that of flowing either way equally well. "one very prevalent evil is loose brick drains which let the deadly gases into houses." "... we are a most melancholy parish, low in level and low in circumstances. the lowest and poorest of the human race drop from higher and richer parishes into our courts and alleys, and the liquid filth of higher places finds its way down to us. we receive the refuse as well as the outcomings of more happily situated places." his report for continued his description:-- "we lose annually per , --there are only two parishes worse than we are. some at least of this mortality is preventable. if we could keep to the average of all london we should lose less a year; or even to that of bethnal green we should lose less. "few people believe we are so bad as we really are, and if we do not believe we shall not of course try to mend it, but it cannot be denied. "the rich londoners pay a low poor-rate. the poor londoners pay a high poor-rate. this bears hardly upon us; it stifles us: more and more packed, more and more impoverished; with very little space between the poor ratepayer and the pauper, there is more sickness and death. "density of population brings you more deaths, more sickness, more expense. "the dreadfully vitiated air of our courts and close rooms produces and fosters consumption." commenting on the common lodging-houses, he wrote:-- "the police regulations for order, cleanliness, and prevention of disease are in the highest degree satisfactory.... the benefits are so great that the employment of the same regulations in the more crowded and filthier houses of the poor can only be a question of time. it is the highest humanity to quicken the progress. "vestries have power sufficient for the purpose. the need is so great, so undoubted by those who have seen the evils with their own eyes, and the benefit to be obtained so certain, that if the local authorities do not enforce the improvements, the police will have to do it. "as to the overcrowding, i have brought many cases before you, each from illness resulting in difficulty of cure, constantly recurring. 'i can never get out of that house,' said the district surgeon of one of them. the eight rooms in this house were always full, the receipts £ s. a week, yet it was dirty, neglected, and overcrowded. so the poor live, and i may say, so they die." "as to some manufactories, some of them are very bad, and their pernicious influence spreads widely. i do not think any manufacturer should be obliged to leave; trades must, of course, be protected; but one man must not, to save a little expense in his building and machinery, be allowed to poison a neighbourhood, containing as this does some , people. "there are various ways of making almost all of them bearable." "in this parish are at least , houses rated under £ a year, and containing , persons." . _ st quarter:_-- "of smallpox and vaccination there are some who neglect this great precaution, and so not only imperil themselves but others. here is the evil, and indeed, i believe, the reason why the disease is not altogether banished." "... a case registered as diphtheria occurred and died; it began in one of the very worst localities and then extended to opener and better places. thus it is that modern society neglects the social condition of its poor, and the poor with a well-ordered revenge bring disease and death as a consequence." referring to some tables he compiled, he said:-- "in this table appear deaths from consumption; it has but recently become prominent how very preventable a disease this is ... the principal causes have here been made obvious enough: sleeping closely in ill-ventilated rooms, overcrowding, and bad ventilation." "it is now quite established that, with close overcrowded rooms--that is, by assiduously causing the continued breathing a tainted atmosphere--you may insure consumption in the most healthy. " , years ago the jewish legislator promulgated laws and duties almost identical with those we are now engaged in carrying out as new in the nineteenth century--but so it is." "... there is a great deal of carelessness touching human life, and a great want of common sense or serious thought in the preserving it. much is left to chance. there is either fatalism or stolid indifference upon the matter pervading highest society, and the poor, driven as they are from richer districts into poorer neighbourhoods, can scarcely help themselves; they lose at last all healthy communication with richer or better neighbours, and all taste for pure air and healthy pursuits; they pack close, they descend a little, often a great deal, toward the lower animals, and so live neither for this world nor the next." "there are , houses in this parish. of these have been visited this year, and in the work ordered has been carried out--sometimes in a most slovenly manner--an apparent compliance with your orders. in the poorer districts the most incompetent men are employed to plaster over, patch over, whitewash, or cover over the evils ordered to be _not covered but amended_. still a great amount of good work has been done. "... overcrowding is the normal state in our poorer districts. small houses of four rooms are usually inhabited by or families, and by , , or persons, _e.g._, inhabitants in houses ... a filthy yard generally implies a filthy house and unclean habits" ... "this parish with its thousands of refuse heaps." "i know that we are on the right track. may pole alley, a cul-de-sac with its houses and people, was once a nest of infectious diseases. i attended some cases of typhus there, some of them malignant enough to destroy life in hours. with great trouble this court has been cleansed and amended. it is very much more healthy." . _ nd quarter:_-- "june--an exceedingly hot and dry month. you may judge of the effect of such temperature upon exposed dung-heaps, wet sloppy yards, and rotten, filthy, uncovered water-butts; three characteristics of this parish.... "the surgeon of the district writes thus to the board of guardians: 'the smell is very bad from a horse-boiling establishment in green street, which causes a great increase of sickness near that part.' this of course refers to the bone boiling and other like establishments, of which there are, in this one small street, three cat gut manufacturers, one soap boiler, one horse slaughterer, and four bone boilers--all very offensive trades. i am receiving complaints in all directions as to this matter. i am inclined to think that this is not altogether just to the , inhabitants who live within the effluvia circle of green street." as to infantile mortality he writes: "i confess i see but little difference between that sanguinary ancient law that directly destroyed weakly and deformed children, and that modern indifference that insures at the very least an equally fatal result" ... "these disturbing truths involving so much trouble and expense, and giving us painful reminders of new duties, as well as of old ones neglected." he complains of having to neglect a great many cases of insanitation owing to want of staff. "... of those upon whom orders come to remove nuisances, &c., a large number are objectors, and not a few positive obstructors...." "the items in this last table merit attention, and throw a sad sort of light upon the condition of the poor of this parish. we have visited unclean and ruinous houses; in which the water was stored in a most unwholesome manner; in which the drains were defective enough to be disease producing; in which the w.c.'s were more or less unfit for use; yards sloppy, not paved, or ill-paved; and in which there was no sufficient provision for house refuse.... "we are packing more and more closely. "in the great mass of our poorer habitations the allowance of breathing room is not more than cubic feet per head--often as low as . in one house reported to me there were in four rooms with only , cubic feet, or cubic feet per individual. this must, of course, be premature death to many of them.... "we cannot overlook what is going on: improvements are being effected elsewhere, the dwellings of the poor are being destroyed, a few parishes are fast becoming pre-eminently poor, over-crowded, and filthy. i need not tell you that this parish is one that gets in this respect steadily worse from the improvement in others. "the temptation is very great to overcrowd; the poor family, however large, by crowding into one room, and by even taking a casual lodger in addition, obtains a sort of home at a cheaper rate, and the owner gets a much larger revenue out of what i must, i suppose, call human habitations. the resulting illness and death are considered inevitable, or are viewed with a stolid indifference." . _ rd quarter:_-- of the greatness of the mass of prevalent evils he wrote: "i have often reported it here, but the very enormity of the evil blunts our appreciation of it...." there had been a high mortality in the quarter. "we are once more, i believe, the worst parish in london...." "the back districts of this parish require relief, as much as ireland ever did, from a class of middlemen who, with some few most honourable exceptions, grind out all they can from the most squalid districts, and carry nothing back in the way of cleanliness or improvement." he gives a long list of streets and courts and places where disease was rampant and deadly owing to the insanitary conditions. "it may perhaps be said that all this is in the order of nature, and cannot be prevented. my experience of a quarter of a century among these diseases points quite the other way. providence does not intend that reservoirs of stinking putrid matter shall stand so close to the poor man's door as to infest him at bed and board.... in the jewish scriptures the places for the purposes here mentioned are ordered to be without the camp, as far from the breathing and eating places as possible; and among us, as you see, when we tolerate such abominations, he visits us with death. it is the result of the irrevocable laws of nature often averted by what appear as happy accidents, but at last, when disregarded, deadly. gentlemen, you are the trustees for life and death to a population of well-nigh , people, who from the force of circumstances are more or less unable to help themselves...." "of course it cannot be expected that we can provide the homes of the poor with the orderly arrangements and benefits of these institutions (dispensaries, &c.)--that, however, will form no excuse here or hereafter for not carrying out the improvements we can easily achieve, and which a wise legislature has given us full authority to do." "total deaths in quarter ended october nd, -- , of which were of children under years = per cent!!" the whole tone of this report was such that he could not possibly continue as medical officer of health to a then existing vestry, and he resigned. he was succeeded by another very able man, dr. henry bateson, from whose reports may be continued the description of this parish up to the census of . "the onward moral and intellectual progress of the human race depends far more upon the sanitary state which surrounds it than has ever yet entered into our imaginations to conceive.... "we have suffered severely from the ravages of smallpox. smallpox is a disease over which we have perfect control, and which, were vaccination thoroughly carried out, might be banished from these dominions." "... men whose nervous systems become depressed and the tone of their system generally lowered, become the subjects of a continued craving for stimulants." "... our wells are but the receptacles of the washings from our streets, the off-scourings from our manufactories, the permeations from our cesspools, and the filterings from our graveyards." - . after five years' local government:-- "the circumstances are various and complicated, which contribute to prevent the improvement of the district, and even make the endeavour seem at times hopeless. no one can know the fertile sources that exist for producing in the mind this feeling of despair save those engaged in sanitary labours; or those perchance whose duty it may be to visit our poorest and lowest localities." ... "it is no light and easy work to remove the aggregate evils of centuries which, like the coral reefs of the ocean, have grown up silently and continuously to their present magnitude.... there are hindrances all around, some of which are unsurmountable, such as those arising from the imperfections of the law itself ... there are also vested rights, customs, ignorance, stupidity, and avarice, all of which have to be dealt with and overcome if possible." "nature never pardons. obey and it is well; disobey and reap the bitter consequences." referring to some houses "of the worst description, having no yards, nor even windows behind, so that ventilation was impossible," he says: "i am sorry to say that there are numbers of similar houses still standing, and occupied by the most ignorant and degraded of our population--a class living almost in the neglect of laws human and divine; and as heedless about the present and the future as the very heathen themselves...." "the state and condition of the dwellings of the poorer classes are a stain upon our civilisation." "... no one can conceive, nor would they believe, unless eye-witnesses, the wretched circumstances in which vast numbers of families have to spend their lives. it is indescribable." "the daily task of keeping clean their houses and families, once a pleasure to them as well as a duty, having to be performed amid overwhelming obstacles on every side, from which no hope of escape remains to cheer them on, is gradually neglected and ultimately abandoned, their spirits become torpid and depressed, and this is necessarily followed by the derangement of the functions of the body. finally they become reckless, and this recklessness increases the evil which gave it birth. there is action and reaction. what marvel then that, like unto those about them, they float down the ebb tide towards the dead sea of physical dirt and moral degradation. it has been truly said by dr. southwood smith, 'the wretchedness being greater than humanity can bear, annihilates the mental feelings, the faculty distinctive of the human being.'" "the heedlessness shown in the building of houses is astonishing. no care is taken about the nature of the subsoil, the position, the ventilation, and means of cleanliness. they are run up anywhere and almost anyhow, and too often become the prolific source of disease." and he quotes: "no man has a right to erect a nuisance, and the public has clearly as good a right, as great an interest in enforcing cleanliness to prevent the outbreak of an epidemic as in requiring walls to prevent the spread of fire. yet, where one is destroyed by fire, how many thousands are there destroyed by disease, the indirect result of such erections?" "we are desperately careless about our health, and apparently esteem it of small value. a great modern writer has truly said: 'the first wealth is health. no labour, pains, temperance, poverty, nor exercise that can gain it must be grudged. for sickness is a cannibal which eats up all the life and youth it can lay hold of, and absorbs its own sons and daughters.'" the descriptions here given enable us to realise how terrible and pitiable a state of things had been reached, and the depths of filth, and misery, and abomination into which the people had been allowed to sink through the indifference of parliament, the absence of any local government, and the neglect or avarice of the "owners." one hope there now was. parliament had at last made laws to remedy these evils, and local governing authorities had been created to administer and enforce the laws. in a public health act was passed by parliament, which put an end to the existence of the board of health, and transferred to the privy council the administration of the diseases prevention act. and the privy council was authorised to cause inquiry to be made in relation to matters concerning the public health. in a medical department of the privy council was formed which has in many ways been of immense service to the cause of public health, and which, as time went on, developed towards a true ministry of public health. all things considered, by the end of the first five years of the working of the new local constitution conferred upon the metropolis, a real beginning had been made in the sanitary evolution of the great city. some of the grossest evils had been attacked, and a start made in lifting london out of the depths of the appalling slough of abominable filth in which it had become submerged. in some of the vitally important matters progress was material. the improvement in the water supply was considerable, the main drainage works had been started; the construction of many new sewers, the abolition of great numbers of cesspools, and the better drainage of houses, were all events of a decidedly satisfactory character. and the death-rate of london as a whole showed a slight decrease--from · per , in to · in . in some districts there was an increase--in the majority, however, there was a decrease. but most encouraging of all was the direct evidence afforded by experience as to the effects of sanitary improvements. thus, in whitechapel, the medical officer of health, in reporting that the cases of fever had diminished from , in to in , said:-- "this diminution may be fairly attributed to the additions made to the sewerage of the district, the improvements effected in the drainage of , houses, the abolition of , cesspools, the better paving of many of the courts, the systematic inspection, &c., of houses where fever occurred, the removal of , nuisances, and to the abolition of several offensive trade nuisances." and the medical officer of health for shoreditch wrote, in :-- "that the diminished mortality and the lesser frequency of epidemic diseases are really due in great measure to sanitary works and inspection is proved by the diminution and even disappearance of certain forms of sickness from streets, courts, and districts where sewers have been constructed, ventilation provided, and other improvements effected; whilst, on the other hand, the districts still requiring those necessary reforms furnish far more than their proportion of the epidemic sickness and mortality." philanthropic individuals were increasing their efforts for the improvement of the people; and societies, working on a self-supporting basis, were taking more active interest in the housing problem, and erecting model lodging-houses and more healthy habitations.[ ] public opinion was more interested than before in sanitary matters, and it was thought that the working classes had also in some degree awakened to the care of their own health. "altogether," wrote the registrar general, in his report on the health of london after the census figures of were known, "there is abundant proof of that increased regard for human life that attends civilisation." footnotes: [ ] and vic. cap. . [ ] and vic. cap. . [ ] and vic. cap. . [ ] section of metropolis local management act. [ ] there is in the library of the london county council an almost complete set of these annual reports inherited from the metropolitan board of works. unless those sent to the secretary of state, as directed by the act, have been preserved, there is no other collection in existence. [ ] st. giles'. [ ] fulham. [ ] rotherhithe. [ ] hackney. [ ] medical officer of health, . [ ] "lungs for london," _household words_, vol. i. p. , . [ ] p.p. - , vol. lxxviii. p. . [ ] clerkenwell, . [ ] fulham, . [ ] whitechapel, . [ ] st. giles', . [ ] st. george the martyr, - . [ ] strand, - . [ ] clerkenwell, - . [ ] and vic. cap. . [ ] shoreditch, - . [ ] st. giles', - . [ ] st. olave, southwark, . [ ] whitechapel, . [ ] whitechapel. [ ] population went up from , in to , in . [ ] "the moral and social benefits conferred by these buildings has been immeasurable," wrote one medical officer of health (st. pancras). "they are institutions whose larger acceptance would save the lives of hundreds, and reclaim the morals of thousands," wrote another. chapter iii - the census of disposed of the various estimates of the population of london, and of the death-rates in its various parishes, and gave authoritatively the actual figures. from , , persons in , the population had gone up to , , in --an increase not very far short of half a million; and the number of inhabited houses had increased from , to , . the natural growth of the population, or in other words, the excess of births over deaths, accounted for but part of this increase. the rest was due to the great stream of immigrants into london, which, notable previously, "continued to flow thither with unabated force." the increase was not equally distributed. the population of the central parts showed a decline. there the great economic forces were most powerful, and under their influence the population of the "city" had decreased by more than , : that of holborn and st. martin-in-the-fields by nearly , each: that of st. james', westminster, by about , , and two or three others slightly. but elsewhere--east, north, west, south--the increases had been great, and in some instances remarkable. poplar had increased in the decade by , ; islington by , ; st. pancras by , ; paddington by , . and on the south side of the river, wandsworth had increased by , ; newington and camberwell by , each; and lambeth by , . the rate of growth in the various wards or parts of the parishes showed, both as regarded persons and houses, great differences, the most rapid increases being in the parts nearest to the centre of london. a most material factor in the sanitary evolution of any great city, and especially so of london, is the introduction into its population of fresh elements from the outside. the returns collected by successive census commissioners gave considerable information upon this point. "london is the metropolis of the empire," wrote the commissioners of , "and thither the representatives of other nations, of the colonies, and of scotland and ireland resort; but it is chiefly the field in which the populations of the several counties of england find scope for their talents and their industry." the majority of the inhabitants of london in were indigenous, for , , were born within its limits; , , were born elsewhere. of these , , , close on , were born in scotland, , in ireland, , in the colonies, and , were foreigners. the remainder--amounting to about , --were born in the extra-metropolitan counties of england and wales. "proximity to the metropolis, and the absence of manufactures at home, first drew the natives of these counties to london. the stream of immigrants from the south-western counties was large: cornwall, devon, dorset, somerset, and wiltshire having sent , of their natives to be enumerated in london." likewise the stream from norfolk and suffolk was large. but the great bulk of the immigrants came from the counties immediately around london. to put the figures in simple form--of every , inhabitants of london, were born in london, the remaining were born elsewhere. and the census provided also the means for ascertaining as correct a death-rate as could be arrived at. in the death-rate was · per , ; in it was · --not much of a decrease, but satisfactory in showing that some of the evil powers of insanitation were stayed. it is, however, always to be borne in mind that either the death-rate, or the number of deaths, gives but an imperfect and incomplete picture of the sanitary condition of a population. it tells but the tale of those who have died of disease--it leaves uncounted and untold the far greater number of those who have been either temporarily disabled or maimed for life by disease. estimates vary considerably as to the number of persons who suffer from disease and recover; and the proportion of recoveries to deaths varies in different diseases, some diseases being so much more deadly than others. but the sick-rate is always, and under all circumstances, very much greater than the death-rate. the mere taking of a census could have no visible or actual effect; the routine of life and the action of the various economic and social forces continued unchanged; but the information gained was of the utmost value. the figures and the facts recorded afforded startling demonstration of the immensity of london, and of the growing gravity and complexity of the great problems of london life. london was huge before--appalling almost in size and population; now it was shown to be huger than ever. everything was on a more enormous scale. the masses of population were far larger, and were rapidly increasing; and with this increase everything concerning their existence became more and more complicated, and every reform more and more difficult. the removal of evils affecting their physical and social being would be a heavier task, the supervision of their conditions of life more onerous and exacting, and the provision of a government to secure their well-being a graver problem than ever. one of the great forces unceasingly at work, and one of the great contributory causes to insanitation and to the maintenance of a high death-rate was, undoubtedly, drink. it led to poverty and overcrowding, it led to ill-health and greater susceptibility to disease; and the evils acted and reacted upon each other indefinitely--a vicious circle from which there was no escape, overcrowding leading to a craving for drink, and drink resulting in poverty and therefore overcrowding with its attendant evils and high mortality. since the unfortunate moment in when parliament deemed it expedient "for the better supplying the public with beer" to give greater facilities for the sale thereof, and scattered broadcast throughout the nation the seed of unlimited evil, facilities for drink not only of beer but of spirits have been practically unlimited. against this source of evil, which is often mentioned in their reports, neither medical officers of health nor vestries could contend, and had no power to contend. but all through the history of the sanitary evolution of london this deep underlying curse was present, acting as a perpetual clog upon sanitary and social progress--a horrible, all-pervading and tremendous power for evil. in the earlier years of this new decade of - the central government--the metropolitan board of works--was demonstrating the great utility of a central governing authority for london, and a task was nearing accomplishment which was absolutely the first essential, the very foundation of an improved state of the public health. it was engaged in pressing vigorously forward the great system for the sewerage and drainage of london designed for taking off the sewage and refuse waters of a prospective population of three and a half million persons, and the rainfall of a drainage area of square miles. until those works were completed no great degree of sanitary improvement could be expected. in the board reported that a portion thereof had been finished, and as the work gradually progressed the vestries were able to avail themselves of the deeper outfalls afforded, and to undertake drainage works in their several areas. by the great task was virtually accomplished. eighty-two miles of main intercepting sewers had been constructed, and the sewage was being conveyed away by them several miles distant from london. their completion enabled the metropolitan board to fill in the open sewers, which had so long polluted the atmosphere, and been such a fertile source of disease in the districts where they existed, and took away from the vestries any excuse for delay in carrying out the construction and putting in order of the local sewers for which they were responsible. the central authority had thus brought into existence a gigantic system of sewerage by which the river near london ceased to be the main sewer of london, and the whole of the metropolis was relieved of many of the most powerful causes of fever, cholera, and other destructive diseases. it was a great work, admirably and expeditiously carried out, and it cleared the way for other sanitary reforms which were impossible without an effective general system of sewerage, yet which were essential if a satisfactory condition of the public health were ever to be attained. the central body also proved its great utility by securing uniformity in the sewerage and drainage works which fell to the duty of the local authorities to carry out. all plans by the vestries had to be submitted to the board so that the board might see that they were consistent with the main system. both main drainage and house drainage were thus steadily being extended and improved, but in many places things were still outrageously bad. nor had the creation of fresh evils been effectually prevented, for from bromley came the complaint that several new estates were rapidly being covered with small house property which drained into cesspools. and the medical officer of health for fulham wrote ( ):-- "the active operations of your board have fortunately relieved the fulham district to a large extent from that pregnant source of mischief--want of drainage; still there are large tracts of building land yet unprovided for, on much of which houses by dozens are being squatted without any regard to this great essential by the builders, save the horrid cesspool system. it is enough to have to counteract the evils of past imprudence without perpetuating them by such wilful recklessness...." the supply of water to the inhabitants of london was of equal importance to an efficient system of sewerage. the problem had by no means been solved by "the metropolis water act" of , which had enacted that within five years after the passing of the act a constant supply should be given by the companies. unfortunately, the supply was in the hands of various public companies over which the local governing authorities had practically little or no control, and, like all sanitary legislation of this period, the results were not commensurate with the intentions of the legislature. an illustration of how insufficient the supply was, was detailed in a report of the medical officer of health for whitechapel in :-- "a return has been made by the inspector of courts in the district. "of these--in which contain houses and have a population of , persons the water supply is by stand taps only, from which the water flows daily (sundays excepted) for a period varying from quarter to half an hour. "this intermittent supply is totally inadequate to the wants of the people." parliament made an effort in [ ] to amend the law, and enacted that where a house was without a proper supply of water the owner or occupier might be required by the vestry to obtain such supply, and if such notice was not complied with, the vestry might do the necessary work and recover the expenses from the owner, and then require the water companies to supply the water. but the act was of little practical value, and was made of less value by the inaction of the local authorities. a few extracts from reports of medical officers of health show how thoroughly unsatisfactory and disastrous to the health of the people the existing condition of affairs was. the medical officer of health for fulham wrote in :-- "the powers at present given by statutes for enforcing a supply of water for domestic use are, within the fulham district, all but inoperative. the cry amongst the cottagers is still for water--water without which all other sanitary appliances are at best abortive, without which in ample and continuous flow no community can be preserved in healthfulness. on this essential will depend the perfect working of our deep and costly sewers, on this alone will hang success in minor drainage matters. water, that first and most important element of health and cleanliness, exists in name alone in masses of our cottage property here, and consequently neither purity of person nor of dwelling can be ensured." the medical officer of health for st. martin-in-the-fields wrote in deploring that the new laws of the water companies did not provide for water being supplied on sunday. "it is to be lamented that people should at any time have to go about begging water, and more especially so on sundays, the very day they most require it." and the medical officer of health for westminster wrote ( ):-- "the water supply to many of the courts and alleys is very unsatisfactory. no sunday supply. "it does seem a monstrous arrangement that for days in the year the public should be deprived of that which they pay for, but have no means of substituting by anything else." and to complete the hardships which the people suffered under in the matter of water supply, if the house-owner did not pay the water rates when called upon to do so, the water company might cut off the supply of the people in the house. this was frequently done, and the medical officer of health for whitechapel recorded how for four months-- "the inhabitants of tuson's court, spitalfields, had been entirely deprived of water in consequence of the water company refusing to continue any longer the supply, as the landlord had not paid the water rate." the quality of the water, though improved by the change of intakes to the part of the thames above teddington lock, left very much to be desired. it was no longer contaminated by the entire sewage of the metropolis, but it was still by sewage poured into the river and its tributaries by towns higher up--oxford, reading, windsor, chertsey, hampton, and others--and received, unchecked, the whole of the pollution, solid and fluid, of the district constituting the watershed. and this same water, after it had been so polluted, was abstracted from the river, sand-filtered, and pumped into the metropolis for domestic uses and distributed to the consumers.[ ] the housing of the people was the problem which, above all others, was more and more forcing itself upon the attention of those whose work brought them into actual contact with the conditions of life of the great mass of the people who were in their charge; not merely the construction of the houses or their situation, but the accommodation afforded and the conditions of life therein. "our forefathers," wrote one of the medical officers of health, "knew nothing about the public health, and cared less. they added house to house, and street to street, according to their own will and apparent benefit, and so have left us this mingled heritage." and there were streets and courts and alleys which were not fit for human habitation, and which could never be made so; and thousands upon thousands of houses where "nothing short of a hurricane would suffice to displace and renew the air." london had enough to suffer under from the state of the existing houses, and an appalling task before her to remedy them, but not alone was this enormous evil practically unattacked, but fresh sources of evil were allowed to be created, and new houses were being erected which would carry into the future the evils which efforts were now being made to put an end to. "a house may be built anywhere," wrote one of the medical officers of health in , "and almost anyhow, provided all the rooms can be lighted and ventilated from a street or alley adjoining. the object of the builder is to save as much ground, materials, and expense as possible. the result is not difficult to foresee...." no regard, moreover, was had to the ground on which new houses were being built, though that was all-important for a healthy dwelling. "... some of the new houses are built upon garden mould or old 'slop shoots,'" wrote the medical officer of health for paddington in - ; "these thin and flimsy shells of lath and plaster truly merit the term 'slop buildings.' a dangerous moisture and miasma arises from houses built upon such an unhealthy foundation." how disastrous the results were to the inhabitants is pointed out by several medical officers of health. the medical officer of health for mile-end-old-town wrote ( ):-- "... many open places now built upon, or being built upon, have been for years the receptacles for all kinds of animal and vegetable refuse, and have become thoroughly impregnated with the products of their decomposition.... the result to the health of the occupants is daily realised by the excessive number of zymotic diseases and deaths which occur in them." the medical officer of health for limehouse wrote:-- "ask about the general health and the houses. 'never been well since coming in, and the children always ailing; and my husband says he feels more refreshed when he comes from his work than after he gets up in the morning. and then everything spoils; meat put into a cupboard is musty in a night. one can keep nothing.' "these are all new houses." and a few years later, referring to this same subject, he wrote:-- "a half mile off, a few years ago, there were some acres of gravel pits. the gravel had gone for road-making, &c. the large pit was then filled up on invitation of the owner, with the aid of the scavenger and others, with all the slush and filth of a large circle of contributors. when this fund of abominations became consolidated, it was built over in the usual style. they were soon occupied by tenants and lodgers. now this site during the epidemic (of cholera) has been a great slaughter field--the mortality was shocking." and he added, "there are thousands of such houses built about london." the building act of was very far from being an effective prevention of such devices as these. it required a notice to be given to the vestry before any new building was commenced, and a plan to be submitted for approval showing the proposed drainage and the levels of the building; but this requirement appears to have been by no means universally complied with, and some local authorities had great difficulty in getting notices of new buildings commenced within the district. and its restrictions were not sufficient to prevent the speculative builder in places from raising his block of houses in the fields with neither road or sewer for their accommodation, and with the frequent result of fever-stricken tenants. with the increasing knowledge of their districts gained by the numerous medical officers of health distributed over the whole metropolis, the widespread prevalence of overcrowding in london, and the virulent evils, physical, social, and moral, consequent thereon, come into greater prominence and more vivid light than ever before. throughout the central parts of london the process of demolition of houses of all sorts and sizes, inhabited by the well-to-do or by the poorest, was continuing. the street improvements which were being carried out in some places entailed extensive demolitions; whilst the construction of railways and the erection of large stations necessitated the destruction of hundreds of others, mostly those inhabited by poorer persons. thus, in the improvements in the holborn valley, houses, accommodating , families and , persons, were taken down and not replaced. and in st. pancras, and many other districts, the dwellings of the poor were constantly being removed by railway expansion. the subject of the displacement of labourers in consequence of great public works in the metropolis was brought before the house of lords in by lord derby.[ ] "it affects," he said, "in the most vital manner the interests of a large portion of the population who are utterly unable to protect themselves against legislation, however unfavourably it may bear upon them. "in the metropolis and its suburbs sixty to seventy miles of new line (railway) are proposed--a great portion of these passing through the most crowded streets." he described specially the parish of st. bartholomew's, in cripplegate, with a population of about , inhabiting houses. "throughout it, there are not ten families who occupy a house to themselves, although the bulk of the houses contain only three rooms. the incumbent tells me the aristocracy of his parish consists of families who are able to indulge in the luxury of two rooms. but the greater number have one room, and one only, and this is sometimes divided between more than one family. "half of these houses are under notice for the railway." and lord shaftesbury described a great demolition of houses which took place a few years previously in the neighbourhood of field lane, city: " , houses were pulled down; , families, comprising , individuals, were turned out and driven into the surrounding tenements." lord granville suggested, as a remedy, the provision of cheap trains to carry artizans from healthy dwellings in the suburbs to the scene of their work, and lord redesdale said he had introduced clauses into the railway bill providing that the companies should run a cheap train every day. but, as lord shaftesbury pointed out,[ ] that would not be sufficient, as-- "in some cases the men are under an engagement to their employers not to live more than a certain distance from the warehouse," in order that no time might be lost in executing orders. the remedy, moreover, could only be very gradual in its operation, and was quite inadequate to meet the existing emergency. this demolition of houses had thus the two-fold result of at once intensifying overcrowding in the remaining houses in the localities affected, and in extending the area of overcrowding by causing a migration to other localities, many of which were themselves rapidly becoming overcrowded. and this, combined with the natural growth of the population and the constant stream of immigration into london, resulted in overcrowding on a far larger scale than had hitherto prevailed. in mile-end-old-town the west ward had received in the decade - an addition of , persons, whilst but new houses had been built--the south ward , persons and new houses built. in shoreditch, in , "the tendency to overcrowding was increasing year by year. "being mostly operatives, &c. ... accustomed to live near their places of employment, they were naturally unwilling to travel further than necessary, and so have accepted the readiest accommodation for their families." of whitechapel, the medical officer of health wrote in :-- "the evil of overcrowding is annually increasing, and if means be not adopted to check it, the overcrowding will soon become of an alarming extent.... "houses formerly occupied by single families are let out in separate tenements, and every room now contains a distinct family; and to such an extent is this separate letting of rooms carried out, that from information given me there is not a single street in the parish of whitechapel that is not more or less a nursery of pauperism in consequence of this sub-division of tenements." away in the west, in fulham, there had been a "flood of immigrants," chiefly of "the lower and labouring classes." the population had increased per cent., and the medical officer of health wrote ( ):-- "in watching the enormous accession of population to the fulham district, one cannot otherwise than observe the constant tendency to overcrowding amongst the labouring people, whilst there seems every possibility of this human tide increasing. the tremendous demolition of the houses hitherto occupied by the working classes more immediately in london itself has dislodged thousands of families, whilst no systematised provision has been made for their reception." in westminster the medical officer of health wrote in :-- "the dwellings of the poor were never in a worse or more unsatisfactory state than they are at present from the large number of houses that have been already demolished. the poor are now driven into the most wretched apartments, and which, in consequence of the increased demand, can only be obtained at the most extravagant rates. they are consequently compelled to herd together in one room, usually barely sufficient for half of those it is now made to hold." the south side of the river was much in the same plight as the north; but there, there was more room for expansion. the medical officer of health for st. saviour, southwark, wrote in :-- "the numerous improvements which continue to be made in and about the heart of london have so increased the value of house property that overcrowding has been almost inevitable. "... in a vast number of instances families numbering four to seven persons, ill or well, live, cook, wash, and sleep in rooms the dimensions of which are not greater than is now demanded for each sick person in the workhouse." the medical officer of health for st. george-the-martyr, southwark, wrote:-- "in many of the districts of the metropolis between and per cent. of the population are compelled to live in one small overcrowded room, and in which every domestic operation has to be carried on; in it birth and death takes place; there plays the infant, there lies the corpse; it is lived in by day, and slept in by night." in the necessity for house accommodation all sorts of places were being pressed into use, and people driven into "places that are themselves unfit for habitation, not having the elements of life and health about them." the medical officer of health for paddington described, in , how mews had been thus utilised:-- "in fact these back streets, originally built and intended for horses and vehicles, and only those persons without encumbrances who are engaged attending to them, have now become the resort of persons with large families following all kinds of business--rag, bone, and bottle stores, shops of various kinds, including beer-houses, builders, carpenters, smiths, tailors, sweeps, find accommodation here. inhabiting the rooms above, too small, and unfitted with proper domestic accommodation for a family, live a vast population of all ages. these evils, rather than otherwise, are increasing." into such houses and such rooms the people were by stress of circumstances compelled to go, and, as the medical officer of health for st. giles' pointed out ( ):-- "a larger rent can be obtained for the same room if it is overcrowded by a large family than if it be hired for only as many inmates as it can properly receive. hence the interests of landlords are constantly on the one side, the health of the poor on the other...." what this pressure upon accommodation produced may be gathered from a few figures given by the medical officer of health for whitechapel:-- houses. rooms. inmates. in slater's court, whitechapel in marlborough court in hunt court "in one room in swan court, having one window, seven persons slept--a man and his wife, the daughter aged in consumption lying in bed, and four younger children; the cubic contents of the room were = cubic feet to each person. "in bell court four persons occupied a room with cubic feet each. "in three rooms in hayes court, each Ã� Ã� feet; each with only one window opening into a narrow court; each occupied by eight persons = cubic feet to each person." the medical officer of health for st. pancras ( ) described some of the consequences of the conversion of a house, built originally for one family, into one inhabited by several families:-- "... at present these families occupy usually a single room only in a house of six or eight rooms adapted for only one family. the water supply is inadequate, and at some distance from the upper rooms, and there is but one closet, one dust bin, one coal cellar, and one wash house for the whole. no one is responsible for the cleanly condition of the closet, the water tank, the single staircase, the basement, the areas, and the yard, or for emptying the dust bin." one of the worst forms of overcrowding was when it resulted in what was described as "indecent occupation." for instance, as reported ( ) by the medical officer of health for whitechapel:-- "in a room in windmill court there slept the mother, two adult daughters, and two adult sons. "in another room in the same court, a man and his wife, the daughter aged , and three adult sons." in instances the rooms were "indecently occupied," that is to say, adult brothers and sisters, or a father and daughter slept in the same room. and he wrote:-- "we may well inquire how such gross indecency and want of self-respect can exist in this country, which is usually considered to be the centre of civilisation, and where so much money is spent in imparting religious and moral instruction to the people--yet such is the state in which many of the inhabitants of this district live, as is ascertained on a house-to-house visitation." and in the following year he wrote:-- "on visiting the houses in low neighbourhoods it is by no means of unfrequent occurrence to find an adult brother and sister, a father and adult daughter, a mother and adult son, occupying the same bed. what good citizenship can be expected to be manifested by a class in whom the moral feeling is so low?" the medical officer of health for st. james', in his report ( ), wrote:-- "this close association of several families in one house is productive of immense evil; it prevents proper parental control; it encourages an association of the sexes which leads directly to one of our greatest social evils; and is one of the most fruitful causes of the spread and fatality of zymotic diseases of childhood, and lays the foundation of the scrofula and consumption which every year carry off a fifth of all who die amongst us.... "it is almost impossible, amidst the filth and stench of dirty houses and imperfect drains, that the working man's family should be able to develop those moral and intellectual qualities which are, after all, more worth to the community than any saving of rates." the medical officer of health for st. martin-in-the-fields, wrote ( ):-- "rents have become so heavy that few labouring men can afford more than one room. overcrowding in such rooms must increase, and with it the fearful results of men, women, girls, and boys, all sleeping in the same apartment. neither religion nor morality can increase under the existing circumstances of our poorer classes. it is almost returning to the habits of our barbarous ancestors or the untutored savages of africa and australia." and the medical officer of health for holborn wrote:-- "depend upon it, the moral and physical training of the people is more influenced by lessons--whether in health and cleanliness, or in religion and morality--that they are constantly receiving at their own firesides than by any extraneous teachings. "when a child has been allowed to grow up with a diseased body, and a polluted mind, in a wretched room, without light, without cleanliness, and without any notions of decency, our curative efforts, whether medical, missionary, or reformatory, are as mere patchwork compared with the great preventive precaution of keeping his home as pure, as decent, and as wholesome, as possible." no more powerful description can be given of the moral evils of overcrowding than that of dr. j. simon in :-- "where 'overcrowding' exists in its sanitary sense, almost always it exists even more perniciously in certain moral senses. in its higher degrees it almost necessarily involves such negation of all delicacy, such unclean confusion of bodies and bodily functions, such mutual exposure of animal and sexual nakedness, as is rather bestial than human. "to be subject to these influences is a degradation which must become deeper and deeper for those on whom it continues to work. to children who are born under its curse, it must often be a very baptism into infamy."[ ] overcrowding was not confined to tenement-house rooms alone. the great bulk of the working classes left their overcrowded abodes to do their day's work in overcrowded factories, workshops, and workplaces; and in very many such places men, women, and even children were crammed together in rooms where healthy existence was impossible. a great deal of information on this great branch of the sanitary condition of the inhabitants of london is given in the reports from the commissioners on children's employment, and in the very valuable reports of special inquiries instituted by the medical department of the privy council. one of these inquiries related to bakehouses, of which there were about , in the metropolis in .[ ] as a rule the place in which the bread of london was made was what in houses in general was the coal-hole and the front kitchen. very many bakehouses in london were stated to be in a shockingly filthy state, arising from imperfect sewerage and bad ventilation and neglect, and the bread must, during the process of fermentation, get impregnated with the noxious gases. the sleeping places were of the worst description,[ ] some of the men sleeping in the bakehouse itself. many bakehouses were infested with rats, beetles, cockroaches, and noxious smells. the smells from the drains were very offensive--the air of the small bakehouses was generally overloaded with foul gases from the drains, from the ovens, and from the fermentations of the bread, and with the emanations from the men's bodies; the air thus contaminated was necessarily incorporated with the dough in the process of kneading. half of the bakehouses in london would, it was stated, require the application to them of the nuisances removal act. another inquiry related to the tailoring trade in the metropolis.[ ] the places in which work was done were reported as varying much in their sanitary conditions, but almost universally were overcrowded and ill-ventilated, and in a high degree unfavourable to health. some were underground, either in the basement of a house, or built like a large kennel in a small enclosed yard, and were such that no domestic servant would inhabit. in exceedingly few shops had there been any attempts at ventilation. the ventilation through the windows was practically inefficient, and instances were given of what had been found in sixteen of the most important west-end shops. in one an average of cubic feet space was allowed to each operative, in another cubic feet, in another cubic feet. deficient ventilation, heat, and draughts, were the causes of diseases. a paper read by dr. e. symes thompson (assistant physician to king's college hospital) at the social science association meeting in london, , described the condition under which printers did their work. "printers often work sixteen to eighteen hours a day in a confined and heated atmosphere; perhaps thirty men and as many gaslights in a low room without ventilation or chimney, where air only enters when the door is opened.... "printing is only one of the many trades which entail the sacrifice of every hygienic necessity, and the cause of the unhealthy looks of the workpeople cannot fail to strike any observant person who may visit their workshops. the rooms are mostly low, the windows fixed, and there is often no chimney or other ventilation. "this is the case in large and small factories as well as in workshops--in the workroom of the milliner, the sempstress, or the bookbinder. "in many occupations, besides the evils alluded to, the air is charged with foreign matters, which are drawn into the lungs at each inspiration; _e.g._, the sorting and tearing up of dirty rags in paper manufactories. the dust and fluff arising in flax, woollen, and cotton factories, and in furworks, produce similar results--and brass finishers." and in another paper at the same meeting mr. george godwin detailed his experiences as regarded the conditions under which milliners, dressmakers, and other needlewomen worked. "in an upper room in oxford street, not feet square, i have seen a dozen delicate young women closely shut up making artificial flowers; and there when business is pressing they work from in the morning till o'clock at night. "many of the workrooms of fashionable milliners are similarly overcrowded, as are those where young girls are engaged in book-stitching." he gave as an example a house in fleet street. "the staircase is confined and without ventilation--the atmosphere is steaming and smells of glue. "in the first room looked into, young women and girls were sorting and stitching books. there was a stove but no ventilation.... there were more than persons in that house, pent up without provision of the first necessity of life--pure air. poor creatures so placed are being slowly slain. "other trades, such as cap and bonnet makers, trimmers, blond-joiners, &c., to which i have looked with some little care, are forced in many places to do just the same thing." "the extent of suffering entailed, and the loss to the community, it would be difficult to calculate. it is time that legislation should be tried to secure wholesome workplaces for the people. interference is needed for thousands of persons--especially young females--the debilitated mothers _in posse_, should they live, of our future population. in our infant schools, too, where incalculable mischief is done by overcrowding, it is greatly required. the evil is sapping the strength of the land." "in several parts of london persons employed in making cheap clothing are boxed up in crowds, ... some striving to get a living in a death-giving atmosphere. "shoemakers are often as ill-placed. in wretched apartments, in an ill-drained house, may be found men and boys huddled together without room to breathe." it was under such pitiable conditions that large masses of the working classes of london had to earn their daily bread. lord shaftesbury truly said that "the sanitary condition of these people was of national importance, not only on account of the waste of life, but the waste of health which every year threw thousands and tens of thousands upon the rates."[ ] and large numbers of children were also employed under insanitary conditions, and were made to do heavy work for long hours, and the consequences to their health were disastrous.[ ] that their constitutions should be undermined and their physical development should be most seriously deteriorated was a necessary result. there was a chorus from the medical officers of health as to the evil sanitary consequences of overcrowding. "overcrowded dwellings are among the most prolific sources of disease, immorality, and pauperism."[ ] "overcrowding--one of the elements by which disease is not only generated but sustained."[ ] "overcrowding is a constant source of fever." "the great difficulty of obtaining lodgment for the working classes has caused overcrowding of the poor in an unprecedented manner, and consequently the development of typhus which is considered to be bred in the pestilential atmosphere of overcrowded dwellings."[ ] overcrowding led to numerous, indeed to all sorts and kinds of diseases. the medical officer of health for st. pancras wrote:-- "it has been shown that consumption and the so-called tubercular diseases are developed by want of pure air more than by any other cause." and not alone did the overcrowding lead to disease, but it rendered it difficult if not impossible to check disease. "how is it possible," wrote one of them, "to prevent the spread and fatality of fever and whooping-cough when six or seven persons are shut up in one small room breathing the same air loaded with zymotic poison over and over again? "the danger of allowing a deadly atmosphere to be engendered by the crowding together of persons in a small room without sufficient ventilation is unfortunately not confined to the inmates of that particular room, but those diseases which are therein generated extend far beyond its immediate vicinity, and under some circumstances a large portion of a district will suffer in consequence."[ ] dr. rendle, previously medical officer of health for st. george-the-martyr, in his evidence[ ] before a select committee in , said:-- "... the overcrowding exists to such an extent that the poor cannot by any possibility do other than breed disease, and when they breed it they give it to others." lord shaftesbury said:-- "as to the effects of all this overcrowding, can anything be more prejudicial to the human system than the filthy squalor, the foetid air, and depressing influences of these dwellings? "when you ask why so many of the working men betake themselves to the ale-house or gin-palace, the answer lies in the detestable state of their homes. "i have had it from hundreds of both women and men that this cause, and this cause alone, has driven them to the use of ardent spirits.... nine-tenths of our poverty, misery, and crime, are produced by habits of intoxication, and i trace those habits, not altogether, but mainly, to the pestilential and ruinous domiciliary condition of the great mass of the population of this metropolis and the large towns of the country."[ ] "no bodily labour induces an exhaustion of the vital powers comparable to that resulting from the habitual breathing of air contaminated by the overcrowding of human beings."[ ] for children born under such circumstances of overcrowding and filth, and in such insanitary surroundings, birth was mostly followed by an early death. "infancy in london has to creep into life in the midst of foes," as the _times_ truly remarked in . among the greatest of these foes was overcrowding. the statistics of infantile mortality are fairly reliable, and, so far as there are errors, those errors were in understating and not overstating it. in st. giles', in , - / per cent. of the total number of deaths were of children under five years of age. "this enormous infantile mortality," wrote the medical officer of health, "is unfortunately only what is customary in our district." in the strand, , the percentage of deaths under five annually exceeded per cent. of the total deaths. in westminster, in , there were , deaths, being those of children under five--of which in st. john's parish, out of deaths, were under five--or over per cent. in bethnal green in it was close upon per cent. in the potteries, notting dale, with a population of , , the deaths of children in under five were per cent. of all deaths. in , per cent. on the south side of the river the same tale was told. in wandsworth per cent. in ; in battersea per cent. in ; in rotherhithe, in , nearly per cent.; in bermondsey, in , per cent. "it certainly," wrote the medical officer of health for fulham, "could not have been intended by providence that of all the children born, nearly one-half should die without attaining one-fourteenth part of the threescore years and ten allotted to mankind--and yet we see the yearly realisation of this astounding fact." other causes besides overcrowding contributed to this great mortality. "poverty," wrote the medical officer of health of poplar, "with its concomitants--defective nourishment, want of cleanliness and ventilation, malaria, overcrowded dwellings, deficient supply or impure quality of water--these all act with unerring force upon the tender constitutions of the young." and another wrote:-- "what with overcrowding, insufficient food, and inattention to cleanliness, it is almost impossible an infant can resist an attack of the commonest disorder." and some places were in such evil sanitary condition that child life was impossible therein. of two courts in islington the medical officer of health reported in :-- "young children cannot live there. all that are born there, or are brought to reside there, are doomed to die within two years." the state of the public health generally as the result of all these sanitary abominations was very unsatisfactory. in the mortality of london was unusually high. the medical officer of health for st. giles' wrote:-- "the year has been conspicuous for a high mortality resulting from the prevalence of epidemics to an unusual degree--smallpox, scarlatina, typhus." the following year he reported to have been-- "a year of exceptional mortality.... death rate · per thousand, or, if the deaths of parishioners in hospitals be included, · .... tubercular diseases, of which consumption affecting the lungs is the most important, were as usual intensely fatal in our district." the medical officer of health for whitechapel drew attention to the increase of mortality in his district. he was evidently puzzled and perplexed by it, and "candidly confessed" his inability to account for it. "i may, however, venture a few conjectures." among them was this very suggestive one--"that a change has taken place in the constitution of the people so that they are now less able to bear the effects of disease than formerly." suggestions and recommendations for ameliorating this appalling condition of things poured in upon many of the local authorities from their medical officers of health. upon several points there was an absolute consensus of opinion. one of these was that all houses let out in separate tenements and inhabited by many families should be registered by the local authorities--that rules and regulations should be made for their management, and that constant inspection by the sanitary authority was an absolute necessity if the proper conditions of health were to be maintained. the medical officer of health for bethnal green wrote:-- "all sanitary evils fall with greatest force upon those who are unable to quit the scene of their misery or to provide the means for its alleviation. "nothing but adaptation of the present houses to the necessities of healthy existence and the demolition of those houses that are unfit for human habitation can contribute so much to life and strength." a committee of the district board in poplar wrote ( ):-- "it would be a satisfactory alteration of the law if no houses were allowed to be tenanted unless a certificate that these premises were fit for habitation were first obtained from the district board of works." and the necessity of constant inspection was even more vigorously expressed. the medical officer of health for hackney wrote ( ):-- "the experience of the past year again shows the necessity of keeping up a regular and efficient supervision of the interior of houses.... "it is only by repeated and careful inspection of the dwellings of the poor, and an inculcation at these visits of the necessity for keeping clean their rooms that epidemic diseases can be kept in check." the medical officer of health for st. james' wrote ( ):-- "the nuisances which are removed, are constantly recurring. it is only by constant inspection and by supervision repeated systematically from day to day, and week to week, that those nuisances can be kept down which are ever ready to destroy the life, and at one and the same time sap the health and undermine the morality of the community." the medical officer of health for whitechapel wrote:-- "if it were not for the vigilance of the inspectors in visiting the houses of the poor, nuisances would remain altogether unattended to; for very few of the poor dare to make a complaint from fear of being compelled to quit their tenements." the medical officers of health recognised that much of the bad condition of the dwellings of the poorer classes was due to the people themselves. thus the medical officer of health for westminster wrote ( - ):-- "it is much to be regretted that in certain districts of the parish only a temporary good is effected by a sometimes lavish expenditure on the part of the proprietor. the habits of the people are such that it is almost impossible to do anything for their benefit. not only are they filthy in themselves, but they take every opportunity to break, destroy, and steal anything that may be of value, and what is even worse they appear to negative any sanitary precaution effected for their benefit." but the broad truth was that the real, the primary responsibility rested upon the "owners." theirs was the property. and them it behoved to keep that property in a condition which was not a danger to the community and to the state. the medical officer of health for whitechapel wrote ( ):-- "the duty and interests of landlords appear to be at variance as regards their doing to their houses what is absolutely necessary for the well-being of their tenants. it is unquestionably the duty of landlords to keep the houses which they let out in separate tenements to the poor in a healthy condition; but this is not always done even if compulsory orders are signed and summonses issued.... "many of the landlords of small house property fully understand and carry out the rights of ownership, but fail to carry out the duties which are enjoined upon them as owners." the medical officer of health for islington, referring to some vile property in his parish, wrote ( ):-- "landlords of such property as this will rarely do anything out of consideration for the health or lives of their tenants; compulsion alone will extort amendments. what is needed here is the closure of the fatal houses until made fit for human habitation." how an "owner" could manage his property can be gathered from the following report of the medical officer of health for paddington ( ), which called attention to "the insanitary condition of a block of houses (about thirty in number) which had been for many years notoriously liable to the invasion of epidemics and to the prevalence of those diseases which are the known product of sanitary neglect--badly constructed and dilapidated, and wanting in the commonest appliances of cleanliness. all were the property of one individual who had been repeatedly urged to put them in a proper sanitary state." but it was not until stringent compulsory measures were taken that he began to do so, and some years elapsed before they were really done. here is another dreadful case of overcrowding and insanitation--this time in st. marylebone ( ). edwards place:-- "ten six-roomed houses occupied by families, persons, houses very dilapidated, many unfit for human habitation. orders for sanitary work are continually being sent out by the vestry to the owner of this wretched property. "a rental of £ per annum would be an extravagant sum to pay for either of these miserable dwellings, yet more than three times that sum is expected from the destitute and indigent people who inhabit them." read by the light of the knowledge that insanitary property meant disease, and disablement, and death to a very high percentage of its occupiers, the proper compulsion to have applied to "owners" such as these would have been proceedings before a coroner's jury for culpable homicide if not for actually deliberate murder. the community has a right to be protected from the evil results of the miserable housing of the poor. mr. george godwin said in , at the meeting of the national association for promoting social science:-- "it should be no answer to the requirement of a certain cubical space for each occupier, that the financial resources of the parties will not admit of it. "a man is not permitted to poison with prussic acid those who are dependent on him because he is poor; neither should he be allowed on that ground to kill them with bad air and set up a fever-still for the benefit of his neighbours." parliament, under the pressure of a slowly-developing public opinion, and in view of the ever accumulating evidence and proof of the almost incredible insanitary condition in which great masses of the people of london were living, was beginning to show less reluctance to discuss and deal with some of the multifarious matters affecting the public health. in it passed an act which, however well intentioned, was not of much effect. it was an effort to secure more wholesome articles of food and drink for the public by preventing their adulteration. the past history of such legislation was rather interesting.[ ] in an act has been passed prescribing a penalty for "sophisticating tea." "several ill-disposed people frequently dyeing, fabricating, very large quantities of sloe-leaves, &c., in imitation of tea, and colouring or staining and dyeing such leaves, and vending the same as real tea to the prejudice of the health of his majesty's subjects." "in year - a further act was passed inasmuch as 'such evil practices were increased to a very great degree to the injury and destruction of great quantities of timber, wood, and underwoods.' "coffee had also been the subject of legislation, 'burnt scorched, or roasted peas, beans, &c.,' being used to adulterate it. "in an act was passed against the adulteration of beer and porter, and the use of molasses, liquorice, vitriol, quassia, guinea pepper, or opium, and a lot of other ingredients being prohibited." "in an act was passed against the adulteration of bread." and now in it was enacted that "every person who shall sell as pure or unadulterated any article of food or drink which is adulterated or not pure," should on conviction be fined. the vestries in the metropolis were empowered to appoint analysts. the appointment was voluntary on the part of the local authorities, and, if analysts were appointed, their duties were confined to receiving and analysing articles submitted to them by the purchasers, and certifying the results. the purchasers had to pay the cost. no officer was appointed to obtain samples or to enforce the act. and the act is therefore worthy of note more as an illustration of the inaction of the local authorities than for any effect it had as regarded the prevention of adulteration. in parliament passed the "bakehouse regulation act,"[ ] which enacted that every bakehouse should be kept in a cleanly state, should be frequently lime-washed, and should be properly provided with proper means for effectual ventilation, and be free from effluvia arising from any drain, privy, or other nuisance. also its use as a sleeping-place was prohibited, and the onus of enforcing the provisions of the act was imposed upon the local sanitary authority. and in it declared[ ] that the law made in as to the inspection and seizure of unwholesome food--meat, poultry, flesh, fish, vegetables, fruit, &c., &c.--was defective, and that other and more effectual provisions should be substituted therefor; and others were accordingly substituted. by an act in the main principles contained in previous factory acts were carried a stage further, in some instances even to trades carried on in private houses. "every factory to which this act applies shall be kept in a cleanly state and be ventilated in such a manner, &c., as to render harmless dust, &c." unfortunately the main breakdown in the metropolis in regard to nearly all the ameliorative sanitary legislation of parliament was directly caused by the very local authorities who had been specially created for the purpose of administering those laws. primarily they were responsible for the failure of very much of that legislation, and they never seem to have at all realised, or been impressed by, the gravity of their trust, or by the great responsibility to their fellow-citizens which their position entailed. even in comparatively small matters their ingenuity in counteracting the intentions of the legislature was remarkable, as can be seen from the following passage in a report of one of the medical officers of health:-- "i refer specially to the sanitary acts, to the adulteration of food act, and to the metropolitan gas act, in each of which cases the powers entrusted to them have not been carried out. "they appointed an examiner under the adulteration of foods act ( ), and also under the metropolitan gas act ( ), but the person appointed had no tools given him with which to perform the work entrusted to him. "both the acts are dead letters in the parish. as to the metropolitan gas act, it conferred a large benefit, both as to purity and cost, on the metropolis, but the vestries failed to carry out a single effective or important provision of that act." in , also, an act had been passed empowering the local authorities in the metropolis to provide vehicles for carrying persons suffering from infectious diseases to hospital, and so obviating the danger to the public of such persons being conveyed in cabs or other public vehicles. that act was also inoperative. the vestries and district boards, however, did perform a considerable amount of useful work. local sewerage and drainage works were on the whole effectively dealt with. the rest of the work done was mostly of the routine order, such as scavenging and paving and lighting, though even that was not always done in the most sensible way, as exemplified in paddington ( ). "the street sweepings of mud collected by the scavengers are stored in enormous quantities in the middle of the parish in a closely inhabited neighbourhood. here it is allowed to decompose, &c. if it were intended to contrive an arrangement for developing malaria in the midst of a town population nothing could be better adapted for the purpose." a few of them had soared to the height of widening a street, or acquiring some small open space; in most, if not all, of these cases receiving financial help from the central authority. but as to the main causes of the prevailing insanitary evils, their aversion to active measures was constantly in evidence; equally so where the enforcement of the law would have entailed cost on the owners of insanitary houses. in some matters the plea of defects in the legislation might have been justifiably urged by them; in others they were often much hampered by the dilatory procedure attending proceedings for enforcing the sanitary provisions of the metropolitan london management act. one of the medical officers of health gives an illustration:-- "a very great nuisance was reported to us. we visited it, but had to wait a fortnight before the vestry met in order to get leave to apply for a summons. the magistrate requires a week before hearing the case, and then he gives a week or two to do the work. so for a month or five weeks the nuisance may remain." the result was that infectious disease was given a long opportunity to spread itself unchecked through a whole district; an opportunity which it freely availed itself of. complaints were also made by some of the medical officers of health that in attempts to enforce the law against "overcrowding" the magistrate leant very much to the landlord. this, too, might have acted as a discouragement to them. what, however, is certain is, that the vestries and district boards were not attempting to grapple with the most crucial questions of all--the overcrowding, and the housing. the medical officer of health for clerkenwell pointed this out, so far as his parish was concerned ( ):-- "the principal sanitary improvements during the last five years related almost exclusively to the drainage, whilst the overcrowding and impure state of the dwellings of the poor have been but little interfered with." the more serious blemish was pointed out by dr. hunter in his report of to the medical officer of the privy council on the subject of overcrowding, and the removal of persons from houses about to be destroyed:-- "there is no authority which can deal with london in these matters as a whole, and they are matters in which uniform treatment is quite necessary. the local authority which finds the whole of its district overcrowded, naturally hesitates before beginning action which may relieve one house only to overfill the next, and may reasonably think that such action, unless done thoroughly, not only through the district, but through the whole capital, might prove hurtful."[ ] and his opinion is weighty. but the local authorities were very far from doing what they might have done to abate many of the insanitary evils connected therewith. dr. william rendell said[ ]:-- "we have had till now but one inspector of nuisances--an unwilling man.... "this is not a question of a defect in the law. these bodies have the power of appointing inspectors, but when inspectors are appointed it brings of course a large amount of work in low property, and expense and trouble are incurred. therefore the easiest way to avoid it is not to have inspectors enough, so that the work may not be found out." in fact, the fuller the information on the subject is, the more clear it is that most of them did not want to move in the matter. the evidence of witnesses, not under vestry control, examined before the select committee on metropolitan local government in , throws some light on this point. mr. james beale, himself a vestryman, said:-- "i have seen a great want both of intelligence and ability among vestrymen. "i should say you may divide vestries into divisions--one-third, as a rule, are of the right class of men who ought to be returned, and two-thirds are not of the class who ought to represent the intelligence or the property of the districts from which they are sent. "the powers of vestries are administered with too great a regard to economy. efficiency is always sacrificed to economy. if an act of parliament requires them to do certain things, it is as a rule avoided." he attributed the failure of the vestries to the inferior calibre of the persons composing them--"they agree to resolutions, but do not carry them out. the ratepayers take no interest in the elections in our parish. there is a large number of the owners of small house property in the vestries who regard with great disfavour any increase of the rates, however beneficial the increase might be to the general health of the district." but some witnesses went further. dr. william rendell, who had been medical officer of health for st. george-the-martyr, said:-- "i believe, the law being new to the vestry, they did not quite understand the mode of carrying it out; but it was partly from corrupt motives, for on one occasion one of the principal members of the vestry, an owner of considerable property in the parish, called me aside and requested me to pass over certain property of his that i found in an extremely bad condition. i did not pass it over, of course. the chairman of the local committee was, as i thought, appointed as a positive obstructer of sanitary measures; at all events he acted as such. the obstructions arose from an unwillingness to incur expense for fear of increasing the rates, and from an interest that the members of the vestry had in keeping up the present state of things." jobbery, and the exercise of influence to obstruct and defeat the law, are hard to prove, especially after the lapse of years, but one fact which stands out conspicuous, and which is incontestable, shows how reprehensibly the great majority of the vestries and district boards failed to administer laws which in the interests of the public health, and therefore of the public welfare, it was their duty to administer. deliberately, and in the light of knowledge, they would not make adequate arrangements even for the sanitary inspection of their respective districts. thus, in bethnal green, in , there was a population of , persons, and , houses. the vestry appointed one single inspector of nuisances to cope with the insanitary conditions of this city of houses, and of this mass of people. shoreditch, with a population of , persons, and , houses, also one inspector. st. george's, hanover square, with , persons and , houses, one inspector; paddington, bermondsey, and several others, all with large populations and thousands of houses, one inspector each.[ ] a few had appointed two inspectors: st. marylebone with , persons and , houses, and islington with , persons and , houses. kensington, lambeth, and limehouse, had appointed three inspectors each. st. pancras headed the list with four, but its population was close upon , living in close upon , houses. how could it be expected that one inspector could within a year possibly inspect even one tithe of the places which it was his duty to inspect apart altogether from other duties he ought to perform? the vestries and district boards had the facts constantly before their eyes (in the returns of work made to them by the medical officer of health)--the numerous insanitary houses unfit for human habitation, the overcrowding, the terrible amount of sickness and misery, and they could calculate from the one man's work, the number of houses in the parish which were in a condition dangerous to the health of their inmates, and to the public health generally. the salary of an inspector was so paltry that they had no excuse on the ground of economy; and the conclusion is inevitable that either they did not care what the sanitary condition of the people was, or that "vested interests in filth and dirt" were so powerful on those bodies that filth and dirt must not be interfered with at the expense of "owners" upon whom the cost of improvement must fall. and a grimmer light is thrown upon these figures by the following statement of the medical officer of health for lambeth made in , but referring to . "the sanitary inspector of twenty years ago (that is to say of ) was an unskilled workman, holding that which might almost be regarded as a sinecure office; an official recruited into the services of the vestry from the rank of ex-sailors, ex-policemen, or army pensioners. a knowledge upon sanitary matters acquired from a course of technical training was not expected from him." the treatment meted out to some of the medical officers of health also showed the hostility of the vestries to action. numerous are the passages in their reports complaining of their recommendations being ignored. these officers were miserably paid, allowing even for their being able to take private practice. the medical officer of health for lambeth was stated to have been the worst paid--receiving only £ a year for the performance of duties attaching to an area of , acres with , inhabited houses upon it, inhabited by , persons. dr. w. farr (of the registrar general's office) said:-- "i believe that in certain districts in london the medical officer of health is under all sorts of restraints. if he is active, they look upon him with disfavour, and he is in great danger of dismissal."[ ] the vestry of st. james', westminster ( ), checked the zeal of their medical officer, dr. lankester, whose salary was £ a year, by reducing it to £ after a year or two when they found he was very earnest in his work. dr. rendell, the medical officer of health for st. george-the-martyr, southwark, resigned "in disgust that he was not allowed to carry out the duties of his office." once more the approach of asiatic cholera--the nemesis of insanitation, and of "fainéant" local authorities--created anxiety.[ ] it had been widely prevalent in europe in , and had even shown itself in england, and it stirred into spasmodic and panicky activity the local authorities of london. in lambeth a systematic house inspection was inaugurated; houses were examined-- of them required sanitary improvements. in bethnal green , were inspected-- required cleansing and purification. in many other parishes and districts extra sanitary work was done. the disease made no further demonstration in the winter, but in april, , a case was reported from bristol, then one from swansea--then from other places; and in july the privy council issued orders in council putting the disease prevention act in force in the metropolitan area. on july th, from poplar, the first case in the metropolis was reported. two days later an alarming number of cases in parts of east london. regulations were issued by the privy council defining and requiring the specific services which local authorities ought to render the public. some parishes appointed extra sanitary inspectors. thus in hackney, where there had been but one, four additional ones were appointed; in st. james' two; in camberwell two; in lambeth two; in st. mary, newington, five extra were appointed. some of the work which was reported brings into striking prominence the extraordinary inefficiency hitherto of the authorities in dealing with insanitary houses as well as the neglect into which houses had been let fall, and which was tolerated by those who were responsible for the health of their districts. in lambeth , houses were inspected in ; , improvements were effected. in camberwell, , houses were inspected; in , sanitary work had to be done. in st. mary, newington:-- "a house-to-house visitation was commenced august th, and concluded on november th, in which period the sub-inspectors called at , houses. "a record was thus obtained of the condition of nearly every house in the parish. the house-to-house visitation was carried out with but little real opposition, and with a great deal of satisfaction.... strict impartiality was the rule of action, and all classes and those in every station were alike subject to inquiry." as the summer went on, the mortality from the cholera increased--it reached its acme on august st, when there were deaths from it, and in the week ending august th when the total of , was reached.[ ] during the weeks of its prevalence , persons died--of whom , died in the east districts alone, and on the south side of the river. and by the end of the year it had gone. that the mortality should have been so much smaller than on previous visitations was attributed to the fact that london was unquestionably less filthy at the time of this outbreak. "a comparison of the mortality with that of former cholera years," wrote the medical officer of health for st. giles', "demonstrates that sanitary work--imperfect as it is--has deprived the disease of much of its power." "the power," wrote the medical officer of health for fulham, "of sanitary arrangements to check the progress of such a formidable disease was clearly evidenced." the medical officer of health for lambeth wrote:-- "i believe the great sanitary improvements effected in the parish in providing proper drainage, abolishing many miles of open stinking ditches, and the removal of other nuisances, rendered an outbreak of cholera, such as experienced in former years, very improbable.... moreover, by the employment of sanitary arrangements for treating the sick, lambeth and other parts of the metropolis were saved from the ravages of the pestilence experienced on former occasions." that the epidemic had been as disastrous as it was, was, however, attributed to "an illegal and most culpable act of the east london water company. in contravention of the th section of the metropolis water act of that company distributed for public use a water (and a most improper water) which had not passed through its filter beds; and strong evidence was adduced to show that the outbreak was occasioned by this illegal and most culpable act." one result of this epidemic was to demonstrate, at the cost of thousands of lives, that the system of private water companies supplying the community with this necessity of life was absolutely opposed to the interests of the community. dr. simon, in summing up his report ( ) on the water supply to the metropolis, wrote:-- "i have been anxious to show what enormous risks to the public are implied in any slovenly administration of water supplies: yet as regards the london supply, what imperfect obedience to the law, and in some cases what flagrant and systematic disobedience was exhibited (at the time of the cholera outbreak in east london in ); and above all what criminal indifference to the public safety was illustrated by the proceedings of the southwark and vauxhall company." as regarded this latter company:-- "not only had there been the long-standing gross inefficiency of the apparatus of subsidence and filtration, but the administrators of the supply had from time to time dispensed to a great extent with even a pretence of filtration, and during some time had, worst of all, either negligently or wilfully distributed as part of their supply the interdicted tidal water of battersea beach. "it seems to me that the public is hitherto very imperfectly protected against certain extreme dangers which the malfeasance of a water company may suddenly bring upon great masses of population. its colossal power of life and death is something for which till recently there has been no precedent in the history of the world; and such a power, in whatever hands it is vested, ought most sedulously to be guarded against abuse." cholera was once more a blessing in disguise, though it seems hard that the sacrifice of thousands of lives should have been required to move government and parliament to fresh measures for the protection of the people from it and the other deadly diseases which unceasingly worked such deadly havoc among them. but the proof given by it was so overwhelming and decisive as to the insufficiency of the existing sanitary law, and the inefficiency of the local authorities, that parliament felt forced to take action. the measures taken were of such increased comprehensiveness and stringency, that the passing of the sanitary act of [ ] marked another great step in the sanitary evolution of london. the act applied to england and wales--and this time actually included the metropolis. the previous definition of the term "nuisance" was enlarged, and "overcrowding" was now for the first time declared to be a "nuisance." "any house or part of a house so overcrowded as to be dangerous or prejudicial to the health of the inmates" was henceforward a "nuisance" and punishable as such. and it was further enacted that "where two convictions for overcrowding of a house, or for the occupation of a cellar as a separate tenement dwelling-place" should have taken place within three months, it should be lawful for the magistrate to direct the closing of such premises for such time as he might deem necessary. under another extension of the term "nuisance" the industrial classes got the shadowy boon of all factories, workshops, and workplaces (not already under special acts), being made subject to the sanitary supervision of the local authorities; and those authorities were given power to inspect such places to ascertain if they were kept in a cleanly state, were properly ventilated, and not overcrowded so as to be dangerous or prejudicial to the health of the inmates. a section in the act aimed at the inefficiency and inaction of the local authorities, and made it obligatory (no longer optional) upon them to make inspection of their districts. "it shall be the duty of the nuisance authority to make from time to time, either by itself or its officers, inspection of the district, with a view to ascertain what nuisances exist calling for abatement under the powers of the nuisances removal acts, and to enforce the provisions of the said acts in order to cause the abatement thereof." an effort was also made to check the spread of infectious disease by giving the local authority considerable powers as regarded disinfection. it was enacted that the local authority might provide a proper place for the disinfection of clothing and bedding which might have been rendered liable to communicate disease to others; and the authority was empowered to maintain carriages for the conveyance to hospital of persons suffering under any infectious or contagious disease. a blow was struck at the iniquitous but common practice of letting a room where there had been dangerous infectious disorder, until it had been disinfected. and provision was made for the establishment of a hospital for the reception of the sick. all these were most considerable reforms, and would have been most useful had they been given effect to and properly enforced. the most important and wide-reaching provision of the act was that directed against overcrowding. the th section enacted that regulations might be made by the sanitary authority (in other words, the vestry or district board) for fixing the number of persons who might occupy a house, or part of a house, let in lodgings, or occupied by members of more than one family. houses so let were to be registered by the vestry. the regulations could fix a certain number of cubic feet of air space which should be available for each person. by this means the number of persons who might live in a house, and in the rooms of the house, could be limited. that was the plan--simple enough in appearance--which parliament devised for contending with the great evil of overcrowding. and then, as regarded the sanitation of the houses when registered, it enacted that regulations should contain provisions for their being put into and kept in a clean and wholesome state. and to secure this being done, regulations were made for their inspection. it was an original and comprehensive scheme of reform. it struck at the root of the two great evils--overcrowding and insanitary dwellings; at overcrowding, by the limitation of the number of persons inhabiting a house, or part of a house, and at insanitary dwellings by a series of regulations enforcing the necessary measures for a decent standard of sanitation. but it was something far more than this. it was the declaration of principles of the utmost importance. it was a declaration of the principle that the responsibility for the condition of the "houses let in lodgings" should be on the shoulders of the "owner" of the house. it was the declaration of the principle that the "owner" should not be allowed to use his property to the detriment, to the injury of the public. it affirmed, so far as london lodging or tenement houses were concerned, the great principle, abhorred by so many "owners," that "property has its duties as well as its rights." the act was, however, even more remarkable for the recognition it contained of another principle of vital importance to the people of london--the principle of central authority over local sanitary authorities who neglected their duties. hitherto the local authorities were practically their own masters, and could with absolute impunity neglect to put the provisions of the existing health laws into operation; and "often their inaction had been an absolutely inexcusable neglect of duty." a power of appeal against this inaction was given. where complaint was made to a secretary of state that a nuisance authority had made default in enforcing the provisions of the nuisances removal acts, he could, if satisfied after inquiry that the authority had been guilty of the alleged default, make an order limiting a time for the performance of the duty, and if the duty was not performed within that time, he could appoint some person to perform the duty and charge the costs to the authority. and where the local authority had made default in instituting proceedings against some sanitary law breaker, he could order the chief police officer to institute them. these provisions were a recognition of the fact, long patent to even the blindest, that local authorities did not do their duty, and of the necessity of devising a means of securing that a necessary public duty should be done. the fact was emphasised a few years later by the royal sanitary commissioners, who pointed out ( ) that-- "however local the administration of affairs, a central authority will nevertheless be always necessary in order to keep the local executive everywhere in action." the real underlying truth now beginning to be discerned was that in the matter of health or disease, london could not be treated in bits, each governed by an independent body, but must be regarded as, what it really was, one single entity or whole. in another way also was the principle of central authority very clearly affirmed. the vestries were not to have a free hand in making their regulations under the th section. any they made had to be approved by a secretary of state. this was a considerable limitation of the freedom of the vestries, but it secured more or less uniformity in the powers of the local authorities in this particular matter. but the vigorous administration by all the local authorities of the laws passed to secure the health of the public, was even more greatly to be desired; for, from force of circumstances, the consequences--one way or the other--could not be confined to the sphere of action of each local authority. the lives and welfare of the inhabitants of this vast city are so closely, so inextricably interwoven that, in matters affecting the public health, the action or inaction of one authority may vitally affect the health and the lives, not alone of its neighbours, but even of the people of the city as a whole. disease and death are no respecters of municipal boundaries, and are not hemmed in or restrained by lines drawn upon maps or recorded in acts of parliament. this community of interest of the inhabitants of london was, however, scarcely, if at all, recognised by the general public--it was but seldom the motive to action by the local authorities--but some of the medical officers of health now and then referred to it in their reports. thus the medical officer of health for mile-end-old-town pointed out ( ) that-- "an untrapped drain, an overcrowded house, an unventilated alley, a rotting dungheap, or a foul closet, may spread disease and sorrow in an entire neighbourhood." and the medical officer of health for paddington pointed out ( - ) that-- "the danger of harbouring a contagious disease is not confined to the individual suffering--it is a matter that concerns the community." and the medical officer of health for whitechapel wrote ( ):-- "here i would remark, that a uniform system of inspection of all the houses in the several districts in london which are let out in separate tenements should be repeatedly and systematically adopted; for if all the vestries and local boards do not act together in this important matter, hotbeds of epidemic diseases will remain undiscovered which will serve as centres from whence such diseases may emanate, and extend over the entire metropolis. the whole population of london, therefore, is interested in the prompt removal of nuisances." immediately on the passing of the act some of the vestries made efforts to deal with overcrowding under the section which enacted that-- "any house so overcrowded as to be dangerous or prejudicial to the health of the inmates" is to be considered a "nuisance." that, however, was only a temporary remedy, and affected only overcrowding. section went to the root of the matter when it insisted that in addition to the prevention of overcrowding, the house in which the people lived should be kept clean and in sanitary condition. "the very foundation of our sanitary structure," wrote the medical officer of health for st. george-the-martyr, "depends upon the right housing of the poor." the section was promptly put in force by a few of the vestries--chelsea and hackney being the first to make regulations and to enforce them. under the regulations, whenever the vestry deemed it desirable to put them in force in respect to any house let in lodgings or occupied by members of more than one family, the number of persons allowed to live in that house was fixed on a basis of cubic feet of air for each adult for sleeping, or for living and sleeping, and the owner had to reduce the number of lodgers to the number so fixed on receiving notice to that effect. the regulations further directed that-- "the owner of such house shall cause the walls and ceilings of every room, and of the staircase and passages, and yards of such house to be well and sufficiently coloured or limewashed, or otherwise thoroughly cleansed once (at least) in every year. "he shall cause every room and the passages to be ventilated. "he shall provide such accommodation for washing, and such a supply of water for the use of the lodgers as shall be satisfactory to the vestry's officers;" and sundry and numerous minor directions. the medical officer of health (chelsea), after the first year's work, reported that the number of houses in the parish inhabited by two or more families was very great, and in many cases their condition was deplorable, and it was found necessary to embrace whole streets as well as courts and alleys in the registration. by the registration in chelsea had been completed, and in the medical officer of health wrote: "i have seen no reason to alter my opinion of the beneficial action of the measure by which we have been able to bring under direct and constant supervision the majority of the houses occupied by the poorer classes in this parish...." the most satisfactory results followed also in hackney. its medical officer of health reported in that nearly , houses had been measured and examined, and in a large proportion of cases the numbers of persons allowed to inhabit them had been fixed. and as to the result of the enforcement of the regulations, he wrote ( ): "a very large number of families now occupy two rooms who formerly lived and slept in one. the gain in health and morality has therefore been considerable." poplar was another of the district boards which made and enforced the regulations. the medical officer of health for the north part of the district reported ( ):-- "extensive improvements have been already effected, but the work must still be systematically continued, for even when every house in the district has been put into good sanitary state (which is far from being the case as yet), it will be necessary to maintain a constant and watchful system of re-inspection to ensure their being kept in order. "of the , houses inspected nearly all required more or less sanitary improvement, and were registered as containing more than one family, and therefore coming under the board's regulations as to registration." but if a few of the vestries made real efforts to utilise the act, others of them either made only a pretence of doing so, or refused altogether. the reports of the medical officer of health for st. giles' ( - ) present a typical picture of the attitude and conduct of these bodies. "a most important amendment of the sanitary laws was made by the 'sanitary act,' of which section gives precisely the powers which, not last year only, but every year since the constitution of the board, the medical officer has demanded for the efficient discharge of his functions in respect of houses inhabited by the poorer classes. that section has given to the local authority the power of making bye-laws for the regulation of sub-let houses, and of enforcing the observance of its rules by penalties. "in st. giles' district, it is this class of houses almost exclusively which need the supervision of the sanitary authorities, and which become without that supervision nests of filth and disease. "accordingly, soon after the passing of the sanitary act, bye-laws were adopted by the board, and sanctioned by the secretary of state for the regulation of sub-let houses.... "the board proceeded to inform owners of all sub-let houses that such houses must be registered in conformity with the regulation. the intention of the board was to apply with all proper discrimination, but quite universally and impartially, the powers vested in them in regard to sub-let houses.... the systematic application of these powers by the board would have done for sub-let houses what the systematic application of the police of their powers under other acts had done for common lodging-houses. cleanliness and decency would have been universally secured, and would have been maintained with a minimum of inspection by a fine for every gross violation of the regulations. "but against a system that should work thus directly and efficiently to the sanitary good of the district, the interests of numbers of house-owners and agents were at once arrayed, and these speedily organised an influential deputation to the board. "the opposite interests, those of the families dwelling in the close and miserable rooms of these sub-let houses, found no organised expression. "the board resolved to recall the notices which had been issued for a systematic registration, and to apply their powers, in the first instance, only to selected instances of flagrant and continuous sanitary neglect." and yet overcrowding in tenement-houses in st. giles' was dreadful. here are some instances of it on the authority of the medical officer of health in . "these houses have for the greater part a family in every room. "in king street there are families in rooms. " lincoln court " " " " " " little wild street " " " " " " wild court " " " " " " in whitechapel ( ), rules and regulations were adopted by the board. "unfortunately," wrote the medical officer of health, the act was permissive, not compulsory. "i brought under the notice of your board several houses which in my opinion ought to be registered. "... the board having reserved to itself the power of determining as to the propriety of causing any house to be placed upon the register, this enactment, which was framed not only for the improvement of the moral and physical condition of the poor, but for the benefit of the whole community, has been carried into effect in only one instance." in islington, draft regulations were prepared, but it does not appear that they were ever adopted. in paddington, the vestry decided against putting the regulations in force. in westminster, "such obstacles were offered by the holders of small property" to the regulations that they were not enforced. and on the south side of the river the story was very much the same. the sting of the enactment was that it put house-owners to the expense of putting the house into, and maintaining it in, habitable and sanitary repair, and to the expense of annually painting or lime-washing it; the provision of proper ventilation--of sanitary and washing accommodation, and for a supply of water: in fact, of doing to the houses that which was essential for the health of their occupants. the regulations simplified and shortened, and made more effective, the processes for enforcing penalties for breaches of the sanitary laws--all which was of course unpalatable to the sanitary law-breaker. and so the great bulk of the local authorities would have nothing to do with this th section or its regulations. the law was not compulsory, but permissive--and they availed themselves of that permission. but the vestries and district boards who took no action, and allowed the principal provision of the act to be a dead letter, proved by their conduct their deliberate determination not to impose what was a just expense upon the "owners," even though the not doing so should result in a frightful annual sacrifice of human life, and in an untold amount of human suffering and misery, and a long train of physical and moral evils of the very worst character. that the act had been successfully administered by some two or three vestries proved that it was quite a workable measure--so no excuse could be raised on that ground by the recalcitrant vestries. their attitude is an irrefutable proof of their selfish indifference to human suffering where it clashed with the "rights of property," and of their incapacity for the position they held as guardians and trustees of the people. "the slaughter-houses and cow-houses are ordered to be whited at least twice a year, while the houses of the poor are allowed to remain for years without this important means of purification." the problem of overcrowding was, undoubtedly, a most difficult one--and some of the medical officers of health were realising how difficult it was to treat with any hope of success. thus the medical officer of health for bethnal green set forth the state of his parish in :-- "the population of bethnal green has now nearly reached , , and we have no more house room than heretofore. the consequence is that overcrowding is as great as ever; and although the public health act of was framed to obviate this great evil, it is practically unworkable, owing mainly to high rents (which in some cases have increased as much as per cent.), dearness of provisions, scarcity of employment, and the imposition of taxes for the first time upon the tenant; and many families who could ordinarily afford to occupy a whole house have been obliged to let lodgings; others who have occupied two rooms have been obliged to put up with one; and where overcrowding has existed, and the law enforced, the people have merely removed to other houses and thus perpetuated the evil which it was the intention of the legislature to obviate." but doing nothing while overcrowding got worse was not likely to make the problem less difficult. except, then, in a few parishes overcrowding was permitted to pursue its own course unchecked, to the great benefit of the various "owners," and to the great misery of great masses of the people, and the evil extended itself year by year and became steadily acuter. and this, too, after parliament had placed in the hands of the local authorities large powers specially designed for coping with an evil which was eating into the very vitals of the community. so rapid was the increase of population that the increase in the number of houses did little to mitigate the over-crowding; nor was the construction of the majority of the houses conducive to the health of those who went to inhabit them. london ground was being rapidly covered with buildings. "many large tracts of our formerly open spaces have been rapidly covered, nay densely packed with buildings. "the operations of the builder have annihilated acres of garden ground by the hundred." "little garden plots, green spots, open spaces, were being absorbed and swallowed up one after another, and covered with houses.... "apparently each builder does that which seems good in his own eyes." paddington afforded an interesting example of this growth. a space near ranelagh road, about acres, had almost all been built upon within the last - years. the streets were feet wide. here were houses packed with , people, or persons to the acre ( ). and another example near paddington road, where houses had been built, and the population was to the acre, showing-- "a high density of population such as ought not to have been tolerated under a wise municipal policy." the rapidity of the increase was extraordinary. in lambeth in the year - , , houses were erected. in battersea in - , , houses were erected--a large number of which were filled with people within a few days or weeks of their completion. the newness of a house, however, gave no guarantee of its sanitary fitness, and a great proportion of them were of the most objectionable and insanitary description. all the art and craft of the speculating builder was too often exercised to evade such legal provisions as there were for the protection of the public, and to get the largest profits he could for the worst constructed house, and the result was that very many of the new houses were little better than the worst of the old ones. unfortunately, the law was very ineffective to prevent this. as was pointed out by the medical officer of health for fulham ( ), the sanitary legislation for the metropolis had never been accompanied by an amalgamation of the building act with the general sanitary statutes. "the building act still works an independent course, and it is not too much to say of it that, whilst its provisions deal strictly with the strength and quality of bricks and mortar, they utterly fail to ensure for us dwellings, especially for the working classes, which have the least pretensions to perfection in sanitary conditions. a large number of habitations of this description have been completed and occupied during the last few years both in fulham and hammersmith, and take the place of our former fever dens in fostering disease. unfortunately the sanitary authorities see these wretched structures raised before their eyes, and have no power to check their progress. it is truly to be hoped that this anomaly will soon be remedied." such as the houses were, however, they were quickly inhabited. the medical officer of health for paddington gives a graphic description of the result in his parish ( ):-- "there has been for some years a large influx of persons, mostly of the working class, coming from over-crowded and unwholesome houses of other districts of the metropolis. large numbers of the newly-built houses being let out in tenements and single rooms attract a class of persons barely able to obtain necessaries of life; amongst these are not a few of intemperate and demoralised habits, with feeble vital stamina, consequently there is, and will be, a larger proportion of sickness, chronic pauperism, and death in the parish than formerly. "this deterioration of race has for some time been recognised by medical officers of health. * * * * * "it must be remembered that most of the working people are fixed to the spot, and cannot get a periodical change of climate, or remove from a locality in the event of impending ill-health, or of contagious disease breaking out near them. "it is of no avail to lament over the laws of absolute necessity, but all parties should combine in a demand for that even-handed justice to the working ranks which, though it may not interfere with a stern destiny which confines them to a life of toil, is bound at least to provide that the theatre of that toil shall be free from the pollutions that endanger the functions of life, and uncontaminated by contagion and death. "i must say it is a scandal to the present constitution of society that the reverse of this continues from year to year in spite of all suggestions of medical officers of health, and the warnings of experience. in vain does one plague after another ravage the family of industrial orders, and like doomed men they stand amidst the harvest of death looking earnestly, but in vain, to the legislature for that help which no other power can give. parents, children, and friends, drop around them, the victims of a poisoned atmosphere; while they hear and feel successive warnings, the irrevocable law of necessity fixes them to the spot, and they cannot flee from the danger." the central authority, the metropolitan board of works, had, during the decade, been doing much useful work affecting the public health, of london, in addition to its great work, the great system of main drainage. it had undertaken and had completed several large street improvements by , intended to provide new and improved means of access from one part of the town to another. "the board had to supply the deficiencies resulting from centuries of neglect: it had also to keep pace as well as it could with the wants of the ever-increasing population, and the needs of a traffic which grew relatively even more than the population," and each work contributed to the improvement of the public health, by facilitating and increasing the circulation of air in crowded neighbourhoods. another matter, important also in reference to the health of the metropolis, had also occupied their attention, namely, the acquisition or preservation of open spaces in london for public recreation and enjoyment. a piece of land, of over acres in extent, was acquired and opened to the public as finsbury park in ; and on the south side of the river, in rotherhithe, some acres of land were purchased in , and converted into a public park a few years later. on the outskirts of london there were a number of commons and other tracts of open ground available for public resort, to which the public had no legal rights, and which were rapidly being absorbed by railway companies or builders. london was thus in danger of losing open spaces which were urgently required in the interests of the public health. parliament, after an inquiry by select committee, passed the "metropolitan commons act"[ ] in , which prescribed a mode of procedure under which the commons in the neighbourhood of london could be permanently procured for the people of london, and the metropolitan board set to work to procure them. the acquisition of hampstead heath was happily arranged in . another great work was also undertaken by the central authority--namely, the embankment of the thames. the offensive state of the river had been greatly enhanced by the large areas left dry at low water on which sewage matter collected and putrefied; and the only way of removing this cause of mischief was by confining the current within a narrower channel. parliament passed an act in , entrusting its execution to the metropolitan board, and the work was soon after commenced. thus in these matters, all of which were closely associated with the public health, the sanitary evolution of london was progressing, and the board was giving visible demonstration of the necessity of that which had so long been denied to london--namely, a central governing authority to deal with matters affecting london as a whole. the board, in their report for - , stated they were: "deeply sensible of what remained to be done to remedy the neglect of past ages, and to render the metropolis worthy of its position as the chief city of the empire;" but they were hampered by the want of means to enable them to carry out desired improvements. "it cannot be questioned," they wrote, "that direct taxation now falls very heavily upon the occupiers of property in the metropolis.... it appears to the board that the most equitable and practicable mode of raising the necessary funds would be by imposing a portion of the burden on the owners of property. it cannot be denied that the interest of the latter in metropolitan improvements is much greater than that of temporary occupiers, and yet at the present time, the occupiers of property in the metropolis bear almost the whole cost of the improvements effected by the board. it is hoped that the representations made by the board will satisfy the legislature of the injustice of the present state of things, and lead to some equitable remedy." the visitation of cholera was doubtless in the main accountable for the excess of energy displayed by parliament about this period in matters affecting the public health. in the same session that the sanitary act was passed, a measure of considerable importance to the consumers of water in london was passed, though many years would elapse before its effect would be appreciable. this was "the thames purification act." "whereas ... the sewage of towns situate on the river thames above the metropolis is carried into the river, and thereby its waters are polluted and the health and comfort of the inhabitants of the valley of the river below those towns of the metropolis are affected," powers were given for the diversion therefrom of the sewage of oxford, reading, kingston, richmond, &c., &c., "whose cloacal contributions to the stream were distributed to masses of the people of london." no less than towns, it was said, cast their impurities into the river. and in the following year the scope of the thames conservancy board was extended and very stringent care exercised to prevent unnecessary pollution of the river. and in the river lea, another of the water suppliers, was placed under a conservancy board. in an act of far-reaching consequence was passed, making vaccination compulsory. in an act[ ] dealing with this matter laid it down that the parent of a child, or the occupier of the house in which a child was born, might, within days, give notice to the registrar as to the vaccination of the child. there was no punishment for the neglect to do so, and no penalty for refusal to give the registrar the information. this new act, which came into operation on the st of january, , enacted that-- "every child shall be vaccinated within three months of its birth." the act was to be administered by the poor law authorities; and boards of guardians might appoint public vaccinators and establish vaccination stations. in , also, another act of very great consequence was passed dealing with one important element in the sanitary evolution of london, to which no reference has yet been made, namely, the provision of hospitals for the isolation of infectious or contagious disease, for the prevention of mortality, and for the speedy restoration of the sick to health. there is, indeed, no part of sanitary work requiring more constant attention than the protection of the community from the spread of infectious diseases, and this is best secured by hospitals affording proper provision for isolation and treatment of infectious cases. next to the adoption of proper measures for the prevention of disease, a suitable provision for the speedy restoration of the sick to health is obviously of the greatest importance to the community. so far as the absolutely destitute were concerned, all had, by the law of england, subject to certain conditions, right to food, shelter, and medical attendance; and they accordingly received gratuitous medical treatment at workhouses, or dispensaries, and in sick wards. indeed, any person suffering from an infectious disease might, if willing to become a pauper, take advantage of such provision as was made by the guardians of the poor, the provision being imperfectly isolated wards and buildings attached to the several metropolitan workhouses and infirmaries. those not so willing were compelled to remain at home, a source of danger to those around them, and if poor, with insufficient medical attendance and nourishment. for a long time the only special provision for certain infectious diseases for the whole of london was that in the london fever, and the london smallpox hospitals, both of which were maintained by private charity. happily, where neither the state nor the local authorities did anything, charity stepped in, and on a larger scale supplied an inevitable want; and medical charities grew up to give relief in time of sickness to those of the working classes of society who were unable to provide for themselves, but this was mostly for non-infectious or non-contagious diseases. none of the vestries or district boards gave any sign of making provision for those who were not paupers, although the duty of giving opportunity for isolation of infectious persons whose diseases made them dangerous to others, be they paupers or not, devolved upon them under the sanitary act of as the sanitary authorities concerned in the prevention of the extension of disease. "indeed it must be admitted," wrote the medical officer of health for chelsea some years later, "that the vestries never recognised their responsibilities (as sanitary authorities) from the very first." grievous scandals having occurred in the treatment of the sick in many of the metropolitan workhouses, the government of decided on a great measure of reform. once more the necessity of central government had to be recognised, and by the metropolitan poor act of a board--elected by the poor law guardians, who themselves were elected bodies--was created as a central authority to relieve poor law guardians of the care of and treatment of paupers suffering from fever and smallpox who could not be properly treated in workhouses, and to provide for their treatment and accommodation, as well as that of the harmless insane of the metropolis. the board was entitled the metropolitan asylums board, and consisted of members; of whom were elected by the various boards of guardians in london, and the remaining being nominated by the home secretary. in the early stage of its existence its duties were strictly confined to those of the pauper class suffering from these diseases.[ ] admission to its hospitals could be obtained only on orders issued by the relieving officers, and those admitted became, if they were not so already, "pauperised" by admission and _ipso facto_ paupers; but later its scope was extended, and it became the hospital authority for infectious diseases in london, and afforded another illustration of the necessity for having one central authority for matters relating to the public health of the inhabitants of the metropolis. the erection of hospitals was at once commenced. the first was opened in january, , and the isolated treatment of many cases of infectious disease was of great benefit to the community. in , too, parliament again dealt with the condition of the workers in factories and workshops. the legislation dealt with the kingdom as a whole, but inasmuch as london was so great a manufacturing city, it affected also the masses of the working population of the metropolis. the commissioners on children's employment, who had been at work since , had completed their inquiry, and made many recommendations, and in the concluding part of their fifth report, dated , they wrote:-- "we heartily trust that we may have thus, in some degree, contributed to bring the time nearer when so many hundreds of thousands of your majesty's poorer subjects of the working classes--especially the very young and those of the tenderer sex--will be relieved from the totally unnecessary burden and oppression of overtime, and night work; will be confined to the reasonable and natural limits of the factory hours ... will perform their daily labour under more favourable sanitary conditions, breathing purer air, amid greater cleanliness, and protected against causes specially injurious to health and tending to depress their vigour and shorten their lives." only in was factory legislation at last of an approximately general character. "fully two-thirds of the century in which england's industrial supremacy swept to its climax was allowed to pass before even an attempt was made to regulate on sound general principles the recognised and inevitable workings of unchecked individualism in the industrial field."[ ] the act of [ ] made better provision for regulating the hours during which children, young persons, and women, were to be permitted to labour in any manufacturing process conducted in an establishment where fifty or more persons are employed--the regulation being in the direction of less onerous conditions of labour. and by another act passed at the same time--"the workshop regulation act, ,"[ ] the protection afforded to workers in factories was extended to workers in smaller establishments, so far as regarded the regulations relating to the hours of labour to children, young persons, and women. "workshop" was defined as-- "any room or place whatever (not a factory or bakehouse) in which any handicraft is carried on by any child, young person, or woman, and to which the person employing them had a right of access and control." no child under was to be employed, and none between and was to be employed more than six and a half hours a day--and sundry other directions. the workshops, moreover, were to be kept in a proper sanitary state, and the administration of the sanitary provisions of the act was placed in the hands of the local authorities--the home office inspectors having concurrent jurisdiction. these acts had a two-fold effect in the direction of sanitary evolution: the improvement of the sanitary conditions under which the people worked, and the prohibition of work entailing consequences detrimental to the physical well-being of the workers. their effect would have been of the greatest value in london had they been vigorously enforced. some of the medical officers of health endeavoured to enforce the act. thus the medical officer of health for the strand reported to his employers ( - ):-- "during the past year the provisions of the workshops regulation act, , have, so far as practicable, been enforced." and the medical officer of health for st. george, hanover square, wrote ( - ):-- "i have endeavoured to carry out the workshops act by the abatement of overcrowding, by enforcing due ventilation, and closing at the legal time, so as to prevent the scandal and suffering of dressmakers still being compelled to toil for hours." but the silence of others on the subject told its own tale and pointed its own moral. active inspection was essential for success, but inspection was not encouraged by the vestries or district boards, and the intentions of the legislature were once more frustrated by the failure of the local authorities to do their duty. after four years parliament took the duty away from their incapable hands and transferred it to the factory department of the home office. one other act of importance parliament also passed about this time, "the artizans' and labourers' dwellings act, ." sanitary legislation has as yet done little more for old property, and the whole of central london was old property, than to improve the drainage, and occasionally to cleanse or whitewash some small fraction of it; and there remained the fact that numerous districts or conglomerations of houses were unreformable, and when the most was done to them that could be done under the law were still unfit for human habitation. in the previous year a bill had been introduced into parliament by mr. torrens:-- "the objects of which were, first, to provide means for taking down or improving dwellings occupied by working men which were unfit for human habitation; and secondly, for the building and maintenance of better dwellings instead. but the act of retained the former only; the latter having been struck out of the bill during its progress through parliament. "the intention of parliament was to provide the means whereby local authorities might secure the effectual repair of dilapidated dwellings, or, when necessary, their gradual reconstruction."[ ] the act conferred powers far exceeding any heretofore possessed by the local authority for effectually dealing with houses unfit for human habitation. "on the report of the medical officer of health that any inhabited building was in a condition dangerous to health, so as to be unfit for human habitation, the vestry, after certain inquiries, &c., was to have power to order the owner to remove the premises, and, in default, themselves to remove them; or they might order the owner to execute the necessary structural alterations, and in default, might either shut up or pull down the premises, or themselves execute the necessary work at the owner's expense."[ ] the act proceeded upon the principle that the responsibility of maintaining his houses in proper condition falls upon the owner, and that if he failed in his duty the law is justified in stepping in and compelling him to perform it. it further assumed that houses unfit for human habitation ought not to be used as dwellings, but ought, in the interests of the public, to be closed, and demolished, and to be subsequently rebuilt. use began to be made of the act soon after its passing, but the operations under it can be more conveniently described in the following chapter. the energy of parliament had a most beneficial effect, and many of the medical officers of health bore testimony to the encouraging sanitary progress which was being made. thus the medical officer of health for fulham wrote ( ):-- "our district is gradually and most manifestly improving in all those great features of hygiene which are truly essential where such masses of people congregate together." and the medical officer of health for st. martin-in-the-fields, who wrote in that:-- "the spread of sanitary knowledge is slow"-- wrote in :-- "upon the whole, i am of opinion that all classes, even the very poorest, are much more alive to their own interest in supporting measures for the maintenance of health." the medical officer of health for st. mary, newington, wrote ( ):-- "the knowledge of a compulsory power, as well as the spread of sanitary knowledge, and a greater appreciation of it, has led to a vast amount of sanitary improvement. "i can but express a strong conviction that the sanitary measures carried out are working slowly but steadily a vast improvement in both the morale and physique of the inhabitants of this metropolis in particular ... a great work is progressing, the effects of which will be seen more and more as years roll on, and will be recognised in the greater comfort, better health, and augmented self-respect of the people, and in an increased and increasing improvement in the homes of those on whose strength or weakness must depend in no slight degree the position for better or worse of the english nation." the medical officer of health for st. george the martyr, in his report for , makes a retrospect of fifteen years:-- "when the vestries began ( ) their mighty task they had to contend against evils and prejudices which had their origin in far away back generations, and which have cast down their roots deep and intricate into our social system.... "the acts under which the vestries had to work were very imperfect. opposition was strong on every hand, the magistrates sympathised with the defendants. property and its rights were apparently invaded; and property and its rights have always claimed more support than property and its duties. "what was our physical condition? (in ). "in every yard were one or more of 'the foulest receptacles in nature,' namely, cesspools; these gave off, unceasingly, foul effluvia, filling meat safe, cupboard, passage and room. the smell met you on entering the house, abode with you whilst you remained in it, and came out with you on leaving it. the parish was burrowed with them, and the soil soddened with the escape of their contents. the emptying of them proved a true infliction. they have now been emptied for the last time, filled up with coarse disinfecting materials.... they would not now be endured for a moment, yet with what difficulty they were abolished. they were clung to as if some old and honoured relic was about to be ruthlessly torn from its possessors." dr. simon, the medical officer to the privy council, gave, in his report of ,[ ] a view of sanitary progress in the country generally, much of which applied equally to london:-- "it would, i think, be difficult to over-estimate, in one most important point of view, the progress which, during the last few years, has been made in sanitary legislation. the principles now affirmed in our statute book are such as, if carried into full effect, would soon reduce to quite an insignificant amount our present very large proportions of preventable disease. it is the almost completely expressed intention of our law that all such states of property and all such modes of personal action or inaction as may be of danger to the public health, should be brought within scope of summary procedure and prevention. large powers have been given to local authorities, and obligation expressly imposed on them, as regards their respective districts, to suppress all kinds of nuisance and to provide all such works and establishments as the public health preliminarily requires; while auxiliary powers have been given, for more or less optional exercise, in matters deemed of less than primary importance to health; as for baths and wash-houses, common lodging-houses, labourers' lodging-houses, recreation grounds, disinfection-places, hospitals, dead-houses, burial grounds, &c. and in the interests of health the state has not only, as above, limited the freedom of persons and property in certain common respects: it has also intervened in many special relations. it has interfered between parent and child, not only imposing limitation on industrial uses of children, but also to the extent of requiring that children shall not be left unvaccinated. it has interfered between employer and employed, to the extent of insisting, in the interests of the latter, that certain sanitary claims shall be fulfilled in all places of industrial occupation.... "the above survey might easily be extended by referring to statutes which are only of partial or indirect or subordinate interest to human health; but, such as it is, it shows beyond question that the legislature regards the health of the people as an interest not less national than personal, and has intended to guard it with all practicable securities against trespasses, casualties, neglects and frauds. "if, however, we turn from contemplating the intentions of the legislature to consider the degree in which they are realised, the contrast is curiously great. not only have permissive enactments remained for the most part unapplied in places where their application has been desirable; not only have various optional constructions and organisations which would have conduced to physical well-being, and which such enactments were designed to facilitate, remained in an immense majority of cases unbegun; but even nuisances which the law imperatively declares intolerable have, on an enormous scale, been suffered to continue; while diseases which mainly represent the inoperativeness of the nuisance-law, have still been occasioning, i believe, fully a fourth part of the entire mortality of the country. and when inquiry is made into the meaning of this strange unprogressiveness in reforms intended, and in great part commanded, by the legislature, the explanation is not far to seek. its essence is in the form, or perhaps i may rather say in the formlessness, of the law. no doubt there are here and there other faults. but the essential fault is that laws which ought to be in the utmost possible degree, simple, coherent, and intelligible, are often in nearly the utmost possible degree, complex, disjointed and obscure. authorities and persons wishing to give them effect may often find almost insuperable difficulties in their way; and authorities and persons with contrary disposition can scarcely fail to find excuse or impunity for any amount of malfeasance or evasion." to this review by one of the ablest and most experienced of men of the time in matters relating to the public health, it must, however, be added that so far as the metropolis was concerned, "the meaning of this strange unprogressiveness" was not so much the formlessness of the law, as the fact that the interests against the enforcement of many portions of the law were predominant, and the non-administration of the law was due far more to that circumstance than to any ambiguities or obscurities in the laws. "vested interests in filth and dirt" were all powerful on the greater number of the local authorities of london, and so the law which would have interfered with those interests was left severely unadministered. against these interests it was difficult to struggle--especially when there was no compulsion upon the administrators of the laws to administer them. sheltered under a permissive, they would not exercise a compulsory power--a power entrusted to them with the control of public money for public good. the true cause of the inoperativeness of the law was, in a way, pointed out by the medical officer of health for st. james', westminster, when he wrote ( - ):-- "the great deficiency of the act of , as of all other english legislation on sanitary matters, is that no public prosecutor is appointed. if vestries neglect to prosecute, and individuals do not see their way to it, people may be killed by infectious diseases to any extent." and the medical officer of health for st. giles' expressed a similar opinion when he wrote ( ):-- "the duty of making these sanitary improvements should be imperative instead of permissive. it was wise, at first, perhaps, that our sanitary legislation should be tentative and experimental; but experience having proved its necessity it should be made more stringent." but neither of them got so far as to see the natural and simple remedy, that where a local authority for one reason or another would not administer the laws made by parliament, the central authority should step in and do the work at the cost and expense of the recalcitrant local authority. if one set of people failed in their duty to the public, it was but right that where such tremendous issues were at stake as the health and physical well-being, not merely of the people of one parish but of over three and a quarter millions of people--and all that their health and well-being implied--the administration of the law should be placed in hands that would administer it. that, however, was but part of the great problem, though it would have gone a long way in ameliorating things. the other necessity was the strengthening and altering of the law which itself stood in need of many and large changes before a sure foundation could be laid for the future health of the great community resident in the great metropolis of london. and other matters which ultimately were to have great influence towards the solution of some of the worst of the health difficulties in london were coming into view, and assuming form and substance. tramways, with their facilities of traffic, were about to be started. in three private acts were passed, authorising the construction and working of tramway lines in the metropolis, and in the following year several more private acts and "the tramways act, ," which was a general measure. its main object was to provide a simple, inexpensive, and uniform mode of proceeding in obtaining authority for the construction of tramways, and to give the local authorities the power of regulation and control. in london the metropolitan board of works was constituted the "local authority" under the act; and that board was empowered to apply for a provisional order itself to construct tramways, and lease them to other persons, and was given, with the approval of the board of trade, a compulsory power of purchase after a period of twenty-eight years on certain conditions. and in another act of the most far-reaching importance was passed, "the elementary education act," which prescribed the establishment of a school board for london, and which in process of time would exercise vast influence towards a cleaner, brighter, healthier life than any hitherto within the reach of the masses of the population of london. but though progress was being made in many ways, the progress had not affected infantile life. "the dreary catalogue of human misery" given in the statistics of infantile mortality was as dreary as ever. in every part of london those statistics were appalling. in , in the whitecross street district of st. luke, no less than · per cent. of the mortality for the district consisted of deaths among children under five years of age. in it was close upon per cent. in bethnal green, in - , of , deaths, , were under five = · per cent. in a sub-division of whitechapel, in - , close upon per cent. were under five; in poplar a fraction short of per cent. in kensington, in , · per cent. were under five. each year the medical officer of health for fulham drew attention to, and protested against, the high rate, nearly per cent., of infantile mortality under five, in - . in wandsworth, in - = per cent. in camberwell, in = nearly per cent. in st. mary, newington, and in rotherhithe = per cent. in bermondsey, in - = per cent. in certain streets the percentage was much higher. thus in paddington ( - ):-- woodchester street per cent. cirencester " " clarendon " " the high infantile mortality betokened high infantile sickness, but of it no records have ever been kept. footnotes: [ ] and vic. cap. . [ ] see p.p. , vol. xvii. report of royal commission. [ ] hansard, vol. clxi. p. . [ ] ibid., vol. clxii. p. . [ ] p.p. , vol. xxxiii. [ ] see p.p. , vol. xxv. report by h. s. tremanheere to the home secretary, . [ ] "in a bakehouse in st. martin's lane, eight men slept in one room (separated from the bakehouse) which had nothing that deserves the name of a window" (report of medical officer of health, ). [ ] p.p. , vol. xxviii. sixth report of the medical officer of the privy council ( ). [ ] hansard, , june , p. . [ ] see reports of the commissioners on children's employment, - . [ ] shoreditch, . [ ] westminster, - . [ ] - . [ ] whitechapel, . [ ] p.p., vol. clxxxvi. select committee of house of commons on medical local government, , p. . [ ] hansard, , vol. clxi. p. . [ ] report of commissioners. p.p. , vol. xxii. p. xlix. [ ] see p.p. . report of select committee on the adulteration of food, &c. evidence of h. owen. [ ] and vic. cap. . [ ] ibid. cap. . [ ] p.p. , vols. xxxiii.-iv. [ ] select committee on metropolitan local government. [ ] see p.p. - , vol. lviii. return of inspectors of nuisances, &c., . [ ] select committee on metropolitan local government, . [ ] p.p. , vol. xxxvii. [ ] p.p., vol. xxxvii. p. . [ ] and vic. cap. . [ ] and vic. cap. . [ ] and wm. iv. cap. . [ ] see report of the metropolitan asylums board for - . [ ] see the edinburgh review, january, . [ ] and vic. cap. . [ ] and vic. cap. . [ ] report of select committee on the working of the artizans' and labourers' dwellings improvement act, , p. iii. [ ] ibid., p. iv. [ ] p.p. - , vol. . chapter iv - in , the decennial census once more afforded reliable information as to the population of london, and gave the means of ascertaining much else of the greatest value. the population had gone up to , , in , from the , , it had been in , an increase of , . but the rate of increase was declining. the decennial increase of population which had been · in - , · in - , had further declined to · in . the returns showed that london contained , , persons born within its own limits, and , , persons born outside its borders. "whence came these multitudes of both sexes, equal in themselves, without counting those born there, to a number greater than the inhabitants of any other european city?" more than , of them came from the chiefly agricultural eastern, south-eastern, and south-midland counties surrounding the metropolis. a large contingent of , was drawn from devonshire, wiltshire, somersetshire, and the other south-western counties. the west-midland counties sent up , . , persons had come from scotland, , from ireland, , from the colonies, and , from foreign parts. in fact, over per cent. of the population of london in were immigrants into the great metropolis--a great rushing river of humanity. the returns were also of special interest in showing the changes in the distribution of the population. speaking broadly, the previous movements were being continued--a diminishing population in the central parts, an increasing population in the outer parts. it appeared to be inevitable that-- "as the trade of london continued to increase, so the districts which lay close to the great centres of business must be expected to be occupied more and more with warehouses, and less and less with the miserable dwelling-houses which had hitherto sheltered its poor and working-class population." the diminution of the population of the central parts of london was in no way a symptom of decay: it was, in reality, proof of the reverse, being the result of increasing trade, commerce, and wealth, which required more house accommodation for the carrying on of their enormous operations. the great economic forces were in fact as active and powerful as ever. in the city the population had fallen in the decade from , to , . in every one of the six parishes or districts composing the central group the population had likewise decreased. in the eastern group, the population of three had decreased, whilst in the others there were increases--notably so in poplar, where there was an increase of , , and in bethnal green, where there was an increase of , . in the northern group all had increased, except st. marylebone--the increase in hackney being over , , and in islington over , . in the west, there were also large increases--fulham , , paddington , , kensington , . only st. james' (westminster) and westminster had decreased, and they in reality belonged more to the centre than to the west. on the south side, with the exception of christchurch, st. olave, and st. saviour's--all in southwark--and greenwich, there was an increase in all the parishes or districts, the increases in some being very large; , in camberwell, , in lambeth, , in wandsworth. the figures thus furnished by the census enabled a fairly accurate calculation to be made as to the death-rate. it now appeared to be · per , living. the registrar general, in his report for , entered into a comparison with previous years which may be assumed to be as accurate as any such calculations could be. the mortality was as high as · in . it was · in (when cholera was epidemic), and it was as low as · in , and · in . "the mortality never having been so low in any two consecutive years since , and by fair inference never so low in any two years since london existed." this was distinctly encouraging, demonstrating as it did the good results ensuing upon the great works of improved drainage and sewerage, and a healthier water supply. as to the housing of this huge population, it was shown that the number of inhabited houses had increased from , to , . the reports of many of the medical officers of health throw much additional light upon, and explain or elucidate the facts set out in the census, and carry on the narrative into later years of the matters recorded by the census commissioners. thus, as regarded the reduction of the population in the central group of parishes, the medical officer of health for the strand district ascribed it in part to the new law courts, and to the circumstance that residential houses were, in increasing numbers, becoming converted into business premises. "but," he added, "it is also probably in some measure due to the greater facilities for locomotion to suburban homes"; which is notable as almost, if not absolutely, the first recognition of this cause affecting the population. in st. james', the decrease of population was "due to the fact that the district had increasingly become the centre for clubs, hotels, and splendid shops. the result had been an enormous rise in the value of houses, and a gradual extrusion of the less wealthy and important residents." in st. george-in-the-east, the medical officer of health stated that:-- "the decrease of population was due to houses being taken by a railway company, by the poor law guardians for an infirmary, for a church, &c." how considerable the clearances were in some districts may be inferred from the figures given by the medical officer of health for st. giles' in . "the clearances in the city of london for the purposes of erecting a new market, and a viaduct, and in the strand district to form a site for the proposed law courts, have aggravated the evil of overcrowding. to effect these improvements (or chiefly so) the large number of , persons have been removed. strand, , ; st. sepulchre (city), , ; st. bride (city), , ; saffron hill, , ." and in st. olave, on the south side of the river, the medical officer of health wrote:-- "since the census of , houses have been pulled down, clearing away whole streets and courts for the formation of railways and the extension of warehouses, displacing families comprising , persons." consequent upon these clearances, and the people having to find dwelling room somewhere, the transition of houses built for a single family into tenement-houses continued in full swing. the medical officer of health for st. mary, newington, reported ( ) that year by year the better class of houses were becoming less and less inhabited by a single family. the medical officer of health for paddington gave a very clear description of the process. "there is a very dense packing of population," he wrote ( ), and he mentioned some instances:-- "brindley street with persons living in houses. hampden street " " " " waverley road " " " " "builders intended these houses at first for one respectable family, but ... in violation of common sense and decency they are let out in tenements and single rooms, without those essential conditions of a dwelling which landlords should in all instances be compelled to provide. "there is yet in reality no law to prevent the creation of unhealthy districts as long as five or six families are allowed to live in one house intended for a single family.... houses should be built with reference to the future health of the people who will have to live in them. "and now, while the fields are open and still unbuilt upon, it would be worth the attempt to overcome the destructive influences likely to be established in building tenement dwellings as the population gathers in this and other neighbourhoods. they will some day be hives of pauperism." furthermore, in some parishes, the natural growth of the population was very rapid. in islington, for instance, the medical officer of health wrote:-- "the life balance sheet of your parish for shows that your losses and gains leave you , lives to the good, or in other words , deaths and , births have been registered in the parish of st. mary, islington." and the medical officer of health for st. marylebone wrote ( ):-- "if we compare the annual number of births with the deaths, we shall find that every year some , or , more persons are born in the parish than die in it; and what, it may be asked, becomes of the surplus population? the only answer is, that it migrates; it could not remain in the parish for the simple reason that there is no room, all available spaces in st. marylebone have long been built upon, and the houses occupied, many of them crowded." to the migration rendered necessary by the natural growth of the population, and by the diminishing number of houses in the central parts, was added the ceaseless stream of fresh immigrants into london. these vast numbers had to find house accommodation somewhere, and they found it, in their tens of thousands, in various parts of the less central portions of the metropolis. in kensington, for instance, the medical officer of health stated ( ) that the larger portion of the increase of nearly , in the ten years was due to immigration. the medical officer of health for fulham drew a graphic picture of this inrush of humanity. "the steady growth of london westward has thrown among us a vast and teeming population of the working classes, as well as those of more well-to-do condition, and for the housing of the former many blocks of wretched and most miserably constructed dwellings continue to be erected with the most utter disregard for drainage or other sanitary appliances now so essential. that part of fulham, once open fields, is still being rapidly covered with streets and houses of this character, and many open spots in hammersmith are being filled in the same way. our healthy neighbourhood may thus be made ere long a land of sickness and disease unless some check is given to such speculative buildings. our natural advantage with all our care will not avail us against such utter recklessness." the increase of , in paddington drew from the medical officer of health the query-- "... whether any and what steps should be taken to prevent the wholesale influx of a colossus of pauperism with the consequent burdens of poverty and sickness." it had already driven the people underground for shelter, for in he described how-- "many of the underground kitchens in leinster street (and four others named) have been inspected where the poor people are found living like esquimaux in underground cave dwellings--places with impure air, want of light, admitted only through a grating in front, the upper sash of the window being often out of repair, or nailed up." the rapid increase of population in london would not have been accompanied with such serious results to the public health as it was, if the houses which were being so rapidly built for the people to inhabit had been constructed on sound sanitary principles. but this was very far from being the case, and the evils described in the last chapter in this respect continued over an enlarged area, and in accentuated form. it is now almost incredible that the laws should have been left in such a state as to enable builders, without any legal check, to put up the houses they did. the medical officer of health for mile-end-old-town pointed out (in ) that "the position and structure of houses has a very distinct bearing upon the public health, yet very little regard is given to sanitary principles in their construction.... the class of small houses for the crowded occupation of the poorer classes is generally built either upon 'made ground' composed of refuse and débris of all descriptions, the organic portion of which presently fills the houses with various disease-producing gases, or upon newly opened ground saturated with miasma, without the least attempt at protection by means of previous drainage or properly protected excavated foundations." and in he reverted to the subject:-- "water, air, and light are nature's disinfectants and preventions of disease. they are abundantly provided, but more meagrely and inefficiently used, and indeed practically ignored, by architects, builders, owners, and occupiers...." a witness before a select committee testified in [ ] that:-- "houses were being built upon the soil--any soil, in point of fact--and the foundations of houses consisted very often of nothing but manure, and old boots, old hats, or anything thrown into it." the medical officer of health for poplar wrote ( ):-- "the continued rapid increase in the number of new streets and houses in various parts of the district presents many unsatisfactory features. "in most cases, before the buildings are commenced, the gravel is dug out, and the hole filled up with so-called brick rubbish, but in reality with road-sweepings, the siftings of the dust yards and similar refuse. the dwelling-houses, mostly of the poorer class, are largely built of soft ill-burnt bricks, and are tenanted generally as soon as they are finished--frequently even before they are complete. "as a matter of course the walls are still damp, the streets unpaved, and the residents suffer often very seriously in their health." the medical officer of health described ten acres of houses in hackney as "almost entirely built upon a great dust heap," built, too, of porous bricks and bad mortar. and another witness before a select committee in described how, in the other end of london--in wandsworth--on an estate "which practically might be considered a small town," the ground has been filled in to a depth of six or seven feet with filth of every description, and houses have been rapidly built upon it. the results to the health of the inhabitants were disastrous. this, however, by no means completed the description of the evil condition of the buildings. the medical officer of health for shoreditch wrote ( - ):-- "not only was the health of the inhabitants endangered by the presence of a large number of old decayed brick drains, but also by many new drains which had been carelessly laid. their joints leaked; in some places neither cement nor clay had been used, and pipes had been connected with drains at right angles." and the medical officer of health for st. george-the-martyr added his testimony ( - ):-- "not only may the materials of which our buildings are constructed be thus defective, but the drainage may be and is indeed mostly laid carelessly and imperfectly.... an eminent civil engineer, one who has had a very large experience in this division of his profession, informs me that per cent. of the houses built are imperfectly drained, that the drains are laid in a reckless manner, the joints often not cemented, and that the way in which they are laid is unscientific and dangerous. no wonder we have continued ill-health of the occupants." the medical officer of health for fulham described in - how in "fulham new town" the basements of the houses had been built below any available sewerage, with the result of constant floodings of cesspool matter to the great danger of the public health. and the materials of which the superstructure was made were as bad as they well could be. porous, and half baked, and broken bricks being used, and mortar mixed with garden mould or road scrapings--"some without a particle of lime in it." in battersea fields-- "you will find them there putting the houses together in such a way that you may kick the walls down with your feet."[ ] the medical officer of health for whitechapel put the subject very tersely when he wrote in :-- "in the construction of houses the only thing that appears to be considered is that of cheapness." until near the end of this decade of - , a building could be constructed without any supervision of the materials, and any number of structures which could not be occupied without danger to life or health might be put up, for no one had power to interfere. the london building act had no adequate clauses to secure the effectual purity of new dwellings, nor had the sanitary authority any power to check the practice of building houses on rotten filth. and so all these evil practices were very widely indulged in; for though there were many respectable men among builders of small houses, there were many who, regardless of all consequences, covered the suburbs with "small, rotten houses." and immense numbers of the people were absolutely unprotected either by the government or by the local authority from abuses which entailed upon them ill-health and death, and from practices which created and spread disease throughout the community. the medical officer of health for st. george-the-martyr, southwark, referring to "the dishonest and scandalous way" in which some houses were built, said ( - ):-- "from the greed of a few builders this traffic in human life, and in what makes life valuable, is openly and defiantly carried on. under such circumstances full health is impossible. yet for the success and permanence of natural existence a high standard is absolutely necessary." of builders such as these it may be truly said that having created a _damnosa hereditas_ in one place, they moved on to create fresh ones in others, and no one prevented them. so glaring were these evils that a select committee, which sat in on the metropolitan buildings and management bill of that year, recommended-- "that the district surveyor or the metropolitan board shall have full power to stop the progress of any building in which the materials or construction is calculated to be dangerous or injurious to health, and to summon the builder or owner before the magistrate." at the rate houses were being built, the defective building laws were a grave disaster. in the two parishes of bow and bromley in poplar, in the five years ending march, , notices were approved for , new buildings. in hackney, in the year - , notices were given of intention to erect new houses, and the extension of streets and houses into the fields had gone on so rapidly that by that time there were but few fields left in the district, or even large grounds belonging to any of the houses. in kensington it was reported in that the increase in the number of new houses brought into occupation had for a considerable period averaged annually. in wandsworth, in - , notices were received for new houses. in - for , new houses. " - " , " " - " , " and in every place land was being grabbed for building purposes. the medical officer of health for whitechapel wrote in :-- "we are now paying very dearly both in health and money for the errors of preceding generations in their having allowed houses to be packed closely together.... several cases have recently occurred in this district of landlords erecting dwelling-houses in the back-yards of those houses which were formerly occupied by a single family. this is a serious evil and ought to be prevented. we have power to prevent the overcrowding of rooms, and we certainly ought to have power to prevent the cramming together of houses on sites of insufficient size for the healthy existence of the tenants." even burial-grounds were not sacred, nor were public authorities even immaculate in this respect. thus in st. luke:-- "the quakers' burial-ground by the side of coleman street is now ( ) in progress towards being covered with buildings, and a portion was taken by the london school board for the erection of a school. in the process of excavation for the foundation, human remains were discovered." and the areas at the backs of houses were also being rapidly covered over. the act of had provided that superficial feet should be left open-- "but the exigencies of trade have led the metropolitan board of works and the district surveyors to permit the area on the ground storey to be covered over."[ ] in fact, the insufficiency of the laws as regarded buildings intended for human habitation, and the mal-administration or non-administration of those laws which existed, resulted in the creation of evils which inevitably and most injuriously affected the health of the public, not merely at the time, but for many years to come. the medical officer of health for st. giles', in , pointed out the necessity of a change of the law. "it is very much to be desired that the law gave more stringent powers to local authorities to prevent the re-erection of buildings upon the old sites, so that the new buildings might not become as unfavourable to health as the old ones.... such a perpetuation of mischief ought not to be permitted, and the rights of landlords should be subordinated to the public good." the condition of existing, as apart from new, houses also stood in need of many changes of the law to effect their redemption. the necessity was forcibly portrayed by the medical officer of health for st. marylebone in . he wrote:-- "of all the obstacles that stand in the way of anything like effective sanitary operations, not only in st. marylebone, but in nearly every other district of the metropolis, there are none so formidable, so apparently irremediable as the miserable house accommodation provided for the labouring classes. year after year i am called upon to tell the same unvarying story of rotten floors, broken walls and ceilings, windows and roofs that let in the wind and the rain, chimneys that will not let out the smoke, and of these wretched tenements being crowded with honest, hard-working people, from the cellars to the attics." parliament continued in this decade the greater solicitude about and interest in matters connected with the public health, which it had recently been showing; and the first year of the decade, , is noteworthy for the adoption by parliament of a measure which had far-reaching effects upon the sanitary evolution of the metropolis. this was the creation (by "the local government board act, ") of a central government authority for the supervision by government of the sanitary authorities in england and wales, and also of those in london. matters relating to the health of the people had become so large a portion of the work of government, that the necessity had forced itself upon parliament of concentrating in one department of the government the supervision of the laws relating to the public health, the relief of the poor, and local government. the new authority, which was entitled the local government board, was not a representative body, but was a government department. it was to consist of a president, appointed by the queen, and of the following "ex-officio" members--the lord president of the privy council, all the secretaries of state for the time being, the lord privy seal, and the chancellor of the exchequer. all the powers of the poor law board were transferred to it, also certain powers and duties vested in her majesty's privy council. several of the powers vested in or imposed on a secretary of state, relative to health matters, were also transferred to it. henceforth no bye-laws made by the sanitary authorities in connection with their duties were to be of any force until approved by the new board. also the board was to possess, in reserve for great epidemic emergencies, a power to issue directions under the diseases prevention act, . but with the exception of such special cases, the function of the new central authority in regard of local sanitary action was primarily one of observation and inquiry. the various vestries and district boards of the metropolis being sanitary authorities thus came under the supervision, and in some respects under the control, of the new central government board, instead of, as previously, under a branch of the office of the secretary of state for the home department; but to all intents and purposes they retained their liberty of administration, or, to state it more accurately, their liberty of non-administration. their relations to the elected central body, the metropolitan board of works, remained unchanged. in , also, parliament dealt with the water supply of london. the essential importance to the health of the population, especially in large towns, of an adequate supply of wholesome water was becoming more generally recognised. "without water life cannot be sustained, cleanliness cannot be maintained, sanitary measures are at a standstill, drains become blocked, offensive and deleterious gases are retained or driven back into the dwellings, disease is caused and fostered, and public as well as private injury caused in all directions." the act of had failed to secure for the inhabitants the advantage which they ought to have long since enjoyed, of a well-regulated supply of water in their houses for domestic purposes. a select committee of the house of commons recommended that every company should afford a constant supply of water to each house,[ ] so that the water might be drawn direct and fresh from the company's pipes at all times during the twenty-four hours, and free from the pollution so often acquired in dirty receptacles. and a royal commission, appointed in , after an elaborate inquiry,[ ] declared that earnest and prompt efforts ought to be made to introduce the constant service system to the furthest extent possible in the metropolis. the report of the royal commission is memorable for the very strong expression of opinion that the water supply of the metropolis should be consolidated under public control. the duty of supplying the inhabitants of a city with water had from a very early period been regarded as a peculiarly municipal function, and the supersession of the municipalities by joint stock companies was a comparatively modern innovation. thus far, however, parliament was not disposed to go. but (by the metropolis water act, ) parliament--contenting itself mostly with "mights"--directed that any company might propose to give a constant supply of water, or the metropolitan board of works might apply to a company for it; failing both of which, and under certain conditions, the board of trade might require a constant supply to be provided. also every company should-- "on sundays, as on other days, supply sufficient pure and wholesome water for the domestic use of the inhabitants within their limits." but the act did not curtail the power of the companies to cut off the supply to a house if the water-rate was not paid by the landlord or owner. an opinion was expressed on this point by the medical officer of health for st. mary, newington, in :-- "i maintain that water is absolutely necessary for the health, cleanliness, and sanitary condition of every one, and that if a monopoly of its supply is granted to any company, no power of withholding it should be allowed. "in the present and increasing crowded condition of our poorer houses the act of one person may enable a water company to refuse it to a household of ten or twelve people.... i do most strongly protest against a continuation of a power which in its exercise undermines the very foundation of sanitary improvement." little, however, was done either by the metropolitan board of works, the board of trade, or the companies to avail themselves of the optional provisions of the act. "perhaps," wrote the medical officer of health for wandsworth, "there never was an act of parliament so completely ignored in many districts as the one in question." "the companies," wrote another medical officer of health, "are too busy in looking after their trade interests to concern themselves much about the health of the people." and the constant supply to the people of london was postponed to the distant future. in another subject also claimed the attention of parliament. an epidemic of smallpox of unexampled severity began at the end of the year , "the like of which had not been known in england since vaccination was first practised." it increased in london at an alarming rate until it reached its height in may, , when people died of it in one week, and it killed in london alone, in that one year, , persons. and as it was reasonable to assume that one death represented at the very least eight or ten times the number of cases of that most loathsome disease, the results were frightful, and the injury inflicted upon the community, present and future, disastrous. at one time more than , smallpox patients were under the care of the metropolitan asylums board, and the admissions into the board's hospitals about the same time averaged a week. in a report on the subject the committee of the house of commons wrote:-- "it is impossible to say what ravages might not have been the result of the smallpox epidemic of - had it not been for the efficiency and energy of the asylums board. although the prophylactic virtues of vaccination have been recognised on all sides, it must be remembered that as yet but a small part of the growing population has been subjected to the operations of the compulsory vaccination act." and they expressed "their strong sense of the great services rendered to the metropolis by the managers." the prevention of smallpox by vaccination was not yet a very potent factor in the diminution of that disease. only slowly could the compulsory vaccination act of produce effect, and as the appointment of public vaccinators and the establishment of vaccination stations had been made only optional, the mortality of the outbreak in - had been but little, if at all, modified by it. the epidemic, however, was used by some to enforce a lesson. thus the medical officer of health for st. james' wrote:-- "the lesson of the great epidemic of smallpox is the necessity for vaccination. "the history of no other disease supplies so assuredly and necessarily the means of its entire destruction." and the managers of the metropolitan asylums board, in a report issued in , wrote:-- "the necessity for re-vaccination when the protective power of primary vaccination has to a great extent passed away, cannot be too strongly urged. no greater argument to prove the efficacy of this precaution can be adduced than that out of upwards of , cases received into the hospitals, only four well-authenticated cases were treated in which re-vaccination had been properly performed, and these were light attacks." parliament passed an act in , making the appointment of paid vaccination officers compulsory on all guardians, and the law generally more effective. likewise in parliament dealt with another matter affecting the public health, and placed on record its opinion of the vestries and district boards by relieving them of the duty of enforcing the sanitary provisions of the workshops act, which they had failed to carry out, and transferring it to government inspectors appointed by the home secretary. this was quite an unprecedented amount of sanitary legislation by parliament in one year, and is very notable as showing the greater position health matters were assuming in the opinion of the nation, and the greater necessity parliament felt itself under for dealing with them. an improvement as regarded the food of the people of the metropolis was also commenced about this time. the corporation of the city of london had undertaken to carry out the provisions of part iii. of the contagious diseases animals act, ,[ ] and had purchased the site of deptford dockyard for the purpose of a cattle market, and for the reception and slaughter of foreign cattle. the market was opened in , and the system of inspection there inaugurated secured the good quality of a great portion of the meat consumed in london. in the following year ( ) the purity of certain articles of the food and drink of the people engaged the attention of parliament. under the act of the vestries and district boards might each appoint an analyst, but the great majority of them availed themselves of the permissive character of the act, and did not appoint one. a sidelight is thrown upon the effect of this inaction of the local authorities by evidence given in by a master baker named w. purvis. he said:-- "when the act passed for preventing the adulteration of articles of food and drink there was an immediate apprehension among those bakers in the trade who adulterate their bread that they would be liable to have their bread frequently analysed, &c. but when it was found that no sufficient means were provided by the act to meet the expenses of this kind of active and constant supervision (the purchaser having to pay the analyst), they became confident again, and have resumed their practice of adulteration without any fear of detection."[ ] it was felt now that some further move should be made, and parliament added another act for preventing the adulteration of food, drink, and drugs to the long list of those which had gone before. "whereas the practice of adulterating articles of food and drink and drugs for sale in fraud of her majesty's subjects, and to the great hurt of their health and danger to their lives, requires to be repressed by more effectual laws than those which are now in force for that purpose-- "be it enacted----"[ ] this act made it incumbent upon all vestries and district boards to appoint public analysts to analyse all articles of food, drink, and drugs, on the request of any parishioners, on payment of a fee; and imposed the duty upon them of procuring and submitting for analysis articles suspected to be adulterated, and on their being certified to be so, of taking proceedings before a magistrate, who was given power to impose severe penalties. the offences were more clearly defined, and the expense of executing the act was to be paid out of the rates. the act did much good, but the amount of good was not to be judged by the number of prosecutions and convictions. "its deterrent effects were undoubtedly great."[ ] a select committee of the house of commons, which had been appointed in to inquire into the subject, recommended the repeal of previous acts dealing with the subject, and the enactment of a new and more compulsory measure, and in concluding their report they said: "your committee believe it will afford some consolation to the public to know that in the matter of adulteration they are cheated rather than poisoned. witnesses of the highest standing concur in stating that in the numerous articles of food and drink which they have analysed, they have found scarcely anything injurious to health." in a further act dealing with this matter was passed amending and strengthening the existing law. in september, , another notable step in the sanitary evolution of london was taken in the creation of an authority for the protection of the metropolis against the importation of disease by sea from foreign countries or from home ports. "it is now acknowledged," wrote the port medical officer of health in his first report, "that, as a natural result of the insular position of the kingdom, and the vast extent of our commerce, the sanitary condition of shipping and of the floating population must exercise a considerable influence on the health of the country as regards the importation and transmission of epidemic diseases ... the urgent advisability of using all means to prevent the introduction of disease into this the largest port in the world is sufficiently apparent." hitherto the prevention of the importation of the various sorts of disease into london by vessels trading to the port of london from all quarters of the world had been confided to the officers of her majesty's customs, and was of the most superficial and inadequate character. the district assigned to the port of london sanitary authority extended from teddington lock to the north foreland, and was miles in length. it included sets of docks and "creeks." in the section of river lying between london bridge and woolwich arsenal pier, about miles in length, there was a constant average of no less than vessels of all descriptions moored on both sides of the river, more than per cent. of which had crews on board. the creeks were more or less occupied by barges containing manure, street-sweepings, gas-liquor, bones and other varieties of foul cargoes, inasmuch as depôts for the storage of these materials existed on the banks. and lying in the docks there was an average of between six to seven hundred vessels, over none of which had the sanitary authorities on the sides of the river any control whatever. this was a most unsatisfactory condition of things, and left london open to the practically unchecked importation of infectious and contagious disease of every kind. by "provisional order" of the local government board, the corporation of london was constituted the sanitary authority of the port of london,[ ] and was made responsible not only for taking proper steps, under orders in council, to prevent the introduction of cholera, but was required also to carry out, within its allotted area, the provisions of the various nuisances removal acts and prevention of diseases acts for england, and the sanitary act of . its authority extended only to things afloat. whatever was landed came within the province of the local sanitary authority, except things landed in the docks, and things "in bond," which were under the control of her majesty's customs. the work was undertaken at considerable expense by the corporation out of the city's cash, and at no charge to the ratepayer. and a medical officer of health for the port and some inspectors were appointed. it was the duty of the port medical officer-- "to inspect, before landing, all emigrants that arrived in the port from the continent for purposes of transhipment, and to isolate all suspected cases, and to carry out all special orders in council relating to the prevention of cholera, or other epidemic diseases." he was also charged with the duty of inspecting, at gravesend, any cases of sickness on inward-bound vessels reported to the authorities by the officers of her majesty's customs. as to the prevention of the importation of epidemic diseases other than cholera, reliance was placed upon a speedy and proper examination of vessels as soon as possible after they had come to moorings. a large proportion of these vessels required constant general inspection. among the various other duties, fumigation and disinfection of vessels, also of clothing, were not the least important. for isolation of the sick a hospital ship was maintained at gravesend. the work done by the port authority was, in spite of many limitations and difficulties, considerable; and the inspection of thousands of ships, the cleansing and fumigation of foul or infected vessels, the removal to hospital of seamen suffering from infectious or contagious disease, and the disinfection of clothing were, sanitarily, of the greatest advantage to the inhabitants of the metropolis. in another matter parliament, in , made a completely new departure. it declared that "it was expedient to make better provision for the protection of infants entrusted to persons to be nursed or maintained for hire or reward in that behalf." and it inaugurated a plan for the protection of the health of the most helpless of its numerous charges--a plan embodied in the infant life protection act. "houses of persons retaining or receiving for hire two or more infants for the purpose of nursing must be registered." the local authority (the metropolitan board of works) was to cause a register to be kept and make bye-laws, and might refuse to register an unsuitable house. and the registered owner must keep a register of the children, &c., &c. if proved to the satisfaction of the local authority that such person has been guilty of serious neglect, or is incapable of providing the infants with proper food and attention, the house might be struck off the register, and penalties be imposed--six months with hard labour, and up to £ fine. the start made was slow, only six houses having been registered in ; but the act laid the foundations of a scheme which has had considerable developments. specially valuable is it to have the views of one of the foremost men of his time upon the phase of opinion existing at this period upon the general question of the public health. they help to mark progress along the road. the late mr. w. e. forster, speaking at the meeting of the british association at bradford in , said:-- "i think our aims in this direction are higher than they used to be. we are aiming not only at preventing death, but at making life better worth living by making it healthy. and we no longer forget that in fighting our battle against disease it is not only those who are killed that are merely to be considered, but also the wounded. in those terrible inflictions of preventable disease throughout the country the loss of life is very sad; but even more sorrowful to my mind are the numbers of our fellow-creatures--fellow-countrymen and women--who are doomed to struggle and fight the battle of life under the most severe conditions because of wounds they have received from preventable diseases." while parliament was thus legislating on several matters considerably influencing the sanitary well-being of the people of the metropolis, the powerful economic and social forces also affecting it were silently and uninterruptedly continuing their work with never-ceasing energy. with the marvellous industrial developments of the time, trade, and commerce, and businesses of various kinds and sorts were spreading over a wider area, and constantly claiming accommodation to carry them on; and the process continued of the conversion of residential houses into offices and shops and warehouses and workplaces. the increase of houses in other parts of london, rapid as it was, barely kept pace with the increase of population, whilst it had practically done nothing as yet to relieve overcrowding in the central parts of london. the excessive density of the population was a great sanitary evil. "it is a well established law," wrote the registrar general in , "that, other things being equal, the insalubrity of a place increases with the density of the population, and that the fevers generated in crowded dwellings have a tendency to spread among the whole of the population." and it was already pretty generally recognised by medical officers of health that the chief condition affecting the mortality of a locality was the density of population. the medical officers of health never ceased pointing out the evils of overcrowding. "overcrowding," wrote the medical officer of health for whitechapel in , "concerns the whole community, as is strikingly shown by the spread of many diseases which are, perhaps, in the first instance endemic, and confined to these overcrowded places, but which soon become epidemic and extend over large areas, attacking, indiscriminately, all classes." and their reports are full of instances which had come under their observation. thus, in , the medical officer of health for whitechapel wrote:-- "at no. , goulston street, i found in the back room of the ground floor, closely contiguous to three closets and a dust hole, one man, six women, and three children sleeping there. the room measured Ã� Ã� feet, giving only a cubic space of feet for ten persons." he mentioned also "a room in cooper's court, occupied by man, wife, and seven children, which contained about cubic feet of space, which allows only feet for each." and numerous other cases of overcrowding and indecent occupation, and a case in which the dead body of a child had been retained in a room for fifteen days. passing on to the larger aspects of this dreadful overcrowding, he wrote:-- "it is manifest that persons living in such circumstances must become so enfeebled in health as to be unfit for any employment which requires much physical strength. the mental capacity of such persons is also so low as to prevent them earning a livelihood in any occupation requiring much thought, and the consequence is an increase of paupers or of criminals, or perhaps of both." "consumption and the whole tubercular class of disease are chiefly caused by the defective ventilation of dwelling-houses, and particularly of sleeping rooms, in which at least one-third of one's existence is passed." and the medical officer of health for paddington, in his report for , wrote:-- "serious evils of physical and moral character are found to afflict the population of these overcrowded houses. the want of fresh air, habitual uncleanliness, bad washing accommodation, with other unsanitary conditions, favour the spread of contagion. there is a notable increase of tubercular and consumptive maladies in our large cities, and the low form of vitality engendered in people who do not enjoy fresh air, leads to the abuse of stimulants and tobacco." in he wrote:-- "... eighteen per cent. of the whole deaths--a formidable proportion--are from the tubercular class of diseases: a greater proportion than zymotic. the deaths from consumption at ages between and show that there exists some general cause silently working great mischief and undermining the constitution of parents at a period of life in health and strength when they can least be spared from their families." and he added:-- "large numbers of sickly and weakly children abound in the tenement-houses of our thickly populated streets." nor were the homes of the people the only place where overcrowding worked its evil will. many children--how many there is no means of knowing--suffered from it in the schools which they attended. the following extracts from reports of an inspector of the school board[ ] present a vivid picture of the condition of many schools in existence so late as the year . . ---- _school_. "this is a wretched place, a disgrace to the metropolis. the 'school' is held in an old dwelling-house in clerkenwell. the house was at one time used as a stable. the approach is most unwelcome, and on entering the schoolroom (upstairs) a most deplorable picture presented itself to the eye. fifty children crowded together in a small, dingy, shapeless room with space for sixteen, and the window and door carefully closed--in fact, the latter and the doors downstairs carefully bolted. the sooner this place is closed the better." . ---- _school_. "as regards the accommodation provided, thirty-six young children were sitting in an upper room into which the rays of the sun on a bright day in june could not enter--twilight in mid-day." . ---- _school_. "it would be impossible for words to describe the inefficient state of this so-called school. eighty-two children of different ages--boys and girls--huddled together in a miserable, badly lighted, badly ventilated room, affording accommodation for twenty-three at the utmost. "no books, no apparatus, no seats; floor and bare walls: the 'teacher' an aged man, standing in the midst of a crowd of children and wielding a cane to keep the 'scholars' quiet, and thus the time goes on." . ---- _school_. "this is not a school--it seems a baby-farm. seventeen children in a small, filthy hovel. there were four infants a few months old; one lay on a small bed, another in a small cot, and the two others in positions which i cannot here describe. the little ones were quite naked. the woman who pretends to look after this 'school' was engaged in a back yard washing. from the woman down to the infant, all here seemed steeped in ignorance and wretchedness." here is a case reported by the medical officer of health for whitechapel, so late as :-- "a schoolroom at , pelham street, spitalfields; feet long Ã� Ã� . there were twenty-five children aged - , and the master and his wife, in all twenty-seven persons, giving · cubic feet for each." and here is a report of an early crêche, or baby farm, also in whitechapel, in :-- "the sanitary inspector found on the ground floor of , freeman street, spitalfields, a woman and twenty-five children all under three. they were left in charge of the occupier of the room from nine until . p.m., who was paid d. per week per child. the room was feet Ã� Ã� , thus affording cubic feet of space per child!! the room was badly ventilated, there were neither chairs nor seats, the children were on the floor, which was in a wet and dirty condition." the other causes of insanitation were also flourishing. "noxious businesses" of various kinds continued to pollute the atmosphere, despite legislation against them, and the existence of local authorities charged with the administration of that legislation--a permanent pollution all the year round, and from which there was no getting away. very commonly the arches under the railways were used for making and storing artificial manures, the smell from which was intolerable. the medical officer of health for st. mary, newington, :-- "the private manure-mixing yards have ever been the cause of much annoyance and illness to those living in the neighbourhood. one of these," he added, "had for years been complained of." and yet the vestry had not shut it up. and the air was tainted and vitiated by the emanations from them, the owners having no vestige of regard for other people's health. another cause of insanitation was the existence of slaughter-houses throughout london, in the most crowded parts, and in close propinquity to dwelling-houses; indeed, in the yards of some of them were slaughter-houses, with all their unpleasant concomitants. cow-houses, too, also close to houses, were numerous, and, in the outer parts of london, even piggeries. a great opportunity was lost in for greatly diminishing, if not actually terminating, the great "nuisance" of slaughter-houses. by an act passed in , it was declared absolutely illegal, on the expiration of thirty years after the passing of the act, to carry on certain noxious businesses in any premises nearer a dwelling-house than feet, or nearer a public way than feet--the business of slaughtering being among the number. until there was no control over slaughter-houses; any one could conduct a slaughter-house who pleased, subject only to the common law as to doing anything which might be considered a nuisance.[ ] the metropolitan market act, passed in that year, required that all slaughter-houses should be licensed by the justices, thus establishing some form of control over them. when, in , the expiration of the thirty years drew nigh, doubts were raised by those interested in their continuance as to the interpretation of the act of . the select committee, which was investigating the subject of "noxious businesses," stated that no evidence had been given before it to show that any of these trades when properly conducted affect the health of the persons living near the premises, and parliament, accepting this view, passed an act which undid the enactment of , and allowed slaughter-houses to be continued indefinitely under license. at the same time it conferred on the central authority, the metropolitan board of works, power to make bye-laws with respect to certain noxious trades. and so this fertile cause of insanitation--slaughter-houses--was perpetuated to the present time. there was, however, a far more general and potent cause of disease and death, and general detriment to the public health, than the pollution of the atmosphere by noxious trades, and that was the reckless scattering abroad of infectious or contagious diseases by persons afflicted with or in contact with such diseases. the metropolitan asylums board had already erected hospitals, and were doing a vast amount of good and preventing the spread of disease. but by the people themselves the seeds of infection were scattered broadcast. dr. simon, the medical officer to the privy council, in his report of , wrote:-- "as to contagions already current in the country, practically any diseased person scatters his infection broadcast, almost where he will--typhus or scarlatina, typhoid or smallpox, or diphtheria, ... the present unlimited license seems urgently to demand restriction." but the license to kill remained without restriction, except that of entering a public conveyance.[ ] as the medical officer of health for st. mary, newington, wrote in :-- "how many are the ways in which the spread of contagious disease is, as it were, invited, no one knows better than a sanitary officer. washing, mangling, needlework, go on in many an infected house; children, aye adults also, the sick and the sound, mix indiscriminately. i have even known the exhibition, as a sight, of the corpse of a smallpox patient...." and the medical officer of health for paddington called attention ( - ) to-- "the extreme indifference displayed with regard to these diseases (measles, &c.), by many of the lower and middle class is an unmistakable sign of an ignorant belief that they are natural events; and such a belief leads to a carelessness of management much to be condemned. "... the working classes generally visit freely during sickness, allowing their clothes to become saturated with contagious poison." the vestries and district boards did do a certain amount of disinfection; but more than three years after the sanitary act of was passed, in twenty-nine districts (out of thirty-eight) no proper disinfecting establishment in accordance with the requirements of the law had been provided (strand, - ). the medical officer of health for st. james', westminster, pointed out ( - ) that in london there was-- "no legal obligation on the part of the head of a family or landlord, or a medical man, to declare the presence of scarlet fever to the sanitary authority. the consequence is, that long before any knowledge of the existence of the disease has been obtained by the medical officer of health the disease has spread far and wide. if it were not so melancholy, one feels inclined to deride the folly and ignorance of a so-called civilised and enlightened nation allowing such a cruel and terrible scourge as this to pass over the country without any attempt to control it." "in sixteen years we have lost persons by scarlet fever in st. james'. where one person dies, - get it and get well. it is vain to calculate the pecuniary expense of such a curse, but every one can make something like an approximation to the cost of such a waste of human life, and form an opinion of the vast benefit of legislation that should put a stop to this disease." the medical officer of health for paddington referred ( ) to the disastrous results of cases of infectious illness not being notified to the sanitary authority, and so enabling precautions being taken to stamp out the infection. "such a state of matters, with the annual huge mortality consequent thereon, will continue until an educated people, conscious of its duties and jealous of its rights, demands from a tardy executive the intervention of the legislature to prevent it." the vestries and district boards were gradually doing a good deal of useful work of the sort which did not much conflict with private interests. the great main drainage works of the central authority had enabled them to improve and extend their sewerage and drainage works, and from up to march, , they had borrowed from the metropolitan board of works £ , for this purpose;[ ] and the total length of brick and pipe sewer which they constructed in that period was very close upon miles. "the large amount which has been expended on works of sewerage and paving, shows that the local authorities in the metropolis have not been unmindful of the requirements of their several districts." st. giles' reported in that its sewerage was very complete, "not a single street or court being without a sewer." st. marylebone reported in :-- "£ , has been spent in new sewers in the parish in the last three years, and £ , is to be spent. over three miles of new sewers were constructed. these are large items in our parochial expenditure, but the fact cannot be ignored that the sewerage of the parish had got into a disgraceful and indeed dangerous condition. "in some of the finest streets and squares of the parish the sewers were but little better than elongated cesspools." bermondsey reported, in , that the entire district was drained into low level sewers, all open sewers, tidal and other ditches, and cesspools having been abolished; £ , expended in widening and improving certain streets, £ , spent in sewerage, paving, and other improvements. st. mary, newington, reported in that the whole of the open sewers and tidal ditches had been covered over; that the drainage was in a satisfactory condition, and that within a few pounds of £ , had been spent since in various parish works and maintenance. in the wandsworth district ( - ):-- "the enormous sanitary works carried on by the metropolitan board of works and the board of the district have, by drying the soil and altering the waterlogged condition which formerly prevailed, completely changed the sanitary aspect of the locality." not all the work reported as done, however, was done as satisfactorily as was to be desired. thus the medical officer of health for st. james', westminster, wrote ( - ):-- "sewers and drains being out of sight admit of a great amount of 'scamping' work. "speaking from experience, some of the local sewers in st. james' are specimens, i hope unique, of the extent to which 'scamping' can be carried." and the medical officer of health for shoreditch wrote ( ) that:-- "some of the new drains (being so badly laid) are more dangerous than the old." the arrangements for water supply were also in some few parishes, in process of years, being slowly improved. in lambeth, in , houses without proper water supply were provided with it; and in , houses. read one way, this was satisfactory. read the other, it was a revelation of the number of houses in lambeth which had been left until without that great essential of health--a "proper water supply." a large amount of street paving had been done, and a few small street improvements had been carried out. considering the very limited staff of inspectors which it suited the policy and purposes of the vestries to appoint, a fair amount of sanitary inspection was done in some parishes and districts. the striking fact about the inspections made is the very high proportion of houses in which the sanitation was defective. in bermondsey, in , where , houses and premises were inspected, , notices were served. in limehouse, in , , houses were inspected; and , orders for sanitary amendments issued. in shoreditch, where there were , houses, the two sanitary inspectors appear to have done a lot of useful sanitary work. in - , , separate nuisances dangerous to health were abated. if anything like a similar proportion prevailed generally throughout london, the housing of its huge population was indeed in a dreadful state. in some ways the local authorities were awakening to their responsibilities, and beginning to avail themselves of some of the provisions placed by parliament at their disposal. in paddington, st. giles', and rotherhithe, the vestries had adopted the baths and washhouses act of , and thus helped to promote habits of cleanliness, and to diminish some of the insanitary evils consequent on the tenements being turned into temporary wash-rooms. and in st. james' (westminster) and lambeth, mortuaries had been provided, which, in some cases, at any rate, obviated some of the insanitary evils consequent on the retention of dead bodies for long periods in single-roomed tenements where death had been caused by contagious or infectious diseases. more action was being taken, too, as regards the disinfection of rooms where there had been cases of infectious disease. thus in lambeth in - , houses were disinfected. here and there, too, the owners of noxious trades were being compelled to adopt methods rendering their businesses less insanitary and objectionable to their neighbourhoods. the local government board had caused an elaborate inquiry to be made by dr. ballard as to-- "'in what measure and by what means nuisances and injury to health from offensive businesses might be avoided,' and the report led to quite a satisfactory result. "it showed that by the application of such knowledge as was at command, all or nearly all businesses that are in a serious degree offensive might be carried on either without offence, or with such important reduction of offence, as should make it tolerable, or even trivial."[ ] in fulham several piggeries were closed by law; not without regret, apparently, for the medical officer of health stated in his report:-- "it certainly is very hard on the pig keepers individually, but it is in accordance with the recognised law of civilisation, that the interests of the few must be sacrificed to the welfare of the many." upon one course of action all the medical officers of health were in agreement--the absolute necessity of inspection and supervision of the houses of the people. in season and out of season they advised it, and urged it as the most essential and the most useful of all duties. in support of these views they could point to the results of inspection and supervision in the registered common lodging houses. in the parish of spitalfields (in whitechapel, ) there were of these houses containing rooms registered to accommodate , lodgers. the class of persons occupying them were, notoriously, the very lowest. "we failed to learn that any respectable mechanic with his wife and family ever applied at these houses for lodging accommodation. yet," reported the sanitary inspector ( ), "we discovered no case of overcrowding. the bedding was clean; the yards and closets were in a good sanitary condition; there was a good water supply, and the walls and ceilings of the houses were clean." if these results were obtainable in dealing with the worst classes, in the overcrowded parts of whitechapel, _a fortiori_, inspection and supervision would have been productive of similar benefits among the general tenement population. the medical officer of health for st. george-in-the-east referred to the low mortality in model lodging-houses, where also there was supervision. "there we find good sound dwellings, &c., &c. no overcrowding is permitted, only a certain number in family being accepted as tenants. cleanliness on their part is expected--enforced if necessary--or a notice to quit is speedily given." while thus recommending inspection, supervision, and compulsory rules, another view was also expressed.[ ] "as laws have been enacted for the abatement of overcrowding, it is easy to say: 'let those in authority put them in force'; but i much fear unless the question is taken up with a spirit of love towards the poorer and more ignorant classes by the upper and middle classes, and measures adopted to give instruction to the poor in matters concerning their physical well-being, the existing state of things will long continue." "no class will become civilised by being left to themselves, as unfortunately is the case in the numerous back slums of london, but improvement, physically and socially, can only be effected by a superior class mixing and associating with a class below them." the medical officer of health for poplar wrote:-- "the poor want more than model dwellings, more than warmth, food and clothing; they want humanity, and the knowledge of the laws governing health." unfortunately those remedies were, at best, a matter of considerable time, and improvement could be but of slow growth. immediate measures were required to cope with the appalling evils, and for the house-owners, even more than for the unfortunate tenants, were supervision and compulsory rules requisite. but not one tithe of the vestries and district boards would enforce against owners the regulations under the th section of the sanitary act of . though something was being done as regarded the inspection of houses and the repair of sanitary defects, hardly any progress could be said to have been made for the improvement of the dwellings of the poor. the artizans' and labourers' dwellings act (torrens) of was to a small extent being made use of. in some parishes houses considered by the vestry or district board as unfit for human habitation had been closed, and were only allowed to be reopened upon proper repairs having been carried out. in other cases where no amount of repairs could put the house into habitable condition, the landlord was directed to pull down the buildings (without his receiving any compensation), and, in default, the vestry could pull it down at his expense. the site remained unoccupied, until the owner or landlord used it again for building purposes, or sold it to some one else. in st. giles' ( - ) the district board has been enabled under the act to enforce "considerable improvements in and immediately adjoining the worst parts of st. giles'." (houses in yards and courts were demolished.) in st. luke the total number of houses "pulled down or closed" amounted by the year to .[ ] in holborn the board had been-- "applying or threatening to apply the act to houses that could be fairly subjected to it. besides having houses, chiefly belonging to one owner, put into a complete sanitary repair, it has been actually applied to houses; thoroughly repaired, demolished, to be rebuilt, and to be closed." there were many difficulties in using the act. notice of houses being unfit had to be given to "owners." a certain case in chelsea was mentioned where-- "there were freeholders, lessees, under-lessees, and sub-lessees, and their trustees and mortgagees, and besides there were the occupiers." but in the great majority of parishes or districts no steps were taken under the act. the act did not give any compensation to the owners of condemned property, as parliament had declared by it that compensation should not be given to those who permitted their property to fall into such a state, whilst at the same time extracting the fullest benefit from it. to such a doctrine there was, of course, the strongest hostility by all those who held the opinion that a man might do as he liked with his own, and extract from it the uttermost farthing regardless of the infliction of disease and suffering and death upon those who were so unfortunate as to become his tenants, and reckless as to the injury his action was inflicting upon the community at large. and so:-- "the reluctance of the local authorities to take away a man's property was insuperable, and consequently no very great demolition took place." the medical officer of health for st. pancras wrote ( ):-- "the act is almost inoperative. the highly penal nature of this statute, which in the event of demolition gives no compensation to the owner whose property is destroyed, makes courts of justice extend every possible leniency to the owner. moreover it does not contemplate any scheme for the reconstruction of the houses demolished, or other provision for population displaced...." and the medical officer of health for st. james', westminster, where no action was taken under it, wrote ( - ):-- "it is scarcely necessary to say that such an act could not be acted upon without the grossest injustice to the owners of property, and the infliction of the greatest hardship on the poor." but there was another view, much nearer justice, which was given expression to before the select committee in . "an owner of property who allowed his property to fall into such a miserable state as to be unfit for human habitation is not a man that deserves the slightest consideration of any kind from parliament--he ought to be treated rather as a criminal than an owner of property. to compensate him is a mistake entirely." and the medical officer of health for whitechapel said it was his opinion that-- "if the landlord leaves his house in a very bad state, and will not listen to any representations, he ought not to be paid by the public when he is creating a nuisance." the act of having helped so little to a solution of the housing problem, and the matter being one of ever-increasing urgency, an effort was made to deal with it in , when a bill for facilitating the improvement of the working classes in large towns was introduced into parliament by sir r. a. cross, and was carried. it often happened that in some of the worst slums, the houses were the property of several owners, and it was not therefore in the power of any one owner to make such alterations as were necessary for the public health. the act[ ] of contemplated-- "dealing with whole areas, where the houses are so structurally defective as to be incapable of repair, and so ill-placed with reference to each other as to require, to bring them up to a proper sanitary standard, nothing short of demolition and reconstruction. accordingly, in this case, the local authority, armed with compulsory powers, at once enters as a purchaser, and on completion of the purchase proceeds forthwith to a scheme of reconstruction."[ ] an official representation, that the houses within a particular area were unfit for human habitation, was to be made to the central authority, the metropolitan board of works, by the medical officer of health of a vestry or district board, and the metropolitan board was empowered to declare the same to be an unhealthy area, and to make an improvement scheme in respect of it. if it decided that an improvement scheme ought to be made, it should forthwith make such a scheme, which, after sundry formalities, was embodied in a provisional order which had to be confirmed by parliament. the compensation to be paid for the property so taken might be settled by agreement between the metropolitan board of works and the owner, but where no agreement was arrived at, an arbitrator was to be appointed by the secretary of state. the arbitrator was to assess the compensation at the fair market value of the lands concerned, due regard being had to the nature and then condition of the property, but no additional allowance was to be made in respect of the compulsory purchase of the area. the value settled, and the land having passed into the hands of the metropolitan board of works, the obligation was imposed on that body of pulling down the buildings, and selling, or letting, the cleared ground for the erection of improved dwellings for the same number of people. the hardship of working class and poorer persons being turned out of houses and no other accommodation being provided for them was formally recognised in this matter, and the scheme had to provide for the-- "accommodation of at the least as many persons of the working class as may be displaced in the area ... in suitable dwellings which, unless there are any reasons to the contrary, shall be situate within the limits of the same area, or in the vicinity thereof. it shall also provide for proper sanitary arrangements." the act was intended to relieve owners of such property without loss or benefit, and several representations as to unhealthy areas were made to the metropolitan board. the facts stated in these representations and subsequently brought out in evidence in the public inquiries held, were illuminating as to the terrible depths which the conditions of life of numbers of the people had been allowed to reach, without the intervention of the law, or the staying hand of the freeholder, lessees, or sub-lessees, who derived financial profit from the property. the medical officer of health for limehouse described one of them:-- "the area, though not large, contained abominations sufficient for an area three times its size. here were crowded houses, built no one knows when; how they stood was a marvel, their walls bulged, their floors sunk, an indescribable musty odour pervaded them; water supply, drainage, closets, all were bad, and in my opinion, nothing could remedy such a state of things short of pulling down the rickety buildings." "the area is inhabited by about people, and the death-rate is about per , ." in another of these schemes, in one court (sugar loaf court) the death-rate was · per , . the medical officer of health for the strand gave a report on the sanitary state of bedfordbury:-- "bedfordbury is the black spot of this parish. it and the contiguous courts are a little over three acres. population census of = , . it is a long narrow street of houses with courts leading out of it on either side. some of the courts are blind and very narrow, thus rendering light and air difficult of access. "these houses are so old and dilapidated that it is quite impossible to make them fit and proper habitation for the poor to live in. * * * * * "even this bright and sunny morning the staircases were so dark that you could not see a single stair--there was not a scrap of ventilation, and no means of getting light or air to them. "no. is occupied by people living in six rooms; on the second floor the two rooms are tenanted by two families, respectively five and seven, and the third floor by two families of six each." no. was very similar. "these two houses may be taken as a type of the condition of the houses in bedfordbury." "off this street were various courts, one of them of six three-roomed houses; its width three feet five. another court--seven houses, rooms in all--population . all of them apparently as bad, or worse, than those in the street--miserable hovels, the birthplace of disease and vice, and centres for infectious diseases, which are likely to spread through the whole community." the births and deaths were almost equivalent. in , there were births and deaths. in , there were births and deaths. "in , there were deaths and only births. the deaths are exclusive of those people who have been removed from the neighbourhood and gone elsewhere to die, either in the hospital or the workhouse, where a great many people at the present time do go to die." of the overcrowded rooms he says:-- "here legions of crimes and legions of vices unite, fostering diseases of body, weakened intellect, and utter destruction of the soul; leading inevitably to a career of wickedness and sin." confirmatory of the medical officer of health's description, was that given in a memorial to the metropolitan board by persons: "the clergy, medical men, bankers, residents, professional men, and traders of the parish of st. martin-in-the-fields, in support of a scheme of improvement." "bedfordbury, with its swarming, ill-built, badly ventilated, rotten, inappropriate, unsavoury tenements, has seemed to us a very forcing pit of immorality." "in it there are people living on one acre of land." "there is a very large number of interests to be paid for. there is first the freeholder; then there is the first lessee; then there are numbers of under-lessees, and all the trades of those little shops, and they ought all to get something." and another area was the "great wild street scheme," in the parish of st. giles'-in-the-fields.[ ] "this area has long been a hot-bed of disease. it contains about - / acres, and houses stand upon it inhabited by , persons. great wild street houses containing persons. drury lane " " " princes' street " " " wild court " " " "many of the courts and passages are approached by a narrow passage under a house at either end which renders ventilation very defective. some of the houses are built close together and have dark passages and staircases, others have no back yards, and their sanitary arrangements are placed in the basement. health under such circumstances is impossible. this part of st. giles' has long been noted for its heavy sick and death rates, especially from diseases of the respiratory and pulmonary organs, and from typhus fever and other zymotic disorders in their most contagious forms."[ ] dr. lovett, the medical officer of health, stated that diseases were very rife in it, and a very high rate of mortality as compared with the number of cases. and he added, "the district is a nest of zymotic diseases of the most contagious kind. in , cases of typhus were sent to stockwell hospital. this state of things cannot be dealt with under torrens' act. the houses are built so close together, the people are so huddled together ... you must make a clean sweep of the buildings." another of these insanitary areas was pear tree court, in clerkenwell, "consisting of small tenements of an exceedingly inferior description. all are more or less calculated to engender disease and filth. the condition of the property has been such as to be a reproach to the neighbourhood. "occupied by the very poorest of the community. when disease made its appearance it has been fostered and engendered and continued by the state in which the property and its surroundings have been--the death-rate is nearly double of that which prevails over the whole parish. "some of the tenements are of the most wretched description--some constructed of lath and plaster--some wooden houses--the floors rotted partly by the cisterns, partly by rain coming in. "in some cases the sanitary convenience is in the very rooms themselves--also the water-butt--thereby engendering and perpetuating the worst kind of zymotic disease: the chosen home of fever and also of smallpox. "an entire absence of ventilation. "... when we come to those occupying only one room each, and remembering that in many of these rooms the closet, the water-butt, the water supply, and everything else was contained in the room itself, and that there was no provision for manure, ashes, or refuse of any kind, you can easily conceive what a wretched state of things that presents. on the average there were · persons per room permanently occupying them. so it cannot be wondered at an outbreak of the zymotic disease finding a resting-place there, and that such a locality becomes a plague spot in the neighbourhood, and extends its ravages thence into healthier neighbourhoods." some of the houses the medical officer of health had known to be in the same state for the last years. "... an ill-constructed, unhealthy warren;" some were "regular old shanties--you could hardly find anything like those in the metropolis, they are worth looking at as a curiosity." "some in clerkenwell close are large and very old wooden houses, all tumbledown. there is no straight line in roof or windows--the windows are like cabin windows." one more case is worth giving details about, as it is one of those rare cases in which one gets a more continuous account of the effects of slum ownership than is usually accessible.[ ] this was the little coram street scheme, in st. george, bloomsbury, in st. giles' district, comprising houses-- , inhabitants. the medical officer of health, in his representation to the metropolitan board, gave a minute description of the place. "the houses are principally let to cab owners, who stable their horses in the lower floor, and reside with their families in the rooms over; they are without back yards, and the rooms mainly derive their ventilation from the staircase leading out of the stable, so that the air is contaminated by the noxious gases which issue from it. all the closets are inside the houses; there are no dustbins, and the drinking-water is often obtained from underground tanks, which serve both for stable, cleaning, and culinary purposes. "these houses are unfit for human habitation." "the district now represented as unfit, &c., constitutes the worst part of the parish of st. george, bloomsbury, and has been notorious for years as largely contributing to the sick and death rates of the sub-district." in it was reported that it had "habitually a much higher mortality than the rest of the parish." in the following years "the mortality was seriously increasing there." in smallpox broke out first in it, and cases occurred in a short time. during the same year the deaths in chapel place from three classes of disease--the zymotic, pulmonary, and tubercular--having been , the death-rate to population was per , without reckoning those from other causes. in the general mortality was per cent. greater in it than that in the parish, whilst that of cholera was four times greater. in , nine cases of typhoid and typhus fevers occurred in it, "and the locality was conspicuous for diseases and premature deaths." in scarlet fever was prevalent. asked what class of disease the people chiefly suffer from, the medical officer of health replied:-- "mostly from debility--zymotic diseases, and infectious diseases--such as whooping cough, typhus, typhoid fever, cholera, diarrhoea, measles, scarlet-fever, &c., &c., smallpox, and gin liver disease.... they are obliged to resort to gin on account of the close and depressing condition in which the people live in these courts free from the public eye. "the women have to stop at home; they do not get out, and therefore do not get any excitement. then they take their drops. you can often see women at twelve o'clock in the day drinking in public-houses." the parochial district medical officer said:-- "the houses are so old that the air is really poisonous; it is full of miasma and dirt ... all the whitewashing and ventilation in the world would do no good. the condition of the property has got worse year by year." these are but some of the cases about which "representations" were made to the metropolitan board of works--sufficient, however, as illustration of others. and what an awful and appalling picture they present. had the condition described been only temporary, a mere passing phase, it would have been dreadful enough; but it had been going on for years--it was permanently so--producing year after year its fearful crop of misery and crime, of disease and death, and scattering broadcast the seeds of disease and death, the "owners" all the while exacting the uttermost farthing they could in rents from the miserable inhabitants, and placidly and remorselessly giving disease and death in return: going on, too, during twenty years of government by "local authority"--vestry and district board--and nearly ten years after the passing of the sanitary act of , with its provisions for the abatement of overcrowding and the maintenance of a certain standard of cleanliness. a few years' experience of the working of the housing act of proved that it was dilatory, cumbrous, and costly to the ratepayers of london. the arbitrator frequently awarded to owners of places unfit for habitation compensation equal or almost equal in amount to what would have been given if the houses had been good and sound. this the metropolitan board felt to be an injustice to the ratepayers upon whom the charge fell, and an encouragement to owners of houses occupied by poor people to allow them to fall into or remain in a dilapidated condition. in the year the board accordingly made representations to the government, and suggested that the owners of unhealthy houses should not be compensated in proportion to the profit they derived from such houses, but according to their value as places pronounced unfit for habitation. the board also pointed out--"the great loss entailed upon the ratepayers by the obligation which the board was under to provide for the accommodation in suitable dwellings in the same area of at least as many persons as were displaced. this obligation rendered it necessary for the board to sell, at a very low price, ground, which, with the dilapidated buildings upon it, had cost the board seven or eight times as much, and which, if the board had been free to dispose of it for commercial purposes, and to provide for the dispossessed people elsewhere, would have realised a much higher price."[ ] on the six areas which had been sold to the peabody trustees it was estimated that the board--or in other words, the ratepayers of london--would lose the large sum of £ , . the board suggested that it should have power to dispose of the cleared ground for commercial purposes, and to provide for the re-housing of the displaced families in other parts of london. this latter suggestion was not adopted, but parliament passed an act in which to some extent lessened, though it by no means removed the defects of which the board complained, for the board declared that "after careful consideration, it thought it well not to prepare any more improvement schemes until some further experience has been gained of the working of the amendment act of ." and in , also, an act[ ] was passed which nominally "amended," but in reality destroyed the real good of torrens' act of , and gave the owner power to require the local authority to purchase the premises which had been condemned as unfit for human habitation, and which the local authorities were to rebuild and hold--thus practically relieving the worst class of slum house "owners" of any consequences for their malpractices, relieving them, too, in the most open way at the expense of the ratepaying public, as it empowered the vestry "to levy a rate of twopence in the pound to bear this expense as well as that of building sanitary dwellings on the site." by one means or another it invariably worked out that the slum owner obtained large sums for his vile property, and that the public had to pay heavily for his iniquities. the work which was within the power of the vestries and district boards to do, in connection with the sanitary condition of houses, was far more wide-reaching in extent, and more immediately effective than any the central authority could do under its powers. practically the vestries had under their supervision the sanitary condition of all the houses of london. moreover they could act upon their own initiative, whereas the central authority could only act when representations were made to it. but with few exceptions, they resolutely fought shy of dealing with the crucial evil--the condition of the tenement-house population of the metropolis. "there is no doubt," wrote the medical officer of health for paddington, in , "from the abundant experience and records of the sanitary department of this and other vestries, that houses let out in single rooms, and to several families, have endangered the life of people, have favoured the spread of contagion, and are a source of pauperism and degradation." the various health acts gave them power to deal with most of the prevalent nuisances. but no act gave them such rapid and effective means of action, or so fixed upon the owner the responsibility and cost of keeping his houses which he let as tenement-houses in proper sanitary order, as did the act of by its th section. this act had conferred power upon them to make effective bye-laws or regulations as regarded such houses; and in the sanitary law amendment act conferred further powers upon them. regulations could now be made as to the paving and drainage of premises, the ventilation of rooms, the separation of the sexes, and to securing notices being given to the medical officer of health, and precautions being taken in case of any dangerously infectious disease occurring in a registered house. by such regulations the notification of infectious disease occurring in tenement-houses could have been made compulsory, and such notification would have been of the very utmost value in enabling sanitary authorities to combat the ravages of infectious disease. the regulations struck at the root of the very worst and most prevalent evils in the homes of the people, and had they been enforced, would have been a charter of health to millions of the people. the medical officer of health for chelsea, in one of his reports, well enforced their importance. "when it is remembered that the whole of the labouring population occupies but part of the house in which their families live; that in many houses three or four families live together; and not infrequently each family occupies only a single room; and when it is considered that whenever necessary all such houses may be registered, it will at once be seen how important is this regulation."[ ] these sections nevertheless remained absolutely a dead letter in nearly every one of the metropolitan districts, and even the newly constituted local government board did not exercise its power of declaring them to be in force in any district. from a return compiled in it appears that:-- (_a_) in only seven parishes or districts[ ] were regulations made and enforced; how imperfectly even in these is illustrated by lambeth where, in , houses only had been registered--there being , in the parish, one half of which were probably let in lodgings. (_b_) in six districts regulations were made but no attempt made to enforce them. (_c_) and in twenty-five parishes or districts no regulations whatever had been made. in hackney and chelsea alone was any widespread use made of the regulation. the explanation usually put forward of the determination on the part of the vestries not to enforce the sanitary laws as regarded houses was their regard for the financial interests of the ratepayers. but the real ground of their aversion was that action would put house-owners to expense. "vested rights in filth and dirt" were strongly represented on the vestries and district boards. as a witness said before a select committee in :-- "so long as vestrymen own little properties, and so long as their relations and friends do the same thing, and they are all mixed up in a friendly association, you can never get the prevention of the continuance of unhealthy tenements carried through."[ ] and not only was there a passive but often an active opposition to work being performed which it was their duty to do. a general inspection would have shown what houses ought to have been made subject to such regulations, but it would also have exposed too publicly the iniquities of house-owners, and would have entailed a heavy expense on those who left the houses in a perpetual state of dilapidation, insanitation, and filth; and so the staff of inspectors was kept as low as possible. a thorough enforcement of the regulations would have necessitated a supervision of their houses by the owners in addition to expense. many straws showed which way the wind blew. thus the medical officer of health for bethnal green wrote:-- "it is by the constant inspection and reinspection of property inhabited by careless and destructive tenants that most good can be done. i recently felt it my duty to recommend a house-to-house inspection of the whole parish--a procedure urgently required to ascertain the condition of the drainage and water supply arrangements. i regret to say this recommendation was not acted upon." and the medical officer of health for st. pancras, in referring to house-to-house inspection, wrote:-- "this most important branch of all sanitary work has received as much attention as the number of the sanitary staff will admit." and so the regulations were not made, or if made were not enforced. and, as the result, the great masses of the working classes, and the poorer classes in the metropolis, were by the deliberate decision of the great majority of vestries and district boards deprived of the protection which parliament had devised and provided for their sanitary and physical well-being; and all the well-known evils of overcrowding were indefinitely perpetuated. apart from the sense of duty or responsibility to the people which ought to have appealed to them, there were other motives which might have done so. the medical officer of health for paddington called attention to one of them in . he wrote:-- "the costliness of preventable disease is enormous. "(_a_) sanitary supervision. (_b_) removal to hospitals. (_c_) disinfection. (_d_) expenses in hospital. (_e_) cost of burial. (_f_) loss of work in wages. (_g_) loss of life to the community. (_h_) cost of widows and children." and the medical officer of health for whitechapel wrote in :-- "... as the local rates are continually increasing for the relief of sickness and the support of widows and orphans, the building of asylums for the insane, and the providing of workhouse infirmaries for the debilitated and prematurely old, it is probable that local boards will direct more attention to the condition of the houses of the poor than they have hitherto done." the cost was brought home to them in --"an exceptional year of mortality caused by the continued spread of smallpox." "it has been," wrote the medical officer of health for lambeth, "one of the most alarming and expensive epidemics that have visited the country for a century. the cost in a pecuniary sense has been great, but it is nothing as compared to the cost of human life. "... i know of no disease that can be made so preventable as this." the medical officer of health for st. george-the-martyr wrote:-- "no extravagance can be compared with that of sanitary neglect. pounds are willingly paid for cure, where ha'pence would be grudged to prevent. some diseases we can create, most we can propagate, and send on their errand of misery and destruction." in the medical officer of health for whitechapel again referred to the subject:-- "it may be asserted without fear of contradiction, that all money laid out for the improvement of the public health will secure an ample dividend.... "the alleviation of suffering and the prolongation of human life is the duty of every noble-minded man to endeavour to promote. "it cannot be too frequently reiterated, too extensively known, that the rich not only pay a heavy pecuniary penalty, but often suffer a heavy affliction in themselves and families by neglecting to improve the sanitary condition of the houses and localities occupied by the poor. it is well known that defective sanitary arrangements in the poorer localities are the chief causes of disease among the poor, and when a contagious disease is once located it soon assumes an epidemic form and attacks, indiscriminately, all classes of the people." these views were sound and true, but the contingencies described always appeared remote, and arguments of more immediate and remunerative results were constantly present. if the conduct of the vestries and district boards was reprehensible for not administering the existing laws for the improvement of the sanitary condition of the poorer classes, and if the consequences of their deliberate inaction were so fatal to the lives of countless thousands of the people and so disastrous to the well-being of the community, the conduct of the "owners" of the houses, for the manner in which they allowed their tenants to live, was still more so. "i often wonder," wrote the medical officer of health for st. george-the-martyr ( - ), "what many of the owners of property think man was created for except indeed that he should be housed in foul, wretched dwellings in order that money may be put in their purses, and so they may reap where they have not sown. a grim kind of harvest that will prove. surely the owners have neither humanity nor justice on their side when they allow their houses to become hotbeds for the fostering and spreading of disease, moral and physical, and in which it is impossible either to maintain cleanliness, or support health, or practice morality. there are thousands of such houses.... "the only true and lasting foundation upon which the glory and safety of a nation can be built, must be upon the cultivation of the moral and physical powers belonging to man." the "owners" were of all classes. an experienced witness[ ] before the committee of , who had acted as arbitrator in some of these cases, referring to some of the worst slum areas in london, said:-- "it came before me that a great many people in life better than that supposed, do draw considerable incomes from insanitary house property." "some of these worst places are held by rich gentlemen and ladies." "the class of landlords we have here are very shrewd money-making men, and they would not show much consideration to their tenants." the medical officer of health for st. george-the-martyr, southwark, reported ( - ):-- "we have heard denounced, times out of number, and in the strongest terms, the conduct of the holders of small property as being most selfish, and they themselves the most persistent and obstinate opponents of sanitary measures and improvements; and moreover that this class formed a considerable portion of our vestries. however this may be, they cannot claim a monopoly to this unenviable distinction.... "much of the small class property is placed in the hands of agents who neither hold nor cultivate any interest in the welfare and comfort of the tenants. "to get the most rent with the least possible trouble and outlay seems to comprise their whole duty (of course there are exceptions). "how much better in all respects would it be that the owner himself should give some personal supervision to his property and to the state of those who dwell in it." and there was another class of "owners"--the middlemen--"the very curse that is incident in all society." "there are a great many middlemen dealing with these properties. a great deal of it is to let out in lodgings. a man goes and buys this wretched property at public auction in different parts of london to pay him or per cent., and he underlets it at so much a room to weekly tenants." "it is these small men who go into it to make a profit, and screw the poor, wretched holders down to the last farthing--in fact they get as much as they can out of the property, and do as little as they can." some of the medical officers of health referred to the difficulties of getting the "owners" to do anything to keep their property in order. thus the medical officer of health for st. james' wrote ( - ):-- "on eastern border of parish a large number of houses are now increasingly being underleased in order to be let out as tenement-houses.... dealers in these houses make enormous aggregate rentals out of the improvident working people whom they thus herd together; and persistent efforts on the part of the sanitary officers are needed to goad some of these 'landlords' into keeping their 'property' in a decent condition." with a very large number of house-owners and other sanitary misdoers, nothing but the vigorous administration of the law would induce them to abate nuisances or do anything for their tenants. "i am quite sure," wrote the medical officer of health for hackney in , "that a prompt and strict enforcement of the various sanitary acts is beneficial not only to tenants, but landlords, because the latter will not allow tenants to occupy their houses who frequently bring them under the notice of the sanitary officers." with many, however, the fact that the law had been put in force against them, and would, if necessary, again be put in force was sufficient. "the number of statutory notices this year was not much more than half. owners have carried out the necessary works for fear of being summoned." and numerous other reports were to the same effect. but a vigorous administration of the sanitary laws against owners was the very last thing which it was of use looking to the vestries or district boards for. some of the vestries and district boards put pressure upon their medical officers of health to prevent energy upon their part. thus the medical officer of health for st. pancras in tendered his resignation, giving the following reasons:-- "that while i am held responsible for the sanitary condition of the parish, i am denied that assistance in outdoor inspection of houses either visited with contagious diseases or habitually in an unsatisfactory condition, which i believe to be necessary. i feel that the severe condemnation which a house-to-house visitation of the poorer parts of the parish has received from a majority of the sanitary committee must of necessity hopelessly weaken my authority with the sanitary inspectors, and render nugatory my efforts to carry out the sanitary acts...." parliament was passing some useful legislation for the improvement of the public health, and taking some action against some of the more heinous existing abuses. several of the evils already described connected with the building of houses were dealt with in an act[ ] passed in . it was at last declared to be--"expedient to make provisions with respect to the making, filling up, and preparation of the foundation of sites of houses and buildings to be erected within the metropolis, and with respect to the quality of the substances to be used in the formation or construction of the sites, foundations and walls of such houses with a view to the stability of the same, the prevention of fires, and for purposes of health." the metropolitan board of works was empowered to make bye-laws respecting the foundations and sites of houses to be constructed, and with respect to the material used in the construction of such houses and of the walls and buildings; and the board issued a set of comprehensive regulations upon the subject. "considerable opposition was manifested by builders before the secretary of state." but, nevertheless, the regulations were sanctioned and approved. and in the same year ( ) parliament had passed an act which materially improved the sanitary conditions under which men, women, and children worked in factories and workshops.[ ] guided by experience, parliament had gradually been extending the operation of the previous acts from one trade to another, and as lord shaftesbury said:-- "the general result had been to introduce and establish a system of order, content, and satisfaction. the children in the factories presented quite a different appearance from that which was their characteristic in former times; they were now hale and stout." and the factory and workshops royal commission[ ] in wrote:-- "the improvement in the sanitary arrangements and ventilation of factories had been most marked in recent years; and the cases in which young persons and women suffer in labour unfitted for their years, or in which young persons and women suffer physically from overwork, are now, we believe, as uncommon as formerly they were common. "much of this great improvement is undoubtedly due to factory legislation." the act directed that:-- "a factory or workshop should be kept in a cleanly state and free from effluvia arising from any drain, or other nuisance." and that they should "not be so overcrowded while work is carried on therein as to be injurious to the health of the persons employed therein, and should be ventilated in such a manner as to render harmless, as far as practicable, all the gases, dust, &c., generated in the course of the manufacturing process and that may be injurious to health." by subsequent order of the secretary of state, cubic feet air space were to be given to each adult during the day, cubic feet after eight o'clock at night. it was to be "the duty of the sanitary authority to make such inquiry and to take such action thereon as to that authority may seem proper for the purpose of enforcing the law." a very material factor in the health of the people was dealt with in this act--namely, the condition of the bakehouses where the daily bread of the community was prepared. legislation as to bakehouses had been left unchanged since the act of , and in harmony with the usual disregard of their duties by the local sanitary authorities, little use was made of that act. the royal commission of reported that it was "only here and there that any active steps had been taken by the local authorities to carry out the provisions of the bakehouse act." by the act passed in the bakehouse regulation act of was repealed, and the duty of regulating the sanitary condition of bakehouses was transferred from the local authority to the inspectors of factories. in , also, the contagious diseases animals act was passed. primarily it was directed to the protection from cattle plague of the cattle of the country, and the prevention of the spread of disease, which had been entailing heavy losses upon their owners, and very stringent precautions were imposed. but it contained also some very valuable provisions as to the condition of cowhouses and dairies, and early in the privy council issued an order providing for the registration of all persons carrying on the trade of cowkeepers and purveyors of milk, for regulating the lighting, ventilation, cleansing, drainage, and water supply of dairies and cowsheds, for securing the cleanliness of milk stores, milk shops, and milk vessels, and for protecting milk against infection and contamination. inspectors were appointed by the board. "at the time of the passing of the order the london cowsheds were, with few exceptions, unsuitable in construction and in sanitary arrangements. by opposing the renewal of licenses the metropolitan board succeeded in abolishing from two to three hundred of the worst of them, and obtained improvements, amounting to entire reconstruction, in the remainder. in the larger dairies and milk stores much improvement was also effected." it was this act of which drew from the medical officer of health for whitechapel the following remarkable passages in his report; passages which are enlightening as to the prevalent views of the time. "we have a striking instance of the great interest that is shown in the protection of property and the comparatively little value that is attached to the health of the people in the recent act--'the contagious diseases animals act .' "as regards the laws which are in force for the protection of the health of cattle, which may be looked upon as property, i have nothing to complain; but as a health officer i may express my surprise that similar laws to those which are now in force respecting disease in cattle are not enacted to prevent the spreading of infectious and contagious diseases among the people. at present there is no general law in force to compel persons, who may become acquainted with the existence of an infectious disease in a dwelling-house, to give notice of the same to the sanitary officer.... "surely it is more important to protect the lives of the people than to protect from loss the dealers in cattle; but until the care of public health is considered to be of more importance than the care of property, little improvement in the laws relating to health can be expected." "the preference which is given by our law makers to the protection of the supposed vested rights of property above that of public health is likewise shown by the rejection of the several building bills for the amendment of the building act. "the opinion of the house appeared to prevail that 'a man has a right to do what he likes with his own, as regards the building of as many houses as can possibly be packed together on his own land, without taking into consideration the health of the people who are to inhabit them, or the health of those in the immediate neighbourhood.' so long as the building act as regards open spaces at the rear of houses remains unaltered, so long will unhealthy houses continue to be built." some of the more capable of the medical officers of health in their reports did not content themselves with mere tables of the births and diseases and deaths in their parishes, and a narrative of the principal incidents in their work during the year, but pointed out the defects in the laws, and made suggestions as to the best ways of coping with some of the great sanitary evils daily confronting them. based upon actual experience, their views and suggestions were entitled to great weight, and were often of very great value. one point, and that the most important of all, finds expression in the reports of more than one of them, namely, that the administration of many of the health laws should be compulsory instead of permissive, and that merely declaring a law compulsory without providing the means for making it compulsory was of little use. what was wanted in london was a real central authority which should have power to make the local authorities carry out the orders of parliament. this did not exist, for the metropolitan board of works had no such powers, and the vestries and districts boards were independent local governing authorities acknowledging no master and free to obey or disobey acts of parliament just as they pleased. "it has been one of the great faults of our sanitary arrangements and legislation for london," wrote the medical officer of health for st. james' in , "that the metropolis has not been regarded as a whole, and that through the ignorance, or carelessness, of one district or local board the whole of the others may be put in peril." * * * * * "it is impossible, with our present municipal machinery, in london, at any rate, to exercise all that power which is necessary for the prevention of the spread of infectious diseases." and the medical officer of health for whitechapel in wrote:-- "if any alteration is made in the constitution of the metropolitan board of works it would be desirable to add to its functions that of a sanitary supervision over the whole metropolis." and in the medical officer of health for kensington wrote:-- "london is grievously in need of a central sanitary department to establish something like unity in the sanitary arrangements of its divisions.... every other large centre of population has but one sanitary authority." though much more time, thought, and labour, were being devoted than ever before to matters relating to the public health, and with very beneficial results, one matter appeared to be quite unaffected thereby, for none of the great measures of sanitary improvement which had been carried out since the central and local authorities had come into being seem to have had any effect during the - decade upon infantile mortality. if anything the figures appear higher. in st. george-in-the-east in - the deaths of children under five years were per cent. of all the deaths. in mile-end-old-town in - , out of a total of , deaths, , , or practically per cent., were deaths of children under five, a mortality which evoked the comment from the medical officer of health:-- "apart from congenital causes, a large majority of these young lives would, under conditions more favourable to existence, be preserved.... it is certain that the present generation of london children is physically degenerate." and a year later he wrote:-- "i consider about two-thirds of the infantile mortality attributable to neglect, improper feeding, impure air from overcrowding, and general bad management through ignorance and carelessness of parents and nurses." in kensington, away in the west, the average annual infantile mortality over a period of ten years-- - --was per cent. of the total deaths. the medical officer of health for whitechapel wrote ( ):-- "there must be something very wrong in the condition of the people when we find that out of all children born about one-fifth die before they are one year old, and one-third before they are five." in the north part of his district in the quarter ended december , , the rate of mortality of children under five was · per cent., whilst in the quarter ended september, , in goodman's fields the rate was · per cent. in st. george-the-martyr, southwark, in - , of , deaths (= · per cent.) were under five. in the same year the medical officer of health for paddington wrote:-- "in taking fifteen streets typical of the ordinary condition of the dwellings in which the working-class reside, i find the annual proportion of deaths under five ranges from to per cent. of the total deaths.... "the deaths from all causes in eighteen such streets varies from · to per , ." the medical officer of health for limehouse wrote in :-- "as usual we find that of , deaths more than are those of children under five." two years later it was per cent. nor was it only in the central parts of london that the infantile mortality was so frightful. in wandsworth, the mean annual rate during the years - was · per cent. the infantile death-rate did not diminish as the decade proceeded. in islington in - the infant mortality was "much about the same" as it had been twelve years previously. in kensington it had increased to · in ; in st. george-the-martyr to · per cent.; in st. pancras in - , of , deaths, , (or · per cent.) were of children under five. the medical officer of health for poplar wrote ( - ):-- "the deaths of children under five years have been more than half the total of deaths--truly a 'massacre of the innocents.'" the medical officer of health for islington wrote ( ):-- "the number of deaths of children under one year is still painfully large.... children seem to be born for little else than to be buried." passing from record to comment, there are some striking passages in the reports of the medical officers of health. thus the medical officer of health for paddington wrote:-- "... of infantile mortality one is tempted to ask whether the provision of so much life, such a prodigality of being, to be followed so soon by an almost pharaoh sacrifice of it, is necessary to the multiplication of the race." and the medical officer of health for st. marylebone ( ):-- "it is sad, and in a sanitary point of view, humiliating to contemplate, that for every three children born in marylebone, one dies before reaching the age of five years; 'tis true that in this respect marylebone stands in no worse position than other large parishes in the metropolis, nor so bad as in the majority of them, but the knowledge of this fact will, i apprehend, afford but slender consolation to those who know from experience and daily observation that hereditary diseases, habitual neglect, unwholesome dwellings, together with other preventable causes, are largely concerned in the sacrifice of infant life." and the medical officer of health for rotherhithe ( ):-- "whilst the houses' drain-pipes, from defective construction and workmanship, and want of being cut off from the main sewer, act as much as sewer ventilators as channels for removing filth ... whilst overcrowded houses and foul smells in living and sleeping rooms are taken as a matter of course; whilst infectious disease is sedulously propagated first by concealment, and then by criminal exposure and neglect, ... so long the yearly recurring herodean massacre of helpless children, whose almost sole use in life appears to be the providing of fees for doctors and undertakers, will continue, in spite of all efforts of sanitary authorities and sanitarians." the evil done, however, by bad sanitary conditions was not limited to the children who died. probably ten or twenty times the number of those who died went through the illness and survived--but of those many were injured in constitution for life. in other respects, however, sanitary progress was being made, and slowly but steadily the conditions of the health of the public were improving. undoubtedly the main causes of that progress were the great system of main drainage and sewerage which had relieved london of the incubus of enormous accumulations of the deadliest filth in its houses, and of an open main sewer through its midst; and the greater quantity, and improved quality, of the water supplied for household consumption which relieved her inhabitants from the necessity of drinking liquid sewage. and the construction of sewers in nearly all the streets, and the substitution of an effective system of house drainage instead of the abomination of cesspools, was also a great stride to improvement. since plans for the construction of a total length of nearly , miles of local sewers had been submitted to the metropolitan board for their approval, many of them being in substitution of old and shallow ones for which the board's new main and intercepting lines afforded the means of improving the gradient and outlet. in their report for the metropolitan board of works gave "a brief summary" of what it, as the central authority, had accomplished since . "there was the great main drainage work which had cost about five and three-quarter millions, an undertaking which 'although fruitful of good results, and of greater magnitude than anything of a similar kind that had previously been accomplished, has left, as might be expected, few visible marks of its existence.'" it is rather the thames embankments and broad new streets which remind the inhabitants of london of the great changes and improvements that the board's operations effected. "on the north side of the thames, from blackfriars to westminster, and from grosvenor road to battersea bridge, and on the south side, from westminster to vauxhall, embankments have been made which, whilst reclaiming from the river a considerable extent of ground, have substituted for the unsightly and offensive mud banks that formerly prevailed, handsome river walls, with broad and commodious thoroughfares, relieved and ornamented by public gardens. new streets have been made, some of the principal of which are queen victoria street, southwark street, northumberland avenue, commercial road, and the new thoroughfare from oxford street to bethnal green; many other leading thoroughfares, which had become inadequate for the increased traffic of the present day, have been widened and improved, greatly to the convenience and comfort of the public; and liberal grants of money have been made by the board to the authorities in aid of the cost of smaller street improvements which have not been of sufficient extent or importance to be carried out by the board. "two new parks have been provided, in districts previously unsupplied with such places of needed recreation. public gardens have been laid out and are maintained in the neighbourhood of dense populations; and suburban commons, to the extent of about , acres, have by the action of the board been secured in perpetuity for the undisturbed enjoyment of the public. "many areas formerly covered with dwellings unfit for human habitation have been cleared, under the operation of the artizans' and labourers' dwellings improvement act, and the ground let to societies which have undertaken to build, and in some cases have built, improved dwellings, in which the humblest class of the working population can live with health, decency, and comfort." these and many consequential improvements, and the better paving of the streets, and the better cleansing of streets, places, and yards, the more rapid removal of filth from london, had made the general conditions of life much less unwholesome. the work, too, being done by the metropolitan asylums board was greatly diminishing the dangers of infection in the metropolis, as well as restoring to life and health thousands who would otherwise have fallen victims to disease. and by "the poor law act, ," the vestries and district boards were authorised to enter into contracts with the board, for the reception and treatment of infectious sick who were not paupers, thus in a measure depauperising the metropolitan asylums hospitals. and a very large amount of most valuable work was done by the port sanitary authority; in the year - over , vessels of all classes having been visited and inspected, the infectious sick removed, and disinfection carried out. writing of the year the registrar general said:-- "london maintains its position as the healthiest city in the world. during the past year its prosperity was indicated by a birth-rate above the average of the preceding years, while a remarkably low death-rate bears testimony to the success which has attended the efforts that have been made during the last half of a century to promote the public health and safety." among the public authorities from which much might have been hoped in the way of improving the public health of the inhabitants of london was the school board. the board stood in an exceptionally favourable position for moulding the physical constitution of hundreds of thousands of children and of successive generations, but education appeared to have almost excluded the consideration of health. in the board resolved "that it is highly desirable that means shall be provided for physical training, exercise and drill in public elementary schools established under the board." but beyond this, little if anything was done, and even it was not made applicable to the girls. and no medical officer was appointed, and no systematic means organised for the prevention of the diffusion of diseases by the schools. indirectly, however, good results were flowing from the schools. the attendance of the children at the schools took them out of their overcrowded tenement-homes for several hours in the day; their playgrounds afforded better means of exercise; the cleanliness expected of them raised their ideas as to cleanliness; the supervision over them was of great use in improving their conduct and character, all helped to improve their physical condition. but how infinitely greater the improvement might have been, not merely at the time but to the rising generation, if the school board had given greater attention to this branch of the children's welfare. about , children were in attendance in the board's schools in . the really encouraging feature of the general position was that a larger section of the public was taking an interest in matters relating to the public health. in battersea, wrote the medical officer of health ( ):-- "much assistance is now derived from the general public, who are more alive to the necessity of sanitary measures than at any previous period." the medical officer of health for st. george-the-martyr, southwark, reported:-- "the health of the people occupies the thought and consideration of an ever-increasing number," and he quoted the declaration of the head of the government that "the sanitary question lies at the bottom of all national well-being." the medical officer of health for north poplar stated that-- "gradually the labouring portion of the population, which so largely outnumbers the remainder with us, is becoming educated to the fact that they must neither breathe air, drink water, nor take food, polluted by filth." but, as a whole, public opinion was more or less inert. "the apathy of the public in matters of health is truly lamentable." nor was all the apparent progress as genuine as appeared on the surface. the medical officer of health for st. mary, newington, in his report of disclosed this material fact. writing of some returns which he had prepared of sickness in seventeen years, he said:-- "in the period we have seen the end of many fever haunts. we have seen hundreds and hundreds of the old tenements removed and new abodes raised in their stead; but with it, alas! we have seen all the defects of new buildings, all the defects of badly laid drains, all the evils of work ill done, its dangers too often not capable of recognition until sickness and death forced the discovery. we have seen too often in the new houses defects of ventilation, of construction, of drainage, and of overcrowding: we have seen many an evil allowed by law, and over which we cannot extend our sanitary rules. we have also to contend with the indifference, the carelessness, the blindness of the people themselves--intemperance and crime stand in our way...." but in he wrote: "sanitary work has borne fruit." the progress of sanitation is almost necessarily slow. "there is not," wrote one of the medical officers of health, "a more difficult task than that of carrying out sanitary reform, for although every one agrees that sanitary laws should be put in force, they are greatly objected to when they interfere with one's self." and another wrote:-- "nuisances crop up, are removed, and re-appear. _it is a continuous warfare due to many causes_, such as carelessness and wilfulness on the one hand, and accidental circumstances on the other." and another:-- "the sanitary labours of your officers increase year by year as the population becomes denser, and the need for sanitary precautions grows more urgent." and underneath all was the view expressed by the medical officer of health for islington ( ):-- "i fear the public have not even yet learned to regard health as a matter of infinitely greater moment than rates and taxes." how far-reaching were the effects of disease was admirably set forth by dr. simon:-- "i do not pretend to give any exact statement of the total influence which preventable diseases exert against the efficiency and happiness of our population, for it is only so far as such diseases kill, and even thus far but very imperfectly, that the effect can be reported in numbers. of the incalculable amount of physical suffering and disablement which they occasion, and of the sorrows, and anxieties, the permanent darkening of life, the straitened means of such subsistence, the very frequent destitution and pauperism which attend or follow such suffering, death statistics testify only in sample or by suggestion."[ ] few people realise the infinite importance of health to a great community. as one of the medical officers of health truly wrote:-- "it is a question whether the greatness of countries will not in future to a very large extent depend upon the standard of public health." one of the very best and most experienced of the men who held the responsible office of medical officer of health during the last half century--dr. bateson, the medical officer of health for st. george in southwark--in his reports often dwelt upon this aspect of the subject:-- "the only true and lasting foundation upon which the glory and safety of a nation can be built must be upon the cultivation of the moral and physical powers belonging to man." "... the quality of a race is of far more importance than the quantity." "health to the majority of the population is their only wealth; without it they become pauperised." "the welfare and safety of this country need a healthy, stalwart race of men--men who can labour and endure." and in his last report ( ), after twenty years' service as medical officer of health, he quoted the prime minister (lord beaconsfield) as saying:-- "the health of a people was really the foundation upon which all their happiness and all their powers as a state depended. if the population of a country was stationary, or that it yearly diminished, or that whilst it diminished it diminished also in stature and strength, then that country was ultimately doomed." "nothing," said dr. bateson, "could be more solemn and emphatic." "for the success and permanence of national existence a high standard of health is absolutely necessary. to maintain in its integrity the vast power which england now wields, and to retain the high position which she now holds will depend upon the nation's health." before considerations such as these, how lamentable the blindness of those who could not see that even a measurable expenditure in health matters would have been productive of immeasurable benefits; how reprehensible the conduct of those who refused to administer laws which it was their duty to administer, and the administration of which would have been of inestimable value to their fellow citizens; and how disastrous their studied inaction to the great metropolis, and through it, to the nation itself. footnotes: [ ] select committee on metropolitan buildings and management bill, . p.p., vol. x. [ ] evidence of g. vulliamy, select committee, . superintending-architect to that board. [ ] see report of select committee, &c., , q. , . [ ] select committee of . [ ] p.p., - , vol. xxxiii. [ ] and vic. cap. . [ ] see p.p. , vol. xxv. report by tremenheere on bakehouses, p. . [ ] adulteration of food and drink and drugs act, , and vic. cap. . [ ] p.p. , vol. vi. [ ] issued on the th of september, , and renewed the th of march, . [ ] final report of the school board for london, - . [ ] see select committee on noxious businesses, . p.p., vol. x. [ ] see sections and of the sanitary act, . [ ] see report of metropolitan board, - . [ ] p.p. - . report of local government board, vol. xxix., p. xiii. [ ] by the medical officer of health for whitechapel, . [ ] p.p. , vol. lxiv. [ ] "the artizans' and labourers' dwellings improvement act," and vic. cap. . [ ] see royal commission report, . [ ] , th march. [ ] inquiry by cubitt nicholls, march , . [ ] appendix. select committee housing, , p. . [ ] see report of metropolitan board, . [ ] and vic. cap. . [ ] the medical officer of health for chelsea (writing of his own parish). [ ] chelsea, hackney, shoreditch, lambeth, st. george (southwark), camberwell, plumstead. [ ] goddard, , select committee, p. . [ ] mr. hunter rodwell, q.c., m.p. [ ] and vic. cap. . [ ] vic. cap. . [ ] p.p., vol. xxix. [ ] j. simon, vol. ii., . chapter v - the census of showed that the population of london was , , persons--an increase this time of well over half a million of persons in the decade. in the central parts of london, with the single exception of clerkenwell, the resident population continued to decrease. in the city, the decrease was nearly one-third; in the strand nearly a fifth, and the parish of st. george, hanover square, was now added to the list of those on the decline. in the east, in whitechapel, shoreditch, and st. george-in-the-east, the population had declined, whilst in bethnal green the increase had been at a much slower rate. but mile-end-old-town, where there had been a good extent of unbuilt-on ground, had added over , to its population; and poplar over , . in the north, with the single exception of st. marylebone, all the parishes showed increases; hackney, the great increase of over , , and islington the still larger one of nearly , . in the west, there were large increases in paddington and chelsea, in kensington an increase of over , , and in fulham over , . in the parishes nearer the centre--st. george, hanover square, st. james' (westminster), and westminster, the population had decreased. on the south side of the river, with the exception of the parishes of st. olave, and st. saviour--both in southwark, and near the city--every parish or district showed an increase. notably was this the case in camberwell, where the increase was , , and most remarkable of all, wandsworth, where the huge increase of over , persons was recorded. thus the movements of population were shown by this census of to be very much on the same lines as those in --a diminution in the central parts, and increases of various magnitudes in the outer parts. interesting information was once more given as regarded the constituent parts of the population. it was shown that of the residents in london in , the proportion of persons born in london was practically the same as in . of every , inhabitants in london, were born in london, in the rest of england and wales, in scotland, and in ireland--the rest elsewhere. the flow of people from the country to london was thus continuing at much the same rate, and the metropolis was still being fed with labour at the expense of the agricultural districts.[ ] "a contingent untrained in the pursuits of town life" was thus annually thrown upon the labour market of london. but they imported a fresh strain of healthy country people into the constituent elements of the town population, and helped to stay part of the deterioration which necessarily ensued from the insanitary conditions of life in london. as to the causes of the shifting of the population in london, the same story continued to be told by the medical officers of health. thus the medical officer of health for the strand wrote ( - ):-- "the material decrease in population is largely connected with the gradual transition of houses from residences into business premises, the construction of new and wider thoroughfares, and the erection of public buildings, combined with the resulting consequence inevitably associated with such changes, a considerable augmentation in the rental or annual value of house property." in st. james' ( )-- "the large decrease of population ( , in last decade), coupled with the fact that the rateable value still has an upward tendency, clearly shows that the character of the parish is undergoing rapid change--offices, warehouses, and clubs taking the place of residences as the centre of trade continues to increase and move westward, and greater facilities are afforded for business men to live in the suburbs." some of the medical officers of health were perturbed by the class of persons coming into their district. thus the medical officer of health for whitechapel drew attention to the fact that of the , people in his parish no fewer than , were foreigners, mostly russian and polish jews. others of them were feeling anxious under the ever increasing numbers. the medical officer of health for paddington wrote ( ):-- "occupying, as the population of paddington does, a limited area with definite boundaries which do not admit of extension, a continually increasing population can only mean a continually increasing complexity of the problems of sanitation." upon one most interesting point as regarded the influx of population into london the medical officer of health for lambeth threw some valuable light.[ ] "the evil of overcrowding is aggravated by causes which derive their origin from the effects of that condition itself. a lowered standard of health, always the accompaniment of close building, is a factor in the further increase of pressure in an already congested district. an unsatisfied demand in the labour market for physical strength is a necessary outcome of that quality in the district affected. muscle and bone in such a locality is at a premium, and that which cannot be supplied in its full development from within must be sought and obtained from without." "here, then, is a vicious circle of concurrent cause and effect. overcrowding is the cause of physical weakness: physical weakness results in an unsatisfied demand in the labour market: the unsatisfied demand is the cause of an influx from without: again that influx results in overcrowding." once, then, that the influx of the physically strong began to diminish--the element which had contributed most to the maintenance of the physical vigour and health of the population of london--it was evident that deterioration would ensue, and the only means of counteracting that result was to improve to the utmost possible the sanitary conditions in which the people lived. the census of is remarkable as being the last to show an increase of country-born immigrants into london. that tide was soon to begin to ebb. the immigrants, however, were far from being all of a desirable character. the medical officer of health for camberwell pointed this out:-- "a considerable percentage of our population is composed of persons whose natural tendency is to grovel--beggars, thieves, prostitutes, drunkards, persons of feeble intelligence, persons of lazy and improvident habits, and persons who (like too many of the poor) marry or cohabit prematurely and procreate large families for which they are totally unable to provide; and such persons gravitate from all quarters to large towns and there accumulate.... a large town like london will always attract undesirable residents." with the increasing population the number of houses in the metropolis increased also. from , inhabited houses in the number had gone up to , in , and the same tale was told as to the crowding of houses on the land as in previous years. the medical officer of health for bethnal green ( ) stated that in his parish most of the available ground was already fully built over. the great eastern railway company, the school board for london, and the metropolitan board of works, were largely demolishing small house property. "if this sort of thing goes on much longer," he wrote, "it looks very much as if london in a few years would become a huge agglomeration of board schools, intersected by railways and new streets." the correct record of the population enabled once more an accurate death-rate to be calculated. the death-rate, which had been · per , in , had fallen to · in . that was most gratifying testimony to the good results following the sanitary work carried out, under many difficulties, in london, and an encouragement to perseverance. the vital subject of the housing of the huge masses of the people of london was, during all the earlier years of this decade of - , uppermost in the minds of those who were solicitous for their welfare. the act of had done but little to help to a solution of the tremendous problem. a short experience of it, and of "cross's" housing act, had shown that instead of "owners" being visited with heavy penalties for their iniquities, they were being actually rewarded. in fact, they secured under these acts not only a full, but an inordinately high compensation for their property--regardless of its infamous condition--and the ratepayers of london were mulcted in large sums to pay them for it. "i desire," said the medical officer of health for hackney in , "to express a very strong opinion that it is most unfair to the ratepayers that they should be compelled to pay for uninhabitable property which has been allowed by the owners to get into a dilapidated state for want of substantial repairs such as cannot be required under the nuisances removal acts...." the first scheme which was initiated by the metropolitan board in was only completed at a net cost of £ , , which sum had to be borne by the ratepayers of london; though why they should have been made to pay for the "owners" neglect which had led to the evil conditions of his property is not very clear, except that parliament willed it so. by the total number of insanitary areas dealt with by the metropolitan board, or in process of being dealt with, was fourteen. the houses in these areas had been inhabited by , persons in , separate holdings, , of which consisted of one room only.[ ] they were acquired by the board at a cost of £ , , . parliament had imposed upon the board the obligation to provide accommodation for at least as many persons of the working classes as were displaced by the destruction of the houses on these areas. as the board were not empowered to undertake the building of the houses in which to re-accommodate the displaced persons, the sites, after having been cleared, had to be sold to persons or companies, who were put under the obligation to erect workmen's dwellings thereon; but inasmuch as the land had been bought at its value for commercial purpose, which was far higher than its value for residential houses, this parliamentary obligation entailed upon the metropolitan board, and through them upon the ratepayers of london, an enormous loss. the goulston street scheme in whitechapel, for instance, was acquired at a cost of £ , . when sold, under the conditions imposed by parliament, it realised only £ , ; and the whitecross street scheme (in st. luke's), which cost £ , , when sold realised £ , . the whole of the transactions, so far, resulted in a net loss to the metropolitan board, or in other words, a net charge upon the ratepayers of london of over £ , , . as mr. chamberlain described the result, in an article he contributed to the _fortnightly review_ of december, :-- "torrens' and cross' housing acts are tainted and paralysed by the incurable timidity with which parliament ... is accustomed to deal with the sacred rights of property.... "the individual wrong-doer is to remain unpunished--retribution for his sins is to be exacted from the whole community." the enormous cost of carrying the acts into effect stayed the hand of the metropolitan board, while the length of time, stretching out into years, required for the various proceedings, militated against the success of the schemes so far as providing residences for the displaced people. an example of the working of the act was described in by the rev. s. a. barnett.[ ] "in the dwellings of , persons in this parish (whitechapel) were condemned as uninhabitable, and the official scheme for their demolition and reconstruction was prepared. during the next four years the 'scheme' ploughed its course through arbitration and compensation with a puzzling slowness. "it was indeed a 'killing slowness,' for, during all those years, landlords whose claims had been settled spent nothing on further repairs; tenants, expecting their compensation, put up with any wretchedness; while the vestry, looking to the approaching reconstruction of the houses, let streets and footways fall to pieces. it was not until that the needful demolition was seriously begun. since that date the houses of some thousands of the poor have been destroyed." and then he described the slowness of the reconstruction, and added:-- "such is the seven years' history of the artizans' dwellings act in a parish under the rule of the metropolitan board of works." he expressed his opinion that the prime source of the evil was not in the law, but in the local administration; but the complications of ownership, the endless legal difficulties and formalities, the numerous arbitrations, necessarily consumed years of time before the land could be cleared for building, and then the actual building of the new houses was by no means rapid. the mode of procedure was attended with such difficulties and disadvantages, and the administration of the acts so clogged, that a select committee of the house of commons was appointed and sat in , and again in , to inquire into the causes of the want of success, and to consider in what way the law might be further amended so as to make it really workable. the condition imposed as to re-housing, and which was so rigorously insisted on, did not by any means achieve the desired result. according to mr. lyulph stanley[ ] in : "not one single person of all the poor displaced in the carrying out of the gray's inn road improvement, powers for which were obtained in , had been re-housed by the board." the medical officer of health for whitechapel, in his evidence in , also showed that many of those in the houses which were to be pulled down were not working men at all. "many of the people do not come into the whitechapel district for the purpose of getting employment. they have other motives; they come from all parts of the country; a great many are tramps, and come up for the purpose of begging, some for stealing, and some to obtain the advantage of the charities which exist in london, and many of them to get out of the way and hide themselves." by this time, moreover, the possibilities of getting accommodation further afield was beginning to come into view. "with the facilities for coming by the early trains and the various tramways that we have now at a cheap rate, the rents of many of the inhabitants of whitechapel would not be increased by moving from it." that the obligation to re-house was imposed alone upon the public authorities and upon railway companies was rather inequitable. in many districts the destruction of houses, and the unhousing of the inhabitants, was carried out on a far larger scale by private owners, and no such obligation was imposed upon them. the policy, therefore, was decidedly onesided, and was very costly to the ratepayer who was in no way responsible for the proceedings of the private house-owner who had caused all the trouble. the committee reported in june, . they expressed their opinion that-- "nothing would contribute more to the social, moral, and physical improvement of a certain portion of the working classes than the improvement of the houses and places in which they live." they stated that "very great hardship would often follow if the provision for the replacement in or near the area of displacement were wholly done away with." "the special calling of many of the work people, the hours of their work, the employment of their children, the maintenance of their home life, the economy of living together in a family, the cheapness of food owing to the nearness of the great evening markets, &c., render it very desirable that a large portion should be enabled to re-house themselves in or near their old houses of living, and if no fresh dwellings be provided the evils of overcrowding will at once increase. * * * * * "still, it is equally true that these observations do not apply to the whole population. many without any special calling may live in one place as well as another. the facilities of transit recently offered by cheap trains, by boats, by tramways, &c., have enabled many to live in the suburbs who can do so consistently with their calling." "your committee are of opinion that the existing law, which requires that the improvement scheme shall provide for the accommodation of, _at the least, as many persons_ of the working class as may be displaced, may be relaxed, and that the accommodation to be required should vary from half to two-thirds." as a matter of fact very few, if any, of the families thus dispossessed returned for the purpose of occupying the new buildings. indeed one witness[ ] said that-- "neither the peabody trustees, nor--more or less--the other artizans' dwellings companies would take in the class of people who had been displaced." the committee called attention to the importance of favouring in every way facilities of transit between the metropolis and its suburbs by an extension of cheap workmen's trains. and they also recommended that-- "all existing sanitary legislation should be more fully enforced, especially in those parts of the suburbs where buildings are so rapidly springing up." a bill was at once introduced into parliament, the object of which was to lay down such rules for estimating the value of the premises to be purchased as would prevent the owners of insanitary property obtaining an undue price for it--"the intention of parliament being that the owner should not gain by having allowed his property to fall into an insanitary state." it was passed, and as an act it further empowered the secretary of state, under certain circumstances, to dispense with the obligation of re-housing the people to a greater extent than one-half of those displaced. into the detailed intricacies of many of these housing acts it is really useless to enter; and the enumeration of the details tends to obscure the broad and essential features of the whole subject. in the effort of the "owners" to repudiate the responsibility for their or their predecessors' infamous neglect, and to shift the blame for the appalling state of affairs on the middlemen and the occupiers; in the effort of the middlemen to evade their responsibilities by availing themselves of every obstructive device the law so lavishly placed at their disposal, and of both of them to extort the utmost amount of money they could for their disease-begetting, death-distributing property; the unfortunate occupiers were the immediate sufferers and victims, and a huge wrong and injury was inflicted upon the community. it was mere tinkering with the subject to pass an act removing some petty technical difficulties for putting some previous and very limited act in force, and to diminish the expense and delay in carrying out the act. it was farcical to amend the standing orders of parliament, fixing twenty instead of fifteen as the minimum number of houses in any one parish which could be acquired by the metropolitan board without preparing a re-housing scheme, as if that would revolutionise the condition of the housing of the people of london, and yet something not far short of revolution was required if the housing of the people was to be reformed, and put on a proper sanitary basis. it is manifest that what was being dealt with by these acts was only a fragment of the great housing question, and that such destruction of insanitary buildings as could possibly be effected by these means would amount to but a fraction of those unfit for human habitation in london, and would not touch the thousands of inhabited houses in every parish of london which were insanitary in varying degree, and dangerous to the individual and public health. it is clear, too, that if the insanitary conditions of the housing of the people were to be dealt with on a large scale, and with success, measures must be taken to secure the sanitary condition of the houses which such legislation did not touch. otherwise general improvement was impossible, and existing conditions must continue indefinitely to flourish, and to produce their inevitable and enormous crop of deadly evil. how urgent was the need for reform in some parts of london may be gauged from the description of the condition of things in bethnal green in , given by the medical officer of health of the parish:-- "the portions of the district i have examined include nearly , houses. "i have visited and carefully examined almost every one of these houses, and i must confess that a condition of things has been thereby revealed to me of which i had no previous conception, for i do not think i visited a single house without finding some grave sanitary defect; in a very large number the walls of the staircases, passages, and rooms are black with filth, the ceilings are rotten and bulging, the walls damp and decayed, the roofs defective, and the ventilation and lighting most imperfect. "the dampness of the walls is in some instances due to defects in the roof, but in many the moisture rises from the earth owing to the walls being constructed without any damp-proof course.... "in almost every house i visited i found the yard, paving, and surface drainage, in a more or less defective condition, a quantity of black foetid mud having accumulated in places." and all this was nearly thirty years after bethnal green had been endowed with a local sanitary authority. returns given occasionally by the medical officers of health revealed the appalling state of insanitation in which people still lived; streets where in nearly every house nuisances dangerous to health were found to exist; a "place" in st. pancras where the death-rate in had been per , , or - / times as much as that for london; a "place" in st. marylebone with six-roomed houses, where the births were less in number than the deaths, and the existing population were extinguishing themselves. and overcrowding had increased in many parts of the metropolis, and some of the medical officers of health had come to regard it as inevitable and impossible to prevent. the reports of the select committees of and , and the outbreak of cholera in egypt in which awakened apprehensions of its spread to england, quickened public interest in the sanitary condition of the metropolis, evoked a stronger expression of public opinion upon the existing evils, stirred up lethargic vestries and district boards to some special show of activity, and awakened the local government board, and brought it into the field as an active inciter of the local sanitary authorities to adequate efforts to improve the sanitary condition of the people, and to grapple with the terrible problems of insanitary dwellings, of overcrowding, and the consequent physical misery and degradation of hundreds of thousands of the people. the position of affairs had become clearer than it had ever been before, and its magnitude and importance was beginning to be appreciated, and the iniquities which were being allowed, and the evils which were tolerated, were coming more into the light of day and were being better understood and realised. though in many ways there had been progress and improvement, yet in many others, of the most vital consequence, it was evident things were scarcely moving at all. it was now manifest that at the rate the demolition of slums and the re-housing of the people could be carried out, a very great length of time must elapse; so great that the remedy must be of the slowest, whilst, by itself, it would be wholly inadequate; and it was beginning to be realised that many of the local authorities, instead of administering the laws they were charged by parliament to administer, were even obstructing and opposing sanitary reforms. once again the alarm of cholera woke up the vestries, and some of the recorded results of such wakening are an illuminating exposure of the normal state of inaction on their part, and of the chronic insanitary condition of their parishes not revealed at other times. in westminster:-- "in anticipation of cholera a thorough inspection by a house-to-house visitation through the whole of the united parishes has been undertaken. naturally many defects were found, and directions given as to what was required. the work has been completed and i consider that the parishes are now in a very satisfactory condition." in poplar, , houses were inspected, of which only were found to be in good order. in lambeth, six men were engaged temporarily for the purpose of a special inspection. " , houses were visited; , required sanitary improvements.... in many houses several defects were reported, bringing up the total of sanitary improvements to , ." in bermondsey, no fewer than , notices were issued for the execution of sanitary works which were required. the sanitary act of had enacted that-- "it shall be the duty of the nuisance authority to make, from time to time, either by itself or its officers, inspection of the district with a view to ascertain what nuisances exist calling for abatement under the powers of the nuisances removal acts, and to enforce the provisions of the said acts in order to cause the abatement thereof." but by many vestries the duty had been either entirely neglected or very imperfectly performed. the medical officers of health were unceasing in pressing upon their employers the necessity of inspection. "it is only by the constant inspection and re-inspection of property inhabited by tenants of this class (tenement-houses) that the houses can be kept in decent sanitary condition," wrote the medical officer of health for bethnal green. "my opinion of the value of regular house-to-house inspection throughout the year," wrote the medical officer of health for poplar, "is more confirmed than ever, and that such is needed for the proper sanitary supervision of the district." "it is by constant inspection," wrote another medical officer of health, "that the vestry can best do its duty in preserving the lives and health of its parishioners." "facts are stubborn things," wrote the medical officer of health for st. mary, newington, after years' sanitary work himself, "and they clearly demonstrate the necessity for a continual supervision of the dwellings of the poor (more especially) and for as constant an attack on all removable insanitary conditions. this after all is the real work to be done." but the vestries and district boards paid little heed to this advice. naturally, inspection was not welcome to sanitary defaulters or misdoers; naturally, the light of the sanitary policeman's lantern into the dark places of slum-owners and 'house-knackers' was resented. it was an invasion of the rights of property, of the privacy of an englishman's home, even if he did not live in that home himself, but let it to somebody else to live in. "why should not a man do as he liked with his own?" and so, as inspection was, from the house "owners'" point of view, an unpopular thing, too much money was not spent by vestries upon sanitary inspectors' salaries, and even in the best inspected parishes or districts the portion inspected was small indeed compared with the whole of the parish or district. how much was left undone, and left undone for years, was proved over and over again by whole areas being represented by their medical officers of health as insanitary, or by their having to shut up houses as unfit for human habitation. the attempt made by parliament in --in the scheme embodied in the th section of the sanitary act--to provide a remedy for overcrowding, and to secure the maintenance of a moderate standard of cleanliness and sanitation in the tenement-houses, had been an excellent one; and parliament improved the scheme in by extending its scope. almost the whole of the existing evils lay in these tenement-houses, for it was there where the great mass of the disease, filth, and misery of london was to be found, and there where the greatest overcrowding, and the deepest moral and physical degradation existed. but with the few exceptions already described practically no use had been made of the powers. "vested rights in filth and dirt" had still too large a representation upon, and too powerful a grip of the local sanitary authorities for any action to be adopted which would entail trouble upon the possessors of those rights. some vestries, for form's sake, had made regulations but never put them in force. a few had tentatively put them in force, and promptly dropped them. a large proportion of them did not take even that much trouble, but simply ignored them altogether; and so, some seventeen years after the act was passed, the whole scheme had ceased to be operative, and was in complete abeyance. in december, , the local government board, having realised the gravity of the situation, endeavoured to get the vestries and district boards to take action, but the local government board could not compel them to make such regulations, as there was no power of compulsion, and there was no penalty for refusal to enforce or even to make them.[ ] the vestries and district boards were, in fact, masters of the situation, and could act or not act, just as they pleased--and most of them did not act. various were the excuses made by the vestries for doing nothing. the feeling which prevailed in the vestry of clerkenwell was that-- "the regulations generally were of such an inquisitorial and troublesome character that they were unsuited to an englishman's home. for instance, it was shown that in some cases even clergymen occupied lodgings which would be reached by these regulations." and yet there were , houses in the parish to which such regulations would have been applicable, and where their application would have been of the utmost benefit to thousands of families. and from up to this power might have been, but was not used. the vestry of bethnal green was-- "unanimously of opinion that it was unnecessary to make the regulations, and considered the existing powers sufficient." the vestry of st. george-in-the-east resolved-- "that whilst fully recognising the necessity of continuing to carry out with vigour the general sanitary laws, the vestry did not consider it advisable in the present depressed condition of trade in the parish to incur the additional expense of enforcing special sanitary regulations for houses let in lodgings" (estimated to number above , ). in westminster, the district board resolved that no further steps should be taken as regarded making or enforcing regulations, as the board-- "already possessed ample powers under existing statutes to enable it to deal promptly and effectively with such sanitary defects as the proposed regulations are intended to remedy"--a contention which, if true, threw discredit upon themselves, as there were thousands of filthy and insanitary abodes in that district which were not dealt with at all. st. pancras vestry refused ( ) to make regulations, though its medical officer of health had made more than one appeal to them to do so. "i would beg to remind the vestry that until proper regulations are made and enforced in st. pancras for this class of houses, the vestry have not exercised to their full extent the powers they possess for improving the condition of their poorer parishioners, and that the moral and physical welfare of those who are least able to help themselves is a question which concerns the vestry as much, if not more, than any other it is their duty to consider." and in the following year he wrote:-- "upon the metropolitan sanitary authorities rests a great responsibility, for it is absolutely within their power to insist upon all dwelling-houses being maintained in condition fit for human habitation, and they may, within limits, prevent overcrowding, which is no less disastrous to health than to morality. "i have repeatedly recommended the vestry to adopt regulations for houses let in lodgings, and have pointed out the power they would then possess for ensuring tenemented houses being maintained in proper sanitary condition. i would desire, in my last report, to urge upon them the further consideration of this subject." there were doubtless difficulties in putting regulations such as these in operation--as, indeed, there are in putting all laws in operation--but two vestries had put them most successfully in operation, and therefore the difficulties were not so great as those who were opposed to them insisted. some of the vestries stated that they could equally well attain the same results under the powers of the nuisances removal acts; but that was not the fact, for there were many and considerable advantages in this form of procedure over the procedure prescribed in other acts relating to health and sanitation. indeed, the medical officer of health for fulham declared (in ) that-- "this section gave almost all the legal power that could be wished for to place the dwellings of the poor in a proper sanitary condition." and in the following year he wrote:-- "it will therefore in future be the fault of the sanitary authority if the dwellings of the poor are not kept as they should be." the medical officer of health for camberwell, discussing the general aspect of the matter, wrote ( ):-- "i cannot help remarking on the feebleness which constantly spoils the best intentioned sanitary legislation, and which is conspicuous in the enactments relating to houses let in lodgings. "the local government board have declared that certain enactments are in force, but they cannot compel the vestries to frame any regulations of their own, nor even can they compel vestries to carry out and enforce regulations which the vestries have framed and the board have sanctioned. "now i am one of those who think that by the judicious regulation of lodging-houses of certain kinds, and in certain localities, very much good might be effected, and much advantage would accrue both to the lodgers and to the public. but it is clear that it ought never to have been left to individual vestries in a place like london, to adopt or not to adopt, the enactments referred to, simply according to their pleasure, still more that they should never have been allowed to frame inconsistent orders or regulations.... "the opportunity (of the act of ) might have been seized, not for giving an empty power to the local government board, but for requiring the metropolitan board of works to frame suitable regulations for the whole of the metropolis, which the vestries might have been required to enforce as they are required to enforce other provisions of the sanitary acts." a similar opinion was expressed by the district board of st. olave, southwark, which, after stating that it had been one of the first to make regulations, it had been found unnecessary or impracticable to enforce them, went on to say:-- "the fact of the enactment having been practically inoperative throughout the metropolis, ... it was considered that it would be unjust to enforce stringent regulations in the district, while in other parts of the metropolis regulations might differ in principle, and be neglected in practice: and what the board wanted to see was a system of sanitary regulations which should be strictly uniform throughout the metropolis, and in which there should be no option on the part of local authorities of enforcing or neglecting." the explanation of this general inaction was the simple and obvious one that on those bodies there were many whose interests ran counter to the adoption of the act, and what its adoption entailed; the sanitary obligations, the annual lime-washings, &c., would entail expense; they were not going to inflict the cost upon themselves or upon their friends if they could avoid doing so. and as they could avoid it, the great bulk of the local authorities deliberately ignored the remedy devised by parliament, and with most reprehensible callousness let the evils go on and increase. but while they remained inactive, death and disease did not. progress in sanitation was retarded also somewhat by other circumstances. the medical officers of health were under no obligation to reside in their district, and were at liberty to take private practice, and so the whole of their time was not given to their public duty.[ ] but furthermore, they were in a state of dependence on their employers, which naturally would often prevent their reporting fully upon sanitary matters, though, happily, there appear to have been few who were influenced by this consideration. and some of the vestries and district boards did not hesitate to put pressure upon their medical officers to prevent energy on their part. it was stated in evidence before the select committee in that a medical officer would very soon "bring a hornet's nest round his ears if he attempted to do his duty strictly and independently." lord shaftesbury declared, in ,[ ] that he was quite certain that-- "they would never have the laws of health properly given effect to, until they asserted the independence of the health officers." nor were the sanitary inspectors as efficient as they might have been, though there had been a great improvement in the class of man appointed. the chief sanitary inspector for clerkenwell[ ] reported:-- "the two men (in clerkenwell) are not very active. it is the greatest trouble i have to get the men to do their duty." "the sanitary inspectors have not always shown as much zeal and interest as they might have done, but lately they have improved.... it is openly talked about in a good many districts in london that a system of bribing goes on."[ ] but those who were energetic were also discouraged by the same pressure which damped some of the energies of the medical officers of health. the medical officer of health for fulham wrote, in :-- "so many are the vested interests that sanitary officers are obliged in the performance of their duty to interfere with, that they must be prepared to meet with injustice and opposition in almost all directions. it is not at all surprising that the dwellings of the poor in london should be in an insanitary condition seeing the great obstacles public sanitary officers have in the performance of their duties." and yet there were many who did their work well, and who did much to improve the conditions of living of those who were under their care or charge; and did it in the face of many obstacles and much discouragement, and of all the opposition that vested interests could bring to bear against them. many of the vestries and district boards were not only not above reproach, but were strongly to be condemned. sir charles dilke, then president of the local government board, speaking in , said:-- "there were some parishes in london which had very zealously tried to work the existing law, but, on the other hand, there were more parishes the government of which was a flagrant scandal." and mr. chamberlain, in an article in the _fortnightly review_ of december, , wrote:-- "in the metropolis, where the evil is greatest, the want of an efficient and thoroughly representative municipal government stands in the way of reform. "the vestries, often in the hands of cliques and chosen at elections which excite no public interest, are largely composed of small house-property owners, who cannot be expected to be enthusiastic in putting the law in force against themselves." and in the house of commons, on the th of march, , sir charles dilke stated that-- "in clerkenwell, the two joint dictators of the parish, who had control of the vestry and its leading committee, one of them being chairman of the principal committee, were the largest owners in the whole district of clerkenwell of bad or doubtful property.... in clerkenwell there were fourteen house-farmers on the vestry and twelve publicans who seemed to work very much with them." nothing more decisively demonstrates the hostility of the vestries to the act of , indeed to all this branch of sanitary reform, than the fact that they would not make adequate provision for the performance of the sanitary duties imposed on them by divers acts of parliament. a return compiled by the medical officer of health for bethnal green in , from information supplied him by the medical officers of health of thirty-eight vestries, shows how the local sanitary authorities crippled sanitary work by a wholly inadequate staff of inspectors. number number of parish or district. of inhabitants to inspectors. each inspector. greenwich , newington , mile-end-old-town , lambeth , poplar , bermondsey , shoreditch , st. pancras , paddington , marylebone , hackney , bethnal green - / , camberwell , in the whole of the metropolis there were inspectors of nuisances--a rough average of one inspector to about , of the population. how could it be expected that one inspector could look after a town of , people? consistently, and, year after year, insistently, did the bulk of the medical officers of health complain of the lack of sufficient sanitary inspectors, and point out the necessity for more sanitary inspectors; some begged for them--but to nearly all these appeals the vestries turned a deaf ear. every now and then some incident occurred or some exposure was made of some abominations of insanitation which were a revelation of the extraordinary methods adopted by some men in utilising land for building houses regardless of all sanitary consequences whatever to others. in the _times_ of december , , an article was published entitled "a curious site for industrial dwellings." "the things which are done in london under the shadow of legal right are sometimes startling." in bethnal green were two disused burial-grounds--"globe fields" and "peel grove." parliament authorised a railway line to be constructed through "globe fields." foundations had to be made for the arches, and trenches had to be dug in the burial-ground. the medical officer of health, on inspecting the place, found a horrible condition of things. but with many precautions against loosing some virulent epidemic in the locality, the human remains were removed and re-interred elsewhere, and, it is stated, part of the ground was built over. fuller particulars were given as to the peel grove cemetery. the ground, several acres in extent, had been leased by a pawnbroker and started as a cemetery as a speculation. the statements made by the writer in the _times_ are specially illuminating. the cemetery was opened about without consecration. the bishop refused to consecrate the ground as burials had taken place in it already, and as some difficulties were consequently experienced, the speculating pawnbroker acted, it is said, for some years as chaplain. ultimately, somehow or other, a chaplain was appointed. about , persons had been buried in it, six deep, and packed as closely as it was possible to pack them--not even earth between the coffins, so anxious was the owner to economise space; large numbers who died of cholera in having been buried there. the last interment took place in september, . in , the ground having served one financial purpose, it became desirable to utilise it for another financial purpose, and the proposal was made to erect houses upon it, and an agreement was entered into with a builder for the erection of blocks of dwellings thereon. this builder commenced excavations for the purpose of laying foundations, and he had sent in drainage plans for a block of industrial dwellings to the vestry of bethnal green. "is such an obvious violation of the laws of health and decency to be permitted?" said the writer. "the vestry are alive to the situation, and appear to be willing to do all in their power to avert the catastrophe. but the law on the subject is by no means clear.... it is little short of scandalous that such doubts should exist. it is repugnant to every feeling of decency and propriety to invite human beings to live in densely packed crowds over a charnel-house." the sanitary condition of any city or district must, as has already been pointed out, depend very largely upon the system of local government in existence at the time, and its efficiency or inefficiency. this was specially true of this great metropolis with its millions of people, its vast extent, its great diversities. to all intents and purposes the main features of the local government of london had undergone little change since . there was still the "city" with its special law, special area, and special government, to which had been added the port sanitary authority. and there was the central authority, the metropolitan board of works; and there were the local sanitary authorities, the vestries and district boards--and to them had been added the metropolitan asylums board, another indirectly elected central body. but there were very manifest and prominent defects of the very gravest nature in this system of london government, and in the government of the day made an effort to construct a better system. sir william harcourt introduced the london government bill into the house of commons. "while london grew," he said,[ ] "the corporation remained stationary." "the central body must deal with the large affairs, ... a central body doing all the great things." "the central principle of the bill is this, that there should be some common control over the vestries which shall give them a uniform action for the benefit of the whole community instead of leaving them as they now are, independent of any such control." "what is the great evil? it is that the metropolis is broken up into fragments acting on a different principle, some doing ill, and those who do well suffering in consequence of the ill-doings of their neighbours." "when the danger (of invasion of cholera) threatens a great metropolis like london, all must desire and want a central authority which should advise, which should assist, which should compel every part of the community to take those measures of precaution which are necessary for the safety of the whole. no such authority exists at this time. "if a vestry refuses to make sanitary bye-laws, or to carry out a proper system of sanitary inspection, you are absolutely powerless to compel them to do so. a single parish may become a plague-spot in london from which disease may be spread all around, and the metropolitan authority have no authority to make the parish do as it ought to do." mr. gladstone said[ ]:-- "the local government of london is, or, if it is not, it certainly ought to be, the crown of all our local and municipal institutions. "the principle of unity (of london) has already been established under the pressure of necessity as a matter which could not be resisted. it has been established in the metropolitan board of works.... there can be no doubt we have established a principle of unity, and that we have found it satisfactory. "the supply of water and the supply of gas ... two of the most elementary among the purposes of municipal government, have been handed over to private corporations for the purpose of private profit because you have not chosen to create a complete municipality for the metropolis. "and that is not all. "the defects of the present system are admitted.... surely if there are these great and intolerable defects they ought to be remedied by the action of some genuine popular local authority. but we have got no genuine popular local authority.... "london, large as it is, is a natural unit--united by common features, united by common approximation, by common neighbourhood, by common dangers--depending upon common supplies, having common wants and common conveniences. "... unity of government in the metropolis is the only method on which we can proceed for producing municipal reform." the bill was strongly opposed in parliament, and was withdrawn at a late period of the session, "but its introduction and discussion had done much to awaken interest and mature opinion on the question of the practicability of the government of london by a single municipality."[ ] up to this time, though overcrowding had occupied so prominent a position in the great health problem of london, no returns of the amount of overcrowding actually existing had been obtained, nor had any estimate even been attempted. the reports of the medical officers of health showed in many graphic descriptions that overcrowding was prevalent in every part of london--more acutely so in some districts than in others--but as to the amount no information was available. the first reliable figures over a large area--a large central district of london--were collected by mr. t. marchant williams, inspector of schools for the london school board, and published in the _times_ of february , . he wrote giving some of the results of his recent investigations into the social conditions of the people residing in his district. "my sole desire," he wrote, "is to record facts. it will be my endeavour to show that these facts are sufficiently typical or representative of the social condition of the elementary school population of london to serve as a trustworthy basis for a fairly accurate estimate of the stupendous difficulties the school board for london has to contend with." "the division of finsbury includes the following parishes:-- ( ) st. giles'-in-the-fields { the whole population in { st. george-the-martyr { was , ; number ( ) { st. andrew, holborn { of children of school age, clerkenwell { - == , , per st. luke { cent. of whom have been stoke newington { scheduled by the officers islington { of the school board." ( ) in st. giles'-in-the-fields there were efficient elementary schools, churches, chapels, public-houses, milk shops. he gave the number of families scheduled for elementary school purposes residing _in more than two rooms_ as , which represents about per cent. of the whole number of scheduled families. per cent. of the families lived each in rooms only, and " " " " " room only. ( ) in the parishes of bloomsbury, st. george-the-martyr, st. andrew, holborn, and part of st. giles'. the number of families scheduled for elementary school purposes residing _in more than two rooms_ was , which is about per cent. of the whole number of scheduled families. about per cent. lived in rooms only. " " " " room only. ( ) lower division of clerkenwell and st. luke's. the number of families scheduled for elementary school purposes residing _in more than two rooms_ was , , which is about per cent. of the whole number of scheduled families. per cent. lived in rooms only. " " room only. he gave similar information as regarded three other sub-districts, and then went on:-- "the foregoing statistics show that there were at the beginning of the present year, in the finsbury division-- " , families consisting of , persons, living, each, in _one_ room only, and , families consisting of , persons, living, each, in _two_ rooms only, a total of , persons living in one or two rooms. "for every efficient elementary school in the division there are more than public-houses, for there are in the division efficient schools, while the public-houses number ; the grocers' shops, ; bakers' shops, ; dairies, ; coffee shops, ; churches, ; chapels, ; mission rooms, ; registered lodging-houses, ." and then he summarised his figures for the city division: number of children of school age == , " " churches and chapels == " " public-houses == number of families living, each, _in more than two rooms_ was , , which is about per cent. of the scheduled families. about per cent. live, each, in rooms only, and nearly " " " room only. the _times_ commented, in a leading article, on this information. "everywhere, and by all sections not immediately affected, the scandal and almost the absurdity of the brutish degradation of an enormous number of habitations in the greatest and most opulent city in the world are thoroughly recognised.... habits of life such as lodgings of the kind now common among london workmen foster and encourage are a positive danger to the whole of society. only by one rank is the question treated as of no pressing importance. that happens to be the body of persons directly interested. "... no more instructive contribution has been offered towards a clear perception of the dimensions of the problem than those given by mr. marchant williams.... "incidentally the census, by the school board, of the classes it was founded to teach, contains the precise materials for informing the public of the extent of the overcrowding which has been shocking the moral sense of the nation. formerly, when instances of overcrowding were cited, it might have been fancied they were exceptions or exaggerations. mr. williams' report allows of no possibility of a doubt. * * * * * "the finsbury educational division contained, in , a population of , . of these, , live in single rooms, at an average rate of four a room; , occupy suites of two rooms, at a rate exceeding four persons and three-quarters for each. for a family of two to monopolise a whole room is a luxury, and to possess two rooms is a marvel. some rooms are made to hold ten, and many to hold six or seven.... "a home partakes of the life of the dwellers in it. they mould and incorporate it with their being, and it helps to mould and fashion them. the , owners of an undivided and indivisible quarter of a hovel in finsbury, and the other hundreds of thousands in like case elsewhere in the town, are curtailed of the essential parts of the rights of humanity by the miserable accident that their locality refuses them reasonable standing room. family life is an impossibility for a whole family collected in the single room to feet by to . in a multitude of instances those tenanting a single room are several families, not one. they have to distribute the floor by square inches, and grow up with less regard to decency than a cat or a dog." and in another letter written a few days later, mr. marchant williams added:-- "it was only the other day that i discovered in one of these streets (near fitzroy square) a house containing nine rooms, each of which accommodates on an average eight persons! "... the rents in the most crowded parts of my district amount as a rule to about a third or fourth of the maximum wages earned by the tenants." he mentions a case, a riveter:-- "he had recently abandoned the room in which he, his wife, and six children had lived for two years." "i have more than once when going my rounds been accosted by a landlord in a state of abject terror, lest i might be arranging to rob him of some of his victims. the landlord's defence invariably is that he is obliged to levy high rents because the tenants frequently run away by night and leave no trace behind them of their whereabouts." more and more did the feeling grow that something must be done to ameliorate the conditions under which the working classes and poorer people were living, and on the nd of february, the marquess of salisbury, in the house of lords, moved in an address to her majesty for the appointment of a royal commission to inquire into the housing of the working classes.[ ] "the attention of persons of every class, of every creed, and school of politics, has been turned to this question," he said. h.r.h. the prince of wales said:-- "i feel convinced that your lordships, in common with all classes of her majesty's subjects, will be gratified to learn that the noble marquess has asked for a searching inquiry into this great and momentous question with regard to the housing and the amelioration of the dwellings of the poor and of the working classes, and that her majesty's government have decided to issue a royal commission for that purpose. "as your lordships know i take the keenest and liveliest interest in this question. "i can assure you, my lords, that i am deeply flattered at having been appointed a member of this royal commission." the government accepted the motion, and a royal commission was forthwith appointed and immediately began its work. while the great question of housing and overcrowding was under discussion and was being investigated, and efforts being made to deal with it, various other matters forming part of the general sanitary evolution of london were attracting attention, or gradually developing. in october, , the limits of the port of london were extended seawards, and in the following year the powers of the port sanitary authority were extended.[ ] most of the powers of an urban sanitary authority under the public health act of were conferred upon it, and the medical officer of health reported that he believed the legal powers of the authority would be found "amply sufficient for the sanitary control and supervision of the port." the authority extended its attention now to the inspection of imported meat. it was a matter of the first importance to watch carefully the food supply of the people. the trade of frozen meat had been rapidly growing, and from time to time large quantities arrived in unsound condition, which it was most necessary should be prevented going on to the market. in connection with another very important article of food--namely, milk--action was also taken. the effect of the order made in by the privy council, as to dairies, cowsheds, and milkshops, had been very beneficial, and a marked change for the better in the conditions under which the milk trade was conducted was the result. that order was revoked in by the privy council, and a new one passed extending the powers of local authorities in the matter, and prescribing further precautions to secure the sanitary condition of all dairies and cowsheds, and for the protection of milk against infection or contamination. another beneficial sanitary improvement was effected in , by the extension of the benefits of the infectious hospitals of the metropolitan asylums board. the royal commission on fever and smallpox hospitals, in , stated that in their opinion it was of paramount importance that the hospitals of the metropolitan asylums board, to which so many classes of persons might become liable to be removed, should be made as little unattractive as the nature of the case admitted, and they considered that the pauper character which attached to the hospitals of the board, and which rendered them repulsive to all but the indigent, would disappear if the distinction between paupers and non-paupers were abolished. this suggestion was partially given effect to by the diseases prevention (metropolis) act of , which enacted that, subject to certain arrangements, the admission of any person suffering from infectious disease into any hospital provided by the metropolitan asylums board, or the maintenance of any such person therein, should not be considered to be parochial relief. the plan was only partly successful, but as years went on the hospitals were increasingly used by persons other than those of the legally recognised pauper class. in the years and the hospitals demonstrated their great utility. there was a severe epidemic of smallpox. from its outbreak in , to its subsidence in the autumn of , no less a number than , patients passed through the hospitals, hospital ships, and camps of the metropolitan asylums board, and the arrangements for the removal to hospital of cases of infectious disease, from the whole of the metropolis, worked smoothly and satisfactorily. the gain to the community in thus removing infectious cases from its midst was immeasurable.[ ] in the report of the royal commission which had been inquiring into the housing of the working classes was published. it presented to the general public a mass of facts of which previously they had taken but little heed, and the vast importance of which they had utterly failed to realise; and it brought into the forefront of social questions the vital question of the public health, and the imperative necessity of remedying evils which were eating into the very vitals of the community. the royal commissioners depicted the widely prevalent and dreadful overcrowding which existed, and which in certain localities was becoming more serious than ever, and they gave numerous instances of it. they described the fearsome condition of tenement-houses, and of the people living therein--the inadequacy of the water supply--the defective sanitary accommodation in houses--the lack of air space--the absence of ventilation--the use of cellars and underground rooms as dwelling-places--the limitless filth. and they pointed out the dreadful results of this condition of things--physical, moral, and material--the prevalence of disease, the heavy death-rate, the destruction of bodily health, the dreadful immorality resulting from overcrowding, the degradation to which masses were doomed, the incitement to drink, and depravity, and crime. they declared that:-- "even statistics of actual disease consequent on overcrowding would not convey the whole truth as to the loss of health caused by it to the labouring classes.... "nothing stronger could be said in describing the effect of overcrowding than that it is even more destructive to general health than conducive to the spread of epidemic and contagious diseases." and they pointed out that there was much legislation designed to meet these evils, yet that the existing laws were not put in force, some of them having remained a dead letter from the date when they first found place in the statute book. and they investigated the causes of many of these things--and they assigned the blame for some of them--and they passed in review the conduct of the local governing authorities--and they recapitulated the existing laws upon these various matters, and suggested certain alterations, and made various valuable recommendations. there was, in fact, placed on record a calm, unimpassioned, and unexaggerated statement of the evils which masses of the population of the great capital were enduring in the last quarter of the highly civilised and enlightened nineteenth century. it was a thorough confirmation of all the reports of the medical officers of health, and of the facts set out, and pressed by them, year after year, upon the attention of the vestries and district boards, and which had so persistently been ignored by so many of those authorities. the commissioners classified the-- "unquestioned causes which produced the overcrowding and the generally lamentable condition of the homes of the labouring classes." the first was-- "the poverty of the inhabitants of the poorest quarters, or in other words the relation borne by the wages they received to the rent they had to pay." the next was the demolition, for various reasons, of houses inhabited by the working classes and poorer people, and the consequent displacement of the people. the third was the relation between the owners of property upon which the dwellings of the poor stood, and the tenants of those dwellings. "the other great remaining cause of the evil was the remissness of local authorities." from their very origin, these "authorities" were unsatisfactory instruments for the performance of the public duties. "but little interest was, as a rule, taken in the election of vestrymen by the inhabitants," instances having been known of vestrymen in populous parishes being returned by two votes, on a show of hands. elsewhere it is reported they elected each other. the commissioners referred to the "supineness" of many of these metropolitan local authorities in sanitary matters, and to the "laxity of administration of some of them." and still worse, to the self-interested action of vestrymen. thus on the vestry of clerkenwell, they said, were-- "thirteen or fourteen persons who are interested in bad or doubtful property, including several 'middlemen'; and ten publicans who, with the exception of one or two, had the reputation of working with the party who trade in insanitary property; and accordingly this party commands a working majority on the vestry." "it is not surprising to find that the sanitary inspectors whose tenure of office and salary is subject to such a body should show indisposition to activity." "the state of the homes of the working classes in clerkenwell, the overcrowding, and other evils, which act and react on one another, must be attributed in a large measure to the default of the responsible local authority." "clerkenwell does not stand alone: from various parts of london the same complaints are heard of insanitary property being owned by members of the vestries and district boards, and of sanitary inspection being inefficiently done, because many of the persons whose duty it is to see that a better state of things should exist, are those who are interested in keeping things as they are." and in another part of their report they wrote:-- "it is evident that the remedies which legislation has provided for sanitary evils have been imperfectly applied in the metropolis, and that this failure has been due to negligence in many cases of the existing local authorities." the part of the evidence which was of greatest value and interest was that which laid bare the responsibility for the dreadful conditions under which such masses of the people lived. apart from the measure of responsibility which fell on parliament itself, and it was no light one, it is clear that those conditions were due ( ) in part to the various classes of "owners," ( ) in part to the people themselves, and ( ) in part to the local authorities. as regarded _owners_, there were first the ground landlords, who themselves, or whose predecessors had leased their land for building purposes, or with houses thereon to a tenant. it would appear clear that these ground landlords or freeholders, or lessors, had power to enforce against the person who held directly from them the repairing clauses of leases. but the existing condition of things showed that they did not do so. one of the witnesses, giving evidence about a particular property, said:-- "by the terms of even the old leases the tenant was supposed to keep the place in proper repair.... the property has gradually deteriorated in consequence of neglect." and lord salisbury, who asked:-- "i suppose it is practically impossible for the ground landlord to see that the conditions are kept?" was told in reply:-- "the only way in which it is possible for him to do that is to keep a very active supervision over his property. "if that was done by ground landlords, and had always been done by them, you would have personal supervision carried out by a sufficient number of people to ensure the conditions being kept." any idea of property having its duties as well as its rights appears to have been non-existent. next to the land-owner was the numerous and varied class of house "owners," from the man who leased the land from the landlord and built the house, or who had leased the house and had sub-leased it to some one else. and often there were sub-lessees, until in some cases there was a chain of persons holding different interests in the same house. and there was the class of persons who take a house and break it up into tenement-rooms, and who were known as "house-knackers," or house jobbers, or house farmers, or as "middlemen," these last being defined as any one who stands between the freeholder and the one who occupies. some interesting descriptions of some of these "middlemen" were given. one of the largest in clerkenwell was a mr. decimus ball, and there was also a mr. ross--both of whom were on the vestry. the witness stated that these men had neglected the houses, and in many cases were very extortionate in their demands against the occupants. mr. ball had many houses which were inhabited by families in single rooms, but which up to a short time previously were inhabited by whole families to a house. mr. ball's profit is "perfectly enormous if he does not do any repairs." and he made very few; and if the rent were not paid on the monday morning, he threatened to raise it. probably the most notorious "middleman" was a certain mr. flight. "he must have been the owner of thousands and thousands of houses in the metropolis." ( , , it was said.) "he owned property in every part of london, and the squalid nature of that property, the wretched condition in which it has been kept, the avoidance of all decent rules by which habitations are governed, was something very fearful." "middlemen," it was stated, sometimes appeared to be making per cent. per annum, but they assert that repairs have to come out of that. repairs, however, were only executed once in three or four years, and in the others they get their per cent. "if the house-farmers do no repairs for years the profits are large.... they collect their rents very sharply. "the middleman makes the tenant pay an excessive rent because he insists upon making an excessive profit." the great work which the commission did was in the enlightenment of the public, and the material they afforded for the formation of public opinion in the right direction. subsequent experience showed that the recommendations made--excellent and helpful as so many of them were--did not by a long way cut deep enough to extirpate the more serious evils. "it is evident," wrote the commissioners, "that the th section of the sanitary act of (dealing with tenement-houses) which contains a remedy for some of the evils which have been described is likely to remain a dead letter in many districts of the metropolis until some improved means be devised for putting it into action." they recommended that the local authorities who had not already made and enforced bye-laws under the section "should proceed to do so." but no compulsion was suggested to make them do so, or for the only effective alternative, the provision of other machinery to act in their default, and so the local authorities were in this matter allowed to remain in their position of complete independence and to continue their policy of inactivity--if not obstruction. as to inspection, and the inadequacy of a sanitary staff, much evidence had been given, but, they remarked:-- "it is evident that where work is performed according to the custom of certain districts of the metropolis it really does not matter whether the staff of inspectors be large or small." they summed up their general view in the following passage:-- "without entering upon questions of policy of far wider application than the more immediate subject-matter of the present inquiry, your majesty's commissioners are clearly of opinion that there has been failure in administration rather than in legislation, although the latter is no doubt capable of improvement. what at the present time is specially required is some motive power, and probably there can be no stronger motive power than public opinion." and with that view they recommended that inquiries should be held as to the immediate sanitary requirements of different districts, and the reports be presented to parliament. public opinion, however, is hard to move, and usually slow in moving; and when it has at last decided on definite action parliament is slow in giving effect to the decision, and, when parliament at last acts, the legislation itself is frequently defective. and so the outlook was rather hopeless. various other more concrete amendments were, however, suggested in the various housing acts to render them more effective for their purpose. and, as a result, in the session of parliament of a bill was introduced dealing with the "housing of the working classes." lord salisbury, in moving the second reading, said[ ]:-- the bill he introduced was to a certain extent "a compromise." "no one need expect to find that it contains any magic formula which will cure all the evils of which this house and the public have heard a great deal, and there is nothing startling, sensational or extreme in its provisions. we are hoping to cure these evils by slow and gradual steps, by the application of remedies apparently not far-reaching in their character, but still judiciously directed to the precise difficulties which arose in each department of our inquiry." the bill duly passed ( & vic. cap. ). most of the reforms embodied in it were of a trifling character and such as could have only the most limited and gradual effect. this act extended generally the operation of the labouring classes lodging houses acts of and , and substituted the metropolitan board of works for the vestries and district boards as the authority under the act. a really useful plan was authorised by it, namely, the sale, at a fair market price, to the metropolitan board of certain prison sites in london for housing purposes. and one other good thing done was depriving the owner of insanitary premises, which had been pulled down by order of the local authority, of the power to require the local authority to purchase such premises. but merely again to declare-- "that it shall be the duty of every local authority entrusted with the laws relating to public health and local government to put in force the powers with which they are invested so as to secure the proper sanitary condition of all premises within the area under their control"--was futile, considering that the authorities in question had steadily ignored the same direction, made nineteen years previously, in the act of . lord salisbury wound up his speech with the following abnegation of parliamentary power:-- "we must not imagine that it is anything we can do in this house, or in the house of commons, that will remove all these evils. it must be done by that stirring up of public opinion which these investigations cause; it is to this that we must look for any real reform, it must be from the people themselves, from the owners, builders, and occupiers, when their attention is drawn to the enormous evils which past negligence has caused, it is from them that the cure of the sanitary evils which have so largely increased the death-rate must come." considering, however, the accumulated mass of evidence which had shown beyond all question that it was the owners and builders who were mainly responsible for those "enormous evils," and who were still hard at work adding to them and perpetuating them, it was rather hopeless to expect "the cure of the sanitary evils" to come from that quarter. unfortunately two general elections, and the heated discussion of great political questions, threw even these great health questions into the background, and not so much immediate benefit as was to be hoped followed the inquiry of the royal commissioners. it is an awful handicap to the welfare of a community, and of a nation, when those who should take a principal share in the duty of raising the physical, social, and moral condition of the people over whom they can exercise influence, and who are more or less under their control, not alone stand idly aside, but absolutely exploit the misery and helplessness and ignorance of masses of the people. the imperial government may make most excellent laws, but the physical and sanitary welfare of the people cannot be secured by a local governing authority alone, nor their moral and religious welfare by the churches alone. there is a great sphere of life where those who stand in the relation of land-owners or house-owners to tenants could exercise an enormous influence for good, and where nobody else could exercise it so effectually or so easily. but the disaster has been that in the great metropolis--the greatest of all cities--a vast proportion of those who ought to have been active in using this influence, have never made the slightest effort to use it, whilst others have used their position, and the dependence of the people upon them, solely to wring from them the last farthing that could be extracted. and these were the men who made the loudest protests and outcry against legislation and against administration which was to make them do that which the vital interests of the community and of the state required to be done. the root of the evil connected with the housing of the people in london lay with the disregard of "owners" for the condition of their tenants. many "owners" appeared to be under the impression that their investment in house property was to be as free from trouble or labour as money invested in the national funds is; and so long as they got the rent they expected, they did not trouble themselves about the state of the houses or of the people living therein. they were loth to spend money on them, as that curtailed their income, and the argument was constantly used that it was useless spending money to put the property in order, when anything they did to it would be promptly destroyed. and they cared not who were their tenants so long as a high rent was obtainable from them. some declared that the people were so sunken, so degraded, so filthy, and depraved, and destructive, that nothing they could do could secure their property being kept in a sanitary or decent condition. doubtless in many districts and many cases the conduct of the tenants was as bad as bad could be. as one of the medical officers of health wrote in :-- "it must be borne in mind that many of the occupants of tenement property are careless and filthy in their habits; and in addition are very destructive; fittings put up one day are pulled down and destroyed the next; ash-bin covers, closet doors, and even flooring boards, share the same fate." and many were the "owners" of various degree who endeavoured to justify their neglect on this ground. were such an argument admitted, the owner could claim to be exonerated from the duty of keeping his property in proper order, and the evil conditions and consequences resulting from his neglect would go on increasing indefinitely, until a state of things destructive to the community was ultimately reached. viewed broadly, and impartially, there was much truth as regarded the misconduct and uncleanliness of great numbers of tenants, but the central fact was that the "owner" was the person mainly interested in, and benefited by possession of the property, and therefore primarily responsible for maintaining it in a condition which should not endanger the health of the community. if, through the neglect and indifference of his predecessors, the property had fallen into a bad state, the consequences equitably fell upon him, just as the consequences of any other bad investment by his predecessor would have done. he had inherited something which was not worth as much as he anticipated--that was all; but the consequences must not be shifted on to the community, nor must his tenants be made the victims. and if he allowed his property to become a danger to his tenants, and through them to the community at large, the community had an absolute right to protect itself by insisting that he should be prevented from so doing. the only way in which, in the interests of the public, abuses can be prevented is by holding the person responsible for them who has the power of preventing them. and that was just what in this case the "owners" did not like. building constituted an important part of the housing problem. the medical officer of health for lambeth, in his report for , gave an interesting account of the process of building in london which shows how even the amended building acts had failed to secure those conditions of air and space which are essential for health. "in proximity to the centres of business every available plot of garden or recreation ground has been converted into building sites. houses constructed from materials of the poorest quality and by workmen employed only for the cheapness of their labour, have been hurried into occupation. "the system of close building, at first confined in its application to the consolidation of the inner zone, has been adopted in the outer, and with the demand for shelter, which increases in a progressive ratio with the growth of the population, the once open suburbs must ere long become indistinguishable in the monotony of house row and pavement. "the art of close building appears a progressive one. in its infancy, twenty years ago, the art has now arrived at a stage nearly approaching perfection. in the earlier examples the space allotted to garden land was larger than that built on. then the size of the two quantities reached an equality--then the covered ground becomes a larger quantity than the uncovered land, until the final stage of development is attained when the extreme limit of encroachment permitted by the building act is reached, and garden land is represented by a yard superficial feet in area." extraordinary loopholes in the sanitary laws, moreover, were constantly being discovered which almost neutralised the original enactment. thus the medical officer of health for camberwell remarked in his report for :-- "it has been long known to the sanitary committee that there has never been any efficient supervision of the drainage and other sanitary arrangements of houses in course of construction.... it is true that every builder has been required before constructing his private drains and connecting them with the public sewers, to send in a plan of his proposed drainage for the sanction of the surveyor. but there has been no machinery by which builders could be compelled to carry out their private works in accordance with the plans submitted, and to ensure that the details of their works had been carried out in a workmanlike or efficient manner. the inspections of houses even recently built have shown that sanitary nuisances complained of have been largely due to scandalous neglect of duty on the part of those concerned in carrying out the drainage works, and that in most cases the plans sent in have not accorded with the arrangements finally adopted." various, indeed, were matters connected with the public health which unexpectedly came cropping up; sometimes matters thought to have been disposed of but only partly so, sometimes, wholly new origins and ramifications of insanitation. thus in the medical officer of health for the south part of poplar district drew special attention to a grievance long previously complained of and for many years endured. "a greater scandal cannot well be shown in matters vital to health than that in spite of abundant evidence of the magnitude of the evil, thousands and tens of thousands of families living in houses, the rates of which are payable by the landlords, may at any moment, without a particle of fault of their own, be suddenly denied one of the first necessaries of life--water--through the neglect and wilfulness of others." the main remedy open to the water companies to recover rates from defaulting non-resident owners of tenement-houses was the simple expedient of discontinuing the supply of water. this course was open to a double objection--first, tenants who had paid their rent were deprived of that for which they had constructively paid; and secondly, a tenement-house deprived of water might speedily become a focus of disease. "that disease and death are directly traceable to this want," wrote the medical officer of health, "no one acquainted with sanitary work in london can doubt. take this instance. water cut off, drains stopped, opening up of ground and drains, removal of filth accumulations, horrid stench, diphtheria, death. "in hanbury place--having six houses--there was no water supply for twenty-six days, and families numbering each seven, nine, two of six, and others had to exist in may, , with choked drains, yard flooded with sewage, and no water--and all because of non-payment of rates by the landlord." in parliament happily dealt with this evil, and by an act passed in that year-- "water companies were prohibited from cutting off the water supply from any dwelling-house for non-payment of water rate, if such rate were payable by the owner and not the occupier of the premises...." in the middle of this decade, too, anxiety revived, owing to the state of the thames, a matter which it was hoped had been finally disposed of. the discharge of sewage at the new outfalls make the river in those parts much what it had previously been in london. a royal commission was appointed to inquire into the subject. they reported that they found a condition of things which they "must denounce as a disgrace to the metropolis and to civilisation." they said that in "the sewage water from the outfalls manifestly reached london bridge." "at greenwich pier the water was very black, and the smell exceedingly strong." "at woolwich the river for its whole width was black, putrid, sewage--looking as if unmixed and unalloyed. the stench was intolerable." "we are of opinion that it is neither necessary nor justifiable to discharge the sewage of the metropolis in its crude state into any part of the thames." this evil was surmounted by the adoption by the metropolitan board of works of a system of treatment of the crude sewage. chemical precipitation was effected by adding to the sewage certain proportions of lime and protosulphate of iron, and allowing it to remain for an hour or two in settling tanks. the effluent water was let flow into the river, and the sludge was carried down the river in barges and cast into the sea. the public interest evoked by the inquiries made by the royal commissioners on housing, and the publication of their report, certainly quickened the activity of many of the local authorities. in several of the parishes and districts the regulations under the sanitary acts of and were being more readily adopted, and being put into force on a slightly more extended scale; and in every case it was reported that the results had been satisfactory, a great improvement taking place in the houses which were registered. a report of the inspector of such houses, for bermondsey, describes this well:-- " were placed on register by vestry. the majority of these houses are situated in the lowest and most densely populated parts of the parish. they are occupied by the very poor, costermongers, dock and waterside labourers, &c. they contain rooms, occupied by families, numbering , persons. rooms were overcrowded. with three exceptions the overcrowding has been abated. previous to registration the number in each house was , present average ." "the sanitary condition of the said houses has been greatly improved. staircases, &c., are now regularly swept and washed. in houses the walls have been stripped and whitewashed. many of the walls had layers of paper, thus hiding filth and harbouring vermin. ventilation in them is also improved. many owners rendered much assistance." several inquiries of the sort suggested by the royal commissioners were held in the course of the ensuing years and reports presented to parliament, but it is much to be doubted whether they had any effect in so inciting public opinion as to make it insist on the recalcitrant local authorities carrying the laws into effect. clerkenwell, mile-end-old-town, bethnal green, and rotherhithe, were inquired into, and reported on. the tale was much the same as that set forth time after time, and year after year, by various medical officers of health--want of adequate sanitary supervision, numerous neglects by the vestries, especially the neglect to make, or, if made, to enforce regulations under the sanitary acts of and . the initiative of dealing with the existing condition of things rested with the vestries. it was forcibly pointed out that complaints could hardly be expected either from the owners of insanitary houses, on whom the cost of the improvements would fall, or from tenants who are too often indifferent to considerations of health and cleanliness, and who in any case would fear to offend their landlords by complaining. rotherhithe came in for the strongest condemnation. of it the commissioners reported:-- "it is, in fact, no exaggeration to say that the results of lax administration abound in rotherhithe, and especially in houses occupied by poor persons." the increase of the sanitary staff was recommended, but the obdurate vestry resolved not to increase it. the absolute necessity of inspection was demonstrated every day of the year to every vestry and district board in the metropolis by the results of such exceedingly limited inspection as was carried out. in st. luke, in , of , houses inspected were found "in fair sanitary condition." in hackney, in , , were inspected; , of them were found to be wanting in some sanitary requirement, or were so dirty as to necessitate orders being served for whitewashing and cleaning. in one street houses were inspected, and in nuisances were found. in st. marylebone, in , , orders were sent out for repairs and various sanitary improvements. in hammersmith, , notices to abate nuisances were served in . in westminster, , notices served for sanitary defects. the medical officer of health for st. saviour, southwark, reported ( - ):-- "the importance of house-to-house inspection may be estimated by the fact that of houses inspected, it was found necessary in nearly every instance to serve notice for the carrying out of urgent sanitary requirements." in camberwell there were, in , between , and , houses in the parish, "of which probably one-half should be inspected periodically." the medical officer of health of bethnal green stated:-- "in my district we have a population of about , , and about , houses, and we have two inspectors. of course there should be periodical inspection, that is to say, every house in the parish should be visited at least once a year by a sanitary inspector, but that with the present staff would be utterly impossible. in my district there is no house-to-house visitation; we simply attend to complaints as we receive them, and this completely fills up the time of the two inspectors." and he further stated[ ]:-- "in my district the sanitary inspectors are not under the control of the medical officer of health." it is of course manifest that if houses had not been inspected, and the necessary sanitary improvements enforced, things would have gone on rapidly deteriorating, and with that deterioration would have come all those causes of disease which would endanger the lives of the occupants and create fresh centres for spreading disease broadcast. it might have been thought that the numerous inquiries into the condition of the working classes in factories and workshops would have laid bare nearly all there was to lay bare. a report to the board of trade on the sweating system in the east end of london, by j. burnett in , rudely dispelled such an idea, and opened out to public view a new vista of causes, deleteriously affecting the public health, a new area of insanitation. though the evils depicted had become acuter, they evidently had been going on for years. "the system may be defined as one under which sub-contractors undertake to do work in their own houses or small workshops, and employ others to do it, making a profit for themselves by the difference between the contract prices and the wages they pay their assistants. "the mass of those employed under the sweating system labour in workshops where much fewer than are engaged, or in the houses which may be single rooms of the 'small sweaters.'" after referring to the numerous branches of the tailoring trade, he said:-- "immense numbers of people of both sexes and all ages have rushed into the cheap tailoring trade as the readiest means of finding employment. the result has been an enormously overcrowded labour market, and a consequently fierce competition among the workers themselves, with all the attendant evils of such a state of things.... matters have been rendered infinitely worse by an enormous influx of pauper foreigners from other european nations. the result has been to flood the labour market of the east end of london with cheap labour to such an extent as to reduce thousands of native workers to the verge of destitution...." "there are, of course, in addition many english workers employed in the same trade and in the same shops, but their number is gradually being reduced, owing to the severity of a competition in which those who can subsist on least are sure to be victorious. "the object of the sweater being his own gain, the inevitable tendency of such a system is to grind the workers down to the lowest possible level.... "the character of the workshops, or places used as workshops, varies considerably. the smaller sweaters use part of their dwelling accommodation, and in the vast majority of cases work is carried on under conditions in the highest degree filthy and unsanitary." "in small rooms, not more than nine or ten feet square, heated by a coke fire for the pressers' irons, and at night lighted by flaring gas jets, six, eight, ten, or even a dozen workers may be crowded. "the conditions of the public health acts, and of the factory and workshop regulation acts, are utterly disregarded, and existing systems of inspection are entirely inadequate to enforce their provisions even if no divided authority tended to weaken the hands of the inspectors. "some of the shops are hidden in garrets and back rooms of the worst kinds of east end tenements, and a third of them cannot be known to the factory inspectors. "it is in regulating the hours of the women that factory inspection should be of most service, but how can two or three inspectors keep in check the multitude of sweating dens of east london? basements, garrets, backyards, wash-houses, and all sorts of unlooked for and unsuspected places are the abodes of the sweater." early in the following year lord dunraven, in the house of lords, moved for the appointment of a select committee to inquire into the sweating system. "the evils which existed there were caused by natural laws which were not by any means of necessity unwholesome in any degree.... but his belief was that though the causes were perfectly natural in themselves they had been allowed to run riot, and had not been put under proper control, and had thus produced the present terrible state of things.... "large workshops were the exception. in the 'dens' of the sweaters there was not the slightest attempt at decency; men and women worked together for many consecutive hours, penned up in small rooms and basements, garrets, backyards, wash-houses, and all sorts of unlikely places, were the abodes of the sweaters." and he quoted the chief inspector of factories and workshops:-- "to add to the evils of overwork pursued by these people, we must note the overcrowded, ill-ventilated, and excessively hot state of the workrooms; ... it is surprising how such people can live under such conditions. "... it was," he said, "a ridiculous and scandalous thing that parliament should pass factory and sanitary acts regulating the hours of labour of women and children, and that those acts should be grossly violated." lord sandhurst said:-- "it might appear to their lordships almost incredible that within three or four miles of that house a state of things, involving so much human misery, could possibly exist as was to be found at the east end of london." the select committee was appointed. the results of its inquiries are stated in the next chapter. in the local government of london underwent a most notable change. in the early part of various rumours gained currency as to questionable dealings in connection with the lettings of land owned by the metropolitan board. certain officials of the board were mentioned. the details do not fall within the history of the sanitary evolution of london, except so far as they affected the central governing authority of london. the allegations made received increasing confirmation, and early in a royal commission was appointed to inquire into and thoroughly sift them, and early in may the commission held its first sitting, the metropolitan board affording every facility for the thorough investigation of the matter. before that time, however--namely, in march--the government had introduced into the house of commons its proposals as regarded the local government of england and wales generally; and the opportunity was taken to deal with the great problem of london government which had so long vexed and perplexed successive governments, and which was becoming more and more insistent as years went on, and london was accordingly included in the general scheme. by the measure now introduced london was to be created--not a corporation, nor a municipality, but a county--with a council as the governing authority of the county. mr. ritchie, introducing the bill into the house of commons, said[ ]:-- "we cannot shut our eyes to the fact that whereas every other borough in the country possesses a body directly representing the ratepayers, no such body exists in london. "there is no one elected by, or responsible to the ratepayers. "we propose to take london, as defined under the metropolis management act, out of the counties of middlesex, surrey, and kent, and we propose to create it a county of london by itself, with a lord lieutenant, a bench of magistrates, and a county council of its own. "we propose that the council shall be directly elected by the ratepayers, as in all other counties and boroughs--that the franchise shall be the same--and that it shall consist, as in all other cases, of elected and selected members; the elected members sitting for three years, the selected for six years (one-half of their number retiring every three years). "it will take over the licensing powers and all the duties of the metropolitan board of works, which will cease to exist." the "city" of london was to be allowed to retain its separate existence within the new county, together with its ancient privileges and immunities for the most part unaltered and untouched. the bill developed into an act, which created a new central authority for london, under the title of the london county council. the area of the new "administrative county" of london was made co-extensive with that of the former district of the metropolitan board of works. and to the new authority was transferred the powers, duties, and liabilities of the metropolitan board of works; and to those were added functions much wider and more extensive than those of that board. the act also conferred upon the council the power of appointing a medical officer of health for the county, and additional powers of making bye-laws. it did not, however, materially interfere with the vestries and district boards, nor did it alter their relation to the central authority. practically it left them untouched. the council was to consist of members, of whom were to be elected triennially by direct election in the various metropolitan constituencies, and to be elected by the council itself as aldermen. finally, the act set a limit to the existence of the metropolitan board of works. while the bill was going through parliament the royal commission had been pursuing its inquiry into the allegations made against that board, and had ascertained that several of the officials had been carrying on-- "... a nefarious course of proceeding by which they had been able to obtain for themselves large sums of money out of dealings with the board's land." and that-- "... two of the members of the board in the architectural profession had availed themselves of their representative position to make personal profit out of some of the business which came before them." under the growing disfavour with which public authorities were regarded who were only indirectly elected, and so not amenable to the influence or control of the electorate, it is improbable that the existence of the metropolitan board of works would have been much prolonged. but it was an unfortunate ending to a great public body which had done really great service to london. its own final words[ ] may be quoted in its defence:-- "it has been a source of pain and sorrow to the board that, at the close of thirty-three years' administration of the local affairs of london, which has been attended with at least some measure of success, and in the course of which the board has carried out some of the greatest works of public utility of which any city can boast, its good name has during the last year of its existence been sullied by iniquitous proceedings of which, though carried on in its midst, its members as a body were entirely without knowledge. it is some satisfaction to remember, however, that a body of commissioners, who in a judicial spirit made the most searching inquiry into the board's proceedings, were able, while exposing the wrong-doings which were revealed to them, and justly distributing the blame, to speak of the board, as they do in their report, in the following terms:-- "'it has had a multitude of duties to perform, and very great works have been constructed by it, which have transformed the face of some of the most important thoroughfares of the metropolis. and there has hitherto been no evidence that corruption or malpractice has affected or marred the greater part of the work which it has accomplished. the same may be said, too, in relation to the conduct of the vast majority of the members of the board. we have received very numerous communications, some anonymous, some bearing the signature of the writers, impugning the action of the board and certain of its members, but against the vast majority of them not even a suspicion of corruption or misconduct has been breathed. we believe that many members of the board have cheerfully given for the public good much valuable time, and have rendered most important public services.'" the change in the constitution, nature, and character of the central authority of london effected by the act was momentous and far-reaching. instead of an indirectly elected body such as the metropolitan board of works, over which the inhabitants of london had practically no control, there was brought into being a body directly chosen by an electorate of nearly half a million of the ratepayers of the metropolis, responsive to the views and desires of the electorate, endowed with the great authority derived from its representative character, and entrusted with the carrying out of the views and policy of london as one great city. london had been unified and welded together into one whole by the constitution of its new central authority; for the first time in his history it had been given a voice--the voice of one great city--and though much remained to be done before its entrance into its full rights as one city--and that the greatest which has ever existed in the world--the idea had been born, and had been embodied in the statutes of the realm that london was one great city, and not a mere conglomeration of petty jarring authorities. the first election of councillors took place on january , . the first meeting of the council took place on the st of march, when the earl of rosebery was elected chairman, and the council entered energetically on the work lying before it. the sanitary evolution of london was vitally involved in the change, but it was at once discovered that the powers of the council relating to the public health of london were of a very limited and unsatisfactory nature. matters concerning it were regulated by the metropolis london management act and a large number of other acts, the execution of which was in the hands of the vestries and district boards. these bodies were practically uncontrolled, and no machinery existed for securing any uniformity of administration in the different parts of the county. and even the metropolitan board had not used certain powers it possessed of making bye-laws for certain sanitary purposes. "we cannot," reported the sanitary committee of the council, "too strongly emphasise our opinion that the london county council should be empowered to frame bye-laws for the proper sanitary government of london, that the new or existing local bodies should put them in force, and that the county council should be the supervising body to see that they are properly carried out." a somewhat similar report was made by the housing of the working classes committee. "the committee," they said, "feels that until the law is strengthened, and fuller powers to enforce the law are placed in the hands of the council, its action in dealing with insanitary areas will be of an imperfect character." the question of the housing of the poor in london was at once energetically taken up by the new body. representations were made to the government as to the necessity of the acts relating to the housing of the working classes being consolidated and amended. consequent upon this, the government introduced a bill which was passed--"the housing of the working classes act, ,"[ ] which repealed and codified fourteen enactments, all having for their object the improvement of the dwellings of the artizan and labouring classes, and the clearing away of unhealthy areas. very large powers were placed in the hands of the council and of the district authorities to secure the better housing of the working classes. and the act may be said to mark a new era in the history of reform in the matter of insanitary areas, giving full power to the council as a central authority to enforce its provisions. before the end of this decade parliament passed two other acts of great advantage to the health of london. one was, "the infectious diseases notification act, ," making the notification of certain specified diseases compulsory in london--smallpox, cholera, diphtheria, membraneous croup, erysipelas, scarlet fever, typhus, and other fevers. in accordance with well-worn usage london had been left behind in this matter. other cities and even towns had, by means of local acts, secured the advantages of such legislation long before. so far back as , indeed, machinery had been in existence in london for the notification of infectious disease in houses let in lodgings. but owing to the neglect of the majority of the vestries and district boards to make or enforce regulations under the sanitary act of , that machinery was left unused to the great detriment of the people of london. thousands of lives must have been sacrificed by this neglect, and innumerable cases of preventable disease not prevented. it was not until a general act was passed that london became possessed of the advantages resulting from such notification. in london, indeed, the health of cattle was better looked after in this respect than that of the people, for cases of infectious disease in cattle had to be notified to the sanitary authorities. by this act it was made compulsory on medical attendants to certify, and on householders to notify, the existence of any of these diseases. hitherto information as to infectious illness only reached the medical officer of health after a sufficient time had elapsed to allow of the spread of the infection. the results of the act of were soon found to be very beneficial in checking the spread of disease. the receipt of the notices of infectious diseases led to the more prompt and general disinfection of premises where infectious diseases prevailed, and led also to the discovery of sanitary defects which might not otherwise have been discovered. the information, moreover, kept the medical officers of health informed of the progress of disease not only in their own districts, but also in contiguous ones, and so assisted them to take prompt measures for the eradication of disease in their respective districts. the other measure which passed the legislature in this same year contained provisions of the highest importance as affecting the metropolis. this was "the poor law act, ." until patients could be admitted only to the infectious hospitals of the metropolitan asylums board on the order of the relieving officer and district medical officer, so, except in certain cases, the hospitals were only open to poor law cases. this measure made practical concession of two principles. free admission to the hospitals of the metropolitan asylums board of sick persons in need of isolation, and devolution upon the metropolitan poor fund of all charges incurred in the maintenance of the sick in those hospitals. the managers were, therefore, enabled to admit other than pauper patients reasonably believed to be suffering from fever, smallpox, or diphtheria. the system was attended with the happiest results in reducing the amount of infectious disease in the metropolis, and proved a great boon to all classes of the community. the board in its annual report wrote:-- "the managers are now, for the first time since the establishment of the board in , virtually recognised as the metropolitan authority for the provision of accommodation for the isolation and treatment of infectious disease--both pauper and non-pauper--and are now empowered to legally perform duties which the legislature had imposed on the district sanitary authorities, but which the managers had hitherto been called upon to perform in consequence of the failure of most of such authorities to provide accommodation for non-pauper patients." the managers by this date had increased the accommodation for patients afflicted with any of these infectious diseases. there were six fever hospitals, , beds; beds in smallpox hospital ships; and beds in the hospital for convalescing smallpox patients. one other act[ ] deserves mention before the close of this decade as it contained an unique section which required the medical officer of health, on notice from the owner of property in which there are separate dwellings let for s. d. or less a week, to visit them and examine all their sanitary arrangements, &c., so as to be able to certify or not-- "that the house is so constructed as to afford suitable accommodation for each of the families or persons inhabiting it, and that due provision is made for their sanitary requirements." the certificate, if granted, was to be handed to the owner, who was then able to obtain the remission of the inhabited house duty. the owner, therefore, obtained a remission of taxes to which he was justly liable, because the dwelling which he lets was in a sanitary condition! in many ways, then, the sanitary evolution of the great city was developing satisfactorily, though by no means so rapidly as was to be desired, or as it might have developed if local governing authorities had done their duty. "the war of the community against individuals for the public good," which had now lasted for over thirty years, and the war against disease in its most dangerous forms, was being waged with good effect; and though an immensity remained to be done, a great deal had been accomplished. larger numbers of all classes were beginning to grasp the idea and to realise that the necessity of securing and guarding the public health was not a craze or form of mental aberration, but was of absolutely vital consequence, not merely to certain classes but to the great community of the metropolis and to the nation itself, and that the future welfare and power, even the very existence, of the nation are dependent upon it. larger numbers, too, were beginning to see who really were responsible for the widely prevalent evils, and who really were obstructing progress towards a higher standard of public health, and how little claim they had to consideration, either from the hands of the legislature or of local administrators. the reports of the medical officers of health of the latter part of this decade were distinctly more hopeful in tone, and recorded more progress than ever before. the catalogue of things in which improvement had taken place had lengthened--sewerage, water supply, the removal of refuse, paving, the regulation of offensive businesses, of cowhouses, dairies, and bakehouses, the provision of open spaces, the better disinfection of houses and of infected articles, the erection of hospitals for the isolation of cases of infectious diseases--all of which things were elemental necessaries if the public health was to be assured. in some parishes, in place of the smaller class of houses, great blocks of artizans' dwellings had been erected. in others great blocks of flats. with the increased wealth of the population finer buildings had been erected in many districts. london had grown enormously in wealth, and the wealth showed itself in finer public buildings and private houses. the district board of westminster, for instance, said in their report for - :-- "whether viewed as to its character, its statistics, its topography, or its sanitary condition, the change which westminster has undergone in thirty years can only be described as a complete transformation." "in the st. margaret's portion, whole streets of fine houses which were occupied by the nobility and the wealthy for residential purposes are now let out in offices for the transaction of legal, scientific, or mechanical business, while narrow streets, wretched courts, and melancholy homes of squalid poverty and misery have been replaced by 'mansions,' 'flats,' &c.; and on the other hand by huge blocks of artizans' dwellings, comprising upwards of , homes." the education act was indirectly producing some good results as regarded the health of the rising generation. a most marked improvement had come over the mortality of children at school ages. mortality has lessened-- - years per cent. - " " - " "[ ] due to the fact that children had been gathered into the schools from their crowded and insanitary homes, and had thus escaped some of the perils of disease. and the medical officer of health for lambeth referred to this same subject in his report for :-- "the children of the pauper and mendicant are withdrawn from the atmosphere of vice and intemperance to which their fathers had become acclimatised, and are placed under supervision in the schoolroom...." some slight improvement there was also as regarded the mortality of children under five years, though in many parishes it was still fearfully high. in mile-end-old-town, for instance, in the deaths under five years amounted to per cent. of all deaths. in deptford district in - they amounted to per cent. in bermondsey in they amounted to per cent. in st. olave, southwark, in - to - / per cent. in st. mary, newington, in , very slightly under per cent. infantile mortality was becoming of greater concern than ever as the birth-rate was showing a decided diminution--that for being the lowest on record since . though the tables as to death-rate in many of the parishes were still more or less vitiated by various local circumstances, there was considerable unanimity that the death-rate was falling and the public health better. some diseases which had previously claimed their victims by thousands, now only claimed them by hundreds. death from tubercular disease had steadily fallen, and the mean death-rate from phthisis in london showed a very satisfactory decrease between - and - .[ ] the _lancet_ of january, , stated that, measured by its recorded death-rate, london was healthier in than in any year on record. in the strand in :-- "the efforts that have been made by the board and its officers have resulted in a marked and continuous improvement in the sanitary state of the district." in st. pancras in the death-rate was "by far the lowest yet recorded." in bermondsey, in the same year, "so few deaths have not occurred since ." these and similar reports from other districts showed that sanitary progress was being made. but, unfortunately, in the autumn of there was an epidemic of measles of exceptional severity, which raised the death-rate. and in there was a sudden increase from · per , to · , a mortality which was higher than any since . the increase served to show the great necessity there was for unceasing watchfulness and for steady perseverance in sanitary work. the forces of disease are ever on the watch for the opportunity to work their evil will, and there were still many weak places in the defences against them. the central government of london had been improved enormously, but the corrective was not extended to where it was most wanted, namely, the local sanitary authorities, the vestries and district boards. footnotes: [ ] to the then existing population of london. the south eastern counties contributed close on , " south midland " " " " , " eastern " " " " , " south western " " " " , " west midland " " " " , [ ] the report was made in , but was as true in as it was in . [ ] see report of select committee, , p. v. [ ] _times_, th november, . [ ] see his speech in parliament, hansard, , vol. ccxc., p. . [ ] robert reid (a surveyor), p. . [ ] the regulations suggested by the local government board laid down that the landlord or owner should not allow a greater number of persons to occupy a room than would admit of free air space for each of cubic feet--if used exclusively as a sleeping room--or feet if used day and night. he was to-- ( ) keep the drainage in good working order, to properly pave the yard, and provide sufficient sanitary accommodation. ( ) keep the cisterns clean and in proper order, and keep the structure of ashpit in proper order. ( ) cause the ceilings and walls of every room to be whitewashed and papered every april. ( ) provide all requisite means for the ventilation of every room, and of the common passages and staircases thereof. ( ) to notify cases of infectious disease. [ ] royal commission, . [ ] hansard, . [ ] royal commission, vol. ii. p. . [ ] ibid. p. . [ ] hansard, , vol. cclxxxix. p. . [ ] hansard, , vol. ccxc. p. . [ ] see report of royal commission on the amalgamation of the city and county of london, . [ ] hansard, , vol. cclxxxiv. [ ] by the diseases prevention (metropolis) act, , and vic. cap. . [ ] the total net expenditure was £ , in . [ ] hansard, vol. ccxxix. p. . [ ] lords' committee on sweating, p.p. , vol. . [ ] hansard, p. , march , . [ ] see the last report of the board. [ ] & vic., cap. . [ ] the customs and inland revenue act, , & vic. cap. . [ ] see speech by sir l. playfair in house of commons, march , .--hansard, p. . [ ] see report from royal commission on tuberculosis, . chapter vi - in the census once more gave authoritative figures as to the population of the metropolis of london. the population had increased from , , to , , . the increase had been in a somewhat lower ratio than the population of england and wales as a whole, and the fact was notable inasmuch as it was the first time that such a phenomenon had presented itself, london having been found in every preceding intercensal period to have gained more or less in its proportions as compared with the country at large. the movements of population had followed very much the same lines as in the previous decade. in the central parts--under the pressure of the great economic forces--the population had increased. in the outer parts it had increased, but "the wide belt of suburbs was beginning to show some signs of repletion." immigration into london had greatly diminished in the decade. fewer immigrants had come from the various counties of england and wales, and the proportion of the inhabitants of london who had been born elsewhere had fallen from persons per , in to in . thus the influx of country people, mostly in the prime of life, and the admixture of fresh country blood into the urban population of london was undergoing diminution--a circumstance which, in the long run, would materially influence the physique of the people. three important facts came into view with the figures set out in the census, giving food for thoughtful minds as regarded the future of london. the first was that the rate of increase of the population had again slackened off. the flood tide of population was not now flowing so fast. the second was that the population was being affected by migration. the natural increase of the population had been , , the actual increase , --so that london had lost by the excess of emigration over immigration more than , persons. this was the first time such an event had happened. london's boundaries, however, were very arbitrary and haphazard, and this emigration was probably only to places immediately outside london for residence at night, whilst work was performed in london during the day--as illustrated by the "city" and the strand, where huge differences existed between the day and night populations. the figures showed, however, a movement of population which was bound to have an effect upon the sanitary condition of the people. a third and portentous fact, ascertained correctly by aid of the census figures, was the decline of the birth-rate in london. this had fallen remarkably since . it was then · per , living. it was now · . deducible from the census figures, reliable calculations could also be made as to the death-rate in the metropolis. in it was practically the same as in , being · per , . it might be inferred that these latter figures did not afford much testimony to the effects of sanitary administration and labours, but the pause in the steady decline was only a temporary one. the authoritative and accurate records thus afforded decennially by the census are invaluable in tracing some of the most important developments in the sanitary evolution of london. another very noteworthy change was also brought into prominence by the census. this was the continued rapid growth of the population immediately outside the boundaries of the county of london. between and it had increased , . between and it had increased by , , and now in it stood at , , , having more than doubled since . a passage in the report of the medical officer of health for islington in illustrates this so far as his own district was concerned:-- "the fact cannot be burked that many of the better classes have gone further into the country to live, induced to do so by the increased facilities for travelling that railways have provided.... the same facilities have also checked the influx of people to the same extent as formerly, so that now in northern london people are flocking to hornsea and hampstead and thereaway." the fact was that the metropolis had burst its boundaries, and just as it had grown up around the "city" so now the "outer ring," as it was called, was growing up around it. how little reliance could be placed on the intercensal estimates of medical officers of health as to the number of inhabitants and the death-rate, is illustrated by the following passage from the report of the medical officer of health for islington in :-- "there was an error amounting to nearly , in the estimated population of the parish in ; consequently all statistics based on the estimated figures during the decade - are more or less erroneous." also "the mortality returns were not kept in such a manner as to lead to accuracy, for while all deaths of non-residents were excluded, the deaths of residents dying outside the district in similar institutions were not included. "it is impossible to make an accurate statement as to the correct meaning of the mortality returns--the returns are erroneous." a similar miscalculation was made by the vestry of st. george, hanover square. in their report for - they stated that they had no reason to believe that the population was much different from what it was in and . the census, however, showed that it had fallen over , . in each successive census the number of inhabited houses in london was enumerated. in this one the number was , --being an increase of nearly , ; but not much instruction was to be obtained from such general figures beyond the fact that houses were becoming more and more densely packed. the substitution of blocks of dwellings for small houses had also made considerable progress during the intercensal period.[ ] the same reasons as to the diminution of the number of houses in the central parts of london continued to be given by medical officers of health. in st. george-in-the-east it had been brought about "by the extension of warehouses and the demolition of insanitary property." in st. martin-in-the-fields it was "due to many former residents having removed to the country, and to the demolition of so many houses for improvements." in the strand to the fact that the district was becoming like all the central parts of london, "a business, as distinguished from a residential district." the vestry of st. james' reported that "buildings formerly occupied as dwellings were being replaced by warehouses and business premises commanding a higher rent. as the centre of trade extends, this condition of things must be expected to continue, just as the increasing volume of trade has converted the city of london at night from a populous place to little more than a city of caretakers," and they drew attention to the "enormous number of people engaged in business in the parish during the day time who resided elsewhere." on the south side of the river the same story was told. the medical officer of health for lambeth remarking in his report that-- "the displacement of population from the central districts of lambeth, and the settlement of population in those districts which are situated in the outer ring, or on the circumference of the inner, is a part of a greater movement which affects the whole metropolitan area." the census of is specially memorable by the fact that for the first time a mass of most valuable information was obtained which was wholly new, and which threw a blaze of light upon the condition of the housing of the population of london. for the first time full details were obtained and published as to the numbers of the people living in tenements of less than five rooms and the numbers and character of the tenements they lived in. a tenement was defined as "any house or part of a house separately occupied either by the owner or by a tenant." these tenements were classified into those of one room, two rooms, three rooms, and four rooms; and the number of persons inhabiting each of these classes of tenements was given. the nearest approach to information of this sort had been given by mr. marchant williams in , but it was only for a particular area in london. the information now given related to the whole of london. the total number of tenements in london in was stated to be , . of these, , were tenements of less than five rooms. and of these-- , were tenements of one room. , " " two rooms. , " " three " , " " four " an examination of the detailed figures revealed some astounding facts. in the central group of parishes and districts, in the parish of st. luke , persons, or over one-half of the population, lived in tenements of one or two rooms; in clerkenwell, over , persons; and in holborn, over , --practically one-half. in the eastern group, in whitechapel, close on , people, or over per cent., lived in tenements of one or two rooms. in shoreditch, over , , or per cent.; in bethnal green, , persons, or · per cent.; in st. george-in-the-east, per cent. of the population. in the northern group, in st. pancras , , or over per cent., lived in tenements of one or two rooms; and in one district of the parish, namely somerstown, per cent. of the population were living in such tenements. in st. marylebone over , lived in such tenements. in the western group over , persons lived in tenements of one or two rooms. and on the south side of the thames, in bermondsey close upon , lived in tenements of one or two rooms; in camberwell, , ; in lambeth, , ; in newington, , ; in st. saviour over per cent., and in st. george-the-martyr , , or over per cent. and examining the numbers of persons living in one-room tenements, it appeared that in chelsea one-tenth of the population lived in such tenements; in st. marylebone somewhat less than a sixth; in holborn a fifth; and in st. george-in-the-east between a fourth and a fifth. these figures show how large a proportion of the population began, spent, and ended their existence within the four walls of a single-room tenement. the total result shown was that in the metropolis , , persons, or one quarter of the population, lived in one- or two-room tenements, and , , in three- or four-room tenements; making a total of over , , , or well over half of the population living in tenements of less than five rooms. of still deeper interest and import was the information obtained as to that dreadful factor in london life--"overcrowding." an effort was now for the first time made to get reliable information upon this matter. hitherto it was only by piecing together the statements made by some of the medical officers of health as to overcrowding in their respective parishes that one could form even the crudest idea of what the sum total in london actually amounted to. here, at last, was material enabling accurate calculations to be made, not only of overcrowding in each separate parish or district, but in london as a whole. the census commissioners laid down the principle-- "that ordinary tenements which have more than two occupants per room, bedrooms and sitting-rooms included, may be considered as unduly overcrowded. "we may," they wrote, "be tolerably certain that the rooms in tenements with less than five rooms will not in any but exceptional cases be of large size, and that ordinary tenements which have more than two occupants per room, bedrooms and sitting-rooms included, may safely be considered as unduly overcrowded." by using the information given in the tables, and excluding all one-roomed tenements with not more than two occupants, all two-roomed tenements with not more than four occupants, all three-roomed tenements with not more than six, and all four-roomed tenements with not more than eight occupants, the desired information would be obtained. and they added:-- "each sanitary authority is now provided with the means of examining with much precision into the house accommodation of its district." provided with the tables as to the occupants of tenements, the medical officer of health for the london county council, in his report for , worked out the figures for the metropolis. the result showed that there were in london , tenements of less than five rooms apiece, in each of which there were more than two inhabitants per room, and each of which consequently was "overcrowded." but it is when one ascertains the number of persons living in these overcrowded tenements that one realises what the extent of overcrowding was. in round numbers, one-fifth of the entire population of london lived in these tenements. the total population was , , ; the number of "overcrowded" persons was , . a few illustrations of the overcrowding in certain parishes brings the meaning of these figures home still more. in clerkenwell, , persons lived in overcrowded tenements; in st. luke, , persons; in shoreditch, , ; in islington, , ; in kensington, , ; in lambeth, , . the larger proportion of these lived in one- or two-room tenements. figures are dry things to read and difficult to understand. to appreciate the true meaning and import of these, and to enable one who reads them to at all realise the conditions of existence of these hundreds of thousands of people, one must recall to mind the descriptions given by many of the medical officers of health of tenement-houses; of all the misery, the filth, the sickness, the physical and moral degradation of life in tenement-rooms. these facts now for the first time revealed the full magnitude and momentous nature of the problem of the sanitary housing of the people. the year is memorable in the history of the sanitary evolution of london for "the public health (london) act, ,"[ ] which consolidated and amended the laws then existing in connection with the public health of the metropolis. the state of the law was recognised as very unsatisfactory, being scattered over some thirty statutes or more--a condition of things which was greatly to the disadvantage of the public health of london. moreover, in accordance with the extraordinary custom, london, which on account of its huge population needed sanitary legislation almost more than any other place, had been excepted from much sanitary legislation which had been in operation for many years, with the most beneficial results, in the remainder of the country. part of this legislation was at long last extended to london. many amendments were made, recommendations of the royal commission of were given effect to, new provisions introduced, and the general result was a sanitary code for london--imperfect still in some important respects, but a great advance on anything which london had previously possessed. the act came into operation on the st of january, , and it applied to the administrative county of london only; some few of the provisions extending to the "city." and for the first time the new central authority--the county council--with extended powers, occupied a prominent place in this legislation. once more did parliament enact the oft-ignored direction that "it shall be the duty of every sanitary authority to cause to be made from time to time inspection of their district" for detection of nuisances--a duty so shamelessly neglected--and "to put in force the powers vested in them relating to public health and local government so as to secure the proper sanitary condition of all premises in their district." with a view to secure fit and proper persons as medical officers of health and sanitary inspectors, their appointment was made subject to the regulations of the local government board. the act greatly strengthened the law both as to the prevention and definition of nuisances. it provided for the immediate abatement of a nuisance, not only where actually proved to be injurious or prejudicial to health, but also where it was dangerous to health. it gave to any person the right to give information of nuisances to the sanitary authority instead of that right being limited to the person affected by the nuisance; and it extended to a sanitary authority the power to take proceedings for the abatement of nuisances arising in the district of another authority should the nuisance injuriously affect the inhabitants of their own district. it transferred from the police to the local authority the enforcement of the provisions of the law against smoke nuisances. it dealt with the removal of refuse. it extended the previous laws as to the adulteration of food and drugs, and the inspection of articles intended for the food of man. it enacted that a newly-erected dwelling-house must not be occupied until a certificate had been obtained of the sanitary authority to the effect that a proper and sufficient supply of water exists; and made the provisions as to the occupation of underground rooms as dwellings more stringent and effective. the notification and prevention of the infectious and epidemic diseases, the provision of hospitals, ambulances, and many other branches of the great subject--the health of the public--were legislated upon. additional duties were imposed on the sanitary authority in the matter of disinfection; the practical result of which was that the whole cost of disinfecting houses, and cleansing and disinfecting bedding, clothing, &c., was thrown upon the rates. in several matters the option given in previous legislation to local authorities to administer the law was taken away, and the duty made imperative. parliament evidently had realised the hostility of many of the vestries to administering some of the principal provisions of sanitary law, and the word "shall" figured much more frequently than ever before. the hitherto optional provision of mortuaries by the sanitary authorities was made compulsory, the need for suitable and convenient places for the reception of the dead during the time that bodies are awaiting burial having long been felt, particularly in the poorer districts, where bodies awaiting burial were of necessity frequently kept in living rooms under conditions dangerous to health, especially where the case was an infectious one. among these "shalls" was that most important of all health subjects--overcrowding--and the condition of the tenement-houses of london. in this matter the local authorities had through a quarter of a century been tried in the balance and found wanting, and it was enacted (sec. ):-- "every sanitary authority _shall_ make and enforce such bye-laws as are requisite for the following matters (that is to say): (_a_) for fixing the number of persons who may inhabit a house, or part of a house, which is let in lodgings; (_b_) for the registration of houses so let or occupied; (_c_) for the inspection of such houses; ... (_d_) for enforcing drainage for such houses, and for promoting cleanliness and ventilation in such houses; (_e_) for the cleansing and lime-washing at stated times of the premises; (_f_) for the taking of precautions in case of any infectious disease." in another matter, which the vestries had long opposed, their hostility was overborne. they were now required to appoint "an adequate number of fit and proper persons as sanitary inspectors," and, in case of their failure to do so, the local government board was enabled, on the complaint of the council, to order the appointment of a proper number. the new central authority, directly representative of the whole of london, was not constituted the chief sanitary authority for london, nor even a sanitary authority. it was given power to make bye-laws for the prevention of nuisances of various sorts in london, except as regarded the "city," to license cow-houses, and slaughter-houses, to appoint inspectors to inspect them, and also dairies and milkshops, and it could extend the number of infectious diseases to be notified. but most important of all was the power given to the county council (by section ), which enacted, on it being proved to the satisfaction of the council, that any sanitary authority (except the commissioners of sewers of the city) had made default in doing their duty under this act with respect to the removal of any nuisance, the institution of any proceedings, or the enforcement of any bye-laws, the council might institute any proceedings and do any act which the authority might have instituted and done, such authority being made liable to pay the council's expenses in so doing. and, furthermore, section provided that "when complaint is made by the council to the local government board that a sanitary authority have made default in executing and enforcing any provision which it is their duty to execute or enforce under the act, or of any bye-law made in pursuance thereof, the local government board, if satisfied after due inquiry that the sanitary authority have been guilty of the alleged default, and that the complaint cannot be remedied under the other provisions of this act, shall make an order limiting the time for the performance of the duty of such authority in the matter of such complaint. if such duty is not performed by the time limited in the order, the order may be enforced by writ of mandamus, or the local government board may appoint the council to perform such duty," and the expenses were to be paid by the sanitary authority in default. "it seems to me right and proper," said mr. ritchie in introducing the bill, "that in regard to the great question of public health in london the county council ought to be charged with the performance of duty, which in the opinion of the local government board after inquiry, has not been adequately and properly performed by the local authority." these sections were strongly opposed by some of the prominent vestries, being held to be "degrading and destructive of local self-government by completely subordinating the local to the central authority." the self-government which many people like is the being able to do exactly as they themselves like, regardless of everybody else's likes and rights. and it is the same with many local government authorities. their idea of self-government too often is to govern for their own objects, and their own interests, regardless of the infinitely greater interests and rights of the great community around them; and when it is brought home to them that they are only a small integral part of a great community, that their sphere of self-government can only be a very limited one, and that they cannot be allowed either by action or neglect to injure the community, they resent it with no little outcry. the principle of self-government, however, was not one to which appeal could be made, for it had been dragged through the mire by too many of the local authorities. once the unity of london assumed definite shapes, as it did in the new central authority representing the whole of london, vestry self-government, except upon certain lines and within certain limitations, was doomed; for it would have to make way for a far larger system of self-government--the self-government of london by londoners. moreover, prolonged experience had proved that the vestries could not be relied on to enforce the laws, and it was manifest that some effective provision must be devised for preventing them perpetually thwarting the intentions and defeating the imperative enactments of parliament designed for the welfare of the community at large. it was unfortunate, however, for the sanitary welfare of great masses of the people of london that the principle thus recognised and adopted by parliament was not given fuller effect to than it was, for it is the only principle upon which any really sound system of public health administration for london can be based. a few years later the principle was reaffirmed by parliament. during the summer of the appearance of cholera on the west coast of europe--particularly hamburg--exposed london to the importation of cases of this disease. the unsatisfactory position of the council with regard to london administration for the prevention of epidemic disease was at once made evident. in order to remove doubts as to the council's responsibilities as to the administration of the law relating to epidemic diseases, a provision defining the council's position was included in the council's general powers bill, which was passed by parliament in . this provision was to the following effect:-- "the local government board may assign to the council any powers and duties under the epidemic regulations made in pursuance of section of the public health act, , which they may deem it desirable should be exercised and performed by the council. "if the local government board are of opinion that any sanitary authority in whose default the council has power to proceed and act under the public health (london) act, , is making or is likely to make default in the execution of the said regulations, they may by order assign to the council, for such time as may be specified in the order, such powers and duties of the sanitary authority under the regulations as they may think fit." parliament thus once more emphasised the policy of the local sanitary authorities being subordinated to the central authority. the new central authority--representative of the people of london--gave early evidence of vitality and energy. the heir had come into his property, with high ideals as to its government, and as to the welfare of the people. a new power had suddenly been brought into london life--an unknown but vigorous force. a capable staff was at once organised, and a medical officer and assistant medical officer of health appointed. inquiries and investigations into the various matters most concerning the welfare of the citizens of london were at once undertaken, and conclusions arrived at, and action taken, with a thoroughness and a rapidity hitherto unknown in the administration of london affairs. bye-laws were made to regulate and unify the administration of sanitary laws by local authorities. several of the water companies were induced to give a constant supply of water to an increased extent. and great efforts were made to utilise the powers conferred upon the council by the recently passed acts--the housing of the working classes act of , and the public health (london) act of . it was at once felt that the problem which first faced the council was the housing of the people, and the council determined to attack it on every side. in the belief that facilities of communication between the working centres of london and residences in healthier localities would help considerably to alleviate some of the worst effects of overcrowding, and towards the successful treatment of the great housing problem, action was taken to turn the cheap trains act of to greater account, and to secure greater numbers of workmen's trains and more moderate fares; so as to enable workmen to travel cheaply between more distant homes and their places of employment. that act, which gave a large remission in the amount of passenger duty paid by railway companies, if the companies would provide a service of workmen's trains, and would convey workmen at less than the usual fares, had so far not been made much use of. on investigation it was found that the facilities afforded to workmen, particularly on certain railways, were very inadequate. there were no workmen's trains at all on one important line--on another only one such train was run, whilst on several others the number of trains run was very small. representations were made to the board of trade and negotiations carried on with the railway companies, and by degrees a considerable extension of the facilities for the conveyance of workmen was secured. the council gave its immediate and more anxious attention to those breeding-places and forcing-pits of disease and misery, the insanitary areas in london. the housing act of (by part i.) constituted the council the authority for preparing and carrying into effect schemes for the clearance and improvement of insanitary areas which were of such size, and situation, and character, as to render their clearance and reconstruction of general importance to the county. the tremendous task of dealing with them was rendered more difficult and costly by the obligation imposed by parliament of providing housing accommodation for the persons displaced; for in the lack of easy means of communication with the outer parts of london it was held to be necessary to re-house the greater number of them in the same locality. the metropolitan board of works had simply acquired and cleared the properties, and disposed of the sites to companies or individuals, placing on them the obligation to erect houses for the working classes. now, however, the council determined itself to erect, let, and maintain, the necessary dwellings. the chief reason for the change was the difficulty experienced in finding companies or persons who were willing to undertake the erection of dwellings on some of the sites. the council had to complete several schemes which it inherited in an unfinished condition from the metropolitan board of works, but it at once initiated many itself, and carried them through to a successful conclusion. and as one after another of the insanitary areas was investigated, so again and again was revealed to public view the appalling condition in which thousands of people--in the very heart of london--dragged out an existence more bestial than human; horrors piled on horrors--a state of things all the more awful because it had been existing for an indefinite number of years--levying annually the heaviest of tolls on those who came within its deadly sphere, and scattering its poison abroad among the community at large. there was the clare market (strand) scheme, some - / acres-- - / acres of human wretchedness and disease and misery and filth. in one sub-area there were upwards of persons to the acre. here the death-rate was · per , in ; in another sub-area, the death-rate had been · per , in ; the death-rate for the whole area having been · in . and in addition to this was the unknown sick-rate. there was the webber row scheme in st. george-the-martyr, southwark--close upon acres in extent, with a death-rate of · per , . there were the roby street and baltic street areas in st. luke, areas which "have about the worst reputation of any in london." the largest scheme which the council undertook was that known as "the boundary street area" in bethnal green. here some fifteen acres of old, dilapidated, crowded dwellings--dwellings so insanitary that the death-rate in them was over per , --were swept away, entailing the displacement of , persons; and the ground so cleared was laid out with wider streets, and a large open space and excellent buildings were erected thereon to contain , persons without crowding. the prince of wales once more testified his deep interest in the welfare of the poorer classes of london by opening the new buildings--a ceremony which took place on the rd of march, --and delivering an impressive speech. a summary of the work accomplished by the council up to this time showed that the council had provided, or was engaged in providing, accommodation for , persons at a total outlay of close upon £ , , , an amount of building operations which, if conducted at one spot, would have resulted in the formation of a town of nearly , inhabitants.[ ] the cost of this work was enormously heavy, owing to the fact that the arbitrator could and did award commercial value for the land; but, as was pointed out by the medical officer of health for the london county council[ ]:-- "the primary object of part i. of the act is not to provide artizans' dwellings, but to secure the removal from the midst of the community of houses which are unfit for habitation, and the faults of which are in large degree due to bad arrangement. where houses are thus situated, and are in a number of ownerships, rearrangement can only be carried out by vesting the property in one ownership, that of a public authority, who can then, by the making of new streets and by complete rearrangement of the area, ensure that the conditions which in future will exist are such as are needed for the health of the inhabitants. the chief value of the act is, therefore, not so much the provision of house accommodation which is fit for habitation, as the abolition of houses which are dangerous to health. part i. is not, therefore, in itself so much a housing act as an act for the removal of nuisances on a large scale." but another reflection also suggests itself, namely, why should the ratepayers of london have been obliged to pay these high sums for property which, by the culpable neglect of the owners and their predecessors, had been allowed to sink into a condition not alone exceptionally dangerous to the lives of its inhabitants, but a constant danger to neighbouring districts--even to london itself. surely in common fairness, those who had let it fall into such a state should have paid the penalty therefor, and not the public of london, who had had no part in bringing the property into such an evil condition. part ii. of the act was mostly a consolidation of torrens' acts, and , with amendments. it enabled the vestries or district boards to take proceedings before a magistrate for the clearing and demolition of single houses unfit for human habitation, and obstructive buildings, and empowered them and the county council to undertake schemes for the improvement of areas too small to be dealt with by the council. the owner might elect to retain the site after the demolition of the building, and in that case received compensation for the building only. if the vestry or district board acquired the site the same procedure as to compensation had to be followed as under part i. a few schemes were undertaken by vestries under this part of the act, the council making a contribution to the cost, and a few by the council. thus in st. george-in-the-east, from november, , to the end of , houses were "represented" as unfit for habitation--gruesome pictures of dirt, dilapidation, and insanitation of every form and variety, and this, too, after nearly forty years of sanitary work by the vestry. many were closed by order of the magistrate, some by the owner, some pulled down, some repaired and re-let. part iii. of the act embodied the idea, originally started by lord shaftesbury in , as to the erection of labouring classes' lodging-houses by the local authorities, and grafted several amendments thereon. power was given for the acquisition by the council of land for the purpose of erecting lodging-houses thereon. such land, however, was to be within the council's jurisdiction. under this part of the act the council erected a common lodging-house in parker street for the accommodation of over persons. it also acquired several sites, including the millbank estate, upon which it proceeded to build houses; and one of acres at lower tooting for the erection of cottages thereon. altogether the work performed under the act was considerable, and the housing for the accommodation of the working classes made sensible progress, the sites sold by the metropolitan board of works to trusts, and public companies, and private persons, having been built upon and covered with artizans' dwellings. private building was proceeding at considerable pace, and in many parts of london the ground was becoming more overcrowded than ever with houses. the older parts of london were being rapidly re-built, and open spaces at the rear of buildings were being gradually covered by buildings. of st. pancras the medical officer of health wrote ( ):-- "... there is a prospect that in course of time the whole of the open space about buildings may disappear.... old houses possessing yards, areas, open spaces, in some form at the front or back or both, are being re-built in such a manner as to entirely cover the whole ground area two or three storeys up--leaving not a particle of open space." the restrictions imposed by the building acts were of the most illusory character, and as the acts were mostly future in their operation, and not retrospective, their effect was also limited. any "owner" was entitled to re-build on "old foundations," no matter how crowded the houses were on the spot, so new buildings were usually only a resurrection in huger and more perpetual and objectionable form of the evils which ought, as far as possible, to have been eradicated. during the year the london building law was consolidated and amended. the act recognised, for the first time in london, the principle that, in addition to the height of the building being proportionate to the width of the street on which it abuts, the amount of open space about the rear of a building should also be proportionate to its height, and hence the future crowding of buildings on area was put under limitation. but how small was the limitation, how small the concessions exacted from "owners" in this matter, and how miserably late they came in the history of london building operations. the tendency of house construction in london was to ever larger size, to greater height. to how great an extent this had been carried on in the "city" was described by the medical officer of health in :-- "it would be a fair and moderate estimate to put the superficial area (of the city) at _four square miles_ instead of one. we have only to point to the construction of business premises--the piling of one floor over another for many storeys high, each floor being occupied by separate occupiers, forming in itself a distinct tenancy, having all the rights and privileges of an independent building, and claiming as much attention from every branch of our municipal system as if it stood alone.... we have, in fact, to deal with about , separate tenancies, with a day population of , ." in some of the more well-to-do parts of the metropolis great blocks of buildings were built and let out in flats, most of them with the minimum of light and air prescribed by narrow laws. in other districts of london considerable numbers of small houses were removed, and large blocks of artizans' dwellings erected in their stead. thus, in the parish of st. luke, nearly one-fifth of the entire population resided in the ten blocks of artizans' dwellings which existed there. in the earlier stages of the reform of the housing of london such buildings had been acclaimed as great improvements, as indeed they were. the later opinions of medical officers of health were not so laudatory. thus, in , the medical officer of health for whitechapel, after stating that there were in his district buildings having , apartments containing , persons, added that he was "not enlisted amongst the enthusiasts of this method of providing for the housing of the working classes." in he wrote: "all model dwellings are not equally models of good sanitary houses." and in :-- "the increased population are housed in huge barrack buildings which sometimes are constructed so as to allow light and air to permeate the rooms and sometimes not. the effect of this modern invention is to increase the density of population to a damaging degree.... "that the direct influence of these barrack buildings upon the health of their occupants--more especially the children--is adverse, i have not the slightest doubt." the vestry of shoreditch reported in - :-- "'model artizans' dwellings' do not appear to have been quite what their title implied. at norfolk buildings, shoreditch, on the medical officer of health causing them to be examined for a certificate for exemption from the inhabited house duty, the whole system of drainage was found to be in a most defective and dangerous state. a number of cases of typhoid, diphtheria, and other infectious illness had occurred on the premises." and a couple of years later the chief sanitary inspector submitted to his vestry a report on some so-called "model dwellings": "these blocks of buildings, feet high, are packed together so as to exclude light and air, and four rooms occupy the site of two: evil conditions which the architect and owner were not only privileged to create, but also, and very practically, in so doing were they privileged to condemn unborn generations of people, whose necessities condemn them to live in these tenements, to endure the evils of their creation." the medical officer of health for st. james' wrote:-- "block dwellings in such an area as st. james' do not provide the conditions in which healthy children can be reared, nor in which there can be a family life comparable with that possible in the open suburbs of london." the medical officer of health for st. olave gave a description of barnham buildings:-- "many of the rooms, &c., on the ground and first floor are generally very dark, and the buildings have not been maintained in a sanitary condition, notwithstanding the hundreds of notices that have been served the past five years. the average death-rate of the past five years of the unhealthy tenements was at least · per , and of the remainder at least · ." the medical officer of health for st. marylebone gave an interesting explanation of the condition of this class of houses:-- "the following is a list of applications, under the customs and inland revenue act, , from which it will be gathered that it is quite exceptional for a block of artizans' dwellings of even recent construction to be in a tolerable sanitary condition. the reason for this anomalous state of things is, that in the building of these dwellings the sanitary authority seems to have no power; a dwelling must be occupied before it comes under supervision." in spite of these and many other drawbacks, however, many of these buildings afforded accommodation far superior to that which had previously existed on the spots where they were erected, and provided residence for large numbers of people who otherwise might have been doomed to living in the worst class of tenement-house. closely connected with the public health act of was another act passed in the same year--"the factory and workshop act." the select committee of the house of lords on the sweating system had finished their inquiry and reported in . the evidence given before it was, as regarded factories, workshops, and workplaces, very much a repetition of that which for thirty-five years had been detailed by medical officers of health as regarded the dwellings of the people, but now obtaining greater publicity attracted more attention. overcrowding and insanitation of almost every conceivable kind pursued large numbers of the unfortunate workers from their overcrowded and insanitary tenements to their overcrowded and insanitary workplaces, and with the same disastrous results. and as regarded domestic workshops the conditions were even worse, workers spending their days and nights often in the one room--sometimes with extra workers brought in. want of light and air and overcrowding in workshops and factories are quite as serious matters as they are in inhabited houses. the select committee, in their conclusions and recommendations, said:-- "the sanitary conditions under which the work is conducted are not only injurious to the health of the persons employed, but are dangerous to the public, especially in the case of the trades concerned in making clothes, as infectious diseases are spread by the sale of garments made in rooms inhabited by persons suffering from smallpox and other diseases. three or four gas jets may be flaring in the room, a coke fire burning in the wretched fireplace, sinks untrapped, closets without water, and altogether the sanitary condition abominable." "a witness told us that in a double room, perhaps nine by fifteen feet, a man, his wife, and six children slept, and in the same room ten men were usually employed, so that at night eighteen persons would be in that one room." "in nine cases out of ten the windows are broken and filled up with canvas; ventilation is impossible and light insufficient--the workshops are miserable dens. we are of opinion that all workplaces included in the above description should be required to be kept in a cleanly state, to be lime-washed or washed throughout at stated intervals, to be kept free from noxious effluvia, and not to be overcrowded--in other words, to be treated for sanitary purposes as factories are treated under the factory law." lord kenry, chairman of the committee, in his draft report, said:-- "it has been shown that the dwellings or shops in which the sweated class live and work are too often places in which all the conditions of health, comfort, and decency are violated or ignored.... sanitary inspection is totally inadequate, and the local bodies have seldom done their duty effectually. at the east end of london generally the sanitary state of homes and shops could not possibly be much worse than it is." and mr. lakeman (government inspector under the factories and workshops act) said, in reference to workshops: "i think that the evidence given your lordships upon the insanitary state of those places is not at all too black." once more the necessity of inspection was insisted upon. "on no point," wrote the chairman, "was the unanimity of witnesses more emphatic than with reference to the necessity of more efficient sanitary inspection, not only of workshops, but of the dwellings of the poor." and just as it was as regarded tenement-houses, inspection here was lamentably deficient, if not absolutely non-existent. "the inspection at present carried on is totally inadequate, and nothing was more clearly proved before us than the fact that satisfactory results cannot be looked for from the system as it now stands."[ ] "even when an unmistakable cause of unhealthiness is discovered, and steps are taken to remove it, the process of applying the remedy is slow and uncertain. the local board meets once a week or fortnight ... the landlord is allowed a fortnight to carry out the work; three weeks may elapse before the inspector can go and see it, then perhaps nothing has been done; the summons, &c., takes time. in any case much valuable time is lost, and smallpox or fever is allowed to pursue its ravages with the source of the disease daily aggravated in intensity. "at present the inspectors under the factory and workshop act of have no power to deal with any nuisance which lies within the district over which the local authorities preside. on the other hand, the local inspector cannot interfere should he discover any breach of the factory act." the home secretary, in moving the second reading of the bill, explained its scope. he said:-- "the design and object of this bill is to bring all workshops and all factories up to the same sanitary level, and to require the same conditions as to ventilation, overcrowding, lime-washing, and cleanliness to be applied to all kinds of workshops in which men alone, or women, children, and young persons are employed. the bill does not deal with 'domestic workshops.' the president of the local government board will introduce a bill dealing with the public health, and the house may rest content with leaving what is called 'the domestic workshop'--that is to say, the working-man's home in which he works with the members of his family--subject to the provisions of the law of public health alone. it is obvious that in the domestic workshop you have not got the presence of the employer and the employé. you have the members of the same family ... and it seems to me that we may allow him and his family to work in a place which is sufficiently good so far as sanitary conditions are concerned for him and his family to live in. now that we are extending the sanitary provisions of the factory act to all workshops throughout the country, of whatever kind they may be except the domestic workshop, so that every cobbler's shop, every blacksmith's shop, every tailor's shop, will come under the provisions of the sanitary law, it seems to me foolish not to take advantage of the existing machinery provided by the local authorities, and the enforcement of the sanitary provisions, so far as workshops are concerned, is by this bill given to the local authorities." the passing of the factory and workshops act ( ) and of the public health (london) act of made the sanitary authorities primarily responsible for enforcing many new provisions. those authorities were charged with the duty of securing the maintenance of the "workshops" in a sanitary condition, of preventing overcrowding in them, and of enforcing cleanliness, ventilation, lime-washing, and freedom from effluvia, and securing the provision of sufficient sanitary accommodation. added to this was the sanitary supervision of the places of "outworkers."[ ] it would appear, however, that only in exceptional instances was any systematic attempt made in to carry out the new duties imposed by the legislature upon the vestries and district boards. in several instances the medical officers of health drew attention to the impossibility of undertaking workshop inspection with their existing staff. thus the medical officer of health of hackney:-- "inquiry has revealed the presence of something like , workshops and dwellings of outworkers which, under this act and order, should be inspected to ascertain the presence or otherwise of any insanitary condition. with the present staff it is impossible that this can be attempted." in st. marylebone the medical officer of health stated, in , that the number of workshops and workplaces in his parish amounted to , . and in he wrote: "the workplaces are so numerous in the parish that it is not practicable for them all to be inspected regularly with the present staff." "increased duties," wrote the medical officer of health for fulham in , "having been placed on the sanitary staff by the 'factory and workshop act' of , relating to outworkers; but with the existing number of inspectors it is not possible to attend to them thoroughly, so that the act in fulham is almost 'a dead letter.'" "in islington," reported the medical officer of health in , "neither the factories nor workshops in the district, nor the smoke nuisances receive any attention worth mentioning, and so far as this district is concerned they may be said to have been entirely neglected. "i look upon the inspection of factories and workshops as one of the greatest necessities of the present day, not only from a health point of view, but also from the social aspect." the manifest solution of this difficulty was the appointment of additional inspectors, but the local authorities had a sort of horror of such appointments, though by this time they must have known that the benefit to workers and to the community generally would have been very great. a report in of the medical officer of health of st. george-the-martyr shows the grievous need there was for inspection of one very important class of workshop:-- "i have inspected sixty-three retail bakehouses within the parish, and found them (with few exceptions) to be in a filthy and unwholesome state, dangerous alike to the health of the journeyman baker, who makes the bread, and to the public who eat it. twenty-one were completely underground.... in times of heavy rainfall sewage forces itself through the draintraps of these cellars, soiling the sacks containing flour, and fouling the atmosphere." parliament again legislated about factories and workshops in . under the act a minimum space was required in each room of a factory or workshop of cubic feet for each person employed. for the prevention of the infection of clothing, the occupier of a factory, &c., was prohibited from causing wearing apparel to be made or cleaned in a dwelling-house having an inmate suffering from scarlet fever or smallpox. an important step was also taken in extending the provisions of the factory acts to laundries, of which there were a great number in london, and where the workers stood in great need of improved conditions of work, and of public supervision. lamentable as were the results of the non-protection of the workers in workshops, still more lamentable and disastrous were they as regarded the , , dwellers in the , tenements of less than five rooms. up to regulations under the sanitary acts of and had been adopted in of the london sanitary districts. in only nine of these was any considerable use made of them. had these regulations been put into force a great amount of overcrowding would have been prevented and the houses kept in a fairly clean and sanitary condition. in the whole of london, with its , houses, only , tenement-houses were on the register in , of which more than a half were in four parishes, namely: , in kensington, , in westminster, in hampstead, and in st. giles'; leaving , in the whole of the rest of london--a mere fraction of the tenement-houses of london. in bethnal green ( ), " · per cent. of the population lived in tenements of less than five rooms. no houses had been registered." in lambeth over one-half of the population lived in tenements of less than five rooms, and of these nearly one-third lived under conditions of overcrowding. there was one sanitary inspector to about , people. the inadequacy of the staff had been pressed upon the vestry by the medical officer of health from time to time for a number of years. considerable ingenuity was in many cases exercised by the opponents of the regulation of tenements in the working of the bye-laws which resulted practically in rendering them inoperative. in some cases all houses were to be exempted where the rent was higher than certain specified weekly sums. the result was that the "owners" promptly raised the rent above these sums, and so secured their exemption, at the same time getting an increased rent. in others, the bye-laws gave the vestry power to decide what houses should be registered, and thus enabled the vestry to evade the necessity of registering any at all. in others, notices were to be given to the "owner" before a house was registered--the notice was not sent. and so, in one way or another, the imperative "shall" of parliament was evaded by the largest proportion of the vestries and district boards. as regarded the vestries and district boards who made a show of putting the regulations in force, the medical officers explained that, owing to the inadequacy of the staff of sanitary inspectors, it was "impossible" to inspect the houses regularly. in other parishes and districts the number registered and inspected was but a fraction of the houses which ought to have been registered. in bow (in poplar) where none were registered, the medical officer of health wrote in : "i should say , houses require registration." in st. mary, newington: "at least per cent. of the houses are occupied by members of more than one family." but as yet none were registered. and this same medical officer of health pointed out how in his parish--"the indisposition that has hitherto been shown on the part of the vestry to put into force the bye-laws for houses let in lodgings has led to great license in house-farming and house-crowding." where really put into operation the regulations had an excellent effect. thus the district board of st. giles' said: "the advantage of these regulations has been very great." and in paddington the medical officer of health stated: "the work done ... has had an excellent effect." of some streets where houses were registered ( - )--"the whitewashing and cleansing has without doubt had a good effect. the streets have been freer from infectious diseases than they have been for several years past." the advantages of the regulations in the administration of the health laws were time after time pointed out and insisted upon by many medical officers of health. the medical officer of health for westminster, where nearly , houses were registered, wrote ( ):-- "the great advantage in legal procedure lies in the fact that a breach of them is a finable offence with a further daily penalty after written notice, and is not a nuisance subject to abatement within a certain time. "if the conditions imposed by the bye-laws are carried out, no doubt one of the best methods for preventing overcrowding is thus achieved." the advantage of this quicker procedure was manifest, for, under the other public health or sanitary acts, the whole process of dealing with, or getting a nuisance abated, took "a long time--a very long time," but the advantages did not appeal to people who did not want to use them. thus there was a most grievous neglect of duty on the part of the great majority of the vestries and district boards, with the inevitable result of the most disastrous consequences to the working and poorer classes all over london. it must have appeared strange, in view of this glaring and scandalous neglect of duty by the vestries in enforcing the regulations, that the london county council as the central authority did not use the powers which they were supposed to possess of acting in the default of the local authorities, or of making representation to the local government board of the neglect of those authorities. the explanation was, that in the administration of this, absolutely the most important of all branches of the housing problem of london, the london county council, had been left entirely out--had not even been given a voice in the framing of the bye-laws or regulations, and therefore had no legal power to act. regulations or bye-laws, drafted by the local government board as "models" for adoption by the local authorities, suggested "exemptions" to what parliament had directed--though there was not a single word in the th section or in any part of the act to justify such a suggestion--or suggested phrases in them which actually placed the enforcement or non-enforcement of the act in the discretion of those authorities, this, too, though parliament had made the explicit imperative enactment that these local authorities should make and enforce regulations. most of the vestries made bye-laws under section of the act, nearly all containing exemption or elusive clauses as suggested; some even avowedly reserving to themselves the option of registering or not registering houses, as they thought fit. the london county council was not in a position to act in their default, as these authorities could shelter themselves under the option contained in the terms of the regulations, and a representation to the local government board would have been useless, as the same defence would be effectively made by the local authorities if called to account. thus, the deliberate enactment of parliament was frustrated; the act was prevented being a remedy for overcrowding, or even a protection against it, and except in a few parishes or districts where the great advantages of the act were appreciated, all the dreadful evils of overcrowding were given free play, and allowed to flourish on as gigantic a scale as ever. the effects of the inaction of the vestries and district boards were unfortunately not confined to the moment. a legacy of suffering, of misery, and physical deterioration was left to subsequent generations. once more might hundreds of thousands of voices of the victims and sufferers have cried out: "while you remain inactive, death and disease do not."[ ] a special census of the population of london was taken on march , , which showed that the population had increased to , , persons, being an increase of , ; and the number of inhabited houses from , to , . as years had gone by, and the necessity and importance of sanitation had become more widely recognised, and as london had grown in size and increased in population, the duties of the vestries had grown heavier, and the tendency of legislation was to broaden the basis of their action. the mileage of public streets to be paved, lighted, cleansed, and watered, had multiplied two, three, and four times since ; the number of houses in many districts had more than doubled; the drainage work had increased proportionally; the scavenging and removing of refuse also. nominal duties had become real ones, and new duties had been added--the disinfection of infected houses and infected clothes, the inspection of food, the working of the food and drugs act--these, with numerous smaller matters, meant a very considerable amount of work, expense, and responsibility. but all these were what one of the vestries in their report described as "well-worn grooves of familiar routine." in addition thereto, and now more than ever of primary importance, was the great duty of inspection--inspection of houses, and of rooms in houses, and of workshops, and often the consequent proceedings for the abatement of nuisances, or the punishment of offenders. "house-to-house inspection," wrote the medical officer of health for islington in , "is the only efficient remedy for extensive sanitary evils. it is the life and soul of sanitary work." house-to-house inspection of their districts was the most necessary of all sanitary work--as it was the means by which most sanitary defects and malpractices were detected--but it was the first to be sacrificed under the increased pressure of work, and the last for which adequate provision was made. "a house-to-house inspection has been attempted more than once," wrote the medical officer of health for islington in , "but it has never yet been brought to a complete and satisfactory finish." in fact the main breakdown of the vestry administration in london was their antipathy to inspection, and their refusal to appoint a sufficient number of inspectors. "the subject of overcrowding alone," wrote one medical officer of health, "if properly attended to, would pretty well occupy the whole of the time of the present staff." the complaints of the medical officers of health were frequent and insistent on the inadequacy of the inspectorate. thus the medical officer of health for fulham wrote:-- "the vestry must clearly understand that the present staff of sanitary inspectors is quite inadequate to properly perform the duties devolving upon the sanitary authority. there is only one sanitary inspector to every , inhabitants. should the vestry persist in their refusal to employ an adequate staff, the inference will be unavoidable that they are unwilling that the acts--for the faithful administration of which, in the interests of the public health, they as sanitary authority are responsible--should be properly carried out." interesting light is often to be found in the reports sometimes of the vestries, and oftener of the medical officers of health, upon various aspects of the great housing problem. sometimes a sentence enables so much else to be understood. thus, in , a medical officer of health wrote:-- "many persons think the public health act an innovation on their privileges." describing the insanitary condition of houses in provost street, shoreditch, the sanitary inspector wrote in :-- "the difficulty of dealing with these houses has been greatly increased by the circumstance that the leases will expire in a very few years. there was, therefore, a very natural objection on the part of many of the leaseholders to execute substantial works, of which the freeholder would in a few years reap the benefit, and without contributing anything to the expense of the improvements." this "very natural objection" entailed, of necessity, sickness and death upon a considerable number of persons. the vestry of st. pancras wrote in :-- "the primary cause of houses and buildings becoming insanitary is the neglect of freeholders to compel lessees to comply with the terms and conditions of their leases. if the vestry were empowered (where freeholders are negligent) to compel freeholders to cause lessees to carry into effect the covenants of the leases, the houses inhabited by the poorer classes would not become so wretchedly dilapidated and a scandal, but might be maintained in a fairly habitable condition." the medical officer of health for bethnal green exonerated some property owners, whilst fixing the blame on others. "... as a rule it is the professional insanitary property owner who has to be summoned time after time, and who exhausts every technicality and raises every possible objection, well knowing that in the usual way only an order costing some few shillings will be made against him." others, however, went further. the medical officer of health for islington wrote in :-- "since there has been a steady forward movement, and ... one now constantly hears of the persecution of the 'poor property owner.' "that owner who for long years had everything his own way, and who did as little as he could to make things healthy for his tenants, knowing well that there were plenty of persons ready to occupy any or every house. property has rights, but so has flesh and blood; and if it be right that property should be protected from unnecessary exactions, it is surely righteous that the health and lives of human beings should be safeguarded in every way." and in the following year, writing about some insanitary bakehouses, he said: "it has always seemed to me a very absurd argument that because a place has been allowed to be occupied for a long series of years to the detriment of the health of the people working therein that therefore it must not be now abolished. "if those insanitary places have been occupied for such a long time, surely they have more than recouped their owners for the money that has been originally spent on their erection?" the medical officer of health for st. james', after twenty-five years' work as medical officer of health, declared in :-- "the only practical course is to saddle the landlord with full responsibility for the neglect or misconduct of the tenants whom he harbours, at large rents, for his own profit." in parliament passed "the local government (england and wales) act," which included london in its scope, and which introduced great changes as to the electorate, the mode of election, and the qualification of vestrymen. a new electorate on almost the widest basis was created, all persons, male or female, on the parliamentary or county council register, including lodgers and service voters, and married women, who were themselves tenants of property, being made parochial electors; and the vestry was to be elected under the provisions of the ballot act of . thus the scandals hitherto associated with vestry elections were for the future obviated, and greater publicity--that safeguard of all public bodies--was assured. additional powers were also obtainable under the act by the vestries on application to the local government board, who could transfer to the vestry the powers and properties of the library commissioners, the baths commissioners, and the burial board; the power of appointing the overseers of the poor, and some other powers and duties of more or less importance, possessed or possessable by parish councils. the elections were held on december , . the new vestries, however, did not mend the ways of their predecessors as regarded "inspection." of bethnal green the chief sanitary inspector said ( ): "with the existing staff (five inspectors) and having regard to other work, it would take five years to visit all the houses in the parish--about , ." the medical officer of health for kensington wrote ( ): "the staff is quite inadequate for the discharge of the duties devolving upon your vestry as sanitary authority." and the medical officer of health for hammersmith wrote in : "the house-to-house inspection of the district is now nearly completed, and has taken six years to accomplish. the result of the inspection is in the highest degree satisfactory ... nevertheless it cannot be contended that inspecting the district once in six years is properly carrying out the st section of the public health (london) act, ." a series of investigations was made by the medical officer of health of the london county council, or by his assistant, into the sanitary condition of various parishes or districts, and an instructive light thrown upon the administration of their affairs by their respective local governing authorities. almost uniformly, so far as they were concerned, it was found that bye-laws as to houses let in lodgings were not enforced, and no, or practically no inspection of workshops, of which there were thousands, nor of "outworkers" had been carried out, and that the sanitary staff was quite inadequate for the work. though much was thus most unsatisfactory, yet in many other important matters which vitally affected the public health, considerable progress was being made. in the matter of water supply a steady but slow improvement had, under public pressure, taken place. in a royal commission was appointed to inquire as to whether the existing sources of supply were adequate, and it reported in the following year. "we are strongly of opinion," they said, "that the water as supplied to the consumer in london is of a very high standard of excellence and of purity, and that it is suitable in quality for all household purposes. we are well aware that a certain prejudice exists against the use of drinking water derived from the thames and the lea, because these rivers are liable to pollution, however perfect the subsequent purification by natural or artificial means may be; but having regard to the experience of london during the last thirty years, and to the evidence given us on the subject, we do not believe that any danger exists of the spread of disease by the use of this water, provided that there is adequate storage, and that the water is efficiently filtered before delivery to the consumers." this statement was to a certain extent satisfactory, but the fact remained that both the thames and lea still received sewage effluents above the intakes, and considerable pollution from other causes; and that diseases might still be water-borne and water-distributed by them. the thoroughness of the filtration also was often open to doubt. improvement was gradually being effected in the system of removal or disposal of filth and refuse of all sorts and kinds; the sweepings of the streets, the refuse from houses. according to the general practice of the local authorities the great bulk of this stuff was first brought to yards or places, the property of the authorities, and there sorted or sifted and sent down the river or along the canals in barges, or sometimes even by rail to the country. but the system was costly and insanitary and inefficient, and as was pointed out--"it could not be deemed satisfactory when large metropolitan districts inflict their filth upon smaller communities in urban districts." a system of destroying much of this filth by fire had been devised, and gradually was adopted by the local authorities. it was found that with a properly constructed and efficient destructor no nuisance need result, and this method of disposing of house refuse was much more desirable from a sanitary point of view than that usually adopted by london sanitary authorities. a certain number of local authorities adopted this method to the great advantage of the community, and though there is still much to be done in this direction, the change, so far as it has gone, has undoubtedly minimised a great evil. both numerous and various are the measures which have to be taken for the protection of the public from disease. one of the most essential of these was disinfection--the disinfection of rooms where there had been infectious or contagious disease, and the disinfection or destruction of clothing or articles used by the person suffering from the disease. the process of disinfection originally was of the most primitive character and doubtful efficacy, but the progress of science had elaborated really effective methods. in the local authorities had been given power to provide a proper place with all necessary apparatus, &c., for the disinfection of infected clothing, &c., free of charge, and to give compensation for articles destroyed. thus every inducement was given to the public to get infected articles disinfected. but many years were to pass before provision by the vestries was extensively made. by the public health london act, , this provision was made imperative on the local authorities. disinfection by steam was considered practically the only efficient system. by twenty-four sanitary authorities had provided themselves with this apparatus, six with an apparatus whereby disinfection was effected by dry heat, and eight had arranged with a contractor. when it is a fact that a few infected rags could let loose disease of the worst type upon a community, the advantages to the public of the general practice of disinfection were incalculable. and in london the advantages were specially great. in almost every district hundreds of houses were disinfected every year, and thousands--even tens of thousands--of articles. the system of the compulsory notification of infectious diseases facilitated greatly the work of disinfection, for by informing the authorities where cases of such disease occurred it enabled them to scotch disease in its breeding-places, and so it was of the greatest benefit to the community. how great may be gathered from the following figures. the number of cases of infectious diseases in london notified under the act of were:-- , in , " , " , " , " of those in :-- , were cases of scarlet fever , " " enteric " " " typhus , " " diphtheria , " " smallpox great work was being done in the prevention of the spread of infectious disease in london by the metropolitan asylums board, in whose hospitals thousands of persons suffering from such disease were isolated. dr. g. buchanan, chief medical officer to the local government board, wrote in :-- "in regard to some infectious cases, notably those of scarlet fever and diphtheria, there are no means at all to be compared to isolation in hospital for preventing the spread of a limited number of cases into a formidable epidemic. "and the wonderful and repeated checks to small outbreaks of smallpox in the metropolis in the course of the past seven years bears overwhelming evidence to the truth of this dictum." as the population of the metropolis increased in density it became more and more necessary in the interests of the people as a whole to make proper and sufficient provision for the prompt isolation of those of its inhabitants who might be smitten with infectious disorders. home isolation in london was difficult even under the best circumstances, but in the smaller tenements it was impossible. "the removal to hospital of so many of the cases (of scarlet fever) is a vast blessing to this neighbourhood," wrote the medical officer for st. mary, newington, in . for some time a growing tendency on the part of the public to accept hospital treatment for infectious cases had been evinced. "the 'depauperisation' of the hospitals had led to a great increase in the admissions, so that the public are on the whole very willing to take advantage of the facilities offered for having their infectious sick cared for in hospital, whereby the other members of the patient's family can follow their avocations without hindrance and without risk to the public generally." the chief sanitary inspector for bethnal green gives information as to the numbers who from his parish availed themselves of the hospitals. "a satisfactory feature, and of the greatest assistance in dealing with infectious disease, is the large number of patients now sent to hospital. this year nearly two-thirds of the cases notified were removed. the importance of this either to the patients themselves or to the public can hardly be overestimated." by the public health london act, , every inhabitant of london suffering from any dangerous infectious disease was entitled to free treatment at one of these hospitals.[ ] on receipt of notice an ambulance was at once sent for his removal. year by year greater use was made of the board's hospitals, and at times there was not sufficient room in the metropolitan asylums hospitals to receive all the cases. in the total number of patients received amounted to over , , there being at one time , patients suffering from all classes of fever or diphtheria receiving treatment in the hospitals, whilst in the admissions amounted to , . by the board had eight fever hospitals, including diphtheria, with , beds; three ships for smallpox cases with beds; and a large hospital for convalescents with , beds. by the accommodation had reached the large total of about , . the chairman of the metropolitan asylums board, reviewing in the thirty years' work of the board, said:-- "whilst, during the first twenty years of the board's experience, london was again and again visited with epidemics of smallpox, during the past seven years it has, thanks to the action of the managers in having removed to and isolated at long reach all cases of the disease, been practically non-existent as a health disturbing factor. "the percentage mortality of smallpox cases treated by the board decreased from · in to · in , and the annual mortality from · to practically zero." the rate of death from diphtheria also showed a continuous fall, and this fall had been coincident with the introduction and increasing use of the anti-toxic serum treatment of the disease. a valuable criticism on the existing machinery for the sanitary government of london was given in a report of the metropolitan asylums board statistical committee in june, :-- "although london possesses an ambulance service and a system of hospitals admittedly unrivalled, yet it has no central authority charged with the duties of tracing out an outbreak of this infectious disease (smallpox), and of taking concerted action towards stamping it out by measures of disinfection and vaccination and re-vaccination. "these matters still remain in the hands partly of the local sanitary authorities, partly of the local government board, and partly of the london county council. "clearly the present arrangements are not only cumbrous and incapable of that rapid action essential to success in dealing with infectious disease, but they are also excessively expensive." in connection with hospital accommodation there were two other factors in the sanitary evolution of london. one of these was the provision made by the poor law for the treatment and care of the sick poor.[ ] previous to the accommodation provided by the poor law for the sick was in the sick wards of the workhouses. the act of that year, which had established the metropolitan asylums board, laid the basis for the removal to separate hospitals of paupers suffering from the worst forms of infectious disease. the same act authorised the building and establishment of poor law infirmaries, thus removing most of the sick from the workhouse wards, giving them better treatment and better prospect of recovery. in the number of new infirmaries was , containing , beds; but a large proportion of the sick were still kept in the workhouses, the returns for showing about , occupied beds in them. and, in addition to these institutions, there were poor law dispensaries. the establishment of these dated from , and by there were of them. the immense amount of work they did is shown by the following figures: "in nearly , orders were given to medical officers for attendance on patients, , being seen at their own homes, and , at the dispensaries. it is calculated that there are about eight attendances on each order. favourable opinions were expressed as to the quality of the treatment afforded at them." there is no means of even forming an estimate of the results of these great remedial agencies, but that they were an immense advance on previous arrangements for the treatment of the sick poor is a well-established fact. the lords select committee reported that:-- "the evidence on the whole appears to indicate a general recognition of the high standard of efficiency attained by the best of the new infirmaries. "the poor do not generally regard the infirmary as they do the workhouse; they look upon it rather as a state-supported hospital; they come to the infirmary, are cared for, cured, and go out again without feeling that they are tainted with pauperism." the other great factor in the sanitary evolution of london was the group of great hospitals--general and special--supported, not by the state nor by aid from the local rates, but by the charitable public, and governed and managed and worked not by officials, paid either by the central or local authorities, but by men--lay and medical--who, from the highest and most public-spirited motives, devoted themselves to this responsible work. the general hospitals in numbered nineteen--some of them great institutions, such as st. bartholomew's, st. thomas's, guy's, the london hospital; and the number of special hospitals--many of them small--was stated to be in . "the total number of beds in the general and special hospitals in london combined was stated by dr. steele to be , , of which , are continually employed. but according to mr. burdett-- , and , ." "the vast numbers of persons who are treated in out-patients' departments of hospitals, the number treated at the eleven hospitals with schools, were estimated by one witness at over half a million." here, again, no precise estimate can be formed of the part these great institutions have taken in the sanitary evolution of london. that their part has been a really great one is evident without figures--proved not only by the millions restored to health and capable citizenship, but even more by their adopting and reducing to practice, and placing within the reach of the whole community, the vast benefits following the great scientific discoveries of recent times. among the many causes of insanitation, and all its miserable accompaniments, one of the most hopeless and most difficult to deal with has always been intemperance or "drink." statistics give no means of estimating its disastrous consequences, but these consequences always have been, and still are, of the most deplorable kind. the overcrowded dwellings and bad sanitary arrangements constantly tended to increase the habit of intemperance, and the moral degradation caused by drink made people indifferent to their housing, and lead to the poverty which increased overcrowding and insanitation. in london the facilities for obtaining drink are practically unlimited. in the evidence given before the royal commission on liquor licensing laws, which was appointed in , it was stated that:-- "in soho district, in an area of a quarter of a square mile, there were inhabited houses and public-houses. in another district, a little over half a square mile in extent, there were public-houses (excluding restaurants and private hotels)." down one mile of whitechapel road there were public-houses. "the streets branching off, the hinterland, are also thickly supplied; some exactly opposite each other." "in one street in st. george-in-the-east so crowded are the public-houses that there are licensed houses out of houses." and these facilities are intensified by the great number of hours during the day in which licensed houses keep their doors open to all comers. parliament has done but little to mitigate this terrible evil. happily, however, other influences are at work. the royal commissioners in their report in said:-- "most persons who have studied the question are of opinion that actual drunkenness has materially diminished in all classes of society in the last twenty-five or thirty years. many causes have contributed to this. the zealous labour of countless workers in the temperance cause counts for much. education has opened avenues to innumerable studies which interest the rising generation. the taste for reading has multiplied manyfold within a comparatively brief period. the passion for games and athletics, which has been so remarkably stimulated during the past quarter of a century, has served as a powerful rival to 'boozing,' which was at one time almost the only excitement open to working men." and then followed this weighty statement: "yet it is undeniable that a gigantic evil remains to be remedied, and hardly any sacrifice would be too great which would result in a marked diminution of this national degradation." and the chairman of the commission (viscount peel), the archbishop of canterbury, and seven commissioners in a minority report stated that-- "the broad facts remain unchallenged of the prevalence of the evil arising from drink." that drink and insanitary housing constitute a vicious circle should by no means deter the most vigorous efforts being continued to improve the conditions of housing and to raise the standard of the public health. there was widespread testimony through the latter half of the decade that the public health in london was improving. thus the medical officer of health for the bow district in poplar wrote in : "we have only to remember what london used to be, and consolation can be found in the comparison. epidemics are not so frequent, disease is not so virulent, and those attacked stand greater chances of recovery through better and more skilful treatment." and the medical officer of health for paddington in : "there has been a steady diminution in water-borne disease since efficiently-filtered thames water has been substituted for the numerous wells and pumps of former days." the medical officer of health for the strand reported in : "the strand district (as to health) compares favourably with other years. the result of your labours is a steady improvement in the health of the inhabitants." and the medical officer of health for islington in reported the death-rate as · --the lowest since registration was introduced in . in whitechapel "the policy of your board has resulted in a considerable saving of human life." the death-rate for the district in was · per , , and in it was · per , . in battersea the death-rate was · in , and · in . but infantile mortality did not show a similar rate of improvement. in many parishes there was a decided improvement. in many, however, infantile mortality remained at a very high rate. in bethnal green, in , nearly half the total deaths were of children under five years of age--a figure which drew from the medical officer of health the remark: "the ignorance of women of the working classes on the subject of infant feeding is colossal." in it was · per cent., and in it was · per cent. in poplar the medical officer of health wrote, in : "i think it my duty to point out the terribly high rate of infant mortality...." in of , births in died under year. bow shoreditch st. george's-in-the-east limehouse "it is an awful state of affairs that so many young children die every year." in shoreditch, in , · per cent. of the total deaths were of children under five; in islington, in , · per cent.; in hackney, in , · per cent.; in fulham, in , per cent. on the south side of the river--in st. george-the-martyr, in , it was per cent. of the total deaths; in st. olave, southwark, · per cent. in . a most hopeful sign was the greater public interest taken in matters pertaining to the public health. the medical officer of health for islington wrote in :-- "with the advance of education the public and parliament appreciate the importance of more and more safeguarding the public health." in :-- "they (middle class) will not tolerate the sanitation of a few years ago; indeed, they expect that the houses they live in will at least be rendered safe against the entrance of sewer gas, and themselves safeguarded against infectious disease." and the medical officer of health for the "city" in :-- "attention has been more particularly directed to premises and dwellings of the better class, the occupants of which are becoming more and more exacting owing to the increased knowledge acquired by the public on all sanitary questions. some of these premises are of great size and employ many hundreds of persons, and many enormous insurance, banking, and gigantic commercial establishments." and that there is a community of interest in a healthy london was becoming more widely realised. that the fact should have taken so long to be grasped is extraordinary as it was so manifest a one. over and over again it had been proved that disease was not restrained by the paper boundaries of parishes, and that once set alight anywhere no limit could be put to its widespread devastations. an unhealthy area in any part of the metropolis constituted a danger to the whole. nor was disease a respecter of classes. all were interested in keeping it away. and, after many painful lessons, people were realising much more than formerly that disease was a most costly infliction. the medical officer of health for st. james', westminster, in his report for , set out the business aspect of it:-- "the position of st. james', as the shopping centre for the best retail trade of the west-end of london, makes the district more and more a city of luxurious shops, hotels, clubs, and lodging-houses. increasing facilities for travel to the suburbs, and the increasing value of premises, necessitate its utilisation for business purposes during the day, and its comparative desertion at night.... its resident population of , persons is therefore an inadequate exponent of the activity of its daily life, of the importance of its retail trade, and of the necessity for active sanitation. an outbreak of smallpox or of cholera would at once so damage the trade of the district as to inflict upon its ratepayers a thousand times the cost which is now incurred by their preventive sanitary service, and by the prompt removal of infectious cases to suburban hospitals as is now done." but that was only a single and a limited case. the industrial classes realised to a greater extent than ever before the disastrous results to themselves and their families of sickness and ill-health; the prolonged suffering, the loss of work and wages, the ensuing hardships. and it was upon them more than on others that the effects of disease fell most heavily. in most matters the interests of the various parts of london, and of the various classes, are one and the same, but in none to anything like the same extent as in the vital matter of public health. here they are one and indivisible. but neither parliament nor the government had got so far as to recognise that yet, and london--the great metropolis--with its four-and-a-half millions of people, was left for its protection against disease to a number of semi-independent local sanitary authorities who had no authority beyond their own area, and who could take no action for the safety of london as a whole. one thing was absolutely certain--and that was that the civic life of london had within the decade been lifted to altogether a higher plane. the publicity of the proceedings of the central representative authority--whether of its meetings in the council chamber, or of its constant applications to parliament for legislation embodying far-reaching civic reforms in london--the triennial elections, when the area of discussion was shifted from the council chamber to the constituencies, quickened the interest and awoke the dormant masses of the people to the importance of civic administration and of civic laws. in this remarkable change the subject of the public health strode to the front. men began to realise how it entered into every branch or part of their own lives and of their families, how its ramifications invaded every part of their existence, how much their welfare and comfort and even their existence depended upon it. and the people had a great load lifted off them--the load of despair begotten by the hopelessness of any amelioration of the conditions of life which so long had weighed them down. they felt now that there was some one to whom they could complain, some public authority who would see that things would be righted, if they could be righted, and hope was born in their lives. in another change was made in the system of local government in london. the act of , while dealing with the central government of london, had practically not touched the local areas. the work was felt to be incomplete, and in commissioners were appointed "to consider the proper conditions under which the amalgamation of the city and the county of london can be effected, and to make specific and practical proposals for that purpose." they reported in august, . their general conclusion was contained in the following paragraph.[ ] "a consideration of the evidence we have received confirms the opinion suggested by the course of previous inquiries and of legislation, or, in other words, by the historic development of the metropolis, that the government of london must be entrusted to one body, exercising certain functions throughout all the areas covered by the name, and to a number of local bodies exercising certain other functions within the local areas which collectively make up london, the central body and the local bodies deriving their authority as representative bodies by direct election, and the functions assigned to each being determined so as to secure complete independence and responsibility to every member of the system." in february, , mr. balfour introduced in the house of commons a "london government bill."[ ] he referred to the act of which created the london county council as effecting a change "so much in consonance with the traditions of english municipal government that it is likely to be permanent," and said:-- "we recognise to the full that there must be a great central authority in london." "broadly speaking," he said, "the administrative vestry and the district board exist now as they were framed in ." "it is with these administrative vestries and district boards that the present bill proposes to deal. it is with the subordinate area, not with the central area, that we are now concerned. "we do not propose to touch the city of london. "we have determined that, by the appointed day it would be desirable that all london should be divided into areas for local government, and that every area should be simultaneously provided with all the necessary machinery for government of its local affairs." he mentioned the areas. "the constitution of the governing bodies in these areas shall be practically identical with the constitution which our great municipal boroughs already possess.... "we propose that there should be mayor, councillors, and aldermen. "as regards their powers--the vestries already possess (except as to police) the great urban powers possessed by other municipalities. certain powers agreed upon between the vestries and the london county council at certain recent conferences will be added, and there would be transferred to them the powers relating to baths and wash-houses, libraries, and burial boards." "on an appointed day every elective vestry and district board in the county of london is to cease to exist. he hoped the plan would come into operation in november, ." the bill became an act--"the london government act"--in . the new municipal boroughs numbered twenty-nine--"the city of london" and twenty-eight others; sixteen of them consisting of single parishes, and the remaining twelve of several amalgamated parishes. a few extra duties were cast upon them. among them the duty of enforcing within their borough the bye-laws and regulations with respect to dairies and milk, slaughter-houses, and offensive businesses; and in some respects their powers were enlarged, the principal addition being the power to adopt and use the provisions of part iii. of the housing of the working classes act, , within their borough. all preparations for the change were completed by the autumn of ; the new municipal councils were elected on the th of november, the forty-three vestries and district boards ceased to exist, and london entered upon a new stage of her career. here, at the close of , the vestries and the district boards of london came to their decreed end, and disappeared from the scene of london civic life. that end was not regretted by the general public, whose opinion may be gauged from the fact that the name "vestry" had become almost synonymous with incapacity, mismanagement, neglect, sometimes even of graver transgressions, though in later years the vestries did something towards removing from themselves that reproach. they certainly had done much useful work, and even at the outset of their existence were a great improvement upon their predecessors. they had found their parishes and districts forty-five years previously in the state described in the first and second chapters of this work--a chaos of filth, a slough of insanitation and deadly disease, and the great mass of the people living in misery indescribable--and the task before them was one which might have daunted the stoutest heart. in many ways they did their work well; local sewerage and house drainage were effectually carried out; the refuse of the great city was regularly removed; the paving, and lighting, and cleansing of the streets were greatly improved. but in many parts of london, and by many vestries and district boards, the larger, graver problems with which they were confronted were scarcely dealt with at all. powers entrusted to them by parliament were not used, vitally important duties imposed upon them by parliament were ignored or neglected. had this been pure incapacity it would have been deplorable, but upon many of the vestries were men who either were themselves interested in continuing existing evils and abuses, or whose friends were, and so laws which should have removed or mitigated the evils were not administered. and the result was the non-prevention of diseases which led to deaths, and the continuance of miseries (consequent on disease) which might have been warded off, and the sowing of the seeds of evils of which we are still reaping the crop. as years went by the pressure of public opinion upon them became more insistent, and their administration improved, but even to the end many of them grievously failed to fulfil the responsibilities of their position. one class of workers under them must, however, be excluded from such blame, namely, the medical officers of health. it is not too much to say that the greater part of the sanitary progress which was made all through the period of vestry rule was directly due to the unceasing labour, the courageous efforts, the insistence of many of these officers. their recommendations were often ignored, their requests constantly denied, their opinions made light of; but in spite of such discouragement they persevered. and not alone did they bravely stand between disease and the people, but they were ever striving to drive it back, and to destroy its prolific sources and its power; ever urging upon their employers the necessity for action to relieve the people from the worst of the evils they were suffering under. the description given in by one of them that their work was "a war of the community against individuals for the public good" had been proved to be absolutely true. and in that war, of them generally, it is to be said that there were no sturdier fighters on the side of the community than they proved to be. in dr. j. liddle, "a pioneer of reform," died after thirty years of "unflinching adherence to duty" as medical officer of health for whitechapel. in dr. n. vinen died after thirty-four years' service as medical officer of health for st. olave, southwark.[ ] in dr. j. s. bristowe passed away after forty years of service as medical officer of health for camberwell. and there are still in the service men whose labours have extended over prolonged periods. such men as these, and others of them who gave their best to the service of the community, have indeed a claim to the lasting gratitude of the citizens of london. footnotes: [ ] see general report of census commissioners, p.p. , vol. cviii. [ ] see speech of the president of the local government board, mr. ritchie, in introducing the bill in april. hansard, , vol. ccclii. [ ] statement by the clerk of the london county council. [ ] see his report for , p. . [ ] p.p. , vol. xvii. see fifth report from the select committee of the house of lords on the sweating system. [ ] see the order made by the home secretary in november, , as to "outworkers." [ ] not much interest appears to have been taken in the proceedings of some of the vestries. thus, in , the vestry of westminster complained of the lack of public interest in the record of their proceedings. "only eleven ratepayers out of , have purchased copies (price d.) of the reports of the vestry in each of the last three years." (a few years later they reduced their reports to a few pages.) and in the vestry of kensington complained of the limited demand for their annual report, though it only cost d. [ ] see rd report from select committee of the house of lords on metropolitan hospitals, . [ ] see the report of select committee of house of lords on hospitals, p.p. , vol. xiii. [ ] see report of royal commissioners on the amalgamation of the city and county of london, . [ ] see hansard, , vol. lxvii. p. . [ ] in his last report he recorded the death of j. munro, who had been inspector of nuisances for thirty-three years, so for that long period they had worked together. chapter vii - once more the census placed on record the actual population of the great metropolis, no longer divided, so far as local government was concerned, into parishes and districts, but now into a smaller number of municipal boroughs. the figures of this census are the last available for reliable deductions as to numerous important matters forming part of that comprehensive subject, the sanitary evolution of london. the enumerated population of london had reached the great number of , , , and showed an increase of , during the ten years to . the rate of increase, however, continued to show a decline, having fallen from · to · per cent. during the intercensal period. the same movement of the population noted in previous censuses was recorded in this one. in the city of london and six of the central metropolitan boroughs the enumerated population showed an actual decline of over , in the ten years, notwithstanding that the recorded excess of births over deaths in that period amounted approximately to , . in all the other boroughs there had been increases. in the eastern group the increases had been very small, with the exception of stepney, where, owing to the immigration of aliens, the population had increased , . in the northern group the greatest increase had been in hackney ( , ). in the western group fulham showed the highest increase, namely, , ; whilst on the south side of the river, wandsworth had increased , , and several others showed large increases. outside the boundaries of the county the "outer ring" had attained to a population of , , persons--an increase of , . if the metropolis and this "outer ring" were regarded as one city--and in many matters it is hard to consider them apart--the total population in was , , . the information as to the birthplaces of the people showed that of the , , persons, , , were natives of london. the proportion of natives of london had increased; the proportion from the rest of the united kingdom had decreased; whilst there had been an increase of , foreigners, the number having considerably more than doubled since . of every , inhabitants, were born in london, and elsewhere, as against and respectively in . once again the arrivals and departures by the gates of life and death were recorded. in the ten years from the st of april, , to the st of march, , , , births had been registered, and , deaths. the excess of births over deaths, therefore, was , ; and as the increase of population was , , it followed that , persons had migrated. as the migration had only been , in , it was manifest that migration to outside the county of london was increasing. the total number of inhabited houses was , , as against , in ; but owing to a variation in the manner of collecting the information, the figures have little value for comparative purposes. the accurate figures given of the population of london enabled the death-rate to be calculated on facts instead of upon estimates. the death-rate was · per , living in , a decrease from · in the previous year, and from · in . but to be set against this was the portentous fact that the birth-rate had declined from · per , in to · per , persons living in , the lowest recorded in london since civil registration began. the public health of london was now altogether on a better level than it had been before, but in the course of the year some cases of smallpox appeared in various parts of london, and in there was the most severe outbreak of it--with the possible exception of - --since , nearly , cases being admitted to the hospitals of the metropolitan asylums board between september, , and july, . ninety-three patients were removed to hospital in one day, and on one day (march th) , cases were under treatment. over , persons died of it in the year. the cost of disease to the community has often been referred to in previous chapters. the metropolitan asylums board stated that so far as it was concerned, the cost for - might be put at £ , --equal to about a threepenny rate--a sum which was wholly apart from loss of wages to the individual, and various other expenses, and apart from the charge upon the rates of those who were pauperised by the death of the breadwinner of the family. was "a year of comparatively very slight prevalence of infectious disorders." in there was "a marked absence of undue activity amongst the infectious diseases of the metropolis." and was the healthiest year in the records of london since registration, the death-rate being · per , . in the five years which have passed since the census of , parliament has passed three acts of the utmost consequence to the sanitary condition of the people of london, marking, in their respective spheres, definite stages in the sanitary evolution of the metropolis. the sanitary evils to which many of the people were subject might, as has already been stated, be roughly divided into two classes--those of their dwellings at night, and those of their workplaces in the day. "the factory and workshop act" of dealt with the latter. it was the amendment and final codification of a mass of piecemeal legislation which had been spread over a period of years. in , previous enactments on the subject had been consolidated into one act. that act was amended in , , and . all were now finally embodied in this act of with several additions and amendments. additional sanitary provisions were made as to the ventilation of factories and workshops, and as to the drainage of floors. bakehouses came within the scope of the act, and the law was made much more stringent as to them. after january , , it would be unlawful to use any underground bakehouse unless certified by the borough council to be suitable. a register of workshops was to be kept, and the medical officer of health was, in his annual report, to report specifically on the administration of the act in workshops and workplaces--a direction which ensured publicity as to the action of the local authorities. the powers of the sanitary authorities were extended by the act, and certain duties necessary for efficient administration imposed upon them. the act also ensured the inspection of dwelling-houses where there were outworkers. the work imposed on the sanitary authorities was very considerable as a very large number of premises came under their supervision, and every workroom in each workshop had to be measured in order that its cubic space might be ascertained; and when the subsequent routine inspection of the premises, and of outworkers' premises, remedying of defects and other duties, were taken into consideration, the magnitude of the work, and the necessity of an adequate staff of officers, were evident. the records show that at the end of , , workshops in london were under the supervision of the local authorities. the necessity of inspection was demonstrated by the fact that , conditions required remedying. improvement was testified to by the medical officers of health, overcrowding was diminished, and it was further stated that "employers are found to co-operate willingly with the local authorities in the remedy of faulty conditions." altogether, then, when a comparison is made between the conditions of the factories and workshops, and workplaces in which the people worked in the middle of the last century and now, the contrast is remarkable. the worst of the evils have been swept away, and healthy conditions of work have taken their place. and the limitations put upon the labour of children and young persons and women have all been to the good of those subjected to them. and the public health of london, so far as this very large and very valuable portion of the population is concerned, has been immensely the gainer. the second of the three acts since , which had a vital bearing on the sanitary condition of the people of london, was "the metropolis water act" of . that the water supply should be under the control and management of the municipality had long been advocated, but though hundreds of county and municipal authorities in great britain--many of them not the hundredth part of the size of london--had a municipal water supply, that great boon was denied to london. the reform was vigorously pressed by the central representative body of london--the london county council--and after several royal commissions of inquiry, parliament dealt with the subject in . but the manner of dealing with it was unfortunate and retrograde. a new public board--the metropolitan water board--was established for the purpose of acquiring, by purchase, for the inhabitants of london, and of certain areas outside london, the undertakings of the eight metropolitan water companies, and for managing and carrying on the supply of water. the great bulk of the purchase money was to be provided by the ratepayers of london, and the great bulk of the debt to be a charge on the rateable property of london. the board was to consist of members, of whom were to be nominated by the london county council, by the metropolitan borough councils and the city corporation, and the remaining by the authorities of localities outside london hitherto supplied by the companies. the board, therefore, was not a representative body directly elected by the ratepayers or electors of london, but was constructed, on the discredited precedent of the metropolitan board of works, of delegated instead of elected members; and though the people of london were emancipated from the control of trading water companies, they got in their place a body over which they can exercise no direct, and therefore very little actual, control. the new board was constituted in the spring of , and took over the undertakings of the water companies on the th of june, , at the cost to the ratepayers of london of not much less than £ , , , a sum immensely higher than that at which they could have been acquired many years before. and inasmuch as the board can call upon the ratepayers of london to make good any deficiency of income resulting from their management, the unsatisfactory result is the establishment in london of a new indirectly-elected public body vested with enormous financial powers affecting the interests of the ratepayers of london, and yet but little responsible to public control. the third of the three important acts, the education london act, was passed in , and carried in its bosom possibilities of the most far-reaching benefits to the health and physical welfare of future generations. by this act the london school board was abolished, and its duties transferred to the london county council, which was constituted the education authority for london. though, indirectly, the schools of the board were having considerable effect upon the physical well-being of the rising generation, it cannot be said that the school board had utilised its vast opportunities for improving the general health. by instruction, by influence, it might have done so much, might have moulded the physical future of generations. but education was always much more in the minds of the board than health, though the two might well have been considered together, and without health education is of little use. the board in their "final report" endeavoured to offer an explanation of their inaction. "it has always been a question how far the board are authorised to spend public money on the medical care of children. on the one hand suggestions have been made for the inspection of their teeth, and the treatment of cases of anæmic condition and arrested development. on the other hand a legal opinion has been expressed that the board are not entitled to do anything, or to take any measures except such as spring from the fact that the attendance of the children is compulsory. on this account it has been thought right to take action only in those cases in which on account of contagious disease, it is necessary to exclude children from school."[ ] even the sanitary condition of the schools does not appear to have been well looked after. in january, , one of the committees submitted a report to the board, on which the resolution was passed-- "that the committee be authorised to thoroughly examine the whole of the drainage of any school of the board where they may think it necessary," &c. the drainage was subsequently examined. in schools the drainage was all right. in of the schools re-drainage was required. for how long that fertile source of disease had been scattering its evil germs among the tens of thousands of children attending these insanitary schools, no information is available. in , just twenty years after its formation, the board appointed a medical officer, and he gave only a portion of his time to the work. "before there was no attempt on the part of the board to prevent the spread of infectious diseases by precautionary measures being adopted in the school."[ ] in the medical officer of health for paddington wrote:-- "school teachers should be required to inform the sanitary authority of any special amount of illness which may occur among the scholars. half a school may be away through sickness if the disease be not a notified one, but no information of such fact comes to the sanitary authority." and in he wrote:-- "the past year had emphasised the need of definite instructions to school teachers to keep the medical officers of health informed of the existence of infectious disease among their pupils. it is surmised that there were upwards of , cases of measles in the parish in the earlier part of the year." and "measles is the most fatal disease of childhood." in evening schools "efforts were made between and to teach the simple laws of health.... prior to gymnastics were taught in only a few schools."[ ] in the medical officer resigned, and a new one was appointed who should give his whole time to the work. his first report ( ) is enlightening as to the methods of the school board in matters pertaining to the health of the children attending the schools. he wrote:-- "the maintenance of sanitary conditions as regards heating, lighting, ventilation, and cleanliness both of the buildings and persons of the pupils, the detection of early cases of illness ... ill-health from many causes, school habits, and school work in their influence on health ... these ... come under the daily work of the teacher, and there is no requirement that any knowledge of such matters should be possessed by him. it is left to his own common-sense, and he muddles through. the definite requirement of hygienic knowledge as part of the equipment of every teacher is a necessity if a great part of the work of this department is not to be useless in result."[ ] and in his report of the following year he wrote:-- "the provision of medical oversight for school life is rapidly becoming a necessity. five-sixths of the population spend a seventh part of their lives under the exceedingly artificial conditions of the schools, and during the plastic period of life. their chief function in the earlier part of that period is to grow, and it is necessary that they should not only do this, but do it under favourable circumstances for development."[ ] soon after the transfer of the administration of the education acts to the london county council, the medical work of the late school board was amalgamated with that of the london county council. the change is one which is likely to be of the greatest benefit to the children in the schools, and through them, as times go on, to the population of london as a whole. the great value of health will receive greater recognition than it has done hitherto, whilst greater facilities for instruction in health matters, and better physical training, cannot fail to have the most beneficial effect. the vast field for this work is evident when it is called to mind that nearly half a million of children are in average attendance at the london county council schools. three other matters legislated upon by parliament claim mention. in the midwives act was passed. it provided for the constitution of a central midwives board with power to frame rules for the registration of midwives and for regulating and supervising the practice of midwives. after the st of april, , no person might use the title of midwife without being certified under the act. the london county council was constituted the local supervising authority for london, and under its supervision much good has already been done. also in the cremation act, which empowered burial authorities to provide and maintain crematoria, and empowered the secretary of state to make regulations as to the conditions under which cremation might take place. and to complete the tale of sanitary legislation since , a few reforms were secured by sections in the annual general powers acts which the london county council obtained from parliament. among these was one rather important one. in the duty of supervising and regulating the common lodging-houses in london, which hitherto had been performed by the commissioner of police, was transferred to the london county council. in that year such houses were on the register, and the authorised number of lodgers was close upon , persons. in the council obtained powers for the annual licensing of such houses. these larger powers enabled the council to improve the sanitary condition of many of these houses. the supervision of these houses has been most satisfactorily carried out, and has been of immense value in securing sanitary abodes for the miserable people who frequent them, and in diminishing what would otherwise doubtless often be a source of infection to the community. the sanitary evolution of london having begun a little before the middle of the nineteenth century, the figures of the censuses of and afford the means for measuring many of the great changes which have taken place in the intervening period. and a comparison of the state of those things which most affect the public health at these two dates enables a reliable deduction to be drawn as to whether there has been evolution to a higher level of public health, or a retrogression; and, if the former, the progress which that evolution has made. in the population of london was , , . in it had reached , , . and when to this is added the fact that all through the intervening years so enormous a mass of people has been cooped up in an area of square miles, and that at the present time there are over , , within that small area, the multiplicity of the matters decisively influencing their health and physical well being, and the vastness of the issues at stake, come into vivid light. as has been often said, the very basis or foundation of the sanitation of a city is an efficient system of drainage. without it sanitation is impossible. what the main drainage of london was up to has been described in the earlier chapters of this book. in effect, nothing less than an entire system had then to be designed and constructed to provide london with this first essential. this was done, and the result was of immediate and enormous benefit to london, and ever since then the maintenance and extension and improvement of this work has received the solicitous attention of the central authority. originally designed for , , people, it had, as london grew, to be considerably enlarged and extended, and as some of the districts outside the boundaries of london were allowed by parliament to drain into the london sewers, still larger works had to be constructed. and now the system serves a resident population of, in round figures, , , people spread over an area of about square miles. it comprises close upon miles of great intercepting and outfall sewers, miles of main sewers, and miles of large relief sewers, constructed for the special purpose of conveying storm-water away. this, however, was but part of the provision which had to be made. during the _régime_ of the metropolitan board of works, more than , miles of new sewers were laid by vestries and district boards in their respective districts, and since the creation of the london county council of , further additions of , miles have been made, making a total of over , miles. all this work was essential to enable a proper system of house drainage to be carried out, and as the drainage of houses into the local sewers was compulsory, the general system of drainage was thus rounded off or completed. the change effected thereby in the conditions of life in london has been remarkable. there are no longer open ditch-sewers polluting the air with their pestilential abominations; no longer streets without sewers, and houses without the possibility of drainage. in the report of the county council for - , prepared by the clerk of the council, there is given a calculation of what these works annually accomplish. "the flow of sewage during the year, namely , million gallons, represents a canal feet wide with a depth of feet, running day and night at the rate of feet per second; or it may be considered as equivalent to a lake of square miles, or about one-third of the area of the county of london, with a depth of - / feet." to the efficiency and thoroughness of the present system is primarily due the greatly improved condition of the public health of london as compared with . water was another of the absolute necessities of existence and of sanitation. an ample supply of good water is essential for health; and the numerous outbreaks of typhoid fever which in recent years have occurred in england with a heavy death-roll, testify to the dangers incurred by bad water, and the necessity for the utmost care being taken to secure its being pure and uncontaminated. the supply of water in the eighteen-fifties had been very limited in quantity, and, with the exception of that supplied by one company, abominable in quality. and progress to a better state of things was slow. improvements were made most unwillingly and haltingly by the water companies, and only under parliament's reluctant compulsion, whilst the inaction of most, and the obstruction of some, of the vestries and district boards, and the hostility of "owners" of houses to being put to expense for water fittings, still further impeded reform, and perpetuated the evils inflicted upon the inhabitants of london--suffering, disease, and death. the "slaughter wells" and the sewer-ditches were, however, filled up and those evil sources of supply ended. and a supply of water was gradually extended to the streets which were without any, and an increased supply to others which had but little; but it was not until , the very end of the century, that the county of london was, for the first time, receiving a constant supply in accordance with the provisions of the metropolis water act of . and by slow degrees the sources of defilement of the water were reduced, and a larger proportion of the dirt ingredients filtered out, until at last some of the worst evils connected with the supply were rectified. and in it was enacted by parliament[ ] that a dwelling-house without a proper and sufficient supply should be a "nuisance" liable to be dealt with summarily. the main cause of all the grave disadvantages the people of london had so unceasingly suffered under in this matter arose from the fact that the interests of the water companies and the interests of the people of london ran directly counter to each other. london, in fact, had from the very outset been at the mercy of trading companies for its supply of this necessity of life, and bitter cause, indeed, had london to rue it. it is too soon to know what improvements will result in the supply of water to the people of london, but in the interests of the public health it is most unsatisfactory that the public should even now be debarred from that direct control which alone can secure them the fullest benefits. in another of the numerous branches of the great subject of the public health of london--the widening of the streets and thoroughfares--the improvements made in process of years was marked, and the better provision of light and air and breathing space has been considerable. the total gross cost of new streets and improvements carried out by the metropolitan board of works had amounted to over £ , , ,[ ] whilst it had contributed another million and a half to the cost of smaller street improvements carried out by the "city" and other districts, which latter also expended considerable sums. the london county council continued the policy of the metropolitan board of works, and by the year - it had carried out, or was in process of carrying out, improvements at an estimated gross cost of over £ , , ,[ ] the greatest and most costly of all being the new thoroughfare--kingsway and aldwych--connecting holborn with the strand, which swept away some of the most notorious and worst slums in london. in addition to these, many local improvements have been carried out by the "city" and by the vestries and district boards, and later by the borough councils. these were estimated to cost about £ , , . the total work accomplished, therefore, has been very considerable, but the cost has been huge; amounting in the whole to about £ , , . of greater value to the health of the people has been the increase of the number of parks and open spaces in london, not merely in preventing land being built over, but in the opportunities afforded the people, and especially the younger portion of them, for exercise. here considerable acquisitions have been made since the time of the metropolitan board of works. immediately after the creation of the london county council two generous gifts were made to the citizens of london--waterlow park of acres and myatt's fields--and the council had acquired hackney marsh, with acres; brockwell park, with acres; and avery hill, acres; and some distance from london, acres of hainault forest. in addition to these several small pieces of ground were acquired and thrown open as public gardens and recreation grounds. the "city" had also acquired, outside the county of london, epping forest, about , acres in extent, burnham beeches, acres; coulsdon common, acres; and a few small open spaces in the "city" itself. and many acquisitions had been made by the vestries and district boards, and, since their supersession, by the borough councils. purity of air was another of the important elements of a satisfactory health condition. once that the thames had ceased to be the main sewer of london, and once that the hundreds of thousands of cesspools were filled in and abolished, the most persistent and fruitful and worst of the causes of the impurity and unwholesomeness of the atmosphere were removed. gradually too, but only too slowly--a slowness resulting in widespread loss of health and life--were the noxious trades in london made amenable to the law, and somewhat less noxious to those living in their immediate neighbourhood; this, too, without that ruin to trade and manufactures which was always predicted when any effort was made to prevent the prevalence of intolerable nuisances. the duty of administering the provisions of the law relating to the abatement of smoke nuisances rested with the police. under their action a steady reduction had taken place in offences against the law. in , , cases were reported, and there had been convictions; and in the numbers had sunk to reported cases and convictions. in , by the public health london act, the duty was transferred to the sanitary authorities. considerable use has been made by them of the act. in many cases severe penalties were imposed, and the general result has been a very satisfactory improvement. much, however, of the fouling of the atmosphere is caused by factories outside london, and consequently outside the control of the local authorities of london. and yet another of the great branches of the general subject of the public health is the food supply of the people. it would be difficult to give any approximate estimate even of the part which good or bad food has in its effect upon the public health, or to produce any statistics on the subject, but, undoubtedly, it is a very large part; and every now and then the outbreak of some serious illness and heavy loss of life, directly traceable to the consumption of bad food, shows how important it is to safeguard the people from such disasters. thus in there was an outbreak of scarlet fever, in which some persons were attacked, directly traced to an infective milk supply. previous to the date of the nuisances removal act of there was, so far as london was concerned, practically no control or supervision over the food sold to and consumed by the people. that act contained a section providing for the inspection of food by the local sanitary authority, so the importance of securing wholesome food for the people was then recognised. little, if any, use was made of the power thus given, and the act was amended and extended; but even then it was almost a dead letter. as years advanced great scientific discoveries demonstrated the fact that some of the most dangerous diseases, such as typhoid and scarlet fever, could be conveyed in food of various sorts, and opened up a new vista of dangers as to the conveyance of disease.[ ] and the huge size of london, and the vast numbers of its population, increased enormously the difficulty of safeguarding the public from the dangers of contaminated food. the first and greater portion of this work was done by the corporation of the city of london. its committee, the port sanitary authority, was able to prevent large quantities of bad meat which arrived by sea being put upon the markets; and the corporation, which administered the principal markets of london--the cattle-markets at deptford and islington, the fish-market at billingsgate, and the others at smithfield and leadenhall and spitalfields--by a system of inspection, prevented large quantities of bad or diseased food being sold to the public. in , , tons of meat reached the central smithfield market, of which , tons were seized as being diseased and unsound. at billingsgate, , tons of fish were delivered, of which tons were condemned. and there were wharves and warehouses in the city where tinned food and tinned meat and vegetables were received. tons were seized. all these places were daily inspected. this, however, was only a portion of the food which reached london. the responsibility for inspecting food in other parts of the metropolis rested (under the public health (london) act of ) with the various sanitary authorities, and the reports of the medical officers of health contain accounts of inspections by them, and of the seizure of meat, fish, poultry, rabbits, tinned food, vegetables, eggs, and sweetmeats, and of prosecutions, and of a few convictions. and many other articles of food were, under the food and drugs act of - , also liable to inspection so as to secure that they should not be adulterated; so that theoretically, and in a very great measure actually, provision exists for protecting the people of london from adulterated articles of food, and from food unfit for human consumption. all this is an immense advance upon the time when there were no laws against the sale of unsound or adulterated food. but there is great room for improvement, for the inspection and means of prevention are far from adequate to secure the protection of the public from this danger; indeed, the existing system of government for dealing successfully with this most important element in the well-being of the people is very defective. the experiences of the past sixty years or so in london have abundantly shown how great is the extent to which the public health is dependent upon the system of local government in existence at the time, and upon the administration of the laws relating to the public health by those authorities. the considerable changes which have taken place in the fifty years since the creation of a central authority, the metropolitan board of works, have been described. so far as regarded the local authorities over the separate areas into which london was divided, the "city" remains practically as it was, with the exception of the addition to its sphere of action of the important duties of port sanitary authority, and such further powers as the exigencies of the times required, and certain changes consequent upon the creation of the london county council. in the metropolis the other local sanitary authorities instead of being vestries and district boards-- in number--are now municipal borough councils-- in number--with some larger powers, including wide powers of rating. the poor law guardians, also with wide powers of rating, have remained much as they were, their sphere of work being a definitely limited one. various commissioners, such as the commissioners of baths and washhouses, library commissioners, and burial boards, have ceased to be; their powers being now exercised by the borough councils. the important changes in the local government of the metropolis have mainly been in the central authorities, whose sphere of duties extends over the whole area of london. the principal central authority, the london county council, which superseded the metropolitan board of works in , instead of being indirectly elected as was that body, is a directly elected body, elected by and representative of the whole electorate of london. its duties and powers have undergone extension and increase; the latest material addition to them being its appointment as the education authority for london. in , owing to the default of the vestries and district boards to make provision of rate-supported hospitals for paupers suffering from infectious or contagious disease, a central authority--the metropolitan asylums board--constituted on the indirectly elected system, with considerable powers to spend money which had to be provided out of the rates of the metropolis, was created to do that work. in another central body was created, the london school board, to deal with the elementary education of the children of london, and though not a health authority, its work was closely associated with the public health. it also possessed the widest powers for spending money, which had to be provided out of the rates of the metropolis. it was a directly elected body, but elected on a system peculiar to itself, and one which in great measure removed it from any financial public control. by an act of parliament in the london county council was made the education authority for london, and the work of the school board was transferred to it. to the two existing central authorities was added, in , another wholly gratuitous central local authority, the metropolitan water board, an indirectly elected body with ultimate rating power over the metropolis. there is a third sphere of government in matters pertaining to the public health--namely, that occupied by the state. it is charged with many duties connected with the public health, and is in close relationship with the various central and local authorities in london. it has undergone large changes since the middle of the last century. at that time some of the powers possessed by the state government in health matters were exercised by one of the secretaries of state. others, for some years, through the general board of health appointed by the government. in , when that board ceased to exist, some of its powers were transferred to the privy council, others lapsed to the local sanitary authorities. so great, as time went on, was the development of local government throughout the country, and so essential was it to have some central government state supervision over the largely increased number of local sanitary authorities, that in a new government department, the local government board, was created to perform this work. to it were transferred most of the powers in connection with sanitation and health matters possessed by the state government, and the various authorities in london came more or less under its supervision. since then, as the sanitary needs of the community grew, and as legislation became more voluminous, fresh duties have been constantly imposed upon that board. summing up these changes, and their broad effects, it is to be said that the machinery for the administration of the sanitary laws in london is undoubtedly far more potent and effective than it has been at any previous time. instead of the vestries and district boards there are now the borough councils; instead of the metropolitan board of works there is the london county council; instead of the privy council and board of health there is the local government board, whilst the metropolitan asylums board and the water board had no predecessors. but on the other hand the system now in existence is very complex, and in many ways cumbersome, and in recent years there has been a most unfortunate tendency on the part of parliament to revert to that which was the curse of london before the act of --the multiplicity of local authorities--all of them, too, with separate rating powers. so far, then, in the way of the machinery of local government has london come on its way to an improved condition of the public health. and parliament, as has been narrated, had, since , multiplied the health laws, which these bodies were charged with the administration of. then, the passing of an act dealing with matters affecting the public health was so rare as to constitute a remarkable event. now acts of parliament and "provisional orders" as to health matters are quite common events. with such numerous laws covering so many phases of the public health, with so much larger and more powerful a machinery for their administration, the crucial point of all is the administration of those laws by the various authorities. it is obvious that the administration is much more searching and effective and wide-reaching than it has ever been before. the central authority, the london county council, has done great work, as has already been shown, in extending and maintaining the efficiency of the drainage system of london, in the clearance of insanitary areas, and the erection of houses for the working classes; in the acquisition of open spaces, in great street improvements, in its efforts to help towards a solution of the great housing problem by the facilities of traffic it has created by its tramways, in the inquiries it has instituted into the insanitary condition of various districts in london, in the unifying of administration by the local sanitary authorities, and in many other ways too numerous to be recited. it has, in fact, vigorously used such powers as it possessed. the metropolitan asylums board has also used its powers effectively, having erected hospitals, and having each year successfully isolated and treated many thousands of cases of infectious and contagious disease. the water board is still too young to have a record. the poor law guardians had improved the workhouses and the infirmaries, and the dispensaries were continuing to do their useful work. the metropolitan borough councils were grappling with their numerous duties. the perusal of the annual reports of these bodies shows their multiplicity. house-to-house inspection--the inspection of factories and workshops, and workplaces, and outworkers; of bakehouses, cowsheds, dairies, and milkshops; of food and the places where food is prepared; of offensive trades and slaughter-houses, and of houses let in lodgings; the management of baths and wash-houses, the removal of dust and filth, disinfection, proceedings under the housing of the working classes acts; measures for the prevention of disease, for the abatement of nuisances, and many other duties connected with sewerage, drainage, and paving and cleansing of streets--all and every one of which closely affect the health of the people. the amount of work done varied considerably. in a well-administered municipality the number of sanitary inspectors had been increased, the number of inspections was high, and the work continuous and heavy. in some, however, the work was less satisfactorily done, and the old vestry antipathy to the expenditure of money upon inspectors appeared to have been handed on. much, nevertheless, was being done, and on the whole matters appeared to be progressing satisfactorily, and in many respects undoubtedly were doing so. but every now and then some revelation occurred of insanitary conditions under which large numbers of the people were living which showed a grievous omission somewhere, and for which some persons were responsible. thus when, under the education (london) act of , the county council had to take over the non-provided schools in london, the schools were inspected, and it was found that their drains were generally in a very bad condition. no fewer than , or per cent. of the school drains which were tested, were declared unsatisfactory. a most prolific source of disease and death was thus laid bare, a source which for years must have been working grave evil--and as in these schools there were about , children in attendance, the number of persons involved in danger was enormous. again, some of the figures published by the census commissioners in disclosed a condition of things of the utmost gravity. similar figures in the census of had passed almost unnoticed; these of reiterated the story, and as the evils they laid bare were on a somewhat smaller scale they were hailed more as a mark of progress and improvement, than as something portentous in themselves. yet they go down to the very roots of the sanitary condition of the people of london, and show how great is the task to be accomplished before the sanitary condition can be considered satisfactory or even safe. they bring into sudden view the fact that the problem of the housing of the people is still unsolved. the census of had recorded that there were , , persons in london. it also recorded that the total number of tenements was , , . it further showed that of these tenements no fewer than , were tenements of less than five rooms; and then going into details of these , tenements it showed that-- , were tenements of one room. , " " two rooms. , " " three " , " " four " comparing these figures with those for it appeared that-- "a marked improvement had taken place in the manner in which persons occupying tenements of less than five rooms are housed in london. the shifting of the population in the ten years from the tenements of one or two rooms to the more ample accommodation provided in tenements of three or four rooms is conspicuous."[ ] there had been a reduction in the number of one-room tenements, which are justly regarded as the worst of all from , in , to , in , whilst there had been an increase in the number of two, three, and four-room tenements. as to the numbers of persons living in these , tenements-- , persons lived in tenements of one room. , " " " two rooms. , " " " three " , " " " four " --------- total , , still, therefore, well over half the population of london lived in tenements of less than five rooms; whilst over , , lived in tenements of one or two rooms--and between one- and two-room tenements there is not much to differentiate. by further details given (as in ) each sanitary authority was "provided with the means of examining with much precision into the house accommodation of its district." the medical officer of health for the borough of finsbury, utilising the figures for that borough, deduced some most instructive conclusions as to the effect of the one-room and two-room tenements upon the death-rates. forty-six per cent. of the population lived in such tenements; the death-rate in one-room tenements was · per , ; the death-rate in two-room tenements was · per , . and the number of deaths occurring in them was per cent. of all the deaths in the borough. "the conditions of life obtaining in one-room tenements," he added, "are such as tend towards poor physique, disease, and death. the density of population is higher, the physical restrictions are greater, and there is less fresh air and more uncleanliness." the information thus given by the census commissioners as to tenements was striking enough, but of deeper interest and import even than these figures was the information as to "overcrowding." the medical officer of health for the london county council, utilising the figures of the census, worked out the facts as regarded the overcrowded tenement population of london. there were , persons living in an overcrowded state in , tenements of less than five rooms. of these-- , lived in , one-room tenements. , " , two " " , " , three " " , " , four " " ------- ------- , , there had been a reduction of overcrowded tenements from , in , containing , persons, to , in , containing , persons. there would appear then to be some hope that the acme or climax of overcrowding has been passed. but even from the most sanguine point of view the improvement is not great, and many decades would have to elapse before "overcrowding" ceased to be a power for evil. a few illustrations show the dreadful condition of things in this respect in certain localities. in the borough of finsbury, over , persons lived in overcrowded tenements of less than five rooms; in stepney, , ; in islington, , ; in st. pancras, , ; in lambeth, a few short of , ; and in southwark, over , . and if some of the figures about overcrowding were looked into a little more minutely it was to be seen that in st. marylebone there were , two-room tenements inhabited by five persons each, by six persons each, by seven persons each, and by eight persons each. in islington there were , such tenements with six persons each, with seven persons, and with eight persons. in st. pancras there were , two-room tenements with six persons in each, with seven persons in each, and with eight in each. in shoreditch there were two-room tenements with six persons in each, with seven in each, and with eight in each. stepney was the worst of all--with , two-room tenements with seven persons in each, with eight persons in each, and with nine persons in each; but this was the result of alien immigration. in lambeth there were tenements of two rooms with six people in each, and similar tenements with seven each, and with eight each. it must have come as a revelation to many of the borough councils to find such a condition of things existing in their municipality. these are the most recent reliable figures. not much change can have taken place since then, and they may be regarded as presenting fairly well the existing condition of the housing of the people of london. the main fact emerging from them is that a population of , persons in london are living in , overcrowded tenements of less than five rooms. the accumulated testimony of the most experienced and capable observers during half a century is clear and precise that overcrowding is disastrous to the physical welfare of the individual. the conditions of life are not much better in one- and two-roomed tenements, and the conclusion is thus forced upon us that, speaking broadly, a fifth of the population of london are at present living in circumstances where physical well-being is impossible, and where even a moderate standard of public health is unattainable. for some time back, fears as to the physical deterioration of certain classes of the population have found public expression, and to such a point did these misgivings come that, in , a committee was appointed by the lord president of the council to inquire into the subject throughout the kingdom. the idea of physical deterioration being at work found expression sometimes in the reports of the medical officers of health even far back. thus, in , the medical officer of health for paddington wrote:-- "in paddington overcrowding in its worst forms cannot be said to exist, but there is an over-concentration of building which will some day be considered a disgrace to our civilisation. it may safely be predicted that besides a high infantile death-rate a concomitant deterioration of race will result.... this high (infantile) death-rate is not the only check to population. another and more painful form of evil manifests itself in the sickly and puny race around us. young men and young women are unable from low vitality to cope with their contemporaries in the labour market, where prolonged muscular exertion is required. we find in this class the seeds of debility and disease." in he gave a table with particulars of five hundred heads of families of the wage-earning class engaged in industrial occupations living in tenement-houses in certain streets near the great western railway terminus. "sixty-four per cent. were born in country places. this," he added, "confirms my statement in former reports that large numbers of men born in cities have poor constitutions and deficient vital stamina, who cannot cope with their competitors from the country, nor command the best labour markets of the world. in the struggles of town-life large numbers are prematurely crushed out at early periods of their existence." and he added: "this deterioration of race has for some time been recognised by medical officers of health." unfortunately the conditions of life conducive to deterioration did not cease to exist in , as evidenced by the figures of the censuses of and , of the population living in overcrowded tenements of less than five rooms. the committee reported in , but while both the report and the evidence are of great interest, it cannot be said that they advanced the question much. the committee stated that-- "there are no sufficient 'data' at present obtainable for a comparative estimate of the health and physique of the people." that being undoubtedly so, the best light obtainable on the subject must be sought for in a different way. fortunately that way exists--and it is possibly the soundest of all--the method of inference from well-established facts. the reports of the medical officers of health for london during the last half-century enable this method to be applied to london. in cases innumerable it has been demonstrated beyond dispute that the death-rate was highest in overcrowded houses or localities, that the sick-rate was proportionately higher, that disease assumed more virulent form in them, and left the victim in a more impaired condition. "it is almost an axiom that the greater the crowding, the greater the sickness and the higher the death-rate." that these conditions affect the health and stamina of persons of all ages, and more especially of the children who are to constitute the new generation, is a truism, and thus the health and stamina of a large proportion of the population is, of necessity, damaged and deteriorated, and a heritage of suffering and debility passes to a succeeding generation. were these evils mere passing events like an epidemic of cholera which sweeps away its thousands of victims and is gone, the results would not be so disastrous. but when to these clearly proved facts is added the awful fact that these evils have been unceasingly in active operation for considerably more than half a century, that the past is still exerting a powerful and pernicious effect upon the present, and that the seeds of evil then sown are still producing a deadly crop, it is a necessary and unavoidable conclusion that there has been a considerable deterioration of race. counteracting these deadly forces have been those which have been described in this book:-- efficient sewerage and drainage, water supply improved in quantity and quality, sounder food, wider thoroughfares, cleaner streets, open spaces, new dwellings, prevention of the defilement of the atmosphere, prevention of the spread of infection--all these, together with better knowledge of health matters, the vast advance in medical science, the better provision for the treatment of the sick, greater temperance, and the great work carried on by numerous philanthropic workers and organisations, have effected vast improvement--an improvement testified to in the fall in the death-rate of london from · per , in to · in since which year it has further decreased. painfully and laboriously, and in the face of persistent obstruction and hostility, has the present sanitary position been attained. "vested rights in filth and dirt" have offered a prolonged and dogged fight against reforms which curtailed their privileges. hundreds of thousands of lives have been needlessly cast away, an uncountable number blighted and made useless by diseases which were preventable, and which were not prevented, and an incalculable injury inflicted upon the community. and the expense to the community has been enormous. millions upon millions of money have had to be spent to make good--so far as could be made good--the ravages of past neglect and culpable management. millions upon drainage, upon hospitals, upon houses for the working classes, upon open spaces--tens of millions upon water supply, and most unjustifiable and regrettable of all, millions to compensate slum owners for their iniquities. and even yet we have not arrived at our goal. what, then, are still the causes of failure? what the impediments? where the shortcomings? the failure is in part due to a great omission by parliament--in part to the non-administration of existing laws by local authorities--in part to a great defect in the system of local government. parliament had, most unfortunately, omitted from all its enactments affecting london any provision for the supervision of the great movement in part economic, in part social, which has been going on in london for well-nigh two-thirds of a century--namely, the change of houses inhabited by one family into tenement-houses, or houses inhabited by several families. that movement with its appalling attendant evils was allowed to go on practically unregulated, uncontrolled, and unsupervised. the great evil of this movement was, that a house which had been structurally and sanitarily designed for one family was sanitarily unsuited for its altered career as the abode of several families. nothing was done to obviate this evil. and so these houses became packed with people and families who had to live in one or two rooms in them without the primary necessities of a healthy existence--without ventilation--without an adequate supply of water--without facilities for cooking food--with the scantiest and filthiest sanitary accommodation--had to live under conditions which put a high premium upon dirt and insanitation, and which absolutely invited disease and death. even the sanitary act of , and its amending act of , did not deal with this crucial matter; and no legal obligation was created by parliament to ensure that the houses undergoing such a change should be adapted to their altered circumstances. the sanitary act of only in part dealt with the evils inherent in such houses. it imposed on the sanitary authority the duty of making regulations which prescribed a standard of the air space for each person, and thus made an effort to prevent overcrowding; it imposed upon the "owner" the duty of maintaining a certain standard of cleanliness--the rooms were to be painted or lime-whitened every year--it laid upon the tenants certain duties also as to maintaining cleanliness. but even this imperfect legislation was completely brought to naught by the opposition of the vestries and district boards to such action as would have secured at any rate some degree of decent accommodation in the tenement-houses of london. by the public health act, , the london county council was empowered to make bye-laws enforcing a certain standard of sanitary accommodation in them, and did make them. but in other respects nothing was done; and so the process still goes on, large numbers of houses hitherto occupied by one family are passing into the occupation of several families devoid of the primary necessaries of a healthy existence. the great movement has by no means spent its force; for long to come houses will be going through this transition, and until legislation deals definitely with this matter the inevitable evils attendant on the change will continue. the second main cause of failure lies at the door of the local authorities who would not and did not administer the existing laws. the local governing authorities are now more active than they have ever been before; the amount of work done in every branch of sanitation is far greater than ever before; the number of sanitary inspectors has been increased from in to in . but the regulations or bye-laws under the act of which parliament had imperatively directed them to make and to use as regarded the tenement-houses in london, are very far from being enforced to the extent they should be. the total number of houses let in lodgings which were on the various registers in was , . with only a few exceptions the borough councils, like their predecessors the vestries, make comparatively little use of this power, though there is a concurrent mass of testimony as to the beneficial results following its use. stepney, under the inrush of aliens, found the benefit of exercising the power, and heads the list with , houses on the register. kensington has , ; westminster , ; st. pancras , ; hammersmith , ; and finsbury , . these amount to , , or per cent. of all the inhabited houses in those six boroughs. in the whole of the rest of london with , inhabited houses, only , of the houses let in lodgings are registered: so that only - / per cent. of the houses in them, as against per cent. in the others, are registered. it is manifest, therefore, how imperfectly the greater number of even the present local authorities perform the duty which has been imperatively imposed upon them by parliament. the borough of shoreditch, for instance, with , tenements of less than five rooms, of which , were overcrowded with , persons living in them, has only of the houses let in lodgings on the register. the borough of lambeth with , tenements of less than five rooms, of which , were overcrowded with , people living in them, had only houses on the register. the borough of bermondsey with over , persons living in overcrowded tenements had only houses on the register. this, as has been explained (see p. ), is not a matter in which the central authority, the london county council, has any authority to interfere. the borough councils are their own masters in this matter, as were their predecessors the vestries, and the responsibility as to administering or not administering in their areas the act of parliament rests entirely with them. the consequences of the non-administration of these bye-laws to the health and physical well-being of great masses of the people are disastrous. various legal decisions in recent years have somewhat impeded the effective administration of the bye-laws in this matter, but the real impediment is the dislike to them of the borough councils. the condition of the vast tenement-house population in this great city is of such immeasurable consequence to the community at large that matters can only be allowed to continue in their present most unsatisfactory state at the most dire cost. the sooner it is thoroughly inquired into by parliament and drastically dealt with the better; great evils will be stayed, great benefits will be secured. the third principal cause of failure to attain a higher level of the public health in london than at present enjoyed has been the want of a real central health authority. the metropolitan board of works was never such. the london county council is only such in a very limited way. a real central health authority for london is an absolute necessity--that is the great moral to be drawn from the history of the last half-century so far as local government in health matters in london is concerned. disease recognises no boundaries, and in a great city like london it is essential that in so vital a matter as the public health full authority should, subject to parliament, be vested in one supreme authority--a central authority which shall secure uniformity of administration; a central authority which shall be able to compel a local authority in london to do that which if it neglects is a danger to the community; a central authority which, in the event of such neglect, shall be authorised itself to undertake that work; a central authority which shall be able to act at once for london as a whole in presence of any sudden or great emergency--that is absolutely essential for the sanitary safety of this great city and of the millions who live in it. the want of such an authority has throughout the whole sanitary evolution of london been a disaster of the greatest magnitude, and is an ever-present peril to this great metropolis. the existence now of a central popularly elected representative body for the metropolis would render this reform quite a simple matter. further measures are also required to aid in the removal of the worst of london evils. in a royal commission was appointed to inquire into the means of locomotion and transport in london. it reported in , having done its work more thoroughly than even most royal commissions do their work. a great portion of its report deals directly or indirectly with the sanitary condition of the people of london. "the question of locomotion," said the commissioners, "affects the health, comfort, and efficiency for work of the whole community.... "witnesses who have special knowledge of the subject are of opinion that the remedy for overcrowding is to be found in the removal of the people to outside districts by providing additional facilities for locomotion, and in this opinion we agree.... "we have come to the conclusion that in order to relieve overcrowding means must be provided for taking the population into and out of london, not in one or two directions but in many directions, at rapid speed, frequent intervals, and cheap rates." to this recommendation of the commission it should be added that means must be devised for preventing in "outer london" a repetition of those circumstances and conditions of life which, for more than half a century, entailed such sufferings and evils upon the people of london. * * * * * in reviewing the principal events, and studying the powerful underlying forces of the great movement of the sanitary evolution of london, the bitter experiences of the time gone by would indeed have been in vain if they did not point the way to an avoidance of past blunders and iniquities, and towards a better and happier future for the people. the lines upon which reform should move gradually become apparent as the events unroll themselves; and the measures now to be taken evolve and shape themselves from the successes and failures of the past. the reforms just suggested are undoubtedly those which are most imperatively necessary. the whole experience of the past justifies the belief that they would soon work a great change for the better in the physical, mental, and moral conditions of life of large masses of the people of london. and from improved and healthier homes would come to the people increased comforts and happiness, and more physical energy and greater strength to fulfil the duties of their lives, and to meet whatever demands the future may make upon them and upon our nation. the strength and even the existence of a nation depend upon the health of its masses. the stake at issue is a vital one to people and nation; and now more than ever is it necessary that the health and vigour of our race should be maintained at the highest possible attainable standard. footnotes: [ ] final report of the school board for london, p. . [ ] see report of medical officer of the late school board for - . [ ] final report, p. . [ ] first report of medical officer for year ended march , , p. . [ ] second annual report to march , . [ ] in the public health (london) act. [ ] the recoupments arising from the sale of surplus lands reduced the actual or net cost to less than £ , , . [ ] here the net cost is estimated to be about £ , , . [ ] the international congress of hygiene, held in brussels in , passed a resolution declaring meat to be unfit for human food when it was derived from animals attacked by bacterial anthrax, glanders, rabies, tetanus, tuberculosis, in certain cases, and several other diseases. [ ] see report of the medical officer of health of the london county council, , p. . index adulteration of food act, , - aldwych, allison, dr., evidence quoted, alteration of food and drink and drugs act, , artizans' and labourers' dwellings act, , - , - , artizans' and labourers' dwellings improvement act, , - , amendment act, , , - avery hill, bakehouses, - , , , - , bakehouse regulation act, , , balfour, rt. hon. a. j., - ball, decimus, ballard, dr., barnett, canon, bateson, dr. henry, reports quoted, , - baths and wash-houses, , , baths and wash-houses act, , , battersea, , , , , , beaconsfield, lord, beale, james, bedfordbury, - bermondsey, , , , , , , , , - , , , - , - , , bethnal green, - , , , , , , , , , , , , , , , , , , , , - , - , , , , , - , billingsgate market, birth-rate, decline of, , - bloomsbury, boundary street area, bow, bristowe, dr. j. s., brockwell park, bromley, building act, , , burial grounds, - , - , , , , - burnett, j., report quoted, burnham beeches, camberwell, , , , , , , , , , , , , , , , census of , , of , - of , - of , - of , - of , of , - , central health authority needed, - , - , - cesspools, , , , , , chadwick, edwin, chamberlain, rt. hon. joseph, , cheap trains act, , chelsea, , , - , , , , children's employment, commission on, - cholera epidemics, of , , of , - of , - , of , - , of , - chichester, bishop of, speech in , "christopher court," whitechapel, "city," the, its commercial character, - its government, , its sanitary condition, its declining population, - , , , , , , - construction of business premises, , amalgamation committee, clare market scheme, clerkenwell, , , , - , , , , , , , , - , , , - , , , , , , common lodging houses, , , , erected by l.c.c., , common lodging houses act, , , commons, acquisition of, , compulsory vaccination act, , consumption, , contagious diseases animals act, of , of , - coulsdon common, cowhouses and dairies, , cremation act, , cripplegate, cross, sir r. a., customs and inland revenue act, , - density of building, , , , , - deptford, , derby, lord, dickens, charles, on burial grounds, speech in , dilke, sir charles, diphtheria, , diseases prevention act, , , diseases prevention (metropolis) act, , - disinfection, , , , , dispensaries, district boards created, - inefficiency and inactivity, - , - , - , - , - abolition, - drunkenness connected with overcrowding and insanitation, , - , - , , , - dunraven, lord, - east london water co., , - education (london) act, , , elementary education act, , , epping forest, factories, overcrowding in, , - , , - royal commission of , need of inspection, - factory act of , of , - of , - of , of , - farr, dr. w., fever, prevalence of, , - connection with cholera, finsbury, , - , - , finsbury park, flight, - forster, w. e., speech quoted, fulham, , - , , , , - , - , , , , , , , , , , , , , , - gladstone, w. e., godwin, george, , goulston street scheme, grainger, dr., evidence quoted, - granville, lord, gray's inn road, greenwich, , , , , , , , grey, sir g., griffith, dr. j., evidence quoted, - grosvenor, lord robert, hackney, , , , , , , , , , - , , , , , , , , , , hackney marsh acquired, hainault forest, hall, sir benjamin, hammersmith, , , , , hampstead, , , , , hampstead heath acquired, harcourt, sir william, hickson, w. e., evidence quoted, holborn, , , , , , , , , - hornsey, hospitals for infectious diseases, - , , - , - hospitals, voluntary, houses, defective building of, - , , housing of the working classes act of , - of , , - , housing of the working classes commission, , , - hunter, dr., - immigration into london, , , - , - , , , infectious and contagious diseases, , - , - , , , , , - , - , , - , , - infectious diseases notification act, , - inspectors of nuisances, , , - , - , - , - , - , their insufficient number, - , - islington, , , , , , , , , , , , - , - , , , , , - , - , jacob's island, foul water in, jewish sanitary laws, , , kenry, lord, kensington, - , , , , , , , , - , , , , , kingsway, labouring classes lodging houses act of , - , of , lakeman, lambeth, , , , , , , , - , , , , , - , , , , , - , , - , lambeth water company, _lancet, the_, description of the thames, lankester, dr., laundries, public, lea conservancy board, lewisham, , , liddle, dr. j., limehouse, - , , , , , , , , little coram street, bloomsbury, - local government of the "city," of greater london, - lack of central authority, act passed in , local government board act, , - , local government (england and wales) act, , locomotion, additional facilities needed, london, bishop of, speech in , london county council created, - powers given by public health act, , - and by housing act, , - constituted education authority, - , summary of its work, london fever hospital report, , london government act, , - london government bill, , - lynch, dr. j., - , marylebone. _see_ st. marylebone measles, meat, inspection of imported, medical officers of health, their duties, , , their reports, - their treatment by local authorities, their labours, - metropolis local management act, , , , metropolis turnpike trusts act, , metropolis water act, , , , metropolitan asylums board, , , metropolitan board of works constituted, - abolished, - metropolitan building act of , , of , , , , metropolitan burials act, , metropolitan gas act, , metropolitan market act, , metropolitan paving act, , , metropolitan poor act, , - metropolitan sanitary association, metropolitan sewers commission, evidence before, - metropolitan water amendment act, , - metropolitan water board, - , , middlemen, - midwives act, , mile-end-old-town, , , , , , , , , , , , milk trade, , millbank estate, "model dwellings," - morpeth, lord, - mortality, in the fifties, - , - , - , , in the sixties, , , - , , - , in the seventies, , - , in the eighties, , - in the nineties, - , , - , mortuaries, , municipal corporations act, , municipal councils, created, - , their work, munro, j., national association for promoting social science, new oxford street formed, new river company, newington, , , , , , , , , , , , , , , , , , , , notting dale, , noxious trades, - , - , , - , - , - , , nuisances act, , - , nuisances removal and diseases prevention act, , - , , , overcrowding, in the forties, - in the fifties, - , - , , , - , legislation against, , - , - , in the sixties, - , - , - in the seventies, - , - in the eighties, - , - in the nineties, - , , - in , - paddington, , , , , , , , - , , , , - , , , , , - , , , , , , , - , - palmerston, lord, parks and recreation grounds, , , , pauperism, paving boards in middle of nineteenth century, peabody trustees, , pear tree court, clerkenwell, pennethorne, j., phillips, j., physical deterioration, - plumstead, , poor law act of , of , poor law guardians, poplar, , , , , , , , , , , , , , , , , , , population, growth of, - , , - , - , - , - , - , port of london sanitary authority, - , , - , printing works, - privy council, medical department of, , public health act of , - , of , public health (london) act, , - , , , - , - , - purvis, w., - redesdale, lord, registrar-general's report after census of , rendell, dr. william, - , , - , ritchie, c. t., , rodwell, hunter, rosebery, earl of, rotherhithe, , , , , , , , , , , , , , , , - , - ross, russell, lord john, russell court, drury lane, burial ground in, st. george, hanover square, , , , , , st. george-in-the-east, - , , , , , , , , - , , st. giles', , , , , , , - , , , , , , , , , - , , , , , , - , , - , - st. james', westminster, - , , , , , , , , - , - , - , , , , , , , st. luke, , , , , , , , , , , , st. martin-in-the-fields, , , , , , , st. marylebone, , , , , , , , , , , , , , , , , , st. pancras, , , , - , - , , , , , , , , , , , , , , , , , , salisbury, marquess of, , , - sandhurst, lord, sanitary act, , , - , - , , , , , , sanitary law amendment act, , , , scarlet fever, , , schools, overcrowding in, - , , - defective drainage in, - school board for london, - , , - , - , scrofula, , sewers, early statutes relating to, glaring inefficiency in the forties, - in the city in the fifties, - , plan adopted by the m.b.w., - medical officers' reports in , - attention paid by vestries and district boards, , - m.b.w.'s scheme carried out, - , , l.c.c.'s report, - sewers, commissioners of, before act of , their authority, , , their incapacity, - after act of , - superseded, shaftesbury (ashley), lord, , , , , , , , , , carries act to regulate common lodging houses, - labouring classes lodging houses act, shops, shoreditch, , , , - , , , , , , , , , , , , - , , , simon, dr. john, - , , , , - , , simpson, w., slaughter-houses, smallpox, - , , , , - , , , , smith, dr. southwood, , , - , smithfield market, society for establishing public baths and washhouses, society for improving the condition of the working classes, soho, southwark, , , , , , , - parish of st. george-the-martyr described, - , , , - , , , , , , , , - , , , , , , , , , , southwark water company, , , spitalfields, , , - , stanley, lyulph, stepney, , - , strand, , , , - , , , , , , , , , - , , - , , , , street improvements, , - , - sutherland, dr., sweating, select committee on, , - tenement houses, - , - , , , - , - _see_ also "overcrowding" thames, the, sewers discharged into, - , source of water supply, - _the lancet's_ description, a medical officer's words in , - embankment constructed, , thames purification act passed, - scope of conservancy board extended, port of london regulations, - , new treatment of sewage adopted, torrens, mr., towns improvement act, , tramways act, , tremenheere, h. s., typhus, prevalence of in , in , in the "city" in the fifties, , , vaccination act of , of , vestries created, - inefficiency and inaction, - , - , - , - , - abolition, - victoria sewer, vinen, dr. n., vulliamy, g., wales, the prince of (now king edward vii.), , wandsworth, , , , , , , , , , , , , water supply, disgraceful condition of, - , - , - , - for the "city," - act of reform passed in , act of , - act of , royal commission of - , - act of , - general survey, - waterlow park, webber row scheme, westminster (_see_ also st. james), , - , , , , , , , , , , , , , , , , whitechapel, , , , - , , , , - , - , , - , , - , , - , , , , , - , , , , , - , , , - , williams, t. marchant, - window tax, woolwich, , workhouses and infirmaries, , - workmen's trains, - workshop regulation act, , - zymotic diseases, - , , , , , - unwin brothers, limited, the gresham press, woking and london. * * * * * transcriber's note: minor typographical errors have been corrected but inconsistent accents and punctuation are as in the original text unless noted below. archaic spellings have been left unchanged. * corrections to the original text the following misprints and other errors have been corrected: page - the text "was it a" changed to "it was a" ("but none the less it was a forward step towards a sounder and wiser system of government"). page - the text "it amounted it" changed to "it amounted to" ("and that is what, undoubtedly, it amounted to"). page - " · of the total deaths." changed to " · per cent. of the total deaths." page - the text "illness resulting difficult of cure" changed to "illness resulting in difficulty of cure" ("each from illness resulting in difficulty of cure, constantly recurring."). page - the text "precisely the powers which not last year only," changed to "precisely the powers which, not last year only," ("section gives precisely the powers which, not last year only, but every year since the constitution of the board, the medical officer has demanded"). page - sentence changed from "and another example near paddington road--where houses had been built, and the population was to the acre; showing" to read "and another example near paddington road, where houses had been built, and the population was to the acre, showing--" page - the text "acccess of energy" changed to "excess of energy" ("the visitation of cholera was doubtless in the main accountable for the excess of energy displayed by parliament about this period"). page - comma added after " per cent." ("the high rate, nearly per cent., of infantile mortality"). page - the text "in the yards of some of them slaughter-houses" changed to "in the yards of some of them were slaughter-houses" ("indeed, in the yards of some of them were slaughter-houses, with all their unpleasant concomitants."). page - the text "for there many" changed to "for there were many" ("for there were many and considerable advantages in this form of procedure"). page - the text "was " changed to "as " ("he gave the number of families ... residing in more than two rooms as , ...."). page - "inhabitating" changed to "inhabiting" ("number of persons inhabiting each"). page - "prejudical" changed to "prejudicial" ("injurious or prejudicial to health"). page - the text " · of the population" changed to " · per cent. of the population" ('in bethnal green ( ), " · per cent. of the population lived in tenements of less than five rooms. no houses had been registered."'). * other changes and notes the following changes to the original text have been made for clarity or consistency: in chapter i, the section numbers have been prefixed with the words "chapter i, part" for clarity. this means that the headings of the sections in this chapter are now-- chapter i chapter i, part ii chapter i, part iii chapter i, part iv chapter i, part v the word "death roll" changed to "death-roll" throughout to match the more numerous instances of the latter form in the original text. page - reference to "the artisans' and labourers' dwellings act (torrens) of " changed to "the artizans' and labourers' dwellings act (torrens) of ". page - reference in the index to "metropolitan markets act, " changed to the correct title of "metropolitan market act, " as cited on page . footnotes have been re-indexed using numbers and collected together at the end of each chapter. where there were multiple references on a page to the same footnote, the second and subsequent reference is now sequentially numbered with its own footnote which says "ibid." the following variations of a word or descriptive term are common in the original text and have been retained: "common lodging house", "lodging house" and "lodging-house" "back-yard" and "backyard" "cow-houses" and "cow houses" "lime-washed" and "limewashed" "over-crowded", "overcrowded" "over-crowding", "overcrowding" "re-built", "rebuilt" "re-build", "rebuild" "re-inspection" and "reinspection" "sub-soil" and "subsoil" "tenement-house" and "tenement house" "wash-houses" and "washhouses" "water-course" and "watercourse" [illustration] on snake-poison. its action and its antidote. by a. mueller, m.d. sydney: l. bruck, medical publisher, castlereagh street. . sydney: webdale, shoosmith & co., printers, clarence street. . preface. since the method of treating snakebite-poisoning by hypodermic injections of strychnine, discovered by the writer and published but a few years ago, has already been adopted by the medical profession throughout the australian colonies, and practised even by laymen in cases of urgency with much success, it has been repeatedly suggested to him that the subject calls for further elucidation at his hands; that the morbid processes engendered by the snake venom and the _modus operandi_ of the antidote should be explained by him in a manner satisfying the demands of science, and at the same time within the grasp of the intelligent, moderately educated layman. when the latter, in a case of pressing emergency and in the absence of medical aid, is called upon to administer a potent drug in heroic doses, the aggregate of which would be attended by serious consequences in the absence of the deadly ophidian virus, an intelligent insight alone into the process he is about to initiate will give him that decision and promptitude of action, on the full exercise of which on his part it may depend whether, within a few hours, a valuable and to him probably dear life will be saved or lost. the foregoing applies, not to australia only, but to all other countries infested by venomous snakes. the introduction of the writer's method in every one of these countries is merely a question of time, for snake-poison acts everywhere according to one uniform principle, however different the symptoms it produces may appear to the superficial observer. the antidote, therefore, that cures snakebite in australia will as surely cure it elsewhere if properly and efficiently applied. to his australian confrères, more especially to those who adopted his method but had to practise it more or less empirically, the writer also owes a more elaborate explanation of his theory of the action of snake-poison in all its bearings on the various nerve centres than is to be found in the scattered writings he has from time to time published in our periodical literature. his warmest thanks are due to them for the records of cases they have furnished to the _australasian medical gazette_, and to the hon. j. m. creed, its able editor, for the ample space he has invariably allotted to the subject, and the valuable support he has given him throughout. by our united efforts we have reared in a dark and hitherto barren field of research a column of solid knowledge, and on this column australia now occupies the highest and will ever occupy the most prominent place. not the least pleasing feature in the history of this discovery is the fact that it has been made without an elaborate series of experiments on animals, that it is a peaceful conquest not attained by means of doubtful justification, and which have hitherto invariably failed in their object. this object--the discovery of the coveted antidote--instead of being brought nearer, was, in fact, further removed by every succeeding series of experiments. however fruitful in results this mode of research has been in other domains, in this particular one it has not only been a failure but an actual bar to progress. nature invariably refused to yield her secret when thus interrogated. the tortured animals, like the victims of torquemada, either did not answer at all or they answered with a lie, and the baffled experimenter abandoned his task in despair. still, these negative results notwithstanding, the writer is confronted by a certain class of would-be rigorous scientists, who tell him that his theory of the action of snake-poison, though it explains all the phenomena, cannot be accepted as correct until it has been proven so by strict test experiments on animals, and that the successful administration of the antidote is proof only of the fact of neither antidote nor snake-poison having killed the patients, who, probably, might have recovered if left to themselves. this may be strict logic, but common sense replies to it that if recovery takes place after proper administration of the antidote in cases which, according to all our previous experience, would have ended fatally, it is not illogical to assume that antidote and recovery stand in the relation of cause and effect. this sceptical attitude of the scientific mind can justly be maintained only with regard to cases limited in number and in which the symptoms left room for doubt as to their final result, but in view of the formidable and constantly increasing records of cures from snakebite during the last three years, it is, to say the least of it, unreasonable. the demand for experiments on animals, in proof of the correctness of his theory, the writer does not feel called upon to satisfy, for, apart from the theory proving itself by explaining all the symptoms the snake-poison produces, it has also stood the test of practical application. it is proven to be correct by the success of the antidote to which it led, and which is the logical outcome of it. after finally attaining a goal one has striven for, it is quite unnecessary to retrace one's steps with a view of ascertaining whether the road that has led up to it is the right and proper one. by a fortuitous concurrence of circumstances, however, even this demand for experiments shall be satisfied in these pages. the writer published his theory of the action of snake-poison in may, , after having practised the strychnine treatment for some years and thoroughly satisfied himself of its efficacy. in the latter part of accounts of feoktistow's researches reached this country. his final conclusions to the effect that snake-poison is solely a nerve poison, that it does not destroy protoplasm, and has no effect whatever on the blood to which its destructive potency on animal life can be ascribed, were in complete harmony with the writer's views, in fact, a re-statement of his theory. it was a strange coincidence, or whatever it may be called, that, independent of each other, at almost opposite parts of the globe, and by opposite methods, we had arrived at almost identical conclusions. those of feoktistow were drawn from elaborate experiments on animals, both vertebrates and invertebrates, made in the laboratory of professor kobert at the university of dorpat and in that of professor owsjannikow at the imperial academy of sciences of st. petersburg. the writer's conclusions, on the other hand, resulted entirely from a careful and happy analysis of the symptoms observed at the bedside of his patients suffering from snakebite. on one point only, but the most important one, he differs from feoktistow. the latter shared the fate of all previous experimenters on animals. though his experiments with snake-poison led him to the correct theory of its action, and even to the correct antidote, his experiments with strychnine and snake-poison were a failure. the animals experimented on died, and, falling into the error of his predecessors, mistaking the functional analogy that exists between the nerve centres of the lower animals and those of man for absolute identity, which does not exist, especially not when they are under the influence of the two poisons, he concluded his researches with the confession that a physiological antidote for snake-poison cannot even be thought of at the present state of science. although, therefore, feoktistow's labors would have led to no practical result, they are, nevertheless, a most valuable contribution to science as being the first to demonstrate the action of snake-poison on a strictly scientific, experimental basis. for this reason, and with so high an authority as professor kobert vouching for the correctness of the experiments, they will be frequently quoted hereafter. [illustration] historical review. snakebite and its cure have always been the despair of medical science. on no other subject has our knowledge remained for centuries so unsatisfactory, fragmentary and empirical. the history of the subject, in fact, may be summed up briefly as a series of vain and spasmodic attempts to solve the problem of snakebite-poisoning and wring from nature the coveted antidote. various and contradictory theories of the action of snake-poison have been propounded, some absolutely erroneous, others containing a modicum of truth mixed with a large proportion of error, but none but one fulfilling the indispensable condition of accounting for all the phenomena observable during the poisoning process and of reducing the formidable array of conflicting symptoms to order by finding the law that governs them all. we have the advocates of the blood-poison theory ascribing the palpable nerve-symptoms to imaginary blood changes produced by the subtle poison, and alleged to have been discovered by the willing, but frequently deceiving microscope. even bacteriology has been laid under service and innocent leucocytes have been converted under the microscope into deadly germs, introduced by the reptile, multiplying with marvellous rapidity in the blood of its victims, appropriating to themselves all the available oxygen and producing carbonic acid, as the saccharomyces does in alcoholic fermentation. others again, and among them those supposed to be the highest authorities on the subject now living, divide the honors between nerve and blood. some snakes they allege are nerve-poisoners others as surely poison the blood, but with one solitary exception they assume the terminations of the motor-nerves and not the centres to be affected. thus then with regard to theories we have hitherto had "confusion worse confounded," and as with theories so it has been with antidotes. they were proposed in numbers, but only to be given up again, some intended to decompose and destroy the subtle poison in the system, others to counteract its action on the system with that action unknown. it is scarcely too much to assert that there are but few chemicals and drugs in the materia medica that have not been tried as antidotes in experiments on animals and dozens upon dozens that have been tried in vain on man. the reasons for this somewhat chaotic state of our science on a subject of so much interest to mankind are various. the countries of europe, in which scientific research is most keenly pursued, have but few indigenous, and these comparatively harmless snakes. the best scientific talent has, therefore, only exceptionally been brought to bear on the subject. in those countries on the other hand in which venomous snakes abound and opportunities for observing the poison-symptoms on man are more plentiful, the observing element has been comparatively deficient. a still more potent source of failure must be sought in the faulty methods of research pursued by most investigators. experiments on animals were far too much resorted to, and their frequently misleading results accepted as final, whilst observations on man did not receive the attention their importance demanded. in the investigation of this subject the first desideratum was no doubt to find the correct theory of the action of snake poison and to define the law governing that action, assuming as a working hypothesis that there is but one law for all snake-poison and not several ones, just as there is one law for the structure of these reptiles, admitting of variations, but not of absolute divergence from the general plan. the shortest and surest way to find this law is close observation and careful analysis of the symptoms produced by the poison on man, and as the opportunities for such observation are not of frequent occurrence to the individual, co-operation and careful comparison of notes on the part of many observers. this method of investigation, which, during the last few years, has been pursued in australia with most satisfactory results, was never practised anywhere else, not even in america, but instead of it each observer, with few exceptions, kept his own notes to himself, and if there happened to be one here and there hungry for more knowledge than his scanty opportunities for observation on man would supply, his resort was usually experiments on animals. a few snakes were caught, a few luckless dogs or other animals procured, and the slaughter of the innocents began. as test experiments to confirm observations on man, or made with a view of finding a correct theory of the action of snake-poison, these attempts were unobjectionable, although, without an elaborate scientific apparatus and in other than skilled hands, they were not likely to produce results of any value. but most of the experimenters were not content with purely theoretical aims. they were seeking to find the antidote by a purely empirical method, and had nothing to guide them in the choice of drugs. a dose of snake-poison was administered to an animal, and then a dose of some drug or chemical, chosen _ad libitum_, sent after it. next day another presumed antidote was tried, another animal slaughtered, and so on _ad nauseam_, until finally the baffled antidote-searcher, not one whit the wiser for all his trouble and the useless tortures inflicted, confessed himself beaten and joined in the "_non possums_" of his predecessors. one important point has been completely left out of sight and ignored in all this experimenting on animals. it is the fact that the action of snake-poison on the human system and on that of animals, more especially dogs, though very similar, is not absolutely identical, and that for this reason alone results of experiments on the latter cannot be indiscriminately applied to man. as pointed out before, analogy has been confounded with identity. when a dog, for instance, has been bitten by a snake he does not usually collapse as quickly as a human being, but is able to drag himself about much longer before his hind legs refuse their service and he is unable to walk. this longer duration of the first stage of the poisoning process is no doubt owing to a higher organisation and greater functional power of the motor nerve centres of dogs. the amount of motor force at their disposal is greater, and hence they offer greater resistance to the invader seeking to turn off this force. when finally the latter gains the ascendency, irregular discharges of motor nerve force still take place and find their expression in convulsions, which in man only exceptionally occur. but the difference between man and dog becomes more marked yet when strychnine is administered to a dog suffering from snake-poison. it counteracts the latter quite as effectually in a dog as in man, but has to be injected with extreme caution, for whilst in man a slight excess in the quantity required to subdue the snake-virus is not only harmless, but actually necessary, any excess of it in a dog will at once produce violent tetanic convulsions and cause the animal to die even quicker than the snake-poison would have killed it, if allowed to run its course. in the face of these facts the judiciousness of the proposal lately made both here and in india to subject the strychnine treatment of snakebite once more to a series of test experiments on animals appears more than questionable. another cause that has largely contributed to render experiments on animals so barren of results must be sought in the injudicious selection of substances intended to serve as antidotes. it is simply impossible to act on an organic compound like snake-poison, coursing through a living system, by chemicals that will either combine with it or decompose it in a manner likely to deprive it of its deadly qualities and render it innocuous. yet what do we find? acids and alkalis, arsenic, bromides and iodides, chlorine, mercurial preparations, &c., &c., have been poured into the luckless animals as if they were so many test tubes. a chemical antidote, a substance possessing special affinity to snake-poison and by means of this affinity combining with it in some mysterious and incomprehensible manner, one can hardy imagine to exist. physiological antidotes, on the other hand, substances acting on the system in a manner the exact reverse of, and in direct antagonism to the snake-poison, though apparently the only feasible ones, have been strangely neglected and almost despised by experimenters. in the vast storehouse of nature the department most likely to furnish such antidotes is the vegetable kingdom. the untutored human mind has for centuries past intuitively clung to this idea, and sought among plants for remedies against the deadly ophidian poison. hence the great number of vegetable antidotes that have from time to time been recommended and the efficacy of some of which at least has been confirmed by reliable observations. but the hint thus given to science was not taken. instead of research being pushed on diligently in the only direction that promised any chance of success, it was cut short by the baneful method of experimenting on animals. when it had been demonstrated that a dog, a cat, or other animal, after having been saturated with snake-poison, did not recover after the administration of an alleged antidote, the illogical conclusion was drawn at once that it could not possibly be of any use to man, whilst, in reality, the only proof rendered by the experiment, if made properly, was that the respective antidote could not be relied on in treating animals of the class experimented on. that some of these despised antidotes are worth a little further investigation may, in the light of present experience as to the value of strychnine in snakebite, be inferred from the fact, that among them is the wood of _strychnos colubrina_, and also the well-known _huang noo_, a vegetable extract made from another variety of the strychnos family, and largely used by the chinese, whilst, according to a letter in the _australasian medical gazette_, july, , the principal ingredient of a strange compound used by the native snake doctors of central america with much success is _nux vomica_. it is superfluous to enter into a criticism of the treatment of snakebite until recently in vogue, for, with the exception of the local one by ligature and excision, it stands self-condemned by its complete inefficiency. it may be summed up as a vain attempt to stem the collapse invariably attending snakebite by the administration of stimulants, such as alcohol, ether, ammonia, &c. the attempt is vain, for a person in collapse from snakebite cannot be stimulated by any of these remedies, since neither the heart nor the nerve centres respond to them in the slightest degree, as they do in the absence of snake-poison, the only one that has any effect at all in slight cases being ammonia. but the attempt is not only in vain, it is highly injurious, especially if made with the usual large doses of alcohol, for, in addition to the latter not having the slightest influence on the snake-poison and its baneful effects, they act as an anæsthetic and thus add to the existing depression, besides increasing the tendency to internal hæmorrhage. it might, under these circumstances, have been expected that any new method of treating snakebite, based on scientific grounds and holding out a sure prospect of success, would be hailed with pleasure, and that conservatism, opposing the new simply on account of its newness, would refrain from its usual tactics in a case where there was really nothing to conserve. but this was not to be, and strange, indeed, it would have been if the writer had escaped the opposition which is almost invariably offered to the discoverer. it appears to be one of the laws of human evolution, wisely designed to prevent precipitate advance, that every new discovery must run the gauntlet of men whose mission it is to act as brakes on the wheels of progress. of the opposition which has been offered to the strychnine treatment it would, therefore, be folly to complain, but just cause of complaint is furnished by the unscientific attitude which was assumed from the very first and has been maintained throughout by its opponents. not a single attempt has been made to disprove the correctness of the theory on which it is founded, yet to leave this theory unquestioned but object to the conclusion to which it leads, must strike even the lay mind as a most illogical proceeding. it is self-evident that, when strychnine is administered as an antidote to snake-poison, the quantity of it injected must be in proportion to that of snake-venom present in the system, and that the doses in which we dispense it in ordinary practice must be entirely left out of sight. still, in the face of these obvious conclusions, we have had veterans, grave and grey, arguing pompously that the heroic doses advocated by the writer could not be countenanced, and that even medical men could not be entrusted with the serious task of administering them. even as late as the last medical congress at sydney this absurd objection to large doses of the antidote was again brought forward. after quantities averaging from half a grain to a grain have been injected many times in australia with continuous success, after banerjee has even gone as high as three and four grains in india without a single failure, and without in one single instance serious strychnine symptoms being evoked, the writer of the paper on "snakebite and its cure" based his principal objection to the treatment on the alleged ground of there not being sufficient evidence before us to justify heroic doses and show them to be safe in practice. when people wilfully shut their eyes against the most conclusive evidence, it is improbable that any amount of it would satisfy them. apart, however, from the fully proven antagonism between the two poisons rendering the large doses of the antidote, which in all serious cases are indispensable, perfectly safe, the fear of strychnine is, in itself, a very strange aberration of judgment on the part of my opponents, considering how easy it is to counteract any noteworthy excess in its action, if, perchance, it should occur through unnecessary overdosing, by appropriate remedies. all other objections to the treatment require but to be glanced at to show their absurdity. certain crude experiments on dogs made many years ago in india, and put forward as irrefutable at first, have been abandoned of late, and my learned opponents have now taken up a position in their stronghold of statistics, supposed to be impregnable, but in reality only the last refuge of the destitute, a position from which, by dexterous handling of alleged facts, anything and everything can be proven, in short, to use a strong expression, not my own, a convenient and respectable form of lying. by means of these statistics they try to prove, in the first place, that australian snake-poison is not at all the insidious death-dealing agent it is supposed to be, since, according to statistics, only persons died from it in three colonies within the last ten years. further study of these statistics leads them to the inference that a strong healthy adult will recover from snakebite _without any treatment_, and thus they finally arrive at the conclusion aimed at, that persons cured by strychnine injections would probably have recovered without them. these are the inferences drawn by men, who, practising in towns, have probably never seen a case of snakebite. how do they tally with the facts of the case? it is true that the mortality among those bitten by snakes is small here as compared with india, though the poison of our snakes, quantity for quantity, has been proven to be quite as deadly as that of the indian ones. our greater immunity is due to our snakes giving off less poison at a bite, and with their short and (excepting those of the death adder) merely grooved poison fangs injecting it very superficially, thus making the process of elimination of the poison by ligature and incision or excision of the punctures much more easy and successful. it is to this treatment, which, as a rule; is immediately adopted in the bush, that our small mortality is due. our children are taught it in school, and the most illiterate bushman knows how to carry it out. where it is omitted by persons not knowing that they are bitten until the poison has been absorbed recovery is as rare as it is with the ox and the horse left to themselves without any treatment. but it requires a prodigious stretch of the logical faculty to understand what our small mortality from snakebite has to do with the intrinsic merits of the strychnine treatment. even if nobody died at all its effects in doing away with the misery and suffering, which, before its introduction, invariably followed snakebite, and often was never got rid of completely, would still be sufficiently beneficial to render the senseless opposition to it on the part of a small section of medical men little short of criminal; for these effects are a matter of constant observation, and cannot, like the rescues from death, be called into question. the statistics brought forward to prove that the treatment has not reduced the death-rate are also most faulty. until it is thoroughly understood and in every instance properly applied it is manifestly foolish as well as unfair to lay non-success and failures at its door. when a medical man is called upon to treat a serious case, and instead of boldly addressing himself to the task of combating the symptoms by injecting the antidote irrespective of the quantity he may require until it has conquered the snake-poison, becomes nervous and ceases to inject, when, after what in ordinary practice would be a dangerous dose, he sees but little effect, or if from the first he injects small doses at long intervals, the cause of failure surely lies with him and not with the antidote, which rarely fails where it is properly applied. the duty of disseminating a sound knowledge of the principles of the strychnine treatment unquestionably devolves on our health authorities, who ought, by this time, to have taken some notice of it. but officialdom remains obtuse and issues circulars on the treatment of snakebite, recommending, _inter alia_, the free use of alcohol. the literature on the subject of snake-poison is very voluminous, but those who seek for enlightenment in it will be as disappointed as the writer was after wading through it. the toilers in this barren field of research were numerous, but with few exceptions, they toiled in vain. fontana may be looked upon as the founder of that hideous experimentalism by which, in his hands alone, four thousand animals were tortured to death without a single tangible result except that in his great work, "reserche fisiche sopra il veneno della vipera," which he wrote at the conclusion of his cruel labours, he left us a grotesque monument of patient, but ill-guided research. other italians, following his method, redi, mangili, metaxa, &c., were equally unsuccessful in shedding one ray of light on the vexed and obscure problem. among the germans who contributed to the subject may be mentioned:-- wagner.--"erfahrungen über den biss der gemeinen otter." prinz maximilian von wiedd.--"beiträge zur geschichte brasiliens." lenz.--"schlangenkunde." heinzel.--"ueber pelias berus und vipera ammodytes." among the french:-- soubeiran.--"rapport sur les vipéres de france." bullet.--"etude sur la mosure de vipére." british and american workers are the most numerous. commencing with the century we have:-- russell.--"an account of indian serpents, collected on the coast of coromandel." later on, s. weir mitchell.--"researches upon the venom of the rattlesnake." halford--"on australian snakes, and the intravenous injection of ammonia, in _british medical journal_, _medical times_, and _australian medical journal_." jones.--"on trigonocephalus contortrix." nicholson.--"on indian snakes." sir joseph fayrer.--"the tanatophidia of india." also, "researches in conjunction with richards, brunton and eward." wall.--"on the difference in the physiological effects produced by the poison of indian venomous snakes." proc. royal soc., , vol. xxxii., p. . among those enumerated above wall is the only one who formulated a correct and thoroughly scientific theory of the action of snake-poison, which has since been confirmed by australian research and by feoktistow's elaborate experiments. it is strange that, after finding the theory that explained all the phenomena, he did not follow it up by applying the antidote to which his theory should have led him. snake-poison and its action. the poison gland of snakes is the analogue of the parotid gland of mammals, both in position and structure. its acini or alveoli are lined with a layer of secretory, columnar, finely granular cells and arranged with great regularity along the excretory duct, which is straight and cylindrical and opens with vipers into the hollow poison fang, with our colubrines into the groove on the anterior surface of it. snake-poison, as it leaves this gland, is a thin, albuminoid, yellow liquid of neutral reaction. on exposure to the air it becomes viscid and slightly acid. of its chemical composition we know as yet but little, and it is very questionable whether the most perfect chemical analysis of its constituents would ever have given us a clue to its action or will enrich our present knowledge of it. like all albuminoid secreta it becomes putrid after prolonged exposure and then, through ammonia production, loses its acid, and assumes an alkaline reaction, still, however, though in a modified degree, retaining its toxic properties, which are completely lost only after an exposure of many months. feoktistow found that freezing at ° r. caused the poison to separate into a solid mass and a thin, very yellow liquid, which, even at a temperature of ° r., remained liquid, and the poisonous properties of which greatly exceeded those of the solid mass. boiling diminishes and, continued for any length of time, completely destroys the potency of the poison. the microscope has done good service in the investigation of snake-poison. it has, in the first place, informed us with absolute certainty that there are no micro-organisms or germs of any kind in the fresh poison immediately after it leaves the gland. but a still more important revelation we owe to it is the fact that these organisms, when we introduce them into a % solution of the poison, do not die, but live, multiply, and enjoy their existence most lustily, as they do in any other non-poisonous albuminoid liquid, whilst animals of a higher type--say a snail or a frog--soon perish in it. in watching the movements of the latter we find that they get slower and slower, and finally cease. we now follow up the interesting research, and take two frogs. under the skin of one of them we inject a few drops of the poison solution, the other one for comparison we leave intact, and place both into a glass globe partly filled with water. in a very short time we have no difficulty to identify the poisoned frog. its hind legs begin to drop and their movements become sluggish. this difficulty increases from minute to minute, until at last all motion ceases, and the legs hang down completely paralysed. at the same time we observe that the animal shows increasing difficulty of breathing, that, even when taken out of the water, and placed on the table before us it gasps for breath and is unable to move. at last respiration ceases altogether and the frog dies. two problems now present themselves for solution. in the first place we have to account for the fact of the snake-poison leaving the lower forms of animal life intact and being fatal to the higher ones. the symptoms we have observed in the frog point unmistakably to an affection of the nervous system as their cause. now we know that the lower forms which the poison does not affect have no such system, and we are justified to infer that to the absence of this system they owe their immunity. this inference leads us on to a second one equally justifiable, namely, that there is a certain unaccountable attraction between the delicate nerve tissue and the subtle ophidian poison, which renders the latter a specific nerve poison. our second problem is to ascertain the nature of the change in the nerves, to find out, if possible, whether it is merely functional or an actual interference with the structure of either cells or fibres. with this end in view we once more consult the microscope. we make two preparations, one of nerve fibres and of nerve cells of the poisoned frog, and, under the microscope, compare them carefully with an analogous one from the killed healthy frog. the result is purely negative as regards structural change. both present identical and perfectly normal pictures of apparently healthy cells and fibres. there being no visible structural change we are driven to the conclusion that only a functional one has been effected by the poison, and with the symptoms observed all pointing in that direction, that it is of central origin. the writer's theory as to the action of snake-poison, formed, in the first instance from observations made at the bedside of his patients only, is thus confirmed by experiments specially instituted by him for that purpose. further proof of its correctness we have in the brilliant results of the strychnine treatment of snakebite in australia, which is the outcome and practical application of this theory. in those desperate cases more especially, reported from all parts of the colonies, in which death was imminent, and pulse at wrists as well as respiration had already ceased, the strychnine injections could not possibly have effected complete recovery within a few hours if the structure of the nerve centres had been impaired or blood changes brought about incompatible with life. feoktistow's experiments, made with viper poison, fully bear out the correctness of the writer's theory, besides proving that there is no essential difference between the action of the viperine and colubrine poisons. he proved conclusively that snake-poison does not destroy protoplasm or interfere with infusorial life, that injected into the heart of a mollusc it causes an almost immediate cessation of its action, that hypodermic injections of it in fish produce contraction of the pigment cells and bleaching of the integuments, followed by asphyxial respiration, general paralysis and death. similar results were observed on frogs. in mammals the symptoms were: dyspnoea, asphyxia, paresis and paralysis of the lower extremities with succeeding general paralysis, sometimes tonic and clonic convulsions, hæmorrhages from bowels, lungs, nose and bladder, and finally complete paralysis of respiration and of heart. action of snake-poison on special nerve centres. it must be borne in mind that the symptoms as about to be detailed are successive only to some extent in the order presented. they commence generally at the lower part of the spinal cord, but immediately afterwards, if not simultaneously, are ushered in with great rapidity from other centres, masking each other and rendering it extremely difficult to observe and analyse them separately. they are also very variable through the poison concentrating its action on special centres, leaving others comparatively intact, and this not only when from different varieties of snakes, but also from snakes of the same variety. another element increasing the difficulties of correct analysis are the depressing effects of fear, inseparable in all but the strongest minds from the consciousness of having been bitten, and so similar in appearance to those of snake-poison, that sometimes it is by no means easy to decide which of the two is in operation, and that only those cases are of real value to the observer from which this element of fear is completely excluded. a.--action on the anterior cornua of the spinal cord. the anterior cornua are almost invariably the first of the motor-centres attacked by the snake-poison, the affection (commencing with paresis and in serious cases generally culminating in paralysis) beginning in the lumbar ganglia and taking an upward course. the lower extremities feel unnaturally heavy and a paretic condition of the muscles supervenes _simultaneously on both sides_. the walk becomes unsteady and staggering, very similar to that of persons under the influence of large doses of alcohol. by a powerful effort of the will, however, persons in this condition are often able to walk and even run for some distance, especially if by prompt ligature the absorption of the poison has been checked. as the affection proceeds, though still able to move the legs in a sitting posture, they are unable to rise again. ere long even sitting up becomes impossible and they collapse helplessly. at this stage sensation is still intact, and reflex action, by pricking the skin, &c., still takes place. the upper extremities generally retain the power of voluntary motion, even after the muscles of the neck have become paretic and the head is held up with difficulty or sinks to one side. with birds, according to feoktistow, the reverse is the case. the wings are usually first attacked, or paresis comes on in wings and legs at the same time. b.--action on the medulla oblongata. a.--the vaso-motor centre. whilst the voluntary muscles are thus brought under the influence of the poison, symptoms denoting the invasion of the oblongata are rapidly developing. the first of these is the deadly pallor and ashy hue of the cold skin, evidently due to the blood receding from the surface, a condition not unlike that obtaining in extreme anæmia. as persons in this state complain of an agonising feeling about the heart and of deadly faintness, a paretic condition of the heart suggests itself as the most obvious cause, more especially when taken in conjunction with the small, frequent, and compressible pulse. but though the heart muscle is no doubt participating in the general paresis, the condition of the surface of the body is in reality one of anæmia. the blood, even at this early stage, begins to accumulate in the large veins of the abdomen, which expand gradually in consequence of the diminishing motor force supplied by the splanchnicus, keeping them in the normal state of contraction when intact and having its centre in the medulla oblongata. when this large vaso-motor nerve is cut in animals anywhere in its course, the veins of the abdomen become distended enormously. the animal is, so to say, bled into its own belly. by a series of most interesting experiments feoktistow has shown conclusively that snake-poison has the same effect on the abdominal circulation as section of the splanchnicus. even slight intravenous injections of the poison produced quickly a high degree of paresis of the nerve and a corresponding engorgement of the veins of the abdomen, whilst after lethal doses, the paresis culminated in a few minutes in complete paralysis, followed by rapid collapse, excessive weakness of the bloodless heart, and death from paralysis of the latter and anæmia of the nerve-centres. one experiment deserves special record, as it also shows the untenability of the blood-poison theory. the whole vascular system of an animal poisoned by intravenous injection was thoroughly washed out with the warm defibrinised blood of four animals of the same species, the blood being infused into an external jugular vein and allowed to flow out of a crural artery. although blood exceeding its normal quantity was left in the animal, when the vessels named were closed, the nerve affection remained unchanged. the blood pressure raised during the infusion sank at once again to zero, when it ceased, and the paralysed veins of the abdomen became engorged once more with the whole, or nearly the whole, of the blood-mass, leaving the rest of the body anæmic as before. this interesting experiment also shows how strong a hold the snake-poison has on the nerve-cells when they are thoroughly under its influence, and how independent this paralysing action is of the blood, persisting, as it was in this case, after all the poison had been washed out of the animal. the heart in vaso-motor paresis and paralysis is weakened in the first instance by the direct action of the poison on the medulla oblongata and the intracardiac ganglia. its pulsations, at first retarded in frequency, become accelerated soon after the introduction of the poison, the pulse rate increasing rapidly and the waves becoming smaller and more easily compressible in proportion to the frequency of the pulse, which generally counts from to and more per minute at a comparatively early stage of the poisoning process. but an equally potent cause of heart failure is its depletion by the simultaneous stagnation of the blood mass in the veins of the abdomen. finally, to complete the mischief, we have not only anæmia of the semi-paralytic oblongata, but the scanty blood supply this important centre receives becomes also surcharged with carbonic acid. oxyhæmaglobin disappears almost entirely from the blood under the circumstances detailed, as both pulmonary and internal respiration are greatly interfered with, the blood tending more and more towards that thin dark condition which it presents after death, and which has been taken as _prima facie_ evidence of the direct blood-poisoning action of snake virus by one and all of previous investigators. that under the powerful combination of causes, each of which is in itself sufficient to endanger life, and greatly intensified as paresis gradually deepens into paralysis, the heart, even of large animals, succumbs in a comparatively short time, may be readily understood. the _blood-pressure_, under the circumstances just detailed, must necessarily be _nil_. observations by means of the sphygmograph at the bedside of a person suffering from snake-poison are scarcely feasible, except, perhaps, in a hospital, and thus far are not on record. we must, therefore, once more fall back on feoktistow's experiments, which show that even the smallest doses ( . to . mllgr.) of the dried poison _per kilo_ injected into the vein of a cat caused a fall in the blood-pressure almost immediately, without influencing either pulse or respiration, but that two to four mgr. were sufficient to reduce the blood-pressure to zero and bring on collapse, infusions of blood only raising it temporarily. of drugs raising the blood-pressure he found ammonia the most effective, but only after slight doses of the poison; after lethal ones it had no effect whatever on the blood pressure but greatly increased the hæmorrhagic process in all internal organs. this important observation should be kept in mind by those who inject ammonia in serious snakebite cases, and it probably applies likewise to _the excessive use of alcohol_. this leads the writer on to the discussion of this singular hæmorrhagic process principally characteristic of viperine poisoning, and only very exceptionally produced by the poison of colubrines. it is among the symptoms of snakebite poisoning one of the most interesting ones, but also one most difficult of explanation. there can be no doubt that it is produced by vaso-motor paresis and paralysis. we further know that it is preceded by dilatation of the capillaries and small veins, and that it is effected principally through the process known as diapedesis, or the passage of both red and white corpuscles with plasma through the unruptured capillary membrane, and even the thin one of small veins, which is nearly of the same structure, being composed of endothelial cells united by cement. this membrane possesses a certain degree of porosity, which is probably increased by dilatation. in the absence of plain muscular fibres contraction and dilatation of the capillaries can only be effected by a corresponding contraction and expansion of the nuclei of the endothelial cells. as fibrils derived from non-medullated nerves terminate in small end-butts in connection with the capillary membrane, we may assume that the nuclei of the endothelial cells are under the sway of vaso-motor nerve currents, that weak ones will expand, strong ones contract them. we may further assume that the red and white corpuscles force their way out of the vessels through pores in the cement substance, since a passage of cell through cell is not thinkable. thus far we see our way fairly clear. but the question now arises: what causes the solid constituents of the blood to force their way through the capillary membranes all over the mucous surfaces, even the conjunctiva, and not these alone, but also through serous membranes such as the pericardium, and strangest of all, through old scars in the skin? if the most modern ideas as to the cause of diapedesis being blood pressure are correct, it is quite incomprehensible how it can take place in the absence of blood pressure, and take place so extensively. the theory of blood pressure may apply to diapedesis accompanying the inflammatory process. in snakebite poisoning it is more likely to be due to passive engorgement of the capillary system and probably also to blockage of corpuscles in the finest capillary tubes. in vaso-motor paresis, and still more paralysis, the arterioles supplying the capillaries are widely dilated, and at the lowest blood pressure probably send more blood into the latter than in the normal state. this circumstance in itself is apt to cause capillary engorgement. in the finest capillaries permitting only a string of corpuscles, one behind the other but none abreast, to pass through in the normal state, dilatation may cause blockage by two or three becoming wedged in abreast and closing the lumen of the vessel by a sort of embolism. on the arterial side of this obstruction the crowded corpuscles force their way through the porous cement substance by what little "vis a tergo" there may be left yet, whilst in the venous side, in the small veins corresponding with the closed capillaries, engorgement must necessarily take place through this "vis a tergo" being entirely absent, and diapedesis, which here also has been observed, follow in due course. the writer has always been inclined to take this view, the correctness of which appears to be borne out by an experiment recorded by feoktistow. he found on sprinkling a two per cent. solution of snake-poison over the mesentery of an healthy animal, that wherever a drop of the solution fell, almost immediately the capillaries and small veins became dilated and small point-like effusions of blood appeared, gradually enlarging and ultimately becoming confluent with adjoining ones. large hæmorrhagic surfaces were thus formed in a comparatively short time. here paralysis of the nerve-cells interspersed in the vaso-motor nerve-ends was evidently the first effect, followed by dilatation of the capillaries and immediately afterwards by effusion. without some obstruction within the capillaries, like that above described, effusion in this purely local poisoning process appears unexplainable. the special preference which the viper-poison has for the vaso-motor sphere will hereafter be referred to. hæmorrhages from australian snake-poison are comparatively rare. even at the bitten place there is as a rule very little swelling and effusion and frequently none at all. when it occurs it quickly disappears after strychnine injections. only a few cases have been reported as yet of blood-vomiting. in one of these the hæmorrhage took place soon after the bite and was so considerable that it must have arisen from actual rupture of vessels consequent on abdominal engorgement and not from mere diapedesis. it is very doubtful whether the latter ever takes place here as it does after viper-bite in india and elsewhere. even the death-adder, although half a viper, and producing more swelling and effusion locally than any other one of our snakes, is not known to have ever produced the extensive effusions from mucous surfaces in pericardium, lungs, &c., described above. more research however is necessary, especially more carefully conducted autopsies. since australia has taken the lead in this hitherto so obscure department, every practitioner should make it his object and special ambition to contribute his quota towards the elucidation of the subject, not only by reporting successful cases, but also the post-mortem appearances in unsuccessful ones, wherever it is practicable. it is not by experiments on animals but by a hearty co-operation of australian practitioners that we can ever hope to supplement our knowledge on this subject. b.--the respiratory centre. paresis of this centre does not play as important a part here as it does in india, more especially after cobra-bite. the peculiar, and as yet unexplained, tendency of snake-poison to act with special virulence on some centres, passing others by comparatively little disturbed, is markedly shown by the cobra poison of india as compared with that of our australian cobra (_hoplocephalus curtus._) the unfortunate victims of the former are tortured by an ever-increasing dyspnoca, and finally die from asphyxia, under what are supposed to be carbonic acid convulsions. they retain their consciousness more or less unclouded to the last, the poison spending all its force on the respiratory centre, and leaving the brain intact. here we hardly ever see actual dyspnoca after the bite of hoplocephalus or any other australian snake. respiration becomes quicker at an early stage, and then, from hour to hour, shallower; but our patients soon pass from sleep into coma, and suffer no respiratory distress even when, in consequence of general paralysis, the respiratory muscles cease to act, which usually takes place a few minutes before the heart stands still. feoktistow records the following observations on cats with reference to the respiratory centre:--small intravenous injections of the fresh poison ( . - . mllgr.) produced a great increase in frequency of respirations ( - per minute). section of both vagi at once reduced this frequency, from which he infers that small doses act as an irritant to the respiratory centre. when small doses were repeated several times, the respiratory movements were gradually retarded, and asphyxia set in through paralysis of the centre. large doses produced this effect at once, without any previous acceleration. very large ones paralysed respiration, heart, and vaso-motors almost simultaneously, and caused the blood pressure to fall to . by the kymograph respirations were found to become shallower in proportion to their frequency. as the latter was reduced, they became at first deeper, but ere long shallower again, and were occasionally interrupted by spasmodic inspirations. artificial respiration prolonged life for a short time only. c.--action on centres of cranial nerves. among the symptoms denoting paresis of motor-centres of cranial nerves, together with sympathetic ganglia, the first and most noteworthy is the early dilatation of the pupil. this truly pathognomic condition is never absent, and becomes intense when paresis becomes intensified into paralysis. the most glaring light, in immediate proximity to the eyeball, has then no effect whatever on the pupil. if it remains dilated after strychnine injections have restored consciousness and the power to walk, it is a sure sign that the snake-poison is not completely counteracted, and will in all probability re-assert itself, necessitating another injection, whilst a pupil restored to its normal condition justifies the conclusion that the patient is safe. another symptom denoting paresis of the cranial nerve-centres is a marked change in the expression of the face. the features become relaxed, and lose their mimetic play. the cornea is dull, and, together with the anterior surface of the eyeball, becomes dry, as the eyelids are moved imperfectly, if at all, and the tears in consequence are not properly distributed over the conjunctiva. the nostrils become more or less immovable, and the naso-labial fold is obliterated, whilst the lower lip hangs down. the lips are apart, as the lower jaw is not held up by the muscles. when paralysis supervenes it drops entirely, and the tongue protrudes. deglutition, somewhat difficult in paresis, is completely suspended in the paralytic stage, through paralysis of the soft palate, the pharynx, and oesophagus. liquids forced on the patient in this extremity may partly flow down the oesophagus, but will also enter the larynx, and their administration should be carefully avoided. d. action on motor-centres of cerebellum and basal ganglia. of this action little if anything is patent to observation. a certain want of co-ordination in the movements has been noticed in the early stage of paresis, and the peculiar staggering walk of persons in this stage is probably owing to an affection of the motor-centres of the cerebellum. that they do not escape the action of the subtle poison, when symptoms denoting the invasion of all the other motor-centres throughout the body are in evidence, we have every reason to assume. the co-ordination and automatic regulation of the lower motor-centres must necessarily escape observation when the function of these centres is partially suspended, and when, moreover, the powerful currents of nerve force the cerebellum and basal ganglia receive from the motor cortical centres of the cerebrum are partially if not wholly withdrawn. e. action of the motor cortical centres of the cerebrum. in all but the very lightest cases of snakebite-poisoning there are always symptoms manifested that cannot be referred to any other cause than an invasion of the centres now under consideration. they range from mere stupor, confusion of thought and delirium to the deepest coma, with complete extinction of consciousness and insensibility to all external impressions. coma is a frequent and in serious cases an almost invariable symptom in australia. after the bite of our death adder only we find persons sometimes collapse and expire suddenly, when still conscious and able to answer questions rationally. coma invariably develops from sleep. it is, in fact, sleep intensified. an almost irresistible desire to sleep is one of the first symptoms to be observed. if the dose of poison imparted by the snake has been small, the desire may pass off or the sleep may not assume the form of coma, but in all serious cases it quickly assumes that form. _vice versa_ the deepest coma becomes sleep again, when the suspended function of the cortical centres is roused by strychnine injections. the insensible and completely paralysed patient usually announces the gradual return of consciousness by a few groans and uneasy movements and not unfrequently begins to snore, as in ordinary sleep, when a smart shake at the shoulder will rouse him into full consciousness. at other times this transition from coma back to sleep does not take place and consciousness returns quite suddenly, the persons opening their eyes and looking around them, dazed and bewildered, but perfectly conscious at once. when coma is fully established and the largest and most powerful motor-centres have succumbed to the insidious poison, general paresis becomes general paralysis and all the motor-centres of the body are in a condition of more or less suspended functional activity. this and this only is the condition of the centres, the whole secret of snake-poison, that has puzzled the human mind for ages and yet appears so simple when discovered at last. it is beautifully and strikingly illustrated in the phenomena before us. we have coma and complete general paralysis, every motor-nerve cell, from the highest psycho-motor one downwards, is thrown into a state of torpor and has ceased to discharge the life force that regulates every process of life and the entire absence of which inevitably must be death. only weak, lingering currents are sent forth yet and put off the inevitable finale for a time. but the strychnine is injected and mark the change. it courses quickly to every one of the sleepers, for whom it also has an affinity, but the direct opposite to that of the deadly venom that has overpowered them. it touches them as if with the wand of a magician and orders them to awake and do their work. there is no disobeying the mandate, for it is founded on one of nature's unchangeable laws. almost immediately the cells begin their work again, the life streams flow afresh, coma and paralysis vanish and within a very short time the subject of this beautiful experiment is snatched from the brink of the grave and restored to life and health. the phenomena of sleep and coma as the result of a poison acting as a depressant of motor nerve force afford food for some interesting speculations, which, however, as more concerning the psychologist, the writer can only glance at here. it is evident that in the highest of psycho-motor centres, the organs of thought and of consciousness, the paresis of the lower centres assumes the form of sleep, and paralysis that of coma. sleep, as a partial, and coma, as a complete, obliteration of thought and consciousness must, therefore, be intimately connected with motor nerve function, sleep being a reduction, coma a suppression of the function, or a suspension of thought. ideation, to use j. s. mill's very appropriate term for the thought process, appears to be effected by motor nerve currents or, at all events, to be accompanied by them and suspended with their suspension. the thinking principle, the nous within us, is no doubt more than mere nerve action, but it can, apparently, not manifest its presence without motor nerve cells in healthy action. every thought, though not synonymous, is evidently synchronous with a current of motor nerve force, and it is not improbable that, by means of these currents, that silent transference of thought is effected from brain to brain, which modern psychology has demonstrated to be not only possible but actual under certain conditions. but further speculation on these interesting mysteries it would be out of place here to indulge in. f. action on sensory centres and the reflexes. the sensory sphere remains comparatively unaffected in mild cases, and in the early stages of more serious ones, but when paresis has deepened into paralysis, sensation becomes ever more blunted, and with the advent of coma, of course, quite extinct. reflexes, both superficial and deep ones, are also completely abolished at this period of the poisoning process, and the nerves of special sense do not react against any, even the strongest possible stimulation. the eye stares vacantly into a glaring light held close before it, and the widely dilated pupil shows no sign of reaction. the ear also appears deaf to any noise, and strong ammonia vapour is inhaled through the nose like the purest air, whilst pricking, beating, and even burning the skin elicit not a quiver of a muscle. feoktistow's experiments with regard to reflexes, more especially their restoration by strychnine, differ in their results entirely from australian observations. whilst we have no difficulty in restoring them with the drug on man as well as the domestic animals, his experiments on frogs were a failure, and merely showed a decided antagonism between the two poisons. he did not succeed in restoring the reflexes, and, instead of following up with experiments on the higher animals, he trusted implicitly to his results on frogs, and thus lost his opportunity. g. irregularities in the action of snake-poison. there is in the whole range of toxicology not a single condition known to us in which the symptoms, both in chronological order and in their strength and relation to each other, show as much variety as those of snake-poison. experienced observers will agree with the writer that it is but rarely we find two cases of snakebite exactly alike in the symptoms they present. some of these puzzling variations have already been alluded to, but it is necessary to consider them a little more in detail. apart from quantitative differences in the poison imparted, they arise principally from the strange capriciousness with which the poison concentrates its action on special nerve centres and leaves others comparatively intact. the nearest approach to regularity and orderly sequence of the symptoms, as described in the foregoing pages, we find in australia after the bite of the tiger snake (_hoplocephalus curtus_) and the brown snake (_diemenia superciliosa_), more especially that of queensland. here we can trace the action of the poison distinctly from centre to centre, from the lowest part of the anterior cornua up to the cortex cerebri, and even throughout the sympathetic ganglia as far as they are patent to observation. the poison of these snakes is extremely diffusible and quickly absorbed. it spreads with rapidity and nearly equal force over all the motor centres, the symptoms following each other so quickly as almost to appear simultaneous, though, in reality, successive. but even the poison of these snakes leaves the arms only slightly paretic, when paralysis in all the other voluntary muscles is well pronounced, and does not paralyse them until coma has set in. it also touches the respiratory centre but slightly. sometimes coma is light and the patients can be roused for a little while, at other times it is deep and lasts till death. but even greater variations are observed occasionally. in one very extraordinary case of tiger snakebite, the patient, a child of years, remained conscious to the last, and after vomiting blood freely died under symptoms of heart failure. in rare cases the symptoms resemble those of cobra poison. if we turn from these to the black snake (_pseudechis porphyriacus_) a different picture presents itself. its poison does not produce so deep a coma and often none at all. the patients generally feel drowsy and fall asleep, but are easily roused and sometimes awake spontaneously. there is also not the same amount of muscular paralysis. they are frequently able to walk a few steps with assistance and can move in bed, the arms especially being almost free from paresis. but the insidious poison none the less does its work, though its effects are less patent. it concentrates its action on the vaso-motor centre. the victims from hour to hour become more anæmic in appearance through increasing engorgement of the abdominal veins. anæmia of the nerve-centres hastens the collapse, and from the combined effects of this and heart failure death takes place suddenly and quickly as if in a fainting fit. here then we have an approach to the effects of viper poison which is also shown in the greater amount of swelling and effusion around the bite and in the bitten limb. this approach is still closer in the poison of the death adder (_acantophis antarctica_). there is generally much extravasation of blood locally. muscular paralysis is also less pronounced, but sudden collapse from vaso-motor paralysis not unfrequently takes place, when the patients fully conscious are still able to sit up. that leading feature of viper poison, diapedesis with hæmorrhage, does not occur with either. if we turn from australian to indian snakes, the peculiar tendency of the poison to concentrate its action on special nerve-centres becomes still more marked. the predilection of the cobra poison for the respiratory centre has already been dwelt on. more remarkable and strange is the action of the indian viper-poison on the minute ganglia in the vaso-motor nerve ends, which control the capillary circulation, and by their paralysis bring about extensive hæmorrhage through diapedesis. it is quite impossible for us with our present scanty knowledge to account for these peculiarities and irregularities in the action of a poison, which we know now to accomplish its destruction of animal life by one uniform design and principle of action. that the protean forms under which the poison-symptoms present themselves are one and all the result of reduction and suspension of motor nerve currents may now be accepted as a well proven and fully established scientific fact. but why the effects of one and the same cause are so varying in their appearance, why the poison of different varieties of snakes, and even that of the same variety under different circumstances, make such a capricious selection among the various motor nerve-centres we can not explain and probably never will. chemical analysis of the dead poison, no matter how minutely and elaborately it may be effected, will probably never throw much light on the "why" of this strange puzzle, for the subtle phenomena of life are apt to elude the grasp of the analyst. we have to do with a poison transferred from one living organism into another one and modified in its action by the condition of the giver and the constitution and peculiarities of the recipient quite as much probably as by slight variations in its chemical composition. accepting the "why" of these phenomena like that of many other ones, simply as a fact not to be accounted for at present, we must be content to know "how" they are effected, and, what is of more immediate and paramount importance to know, that we now have an antidote that will deal successfully with them all, that the convulsions and hæmorrhages of the indian viper-poison and the asphyxia of that of the cobra will yield as readily to strychnine, when properly and boldly applied, as the coma and general paralysis following the bite of the deadly tiger snake. [illustration] the antidote. the theory of the action of snake-poison as that of a specific nerve-poison, depressing and more or less suspending the function of the motor nerve-centres throughout the body, has in the foregoing pages received a double proof of its correctness. in the first place, all the symptoms the snake-poison produces have been passed in review, and shown to be fully explainable by this theory. on this ground alone it may be claimed to have been fully established; for it is an axiom in science that a theory on any subject must be accepted as correct, if it accounts satisfactorily for all the phenomena observable in connection with that subject by showing them to result from the operation of one law. the second inductive proof of the correctness of the writer's theory has been rendered by the experiments of feoktistow on animals. science, however, demands that a theory thus established inductively must also stand the test of practical application or deduction. it says in the present case:--"granting your theory to be correct, it is but a theory, which, however valuable it may be as a contribution to science, is of little value to mankind if you cannot apply it practically. if snake-poison merely acts as a depressant on motor nerve-cells without interfering with their structure, you must be able to counteract it by administering some drug or substance which acts as a powerful stimulant on these cells, if such a substance can be found." it is another illustration of that wise adaptation of means to ends which, throughout the domain of nature, denotes the presence and rule of a supreme intelligence, that this substance has been provided for us by nature, though we have been long in finding it. its discovery in strychnine, and its successful application as the long and vainly sought antidote to snake-poison, are glorious triumphs of scientific deduction. strychnine is the exact antithesis to snake-poison in its action. under its influence every motor nerve-cell throughout the system sends forth stronger currents of nerve force than it does in its normal state. these currents run alike from cell to cell, and from cell to peripheral fibre, and act by means of the latter on all contractile, and especially all muscular tissue, causing contractions, which, after poisonous doses of the drug, assume the form of tetanic convulsions, provoked by the slightest touch or even noise in consequence of highly intensified reflex action. whilst, then, snake-poison, as we have seen, turns off the motor-batteries and reduces the volume and force of motor-nerve currents, strychnine, when following it as an antidote, turns them on again, acting with the unerring certainty of a chemical test, _if administered in sufficient quantity_. purely physiological in its action, it neutralises the effects of the snake-poison, and announces, by unmistakable symptoms, when it has accomplished this task, and would, if continued, become a poison itself. previous to this announcement its poisonous action is completely neutralised by the snake-poison, and the latter would therefore be equally as efficacious in strychnine-poisoning as strychnine is in snake-poisoning. strychnine, in short, is the antidote _par excellence_ of snake-poison, and cannot be surpassed by any other substance known to us. with the symptoms following the introduction of the subtle ophidian virus into the human and animal system so markedly pointing to strychnine as the antidote, it appears a matter of surprise that it was not used as such before and that it was left to the writer to discover the antagonism between the two poisons. misleading experiments with the drug on animals erroneously considered to be final in their results, together with confused and contradictory notions about the action of snake-poison, were the chief factors, already pointed out, that caused research on this important subject to remain for centuries so barren of results, and made even able investigators with more correct views than the rest, postpone the discovery of a physiological antidote to a more advanced state of science, when all the time it was lying ready at their hands. it is self-evident from preceding statements, that in the treatment of snakebite with strychnine the ordinary doses must be greatly exceeded, and that its administration must be continued, even if the total quantity injected within an hour or two amounts to what in the absence of snake-poison would be a dangerous if not a fatal dose. timidity in handling the drug is fraught with far more danger than a bold and fearless use of it. the few failures among its numerous successes recorded during the last four years in australia were nearly all traceable to the antidote not having been injected in sufficient quantity. even slight tetanic convulsions, which were noticed in a few cases, invariably passed off quickly. it should be borne in mind that of the two poisons warring with each other that of the snake is by far the most insidious and dangerous one, more especially in its effects on the vaso-motor centres. the latter are wrought very insidiously, and where they predominate require the most energetic use of the antidote, for whilst the timid practitioner after injecting as much strychnine as he deems safe stands idly by waiting for its effects, the snake virus, not checked by a sufficient quantity of it, continues its baneful work, drawing the blood mass into the paralysed abdominal veins and finally by arrested heart action bringing on sudden collapse. in such cases even some tetanic convulsions are of little danger and may actually be necessary to overcome the paralysis of the splanchnicus and with it that of the other vaso-motor centres. whilst then it must be laid down as a principle that the antidote should be administered freely and without regard to the quantity that may be required to develop symptoms of its own physiological action, the doses in which it is injected and the intervals between them must be left to the practitioner's judgment, as they depend in every case on the quantity of snake-poison absorbed, the time elapsed since its inception and the corresponding greater or lesser urgency of the symptoms. if the latter denote a large dose to have been imparted and it has been in the system for hours, delay is dangerous and nothing less than minims of liq. strychnine p.b., in very urgent cases even to minims should be injected to any person over years of age. even children may require these large doses, as they are determined by the quantity of the poison they have to counteract and are kept in check by it. the action of the antidote is so prompt and decisive that not more than to minutes need to elapse, after the first injection, before further measures can be decided on. if the poisoning symptoms show no abatement by that time, a second injection of the same strength should be made promptly, and unless after it a decided improvement is perceptible, a third one after the same interval. as the action of strychnine when applied as antidote is not cumulative, no fear needs to be entertained of violent effects suddenly breaking out after these large doses repeated at short intervals. they are, so to say, swallowed up by the snake-poison and remain latent except in counteracting the latter. this has now been proven abundantly by scores of qualified observers in all parts of australia, and still more by banerjee in india. no hesitation, therefore, should be felt by medical men in other snake-infested countries to adopt the australian treatment. it is seldom that more than half a grain of strychnine administered in m. doses of liq. strychniæ is required here to effectually counteract the venom and place its intended victim out of danger. ligature and excision of the bitten skin have usually been practised and much of the poison eliminated before the antidote is applied. our snakes, however, as already pointed out, with their shorter and merely grooved fangs, do not perforate the cellular tissue to such depth nor instil as large a quantity of poison as the cobras, kraits and vipers of india or the rattlesnake of america, all having perforated and much longer fangs and much more productive poison glands. even if after the bite of a vigorous cobra, for instance, a ligature has been applied and the bitten part deeply excised, a comparatively large quantity of poison will probably be absorbed requiring much larger quantities of the antidote, perhaps grains of it, to effect a cure. if under the influence of these large doses the symptoms abate, or if the latter are comparatively mild from the first, smaller doses of strychnine should be injected, say from / th to / th of a grain, but under all circumstances the rule that, distinct strychnia symptoms must be produced before the injections are discontinued, should never be departed from. this rule is a perfectly safe one, for its observance entails no danger, a few muscular spasms or even slight tetanic convulsions being easily subdued and harmless as compared with that most insidious condition exemplified in case no. , cited below, the first one treated with strychnine by the writer, who, having no experience in the treatment, did not administer quite enough strychnine. the patient, after apparently recovering from a moribund condition and being able to walk and even to mount a horse, remained partly under the influence of the poison and succumbed to it during sleep, when, according to subsequent experience, one more injection would have saved him. the tendency to relapses is always great when much snake-poison has been absorbed. apparently yielding to the antidote for a time, the insidious venom, after a shorter or longer interval, during which it appears to have been conquered, all at once re-asserts its presence, and has to be met by such fresh injections, regardless of the quantity of strychnine previously administered, but the amount required in most relapses is not a large one. the writer formerly inclined to the belief that the strain thus put on the delicate nerve-cells would limit the usefulness of the antidote to cases requiring not much above a grain. knowing the indian snakes to impart to their victims such comparatively large quantities of venom, he had strong misgivings as to his method standing the severe test of indian practice; and it was most fortunate for this method that its first practical application in india was made by a gentleman who, whilst thoroughly familiar with its principles and convinced of their correctness, had the courage to apply them fearlessly by injecting what to us australians appear enormous quantities, ranging as they do up to three and four grains per patient. dr. banerjee's eight cases, all successful, and of which the most important one, relating to the much and justly dreaded duboia russellii, was published in the november number of the _australasian medical gazette_, settled the treatment of snakebite in india as well as elsewhere. if the poison of bungarus coeruleus, echis carinata, and duboia russellii can be successfully counteracted, and if for this purpose four grains of strychnine can be injected with perfect impunity, it may be inferred with certainty that the poison of the cobra, fer-de-lance, and the rattlesnake--in fact, of any snake known to us will be found amenable to the antidote, and that, if four grains can be injected with safety, we may venture on six and eight grains, if they are required. in those cases only where the long fangs of these snakes perforate into a vein, and a large quantity of the venom injected into the blood-stream overpowers the nerve-centres so as to make death imminent, if not almost instantaneous, the subcutaneous injections may be found of little use. here intravenous injections of half a grain and even one grain doses would appear to be indicated, and might yet fan the flame of life afresh, even when respiration and pulse at wrist have already ceased. we have seen both these functions extinct in australia and restored by comparatively small doses of the antidote, and can see no reason why a more energetic use of it should not restore them in india. considering the terrible mortality from snakebite in india, dr. banerjee's merit in being the first to introduce the strychnine treatment there is of a very high order, and his grateful countrymen will ever cherish his memory. when his excellency the viceroy had been appealed to in vain by the writer, and the adoption of his method in india urged through two australian governors, a native of india has stepped forward and taken the first step towards alleviating an evil that has hurried over two millions of his countrymen in every century to an untimely grave. the cases as reported by him to the _australasian medical gazette_ are cited below. [illustration] cases. if the deductions and conclusions set forth in the foregoing chapters are correct, it may be justly contended that all cases of snakebite treated with strychnine should invariably end in recovery if the antidote is properly applied, according to the rules above detailed. this contention the writer fully and cordially endorses. given the largest amount of poison a snake can give off at one bite, strychnine injected in time and sufficient quantity--either by the hypodermic, or, if urgent, by the intravenous method--must rouse the dormant nerve-cells into action, as long as the vital functions are not completely extinct. wherever it fails, the fault lies with the operator not injecting it in sufficient quantity--a fault committed by the writer himself in his first case. the following condensed accounts of fifty cases treated in australia, and eight in india, the writer has taken mostly from the _australasian medical gazette_. two of these only are from his own practice; others were kindly communicated to him by his colleagues. it is not claimed that all these cases were rescues from certain death. some of them undoubtedly were, others would have recovered under some other treatment or no treatment at all; but in none of them would recovery have been so rapid and complete. the two poisons are thrown out together, and no ill-effects of either are experienced beyond a certain degree of weakness, which passes off quickly. this is a boon to be appreciated fully by those only who have gone through the slow, lingering, and painful process of convalescence from snakebite as formerly treated, with its deadly languor and weariness, making life itself a burden and all physical and mental exertion impossible. case .--a. h., years old, a farm labourer, was bitten on the right index finger whilst feeling for a rabbit in a burrow. did not see the snake nor suspect snakebite, but collapsed helplessly in a few minutes after returning to his work. the writer saw him three hours after the accident. he was then completely paralysed and in deep coma; pupils widely dilated and not reacting to light; sense of sight and hearing dead; heart action extremely feeble; pulse small, thread-like, and scarcely countable; respiration quick and shallow; skin blanched and very cold. seeing him dragged along the road between two men, had him quickly carried to the next house, and injected minims of liq. strychnine. only a groan or two and a slight improvement in the pulse, indicating a change in his condition, gave him a second injection about twenty minutes after the first one. a change for the better then became rapidly conspicuous. the pulse gained in strength from minute to minute, respiration became deeper, and the coma was visibly reduced to mere sleep, from which there was no difficulty in rousing him to full consciousness by a vigorous shake of the shoulders. this marvellous change was brought about within forty minutes; and this being the first case to which the writer had applied his theory by injecting strychnine, its unparalleled success exceeded his most sanguine expectations, but unfortunately also lulled him into a false sense of security, which proved disastrous to his patient. not knowing then as he does now that the snake-poison after having been subdued by the antidote is not thrown out of the system as quickly as the strychnine, and is therefore apt to re-assert itself, he allowed another urgent engagement to take him away from the lad after watching him for two hours and actually taking the evening tea with him. his instructions to the mother not to let her son go to sleep and to watch him carefully for the slightest sign of the return of symptoms, were unfortunately disobeyed. both mother and son went to sleep, deeming all danger over. during this sleep the lad again relapsed into coma and was found so at daylight. all attempts to rouse him were fruitless, and he died before the messenger intended for me had time to saddle a horse. the death of the unfortunate lad, however, has saved some lives since. it taught the writer the lesson never to trust to the apparent success of the antidote until it shows distinct signs of its own physiological action, and even then to watch his patients carefully for the first twenty-four hours, and let them sleep for short periods only. case .--a.h., a vigorous girl of years, bitten above the left ankle by a snake in some long grass, and therefore not identified. had applied two tight ligatures above the bite, ran home and got her mother to cut out the bitten skin, showing two distinct punctures. seen within an hour after the bite the girl presented distinct, but moderate symptoms, deadly paleness, very cold skin, small frequent pulse, and a peculiar feeling of agony about the heart, just able to sit upright, but unable to walk. all symptoms increased rapidly after writer cut ligatures. she reeled from side to side, and suddenly fell forward as if in a swoon. injected / th grain of strychnine and, as she did not lose consciousness, was able to watch the interesting and rapid effect of the antidote. it had not been injected more than five minutes when slight colour returned to the cheeks, naturally very red. patient then stated that the distressing feeling about the heart was getting less and also that of drowsiness. from minute to minute her condition improved, and in about ten she was able to rise and walk a few steps. profiting, however, by the lesson his first case had given him, the writer did not trust to her apparent recovery, but seeing that much of the poison had been eliminated by the prompt measures taken before he saw her, he injected only / th of a grain, which produced slight muscular spasms. careful precautions were taken in this case against a relapse, but none took place, and when visited next morning the girl declared herself as well as ever she had been in her life. the following notes of two cases of tiger snake bite (_hoplocephalus curtus_), treated with strychnine, were read by dr. thwaites before the intercolonial medical congress of . this gentleman, a young practitioner just entering practice, had the courage to use the antidote according to the writer's directions in spite of the hostile criticisms of his seniors in the profession and even his own university teachers, and thereby not only saved two valuable lives, but also set a praiseworthy example, which was soon followed by others. the writer gives the notes abbreviated. case .--j. b., a strong, robust labourer, bitten by a tiger snake on the back of right hand. killed the snake, which hung on to the hand and was with some difficulty shaken off. made slight incision through the punctures and tied a rag round the wrist, but too loosely to check circulation; then started for the next neighbour's house, distant a mile, which he reached with difficulty, staggering like a drunken man when he arrived. the bitten skin was here excised, whisky administered and patient sent on in a buggy, but distance being miles to dr. thwaites' residence, a messenger on horseback galloped ahead to get dr. thwaites to meet buggy on road. the latter writes: "i met buggy four miles from my residence. patient had to be held up on the seat of the vehicle between two men. he had not spoken for some time, pulse very weak, pupils greatly dilated, face very pale. i injected minims of liq. strychnine p.b. at once, and in a few minutes noticed some improvement. he now answered when spoken to, his pulse became stronger, and he could walk a few steps. this was at . p.m., and he kept up fairly well till . , when he collapsed completely. i now injected minims of liq. strychniæ, which in a short time brought him round; but at . another relapse took place, when a third injection of m. was made. this was followed by slight twitching about the face and neck, after which improvement and recovery were uninterrupted." dr. thwaites' second case is even more remarkable and telling. when the girl, after a journey of miles, was carried into his surgery, she appeared to be dead, and a second medical man, who happened to be present, declared her to be so, and all attempts to revive her useless. case .--a. d., aged years, a schoolgirl, bitten by a vigorous tiger-snake on the outside of left leg, the snake also holding on for some time. she at once tightened her garter above the knee and ran home, a distance of three-quarters of a mile. the bitten skin was at once excised, another firm ligature applied, whisky administered, and a hurried start made for dr. thwaites', distant miles, where she arrived five hours after accident. the latter writes:--"she was then pulseless at wrists, cold as a stone, and with pupils insensible to light. i could not perceive any respiration, but felt the heart yet faintly fluttering. she was to all appearances just on the point of death. i injected at once minims of liq. strychniæ. in about two minutes she sighed, and then began to breathe in a jerky manner. in about ten minutes, on my pulling her hair, she opened her eyes and looked around, but could not recognise any one. pupils now acted to stimulus of light. in a short time she could speak when spoken to, but not see at any distance. her sight gradually returned completely; she kept on improving, and in four to five hours after the one injection she seemed quite well, but rather weak. i gave small doses of stimulants till morning, and did not let her go to sleep till next evening. she suffered no relapse, and her recovery was complete." case .--this remarkable case was not published in the medical press, but in many of the papers of queensland, where it created much sensation. the writer is indebted for an account of it to dr. thwaites, who vouches for its correctness. it appears that this gentleman acquainted the well-known explorer of northern queensland, mr. johnstone, who is his uncle, and now police magistrate at maryborough, queensland, with his success in treating snakebite with strychnine. mr. johnstone, who during his explorations had seen much of snakebite and many deaths from it, wrote rather incredulously in reply, stating that our southern snakes were innocuous in comparison with those of the north; and that, having seen twelve persons bitten and die by the deadly brown snake of the north (_diemenia superciliosa_), he must withhold his belief in the new antidote until he had witnessed a case of brown snakebite cured by it or reported on good authority. this desire he had quickly gratified, and by a strange fatality in his own person. whilst taking his children for a walk in the bush a few weeks afterwards he stepped aside the path to pluck a flower from a bush, and in doing so was bitten on the leg by a vigorous brown snake. he at once applied a ligature, and had the punctures sucked by an aboriginal, but became comatose before he reached home. three medical men were summoned in haste, injected ammonia into several veins, and finally had to resort to artificial respiration, declaring the case a hopeless one. in this extremity mrs johnstone rushed to a fourth one, who had seen dr. thwaites' letter, and discussed its contents with her husband in her presence. this gentleman--dr. garde--laid up in bed, quickly furnished the lady with liq. strychniæ, accompanied by the request to his colleagues to inject it freely. she came back to her husband's bedside, when artificial respiration was about to be given up, but the very first injection rendered it no longer necessary and two more restored mr. johnstone completely. saving the life of this highly respected and popular functionary, who was the first in queensland treated with the antidote, paved the way for it in that colony, where it is most needed and is now highly appreciated. these five cases, thoroughly typical of the effects of strychnine in snakebite, are almost in themselves sufficient to bear out the correctness of the writer's deductions, but for the benefit of a certain class of rigorously incredulous scientists, who would not be satisfied with five cases, the writer submits more and in addition to these--last but not least--dr. bannerjee's eight indian cases. they are all well authenticated, being mostly taken from the _australasian medical gazette_ or from private notes, but to avoid useless repetition the greater part of them will be merely cited and only the more remarkable ones be given in detail. whether in the face of this formidable array of evidence that blind incredulity and senseless opposition, usually blocking the way of every new discovery, will at last give way, remains to be seen. the writer has had his full share of them, and but for the valuable aid he received from the hon. dr. creed, the able editor of the _a. m. gazette_, would probably be struggling yet for the introduction of his antidote. when it is considered that, in spite of such evidence as here produced, his discovery has as yet received no official recognition from any of the australian medical authorities, and that even now there are medical men who can write such effusions as that of dr. t. l. bancroft, of brisbane, beginning with the words: "it is deplorable to still see recorded cases of snakebite treated with strychnine, &c.," (see _gazette_ for july, )--the attitude assumed from the first by dr. creed and his unfailing advocacy of the antidote can not be too highly appreciated and lay both the writer and the public under a debt of deep gratitude to him. but for his early recognition of the soundness of the writer's theory and treatment of snakebite many valuable lives now saved would have been lost. as early as june, , dr. creed wrote in an editorial: "we desire to call the special attention of the profession to dr. mueller's papers on the pathology and cure of snakebite, published in our issues for nov., dec., feb, april and may last, and to press upon them the justice and, we submit, the necessity of extremely careful consideration of his theory and of the results shown in the cases in which, acting on it, he has used hypodermic injections of strychnine for the treatment of snakebite. we formerly expressed our concurrence in the opinion of sir joseph fayrer, who wrote: 'i do not say that a physiological antidote is impossible, all i assert is, that it is not yet found.' we are indeed pleased to state that we believe such an antidote is now found and that dr. mueller is the happy discoverer. we are of opinion that his theory as to the pathological changes set up in the human system by the injection of snake-poison is a sound one and that the treatment he has suggested and used is correct and proper, and the one likely to avert death in cases of snakebite, which would otherwise in all probability prove fatal. we therefore press the use of hypodermic injections of strychnia in the manner described by him upon the attention of practitioners who may have to treat cases in which the symptoms present are the result of snake or dangerous insect poison, and think that, should the patients die without its having been used, all will not have been done to save life that might have been." without such utterances repeated from time to time and without the ample space always allowed in the _gazette_ to the subject, a record like that now submitted would not have been possible. case .--p. evans, a girl of years, bitten on wrist by a brown snake. symptoms--staggering gait, drowsiness, &c. only / th grain in four injections. notes furnished by drs. mahoney and kennedy, of albury. case .--w. thiplin, a labourer, bitten on hand by brown snake. three injections. notes by dr. baird of healesville. case .--luke dewhurst, labourer, bitten on hand by tiger snake. cured by one injection of m. xv. liq. strychniæ after ammonia had failed. notes by dr. dutton, of lillydale. case .--p. moroney, labourer, bitten on thigh at night, snake not identified. cured by three injections of / th grain each. notes by dr. pardey, of myrtleford. case .--mrs. skinner, bitten on thigh, at carrum. treated by dr. verity. case .--child of mr. weeks, aged three years. treated by dr. degner, of myrtleford. case .--annie rankin, servant, at corowa. treated by local chemist. case .--child of mr. f. daniels, of mount kent, queensland, _only two years old_, bitten by a death adder on fourth finger of left hand, the snake found clinging to finger. ligature applied and finger chopped off, but condition of child very precarious when admitted to toowoomba hospital, after a night's journey, at daylight, in complete collapse. pronounced out of danger by dr. hunt, the house-surgeon, at . and taken home in the afternoon. notes not furnished. case .--reported by dr. pain, of allora, queensland. symptoms serious. four injections of m. xv., x., viii. and vii. case .--reported by dr. garde, of maryborough, queensland, girl of years, bitten by brown snake, requiring only two injections of m. xv. and x. case .--reported by dr. st. george queely, of maytown, queensland, lad of years, bitten by black snake, symptoms serious. four injections of m. xv., xv., xx., and xv., total minims of liq. strych. p.b. injected within less than two hours, muscular spasms appearing after last injection. patient made rapid recovery, riding home, a distance of miles, within a few hours after treatment. case .--reported by dr. ray, of seymour, severe bite of a tiger snake. within six hours / th of a grain administered subcutaneously, besides a considerable quantity given by the mouth. patient made a good recovery. "every injection after the second one," dr. ray reports, "having a distinct effect within three or four minutes, and lasting from one to one and a half hours before tendency to coma returned." case .--very remarkable. read by dr. forbes, medical officer of hospital, charters towers, queensland, before the north queensland medical society. boy, years old, was admitted to hospital at p.m. on th october, , bitten on foot by a death adder, which was killed and identified. dr. forbes reports: when seen by me, two hours after the accident, he was sitting on his mother's knee with his head hanging on one side, but quite conscious, and answering questions rationally, pupils widely dilated with almost no reaction to light, pulse very fast and soft, &c. thinking his condition might be due to fear i hesitated to use strychnine. so, ordering strong coffee, i hurried to attend an accident case just admitted with severe hæmorrhage, and left the boy in charge of a nurse, with orders to call me at once if she saw any change. i had scarcely been away minutes when the father rushed in saying his boy was dead, and indeed his statement seemed but too true. the child was lying quite limp, face blue, eyes half shut, extremities very cold, no pulse perceptible, no respiration visible. i at once injected m. x. of liq. strychniæ p.b. and made artificial respiration. he soon began to improve, and in about minutes was able to speak. he was watched all night, but suffered no relapse, and was discharged on the next day. cases to , reported by dr. weekes, of lithgow, n.s.w. dr. weekes writes:--"within the last year i have had three cases under my care, all bitten by black snakes, and all in about the same place, on the outside of the calf of the leg. the patients were all comatose, exhibiting all the usual symptoms of snakebite-poisoning, and in one, my last case, _the patient had convulsions_. in all of them i made hypodermic injections of m. xv. liq. strych., and the effects were most marked, the patients being completely roused and becoming quite sensible and rational each time," &c. case .--mrs. ryan, of oberon, n.s.w., bitten on leg by tiger snake, comatose and nearly pulseless after three hours, treated by dr. kingsburry, amount of strychnine not stated. case .--benjamin childs, bitten on finger by death adder, treated by dr. campbell, of grafton, n.s.w. case .--rather remarkable. reported by dr. lloyd parry, of emmaville, n.s.w., in _gazette_ of march, , and further particulars in private correspondence with writer. a chinese miner, aged years, was bitten on the back of the foot by a death adder. his mates, deeming medical aid useless, did not send for dr. parry until death was imminent, and then only with a view of getting a certificate of death, and avoiding autopsy and inquest. when seen, three hours after infliction of bite, the man was deeply comatose and pulseless, skin icy cold, pupils dilated and insensible to light, lower jaw hanging down and tongue protruding, respiration scarcely perceptible. he was in fact so near death that this event was expected to take place from minute to minute. in order to task the antidote to the utmost, dr. parry cut the tight ligature without excising the bitten skin and then injected xv. of liq. st. p.b. to his surprise in a few minutes the man began to groan and very soon afterwards became conscious. dr. parry then watched him carefully and in about an hour found coma returning, when another injection was made and roused him for good. there was much swelling and effusion in the leg, but no ill effects followed. in this case, judging from the comparatively small quantity of the antidote required, only a small amount of poison had been imparted, the bite being on the back of the foot, where the fangs cannot penetrate deeply. still there can be no doubt that even this small quantity of the justly dreaded death adder poison would have proved fatal, if it had not been counteracted by the antidote. case , reported from tasmania by dr. holmes, of launceston, presents different features, showing the very large quantity of the antidote sometimes required. after describing the condition of his patient, a mrs. frazer, of st. leonards, dr. holmes writes:--"from her desperate condition i thought it too late for the ammonia treatment and decided on injecting liq. strychniæ. at . p.m. injected m. xv, at . , m. xv., at . , m. xv., at . , m. xv., and . , m. xv., at p.m., m. x., and at , m. x. a few minutes after the last dose i noticed the physiological action of the drug and desisted from injecting. at p.m. she seemed almost well, pupils normal in size and reacting well, was not sleepy and could swallow easily. the patient made a good recovery." this is the largest quantity of strychnine that has been required in australia, namely, minims of liq. strych., or - / th gr. injected in less than five hours, with the most beneficial result. surely the most cynical scepticism must give in to such facts. case .--reported by dr. macdonald, of murwillumbah, n.s.w. mr. s., bitten on leg by a black snake. coma, complete paralysis, chin hanging down to sternum, pupils dilated, &c. an injection of m. xv. had no effect; one of m. xx. very little. after a third one of m. x. patient suddenly became conscious, could walk without assistance, and in half an hour was sent to bed perfectly recovered. case .--reported by dr. yeatman, of auburn, south australia. mr. d., a farmer, aged years, bitten on thumb; snake not named; cured by three injections of only m. v. each. convulsions lasting for an hour came on three hours after treatment--a very rare occurrence--by dr. yeatman erroneously ascribed to the strychnine, which in so small a dose would not have produced them in the absence of snake-poison. case .--reported by officer in charge of police at grenfell. boy of years, bitten by brown snake, and treated by dr. rygate. case .--w. toomer, aged , bitten by tiger snake on thumb and index finger, and not treated until - / hours after bite, having a long distance to travel. recovery very slow through timid use of antidote, five injections of / th grain having but little effect, until one of / th restored him. treated by dr. stokes, of echuca. case .--reported by dr. bennett, surgeon, gulgong hospital, n.s.w. mrs. mears admitted to hospital comatose and pulseless, nothing having been done to check absorption. the intravenous injection of ammonia failing to rouse her, m. xv. of liq. strych. were injected, when pulse returned, but coma continued. after a second injection of m. xv. she suddenly became quite conscious, and in an hour was fully restored. case .--reported by dr. mead, of quirindi, n.s.w. john simson, aged years, bitten by a death adder on forefinger of right hand. dr. mead living miles away, and the lad collapsing, a layman, mr. robert simson, had to undertake treatment, and injected during the night m. of a one in solution of strychnine, equal to / ths of a grain. dr. mead, finding the lad conscious and only a little drowsy, did not inject any more strychnine until p.m., when a relapse took place. he then injected m. viii. of liq. str. p. b., and in half an hour m. vii. more. the last injection produced slight muscular twitchings, and subdued the snake-poison effectually, the lad making a good recovery. the total quantity used in injections was over three-quarters of a grain within hours. case .--this case is another instance of the successful use of the antidote by a layman, and can be verified by the writer, who saw the patient, a girl of years, after her father had carried out the treatment successfully. the girl had been bitten by a large brown snake whilst walking through a paddock, and very soon afterwards lost the use of her legs, and for a time also her eyesight. the symptoms being so very alarming, and the girl at a distance of miles from the writer's residence, the father at once injected / th of a grain of strychnine, and in a very short time another / th. the child then rallied somewhat, and a start was made to bring her in, the father taking the precaution of bringing the antidote-case with him. this was fortunate, for the child collapsed several times, and each time had to be roused by an injection before reaching the writer. when finally she presented herself, walking into the writer's surgery with a firm step, not a trace could be discovered either of the strychnine, of which nearly half a grain had been injected, nor of the snake-poison, also imparted no doubt in a fatal dose. the two punctures on her leg, testifying to the size of the snake that had bitten her, were the only tokens of the ordeal she had gone through; and the only task remaining for the writer was to congratulate her father (mr. james trebilcock, a farmer, of tawanga), on the plucky manner in which he had carried out the treatment, and see to the child being properly watched during the night in case of a relapse taking place. none, however, occurred, and she left next morning perfectly well. cases of this kind, in which no doctor is called in, are frequently reported to the writer, who finds that laymen are even more successful because less timid than many medical men. case .--joseph cartledge, bitten on calf of leg by a black snake, was treated by dr. browne, of sale, five hours after accident. two injections of / th grain each used. case .--miss davie, teacher, at nerung, queensland, treated by dr. hannah, of southport. particulars not given. case .--mrs. rogers, of bulu bulu, gippsland, bitten on finger by tiger snake, and treated by dr. trampy, first with intravenous injections of ammonia, which had no effect, and when sinking with strychnine injections, which had almost immediate effect, and in a few hours placed her out of danger. case .--son of mr. j. beveridge, squatter, of glengower, treated successfully by dr. andrew, of clunes, with strychnine injections. case .--theresa byrne, aged years, bitten whilst bathing, snake not seen. treated by dr. cuppaidge, of normanby, queensland. only minims of l. s. required. case .--mr. bullock, of tenterfield, n.s.w., bitten by black snake and treated by dr. morice. case .--a boy, j. taylor, bitten at mount keat, agricultural settlement, queensland, by a black snake, and treated successfully by a layman, mr. james daniels. case .--george neilson, a danish miner, bitten by a tiger snake whilst bathing. case reported by dr. gamble, of walhalla. forty minims of liq. strych. required; recovery complete next morning. cases and , reported by dr. helsham, of richmond, n.s.w. in one of these where, judging from the symptoms, a large dose of snake-poison had been absorbed, but very small doses of strychnine were injected, convulsions set in, _whilst coma was still present_, and lasted for two hours. though semi-tetanic in appearance they were erroneously ascribed to m. xxvi. of liq. strychniæ, which at the time of their appearance had not removed the symptoms of snake-poison. they were evidently produced by the latter and quite on a par with those occasionally occurring in man before the strychnine is administered, and almost invariably in dogs. as long as coma is present with other symptoms denoting the snake-poison to be in active operation, such convulsions rather call for the antidote, than contra indicate its use, for the strychnine never produces them until it has completely conquered the snake-poison, and even then they are always preceded by local spasms and never set in suddenly. timid medical men, when administering the antidote and anxiously watching for the dreaded strychnine effects, are too apt to see them in the slightest irregular muscular action. case , reported by dr. johnson, of avoca, patient bitten by a tiger snake, was comatose, pulseless, with very shallow respiration, &c., and restored by three injections of m. xvi., xv. and x. within less than three hours. case .--reported in _australian journal of pharmacy_, from tasmania, treated by dr. tofft, of campbell town. the report concludes: we have had some fatal cases of snakebite already this season, and the successful treatment in the above case has created a strong feeling in favour of strychnine in such emergencies. cases to .--reported by dr. alex. barber to _a.m. gazette_. he writes: "during the last year i treated four cases of snakebite successfully with strychnine. in one of these, a bite of a brown snake, i injected three doses of m. xx. each of liq. strych. p.b., in all over half a grain, in one hour." case .--reported by dr. barrington, of benalla (vic.), bite of tiger snake, symptoms moderate. completely removed in three hours by minims of liq. strych. p.b. _notes of eight cases as reported to the "australasian medical gazette" for july and november, , by r. p. banerjee, b.a., g.b.m.s.l., medical officer, salt mines, pachhadra, rajputana, india_:-- case .--bhagwan singh, aged , hindu male, sepoy, e. t. force, was bitten by a viperine snake (_echis carinata_) at p.m. th june, , in the dorsum of left foot. he was removed to the hospital, tight ligature applied, and with the following symptoms:--heaviness of both legs, staggered if allowed to walk, giddiness, sense of sinking at the pit of the stomach, bleeding from mucous surfaces and old scars; soon fell swooning. treatment.--the punctures incised, and blood let out, one-twelfth of a grain of strychniæ; acetas hypodermically injected. again, the insensibility not gone after minutes, another dose given, and so repeated the third time. the _bleeding stopped_ and the man recovered his senses, but could not raise himself to talk. many more doses were given under the skin, with hour intervals, and the man recovered the next day; but he was much exhausted and treated for weakness three days, and discharged to duty on the th. punctures were distinct, symptoms well developed. took _one and a half grains_ of strychnine to effect cure, leaving no after effects of the drug or poison. case .--sadig husain, a mussulman boy, aged years, bitten on the right ankle, just below the inner malleolus, by _echis carinata_ (khapar) on the th august, , brought in with usual symptoms, as before. treatment as before. this case took only one-fourth grain of strych. acet. the boy was weak and sickly. he was discharged cured on the third day, _i.e._, th august, . case .--nathey khan, mussulman, customs peon, aged years, robust and strong, bitten by _echis carinata_ (yellow variety). punctures were on the left ankle, over the outer malleolus. symptoms as before given. treatment as before stated. this case took as much as one and three quarter grains of strych. acet. was admitted on the th august, , and discharged on the th august, , cured and fit for duty. case .--musamat jewai, hindu female, a labourer, age , strong built. bitten by kerait (_bungarus coeruleus_), about - / feet long, above the left knee joint; ligature below the hip was used, but all the symptoms were present and the patient was insensible. cyanotic marks were seen on the arms, abdomen, back and neck. at first all hopes of recovery were given up, but attempts were made to see if anything could do good. treatment.--punctures scarified and cupping applied. repeated doses of strychnine acetas hypodermically given, but in _quarter grain_ doses. it seemed marvellous. the cyanotic patches in the skin gradually faded away and the body became warmer. it was wondered if the person had expired, but suddenly the woman called for a drink of cold water to bathe her dry and parching mouth. this was done and she recovered sense. she was admitted on the rd september, , and discharged on the th. took _three grains_ of acetate of strychnine to effect a cure. case .--paroati devi, hindu female, aged years, healthy constitution. bitten on big toe of left foot on th september, , symptoms were as preceding. the wound was cauterised. treatment.--strychnia was given very cautiously, as the patient was over-aged, the degeneration of the heart kept in view-- / grain eventually showed the peculiar strychnine symptoms. the patient was cured in two days and discharged cured on the third day, th september, . this patient took in all _one and a half grains_ of acetate of strychnia. case .--maya swuper, aged years, bitten by echis carinata (without dots) on the lower third of the left leg, on the outside of it. mucous membrane of the mouth, eyes, nostrils, ears, and urinary passages all bled profusely. urine had clots in it and symptoms resembled those in the first case. treated with strychnine and recovered in four days. was admitted on the th september, , and discharged to duty on the th september, . took in all _three grains_ to effect cure. case .--avghunandan, customs semadar, aged years, hindu male. bitten at a.m. on the th march, , by echis carinata (brown variety) on the right foot near the cuboid bone. the punctures were distinct and the symptoms like those of case . bleeding was profuse in this case. treatment.--strychnine acetas injected _in quarter grain_ doses under the skin and repeated as often as desirable. patient recovered after the sixth day and took in _all four grains of strych. acet._ in six days. only the bitten leg had erysipelatous inflammation, which had to be treated afterwards, but the man was quite safe. remarks.--in connection with echis bites one peculiar symptom was always noticed, namely, the free oozing of blood from mucous surfaces and old scars of wounds. the power of co-ordination was very much affected from the first setting in of other symptoms. usually after hours symptoms showed a relapse. in the treatment with strychnia neither the symptoms of the drug nor of the snake-poison ever showed themselves afterwards. both seemed to neutralise each other. bungarus coeruleus, or kerait-bite, had its own peculiar symptoms of cyanotic patches and insensibility, swooning and stertorous breathing. the true comatose state was not present in any, but only a slight one noticed in cases and . the other cases were generally delirious in the beginning. case .--dr. banerjee communicated this case to the _australasian medical gazette_ separately and quite recently, november, . it is, of all his cases, the most important one. he writes:--"the following case increases my number to eight, and should clear away prejudice and prepossessed ideas, as strychnine saved this case, a bite of _duboia russellii_. this snake is admitted by all hands to be virulently poisonous, and the poison is said to be even more virulent than that of the dreaded cobra:"-- _rahimudden_, aged , mussulman, customs peon, admitted for treatment of snakebite on the th september, , at . p.m., to the north india salt revenue hospital, pachhadra, rajputana, india, and put under my treatment. _history of the case._--the man is of strong build and healthy constitution. while on duty he went round the salt pit, near his beat. suddenly he felt a prick on his foot, and, suspecting snakebite, struck out with a bamboo stick he carried in his hand, and heard the snake make a loud noise. he at once tore a piece of cloth from his turban, and tied it tightly above the right ankle joint round the leg, then tried to kill the snake, but could not do so with certainty, as it was dark. he reported the case to his superiors, and was carried to the hospital. bitten at . p.m.; admitted at . p.m. _present symptoms._--patient was delirious, and could not understand what was told him; body cold and covered with perspiration; breathing hurried, with a low rattle at the end of expiration; mouth, tongue, and palate all dry; tongue leather-like and cracked, and felt cold; tickling of throat, not exciting vomiting; pupils dilated; conjunctiva congested; pulse ; patient talked, or rather muttered, with difficulty; could not tolerate strong light or loud noise; the mucous membrane of the mouth showed irregular dark patches of ecchymosed blood. the right foot was swollen, and in a line between ankle and knuckle of big toe showed two punctures--one deep and bleeding, and surrounded by ecchymosis; the other one below this, more superficial, the blood oozing thin and not coagulating. received, at . p.m., / th grain of strychnine in left arm. at p.m., the same dose; breathing the same, but no rattle; stupor rather deepening; incoherency increasing. at . , the same dose; breathing easier; stupor the same; pulse, ; temp, . ; delirious at times, and moaning with inarticulate cries; could not hear when spoken to in loud voice. . p.m., the same dose; no change in condition. . p.m., the same dose; stupor now fading away; delirium present; intolerant to light and noise; peculiar grin and cramp in face-muscles when attempting to talk; temp, . ; pulse very hard; intense thirst; less bleeding from punctures and blood thicker. p.m., the same dose; no stupor now, but cramps in lower extremities; no incoherency; only occasionally uneasy and senseless for a moment, and then rising suddenly like one startled when sound asleep. . a.m., no further symptoms; bleeding stopped; great thirst; eyes red and glaring; saccharine drinks given; no injection. a.m., no sleep, but only slight slumber; no pain in foot; no bleeding; temperature, . ; thirst unabated; only drinks given. _sept. th, a.m._--better, but talking slightly incoherent; received another injection of / th grain of strychnine. p.m., better; had good appetite; given milk and sago. _sept. th, a.m._--better. p.m.--better; had three motions, rice and milk diet given, slept soundly between a.m. and p.m., no redness in eyes, swelling of foot abated. _sept. th._--better, only complaining of heaviness in head. at p.m. had a fit of stupor all of a sudden, became insensible, and commenced to bleed again from the mucous membrane of mouth and nose. the patient became almost insensible, and could only be roused with difficulty. twenty minims of liq. strychnine, equal to / th grain, were now injected into the right arm. _at . _ stupor had passed away and consciousness was fully restored. from this time onward convalescence was uninterrupted, and patient was discharged cured on the th sept., . in his remarks on this case dr. banerjee, after reporting that the snake with back broken in two places was brought to him on the following day from the exact locality where rahimudden had been bitten, gives the following description of it:--head, large and triangular; nostrils, large and kidney-shaped; scales, much imbricate, ventral scales , subcaudals ; confluent, irregular ring-like, dark brown spots along the back, and with lateral black patches or rings with white borders. the head marking very peculiar double v shaped mark, the angle directed between the nostrils; interstitial coloration, yellowish brown, belly white, and with brown or amber spots; eyes, large, pupils erect, irides yellow; body, stout and compressed laterally; poison fangs, large and recurved, size about half an inch. the length of snake was feet inches, and from these characters it was identified to be the chain viper (_duboia russellii_, _gray_), the most venomous of indian vipers. the total quantity of the antidote in this case administered was only minims of a one in solution of strychniæ acetas, or / ths of a grain of that drug. considering the extremely venomous nature of the snake and the large quantities of strychnine required in some of the previously reported cases of echis and bungarus bites, the quantity used seems disproportional, but this evidently is explained by the fact that only one of the fangs perforated deeply, and at the back of the foot, probably struck the bone before entering to its full length, the snake thus failing to impart the full quantity of venom at its disposal. the chief interest of dr. banerjee's cases centres in the fact that they are mostly viper-bites. they prove conclusively, as do feoktistow's experiments on the lower animals, that the theory of viper-poison being a blood poison, as asserted in all works on the subject, is not tenable and must be abandoned. if it effected changes in the blood, incompatible with life, strychnine, acting solely on the nerve-centres, could not possibly obliterate these changes within a few hours or even days. on the other hand the successful treatment of bungarus bite with strychnine places it beyond doubt that cobra-poison will also yield to it, if fearlessly and vigorously applied. it is most gratifying to the writer to know from good authority that sir joseph fayrer, the president of the medical board at the india office, has recommended to the english government the adoption of the strychnine treatment of snakebite in india, and that this adoption will not be subject once more to the doubtful result of experiments on the lower animals, which, according to newspaper reports, were contemplated at calcutta as a test. it would have been deplorable to see more precious time lost in these experiments, whilst the only proper subjects for experiments, the unfortunate natives, are perishing by thousands. the step taken by sir joseph fayrer does honour both to his head and his heart, and if his recommendation is accepted and vigorously carried out it will still further increase the debt of gratitude which india owes to british rule, and with regard to its terrible snake plague, to the one englishman who of all others has distinguished himself by an almost life long study of the subject and indefatigable labours for its alleviation. her majesty the queen has also been pleased most graciously to interest herself in this subject. memorialised by the writer before sir j. fayrer's recommendation to the british government, above alluded to, was known to him, our gracious sovereign, ever intent on the welfare of her subjects, has resolved on having the writer's method thoroughly tried in india, and communicated this her intention to him in a despatch from the secretary of state for the colonies to his excellency the governor of victoria, dated th nov., , inviting him, at the same time, to forward any proposals he may have to make direct to the secretary to the government of india in the home department; and thus adding one more to the many noble deeds that mark her benevolent, long, and glorious reign. unsuccessful cases. considering the newness of the strychnine treatment it would be folly to expect that the conditions necessary to insure success should have been observed in every case, and that every practitioner should at once have made himself familiar with it and the theory on which it is founded. hence a few failures were unavoidable. of these a record has been kept, but for obvious reasons the writer withholds it here. to give names and dates would be invidious, though the opponents of the treatment have exultingly pointed to the few deaths that have occurred as palpable proofs of its uselessness, some of them even going so far as to ascribe these deaths to the direct action of the antidote. there is, however, not a single case on record, in which death took place under strychnine-convulsions. all the patients died under palpable symptoms of snakebite-poisoning. as these symptoms have now been proven beyond all doubt to yield to strychnine, when properly administered, the inference that it was not so administered in the cases referred to becomes not only justifiable, but unavoidable. in one case only, that of a child of tender years, blood was vomited so copiously that death may be ascribed to that cause and the snake-poison combined, but in all the other six fatal ones, mostly of children, it was undoubtedly due to the snake-poison not being properly checked by the antidote. the gentlemen who officiated on these occasions were evidently not banerjees, but the very reverse of their indian confrère. they do not appear to have had very clear ideas of the absolute antagonism existing between the two poisons, and entirely disregarded the most important point in the treatment, namely, the necessity of administering the antidote until it has completely subdued the snake poison, regardless of the quantity that may be required for that purpose. in a few instances the treatment was correct enough at first, but when, as is often the case, a relapse took place after the patient had apparently recovered, the large quantity of the antidote already administered appears to have given rise to the erroneous notion that it would be useless to resort to it a second time, and thus, through this error and the fear of strychnine-convulsions, the patients were allowed to die. in most of the six fatal cases collected by the writer, however, the doses and total quantities given were altogether inadequate to cope with the poison. they did probably more harm than good, for the snake-poison when only partially checked by strychnine seems to renew its onslaught on the nerve-cells even more insidiously than when not interfered with at all. convulsions also, as shown in cases, are sometimes called forth by this timid use of the antidote. a few instances will show the correctness of these observations. thus an old woman sleeping in a shed is awakened at daylight by a tiger snake having fastened on to her wrist. she pulls off the snake, alarms the neighbours, and a doctor, living only a mile away from the place, is sent for. he appears on the scene four hours afterwards, when complete coma and collapse has set in, makes two injections of gr. / each, which of course had no effect and the patient is allowed to die without any further effort on the part of her medical attendant. case .--a boy of years is admitted to a n. s. wales hospital in a state of complete collapse, barely alive, having been bitten by a brown snake hours before admission. instead of a rousing injection of at least minims and the same or smaller ones repeated at short intervals, he receives only minims of liq. strychniæ p.b. every twenty minutes, when death was imminent, and dies minutes after admission. case is also that of a boy in an hospital. he is admitted fully conscious and apparently but slightly under the influence of snake-poison, for a five minims injection is reported to have removed the symptoms. on the following day, however, he became comatose, and instead of having the antidote freely administered, gets only one more injection of five minims and dies in coma. case is even worse. a little girl of years, bitten by a tiger snake, receives three minim injections every half-hour, and after three of them, whilst in a state of complete coma, gets convulsions. these are attributed to the strychnine, which thereupon is withheld, the finale being death in coma. there can be no doubt that in all these cases life could have been preserved under a more energetic treatment. hereafter, when theory and treatment are better understood, and when officialdom has seen fit to issue instructions as to the proper treatment of snakebite to medical practitioners, such cases as those cited will be put down as malpractice and have to be accounted for. until then the guardians of the health and the lives of her majesty's subjects, and a certain portion of the medical press of australia, superciliously and persistently ignoring the subject, are more responsible for the lives lost than the busy country practitioner, who may not have had time or opportunity to inform himself thoroughly on a comparatively new subject, more especially at a period when banerjee had not yet taught us that in administering strychnine as antidote to snake-poison we can venture into grains of it with impunity. * * * * * since the above chapters were put in proof, the writer has seen a fatal case of tiger snake bite, conveying two lessons of such interest and importance that it must be placed on record here. it illustrates in an extraordinary and forcible degree the erratic, capricious, and insidious course the snake-poison takes at times. * * * * * a handsome girl of is bitten in a bathroom on the back of the second right toe at dusk on a sunday evening by a half-grown tiger snake, subsequently caught and killed in the room. she does not suspect snakebite, and no ligature is applied until the poison has been absorbed and overpowers her. instead of sinking into coma, she becomes unconscious for a short time only. her brain then clears itself, and all symptoms seem to disappear so completely that when a medical man of undoubted ability and skill sees her a few hours after the bite, she declares herself quite well again, and does not appear to require any treatment, least of all that by strychnine injections. she passes a good night, but on monday morning symptoms denoting paresis of the respiratory and glosso-pharyngeal centres make their appearance, almost identical with those described by indian writers as following cobra-bite. she has difficulty in breathing and swallowing, but one injection of / th of a grain removes it completely and speedily, and once more all danger is thought to be past. on monday evening, however, dyspnoea and dysphagia appear again in an aggravated form. the urine also becomes scanty and loaded with albuminates. strychnine now is again resorted to, but it fails to act as before, and from hour to hour the young lady's condition becomes more critical. when the writer reached her on tuesday afternoon, hours after the bite, paralysis of the centres named was imminent, and her case appeared a hopeless one, unless a vigorous use of strychnine yet turned the scales in her favour. one-tenth grain doses were therefore injected every half-hour, and continued until the physiological action of the drug showed itself. this took place, but failed to have the least effect on the affected centres; and complete paralysis ensued hours after the infliction of the fatal bite. the first lesson the australian practitioner should learn from this sad case is that of extreme care and caution in dealing with any case of snakebite, no matter how slight it may appear at first sight. it is not for the first time we have been taught this lesson, though it has rarely, if ever, been conveyed in so singular a manner. recent utterances about the innocuousness of australian snake-poison find a fitting answer in this melancholy occurrence. the second lesson it conveys is a new one, even to the writer. from the fact of one strychnine injection removing all poison-symptoms early on monday, but the free use of the antidote failing entirely to have this effect on monday night and on tuesday, we are warranted to draw the conclusion that the antidote can only be relied on within the first hours after the bite; and that, after this period, the snake-poison produces organic changes in the affected nerve-cells, preventing their depressed functional activity from being restored by the antidote. further observations, of course, are required to confirm these conclusions. their correctness, however, appears to be borne out by the fact observed by the writer, that the larger domestic animals, who sometimes linger on for days after being bitten by a snake, usually recover under the strychnine treatment if it is applied immediately or soon after a bite, but die when found and treated in an advanced stage of the malady. that the grave kidney complication, checking the elimination of the poison from the system, militated against recovery in this case, and greatly influenced the singular course of the poisoning process, cannot be doubted. [illustration] conclusion. in the little work submitted herewith to the medical profession and the general public, for both of whom it is intended, the author may justly claim to have solved the difficult and long-standing problem of snake-poison. we have at last a correct theory of its action, and, what is of more importance to the public, we have an effective antidote. these facts, being as fully established in these pages as any scientific facts can be, the most exacting and even captious criticism will not upset, nor can further research add anything very material to the writer's deductions and their final result. in order to show how an obscure australian country practitioner succeeded in a discovery, for which all his predecessors in this field of research had laboured in vain, it will be necessary in conclusion to give a short history of the discovery as by slow degrees it has originated and matured in the writer's mind, who during the last years with respect to this subject had followed the advice which schiller gives in his grand poem, "die glocke:"-- wer etwas treffliches leisten will, hätt' gern was grossesgeboren, der sammle still und unerschlafft im kleinsten punkte die grösste kraft, which, translated into english, means that whoever aims at any great achievement must quietly, but indefatigably, concentrate the highest force on the smallest point. now this smallest point has to the writer been snake-poison from the very commencement of his australian career. when yet a new-chum, a vigorous tiger snake gave him the first lesson on the action of the insidious venom which nearly cost him his life, but afforded some valuable glimpses into the mystery of snakebite--in fact, gave him the key to unlock that mystery. on analysing the horrid sensations he had experienced before he lost consciousness, and even after regaining it, he saw "depressed nerve-action, emanating from the central nervous system," written on the face of every one of them, so much so that this became the foundation and corner stone of his present structure, which, however, it took him a quarter of a century to erect; for the material he required, namely, cases of snakebite observed from an early stage, and from which all disturbing elements were excluded, did not occur very frequently in his practice. though he lived all the time among mountains, the beautiful australian alps, on the rivers and creeks of which snakes are abundant, and though these creatures and anything connected with them had an almost fascinating interest for him, years sometimes elapsed without adding one single good case to his notes. sometimes his patients were dead when he reached them, and all his entreaties for an autopsy were in vain with the relatives. more frequently he found that they were not bitten at all, and only suffered from the effects of fear or of enormous doses of alcohol. on persons really bitten, but completely paralysed and comatose, observations were also unsatisfactory, as they had to be supplemented by second-hand evidence obtained from those who had been with them before they became unconscious. thus within years the author did not see more than half-a-dozen really instructive cases; and frequently his desire for more evidence overcame his reluctance to inflict on animals the agony of snakebite he had himself endured, and he made a few experiments, but soon gave them up again as unsatisfactory. all the evidence, however, he had thus far collected tended to confirm the correctness of his ideas as to the action of snake-poison. at last, some ten years ago, he obtained absolute certainty, and this, strange to relate, by a case of spider bite. he was called early one morning to visit a little boy, two years old, and on examination found that he presented symptoms almost identical with those of snakebite poisoning. although there was no evidence of the child having come in contact with a snake, the writer naturally concluded that during the night a snake had obtained access to the bedroom through the open door or window, and after biting the child sleeping in its low cot, had escaped again. he therefore searched most carefully for the usual two punctures, but they were not to be found. the child evidently laboured under the effect of some poison, and spiderbite suggested itself, but the symptoms were so much more aggravated than anything the writer had frequently seen of spiderbite that he hesitated to accept it as the cause, although it appeared almost the only possible one. a careful inquiry into the history of the case elicited from the mother the important fact that on the previous afternoon the little fellow, just able to toddle about, had gradually lost the use of his legs, and also become very peevish, and that suspecting nothing but a little temporary indisposition, she had put him to bed, to find him in the morning all but dead. he was scarcely breathing when the writer saw him, and only the stethoscope gave evidence of the heart still beating feebly. his body was very cold, pupils widely dilated, and the sight even apparently gone, the eyes wide open, staring fixedly upwards and not noticing a lighted match in closest proximity to them. consciousness also appeared extinct, as liquids introduced into the mouth were not swallowed. examining once more for traces of spiderbite in the skin, the writer noticed faint red stripes extending up the arm from a little cut on the right index finger near the nail, and on inquiry it was ascertained at last from an elder brother that he had seen the child pick up a little black spider with a red back, hold it for some time between thumb and index finger, and then throw it away. this was evidently the katipo (_latrodectus icelio_), the poison of which acts on the same principle as snake-poison, but generally much milder. the greater severity of its action in this case was accounted for by the mandibles having been inserted into the cut, and the insect, being squeezed by the child, having emptied the whole available contents of its poison gland into the cellular tissue exposed in the cut, whence it was quickly absorbed. this also accounted for the absence of all irritation and of the neuralgic pains usually accompanying spiderbite, when the mandibles merely perforate the epidermis and the poison is deposited in the upper cutis, where absorption is slow and local irritation consequently greater. minuteness of detail in relating this case must be excused on account of the extreme interest and importance attached to it. being brought about under such peculiar and almost unique circumstances it presented the effects of spider-poison in a superlative degree and showed them to be identical with those of snake-poison. but whilst the latter ushers in the symptoms with such rapidity that they cover each other and are difficult of separate analysis, in this case the highly significant paresis of the lower extremities, evidently of central origin, remained separate for some time. taking this symptom for his guide and interpreting the formidable array of the others, developed during the night, on the same principle, the writer's diagnosis of the case, as it presented itself to him, was paralysis of the motor and vaso-motor nerve-centres. this, he found, and this alone could explain all the symptoms, and he therefore determined to put its correctness to a practical test. there was but one remedy to make this test with and this had to be applied without delay, for the child was rapidly sinking and had almost ceased to breathe. _one twelfth of a grain_ of strychnine was therefore injected in the arm, a bold dose for so young a child, but, as the result showed, exactly the one that was required. the test was eminently successful. having to leave the child immediately after the injection, the writer on returning in half an hour found his little patient sitting up in bed, perfectly restored, with both poisons so completely neutralising each other, that not a trace of either could be detected. thus the writer's structure was at last completed, and an insignificant spider furnished the last material required for an important discovery. there are a few hypothetical points yet in the explanation of some of the symptoms of snakebite-poisoning by the writer's theory, but these imperfections are more those of science than of the theory. the whole subject of vaso-motor paralysis for instance, and of the pathological changes that follow it, is more or less a _terra incognita_. diapedesis is now supposed to be the result of blood pressure, but it occurs in snakebite, where blood pressure is at zero. feoktistow, we have seen, produced it locally on the mesentery of animals with normal blood pressure, whilst banerjee arrested by strychnine-injections profuse hæmorrhages from all the mucous surfaces, which were no doubt the result of diapedesis. we know that neither snake-poison nor strychnine affect the nerve ends but only the nerve cells. there must therefore be nerve cells at or near the terminations of the nerves regulating the capillary circulation in the mucous membranes, but microscopical anatomy has yet to find them, for minute ganglia have only been discovered at present in sympathetic nerve ends of the abdomen. on other subjects also, besides that of vaso-motor paralysis, the strychnine treatment of snakebite has thrown an unexpected light. we did not know before it was demonstrated by this treatment that sleep is merely a reduced discharge of motor-nerve force, a partial turning off of the motor-batteries, by which, through rest, they are invigorated for fresh action during the waking hours, and that the degrees of this reduction range in their effects from sleep, more or less deep, down to coma, and can be raised again from coma to sleep, and from sleep to complete wakefulness. we knew that every movement and action is brought about by a discharge of this force, but we did not know that even the silent thought must be carried on the wings of it, and cannot take place without it, at least not in our present state of existence. all these important revelations are now the property of science, and it will be well for science to take note of them. * * * * * in conclusion, the writer may be permitted to express his joy and thankfulness for having been made the instrument, by divine providence, to confer a boon on humanity that will prevent much suffering and thousands of premature, untimely deaths. +-----------------------------------------------+ | transcriber's note: | | | | inconsistent hyphenation and spelling in the | | original document have been preserved. | | | | typographical errors corrected in the text: | | | | page intracardial changed to intracardiac | | page banarjee changed to banerjee | | page ease changed to case | +-----------------------------------------------+ the court of cacus; or, the story of burke and hare. by alexander leighton, author of "curious storied traditions of scottish life," etc. london: houlston and wright, paternoster row. edinburgh: w. p. nimmo, st david street. . edinburgh: printed by ballantyne and company, paul's work. preface. i have not written this book,--narrating a series of tragedies unprecedented in the history of mankind, as well for the number of victims and the depth of their sufferings as for the sordid temptation of the actors,--without a proper consideration of what is due to the public and myself. if i had thought i was to contribute to the increase of a taste for moral stimulants, said to be peculiarly incident to our age--and yet, i suspect, as strong in all bygone times--and without any countervailing advantage to morals and the welfare of society, i would have desisted from my labours. but, being satisfied that what has really occurred on the stage of the world, however involving the dignity of our nature or revolting to human feelings, must and will be known in some way, wherever there are eyes to read or ears to hear, nay, was intended to be known by him through whose permission it was allowed to be, i consider it a benefaction that the knowledge which kills shall be accompanied by the knowledge which cures. nay, were it possible, which it is not, to keep from succeeding generations cases of great depravity punished for example, and atoned for by penitence, the man who tried to conceal them would be acting neither in obedience to god's providence nor for the good of the people. we know what the bible records of the doings of depraved men, and we know also for what purpose; and may we not follow in the steps of the inspired? but a slight survey of the nature of the mind may satisfy any one, not necessarily a philosopher, that it requires as its natural food examples of evil with the punishment and the cure. if it had been so ordered that there were not in the soil of the heart congenital germs of wickedness ready to spring up and branch into crimes under favouring circumstances, which the complications of society are eternally producing, and that, consequently, all evil was sheer imitation, something might be said for concealing the thing to be imitated, even at the expense of losing the antidote. even in that case the "huddlers-up" would not be very philosophical or very sensible; religious they could not be, because the supposition is adverse to the most fundamental truth of christianity--for, as the imitation must of necessity be admitted to be catching, where so many are caught, the deterring influences would be more necessary. but as all must admit that the evil comes of itself and the antidote from man, those who would conceal the latter must allow to the former its full sway. in all this, i do not overlook the benefits of abstract representations of the beauty of virtue and the ugliness of vice. these belong to the department of the imagination, where no principle of action resides; and every one knows that the images must be embodied, in particular instances taken from the real world of flesh and blood, so that the historian of real occurrences must still work as an adjunct even to the fancy. if it be said that he narrates stories that are revolting, the answer would seem to be that, as the law still justifies example, and society calls for it, the objection that the interest of a story is _too deep_ can only be used by those who view the records of wickedness as a stimulant and not as a terror, or those who, amidst the still-recurring daily murders, consider society as beyond the need of amendment. the objection is thus an adjection. fortunately, none of us are acquainted with _amiable_ enormities, and the longer these remain unknown to us, the better for us and mankind; so that it seems to follow, that he who can render the acted crimes of history as disagreeable and hateful as they can be made, even with the aid of the dark shadows of his fancy, performs an act favourable to the interests of society. yet i have done my best to save from revolt the feelings of the virtuous, as far as is consistent with the moral effect intended by providence to be produced on the vicious. york lodge, trinity, _september _. contents. page first appearance in surgeon's square, intercalary, the young amateurs, the regular staff, sympathising sextons, doctors, and relatives, preying on each other, resumption of the great drama, the quaternion, the opening of the court--the old woman of gilmerton, the mother and daughter, the grandmother and the dumb boy, the stray waifs, the relative, the study for the artist, daft jamie, the brisk little old woman, the discovery, the complicity of the doctors, the trial, the jail, vejove, the exhibition, the prosecution against hare, the hunt out, the final cause, first appearance in surgeon's square. when the gloaming was setting in of an evening in the autumn of , and when the young students of dr knox's class had covered up those remains of their own kind from which they had been trying to extract nature's secrets, one was looking listlessly from the window into the square. the place was as quiet as usual, silent and sad enough to gratify a fancy that there existed some connexion between the stillness and the work carried on from day to day and night to night in these mysterious recesses; for, strange enough, whatever curiosity might be felt by the inhabitants as to what was done there, few were ever seen within that area except those in some way connected with the rooms. so was it the more likely that our young student's eye should have been attracted by the figure of a man moving stealthily under the shade of the houses. then he looked more intently to ascertain whether he was not one of the regular staff of body-snatchers who supplied "the thing," as they called it. but no; the stranger, whoever he might be, was neither "merryandrew," nor "the spune," nor "the captain," nor any other of the gouls,--some half-dozen,--yet he would have done no discredit to the fraternity either as to dress or manner: little and thick-set, with a firm round face, small eyes, and irish nose, a down-looking sleazy dog, who, as he furtively turned his eye up to the window, seemed to think he had no right to direct his vision beyond the parallel of a man's pocket. the student, who could dissect living character no less than he could dead tissue, immediately suspected that this meditative "worshipper of the sweets of eve" was there upon business, but, being probably new to the calling, he was timid, if not bashful. yes, bashful; we do not retract the word, comely as it is, for where, in all this wide world of sin and shamelessness, could we suppose it possible to find a man who lives upon it, and is shone on by its sun, and cheered by its flowers, capable of selling the body of his fellow-creature for gold without having his face suffused with blood, cast up by the indignant heart, at least for the first time? and perhaps it was the first time to this new-comer. but in whatever condition the strange man might be, the student had got over _his_ weakness, that is, nature's strength, and, resolving to test the lounger, he went down, and, shewing himself at the door, beckoned the bashful one forward. "were you looking for any one?" said he, as he peered into the down-looking face, where there never had been a blush. "'mph!--are you dr knox?" "no; but i am one of his students," was the reply of the young man, who was now nearly satisfied of the intention of the stranger. "and, sure, i'm not far wrong thin, afther all." "and i may suit your purpose as well, perhaps." "perhaps." "well, speak out; don't be afraid. have you got 'the thing?'" "doun't know what you mean." "ah! not an old hand, i perceive. you were never here before?" "no." "and don't know what to say?" "no." and the bashful man again turned his gloomy eyes to the ground, and didn't know what to do with those hands of his, which were not made for kid--perhaps for skin of another kind. and shouldn't this hardened student have been sorry for a man in such confusion; but he wasn't--nay, he had no sympathy with his refinement. "why, man, don't you speak out?" he said impatiently. "there's some one coming through the square there," was the reply, as the man looked furtively to a side. "come in here, then," said the student, as he pulled him into a large room where there were three young men who acted as knox's assistants. and there they were in the midst of a great number of coarse tables, with one large one in the middle, whereon were deposited--each having its portion--masses or lumps of some matter which could not be seen by reason of all of them being covered with pieces of cloth--once white, but now dirty gray, as if they had been soiled with clammy hands for weeks or months. nor were these signs, though unmistakeable to even the neophyte, all that there spoke with a terrible eloquence of man's lowly destiny upon earth; ay, and of man's pride too, even that pride of science which makes such a fool of him in the very midst of the evidences of his corruption; for although the windows were opened a little way, the choking air, thick with gases which, in other circumstances, the free wind carries off to dissipate and purify in the storm, pressed heavily upon the lungs, so that even the uninitiated shrank with unfeigned feeling, as if he shuddered under an awe that was perfectly foreign to his rough nature. "sure, and i'm among the dead," said the man, whom the reader will have discovered to be an irishman; "and i have something ov that kind to----" "sell," added one assistant sharply, as, in his scientific ardour, he anticipated the merchant. "yes." and now the bashful man was relieved of his burden of shame, light or heavy as you please; but we verily say of _some_ weight, as we have him at the beginning of a career which made the world ring till the echoes might have disturbed the gods, and we know that he was not otherwise without feelings pertaining to humanity; nay, we know, and shall tell, that on one occasion pity suffused an eye that was destined to be oftener and longer red with the fires of cruelty than was ever before in the world's history the orb of a human being. "and what do you give for _wun_?" he whispered, as he sidled up to the ear of the young anatomist who had been speaking to him. "sometimes as high as £ ." and for certain, if the student had been curious enough to estimate the effect of such words upon such a man, to whom "ten pennies" would have been words of inspiration, he would have seen in that eye, no longer dull and muddy, the first access of that demon mammon, as by the touch upon the heart it raised the first pulses of a fever which was to grow and grow, till it dried up into a parched and senseless thing the fountain of pity; for, however inoperative, we are bound to say it was still there, as if abiding god's judgments--and transform one nature altogether into another--_for a purpose_. "and wouldn't you give a pound more for a fresh wun?" said he, with that intoxication of hope which sometimes makes a beggar play with a new-born fortune. "sometimes more and sometimes less," replied the other; "but 'the thing' must always be seen." "and by my sowl it is a good thing, and worth the money any how." "where is it?" "at home." "then if you will bring it here about ten it will be examined, and you will get your money; and since you are a beginner, i may tell you, you had better bring it in a box." "and have we not a tea-chest all ready, which howlds it nate, and will not my friend help me to bring it?" "well, mind the hour, and be upon your guard that no one sees you." and so the man, however much an adult in the common immorality of the world, in this singular crime as yet an infant, left to complete his sale of merchandise. it would not be easy to figure his thoughts,--perhaps more difficult to estimate his feelings,--yet it might be for good that we could analyse these states of the mind, which are nought other than diseases, that we might apply the cure which god has vouchsafed to our keeping; even as that student strove to inquire into the secrets of the body, that he might learn how to deal with the living frame when it is out of order, or, perhaps, hastening to a premature dissolution. that man was william burke, and we say this as a historian might have said, that man was alexander of macedon, or that julius caesar, or that napoleon--all equally great, or at least great with the difference that the first _as yet_ only desecrated the temple for money, and the others took from it the deity for ambition. ay, and with this difference also, which time was to shew, that while there have been many slaughtering kings, there never was but one william burke. intercalary. the ardour of the study of anatomy was in the youth, and it was there from sympathy; yea, for years before, the square and the college had been under the fervour of competition. nor was this fervour limited to the scottish metropolis, from which the fame of the successive monroes had gone forth over the world. there had arisen barclay, who, as an extra-academical lecturer, had the faculty of inspiring his students with all the zeal which he himself possessed, and to his class in the square there had come students from england and ireland, as well as foreign parts. even in prior times, when the teaching was almost limited to the college, the reputation of the professors had so accumulated _élèves_ that scotland groaned, and groaned ineffectually, under the invasion of her sacred graveyards. the country teemed with stories, in which there figured the midnight adventures of those strange men who gained a living by supplying, at all hazards, what was so peremptorily required in the scientific hall and its adjacent rooms.[ ] anxious mourners visited by the light of the moon the places where their dear relatives lay entombed, as if they could thereby satisfy themselves that the beloved bodies still rested there in peace, though it was certain that the artists became in a short time so proficient in their work that they could leave a grave apparently as entire as it was at the time when the mourners deposited their burden. that these adventures should have taken strange and sometimes grimly-ludicrous turns might have been expected, and yet it is more true that they transcended belief. there was one long current in leven in fife of a character more like fiction than truth. a middle-aged man of the name of henderson had died of an acute fever, and was buried in due time. he left a widow and daughter, and we need not speak, even to those who have not experienced such privation, of the deep valley of grief through which it takes so long a time for the light of a living hope to penetrate, if, in some instances, it ever penetrates at all. yet people must live, and the widow was to keep the small public-house in the skirts of the town which her husband had conducted. six days had passed since the funeral, when one night, at a late hour, two men asked and got admittance for the purpose of refreshment, one of them, according to their statement, having been taken ill. they were introduced through a dark lobby into a room, where there was one of those close beds so common in scotland, and left there with the drink they had ordered. by and by a loud knock came to the door, and the voice of an officer demanded to know if some thieves who had broken into a neighbouring house had there taken refuge. the noise and the impending search had reached the ears of the two men who had entered shortly before, and having had some good reason for being afraid of justice, they took advantage of a window and got out, but they had made so much noise in their flight, that the officers were directed to a pursuit, in which, however, they ultimately failed. on their return they thought of examining the room, with a view to ascertain whether the supposed thieves had left in their hurry any of the booty; but all that they found was an empty bag, which they took away with them for the purpose of an expected identification. the confusion having ceased, the widow, in the depth of her grief for her departed husband, went into the room to betake herself to bed. she approached it for the purpose of folding it down, and in an instant was transfixed; before her on the bed lay the dead body of her husband in those very grave-clothes made by her own hands, and in which, six days before, he had been buried. the explanation of the mystery was not difficult. the two men belonged to the college staff of body-snatchers; they had succeeded so far in their enterprise, and would with their burden have avoided all houses, if one of them had not been taken ill, and the other had not also wanted to participate in a restorative after their night's work. it is supposed that, thinking themselves secure in the quiet house, they had taken the body out of the sack for some purpose only known to themselves, and thinking, when the noise got up, that the pursuit was after them, they had flung it into the close bed and flown. once upon a track of such grim romance, so rich in specimens of a bypast phase of society, it is not easy to get rid of it, nor is it any more wrong to pursue it so far, to shew our social ameliorations, than it is to search for underlying strata in the physical world, which tell us of a rudeness in nature's workings from which she progresses to more perfect organisms. another of these stories is scarcely less interesting. a young student of the name of burns saw one day on the big centre-table of the college practical hall what he considered to be the body of his mother. rendered wild by the conviction, he flew out of the room, took a ticket for dumfries, and, on arriving there, told his father (who, half-dead in grief, was confined to bed,) his terrible story. it was night, and the snow had been falling during the day, so that the graveyard was covered nearly a foot in depth, and one might have thought that the father would have put off the execution of a resolution, to which he came on the instant, of examining the grave, till the following day; but without saying a word, he rose deliberately, as if some new energy had seized him and restored him to the active duties of life, and betaking himself, accompanied by his son, to the place of sepulture, roused the sexton to the work of investigation. the lantern and the spade were put in requisition, and with the father and son as mute spectators, the green sod was removed and the mould shovelled out till the coffin was laid bare. then the lid was unscrewed and taken off, and there lay, exposed to the eyes of the husband and the son, the body of the endeared one--the centre once of so many loves, and the source of so many domestic joys--calm in the stillness of death. we have even a little poetry in some of these almost innumerable stories of a state of social polity that will never return again. one was a favourite of the students about . one, george duncan, from angus, lodged in the potterow with another of the name of ferguson from a shire further north. they were both in love with a miss wilson, who resided somewhere about bruntsfield links; and so embittered were they by this feeling of rivalship, that they slept together, and ate their meals together, and walked and talked together, without ever the name of the girl being mentioned by either. there seemed to be a tacit admission that each knew that the other was in love with the same individual, and that each supposed the other the favourite, and that each hated the other with all the virulence of an unsuccessful competitor. in this strange state of things between two who had once been loving friends, ferguson died of a disease the nature of which baffled the acuteness of the best surgeons, and in the course of a few days duncan's rival was consigned to a grave in the buccleuch burying-ground. and now comes a far more singular part of the story. duncan, in league with a noted snatcher at that time, called the "screw," from the adroit way in which he managed the extracting instrument, repaired, on the second night after the funeral, to the cemetery where poor ferguson had been deposited, with a view to lifting the body and carrying it to dr monro's room. it was late, and the moon shed more abundantly than the adventurers wished her soft light over the still graves, and especially that of him whose nineteenth summer sun had shown in a succession, with small interval, the smile of beauty and the grin of death. but if this poetry of nature did not affect the rival and the anatomist, something else did; for as the two slouched behind one of the grave-stones to conceal themselves till the glare of the moon should be hidden in a welcome cloud, who should be seen there, wrapped in a night-cloak, and hanging over the grave of ferguson, but the object of their mutual affection? nay, so near were they, that they heard her sobs and her ejaculations of "henry, dear henry," and many others of those soft endearments with which the heart of grief is so eloquent. if the iron had entered into duncan's soul before, it now burned there in the red fire of his hatred. the sobbing figure rose and vanished, as do the night-visions of these places, so suggestive of flitting images, and within an hour the body of ferguson was extended on the table within the college. nor does the story end with this terrible satisfaction, for duncan more than once afterwards, in the moonlit nights, witnessed from the same hiding-place, and with what satisfaction to his relentless soul may be guessed, the same offerings of the poor girl's affection over an empty grave. and so forth, through all the number of such stories as used to be rife at that time, but have now died away amidst narratives of a more living interest. but towards the close of barclay's labours, in his class the materials for such were rather on the increase, for the reason that the invasions on consecrated places kept a proportion to the requirements of an increasing class of students. nor, when barclay ceased to lecture, and was succeeded by knox, did this scotch shame undergo any diminution, if it did not wax more brazen in its features. knox was destined, as well by his powers as a public lecturer as by his ambition and vindictive impatience of an intruder on his peculiar walk, and independently altogether of the dark suspicions which rose like thick exhalations out of the depths of the great tragedy subsequently enacted, to become a marked man, and the centre of attraction to ardent students. his ambition felt, too, the quickening spur of liston, who, as an extra-academical lecturer on surgery, offered for even more than a national reputation. the professional emulation of these men soon degenerated into professional, if not personal hatred, scarcely alleviated by the collateral envy they both bore towards the academical professor, who, himself a good anatomist of the old school, with family honours not distinguished from a professional inheritance, could afford to view the new men with an easy if not proud disregard. with these feelings among the lecturers, we may easily fancy the almost natural effects among the students, always remarkable for devotion to their teachers. the spirit of the latter went through them like an inoculation, and, while working in them as a rancour, it took the form, as in the elders, of a professional emulation. nay, it seemed to become almost a frenzy among them, that those of one class should excel those of another in the knowledge of the human body. questions came to be discussed among them, often suggested by faults imputed by one lecturer to another, and the quarrels of the masters thus became bones of contention among their scholars. an unsuccessful operation would be seized on as a pretext to run down the operator; and as the anatomical books could not always, or often, settle the dispute, the area of controversy would be in the halls of dissection. in this state of affairs, it behoved that the demand for subjects, which ever since the advent of barclay had been on the increase, should become day by day more clamant, and the number of vagabonds who betook themselves to the calling came soon to take on the form and organisation of a regular staff. unfortunately the characters of the leaders, with the exception of monro, were not calculated to temper this zeal with discretion, or throw a veil of decency over the transactions of low men, which, however justified, as many said, by the necessities of science, were hostile to the instincts of nature, and fearfully resented by the feelings of relatives. liston was accused, whether justly or not, of wiling patients from the infirmary, to set off by his brilliant operations the imperfections of the regular surgeons of that institution; and great as he was in his profession, it is certain that he wanted that simplicity and dignity of character necessary to secure to him respect in proportion to the admiration due to his powers. but knox was a man of a far more complex organisation, if it was indeed possible to analyse him. a despair to the physiognomist who contemplated his rough irregular countenance, with a blind eye resembling a grape, he was not less a difficulty to the psychologist. there seemed to be no principle whereby you could think of binding him down to a line of duty, and a universal sneer, not limited to mundane powers, formed the contrast to an imputed self-perfection, not without the evidence of very great scientific accomplishments. even before he took up barclay's class he was damaged by a story which went the round of the public, and was brought up against him at the time of his great occultation. on returning from the cape, where he had been attached as surgeon to a regiment, he was one day met by his old teacher, professor jameson, who, after a kindly recognition in his own simple way, inquired what had been his pursuits when abroad. "why," replied knox, with one of these expressions of an almost unreadable face--something between a leer and overdone sincerity--"why, i was busy in your way,--keen in the study of natural history. no place in the world excels the cape for curious objects in that department; will you believe it, professor, i have made an extraordinary discovery?" "discovery! ah, you interest me." "and well i may," he continued, as the light of the one orb expressed the new-born zeal of the naturalist. "i have found a new species of animal. yes, sir, altogether new, and at a world's-wide distance from any congeners with which you are acquainted--quite an irreproducible phoenix." "then we must identify it with your name,--some adjective connected with night, but not darkness." "and that i have done, too," continued the naturalist. "why, then, the description will form an excellent article for our journal. i could wish that you write it out and send it to me. it will be something grand, to shew the southerners we are _en avant_." "i will do it," was the reply; "and you shall have it for the next number." nor was knox worse in this instance than his word, if he could be, for by and by there came to the professor a spirited, if not elaborate description of the new species, which, having been approved of by the simple professor, flared brilliantly among the heavy articles of his beloved work. but unhappily for the discoverer, no less than for the editor, the article fell under the eye of dr buckland, who soon found out the whole affair to be an excellent hoax. often afterwards jameson looked for his contributor to administer a reproof in his gentle way, but this opportunity never awaited him, for knox, though with one eye, had a long sight when there was danger ahead, and the professor in the distance sent him down the nearest close with even more than his usual celerity. those who knew the man would have no hesitation in placing such an example of his recklessness to the credit of his rampant egotism,[ ] certainly not to that of practical joking, a species of devil's humour not always dissociated from a _bonhommie_ to which the earnest mind of the man was a stranger. even the bitterness of soul towards competitors was not sufficiently gratified by the pouring forth of the toffana-spirit of his sarcasm. he behoved to hold the phial with refined fingers, and rub the liquid into the "raw" with the soft touch of love. the affected attenuation of voice and forced _retinu_ of feeling, sometimes degenerating into a puppy's simper, bore such a contrast to the acerbity of the matter, that the effect, though often ludicrous, was increased tenfold. we may now read such a passage as we subjoin,[ ] serving merely as a solitary example of the style; but it would be vain to try to estimate the effect from the mere allocation of vocables disjoined from the acrimony they collected in their passage through the ear and carried to the brain. the young amateurs it would seem that conspiring circumstances at the time pointed to that kind of denouement which is the issue of an evil too great for society to bear. in barclay's time, the increased demand for the physical material of the dissecting halls was supplied by a most convenient arrangement of places. there was the infirmary a little to the west, where deaths were occurring several times a week, and many bodies left unclaimed by their friends. then, at the back of barclay's hall was a little "death's mailing" set apart for those who had been relieved of life in that refuge of the wretched, and, strangely enough, the windows looked out upon the tempting field; so that a man or woman, dreaming of no such fate, might die and be buried, and taken and dissected, all within the temporal space of a few days, and the physical of a few yards. no great wonder that there was there a rope-ladder of ominous intention, and a box with such accommodating appurtenances as would permit of the insertion of hooks at the end of lines, whereby it might be let down empty and light, and brought up full and heavy. nor was it inappropriate that young cullen, the grandson of _celeberrimus_, should be the man who accomplished with greatest spirit these easy appropriations. some will yet recollect how these young gouls grinned with a satanic pleasure, as they saw the heavy-looking sextons busy with the work which they were so soon to undo, if it was not also more than surmise that these grave men could smile in return, even while they were beating down the green sod, as if it were to remain till the greater resurrection, in place of the smaller. as connected with the continued spoliation of this unfortunate little golgotha, a story was current out of which was formed a mock heroic imitation of the th book of the "iliad." it seemed that an old beggar of the name of sandy m'nab, who used to be known in edinburgh as a cripple ballad singer, had died of almost pure old age in the infirmary, and was, in due time, consigned to that rest of which, as a peripatetic minstrel, he had enjoyed so small a portion in this world. yet how little one knows of the fate to which he may be destined! who could have supposed that sandy m'nab, about whom nobody cared more than to give him an occasional penny, and who was left to die in an hospital, would become as famous, within a limited space, as patroclus. it seemed that cullen and some others had, according to their custom, appropriated the body of the minstrel, so far as to have it safely deposited in the box, and that box carefully placed below the window waiting for the application of the rope, whereby it was to be drawn to the upper regions; but in the meantime, some three or four of monro's trojans, jealous of the greeks, had got over the wall with the same intention that had fired their opponents. though the night was dark, with only an occasional glimpse of a shy moon, who got herself veiled every now and then, as if ashamed of those deeds of man enacted under her light, the collegians soon ascertained that their envied minstrel had been exhumed, yea, that that body, which once contained a spirit all but cosmopolitan, was cribbed and confined in cullen's insatiable box. the discovery inflamed an original intention of mere body-snatching into an emprise of stratagetic war against their professional foes; and straightway they commenced to remove the box to the other side of the yard, with a view to getting it hoisted over the wall. but the work had scarcely commenced, when the watchful enemy, who, in fact, all the time were busily undoing the rope in the hall above, observed the stratagem below; and issuing forth, some three or four of them, under the influence of something more like chivalry than the stealing of bodies, they commenced an attack upon the intruders, which was met by a stout resistance. the box had been removed to nearly the middle of the yard, and round the sacred centre where lay the dead patroclus, the battle raged with a fierceness not unworthy of the old and immortal conflict. at one time sandy was in possession of the barclayens, at another in that of the monroites; so that the old quotation, which was subsequently incorporated in heroics, was perhaps never, in all time, so applicable,--"_danai trojanique cadaver manus commiserunt_." taken and retaken, and guarded with menaces, the inner contest was, meanwhile, illustrated by hand-to-hand fights over the swelling tumuli, perhaps not less glorious in their small way than many which have involved the fate of a kingdom; and yet the object of the conflict was the body of a wandering beggar. nor is it known how long this affray might have lasted, if some people in the neighbourhood, having heard the uproar, had not threatened, by getting to the top of the wall, to bring the champions before the authorities. the monroites fled, and the object of all this contention was left in the hands of those who, by possession, had at least the prior right. the box was hoisted to the rooms amidst the acclamations of the conquerors. "_sic hi alacres cadaver extulerunt e bello._" the want of this fruitful field behoved afterwards, on the advent of knox, to be supplied by increased exactions over the country; and hence came a more perfect organisation of a staff, composed of men who, without the excuse of a stimulus for science, were attracted to the work by the bribe of high payments. we have already seen to what extent that bribe reached; and whatever otherwise may be thought of those grim minions of the moon, they had more to stir the low passions of human nature than those older minions on the borders, who, for the sake of living steers, often made dead bodies. science became the nemesis of the dearest and most sacred affections; and what may appear strange enough, the students themselves engaged in the work with a feeling, as we have hinted, approaching to chivalry. they were sworn knights of the fair damsel science, though the rites were those of melpomene, with the grotesque shapes of those of thalia. the midnight enterprises had charms for them, but they were death to those feelings of a christian people, which require to be viewed as a natural and necessary part of a social fabric, to be tampered with only to the ruin of virtue. among these knights at an earlier period stood robert liston, whose hardihood and coolness in such midnight adventures could only be equalled by his subsequent surgical handlings; and like all other vigorous and enthusiastic men, he had the power of enlisting associates, warmed by the fire he himself felt. a favourite theatre for these dark deeds was the banks of the forth, along which are to be seen many of those small unprotected graveyards which, attached to villages, are as the shadow of the life that is within them. yes, grave or merry as the hamlet may be, that shadow is never awanting--often within the sound of the marriage-dance, and refusing to be illumined by the light of man's earthly happiness. sometimes in poetics called the gnome that points to eternity, no man can but for a few brief moments of seducing joy keep his eye from the contemplation of it; and, whether he can or not, he must be content to lie within its dark outline. these are common thoughts, which are sometimes condemned as a species of moralising; yet surprise will not the less pass even into vertigo when we think of individuals of the same species reversing rites which even lower instincts shudder to touch. we are always looking for seriousness in nature, and it is long till we are forced to confess that she is continually mocking us. "_usque adeo, res humanas vis abdita quædam obterit et pulchros fasceis sævasque secureis proculcare ac_ ludibrio sibi habere _videtur_." on one occasion our anatomist, having got a companion up to the point of courage, resolved to pay a night-visit to one of these outlying places, where, from information he had gained, there had been deposited an object which had a charm to him other than that of the mere "thing." the man had died of a disease which the country practitioner had reported to liston as something which had stimulated his curiosity, but which he could not be permitted by the friends to inquire into in the manner so much desired by doctors. the two knights got themselves arrayed as sailors--with the jacket, the sou'-wester, the unbraced trousers, striped shirt, and all the rest--and getting on board a pinnace, made their way to cures. they had on arrival some time to pass before the coming of the eery hour when such work as they had on hand could be performed with the least chance of interruption. the night, as the principal performer described it, was as dark as the narrow house whereof they were to deprive the still inhabitant, so that even with the assistance of the doctor's apprentice, who went along with them, they had the greatest difficulty to discover the limited spot of their operations. but liston had encountered such difficulties before, and then "what mattered if they should take the wrong one?" for with the exception of the pathological curiosity, as in this case, these children of science had no more scruples of choice. in a trice the game was bagged, as they sometimes described the work, and the boy, getting alarmed, flew off with the necessary injunction of secrecy, which only added to his alarm, as they could plainly perceive by the sounds of his rapid receding steps heard in the stillness of the haunted spot. but the work there was generally the least difficult of such enterprises, for as yet the people had not throughout the rural districts been roused to the necessity of the night-watch, which afterwards became so common. the danger lay in the conveyance, which in this, as in most other instances, was by the means of a pair of strong shoulders. the burden was accordingly hoisted on liston's broad back, and the two, stumbling over the green _tumuli_, got to the skirts, and away as far as they could from habitations. the field side of a thick hedge was the selected place of deposit until the morning gave them light for achieving the further migrations of the unconscious charge; and then there was to be sought out a place of rest for the two tars, wearied with travelling all day homewards in the north after so long a cruise in the south sea. nor was it long before a welcome light proclaimed to liston, who knew the country, the small wayside inn, in which they would repose during the night. and there, to be sure, they got that easy entrance, if not jolly welcome, so often accorded to this good-hearted set of men. they were soon in harmony with the household, and especially with a "mary the maid of the inn," who saw peculiar charms in seamen in general, and in our friend robert in particular; nor was the admiration all on one side, though mary's predilection for his kind was, as matters turned out, to be anything but auspicious to the concealed students. then the coquetting was helped by a little warm drink, if not a song from the companion about a certain "sheer hulk," which lay somewhere else than behind the hedge. all this, be it observed, had taken place by the kitchen fire--an appropriate place for benighted seamen; and it being now considerably beyond twelve, they were about to be shewn their room, when they were suddenly roused by a loud shout outside, the words, "ship, ahoy!" being more distinctly heard by our _quasi_ tars than they perhaps relished, for, after all, neither of our students, however they might impose upon mary, felt very comfortable under the apprehension of being scanned by a true son of neptune. "that's my brother bill," said the girl, as she ran to open the door; "i fear he has been drinking." the door being opened, the "ship, ahoy" entered; and what was the horror of liston and his friend when they saw a round, good-humoured sailor staggering under the weight of that identical bag and its contents which they had placed behind the hedge only a very short time before! "there," cried the blustering lad, who had clearly enough been drinking, as he threw the heavy load on the kitchen-floor with the something between a squash and thump which might have been expected from the nature of the contents--"there, and if it aint something good, rot them chaps there who stole it." "what is it?" said mary. "and why should i know? ask them. didn't they put the hulk behind a hedge when i was lying there trying to wear about upon t'other tack? what ho!" he continued, "where did you heave from? but first let's see what's the cargo." and before the petrified students could bring up a sufficient energy to interfere, bill's knife had severed the thick cord which bound the neck of the bag. then mumbling to himself, "what under the hatches?" he exposed, by rolling down the mouth of the bag, the gray head of a man. the tar's speech was choked in a moment, and while the girl uttered a loud scream, and rushed out into the darkness, there stood the brave seaman, whose courage was equal to an indifference in a hurricane of wind or war, with his mouth open, and his eyes fixed in his head, and his arms extended as if waiting for the swing of a rope; all which culminated in a shout of terror as he ran after his sister, and left the field to those who could not by their own arts or exertions have got the command of it. so true is it that man's extremity is also not only god's opportunity, but sometimes his own, though against his will and his laws. not a moment was to be lost. without binding again the bag, the burden was again upon the back of the now resolute liston, and without having time to pay for their warm drink, or to remember mary for her smiles, the adventurers were off on their way to the beach. of all the unfortunate places on the banks of the estuary resorted to for these midnight prowlings, no one was more remarkable than that romantic little death's croft, rosyth, near to limekilns. close upon the seashore, from which it is divided by a rough dike, and with one or two melancholy-enough-looking trees at the back, it forms a prominent object of interest to the pleasure parties in the forth; nor is it possible for even a very practical person to visit it, when the waves are dashing and brattling against the shore, to be unimpressed with the solitude and the stillness of the inhabitants, amidst the ceaseless sounds of what he might term nature's threnody sung over the achievements of the grim king. often resorted to by strangers who love, because they require the stimulus of the poetry of external things, the more, perhaps, because they want the true well-spring of humanity within the heart, it is a favourite resort of the inhabitants of the village, where bereaved ones, chiefly lovers of course, sit and beguile their griefs by listening to these sounds, which they can easily fancy have been heard for so many generations, even by those who lie there, and who have themselves acted the same part. the few old gray head-stones, occasionally dashed by the surf, have their story, which is connected through centuries with the names of the villagers; and such melancholy musers find themselves more easily associated with a line of humble ancestors than can occur in the pedigrees of populous towns. surely it is impossible that these holy feelings can have a final cause so indifferent to him who, out of man's heart, however hardened, "brings the issues of love," that it can be overlooked, defeated, and mocked by that pride of science of which man makes an idol. the _ludibrium_ referred to by lucretius is in this instance, at least, of man's making; and if it is conceded to be necessary that the bodily system should be known, that necessity, which is so far of man's thought, must be restricted by that other necessity, which is altogether of god's. it was not to be supposed that this romantic mailing should escape the observation of our anatomist. nor did it; and we are specially reminded of the fact by an admission made by liston himself, that, unpoetical and rough as he was, an incident once occurred here which touched him more than any operation he ever performed. on this occasion he and his friends had made use of a boat specially hired for the purpose--a mode of conveyance which subsequently passed into a custom, before the limekilns people were roused from their apathy, and became next to frantic under circumstances which left it in doubt whether any one of them, husband, wife, father, mother, or lover, could say that their relations had not been stolen away from their cherished rosyth. the adventurers studied their time so well that their boat would get alongside of the dike under the shade of night, and they could wile away an hour or two while they watched the opportunity of a descent. they were favoured by that inspissated moonlight, which was enough for their keen eyes, and not less keen hands, and yet might suffice to enable them to escape observation. but just as they were about to land they observed the figure of a young woman sitting near one of the head-stones. the stillness all about enabled them to hear deep sobs, as if the heart had been convulsed, and tried by these efforts to throw off the weight of a deep grief. the story was readable enough even by gouls, but so intent were they on their prey that they felt no response to these offerings of the stricken heart to him who, for his own purposes, had struck it. the scene continued beyond the endurance of their patience, and science, as usual, murmured against nature's decrees; but at length she who was thought an intruder rose, and after some movement of the arms, which came afterwards to be understood, slowly left the spot. the coast, as the saying goes, was now at last clear, and with a bound the myrmidons overleaped the wall. they were presently on the spot where the female had been seated, and even in their hurry observed that the heart-broken creature had been occupied as her last act by throwing some silly bits of flowers over the grave,--signs which as little physically as morally interfered with their design of spoliation. in a few minutes the object they sought was in their possession, and if there was any care more than ordinary observed in putting all matters to right on the surface, it was the selfish wish to keep so convenient a place free from those suspicions which might bar another visit. nay, so heartless were they, that one of the party, whether liston himself we cannot say, though it would not have been unlike him, decorated his jacket by sticking one of the slips of offering into the button-hole. they now hurried with their burden to the boat and pushed off, but they had scarcely got beyond a few yards when they saw the same figure hurrying to the dike. the light of the moon was now brighter, and they could easily observe the figure as it passed hurriedly, as if in great excitement, backwards and forwards, occasionally holding out the arms, and uttering the most melancholy sounds that ever came from the human heart. it might be that as yet she had hope in mere adjuration, but as the boat moved further and further away, there came a shrill wail, so piercing that it might have been heard even at the distance of the village. but heedless of an appeal, which nature responded to faithfully by an echo, they rowed away, still hearing, in spite of the splash of the oars, the same wail as it gradually became faint in their increasing distance. at length they could hear nothing but the sweltering of the waters, and rosyth with its solitary mourner bade fair to be forgotten under the lethe of the flask, which on such occasions was never awanting. this story was very soon made readable to liston and the others by the concatenation of certain very simple circumstances. a newspaper report which liston had seen some days before, had announced the death, by drowning, of a young sailor belonging to limekilns. the account was sufficiently lugubrious for any readers; but the editor, as usual, had mixed up with it, whether truly or not, the old story of love and impending marriage; the object too being, of course, young, brave, virtuous, and comely. then came the account of the funeral, also touchingly given. but it seemed that all this poetry had been thrown away upon the ardent anatomist; nor even when afterwards, in the hall, he became satisfied that he had secured the right object, would he in his heart admit that he had in this adventure done anything more than would be justified by the use he could make of his knowledge in ameliorating physical evils in his fellow-men, however dearly that advantage might have been acquired in the agony of that figure he had left wailing at rosyth. yet it is but fair to say that liston himself admitted that the sound of that cry, the sight of those wringing hands, and the rapid goings to and fro of the shade on the shore, never passed from his memory. robert liston, beyond all the others, carried so much of the spirit of chivalry into his adventures of body-snatching, that he thought it as noble an act to carry off a corpse as an ancient knight-errant did to bear off a prisoner; but his followers were more like mimallons than myrmidons, and required more of the flask to keep up their spirits. some of these youths once made a mistake at rosyth. having run up their boat, they proceeded to the little death's croft to take up the body of a woman who had died in child-bed. the night was dark and gusty, and the wind whistled through the long grass as if nænia had been presiding there to hear her own doleful music; but our youths cared little for these things, and, after twenty minutes' work, they pulled up "the tall beauty," as they called her after they got home. away they hurried her to the dike, upon which they laid her, till two got over to place her in the boat. all seemed fair, but just at the moment, some ill-mannered tyke set up, without the excuse of a moon,--for she was far enough away beyond the shadows,--a deep howl, so prolonged and mournful, that even all the potency of the flask could not save them from being struck with awe, as well as a fear of detection. but they had more to be afraid of, for almost immediately after, one of them called out, "there's a lantern among the graves;" and thus flurried, yet determined not to lose their prize, they rugged the body from the top of the rubble dike so roughly, if not violently, that a great portion of the long hair, which had got entangled among the stones, was, along with a piece of the scalp, torn away, and left hanging on the other side. safe on board, they lost no time in pushing off, in spite of the surly breakers that threatened to detain them; nor did they now care for either the dog or the lantern, the latter of which they saw through the dark medium, dodging towards the very spot they had left, and then remain stationary there, as if the bearer had been stayed and petrified by the relic they had left. up to not a very late period, the story went in the neighbourhood that he who bore the lantern was the husband of "the tall beauty," and that he discovered the hair, and knew from the colour, which nearly approached flaxen, that it was that of his wife, whose untimely death had rendered him frantic. there was no loss in that case; but another which was current among the classes not long after was less fortunate, though not less true, as indeed may be verified by the brother, still living, of the young student who figured in it. somewhere about gilmerton or liberton, we are uncertain which, a small farmer who had lost his wife went out one morning very early, probably because he could not rest in his bed for the dreary blank that was there,--that negative so much more appalling to love than the dead positive. on going along the edinburgh road, he observed some white figure lying close by the footpath, and making up to see what it was, he came upon the corpse of a woman, dressed in her scolloped dead-clothes, and lying extended upon her back, with the "starr eyes" open, glazed, and fixed. on looking more narrowly, he discovered that it was his own wife, and, all dismayed and wild as he became, he could still have the power to think that she had come back to life after having been buried and lain in the grave for three days, and had thus far struggled to get to her beloved home. frenzy knows nothing of logic, and was he to think how she could have thrown off a ton of earth and got up again to the light of the sun? the idea took him by force, and, throwing himself upon the body, he looked into the dead orbs, and watched the cold stiff lips, and listened for a breath. vain heart, with all its hopes and tumults! no sign in return for all this madness. yet he persevered, and gave up, and resumed, and, as the hope died to come back again, he writhed his strong body in an agony tenfold more acute than his first grief; nor would he in all probability have renounced the insane hope for a much longer time, if the penicuik carrier had not come up, and, hearing the wonderful tale, hinted the explanation of an interrupted body-snatching. the light flashed upon him in an instant, and, in pursuance of a desire to keep the occurrence secret for the sake of her friends, he prevailed upon the man to take the body in the cart and remove it to his house. it was buried again privately on the following night, and few ever heard of the occurrence. and now comes the explanation of a story which may seem altogether incredible. a young student of the name of f----y, belonging to monro's class, entered with two others into an adventure of body-snatching, in imitation of those whose exploits had produced in them an enthusiasm untempered by prudence, and not directed by experience. they fixed upon their ground, and hired a gig, and the hour was regulated by an obituary. away accordingly they set, with no more knowledge of the secrets of the art than what they could get from the regular purveyors of the class, but provided with the necessary instrument. they soon got to their destination, and, leaving the gig in the charge of one of them, the two others got over the low wall, and, by the aid of the moon, discovered the last laid turf. going to work vigorously, they succeeded in raising the body of a woman, but not having brought from the gig the indispensable sack, and, being fluttered and hurried, they bethought themselves of carrying the object to the side of the road, just as it was with the dead-clothes, and then running along by the side of the hedge to where their companion waited. f----y accordingly, with the aid of his friend, got the white burden hoisted on his back, holding it as firmly as he could by the linen. so far all was well, and they were fortunate, moreover, in getting out by a gate which they could open; but just as f----y got to the road, along which he had to go a considerable space, the grasp he had of the shroud began to give way, perhaps almost unknown to himself, the effect of which was that the body slipped so far down that the feet touched the ground. the consequence was altogether peculiar; as f----y bent and dodged in the hurry of getting forward, the feet of the corpse, coming always to the ground, resiled again with something like elasticity, so that it appeared to him as if it trotted or leaped behind him. fear is the mother of suspicion, and the idea took hold of him that the body was alive. he uttered a roar,--threw his burden off, and crying out to his friend, "by g----, she's alive!" jumped into the gig. his friend was taken by the same terror, and away they galloped, leaving the corpse in the place where it was found next morning by the husband. the regular staff. it is, we think, laid down in that strange book of robert forsyth's on morals, that the gratification of the desire of knowledge is, at least on this earth of ours, the true end of man; and, no doubt, were we to judge of the strength of this desire in forcing man down into the bowels of the earth, and up into the heavens, across unknown seas, and over equally unknown continents, we would not be slow to confess its great power. and yet how many there are who assign the same place to the power of mammon, while others stand up for love and the social affections! we will not presume to decide where the range goes from the things of earth to those of heaven; but it appears pretty certain that there have been a good many charles kirkpatrick sharpes, who have lauded, while in health, the practice of leaving the body to the doctors, and who yet have shrunk from the personal example when the shadow of the dark angel was over them. there have been also, we suspect, fewer jeremy benthams, who actually have left their carrion to the vultures of science, than of merryleeses, who have robbed churchyards, and sold the stolen article for money.[ ] nor, in estimating the motives of the few scientific testators, can we say that we have much belief in their professions, if it is not more true that they are only seekers of notoriety, sometimes, as in the case of the author of the fallacies, so weak as to be bribed by the offer of having their skins tanned and distributed in slips--the skin being, in such instances, the most valuable part of their corporations. in pursuance of these notions, we may safely infer that if the wants of the halls had been left to be supplied by the scientific zeal of the amateurs, the state of anatomy would have been less perfect than we find it under the auspices of such men as schwann, or bell, or hall, in our day. and we say this without being much satisfied that all the boasted discoveries have led to much more than the conviction that we get deeper and deeper into the dark, while--admitting many ameliorations--the people recover from operations, or die of diseases, very much as they used to do. what are called the high cases might very well be left alone, so that we might be still bound to admit that nature's purpose, in imposing the sacred feeling for the dead, is consistent with her determination, that if in this defeated by man, he shall earn nothing by trying to get at her secrets. but there was no necessity that the matter of purveyance should be left to the students. there have always been body-thieves; but the time had come in scotland, when not only their number behoved to be increased, but their energies also, by the multiplied demands of the halls. how far this increase might have progressed, but for the great drama of "the scotch court of cacus," it is impossible to say; but for a time the staff of knox's artists were rather put upon their wits and exertions, than increased by dangerous bunglers. the trade was perilous, and required attributes not very often found united,--a total bluntness of feeling, a certain amount of low courage, much ingenuity of device, clever personal handling, and total disregard of public opinion--the love of money being the governing stimulant. few classes of men could have afforded a better study in the lower and grosser parts of human nature. there was one called merrylees, or more often merry-andrew, a great favourite with the students. of gigantic height, he was thin and gaunt, even to ridiculousness, with a long pale face, and the jaws of an ogre. his shabby clothes, no doubt made for some tall person of proportionate girth, hung upon his sharp joints, more as if they had been placed there to dry than to clothe and keep warm. nor less grotesque were the motions and gestures of this strange being. it seemed as if he went upon springs, and even the muscles of his face, as they passed from the grin of idiot pleasure to the scowl of anger, seemed to obey a similar power. every movement was a spasm, as if the long lank muscles, unable to effect a contraction through such a length, accomplished their object by the concentrated energy of violent snatches. so, too, with the moral part: the normal but grotesque gravity was only to be disturbed by some sudden access of passion, which made him toss his arms and gesticulate. so completely was he the cause of fun in others, that often on the street some larking student would cry out, "merry-andrew," for no other purpose than to see him wheel about, clench his hands, and throw his face into all manner of furious contortions. all this only conspired to make him a butt, and the loud laugh which always came when there was nothing to laugh at, or rather something which would have produced gravity in another, helped the consummation. yet withal this same idiot was the king of knox's artists. nothing dared him, and nothing shamed him, if he was not even proud of a profession which was patronised by gentlemen and men of science, and paid at a rate which might have put industrious and honest tradesmen to the blush. like many other half simpletons, too, he had a fertility of device in attaining his object, which insured success, when others apparently more intelligent despaired. so he was a leader upon whom often depended the hopes of the students, when their material was scarce or awanting. when not engaged in his rural exploits, he was always hanging about the infirmary, where, no doubt, he was in secret communication with the _élèves_ of that institution connected with knox's rooms. from these he got intelligence of likely deaths, where there was a chance of the persons not being soon claimed by their relatives. now was the opportunity of this genius. he kept a brown black suit for the occasion of a mourner, repaired to the infirmary, and acted the part of the relative to such perfection, that the nurses at least--for the medical men could wink--were deceived. nay, he looked at all times so much the afflicted, that the personation even to something like tears was as easy to him as to the weeper in the house of commons, who cried "like a crocodile with his hands in his breeches' pockets." the moment the body was got outside in the white coffin, the bearers actually _ran_ with it to the hall, under the inspiration of the, to such glandered hacks in the shape of men, so enormous a reward. another of the leaders, though far inferior to merrylees, was the "spune," a name given to a man whose real one was scarcely known in the rooms, and which was supposed to indicate some superior genius in lifting out the contents of a coffin. he was a littleish man, with a clean-shaved face, surmounting a dirty black suit, worn down to the cotton, which time had glazed. one would have taken him not certainly for a remunerated methodist preacher, but one who would have given a great amount of doctrine for as much as would have got him a dinner. yet he was in reality a mute, being one of those dumb worshippers of philosophy whose thoughts, going down into the earth, if not up to heaven, are too deep and sacred for human speech. nay, so grave, precise, and wise did he look, that you would have said he bore all the honours of the science to the advancement of which he contributed so much; nor is it certain that he did not really feel--so necessary if not indispensable they considered themselves to be to the professors--that he was engaged in the holy cause of the advancement of mankind and the amelioration of their natural ills,--a conviction this, on the part of the "spune," not modified by the reception of his fee, which he considered to be the wages of virtue; for while merry-andrew clutched his reward with a spasm and a spring, his compeer took his with the dignity and nonchalance of one who laboured for the benefit of his species. however ludicrous all this, one could scarcely say that it was out of place, for without the "spune" the indagators in the hall would have had small chance of extracting anything from that deep well where it is said truth can alone be found. another was a man whose real name was mowatt, but who was christened by the professional appellation of "moudewart," (_moldewarp_,) sufficiently indicative of his calling in burrowing into the bowels of the earth. an old plasterer, too lazy to work, he had betaken himself to this trade from a mere love of the money, so that he behoved to rank in a much lower grade than the "spune." then, so essentially insensible was he to the honour of contributing to science, that he did not take on a particle of dignity, even from the sympathy of his fellow-labourers. it might be in vain that the "spune" tried to impress him with the importance of his calling,--he was a man of merely so many pounds for what is in the bag, and no more. without that principle of receptivity which enables a congenial soul to take on the reflection of the beauty or honour of an act, he was equally dead to the sublime inspiration of knowledge. even merry-andrew had collected some scientific terms--such as _caput_, or _cranium_, sometimes even attempting _occiput_--all parts of the body with which alone he had anything to do in the process of abstraction; and as for the "spune," he could even discourse of _tibias_ and _fibulas_, if he did not stagger under _os coccygis_, in a manner which might have made his companion prick up his ear at the wonder that any such head could carry such terms. but what can be done with a man who has no symptoms of a human soul but that which shews itself when the eye counts with something like pleasure the price of a human body? yet, strange enough, and perhaps unjustly enough, the two others were not more prized by their patrons than this degraded son of science, who served their purpose equally well--a fact which would have brought down the learned dignity of his co-labourers if they had had sense enough to notice it. the others of the staff (the names of some of whom we could give) were not to be compared to these leaders--not even to the "moudiewart," who, however stupid in respect to the science, was really sufficiently up to "the thing" to entitle him to rank as a successful if not respectable merchant. they were so utterly insensate, that they could not even commit the great mistake of supposing that their occupation degraded them, for the good reason that they were unconscious of degradation. not that they were unhappy in consequence of not liking the work, for they were even fond of it as a means of getting them drink and tobacco, without the hope of which they might have been dull or sad, but not unhappy, a term which implies something like intelligence, if not sentiment. fitted only for the humblest parts of the calling--the carrying, the watching, the calling out when intruders loomed in the distance--they had no envy towards the higher orders, and being thus free from all care, they could sing or whistle beneath the burden of a poet without thinking that they desecrated the profession of the muses. we might thus liken them to those interlusive gentry who play the punning parts of a terribly deep tragedy, and who, not knowing where the pathos lies, as when hamlet discourses on the skull, are contented with the duty of shovelling out either soil or song. if we were inclined to moralise a little on the condition of such men as these, if men they can be called, we would hesitate to subscribe to the old johnsonian notion that happiness has any relation to the number of ideas that pass through the mind, if we would not go to the other extreme, that for aught we know, there may be as much of that kind of thing between the shells of an oyster as between the ribs of a human being--at least the question must remain unsettled until we come again in the round of changes to the doctrine of transmigration of souls. the world is full of the examples of the meeting of extremes; and if you want one more, just take that afforded by the fact that these men we have been describing could carry on their shoulders in a canvas bag a rothschild or a byron, and never think that they were to any degree honoured by the burden. all one to them--the beautiful young creature who died of a scorned affection, the shrivelled miser who expired in a clutch of his gold, or the old gaberlunzie whose puckered lungs could no longer inflate themselves or the bagpipes which once received so joyfully the superabundant wind. but seriously, although these things have been, are we entitled to go with the fatalist, who says that what is, is as it ought to be? though the wily fox contrived to get his neighbours to cut off their tails to make them like himself in his misfortune of being excaudated, is that any reason why nature should repeal her law and produce therefore tailless foxes? we hope not. and so also, because science run mad decreed that she should be served by such men and such acts, in opposition to the first and last throbbings of the love of kindred, is that any reason why nature should renounce her right of forming man in the image of god, and with affections which are to endure through all eternity? but we have even now, when it is whispered that subjects are again becoming scarce, men of the christian faith who speak lightly of the dead human frame as nothing when deprived of the spirit. this may do for the logic of physics, but we have been led to believe that the religion we profess is not that of merry-andrew or the "spune," but a divine intimation that the temple of the soul is not limited to the time of the earth--yea, that it is something which, _only changed_, shall rise again and endure for ever. even this is not adverse to the claims of science; but as a shade distinguishes homicide and murder, so does a shade distinguish between science in reverence to god, and science in desecration of his first and most universal laws. sympathising sextons, doctors, and relatives. all forces are measured by opposition, as, indeed, all the phenomena of nature are known to us by comparison, and so, in all fairness, we must estimate the turpitude of the professors and students the more lightly, in proportion to their freedom from all endearing feelings of recognition or friendship towards those whose remains came within their studies. the same metre is due to the class of purveyors, and heaven knows how much, after all this abatement, remained at their debit, cognisant as they behoved to be of the certainty that they were sowing the bitter seeds of misery throughout the land. but what are we to say of others--doctors in the country who were privy to the remunerated exhumation of their patients--sextons who gave the pregnant hint, and then went to sleep in the expectation of a fee in the morning--nay, of those, and such at that time were counted among human beings, who bartered their friends and relatives for a smile of mammon? out of these materials how easy could it be to add so much, and so many more darker shades to the picture. we have no great wish to lay them on either thick or thin--the mind will paint for itself, as rises the contemplation: the family doctor hanging over his patient with professional sympathy, and perhaps something finer, dreaming the while of a _post-obit_ fee, in addition to that paid for his skill to cure--the sexton clapping down the sod over a companion who had often set the table in a roar, in which the grave official had joined, and meditating a resurrection through his means in the morning--the relative who had even got the length of tears, dropping them on the pale face of an old friend, all the while that he meditated a sale of the body. but it is true that the annals of the period justified all these grim pictures. many will still recollect the young irish doctor who went in the square under the name of the "captain"--a man of such infinite spirits, always in a flow of his country's humour, that you could not suppose that there was time or room in his mind for a little smooth pool to reflect a passing cloud of sadness. in his native town he drove a great trade for the edinburgh halls--his largest contribution being laid on the graveyard of his native town. and surely, in his case, we would have thought the chinese system of paying a doctor, only in the case of recovery, would have been an example of irish prudence. nay, so many were the barrels, with a peculiar species of _contenu_, he sent by leith, that it was difficult to avoid the suspicion that the rollicking son of erin had a faith in his medicines stronger than the hope which illumined the faces of his patients. these barrels of the "captain" were quite well known, not only to the skippers, but the porters about the pier, ay, even the carters who made the final transport; and here, again, mammon was the seducing spirit. it was only when he came over for his large accumulated payments that he was seen in the hall, where his jokes and immeasurable laughter might have made those quiet heads on the tables rise to get a look of their once sympathising surgeon. nor, in the consideration of the students, was his laughter unjustified by his jokes; as once where, pointing to a certain table, he apostrophised the burden it carried--"ah, misthress o'neil! did i spare the whisky on you, which you loved so well,--and didn't you lave me a purty little sum to keep the resurrectionists away from you,--and didn't i take care of you myself? and by j----s you are there, and don't thank me for coming over to see you;" or when, in the same brogue, he told them that, not long before his coming over, he had, for lack of "the thing" in his own town, taken a car and rode to a neighbouring village, where he got precisely what he wanted; that, on returning at a rapid rate with his charge, he met the mother of it with the words in her mouth-- "well, docther, is it all right wid the grave ov poor pat?" "all right, misthress. didn't i tell you afore there were no resurrectionists in that quarter?" "and you are sure you eximined it complately?" "no doubt in the wide earth." "then i may go back, and you'll give me a ride?" "surely, and plaisant," said he; "just get up." "and," continued the captain to the delighted students, "i dhrove the good lady home agin without breaking a bone of her body, and pat never said a word." "but," he went on, "if i were to tell you all my irish work, i would never get back to my ould country agin." "just another adventure, captain." "well, then, didn't a purty young girl--and i have hopes of her yet for myself, for she has money galore--come to me one day in a mighty fit of grief?" "'my poor mother has been rizzt,' said she, as she burst out in the way of these gentle craturs. "'and she has not,' said i--(the more by token that i had the ould lady in the house.) "'i have been at the grave,' said she, 'and i see it has been disturbed.' "'and it has not,' said i; 'for wasn't i there this morning before ever a soul in all the town was stirring? and didn't i leave it all right with my ould friend?' "'but i have seen marks,' said she again; for she was so determined. "'and do you think i don't know you have?' said i; 'and didn't i see them, after i got a spade from the sexton and put on a nate sod or two more to make the grave dacent and respectable?' "'oh, i'm so glad,' replied she, all of a content. "'and you'll be gladder yet, my darling,' said i, as i gave her a kiss. 'go home and contint yourself, and perhaps, when your mournings are off, you may consent to make a poor docther happy.' "and so she went away, blushing as no one ever saw except in a raal rose." and the laugh again sounded through the hall among the dead. whether these stories were true, or merely got up by the extravagant love of fun in the captain, it would not be easy to say; but certain it is, that their being told and responded to in the manner thus described, from the lips of an ear-witness, shews us the atmosphere of moral feeling that then obtained in places proudly designated as being dedicated to the interests of humanity, and from which, too, we could draw the conclusion that what was gained in the amelioration of physical disease was required to be debited so largely with the deterioration of morals and a wide-spread infliction of pain. but even darker deeds were done in scotland than those for which the captain took so gasconading a credit. from a certain village called s----e, the myrmidons of the square, and particularly the "spune," got more material for the hall than could have been expected without a resident sympathiser and participator in the profits. that zealous correspondent was not the sexton--no, nor the minister; but he was the minister's brother, and, so far as we can learn, a member of the profession. need it be remarked how convenient the relation between the messenger of heaven and the benefactor of earth--the physician of souls and the curer of bodies--the man of prayers and the man of pills--the distributor of the great catholicon and the dispenser of the small! we can fancy the godly man, we believe all unconscious of the intentions of his brother, pouring the holy unction of his prayers over the struggling spirit of the dying christian, and the doctor counting the pulses as they died away into that stillness which was to be the prelude to the payment--five pounds--for the deserted temple. one recording angel would fly to heaven with a name to be inscribed in the roll of eternal salvation, and the other to edinburgh to announce that another body was to be inserted in the black list of surgeon's square. even this was not the culmination of the evil. the head of the scorpion--society--was to swallow its tail, so that the virtue and the poison would meet and traverse together the circle. mammon, through the medium of the leaders of the purveyors of science, extended his charm to the hearts of relations and friends, changing the soft glance of love and pity into the fiery glare of sordid rapacity. throughout the high street and canongate, and down through the squalid wynds and closes, where, though crime and misery shake hands over the bottle of whisky, the death-bed still retains some claims over the affections, and where religion is sometimes able to extort from the demons of passion the unwilling tribute of compunction, these strange men prowled in the hope of finding or making a monster. and in this it is certain that they succeeded more often than was then suspected, or is even yet known. their first inquiry was for death-beds, and the next for evidence of squalid poverty combined with vice. the subject was approached cautiously where the ground had all the appearance of being dangerous. if they were met by deliberation or hesitation, between which and blows there was no space, their object was secured, as the devil's is, by exposing to the haggard eye of penury the very form and substance of the bribe. in one case, reported by merrylees himself, the bargain was struck in a whisper by the bed-side of the dying friend. how far the relationship extended in any of these cases we never could ascertain; and it is only fair to assume, for the sake of human nature, that in the majority of instances the success was only over the keepers of stray lodgers, and mere friends, as distinguished from relatives; but that there were, some where there behoved to be the yearnings of affection, and a consequent struggle between love and mammon, there can be no doubt. thus, however difficult or delicate the moral impediments that required to be overcome, the physical parts of the contract were of easy management. the coffining was made a little ceremony, performed in presence of some of the neighbours. there would be tears, no doubt, if not an irish howl, and the louder perhaps the greater the bribe; and in the evening a bag of tanners' bark supplied the place of the friend of the many virtues discoursed of at the wake. nor was there less care taken in carrying this box of bark to the canongate burying-ground than was displayed by "merry-andrew" in conveying the _surrogatum_ to surgeon's square; but, of course, there would be a difference in the speed of the respective bearers. taking all these details into account, we can scarcely deny that these men wrought harder for their money than if they had pursued a regular calling. but, then, they liked it. even after the bargain for the living invalid was struck, how many anxious watchings at a wynd-end were to exhaust the weary hours before the spirit took wing from the sold body! the gaunt figure of merrylees, as he jerked his lank muscles and threw his face into the old contortions, might be seen there, but none would know what this meant. one night, a student who saw him standing at a close-end, and suspected that his friend was watching his prey, whispered in his ear, "she's dead," and, aided by the darkness, escaped. in a moment after, "merry-andrew" shot down the wynd, and, opening the door, pushed his lugubrious face into a house. "it's a' owre i hear," said he, in a loud whisper; "and when will we come for the body?" "whisht, ye mongrel," replied the old harridan who acted as nurse; "she's as lively as a cricket." a statement which, though whispered in the unction of secresy, and with most evident sincerity, merrylees doubted, under a suspicion that the woman's conscience had come between her and the love of money; and, jerking himself forward to the bed, he threw the shadow of his revolting countenance over the face of the terrified invalid, enough of itself to have sent the hovering spirit to its destination, whether above or below. not a word was spoken by the victim. she had heard enough to rouse terror sufficient to deprive her of speech, if not of breath; and all that the ogre witnessed was the pair of eyes lighted up with the parting rays of the fluttering spirit, and peering mysteriously as if into his very soul. but then, as it happened, "merry-andrew" had only a body, and this look, more like as it was to a phosphoric gleam than the light of the living spirit, fell blank. enough for him that she was not yet dead; and, taking one of his springing steps, he was out of the room, forcing his way up the wynd, to seek, and, if possible, to wreak a most imprudent vengeance on the larking prig who had put his long muscles to such unfruitful exercise. meanwhile, the young rogue had waited for the butt, to see some more of his picturesque spasms; nor was he disappointed, for the moment merrylees cast his eye on him, he tossed up his hands, and, with a shout which might have been taken by one who did not know him, or even by one who did, as an indication either of intense fun or fiery anger, made after him at the rate of his long strides. the student, of course, escaped, and merrylees, convinced that the invalid was not so near her end as he wished, went growling home to bed. but this tragedy, with its ephialtic forms reflecting these coruscations of grim comedy, did not end here. the old invalid, no doubt hastened by what she had witnessed, died on the following night; and on that after the next succeeding, when he had reason to expect that she would be conveniently placed in that white fir receptacle that has a shape so peculiarly its own, and not deemed by him so artistic as that of a bag or a box, merrylees, accompanied by the "spune," entered the dead room with the sackful of bark. to their astonishment, and what merrylees even called disgusting to an honourable mind, the old wretch had scruples. "a light has come doon upon me frae heaven," she said, "and i canna." "light frae heaven!" said merrylees indignantly. "will that shew the doctors how to cut a cancer out o' ye, ye auld fule? but we'll sune put out that light," he whispered to his companion. "awa' and bring in a half-mutchkin." "ay," replied the "spune," as he got hold of a bottle, "we are only obeying the will o' god. 'man's infirmities shall verily be cured by the light o' his wisdom.' i forget the text." and the "spune," proud of his biblical learning, went upon his mission. he was back in a few minutes; for where in scotland is whisky not easily got? then merrylees, (as he used to tell the story to some of the students, to which we cannot be expected to be strictly true as regards every act or word,) filling out a glass, handed it to the wavering witch. "tak' ye that," he said, "and it will drive the deevil out o' ye." and finding that she easily complied, he filled out another, which went in the same direction with no less relish. "and noo," said he, as he saw her scruples melting in the liquid fire, and took out a pound-note, which he held between her face and the candle, "look through that, ye auld deevil, and ye'll see some o' the real light o' heaven that will mak' your cats' een reel." "but that's only ane," said the now-wavering merchant, "and ye ken ye promised three." "and here they are," replied he, as he held before her the money to the amount of which she had only had an experience in her dreams, and which reduced her staggering reason to a vestige. "weel," she at length said, "ye may tak' her." and all things thus bade fair for the completion of the barter, when the men, and scarcely less the woman, were startled by a knock at the door, which having been opened, to the dismay of the purchasers there entered a person, dressed in a loose great-coat, with a broad bonnet on his head, and a thick cravat round his throat, so broad as to conceal a part of his face. "mrs wilson is dead?" said the stranger, as he approached the bed. "ay," replied the woman, from whom even the whisky could not keep off an ague of fear. "i am her nephew," continued the stranger, "and i am come to pay the last duties of affection to one who was kind to me when i was a boy. can i see her?" "ay," said the woman; "she's no screwed doon yet." enough for "merry-andrew" and the "spune." they were off, and up the wynd in a moment, followed by the stranger, who, for some reason that has not in the story yet appeared, gave them chase, only so much as to terrify them into a flight, but without being carried so far as to insure a seizure, which he did not seem inclined to achieve. nor did he return to bury mrs wilson--a strange mystery to the unnatural nurse, who, however, did not lose all, for the three pounds had been left on the table, and were quickly appropriated without the least consideration. the story next day went the round of the hall; and it was not until the woman was buried, that merrylees and his friend were made aware that the same student who had played the principal performer at the head of the wynd was the stranger in a very well-assorted disguise. preying on each other we are surprised when we find a man turn wicked all of a sudden, and seldom think that we are simply drawing a false conclusion, insomuch as the suddenness of the supposed change is a mere jump of development,--the consequence of a long train, dating perhaps from infancy. so true is it, that the increase of depravity is the progression of degrees, all according to that law of nature whereby god wills to act by the regular process of cause and effect, each change helping another, till matters come to a burst, when the often-split powers take new directions, to begin in new courses, and go on increasing as before. we have already seen the demon mammon obeying the law of increased power, spreading from a centre in surgeon's square among the people, and trying heart after heart, even to that core where he battled successfully with affections which god seems to have consecrated to himself. yes; and the demon was to go farther and farther,--even beyond the stage where we are sure to find him,--contesting even the breasts of the regular traders, the very centres of their natural affinities. we have already noticed the use to which "merry-andrew" put that brown-black suit of his, the white neckcloth, the haggard cheeks, and the tears,--all so often the stage property in the melodrama of life, and as easily put off as the personation of the character, unless kept on by the adhesive effect of a good legacy. but as every man is once or twice in his life doomed to experience in reality that which he falsifies in theory, so our mourner over those he had never seen before was on one occasion, at least, placed in a position where it might have been expected he would experience something like a qualm about the thing which was in form, if not in consistency, a heart. it seems that merrylees had a sister in penicuik, with whom he had been brought up, and towards whom, before he had experienced the hardening process of mammon's manipulations, he had entertained something like affection. that sister happened to die; and, on a certain day, merrylees appeared in the square once more in the old suit which had so faithfully repaid its original cost twenty times over. he had sense enough--and the reason thereof may appear, on a little consideration of the character of his compeers--to keep the circumstance of the death to himself; and, accordingly, when the apparition appeared in the ominous suit, they anticipated another descent of grief upon the infirmary. this suspicion very soon passed away, for not only was there no sign of that puckering up of the lank muscles, not deserving the name of a look of vivacity, which preceded his lugubrious personation in the hospital, but the day passed without any aid being asked from the others to help to carry, or rather run, with the white coffin. the methodist "spune" was the first to divine the real cause of the chief's melancholy; and whether it was, as was said,--for we are not certain of the fact,--that the two had had a quarrel some time before about the division of spoil, it was certain that the worsted competitor began to entertain some very dark thoughts about a visit to penicuik church-yard, whereby he could not only remunerate himself in the shape of money, but achieve one of the most curious revenges that ever were enjoyed since nemesis began to have her fiery eyes. so, taking mowat to a side of the square, the "spune" began to look mysteriously into his face--a most unnecessary process, where there never was any change of expression since first nature squeezed the clay into solidity. "i suspect merrylees' sister's dead at last," said he; "isn't she as good as another?" "nae difference," was the answer, without any surprise. "yes, ye fule, some; and you're so stupid you don't see it." "i can see nane,--a' is alike to me; ae worm's as gude's anither to the 'moudiewart.'" "ay, but if a worm had bitten ye, man, wouldn't you squeeze it the harder?" "maybe." "and have you forgotten the ten shillings in blackfriars' wynd?" "i'll tak it oot o' his blude," was the surly reply. "and why not out of his sister's?" said the "spune," with another dark look as unnecessary as the former. "just as sune,--a' ane." "and," continued the tempter, where no temptation was necessary, "i know where she lies, just in the southeast angle, where he told me his father was laid." "why no him?" replied mowat; "a' ane." "rotten ten years ago, you idiot," said the other, getting impatient. "weel, the fresh ane then." "now you are sensible," continued the friendly counsellor; "we might have her here in the morning, with five pounds each in our pockets, and a laugh in our sleeves at merrylees." "i never saw you laugh," said mowat, in perfect innocence. "no more you did, nor any other person, 'cause its always in the sleeve. doesn't do to laugh about these things--they're scientific." "umph! dinna understand that; but i'm ready when you like." "that's right," replied the gratified "spune." "have cameron's donkey and cart at the south end of newington by ten o'clock. it's moonlight, i think." "dinna ken, but it's a' ane. i'll be there; but, mind, you stand the whisky this time." and so (having indulged, perhaps, in our own way of putting this conversation--the _contenu_ being the same) the important enterprise was arranged with that zest on the part of the grave and precise principal which results from secrecy; for it was impossible to suppose that merrylees could suspect that even they were capable of preying on their fellow-labourer, and robbing the nest of any affections that might hang about it. at the appointed time the "moudiewart" was at his post with the little cuddy and the cart, where he was soon joined by his friend. away they went,--mowat driving, and the "spune" lying extended in the vehicle, in utter disregard of the poor animal, not much larger than himself. with such an object before them, comprehending within the success of its acquisition the gratification of two of the strongest passions of degraded man, and no sensibility to admit of the feeling of a reaction in the quietness of the road and the increasing stillness of the hour, with, in addition, an auspicious moon, in whose face they could look only as a light-giving thing that makes gnomes out of head-stones, they might have been supposed to be merry. but no, there were no salient points in their natures from which could spring even that mirth which rides on the back of horrors. mutely they drove along, with no sounds to break the silence, save the patter of the donkey's feet and the turns of the wheels. very different this silent progress from those expeditions in which merrylees formed a part, and where, if there was necessarily absent everything like the rational discourse of human beings, there was yet something to relieve the monotony in the shout after draining off a glass, the muscular contortions, and the _bizarres étourderies_ of their strange friend. it was the caravan without the fool, and even he, as a son of momus and angerona, or some such mongrels, was a droll against his will. sad fate to him who, even in his efforts not to be the cause of mirth in others, could himself become the butt of those whom, not more stupid, he could, in his self-protection, afford to despise. but merrylees had at length fallen among his enemies, and must abide the issue of a terrible revenge. by about the hour of half-past twelve they had reached a part of the road where, by the convenience of a slap, they could leave their equipage, with the donkey's neck fixed to a post, and his head within reach of some tempting provender. all this arranged to their satisfaction, they searched about for stray loungers, none of whom could be espied,--so straight they went to their destined work. as familiar with the burying-ground as they were with their own squalid dwellings, they were soon among the green hillocks, few of which, as they saw by the light of the moon, which came upon them in fitful gleams, making all these sombre things more like the productions of _feerie_ than of honest nature, held out any temptations to these lovers of new sod. but at length the "spune" stopped at an elevation more recent than any around it. "this is the grave of merrylees' father anyhow," said the superior. "then out with him," said the stolid mowat. "still the idiot," said the other. "did i not tell you last night he's gone into powder ten years ago, and that it's the sister we're after?" "then out wi' her," was the sulky reply. nor did the "spune" need the stimulus of the stolid. he began straight the work,--difficult and arduous to all but such adepts,--puffing, and drawing wind to puff again. "hush!" said mowat. "i heard a noise." and the "spune," who after all was a great coward, stood motionless to listen, but all was so still, even as the dead that lay around, that even the breathing of the men sounded like strong whispers. then away wrought the reassured again, and anon the screwing, the jerking, the pulling, till at last came the final pull, shewing, in the passing beam, the long white shroud, with what it enveloped, extended on the green turf. at that moment the whole area rang with a shout, something between a roar and a yelp, and looking round they saw, behind a low head-stone, a tall figure in white (of course), with its long arms tossed up as with a sudden fling. the apparition was appalling even to men who had no more faith in ghosts than they had in souls; and just as another toss announced the coming shout, they took to flight, staggering as they flew over the numerous inequalities, but making more speed under the spur of terror than ever they had done under that of mammon. they were gone. and now the apparition, after making some more strange movements, proceeded to take off a white sheet, which he deliberately stuck into the bottom of a coarse bag. two or three giant steps brought him to the spoiled place of rest. "and you're there, sarah merrylees?" he said, in a voice sufficiently hollow for the part he had so recently assumed. "the 'spune' is without its porridge this time; and shall not man live on the fruit of the earth?" and one might have fancied there was a chuckle, as if the creature had been satisfied with its own fun. but now came the part of this tragedy which will for certain be scouted as the work of fiction, but which as certainly made a part of the story. merrylees,--for it was he, who, having met david cameron of the west port on the previous night, had learned the intention of his friends to visit penicuik, and thereby came to the conclusion that his presence there would be useful,--then took out a rope, and, having gone through a process at which he was very expert, he was soon standing by the side of the wall under his burden of sarah merrylees. nor was it long till he reached the high road, where, keeping by the dark side of the hedge, he intended to proceed to a convenient spot where he might leave his load till he could contrive to bring a conveyance. he had not proceeded far when he heard the roll of the cart, and saw his two friends alongside of it. there was no time to throw away over the head of such an opportunity. so, depositing his burden at the foot of the hedge, close by his side, he ran forward as far as was safe, crying out, "stop the robbers!"--_nestor graecos objurgavit_; whereupon the terrified "spune," with the white apparition still in his mind's eye, fled with renewed precipitation, closely followed by mowat, and leaving david cameron's cart with the donkey to whatever fate might overtake it. the coast being thus once more clear, and being well satisfied that his friends were too cowardly to return, he ran forward and stopped the donkey; then returning for his burden, he carried it to the cart, wherein he deposited it. a long sauntering journey brought him to town, where, after going through many manoeuvres, he at last contrived to lodge his capture in the hall of the square. this terrible story--which, we may add, was a favourite among the students--was told by merrylees, so far as pertained to him, as altogether applicable to another body, whereby he afforded proof that there is no hardness of heart to which man can attain that is utterly exclusive of a spot where some permeating feeling still supplies the issues of shame. about his part of it the "spune" had small compunction; but, to confess the truth, it was not till we knew what occurred afterwards that we could bring ourselves to believe that it was possible for it to be true. to those who know human nature, in the only proper way in which it can be known, it is scarcely necessary to say that we are always under the influence of that error which induces us to estimate the feelings of others by our own. but there is something about these judgments of others even more fallacious, in so far as it almost amounts to an impossibility that we can, through a feeling present, fancy the total absence of it in others. unable to attain to a negative except in relation to the positive, through which it is thought to be seen, we must either project in some way the matter of our thoughts and feeling into the supposed non-existent, or not think at all. if we could suppose a total death of the affections in a brother as easily as the overwhelming domination of money, we would not deny credit to this most wonderful story; but there lies the difficulty, and you must get out of it the best way you can. even if you don't succumb in despair, you are far still from the court of cacus, so soon to be opened to you by a pen, even as hell was opened to virgil by the golden _ramus_. resumption of the great drama. the man whom, in our first chapter, we described as a neophyte, left the students with his bashfulness, if we can so call it, supplied by confidence. the power which we have already seen making such havoc among feelings and affections deemed all but ineradicable, had produced the first thrill in a heart long since dead to the pulses of pity. we may say so much, that his life, prior to this day--when there opened to him a vista through which he could see, amidst moving furies, the illuminated figure of mammon, with the means of getting money without hard labour--had been little else all through than a wrestle with poverty, often degenerating into squalid misery; and we may thus estimate the state of his mind, under the new-born hope of what, to such a man, might have the appearance of a small fortune. but even with the view which the information given him by the students opened up of a new means of making money, we are not entitled to suppose that, as he that night directed his steps to the cowgate with the intention of reaching the lodgings which he occupied in the west port, he had any prevision of the extent to which this new pursuit would lead him. his expectations could only, as yet, be limited to the acquisition _in some way_ of those objects required in the halls of the square, and the value of which had previously come to his ears through the medium of that under-current of whispers to which the exploits of merrylees, and the others then in the full progress of their career, had given impulse and meaning. sure it was, at any rate, that he was utterly unconscious that he was permitted to be an agent, selected after due care by the devil, to push and force those passions by which a christian country, with a name renowned throughout the world for virtue, had been scourged and scathed to a climax. far less could he foresee the means--to our obscure vision of the ways of providence--so out of proportion to the evils (already set forth by us) which they remedied, if not put an end to. so it has been said. but by what right do we make out that want of proportion? we know pretty nearly the amount of evil subsequently perpetrated by william burke,--name of fear, and which even yet only passes in a whisper,--but we do not know (for all we have said is only an inkling,) and never will know, the amount of that other evil which his deeds were to be the means of bringing to an end. the cry had for years gone up to the great white throne of the outraged feelings of a christian nation. there was only the exception of those who appealed to the pride of science, and man's natural love of life and a sound living body. meanwhile, those in power, to whom heaven had accorded the means of reconciliation, looked on with apathy, at least without interest,--an observation which may lead us to the thought that there was less of profanity than is generally supposed in the suggestion which some have ventured, and some have approved, that this man had a mission, yea, that the devil was permitted to tempt him to commit deeds which would rouse the country to seek a remedy sufficient to stop the violation of natural feelings, and at the same time provide for the claims of science. so, with the sordid thoughts suited to his mission, he trudged along, looking about for some one he expected to see; and by and by there came from behind, and joined him, an individual, in the shape of a spare wretch, gruesome and goulish, of moderate height, with a cadaverous face, in which were set, in the most whimsical manner, two gray eyes, so far apart that it did not seem possible for him to look at you with both at the same time. there was in these oblique orbs, too, a leer which seemed to be the normal and unchangeable expression of a mind which not only disregarded the humanities and rights of his species, but mocked and laughed at them. most creatures, even the wickedest, are at times surprised into moments of _bonhommie_. nature seems to demand this as a kind of rest to the spirit, as if evil were a disturbance, which, to be sure, it generally is; but the malignity of this wonderful being was so thorough-going, smooth, and natural, that even what he might intend for a bastard kind of love or friendship was only a modification of his diabolism, so that his smile was merely a relaxation of his congenital enmity towards all that was good and beautiful in nature. this man was william hare,--a name which, not less than that of william burke, will ever be as an apparition to the retina of the ear of mankind. the forgathering of these men was followed instantly, but secretly, as if they feared the chances of a whisper having a collateral fall, by the reciprocation of confidences, in which, as a matter of course, was included the success of the visitor to the square, and over the face of the listener there came merely a stronger phase of the ordinary expression of the malign pleasure which less or more always played in those divergent eyes. but these conferences cannot be understood without a knowledge of what had taken place in the latter's house in tanners' close, to which they were loungingly directing their steps, and where the former lodged. and many others lodged there too, for it was one of those low caravanseries or lodging-houses which are as well the refuge of trampers, who would pass there a night, as of more permanent residenters, who, deprived of a home by vagabondism, earned a desultory livelihood as chance carriers or troggan-mongers, fish-hawkers, or peripatetic dealers in small wares. sometimes a lodger a little above these classes would find his account in the cheap refuge, and three days before that night a tall man, a pensioner, who ordinarily went by the name of donald, had died, a short time only before his pension became due. to that pension the master of the establishment had looked forward as the means of being reimbursed for several months' rent and advances, amounting to somewhere about £ . this loss rankled in the mind of hare, for though donald was not without some poor friends who would see him decently buried, they were without the means, as well perhaps the will, to pay a debt for the justice of which the bad character of the creditor could be no guarantee. and here we have the best evidence, that even on that day when donald died, and up to the morning of the funeral, and eight or ten hours previous to this forgathering in the cowgate, no thought had crossed the mind of either of these men of taking the debt out of the body of the pensioner. allowing for all discrepancies as to the time when the tongue of one of them gave expression to the dark purpose, it is clear that the communication would not, on the supposition of the thought having been slumbering in the mind, have been delayed till the morning of the funeral, nor even to the hour of bringing in the coffin. no doubt they had been both aware that such things had been done, and were being done, in edinburgh at that time, and the temptation had crossed them, not without being accepted by their sordidness. the intention and the thought sprang up together, and, by all accounts, it was the mind of hare that produced the birth; but the exclusiveness of the _credit_ was just so much the less in proportion to the readiness by which it was on the instant adopted and cherished by his friend. you may here mark an analogy, which it might be of pregnant interest for all men, and women too, to ponder, as a _little_ sermon, and not the less that this entire history is a _big_ one:--the tiny seed will lie in the ground for years, and though the soil may be known to be congenial in the wealth of rottenness, it will not spring to the expectation of the gardener. it may be tossed over and over, and hither and thither for years, and appear above ground, shooting resolutely its stem, when not only not looked for, but against all expectation. so it is with the mind and its germs. the small shoot of an invention takes its start from an agreement of circumstances unknown to us, and grows and grows into branching horrors; nay, every branch, and leaflet, and poisonous calyx has its secondary origin in a germ as mysteriously stimulated as the one that lay so long perhaps in the earth. and what then? why, just this--that our practical philosophy is ever vexing itself by tugging at the cords of calvinism. why and how did this thought arise in the mind of hare? because he was a wicked man. and why was he a wicked man? the old story of the scroll, whereon were marked in fire the names of the reprobates. but reject it, and say that he made himself a wicked man. try that process upon yourself, if you happen to be a good one, or the opposite, if you happen to be bad, and see how you will succeed by such decree of your own. the proposition was thus made that the body of the stalwart donald should be sold to the doctors, and at once agreed to by the listener, only with the scruple that there was no time between the period of their conversation and the funeral to get all matters arranged--a sorry objection from such a man, and so accordingly made small account of by either. and so they straightway set about getting the bag of tanner's bark--a circumstance which shews us that the practices of merry-andrew and his brethren had reached their ears. nor are we to have the smallest hesitation in assuming that helen m'dougal, with whom burke lived in concubinage, and hare's wife--the two females in the house--joined to form that quatern destined to the orgies of the court of cacus. the bag of bark was speedily procured, the body of donald hauled out of the coffin and deposited on a bed, the bark was put in, the lid screwed down, and all made decent and fair for the bearers. when the vice has fructified into an act, how easy is the tribute paid to virtue! and so these men, according to the normal course, joined with long faces the train of the mourners, among whom--though some of them who loved the jolly old pensioner had tears in their eyes--they could hold up, or rather down, their faces as mournfully as the best. the interlude of this play of the forenoon, and the melodrama of the night, consisted in the appearance of burke in the hall in surgeons' square, and having forgathered in the cowgate in the manner we have set forth, the two friends, bound together by prior confidences, of which no man ever knew the extent or nature, pursued their way to tanners' close, where they were welcomed by the women with the remainder of the whisky got for the funeral. the offering was to nerve them for the work in which they were merely apprentices; nor was the offering given and participated in less cheerfully by the women themselves, that they had both applied the soft hand of feminine attentions to the gallant pensioner,--even hung over his squalid couch tenderly, and wet his dry lips, and all the more, surely, that he had been a soldier, had seen and mixed in battles in his day, and therefore deserved something better than a bag for a winding sheet, and the knife of the anatomist coming after, at so long a distance, the bayonet of the enemy. such gilt, which shews itself everywhere as society gets more civilised, is easily rubbed off; and with the knowledge of these tender nurses, the two men proceeded to their work, which, coarse as it was, was easily executed. the bag was filled and hoisted on the shoulders of burke, who carried it in the dark as far as bristo port, where hare, as a relay, took up the burden. so well known along the grassmarket and cowgate, where their figures might have excited attention, they took then the round-about way of college street, and, getting to the square, they felt some of that hesitation--shall we call it bashfulness?--which burke had betrayed at his prior visit. they accordingly placed their load at the door of a cellar in the lower part of the buildings, and mounting to the room where one of them had been before, encountered the same three young assistants still engaged in their ardent work. "bring it up," was the reply of more than one, when they had heard the words of the merchants, as they hung fire in their mouths and tongues. up soon _it_ was, and drawn out and laid upon the table in the winding-sheet. yes, a piece of delicacy that which was soon to be dispensed with as extravagant and unnecessary. and the covering partially drawn off, there is that rapid and curious, yet never perfectly composed, scanning of the eyes of even old students, but with no recoil on the part of the sellers, who had sat and drank with the old soldier, and heard his stories of peninsular battles, and laughed at his jokes. not the less racy these, that he thought his companions kind and jolly souls--how far away from the intention of selling his body for gold he never imagined, for the idea could not have entered the mind of suspicion herself, if there be any such goddess in the mythology of poets. but all such reminiscences, if they threatened to force an entry into the minds of these men, were quickly sent back to the limbo of obliviousness by the obdurate mammon. by and by, and after the exit of one of the students, there came in the monoculus himself, knox, and the covering was altogether withdrawn. it seemed to him a fair mercantable commodity. that is, it was not too old for any of the valuable tissues,--in the midst of which lay the secrets these students were so anxious to reveal, not for the purpose of filling their pockets in after-times, but for the benefit of mankind,--to have been dissolved or injured. seven pounds ten shillings is pronounced as the price of the body of the veteran. a shadow passed over the faces of the sellers; the sum did not come up to the hopes inspired by the reports which had oozed out of the earnings of the merry-andrews and the "spunes." yet the sum, to these wretched earners of pennies for vagrants' beds and cobbled shoes, was a _coup_ of mammon sufficient to have made their hardened hearts clatter upon their ribs, and scare away the last trace of humanity inspired by the lips of a mother, kept otherwise, and up to this time, unscathed by the temptations of the devil. but they could not refuse the sum,--that is, they had not yet hardihood to chaffer; and, the money being paid, they were on the eve of departing, when they were told that they would be made welcome again, if they came with an equally good recommendation. and as they went, they did not forget the shirt. so, with the first spoil in his pocket--for burke was the foremost man, and got the money--he and his friend betook themselves to tanners' close, keeping, no doubt, in remembrance, the words of the students, that they would be welcome again. nor can we have any doubt that when they arrived at home, after a day of such novel and ingenious, and, we may surely add, triumphant performance, they would celebrate, with the women, in an orgie debauch of hours, this great event of a new birth of hope, the realisation of which would elevate them even to an upper caste among the humble inhabitants of portsburgh. but even they themselves did not know what progeny would come of this cockatrice's egg, laid in the dark corner of the habitation of sin. our story would not have carried that moral, which is the eternal burden of all histories of crime, if the thought of murder had come to them without that prelusive conciliation, under the condition of which the devil is permitted to arrive at his greatest achievements. much, even at this early stage, was made of the conduct of knox and his assistants, but, we think, with little justice to these men. why did they not ask those dark and suspicious-looking ruffians, who did not belong to their regular staff, where they got the object thus brought to them? the answer appears to be satisfactory, whatever might be thought of their subsequent defence and explanations. there was nothing here to excite suspicion, except, as it was said, the absence of certain marks often made by resurrectionists in their process of working, but the exception went for nothing in the face of an assertion that such marks are seldom to be seen; and then, as for the asserted naturalness--if we may use the expression of an inquiry of such a kind--it was said, and may be repeated, that that which appears to be natural is not always expedient. we are here to keep in view that the medical men were aware that they were dealing in smuggled goods, the participation on their part being, as they conceived, justified by the necessities of their profession; and when was it ever known that the dealer with a smuggler questioned him as to the whereabouts and the manner of his contravention of the laws? it does not need even to be remarked, that to discourage is not the best way to lay the foundation of a new bargain; nay, there was weight in the observation, that the prudent avoidance of such interrogation had become a habit, and though they were perfectly aware that bodies had been brought to them which had never been in graves, and, consequently, that there existed a practice of sale and purchase between the men devoted to this profession, and the friends or distant relatives of the dead, they still considered that all such cases were covered by the claims of science, whereby society got returned to it, in the shape of an increased knowledge and skill of cure, that which had been taken from it against the sanction of human affections. then it was admitted, even by the "howlers," that never, up to this time, had there been offered a body which could be said to have borne marks of violence; and if the minds of at least these generous and well-bred youths never entertained a suspicion of murder, the fact might more properly have been adduced as honourable to their estimate of mankind, than as an objection to their want of guard against an evil which had not yet appeared in the world, and which was to become, unhappily, in good old scotland, a new species of crime. the quaternion. we suspect there is scarcely a life of a great man, whether he has been great for good or for evil, in which you will not find passages that are analogous to some things in your own. as with the physical monsters, described by such men as dr denham, in which there is always a natural foundation out of which grow the amorphous excrescences which we call monstrosities, so in the moral there is always something that pertains to the natural, insomuch that we may say, that the abnormal beings who go by the name of monsters are, as respects their unenvied peculiarity, the result of a twist in the development of what was intended to be according to the ordinary rule. the observation may serve as a _cave diabolum_ even to those who think they are for certain out of the reprobatory decrees. william burke was born in the parish of orrey, county of tyrone, ireland, in the spring of . when at school, he was distinguished as an apt scholar, and was, besides, cleanly and active in his habits. though bred a catholic, he was taken when very young into the service of a presbyterian minister, a circumstance which may explain the religious tendencies he subsequently exhibited; but even at this early period, he began to shew signs of that versatility of purpose which, leading sometimes to success, more often ends in vagabondism. having left the minister to try the trade of a baker, he renounced that for the occupation of a weaver; and from that he enlisted in the donegal militia. yet in the midst of these changes he observed so much moral regularity that he was selected by one of the officers as his servant. while thus employed he married a young woman in ballinha; and after seven years he returned to live with her, on the disbanding of the regiment. still with a fair character, he then became the servant to a neighbouring gentleman, with whom he lived three years. meanwhile he had a family by his wife; and having taken it into his head that he would be able to maintain them by getting a sub-lease of a piece of ground from his father-in-law, who was himself a tenant, he insisted for this right, which was refused, and the quarrel which ensued sent him to scotland. still, however, even in his advanced manhood, without any other stain than an imputed infidelity to his wife, we are assured, at least, that as yet he had shewn no indications of what may be termed cruelty even by the fastidious, if it was not that he bore the reputation of mildness approaching to softness. yet he came to scotland with this blot on his soul, and it was soon deepened, when, having gone to work as a labourer on the union canal, he fell in, at meddiston, with helen m'dougal, a comely, if not good-looking, young widow, then residing there after the death of her husband. it has been always said that this was an affair of love, at least it ended in a connexion so close that they resolved to live together. it would appear that the connexion thus formed having been communicated to his priest, he was admonished, and recommended to return to his wife; and a consequence of his refusal was the ordinary excommunication. yet he continued to have religious fits, during the continuance of which he avoided the chapel, from the terrors of the anathema. we trace him afterwards, as he returned with his paramour to edinburgh, where he fell, as the consequence of his continued versatility, into peripatetic pedlery, buying and vending old clothes, skins of animals, human hair, and other small articles and wares. nor did he stick by this, soon betaking himself to cobbling, for which, in a rude way, he discovered that he had a turn, though he had never been taught the craft; and by purchasing old shoes and boots, to which he applied his art, and getting m'dougal to hawk them, he contrived to realise fifteen or twenty shillings a-week. at this time he was a lodger in "_the beggars' hotel_," kept by the well-known mikey culzean,--an establishment which had a famous termination, when, being one day burned to the ground, there came forth, driven by the flames, such a swarm of beggars, halt and blind, that their congregation seemed as difficult to account for as the assemblage of a colony of rats. among them appeared burke and m'dougal; but there were left behind in the fire the library of the cobbler, consisting of ambrose's "looking unto jesus," boston's "fourfold state," "the pilgrim's progress," and booth's "reign of grace." once more he became a lodger with mikey, who took up a new hotel in brown's close, grassmarket. that the man, originally neither cruel nor profane, was not yet, like balaam, left to his idol, would appear from his continued religious exercises. the grace of the lord tracks the devil in his darkest caves. in the next house the candle of salvation burned, and even cast its light into the thick atmosphere of the surrounding dens. thither burke repaired, and joined, with apparent seriousness, in the exercise of devotion; nor did he fail to tax the incurable mikey with profanity, when that notorious lover of a joke, even at the expense of divine things, thrust his head through the papered partition, and cried out, to the dismay of the devotees, "the performance is just going to begin." in all this there seemed to be no hypocrisy, because there was no use to which he tried to turn it; and then his conversations on the subject of the service, which, after the company dispersed, he had with the man in whose house the meetings were held, seemed to be too secret for the displays of the mere dissembler. other traits conspired to shew the nature of the man, before the temptations of the idol changed it. kind and serviceable, inoffensive and playful, he was industrious as well, and seldom inclined for drink. fond of singing and playing on the flute, he sought, in his melancholy moods, the solace of plaintive airs. all which qualities were combined with a jocular and quizzical turn, which, displaying a fund of low humour, made him a favourite. some anecdotes are given in illustration,--as where, one day, when he heard a salt-wife bawling out, "wha'll buy salt?" he replied, "upon my word, i doun't know; but if you ask that woman gaping at the door opposite, perhaps she may inform you;" or where, on another, when, having been abused by a painted jezebel on the high street, he tried to shame her by an accusation: "i might have passed over the painting," said he, "if it had been properly done, but it's shameful to come to the street bedaubed in that unskilful way,"--an objurgation which was applauded by the bystanders. yet, withal, there were deductions to be made from such favourable accounts, inducing the conviction that there is small faith due to drawn characters, where, perhaps, the potentialities may have been asleep, only awaiting the touch of the demon. but is not this less or more the case with all of us? if it be not metaphysically true that every unregenerated man has his price,--that is, every such man has a sacrifice of moral principle to sell, if a price and a purchaser can be found to his liking. what a million of money will not purchase, may be bought by the smile or tear of a woman. the paradox cannot be disproved, because the eventualities of temptation cannot be exhausted in any one man's life. this man, though appearing to have kindly feelings, could be cruel to the woman who, whatever her faults, had followed him in all his wanderings and misery; but then, of course, there was _the occasion_, as where, having roused her jealousy by attentions to a young woman who was related to her, he, in return for her complaints, almost murdered her. the story current at the time was, that the three having slept in the same bed, the quarrel began between the two women, who, betaking themselves to the floor, entered into a battle. so long as the conflict was maintained on nearly equal terms, the man contented himself with witnessing it; but when the elder virago was likely to master the young one, he rose out of bed, and interfered in behalf of the latter. his interference soon turned the scale; and he inflicted an unmerciful punishment upon his partner. then came the neighbours, who found m'dougal extended upon the floor apparently lifeless, with the man standing by, and contemplating. after some time she exhibited signs of life, when again seizing her by the hair, he cried, "there is life in her yet!" and dashed her head violently on the floor. by this time the police were attracted by the noise, who, upon asking burke whether the woman was his wife, got the reply in a mild, if not insinuating tone, "yes, gentlemen, she is my wife." we thus get to one of the secrets of this man's character. the passions are said to occur in opposite phases--strong loves, and strong hatreds, and so forth; but there is one which nature, in love, has reserved, pure, solitary, and unchangeable, without counterpart to dim its lustre, or antagonist to neutralise its effect, and that is _pity_. this man wanted pity. if we were fanciful, we might here go with the gentle poets, who tell us, in their way, that, like the dew-drop which falls in the evening, and shines equally clear on the deadly nightshade and the rose, it solaces virtue in adversity, without scorning sin in the pains of retribution. if, in our analysis of man's character, we find not his heart, as the fire-opal, enclosing one of nature's tears, we may throw the crucible aside, extinguish the fire, and cast the _caput mortuum_ to the dogs; and yet dogs have pity. we have found, even already, enough to lead us to another clue. he possessed radical cunning, the greatest and most insuperable of all the obstacles to moral and religious emendation. other evils only hang about the heart, but this, the true gift of the devil, is the very blood of the organ. we are, then, led to suspect him of religious hypocrisy. if we were not told there is hope for all, we might surely say that the advent of the spirit of grace is possible in every case but that of hypocrisy veiled by religion; yea, the creature cursed with this vice, faith views in the distance as an impossibility, and flies past in despair, to try her persuasions on the _honest_ sinner. the subsequent notices of this man's life, up to the commencement of the deeds which have rendered him famous, only tend to confirm these observations. renouncing once more his cobbling, he went, still followed by his partner, to peebles, where he was employed in road-making. though still maintaining some pretensions to religion, he now began to shew a gradual deterioration of character, keeping suspicious hours, and making his house the resort of profligate characters, where scenes of drunkenness and riot were of common occurrence, especially on saturday nights and sundays. retaining the same vagrant habits, he next betook himself to penicuik, and after the harvest of , still accompanied by m'dougal, he came once more to reside in edinburgh, where the occasion offered of getting acquainted with hare, and becoming a lodger with him in his house in tanner's close, called log's lodgings. this house, which afforded room for seven beds, was kept under the name of mrs hare's first husband, log, and being the resort of all kinds of loose wanderers, washed off from the lowest bed of the conglomerates, was the scene of still greater riots than the lodger had ever patronized in his own. that the intimacy between him and his landlord had soon ripened into such friendship as these people are capable of, was proved by an occurrence mentioned by a person who called on burke with the intention of giving him a job. he found hare beating without mercy his friend's paramour, who was extended on the floor, while burke was sitting unconcernedly at the window. when asked why he allowed another man to beat his wife, "oh, she deserves all she is getting," was the reply. yet the man still preserved more of a respectable character than those with whom he here associated--retaining even yet much of his disposition to serve, his quiet humour, if not a species of politeness, all of which was perfectly reconcilable with the presence of that potentiality of crime which lay slumbering in the heart, under the thin veil of religion, and not to be crossed or checked, when roused to action, by pity, no trace of which appeared to be in him. he was set aside for his idol, and only waited the temptation to become what he became. william hare, the second of our quaternion, was also a native of ireland, having been born in the neighbourhood of londonderry. like so many of the poor children of that country, he was never trained to any trade whereby he might have been saved from that gradual descent into desultory modes of earning a livelihood, which leading, as we have already said, to vagabondism, is the introduction to so many temptations. after working at country work for some time near his native place, he came over to scotland, where he engaged as a common labourer upon the union canal, and assisted for some time in the work of unloading mr dawson's boats at port-hopetoun. it was here that he became acquainted with log or logue, to whose widow he was subsequently married, and with whom he came to lodge. after the canal was finished, he betook himself to the occupation of a travelling huckster, going about the country with an old horse and cart, selling at one time fish, at another crockery, or exchanging the latter for old iron, which he disposed of to the dealers. from the cart and the horse he went down to the hurley, using that vehicle for much the same purposes. some quarrel with log, before the latter's death, drove him to new quarters; but not long after, and when log had been dead and buried, he returned to tanner's close, where he assumed all the rights of the landlord of seven beds, as well as the privileges of the husband, though mrs log was never called by his name. it was now that, having tasted power in becoming a landlord with such drawings as twopence or threepence a night, he shewed more of his character than had previously been known. always inclined to take drink, wherever and whenever he could get it, he now, as a consequence of idleness and opportunity, became drunken and dissolute--the effect of liquor being to render him quarrelsome and always ready to fight. nay, so strong was this propensity in him, that he appeared always to be on the outlook for a contest, picking a quarrel upon any opportunity, and even trying to make one out of the simple act of looking at him. though a sorry pugilist, he had no fear of an opponent twice his size, and never gave in until fairly disabled--even then endeavouring to wreak, in so far as oaths could, a vengeance on the head of his enemy. on the failure of an opponent without, he had no difficulty, so long as mrs log was there, of finding one within; nor was she, also a drunkard, loath to encounter him upon equal terms, so that the house was seldom free from brawls, if it did not often exhibit a regularly-contested battle between the master and mistress. even vice has its traits of ludicrousness. those of the neighbours who were fond of sights were often enough gratified by some wag going and reporting to the landlady that willie hare, as he was usually called, was upon the street drunk, whereupon the wife, herself probably in the same state, would issue forth in search of him, when a battle was the issue of the rencontre. such was the kind of life led by this couple up to the time of burke's entry. the passion of violence produced by inebriation will not always, or indeed often, afford any clue to character. it may be hardly necessary to say that hare was naturally cruel, yet we have seen that burke could scarcely be said to present that feature unless when roused by some strong motive, so that we have no difficulty in finding at the first glance an essential difference in the two men;--the one being, in his very nature and constitution, vindictive and malign--the other ready to suffocate the humanity that was in him at the beck of an impulse strong enough to move him. only one of them could probably have been guilty of such an action as this: on one occasion, when a person of the name of m'lean (the narrator) was returning from shearing at carnwath, he got into company with hare, burke, and his wife, and the party went into a public-house at balerno, near currie, to get some refreshment. when the reckoning was, as they call it, clubbed, hare snatched up the money from the table and pocketed it, whereupon burke, in the fear of a disturbance, advanced the sum. on leaving the inn, m'lean taxed the offender with his trick, who, in place of being ashamed or even pocketing the affront, knocked the feet from his companion, laid him on the ground, and kicked him with his shoe pointed with iron plates. if we add to this inborn malignity which, in feeling, whether expressed by words or acts, arrayed him against mankind, and scarcely ever alleviated by those emotions of friendship which are to be found in the most hardened breasts, that scorn of human nature, not unaccompanied with satirical laughter, to which we have alluded, we have that foundation of character in the man upon which was so easily reared the towering edifice of his crimes. yet after all this information, which was so industriously gleaned, the psychologist was not satisfied. he wanted to vindicate human nature from even a possible diverging incidence of a law which could account for such crimes, by tracing them to malignity and mammon. we would fain look with favour on such scepticism; and it is to be admitted that all who had the curiosity to see and converse with this man discovered a want. with a low animal brow, he justified the phrenologist by discovering no power of ratiocination, if, indeed, what is termed reasoning was not an impossibility to him. his mind was entirely under the government of external objects, among which selfishness made its selection, irrespective of the humanities, of which he had none. we might thus term him, as he has been called, a fool or semi-idiot, only within the limits of that responsibility which the law is bound, for the preservation of mankind, to push far beyond the verge where nature draws her distinctions between the morally sane and the insane. we thus get quit of the heavy imputation which the doings of such a man cast upon our kind; and if we are met by the reflection, that burke had both thought and sense to an extent which was rather a surprise to those who conversed with him with a view to ascertain the structure of his mind, we have the advantage of the reply, that, naturally indolent, if not soft, he allowed himself to be ruled by another, who, with all his defects, possessed resolution and a dominating will. the history of mankind is full of the phenomena of "imposed will"--the source of more divergence from the normal line than we ever dream of. we come now to the third of our quaternion, helen m'dougal, a native, as we have said, of the small village of meddiston, in the parish of muiravonside, and county of stirling, where her early years were spent. her maiden name was dougal. at no time, however early, did her character exhibit any such diversity of oscillation between the good and the evil, as, giving play to contending passions, creates an interest in the inquirer into human nature. all seemed to be straight, on and down from the beginning. at an early period she formed a connexion with a man, m'dougal, who resided in the same village, to whom she bore a child during the lifetime of his wife. after the latter's death, the intercourse which continued led to cohabitation, passing for marriage, and she bearing his name. afterwards coming together to leith, where he followed his occupation of a sawyer, she was left alone, poor and friendless, by his death, which took place from typhus while he was confined in queensberry house. she now returned to her native village, where she met with burke, then, as we have seen, a labourer on the canal, when that intercourse commenced, the evil auspices of which were to be so terribly verified. thereafter, wherever they resided, there seems never to have been much change in the character of this woman. in edinburgh, leith, peebles, or penicuik, she was always distinguished for loose and drunken habits; nor were these ever relieved by any geniality of nature, the uniform expression of her mind and countenance being a stern moroseness which concentrated upon her universal dislike, so that it was often said that she was unworthy even of burke. from all this it may easily be induced that she was not, in the crimes of which she was cognisant, or in which she took a part, under any influence of an imposed will on the part of burke; the contrary being rather to be presumed, that she ruled him, and that it was only when he was roused by her fierceness of temper or jealousy that he repaid her domination by a cruel punishment. the last of the four, margaret laird or hare, was, like her husband, a native of ireland, and accompanied her first husband, log, to scotland. the latter bore the character of a decent, hard-working man, who had not only the world out of doors to contend with, but within, the temper of a masculine wife. some success enabled him to become a small contractor on the union canal, and for some time he worked his contract, with a detachment of his countrymen, in the neighbourhood of winchburgh; but we may estimate the extent of his contract, and not less the irish peculiarity of both the man and his wife, when we know that the contractor's lady worked along with the men in the character of a labourer, with a man's coat on her back, wheeling a barrowful of rubbish as stoutly as any of her men. at that time, they inhabited a temporary hut on the banks of the canal, and, whatever her faults may have been, she exhibited here nothing but economy and industry. the work being finished, log settled in edinburgh, where, though honest enough, the contractor became sunk in the huckster, and the keeper of a beggars' hotel, which was soon to rival even mickey culzean's. upon his death, the lodging and furniture, such as it was, with any small earnings he had saved, devolved upon the widow, and thereafter she conducted the establishment; but she soon shewed the smallness of her gratitude and the strength of her passion by cohabiting with one of her lodgers, described as young and good-looking, and, thereafter, the depravity of her taste in accepting hare after the young lover forsook her. yet her choice was only that which is made by those who seek their kind. the drunkard and semi idiot had charms for one who was herself destitute not less of virtue than of prudence, and we are soon to see her descending into unparalleled crime, not by the imposed will of hare, but the ready suggestion of her own heart. such are the characters of our wonderful story; and we make no apology to sensible men for disentombing such specimens of our kind from the dust-covered chronicles of their deeds. a salutary horror, not only of their great crimes, but also of those lesser ones which led to these, pervaded the people of scotland long after the tragedy of so many acts and scenes was performed; and thus it is, in the providence of god, that virtue becomes brighter by the contrast with vice. it is only, as some one has observed, when the tempest tosses the waves of the ocean into mountains that we see into its depths. it was by the light of burning troy that Æneas saw the faces of the gods; and so it is through the light of human passions that we discover the nature of the heart of man. the opening of the court--the old woman of gilmerton.[ ] the house which went by the name of log's lodging-house, and which was occupied by william hare, as raised by the favour of the widow to the elevation of landlord, was, as already said, situated in tanner's close,--one of those narrow passages that wind from the north side of the west port. the entry from the street begins with a descent of a few steps, and is dark from the superincumbent land. on proceeding downwards, you came--for the house, which was rased for shame, is no longer to be seen--to a smallish self-contained dwelling of one flat, and consisting of three apartments. one passing down the close might, with an observant eye, have seen into the front room; but this disadvantage was compensated by the house being disjoined from other dwellings, and a ticket, "beds to let," as an invitation to vagrants, so many of whom were destined never to come out alive, distinguished it still more. the outer apartment was large, occupied all round by these structures called beds, composed of knocked-up fir stumps, and covered with a few gray sheets and brown blankets, among which the squalid wanderer sought rest, and the profligate snored out his debauch under the weight of nightmare. another room opening from this was also comparatively large, and furnished much in the same manner. in place of any concealment being practised, so far impossible, indeed, in the case of a public lodging-house, the door stood generally open, and, as we have said, the windows were overlooked by the passengers up and down; but as the spider's net is spread open while his small keep is a secret hole, so here there was a small apartment, or rather closet, the window of which looked upon a pig-sty and a dead wall, and into which, as we know, were introduced those unhappy beings destined to death. the very character of the house, the continued scene of roused passions, saved it from that observation which is directed towards temporary tumults, so that no surprise could have been excited by cries of suffering issuing from such a place, even if they could have been heard from the interior den; and that was still more impossible, from the extraordinary mode of extinguishing life adopted by the wary and yet unwary colleagues. in this inner apartment burke used to work when he did work, which, always seldom, soon came to be rare, and eventually relinquished for other wages. it will thus be seen that this small dark room was the appropriate place where the words of secrecy would pass to the ear, or be blurted forth, coarse and broken, under the fevered brain of drunkenness. since ever that night when the £ , s. flared its magnetic influence over their eyes, and was communicated, by confidence and sympathy, to the two females, the little world of this quaternity was changed. the women saw that other lodgers would die, and the inspiring hope, not so demoniac as to curdle the remaining drops of human kindness that refused to leave the female breast, pointed in the inevitable direction of gaudy finery, which they might flaunt in the wondering eyes of the poor people of portsburgh; but so slow a process did not suit the inflamed passions of the men. hare had been revolving in his mind a scheme to set up his own will as the arbiter of the occasion, which would secure more money, even as he wished it; and the secret of this talisman behoved to be communicated to his friend, now poor and miserable, and dissolved in habits of sloth and inebriety. it was in that small room, and while the two women were engaged in the front apartments, that this mystic rite was performed between the solitary inmates, over, as might be expected, the caldron fires of drink. yes, the mouth found power to utter the words which came as the dictates of a mere desire for money, that they should seize the opportunity so often presented to them of people lying drunk and senseless, and deprive them, by suffocation, of life. the proposition was accepted under the same approving auspices of mammon, who had already made both his own; and under the force of that temptation involved in the words which had been uttered in surgeon's square, offering a welcome to a return with a similar burden to that of the pensioner. you may cease to indulge here in those visions of the fancy which would represent human nature in convulsions, panting under the impression of a thought which, at first, produced a revolt, and then became conciliated. the "make" of each of these men was perfect under its own conditions, and if there was any seriousness, it was only a passing fear that they might bring their necks into jeopardy. pity, which never lived in them, could not be said to be dead; the impress of the first money had burned into their souls; the welcome of the doctors rung in their ears; and grace, studying them in the distance, had flown past them as an impossibility. there is reason to believe that this resolution come to by these men, sitting together in this dark room, passed as an element into an orgy, different from all those in which they had so often indulged, if not from any that the world ever witnessed; nor was it modified, if it was not inflamed, by those visions of struggling nature expiring among their hands, which, rising as mere spectral forms, disappeared as soon before the images they pictured of a life of sensual indulgence and enervating sloth. if the project had sprung out of the ebullitions of intoxicated passions, it might have died away on the morrow, but, the result of calculation, it only received strength from the hopes which it roused, and which again were inflamed by the celebration. nay, time, as day by day passed without a likely lodger coming in, increased the desire to begin, and chafed them into impatience. hare accordingly resolved to commence prowling about the streets for some promising individual whom he might seduce into the house, and for some days he followed this occupation, but his efforts failed, and the report at night only again inflamed the desire of the morning. one afternoon, it was in december , he again betook himself to the street, and for hours dodged about searching among the poor and miserable for some one who, already intoxicated, might offer those facilities to a beginner which were afterwards held of small account when practice gave proficiency and success confidence. at last he observed in the grassmarket a decent-looking elderly woman (abigail simpson, as afterwards ascertained) whose wandering eye and irregular step shewed that she had got more of the publican's drug than her perhaps weak head could carry. his eye was immediately fixed upon her, and the old smile, which always obeyed the bidding of an evil thought, played over his face, nor did he let her out of his sight as he dogged her irregular movements from place to place. he could see that she was poor, that she was probably friendless, and, above all, that she was tipsy, and he knew enough of degraded nature to tell him what the proverb has settled, _qui a bu boira_,--he who has drunk will drink more. making up to her, he introduced himself as one who had met her before, and to his delight, discovered that she was inclined to be communicative, if not garrulous. it was not a difficult matter to advise her to accompany him to his house, where he would treat her with the old bribe of "a dram." so away they trudged together, the dissembler taking special care as he went to keep her on her course, from which she was every moment inclined to stray, by professions of interest and friendship. arrived at the lodging-house, the woman was introduced to burke, with what looks between the two may easily be imagined, as an old friend, and drink was immediately procured. there was now a party which was joined by the two women, who, when they saw the men plying the stranger with whisky--the full value of which their difficulty in getting it to the extent they desired was sufficiently known to them--must have been aware that there was at the bottom of this generosity more than the friendship professed by men dead to the feeling, even as regards those who might have had a claim to it. the time passed, and the party became merry, nor was the stranger the least joyous of them, for had she not fallen among friends by sheer accident? and should she not prove her gratitude by being happy, ay, and communicating to them all her secrets? was she not fortunate in being able to tell them that she was a pensioner of a gentleman in the new town, who paid her regularly one shilling and sixpence a-week, besides little gratuities, such as the can of kitchen-fee she carried with her, and put aside till she should depart? yes, and more, that she was blessed with a fine young daughter she had left at home, and who would be anxiously waiting her return. and then that daughter was not only good, she was _beautiful_, and the very pride of her soul. all this hare heard; and he could carry out the play she had begun, even amidst the intentions he entertained, by expressing an interest in the mother's paragon, so deeply felt, that, being unmarried, he would put in for her hand, provided the mother would consent. and consent she did, so far as her condition would allow, and here, newly forged, was another bond of friendship. nay, when he and the daughter should have become man and wife, it behoved that they could not live without the good old mother--who, accordingly, would take up her residence with them, with no more cares of poverty, and no dependence upon the pensioning gentleman of the new town. could any human creature be more happy? nor were the actors less so, though for a reason so very different. but the drink went done, even with the forbearance of the men, that she who would pay so dearly for it should have enough for their purpose. mrs hare had money, and there was the can of kitchen-fee, which the stranger could sell, and take home with her--_when the time came_--the price, one and sixpence, to help her little pension, and get a dram at another time, when they would not be there to give it to her. then, to make the play even more merry and ingenious, this small sum was, very soon after, again, taken from the now almost unconscious woman's pocket, and laid out on more spirits, that the expected opportunity might be made more propitious. the scene progressed with even increased symptoms of noisy merriment. the old woman revived, and, under so many influences bearing on a kindly heart, did her best to sing some of her old songs--household words to her, no doubt, and feelings as well, with which she often at home wiled back the days of her youth, and charmed the ear of that daughter of whom she was so proud and so fond. nay, we have the hearsay of the day for saying, that burke contributed his part, singing, as he was so much in the habit of doing, some of those airs, generally, according to the account of those who knew him, sentimental, if not melancholy. and here we are obliged absolutely to stop for a moment, not that we wish to intrude upon the reader a moralising spirit, where every word suggests a sermon out of more hardened things than stones, but that we are mystified, and are inclined to ask counsel. could that man have had any sense of the beautiful in the sentiments of these lyrics which, it was said, he sang with feeling, if not pathos? can it be possible that such a sense can be consistent with a demoralisation such as his? we suspect that it is. we are led to expect its impossibility by a reference to opposite, if not antagonistic, feelings: we cannot love and hate the same object. this is true, and would seem to disprove our proposition _à priori_. we can reconcile the contradiction only by having recourse to the different faculties of the imagination and the sense. the poet who has ravished his readers by a description of the beauty of female virtue and innocence has been found in a brothel. one of the most touching religious poems in the world has been sung by one who, among brawling revellers, maligned religion and its votaries. the praises of temperance have been enchantingly poured forth by a bacchanal. the oppressor of the poor has wept at a representation of affecting generosity. any one may fill up the list without perhaps including a hypocrite. the imagination has its emotions, and the sense its feelings, or, perhaps, no feelings. the why and the wherefore touch the ultimate, and we are lost; but the fact remains, as proved by evidence, that william burke could, in song, be pathetic. recurring to our real tragedy, the effect of the drink soon again sent the creature from her lyrics into a condition which might have suited the purpose of the men; but whether it was that, as beginners, they lost courage, or that lodgers came in and defeated their intentions, they failed that night in effecting their object. the unconscious woman was lifted into a bed, where she lay till the morning. a severe sickness was the consequence of the importunities of her new-made friends; and the colleagues, exasperated by their defeat of the previous night, were alongside of the bed, with offerings of sympathy, and more drink. in the midst of all this, she cried that she wished to get home to her beloved daughter, at the very time that she weakly accepted that which incapacitated her. by and by, the lodgers for the night began to leave the house; and the victim being once more reduced to unconsciousness, they fell to their work in the precise manner they had planned. hare laid hold of the apertures of breathing, and burke throwing himself on her body to repress struggles and keep down the ribs, maintained his position till the last sob escaped from the oppressed lungs; and the woman, after a struggle of fully a quarter of an hour, was a corpse. in the evening the body was conveyed to surgeon's square, and ten pounds procured for it. all this tragedy was being acted while the daughter, at gilmerton, was waiting anxiously for the return of her mother. the evening had passed without exciting in her much alarm; but when the morning came, with no mother, and no intelligence, she became oppressed with fears. without having tasted breakfast, she sallied forth. the village was gone through, and afforded no trace. she next directed her steps to edinburgh, inquiring at every one she met if they had seen a woman of the appearance she described. at length she resorted to the house of the gentleman who paid the pension, but beyond the information that she had been there on the previous day, she could get no satisfaction. she then wandered through all parts of the city, calling on every one she knew, and putting the same question--if they had seen her mother?--but always receiving the same answer. no weariness oppressed her in this vain search. the night set in only as a prelude to the revival of her hopes in the morning; and search followed search, and day followed day, every hour diminishing hope. the time was now counted by weeks, and as these sped, by months, yet ever as the time flew, and the hope decayed, the love increased with every accession of her grief. at length even hope was relinquished, and all speculations were lost in mystery. the only conclusion that could rationally be come to was, that the missing one had wandered by the canal and been drowned; for that a human being could disappear and be for ever lost in the city of edinburgh, with its humane inhabitants ready to render succour, and its vigilant police ever on the watch, was what no one could conceive. the explanation was to come at a time which, to grief, might be thought long in the future; and such an explanation to a daughter! ay, and a daughter of whom the mother was so proud and so fond. the mother and daughter. if we were to estimate the benefits derived from sacrificing to mammon, according to the material uses to which they are devoted, we would be apt to form a very humble estimate of his godship; but these, we suspect, constitute, even with the lowest of his worshippers, only a small part of the charm of his gifts. seventeen pounds ten shillings, the price of one dead body, and that of the life and the corpse of another, produced a change in the economy of log's house and in the minds of its ruling inhabitants. this appeared first in the dresses of the women, who, from being little better than trulls, with clothes bought in pawnshops, and often not far removed from ragged tanterwallops, began to be equipped like respectable people. bonnets were got from the milliner direct; and it is even said that fine prints appeared in gaudy colours on the two women of log's house. it was observed, too, that they held their heads higher, and walked more circumspectly, as if some species of pride--the kind we leave to the moral analyst--had asserted its universal power, undismayed by the scowl of vice. lodgers began to be less cared for, as mere lodgers, though the most squalid of them had recommendations of another kind, of which they themselves were not aware; and as for the men, the producers of this wonderful change, they were now gentlemen at large--the huckster's cart, the hurley, the old horse, the stool, and the awl-box, having been discharged and despised as unworthy of those who held in their hands a charm invested with even greater power than the ring of giges or mongogul, even that of turning, by a touch, the mortal part of human nature into gold. hitherto even the philosophers had been wrong in their estimate of man and the world on which he lives. the ill-natured cynics represented that, in his earthly aspect, man is a parasite on the great animal the world; preying on his fellow-creatures, he is, in return, preyed upon by parasites. there are those that prey upon his body, others that, in the form of pains, ride upon the back of his vicious pleasures. there are those that fawn upon him, and feed upon his fortunes, and when he dies he is eaten by parasites. but there was in reserve, and unknown to these detractors, a chapter on human nature only laid open to our time and country, for though the easterns had their fable of the gouls, it was received only as a fairy tale by the westerns, till they were surprised into a belief even transcending the images of arabian fancy. yet the more hopeful philosophers, who draw their inspirations from calvary, where was seen the consideration for the shekels of silver, are not dismayed. yea, in this lowly thing we call our body, which preys on garbage, and is preyed upon in return, is a microcosm, which represents, in extension, that which has no limit--in perfection, that which is without end--in beauty, that which the poet cannot, with all his inspiration, describe. we would not be true to human nature if we limited the effects of this change in the fortunes of log's house to what we have already described. the vicious heart pants for pleasures to worry it. _la lampe inextinguible du plaisir_ must burn, though fed with rancid oil extracted from decayed organisms; and so there was a growing increase, not only in the number, but in the intensity of the "enjoyments" of the bacchanalian nights. if the neighbours had noticed the external changes, they were not the less observant--though destined to be long ignorant of the cause--of what was nightly acted within. the brawls and fights were louder and more frequent, and the dithyrambics which mixed with them in grotesque inconsistency had more of the _ménad_ of the priests of cybele. yet all this, by god's law, was sternly a necessity: we need no moral here. secrecy and publicity are separate instruments of divine retribution, working strangely and mysteriously to the same end. even the ordinary secret sin corrodes the heart by its immurement, and the sin of log's house was not an ordinary one. the more it is suppressed, the greater the elasticity of the torment. when freed from the prison of the heart it produces that recoil of the good which isolates the criminal from the smiles of fellowship and the help of society. yes, this is the point with the diverging paths of ruin or redemption, and heaven still vindicates the old economy. if the sinner will be saved by penitence, he must give signs of his suffering, and the world will profit by it as well as himself. if he hurries to ruin, he will still give evidence of his agony. in either case, that providence which watches over us will still serve its purpose. only one of these paths was here open, and the quaternity even rushed into it. the progress of the ruin must keep apace. the excitement, in the shape, to them, of pleasure, must be sustained; and above all, the men had tasted the _power_ of money--not to be estimated by what it produced--in what simply pleased such strange natures. they had got their heads into the dagon temple, and though all the rest of the body was exposed, they felt, however much they were in danger of justice, that they had some security against a continuance of the misery and contempt of their prior lives. they must, accordingly, go on, for they were dipsomaniacs in blood. the £ , s. must, if it had not already, come to an end, under the expense of these nightly orgies, and, behold the prowler again out to look for a new victim. there had been known to both of the men, and not less to the women, an unfortunate creature of the name of mary haldane, whose vagrant beat was the old scene of the grassmarket. her life had not been all through a succession of those scenes in which her class figure; for, previous to the birth of a natural child, the fruit of seduction, she had been not only respected for a fair reputation, but looked on favourably for those personal qualities so often the means of ruin. then the demon drink had met her at that turn of the fortunes of so many of her kind, when decayed beauty is not compensated by the consolations of penitence. the road down was easy, even to that stage where flapping rags could scarcely cover the body. need we say that this creature was likely, when the prowler knew from his own experience that she would drink _to the point_. one day he accordingly issued forth to seek for mary, but mary had been in the drink fever for days, and he could only regret that so favourable a condition had not ensued in log's house, where the termination would not have been the recovery which this time once more awaited her. exasperated by his disappointment, he was only the more determined to overlook other tempting objects in that fruitful field of human weeds, fit enough for death's scythe. nor had he to wait long. two days afterwards mary was standing at the mouth of the narrow close up which she lived.[ ] the moment he saw her, the old smile and eloquent twinkle again illuminated or darkened his face, for he was as sure of his prey as the fox is of its spoil when it sits in the roost with its head under its wing. nor was the smile less expressive that mary presented to him. the red and swollen eyes, the quivering cheeks, and all the other signs of that unhappiness through which the rebel spirit will still shoot its buoyance in spite of depressed nature. misery is easily approached. the dram is again the bribe, and the kindliness of the offer a recommendation, which was as much a surprise as a pleasure to one from whom all kindliness had been long barred by the magnetic repulsion of poverty and degradation. poor mary was once more happy; and, accompanying her "friend," she trudged along to the place where the _envied_ stimulant awaited her. as they were slowly wending their way along the west port, the people, as some of them afterwards stated, looked earnestly at the couple, without being able to explain the sympathy which brought them together; for already hare was upon the rise in society, with a new coat and hat, and even a tie; but the presence of the _gentleman_ did not prevent the children from pursuing their old game of teazing mary, nor could the threatenings of her protector keep them off. at this juncture, who should approach from the opposite direction but the colleague. the mutual smile--yea, more. would burke, who had the character of being serviceable to the unfortunate, permit mary haldane to be abused while he was present? he would protect the friendless; and so the boys got a drubbing, and injured misfortune was vindicated. having accomplished this act of justice, burke, who had now so little to do, and was so far above cobbling, proceeded on what had been intended as a pleasant stroll, while his friend and mary held their way to log's lodgings. in a short time he was seen to return with a quicker step; and by and by they are all assembled in the little dark room "with the window looking out on the dead wall"--where the women, who knew that the money was getting exhausted, received them with their peculiar welcome. well, you expect something, and already the heart throbs,--and do not stop it; for pity does not close her eye upon the unfortunate, even where sin has contributed to the misery of the sufferer. but here you cannot help yourself: the inevitable recoil from cruelty will open the issues of compassion whether you will or no; and so strangely formed are we, that here you may be the more willing to acknowledge the soft emotion, that mary's eyes reeled with delight when she saw helen m'dougal place upon the table a supply of whisky, which to her share would transcend even the necessities of "the want" after the fever. there was on this occasion no necessity for the siren song to charm into confidence where the bottle was, a band more hallowed, in the estimation of the guest, than the pledges of love. neither hare's sardonic jollity nor burke's pathos was needed where the work was apparently so easy; and they were no longer neophytes, but adepts, not only in confidence, but manipulation. yea, it was the work of apprentices, and they were journeymen; nor was it necessary that they should concern themselves with more than filling the glass and contemplating the imbodied value--ten pounds--as, by her fading energies and impending unconsciousness, it assumed its full proportions. all is ready--the drooping head--the closing eye--the languid, helpless body. the women get the hint. they knew the unseemliness of being spectators--nay, they were delicate. a repetition of the former scene, only with even less resistance. hare holds again the lips, and burke presses his twelve stone weight. scarcely a sigh; but on a trial if dead, a long gurgling indraught. more required--and all is still in that dark room "with the window looking out on the dead wall." after a preliminary visit to the college, where arrangement was made for the reception, the colleagues carried their burden, at an hour approaching to twelve, to its destination. as usual, it was examined before payment,--the amount of which, in this instance, we do not know; but, whether from some want of success, consequent on the increased watchfulness over cemeteries, attending the midnight adventures of our friends merrylees and the "spune," or from a greater avidity for science on the part of the surgeons, it is certain that, as the supply from log's lodgings increased, the value given for a burden became greater, amounting, in some instances, to £ or £ . the band was thus again supplied with resources, and the consequence was an increase of extravagance and riot--the former exhibiting itself in a still more inconsistent style of dress on the part of the females, and the latter in more frequent disturbances of the neighbours. even questions began to be put to helen m'dougal, which were parried by the intelligence that she communicated,--that she had fallen heir to some house property about her place of birth, and that it was only right that decent people should rise in the world, and take the use of their own. nor was mary hare less adroit in her fences. but the explanations thus given of what appeared to be a mystery were not deemed satisfactory, though no theory could be formed by the remonstrants. on the part of the _fortunate_ crew, the sums they received seemed only to stimulate their avidity. not now waiting for the dispersion of the earnings, they aimed at a store, perhaps apprised by some looming suspicion that their fortune was too good to last, and a strange circumstance soon threw another temptation in their way. young mary haldane, the daughter of her whom we have seen so easily and suddenly removed from the world and life, with all those sins on her head which had accumulated from the day of her seduction, had been brought up by the mother to ways as shameless as her own. as yet, however, it was the morning of life to the girl, and it is not always or often that wayward affections spent upon men more profligate than themselves, diminish the love of such creatures to their parents, even if the latter ought, by their neglect, to have earned nothing but hatred. we have seen one daughter cast into inconsolable grief, another was to be a wanderer and inquirer for her parent, with another and even more terrible issue. having ascertained, on the morning subsequent to that evening when the burden was conveyed to surgeon's square, that her mother had not been seen on the previous night, mary occupied the day in searching. the woman was a ken-speckle, the familiar object of all in the neighbourhood, as well as the game of the urchins; and much curiosity was added to the sympathy for the orphan, who, unfortunately, was scarcely less notorious. many aided in the inquiry, but with no more success, of course, than that which attended the efforts of the daughter. it is still remembered how she went about in her decayed finery, with swollen eyes, and the tears on her cheeks, sobbing out her grief, amidst the fruitless question, "had any one seen mary haldane?" at length, one of the neighbours was told by a grocer in portsburgh, that the woman had been seen going towards log's lodgings in the company of william hare--a trace which, as no suspicions as yet attached to the man, held out some hope of success. the information was immediately conveyed to the young woman, who thereupon hastened to the west port, where she got the story confirmed, with all the minutiæ of burke's gallant rescue of hare's _protégée_ from the assaults of the urchins. nor did she stop till she got to log's lodgings. mrs hare denied that the woman had ever been in her house--a statement corroborated by helen m'dougal, who, in her new-born pride, resented the imputation that it could be possible for the beggar to have the impudence to approach the residence of respectable people; but hare, who in the back room had heard the rencontre, came forth, and taking the part of the girl--with what expression of countenance to his companions, it would be difficult for a mere pen to give the symbols of an idea--sympathised with her, and even more, asked her to come into the room with the window opening to the dead wall, and get a dram to dry up her tears. the girl, also given to drink, was tempted, and complied with the kind invitation. it was not long till the colleague made his appearance, having, it is supposed, seen mary enter when he was lounging idly about the top of the close. they were no sooner seated, and the whisky put upon the table by helen m'dougal, than hare began his explanation. he told her that her mother had spoken to him on that day when she disappeared; that she told him she was going to midcalder, (where he knew she had some friends;) and that he had no doubt she would be found there, to the great joy of the despairing girl. and no doubt the poor girl's heart jumped to the valediction. she began to get cheerful under the new-lighted lamp of hope; and if there was any deficiency in the oil, it was supplied by the cognate combustible which, like all other agents of the same kind, consumes by its latent fires those who consume it. glass succeeded glass, and with hope getting brighter and brighter before her eyes, now dry enough, and sympathy sounding louder and louder in her ears, what marvel that mary haldane should be as happy as those who had preceded her in those jubilations. she talked of her lovers and her youthful escapades--not forgetting those whisky-born fortunes, embracing equipages and servants, which are the continual destiny of the wretched, as if nature, in some mood of pity, made an imaginary compensation for real privations and as real misery. how little conscious was she that the two men, who responded so exuberantly to her wild aspirations, were watching when they would exhaust and bring her "to the point." nor was the issue long delayed. mary was one of those who, once fairly begun, never stopped, if the means were in her power, till she had run the full course. the symptoms of the artificial narcosis began to shew themselves,--the thick speech, the heavy eye, the bent head, and only a little longer and she was extended on the floor. let us not speak of this girl's youth, the interest of her peculiar fortunes, with no chance ever given her of putting even the first step in the path of virtue. why, there was, even in the estimation of those who stood over, ready for the work of their calling, a curious if not stimulating aptitude in sending her after her mother. did she not call there to see her, and find her? and why should they defeat so laudable a purpose? the quarter of an hour's suspension between life and death, with those mysterious agonies of which the organism is capable, even in the absence of manifestations, or at least in their suppression by external force, and mary haldane experienced the fate of her mother. and with her mother, too, she lay that night in the hall of surgeon's square. the grandmother and the dumb boy. it has been said, that in the course of one man's life there occurs usually only one springtide on which he may direct his barque to fortune, and, so far as we have seen, this chance was not denied to the governors of log's lodgings; but nature has not equally decreed that the voyagers shall see beyond that fortune, or to what it may lead. nay, is there not something in the circumference of the objects of a day, if not an hour, if not a minute, which, like that which surrounds the scorpion, keeps all inside inviolate from the anathemas beyond? but then the circumference is ever changing, and ever enclosing new objects, till the last, with an opening in the side, looks out upon the dark or light theatre of retribution or salvation. we sometimes see this solitary springtide surmounted by the shattered barque of age, from which the waters of life are fast receding, and yet the voyager moves on. his fortune is a _hysteria_, through the ecstatic delirium of which he cannot see the gulf before his nose. these two men and two women whose history we record were on their springtide, and we are not to wonder that, beyond the circumference of rock and cloud, they were prevented from looking; not that there were not openings through which they could see ruin, but that the insanity of a fruitful wickedness made them revel blindly in the buoyancy of their progress, heedless of all rocks and gulfs of retribution. poor moralising this, we suspect, as regards men whose pleasures, bought at such a price of a revolt against nature, could be termed only "painted pain." but even they could not be exempted from the laws of human nature. the circle behoved to contain its objects, and to change from day to day till the last came, with the lateral opening looking into perdition; perhaps any other mode ever devised by man of bringing sacrifices to mammon might not have been utterly exclusive of an attempt to get into a caste above. bankrupts, thieves, adulterers, and even ordinary murderers, sometimes in our day try their hands at this, and make wonderful successes, for even these crimes which make men what they are, are not absolutely incompatible with a modern conventional status; but the crime of the men of our history involved in its very nature the impossibility of ever holding up the head in any other way than a swagger of desperation, or directing the eyes to an honest face, except as a look of dogged defiance. so, in addition to those evidences of change at log's lodgings, we have only to mention the restlessness of the moneyed vagabonds driving them out to the streets to pull companions of their grade into drinking-houses, and treating them with the money which, however they might love it, burnt their hands that dispensed it. the delirium of intoxication amidst living objects that carried the mind out, was the refuge from, not the spectre of conscience, for conscience they had none, but that of justice, which no averting of the eyes could enable them to avoid, only the reeling of them could make it a changing phantasmagoria. and why, when we have so much deeper tragedies to recount, ought we to stop our narrative to record--unless, indeed, for the mere sake of the arithmetic of murders--a mere interlude resorted to as a relief from dithyrambism? childermas day came round again! poor joe the miller could bring his price of eleven pounds as well as the rest of them. no doubt, when he offered himself, in the heyday of his life, to jenny the farmer's daughter, he thought himself of greater account than merely eleven pounds; but men undergo deterioration. even when rejected, he would have spurned the valuation when he sung that jolly song of independence so often sung by his craft, and which declares the determination that neither lawyer nor doctor would "e'er get a fee from him,"--true enough, yet, alas! not false in the reverse, that doctors would give a fee _for_ him. joe's miscalculations were due to his ignorance of the effects of intemperance, for it will not do to say that these are known when every day brings up new developments of consequences resulting from this most dangerous of all the voluntary evils of man. say that the drunkard dares the advent of poverty, crime, the horrors of _delirium tremens_--death,--could he say that this last is a greater violence to nature than that produced by the grip and the pressure which, in all these cases, were only consequent upon the inebriation, which, again, was the act of his own will? it was while in a state of inebriety that the prowler met joe. he was already made and prepared, and the subsequent decoyment, the additional drink, the final onset of the grim actors, their success, were only the development of a drama wrought out by actors who took an advantage accorded by himself. our authority for treating this case as a mere interlude is derived from the admission of burke himself, who, as a great judge could estimate the importance of what by others cannot be estimated at all, for the simple reason that the smallest of these tragedies so far transcends all power of comprehension that comparison becomes a farce; yet though this once jolly son of a jolly craft might have earned the contempt attributed to a facility of dying, he was, we are assured, mourned in the hamlet of his birth, where his frailties, if condemned, were placed, as is too often the case, to the account of a good heart. nay, for aught we know,--and we say it the more readily that no one can trace or enumerate the threads which the poorest of god's creatures leaves ramifying from heart to heart, all to respond, as by electric sympathy, to the shock of his death,--the farmer's daughter might even be concussed to tears--how much too late--when the terrible tragedy was divulged. we may be at least certain that joe never dreamed that a man's character in the world depends upon his manner of leaving it, or he would have saved his reputation by a greater resistance when the enemies were upon him, but he was also then too late: the devil, whom he might have fought with and defeated if sober, had taken on a strange form, and was unknown to the victim, for the reason that the victim did not know himself. however unimportant he might be in these annals, the price which the miller brought was sufficient to stimulate the now, and long before, irredeemable actors to a deed which, in the estimation of burke himself, as it must ever be in that of a blushing nation, stood unparalleled among his own atrocities, as by all experiences else it was unparalleled in the world. before entering upon the detail, we feel inclined to philosophise a little. we have been obliged to speak of these men as men, because they possessed all the physical characters of the species. in a natural view it has been said that, by the presence of the lower animals in the world, man is more injured in his ideas of a high nature and destiny than he is benefited in the temporal advantages of being fed and clothed by them. the roman felt the inconveniences of the presence of apes in the same world with him, when he cried out, in rage or satire or pity, _simia, quam similis, turpissima bestia, nobis_! then what is the use of these beings always putting us in mind of our resemblance to them? if we are to believe pythagoras, mr tweddel, or mr smith, or any one of the vegetarians, we could, in their absence, live on herbs and fruits, and be clothed with cotton and linen. their presence in the same world, and with so much in common with us, is a continual satire on man's psychological privilege or peculium, and to get quit of this many early nations accorded a soul and a hereafter to them. the satire was inverted when men made gods of them. we of a modern age shew our respect by an act of parliament against being cruel to them; and secondly, by eating them. in the midst of such curious speculations we are always apt to forget that within the moralities of our species we have gorillas far fiercer than any brother or sister of that "splendid specimen" described by du chaillu, and yet the strength and savagery of this animal have been called in doubt. one day, about a month after the disposal of joe the miller, hare was again on the track of the unfortunate, and this time, as it was said, sent out by his colleague, as if the latter had wished to seek in repetition the assuagement of familiarity. alas! the old search. you cry me mercy, and i would forbear did i not know that truth must bear her crown amidst the lying conventionalities of refinement; and virtue, who is her companion, looks to her for strength, while she shines the brighter for the proximity of vice. yes, the old threading through the mazes of human beings,--now passing between the ripe and the raw, the full-blooded youth and the tottering beggar, the rich and the poor--apportioning the meed of his approbation according to the selective affinities of the possible. polypheme had no tastes; this man was refined. yea, even like the good philanthropist who passes by those who do not require his help, and turns kindly to the maimed and the blind and the miserable, his were claimed by those on whom the hard and heavy hand of calamity had pressed. the goddess pitied iphigenia, and made her a priestess, not because she was beautiful and the daughter of a great king, but because she was unfortunate. but on this occasion the searcher was _sought_. while standing on the high street holding the button of the ragged coat of an old man who pleased him, and whose escape, seeing he was a dipsomaniac, would be nothing short of miracle, there came up to him an irishwoman, also advanced in years, apparently a weary tramp, her shoes covered with dust, and her poor clothes looking as if she had slept in them all night among straw. she was a stranger in a strange city, and by her side was a little boy whom she held by the hand, for he was one of god's stricken--deaf and dumb--with that wistful peering of the eyes which is as often the effect of the infirmity as of the habit of solicitation. she told him that she was from ireland, that she was on the search for some one of her countrymen or countrywomen whom she knew, and from whom she intended to claim that privilege of friendship and assistance which the people of that country, with all their faults, are so liberal in according. was there need for a bond of confidence? he himself was of the ould country, and would he not assist a country-woman with a charge so helpless, so pitiful, so burdensome, except for the love which bore it? nay, did he not know the very person she sought? and did she not reside in log's lodgings, whereto he would be so delighted to lead her? happy escape for the button-held, and yet strange freak of the mind as it works awry often for an opposite; for he seemed, as he departed, to envy the new comer, who had thus secured the friendship of one now possessed of money, and not backward in shewing it. so along they went, up between the high houses of edinburgh's principal thoroughfare and down by the then old bow, with its strange old fronts and leering storm windows, as if they were curious about the modern people, so unlike their ancient inhabitants, all which sights raised a wonderment in the western celt, which could only be satisfied by questions, and which, again, were answered with as much particularity as if she was not only to see them all again, but to seek them out for a purpose. then how the boy watched the face of the man, as if some instinct had told him he would befriend his grandmother, and be in the room of a father to him. and what had this boy ever learned yet through his eyes alone, to be able to read backwards the looks of love. do we not get dreary? the road has no windings, and there are no trees to conceal the cave of skulls on the aventinian mount. once again with his victim,--for surely we cannot count the deaf and dumb boy with the wistful eyes as being destined to have his name--if it could be known in the strange country--recorded in the list, within the little back room. the colleague was there, lying drowsy from the prior night's potations, but not unexpectant of the return of his friend. his eye brightened as the quickened orb threw off the drowsy vapours; and could he be otherwise than polite--the word is not misapplied--to the strangers? but where was the irish friend? oh, she would come in good time; and though it were long, did not helen m'dougal place upon the table, in a goodly bottle, that which qualified the ardour of impatience? the boy must be cared for too till the friend came, and mary hare would do that duty in the front room--yea, might there not have been sweetmeats in log's lodgings when the logs had now waxed wealthy? in two hours that woman was lying a corpse in the bed of the small room "with the window looking out on the dead wall." the boy was dumb, but he had wistful eyes, and begged imploringly with these to see his grandmother. the women could not even lie to him, and tell him he would see her in the morning. in the evening the two men sat over the fire in that same room, with the body of the woman stretched out on the bed which was at the back of the wall behind them. the boy was still under the charge of mary hare in the front room. every moment that had separated him from his grandmother--to him all the world of his knowledge and affections--rendered the duty of the governess more difficult, and even strange sounds, between a groan and a scream, made their way out of his speechless mouth, as if nature in an agony struggled against her own decrees. the sounds found their way to the back room, and it came to be a question with the men, as they still sat looking into the fire, what was to be done with him. it was proposed by one, we know not which, that he should be taken out in the dark to the canongate and there left. the policy had two reasons to support it. in the first place, he could not peach, and was therefore safe; in the second, they could hardly venture the offer of two burdens, however welcome at surgeon's square, for fear of awakening suspicions, a reason, this latter, which was rejected by the other, supposed to be burke, for the other reason, that the boy, when dead, could be kept in the house for a few days without great depreciation in value; and even if they should get for him a pound or two less, they could make it up upon a fresher one next time. there was thus some little disagreement between the faithful friends, which must await a settlement; and, in the meantime, hare went out to get a tea-chest for the conveyance of the inhabitant of the bed against the wall. on his departure, his friend sat ruminating. at one time, when alone, and amidst the sombre yet sometimes _soft_ influences of melancholy, with her throng of shades of the past and gone, he used to sing to himself plaintive airs. perhaps his melancholy at these times was poetical. these shades point to the ghosts of our friends, that seem to stand on yonder shore of the land of shadows, and beckon us to them. we resist the appeal from day to day for the sake of those that remain. these die too, and the crowd of beckoners increases, till all that formed our world seem to have flitted away, and then we make the sign of resignation to the hermit shadow (in his case the hangman) that is to lead us to them. if he ever did indulge in these plaintive airs, now was the propitious time, but his mind was engaged on something more practical--the resolution, turned and turned again, and examined and laid aside to come back--yes, the resolution to send the boy after his grandmother. the night passed, the boy having by some means been made to understand that his protectress was in bed unwell, but the mutterings of the mute might have indicated that he had fears which, perhaps, he could not comprehend. the morning found the resolution of the prior night unshaken; and, in that same back room where the grandmother lay, burke took the boy on his knee, and, as he himself expressed it, broke his back. no wonder that he described this scene as the one that lay most heavily upon his heart, and said that he was haunted by the recollection of the piteous expression of the wistful eyes as the victim looked in his face. the lad was laid on the bed along with his grandmother; and in the evening an old herring barrel held the couple who in life were each to each the one thing loved--and love is the same in the high and the low--had the same fate, enclosed in the same receptacle, and dealt with in the same way in surgeon's square. it was recorded that a curious incident happened in connexion with this affair which had wellnigh put a stop to the career of these wonderful men, and we cannot help thinking, in looking back upon it, that it should not have led to a complete discovery. the herring barrel, containing the two bodies, was placed in a cart. an old horse, which hare had used in his traffic in fish and crockery-ware, was yoked to it, and the two set out in the darkening to surgeon's square with their cargo. they proceeded along the west port without anything remarkable happening, but when they reached the marketplace, at the entrance to the grassmarket, the horse stopped, and, notwithstanding all their efforts, would not move a leg. they were in confusion. exposure was imminent. as burke afterwards said, they thought "the poor old horse had risen up in judgment against them." a crowd collected, but, strangely enough, the people were so much occupied with the horse that they never thought of inquiring what was in the cart; and when it was found that neither entreaties nor blows would induce the animal to move forward, two porters were allowed to bear off the burden without any particular notice. nay, these men so much less squeamish than the horse, took the barrel to the dissecting rooms without ever asking what they were carrying. the horse, which it is probable age and hard usage had arrested in its progress, was, in revenge for the fright it had caused its masters, led to a neighbouring tannery and slaughtered. it was of no value in surgeon's square.[ ] the stray waifs there is no great wonder that thinking people, while admitting ruling motives of action, should be chary about the question of their origin; how one rises out of another, and that out of one further removed, and so forth, as deep down as you please. the harlequin jackets may be removed one after another, till you come to the skin, which, being white, is said to be of no colour, only a negative, as also has been said of black. in another view, the subject appears still more unfruitful; for, as you may bring a tune, combining the grave and the gay, out of one length of catgut, so the human mind will give you off all sorts of feelings, some good and some bad, in the course of the same hour. in truth, as our doings are made up of passions and restraints, which latter may be passions as well, we will never understand thoroughly a human action. when we admit that these great criminals took away lives, right and left, for the sake of money, how much do we achieve? we just accuse them of what the greeks called _chrysomania_, or madness for gold. strange that in our country, where the passion is pretty strong, we have no such name, avarice being entirely different; but this passion may have been a rider on the love of drink, and then we cannot estimate either the one or the other, till we know the force of the countervailing restraints. if these--and there are many--are weak or _nil_, the passion may be a very weak affair, so that such beings as our principal actors might--seeing they wanted pity and religion and fear--have thought less of suffocating a fellow-creature than bellarmine did of removing a fly from his face. with no pretension to be teachers, we offer these hints merely as explanatory of our manner of treating a subject much discussed at the time. of one thing, however, we may be certain, and that is, the effect of familiarity in removing those inconvenient asperities called scruples, which nature is continually casting up to preserve the triumph of the good over the evil; and so we may well be satisfied that every succeeding success operated with the double effect of confirming the prior purpose and stimulating to a repetition. this is merely the confidence inspired by habit, with which we are all daily cognisant; and therefore the subsequent atrocities ought really to excite less curiosity, though not less revulsion, than those that went before. yet this is not found to be the case, and the reason is, that even great men in the murdering way are generally content with one trial, as being sufficient for all their power to carry before the judgment-seat of god. it is always to be remembered that all these moral wonders took place in very quick succession, and only a few weeks pass until we arrive at the waifs. the actors had come to see that they had a great stage to perform on, and supplied as well with innumerable objects. they had only to look a few yards to the west, up portsburgh, or to the east, up the grassmarket and cowgate, to be certain that "a ten pounds," all prepared, was walking or staggering as if every roll to a side offered to be one into their arms. they had thus reason, if they had been of a philosophical habit,--and one had the poetry of sentiment--to thank the great genius society for his injustice to his own members. and what an extraordinary injustice it appears, when we consider that the high head of wealth is upheld by the tax of respect imposed upon the poor and the humble! if there were no inferiors to witness a man's greatness, he would be great no more; and yet those who are the soil from which this moral grandness springs are left to rot, as if the more it approached to compost the ranker would be the tribute to his mightiness: so, without abating our horror of these men, we cannot altogether forget that the sufferers in most instances were cast away by mammon to be in turn immolated to mammon. they had in short a bank--heaven knows, not of "elegance"--upon which they could pass a draft when they chose; nor was it forged--they were themselves the drawers, and the money seemed to belong to no one; so careless at that time--it is, we hope, different now--was society of those whom it was bound to look after and protect. so money was again needed, and burke was to pass the draft, because perhaps his companion thought that as there is (of course) honour among thieves, so fair play must be esteemed a jewel among manslayers. and here the strange circumstance occurred, in the midst of all these strange things, that his draft was to be endorsed _by a constable_. he had been among his dear friends in the canongate,--and a man or a woman had now a value for him which a short time before he never dreamt of,--thinking of how he could make some of them more dear to him than they seemed to be to themselves, when his attention was directed to a poor unfortunate, steeped in poverty and drink, in the hands of a police officer. mixing with the crowd, he went up to the officer, and, with much apparent sympathy, interfered for one who had no home and no friends to care for her. he would furnish that home, at least for a time, and be that friend. the poor woman, like some of the others who had wondered that they should become objects of interest, looked at him as one may be supposed to do who has considered herself past the hope of man's charity. some of the crowd, struck with the offer, backed the sympathiser, and the policeman, considering for a little, at last consented, giving her up to the kind friend,--no other than a philanthropist of the humbler order, but perhaps not the less sincere,--and enjoining upon him the due performance of his promise. having got his charge, the crowd--whose curiosity was served not less than its benevolence, for these poor people feel intensely for each other's sorrows, the more by reason that no one else does--separated. then, alas! the old story. the tempter and the victim pace the streets towards the block-altar of the sacrifice; and as they go, we may consider how many have achieved a world-wide notoriety for having concocted one of these acts, with the attending circumstances of having watched their opportunity and been defeated, and still kept to their purpose, and, veiling all in romantic mystery, at length effected their object. such men, and their solitary performance, with which they were contented, or to which they were limited by the gallows, are only qualified to form a meagre episode to the terrible drama we are with so much imperfection evolving; even as faust's vision rose in curling smoke, and took on the gigantic form of a being out of nature and belonging to another world. we have heard of hardened men who gave those they intended to sacrifice time to pray. there was allowed only short shrift in log's lodgings. before nightfall this woman lay doubled up in a tea-chest. we will not disturb you in your pause as your mind, led by her who dropped pity's tear on the written words of the recording angel, goes away back to the youth or the maidenhood of this woman. the "perhaps" has a weakness in it, but who shall gainsay, with the doctrine of chances against him, that she was, as you may be, beautiful and good, yea, at one time looking forward to years of happiness, a redeemed's death, and a christian's funeral, even with that confidence which--blessings on your pitiful heart!--will be sanctified and verified to you, because it is in god? we are not done with the waifs even so far as known, and their number has never been recorded. it was a practice of burke to wander out in the early mornings. he would have been seen pacing the solitude of the deserted streets even before cock-crow. nor could any man tell the reason: it was not asked, not even speculated upon. like the traces of sympathetic ink, the notice lay unverified, till the great disclosure, when it came up fresh into many minds. and it came up all at once, with the suspicion that he did not go those solitary rounds for contemplation, far less from remorse; a feeling which, so far as can be ascertained--for the pang of the wistful look of the dumb boy was suspected to be a mere trick of the prison confessional--never ruffled his pillow. the night-hawk goes to bed in the early morning, before the choir offer their song to the rising sun, and these catch no flies till he is far up in the heavens. the first surmise of the discovery of what had been doing in log's lodgings sprang the suspicion with elastic rapidity, that these early walks were undertaken in prosecution of the old purpose, and specially stimulated by an interest in that institution--to be found, we believe, nowhere else--the cinder-women;[ ] not singing-birds these, if he was not a night-hawk; but the osprey is as early on the long sands, when there is not to be seen there a living thing, except the gulls, as they pace so securely the edge of the sea. a very early riser in edinburgh is impressed with the sight of these thin, haggard figures flitting from backet to backet in the great solitude. the only moving creatures in the long streets,--if you did not know they had any other object in view,--you would think that, being immured in the dark dens of the old town, and ashamed to shew their faces during the day, they crawl out to get a _glimpse_ of their old haunts, where, as unfortunates, (the greater number,) they once flaunted their charms, till they faded to the point of recoil. you would say, too, that they belonged neither to this world nor any other--mere pendencies, with no solidity to keep them on the earth, and no wings to take them from it--hopeless, too, and fearless, not from despair or passion, but from sheer inanity--glimmers, not lights, flickering at the end of wicks, with no oil except what they have imbibed long before. it was this prey that brought the prowler out so early in the morning; and he might have revelled in a field so fruitful long enough, without that risk of discovery which attended his other assaults. friendless as they are, with years intervening since they were cast off, not only from society, but from those who once knew them,--some worshippers of beauty, perhaps,--there were none to inquire after them, scarcely any to miss them, except a sister straggler, who might wonder for a moment why a shadow had disappeared. that more of these creatures fell into his hands than the culprit confessed, was the general opinion of the time. one, at least, was certain, as a waif scarcely worthy of mention among so many cases, and these so much more _éclatants_. on that eventful morning he was more early than usual; the gray mists only as yet disappearing, and the figures he sought for looming as shadows here and there at long intervals. it was supposed to be in the new town where he encountered the hopeless, soulless creature, scraping as usual in a dust-box, picking up the bits of cinders, and peering in the dim light for the chance turn-up of the sign of some servant's _lâcheté_. a more easy approach than ever, with the charmed "dram" on his lips, sufficient to bring the light of hope once more to the cinder eyes. even the long distance from the new town, by the mound and the bow, to log's lodgings, as they paced and paced, would only increase the hope, to be gratified at the end. and of course it was gratified; so cheap a purchase, too, where the oil was all in the wick, and the blue glimmer, rendered for a short time white by a glass only once repeated, would recede into unconsciousness almost before the energy to take advantage of it was up in arms. while this work was doing, in which the accomplice rose from his sleep to join, the women were in bed--saved in this instance from the trouble of their delicacy in going into another room, or the passage, as they sometimes did. nay, the cock had not crowed before all was over. the gurgling sound would be weak. it has been said that the death-scream of the surprised sinner, and the dying prayer of the christian, are the extremes which terminate two courses of life. they may be the last signs in this world and the first in the next, as they are the farewell to time or the salutation to eternity. who was there to care? the relative. so far we have had details through the medium of confessions uttered when the only _terriculumentum_ to be feared by those who had no belief in a hereafter--the law--had given forth her decree of death, supplemented as these were by collateral testimony, or, rather, desultory remarks of others who had seen portions of the drama; but in some instances there were thrown across the light which at last illuminated the mystery, certain shadows with no defined forms, and through which the light shone only to make them lurid. of this kind of partially-revealed secrets was the story of the young cousin. no name or personal marks or place of origin ever came to the public ear, far less the form or features of the sacrificed; only, and no more, that a cousin of helen m'dougal's,--by uncle or aunt uncertain,--left her mother and sister,--from whence, also under the gnome,--to visit her relative in edinburgh. it was known that she entered under the door-lintel of log's lodgings, and was never seen again. if the world, as a spasmodic poet tells us, were destroyed, a few atoms left of the wreck, with their internal forces of attraction and repulsion, would enable a philosopher to tell how it was made. we smile at the extravagance, while we acknowledge some kind of truth, which we cannot understand. these small traces of the little world of crime within the back room "with the window looking out on the dead wall," long since destroyed and erased from the bigger world of which it formed a part and the shame, may be brought together and filled up by the imagination, with a certainty so far removed from the feeling of fiction, that we might scarcely regret the want of particulars. we have had small need of that faculty in our history; yet, comparatively, of that little world we know next to nothing. we might as well deny to the welcomed cousin a name and a place of birth, as refuse to believe that she went into that house with the expectation of meeting friendship, if not love, to a greater degree than what was held out to the hope of others. they would shake hands with her--(what love and hypocrisy don't?)--and there would be inquiries after the mother, and the sister too;--just what takes place at all such meetings. nor are we to forget the welcome in the still more common shape, not the fatted calf, but the bottle of whisky, so useful an auxiliary there. if the paramour or husband of her cousin ever sung his sentimental airs, he would surely not refuse on the occasion of a visit of one allied to him in the bonds of affinity. there could not help being joy, for it was through the light of the feeling of mirth that these eight eyes looked on the guest they were making happy. those who have read the german tale of the two eyes which followed everywhere hans kauffmann, and never glared upon him but when he was alone in the dark, and which at an after-period he saw shining in the face of his enemy, as that enemy, the wreaker of vengeance, stood over him with the thirsty sword, may trace a resemblance; but as for these eyes of the four hosts looking anger on the poor relative, we may safely place that among the impossibilities--and surely we do that more easily than we can fancy the expression of that peculiar welcome. we wonder how nature so often leaves us in the dark. we cannot understand that she has so much to do that she is for ever in a hurry, so that we only see at times the skirt of her cloak. then we are ourselves so restless and impatient for knowledge, that we snuff the candle of our inquiry so often that we can see nothing. perhaps all this is intended for the purpose of giving us a wider world of imagination, and more ardour in peopling it with all its strange beings, spectral images, protean forms, wild movements--for what further end we know not, but we work our privilege in these days of fiction very well. the veil is often an exaggerator, but in this act of our drama it seems hard to fill up the unknown recesses with possibilities equal to the realities. just try to supply the required minutiæ to the few words said to have been uttered by helen m'dougal. after many months of fruitless inquiry, met with a denial that any one in log's lodgings had seen the young cousin, the mother and sister, probably under suspicion of some foul play, went to the house of constantine burke, the brother of our man. helen m'dougal happened to be present, and to the request again made to know what had become of the girl, the woman, who must have been under the influence of drink, for at this time the explosion had not taken place, answered, "oh, you need not trouble yourselves about jessy. she was murdered, and sold long ago." among the cases of mere outline and shadowy traces, suspected to have been more in number, as including more waifs than admitted, we may place another. it seems to have been a bargain between the two principal actors that their work should be conjunct in action as well as in payment. on one occasion, burke, having now plenty of money, went to the country on a pleasure jaunt. yes; pleasure. amidst all our philosophy and inquiry into causes and motives, would we not save ourselves a deal of trouble by attributing nine-tenths of the actions of men, not excepting murder, to a desire for pleasure? all swallow the love-apple bait presented by some wicked genius of the devil, who sports with the affections of mankind. the beguiler laughs as he angles. some victims afford him fine "rises," and look shy, only to come again to bite in earnest. some swallow and enjoy the sweet morsel, until the hook approaches the pylorus of their reason. some disgorge it, to seek it again; others break the line and run away with the hook, to die in secret places under a crag. some are caught by a fin, and carry the mark of the forbidden pleasure only to excite them to another trial; others are held on till they reach the bank, where they writhe in agony amidst sunbeams, wild thyme, and gaudy flowers, with the laugh of the tempter sounding in their ears. and some, on being swung ashore, get entangled _in a tree_, and hang there by the neck. how few can nibble off cunningly the _cibum præfixum ære_, and avoid the snare! burke had gone on a pleasure jaunt--not to be hooked yet. on his return he found log's lodgings as he left them; nor did he suspect that any of the unholy work had been performed in his absence. if the old orgies had been continued,--and how could they now be renounced when the increasing weight of all those deeds must have been pressing more and more on their hearts, however they might try to conceal it, and required the old art of buoyancy as a counter-agent?--there had been plenty of money to supply the means, so that burke thought that no march had been stolen upon him by his cunning colleague. it happened, however, that he had occasion soon after his return to call at the hall in surgeon's square--perhaps to get the price, or part of it, of the last burden. he was there told by one of the assistants that his friend had been there shortly before with a box, not empty, and had been paid for it. he even got the day of the month and the hour of the evening, from which he saw that his co-actor had been secretly, as he said, working during his absence "on his own hook." enraged at this want of honour, he repaired to the house, where he found his friend, and taxed him with the fraud. hare stoutly denied the charge. the women were appealed to, but neither of them would admit anything; for we are to remember that both of them were not only in fear of their respective lords, but of those of each other. nay, we have seen hare using as much liberty of punishing m'dougal when his friend was present, as burke had of thrashing mrs hare, which it is certain he often did. nay, the women even had their battles royal, and the men were, as well, often engaged in fierce conflict. the present subject was a _delicate_ one. it touched the honour of contractors, the purse of sordidness, and the faith of friendship. well, we verily believe that even burke was fit for these heroics, and he was fit for something else. he fell upon his friend with fury, and hare, ever ready for battle with all and sundry, not excepting his wife, retaliated. they fought long and desperately, the women looking on with only that concern which might find its account in so being revenged for some prior cruelty exercised toward them by one or the other, perhaps both. this was one of those riots which so much disturbed the neighbours. a crowd, as usual, collected at the door, but even the exasperation of the parties could not force out the secret of their quarrel. it would have been strange indeed if it had! and we say this even in the midst of daily examples of anger roused to a pitch of opening the floodgates of very dark things, even to the confusion and ruin of the angry, and so far involuntary, confessor. how little did that crowd of spectators know what these men were fighting about! but if the subject was the price of a human body, whose spirit was it that enlivened it--man or woman, young or old, good or evil? the creature passed away in the middle of a large city renowned for civilisation, and even with the tread of passers-by reaching the scene, more secretly than one who perishes at sea; for, in that case, though there is none to see, there are always some to draw a conclusion. yet, withal, we cannot say that providence does not vindicate the importance of its creatures. that victim would, for certain, be mourned somewhere. there are even notes of woe in the grove, when the missing mate is snared by the fowler, though no one may be there to hear. it was remarked at the time when the great secret burst, and the news flew on the back of broadsheets throughout the land, that there were scarcely any direct declarations of claims. even when conviction was heavy on the heart that a missing relative could in a certain way be accounted for, the issues were spasmed, and people only looked their thoughts. if the whisper passed, it was only among close relatives, and they kept the secret to themselves, even to the exclusion of friends. it was from this cause that the papers could not, with all their efforts, pander to the curiosity of the public by giving names. nay, so awe-struck was that public itself, that, after the first excitement and wonder, and after burke had paid the penalty, there seemed a wish to hurry away from both the subject and its details. they wanted back to their natural feelings and sympathies; and the hurriedness with which the crimes were laid past, with the resolution that they should not be mentioned, seemed to hold some ratio to their gigantic proportions. but the reasons which actuated the people of the time are not these by which posterity is to be influenced; for vice, whatever may be its degree, must ever be the foil of goodness, and the punishment of the wicked the sanction of virtue. it was even said by one of the newspapers of the day, that these records would at some future time form the materials out of which some sir walter would weave a romance. the prophecy is not justified in us. the romance-writer will come; at present, we are content with the office of chronicler. how much we could wish that these things had never been left to us to chronicle, and how much too that what we have already said were the worst we have to say! but thus begun, it behoved that the obstinacy of these men should harden more and more; that the recklessness increased by success should, according to rule, get more and more regardless of danger, till the delirium of wickedness should throw them into the hands of justice. already "the voice of thy brother's blood crieth unto me from the ground." the study for the artist. if these conspirators against society had limited their operations to the waifs,--a wide enough field surely in a city like edinburgh, renowned at the time for the extent of the wide tattered fringe of the social web,--they might have remained undetected for a lengthened period;--ay, even until they had cut off hundreds; and why they left this secure area can only be accounted for by that universal law whereby the doers of evil acquire a confidence which blinds them to all sense of danger. the bold and reckless case of the young cousin was the first indication of the coming change, and we will see with what rapidity the progress was pursued in terms of that inevitable decree of providence. it has been mentioned that burke had a brother of the name of constantine, who, having driven a desultory trade something of the nature of that followed by his brother and his associate, had become a street-sweeper or scavenger, and lived in gibb's close in the canongate. it never was satisfactorily established that this man was acquainted with the conspiracy, although many suspicions, especially arising out of the case of mary paterson, which is now to form the burden of our chapter, appeared to hang heavy upon him. for once the scene of death was changed from the old shambles to gibb's close. mary paterson, a young girl of eighteen or nineteen years of age, of remarkably handsome form, as to which we will hear more by and by, and who turned her attractions to no other use than that of _the old abuse_, had been, along with a companion named janet brown, lodged in the canongate police-office, on tuesday the th of april . they were kept till four or five o'clock next morning, when they repaired to the house of a person called mrs laurie, where they had formerly lodged together. they had been for some time constant friends, and had more of affection for each other than is generally found among individuals of their class. the woman, who felt for them, expressed a wish that they should remain, but, for some reason unknown, they preferred another course, and went to the house of one swanston, who sold drink. they got there a gill of whisky, and when they were drinking the spirits, their eye fell upon burke, who was there even at that hour, busy drinking rum and bitters with the landlord. they had never seen burke before, and made no sign of a wish to enter into conversation with him; but he, who appeared to have been watching them, came forward, and, affecting to be much taken with them, ordered an additional supply of the rum and bitters; nor did this drinking bout finish till three gills were consumed in addition to what they had drunk before. of this drink burke participated largely; and, indeed, it was supposed that he often wrought himself designedly up to his required point of courage by the means of liquor when he had any special work to accomplish. in the course of the debauch, and when he discovered that the girls were of that kind who, when begun to drink, are regardless of limits, he proposed that they should accompany him to his lodgings, which he said were close by. mary was willing enough, but her companion, brown, shewed signs of reluctance, not probably being much enamoured of their new friend. whereupon he roused himself to remove her scruples, by shewing money, and stating that he was a pensioner, and could keep her, brown, handsomely, even make her comfortable for life; and that if she had any fears of the people in the house, he would stand by her against any insolence or abuse. all this attention, as brown subsequently stated, was, as she thought, directed to her in preference to mary--with whom, as for personal recommendations, she could not compete--in consequence of her shy and backward nature wherein she was a contrast to her friend, who was of a disposition fearless and forward. besides, he knew from their apparent affection for each other that the one would not accompany him without the other. at length brown gave up her scruples, and all the more readily that he made the additional offer to provide a good breakfast for them, as an earnest of all that which he had promised to do for them. matters being now arranged, he bought from swanston two bottles of whisky, one of which he gave to each of the two girls to carry. he then conducted them to the house of constantine burke, where they found that man and his wife already up, but with the fire as yet unlighted. whereupon burke got into a great fury, abusing the woman for negligence in not paying more attention--a feint with a meaning of which some supposed she was not altogether ignorant. straightway the gloomy aspect of the miserable house, the residence of so rich a pensioner, was removed by the new-lighted fire, and the woman with all activity set to work, in which she was joined by her handy brother-in-law, to produce a hearty breakfast for her lodger and guests. tea, bread and butter, eggs and finnan haddocks, covered the table. they were now merry: the effects of the previous drink had not yet died away, while the breakfast before them, and the promises of the new friend, all tended towards a state of happiness to which the poor girls were total strangers. meanwhile the brother, who joined in the breakfast, left shortly to proceed to his work; and the meal having been finished, with the cups and other things left remaining on the table, the two bottles of whisky were produced. the drinking again commenced, burke still participating to a large extent, at the same time that he pressed glass after glass profusely upon the girls. the impulsive and reckless mary, still true to her character, shewed no scruples. one glass followed another, till by and by the drug began to shew signs of a speedy triumph; but brown was more chary, often refusing the proffered poison; not that she had any suspicions of evil design on the part of the generous pensioner, but simply because she did not wish to get drunk--a consummation so clearly impending, with two bottles on the table, and only three participants. burke now saw that mary, who had fallen back on the chair all but unconscious, was safe. the next step to be taken in his scheme, which, notwithstanding the enormous quantity of drink he had swallowed, he prosecuted deliberately, was to get brown, still comparatively sober, out of the house; and he cunningly proposed to go along with her for a walk, to revive them after their potations. the girl at once agreed, and, leaving mary in her narcotised condition, they sallied forth; but the purpose of a walk was changed, and, inconsistently enough, brown soon found herself in another public-house with her generous and most persevering friend. here two bottles of london stout were ordered, along with a pie, and the girl, whose natural caution and shyness were not proof against so much seduction, drank a large share of the porter, burke himself shewing no reluctance to participate as well, knowing not only that he could stand a great amount of drink, but that the more he took, within the limits of consciousness, if not coolness, the better able he would be for the execution of his purpose--in this instance, as it appeared, a double one, involving both the girls at the same time, or, at least, with a short intervening interval. the porter having had its due effect upon brown, who was yet, however, far from "the point," he then induced her to accompany him again to the house they had left. here the remainder of the two bottles of whisky was produced, mary all the time lying almost unconscious, and only raising her head at times, and looking with stupid earnestness on the proceedings. now there comes up a new incident in the play, which has never been well explained. all of a sudden helen m'dougal, whom we might have supposed to be in log's lodgings, who had not appeared at breakfast, and had not hitherto been seen by the girls, starts violently out of a bed. there is a whisper by constantine's wife in the ear of brown, that the apparition is no other than burke's wife; and the latter immediately commenced, with all appearance of a jealous fury, to accuse the girls of having the intention of corrupting her husband. the part was so well acted, that brown, getting alarmed, entreated forgiveness, on the plea that neither she nor mary had known that he was married, otherwise they would not have remained in his company. the play proceeds. helen m'dougal breaks down: she was, she said, not angry with them, only with her husband, who was continually deserting her, spending his money on loose women, and leading a life of dissipation. she then asked them to remain, and with such apparent sincerity that brown was satisfied, but as for mary she was incapable of understanding a much less complicated plot. m'dougal next turned against burke, upbraiding him for his infidelity, taking up the things that were upon the table, dashing them into the fire, and otherwise exhibiting the height of a woman's passion. nor was burke indolent or regardless of this fierce onset; he retaliated, and taking up a dram-glass hurled it against her face, hitting her above the eye, and cutting, even to profuse bleeding, her forehead. at this time, or a few minutes before, constantine's wife rushed out of the house, with the intention, as brown subsequently supposed, of bringing hare, but it is more probable, on the supposition of an art-and-partship, to the extent at least of knowledge, that she found some good reason for being merely absent. immediately after her departure, burke succeeded, with an apparent effort, in turning helen m'dougal to the door, and locking it after her. pausing a little in the midst of our narrative, we may remark, that although it was generally supposed that this quarrel between burke and helen m'dougal was got up for the purpose of confusion, yet it is not easy to see how any end could have been served by it; while the cutting of the woman's face had too much seriousness about it, even as a part of the terrible drama, to admit of the theory of an entire feint. the discrepancy may be reconciled by the introduction of another passion, jealousy, but this we cannot recognise, however true, except upon the assumption that m'dougal had some reason in her own mind to lead her to the suspicion that burke could be unfaithful to her with the very women he intended to slay. nor, however aggravating this may be, where aggravation seemed impossible, it cannot be held as transcending the potentialities of a nature altogether alienated from god, especially when we keep in remembrance the true character of the passion thus imputed to burke, as being so often utterly independent of the emotion of love, in which a moral sentiment forms a necessary element. this collision, as it were, between the desire that burke should _kill_, and another, that he should not _possess_, would produce that irregularity, as we term it, in the plot which imparts to the acting the incongruity so difficult to the analyses of the time. but while it in some measure interferes with the unity so congenial to the romancist, and which we unreasonably look for in nature, because it is more consistent with art, it presents us with a picture of human nature never before witnessed out of the domain of extravagant fiction. at the time that burke returned, after the locking out, mary was lying across the bed, not having been able, even during the heat and noise of battle, to lift her head to satisfy the natural curiosity of her sex, if the curiosity itself was not altogether sopited. burke knew the prolonged continuance of these states, proportioned as they were to the quantity of poison he had seen swallowed. so mary is laid up as a reserve, ready for his assault at any time within the period of hours. he therefore turned his attention to the less easy subject, her companion, expressing still greater kindness to her, and pressing her by all manner of solicitation to lie down along with him in the bed from which, shortly before, his wife had so unexpectedly sprung, and who, even yet, with continued inconsistency, persisted in knocking at the door. so strong were these solicitations, and so affected was brown with the drink she had taken, that, according to her own statement afterwards, she would have complied with his request if it had not been that she was terrified by the noise made by m'dougal. either supposition is possible, that he wished to gratify a purpose upon the one, and then execute his final intention upon her companion; or that he intended to immolate first the more difficult victim, and then take his own time with the other. fortunately the poor girl was able to resist his entreaties, as much probably through some instinctive feeling as from prudence. anxious to get away, she expressed a wish to depart, to which burke at first shewed no inclination, but at length, and probably under the pressure of an apprehension that, inebriated as she was, she might call for assistance, and thus deprive him of mary, whom, as she lay still senseless, he already calculated upon as his own, he agreed to her request. he even conducted her past helen m'dougal, who was still upon the stair, either under the influence of her jealousy or of the old delicacy which so often took her out of the view of the final catastrophes. in all this brown made a narrow escape, for whether mrs constantine burke had really gone for the other, and perhaps greater, arch-conspirator, hare, or not, it is certain that that fearful man arrived at gibb's close not long after the departure of brown. the moment hare arrived, and there being now no one in the house except themselves, and the unconscious mary still lying in bed, they fell straight upon their victim. the old story again. the process was familiar to them--the energy at ready call--the execution easy. burke springs upon the senseless victim--hare is at his post--the heavy body pressing with the knees upon the soft bosom--the closing up of the mouth and nose--the gurgling--the long inspirations--the watchings to listen, and listen again, and examine if all was finished--the make-sure--the finish. so quickly had the process been gone through that, on brown's return, not more than twenty minutes afterwards, mary paterson was lying dead, but concealed from her observation by having been flung into a corner and covered up. it may be of interest now to trace brown. after getting past helen m'dougal, who was on the stair, about, no doubt, to watch the process inside, she went straight to mrs laurie's, and told her, with a laugh, that she would not remain with her, as she had got fine lodgings elsewhere; but after informing the landlady more seriously of the circumstances, she was advised to go back, along with mrs laurie's servant, and endeavour to get mary removed; not, however, that either the one or the other had any fears of her ultimate safety. the accompaniment of the servant was probably another of the apparently accidental means by which the life of this girl was preserved. half stupified as she still was, she did not recollect the name of the close in which the house was situated, and being at a loss, but still anxious about her comrade, whom she loved, she applied to swanston for a direction to the residence of the man whom she had seen there in the morning, and with whom she and her friend had gone. the man replied, that they ought not to have gone with him, because he was a married man, and did not keep company with women of their kind, but that she would probably find him in his brother's house, in gibb's close. still, so stupified was she that, after getting into the close, she went into the wrong house, where she was told that the people there kept no company with such characters, but that she would probably feel herself in the right direction by going up-stairs. they accordingly ascended, entered, and found there helen m'dougal, hare, and hare's wife. the dead prey had collected the ravens even within so short a time. burke was absent--no doubt in surgeon's square; but those present, with the corpse within a few feet of them, were as unconcerned as if one among them had been engaged in throttling a chicken for dinner. upon inquiry for her friend, mrs hare rushed forward and attempted to strike brown,--a movement not easily accounted for, except upon the supposition of a feminine way of repelling an intruder upon their secrecy, who might be dangerous; but this burst gave way to a quieter demeanour, the result of greater prudence, for the recklessness of passion is not exclusive of minor means of self-preservation. they told her that mary had gone out with burke, and invited her to sit down and take a glass with them, upon which the servant left. brown now saw hare's eye fixed upon her, and no doubt her partial inebriation was a temptation which was touching; and helen m'dougal continued her part of the play, by railing against her husband for going away with the girl whose dead body was actually in the room. brown, surrounded by the three fiends, was again in danger; but, fortunately, mrs laurie, who had got alarmed at the report of the servant, upon what precise grounds is not known, sent back the girl to bring away brown. no attempt was made to retain her in the presence of the servant, but she was invited to return,--a circumstance so adverse to the policy of keeping away so interested an inquirer as to be almost proof of their intention to send her after her friend, the double object of the price of her body and the seal of secrecy being the motive. meanwhile, changes had been going on in the house; and when brown, in the afternoon, again called, hare was gone--having given up his hope of the further prey, as he would calculate upon brown's gradual return to sobriety. she was now told that burke and mary had never returned. further inquiries were made, not only by brown, but by a mrs worthington, with whom the two girls lived, and then another story was trumped up, to the effect that mary had gone on the tramp with a packman to glasgow. this story pleased brown less than the other, which carried the inconsistency of a recovery from drunken unconsciousness in so short a time; while the tramp to glasgow, and no intimation from that quarter, were equally unlike the habits of the girl, who could write an intelligent letter, and would certainly have done so if for no other object than to inform brown of her departure and to claim her clothes, which still lay in mrs worthington's. no further intelligence was ever obtained till the great break up. the fate of mary paterson was meanwhile a mystery. but when we take into account the vagrant habits of these restless and changeful beings, we need make no reproach on the want of affection of friends or relatives. we may state here that brown believed firmly that constantine burke and his wife were cognisant of this affair, both from their manner at the time and the conduct of the man afterwards when she questioned him about mary. often, when he was at his work in the morning, she inquired if he had heard any further intelligence of her companion, but the answers were surly and snatchy,--"how the h--ll can i tell about you sort of people, here to-day and away to-morrow?" or, again, "i am often out upon my lawful business, and how can i answer for all that takes place in my house in my absence?" and so the inquiries for mary paterson died away for lack of satisfaction, and the only hope that remained was that some day she would cast up when weary of her wanderings with the packman. the account which brown gave of this unfortunate creature is touching. she admitted that she was irregular in her habits, but far from being low in her grade; and expressed her indignation at a paltry print which appeared of her, representing her in the garb of a servant, a dress in which she never appeared. she had been well educated for one in her sphere, and possessed, as we have already said, a fine person, for which she was remarkable. she was a native of edinburgh; and her mother being dead, she was left to herself, driven along in her career by a frowardness of purpose and impulsiveness of feeling, not yet inconsistent with a warm heart and kindly affections. the supplement of the story is given by one of the confessions of burke. he cut the hair off her head when she was still warm. it will be remembered that he formerly dealt in this commodity, and mary's was too long and beautiful to be given to the doctors. it might one day figure as her own on a lady of rank;--and how little she would know of the fate of her whom it had adorned, as adorning it! but to what end? even that of the poisonous flower of paphos, which is said to have the most beautiful petals, and to throw them the soonest away. within four hours burke and hare took the body to surgeon's square. it was then cold enough, but had not yet got time to assume the stiffness of the dead. when uncovered, a tall lad who was along with mr ferguson, one of dr knox's assistants, expressed surprise and said that he knew the girl, and had been with her a day or two before. sharp questions followed as to where and how she had been got, when burke satisfied the inquirers--wondrous facility!--that he had purchased the body from an old woman at the back of the canongate. nor did the story finish here; so struck was knox with the beauty and fine proportions of the body of mary, that he invited an artist to come to the rooms to see it, for the benefit of his profession; and with the conservative instinct of an old museum collector, the curious professor kept his favourite specimen three months in whisky. no wonder that this case roused the suspicions of the public against the doctors,--a subject we will take up in a subsequent chapter. opinions ran high, and both sides had their reasons and their arguments, upon all which we shall attempt a judgment. daft jamie. the work goes on, with a change of shambles. some time after the scene in constantine burke's house in gibb's close, burke and helen m'dougal removed from log's house to that of a relation of theirs of the name of broggan. it was never properly ascertained whether this separation was the consequence of a quarrel between the parties, or whether it was imagined that another establishment would furnish additional opportunities for carrying on the trade. the latter opinion seems to have been justified by their joint operations having undergone no interruption. broggan's house was admirably adapted for working the conspiracy, provided the inmates could be relied on, a condition indispensable where the house consisted of only one apartment, though with a convenient dark passage into which the females could retreat as a safeguard to their feelings. if we are surprised that four individuals could be found in the world to harmonise in a confederacy for so extraordinary a purpose, we come to be appalled with wonder and dismay at the apparent facility they found in conciliating the scruples of those who could have derived but little reward for their silence. we have seen constantine burke and his wife acting the aiding confidants, and now we see another man and his wife brought over with apparently little difficulty. we seek for the explanation of course in the power of money, but this does not allay the wonder, if it does not rather increase it, as extending the charm of that agent even beyond what we could ever have dreamed of its influence. the first tragedy in the new theatre involved the fate of a decent woman, the widow of a porter named ostler, who lived in the grassmarket, and who had died shortly before. she gained her livelihood in an industrious, if not laborious way, mainly by washing and dressing, eking it out by any desultory work she could find, sometimes in the country during harvest. she had been accustomed to visit broggan's house in her vocation of washerwoman, and was well known to the neighbours, both from her long residence among them, and her frequent visits to the mangle at that time kept by a woman of the name of mrs law. one day this woman was seen to enter broggan's house at a time when burke was known to be there, and some of the neighbours noticed, though without paying any particular attention to the circumstance, that some time after she entered, there came from the apartment sounds of jollity, as if the inmates had got merry under the influence of drink. burke himself exerted his musical powers, and mrs ostler, not to be behind, favoured the happy party with her favourite song--"home, sweet home," which she sung in a wavering treble, not without sweetness. the symposium was no further noticed, nor was it exactly known who formed the party, but that broggan's wife was in the house at the time, may be inferred from the fact, afterwards ascertained, that about that period she lay in of a child. from that hour mrs ostler was never seen. she was despatched some time after the singing of "home, sweet home," and carried to surgeon's square the same evening. the ancients were fond of the subject of the shortness, the brittleness, and the vanity of human life. homer has his soap-bubble, plutarch his point of time, plato his peregrination, and so forth, and the moderns imitate them. yet, at the worst, man has generally made some little sign even at the death of a beggar. it was reserved for portsburgh to be the place where life disappeared like a snuffed-out candle in mid-day--the hand unseen, the light scarcely missed--even the material which supplied it gone as if by magic. if mrs ostler was soon missed, the speculation died away under the ordinary supposition, that she had fallen into some water; and there was an end. the first murder after the change of residence was a mere prelude to an act--_heu! heu! vita vehementer effera et barbara!_--altogether cyclopic. there lived in edinburgh in that year-- --an imbecile of the name of james wilson, or, as he was called, "daft jamie." his residence was in stevenson's close, canongate; but, with the exception of the night-time, he was seldom at home, being, like most of his class, a great wanderer; nor were his wanderings limited to the old town--he was seen everywhere, and seemed never to be weary. though evidently deficient in intellect, he was strong and healthy in the body, going in all weathers bareheaded and barefooted, without injury to his constitution, and without a murmur of discontent. never was there a more happy creature of the kind than daft jamie; for while, as we too well know, those thus afflicted were at that time, when they were less than now under the public care, often the objects of hatred, more often of sport and play to the young of the lower classes, jamie was a universal favourite. it was not that the inhabitants of edinburgh merely pitied him--they really liked him. perfectly harmless and inoffensive, and not uncomely in his appearance, he possessed great kindliness of heart; and to all who had occasion to be on the streets of edinburgh, whether early or late, he was familiar, always dressed much in the same way,--the good-humoured, winning smile never absent from his full round face,--always ready to salute by a peculiar manner of taking the front lock of his hair between his finger and thumb, nodding quickly, bowing and smiling. we can say, from experience, that there was no resisting jamie's smile and the twitch of the lock, and you felt this if you had a penny in your pocket, which was all the more readily given that he never seemed to wish for it. nay, he sometimes rejected money, saying that he didn't need it, for that he had "the feck o' half-a-croon on him." this _bonhommie_ was perfectly genuine, not more the result of the universal favour with which he was regarded than of heartfelt kindliness, and a robust health independent of all weathers. another peculiarity consisted in the importance he attached to his brass snuff-box and spoon, which he always carried about with him, and used with great economy, and with so much of selection, that while many might be favoured with the smile and the bow, it was only a very select few, principally favourites among the young collegians, to whom he condescended to offer a spoonful of his rapee. though undoubtedly imbecile, and incapable of any continuous mental effort, he possessed a small portion of intellect, never exhibiting any of the vagaries of his class. he kept up a correct knowledge of the days of the month and week,--a species of learning of which he was very proud,--and even went far beyond this in a certain facility he had in calculating the day on which any feast or commemoration would take place; so that to the students and boys he served as a kind of walking calendar. he had musical talents too, so well appreciated, that he was often called upon to entertain his juvenile acquaintances with a song, which he executed in tolerable style. in addition to all these recommendations, he was scrupulously clean in his person, changing his linen, it was said, three times a week; and his hands and feet, though always uncovered, appearing as having been carefully washed before he came out. it was stated at the time that almost all the naturals then recollected on the streets of the city had met with violent or untimely deaths. there was bobby auld, who may yet be remembered as being a great crony of jamie's. bobby was killed by the kick of an ass, and fell into the hands of dr monro. some others were mentioned. nothing was more curious than to witness a forgathering between these two. they talked about affairs in general with the greatest complacency, not hesitating to criticise each other's knowledge or perspicacity--even venturing the word _fool_ when the detected ignorance or error warranted the liberty. it is narrated that on one occasion bobby and jamie met accidentally in the neighbourhood of the grassmarket. "it's a cauld day, bobby." "ay is't, jamie. wudna we be the better o' a dram? hae ye ony siller, man? i hae tippence." "and i hae fourpence," says jamie. "ou, man," rejoins the other, "that'll get a haill mutchkin." and away they went to a neighbouring public-house, where the money having been first shewn as a necessary security, the whisky was demanded with great dignity, and placed before them but before either of them had tasted the liquor, "lord, man," said bobby, "did ye see the twa dougs fechtin' on the street? they're no dune yet; i hear their growling and their biting." "no," replied jamie, "i saw nae dougs fechtin'." "it's a grand sight, though," continued the other natural. "it has lasted half-an-hour, an's weel worth seeing. i wud advise ye to gang to the door and see it, for ye'll maybe never see the like again, in this world at least." then jamie proceeded unsuspiciously, for he had no guile or cunning about him, to see this wonderful dog-fight; but speedily returned with the information that he could see nothing of the kind. "they'll just be dune, then," coolly observed bobby. "but what's come o' the whisky?" said jamie, as he opened wide his eyes on the stoup standing empty. "ou, man," was the treacherous reply, "ye see i couldna wait." upon jamie's being questioned how he had revenged this foul play, his answer was in perfect character,--"ou, what could ye say to puir bobby? he's daft, ye ken." though much inferior to his crony in trickery--of which, indeed, he had none--jamie was much his superior in intellect and knowledge. his father is said to have been a decent religious man, who took him regularly to a place of worship in the old town on the sabbaths; and jamie, perhaps from habit, continued as regularly to keep up the practice. on one occasion, when examined by a worthy elder of the congregation, it was said that jamie not only shewed far more knowledge than could have been expected from him, but turned the tables upon his querist, putting considerably more than the old theological questions of the _enfants terribles_, which no one has been able to answer any more than our learned elder. and then, to crown all, there was the parting valediction, "if ye wud like ony mair information, mr ----, ye ken brawly whaur to fin' me." one morning in the month of september or early in october of the same year, jamie was, as usual, wandering about in the grassmarket, giving his bow and twitch of the lock to any superior person he met; for he well knew the differences of caste, considering himself far above the lowest, if not even up to the line which he drew between the giving and the withholding of the brass box and the spoon. kindly affected towards his mother,--to whose love in return he was indebted for the clean way in which he was kept, and many attentions, for which, by a wise providence, the natural comes in, as if for compensation, to the exclusion of his brothers and sisters,--jamie was looking for his parent. at this time he was observed by mrs hare,[ ] who, going up as she had often done before, asked him who he was looking for. "my mither," was the answer; "hae ye seen her ony gait?" "ay," said the woman, "she's in my house." and with this temptation she induced him to go with her. they were soon in the old den--log's lodgings--where hare himself was crouching for prey. behold jamie introduced to the court with the old honour--the fatal wink! there left with one who would take special care that he would not escape, the woman, as a provider of another kind--for she catered for life as well as death--went to mr rymer's shop to get some butter, and it chanced that burke was at the time standing beside the counter. she then asked her friend, who, as we have said, was now in other lodgings, for a dram, which was accordingly handed to her by mr rymer, and when she was drinking it off, she stamped with her foot upon burke's, as if to tell him that he was wanted. he knew instantly the meaning of the sign, having previously seen her leading jamie, to use his own words, as a dumb lamb to the slaughter. the moment she departed, he followed; and when he entered, he was accosted by mrs hare with the words, "you have come too late; the whisky is all done." at this time, jamie was sitting in the front room, with the cup (used for a glass) in his hand, smiling and talking, and every now and then looking round for the entry of his mother. hare was alongside of him, and burke took a seat opposite. it was proposed to send for another half-mutchkin, and this having been procured, they invited jamie to the fatal back room with the window looking out on the dead wall. on getting him into the apartment, they advised him to sit down on the front of the bed, to which he assented; and hare's wife, after getting some of the spirits, went out, and locked the door quietly, and put the key in through an opening below it, supposed to have been made for the purpose. now was the time to tempt jamie with the whisky; but to their utter disappointment, they found that he would drink no more than he had done, and that scarcely amounted to a glass. it was his mother he wanted, and for her he repeatedly called, in those accents of yearning which, though coming from a youth, had, in perfect consistency with his nature, all the pathos of infantine simplicity. alas! there was no mother there. even the woman, who might have understood the yearning,--for she was herself a mother,--had locked him in with demons. the two men were driven out of their reckoning by jamie's refusal to drink, and were necessitated to manoeuvre; but in any view, they had a young and strong individual to deal with, and they knew, from prior experience, that unless aided by the effects of drink, they must lay their account with a desperate resistance. no effort was left untried to get jamie to take more whisky, but still with the unsuccessful result. as yet kindly to him, he did not suspect them; and, at length, so far overcome even by the small quantity of spirits he had drunk, he lay down on the bed and fell asleep. but this state, which even in the most wicked has the appearance of innocence, was to be no guard against those to whom the old proverb so well applied,--"_somnus absit ab oculis_." yes, they required to be awake, for they had _work_ to do. they must kill a young, full-blooded youth, without the use of a lethal weapon, and without leaving a mark. they must wrestle to do this against the piteous appeals of innocence from one god-stricken, and who had never injured human being. they must do it with the ferocity of the striped lord of the jungle; they must do it without the help or the excuse of revenge; they must do it with the ingenuity of an artist. burke, who was up to the pitch of mammon's inspiration, and all the more that he had been fretted by being so far foiled by an idiot, sat watching his opportunity. the two were silent, only occasionally looking at each other, and then at jamie, as he lay still sleeping on the bed. at length burke said, "shall we do it now?" to which hare replied, "he is too strong for you yet." burke accordingly waited a little, as probably misgivings crossed him that the conflict would be too furious to risk, and the noise might attract attention at that hour. jamie got some more moments to live. but this could not continue long; nor did it. burke, become hot with impatience, suddenly threw himself upon the still sleeping simpleton, and, clutching him by the neck, attempted to strangle him. the onset roused the instinctive energies of the lad, who had sense enough to see his danger. the fear which in other circumstances would have made him run to avoid his enemies, seemed to pass into courage, and nerve him to sudden desperation. he clutched his assaulter with great force--his eye darted forth his fury--the mantling foam stood upon his lips like a lather--and throwing off the tiger with a bound, he sprang to the floor, stood erect, and awaited another onset. nor did he wait long. burke, in his turn, roused by opposition to the height of his wrath, again seized him, with the intention to throw him; but jamie had the greater strength, and, besides, he fought for his life, so that he was again likely to become the master, when burke cried out to hare, who had hitherto kept back, as if afraid to enter into the struggle, to come forward and assist him, otherwise "i will stick a knife in you." the threat had its effect, for hare, rushing forward at the very moment when jamie was mastering his enemy, tripped up his heels, and laid him on his back on the floor. not a moment was now to be lost, as the continued thumping and knocking against the furniture and the screams of the lad might reach the close, and they must do their work, as we have said, without a knife, (which would have quickly brought matters to a termination,) otherwise no price at surgeon's square. the next moment saw burke extended upon the body of the still struggling simpleton, while hare, at his head, was engaged in the old process of holding the nose and mouth. even after this, it was still a struggle of considerable duration. the men were sweating and breathing loud with their mere efforts to kill, and burke, roused to fury, was often thrown off, only to spring again with greater ferocity. by and by, jamie's struggles got weaker and weaker--relapses into stillness--wild upraisings again--spasmodic jerks of effort--those indescribable sounds which the doctors say attend cynanche--all receding gradually to the last sign. nor did they quit their grasp till they were pretty sure they had effected their purpose. they hung over him--listened for breathings--made surety surer. daft jamie is dead! this was beyond all question the most imprudent of all the acts of these terrible beings. without supposing them mad, it is hardly possible to imagine that they could place before young men of the college, who were in the daily habit of conversing with their victim, a body which could scarcely fail to be recognised upon the instant. yet on that very day it was put into a chest and conveyed to the rooms, where, _after examination_, it brought the price of £ . burke, when he rose up after being satisfied that jamie was dead, rifled his pockets, and took out the small box and the spoon, giving the spoon to hare, and keeping the box to himself. the clothes he gave to his brothers children, who, when the bundle was unbound, fell to fighting about them; connected with which part of an atrocity which the paper will scarcely bear the impression of, is the curious fact that a baker some time after recognised upon one of constantine burke's sons a pair of trousers he had not long before given to jamie. but here, again, though the mother of the lad, distracted by his sudden disappearance, ran about searching and inquiring everywhere for her poor boy, and though it was circulated that one of dr knox's students had affirmed that he saw jamie on the dissecting-table, no suspicion of the manner in which he had been disposed of was ever hinted, till the final discovery, which arose out of another case. yet it is certain that even before this event there had begun to move an under-current of uneasiness in the public mind, and even some dark hints appeared in the public prints; not that any of these pointed to anything of a defined character, but that they gradually gave rise to a suspicion that there was some great secret to be unfolded--what, no one could tell, no one even surmise--which would startle the public ear, and lay open some terrible conspiracy. theories flew about in various guises, all as dark as they were ridiculous. some said that there existed somewhere in the city a secret association of men, bound together by a fearful oath to avenge fancied wrongs by a crusade against society, and that the members prowled about at night for their victims, which they immolated amidst oaths and curses. others, still more wild, whispered that the missing individuals were slaughtered and eaten by a gang of famished wretches, who having once tasted human flesh, got keen upon the zest. sawney bean and christie of the cleik rose up again, and became what they had been in olden times, the bugbears of grown children. and, however ridiculous all these fancies might appear after the disclosure of the true secret, it cannot be denied that even sensible people, who looked sharply into human nature, and were not utterly sceptical of the old legends, might, without the charge of being fanciful, be led into thoughts which they would otherwise have been ashamed of. the fact that so many individuals, old and young, had disappeared within so short a time, without a trace being left, and in many cases with their clothes lying unclaimed, remained to be accounted for, and there was no experience to guide, and no theory of human nature to explain. after all, was it possible that any supposition could transcend, yea, come up to the reality? the brisk little old woman. it has been stated that burke went to live in the house occupied by the man called broggan. this house, after broggan's departure, continued to be possessed by the lodger and his paramour. in a land to the eastward of that occupied by hare in tanner's close, you reached it after descending a common stair, and turning to the right, where a dark passage conducted to several rooms, at the end, and at right angles with which passage, there was a trance leading solely to burke's room, and which could be closed by a door, so as to make it altogether secluded from the main entry. the room was a very small place, more like a cellar than the dwelling of a human being. a crazy chair stood by the fireplace; old shoes and implements for shoemaking lay scattered on the floor; a cupboard against the wall held a few plates and bowls; and two beds, coarse wooden frames without posts or curtains, were filled with old straw and rags; so that of the money which the parties had received no part had ever been devoted to any other purpose than meat and drink, after allowing for the expense of the transitory effort on the part of the women to appear better dressed. on the morning of a certain day of december, burke chances again to be in the shop of mr rymer, where he saw a poor beggar woman asking for alms, whose brogue revealed that she was one of his country-women. the old story, you will say. yes, alas! the old story, but with a difference. she would be garrulous--are not all poor people so?--yet the good heart admits that there is some cause for garrulity where there are wants to supply and no one willing to lend an ear. she would tell burke, who had accosted her with the old accents of sympathy, that she had come over to scotland to seek for her son. so straightway the sympathiser's name becomes docherty, and he would be glad to shew kindness to his country-woman, whom he accordingly invited to his house. the proposal was accepted on the instant, and, burke leading the way, they proceeded to this asylum, which had so miraculously come in the way of one who had no place she could call a home upon earth. on their arrival, the old play begins. burke sets before her a breakfast, and, having left helen m'dougal to attend to her wants, he went straightway to find his associate, whom he informed that he had got "a shot in the house," a piece of information always welcome to that fearful man. meanwhile helen m'dougal performed her part. at the very first appearance of the poor stranger she knew the fate that awaited her, and yet she set her to work in the cleaning of the house--a duty which the woman would cheerfully undertake out of pure gratitude to those who had thus generously taken in the weary wanderer and filled her empty stomach, yea, promised her harbourage for a time. hours passed, during which, in the absence of burke, who would appear in due time, the two females were feminine, for they were engaged in acts which, as the natural work of their instincts, constitute so far the difference between the sexes; nor was the friendship which these acts were calculated to cement and strengthen to be weakened, in the estimation of the guest, by the arrival, in the evening, of burke and hare, and the latter's wife--a jolly crew, who could render compatible, again as so often before, the orgies of a wild mirth with the foreseen doom of the one round whom these orgies were celebrated. when these parties entered, there were in the house a person of the name of gray and his wife, who had been for some time lodgers with burke. it was necessary that these persons, who could not be trusted, should not sleep there that night, and burke accordingly went out to seek lodgings for them, whereupon, at a certain hour, they departed, taking with them some suspicion that their banishment from their quarters did not quadrate with the excuse that a wandering beggar, albeit represented as a relative, should take their place, if they had not some other grounds, derived from particular observations, to lead them to a thought which was destined to be the original spark to raise into conflagration a long collected mass of rottenness. on the departure of the grays, the saturnalia preceding the sacrifice commenced, and the scene was too fraught with enjoyment for the females, always ready for scenes of excitement, to be absent. the inevitable whisky was brought, and the poor stranger, to whom it would be as warmth to a heart cold enough from poverty and privations, must partake. and now there was to be one of those apparent inconsistencies which the one string of catgut exhibits in every day of our lives. if the joyous scene was to finish by the death of her around whom, and for whom, it was celebrated, surely the more remote it was kept from observing eyes the safer; so says prudence, but prudence forgets that she belongs exclusively to the natural and the rational, and like all reasoners who argue from _egoism_ to _tuism_, she expects abnormals to follow her maxims, which appear to them to be as abnorm as they are to her. so while their spirits are up, as well from the stimulant of drink as from that of the coming sacrifice, they go, whither the destined victim had preceded them, into the neighbouring apartment, occupied by a mrs connoway. there the scene was continued, or rather begun afresh. more drink was brought by m'dougal, and the enjoyment was elevated into the altitudes of dithyrambism. songs were sung, accompanied by a chorus of hoarse, broken voices, among which the _tremula_ of the "brisk" little old woman mixed its quavers, till at length they all rose and danced. this scene continued for a considerable time, when they left. it was now eleven o'clock, and they were all again in their old quarters. we have already seen that it formed a part of their plan of assault that some of the parties should quarrel and fight--the confusion thus produced being the opportunity of the assault. and the scheme was not departed from on this occasion. in the heat of the pretended _mêlée_ the little old woman, who had interfered on behalf of burke, because he had been "kind to her," was cast down by force, for she had not drunk so much as they wanted her to do, and by keeping her senses had driven them to the necessity of the fighting prelude. this was the sign. the women, in the knowledge of the approaching struggle, hurry out of the room. at the very moment, burke throws himself, with all the desperation of his purpose, on the body of the prostrate woman, clutching her by the throat, while his companion, bounding to his help, joins his energies in the old way, so that by the combination of powers utterly beyond resistance, she was held for full fifteen minutes, until, amidst the silence of deep hush and listening, they thought her dead. not yet. they were deceived: there was more life than they counted upon in the little old woman, and the signs of reaction, as nature vindicated her guardship of the spirit, challenged a further effort. the weight and compression were renewed, and continued till there could be no doubt. the little old woman was dead, and in an instant after doubled up and thrown among a parcel of straw there for the purpose, in a corner of the room, between the foot of the bed and the wall. when they were satisfied that the act had been accomplished, the women returned from the dark passage; whereupon burke--it was now about twelve--went to the residence of dr knox's curator of the rooms, who lived near by, and bringing him along with him, pointed to the straw, and said, "there is a subject for you, which will be ready in the morning." after the departure of the curator, the party sat down to begin again their debauch, in the course of which they were joined by a young man called broggan, when the revelry being continued, was carried on till four or five in the morning, at which time the two women lay down in bed, with broggan alongside of them. next morning, and after hare and his wife had left for their own house, mr gray and his wife, who had slept there during the night, returned to burke's, in consequence of an invitation given them by him to come to breakfast. on entering the house, they looked for the little old woman, and were surprised that she was not to be seen. thereafter mrs gray having, during a search for her child's stockings, approached the bundle of straw, was met by burke coming forward and intercepting her, by crying, "keep out there!" with a _nod_. broggan was then requested by burke to sit on a chair so situated as to guard the straw, and prevent an approach; but during the day he deserted his post, and mrs gray, still more satisfied that there was something to be discovered, took the earliest opportunity of a search. the dissipation had driven all the actors right and left, so that at length the coast was clear. assisted by her husband, she began to remove the straw, and the first thing she touched was the arm of the dead woman. they then examined the body, which was entirely naked, and discovered that the mouth and a part of the face were covered with blood. they had seen enough, and thought it high time to get out of that house--a purpose they were in the course of executing when they met helen m'dougal on the stair. gray immediately told her he had seen the dead body, whereupon she got alarmed, implored him to hold his tongue, and said that if he did it would be worth ten pounds a week to him; but the man was honest, and replied, "god forbid that i should have that on my conscience!"[ ] now, at last, the great secret had got into a mind true to god and nature; and here you have to mark, with gratitude to him who takes his own time to bring evil to light and crime to retribution, the beginning of the end of all these terrible evils. the discovery. the records of human actions, though so often blotted by stains of blood shed by the power of money, have, as we have observed, seldom shewn more than some one individual act of violence. we exclude, of course, those which set forth the actions of regularly-organised banditti; and even there the robberies with mere violence form the general theme,--the cases of killing being the exception. here again we see the agent not only working its wonders in the four actors, but extending its influence all around in closing up the issues of discovery. the bribe offered by helen m'dougal to gray, gives us a further insight into this collateral part of the conspiracy; and while we have the young man broggan clearly enough brought in as an additional confidant, we cannot avoid the conclusion that he too had been got over by the all-powerful agent. nor can we account for the conduct of one more, who came into the scene at a still later period, by anything short of this paid "winking toleration." in the evening, after gray and his wife left the house, the body of the little old woman, which had been seen by them, was despatched to surgeon's square in a manner somewhat different from that of the others. indeed, during the whole of this day, all the actors appear to have been deranged, hurrying hither and thither without definite aim, as if under the influence of a demon. the invitation to breakfast given to the grays; the nod of burke when he scared mrs gray from the straw; the imprudent watch committed to broggan, and, above all, the leaving of the house with the body lying in the corner, and the grays there, so evidently upon the alert, can only be accounted for on the supposition of frenzy. the new element of the discovery made by the grays, with the threatened communication to the authorities made by the husband, was calculated to aggravate that restlessness, so much better expressed by the german word _verwirrung_. the nest was fluttered: all went to and fro, but whether it was that the main chance could not, even by all this confusion and fear, be driven from their minds, or that they saw the pressing necessity of getting the body quickly out of the house, burke hastened and engaged a porter of the name of m'culloch to convey the tea-chest, already procured, with its burden, to surgeon's square. when the man came in the evening, the body was not even put into the chest, and so confused and irresolute were the two principals, that m'culloch was obliged to help the packing. he saw and handled the body,--forced it down with much pressure, and, even when he was on the point of getting it upon his shoulders, he noticed an oversight to which the others were blind. a part of the hair stuck out, and so, with great caution, this careful cadie took the trouble to put all to rights. meanwhile, the other harpies, under the prevailing restlessness and flutter, were on the watch. m'culloch, with the burden, sallied forth by the cowgate to find his way to the top of the high school wynd, where he was to be met by burke. when half way up that passage, he was joined by burke and helen m'dougal, and before he got to the square, hare and his wife were there, so that all the four were thus, and on this occasion of delivery only, drawn together by the double motive of clutching the money, and the apprehensions enveloped in the long-reaching shadow of frowning justice. nor did they stop there. when the burden had been deposited, and m'culloch requested to go to newington, where dr knox resided, to get his five shilling fee for his winking toleration, they all set off together, and, though there was some straggling and separating, the women never lost sight of the men. arrived at newington, dr knox's curator took the principals, along with m'culloch, into a public-house, the women hanging about outside on the watch, and a part of the price, to the extent of £ , s. having been paid and divided, the whole party returned to the city. while all this was going on, the man gray, having been finally moved to his purpose of informing the authorities of what he had witnessed, and having also seen the removal, had repaired to the police-office, where, after waiting some time, he saw the officer, john fisher. to him he detailed what he and his wife had witnessed.[ ] the bringing in of the "brisk" little old woman--her good health--the manoeuvre to get him and his wife to sleep at hare's--so much of the orgie with its dancing and singing as he knew--the disappearance of the stranger in the morning--the discovery of the body under the straw--the blood upon the mouth--the bribe of £ a-week--the removal of the body. whereupon fisher, after despatching his informant before him, repaired to the premises, but he went with no other thought in his mind than that gray was influenced by spite;--so near again was the conspiracy to an escape from detection. nor did even what fisher found and heard tend to awaken him. on getting to the house, he met burke and m'dougal, with gray and another man called finlay, coming up the stair, and having told burke that he wanted to speak to them, they all returned to the room. fisher then began his interrogations. "where are all your lodgers?" he said, directing himself to burke. "there is one," replied he, pointing to gray. "i turned him and his wife out for bad conduct." "but what has become of the little woman who was here yesterday?" he continued. "she's away." "when did she leave?" "about seven o'clock in the _morning_, and hare will swear he saw her go." "any more to swear that?" "oh, a number!" replied burke, insolently. whereupon fisher began to look about the house, and especially the bed, where he saw many marks of blood. "how came these there?" he inquired at helen m'dougal. "oh," replied she, confidently, "a woman lay-in there about a fortnight ago, and the bed has not been washed since; and as for the little old woman, she can be found. she lives in the pleasance, and i saw her to-night in the vennel." "and when did she leave this?" he rejoined. "about seven o'clock _at night_," replied the incautious helen. upon this small discrepancy depended the further prosecution of the inquiry, and, consequently, either the present discovery of the conspiracy, or the continuation of it, with, probably, if possible, increased atrocity, for fisher was satisfied as to the blood as well as to gray's spite, and, according to his own assertion, came to the resolution of taking burke and m'dougal to the office, _only_ on the mere chance ground of their difference about a time of the day. on arriving before the superintendent, fisher mentioned what he had seen, and also what he thought; but the superior, quickened by the mention of the blood, which so far, hypothetically, at least, harmonised with gray's story, took another view. yet how far was he from suspecting that he had in his very hands the key to that chamber of horrors, the untraceable existence of which had for a time produced so much deep-breathing oppression in the public mind! he immediately paid a visit to the house, along with the police surgeon, mr black, and fisher himself. there they found a stripped bed-gown, which mrs law, who came in, stated belonged to the little old woman, and in addition to what fisher had seen, a quantity of fresh blood, mixed with _fifteen or sixteen ounces of saliva_, among the straw now under the bed, but which, as we have seen, lay formerly between the end of the bed and the wall. on the following morning, the same three parties proceeded to dr knox's rooms in surgeon's square, and having got the curator formerly mentioned, who felt no hesitation in assisting their inquiries, they were led by him to the cellar. "there is the box," said he, "but i do not know what is in it." on opening it they found the body of a woman quite naked, and gray having then been sent for, came and identified it as that of the little old woman. thereupon the body and box were conveyed to the police-office; and on the day following an examination was conducted by dr christison and dr newbigging, assisted by mr black, which, according to the conjectures of the first, who as yet knew nothing of the real manner of death, harmonised wonderfully with the _res gesta_. there were several contusions on the legs, probably caused by the heavy shoes of the assailants--another on the left loin--another on the shoulder-blade--one on the inside of the lip, the consequence of pressure against the teeth, and two upon the head, probably from being knocked against the floor in restraint of efforts to rise. above all, as an index to the _modus_, there was a ruffling of the scarf skin under the chin, and as a proof of the _force_, a laceration of the ligaments connecting the posterior parts of two of the vertebræ, whereby blood had effused among the spinal muscles as far down as the middle of the back. there was also blood oozing from the mouth and nose. the body appeared to be that of a healthy person, all the organs of the vital parts being unusually sound. from all which, dr christison, and also the two other doctors, drew the conclusion, that the woman had met with a violent death by means of throttling--a form indicated by the ruffling of the skin below the chin as more likely than that of smothering or suffocation. nor was this conclusion liable to be affected by the fact stated by mr black, that many of the intemperate people of the city, and so many that he had seen six cases in the police-office at one time, were often on the eve of death, nay, altogether deprived of life, through accidental suffocation from drink, produced by chance obstruction of the mouth, or lying with the face on a pillow. all this information having been obtained, the authorities were at length roused, and the lord advocate, it is said, saw at once that he was on the eve of a great discovery, which would explain the recent disappearances. all secrecy was imposed upon officials, yet in spite of the precaution, parts of the story got currency among the people, and, offering a solution as they did of the prevailing mystery, deepened the awe, while they stimulated the curiosity not of the city only, but the kingdom. hare and his wife were laid hold of, and inquiries in every direction set on foot and prosecuted. recourse was had to the culprits, in the hope that some one or more of them would confess, but at first there was no success in this direction, each of them maintaining that they knew nothing of the death of the woman, or the fate of any of the prior victims. on the d and th of november, burke and helen m'dougal, finding that one fact could not be denied, that a dead body was found in their house, issued declarations whereby a story was trumped up to the effect that it was brought there by a stranger, who called one day to get some work performed by the former; but these were disregarded as inconsistent and ridiculous, and the authorities were left to their scent. the evidence of the grays was of great importance, and other people were found who could speak to isolated facts. hugh alston could swear that at half-past eleven on the night of the st of october, when he was going to his house, in the same land where burke resided, he heard a noise coming from the latter's room--men quarrelling and fighting--(the feint preceding the onslaught)--and amidst the uproar the peculiar voice of a female crying murder, then after some minutes the uproar diminished, and he heard a cry as if proceeding from a person or animal that had been in the act of being strangled. this circumstance recurred to him, and struck him forcibly next evening, when he heard that a body had been found in that house. additional information was got from mrs connoway, who occupied a room on the right hand of the main passage leading to that other which terminated in burke's apartment. she remembered that, on hallowe'en night, burke brought in with him a little old woman; that, on subsequently going into his house, she saw her there sitting by the fire supping porridge and milk, and upon her saying, "you have got a stranger," m'dougal replied, "yes, a highland woman, a friend of burke's." in the darkening, the woman came into her house, and she was surprised to hear her calling burke by the name of docherty, wherein she corrected her. by and by, hare and the two women followed, one of the latter having a bottle of whisky, part of which the stranger partook of along with the rest. thereafter they got merry, when they all rose and danced, the little old woman among the rest. when the others left, the woman remained till such time as burke, who was out, should return to his own house, because she trusted to him for protection. during the night she was disturbed by a terrible noise as of a fight; and in the morning, about nine or ten, having gone ben, she found collected mrs law, young, broggan, m'dougal, and burke, the last drinking whisky, and sprinkling it over the bed and the straw, and m'dougal singing a song. on inquiring where the little old woman was, she was told by helen that she had kicked her out, because she was "ower freendly" with her husband. towards six she was called upon by mrs gray, who having previously told her of the dead body, asked her to go in and see it, but when she complied, she got so frightened that she turned and ran out. further on, her husband told burke that it was reported that he had murdered the woman; on hearing which he laughed very loud, as well as m'dougal, who was present, and then said, he "did not regard what all scotland said of him." nor did he seem to be in the smallest degree afraid. this information afforded by mrs connoway was corroborated to a certain extent by mrs law, who occupied a room in the main passage opposite to that of the former; and broggan was willing to go so far as to admit certain things, among the rest, the charge of sitting on the chair opposite to the straw. withal though this evidence could leave no doubt on the mind that murder had been committed, it did not amount to proof against any particular person. all that pertained to the disposal of the body at surgeon's square was frankly told by the curator; but, with this exception, there was much to complain of as regards the doctors. knox and his assistants, all of whom shewed from the beginning a marked, if not determined, refusal to help the authorities in the furtherance of justice. but if all the testimony that could be procured in support of the charge in this case was insufficient, the deficiency was still greater in regard to those of mary paterson and daft jamie, for unfortunately no one, with the exception of the accomplices and the gentlemen in surgeon's square, had seen their dead bodies, or could even say they were dead, so that the _corpus delicti_ was literally little better than a myth. the authorities were therefore placed in a very trying position. the people cried for vengeance; and the lord advocate could only respond, "the decrees of the blind goddess are not gropings in the dark;" and he moreover, said, that an ineffectual trial, followed by an acquittal, would not only be injurious to the interests of justice, damaging to the prestige of official dexterity, but dangerous to the country, in the humour in which the inhabitants of edinburgh felt themselves. that humour had often shewn itself before. the example of the porteous mob was not only a lesson, but, as regards the crimes, a derision; and it was just as certain as the death of the brisk little old woman, that the big old edinburgh would take the blind lady into their own hands, and if she would not _see_ that it was right that these four persons should be hanged, whether on a barber's pole or not--they would extract her cataract or cure her _amaurosis_ for the purpose, and then immolate the criminals at her altar. from this anxiety with which the lord advocate was oppressed, there was an impending relief. the diligent officials, all straining for the satisfaction of the people, the vindication of justice, and the comfort of their superior, were continually attempting the prisoners, and at length it was discovered that the crafty, cruel, and cowardly hare, and also his wife, were beginning to shew signs of inclination to buy their lives at the expense of those of their perhaps less guilty associates. the leer of the "fearful man," when the proposition was made to him, was a repetition of the old satisfaction when a "shot was in the house," and it is not unlikely that he chuckled at the rising thought of sending him to the college for the benefit of science and the good of his fellow-creatures; nor was the indication either unnatural to him or fallacious to the public. in a short time he declared himself, but on the condition of a firm bargain. the "shot" must be paid for by the price of immunity to his person and that of his wife. when this information reached the law officers of the crown, they hailed it with that amount of satisfaction which might be felt when a man procures by chemical agents from pollution the means of reproducing health. it could be doubted by no one that the evidence of such a _socius criminis_ as hare, or _socia criminis_ as the amiable mary, would be worth less than the value of an old song, insomuch that while the old song _might_ be true, the words of hare, in a transaction where he himself was concerned, could _not possibly_ be true. he would represent, and the people knew it, the janus head with one face looking simpering peace to himself, and the other bloody war to his friend. nor was this foreknowledge of the man, founded as it was upon such an array of actions, belied by the result. the precognition was, from beginning to end, a long train of lies, wherein he represented himself as a good, easy soul--his wife as well--who allowed burke to have his own way, neither advising him nor assisting him, only not obstructing; and even where he could not avoid some confession of participation, attributing his weakness to the easiness of his nature. how innocently he took a little liquor so as to make him, not drunk, but merely put him in a sort of "drunkish way!" how benignantly he sat on the chair at the side of the bed when the ruffian burke was fighting like a tiger to squeeze the life out of the little old woman! as for the money, he merely accepted it--never earned it; and who refuses money? so glaring was the falsehood of the man's statement, and not less that of his wife, that the lord advocate was by no means sure of a verdict. _socii criminis_ have shades of character, but they are only to be believed when they shew penitence, and strike with vigour their own persons; but hare only held on and kicked out; and a jury true to their consciences might, after all, become disgusted, and find a verdict of "not proven." the complicity of the doctors. if the world is rife in unknown crimes, it is still more rich in winking toleration, insomuch as there is generally several winkers to one actor, and the former are of various kinds, while the latter is limited in his passion. some are cowardly accorders, who favour the crime which they have not courage to commit; others are selfish, and expect benefit from their convenient nictation; and some there are who would be injured by the virtue of others having its own reward. so it is that the world, notwithstanding grave faces and simpering moralities, contains within its circumference only a trifle fewer rogues than inhabitants, the residue being god's own--stern beings who have fought the devil at his own weapons and conquered. these have a certain price in another place, where the golden streets are happily not liable to be coined; but here they are of small account, where money is the measure of a man's worth. we have already seen that even such men as burke and hare had their sympathisers and secret-keepers; but these were low, and therefore liable to be tempted; and it may be said that we have different men to judge when we go to the halls of science and seek for the winking tolerators of wholesale murder. so far we admit, and we would be sorry indeed to do these men and youths injustice. we know that great authorities, such as _blackwood_, and smaller ones, such as colonel cloud, accused them of art-and-partship as resetters, and that the public at large did not hesitate even to vociferate anathemas before a regular trial--with the devil's advocate to plead for them--qualified them for excommunication by book, bell, and candle. all this goes for nothing with us at a time when it was said the fire of passion would be allayed, and sober reason exert her authority.[ ] it is fair, and even necessary, to assume as a fact, which, indeed, we have seen established by the practice of "merry-andrew" and the "spune," that the disinterring craft were in the habit of purchasing dead bodies from poor lodging-keepers or relatives, in all which cases the bodies would be very different in appearance from those procured in the ordinary way. we suspect, from the nature of the scotch character, with its sympathies and friendships, that those examples were not at any time many; and the best evidence of this is, that under such an easy system, the resurrection trade, always difficult and precarious, would not, especially after the indictment of dr pattison of glasgow in , have been so assiduously prosecuted. such a system, too, depending upon the character of a people and the feelings of individuals, must be supposed to have been under the regulation of those natural, or, if you like, unnatural, laws to which all organic beings are subjected. if, during a period of a decade, examples of such purchase and sale were only one or two in a year, even increasing _paulatim et gradatim_ to three or four, we would not be prepared for a sudden increase starting up all at once in one year to from sixteen to twenty; and there were many people who calculated the number in our "court of cacus" at thirty. we may insist here a little upon this view, because, amidst all the outcry against knox and his assistants, it was never taken into account. nor could this sudden rise have appeared the less startling to any mind below that of an idiot, that this new trade was not spread over a great number of persons--and nothing less than a _very_ great number could have sufficed for watching, ferreting, persuading, bribing--overcoming all the prejudices arrayed against an act of sale--but was altogether engrossed by two poor squalid irishmen, who had come into the trade by a leap, and all but superseded the old experienced hands. if we were to make the supposition, that now, or at any other period in the history of scotland, two irishmen had taken it into their heads to set up a trade of this kind in the city of edinburgh, we would soon come to an estimate of their success, if the doubt would not rather be, that if they got one body in the course of a whole year, it would be no less a wonder than a shame. nor was there any reasons which might have led the recipients in the square to suspect that these two solitary individuals were merely the agents or hands of a "dead-body company," or a joint-stock affair, with one of the crack names, "association for the purpose of purchasing dead bodies, for the benefit of science and the human race," a supposition which alone could have reconciled men with eyes in their heads, and brains in those heads, to the anomaly before them. but above all, that which had so much the appearance of justifying the public rage, was the state in which the contents of these bags, boxes, and chests were presented to the purchasers. one example may serve for the whole. there was no reason for supposing that more violence was expended upon mrs docherty than upon the others, if we are not rather to suppose that the younger and stronger cases required more vigour, as presenting more resistance. even in the weakest cases, the _præsidia vitæ_ upon which nature has expended so much labour are not to be overcome by external force weakly exerted, and without leaving marks easily detected, even by the unlettered in anatomy; but we have only to mention the case of daft jamie, who fought manfully to the end, as an example of the necessity of leaving upon the body even greater signs of violence than those presented to the eyes of dr christison. taking the little old woman as a fair medium between the young and the old, the weak and the strong--you may remember the examination report: contusions and bruises everywhere, extravasation of blood, blotches of the same crying evidence, and finally the lydian test of the abraded skin of the throat,--while less or more of these marks must have appeared in every one of the sixteen known cases, we cannot even suppose a solitary example of one where they could have been altogether wanting; and this led many to wonder at the time how the men preferred violence, with so many chances of detection, to the soffana death-drops of some subtle poison, the effects of which were far less likely to be discovered by mere anatomists, curious about structure only, and so far removed from the duty of a _post-mortem_ examination. with no pathological views in their minds, they never would have dreamt of smelling for prussic acid, or searching for the ravages of green vitriol or arsenic, any more than they thought of drawing up their noses under the effluvia of whisky--an evidence which was never absent, and could not be mistaken, and must have led to the curious conclusion that all the bodies sold by friends were those of drunkards, and drunkards alone. these contusions, and the invariable thumb-mark on the throat, were, according to the gentle supposition, to be overlooked by men all on the alert to see the cloth taken off--curious investigators into the arcana of nature--most zealous inquirers into the structure of the human body--among whom anything abnormal, or departing from ordinary laws or appearances, produced a speculation, fraught not only with the ardour of science, but the contentious conceit of young aspirants. nay, these sharp professional eyes were not the first examiners, for they came after the decision of the mercantile, which scanned the value to fix the price. we are aware that there never was an enunciation, not excepting the famous _what is is_, without the condition of being liable to argumentation, and we are far from wishing to deprive these men of their defence; but that they should have treated as they did the imputation cast upon them, of, we do not say winking toleration, but something like pretty wide-awake suspicion, as an argive calumny, pointed with venom and shot by passion, was going to the other extreme. offended innocence is not always the meek thing represented by poets, yet it seldom takes on the form of a man at a window[ ] threatening to shoot the officials of the law if they dared to question for the ends of justice so innocuous and ill-used a victim of public prejudice. in all we have said we have assumed that these suspicions were to cast up their shadows in the magic-lantern of minds, quite free from any recollections or surmises of any body having ever been offered, in the square or neighbourhood, which could be said to have come to a violent death. the assumption which was set forth at the time was not true, for it turned out to have been pretty well known--and what professional scandal is unknown to students?--that some six months only before, and when the irishmen were in full feather, the body of a female was offered for sale by some ill-looking men--we do not say, as was said, of burke's gang--to the assistant of another teacher of anatomy in the city. the men were not known to him as regular "spunes," but as a subject was required, he consented to accept of it, after being satisfied that it suited him. they said that they had it now, and would bring it to the rooms in the evening, between nine and ten o'clock, and at the appointed hour they made their appearance, with a porter bearing the sack. the burden was taken in and turned out of the bag, when it proved to be the body of a woman of the town, in her clothes, with her shoes and stockings on. the startled assistant proceeded at once to an examination, when he found a fracture on the back part of the head, as by a blow from a blunt instrument. "you d----d villains," cried this honest doctor, "where and how did you get this body?" whereto one, with much self-possession, replied, "it is the body of a w----e, who has been _popt_ in a row in halkerston's wynd; and if you don't take it, another will." the assistant then proposed, with the intention of having them apprehended, that they should wait till he sent for his principal; but the men, taking alarm, made off with their cargo, and soon found a less scrupulous customer. this statement, which was given on authority, was accompanied by an assurance that equally suspicious cases were by no means rare. in addition to this preparation of the mind, as it may be called, to look suspiciously on introductions coming out of the regular way, with the admission made that they had not been exhumed, and with the inevitable traces of violence which could not be blinked, there was the peculiarity on which, perhaps, the greatest stress was laid, that in one of the cases, at least, there was a recognition of the individual by one of the students as having been seen and conversed with by him, in terms of more than ordinary intimacy, only the night before, or at least a very short period, countable by hours. we allude to mary paterson, "the study for the artist," who, though naked, was said to have made her appearance on the table _en papillote_--not to be believed--but who, for certain, attracted so much observation, yea, admiration, that the recognition by the youth could not have fallen as an idle brag. the case of daft jamie, the collegians' favourite of almost every day's fun, was so much stronger, that there seemed no mode of accounting for the pure innocence of surgeon's square, except upon the supposition that all the students had, in the course of a day, been merged in some lethe. no great wonder that the most zealous defenders of the craft were here contented with a simple shaking of the head, for, to be sure, even the devil's advocate has not an interminable tether. these charges are very practical, and even to us, at this distant period, who would be regulated by reason and truth, and cannot be under the influence of passion, are hard bones. independently of our estimate of youths--putting knox out of the question,--of good birth and parentage, whose generous hearts would revolt from the thought of a guilty cognisance,--some of these assistants who came in contact with burke, "and no questions asked," have risen to rank in their profession, and bear a high character for honesty and humanity. "they ken their ain ken;" but their negative defence leaves their friends to the slough of mere metaphysics. we all know that mysterious attractiveness and repulsiveness of the mind which makes such fools of even the most practical of mankind. the man would not look through galileo's telescope, because he knew beforehand that there was nothing to be seen; but he did no more than every man does every day he lives. we all know that we may look, and not see, hear, and not understand; yea, though the image of the outer thing may be in black and white on the back of the eye, and the words play their intellectual tune on the drum of the ear, you may neither see the one nor hear the other. the bird-lime of acceptance is not present, and there is even more--an absolute recusancy in proportion to some reigning wish in the form of what we call a prejudice. all this is alphabetic, and we might go deeper and get lost, but there is no occasion. the truth is, that these medical students had a strong wish for subjects. this rose out of another wish, that for knowledge, and this again came out of one behind, a wish to shine or make money,--the benefit to mankind being only that thing which we all understand when we hear people getting philanthropical in recommending their leather, as contributing to the good of the eternal sons of god. then the next truth is, that they _did_ suspect, and becoming the paradoxes which so many unconsciously become, did not _know_, in the sense of an apprehension, that they suspected. when the thought sought entrance to the mind, always under the cogency of the repulse of unwillingness, it was either thrown out or dissolved; to all which the authority of their leader or lecturer contributed, and not less the generosity of their own hearts, naturally seeking uniformity, and averse to think so ill of human nature, as was required to be implied in an atrocity never before heard of in the world. if the thought had ever come so strong upon them as to have amounted to an active conviction, why, then they must have glided into the crime of winking toleration, and to that, we verily believe, they never came. there were only three of these young men who took an active charge. if there had been a score, we might have conceded that one, perhaps two, might have been found among them capable, by the predisposition of an evil nature, to have quietly succumbed to the force of such startling appearances; but judging of the proportions according to what we find among men, we require a large number for the successful selection of the devil's own. in short, they were very much in the position of resetters, who, standing in great need of the article, take refuge from a suspicion which would injure them in the fallacious eloquence of the naturally selfish heart, and casting up behind them intervening obstructions to the light--a kind of weakness into which all mankind are less or more liable to fall, and against which they are ready to recoil when the passion of possession decays. it requires only superficial looking to bring us to the conclusion, that the world is a great collection of "wee pawns," every man resetting some thought or feeling, false in itself, and improperly come by, and wrongfully retained. the difference here lies in the fact, that we have not yet come to hold this a crime, nor are we likely to do so till regeneration comes wrapt up in the world-wide cloak of the millennium. in what we have said, we refer only to those who superintended the division of the bodies and the work of the rooms, and were those who came in contact with burke. as for the curator, who is still a respectable inhabitant of edinburgh, and upon whom the short-lived blind fury of some newspapers of the time fell, with much surprise to himself, and much indignation elsewhere, he was, of all the parties concerned, the most free from blame; nor did any one but himself come forward and assist the authorities in the prosecution. nay, it is understood that, under a passing reflection that the number of apparently unexhumed bodies brought by these men required explanation, he mentioned the circumstance to his principal, and that gentleman silenced him at once by the statement that they had long known of the practice of sale and purchase, and so the suspicion passed away. and, indeed, in reference to them all, it requires to be kept in view that dr knox's great characteristic was his desire to subjugate all people to his will; and every one knows the insidious power of authority. accordingly, in so far as regards that gentleman, left to the active fury of a mob which he braved, and to the suspicion of more thinking people whom he tried to conciliate, we have little to say. his whitewashing process, consisting of the printed judgment of his conduct by a committee of eminent men, went a considerable length in his favour, and yet did not save him from almost general suspicion. the evidence was all of his own selection; the world never knew what it consisted of; and though we are bound to admit that the umpires vindicated the privilege of searching and satisfying themselves, he behoved to be still their director, and, if he chose, their obstructor. perhaps those who knew the man the best, and those who knew him the worst, were the least satisfied,--the latter being under passion, and the former aware of a power of conciliation and persuasion under the guidance of a self-love and power of will not often to be met with, and all this professedly not regulated by any sense of religion or respect for public morals. in him we have seen already the one gut-string playing several airs, but without a touch of pity: the soft was not indeed his forte, his preference lying in the direction of those examples we have already given--the joke upon professor jameson, the poisoned satire upon liston, the egotism among the taymouth castle guests, the adulation of the marquis of breadalbane. nor can we forget, beyond all, the admitted perspicacity of one of the best anatomists of his time, which, if it had been called in question in an ordinary autopsy, with the most recondite appearances of poison or violence, would have been vindicated by a power and success, accompanied by a bitterness not often witnessed among scientific men. in his letter of th january , to the curator of his rooms, he said, "all such matters as these subside in a short time." "not so," added the editor of the _mercury_; "such matters cannot subside till such time as he (dr knox) clears himself to the public satisfaction." time, we fear, has shewn the falsehood of the one statement, and the hopelessness of the other. the same suspicion remained, yea, remains still, and we fear will go down through all time with the record of a story destined ever to be the greatest example of man's wickedness, when left to his idol, that has ever appeared. the trial. in november , a citation was served upon william burke and helen m'dougal to appear before the high court of justiciary to be held at edinburgh, the th day of december, at o'clock forenoon, to underlie the law in the crime of murder, on three separate indictments. the first comprehended the case of mary paterson, as having occurred in the preceding month of april in the house of constantine burke; the second--that of james wilson, or daft jamie--in october of the same year in log's house, situated in tanner's close; and the third--that of madgy, marjory, or mary m'gonegal or duffie, or campbell, or docherty--in november, in burke's house, portsburgh. the libel contained also a list of a great number of articles of dress worn by the victims, and identified, and, among others, mrs docherty's gown, and daft jamie's brass snuff-box and spoon. the presiding judge of the court at that time was the lord justice-clerk boyle; the other judges, lords pitmilly, meadowbank, and m'kenzie; and the prosecutor, sir william rae, lord advocate. the leading counsel for burke was the dean of faculty, that for m'dougal, henry cockburn, james tytler being the crown agent. the witnesses were fifty-five in number--the two principal, hare and his wife, received as king's evidence in the characters of _socii criminis_. the panels having taken their places at the bar in the midst of a crowded court, filled long before the opening of the doors by people who had the privilege of influence, and whose numbers were only as a trifle in comparison of the mass outside, mr patrick robertson, one of burke's junior counsel, made a technical objection to the reading of the indictment, which was overruled. a defence was then lodged for burke, and supported by the same counsel, on the ground that it was contrary to the law of scotland to combine in one libel so many charges and two separate panels. the argument, which was a long one, involving points of law and practice, was followed up by the dean of faculty, and answered by the lord advocate, with this result, that the judges, with the consent of the public prosecutor, agreed to limit the charge to the case of docherty, and thus limited, the proceedings went on. the various witnesses, forming, however, a very small portion of the whole fifty-five cited, appeared in succession to give their evidence. every word uttered by every one was caught by ears strung to the highest pitch of sensibility; and throughout the entire day, the deep silence, more like that of a death-chamber than a court, was as much the expression of curiosity as of awe--reminding one, too, of the stillness of an audience where the feelings are claimed by oppressed virtue with the encircling meshes in which innocence is to be involved by death getting closer and closer as the scenes succeed. the interest lay in the gradual development, while the heart was affected by all the different passions which, changing from pity for the victims to hatred of the murderers, were kept in continual agitation. over all, there was the oppressive awe inspired by the presence of the fearful men and women, as if they had been demons of monstrous forms and powers placed there under restraining bonds. at several times,--and especially when hare described the screigh of the little old woman which preceded that ten minutes' agony in which she lay under the pressure of burke--hare being all the while, according to his lie, sitting coolly looking on,--you might have heard deep sighs escaping from strong hearts, in spite of resolutions to restrain them. even then the grateful creature, who seemed to have trusted burke alone, and defended him in the preceding sham fight, was only "dead a wee," and the process was to be resumed. but even this effect was transcended, if possible, by the very manner in which the witness stated how the victim was presently stripped, and after being bound neck and heel, was cast, mangled and bloody, among the straw in the angle between the bed and the wall. the dominant idea seemed to bring into light all the surrounding objects--the table pushed aside, the old chairs, the squalid bed marked with the blood of prior victims, the women listening with expectation in the long dark passage, the two men panting after the struggle, and bringing forth on the top of their long-drawn breath ribald jokes, and even accomplishing a laugh,--all followed by the rush in of the women, and the resumption of the drink, the song, and the dance. to the greater part of those assembled in the court, all this was comparatively new, for great secrecy had been observed by the officials. yet the effect of the great scene did not diminish, or rather, it increased, the interest in the particulars,--the suspicions of the grays--the restlessness of the murderers under the impression of impending discovery--the lies about having turned the poor creature out because she was too intimate with burke--the start of mrs gray when she seized the arm of the body among the straw--the lifting up of the head by her husband, and the recognition of the features of the woman who had been dancing and singing so short a time before--then the pressing down into the tea-chest, and the sally forth of the whole gang to surgeon's square, from thence to newington for the price. and as in a tragedy we find collateral lights thrown in by the scintillations of genius to increase the effect of the stronger scenes, so here these were not wanting. how much the sympathy for the little old woman was increased by the love and gratitude she expressed for her benefactor, burke, when contrasted with the savage eyes that glared upon her as she lay under his death-grasp! another of these smaller traits going to the aid of the general effect, was the fact stated by the prior witnesses, that when she met burke, she was going about seeking for her son; and this yearning had only given place for a little to the new feeling of gratitude with which she strove to repay the sympathy of him who had from the first made up his mind to slay her. it was even whispered that that son was in the court listening to the fate of his mother; and, whether true or not, it did not fail of its contribution. nor was all this exclusive of that mingling of the grotesque with the serious which the playwright, following nature, resorts to for deepening his shadows. the face of hare, as he stood in the witness-box, seemed incapable of the expression of either seriousness or fear. the leer was irrepressive, even had there been a wish within to repress it--and there was none; and as for any effect from without, that seemed equally unfelt by him, if the gloom and awe which pervaded the court did not rather increase an inborn propensity to be humorous. he could not say seriously that the woman was dead, only that she was "dead a wee,"--nor that he was drunk, only "drunkish-ways;" and when asked if the word "shot" implied murder amongst the crew, he answered, as impeaching burke, "amongst him;" so that if you took his looks and words together, you could not, if you had read the accounts of the classic satyrs, avoid the impression that, like these creations of the poets, he was condemned to an eternal grin of self-satisfied sarcasm against the whole human race. nor, strange as it may seem, did he appear to consider this as incompatible with a wish to produce the impression that while he could mix in and receive the price of murders, he was only (as we have already said) an indolent and easy spectator--a kind of lover of the play, but not an actor. it appeared, indeed, evident that it required only an indication on the face of his questioner to prompt him to laugh, and this was probably all that was wanting to complete an exhibition which no one could ever forget. the appearance of his wife, who had a child in her arms, was scarcely less impressive, but not from any characteristic indicating the successful cunning displayed by the husband. she could scarcely contain herself. you saw the bloated virago always appearing from under a bunchy and soft mass, with small fiery eyes that peered about in every direction, as if she felt she had come there to favour the judges, who were bound accordingly to admire her. like most of the famous examples of her sex renowned for cruelty, it was clear she could be as mild as gentleness itself; and it was only when she came to the great scene when she saw burke lying on the body of his victim, and "flew out of the house" because of her delicacy, and stood in the passage "quite powerless," unable to "cry out," that you could come to form a true estimate of that combination of the devilish and the soft, which so much distinguishes the wicked of the one sex from those of the other. she admitted that she knew very well that burke was murdering the woman, because she had seen "such tricks before;" yet she had "no power to remove herself from the passage;" and whenever the counsel or judge wished to know whether the victim screamed or shewed any indication of violent suffering, her mouth would give out nothing but soft words, so afraid was she to see anything "come upon the woman," all the while that the fiery scintillations escaped from these small eyes. to the next question, she admitted that she went for the tea-chest, trying to save herself by the qualification that burke said it was to hold old shoes; and then, in a few minutes after, "she knew that the body was put into that box." nor was the audience less struck with the manner in which she used the infant as an instrument to produce pity, and a mean of fence against searching questions. the poor creature was under the influence of hooping-cough, and as the long choking inspirations came every now and then ringing through the court, they reminded the audience of the strangling of the victims, and seemed to be intended by god as a mysterious kind of sign. she was not only a woman but a mother; and should not this produce sympathy even to one who had fought the fight of the drunken virago in the street of portsburgh, been art-and-part in a dozen of murders, who had led the kind-hearted simpleton as a dumb lamb to the slaughter, and had so often watched under the hush of breathless expectation for the sign when the work was done, and then hung, like one of those fabled creatures called "furies," round the slayers and the slain, to get her part of the prey? when the witnesses were all examined, there ran through the court a whisper, "where are the doctors?" and well there might, for in all that crowd you could not have got half-a-dozen who did not think these men nearly as culpable as the principal actors. it was known that their names had been placed on the back of the indictment as witnesses, but a very small amount of consideration might have satisfied any one that, whether appearing for the prosecution or the defence, they would be exposed to the danger either of self-crimination or falsehood. they could not have appeared with any effect on the one side without swearing to marks of violence, which would have proved their condemnation; nor on the other without witnessing to the total absence of those signs, which would have convicted them of premeditated lying. the indomitable leader had long before settled the question of their appearance, by ruling them, as he attempted to do the straightforward curator--the only person connected with the square who came forward--to the determination of being the mutes of the tragedy; and there can be no doubt that his policy was the right one, when it was found that they not only kept themselves scathless from all but the argive calumny, which, in their case, died away, but afterwards rose to wealth and estimation. if they were ardent students of the science of anatomy, it did not follow that they should also be ardent students of that of justice; and then self-preservation is the first duty of nature--a keen-eyed deity, who is somewhat before her who is blind. but all these things were not weighed and computed by the dissatisfied people who were in the court that day, and they still looked for the doctors even after the lord advocate had begun his speech to the judges and the jury. that speech was perhaps the best sir william rae had ever spoken; and it was not without its delicacies and difficulties. he knew that if the evidence of the hares, which was, even on the face of it, a tissue of lies, were disbelieved by the jury, he had no case; and he trembled under the responsibility of satisfying an infuriated people, who, surrounding the court-house with ominous faces, made themselves heard by shouts even within the walls of the court. "i do not," he said, "present those persons, hare and his wife, to you as unexceptionable witnesses. assuredly they are great criminals; but the law has said that their testimony is admissible, and thus pronounced it is not undeserving of all credit. it is for you to judge of the degree of credit to which they are entitled. you saw them examined, and will draw your own conclusions. i may be prejudiced, but to me it did appear that, while the evidence of the wife was in many points exceptionable, hare himself spoke the truth. notwithstanding all the ability shewn in the cross-examination, i do not remember one particular in which he was led to contradict himself, or state what must be false. doubtless there exist inconsistencies betwixt his evidence and that of his wife; but these are not of a nature that ought to induce you to withhold all credit from their testimony. your experience will tell you how difficult it is to find two individuals who, however disposed to speak the truth, will concur in such particulars in regard to an interview which occurred at the distance of two months. but look to the situation in which these persons were placed. look to the size of the apartment in which all this occurred. recollect that all present were proved to have been nearly intoxicated at the time, and remember that an act of foul murder was at the time committing. is it possible that they should not have been in a state of unusual excitement and alarm at the time? and is it wonderful that their memories should have served them differently in regard to such trifling particulars as those to which i have alluded? if they had been at one in all these points, the only just inference would have been that the story was entirely made up between them, and their evidence, in consequence, not entitled to any credit. but look to the main point of the case--the murder, and the mode in which it was done. that was a fact sufficient to rivet attention, and render sober any one, however inebriated. on this material point you find these witnesses entirely concurring,--both describing the same mode of death, and both describing a mode which corresponds completely with the appearance of the body, and which, in the opinion of the medical men, satisfactorily accounts for the death. that both burke and hare were participant in the foul act, no one can doubt; and i need not state to you that it matters not which was the principal aggressor in its execution. they are both art-and-part guilty." the dean of faculty, for burke, then spoke; and afterwards came henry cockburn, for helen m'dougal, with that speech, so renowned among the displays of forensic eloquence, as almost rivalling that of jeffrey for mrs smith. his point of attack was--the credibility of hare and his wife. "our learned friend, who prosecutes here, has demonstrated by his conduct, that he is satisfied you ought not to convict without the evidence of the associates; and thus we are absolutely driven to consider what credit is due to those witnesses. if you shall agree with me in thinking that it is an absolute sporting with men's lives, and converting evidence into a mockery, to give the slightest faith to anything these persons may say, then we have the authority of the public accuser himself for holding that you must acquit. now, on what does these witnesses' claim to credit rest? one of them is a professional body-snatcher, the other is his wife; so that, independently altogether of the present transaction, they come before you confessedly vitiated by the habits of the most corrupting and disgusting employment which it is possible to be engaged in, and one of which the chief corruption arises from its implying that he who practises it has long been accustomed to set law, feeling, and character at defiance. then they both confess their direct accession to this particular murder--a confession which, if it had been made at the bar, would have for ever disqualified them from giving evidence in any court of justice; not having been made at the bar, they are admissible. but, since they have made the very same confession in the witness-box, their credit is as completely destroyed in the one case as it would have been in the other. hare not only acknowledged his participation in this offence, but he admitted circumstances which aggravated even the guilt of murder. he confessed that he had sat coolly within two feet of the body of this wretched old woman while she was expiring under the slow and brutal suffering to which his associate was subjecting her. he sat there, according to his own account, about ten minutes, during which her dying agonies lasted, without raising a hand or a cry to save her. we who only hear this told, shudder, and yet we are asked to believe the man who could sit by and see it. nor was this the only scene of the kind in which they had been engaged. the woman acknowledged that she '_had seen other tricks of this kind before_.' the man was asked about his accession on other occasions, but at every question he availed himself of his privilege, and virtually confessed _by declining to answer_. "but why does the law admit them? why, just because after they are admitted it is the province of you, gentlemen, to determine how far they are to be believed. you are the absolute monarchs of their credibility. but in judging of this, do not be misled by what juries are always told of those who turn king's evidence, that they have no interest now but to speak the truth. but it is notorious that there is nobody by whom this is so universally forgotten as by those who make a bargain for saving themselves by betraying their associates. these persons almost invariably hurt the interests of their new master by the excess of their zeal in his service. they exaggerate everything, partly by the desire of vindicating themselves, and partly to merit the reward for which they have bargained. and you will observe that, in this case, these persons stand in this peculiar situation, that, so far as we know, they are still liable to be tried for similar offences. there are other two murders set forth in this very indictment, one of them committed in hare's house, and if we may judge from what these persons say, they have been engaged in other transactions of the same kind. they came from the jail to this place to-day, and they are in jail again. do you think that it is very improbable that when coming here they should feel that if this prosecution failed, public indignation would require another victim, and that nothing was so likely to stifle further inquiry as the conviction of those persons? "the prosecutor seemed to think that they gave their evidence in a credible manner, and that there was nothing in their appearance, beyond what was to be expected in any great criminal, to impair the probability of their story. i entirely differ from this; and i am perfectly satisfied that so do you. a couple of such witnesses, in point of mere external manner and appearance, never did my eyes behold. hare was a squalid wretch, in whom the habits of his disgusting trade, want, and profligacy, seem to have been long operating in order to form a monster whose will as well as his poverty will consent to the perpetration of the direst crimes. the lord advocate's back was to the woman, else he would not have professed to have seen nothing revolting in her appearance. i never saw a face in which the lines of profligacy were more distinctly marked. even the miserable child in her arms, instead of casting one ray of maternal softness into her countenance, seemed at every attack (of hooping-cough) to fire her with intenser anger and impatience, till at length the infant was plainly used merely as an instrument of delaying or evading whatever question it was inconvenient for her to answer." the lord justice-clerk then charged the jury, going over the evidence, and at last directing his special attention to the case of m'dougal:--"it is not in evidence that she took any part in the actual perpetration of the crime; but the question remains, and if answered in the affirmative, will be equally fatal to her as if she had done so, namely, whether she was an accessory, and, therefore, to be held in law as art-and-part guilty along with the other prisoner. accession to a crime may take place before the fact as well as at the moment the crime is committing. it may likewise be _inferred_ from the conduct of the party after the fact; and if you are to believe the evidence which you have heard, i am much afraid there are but too strong grounds for concluding that the female panel at the bar has been guilty of accession to the crime under investigation, whether you consider her conduct before or after the fact, or while it was perpetrating. it is impossible to conceive for one moment that, under all the circumstances of the case, the panel m'dougal could be ignorant of the purpose for which this wretched woman docherty was brought to the house. the state in which burke and she appear to have lived, their brutal and dissipated habits, make it impossible to believe that either of them kept the woman in the house from the humane or charitable motives they professed to feel, and affected to shew, towards that unfortunate creature. on one occasion, it would appear, indeed, from the evidence of gray's wife, that m'dougal actually opposed the proposition of the woman going out of the house. the manner, too, in which she communicated the fact to mrs hare, that they had got a shot in the house, shews distinctly her complete knowledge of what was in view, and implicates her morally as well as legally in the guilt that afterwards ensued. again, as to her accession during the perpetration of the crime, thus much appears, according to the evidence of hare and his wife, that both mrs m'dougal and mrs hare were in the room, at least--whether in the bed, as hare states, or standing between the bed and the door, as his wife swears, seems immaterial--when burke placed himself on the body of the woman; and that upon her hearing the first screech of the woman they both flew, as mrs hare expresses it, to the passage, where they remained till the door was opened. by this time the crime had been accomplished, and the body thrown among the straw." before the jury retired, and during the time they were enclosed, burke endeavoured to prepare the mind of m'dougal for her fate, as, from the address of the lord justice-clerk, he supposed she would be found guilty. he even gave her directions how to conduct herself, desiring her to look at and observe him when the sentence was pronounced. the jury retired at half-past eight in the morning, and after an absence of fifty minutes, returned the following verdict:--"the jury find the panel william burke guilty of the third charge in the indictment; and find the indictment not proven against the panel helen m'dougal." on hearing the words of the foreman, burke turned to m'dougal, and coolly said, "nelly, you are out of the scrape." thereafter, lord meadowbank proposed the sentence, prefacing at considerable length:--"your lordships will, i believe, in vain search through both the real and the fabulous histories of crime for anything at all approaching this cold, hypocritical, calculating, and bloody murder. be assured, however, that i do not state this either for exciting prejudices against the individual at the bar, or for harrowing up the feelings with which, i trust, he is now impressed. but really, when a system of such a nature is thus developed, and when the actors in this system are thus exhibited, it appears to me that your lordships are bound, for the sake of public justice, to express the feelings which you entertain of one of the most terrific and one of the most monstrous delineations of human depravity that has ever been brought under your consideration. nor can your lordships forget the glowing observations which were made from the bar in one of the addresses on behalf of the prisoners, upon the causes which, it is said, have in some measure led to the establishment of this atrocious system. these alone, in my humble opinion, seem to require that your lordships should state roundly that with such matters, and with matters of science, we, sitting in such places, and deciding on such questions as that before us, have nothing to do. it is our duty to administer the law as handed down to us by our ancestors, and enacted by the legislature. but god forbid that it should ever be conceived that the claims of speculation, or the claims of science, should ever give countenance to such awful atrocities as the present, or should lead your lordships, or the people of this country, to contemplate such crimes with apathy or indifference. with respect to the case before us, your lordships are aware that the only sentence we can pronounce is the sentence of death." then the lord justice-clerk, putting on the black cap, said:--"william burke, you now stand convicted, by the verdict of a most respectable jury of your country, of the atrocious murder charged against you in this indictment, upon evidence which carried conviction to the mind of every man that heard it, in establishing your guilt in that offence. i agree so completely with my brother on my right hand, who has so fully and eloquently described the nature of your offence, that i will not occupy the time of the court in commenting any further than by saying that one of a blacker description, more atrocious in point of cool-blooded deliberation and systematic arrangement, and where the motives were so comparatively base, never was exhibited in the annals of this or of any other court of justice. i have no intention of detaining this audience by repeating what has been so well expressed by my brother; my duty is of a different nature, for if ever it was clear beyond all possibility of a doubt that the sentence of a criminal court will be carried into execution in any case, yours is that one, and you may rest assured that you have now no other duty to perform on earth but to prepare in the most suitable manner to appear before the throne of almighty god to answer for this crime, and for every other you have been guilty of during your life. the necessity of repressing offences of this most extraordinary and alarming description, precludes the possibility of your entertaining the slightest hope that there will be any alteration upon your sentence. in regard to your case, the only doubt that has come across my mind is, whether, to mark the sense which the court entertains of your offence, and which the violated laws of the country entertain respecting it, your body should not be exhibited in chains, in order to deter others from the like crimes in time coming. but taking into consideration that the public eye would be offended by so dismal an exhibition, i am disposed to agree that your sentence shall be put into execution in the usual way, but unaccompanied by the statutory attendant of the punishment of the crime of murder--viz., that your body should be publicly dissected and anatomised, and i trust that if it ever is customary to preserve skeletons, yours will be preserved, in order that posterity may keep in remembrance your atrocious crimes. i would entreat you to betake yourself immediately to a thorough repentance, and to humble yourself in the sight of almighty god. call instantly to your aid the ministers of religion, of whatever persuasion you are; avail yourself from this hour forward of their instructions, so that you may be brought in a suitable manner urgently to implore pardon from an offended god. i need not allude to any other case than that which has occupied your attention these many hours. you are conscious in your own mind whether the other charges which were exhibited against you yesterday were such as might be established against you or not. i refer to them merely for the purpose of again recommending you to devote the few days that you are on earth to imploring forgiveness from almighty god." the written sentence was in conformity. such was the sentence of burke, sending very appropriately his body where he had sent so many others. the people were so far pleased that they had got an instalment;[ ] but, in spite of the approbation bestowed on the jury by lord boyle, the finding of "not proven" against helen m'dougal was looked upon as a mere bilking of justice. no man could have any doubt of her guilt, as being art and part, and if ever a jury acted in defiance of their consciences, it was in liberating this woman; nor do we believe that they did not think the charge proven against her--they were simply desirous that they should not afford an opportunity for the application of an old law seldom put into execution. this motive might have been looked upon as humane in an ordinary case, for assuredly the law of art and part is apt to take on cruel forms, but to withdraw helen m'dougal from its power was, at the very best, a squeamish and sickly humanity. so, too, thought the public, and their anger rang through the city, even in the midst of the satisfaction universally felt at having got, at least, an instalment of justice. but were the other murderers also to get free? the jail. we may find an interest in following this unexampled criminal to the lock-up, whither he was conveyed immediately after sentence, and where, too, m'dougal, for the sake of safety, was placed till an opportunity was afforded of sending her away unknown to the mob. as for hare and his wife, they behoved to continue as prisoners. no sooner had burke been removed to the prison and placed in his separate apartment, than the old devil in him broke out. "this is a d----d cold place you have brought me till." one of the men rebuked him, but as yet it was of no use. the spirit of the man had not been touched, and as yet he lay under the gloomy weight of anger at having been betrayed, frequently bursting out in maledictions, and saying that hare was the more guilty of the two. "he murdered the first woman," he continued. "he persuaded me to join him, and now he has murdered me; and i will regret to the last hour of my existence that he did not share the same fate." he then threw himself upon the stone bed, and lay with clenched hands, occasionally starting, as if the desire to wreak vengeance upon his betrayer had flashed through his mind, and nerved his arms to his customary assaults. while in this fit, one of the officers, not relishing the idea that he wished to excuse himself by casting even more than his share upon his colleague, made the remark, "i think i could never wish to see that man forgiven who could murder that poor, harmless, good-natured idiot, daft jamie," whereupon the prostrate man started, and said, "my days are numbered. i am soon to die by the hands of man. i have no more to fear, and can have no interest in telling a lie, and i declare that i am as innocent of daft jamie's blood as you are. he was taken into hare's house, and murdered by him and his wife. to be sure, i was guilty in so far, for i assisted to carry his body to dr knox, and got a share of the money." and how often do we find even the condemned, and how much more often the still successful criminal, anointing with the saliva of their own lying tongues their own ears, ay, even with the whine of self-sympathy! as the day advanced, the perturbations produced by revenge gradually subsided, giving place to others more connected with the condition in which he now found himself, and his state of mind was attempted to be taken advantage of by the officers, always anxious to get their curiosity gratified by confessions, which they know, too, will be welcome to their superiors. but they were successful only so far that he no longer denied his guilt, even going the length of admitting a general scheme of watching poor and wretched strangers who were not likely to be inquired after by friends. beyond this he would not go, expressing even a determination to withhold all particulars, unless counselled otherwise by his priest. even this shewed that a great change had come over him, and shortly there was to be a still more undoubted sign, for, after remaining silent and meditative, he inquired, with an appearance of humility, and even of that politeness which was said to have formed a feature of his character at a prior period of his life, whether he would be permitted to offer up a prayer. and upon the permission having been given, this man who, only a few hours before, had exhibited the same continued impenetrability of heart manifested through the long period of his confinement, dropt upon his knees, imploring forgiveness from almighty god for the wicked life he had led, and especially for that great crime for which he was to suffer on the gibbet; entreating, also, that his wretched partner in guilt might be brought to a full sense of her guilt--that she might repent and atone, as far as it was in her power to do so in this world, by a life of quietness, piety, and honest industry. on rising, he requested the officer to read to him a part of the scriptures; chapter after chapter, till they amounted to six, were listened to, if not greedily accepted, with occasional remarks of the applicableness of particular passages to his crimes. withal he had, as yet, indicated no fear--the first emotion after sentence having been revenge, and that which followed, humility and resignation, which were to remain as the prevailing condition of his mind up to the final day. meanwhile, the usual anxiety as to the state of the criminal's soul produced outside that conflict between the calvinists and the indifferents which is so common in scotland. the one party maintained the possibility as well as the merits of the new birth, even up to the throwing away of the handkerchief; the other did not consider it either possible or probable: and while the one wished for, and waited for, the proof, the other thought, and with some reason, that so easy a way of getting quit of the consequences of the murders would not be very favourable to their non-repetition. all this burke settled in his own roman way, by satisfying himself that, if he wished, he could get to heaven through the ear of his confessor but there was not much evidence to shew that he entertained any strong wish on the subject, if he did not suspect that he was not a very proper person to appear in heaven. we have no wish to be irreverent, but, setting aside the old question as being inscrutable and insoluble, it is all but certain that this man never shewed a trace of that anguish of spirit under the mordacious fangs of remorse which can be accepted as the only sign of an approach to the saving faith which is in jesus. the approvers founded upon a statement he was said to have made, that he would not accept a pardon if it had been granted. if he had been tempted by an offer, we would likely have had another tale; nor would he have been to blame, unless we are to suppose that true conversion brings along with it a predilection for being hanged, and that, while it prepares a man for death, it incapacitates him for worthily continuing in life. independently of the total want of any signs of the real pathology of repentance, there are positive proofs that his thoughts were continually recurring to earth. he thought more of helen m'dougal than of a saviour; and otherwise, we have even a ludicrous example of his sublunary grovellings. on one occasion, his mind seemed to one who was sitting by his bed to be occupied by thoughts of eternity, as he lay silent and meditative. the omen was propitious, and the pious assistant waited for the sign, which could not be less than a burst of tears, not one of which he had yet shed, or had ever been seen to shed. the sign came. "i think," said he, with a start, "i am entitled, and ought to get that five pounds from dr knox which is still unpaid on the body of the woman docherty." "why," replied the astonished pietist, "dr knox lost by the transaction, as the body was taken from him." "that was not my business," said burke sharply. "i delivered the subject, and he ought to have kept it." "but you forget," said the other, "that were the money paid, hare would have the right to a half of it." and then came, after a little meditation, the explanation. "i have got a tolerable pair of trousers," he continued; "and since i am to appear before the public, i should like to be _respectable_. i have not a coat and waistcoat that i can appear in, and if i got the £ i could buy them." but it is to be admitted that while he shewed no real signs of penitence in a calvinistic sense,--so different these we suspect, from what are found in a votary of the confessional,--he evinced none of the dogged surliness of the hardened sinner, if his general mildness and continued politeness were not remarkable. indeed, as we have seen, these characteristics were always, when he was not intoxicated, the prevailing features of his demeanour, from which many inferred that he purposely roused himself by large draughts of whisky to the fury which he found necessary to the perpetration of his onslaughts. this would seem to receive confirmation from the statement of a witness, who said that on these occasions he did not drink out of an ordinary measure, but used a strong-ale glass, which he would fill almost to the brim. were this true, it would be no abatement from the malignity and sternness of the sober purpose which assuredly he must have entertained, while his external aspect was still as composed, if not as mild, as it was said to be. as a consequence of this placability, he gave way alternately to those solicitations with which he was daily pursued to utter a confession. he first made one and then another, but while these documents exhibit many discrepancies, they shew, from their curtness and desultoriness, that they were the result of a mere carelessness, only brought up to the point by pestering solicitations. ten lines are devoted to the whole story of the murder of a human being, and if it had not been that circumstances came out on all sides, often from unknown sources, no more would have ever been known, at least as regards many of the victims, than simply that they perished. even for these the gaping mouth of curiosity, and not less the hopeful heart of piety, was sufficiently thankful, while the hardened sceptics still refused to see the sign of the new birth. nor, as the short days passed to usher in the last morning, for which he said "he would not greatly weary," was there any other more signal appearance of a radical change. no doubt he received the visits of clergymen, not caring much whether of one denomination or another, and none of them were gratified with more than very ordinary manifestations of regret. there always haunted him a desire to have hare brought to trial, yet he had art enough to place this, not to the account of revenge, but that of _humanity_. even burke became a philanthropist, or, what is often the same thing, could use the hackneyed words which are the fashionable tribute paid by vice to virtue. if he was not thus unable to forget the enormous debt due by his fearful associate, he was, and continued to the end to be, not less mindful of his paramour. he sent his watch and what money he possessed to her--"poor thing, it is all i have to give to her; it will be of some use to her, and i will not need it." yet no moisture of the eyes--the pity was only the bastard offspring of animal love. withal, we are frank to admit that even the breaking down of the adamant, to the extent of confession and regret, in a man like burke, was a triumph to religion. there is no natural way of accounting for that phenomenon of which every man is doomed to feel the experience, that while death asserts his power over the body, he extorts a contribution from the soul. turn the question in any way you please, your final cause is nowhere, unless it be that the experience of agonised death-beds is the opportunity of virtue--a poor back-handed way of making people better, and certainly bought at a terrible expense. but even taking the advantage in this limited form, it does not exhaust the conditions of the question; for while the dying sinner is altogether unconscious that his agonies will go forth to the world and be an example, his mind is in another direction. he looks forward, and the more keenly, that he cannot look backwards. where is the final cause now? try again, and we suspect you will find it only in heaven. vejove. we are so apt to take signs for things, and so glibly too do the one pass into the other, that we find almost all descriptions of individuals previous to execution very much the same; and so they must needs be, for fate is the great man-tamer, and man only: the brutes merely feel the stroke when it falls--man sees it coming, knows its necessity, and therefore commits himself to resignation. then, resignation is so grave an affair that it is often mistaken for genuine seriousness, if not for religious impression; but even here we have exceptions of men who could be merry under the gibbet or the axe--strange beings these, and more often of the virtuous than the vicious; for vice in the clutch is but a sorry affair. this doomed man, who was represented as having behaved so decently, could sing and dance the minute before he braced his cruel sinews to the work of death; and if he had been consistent, he would have acted macpherson under the cross-beam; but the highlander only stole cattle, while the irishman immolated human beings, and so we find him grave and decorous because he was now to be throttled in his turn. at four o'clock on the morning of tuesday the th,--that previous to the day of execution,--he was taken off the _gad_ and removed to the lock-up in liberton's wynd. the reason of the early hour is evident, for the excitement of the people was such that the authorities were not satisfied that he would not be claimed by a furious mob, and dealt with as he had dealt by so many others. notwithstanding the long period he had been in jail, there was no great change in his appearance, except a slight paleness, which, with some weakness of body, was the result of a peculiar external malady with which he had for a considerable time been afflicted;[ ] nor could the sharpest observation of captain rose, who accompanied him, detect any diminution of that composedness, or, if you please, insensibility, which had marked his demeanour all along. if there was a flutter at all, it was when he was presented with his new suit of black--either the passing feeling of the ominous dress, or satisfaction of his wish to appear respectable. in the course of the day the catholic priests, messrs reid and stewart, as well as the protestant ministers, messrs marshall and porteous, paid him a visit, and were rewarded with the usual amount of earthly regret; but with how much of remorse or faith in the redeemer, even they could not tell, immovable as he was, and apparently unconcerned. indeed the sole animating feeling was a desire to have the business over. "oh, that the hour were come that is to separate me from the world!" but not a word of faith, and far less of hope. in the morning, too, when the jailer took off his heavy fetters, and they fell with a clank upon the floor,--"so may all earthly chains fall from me." at seven, and after having experienced a sound and unbroken rest for at least five hours, burke walked with a steady step into the keeper's room, followed by the confessor; nor yet was there any appearance of agitation or dismay. he took his seat in an arm-chair by the side of the fire, and twice or thrice arrived at that point of distress which is marked by two or three sighs. then commenced the catholic devotions, in which, as he had done before, he engaged with an appearance of fervour. the protestant ministers followed up the catholic service with some serious exhortations, in the course of which, mr porteous having dwelt on the words, "you must trust in the mercy of god," the doomed man exhibited symptoms of anguish; but as for anything like that "awe which is illumined by hope," he seemed to have a secret feeling that he was too deeply sunk in crime even to think of the infinite mercy of heaven. after this portion of the exercises was gone through, he was on his way to an adjoining apartment when the executioner met and stood before him. even this apparition, generally so fearful to a criminal when he first makes his appearance, did not dismay him. "i am not ready for you yet," was the brief salutation; and in a short time after, when he was pinioned, he bore the operation composedly, and without uttering a word. he was now asked to take a glass of wine, and having accepted the offer, he bowed to the company, and drank "farewell to all present, and the rest of my friends." the magistrates having now gone out, returned in their robes, with their rods of office, and burke, before going forth, expressed his gratitude to the bailies and all the other officials for the kindness and attention he had received at their hands. meanwhile the crowd outside had attained its greatest density. at ten o'clock on the previous night, the ceremony of setting up the scaffold had commenced. this has always been a scene in edinburgh, but now it was a festival. the din of the workmen, and the clang of the hammers, were mingled with the shouts of the assembled people to the amount of thousands. whenever an important part of the erection was completed in the light of the torches, up rose the cheer, as if so much had been done towards the satisfaction of their vengeance. when all was finished, and the transverse beam looked so ready for its weight, the event was honoured by three of these cheers so loud and prolonged that they were heard in princes street. even the services of the workmen, always averse as they are to gallows-work, were on this occasion, and certainly never before, volunteered with emulation. by this hour, two in the morning, the closes and stairs near the spot were blocked up by masses of people, who had resolved, at the expense of so many hours' watch, to secure a good view. the inclemency of the weather drove them to any shelter that could be obtained,--in very few cases homeward,--where the morning broke upon them in gray dawn, but with the inspiration of hope. in addition to all this confusion, a constant bustle was kept up by those who, either for favour or for money,--and high prices were paid for good stances,--had procured the envied windows. after this a solemn stillness pervaded the whole scene, broken only by the splashing of the rain, which fell in torrents, accompanied with gusts of wind which whistled and moaned through the long closes. as the morning advanced, the groups were seen hastening to their windows, and about five, the people generally began to pour in, taking their stations in front of the gallows, and upwards towards the castlehill, while large parties of policemen and patrols successively arrived, to be posted in a strong line in front of the railing--the space left free being much larger than ordinary. nor were the crowd on this occasion in their ordinary humour of annoying or retarding the constables in the execution of their duty, which they rather viewed as a common cause. from six to seven the concourse increased, thronging every avenue to the high street, and hurrying in from every quarter, till the whole space, from the tron to the bow, threatened to be too small to hold them. nor were the masses entirely composed of the class that usually attend such scenes. there were included, especially about the windows, not only of the dingy houses of the lawnmarket, but also of the county buildings, great numbers of well-dressed ladies, imparting a variety, scarcely to have been expected, to the scene, already otherwise picturesque. after seven, and when the rain, which had been excessive some hours before, began to cease, the crowd became rapidly larger still, and at eight, the entire area between the two points we have mentioned presented the aspect of an immense and closely-wedged mass of human beings, all still and watchful, never before seen there, except, perhaps, on the occasion of the king's visit. all round the scaffold you saw the crowd was composed of men--gradually outwards giving place to women, many of whom, being pressed by the dense mass around them, sent forth screams of distress; and where the pressure got less, chiefly about the circumference, the numbers of that sex were still considerable--the entire assemblage, as is the case where density is great, being moved, as it seemed, all throughout by the same impulse, coming from whatever direction. the numbers at this time were computed at , or , . but there was one feature of this crowd which was more extraordinary than its extent or composition. in ordinary cases, at least in scotland, there is usually manifested sympathy for the sufferer, or at least a sedate and solemn manner, as if the occasion were melancholy and instructive. all this was changed now. there was on every face an expression of something approaching to joy, as if the heart felt it was to get quit of a painful feeling of revenge, and that the relief was near. it is now eight,--st giles's rolls forth the sounds, and every noise is stilled. precisely at the hour burke was on his feet, eager to be dead, and the procession moved. he was supported by the two catholic priests, more from the difficulty he experienced in walking with his arms so closely pinioned, than from any weakness or faltering of step. in the progress towards and up liberton's wynd he shewed even increased coolness and self-possession, turning from side to side in conversation, and at one part, where the ground was wet, carefully picking his steps; but at the head of the entry, where he was to get a view of the crowd, he winced, and half-closing his eyes, hurried on, as if more eager still to be out of the roar of that terrible assemblage. nor was that roar long delayed. upon bailies crichton and small issuing from the wynd, the shout was raised in one long-continued yell, and when burke himself was seen ascending the stair, the roar was repeated with double intensity, mixed with articulated execrations,--"burke him!" "choke him!" "no mercy, hangie!" yet amidst all, burke walked with steady step, and stood coolly below the apparatus of death. if he was much moved at all, it was to cast a look at the crowd of fierce and desperate defiance, as if he could have felt it in his heart to repeat upon every one of them his old experiment, and we suspect that he would have done it if he had had the liberty and the power. having taken his station in front of the drop, he kneeled with his back towards the spectators, his confessor on his right hand, and the other catholic clergyman on the left, and repeated a form of prayer dictated by one of these reverend gentlemen. mr marshall, meanwhile, offered up a supplication on his behalf, the bailies and other officials joining in the devotions, with the exception of the executioner (williams) and his assistant, who stood at the back of the drop. during all this time there was silence. on rising from his kneeling posture, burke was observed to lift a silk handkerchief, on which his knees had rested, and put it into his pocket. there was now some hesitation in his manner, as if loath to mount; and one of the persons who assisted him to ascend, having, perhaps inadvertently, pushed him somewhat roughly to a side, that he might be placed exactly on the spot, he looked round with a withering scowl. he then _ran_ up the steps, as if he hurried to death, to get beyond the reach of these terrible howls. some further delay took place, from the circumstance of williams, who stood behind him, endeavouring to loose his handkerchief, in which he found some difficulty. "the knot is behind," said burke,--the only words not devotional uttered by him on the scaffold. when williams succeeded in removing the neckcloth, he proceeded to fasten the rope round his neck, pulling it tightly, and, after adjusting and fixing it, he put upon his head a white cotton night-cap, but without pulling it over his face. while this was going on, the yells became fiercer and fiercer, mixed with the ejaculations, "where's hare? hang him, too." "don't waste rope on him." "you ----, you will see daft jamie in a minute." the rev. mr reid then advanced, and conversed with him shortly, but earnestly, and directed him to say the creed, which he did. as he muttered the words, his face was pale and livid, but he was still composed, unflinching, and motionless. the next act was the advance of williams to draw the cap over his face. he manifested a repugnance to this, as if he would brave the yelling crowd even to the last extremity, and it was with some difficulty this was accomplished. everything is now ready. he utters an ejaculation to his maker, imploring mercy, and throws away the handkerchief with a jerk of impatience, the bolt is drawn, and burke swings in the air amidst the deafening roar of thirty thousand people.[ ] but burke was not yet dead. he must be dead before that crowd is satisfied. from the limited length of the fall, there had been no dislocation; and for five minutes the body hung motionless, except from the impetus given by the fall, when a convulsive motion of the feet, and a general heaving, indicated a still lingering vitality. upon observing this, the crowd raised another cheer. twice these motions were renewed, and twice again rose the shout. generally, the scene of an execution is soon deserted; people give a shudder, and run away, like one who has been obliged to obey a feeling which is not pleasant, and yet is inevitable, and who enjoys a relief from the emotion. this did not occur on this occasion. the people shewed no disposition to disperse. they seemed desirous of prolonging their gratification by gloating on the ghastly spectacle, as, driven by the wind, it swung to and fro. at five minutes to nine, the bailies again came up liberton's wynd, still in their robes, and with their rods, and stood round the scaffold. williams then mounted and lowered the body, and this, the last act, was celebrated by the finishing yell. the crowd then separated. the public prints got immediately into a discussion as to the propriety of these demonstrations of feeling among a civilised people. it was by one party represented as barbarous and shocking, opposed to christian forgiveness, and indicative of a fierce and relentless nature. the crowd was described as if made up of the _diables_, _diablesses_, and _diabletons_ of the old dramas, and their cries got the name of hell-yells. there are people who, their throats being safe and their bellies well filled, look upon sin, even in its most devilish form of cruelty, as something to be dandled and conciliated into virtue like their own by sugar-plums. those who feel no natural detestation of cruelty are not far from those that could be cruel. but supposing that these good people were as great haters of cruel men as those who shouted in the crowd, but that they felt their feeling satisfied by the arm of the law, they could only say that these people felt more satisfied than they, and that, in place of concealing their satisfaction, they expressed it openly, if you like, noisefully; and if this satisfaction must be held to be in the ratio of detestation, they were better haters of sin than those who impeached them with barbarity. so the good people get into a metaphysical net, out of which it is not very easy to get. but the question was very well settled by the _times_, who took and shook the simperers, telling them that virtue has two sides, like everything else--one, a love for the good, and another, a hatred of what is evil, neither of which can exist without the other, and that the roused hearts of those who made the welkin ring with their roar, were just the hearts from which one might expect indications of pity for the miserable victims of that man's cruelty. it may be well for us to remember, amidst all the affected refinement of our times, that the churlishness of the honest man is the impatience of shuffling deceit and hypocrisy. when we get behind the frieze veil of the sanctuary of his affections, we often find kindness sanctified by trust,--a generosity which does not see itself, and is too often cheated by its object, and a pity, which is the more beautiful, that it wells from the stern rock of honesty and justice. the exhibition. the earthly destiny of this marvellous man was not yet finished--the celebration of justice did not terminate by the dispersion of the thirty thousand who had assembled in the hall of the goddess nature's own arena. they had more to do. they knew that the goddess had other forms than that in which she sends down her fiery-eyed priestess nemesis, even that in which she despatches her moral retributions, and works them through her votaries, and that, too, wherein she is called poetical justice, and wherein she relaxes the stern brow, and smiles with a little satire upon her beautiful lips. it is in this last form she is best loved by the imaginative; yea, and even those who, cultivating the muses, have yet a spice of humour, not inconsistent with the gravity of virtue. had not this man sent a score of human beings to the dissecting-room? let it be that they served the purpose of a physical science, might not he serve also the purpose of a moral cult? during the whole of wednesday the college was surrounded by hundreds, whose curiosity prompted them to see once more him who had immolated so many of their kind; but dr monro did not choose to run the risk of losing his subject, and the authorities were still afraid of a seizure, and so it was not till thursday morning that the body was removed from the lock-up to the dissecting-rooms of the college. at an early hour, several men dedicated to science, and among the rest mr liston, mr george combe, and his opponent sir wm. hamilton, and mr joseph, the eminent sculptor, went to have the advantage of an examination, before the rush of the students should put that out of their power. mr joseph took a cast for a bust, and several amateur students gratified their curiosity by sketches. the body was that of a thick-set muscular man, with a bull-neck, great development about the upper parts, with immense thighs and calves, so full as to have the appearance of globular masses. the countenance, as we saw it, was very far from being placid, as was commonly represented, if you could not have perceived easily that there remained upon it the bitter expression of the very scorn with which he had looked upon that world which pushed him out of it, as having in his person defaced the image of his maker.[ ] laid upon the table, the body became the subject of a lecture by the professor, and, in order to implement the sentence of the court, without so much mutilation as would interfere with the object of future inspection, the investigation was limited to the brain, laid open by removing the upper part of the cranium; the part sawed off to be subsequently replaced, so that the division could scarcely be noticed. so far, all had proceeded in peace and with decorum; but the college was, by and by, to be the scene of a renewed excitement. about half-past two, a body of young men, consisting chiefly of students, assembled in the area, and becoming clamorous for admission, it was found necessary to send for the police,--a class of men of whose interference within the walls of the college these assertors of scholastic liberty have always shewn themselves impatient. indignant at the opposition they had met with in the rooms, and still more angry at the conduct of the police, they made several sorties, in which they nearly succeeded in overpowering the opposition arrayed against them, at the same time that they smashed the windows at either side of the entry to the anatomical theatre. the police, finding themselves hard pressed, retreated, merely brandishing their batons; but blows received by several of them raised, in its turn, their anger, and the official weapon was used with more vigour than the magistrates, and especially the lord provost, who was present, seemed to relish. that dignitary accordingly got up to harangue the inflamed youths,--a liberty which could be brooked still less than the use of the batons, and amidst the cries of most opprobrious epithets, he, and along with him bailie small, were obliged to fly. attempts were now made by the police to cross the square and seize prisoners; and so far they succeeded, but it was only to be left to witness the captured _élèves_ reclaimed, and carried off amidst shouts of triumph. even some, whom the police got conveyed to dr monro's rooms, were searched for, and pulled out into liberty, adding, in their turn, to the shouts of the liberators. it was then attempted to make a dash, and clear the area of the assembled collegians by a promiscuous pell-mell, but the police again found themselves overmatched, and could not even retain their own ground in the open area. the contest was renewed more than once with varying success, and no man could tell how long the battle would last, as time, in place of moderating the passion of the students, served only to increase it, and every sortie and shout threatened some issue involving life. one or two of the police were carried off wounded, amidst cries of victory, and the battle, which had now lasted from half-past two to four, threatened even worse consequences than had yet resulted, when the professors got alarmed. dr christison at length made his appearance with the olive, and intimated to the youths that he had made arrangements whereby they would be admitted to see the body of burke in fifties, giving his personal guarantee for their good conduct. this intimation, which was in fact a victory,--achieved, too, with a compliment to their honour,--was received with loud cheers of "hurrah for christison!" and "burke's our own!" and presently all their fury subsided amidst the returning hilarity of loud laughter. but matters were not at all satisfactory outside in the street. the people had been restless all day. the sight of the hanging, in place of allaying their passion against burke, seemed to have inflamed them into a desire to gloat their eyes on his remains; and many intimated their design, in the event of being defeated, of forcing an entry into the anatomical theatre, and dragging the body out, to tear it in pieces. to this, the news of the success of the students inflamed them the more, but as it was now getting dark, and several scouts sent among them by the authorities having circulated the report that the magistrates and dr monro would make arrangements for general admission to the anatomical theatre next day, the crowd began to separate, but each carrying away the determination, which they growled out as they went, that unless the terms were adhered to, their purpose would be executed on the morrow. on friday the arrangements were made for a grand public exhibition. the body of the hanged man was placed on the black marble table of the theatre, so as to be seen by the visitors as they passed from one door to another, from which they could get exit in another direction. the news meanwhile had spread through both the old and new towns that the body of burke was to be seen by all and sundry, and the commotion throughout all ranks, high and low, was only equalled by that of the day of execution. the old town presented the appearance of a holiday. thousands took their way to the college, where they found the doors open and the exhibition begun, but as the stream of entrants was necessarily narrow, and of slow movement, the street and the area inside soon presented an appearance scarcely less crowded than on the day previous. the programme was very soon understood, and was indeed so simple and easily wrought, however tedious as regards time, that the people had only to try to get into the moving stream when they were pushed forward quietly and orderly enough to the envied scene. there on the table lay the victim naked, with the part of the scull which had been sawed off so artistically restored that the mark of the junction could scarcely be observed. the spectacle was sufficiently ghastly to gratify the most epicurean appetite for horrors. there was as yet no sign of corruption, so that the death pallor, as it contrasted with the black marble table, shewed strongly to the inquiring and often revolting eye; but the face had become more blue, and the shaved head, with marks of blood not entirely wiped off, rather gave effect to the grin into which the features had settled at the moment of death. however inviting to lovers of this kind of the picturesque the broad chest that had lain with deadly pressure on so many victims--the large thighs and round calves, indicating so much power--it was the face, embodying a petrified scowl, and the wide-staring eyes, so fixed and spectre-like, to which the attention was chiefly directed. as the stream moved on with recurring pauses, when some, more intent than others, held back to have a moment or two's more time, it was curious to view the ever-varying emotions of the spectators. many were there who could not in any other circumstances have looked upon a corpse at all, and you might have seen some half-irresolute adventurers who, as they neared, feared the sight, and would have backed out but that they were compelled to proceed, when the unsteady eye, anxious to avert itself, was caught by the horrible charm and fixed. no one, so far as we could see, however nervous, either shut the eyes or turned them away altogether; nor could you detect a single trace of pity--the prevailing expression, a malign satisfaction, strangely and staringly returned, as it were, by the grin of the corpse, which had the advantage of eternal persistency. extraordinary as all this moving scene was,--and certainly nothing of the kind had ever been witnessed in edinburgh before,--it was rendered more so by the occurrence among the close stream of a few women, amounting in all, we understood, to seven or eight, who, having made their way up-stairs, not perhaps with the intention of going altogether forward, were moved on and could not escape. the caught virgins, true to their nature, struggled so well in the net of their curiosity, that you would have said they were really anxious to get back, and yet somehow their struggles seemed unaccountably rather to help them on; but at any rate it was certain they were modest, and shrank at the thought of the coming sight, for they held down their heads to avoid the stare of the men, and when they arrived at the point, only looked with a squint, sufficient at once for entire gratification as well as for immunity from the charge of not being feminine and delicate. it is doubtful, notwithstanding, however influenced by the sense of the _nil dulcius quam omnia scire_, whether they would venture again upon such another junonian venture; for the males, who reserve to themselves the exclusive right of witnessing such spectacles, bestowed on them such and so many tokens of indignation as might have cured them for ever of their original sin. the numbers who supplied this continued stream may be judged of when it is mentioned that by actual enumeration it was found that upwards of sixty per minute passed the corpse. this continued from ten in the morning till darkening, and as the crowd, when we saw it at three o'clock, was still increasing, as one told another of what he had seen, we cannot compute the numbers at less than twenty-five thousand persons; add to this those who had a private interview, and we arrive again at the number present at the execution, thirty thousand--a greater number than ever visited royalty lying in state, at least within the kingdom of scotland. nor did the entire day suffice for the satisfaction of this curiosity. as many were ready for the following day; but, to the disappointment of these, it was announced that all further ingress would be denied. next day, saturday, the front of the college again presented a scene of confusion. another crowd had collected--growling at the conduct of the officials--crying for the opening of the anatomical theatre; and long after they had ascertained that no further exhibition would be permitted, the people stood and continued to gaze at the college walls, till, exhausted of their patience, they reluctantly departed, leaving fresh arrivals, which continued during the entire day to occupy their places.[ ] one might have thought that the excitement, at least in so far as regarded burke--for the other culprits were a precious reserve, whose fortunes might fill a volume of great interest--would have thus ended; but at that time the science of phrenology was in its zenith, the combe-and-hamilton controversy in full vigour; and so, next came the battle of the phrenologists and the old scotch school of mental philosophers. burke's head, so ingenious in devising a new species of murder, which should bear his immortal name, as well as in discovering a new estimate of the value of the human body, was measured and mapped into philoprogenitiveness, veneration, destructiveness, and all the rest, so as to be in all time coming the example and test of the character possessed by the genuine _à priori_ and _à posteriori_ murderer. and it was a solemn occasion. the measurements were recorded and published. the accuracy of the mere figures was not denied, but the inferences were disputed with such acrimony that the scientific battle commenced. everywhere there was a measuring of craniums, and even wise people, who never had any doubt of the smallness of their destructiveness, were startled into the conviction that they required not only to take care of themselves, but to be taken care of by others. mr combe bade fair to be the only man who was to be benefited by the labours of burke. a considerable number of people, who were not sure of their harmlessness, notwithstanding they were very timid, and to others and themselves very innocent, waited upon him to ascertain what they in reality were; and if you had stood at his door, you might have judged by the faces of his consultors how much they were above or below the fatal · --the most marvellous bump that had ever been seen on the head of man since the days of that great man-killer hercules. it was in vain that the hamiltonians brought forward the measurements of men scarcely less famous in their philanthropic way than howard. the great development of destructiveness had in their cases been accompanied by _inactivity_, and the examples went for nought; and so, in like manner, the examples of other murderers who could not boast of more than · , were satisfactorily set aside for the reason of _activity_. the hamiltonians pushed their advantage, and demanded a return to the old doctrines and common sense; but the combeans would not admit the demand. the frying-pan sued for could not be returned or paid for-- st, because it was an old one with holes in it; dly, because it was returned long before; and, dly, because it was never borrowed. if one thing won't do, another will: if you drive us out of size, we fall back upon activity; if from activity, we flee to size. burke, in addition to all his other achievements, thus killed a science. having wrought so assiduously for anatomy, he ended by burking phrenology. the prosecution against hare. the public had got only an instalment; and the fingering of the money produced only desire for more, to make up the debt to justice. whatever might become of the women, hare must be hanged, dissected, and exhibited in the same way as burke, otherwise the peace of the city would be again in jeopardy. he was the greater criminal of the two, and the people had no moral vision to comprehend how the lord advocate could bargain with, and feel himself bound to keep honour with, one who, having lost the form and features of the sacred "image," was beyond the pale of humanity. you don't think of the moral obligation to refrain from killing a tiger merely because he left in your way another cruel animal, which, for want of a lamb eaten by the more rapacious, you found it convenient to dine off. after his examination, and when the officers were removing hare from the court-house to the calton jail, they were struck with dismay to find that he had been seized with a fit of glee, which, for want of an epithet derived from humanity, we may term diabolical; but the officers were simple, and so was he: they should have known the man, and he knew himself--a creature in whom there being no good to produce the variety which constitutes character, there could be nothing but pure and unmixed evil. if the devil is not a simpleton,--father of lies and master of devices as he is,--it is just because having once known the good he could hate it. hare never knew even that, and could not be said to hate what he could not understand. yet he laughed, not heartily, that would be a misnomer, but hepatically, from the liver, because he fancied that he had escaped from justice at the expense of the life of his accomplice. the public, much as they cried for his blood, were simple too, in so far as they believed that while in jail he shunned the public gaze, and muffled himself up in the bed-clothes when visited by the authorities; whereas the man, instead of thinking he had done anything shameful or even wrong, was rather proud of his ingenuity, not only amusing himself in the public ground attached to the ward, but exhibiting rather satisfaction at being looked at.[ ] nor, while in the very height of his effrontery, did he construe the marked dislike of the prisoners, every one of whom shrank from his touch or even approach, into anything short of spite because he was now free--being only there as under the protection of the authorities--and his companions poor bond devils. so far we may believe; but there might have been a small tax on the credulity of the time, when it was believed that he construed in the same way the conduct of those companions when, upon the occasion of there being more onlookers from without than the shame of the jail-birds relished, they were in the habit of hitching him forward as a great spectacle, by the attraction of whom their merely comparative merits might be overlooked. by and by, as the vengeful feeling of the public against the man increased, and nothing for a time was heard but the stifled groans for the second victim, it came out that the public prosecutor, having procured hare's co-operation as a _socius criminis_ to convict burke, and all the information which was necessary to bring home to the latter the three charges in the indictment, the crown was pledged in honour not to proceed against him on any one of these counts. this was, in effect, to say that he was free whenever he could get out of the hands of the infuriated people; because, in so far as regarded the other cases, there was no evidence independently of his, and he would take precious care to withhold every word to criminate himself. it is needless to say that the most sensible of the editors, and all the thinking and honourable of the people, considered this statement of the authorities as reasonable and proper. they would stand upon the honour of the crown and the dignity of human nature, even at the expense of giving liberation to a man who, by his own confession, was a murderer. they would therefore leave the vulgar to the _charum lumen_ of their prejudices, and so they were left. but, while thus taking this high and dignified ground against those whom a natural hatred of atrocity was said to make low, some ingenious one of their ranks struck out the idea that, though the crown was shut up to let hare off, some relative of one of the murdered persons might prosecute for assythment, or a compensation for the loss of life; and immediately it was found that daft jamie's mother, mrs wilson, with his sister, janet wilson, would be willing, if not anxious, to take the post of prosecutor--a piece of intelligence which pleased the public wondrously. this proposition was brought to bear by an application presented to the sheriff on the part of the wilsons, praying for liberty to precognosce witnesses with a view to the prosecution of hare; on the deliverance upon which progress was being rapidly made in the examination of several persons, when immediately there was presented to his lordship a petition for hare, craving to be set at liberty. on the st of january, the sheriff pronounced an interlocutor refusing the prayer of hare's petition, on the ground that there was no decision finding that the right of the private party to prosecute is barred by any guarantee or promise of indemnity given by the public prosecutor; but, in consequence of the novelty of the case, he superseded further progress with the precognitions, in order that hare might have an opportunity of applying to the court of justiciary. this judgment was accordingly brought under review of the high court by what is technically called a bill of advocation, suspension, and liberation--the meaning of which is simply that hare tried another chance for freedom by applying to the highest tribunal. the lord justice-clerk, who saw at once that the question was so far new, and of the first importance, not only in its merits, but viewed in relation to the state of the public mind, wished to have it judged of by all the lords, and he therefore called upon the public prosecutor to answer the request of hare. the lord advocate, who, no doubt, felt himself placed in a delicate position, but still determined to stand by the law and the dignity of the crown, accordingly presented his answer; and long pleadings, called informations, having been lodged, the case came to be tried before the court on the d february. the celebrated jeffrey appeared for mrs wilson, and duncan m'neill for hare. it was maintained on the part of hare, said mr jeffrey, that the public prosecutor was entitled to make a compact, to which compact their lordships were bound to give effect; that their lordships had no discretion, but that it rested entirely with the lord advocate to enter into such compact, and to extend immunity to any number of cases, without the control of the judge; in short, that the lord advocate possessed the uncontrolled power of exercising the royal prerogative. and this he might do, not merely in respect of the particular crime as to which a _socius criminis_ was to be used as a witness, but might, if he chose, extend it to all other crimes of which he might have been guilty. whenever the lord advocate stipulated an immunity, it seemed to be maintained, on the other side, that a sufferer by housebreaking, fire-raising, and other crimes, was to be deprived of his right, as a private party, to prosecute the guilty perpetrator of the wrong, and that the lord advocate had a power to enter into a compact by which he could grant immunity for offences, past or future, known or unknown. such a prerogative would be to invest the public prosecutor with a power of pardon which only belonged to the crown, and this, too, without a tittle of authority, amounting to an assumption of the authority of parliament; and so forth. but all the eloquence of jeffrey would not do. the judges had, long before this day of judgment, been down in the deep wells of authority, and, as one of the enraged people said, came up drunk with law, and kicked sober justice out of court. certainly, if such a profane expression could be used, these learned men might have been in that state, for seldom had they appeared so surcharged with authorities. they seem to have rummaged every corner of the advocates' library and the register-office to find out the origin of the law of king's evidence, and to have hunted out every decision bearing upon the case, so that, it would seem, hare should be rendered as famous for settling a great and hitherto doubtful point of law, as burke was destined to be for putting an end to a science. after all, the judges who decided for hare were found to be right; and, indeed, any one looking at the subject, could not fail to see that, as the lord advocate represented the king, and the king, as the great public protector of his subjects and prosecutor of their wrongs, represented his people, and mrs janet wilson and her daughter among the rest, the immunity promised by his lordship to hare really included an immunity implied as given by mrs wilson and her daughter. while the case was going on, and hare anxious to get out, he founded his hope on an extraordinary delusion, which could have occurred to nobody but himself. he understood well enough the meaning of the long word assythment, and asked his agent, with one of his leers, what was the value of daft jamie. the price given by the doctors, he said, was too much, because, if he had been offered alive to any one, he would not have been bought at any price, so that his mother had no claim, and the judges were just trifling away both their time and their brains about a thing of no value. incredible as this may seem,--and doubtless many reports passed that were not true,--it is not unlike the man; for it never was asserted, by those who had access to him, that he had the slightest notion of having done anything that was wrong. he was, indeed, one of those men, not so uncommon as the optimists may think, or so impossible as the christian philosophers maintain, whose consciences are entirely turned round about, and who, when they come to think seriously, find the worm gnawing on the wrong side. their pain is for any good they may have been tempted to do, their relief for any evil they have been fortunate enough to perpetrate, so true is it that nature is jealous of man's having it in his power to say that any proposition is absolutely true, and without an exception. but such phenomena, which, after all, are so uncommon as to deserve the name of monstrosities, need not flutter the faith of such men as chalmers, who found upon the universality of the law of conscience as proving the goodness, if not also the existence, of god. it is only a matter of curiosity that, while such advocates recognise and explain alone the exceptional cases, where there is simply a _want_ of the faculty, they do not seem to think that there can occur, or ever could have occurred, a case where its decrees are absolutely reversed. but, after all, we have to keep in view that the whole conditions, even of hare's nature, were not exhausted. for aught we know, if he had been condemned to die, providence would have vindicated her rule even as to him, and the faculty been observed to right itself. hare was, at any rate, declared at liberty. the hunt out. we take up the end of the thread of our last chapter, and say, that as the potential developments of a man's heart cannot be exhausted except by death, we cannot pronounce, until that issue arrives, of god's purpose with him. we have known many men who, by a redundancy of the oil of self-satisfaction, have kept the lamp of jovial humour, or light recklessness, or flippant egotism, burning for a long period of years, and indulging all the while in the boast of an indomitable persistiveness. there are many such, but we suspect they are generally mere actors; and we are the more satisfied of the hollowness of their pretensions when we learn the account of them from those who have access to their privacy, and are apt to verify the saying that, as no man is a hero to his valet, so no jolly fellow, _pococurante_, or devil-darer is always such to his wife, children, servants, or friends. even were it so, we would still say that the conditions have not been exhausted by some calamity which _may_ come, or by death, who _must_ come; and as there are worse evils than even death, the power of holding out is only an inverse mode of expressing the power of what is held out against. these remarks occur to us as we are now to follow the fortunes of the remaining three of the quaternity. hare was still hare up to the hour of his freedom, and that freedom, for which he had sacrificed the life of the man whom he had taught the trade of murder, was to be the test to try his obduracy, and prove the ruin of that persistency in evil which had mocked the ghosts of a score of murdered beings. he was let loose only to flee, and to flee under the only terror he felt--the uplifted hands of an avenging people. at a little past eight on the thursday night, after the decision of the high court of justiciary, he was relieved from his cell in the calton hill jail. it was a night of bitter frost, just such a one as vejove would select for sending a cain-marked murderer out upon the world. after being muffled up in an old camlet cloak, he walked, in company with the head turnkey, as far as the post-office in waterloo bridge without meeting with the slightest molestation. at this point his companion called a coach, and conveyed him to newington, where the two waited till the mail came up. the guard's edition of the story varies thus far, that he took up an unknown passenger in nicolson street, where he was ordered to blow the horn. but the difference is immaterial, and might easily arise from hare's state of mind. be this as it may, he got safely seated on the top of the coach without challenge and without suspicion. in the way-bill he figured as a mr black--not an inappropriate name--and the tall man who came to see him off, exclaimed, when the guard cried, "all's right," "good-bye, mr black, and i wish you well home."[ ] at noble-house, the second stage on the edinburgh road, twenty minutes were allowed for supper; and when the inside passengers alighted and went into the inn, hare was infatuated enough to follow their example. at first he sat down near the door, behind their backs, with his hat on, and his cloak closely muffled about him. but this backwardness was ascribed to his modesty, and one of the passengers, by way of encouraging him, asked if he was not perishing with cold. hare replied in the affirmative, and then, moving forward, took off his hat, and commenced toasting his paws at the fire--a piece of indiscretion which can only be accounted for by his characteristic recklessness, not yet cured; and little, indeed, was he aware that mr sandford, advocate, one of the counsel employed against him in the prosecution at the instance of daft jamie's relations was then standing almost at his elbow. a single glance served all the purpose of the fullest recognition, and, as hare naively enough remarked, "he shook his head at me," somewhat after the fashion, we suppose, of the ghost in macbeth. on the horn being blown, he contrived, after the manner of the greek slayer, who was always ahead of the three furies, to be first at the coach door, and finding an empty seat inside, he actually occupied it. "take that fellow out," cried the indignant counsel, and out accordingly he was taken, and transferred to the top, whereupon mr sandford, eager, perhaps, to justify what had the appearance of cruelty on so bitter a night, revealed to his fellow-travellers what, perhaps, he ought not to have done. a secret is like gas, it spreads without burning, and at beattock, the guard as well as the driver, knew all. they were only obliged to conceal it because there was no one to tell it to; but on the arrival of the coach at dumfries, the servants who attended to take the inside passengers' luggage, got the hint, and the news flew like a fire-flaught. meanwhile, hare had slunk into the coach-office of the king's arms. people were seen hurrying thither from every direction, crying, "hare's in the king's arms!" by eight o'clock, a large crowd had collected, and by ten it was perfectly overwhelming. you might have walked over the heads of a mass of people in the high street and buccleuch street, amounting to , reminding us of a great fair, when the country empties itself into the town. their object they did not tell, nor was it necessary, except in so far as having known that he was for port-patrick, they proposed to do the great man honour _in their own way_. if hare had got among these people, he would assuredly have been sacrificed, for the dissatisfaction at his release was not confined to the metropolis. meantime, the man, considering himself safe inside, and having from the first been surrounded by a knot of coachmen and guards, who handed him part of their ale, he clattered away, drinking absurd toasts, such as "bad luck to bad fortune," and not denying his identity: "no use for that now;" but all questions about his crimes he evaded; "he had said enough before;" "he had done his duty in edinburgh." yet we suspect that the light talk was the effect of the ale, for, to a gentleman who visited him, with a view to know something of his early history, he complained that he had no money, and when a guinea was handed to him, "he burst into tears." yes, the time had come, or was approaching, when the hitherto maintained conditions of insensibility were to be broken, not for penitence, not even for remorse, but for regret, if not despair. when this visitor retired, the people forced the door, and in an instant hare was squeezed into a corner, reminding one of a hunted fox when, getting into a _cul de sac_, he turns round, shews his teeth, and vainly attempts to keep the jowlers at bay. in the absence of the police, his situation was far from being free from peril. the torrent of imprecations was fearful, and "burke him!" came so savagely from so many throats, that he seemed on the very eve of being laid hold of and torn asunder. it is reported that one old woman was not only wonderfully emphatic and ferocious in her gestures, but strove to get forward to strike "the villain" with the end of her umbrella. and lucky it was that she did not get in the front, for mischief, like fire, needs only a beginning, and if one individual had lifted a hand, his fate would have been sealed. when the police arrived, the room was cleared, and hare conveyed to a safer place till the galway mail should start. with a view to this the inn-yard was closed with difficulty, the horses put too, and the coach brought out. but the mob, with rather more eyes than the old watcher, had previously taken their plans, as if by instinct, and their aspect appeared so threatening that it was impossible to drive the mail along the high street with the "fearful man" either inside or out. the coach accordingly started perfectly empty, two passengers having been sent forward a few miles in a gig. the crowd opened and recoiled--the tremendous rush, the appalling waves on waves of people, heaving to and fro; and now the coach is again surrounded, amidst yells the doors opened, the interior exposed, even the boot examined. the people were still more exasperated because their plan was defeated--no other than to stop the mail at the middle of the bridge, and precipitate hare from the parapet down into the river. failing in this, they had determined to waylay the coach at cassylands toll-bar, and there execute their purpose in another way, and as a preparation they had forcibly barricaded the gates. the crowd now rolled back in one continuous wave; and when the fact became known that he was still in the room of the inn, he was again broken in upon, forced to sit and stand in all positions and postures, turned round and back again, so that cool, insensate, and apathetic as he was, he was now stimulated into terror. amidst all this the imprecations were repeated, and another woman, after having exhausted her ingenuity in words, seized him by the collar, and tugged so manfully that he was nearly strangled. at one moment the voice of a sturdy ostler got ascendancy over the noise:--"whaur are ye gaun, man? or whaur can ye gang to? hell's ower gude for ye. the very deevils, for fear o' mischief, wadna daur to let ye in; and as for heaven, that's entirely oot o' the question." others, who wanted to drive matters to extremity, pretended to take his part, and urged him on. the old spirit came again, and he called out, "to come on, and give him fair play;" but this was a spurt, for despair was extending over him her dark wings, and so crucified was he, that he started, took his bundle, determined to "let the mob tak their will o' him"--a resolution in which he was checked by a medical man. the innkeeper, mr fraser, in the meantime, apprehensive for the safety of his premises, was anxious to eject his dangerous customer. the entire town was, in short, so completely convulsed that it was impossible to tell what would happen next, and, after deliberation, the magistrates, who had a very onerous duty to perform, hit upon an expedient for getting quit of him, which, though successfully executed, had ten chances to one against it. betwixt two and three, a chaise and pair were brought to the door of the king's arms, a trunk buckled on, and a great fuss made; and while these means were employed as a decoy-duck, another chaise was got ready almost at the bottom of the back entry, and completely excluded from the view of the mob. the next step was to clear the room, and, after this, to get hare to clamber, or, rather, jump out of the window of his prison, and crouch, cat-like, along the wall facing the stables. the task was well executed: the moment he got to the bottom and sprang into the chaise, the doors were closed and the whip cracked. never before did a chaise rattle so furiously along the streets of dumfries. to pass mr rankin's and round the corner of richardson's brewery occupied only moments; but here the turn was taken so sharply that the chaise ran for a time on two side wheels. had it upset, hare was doomed; but the driver recovered the position of the coach, and away again at even a more rapid rate. the mob by this time had become suspicious of a manoeuvre, and, as the driver had a considerable round to make, they rushed in a twinkling and in prodigious masses to intercept him at the middle of the sands. a rush down bank street like the letting out of waters, and from the opposite side of the river, numbers, suspecting the cause, hurried with such fury over the old bridge that the driver seemed destined to be outflanked and surrounded; nor could he have avoided this had it not been for the mettle of his horses and the willing arm that urged them on. once again his charge is saved from instant death. even yet the flight was far from being accomplished. at every instant, he was intercepted and threatened, and, though he cowered down, stones threatened him on every side. some stood still from inability to run, but others immediately supplied their places, filling up with almost the speed of thought the wake of the careering coach. an impression now prevailed that the driver meant to gallop out the galloway road, and a rush was made to the western angle of the new bridge--a mistake which operated as a diversion in favour of the driver--nor were the few moments gained misemployed. the sharp corner of dr wood's laboratory was cleared almost at a single bound, and as he had now a broad street before him, nothing could exceed the fury with which he drove up to the jail door. mr hunter had previously received his cue, and, though a strong chain was placed behind the door, an opening was left to admit the fugitive. a spring over the gulf, and hare is again safe. his escape enraged the mob still more. as the numbers increased, they laid regular siege to the place of safety, preventing all ingress or egress. from four to eight, all was clamour and execration, and at nightfall, for reasons of their own, they smashed and extinguished the neighbouring lamps. a ponderous piece of iron was used as a battering-ram, aided by heavy stones, the rebound of which was so incessant and long-continued, that every fear was entertained they would succeed in forcing the jail. it was next proposed to apply tar barrels and peats for the purpose of forcing the door. by this time the magistrates were thoroughly roused. the militia staff and police had done their best without avail, and it was not till one hundred special constables were sworn in and marched to the spot, with batons, that the peace of the city was restored. still the streets were in commotion, and it was afterwards ascertained that the mob still retained the intention of forcing the prison; but as the night waxed, their resolution waned, and at one o'clock on saturday morning not an individual was seen in buccleuch street. as the opportunity was too good to be lost, hare was roused from his bed, where he had so long shivered, and ordered to prepare. while putting on his clothes, he trembled violently, yet inquired eagerly for his cloak and bundle; but as these articles were not at hand, he was told he must go without them. as the whole population of galloway were in arms, and as the mail had been surrounded and searched at crocketford toll-bar, and probably at every other stage betwixt dumfries and port-patrick, it would have been madness to send him across the bridge, and he was recommended to take another route. at three o'clock he was seen by a boy passing dedbeck, and must have been beyond the border by the break of day. the driver of the mail reported that he saw him at a quarter-past five sitting on a heap of stones within two miles of carlisle. it seems he had been again recognised, and told that the people of carlisle were prepared to kill him; and although he appeared completely done up, he turned by the newcastle road, and doubtless made his bed in the open fields. little more was ever heard of hare. if the almighty, as mr m'diarmid added, when he appeared specially in the affairs of the world, left cain to wander hopeless on the face of the earth, why should not hare have been subjected to the same species of punishment? and, without wishing to refine too far, we may say, as the roman said long ago, "everything must bow to the majesty of the law; and that, from the weightiest circumstance down to the smallest, there is a medium course--a middle path--beyond which no rectitude and no safety to mortals can exist." as for mrs hare, she was liberated as soon after the trial as safety would permit; but almost immediately upon her release, a crowd collected round her. it was a cold, snowy day. she was pelted with snow-balls and stones, and had some commiseration not been felt for the child she carried, she would, in all probability, have fallen a victim to the violence of the mob. rescued by the police, she was conveyed to the police-office, where she found shelter and protection. she afterwards escaped, and wandered about the country, not knowing whither to betake herself. at length she turned up in glasgow, in the hope of getting a steamer for ireland. for this purpose she was obliged to wait, and at night she ventured out to the broomielaw to get information. next morning she repeated her venture, and in clyde street was recognised by a woman, who cried out, "hare's wife--burke her!" and threw a large stone at her. the signal was enough. a crowd soon gathered, and pursuing her into the calton offered her every indignity, nor can it be known how far they would have proceeded if she had not been taken from their hands by the police. it was described as truly pitiful to see her stretched on the guard bed of the cell, with her child clasped to her breast, weeping bitterly, and imploring the officers not to allow her to be made a show of. she was entirely ignorant of the fate of hare, with whom she said she would never live again. all she wanted was to get to ireland, and end her miserable life in some retired part of the country with penitence. she afterwards left glasgow in the fingal, and nothing more was ever heard of mrs hare.[ ] some traces were also got of helen m'dougal.[ ] upon her release from the lock-up house, she had the audacity or folly to repair to her old haunts in the west port, and even to appear in the street. she was recognised in an instant, and at once surrounded by a mob threatening to seize her, but fortunately the proximity of the district office insured protection, and with difficulty she was lodged. yet this was only the sign for an uproar. the mob increased to an alarming size for the slender force, and the officers were obliged to resort to an expedient to prevent an assault. a ladder was placed at a back window, by which it was pretended that she had got down, and the mob having dispersed, probably to pursue her, she was conveyed, under an escort, to the head-office. again venturing out, she was repeatedly exposed to similar dangers, till, finding it impossible to put out her head in edinburgh, she left secretly for redding in stirlingshire. she afterwards left that village, no doubt to be a wanderer, like the others, and with as little hope of rest to her feet as of peace to her soul. the final cause. there are one or two considerations connected with the history we have given which, though having something of a philosophical look, are yet sufficiently practical to be appreciated by the ordinary observer of human nature and the ways of god with his creatures. it is doubtful if, from the beginning, the actors in this drama were ever sufficiently understood; if it is not more true to say, that the people, eager to conserve the prestige of man's dignity, have been inclined, after the manner of purists, to set off exceptions to the general laws of human nature as the foil of some heaven-born exemption from crime. they have uniformly mixed contempt with their hatred of these strange men. they have not thought them entitled to be objects of consideration, far less study. they have represented them as something so far below their kind, that their deeds can no more enter as elements into a lesson than those of maniacs, or of the lower animals, who are exempted from the laws of responsibility, and so they have shewn an inclination to cast them out of the wide province of history; or, if they would allow them to remain within the precincts of annals, they would consign them to the grotesque page of _monstra horrenda_. it is no doubt beneficial for man to think well of the good, but it is not advantageous for him to think lightly of the evil potentialities of his nature. we cannot deny that these men and women were sane; and we have higher authority than a wish-born logic or a self-gratifying rhetoric to satisfy us that "the heart of man is deceitful above all things and desperately wicked." the authority is from heaven, and there is no want of verifying examples upon earth; nay, if we abate the "putrid coruscations," or what have been called "the blue lights of necromancy" that play round these sordid murders, and which are at least nourished by the fancy, we may find every day cases scarcely less cruel and scarcely less sordid,--if we might not even say that it requires some analysis to find the difference in mere turpitude between a man who murders for the money that is about the body and one who slays for that which the body will bring. then the repetition adds nothing to the atrocity of the individual act, while the premeditation is as signal in the slouching highwayman as in him who wiles the victim to the fatal den. in short, we may make what parade we please of the gradations of atrocity and the shades of our feelings, but we must always come back to the beginning, that there are no degrees of wickedness in those who have renounced god. not only, however, were these individuals sane; one among them, and the leader, was intelligent, had wit and humour, could feel the superficial sentiment of a pathetic lyric, and, above all, possessed ingenuity to the extent of inventing a new crime which has gone, with his name, over the world. the women, too, were intelligent and apt; nor has it been said that mrs hare did not feel the yearnings of a mother, or that m'dougal was false to the affection, however low, which bound her to the tyrant who enslaved her. even hare was not a fool--a character inconsistent with a will-power which could govern a woman of his wife's acknowledged adroitness, and lead, if not rule, a man such as burke, so that we may say that, so far as regards mere intelligence, the quaternity were a fair enough specimen of the people of their class, in which certain parts of our city abound; while burke may be safely pronounced as being considerably above the average of uncultivated minds, left as a waste for the culture of the devil. but not only in this aspect were they worthy of study--they were perfect in their moral organisation as embodiments of evil, with no scruples, no misgivings, no backcomings of penitence, no fear of the future, and no remorse for the past. they were not only "clear grits"--they were "crystals." they were, out of millions, creatures suited to the work they did--the work was suited to them, and they did it with all that concentration of purpose and uniformity of action which proclaim the being under alienation from the almighty. in what we here venture to say we have a sufficient apology for disinterring these people and their deeds, as constituting the great lesson, that it is the _occasion_ that tests the man; even as it is true what the proverb says, that a man is never known till he is invested with power. as an abstract aphorism, that proverb has but little influence; it is only when we see it reduced to the concrete that we feel its truth and lay it up in our hearts; and this we are the more ready to do that, while we are well penetrated by that horror which is fear, we are not the less under the influence of that other horror, which is hatred. and here we insist for a distinction which may silence those who indulge in the fancy, that it is not useful or good to pander to an appetite for details which, while they harrow the heart, are yet, by some strange peculiarity in our nature, not without a grim charm calculated to fascinate and yet not to deter. the fault here lies at the door of the chronicler, for it is he who holds the wand, and it requires only the mode of using it to change the appetite into a revulsion, and to make the horror which is hatred paramount for good. it is only man who is false to nature, never nature to herself. such deeds she exhibits in their true colours, and he who interprets her can only be true to his office when he produces those emotions which she produced in him uncoloured by the lights of a factitious fancy. we may thus, even without going further, find a final cause in these terrible acts done by creatures made after the image of god. we have no more right to inquire why evil should be made to deter from evil, than to investigate into the origin of evil itself. enough if we know and experience that the wages of sin is death; but we have here even more to consider. while we can have no doubt that the tragedy of burke and hare is calculated to deter not only from that sin which it involves, but from all those lesser ones which follow from the temptations of mammon, we have to recollect that it put an end to a pre-existing evil of gigantic magnitude, and which all the adjurations of a distressed people were not able otherwise to effect. that evil, as we have seen, was body-snatching. no sooner were the murders which the temptations of that practice induced brought to light, than our legislators took to their powers and duties, and righted the nation. they saved the affections of the heart without annulling the aspirations of the intellect, served the purpose of science in its remedial application to physical ills, without desecrating the temple where burned the light of the spirit, and through which these ills are felt. ballantyne and company, printers, edinburgh footnotes: [ ] scotland, with her open church-yards in secluded places, groaned under this infliction for centuries. see "an account of the most horrid and unchristian actions of the grave-makers in edinburgh, their raising and selling of the dead, abhorred by turks and heathens, found out in this present year, , in the month of may." we offer an extract:-- "methink i hear the latter trumpet sound, when emptie graves into this place is found, of young and old, which is most strange to me, what kind of resurrection this may be. i thought god had reserved this power alone unto himself, till he erect'd his throne into the clouds with his attendants by, that he might judge the world in equity; but now i see the contrair in our land, since men do raise the dead by their own hand." the price was known too, as a fixed thing apparently-- "as i'm inform'd the chirurgeons did give forty shillings for each one they receive." [ ] take this specimen of his self-esteem:--"gentlemen, i may mention that i have already taught the science of anatomy to about medical men now spread over the surface of the earth, and some of these have turned out most remarkable for their knowledge, genius, and originality, for they now occupy some of the most conspicuous and trying positions in europe. as a piece of curious testimony to my capabilities of communicating to you knowledge, i may venture to mention to you an interesting fact which took place last summer while on a visit to my distinguished friend and pupil, the right honourable the earl of breadalbane, at his beautiful and picturesque seat of taymouth castle, in the shire of perth. at a large party given by the noble earl to the leading nobility and gentry of scotland, where, to use the beautiful language of byron, 'a thousand hearts beat happily, and when music arose with its voluptuous swell, and all went merry as a marriage-bell;' i, who was there as the earl's guest, and knew personally none of the noble earl's distinguished personages of the party, happened to fall accidentally into conversation with a noble lord--an adjoining proprietor of our generous host's--on the subject of the breeding of cattle; and, although our conversation originated in the slightest possible observation, it went on naturally enough, until, by imperceptible degrees, i was forced to open up the whole extensive stores of my anatomical and physiological knowledge, (especially the comparative departments of these subjects,) and before i had addressed myself to the noble lord for ten minutes continuously, for i actually felt myself inspired by my situation, the whole beauty and fashion of the large suite of rooms were surrounding me, and seemed entranced with the deep thought that poured from my lips. i naturally felt somewhat abashed that i had drawn upon myself so much observation, but the direct and indirect compliments that were paid to knowledge and eloquence amply compensated for this painful sensation. among other things, i shall never forget the observation of an old, fashionable, and distinguished dame, evidently belonging to the middle portion of the last century, in these memorable words, 'he's a cunning loon that, he would wile the lav'rock frae the lift,' for her quaint remark seemed to embody, in few words, the entire sentiment of the large and distinguished company, all illustrating the adage of bacon, that knowledge is power; and, when brought to bear with eloquence and propriety, it affects equally all conditions of life with its mighty overwhelming strength." [ ] the following, extracted from the ms. notes of a student, may be taken as a specimen of knox's mode of dealing with his brethren:-"before commencing to-day's lecture, i am compelled by the sacred calls of duty to notice an extraordinary surgical operation which has this morning been performed in a neighbouring building by a gentleman [mr liston] who, i believe, regards himself as the first surgeon in europe. a country labourer from the neighbourhood of tranent came to the infirmary a few days ago with an aneurism of considerable extent, connected with one of the large arteries of the neck; and, notwithstanding of its being obvious to the merest tyro that it was an aneurism, the most distinguished surgeon in europe, after an apparently searching examination, pronounced it to be an abscess. accordingly, this professional celebrity--who, among other things, plumes himself upon the wonderful strength of his hands and arms, without pretension to head, and is an amateur member of the ring--plunged his knife into what he thus foolishly imagined to be an abscess; and the blood, bursting forth from the deep gash in the aneurismal sac, the patient was dead in a few seconds. this notable member of the profession is actually an extra-academical lecturer on surgery in this great metropolis; and on this occasion was assisted by a gentleman similarly constituted, both intellectually and physically, who had been trained up under the fostering care of a learned professor in a certain university, who inherited his anatomical genius from his ancestors, and who has recently published a work on the anatomy of the human body, in which, among other notabilities, no notice is taken of the pericardium. tracing the assistant of our distinguished operator further back, i have discovered that he had been originally apprenticed to a butcher of this city, but that he had been dismissed from this service for stealing a sheep's head and trotters from his employer's shambles. it is surely unnecessary for me to add that a knowledge of anatomy, physiology, pathology, and surgery, is neither connected with nor dependent upon brute force, ignorance, and presumption; nor has it anything to do with an utter destitution of honour and common honesty."--(roars of applause, mixed with a few hisses.) [ ] however little connexion there seems between our indifference as to what becomes of the body and our belief in the immortality of the soul, it is, nevertheless, certain that believers and unbelievers do not view the subject in the same light. the ancients, in spite of aristotle, (as we find him construed by pomponatius,) were greater _natural_ believers in the doctrine of the soul's immortality, than the moderns, in spite of des cartes. and see how they venerated the dead! the athenians put to death six generals who had achieved for them the greatest of their victories, because they had omitted to bury those who had been killed. when alcyoneus took the head of pyrrhus to his father antigonus, that king struck the bearer with a staff, covered his eyes, and wept, and ordered that the dead body and the head should be honourably put on the pyre. the rabbinical fable of the _luz_, or little bone of the size of a grain, which could not be destroyed even by fire, and from which _nostrum corpus animate repullulascet_, seems to have spread beyond judea. we need not speak of egypt and its sacred mummies. [ ] if, in these narratives, it may be found that i depart in some details from the discrepant confessions of burke, i have to plead such authority as i possess, in a collection of notes taken at the time by one who intended to use them in a fuller account than that comprised in the two pamphlets published by buchanan. [ ] she had been once a lodger in log's house. [ ] on examining the animal, the knackers found that many old sores become hollows had been filled up with tow, and then plastered over with a thin skin. [ ] they are fully described, for the first time we believe, in "curiosities of crime in edinburgh." [ ] we adopt this version in preference to another, which substitutes burke. [ ] it was never believed that the cases confessed to by burke exhausted the real list. one in particular, that of a little italian boy, ludovico, who went about with white mice, was a favourite story which could not be doubted, when it was known that the people of tanner's close saw, for years afterwards, the two little animals haunting the dark recesses, where their young master had been sacrificed. and many other visions were seen there besides those of the white mice. but, apart from these superstitions, it is certain that there was found in hare's house a cage with the mice's turning-wheel in it, which clearly had belonged to one of these italian wanderers. the silence of burke on the subject is of no importance, for his confessions did not agree, and, besides, it was properly asked, might not poor ludovico have been the subject which hare managed "on his own hook" unknown to burke? like the others, he would be mourned, but it would be far away in some little hamlet among the apennines. [ ] a subscription was raised for gray. he had saved the lives of probably a score of men and women; but so poorly was he remunerated, that he did not get a pound a head for these _lives_, or a tenth of that got by burke for his _bodies_. [ ] the fury against the doctors ran so high not only in edinburgh, but in dumfries, that they were exposed to the risk of the fate they experienced under cato the censor:--"romani quondam, sub catone censorio, medicos omnes et urbe tota et tota italia pepulerunt eorum funesta mendacia crudelitatemque aversati."--_agrippa de van. scien._ cap. . see, too, montaigne:--"les romains avaient este six cens ans avant que de recevoir la médecine; mais après l'avoir essayée, ils la chassèrent de leur ville par entremise de caton le censeur." this proscription of doctors lasted to the time of the first emperors; but even if they had been tolerated, the national reverence for the dead would have been an effectual bar to such practices as scotland groaned under for centuries. we are not left to wonder how they contrived to keep the body right in these ancient times, for we know that cato purged his household; and horace lets us up to the knowledge the old women had of simples. [ ] the allusion is to knox. his house was afterwards surrounded by a furious mob, who smashed his windows, and he was obliged to secrete himself for a time. [ ] the entire parliament square rang as by the echoes of a jubilee. [ ] the story that the cancerous affection arose from the saliva of daft jamie, communicated by a bite, was resolutely held to by the people. [ ] "he struggled a good deal," says an eye-witness, who was very near, "and put out his legs as if to catch something with his feet; but some of the undertaker's men, who were below the drop, took him by the feet, and sent him spinning round,--a motion which was continued until he was drawn up above the level of the scaffold." [ ] an eye-witness, whose notes we have, says, "he (burke) was one of the most symmetrical men i ever saw, finely-developed muscles, and finely-formed, of the athlete class." [ ] "after this exhibition," says an eye-witness, "burke was cut up and put in pickle for the lecture-table. he was cut up in quarters, or rather portions, and salted, and, with a strange aptness of poetical justice, put into barrels. at that time an early acquaintance and school-fellow was assistant to the professor, and with him i frequently visited the dissecting-room, when calling on him at his apartments at the college. he is now a physician in the carse of gowrie. he shewed me burke's remains, and gave me the skin of his _neck_ and of the right arm. these i had _tanned_--the neck brown, and the arm white. the white was as pure as white kid, but as thick as white sheepskin; and the brown was like brown tanned sheepskin. it was curious that the mark of the rope remained on the leather after being tanned. of that neck-leather i had a tobacco-doss made; and on the white leather of the right arm i got johnston to print the portraits of burke and his wife, and hare, which i gave to the noted antiquarian and collector of curiosities, mr fraser, jeweller, and it was in one of his cases for many years--may be still, if he is alive." [ ] the portraits of burke and m'dougal were got by the artist's having been introduced into the judges' private room, behind the bench. to complete the group, mr johnston, the engraver, managed through the governor to get an artist into the passage between the airing-grounds, when hare was taking his walk. hare saw the party sketching, came right up to the iron grating, and stood like a soldier at attention, until the sketch was completed. he then said, "now, sir, peetch me a shilling for that." [ ] for much of what follows of hare's flight we are indebted to the pencil-pen of mr m'diarmid of the _dumfries courier_. [ ] we might, perhaps, say, except till now. not long ago, we were told by a lady, who was in paris about the year , that, having occasion for a nurse, she employed a woman, apparently between sixty and seventy years of age. she gave her name as mrs hare, and upon being questioned whether she had been ever in scotland, she denied it, stating that she came from ireland. yet she often sung scotch songs; and what brings out the suspicion that she was the real mrs hare the more is, that she had a daughter, whose age, over thirty, agrees perfectly with that of the infant she had in her arms when in court. in addition to all this, the woman's face was just that of the picture published at the time. [ ] after burke's execution, m'dougal is said to have made a wonderful revelation. one night, when the two men were deep in an orgy, burke put the question, "what they would do when they could get no more bodies?" to which hare answered, "that they could never be absolutely at a loss while their two wives remained, but that would only be when they were hard up." the conversation had been overheard by one of the women. popular works by alexander leighton, author of "the court of cacus," &c. second edition, crown vo, cloth extra, price s. d., curious storied traditions of scottish life. by alexander leighton. contents:-- the white scalp. the ten of diamonds. sergeant davies' ghost. the chance question. the woman with the white mice. the knife-thrust in the dark. the scored back. the long slipper. the diamond eyes. the lord advocate's warrant. "mr leighton, in this volume, has collected nine or ten stories, and has told them very clearly and effectively.... some of the stories relate incidents of a curious kind, that have formed the subject of inquiry in criminal courts of justice.... the volume makes an excellent whole."--_the saturday review._ "in the story of the 'woman with the white mice,' we have a graphic account of the extraordinary trial of mrs s----of d----; a case of murder in which jeffrey performed his greatest feat of oratory and power over a jury.... besides being characterised by variety of incident, vigorous thought, and simplicity of expression, these tales have a noble purpose to serve."--_the literary gazette._ "all the tales are remarkably well told, and, in some instances, wrought up to a climax of no ordinary excitement."--_the leader._ "an admirable book for the fireside; and those who love excitement will find it in these pages without stint."--_the weekly dispatch._ "a very entertaining volume, evincing no ordinary powers of characterisation and description, caustic humour, and varied knowledge."--_scottish press._ "this volume is one to which mr leighton may be proud to prefix his name as its author."--_northern ensign._ "the 'ten of diamonds' is one of the most exciting tales ever written."--_morning star._ "the wild weird interest of some of these stories is almost supernaturally intense."--_caledonian mercury._ price s. d., crown vo, cloth extra, a second volume of curious storied traditions of scottish life. by alexander leighton. author of "the court of cacus," &c. contents:-- the amateur robbery at muttonhole. the dowser of arthur's seat. the college porter of st andrews. the house in bell's wynd. the cradle of logie. the bride of bell's tower. swinton house and its fairy. the murder in the king's park in . "we defy any one who loves a tale to sit down to one of these and not to be nailed to his chair till the 'charm's wound up.'"--_athenæum._ "to those who love good tales of terror and crime, the present volume will be delightful."--_spectator._ "the stories are told with great dramatic skill."--_westminster review._ "this volume will be welcome to a very large circle of readers."--_glasgow citizen._ "in this volume a great amount of ingenuity is employed, and an even greater amount of odd out-of-the-way reading is indicated.... the volume is curious and interesting."--_the scotsman._ "the story of the 'house in bell's wynd' is almost tremendous in its gathering climax, the breathless terror evolved by the main leading feature not in any degree suffering from the quieter termination of the narrative. the other stories are of a startling order, and, for the fireside, with the muttering winds and the falling snows without, we do not know of a more fascinating volume."--_weekly dispatch._ "mr leighton has a power of vivid description, and an art of interpolating mysterious thoughts and reflections, which makes him unrivalled in the recital of a tale of mystery or murder; and in certain portions, where the awful story arrives at its climax, he seems to revel in his description of the details."--_glasgow herald._ "mr leighton is one of the best story-tellers of our time. he puts in his shadows so very deep and dark as sometimes to make the feeling of horror, although romantic, too intense to be agreeable; but he never fails strongly to interest one, which is the sure test of success in this sort of writing."--_dundee advertiser._ file was produced from images generously made available by the library of congress) ------------------------------------------------------------------------ a treatise of cleanness in meats and drinks, of the preparation of food, the excellency of good airs, and the benefits of clean sweet beds. also of the generation of bugs, and their cure. to which is added, a short discourse of the _pain_ in the _teeth_, shewing from what cause it does chiefly proceed, and also how to prevent it. by _t h o. t r y o n_. _l o n d o n_, printed for the author, and sold by _l. curtis_ near _fleet-bridge_. . _of cleanness in meats and drinks. of the excellency of good airs, and of the contrary. of the benefits of clean sweet beds, and of the inconveniences of feather-beds. what matter it is that does occasion the generation of that pernicious vermin called bugs, that so many hundreds in this city, and other great towns, are infested with; more especially in_ holland, italy, new-england, barbadoes, jamaica, _and in many other places. that they are never bred but where beds are: and that their being generated from wooden bedsteads, or from hogs hair in the plaisterings of the walls, is a meer story, promoted inconsiderately by persons mistaken in the productions of nature: also, how all such persons as are troubled with them may be cured without using medicines, and directions how to avoid ever having them again._ i. _of cleanness in food._ what is more profitable for all lovers of health and wisdom, than food that is radically clean? and as bread hath deservedly the first place, together with herbs, and various sorts of excellent fruits; so the next is milk, which of it self is a brave, mild, and most friendly food to nature, very fit and profitable for all ages and complexions; and if it do not agree with some people, it is because their stomachs are made sharp and soured by superfluity of dainty food, and the continual use of strong drink. also milk being altered, it makes many sorts of wholesom healthy food. next to these, are various sorts of flesh, which being killed in their proper times and seasons, and when they are free from their uncleannesses, surfeits, and other inconveniences, which most beasts are subject to; and if care be taken also that they be well and moderately seasoned with salt, and boyled in plenty of river or spring-water (which is the best of all waters except rain-water) they become wholesom nourishment. for, river-water hath the advantage of running through various sorts of earth, by which it sucks into it self a fat, oylie, and saline quality, which the surface of the earth does plentifully afford; which also is the cause of all vegitation, and the lovely green colour which all vegitables are cloth'd with, does arise from this saline quality. for these reasons, river-water will brew, boil, and wash, and it is more profitable in all uses in houswifery, than spring or pump-water, and far wholesomer for men and beasts to drink. also your vessel in which your food is boyled, ought to be uncovered all the time it boyls; for if the air have not its free egress and regress, the pure spirits in the food become as it were suffocated, and then the food so prepared becomes dull and heavy; for the air is the essential life of the spirit; and all food that hath not plenty of water, and the free influences of the air, in its preparation, does certainly lose its natural colour, with the pure smell and taste: for if those three qualities be not preserved in all preparations of food, then the genuine vertue and lively tinctures are in part lost. the same is to be observed in all physical operations. and if the above-mentioned order be not observed, then the food is not so pleasant to the pallate, nor so easie of concoction; it lies heavy in the stomach, dulling and stupifying the senses; it generates a gross nourishment, and bad blood, whence does proceed many diseases: whereas if the above-mentioned rules be observed, and your fire quick, that your food do not stand still, or cease from boyling, till it be sufficiently done, the effects are contrary. it is also much better the food should be a little under-prepared, than too much: for when the gross phlegmatick body of any food is by preparation digested, then presently the lively spirituous quality is set at liberty, whence does proceed a most pleasant smell and taste; which pleasant quality, before the preparation, lay hid or captivated in the body of phlegm; but so soon as this phlegmatick body is in part destroyed, the spirit becomes volatile; and then, if the preparation be continued, those pure spirits do either become suffocated, or evaporate; and then the sweet balsamick body turns as it were sour. for these reasons, all sorts of food, either over prepared, or twice prepared, are of a strong fulsom taste and smell; as all meats heat again, and also pottages, and all such things, do obstruct nature, and generate many diseases. but if the forementioned rules be observed, the food so prepared is not only more pleasant to the pallate, but far lighter of digestion, and breeds better blood. for that universal distemper (the _scurvy_) which reigns so much in _england_, is chiefly caused by food ill prepared, and the eating of too much flesh, and fat things, especially in the improper seasons of the year, _viz._ from _july_ to the last of _november_. in this season the sun, which is the true life and power of all things, declines; and all sorts of herbage, which is the food of all beasts that are generally eaten, doth the same: the grass all this season is fraught with a gross phlegmatick matter; besides, it is a fainty hot time; the air, which is the cherishing life of all things, is more gross, and full of humidity, than all other times of the year; the spirits of all sorts of creatures are also weak, and on any accidents are quickly wounded, or evaporated, more especially those beasts that come from remote parts to great cities. besides, it is then the principal time of their generating, which renders them unclean. are not the people ten-fold as sickly in this season, and double the number die, than they do at other times? also you may observe, that the rots amongst sheep, and murrains that attend other beasts, are all or most of them in this season: therefore all sorts of people ought to be more careful of their health, both in exercises, meats, and drink, that they do not exceed either in quantity, nor eat things that are improper in quality. this is the time that all shepherds, and also those that are drivers of horses, and indeed all that have the government of cattel, ought to have and use double the prudence in the management of them, than at other seasons of the year, as i have more largely discoursed in a small treatise, which i intend to put forth, if i am permitted, of the preservation of sheep from the rot, and horses from surfeits. there are three marks by which every one may know whether the flesh be good. the first is by its pure white and brisk red colour, when raw. the second is by its continuing its firmness, being plump or swelled when boyled, having a brisk and lively taste, and that after eating it feels easie and pleasant in the stomach. the third is, by its taking salt well; for if your flesh be free from heat and surfeits, and not over-fed, which charges the body with gross phlegm; as also if it be not kept longer after it is killed (as indeed it ought not) than it be thought to be cold, before it is salted; all such flesh will take salt greedily, and it will not only keep longer from putrifaction, but it will eat much sweeter, and breed better nourishment. for, if any sort of cattel be over-fed, surfeited, or any other inconveniency attends them, and they be killed before they have recovered themselves of those injuries; or if it be in _august_, _september_, or _october_, this flesh will not take salt so well as the former, neither will the salt preserve it half so long from corruption. also, as it is before-mentioned, if flesh be kept too long after it be killed, such flesh will not receive salt into it, as other will, which is salted as soon as it is cold: for by keeping it does certainly lose its pure spirituous quality, so that the body becomes heavy, gross, and dull. does not the life and spirits of most sorts of food waste and evaporate by keeping, if there be not a proper way of preservation used? if flesh, by any inconveniencies, have lost its pure lively spirits and vertue, salt then hath no power to preserve such flesh from putrifaction: for salt cannot preserve the body from corruption, but by vertue of the pure subtile spirits, which are a pleasant habitation for the salt to incorporate it self with: for salt will not preserve flesh from putrifaction, any longer than the vertue and power of the spirit does continue, as it does appear by all salted flesh and fish: for through length of time the spirits become either suffocated, or evaporated, and then it presently falls into putrifaction: and yet this same flesh does still continue salt; for salt does not destroy and purge the flesh from its corruption, but incorporates it self with the essential spirits, and those two do as it were tie or hold the corrupt part captive, till the spirit and life of the flesh be spent or wasted, and then the flesh falls into putrifaction, which cannot be recovered, eitheir by salting, or any other art, to its first state: but if the salt had purged or destroyed the humidity and gross part, then there would have been no room nor matter for putrifaction, and then it would have continued firm and sound, as many other things do, which are freed from that gross humid matter from which putrifaction does proceed. therefore flesh is naturally the most unclean of all food, it being of a gross phlegmatick nature; and if care be not taken, and order and temperance observed in the eater, it generates abundance of crude and noxious humours. . cleanness in houses, especially in beds, is a great preserver of health. now beds for the most part stand in corners of chambers, and being ponderous close substances, the refreshing influences of the air have no power to penetrate or destroy the gross humidity that all such places contract, where the air hath not its free egress and regress. in these shady dull places beds are continued for many years, and hardly see the sun or elements. besides, beds suck in and receive all sorts of pernicious excrements that are breathed forth by the sweating of various sorts of people, which have leprous and languishing diseases, which lie and die on them: the beds, i say, receive all these several vapours and spirits, and the same beds are often continued for several generations, without changing the feathers, until the ticks be rotten. besides, we have many feathers that are imported from several countries, which are the drivings of old beds, the uncleanness whereof is not considered. as to the nature of feathers, they are of a strong, hot, fulsom quality: for, fowls, of all creatures, are for the most part the hottest; and their feathers contain the same nature: therefore the constant lying on soft feather-beds, does not only over-heat the back and reins, weakning the joynts and nerves; but they have power also not only to receive but retain all evil vapours and excrements that proceed from, and are breathed forth by various diseased people. hence it comes to pass, that sundry distempers are transferred from one to another, by lying upon or in such beds, which distempers do secretly steal on a man by degrees, so that he cannot imagine whence the disorder proceeds, or what the cause thereof should be. but i would not have the reader mistake me; all people are not subject to get diseases this way: there are some whose constitutions are strong, and their natural heat and spirits are vigorous and lively, by the power and vertue whereof they withstand and repel all such evil vapours and scents as do proceed from such beds, when a man is hot and sweats in them, that they have no power to seise the spirit: but, on the contrary, when such people shall lie on such beds, whose natural heat is weak, their spirits few, and whose central heat is not able to withstand or repel those vapours and scents which such beds send forth when a man is hot in them, this last sort of people are subject to receive injuries, and contract diseases: for those evil vapours do powerfully penetrate the whole body; and if they are not withstood by the central heat and power of the spirits, then these evil vapours do seise the spirits, and incorporate themselves with their likenesses: for every particular thing does sensibly and powerfully seek out its likeness, and wheresoever it finds its simile, it hath power to incorporate, and become essential. these are the chief reasons why one man gets diseases by lying with diseased persons, and in unclean beds, and others not. it is a general custom, when men go abroad or travel, to desire clean sheets, imagining them to be a sufficient bulwark to defend them from the pernicious fumes and vapours of old stale beds; but it is too short. for, it is certain, that most or all beds do perfectly stink, not only those in inns and houses of entertainment, but others: not but that every ones bed does smell indifferent well to himself; but when he lies in a strange bed, let a man but put his nose into the bed when he is thorowly hot, and hardly any common vault is like it. now this sort of uncleanness, which does proceed from old beds, is not only the greatest, but also the most injurious to the health and preservation of mankind, and the least care is taken to prevent it: every one that can, will have plentiful changes both of linen and woollen garments; for if they have not, experience does shew, that the excrements and breathings of the body will generate vermin. also do not most people take care that their furnitures are daily brushed and rubbed, and their very floors washed, as though they were to eat their food on them? but all this while they lie on beds that have not been changed, or hardly aired, in several years. let any indifferent person judge, which is most pleasurable and healthful, to have a clean floor to tread on, which costs many hard days labour to keep so, and is dirtied in a moments time; or to have a clean sweet bed to lye on. there is no comparison to be made, the difference is so great; the one being essential either to health or sickness, the other an indifferent thing. if there was but the tenth part of the care taken to keep beds clean and sweet, as there is of clothing and furniture, then there would be no matter for the getting of diseases, nor for the generation of bugs. i would have all housewifes, and others, consider the reasons of these things. are not lice, that troublesom vermin, bred from the breathings of the body, for want of often change both of linnen and woollen? and will not fleas breed from the very dust of chambers where people lie? also any woollen that hath been used about beds, although the cold winter hath destroyed them, yet if these clothes lie in any close place, where the air hath not its free egress and regress, these very garments will generate fleas the summer following: but if these clothes had never been used about men and women, they would never have bred fleas: for there is no matter of element in wooll or cloth for the generation of such creatures; but wooll, cloth, furs, and hair are chiefly the element of moths, and sometimes of small worms; that is, if such things are kept in places where the refreshing influences of the air have not their free egress: for all such places do contract great store of moisture, which, when hot weather comes, causeth putrifaction, whence all such vermin do proceed. but if those things be in daily use, and exposed to the open element, they never breed any vermin: so that the generation of those things are generally caused by accidents; not but that there is matter in the radixes of such things for the generation of such vermin. . from the pernicious smells and putrified vapours that do proceed from old beds, are generated the vermin called bugs, (of which, neither the ancients, nor the modern writers of this age, have taken any notice) according to the degrees of uncleanness, nature of the excrements, and the closeness of the places where beds stand: for some peoples excrements are not so unclean as others: also in all close places, especially in cities and great towns, the spirits and thin vapours of the air are suffocated, which makes the same air sulphurous and humid, whence does proceed putrifaction. therefore it is not to be thought a general rule, _that all old beds should breed bugs_, as some (who are ignorant of the operations of nature) will be apt to say, _if one bed do breed them, why not all?_ no, it is according to the nature of the uncleanness, and other accidents that do happen: for where (as is said before) the thin pure air, with the refreshing influences of the sun and elements, have their free egress and regress, all such matter is destroyed whence such vermin is produced. the original of these creatures called bugs is from putrifaction, occasioned by stinking scents and vapours which do proceed from the bodies and nature of men and women, and the mixing or incorporating of these vapours with moist and sulphurous airs: for where there is no heat nor humidity, there can begin no putrifaction. therefore all that have attributed the generation of this vermin to wood, as bedsteads, and the like, are grosly mistaken in the productions of nature; for there is no matter in wood that can generate such a vermin, it being productive only or chiefly of two creatures in _england_, _viz._ of wood-lice, and a small worm. these wood-lice are never generated but in places where the sun and air have not their free influences, so that there is store of humidity contracted; and when the sun comes to such degrees of the zodiack, this creature is generated, which is of as different a nature from bugs, as sweet wood is from a stinking bed. also wood does breed a certain small worm, but never till the salts nature and power is decayed through length of time; then the air enters it, which does presently cause it to contract a humid quality, from whence proceeds putrifaction, whereof, when the sun is powerful, this worm is bred. but so long as wood continues sound, and is kept dry, the air having its free influences on it, i affirm, that no sort of wood ever breeds any kind of vermin. . there are many also that attribute the generation of this creature to hogs hair, which being mixed with lime, and houses plaistered with it, does occasion (say they) the generation of bugs. now it is most certain, that there is no possibility in nature for this production: for no kind of hair ever breeds any living creature, except it be put into water or mud when the sun is powerful, and then this creature, thus generated, retains its first _species_, _viz._ a hair, with a live head, which was its element whence it proceeded: but if you take it out of the water, it presently dies: so also it doth when the sun declines in heat, as most sorts of vermin that are bred through heat and moisture do. but hair being mixed with lime, all matter of generation is thereby totally destroyed: for lime does chiefly contain a harsh, fiery, keen, sharp, corroding quality; it is so sharp, that it does destroy all life, and is as contrary to it, as light is to darkness; the predominant quality in it is the salts nature, from which no living creature can be produced. besides, if there were never so much matter in hair for the generation of such vermin, lime would destroy it; for in lime there is only a sal-nitral fiery vertue. . if the reasons before-mentioned be not sufficient to convince the ignorant of their erroneous opinions in this particular, then i hope the following one will, which is more familiar to every one. it hath never been known, that this troublesom vermin was ever seen in warehouses, kitchens, parlours, dining-rooms, or any places where beds have never been, except they have by accident been brought into such rooms or warehouses, by furniture of chambers that have been troubled with them, though all such places have the same furniture as chambers, except beds. . from the same substance or matter whence bugs are bred, is also occasioned the generation of many nasty diseases in the blood; so that the destruction of the matter that breeds them, is of greater consequence than most people are sensible of: and if these following rules be observed, i dare affirm, that the generation of bugs will cease, and also many other inconveniencies and distempers, that are got by this sort of uncleanness, will be avoided. first, you are to destroy all press-bedsteads which stand in corners of rooms, being made up with boards so close, that the air cannot penetrate or dry up and consume the moist sulphurous vapours that are contracted. these sorts of beds, that stand so, are apt to have them more than others. also you are to set your other sorts of beds as near as you can in the most airie places of your rooms, exposing them to the air the most part of the day, with your chamber-windows open, that the air may freely pass, which is the most excellent element, that does sweeten all things, and prevents putrifaction. in the night also you ought not to have your window-curtains drawn, nor your curtains that are about your beds; for it hinders the sweet refreshing influences of the air, so that the air of all close places becomes of a hot sulphurous nature and operation; the thin pure vapours, which do wonderfully refresh nature, are as it were suffocated: and this preventing the influences of the air, is in an especial manner observable, when people are sick, or out of order; as though the sweet pleasant air had been the cause of their disease: such rooms being so very close, with great fires in them, that if a healthy person do but continue three or four hours in them, the fulsom steams and thick vapours will much disorder him, and take away the edge of his appetite: and if so, what will the operation be on those whose spirits are weak and disordered with distempers? what is more pleasant and healthful than good air? it chears and comforts the spirits, it opens the passages of the joynts and nerves, it purifies the blood, creates an appetite, increasing strength and vigour: but, on the contrary, hot, thick, sulphurous airs do not only obstruct the passages of the spirits, but suffocate them, loading the joynts and nerves with evil juices, whereby the limbs and members become full of pain, causing a general tenderness to possess the whole body, and destroying the appetite, and the power of the digestive faculty in the stomach. also, do not all houses and places grow musty, and contract too great store of moisture, if the air be any way prevented, by window-shutters, or the like, that it cannot have its free egress and regress? therefore moderate clothing, hard beds, houses that stand so as that the pleasant briezes of wind may air and refresh them, and also houses that are full of windows, are to be preferr'd: for where the air hath not its free influences, the spirit becomes dull and heavy, this being the true life of the spirit in every thing. . now the certain means and way not onely to prevent the generation of this vermin, but also to preserve health and strength, are straw, or rather chaff-beds, with ticks of canvas, and quilts made of wooll or flocks to lay on them; which certainly is the most easie and pleasant lodging that can be invented: and a little custom will make it appear friendly to nature, and in every respect far beyond the softest feather-beds, on which, when a man lies down, he sinks into them, as into an hole, with banks rising on each side of him; especially if two lie together, when first they go to bed they lie close, and after a little time, when they begin to be hot or sweat, they are generally willing to lie a little further off, that they may cool themselves, but cannot do it without great difficulty and trouble, by reason of the softness of the bed, and those banks that rise on each side. besides, such soft feather-beds do over-heat the reins and back, making all the parts tender, and causing sweatings and many other inconveniencies to attend the body. feather-beds also are nothing so easie as quilts, after a little time being accustomed to them; they are also extream fulsom, and by their heat they do powerfully dry up the radical moisture, causing a general faintness to attend the whole body. but, on the contrary, hard, even beds, that lie smooth, are not only easie through custom, as is mentioned before; but a man may turn freely, both sleeping and waking: they harden and strengthen the whole body, especially the back and reins, make the nerves and sinews strong, preventing the immoderate evacuations by sweating, and keeping the body in a temperate heat. besides, such beds may be often changed, with but little trouble, and less cost; they send forth no stinking fumes or steams, as feather-beds do; but are sweet and clean. certainly nothing is more healthy, next to temperance in meat and drink, than clean hard beds. . all sorts of beds, especially feather-beds, ought to be changed, driven, or washed, at the least three or four times in a year; or else it is impossible to keep them sweet and clean, and to prevent the generation of vermin, or the other inconveniencies before-mentioned. would not every one condemn a man, if he should wear a shirt a year, and lie in sheets seven years? which if any should do, it would not either endanger his health, or bring half the inconveniencies on his body, as old stinking feather-beds do; which possibly stunk before ever they were lain on, by reason of the fulsom excrements that the quills of the feathers contain. also feathers do certainly contain an unclean putrified matter, that hath a near affinity with the nature of bugs; and therefore feather-beds are more apt to breed them, than wooll, or flocks; though both will do it, if the forementioned rules be not observed. but if you are not willing, or so lowly-minded, to have straw or chaff-beds under your quilts, then you may have flock-beds, with canvas tickings, which may be both aired and washed as often as you please, with little trouble and charge. if any shall question the truth of what i have alledged concerning beds, i desire they would please but to try the experiment, by filling a bed with the freshest and cleanest straw or chaff, which will smell very pleasant; and having so done, let them lie on it half a year, in a corner of a room, as beds generally stand, and then smell to it; and in stead of sending forth a pleasant scent, as it did at first, it will send forth a strong, fulsom, musty steam or fume. and if this will do so, what will feathers do, that in the root of nature are unclean fulsom excrements, of a hot strong quality? therefore they have the greater power not only to attract and suck in to themselves the fulsom excrements that are breathed forth of the body by sweatings, and the like; but they have also power to retain such evil vapours: and when others come to lie on them, and are thoroughly hot, it awakens those pernicious steams, which often bring many inconveniencies on the body. besides, it is very unpleasant to lie in such beds; a man must always be forced to keep his nose above-board. indeed each mans own bed does not stink or smell strong to himself, because he is accustomed to it; neither does a tallow-chandler smell those horrible scents and pernicious fumes that old tallow sends forth when it is melted: but let any other person, that is not accustomed to it, be near such things, and it will be very offensive to him. even so it is in all other stinking trades, and things of this nature: so that the greatest slut in the world does hardly smell her own house or bed stink: for in man is contained the true nature and property of all things, both of good and evil; therefore he is both liable and also apt to receive all impressions, and to be wrought on by all things he shall either communicate with or joyn himself to, whether it be cleanness, or the contrary. also by meats, drinks, and communication, all things have power, by a sympathetical operation, to work on man, because he is like unto all, bearing a proportionable nature unto all things. if people did understand this, they would prefer sobriety and temperance, with cleanness, far beyond what they do; and then men would not be subject to so many diseases as now they are. . heat and moisture is the root of all putrifaction; and therefore bugs are bred in summer; but they live all the winter, though they are not then so troublesom. they harbour in bedsteads, holes, and hangings, nitting and breeding as lice do in clothes: but all men know, that woollen and linnen are not the element of lice, but they are bred from the fulsom scents and excrements that are breathed forth from the body. the very same radix have bugs; and if there be any difference, they are from a higher putrifaction, and therefore they are a more noisome stinking creature. . the whole preservation of mens health and strength does chiefly reside in the wisdom and temperance of women. therefore the ancient wise men in former ages, did direct and accustom their women to a higher degree of temperance than the men. which customs of sobriety the women of several countries do maintain to this day, as in _spain_, great part of _france_, _italy_, and many great countries under the dominion of the _grand seignior_. their women do always drink water, their food being for the most part of a mean and simple quality; and for this reason neither they nor their children are subject to several diseases which our women and children are. wine and strong drink should be sparingly drunk by women, till they are past child-bearing; because the frequent and common drinking of strong drinks, does generate various distempers in the female sex, such as are not fit to be discoursed of in this place, which their children often bring with them into the world. if the seed be good, yet if the ground be bad, it seldom brings forth good fruit. also women are our nurses for fifteen or sixteen years; and they do not only suffer us to be gluttons, by letting us eat and drink often, of their ill-prepared food, beyond the power of the digestive faculty, and more than the stomach can bear; but many of them will entice us to gluttony, and some will force their children to eat even against their stomachs, till they cast it up again. now if it be a difficult point for a man of age and experience to observe the necessary rules of temperance, how careful then ought mothers and nurses to be in ordering their children? a great part of the children that die, especially in towns and cities, is occasioned either by the intemperance of their mothers, during the time they go with child, or afterwards by their unnatural and badly-prepared food, and suffering them to eat to excess; also by their keeping of them too warm, and too close from the air, and lapping of them up in several double clothes and swathes, so tight, that a man may write on them, and then putting them into warm beds, and covering them up close. if a strong man was so bound up, he could not endure it, without great injury unto his health. besides, the window-curtains are drawn, and also the curtains about the bed; by which means the air becomes so hot and sulphurous, that it causes great disorders to attend both the mothers and the children. this ill kind of management does also cause such a tenderness both in the mother and the child, that on every small occasion they are liable and apt to get colds, and divers other distempers. also women have the entire management of all things that concern our healths, during the whole time of our lives; they prepare and dress our food, and order all things in our houses, both for bed and board. there is not one man of a hundred that understands or takes any notice whether his food be well prepared or not; and if his bed stinks, he is used to it, and so counts it all well. mens time and study is chiefly taken up about getting a livelihood, and providing things necessary for themselves and families; so that there is not one among a thousand that understands any thing what belongs to the preservation of his health: whatever the women do and say touching the preparation of food, and other ordering of families for health, most men believe, not making the least scruple or question of the truth thereof. and well they may: for the chiefest doctors of our times do bow before them, and are altogether as subject to the rules and directions of women, as other men. where are your doctors that teach men sobriety in their lives, or the proper and natural way of preparing meats fit for the stomach? which of them adviseth against the evil custom of keeping their chambers so over-hot, when people are sick, and in the time of womens lying in child-bed? why do they not advise them not to have their curtains so close drawn, both before the windows and beds, insomuch that they are oftentimes in a manner suffocated for want of the fresh air? for, i affirm, that all sorts of people that do keep their beds, let the occasion be what it will, have ten-fold more need of the refreshing influences of the air, than others that are up: for, the bed being much hotter than a mans garments are when he is up, the thin, refreshing, moist vapours, that do penetrate the whole body more powerfully when a man is up, are thereby hindred. this is one chief reason why a man cannot digest a supper so well in bed, as if he sits up. all men know, that the bed destroys appetite. if a man go to bed at eight a clock, and lies till eight in the morning, he shall not be hungry; but if he goes to bed at the same time, and rises at four in the morning, though he sits still without action, yet by eight he shall have a good stomach to eat and drink; so great is the power of the air: for when a man is up, his body is cool, and the pure spirits and thin moist vapours of the air have power to penetrate the body; which element the body sucks in like a spunge thorow the pores; and this does not only cool and refresh the spirits, and the whole body, but also powerfully strengthens the action of the stomach. but i pity the young children most, who are so tender, and of so delicate a nature, both in their body and spirits, that every disorder does wound them to the very heart. nothing is more grateful and refreshing to them, than the pleasant air: it comforts their spirits, and causeth a free circulation of the blood and radical moisture, begets appetite, and makes them grow in strength: but, on the contrary, hot sulphurous airs, with great fires, and warm clothing, do not only hinder the circulation of the blood, but suffocate the spirits, and destroy the appetite, causing an unnatural heat to possess the whole body; whence does proceed various disorders and diseases, making them to cry, and be very forward. also close bindings, and over-warm clothings, and thick hot airs, do oft in weak-spirited children cause convulsions, vapours, and fumes to fly into the head, sometimes occasioning vomiting, which people call windy diseases. again, the food of most children, of late years, is so enriched with _west_ and _east-india_ ingredients, that is, with sugar and spices, that thereby their food becomes so hot in operation, that it does not only breed too much nourishment, which generates obstructions and stoppages, but it heats the body, drying up and consuming the radical moisture, and infecting the blood with a sharp fretting humour, which in some complexions and constitutions causeth languishing diseases, contracting the breast and vessels of the stomach, and hindering the passages of the spirits, so that the joynts and nerves become weak and feeble: in others, with the help of bad diet, and other uncleanliness, does cause botches, boils, and various sorts of leprous diseases. also many that have wherewithal, will frequently give their children sack, strong drinks, and fat meats, as long as they will eat, which is abominable, and absolutely contrary to the nature of children. there are a hundred other disorders and intemperances that many mothers and ignorant nurses affect their children with, which i have no room in this place to discourse of: therefore i commend unto the women milk that is raw, only made so hot as the mothers or nurses milk is when the child sucks it; and sometimes milk and flower boyled together, giving it the child about the warmness of breast-milk; and indeed, neither children nor others ought to eat any food hotter. also no children ought to drink any kind of strong drink: i could commend water, as the most wholesom; but it being contrary to our custom, ordinary beer may do well, or rather small ale. if women did understand but the hundredth part of the evils and diseases those indulging and intemperate ways do bring both to themselves and children, they would quickly be of my mind; which i never expect; _they are too wise_. a short discourse of the pain in the teeth, shewing from what cause it does chiefly proceed, and also how to prevent it. the terrible pains and diseases of the teeth do chiefly proceed from two causes. the first is from certain filthy phlegmy matter which the stomach and vessels do continually breathe and send forth, which does lodge or center in the mouth, especially between the teeth, and on the gums; and some people having fouler stomachs than others, such do breathe forth very sour, stinking, phlegmy matter, which does not only increase the pain, but causeth the teeth to become loose and rotten: and for want of continual cleansing and washing, those breathings and this phlegmy matter turns to putrifaction, which does eat away the gums, as though worms had eaten them: and this defect is generally attributed to the disease called the _scurvey_; but it is a mistake: the cause is chiefly, as is mentioned before, from the stomach, or for want of cleansings. . this distemper of the teeth and gums does also proceed from the various sorts of meats and drinks, and more especially from the continual eating of flesh, and fat sweet things, compounded of various things of disagreeing natures, which do not only obstruct the stomach, but fur and foul the mouth, part thereof remaining upon the gums, and between the teeth. for all such things do quickly turn to putrifaction, which does by degrees corrupt both the teeth and gums. besides, our beds take up near half the time of our lives, which time the body is not only without motion, but the bed and coverings do keep it much hotter than the day-garments, especially of those that draw the curtains of their windows and beds so close, that the pure spirits and thin refreshing vapours of the air are hindred of having their free egress and regress, which does dull and flatten the action of the stomach; and this is the chief cause why suppers lie hard in the stomach, and require more than double the time for perfect concoction, than the same food does when a man is up, and in the open air: for this element, if it hath its free influences, is sucked in, as by spunges, through all the pores of the body, and does wonderfully refresh, comfort, open, and cleanse all the parts, having power to assist and help concoction: but hot, dull, thick airs do destroy the action of the stomach, and as it were suffocate the pure spirits, drying up and consuming the radical moisture. therefore the night does foul the mouth more than the day, furring it with a gross slimy matter, especially those that have foul stomachs, and are in years, which ought to be well cleansed every morning. . whatsoever are the disorders in the body, the mouth does always partake of them; besides the evils that the variety of food, and the improper mixtures of flesh and fish, and many other things, which do foul and hurt both the teeth and gums. when any person is disordered with inward diseases, does not the mouth quickly complain of the evils thereof? this very few do consider in time. . it is to be noted, that most people do attribute the diseases of the teeth to colds, and rheums, and other outward accidents. it is true, outward accidents will further this disease, but then there must be matter before-hand, otherwise outward colds can have no power to cause this pain. the same is to be understood in all stoppages of the breast, and other obstructions, as coughs, and the like. for, if any part be obstructed, or there be matter for distemper, then, on every small occasion of outward colds, or the like accidents, nature complains. if your teeth and gums be sound, and free from this matter, take what colds you will, and your teeth will never complain, as daily experience doth shew. for all outward colds, and other accidents of the like nature, have no power to seise any part of the body, except first there be some inward defect or infirmity: suppose the teeth be defective, then the disease falls on that part; or if it be the head, eyes, breast, back, or any other part or member of the body, that is obstructed, the evil is felt in that part. therefore if the mouth be kept clean by continual washings, it will prevent all matter which may cause putrifaction; and then colds, and the like accidents, will have no power to seise this part, or cause this terrible pain. even so it is in all other parts of the body. if temperance and sobriety be observed in meats, drinks, and exercises, with other circumstances belonging to health, then stoppages, coughs, colds, and other obstructions, would not be so frequent on every small occasion: for temperance has an inward power and operation, and does as it were cut off diseases in the very bud, preventing the generation of matter whence distempers do proceed, increasing the radical moisture, and making the spirits lively, brisk, and powerful, able to withstand all outward colds, and other casualties of the like nature. . there are many various things, of divers natures, prescribed by physicians, and others, as washes to preserve the teeth and gums; but most of them, if not all, to little or no purpose, as daily experience teaches: for, all high, sharp salts, and things of a sour or keen nature, do rather cause the teeth to perish, than the contrary; as do all hot spirits, be they what they will: many have destroyed their teeth by the frequent use of such things, and it hath hardly ever been known that any such things have ever cured or prevented the aking pains of the teeth, but water only. many examples i could mention, if it were convenient. physicians, and others, do daily prescribe such things for the cure and prevention of this disease of the teeth, which most of them do know by experience can do no good, but rather the contrary: but when people come to them, they must give them something for their money; for interest and ignorance have more affinity with this sort of people, than vertue, and the true knowledge of the nature of things. most certain it is, that the shepherd and husbandman do know far better how to prepare the meat for their cattel, and also how to preserve them from disorders, than many physicians do their food or physick: and a man shall understand more by conversing with some of this sort of people, than with the learned: for the shepherd and husbandman understand something of nature; but most of the learned are departed from the simple ways of god in nature, putting out their own eyes, and then boasting what wonders they can see with other mens: they have invented many words to hide the truth from the unlearned, that they may get the greater esteem. this hath chiefly been done to advance pride and interest; so that the divine eye is departed from many of them, who never make any inspexion into the true nature of things, being contented to take other mens words, let it be right or wrong, as long as they have authority and law on their sides, wherefore should they trouble their weak heads? . the best and most sure way to prevent the diseases and pains in the teeth and gums, is every morning to wash your mouth with at the least ten or twelve mouthfuls of pure water, cold from the spring or river, and so again after dinner and supper, swallowing down a mouthful of water after each washing: for there is no sort of liquor in the world so pure and clean as water; and nothing doth cleanse and free the teeth and gums from that foul matter which does proceed from the breathings and purgings of the stomach, and from the various sorts of food, so well as water: the use of other washes is to little or no purpose; but whosoever do constantly wash their mouths with water, as is before mentioned, shall find an essential remedy. all hard rubbing and picking of the teeth ought by any means to be avoided for that is injurious to them. also whensoever you find your mouth foul, or subject to be slimie, as sometimes it will more than at others, according to the good or evil state of the stomach, though it be not after eating; at all such times you ought to wash your mouth. this rule all mothers and nurses ought to observe, washing the mouths of their children two or three times a day; and also to cause their children to swallow down a little water, which will be very refreshing to their stomachs: for milk does naturally foul and fur the mouth and teeth, and if they be not kept clean by continual washing, it causes the breeding of childrens teeth to be the more painful to them. . to keep your teeth white, one of the best things is a piece of a _china_ dish, or a piece of a fine _dutch_ earthen dish, made into fine powder, and the teeth rubbed with it. . few there be that understand or consider the excellent vertues of water, it being an element of a mild and cleansing nature and operation, friendly unto all things, and of universal use: but because it is so common, and so easily procured, i am afraid that many people will be like _naaman_ the _syrian_, when the prophet _elisha_ advised him to _wash seven times in the river of jordan to cure his leprosie_; it being the ignorance and folly of most people, to admire those things they do not know, and, on the other side, to despise and trample under foot those things and mysteries they do know; which the learned in all ages have taken notice of: for, should some people know what apothecaries and others give them, they would despise the physick, and have but little respect for their doctor. all housewifes do know, that no sort of liquor, be it what it will, will cleanse and sweeten their vessels, but only water; all other liquors leaving a sour stinking quality behind them, which will quickly cause putrifaction: but water in its own nature is clean and pure, not only for all uses in housewifery, and the preservation of health; but the saints and holy men of god have highly esteemed this element, by using it in the exteriour acts of divine worship, as having a simile with the eternal water of life, that does purifie and cleanse the soul from sin. _finis._ transcriber's notes. this book is years old and the advice given has been superceded by more modern methods and is only of historical value. the spelling is not consistent. italicized words and phrases are presented by surrounding the text with underscores. legal chemistry. a guide to the detection of poisons, examination of tea, stains, etc., as applied to chemical jurisprudence. translated with additions from the french of a. naquet, _professor to the faculty of medicine of paris_. by j. p. battershall, nat. sc. d., f.c.s. _second edition, revised, with additions._ new york: d. van nostrand, publisher, murray street and warren street. . copyright. d. van nostrand. . transcriber's note: text originally marked up as bold is surrounded by *, text in italics by _. obvious printer errors have been corrected. a list of all other changes can be found at the end of the document. in the appendix of the book, only the most obvious errors of punctuation were remedied. preface. the importance of exact chemical analysis in a great variety of cases which come before the courts is now fully recognized, and the translation of this excellent little book on legal chemistry, by one of the most distinguished french chemists, will be appreciated by a large class of american readers who are not able to consult the original. while it is to be regretted that the author has not presented a much more complete work, there is an advantage in the compact form of this treatise which compensates, in some degree, for its brevity. the translator has greatly increased the value of the book by a few additions and his copious index, and especially by the lists of works and memoirs which he has appended; and while he could have further increased its value by additions from other authors, we recognize the weight of the considerations which induced him to present it in the form given to it by the author. some chapters will have very little value in this country at this day, but the translator could not, with propriety, omit anything contained in the original. c. f. chandler. preface to the second edition. the principal change to note in this edition of the legal chemistry is the addition of a chapter on tea and its adulteration. the general interest at present evinced concerning this species of sophistication appeared to call for a simple and concise method of examination which would include the requisite tests without entering upon an exhaustive treatment of the subject. the translator's practical experience in the testing of tea at the united states laboratory of this city has enabled him to make a few suggestions in this regard which, he trusts, may be of use to those interested in food-analysis. numerous additions have also been made to the bibliographical appendix. j. p. b. contents. page introduction methods of destruction of the organic substances by means of nitric acid " " sulphuric acid " " nitrate of potassa " " potassa and nitrate of lime " " potassa and nitric acid " " chlorate of potassa " " chlorine " " _aqua regia_ dialysis detection of poisons, the presence of which is suspected. detection of arsenic _method used prior to marsh's test_ _marsh's test_ _raspail's test_ _reinsch's test_ detection of antimony _flandin and danger's apparatus_ _naquet's apparatus_ detection of mercury _smithson's pile_ _flandin and danger's apparatus_ detection of phosphorus _orfila's method_ _mistcherlich's method_ _dusart's method, as modified by blondlot_ _fresenius and neubauer's method_ _detection of phosphorus by means of bisulphide of carbon_ _detection of phosphorous acid_ _estimation of phosphorus_ detection of acids _hydrochloric acid_ _nitric_ " _sulphuric acid_ _phosphoric_ " _oxalic_ " _acetic_ " _hydrocyanic_ " detection of alkalies and alkaline earths detection of chlorine, bromine and iodine _chlorine and bleaching chlorides_ _bromine_ _iodine_ detection of metals detection of alkaloids and some ill-defined organic substances _stas's method_ " " _as modified by otto_ " " " " _uslar and erdman_ _rodgers and girdwood's method_ _prollius's method_ _graham and hofman's method_ _application of dialysis in the detection of alkaloids_ _identification of the alkaloid_ _identification of digitaline, picrotoxine and colchicine_ method to be employed when no clew to the nature of the poison present can be obtained indicative tests determinative tests miscellaneous examinations determination of the nature and color of the hair and beard _determination of the color of the hair and beard_ _determination of the nature of the hair_ examination of fire-arms _the gun is provided with a flint-lock and was charged with ordinary powder_ _the gun is not provided with a flint-lock_ detection of human remains in the ashes of a fire-place examination of writings examination of writings, in cases where a sympathetic ink has been used falsification of coins and alloys examination of alimentary and pharmaceutical substances _flour and bread_ _fixed oils_ _a olive oil intended for table use_ _b olive oil intended for manufacturing purposes_ _c hempseed oil_ _tea_ _milk_ _wine_ _vinegar_ _sulphate of quinine_ examination of blood stains examination of spermatic stains appendix books of toxicology, etc. memoirs on toxicology, etc. index legal chemistry. the term legal chemistry is applied to that branch of the science which has for its office the solution of problems proposed in the interest of justice. these most frequently relate to cases of poisoning. when the subject of the symptoms or anatomical lesions produced by the reception of a poison is under consideration, the services of a medical expert are resorted to; but when the presence or absence of a poison in the organs of a body, in the _egesta_ of an invalid or elsewhere is to be demonstrated, recourse is had to the legal chemist. investigations of this character require great practice in manipulation, and, however well the methods of analysis may be described in the works on the subject, there would be great danger of committing errors were the examination executed by an inexperienced person. the detection of poisons, although perhaps the most important, is not the only subject that may come within the province of the legal chemist; indeed, it would be somewhat difficult to define, _a priori_, the multitude of questions that might arise. in addition to cases of supposed poisoning, the following researches are most often required: . the examination of fire-arms. . the analysis of ashes, in cases where the destruction of a human body is suspected. . the detection of alteration of writings, and of falsification of coins and precious alloys. . the analysis of alimentary substances. . the examination of stains produced by blood and by the spermatic fluid. each of these researches justly demands a more extended consideration than the limits of this work would permit. the several subjects will be treated as briefly as possible, and at the same time, so as to convey an exact idea of the methods employed, leaving to the expert the selection of the particular one adapted to the case under investigation. we will first mention the methods used in the search for toxical substances. the poisons employed for criminal purposes are sometimes met with in a free state, either in the stomach or intestines of the deceased person, or in the bottles discovered in the room of the criminal or the victim. under these circumstances, it is only necessary to establish their identity by means of their chemical properties, as directed in the general treatises on chemistry, or by their botanical, or zoological character, in case a vegetable or animal poison, such as cantharides, has been administered. examinations of this class are extremely simple, the analysis of the substances found, confined to a few characteristic reactions, being a matter of no great difficulty. we will not here dwell longer upon this subject, inasmuch as the analytical methods used are identical with those employed in more complicated cases, with the sole difference that, instead of performing minute and laborious operations in order to extract the poisons from the organs in which they are contained, with a view of their subsequent identification, we proceed at once to establish their identity. the directions given in regard to complicated investigations apply, therefore, equally well to cases of a more simple nature. the detection of a poison mixed with the organic substances encountered in the stomach, or absorbed by, and intimately united with the tissues of the various organs is more difficult. if, however, other information than chemical can be obtained, indicating the poison supposed to be present, and the presence or absence of this one poison is the only thing to be determined, positive methods exist which admit of a speedy solution of the question. when, on the other hand, the chemical expert has not the advantage of extraneous information, but is simply asked,--whether the case be one of poisoning?--nothing being specified as to the nature of the poison used, the difficulty of his task is greatly increased. up to the present time, the works on toxicology have, it is true, given excellent special tests for the detection of particular poisons; but none have contained a reliable general method, which the chemical expert could use with the certainty of omitting nothing. impressed with this need, we proposed, in , in an inaugural dissertation then presented to the faculty of medicine, a general method, which, after some slight modifications, is now reproduced. the special methods which allow of the detection of various individual poisons will, however, first be indicated. in cases where the poison is mixed with organic matter, the latter must be removed as the first step in the investigation, as otherwise the reactions characteristic of the poison searched for would be obscured. when the poison itself is an organic substance, this separation is effected by processes modified according to the circumstances. if the detection or isolation of a metallic poison is to be accomplished, the most simple method consists in the destruction of the organic substances. the various methods for effecting this decomposition will now be described. i. methods of destruction of the organic substances. by means of nitric acid. in order to destroy the organic matters by this process, a quantity of nitric acid equal to one and a half times the weight of the substances taken is heated in a porcelain evaporating dish, the amount of acid being increased to four or six times that of the organic substances if these comprise the brains or liver. as soon as the acid becomes warm, the suspected organs, which have previously been cut into pieces, are added in successive portions: the organs become rapidly disintegrated, brownish-red vapors being evolved. when all is brought into solution, the evaporation is completed and the carbonaceous residue obtained separated from the dish and treated either with water, or with water acidulated with nitric acid, according to the nature of the poison supposed to be present. several objections to this method exist, the most serious of which is based upon the fact that the carbonaceous residue, containing, as it may, nitric acid, readily takes fire and may therefore be consumed, or projected from the vessel. this objection is a grave one, and is not always entirely removed by the continual stirring of the materials. according to _m. filhol_, the addition of to drops of sulphuric acid to the nitric acid taken obviates the difficulty; not having personally tested the question we cannot pronounce upon it. if it be the case, this process is an advantageous one, as it is not limited in its application, but can be used in the separation of all mineral poisons. by means of sulphuric acid. the organic matter to be decomposed is heated with about one-fifth of its weight of concentrated sulphuric acid, the complete solution of the materials being thus accomplished. the excess of acid is next removed by heating until a spongy carbonaceous mass remains. the further treatment of this residue depends upon the nature of the poison supposed to be present. if the sulphate of the suspected poison is a soluble and stable compound, the residue is directly treated with water; if, on the contrary, there is reason to think that the sulphate has suffered decomposition, the mass is taken up with dilute nitric acid; if, finally, the presence of arsenic is suspected, the residue is moistened with nitric acid, in order to convert this body into arsenic acid. the acid is afterwards removed by evaporation, the well pulverized residue boiled with distilled water, and the solution then filtered. this method, when applied in the detection of arsenic, is objectionable in that the carbonaceous residue, in contact with sulphuric acid, almost invariably contains sulphurous acid, detected by means of permanganate of potassa. this acid, being reduced in the presence of hydrogen, would cause the formation of insoluble sulphide of arsenic, and in this way prevent the detection of small amounts of arsenic by the use of marsh's apparatus. _m. gaultier de claubry_, indeed, states that he has not been able to detect the presence of sulphurous acid in the carbonaceous residue; but one affirmative result would, in this case, outweigh twenty negative experiments. a further objection to this process consists in the fact that the materials to be destroyed almost always contain chlorides, which, in presence of sulphuric acid and an arsenical compound, might determine the formation of chloride of arsenic, a volatile body, and therefore one easily lost. this difficulty is doubtless of a less serious nature than the preceding, as the operation can be performed in a closed vessel provided with a receiver which admits of the condensation of the evolved vapors; but even then the process would be prolonged. the above method is still again objectionable on account of its too limited application, it being serviceable almost exclusively in cases where the poisoning has been caused by arsenic, for, if applied in other instances, a subsequent treatment would be necessary in order to redissolve the metal separated from its decomposed sulphate. by means of nitrate of potassa. this method was formerly executed as follows: nitrate of potassa was fused in a crucible, and the substances to be destroyed added in small portions to the fused mass. the organic matter soon acquired a pure white color; owing, however, to the imperfect admixture of the organic matter with the salt used for its decomposition, it was necessary to take a large excess of the latter. the following process, suggested by _m. orfila_, remedies this inconvenience: the organs are placed in an evaporating dish, together with one tenth of their weight of caustic potassa, and a quantity of water varying with the weight of the substances taken. an amount of nitrate of potassa equal to twice the weight of the organic matter is next added, and the mixture evaporated to dryness. the residue is then thrown by fragments into a hessian crucible heated to redness, the portions first taken being allowed to become perfectly white before more is added. whichever process has been employed, the fused mass is decanted into a porcelain crucible, which has previously been heated in order to avoid danger of breakage. the portion remaining in the vessel is taken up by boiling with a small quantity of distilled water, and the solution so obtained likewise added to the crucible. the mass is then heated with sulphuric acid until all nitrous fumes are expelled, as these could give rise to an explosion, when, in the search for arsenic, the substance is introduced into marsh's apparatus. as soon as the nitric acid is completely expelled, the liquid is allowed to cool; the greater portion of the sulphate of potassa formed now separating out in crystals. the fluid is next filtered and the crystalline salt remaining on the filter, washed, at first with a little distilled water, then with absolute alcohol, which is subsequently removed from the filtrate by boiling. this method is scarcely applicable otherwise than in the detection of arsenic, as in other instances the presence of a large amount of sulphate of potassa would be liable to affect the nicety of the reactions afterwards used. its application, even in the search for arsenic, is not to be strongly recommended; on the contrary, the separation of the potassa salt by filtration is indispensable, as otherwise a double salt of zinc and potassium, which might be formed, being deposited upon the zinc used in marsh's apparatus, would prevent the disengagement of hydrogen, and every chemist is too well aware of the difficulty of thoroughly washing a precipitate, not to fear the possible loss of arsenic by this operation. by means of potassa and nitrate of lime. in this method the organic materials are heated with water and to per cent. of caustic potassa. as soon as disintegration is completed, nitrate of lime is added, and the mixture evaporated to dryness. a glowing coal is then placed upon the carbonaceous residue obtained: the mass, undergoing combustion, leaves a perfectly white residue. this residue dissolves in hydrochloric acid to a clear fluid which is then examined for poisons. the above process possesses the undeniable advantage of completely destroying the organic substances, at the same time avoiding the introduction of sulphate of potassa, the presence of which impairs the usefulness of the preceding method; but it necessitates the presence of numerous foreign bodies in the substance to be analysed, and this should be avoided. the _absolute purity_ of reagents is not always to be attained, and the results of an analysis are the more certain, in proportion as they are less numerous and more easily purified. by means of potassa and nitric acid. it has been proposed, instead of using nitrate of lime, to dissolve the organic matter in potassa and then saturate the fluid with nitric acid. this method is evidently more complicated than the simple treatment with nitrate of potassa, and possesses, moreover, no advantages over the latter process. by means of chlorate of potassa. the organic materials are treated with an equal weight of pure hydrochloric acid, and water added, so as to form a clear pulp. this being accomplished, two grammes of chlorate of potassa are added to the mixture at intervals of about five minutes. the fluid is next filtered, and the insoluble residue remaining on the filter washed until the wash-water ceases to exhibit an acid reaction. the filtrate is then evaporated, an aqueous solution of sulphurous acid added, until the odor of this reagent remains distinctly perceptible, and the excess of the acid removed by boiling the solution for about an hour. the fluid is now adapted to further examination for arsenic, or other metallic poisons. this method is one of the best in use, both chlorate of potassa and hydrochloric acid being reagents easily procured in a state of great purity; their use, however, is liable to the objection that they convert silver and lead into insoluble chlorides. by means of chlorine. _m. jacquelain_ suggests, in the search for arsenic, the decomposition of the organic matters by means of a current of chlorine, and recommends the following process: the organic substances are bruised in a mortar and then macerated with water. the fluid so obtained, in which the organic matter is held suspended, is next placed in a flask into which a current of chlorine is passed until all the organic matter is deposited in colorless flakes on the bottom of the vessel. the flask is then well closed and allowed to stand for hours, when the odor of the gas should still be perceptible. the fluid is now filtered, the filtrate concentrated by heating in a vessel which permits of the preservation of the volatile chloride of arsenic possibly present, and then examined for poisons. this process fails to possess the degree of generality desirable, and presents the disadvantage of requiring considerable time for its execution. by means of aqua regia. this method is exceedingly simple: _aqua regia_ (a mixture of two parts of hydrochloric and one part of nitric acids) is placed in a tubular retort provided with a receiver, and the organic materials, which have previously been cut into small pieces, added; the reaction commences immediately; if it is not sufficiently active, it is accelerated by a gentle heat: lively effervescence now occurs, and the destruction of all non-oleaginous substances is soon accomplished. the latter substances alone are not immediately decomposed by _aqua regia_, which attacks them only after prolonged action. as soon as the operation is concluded, the apparatus is removed from the fire and taken apart. the fluid condensed in the receiver is added to that remaining in the retort, and the whole thoroughly cooled in an open dish. the fatty matters now form a solid crust upon the surface of the fluid, which is removed and washed with distilled water, and, the washings being added to the rest of the solution, the latter is directly examined for metallic poisons. it is recommended by _gaultier de claubry_, in cases where the detection of arsenic is desired, to saturate and afterwards boil the suspected fluid with sulphuric acid, in order to remove the nitric and hydrochloric acids present. dialysis. the application of the dialytic method was first proposed by _graham_. by its use we are enabled to distinguish between two large classes of bodies, viz., _colloids_ and _crystalloids_. albumen, gelatine, and analogous substances are typical of colloid bodies; crystalloid substances, on the other hand, are those that are capable of crystallization, either directly or in their compounds, or, in case they are fluids, would possess this property when brought to the solid state. graham discovered that when an aqueous solution containing a mixture of colloid and crystalloid substances is placed in a vessel having for its bottom a piece of parchment or animal membrane, and this is immersed in a larger vessel filled with water, all of the crystalloids contained in the first vessel transverse the porous membrane and are to be found in the larger vessel, the colloid bodies being retained above the membrane. the organic matter to be eliminated in toxicological researches being colloids, and the poisons usually employed being crystalloids, the value of dialysis as a method of separation is evident. the process is executed as follows: [illustration: fig. .] a wooden,--or better, a gutta-percha--cylinder (fig. ), cubic centimetres in height and from to c. c. in diameter, is employed. a piece of moistened parchment is securely attached to one of the openings of the cylinder, which, upon drying, shrinks and completely closes the aperture. if its continuity becomes impaired, the pores of the membrane should be covered with the white of an egg which is subsequently coagulated by the application of heat. the organs previously cut into small pieces, or the materials found in the alimentary canal, etc., after having been allowed to digest for hours in water at °[a]--or, in dilute acids, if the presence of an alkaloid is suspected,--are then placed in the upper vessel, which is termed the dialyser. the whole should form a layer not over cubic centimetres in height. the dialyser is next placed in the larger vessel filled with distilled water. in about hours three-quarters of the crystalloid substances present will have passed into the lower vessel. the solution is then evaporated over a water-bath, and submitted to analysis. the portion remaining in the dialyser is decomposed by one of the methods previously described, in order to effect the detection of any poisonous substances possibly present. instead of the above apparatus, the one represented in fig. can be employed. the fluid under examination is placed in a bell-shaped jar, open at the top and closed below with a piece of parchment, which is then suspended in the centre of a larger vessel containing water. in other respects the operation is performed in the same manner as with the apparatus represented in fig. . [illustration: fig. .] [a] the degrees of temperature given in the text refer to the centigrade thermometer; their equivalents on the fahrenheit scale can be obtained by means of the formula: / c° + = f°. --_trans._ ii. detection of poisons, the presence of which is suspected. detection of arsenic. it is frequently required, in chemical jurisprudence, to institute a search for arsenic in the remains of a deceased person, whose death is supposed to have been caused by the reception of a poison. under these circumstances the poison is mixed with a mass of substances which would obscure its characteristic properties, and it becomes necessary, in order to accomplish its identification, to isolate it, and then, by decisive reactions, determine its character. three methods exist which permit of this result; they are: st. the method used prior to marsh's test. nd. marsh's test. rd. a method more recent than marsh's, proposed by _m. raspail_. method used prior to marsh's test. the materials supposed to contain arsenic are boiled in water which has been rendered strongly alkaline by the addition of pure potassa. the fluid is then filtered, an excess of hydrochloric acid added, and a current of sulphuretted hydrogen conducted through it. if arsenic be present in the suspected fluid, it is soon precipitated as a yellow sulphide. in dilute solutions the formation of the precipitate fails to take place immediately, and only a yellow coloration of the fluid is perceptible; upon slightly boiling the solution, however, the precipitation of the sulphide is soon induced. the precipitate is collected on a filter, well washed with boiling water, and then removed, if present in a quantity sufficient to admit of this operation. it is next dissolved in ammonia,[b] and the solution so obtained subsequently evaporated to dryness on a watch-glass. the residue of sulphide of arsenic is placed in a tube closed at one end containing nitrate of potassa in a state of fusion: it is decomposed by this treatment into a mixture of sulphate and arsenate of potassa, the reaction being completed in about fifteen minutes. the mixture is now dissolved in water, and lime water added to the solution: a precipitate of arsenate of lime is formed, which is separated from the fluid by filtration, dried, mixed with charcoal, and introduced into a second tube. a few pieces of charcoal are then placed in the tube adjoining the mixture and exposed to a red heat, the part of the tube containing the arsenical compound being also heated. by this operation the arsenic acid is reduced to arsenic, which is deposited upon the cold portion of the tube in the form of a metallic mirror. this mirror is then identified by subsequent reactions. the method just described is no longer in use, although the precipitation of the arsenic by sulphuretted hydrogen is still often resorted to in its separation from the other metals with which it may be mixed. the destruction of the organic substances is, however, accomplished by means of chlorate of potassa and hydrochloric acid. to insure the complete precipitation of the arsenic, it is advisable to conduct sulphuretted hydrogen through the solution, at a temperature of ° for twelve hours, and then allow the fluid to remain in a moderately warm place, until the odor of the gas is no longer perceptible, the vessel being simply covered with a piece of paper. the precipitate is next freed from the other metals possibly present, as directed in the general method of analysis, collected on a filter, and dissolved in ammonia. the ammoniacal solution is evaporated on a watch crystal, as previously described, and the residuary sulphide reduced to metallic arsenic. this reduction is effected by a process somewhat different from the one previously mentioned: the residue is fused, in a current of carbonic acid gas, with a mixture of carbonate of soda and cyanide of potassium. the apparatus employed is represented in fig. : _a_, is an apparatus producing a constant supply of carbonic acid. upon opening mohr's clamp, _g_, the gas passes into the flask _h_, which contains sulphuric acid; it is then conducted, by means of the tube _i_, into the reduction tube _k_, which has an interior diameter of mm. this tube is represented, in half size, in fig . [b] the sulphur, usually accompanying the precipitate of sulphide of arsenic, is insoluble in ammonia.--_trans._ [illustration: fig. .] [illustration: fig. .] the reduction is performed as follows: the sulphide of arsenic is ground in a small mortar, previously warmed, together with parts of a mixture consisting of parts of carbonate of soda and part of cyanide of potassium, both salts being perfectly dry. the powder thus obtained is placed upon a piece of paper rolled in the form of a gutter, and introduced into the reduction tube. the latter is then turned half round its axis, so as to cause the mixture to fall in _de_ without soiling the other parts of the tube. the paper is now withdrawn and the apparatus mounted. upon opening the clamp _g_, and strongly heating the mixture by either the flame of a gas or an alcohol lamp, a mirror-like ring of metallic arsenic is deposited at _h_, if this poison be present in the substances under examination. when the coating is too minute to permit of perfect identification, it should be driven by heat to a thinner part of the tube; in this way it is rendered easily visible, being condensed upon a smaller space. the above process possesses the advantage of not allowing arsenic to be confounded with any other body; it also permits of a quantitative estimation of the poison present. for this purpose, it is only necessary to previously weigh the watch-crystal, upon which the ammoniacal solution of sulphide of arsenic was evaporated, and to determine its increased weight after the evaporation; the difference of the two weighings multiplied by . , gives the corresponding weight of arsenious acid, and by . , the weight of the corresponding amount of metallic arsenic. marsh's test. marsh's test is based upon the reduction of arsenious and arsenic acids by nascent hydrogen, and the subsequent transformation of these bodies into water and arsenetted hydrogen, a compound from which the arsenic can be readily isolated. when pure hydrogen is generated in a flask having two openings, one of which is provided with a perforated cork through which a safety-tube passes, the other with a tube bent at a right angle and drawn out to a small point at the free extremity, the evolved gas, if ignited, burns with a pale non-luminous flame. the air should be completely expelled from the apparatus before igniting the gas. upon bringing a cold porcelain saucer in contact with the point of the flame, only water is formed. if, however, a small quantity of a solution containing arsenious or arsenic acids is introduced into the apparatus by means of the safety-tube, arsenetted hydrogen is produced. this gas burns with a bright flame, yielding fumes of arsenious acid. in case a large amount of the poison is present, it can be recognized by the appearance of the flame, and by inclining a glass tube towards it upon which a portion of the arsenious acid becomes deposited. these indications are, however, not distinguishable in presence of only a small amount of arsenic, and the following distinctive properties of the gas should be verified: st. at an elevated temperature it is decomposed into its two constituent elements. [illustration: fig. .] [illustration: fig. .] nd. the combustibility of the constituents differs: the arsenic being less combustible than the hydrogen, begins to burn only after the complete consumption of the latter body has taken place. for this reason the flame (fig. ) is composed of a dark portion _o_ and a luminous portion _i_, which surrounds the first. the maximum temperature exists in _o_ at the point of union of the two parts of the flame. owing to an insufficient supply of oxygen, the complete combustion of the arsenic in this part of the flame is impossible, and if it be intersected by the cold surface _a b_, that body is deposited as a brown spot, possessing a metallic lustre. the metallic deposit originates, therefore, from the decomposition of the arsenetted hydrogen by heat and from its incomplete combustion. if the spot is not large, it fails to exhibit a metallic lustre; an experienced chemist, however, will be able to identify it by the aid of proper tests. spots are sometimes obtained when the substance under examination does not contain the least trace of arsenic. these may be caused by antimony or by a portion of the zinc salt in the generating flask being carried over by the gaseous current. this difficulty is remedied by giving the apparatus the form represented in fig. . _a_ is the flask in which the gas is generated. the delivery-tube _i_ connects with a second tube _h_, filled with asbestus or cotton; this is united by means of a cork with a third tube _c_, made of bohemian glass. the latter tube is quite long, and terminates in a jet at its free end, enclosed in tin-foil;[c] it passes through the sheet-iron furnace _r_, supported upon _g_. the screen _d_ protects the portion _d e_ of the tube _c_ from the heat. the gas disengaged is ignited at _e_ and the porcelain dish _p_ is held by the hand in contact with the flame. the apparatus being mounted, zinc, water and some sulphuric acid are placed in the generating flask,[d] and the solution containing arsenious acid added: the evolution of gas commences immediately. the tube _h_ serves to retain any liquids that may be held suspended. the gas then passes through the part _c d_ of the tube _c_, which is heated by placing a few live coals upon the furnace _r_. the greater portion of the arsenetted hydrogen is decomposed here, and is deposited on the cold part of the tube, in a mirror-like ring. the small quantity of gas that escapes decomposition, if ignited at _e_, produces a metallic spot on the dish _p_. in order to determine that the spots are due to the presence of arsenic, and not produced by antimony, the following tests should be applied: [c] the fusing of the point of the tube is also prevented by platinizing it. the tube is drawn out, its end roughened by filing, and then immersed in solution of bichloride of platinum, so that a drop or two of the fluid adheres. the point, upon heating, now acquires a fine metallic lustre, and by repeating the operation a few times a good coating of platinum is produced both on the exterior and interior of the tube.--_trans._ [d] the addition of a few drops of solution of bichloride of platinum to the mixture of zinc, water and sulphuric acid is advisable.--_trans._ . the color of the spots is distinctive: arsenical spots are brown and exhibit a metallic lustre, whereas those originating from antimony possess a black color, especially near their border. this difference is, however, not perceptible when the deposits have a large surface. . if the mirror be arsenical, it is readily volatilized from one part of the tube to another, when the latter is heated, and a current of hydrogen, or carbonic acid gas made to pass through it. spots that are due to the presence of antimony are much less volatile. . if the tube is held in an inclined position so that a current of air traverses it, and the part containing the arsenical mirror heated, the arsenic oxidizes and arsenious acid is sublimed and deposited higher up in the tube in the form of a ring, which exhibits octahedral crystals when examined with a magnifying glass. this ring should be further tested as follows: _a._ if it is dissolved in a drop of hydrochloric acid and a solution of sulphuretted hydrogen added, a yellow precipitate of sulphide of arsenic is formed. this compound is soluble in ammonia and in alkaline sulphides, but insoluble in hydrochloric acid. _b._ if the ring is dissolved in pure water and an ammoniacal solution of sulphate of copper added, a beautiful green precipitate ("_scheele's green_"), consisting of arsenite of copper, is produced. . when produced by arsenic the spots are soluble in nitric acid, and upon evaporating the solution so obtained to dryness, a residue of arsenic acid, which is easily soluble in water, remains. if an ammoniacal solution of nitrate of silver is added to the aqueous solution of the residue, a brick-red precipitate is produced. spots consisting of antimony give, when treated with nitric acid, a residue of an intermediate oxide, insoluble in water. . upon treating the spots with a drop of solution of sulphide of ammonium, the sulphide of the metal present is formed: if sulphide of arsenic is produced its properties, as enumerated above, can be recognized. it may be added that the sulphide of antimony formed is soluble in hydrochloric acid, and possesses an orange red color, whereas sulphide of arsenic is yellow. . when spots originating from arsenic are treated with a solution of hypochlorite of soda (prepared by passing chlorine into solution of carbonate of soda), they are immediately dissolved; if, on the other hand, they are produced by antimony, they remain unaltered by this treatment. such are the properties exhibited by soluble compounds of arsenic when treated by marsh's process; the following precautions are, however, necessary when this test is made use of in medico-legal examinations. . if small white gritty particles, resembling arsenious acid, are discovered in the stomach or intestines, they are directly introduced into marsh's apparatus. when this is not the case, the destruction of the organic matter is indispensable even though, instead of the organs themselves, the contents of the alimentary canal are taken. in the latter instance, the solids are separated from the fluids present by filtration, the solution evaporated to dryness and the residue united with the solid portion; the organic matter is then destroyed by one of the methods previously described. in the special case of arsenic, the separation of the poison from the accompanying organic materials can be accomplished by a process not yet mentioned which may prove to be of service. the suspected substances are distilled with common salt and concentrated sulphuric acid. by this operation the arsenic is converted into a volatile chloride which distils over. the poison is isolated by treating this compound with water, by which it is decomposed into hydrochloric and arsenious acids. we must give preference, however, to the method by means of chlorate of potassa and hydrochloric acid. . the solution having been obtained in a condition suitable for examination, the air is completely expelled from the apparatus by allowing the gas to evolve for some time, and the suspected fluid then introduced into the generating flask. danger of explosion would be incurred were the gas ignited when mixed with air.[e] [e] the effervescence of the mixture is prevented by _slowly_ adding the arsenical solution to the generating flask. in order to avoid loss of arsenetted hydrogen, the cold dish should be directly applied to the flame even before the introduction of the suspected solution, and its position changed at short intervals, so as to allow the deposit to be formed on different parts.-_trans._ . it is indispensable, in applying this test, to have a second apparatus in which only the reagents necessary to generate hydrogen are placed: in this way, if no spots are now produced by the use of the second apparatus, it is certain that those obtained when the first apparatus is employed do not originate from impurities present in the reagents used. it has come under the author's observation, however, that a sheet of zinc sometimes contains arsenic in one part and not in another; in fact, the shavings of this metal, as purchased for laboratory use, are often taken from lots previously collected, and may therefore have been prepared from several different sheets. if this be the case, it is supposable that the zinc used in the second apparatus may be free from arsenic, whereas the metal with which the suspected solution is brought in contact may contain this poison; serious danger would then exist of finding indications of the presence of arsenic in materials that did not originally contain a trace of the metal. in order to obviate this important objection, which might possibly place a human life in jeopardy, we propose the following modifications: pure mercury is distilled and its absolute purity established. as the metal is a fluid and is therefore homogeneous, it is evident if one portion be found pure, the entire mass is so. sodium is then fused under oil of naphtha, in order to cause the complete admixture of its particles, and the purity of the fused metal in regard to arsenic tested. an amalgam is next prepared by uniting the mercury and sodium. this is eminently adapted to toxicological investigations: in order to generate a supply of very pure hydrogen, it is only necessary to place the amalgam in water kept slightly acid by the addition of a few drops of sulphuric acid, by means of which the disengagement of gas is rendered more energetic.[f] [f] owing to the impurities often occurring in zinc, the use of distilled magnesium in marsh's apparatus has also been suggested. this metal is now to be obtained in a state of great purity; it is, however, sometimes contaminated with silicium, which body likewise gives rise to a metallic deposit, but one that is readily distinguished from arsenical spots by its insolubility in nitric acid, _aqua regia_, and in hypochlorite of soda. the presence of magnesium causes the precipitation of the non-volatile metals possibly contained in the fluid tested for arsenic.--_trans._ it should be borne in mind that the solution introduced into marsh's apparatus must not contain organic substances, and that, in case their destruction has been accomplished by means of nitric acid all traces of this compound are to be removed. the sulphuric acid used should also be completely freed from nitrous vapors. according to _m. blondeau_, nascent hydrogen in the presence of nitrous compounds converts the acids of arsenic not into arsenetted hydrogen (as h{ }), but into the _solid_ arsenide of hydrogen (as{ } h{ }). this latter compound, upon which pure nascent hydrogen has no effect, is transformed into gaseous arsenetted hydrogen by the simultaneous action of nascent hydrogen and organic substances. these facts are of the greatest importance, for they might possibly cause a loss of arsenic when it is present, as well as determine its discovery when it is absent. the first case is supposable: should traces of nitric acid remain in the solution, the arsenic would be transformed into solid arsenide of hydrogen and its detection rendered impossible. the second case may also occur: if the zinc placed in the apparatus contains arsenic, and the sulphuric acid used contains nitrous compounds, the evolved gas will fail to exhibit any evidence of the presence of arsenic, owing to the formation of the solid arsenide of hydrogen. upon adding the suspected solution, which, perchance, may still contain organic substances, this arsenide is converted into arsenetted hydrogen, and the presence of arsenic will be detected, although the solution under examination was originally free from this metal. raspail's method. m. raspail suggests the following method for detecting arsenic: the surface of a brass plate is rasped by filing. in this condition the plate may be regarded as an innumerable quantity of voltaic elements, formed by the juxtaposition of the molecules of zinc and copper. the suspected materials are boiled with caustic potassa, the solution filtered, a drop of the filtrate placed upon the brass plate, and a drop of chlorine water added. if the plate is then allowed to stand for a moment and the substance under examination contains arsenic, a mirror-like spot is soon deposited upon its surface. in order to avoid confounding this deposit with those produced by other metals, the substitution of granulated brass for the plate is in some cases advisable. the granulated metal is dipped successively in the suspected solution and in chlorine water. the granules retain a small quantity of the solutions and, owing to the action of the chlorine water, become covered with metallic spots, if arsenic be present. they are then dried, placed in a tube closed at one end, and exposed to the heat of an alcohol lamp. in case the spots are arsenical, the metal volatilizes and condenses in a ring upon the cold part of the tube, which is submitted to the tests previously described. this method can hardly be of great service, inasmuch as it extracts the poison from but a very small portion of the solution containing it: we have not, however, personally tested its merits.[g] [g] the omission in the text of reinsch's test should be supplied. this test is based upon the fact that when solutions of arsenious acid or an arsenide are acidulated with hydrochloric acid and boiled with metallic copper, the latter becomes covered with a film consisting largely of metallic arsenic: it is extensively employed in chemico-legal examinations. the materials to be examined are completely disintegrated by boiling with hydrochloric acid, and the fluid filtered. some pure copper gauze or foil, having a polished surface, is then immersed in the boiling solution, and notice taken of the formation of a grey deposit. if a coating be formed, fresh pieces of the metal are added, so long as they become affected. the copper is then withdrawn from the solution, thoroughly washed with water, and dried, either by means of the water-bath or by pressing between bibulous paper. it is next introduced into a dry tube, and heated over a spirit lamp. the arsenic present volatilizes and is oxidized to arsenious acid which forms a deposit, consisting of octahedral crystals, on the cold part of the tubes. these are subsequently tested by means of the reactions distinctive of arsenious acid. it need hardly be added that the absolute purity of both the hydrochloric acid and of the copper is to be carefully established. the deposit obtained in the above operation was formerly regarded as pure arsenic, but it has been proved to be an alloy consisting of per cent. arsenic, and per cent. copper. reinsch's test possesses the advantage of requiring but little time for its execution, of being applicable to complex organic mixtures, and of effecting the detection of a very minute trace of the poison.--_trans._ detection of antimony. strictly speaking the salts of antimony are more therapeutic than poisonous in their action. in fact they usually act as emetics and, under certain circumstances, may be taken in large doses without incurring serious results. there are instances, however, in which their action is truly toxical, and it becomes necessary to effect their detection in the organs of a body. it should be remarked that these salts, if absorbed, remain by a kind of predilection in the liver and spleen. a special examination of these organs should therefore be instituted, particularly if the fluids of the alimentary canal are not at hand, which is frequently the case when some time has elapsed before the investigation is undertaken. the remarks made in the preceding article concerning the distinctive properties of arsenic and antimony need not be repeated here. the search for antimony is likewise executed by aid of marsh's apparatus. we will confine ourselves to a description of a modification to this apparatus proposed by _mm. flandin_ and _danger_, and employed in the separation of antimony and arsenic, when a mixture of these metals is under examination. another process, by means of which we arrive at the same result with greater certainty and by the use of a less expensive apparatus, will then be mentioned. we will, however, first indicate the preferable method of destruction of the organic substances. were the decomposition performed by means of sulphuric acid, sulphate of antimony, a slightly soluble salt and one not well adapted to the subsequent treatment with nascent hydrogen, would be formed. in order to obtain the metal in a soluble state, the formation of a double tartrate of antimony and soda is desirable. this may be accomplished in the following manner: . a cold mixture of nitrate of soda, sulphuric acid, and the suspected materials is prepared in the proportion of grammes of the nitrate to grammes of the acid, and grammes of the substance under examination. this mixture is heated and evaporated to dryness, and the decomposition of the organic matter completed in the usual manner. the carbonaceous residue obtained is pulverized, and then boiled with a solution of tartaric acid. by this treatment the antimonate of soda present is converted into a double tartrate of antimony and soda, which is easily soluble in water. the solution is filtered and then introduced into marsh's apparatus. . another method consists in heating the substances under examination with one half of their weight of hydrochloric acid for six hours on a sand-bath, avoiding boiling. the temperature is then increased until the liquid is in a state of ebullition, and to grammes of chlorate of potassa, for every grammes of the suspected matter taken, added in successive portions, so that a quarter of an hour is required for the operation. the liquid is next filtered, and the resinous matter remaining on the filter well washed with distilled water; the washings being added to the principal solution. a strip of polished tin is then immersed in the liquid: in presence of a large amount of antimony the tin becomes covered with a black incrustation: if but a minute quantity of the metal is contained, only a few blackish spots are perceptible. after the tin has remained immersed for hours, it is withdrawn and placed in a flask together with an amount of hydrochloric acid sufficient for its solution in the cold. if, after several hours, blackish particles are still observed floating in the liquid, they can be dissolved in a few drops of _aqua regia_. the solution may then be directly introduced into marsh's apparatus. apparatus proposed by flandin and danger. [illustration: fig. .] this apparatus consists of a wide necked jar _a_ (fig. ) for the generation of the gas, the mouth of which is closed with a cork having two openings. the safety tube _s_, which is funnel-shaped at its upper extremity and has its lower end drawn out to a point, passes through one of these apertures; the other opening contains the small delivery tube _b_, open at both ends, and terminating in a point at its upper extremity: it is also provided with lateral openings, in order to prevent the solution being carried up to the flame. the second part of the apparatus is the condenser _c_, . metre in diameter, and . metre in length. this terminates at its lower extremity with a cone, and connects at the side with the tube _t_, slanting slightly downwards. in the interior of the condenser, the cooler _e_ is contained, the lower end of which is nearly in contact with the sides of the opening _o_. the combustion tube _d_, . metre in diameter, is connected by means of a cork with the tube _t_; it is bent at right angles, and encloses the tube _b_, in such a manner as to allow the evolved gas to burn in its interior. the dish _f_ is placed beneath the opening _o_. if the gas which burns in the combustion tube contains arsenetted hydrogen, water and arsenious acid are produced. a portion of this acid is retained in the tube _d_, the remainder is carried over, with the aqueous vapor, into _c_, where it condenses, and finally falls into the dish _f_. both portions are subsequently examined by means of reactions necessary to establish the presence of the acid. if the ignited gas contains antimonetted hydrogen, water and an intermediate oxide of antimony are formed. the latter compound is entirely retained in the tube _d_ separated from the greater part of the arsenious acid, if this body be present, and can be brought into solution by means of a mixture of hydrochloric and tartaric acids. a fluid is then obtained which can be introduced into marsh's apparatus, or otherwise examined for antimony. naquet's apparatus. [illustration: fig. .] although the separation of arsenic from antimony is the chief object in making use of the apparatus proposed by flandin and danger, it is evident that this result is not fully accomplished, since a small portion of arsenious acid remains in the tube _d_ (fig. ), together with the intermediate oxide of antimony. the following method secures the complete separation of these metals: an amalgam of sodium and mercury is introduced into the flask _a_, (fig. ), which is provided with two openings. the tube _b_, terminating in a funnel at its upper extremity, passes through one of these orifices. the other aperture contains a cork enclosing the small tube _c_, which is bent at a right angle and communicates, by means of a cork, with the larger tube _d_ filled with cotton or asbestus. a set of liebig's bulbs, _e_, containing a solution of nitrate of silver, is attached to the other extremity of this tube. the apparatus being mounted, the solution under examination is slightly acidulated and introduced by means of the tube _b_ into the flask _a_: the disengagement of gas begins immediately. if arsenic and antimony are contained in the solution, arsenetted hydrogen and antimonetted hydrogen are evolved. both gases are decomposed in passing through the solution of nitrate of silver contained in the liebig bulbs: the arsenetted hydrogen causes a precipitation of metallic silver, all the arsenic remaining in solution as arsenious acid; the antimonetted hydrogen is decomposed into insoluble antimonate of silver. after the operation has continued for several hours, the apparatus is taken apart, the nitrate of silver solution thrown on a filter, and the precipitate thoroughly washed. an excess of hydrochloric acid is then added to the filtrate, and the precipitate formed separated from the solution by filtration, and well washed. the wash-water is added to the solution, and the whole then examined for arsenic by means of marsh's test. the precipitate formed in the nitrate of silver solution, which contains antimonate of silver, is well dried, mixed with a mixture of carbonate and nitrate of soda, and calcined in a porcelain crucible for about three-quarters of an hour. the crucible is then removed from the fire, and the cooled mass treated with hydrochloric acid until a drop of the filtered fluid ceases to give a residue when evaporated upon a watch-glass to dryness. a current of sulphurous acid is now conducted through the filtered solution until the odor of this gas remains persistent. the excess of acid is then removed by boiling, and the solution placed in marsh's apparatus and tested for antimony. detection of mercury. if a mercurial salt exists in a considerable quantity in the substances extracted from the alimentary canal, or ejected either by stools or vomiting, it can be isolated by treating these materials with water, filtering the liquid, and evaporating the filtrate to dryness. the residual mass is taken up with alcohol, and the solution again filtered and evaporated. upon dissolving the residue obtained by this operation in ether and filtering and evaporating the solution, a residue is obtained which when dissolved in water forms a fluid wherein the presence of mercury can be detected by means of the ordinary tests. when, however, only a minute quantity of mercury is present, and this has been absorbed, its detection is more difficult. it will be necessary under these circumstances to make use of either smithson's pile or flandin and danger's apparatus. smithson's pile. smithson's pile consists of a small plate of copper around which a piece of thin gold foil is wrapped. this is immersed in the solution to be tested for mercury, which has previously been slightly acidulated: if mercury be present, the plate acquires a white color which disappears upon exposure to the flame of a spirit-lamp. a similar reaction occurs in presence of tin, as this metal would likewise be deposited upon the plate, and, upon heating, would penetrate the metal and restore to it its natural color. the danger of mistake arising from this fact is obviated by introducing the copper plate into a tube closed at one end and bent at a right angle. the open extremity of the tube is drawn out to a fine point and immersed in water contained in a second tube also closed at one end. upon heating the plate in the flame of an alcohol lamp, the white color disappears if produced by mercury, and at the same time this metal condenses in the narrow extremity of the tube. the metallic globules formed can be recognized either by the naked eye or with the aid of a lens, or by rubbing them with a piece of gold foil when the latter will acquire a white coating. when smithson's pile is employed, the organic substances are most advantageously decomposed by means of chlorine. it is advisable to operate with as small a quantity of fluid as possible, for, owing to the volatility of bichloride of mercury, a portion of this salt may be lost by the evaporation of aqueous, alcoholic, and even etherial solutions, and the detection of minute quantities rendered impossible. apparatus proposed by flandin and danger. [illustration: fig. .] this apparatus consists of a stand _s_, (fig. ) supporting a balloon _a_, which serves as the reservoir of the suspected solution, and a funnel _b_, into which the neck of the balloon is dipped. the funnel _b_ is bent at a right angle and is drawn out at its lower end under which the dish _c_ is placed for the reception of the escaping fluids. a fine wire of pure gold, forming the negative electrode of a bunsen's battery, passes through the lower extremity of the funnel. the end of this wire nearly comes in contact with a second wire, inserted in the upper part of the funnel, and connected with the positive pole of the battery. if the balloon filled with the solution is inverted and immersed in the funnel _b_, its neck will be submerged at first; soon, however, it becomes uncovered, owing to the depression of the level of the fluid caused by the escape of the latter through the tapering extremity of the funnel: a bubble of air then passes in the balloon and expels a drop of the solution. this process is repeated at short intervals, causing a continuous flow of the fluid, the rapidity of which is easily regulated by elevating or lowering the balloon, thus raising or depressing the level of the liquid. the apparatus having been mounted in this manner and the battery set in action, the disengagement of gas commences. should mercury be contained in the solution under examination, this metal will be deposited upon the negative wire. when the operation is completed this wire is detached from the apparatus, washed with ether, and dried. it is then introduced into a small tube provided with a bulb, and the mercury volatilized by means of the blow pipe flame: the metal condenses in the bulb of the tube in globules which are readily recognized. they can also be dissolved in nitric acid, and the presence of a mercurial salt in the solution confirmed by further tests. the solution to be examined in the preceding apparatus, is prepared as follows: the suspected organic matter is treated with cold sulphuric acid of ° _b._ until liquefied, and hypochlorite of lime, and distilled water then added: if necessary, the evolution of chlorine can be accelerated by a further addition of sulphuric acid. as soon as the liquid becomes clear, it is filtered, concentrated and examined as described above. the solution contains the mercury in the state of bichloride, a salt soluble in water and well adapted to the above test. the substitution of a large balloon, having a capacity of about litres, in place of the small vessel of flandin and danger's apparatus, is to be recommended as doing away with the necessity of evaporation; an operation which invariably causes a loss of substance. the apparatus, modified in this manner, is the most delicate in use for the detection of mercury. detection of phosphorus. orfila's method. the solid substances found in the alimentary canal are mechanically separated from the fluids present by means of a linen cloth. they are then examined by aid of a magnifying glass, and any fragments of phosphorus found separated and preserved under water. if none are discovered, the presence of phosphorescent vapors may possibly be detected by examining the materials in the dark. in any case, a portion of the suspected materials should be treated with nitrate of silver: in presence of phosphorus the materials acquire, first, a reddish-brown, then, a black color. the remaining portion is spread upon a shovel and heated: a white flame, burning at various points of the mass, and originating from the combustion of phosphorus, is observed, if this body be contained in the substances under examination. this method is evidently far from perfect. mitscherlich's method. mistcherlich's method is based upon the luminosity of the vapors of phosphorus. the suspected materials are moistened with dilute sulphuric acid, and heated, in a flask communicating with a glass worm which passes through a glass cooler into a receiver. if the apparatus is placed in the dark, and the materials contain phosphorus, luminous vapors will be observed in the flask and receiver. when the quantity of the poison present is considerable, the phosphorous acid formed can be collected and its properties tested. dusart's method, as modified by blondlot. [illustration: fig. .] dusart's process takes advantage of the facility with which hydrogen combines with phosphorus. the substances under examination are placed between two asbestus stoppers in a tube, one end of which tapers to a point, and a current of pure hydrogen conducted over them. in presence of phosphorus the evolved gas will burn with a green flame, and, upon bringing this in contact with a porcelain plate, red spots will be deposited upon the latter. _blondlot_ prefers to introduce the suspected materials into the flask in which the hydrogen is generated. he employs the apparatus represented in fig. : _a_ is a flask for evolving hydrogen; _b_ is a u tube, filled with fragments of pumice stone which are saturated with a concentrated solution of potassa; _c_ is a mohr clamp; _d_ a screw-clamp; _e_ a platinum jet. this jet is necessary in order to avoid a yellow coloration of the flame by the soda contained in the glass. pure hydrogen is at first evolved, in order to ascertain that the flame is colorless and red spots are not produced when it is intersected by a cold plate. the purity of the reagents used having thus been confirmed, the clamp _d_ is closed until the acid is forced back into _f_; and the materials to be examined are then added to the fluid. upon opening the clamp the liquid passes from _f_ into _a_, and the evolution of gas recommences. the gas is then ignited: the flame possesses the characteristic properties mentioned above, if the suspected substances contain phosphorus. method proposed by fresenius and neubauer. according to this method, the materials are brought into a flask provided with a doubly-perforated stopper, and water, acidulated with sulphuric acid, added. the flask is then heated over a water-bath, and a current of carbonic acid conducted through the mixture for at least two hours. the gas, on leaving the flask, passes into a solution of nitrate of silver. should no precipitate form in this solution, the absence of free phosphorus is established, for, were this body present, a portion would be volatilized, and a black precipitate, consisting of phosphide of silver, together with phosphoric acid, produced. the formation of a black precipitate is, however, not necessarily a proof of the presence of phosphorus. in order to conclusively determine the character of the precipitate, it is collected on a filter and examined by the method of dusart and blondlot. this process has given result in cases where none were obtained by mistcherlich's method. it possesses, moreover, an advantage over the latter process, in not being influenced by the presence of foreign bodies; whereas, in mistcherlich's method, some time must elapse before the luminosity of the vapors becomes apparent if ether or alcohol is contained in the solutions, and this phenomenon totally fails to appear in presence of oil of turpentine. detection of phosphorus by the use of bisulphide of carbon. in a report read before the academy of sciences in , presented by an examining commission, of which mm. _dumas_, _pelouze_ and _claude bernard_ were the reporters, the following results were contained: phosphorus may remain, in the _free state_, in the organs fifteen days after death, and even then its isolation can easily be accomplished. for this purpose the stomach or intestines, and the articles of food contained therein, are cut into pieces and treated with bisulphide of carbon. upon filtering the liquid, a solution is obtained containing all the phosphorus present, which exhibits the following properties: st, when ignited, it burns with a very luminous flame; nd, if allowed to spontaneously evaporate (the combustion of the phosphorus being prevented by the organic matter present [_naquet_]) an inflammable residue is obtained, which, if dissolved in boiling monohydrated nitric acid, gives a solution that, after saturation with ammonia, produces a precipitate soluble in acids in solutions of barium salts. if the solution is mixed with perchloride of iron, and the sesquioxide of this metal subsequently eliminated by the addition of ammonia, it no longer causes a precipitation in barium solutions. the fluid acquires a yellow coloration when boiled with a solution of molybdate of ammonia. according to our personal experience, the apparatus employed by flandin and danger for the detection of arsenic, can also be made use of in the examination of the bisulphide of carbon solution. to this end, the fluid supposed to contain phosphorus is mixed with perfectly pure alcohol, and the mixture placed in a small spirit-lamp provided with a very loose asbestus wick. the lamp is then ignited and the flame introduced in the combustion tube _d_ (fig. ). [illustration: fig. .] by the combustion of the mixture, sulphurous, carbonic, phosphorous acids and water are formed. the water condenses in _c_, and, falling into the dish _f_, carries with it the sulphurous and phosphorous acids. the acid liquid collected in this way is evaporated to dryness, some nitric acid added, and the solution again evaporated. the remaining mass is then dissolved in water to which some ammonia is added, and the solution tested for phosphoric acid. this method is an advantageous one as the phosphoric acid formed must originate from phosphorus in the _free state_, and not from any phosphates which, owing to the presence of organic matter, might be contained in the bisulphide of carbon solution. it would, however, lead the analyst into error if the person, supposed to have been poisoned had eaten cerebral substances or eggs previous to death, as these contain glycero-phosphoric acid; it is therefore advisable to compare the results given by this process with those obtained by the use of other methods. detection of phosphorous acid. provided free phosphorus has not been detected, it is necessary to search for phosphorous acid. to this end, the residue remaining in the flask, in either mistcherlich's or fresenius and neubauer's method, is introduced into the apparatus of dusard and blondlot. if the phosphorus reaction appears, it is sufficient; otherwise, its production may have been hindered by the presence of organic matter. in case, therefore, the flame is colorless, the evolved gas is conducted into a neutral solution of nitrate of silver. if the materials contain phosphorous acid, a precipitate of phosphide of silver is formed which should be collected and washed. the precipitate, which is now free from organic matter, is then examined for phosphorous acid by means of the apparatus of dusard and blondlot. estimation of phosphorus. the best process for determining quantitatively the amount of phosphorus present is the one recommended by fresenius and neubauer. the gaseous current is continued until a fresh nitrate of silver solution is no longer precipitated. the solution is filtered, the precipitate washed and then dissolved in nitric acid. the silver is next precipitated by addition of hydrochloric acid, the fluid again filtered, and the precipitate well washed. the washings are added to the filtrate, and the liquid concentrated in a porcelain capsule. a solution of sulphate of magnesia, containing ammonia, is next added to the fluid, and the phosphoric acid determined as pyrophosphate of magnesia: the precipitate formed, is washed, heated to redness, in order to convert it into the pyrophosphate, and then weighed. detection of acids. the search for acids is to be instituted exclusively in the alimentary canal and its contents. were acids contained in the other organs, their presence would be due to the blood in which they had previously been absorbed, and, as in this case they would be partially neutralized by the bases contained in the blood, a conclusive decision in regard to their original existence in the suspected materials would be impossible, the salts of the acids usually searched for being normal constituents of the blood. in order to detect the presence of acids, the alimentary canal and contents are first boiled with water which is renewed until the solution ceases to exhibit an acid reaction when tested with litmus paper. the fluid is then filtered, alcohol added to the filtrate, in order to precipitate organic substances, the liquid again filtered, and the solution tested separately for the various acids as directed below. hydrochloric acid. the solution is placed in a retort provided with a receiver and distilled until the residual fluid assumes a pasty consistence: the operation is then discontinued. if hydrochloric acid be present in the materials under examination, the distillate will have an acid reaction, and, upon addition of solution of nitrate of silver, a white precipitate, which is easily soluble in ammonia but insoluble in nitric acid and in short possesses all the properties of chloride of silver, will be formed. nitric acid. the distillate, obtained as in the preceding process, is neutralized by the addition of potassa or soda, and evaporated to dryness. the residue is mixed with copper filings, and introduced into a glass tube closed at one end and provided at the other with a cork through which a delivery-tube passes. sulphuric acid is then added to the mixture, the cork inserted, the tube heated, and the evolved vapors conducted into a solution of protosulphate of iron. the latter solution acquires a brown coloration which, upon addition of sulphuric acid, changes to a violet, if nitric acid be present. upon conducting the disengaged gas into a solution of narcotine, the latter acquires a beautiful red color. another portion of the residue should deflagrate when saturated with an alkali and projected upon live coals. sulphuric acid. in order to detect this acid, the solution obtained by treating the organs with water is not distilled but is concentrated to one-sixth of its original volume, and then agitated with ether for about ten minutes. by this treatment the ether takes up the free sulphuric acid, but not the acid sulphates present. after ten minutes contact, the ether is decanted and allowed to spontaneously evaporate. upon treating the residue, which contains the free sulphuric acid and fatty substances, with water, a solution containing only the sulphuric acid is obtained. nitrate of baryta is then added to a portion of the fluid: in presence of sulphuric acid, a white precipitate, insoluble in acids, is produced. if this is heated on charcoal before the blow-pipe, a mass is formed, which, when moistened with hydrochloric acid and placed upon a clean silver coin, produces a black spot on the metal. another portion of the solution is mixed with copper and the mixture evaporated in a tube closed at one end: sulphurous acid is evolved towards the end of the operation. this gas is detected by allowing it to pass over paper saturated with a mixture of iodic acid and starch; a blue coloration is produced which, owing to the transformation of the iodine set free into hydriodic acid, subsequently disappears. (we have never been able to effect the disengagement of sulphurous acid spoken of above when an exceedingly dilute sulphuric acid was used, even upon evaporating the mixture to dryness, notwithstanding orfila's statement that the reaction occurs very readily.) phosphoric acid. the aqueous solution is evaporated to dryness, the residue taken up with alcohol of ° b., the fluid again evaporated, and the second residue dissolved in water. upon adding acetate of lead to the solution, a white precipitate is produced if phosphoric acid be present. the precipitate is washed, suspended in water and a current of sulphuretted hydrogen passed through the mixture. if the fluid is then filtered, and the excess of sulphuretted hydrogen expelled from the filtrate by boiling, a liquid possessing the distinctive properties of a solution of phosphoric acid will be obtained. this should then be submitted to the following tests: some pulverized charcoal is added to a portion of the solution, the mixture evaporated to dryness, and the residue obtained introduced into a hessian crucible heated to redness: in presence of a considerable amount of the acid, free phosphorous is liberated and burns with a bright flame in the upper part of the crucible. in case this reaction fails to occur, other portions of the fluid are treated with a solution of a baryta salt, which causes a white precipitate, soluble in nitric acid; with an ammoniated solution of sulphate of magnesia, which throws down a crystalline white precipitate; and by boiling with molybdate of ammonia, acidulated with nitric acid, which produces a yellow precipitation, or at least a yellow coloration of the solution. oxalic acid. the solution is subjected to the same treatment as in the search for phosphoric acid, with the exception that, instead of adding acetate of lead to the fluid obtained by taking up the residue left from the alcohol with water, it is divided into two portions which are examined separately. a solution of a lime salt is added to one portion: if oxalic acid be present, a precipitate, which is insoluble in acetic acid or in chloride of ammonium, and effervesces when slightly calcined and treated with hydrochloric acid, is formed. nitrate of silver is added to the remaining portion of the solution: the formation of a precipitate, which detonates when dried and heated in a glass tube closed at one end, is further evidence of the presence of the acid. acetic acid. the solution obtained by treating the alimentary canal with water is distilled, as in testing for nitric and hydrochloric acids, and the following properties verified in the distillate: st. it has an acid reaction, and possesses the odor of vinegar; nd, unless previously neutralized with a base, it fails to redden the per-salts of iron; rd, if the distillate is added to a solution of the per-salts mentioned and sulphuretted hydrogen conducted through the fluid, a black precipitate is formed; th, upon boiling the still acid fluid with a small quantity of starch, the property of the latter to become colored in presence of free iodine is not changed; th, if heated with an excess of litharge, a basic salt which restores the blue color to reddened litmus paper is produced. hydrocyanic acid. the detection of hydrocyanic acid requires special precautions. the substances to be examined are mixed with water, if solids are present, and introduced into a retort provided with a delivery-tube which dips in a solution of nitrate of silver. the retort is then heated over a water-bath. if the evolved vapors produce a precipitate in the silver solution, the heating is continued until a fresh portion of the latter is no longer affected. the operation is now interrupted, hydrochloric acid added to the retort, and heat again applied. should a second precipitation of cyanide of silver occur, the presence of a _cyanide_ in the suspected materials is indicated; whereas the formation of a precipitate by the simple action of heat would point to the presence of free hydrocyanic acid or cyanide of ammonium.[h] in case the latter compound is present, ammonia will be contained in the distillate. [h] ferrocyanides and ferricyanides--non-poisonous compounds--likewise, evolve hydrocyanic acid when distilled with a strong acid. their presence is indicated by stirring a small portion of the materials with water, filtering the fluid, acidulating the filtrate with hydrochloric acid, and testing two portions: one with sesquichloride of iron, the other with protosulphate of iron. if either of the above salts be present, a blue precipitate is produced.--_trans._ in order to identify the cyanogen, a portion of the precipitate is collected upon a small filter, washed, dried, and then allowed to fall into a rather long tube, closed at one end, in the bottom of which some iodine has previously been placed. a column of carbonate of soda is then introduced above the precipitate for the purpose of retaining the excess of iodine probably taken. upon heating the lower end of the tube, white fumes of iodide of cyanogen, which condense in needles upon the cold portion of the tube, are produced. these are easily recognized by aid of a magnifying glass. they are colorless and are readily volatilized by heat. some ammonia is next added to a solution of protosulphate of iron, the precipitate formed thoroughly washed, and exposed to the air until it acquires a greenish hue. the iodide of cyanogen is then withdrawn from the tube and mixed with potassa-lye and the precipitate mentioned above. the mixture is evaporated to dryness, the residue obtained treated with water and the filtered solution then acidulated with hydrochloric acid. if a solution of a persalt of iron is now added to the fluid, a blue precipitate is formed. the addition of salts of copper produces a reddish precipitation. the remainder of the precipitate formed in the nitrate of silver solution is heated with sulphur and then boiled with an aqueous solution of chloride of sodium: if cyanogen is contained in the precipitate, a solution of sulphocyanate of soda will be formed, and upon adding sesquichloride of iron an intense red coloration produced. it is evident that the presence of another acid in the solution examined for hydrocyanic acid would render the detection of _cyanides_ impossible, but in all cases hydrocyanic acid can be separated without arriving at a decision in regard to its original state of combination. nitric, hydrochloric, and several other acids would not be distilled at the temperature of the water-bath; an examination for these by the methods already described can therefore be instituted simultaneously with the search for hydrocyanic acid. detection of alkalies and alkaline earths. the separation of these bodies in the caustic state is a matter of difficulty owing to the great tendency they possess to become converted into carbonates; the carbonates of lime, baryta and strontia, moreover, being non-poisonous in their effects, will not be employed with criminal intent, and the carbonates of soda and potassa are extensively used as pharmaceutical preparations. notwithstanding the small chances of success, the isolation of the compounds under consideration in the caustic state is to be attempted. to this intent, the organs to be analysed, together with their contents, are placed in a glass retort provided with a receiver, water added, and the mixture boiled. the distillate will contain the ammonia present. when, however, putrefaction has begun, the detection of this compound does not necessarily indicate its original presence in the suspected materials. if, after an hour's boiling, the fluid in the retort possess an alkaline reaction, it is to be examined for soda, potassa, strontia, baryta and lime. the undistilled solution is filtered, the filtrate evaporated to dryness, and the residual mass treated with alcohol. by this treatment, potassa and soda go in solution, lime, baryta and strontia[i]--as well as the alkaline carbonates--remaining undissolved. the potassa and soda are separated from the other salts present by filtering and evaporating the alcoholic solution to dryness and then calcining the residue in a silver crucible. the mass, which should still be alkaline, is then dissolved in dilute sulphuric acid. if the solution is turbid, traces of baryta or strontia may still be present and should be removed by filtration. some hydrochloric acid and solution of bichloride of platinum are then added to a portion of the filtered liquid: in presence of _potassa_ a yellow precipitate is formed. [i] baryta and strontia dissolve in alcohol, but only when they are anhydrous and the alcohol is absolute, which is not the case here. another portion is treated with tartaric acid: a white granular precipitate is produced. hydrofluosilicic acid is added to a third portion of the solution: the formation of a gelatinous precipitate is a further indication of the presence of potassa. if the preceding tests have given negative results, and a white precipitate is formed by the addition of antimonate of potassa to another portion of the solution, _soda_ is present. in both cases, it is necessary to confirm the results by means of the spectroscope. the above reactions are distinctive only in the absence of metals precipitated by sulphuretted hydrogen, sulphide of ammonium or carbonate of soda, and small portions of the solution should be tested with these reagents. in order to detect baryta, strontia and lime, the residue, insoluble in alcohol is dissolved in dilute nitric acid, and an excess of carbonate of ammonia added to the solution: the three bases, if present, are precipitated as carbonates. the precipitate formed is separated from the solution by filtration, dissolved on the filter in dilute hydrochloric acid, and the solution then filtered and divided into two parts: sulphuric acid is added to one, the fluid filtered from the precipitate of sulphate of baryta formed, and the filtrate treated with ammonia and oxalate of ammonia. if _lime_ be present,--although its sulphate is not easily soluble--sufficient will be contained in the filtrate to give a white precipitate of oxalate of lime. the remaining portion of the solution is evaporated to dryness, and the residue treated with absolute alcohol. chloride of strontium goes into solution, chloride of barium remaining undissolved. if upon evaporating the alcoholic solution a residue is obtained which, when dissolved in water, produces turbidity in a solution of sulphate of lime, _strontia_ is present. the residue, insoluble in alcohol, is dissolved in water. if a precipitate is produced by the addition of sulphuric acid or hydrofluosilicic acid to the solution, _baryta_ is present. the latter reaction distinguishes baryta from strontia, which is not precipitated by hydrofluosilicic acid. should the tests mentioned above fail to give affirmative results, and poisoning by means of baryta and strontia be nevertheless suspected, these compounds may possibly have remained in the materials contained in the alimentary canal, in the state of insoluble sulphates. to effect their detection under these circumstances the organic substances must be decomposed by means of sulphuric acid. the carbonaceous residue is calcined in a crucible at an elevated temperature, and the remaining mass treated with water. in this way, a solution of sulphides of barium and strontium is obtained, which is then tested as directed above. detection of chlorine, bromine, and iodine. chlorine and bleaching chlorides. the detection of chlorine is very difficult owing to the great tendency it possesses to become converted into chlorides or hydrochloric acid, and it is only when found in a free state that its discovery is of importance. in case the gas exists uncombined in the alimentary canal, its odor will be perceptible, and, upon boiling the suspected materials with water, vapors will be evolved which impart a blue color to paper saturated with a mixture of iodide of potassium and starch paste. if the addition of sulphuric acid is necessary in order to produce the above reactions, there is reason to suspect the presence of "chloride of lime" or "_eau de javelle_."[j] [j] the so-called "chloride of lime" is probably either a mixture of chloride and hypochlorite of calcium or an oxydichloride of the metal; "_eau de javelle_" is the corresponding potassium compound.--_trans._ bromine. in case bromine exists in a free state at the time the autopsy is made, its presence will be detected by the reddish color and unpleasant odor it possesses. its isolation is accomplished by treating the materials with bisulphide of carbon which, upon dissolving the bromine, acquires a red color. if potassa is then added to the solution, it combines with the bromine and, upon evaporating the decanted fluid, calcining the residue, and treating it with water, a solution of bromide of potassium is obtained. upon adding chlorine-water and ether to a portion of the fluid, and shaking the mixture, the bromine is liberated and is dissolved by the ether. the etherial solution of bromine, which possesses a reddish-yellow color, does not mingle with, but floats upon the surface of the colorless aqueous solution. if nitrate of silver is added to another portion of the aqueous solution of bromide of potassium, a precipitate of bromide of silver, soluble in ammonia, is formed. in case the bromine has been converted into a bromide, it is necessary to boil the alimentary canal and the articles of food contained therein with water. the fluid is next filtered and agitated with chlorine-water and ether. the liberated bromine is dissolved by the ether, which acquires a reddish-yellow color. upon decanting the solution, and treating it with potassa, bromide of potassium is formed, and can be detected as directed above. iodine. the detection of iodine is accomplished by a process almost identical with the above. the isolation of the iodine having been effected, it remains to be ascertained that it imparts a blue color to starch paste, and a violet color to bisulphide of carbon. detection of metals. under this head we will indicate the systematic course of analysis to be pursued, supposing a mixture of several metals including arsenic and antimony, to be under examination. the organic substances are first destroyed by means of chlorate of potassa and hydrochloric acid. when this is accomplished, the excess of chlorine is removed by boiling and the liquid filtered. the portion remaining on the filter is preserved: it contains all the silver and a large portion of the lead, if these metals are present. we will designate the residue as a, the filtrate as b. treatment of residue a. the residue is calcined with a little carbonate of soda and cuttings of pure swedish filtering paper, the chlorides present being reduced to the metallic state by this treatment. the residue is next taken up with water acidulated with nitric acid, and the solution filtered. an insoluble residue, that may remain, is washed with hot water until the wash-water ceases to precipitate solution of nitrate of silver, and dried. it is then dissolved in boiling nitric acid, the solution diluted with water, and filtered.[k] [k] if an insoluble residue remains by the treatment with nitric acid, it may consist of _tin_. in this case, it is dissolved in _aqua regia_, the metal precipitated by immersing a plate of zinc in the solution and then re-dissolved in boiling hydrochloric acid. upon adding chloride of gold to the solution so obtained, a purple precipitate is formed. sulphuretted hydrogen produces a brown precipitate, soluble in sulphide of ammonium, in presence of tin. sulphuric acid is added to the filtrate: if no precipitate forms, the absence of _lead_, in the residue a, is indicated. if, on the contrary, a precipitate is produced, it is collected upon a filter and washed. in order to make sure that the precipitate consists of sulphate of lead, it is treated with a solution of tartrate of ammonia: it should dissolve, forming a solution in which sulphuretted hydrogen produces a black precipitate. the fluid which has failed to be precipitated by the addition of sulphuric acid, or the filtrate separated from the precipitate formed, can contain only silver. upon adding hydrochloric acid, this metal is thrown down as a caseous white precipitate, which is soluble in ammonia, but insoluble in boiling nitric acid, and blackens upon protracted exposure to light. the formation of a precipitate possessing these properties, leaves no doubt as to the presence of _silver_. _remark._--in the operations described above, as well as in those following, the difficulty in separating minute precipitates from the filter is often experienced. when the precipitate is to be dissolved in reagents that do not affect the paper, such as ammonia, tartrate of ammonia, and dilute acids, it can be brought in solution directly on the filter. in cases, however, where reagents which attack the paper are employed, the precipitate should be separated. this is accomplished by mixing a small quantity of pure silica, obtained by the decomposition of fluoride of silicium by water, with the solution, before filtering. the precipitate becomes intimately mixed with the silica, and can then be readily removed from the paper. the presence of silica does not interfere, it being insoluble in the reagents commonly made use of. treatment of filtrate b. a current of sulphuretted hydrogen is conducted for twelve hours through the solution, which is kept at a temperature of °. by means of a water-bath. the flask containing the liquid is then closed with a piece of paper, and allowed to remain in a moderately warm place until the odor of the gas is no longer perceptible. the solution is next filtered with the precaution mentioned in the preceding remark, and the precipitate (_a_) thoroughly washed. the water used in this operation is united to the filtrate, and the fluid (_b_) examined as directed further on. treatment of precipitate _a_. in order to free the precipitate from the organic substances possibly present, at the same time avoiding a loss of any metal, it is dried, moistened with nitric acid, and the mass heated on a water-bath. some swedish filtering paper is next added, the mixture well impregnated with sulphuric acid, and then maintained for several hours at a temperature of about °. until a small portion (afterwards returned) gives a colorless solution when treated with water. the residue is now heated with a mixture of one part of hydrochloric acid and eight parts of water, the liquid filtered, the matter remaining undissolved washed with dilute hydrochloric acid, and the washings united with the filtrate. the residue i. and the solution ii. are separately examined as directed below. residue i. this may contain lead, mercury, tin, bismuth and antimony. it is heated for a considerable time with _aqua regia_, the solution filtered, and the second residue, should one remain, washed with dilute hydrochloric acid. if the second residue is fused with cyanide of potassium, the compounds present are reduced to the metallic state. the liberated metals are treated with nitric acid, which dissolves _lead_, but leaves _tin_ as insoluble metastannic acid. the nitrate of lead is then filtered from the metastannic acid, and both metals are identified as described in the treatment of residue a. the solution, obtained by the action of _aqua regia_ on residue i, is treated with sulphuretted hydrogen. the tin and antimony are separated from the lead, mercury and bismuth by treating the precipitate produced with sulphide of ammonium, which dissolves only the sulphides of the first two metals. the solution in sulphide of ammonium is afterwards examined for these metals, as directed under the head of solution iv., the search for arsenic, however, being here omitted. upon treating the residue insoluble in sulphide of ammonium with nitric acid, lead, copper and bismuth go into solution, mercury remaining undissolved. the liquid is filtered, and the undissolved mercury submitted to the special examination previously described. sulphuric acid is added to the solution and the precipitate of sulphate of lead formed, separated, washed, and examined as directed while treating of residue a. finally, the solution separated from the lead is tested for _bismuth_ and _copper_, as in examination of precipitate iii. solution ii. the solution is concentrated by heating on a water-bath, a small quantity of carbonate of soda cautiously added to a portion, and notice taken if a precipitate forms. the part taken is then acidulated with a little hydrochloric acid, returned to the principal solution, and sulphuretted hydrogen conducted through the fluid, as in the examination of solution b. in case a precipitate fails to form, all metals are absent; if, on the contrary, a precipitate (_c_) is produced, it is examined as directed below. examination of precipitate _c_. if the solution merely became turbid, or the precipitate formed was of a pure white color, it consists probably of sulphur. it is, however, indispensable, even in this case, to collect the precipitate and examine it for _arsenic_. provided it is of a pure yellow color, it is treated with ammonia. in case it is entirely dissolved by this treatment, and the addition of carbonate of ammonia failed to produce a precipitate in solution ii., it is certain that arsenic, and no other metal, is present. under these circumstances, the ammoniacal solution is examined as directed in the article on the detection of arsenic. if, on the other hand, the precipitate is not yellow, or being yellow, is but imperfectly soluble in ammonia, and a precipitate was formed by the addition of carbonate of ammonia to solution ii., it is necessary to likewise search for tin, antimony, mercury, copper, bismuth and cadmium. in this case, the precipitate is placed in a small flask, allowed to digest for several hours with ammonia and sulphide of ammonium in a moderately warm place, and the solution filtered. the remaining residue (iii.) is washed, labelled, and preserved for subsequent examination; the _filtrate_ (iv.) is treated as directed below. treatment of solution iv. the solution, to which the water used in washing the residue has been added, is evaporated to dryness, the residue obtained taken up with pure fuming nitric acid, and the liquid again evaporated. the second residue is next saturated with a solution of carbonate of soda. a mixture of part of carbonate and of nitrate of soda is then added, the mixture evaporated to dryness, and the residual mass heated to fusion. the fused mass, when cold, is treated with cold water, and any remaining residue washed with a mixture of equal parts of alcohol and water. the filtered fluids are now evaporated in order to remove the alcohol, sulphuric acid is then added, and the mixture heated until white fumes of the acid begin to evolve. in this way the complete expulsion of the nitric acid present is rendered certain. when cold, the residue is treated with water and the _solution_ introduced into marsh's apparatus, or, in case a quantitative estimation of the arsenic is desired, it is treated with sulphuretted hydrogen and the weight of the precipitate formed determined, as directed under the detection of arsenic. should a residue insoluble in water remain, it may contain tin, antimony and traces of copper. upon dissolving it in _aqua regia_ and placing a sheet of pure zinc in the solution, these metals are thrown down in the metallic state. the precipitate is collected, the zinc present completely removed by treatment with _dilute_ hydrochloric acid, and the residue boiled with concentrated hydrochloric acid which dissolves the _tin_ present. the fluid is filtered and the _filtrate_ tested for this metal by adding solution of chloride of gold, which, in its presence, produces a purple precipitate, and, by treating it with sulphurated hydrogen, which forms a brown precipitate, soluble in sulphide of ammonium. if the _residue_, insoluble in concentrated hydrochloric acid, is thoroughly washed and then treated with nitric acid, the copper present goes in solution. the fluid is filtered, and ammonia added to the filtrate: in presence of _copper_, the solution acquires a blue color, and gives a reddish precipitate upon addition of ferrocyanide of potassium. _antimony_, if present, remains by the treatment with nitric acid as an insoluble intermediate oxide. this is dissolved in hydrochloric acid, in which it is now soluble, and the solution introduced into marsh's apparatus. treatment of precipitate iii. this precipitate may contain the sulphides of mercury, copper, cadmium and bismuth. upon treating it with nitric acid, all but the sulphide of mercury are dissolved. in case no residue remains, the absence of _mercury_ is indicated; if, on the other hand, a residue is left, it is well washed, dissolved in _aqua regia_, and the solution examined, either by means of smithson's pile, or in the apparatus of flandin and danger. (_vide detection of mercury._) whether a residue remains or not, an excess of ammonia is next added to the filtered solution in nitric acid: the formation of a permanent precipitate denotes the presence of _bismuth_. in this case, the fluid is filtered, and the alkaline filtrate further tested for copper and cadmium. for this purpose, cyanide of potassium is added, and sulphuretted hydrogen conducted through the filtrate: if _cadmium_ be present, a yellow precipitate is produced, copper not being thrown down in presence of an alkaline cyanide. the precipitate of sulphide of cadmium is separated from the solution by filtration, and the filtrate saturated with hydrochloric acid. _copper_, if present, is now precipitated as sulphide: its separation is completed by conducting sulphuretted hydrogen through the fluid. the precipitate is collected, washed, dissolved in nitric acid, and its identity established as previously directed. if the metal be present in sufficient quantity, it should be obtained in a metallic state upon a plate of iron; it is then coherent, possesses its natural color, and can conveniently be exhibited to the jury. treatment of solution _b_. this solution may contain: cobalt, nickel, iron, manganese, chromium, zinc and aluminium. of these, only zinc and chromium are poisonous; the search for these two metals is therefore all that is necessary in criminal cases. the solution is treated with a slight excess of ammonia, sulphide of ammonium added, and the fluid, after being allowed to stand for several hours, filtered. the precipitate may consist of sulphide of zinc and hydrated oxide of chromium, as well as of traces of sulphide of iron and phosphate of lime. if the suspected materials contained a _chromate_, this salt, in presence of hydrochloric acid and sulphuretted hydrogen, would be converted into sesquichloride of chromium a compound which is precipitated by sulphide of ammonium as a hydrated oxide. the precipitate is washed with water, to which a little sulphide of ammonium is added, then dried, and fused with four times its weight of a mixture of equal parts of carbonate and nitrate of potassa. after the mass has remained in a state of fusion for a quarter of an hour, it is treated with boiling water, mixed with a little alcohol, in order to decompose the manganate that would be present were manganese contained in the materials under examination. the alcohol is then expelled by boiling the fluid, and the solution filtered. the _filtrate_ may contain phosphate of potassa, originating from the phosphate of lime present, and _chromate of potassa_, resulting from the oxidation of the sesquioxide of chromium. in presence of the latter compound, the following reactions will occur in the solution: st., upon acidulation with acetic acid and addition of solution of acetate of lead, a yellow precipitate, soluble in potassa, is formed; nd., if hydrochloric acid is added and sulphuretted hydrogen conducted into the solution, the latter acquires a green color, and, upon adding ammonia, a bluish-grey precipitate of chromic hydrate is produced; rd., if nitrate of silver is added to the solution, a brick-red precipitate is formed. the _precipitate_ remaining on the filter, may consist of zinc, mixed with the oxides of iron, nickel, cobalt, aluminium and manganese. it is dissolved in boiling hydrochloric acid, acetate of soda added, and the fluid boiled until no further precipitation occurs. the iron is now completely separated. the solution is then filtered, the precipitate washed, and an excess of potassa added to the _filtrate_; if the solution contains cobalt, nickel or manganese--which is improbable--a permanent precipitate is formed. this is separated from the fluid by filtration: its further examination is, however, unnecessary, as the metals of which it consists are not poisonous. the _filtrate_ may contain aluminium and _zinc_. the latter metal is detected by acidulating the filtrate with acetic acid, and adding a solution of sulphuretted hydrogen: in presence of zinc a white precipitate of its sulphide is formed. in case organic substances are present, the precipitation of chromium by sulphide of ammonium may possibly have been hindered, and the metal have passed into the filtrate. when, therefore, chromium is not detected in the precipitate, the filtrate should also be examined. for this purpose, the fluid is evaporated to dryness, and the residue obtained fused with a mixture of nitrate and carbonate of soda. the fused mass is then taken up with water, the solution acidulated with acetic acid, and a solution of acetate of lead added: if chromium be present, a yellow precipitate, soluble in potassa, is produced. detection of alkaloids and some ill-defined organic substances.[l] a general method for effecting the detection of alkaloids was first proposed by _stas_. since the publication of this method, modifications to it have been recommended by _otto_, and by _l. uslar_ and _j. erdman_. other processes have been suggested by _rodgers_ and _girwood_, by _e. prollius_, and by _graham_ and _hofman_. the latter will doubtless become general in their application; but up to the present time they have been employed exclusively in the detection of strychnine. dialysis has also been recently applied in the separation of alkaloids. [l] colchicine, picrotoxine and digitaline. stas's method. this method is based upon the facts: (_a_), that the acid salts of the alkaloids, especially those containing an excess of tartaric or oxalic acids, are decomposed by caustic alkalies and by the bicarbonates of soda and potassa; (_b_), that the alkaloids, when liberated in this manner, are combined with a certain amount of water which determines their solution in ether, although, in a desiccated state they may be insoluble in this menstruum; (_c_), that they may be extracted from their aqueous solutions by agitation with ether. stas's original method is as follows: the suspected substances, if organs are contained, are cut into fine shreds, then mixed with absolute alcohol, . to . grammes of tartaric or oxalic acid added and the whole introduced into a flask and heated at a temperature of ° to °. when quite cold, the mixture is filtered, and the undissolved portion remaining on the filter washed with absolute alcohol, the washings being added to the filtrate. the alcoholic solution is evaporated, either by placing it under a bell-jar connected with an air-pump, or by passing a current of air, having a temperature not exceeding ° over it, until reduced to a quarter of its original volume: the complete expulsion of the alcohol being then rendered certain. if insoluble matter separates during this operation, the concentrated fluid is passed through a moistened filter, the water used in washing the residue being united to the filtrate which is then evaporated to dryness by aid of the air-pump or by placing the fluid in a bell-jar over concentrated sulphuric acid. when the evaporation is completed, the residue is treated with absolute alcohol, the alcohol allowed to evaporate at the ordinary temperature of the air, and the second residue dissolved in the smallest possible amount of water. the fluid thus obtained is placed in a test-tube, and a concentrated solution of bicarbonate of soda added so long as effervescence takes place. ether is then added, the mixture thoroughly shaken, and after it has remained at rest for some time, a small portion of the supernatant ether removed and evaporated on a watch-glass: the residue obtained will consist of the alkaloid present. two cases are now possible: the alkaloid is a solid, or it is a liquid and is volatile. the further treatment of the solution is modified according to these circumstances. _a._ the alkaloid is liquid and volatile. if, upon the evaporation of the ether, oily streaks were left on the watch-glass, a volatile alkaloid is probably present. in this case, a solution of caustic potassa is added to the test-tube, the mixture shaken, the supernatant ether decanted[m] into a flask and the remaining solution again washed with ether until the last portion fails to leave a residue upon evaporation. the etherial fluids are then united, and two cubic centimetres of water, acidulated with one-fifth of its weight of sulphuric acid, added. this acid retains the alkaloid, which is now in the state of a pure acid-sulphate soluble in water, the animal matters present remaining dissolved in the ether. the ether, in which some sulphate of conia may be contained--although the greater portion of this compound would remain in the aqueous solution--is then decanted. the remaining aqueous solution of the pure sulphate of the alkaloid is placed in a test-tube, a solution of caustic potassa and some ether added, and the mixture well shaken. the ether is next decanted and allowed to spontaneously evaporate in a dry place at a very low temperature, and the ammonia possibly present is then removed by placing the vessel containing the residue over sulphuric acid. the residue now obtained consists of the alkaloid present in a state of purity, and can be directly identified by means of the reactions described further on. [m] the necessity of decanting etherial and other solutions is advantageously obviated by the use of a pipette.--_trans._ _b._ the alkaloid is solid. it sometimes occurs that ether fails to take up all of the alkaloid present in the fluid treated with bicarbonate of soda. under these circumstances the fluid should be mixed with caustic potassa, the mixture shaken, and the ether decanted; this operation being repeated several times, until the entire amount of the alkaloid is removed; the ethereal fluids are then united in a capsule, and allowed to spontaneously evaporate. the result of the evaporation may be solid; more frequently, however, a milky liquid remains which restores the blue color to reddened litmus paper; if so, the presence of a vegetable alkaloid is certain. in order to purify the residue, a few drops of water, slightly acidulated with sulphuric acid, are added to the capsule, and the latter turned, so as to bring the fluid in contact with the substance at all points; in this manner a colorless and limpid fluid is obtained, the fatty substances adhering to the dish. the liquid is decanted into a second capsule, the remaining residue washed with a little acidulated water, and the washings likewise added to the principal solution. the fluid is now evaporated either _in vacuo_, or over sulphuric acid, to about three-fourths of its original volume a concentrated solution of neutral carbonate of potassa added, and the mixture treated with absolute alcohol, which dissolves the liberated alkaloid, and separates it from the sulphate of potassa formed and the excess of carbonate of potassa. the alcoholic solution is decanted and allowed to evaporate _in vacuo_ or in the air: the alkaloid now crystallizes out in a state suitable for further examination. modifications to stas's method, proposed by otto. in stas's method, the loss of morphine is possible, for, if ether is not added immediately after the addition of carbonate of soda, this alkaloid crystallizes and is then no longer soluble in that menstruum; and, if the ethereal solution is not quickly decanted, the portion dissolved will likewise separate out in small crystals. in both cases, morphine will remain in the aqueous solution from which the other alkaloids have been extracted by the ether. _m. otto_ recommends the addition of chloride of ammonium and a little soda-lye, in order to dissolve the alkaloid. upon allowing the solution so obtained to stand for some time exposed to the air, crystals of morphine are deposited. according to the same authority, it is advisable to omit the distinction drawn by stas between volatile and fixed alkaloids, and submit both to the treatment recommended for those that are volatile. otto also recommends the agitation of the fluid containing the oxalates or tartrates of the alkaloids with ether, previously to their separation by means of bicarbonate of soda. by this treatment the elimination of the coloring matter present--as well as of _colchicine_, _digitaline_, _picrotoxine_, traces of _atropine_, and various impurities--is accomplished. as soon as the ether ceases to become colored and to leave a residue upon evaporation, alkali is added, and the operation concluded as usual. in this way the alkaloid is obtained, almost directly, in a pure condition. this last modification appears to us to be a very happy one, inasmuch as it greatly facilitates the purification of the alkaloid present. modifications to stas's method, proposed by uslar and erdman. st. the materials to be examined are brought to the consistence of a thin paste, and digested for about two hours with water, to which some hydrochloric acid has been added, at a temperature of ° to °. the mixture is then filtered through a moistened linen cloth, and the residue washed with warm acidulated water; the washings being added to the solution. nd. some pure quartz sand--or, preferably, silica prepared by the decomposition of fluoride of silicium--is added to the filtrate, the fluid supersaturated with ammonia, and evaporated to dryness over a water-bath: the addition of silica renders the residue friable. rd. the residue is boiled repeatedly with amylic alcohol, which extracts all the alkaloid present as well as the fatty and coloring matters, and the extracts filtered through filter paper that has been moistened with amylic alcohol. th. the filtered fluid is thoroughly agitated with ten or twelve times its volume of almost boiling water acidulated with hydrochloric acid: the hydrochlorate of the alkaloid present goes into the aqueous solution, the fatty and coloring substances remaining dissolved in the oily supernatant layer. the latter is separated by means of a pipette, and the acid aqueous solution shaken with fresh quantities of amylic alcohol until completely decolorized. th. the aqueous solution is then concentrated, ammonia added, and the mixture well shaken with warm amylic alcohol, in which the alkaloid dissolves. as soon as the solution forms a supernatant layer upon the surface of the fluid, it is drawn off with a pipette and evaporated on a water-bath. in this manner, the alkaloid is usually obtained in a sufficient state of purity to admit of its immediate identification; if, however, a small portion turns brown when treated with concentrated sulphuric acid, the process of purification must be repeated. under these circumstances it is re-dissolved in dilute hydrochloric acid, the solution repeatedly shaken with amylic alcohol, in order to extract the impurities present, and the alkaloid then extracted with ammonia and amylic alcohol, as previously directed. the method of _von uslar_ and _erdman_ differs from that of stas merely in the substitution of amylic alcohol for ether, and of hydrochloric acid for oxalic or tartaric acid. it offers no advantages over stas's method if the alkaloids present are soluble in ether but is even less advantageous in this case, inasmuch as its execution requires a longer time. in cases where the detection of morphine, or an unknown alkaloid, is desired, the use of amylic alcohol instead of ether is, it is true, preferable; still, with the exercise of care, ether can also be employed, and, as this process greatly facilitates examinations when no clew to the poison present exists and all alkaloids may possibly be absent, we prefer it to the one just described. rodgers and girdwood's method. this method--which as yet has only been employed in the detection of strychnine--is based upon the solubility of this alkaloid in chloroform. the substances under examination are digested with dilute hydrochloric acid, and the mixture filtered. the filtrate is then evaporated to dryness on the water-bath, the residue taken up with pure alcohol, the alcoholic solution evaporated, the second residue treated with water, and the solution so obtained filtered. the filtrate is next supersaturated with ammonia, and well shaken with chloroform, which, upon being separated by means of a pipette and evaporated, leaves the alkaloid in an impure state. concentrated sulphuric acid is then poured upon the alkaloid: the latter is not affected by this treatment, whereas the foreign organic substances present are carbonized. after the lapse of several hours, the mixture is treated with water, the fluid filtered, and the strychnine extracted from the filtrate by means of ammonia and chloroform, as already described. the operation is repeated until the residue obtained by evaporating the chloroform is no longer affected by the treatment with sulphuric acid. prollius's method. the suspected substances are boiled with aqueous alcohol, mixed with tartaric acid, and evaporated at a gentle heat. the remaining aqueous solution is then passed through a moistened filter, ammonia added to the filtrate, and the mixture shaken with chloroform. the chloroform is separated, the last trace of the original solution removed by washing with water, three parts of alcohol added, and the fluid evaporated. if strychnine be present, it will now separate out in crystals. this method is applicable only in presence of a considerable quantity of strychnine, and is less serviceable than the one preceding. graham and hofman's method. this method, which is applied to the detection of strychnine in beer, is founded upon the fact that an aqueous solution of a strychnine salt yields the alkaloid to animal charcoal, from which it can be subsequently extracted by boiling with alcohol. the beer to be examined is shaken with grammes of animal charcoal, and the mixture then allowed to stand twenty-four hours, with occasional shaking. the solution is next filtered, the animal charcoal washed with water, and boiled for half-an-hour with four times its weight of per cent. alcohol. the apparatus represented in fig. is employed, in order to avoid a loss of substance in this operation. [illustration: fig. .] the alcohol is filtered hot, evaporated, and the residue obtained treated with a small quantity of solution of potassa, and then agitated with ether. upon spontaneous evaporation, the ethereal solution leaves the strychnine present in a comparatively pure state. _macadam_ proposes to use this process for the detection of strychnine in animal bodies. for this purpose, the suspected materials are heated with a solution of oxalic acid, as in stas's method, and the strychnine detected in the filtered solution in the manner just described. this method is scarcely to be recommended: the use of animal charcoal is doubtless serviceable in the examination of beer, as it effects the separation of a small amount of strychnine from a large quantity of fluid, but its application to other researches is much less to be advised. application of dialysis in the detection of alkaloids. in order to apply the dialytic method to the separation of alkaloids, the suspected substances are heated with hydrochloric acid, and the solution introduced into the dialyzer. the hydrochlorates of the alkaloids, being crystalline bodies, transverse the membrane, and are contained, for the greater part, after twenty-four hours, in the outer solution. the fluid is then concentrated, and the alkaloids either directly precipitated, or purified by one of the preceding methods. identification of the alkaloid. the alkaloid having been isolated by one of the preceding methods, it remains to establish its identity. owing to the small number of reactions characteristic of organic compounds, this is a matter of considerable difficulty. there are two cases possible: the alkaloid may either be volatile or fixed. the alkaloid is volatile. in this case it may consist of nicotine, conine or aniline: less known alkaloids (piccoline, etc.) may also be present. we will confine ourselves to the consideration of the three first mentioned. the alkaloid is divided into several portions which are placed on watch-glasses and submitted to the following tests: _a._ a drop is treated with nitric acid: this may, or may not, impart a red tint to the alkaloid; if it does, another drop is treated with dry hydrochloric acid gas: if it assumes a deep violet color, it probably consists of _conine_. _b._ in case a red color was not produced by the addition of nitric acid, another drop is treated with chloride of lime. if it acquires a violet tint, and two other drops, when heated, one with arsenic acid, the other with nitrate of mercury, become red, the body present consists of _aniline_. or an homologous base. _c._ should the above tests fail to give positive results, and the substance, when treated with chlorine, assumes a blood-red color, and with hydrochloric acid does not change in the cold but turns to a deep violet color upon boiling, it probably consists of _nicotine_. the alkaloid is fixed. a very minute quantity is dissolved in the smallest possible amount of hydrochloric acid, and an excess of ammonia added. three cases are now possible: (_a_) a precipitate, insoluble in an excess of the precipitant, is immediately formed; (_b_) a precipitate is formed, which, at first dissolves, but is subsequently deposited from the fluid; (_c_) no precipitate is produced, or, in case one forms, it dissolves in an excess of the precipitant and fails to separate out upon allowing the fluid to stand. _a. ammonia produces a permanent precipitate._ a small quantity of an aqueous solution of carbonic acid is poured over the alkaloid in the water-glass, and notice taken whether it dissolves or not: in either case the mixture is evaporated on a water-bath to dryness, in order to avoid a loss of substance. carbonic acid fails to dissolve the alkaloid. after the evaporation is completed, ether is added to the watch-glass: the alkaloid may, or may not, be dissolved. the ether is then evaporated at the ordinary temperature of the air. _ether fails to dissolve the alkaloid._ it probably consists of _berberine_. in this case, it will possess a yellow color, and its hydrochlorate will give a reddish-brown precipitate upon addition of sulphide of ammonia. _ether dissolves the alkaloid._--a small portion is treated with nitric acid. if an intense green coloration is produced, the remaining portion is dissolved in ether, and an ethereal solution of oxalic acid added. if the precipitate now formed does not dissolve upon the addition of a little water, there is reason to suppose the presence of _aricine_. provided the addition of nitric acid did not produce a coloration, the mixture of the alkaloid and this acid is treated with a small quantity of sulphuric acid: if the fluid now acquires a red color, the substance probably consists of _narcotine_. should both nitric and sulphuric acids fail to cause a reaction, the alkaloid is dissolved in ether, precipitated by an ethereal solution of oxalic acid, and the precipitate treated with a little water. if it dissolves, it probably consists of _papaverine_. carbonic acid dissolves the alkaloid. the substance is treated with ether, notice being taken if it dissolves, which is evaporated at the ordinary temperature of the air so as to prevent a loss of minute portions of the alkaloid. _ether dissolves the alkaloid._--if nitric acid gives first a scarlet, then a yellow color, sulphuric acid a yellow, changing to red and violet, and hydrochloric acid a violet color, the alkaloid present is probably _veratrine_. if the above colorations are not produced, chlorine water is added to another portion of the substance, then ammonia; the formation of a green color, changing to violet and turning red upon a renewed addition of chlorine water, denotes the presence of _quinine_. in case all of these tests give but negative results, and the alkaloid is soluble in concentrated sulphuric acid, a solution being formed which assumes a reddish-violet tint when stirred with a glass rod previously dipped in bromine water, the presence of _delphine_. is indicated. _ether fails to dissolve the alkaloid._--if the substance is capable of being sublimed,[n] it consists of _cinchonine_. [n] cinchonine, when sublimed, condenses in minute brilliant needles.--_trans._ _b. ammonia produces a precipitate, which redissolves in an excess of the precipitant, but separates out after the lapse of an hour._ the substance is treated with cold absolute alcohol and its solubility in this menstruum noted. if it readily dissolves, it probably consists of _brucine_. the presence of this alkaloid is confirmed by applying the following tests: ( ) nitric acid imparts a blood-red color to the substance; ( ) if treated with sulphuric acid, it acquires a reddish tint which subsequently changes to yellow and green; ( ) chlorine at first fails to cause a coloration, but after some time a yellow color which afterwards changes to a red is produced; ( ) upon treating the substance with bromine, it immediately assumes a violet tinge. in case the alkaloid is only slightly soluble in alcohol, there is reason to infer the presence of _strychnine_. the following confirmatory tests should be applied: ( ) if the substance is treated with a mixture of sulphuric acid and an oxidizing body, such as bichromate of potassa, binoxide of manganese, or peroxide of lead it acquires a violet color, which changes into red and finally passes into a clear yellow; ( ) the addition of bichloride of platinum produces a precipitation of the hydrochlorate. should, however, the substance be only slightly soluble in alcohol, and the above reactions fail to take place, the presence of _solanine_. is indicated. in presence of this alkaloid the following reactions will occur: ( ) upon treating the substance with concentrated sulphuric acid, it assumes a rose tint, which changes after some time has elapsed first to a deep violet, then to a brown color; ( ) a solution of a salt of the alkaloid reduces gold and silver salts; ( ) the addition of oxalic acid produces a precipitate in the aqueous and even acid solution of its salts. _c. ammonia fails to produce a precipitate, or redissolves permanently the one formed._ the solubility of the alkaloid in ether is ascertained. if it be soluble, it may consist of aconitine, atropine or codeine; if insoluble, of emetine or morphine. _the alkaloid is soluble in ether._--if bichloride of platinum fails to precipitate the hydrochlorate from a neutral solution of the alkaloid, and sulphuric acid causes it to assume a yellow color which subsequently changes to a reddish-violet, it probably consists of _aconitine_. in case bichloride of platinum causes a precipitate and sulphuric acid fails to produce the yellow coloration referred to above, the presence of either atropine or codeine is indicated. in order to decide which of these bases is present, the substance is dissolved in pure chloric acid and the solution allowed to spontaneously evaporate. if the alkaloid is deposited during this operation, it probably consists of _atropine_. if this is not the case, there is reason to infer the presence of _codeine_. _the alkaloid is insoluble in ether._--if it dissolves in acetone it probably consists of _emetine_. if acetone fails to dissolve it, the presence of _morphine_. is indicated. the following confirmatory tests should be applied: ( ) upon treating the substance with nitric acid, it acquires a blood-red color; ( ) the addition of a solution of a persalt of iron produces an evanescent blue coloration; ( ) chloride of gold is colored blue, when treated with the alkaloid; ( ) the substance reduces iodic acid: this reduction is detected by adding to the acid a little starch-paste, which turns blue upon the liberation of the iodine; ( ) permanganate of potassa, if heated with the substance, is reduced and acquires a green color. identification of digitaline, picrotoxine and colchicine. it has already been remarked that in exhausting the first acid solution with ether--previous to the neutralization, according to otto's method--colchicine, a weak alkaloid, digitaline, an indefinite mixture, picrotoxine (which appears to possess the properties of an acid), and traces of atropine, pass into solution. the ether is evaporated on a water-bath to dryness, the residuary mass treated with slightly warmed water and the solution filtered from the undissolved resinous matter. the aqueous solution is next rendered feebly alkaline by addition of soda lye, and then well agitated with ether, until this fluid ceases to leave a residue upon evaporation. the ethereal solution is now decanted, and the water present removed by means of chloride of calcium. if it is evaporated, a residue containing the _colchicine_, _digitaline_ and traces of atropine (mixed possibly with a minute quantity of picrotoxine, which is here left out of consideration) is obtained. _a._ the _alkaline solution_, from which the ether has been removed, is acidulated with hydrochloric acid and again shaken with ether. the _picrotoxine_ present is now dissolved, and upon dehydrating (by means of fused chloride of sodium) and evaporating the ethereal solution can be obtained in crystals. the crystals of picrotoxine are easily recognized by their forming in feathery tufts as well as by their length and silky brilliancy. should crystals fail to form in a short time, it is advisable to take up the residue, left by the evaporations of the ether, with slightly warmed alcohol, and to allow the latter to spontaneously evaporate on a watch-glass, or, if the quantity of substance is exceedingly minute, on the slide of a microscope. after determining the form of the crystals, it should be ascertained that they possess an intense bitter taste and exhibit the other characteristic properties of picrotoxine. the following reaction is distinctive: if the crystals are dissolved in an aqueous solution of soda and a few drops of "fehling's solution"[o] added, a reddish precipitate of cuprous oxide is formed. [o] an alkaline solution of tartrate of copper, employed in the examination of sugar, urine, and wine.--_trans._ _b._ provided picrotoxine has not been found, the _ethereal solution_ obtained by agitating the alkaline fluid with ether is to be examined for colchicine and digitaline. to this end, the residue obtained upon evaporating the solution to dryness is taken up with water, and the filtered fluid tested as follows: . it is ascertained if a drop of the solution possesses the bitter taste of digitaline. . another drop is treated with solution of tannin; if either alkaloid be present, a precipitate is formed. . two drops of the solution are next tested: one with tincture of iodine, the other with chloride of gold. these reagents precipitate colchicine, but do not affect solutions of digitaline or picrotoxine. unfortunately traces of atropine, possibly present, would cause the same reaction; the test therefore fails to be conclusive. . several portions of the solution are evaporated on watch crystals. concentrated nitric acid is added to one portion: if colchicine be present, an evanescent violet coloration is produced, which changes to a light yellow upon addition of water, and to a pure yellow or reddish-orange color, if the mixture is saturated with a slight excess of caustic alkali. . another portion of the residue is dissolved in a few drops of concentrated sulphuric acid, and the solution stirred with a glass rod moistened with bromine water: in presence of digitaline a violet-red color is produced. this coloration is more distinct when a small quantity of the alkaloid and an excess of sulphuric acid are present. . if a large amount of substance is at hand, the residue can be boiled with hydrochloric acid, and the green or brownish color and characteristic odor of digitaline produced, in case this body be present: this, however, is not a very delicate test. . finally; it is advisable when the presence of digitaline is suspected to ascertain its physiological action. for this purpose, a minute quantity of the substance is placed upon the heart of a frog: in presence of the alkaloid, the pulsations are immediately retarded, or even arrested. * * * * * although by means of the tests given above the existence of a special alkaloid, or of one of the ill-defined substances just mentioned, may be justly regarded as probable, its presence has not yet with certainty been demonstrated. this is especially true in cases where the compound possesses but few characteristic properties. when possible, the suspected substance should be obtained in a crystaline form, and then compared by aid of the microscope--if the small quantity present permits of no other examination--with crystals of the pure alkaloid, prepared under the same conditions. in case or even centigrammes of substance are at hand, it is best to convert the alkaloid into its hydrochlorate, and evaporate the solution of this salt to dryness. the residue, after being weighed, is dissolved in water, and a solution of sulphate of silver added. the precipitate of chloride of silver formed is collected and carefully weighed, in order to calculate the weight of the chlorine contained in the hydrochlorate and consequently the molecular weight of the alkaloid. the filtrate from the chloride of silver, which contains the alkaloid in the state of sulphate, is treated with hydrochloric acid, to remove the excess of silver present and the fluid then filtered. the filtrate is next shaken with potassa and ether. upon decanting and evaporating the ethereal solution, a residue consisting of the alkaloid present is obtained, which is then purified by crystallization from alcohol. an elementary analysis of the alkaloid is now executed. _certainty_ as to the presence of an individual alkaloid is attainable only when the execution of this confirmatory test is possible. the reactions previously described can be performed with fifteen centigrammes of substance, and this amount is sometimes contained in a cadaver. if but one or two centigrammes are at hand, it is still possible to detect the presence of an alkaloid; a conclusion, however, as to _which_ cannot be arrived at, especially if the substance found is a liquid or an amorphous body, and one that presents few distinctive properties. iii. methods to be employed, when no clew to the nature of the poison present can be obtained. if poisoning has been caused by the administration of a mixture of numerous substances and these greatly differ in their properties, it is impossible to demonstrate in an incontestible manner the presence of each individual poison. this contingency fortunately but seldom arises; the criminal usually has recourse to one or two poisons, the detection of which is possible. it must not be imagined, however, that the presence of a poison in an organ can at once be detected with certainty by the mere application of a few tests; because, in searching for a substance which is absent, we may unwittingly destroy the one present, or, at least, transform it into combinations which would not allow of a definite conclusion as to its original condition. in order to follow a systematic method in researches of this nature, it is advisable to divide the materials under examination into three parts: one portion is preserved, in order to ascertain its physiological effects on animals, the chemical analysis having failed to give positive results. the other portions are submitted to analysis, but with slightly different objects in view; one is subjected to a series of tests which are adapted, under all circumstances, to place the chemist on the track of the poison present, and which, in some cases, may even give conclusive and definite results. should these tests furnish only _indications_ of the nature of the poison, the remaining portion serves, with the assistance of this information, to establish beyond doubt the identity of the substance. indicative tests. two cases may present themselves: the materials to be examined possess either an alkaline (or neutral) or an acid reaction. as the methods to be pursued in either of these cases differ somewhat, they will be treated separately. the substance possesses an acid reaction. the materials are mixed with water, placed in a retort provided with a delivery-tube which dips in a solution of nitrate of silver, and heated over a water-bath: if a _cyanide_ be present, hydrocyanic acid will be disengaged, and a white precipitate of cyanide of silver formed: this is examined as previously directed (_vide_ p. ). in case a precipitate is not produced by the above treatment, more water is added to the retort, and the mixture boiled for about an hour, care being taken to collect the evolved vapors in a well-cooled receiver. the portion remaining in the retort is thrown on a filter and the filtrate obtained united with the distillate. the residue remaining on the filter is next washed with boiling absolute alcohol, the washings being added to the aqueous solution. in this way, the suspected substances are divided into soluble and insoluble portions, which are examined separately, as directed below. _a._ liquid portion. if the addition of alcohol caused a precipitation of animal matters, these are separated by filtering the solution. the filtrate is then placed under a bell-jar over concentrated sulphuric acid until its volume is considerably reduced. the solution may contain organic and inorganic bases and acids. in order to detect all bodies that are present, the following course is pursued: ( ). a current of sulphuretted hydrogen is conducted through the solution: the precipitation of some metals, usually thrown down by this gas, may fail to take place in this instance, owing to the presence of organic substances; however, some metals are precipitated, even in presence of organic compounds, and organic acids are but seldom present. in case a precipitate is formed, it is mixed with pure silica, collected on a filter, and treated with nitric acid. if the precipitate fails to dissolve, it is treated with _aqua regia_. in either case, the solution obtained is examined for metals by the ordinary methods. ( ). the solution in which sulphuretted hydrogen failed to produce a precipitate, or the filtrate separated from the precipitate formed, is divided into two parts: one portion is treated with ether and a solution of potassa; the other with ether and a solution of soda. both mixtures are then well agitated, and notice taken if the ether dissolves any thing: if so, the operation is repeated several times until all soluble substances are removed. the ethereal solutions are next decanted and united, and then submitted to the examination for alkaloids as directed pp. - . ( ). if--the above treatment giving either positive or negative results--a precipitate insoluble in ether is formed by the addition of potassa or soda, it is collected on a filter, washed, and dissolved in an acid. the solution is then tested for mineral bases. ( ). in case no definite result has been obtained by the preceding operations, one of the portions (for instance, the one to which potassa was added) is tested for the acids possibly present in the state of salts. the solution is divided into two parts (a and b) which are examined separately: portion a.--this is evaporated to dryness and the residue divided into four parts which are then tested for hydrofluoric, nitric, oxalic, and acetic and formic acids. _a._ hydrofluoric acid.--a portion of the residue is heated in a platinum crucible with sulphuric acid, and the crucible covered with the convex face of a watch-crystal coated with wax in which lines have been traced with a pointed piece of wood. if, after gently heating the crucible for some time and removing the watch-crystal, the lines traced in the wax are found to be etched in the glass, the substance under examination contains a _fluoride_. _b._ nitric acid.--if this acid be present, and a second portion of the residue is heated with sulphuric acid and copper, reddish-fumes are evolved. upon conducting the vapors into a solution of sulphate of iron or narcotine, the reactions already mentioned in treating of nitric acid take place. _c._ oxalic acid.--the third portion of the residue is heated with sulphuric acid, and the evolved gas carefully collected. it should then be confirmed by an elementary analysis that the gas consists of equal volumes of carbonic oxide and carbonic acid. this test is not conclusive; it is also necessary to ascertain if the precipitate produced by the addition of a baryta solution (_vide_: under portion _b._) produces the same reaction, inasmuch as other organic bodies could give rise to carbonic oxide and carbonic acid, and the danger of both admitting the presence of oxalic acid, when it is absent, and omitting its detection, in case it is present, would be incurred. _d._ acetic and formic acids.--the fourth portion of the residue is distilled with dilute sulphuric acid. after determining that a small portion, previously neutralized with a base, acquires a red color, upon addition of a solution of a persalt of iron, the distillate is divided into two parts. one portion is treated with bichloride of mercury: if _formic acid_ be present, metallic mercury is formed, with evolution of carbonic acid which produces turbidity in lime-water. the remaining portion of the fluid is digested, in the cold, with an excess of litharge: in presence of _acetic acid_, a soluble basic salt of lead, possessing an alkaline reaction, is produced. portion b.--the second portion of the solution is supersaturated with nitric acid, and this neutralized by addition of a slight excess of ammonia. the ammonia is then expelled by boiling the fluid, and a solution of nitrate of baryta added. if a _precipitate_ forms, it is collected and subsequently examined for sulphuric, phosphoric, oxalic and boric acids as directed below. the _filtrate_ is preserved and tested for hydrochloric, hydrobromic and hydriodic acids. _a._ oxalic acid.--a portion of the precipitate produced by the addition of nitrate of baryta is submitted to the test mentioned under the treatment of portion _a_. _b._ sulphuric acid.--if an insoluble residue remains upon treating the remainder of the precipitate with dilute hydrochloric acid, it consists of sulphate of baryta and indicates the presence of _sulphuric acid_. _c._ phosphoric acid.--an excess of solution of alum and ammonia is added to the portion of the precipitate dissolved in hydrochloric acid. if phosphoric acid be present, insoluble phosphate of alumina is precipitated. this is brought upon a filter: the _filtrate_ being preserved and subsequently examined for boric acid. upon boiling the precipitate with solution of silicate of potassa, silicate of alumina is thrown down, and phosphate of potassa remains in solution. chloride of ammonia is now added to the liquid--in order to eliminate the excess of silica from the silicate--and the solution filtered. the _filtrate_ is then tested for phosphates, by means of molybdate of ammonia (_vide_: _detection of phosphoric acid_, p. ). _d._ boric acid.--the filtrate from the precipitate of phosphate of alumina is evaporated to dryness, the residue mixed with sulphuric acid and alcohol, and the latter ignited. if the substance contains _boric acid_, the alcohol will burn with a _green_ flame. the _filtrate_, separated from the precipitate produced by the addition of nitrate of baryta, may contain hydrochloric, hydrobromic and hydriodic acids. in order to detect these compounds, some nitrate of silver is added to the solution, and the precipitate that may form carefully washed and decomposed by fusion with potassa. the mass is then dissolved in water, and the solution submitted to the following tests: _e._ hydriodic acid.--some starch paste and nitric acid--containing nitrous acid in solution--are added to a portion of the solution: in presence of an _iodide_, the fluid immediately acquires a blue color. _f._ hydrobromic acid.--in case iodine has not been detected, chlorine water and ether are added to a second portion of the fluid, and the mixture well agitated. if _bromine_ be present, the ether will assume a _brown_ color. in case iodine is also contained in the fluid, and the detection of bromine is desired, it is necessary to acidulate the solution with hydrochloric acid, and then shake it with chloride of lime and bisulphide of carbon. the bisulphide of carbon dissolves the iodine, acquiring a _violet_ color, which disappears upon a renewed addition of chloride of lime; whereas, in presence of bromine an _orange_ coloration remains, even after the disappearance of the iodine reaction. _g._ hydrochloric acid.--since the substance under examination will already contain hydrochloric acid, it is unnecessary, in most cases, to institute a search for this compound. nevertheless, it may be well to take a quantity of the solution, corresponding to a known weight of the original substance, and precipitate the acid by adding nitrate of silver. the precipitate formed is dried and weighed. it is then heated in a current of chlorine, in order to completely convert it into chloride of silver, and its weight again determined. only in case the amount of chloride found is very large, is it to be inferred that the poisoning has been caused by hydrochloric acid. _h._ hydrosulphuric acid.--(_sulphuretted hydrogen_). if the precipitate produced by nitrate of silver possesses a black color, it may consist of a _sulphide_. upon treating a portion with solution of hyposulphite of soda, all but the sulphide of silver is dissolved. in case a residue remains, it is calcined with nitrate of soda, and the sulphate formed detected by adding a soluble barium salt to its solution. sulphates, chlorides, carbonates and phosphates are most frequently met with in the preceding examination, and it should be carefully noticed which of these salts exist in the greatest abundance. if acids of comparatively rare occurrence (such as the oxalic and tartaric) are found, their approximate amount is also to be noted. these facts, together with the original acidity of the materials and the absence of other toxical bodies, would lead to the conclusion that the poisoning was caused by the reception of an acid, as well as to the identification of the special acid used. in subsequently effecting the detection of the poison by the determinative tests, the danger of destroying other poisons possibly contained in the substance will be obviated, as the question of the absence or presence of these latter will have been previously decided. ( ). the examination for acids concluded, the various fluids which have accumulated, and from which the acids present have been separated, are united and the whole evaporated to dryness. the organic substances, present in the residue obtained, are destroyed by means of nitric acid, and the residual mass examined for _soda_. if this substance has not been introduced into the portion of fluid examined, and is discovered in a quantity largely in excess of the amount normally contained in the organism, it is probable that poisoning has been caused by its administration, and that an acid has also been given, either in order to mask the poison, or to act as an antidote. in this case, it is necessary to carefully search for acetic acid, as this is the substance usually employed as an antidote for alkalies. ( .) whatever results have been obtained by the preceding examinations, the portion of the fluid which has been treated with soda (_vide_ p. ) is evaporated to dryness. the organic matters possibly present are destroyed by means of nitric acid, or _aqua regia_, and the residue taken up with water. the solution so obtained is then examined for metals (including potassa, which salt has not been introduced into this portion of the fluid in any of the preceding operations) by the usual methods. ( ). the soluble portion of the suspected materials having been thoroughly tested, the undissolved substances remaining on the filter are next examined. _b._ solid portion. ( ). the organic matter present is first destroyed by treatment with _aqua regia_. the fluid is then evaporated to dryness, and the residue heated until the nitric acid is entirely expelled; the escaping vapors being collected in a cold receiver. the residue is next taken up with water, the solution filtered, and sulphuric acid added. should a precipitate of sulphate of lime, sulphate of baryta or sulphate of strontia form, it is separated from the fluid and further examined. the filtered solution is then introduced into marsh's apparatus, sodium amalgam being employed for generating the hydrogen, and tested for _arsenic_ and _antimony_ by means of the reactions previously given. ( ). whether one of the above poisons be discovered or not, the still acid fluid is removed from the flask, a current of chlorine conducted through it for several hours and the solution then examined for _mercury_ by flandin and danger's method. in case mercury is found it could scarcely have originated from the metal in marsh's apparatus, as this would not be attacked by cold dilute sulphuric acid: however, to remove all doubts, the test should be repeated with a portion of the substances reserved for the examination by the determinative tests. ( ). whatever have been the results of the above examinations, it is still to be ascertained if the fluid, which has been successively treated by marsh's and flandin and danger's methods, does not contain other metals. this is accomplished by means of the ordinary reactions. the substance possesses a neutral or an alkaline reaction. the examination is conducted in precisely the same manner as in the preceding case, excepting that the materials are first acidulated with oxalic or tartaric acids. particular attention should be given to the search for soda, potassa, lime, baryta and strontia, and the determinative tests subsequently applied according to the indications obtained. determinative tests. in many instances the tests we have termed indicative become determinative in their character. this is the case when the isolation of an alkaloid or a metal (unless mercury be found under the circumstances already mentioned) is accomplished; the results obtained are then _conclusive_. if, on the other hand,--not being able to separate either an alkaloid or a metal--upon saturating the originally acid fluid with potassa, or soda, the salts of these bases have been found in abundance, there is reason to _infer_ that the poisoning has been caused by an acid; or, if, after the neutralization of the originally alkaline solution with an acid, potassa or soda are discovered in a large quantity, poisoning by an alkali is _indicated_. in case the fluid is neutral, but more or less colored and odoriferous, and iodides or bromides are detected, we may justly _suspect_ that the poisoning has been caused by the reception of iodine or bromine. according to the indications furnished, iodine, bromine, one, or all of the acids, the caustic alkalies, etc., are then detected by means of the methods to be employed in cases where the expert has a clew to the poison present. in this manner, the presence of potassa and soda, and of bromine and iodine, even in mixtures, is easily ascertained. it only remains to mention the course to be pursued when suspicion exists that poisoning has been caused by the administration of a mixture of several acids. the suspected materials are boiled with water, and alcohol added to the solution in order to coagulate the animal matters. the solution is next filtered, the filtrate placed in a retort provided with a receiver and distilled until the residual portion acquires a pasty consistency. in this way, the acids present are separated into two classes: (_a_) those that are sufficiently volatile to have passed into the receiver, such as, acetic, nitric, hydrochloric and sulphuric acids (the latter acid will only be partially volatilized); and (_b_) those that remain in the retort. the former are detected by examining the distillate as previously directed. the residue remaining in the retort is treated with absolute alcohol, the fluid filtered, and a solution of acetate of lead added to the filtrate: sulphuric, phosphoric and oxalic acids, if present, are precipitated. the precipitate is suspended in water and decomposed by means of sulphuretted hydrogen. the acids contained are now set free, and are detected by applying the tests already mentioned. if there be reason to suspect the presence of both sulphuric and oxalic acids, the distillation is discontinued after a short time. the two acids are dissolved by shaking the moderately concentrated fluid remaining in the retort with ether, and, upon evaporating the solution, will be obtained in a state suitable for examination. oxalic acid is then detected by means of sulphate of lime; sulphuric by means of oxalate of baryta. the above examinations would fail to effect the detection of _phosphorus_, and it is necessary to examine a separate portion of the original substance for this body. iv. miscellaneous examinations. determination of the nature and color of the hair and beard. a criminal, in order to conceal his identity, may change the color of the hair and beard by artificial means; either to a darker shade, in case they were naturally of a light color, or, to a lighter hue, if they were originally dark, and the chemical expert may be called upon to detect this artificial coloration, and restore the original color of the hair. it may also happen, that portions of hair still adhere to the clots of blood sometimes found on an instrument which has been employed in the commission of a crime, and consequently the question may arise as to the nature of the hair, whether it be human or animal. determination of the color of the hair and beard. the mode of examination necessary when the hair has been blackened is different from that used when it has been decolorized. _the hair has been blackened._ as various methods of dyeing hair black are in use, the means of restoring the original color differ. the following are the methods most usually employed in dyeing: º. the hair is well rubbed with a pomade, in which finely pulverized charcoal is incorporated. this preparation, which is sold under the name of "_mélaïnocome_," possesses the disadvantage of soiling the fingers and clothing, even for several days after its application. º. the hair is moistened with a dilute solution of ammonia, and a perfectly neutral solution of a bismuth salt (chloride or nitrate) is then applied. it is subsequently washed, and allowed to remain in contact with a solution of sulphuretted hydrogen. º. the same operation is performed, a lead compound being substituted for the bismuth salt. º. a mixture of litharge, chalk, and slacked lime is applied, and the head covered with a warm cloth. the hair is afterwards washed, first with dilute vinegar, then with the yolk of an egg. º. the hair is first cleansed with the yolk of an egg, and then moistened with a solution of plumbate of lime; or, º. it is moistened with a solution of nitrate of silver, to which a quantity of ammonia sufficient to dissolve the precipitate first formed has been added. the first method merely causes a mechanical admixture of a coloring matter with the hair. in the four succeeding processes, a black metallic sulphide is produced; either by the subsequent application of a solution of sulphuretted hydrogen, or by the action of the sulphur normally present in the hair. in the last method, the formation of sulphide of silver doubtless occurs; but the principal change that takes place is probably due to the action of light, which, as is well known, decomposes the salts of silver. in order to restore the original color to hair which has been treated with "_mélaïnocome_," it is only necessary to dissolve in ether the fatty matters present, and then remove the charcoal by washing with water. in case the hair has been dyed by means of a bismuth or lead salt (as in methods , , and ), it is immersed for several hours in dilute hydrochloric acid: the metal present dissolves, as chloride, and the original color of the hair is rendered apparent. it then remains to detect the metal dissolved in the acid solution, in order to establish, beyond doubt, the fact that a dye has been employed. this is accomplished by means of the methods used for the detection of metals in cases of supposed poisoning. if, finally, an ammoniacal solution of nitrate of silver has been employed to cause the coloration, the hair is immersed, for some time, in a dilute solution of cyanide of potassium, and the fluid subsequently examined for silver. in case a portion of the salt has been converted into the sulphide, it will be difficult to restore the original color, as the removal of this compound is not easily effected. _the hair has been decolorized._ black hair can be bleached by means of chlorine-water, the various shades of the blonde being produced by the more or less prolonged action of the reagent. in this case, the odor of chlorine is completely removed only with great difficulty, and the hair is rarely uniformly decolorized. the expert may therefore be able to observe indication that will greatly assist him in arriving at a definite conclusion. the hair should be carefully examined up to the roots: if several days have elapsed since the decolorization has been performed, the lower portion of the hair will have grown and will exhibit its natural color. no method has yet been proposed that restores the original color to bleached hair. it is very possible, however, that this end would be attained by allowing nascent hydrogen to act upon the decolorized hair. for this purpose, it would be necessary to immerse it in water containing some sodium amalgam, and slightly acidulated with acetic acid. determination of the nature of the hair. in examinations of this character use is made of the microscope. the hair to be examined is suspended in syrup, oil, or glycerine and placed between two thin glass plates. human hair is sometimes cylindrical; sometimes flattened. it consists either of a central canal, or of a longitudinal series of oblong cavities which contain oily coloring matter, and possesses the same diameter throughout its entire length. the brown hair of the beard and whiskers, medium-sized chestnut hair, the hair of a young blonde girl, and the downy hair of a young man possess respectively a diameter of . to . ; . to . ; . ; and . to . millimetres. these exhibit on the surface slightly projecting scales, which are irregularly sinuous at the border, separated from each other by a space of about . m.m., and are transparent, whatever may be their color. the hair of ruminants is short and stiff, and is characterized by containing cavities filled with air. wool, however, forms an exception, as it consists of entire hairs, homogeneous in appearance and possessing imbricated scales, which bestow upon it the property of being felted. the hair of the horse, ox and cow never exceeds m.m. in length, and is tapering, its diameter gradually diminishing from the base. it is perfectly opaque, and does not appear to possess a central canal; has a reddish color, and frequently exhibits lateral swellings, from which small filaments occasionally become detached, in the same manner as a twig separates itself from the parent branch. examination of fire-arms. (_proposed by m. boutigny._) the examination of fire-arms is sometimes useful in determining the date at which a weapon has been discharged or reloaded. the methods used in examinations of this nature vary, as the weapon under inspection is one provided with a flint or an ordinary percussion lock. the value of the tests employed is also affected by the kind of powder used; _i. e._, whether common gunpowder, gun-cotton or white gunpowder (prepared by mixing yellow prussiate of potassa, chlorate of potassa and sugar) has been taken. the gun is provided with a flint-lock, and was charged with ordinary powder. in case the weapon has been wiped or exposed to moisture subsequent to its seizure, it is impossible to form any conclusion as to the date of its discharge, etc. it is therefore advisable, upon receiving the weapon, to carefully wrap the lock in a woollen cloth, and to close the barrel. the exterior of the gun is at first submitted to a careful examination, and notice taken of the approximate thickness of any existing rust spots. the fire-pan and adjacent portion of the barrel are also examined by aid of a magnifying glass, especial attention being given to the detection of traces of a moist and pulverulent incrustation of a greyish or blackish color, formed by the combustion of the gunpowder, and of crystals of sulphate of iron. if the weapon is loaded, the wad is withdrawn and the color of its cylindrical portion and of the powder, as well as the size of the ball or shot, noted. this preliminary examination ended, the barrel and fire-pan are separately washed with distilled water, and the washings passed through filter paper which has previously been well washed, first with pure hydrochloric acid, then with distilled water. the filtrate is next divided into three portions, and these separately examined for: ( ) sulphuric acid, by addition of chloride of barium; ( ) for iron, by oxidizing the salts contained in the fluid with a few drops of nitric acid and adding a solution of ferrocyanide of potassium, the presence of iron being indicated by the formation of a blue coloration, or a blue precipitate; and ( ) for sulphides, by means of a solution of subacetate of lead. if a bluish-black incrustation is discovered on the fire-pan or on the neighboring portions of the barrel, and both rust and crystals of sulphate of iron are absent, and the washings, which were originally of a light-yellow color, assume a chocolate-brown coloration upon the addition of solution of subacetate of lead, _the gun has been discharged within two hours at the longest_. if the incrustation possesses a lighter color and traces of iron have been detected in the washings, but neither rust nor crystals have been discovered on the barrel or fire-pan, _the weapon has been discharged more than two, but less than twenty-four hours_. in case minute crystals of sulphate of iron and spots of rust are found, and the washings contain iron in a considerable quantity, _the weapon has been discharged at least twenty-four hours, at the longest ten days_. if the quantity of rust found is considerable, but iron is no longer to be detected, _the discharge of the gun occurred ten days, at the longest fifty days, previously_. _if the weapon has been reloaded immediately after its discharge without having been previously washed_, the portions of the wadding which have come in contact with the barrel will possess a greyish-black color during the first four days, the color gradually becoming lighter, until, at the fifteenth day, it turns grey and remains so permanently. in this case, the washings will contain sulphuric acid. the objection has been advanced to the last test that sulphuric acid might be discovered, even if the gun had not been discharged, if the paper of which the wadding was made contained plaster. m. boutigny states, however, that this objection is untenable, if the wadding has not been moistened by the water introduced into the barrel. _in case the gun has been washed and dried before being reloaded_, the cylindrical portion of the wadding possesses an ochre-yellow color up to the first or second day, assumes a decided red hue on the days following, and acquires a clear rusty color on the sixth day. during the fifth day the powder also possesses a reddish appearance, owing to an admixture of rust. sulphuric acid is not present in the washings. _if the weapon has been reloaded immediately after being washed_, the wadding possesses a greenish-yellow appearance for the first few hours, and subsequently acquires a reddish color, as in the preceding case. _if, finally, the barrel has been washed with turbid lime-water_, rust is still to be found and the wadding possesses the color mentioned above. the following colorations are also to be observed in case the gun has not been washed, or has been dried near a fire: barrel dried near a fire. unwashed barrel. after day slight reddish yellow color greenish yellow color. or days a little darker " reddish-brown " days a redder " reddish-brown " or more days a rusty-red " rusty-red. " the gun is not provided with a flint lock. at present weapons having flint-locks have almost entirely gone out of use and have been superseded by the ordinary percussion gun; these latter, in turn, are being gradually replaced by breech-loaders, charged with or without a metallic cartridge. the indications obtained in the preceding examinations by means of the fire-pan, will therefore disappear; the results given by the inspection of the barrel may possibly hold good. in regard to breech-loaders, all the useful indications furnished by the coloration of the wadding and powder fail to occur; the latter being enclosed either in a paper cylinder or in a copper socket. the fact that gun cotton and white gunpowder are occasionally made use of, adds to the difficulty of obtaining reliable results by the mere inspection of a weapon. white gunpowder does not oxidize the gun, fails to give rise to any salt of iron, and possesses a white color; gun-cotton produces distinctive indications varying with its purity. owing to these facts, it is evident that the method proposed by m. boutigny is of no real value, save in the rare instances where a gun provided with a fire-pan, and charged with ordinary powder, is under examination, and the question of the lapse of time since the discharge of a weapon must remain undetermined so far as scientific tests are concerned. detection of human remains in the ashes of a fire-place. this class of examinations is particularly necessary when the crime of infanticide is suspected. as the complete incineration of a cadaver is a long and difficult operation, it frequently occurs that bones--partially or completely carbonized, but retaining their original form--are discovered by the careful examination of the ashes of the fire-place in which the combustion was accomplished. when this is not the case and complete incineration and disaggregation have occurred, recourse must be had to the indications furnished by a chemical analysis. these indications are reliable, however, only when the certainty exists that bones of animals have not been consumed in the same fire-place; otherwise, the results obtained are entirely worthless, the reactions given by ashes of animal bones being identical with those produced by the ashes of a human body. two tests are employed to detect the presence of bones in the residue left by the combustion of animal matter. . a portion of the ashes is placed in a silver crucible, heated with potassa, and the mass afterwards treated with cold water. if animal matter is contained in the consumed materials, cyanide of potassium will be present in the aqueous solution. in order to detect this salt, the fluid is acidulated with hydrochloric acid, and a solution of persulphate of iron added: the formation of a blue precipitate indicates the presence of the cyanide. . the ashes are next examined for phosphate of lime. as wood, coal, and the other substances usually employed for heating purposes contain none or little of this salt, its detection in a notable quantity would lead to the inference that bones have been consumed. the ashes are allowed to digest for twenty-four hours with one-quarter of their weight of sulphuric acid. water is next added to the pasty mixture, and the fluid filtered. if phosphate of lime be present, it is converted by this treatment into a soluble acid phosphate, which passes into the filtrate. upon adding ammonia to the filtrate, a precipitate of neutral phosphate of lime is formed, neutral phosphate of ammonia remaining in solution. the fluid is again filtered, the filtrate acidulated with nitric acid, and then boiled with a solution of molybdate of ammonia likewise acidulated with nitric acid: in presence of a phosphate, a yellow precipitate, or at least a yellow coloration of the fluid, will be produced. it has been stated that the disengagement of sulphuretted hydrogen, upon treating the ashes with sulphuric acid, is an indication that the combustion of a human body has occurred; this reaction is, however, valueless, inasmuch as coal and certain vegetable ashes likewise evolve the gas when subjected to the same treatment. examination of writings. contracts, checks, etc., are frequently altered with criminal intent, either by erasing the portion of the writing over the signature and substituting other matter, or by changing certain words, in order to modify the signification of a sentence. writings are altered either by erasure or by washing. erasure, although more easily executed, is seldom employed, as it renders the paper thin in places, and in this way leaves effects apparent even to the naked eye, and, although the original thickness can be restored by application of sandarac or alum, these substances possess properties differing from those exhibited by paper, and may, moreover, be completely removed, thus exposing the thinning of the paper. in case washing by means of chlorine has been resorted to, the sizing--which renders the paper non-bibulous, and which is only with difficulty replaced--may have been removed. formerly paper was sized by immersion in a solution of gelatine; at present, however, a soap of resin, or wax, and alumina (a little starch being added) is more commonly used. in the latter case, the sizing is less easily removed by the action of water than when the gelatine preparation is employed; the detection of its attempted restoration is also a matter of less difficulty, as gelatine would be employed for this purpose, and this body possesses properties different from those exhibited by the substances normally contained in paper: iodine, for instance, which imparts a yellow color to gelatine, turns starch violet-blue. in order to detect the alteration of a writing, the following examinations are made: º. the paper is carefully examined in all of its parts, and in various positions, by aid of a lens. in this way, either thinned points, caused by erasure, or remaining traces of words, may possibly be discovered. º. the paper is next placed upon a perfectly clean piece of glass, and completely and uniformly moistened with water. the glass is then removed, and the transparency of the paper examined by aid of a lens. when uniform transparency is exhibited, and certain portions are neither more transparent nor more opaque than the rest of the paper, it is probable that erasure has not been attempted. if, on the other hand, opaque points are observed, it is almost certain that letters have been erased, and sandarac, which is not affected by water, subsequently applied. in case transparent points are detected, there is reason to suspect that words have been removed, and the spots either left intact or afterwards coated with a substance soluble in water, such as alum. º. the paper is dried and the above operation repeated with alcohol of per cent. indications may now be observed which failed to occur in the treatment with water; as well as these latter confirmed. as alcohol dissolves sandarac, the points that formerly appeared opaque may now become transparent. º. the paper is again dried, then placed under a sheet of very thin silk-paper, and a warm iron passed over it. this operation frequently causes the reappearance of words that have been partially obliterated. it is also advisable--as suggested by _m. lassaigne_--to expose the paper to the action of iodine vapors. if alteration has not been attempted, the paper will acquire an uniform color; yellow, if sized with gelatine; violet blue, if sized with the mixture of soap, resin and starch. when, on the contrary, a subsequent sizing of gelatine has been applied in order to mask the alteration--the paper having been originally sized with the above mixture--it will assume in some portions a yellow, in others a violet-blue color. º. it is ascertained whether the paper possesses an acid reaction. if so, its acidity may result from the presence of hydrochloric acid, in case the paper was washed with chlorine, or of other acids. alum, used to disguise erasure, would also cause an acid reaction. the mere detection of acidity is, in itself, of little importance, as, in the manufacture of paper, the pulp is bleached by means of chlorine, and this reagent may not have been entirely removed by washing. if, however, the paper is acid only in certain spots, and these points produce a red coloration upon blue litmus paper, having the form of letters, the indication is of value. in order to ascertain if this be the case, it is advisable, before wetting the paper, to slightly press it upon a sheet of moist litmus paper: the acid spots will then leave a reddish trace upon the latter. º. the manuscript under examination is again spread upon a glass-plate, and a solution of tannin (or preferably, a solution of ferrocyanide of potassium containing one per cent. of the salt, and acidulated with acetic acid) applied by means of a brush. if the original writing was executed with ordinary ink (which has as its base tannate of iron), and the washing has been but imperfectly performed, it is quite possible that a blue coloration will be produced by the action of the ferrocyanide. it is, however, often necessary to apply the above reagents several times before the original writing becomes apparent; indeed, in some cases months have elapsed before the reaction has occurred. in case the alteration or destruction of the document is feared in the above test, it is well to previously provide the court with a certified copy, and then proceed with the examination. º. if the paper possesses a friable appearance, it has possibly been washed with sulphuric acid. this property may however originate from other causes, and the presence of the acid should be confirmed by washing the document with distilled water, and adding a solution of chloride of barium to the washings. the precipitate should form in a considerable quantity, as a slight cloudiness could be due to sulphates contained in the water used in the preparation of the pulp. if much sulphuric acid be present, it may be so concentrated by heating as to cause the carbonization of the paper. º. it is also well, should washing with sulphuric acid be suspected, to ascertain, by aid of a lens, if the filaments on the surface of the manuscript possess an inflated appearance. this would be caused by the escape of carbonic acid, originating from the action of sulphuric acid upon the carbonates contained in the water used in the manufacture of the paper. º. old ink is more difficult to remove than new, and it is therefore sometimes possible to cause the reappearance of old writings, over which words have been subsequently written. for this purpose, a solution containing per cent. of oxalic acid is applied with a fine brush over the suspected points. as soon as the ink disappears, the acid is immediately removed by washing with water, and the paper dried. upon now repeating the operation, the presence of a former writing may be detected after the complete disappearance of the words last written. º. according to _m. lassaigne_, when the same ink has not been used throughout a document, washing with dilute hydrochloric acid will demonstrate the fact. this acid, while causing the gradual obliteration of characters written with ordinary ink--the shade of the paper not being altered--produces a red color, if ink containing log-wood has been employed, and a green coloration, in case the ink used contained prussian blue. the expert may possibly be called upon to give evidence as to the existence of a "_trompe-l'oeil_;" as was the case in the trial of _m. de preigne_, which took place at montpelier in . a "_trompe-l'oeil_" consists of two sheets of paper, glued together at the edges, but having the upper sheet shorter than the other which therefore extends below it. this species of fraud is executed by writing unimportant matter on the uppermost sheet, and then obtaining the desired signature, care being taken that it is written on the portion of the paper projecting below. the signature having been procured, it is only necessary to detach the two sheets in order to obtain a blank paper containing the signature, over which whatever is desired can be inserted. the trial referred to above, was in reference to a receipt for , francs. the expert, upon placing pieces of moistened paper upon the suspected document, noticed that they adhered to certain points, and that these formed a border around the paper but passing _above_ the signature. the fraudulency of the act was thus established, and so recognized by the court, although the accused was acquitted by the jury. numerous means have been proposed, in order to render the falsification of documents a matter of difficulty. the most reliable of these is the use of "grimpe's safety-paper," containing microscopic figures, the reproduction of which is impossible. unfortunately, up to the present, the government has adopted methods less sure. examination of writings in cases where a sympathetic ink has been used. sympathetic inks are those which, although invisible at the time of writing, become apparent by the application of certain agents. they are of two classes: those which are rendered visible by the mere application of heat, such as chloride of cobalt, or the juice of onions; and those which are brought out only by the action of a reagent. the inks of the second class most frequently used are solutions of acetates of lead, and other metals which give a colored sulphide when treated with sulphuretted hydrogen. characters written with a solution of ferrocyanide of potassium acquire a blue color, if washed with a solution of perchloride of iron. it is scarcely necessary to add that the latter solution can be used as the ink, and the ferrocyanide as the developer. when the presence of characters written with a sympathetic ink is suspected, the document is examined as follows: . the paper is at first warmed: if the ink used is of the first class, the characters will now become legible; otherwise the examination is continued as below. . the paper is exposed to the action of steam, in order to moisten the ink present (care being taken to avoid dissolving the characters), and a current of sulphuretted hydrogen allowed to act upon it. if the ink used consists of a lead, bismuth, or gold salt, a black coloration will ensue; if salts of cadmium or arsenic were employed, the characters will acquire a yellow color; if, finally, a salt of antimony was used, a red coloration will be produced. . if no coloration was caused by the action of sulphuretted hydrogen, it is probably that either a solution of ferrocyanide of potassium or a persalt of iron has been resorted to. each of these solutions is separately applied on a small portion of paper by means of a brush, and notice taken if the characters become visible. the solution that produced the change is then applied over the entire sheet. . in case only negative results were obtained in the preceding operations, it must not yet be concluded that a sympathetic ink has not been used, although we are left without further recourse to chemical tests. numerous organic compounds may have been resorted to, the detection of which is almost impossible; moreover, if a mistake was made in regard to the preparation supposed to have been used, the reagents employed for its detection may render the discovery of another ink absolutely impossible. it is therefore often necessary to apply mechanical tests. for this purpose, the paper is spread upon a glass plate, uniformly moistened with water, and a second plate placed over it: if the characters were written with a pulverulent substance suspended in water or mucilage, they may often be observed upon examining the transparency of the paper. in case the substance used is both colorless and soluble, the detection of the written characters will be more difficult; still, indelible traces may possibly have been left by the pen. if, however, the ink employed is a colorless and transparent organic compound of rare occurrence, and was applied with a fine pencil-brush which failed to affect the paper, it must be acknowledged that little or nothing can be definitely determined as to its presence or absence. falsification of coins and alloys. in all civilized countries a fixed standard for coins and precious alloys is established by law, in order to prevent the perpetration of frauds which would be of serious injury to the public welfare. the substitution of coins consisting of an alloy inferior in value to the standard fixed by law, is too advantageous a fraud not to be often attempted. coins are most frequently altered by _clipping_; by _stuffing_, that is, by boring the coin and inserting an alloy of small value; by _doubling_, which operation consists in covering its face with two thin laminæ taken from a genuine coin; and by applying a coating of gold or silver by means of electro-plating. in order to ascertain if a coin has been counterfeited, its weight should at first be determined. if it has been clipped, or consists of an alloy possessing a density less than that of silver or gold, the fact is immediately demonstrated by its decreased gravity. the coin is further tested by throwing it down upon a hard substance: gold and silver give a ringing sound, whereas the majority of other metals produce a dull sound. the result obtained by this latter test often fails to be reliable. a skilful counterfeiter may prepare an alloy equally sonorous and heavy as silver or gold; in fact, _m. duloz_ exhibited to the author an alloy, prepared by him, possessing the density, sonorousness and lustre of silver; the composition of which, for obvious reasons, has not been published. in instances of this nature the fusibility of the coin should be determined, and the result obtained compared with the melting point of the legal alloy, or, this failing, a chemical analysis executed. in order to perform the latter test, the coin under examination is boiled with nitric acid: all metals are dissolved, with exception of gold and platinum, which remain unaltered, and tin and antimony, which are converted respectively into metastannic and antimonic acids. the fluid is filtered, the insoluble residue well washed, and then boiled with hydrochloric acid, which dissolves the metastannic and antimonic acids. the solution is again filtered, and the second residue dissolved in _aqua regia_. the metals dissolved in the several filtrates are then detected, either by the processes previously given for the detection of metallic poisons, or by the more complete methods contained in works on chemical analysis. this qualitative test is, however, insufficient, in case the falsification consisted in merely diminishing the proportions of the valuable metals contained in the alloy, without changing its qualitative composition: it is then necessary to execute a quantitative estimation of the metals present. as this operation requires considerable practice and the methods employed are to be found in all treatises on quantitative analysis, we will not reproduce them here. examination of alimentary and pharmaceutical substances. we will next enumerate the methods employed in the detection of the principal adulterations to which flour, bread, oils of seeds, milk, wines, vinegar and the sulphate of quinine are subjected. these researches, united with those preceding, fail to embrace all the diverse examinations which the chemical expert may be expected to execute; but we do not claim to foresee all the contingencies that may arise, and will describe the steps to be pursued in instances which are anticipated, at the same time indicating general methods applicable to cases not here included. flour and bread. the adulterations to which flour and bread are exposed usually consist in adding damaged or an inferior grade of flour to wheaten flour, or in disguising the presence of a poor quality of flour by the addition of mineral substances, such as: plaster, chalk, lime, alum, and sulphate of copper. good flour has a white color, possessing a slightly yellow tinge, but is entirely free from red, grey or black specks. it is soft to the touch and adheres to the fingers, acquiring, when compressed in the hand, a soft cushion-like form. if mixed with water, it forms an elastic, homogeneous, but slightly coherent dough, which can be extended out in thin layers. flour of an inferior quality possess a dull white color, and does not assume the cushion-like condition mentioned above, when pressed in the hand, but escapes between the fingers: the dough formed is of a poorer quality. flour which has been damaged by moisture has a dull or reddish-white hue, and possesses a mouldy, or even a noxious, odor, as well as a bitter and nauseous taste which produces a marked acid sensation in the throat. occasionally the presence of moisture causes the growth of _fungi_, the introduction of which in the digestive organs would cause serious results. the constituents of pure flour are: _gluten._ _starch_, in the proportion of to per cent. _dextrine_, in the proportion of several per cent. _glucose_, in the proportion of several per cent. _salts_, remaining in the ash obtained by the calcination of the flour, in a proportion not exceeding per cent. _water_, of which it loses to per cent., at the heat of a water-bath, and to per cent., at a temperature of °. _bran_, (ligneous and fatty matter,) in a very small proportion, when the flour has been properly bolted. in the process of bread-making, the gluten undergoes fermentation by the action of the leaven and liberates carbonic acid, which causes the dough to become porous and swell up, or, as it is termed, to _rise_. bread contains the same substances as flour, but gluten and starch are present in a state that does not admit of their separation by mechanical means, and glucose, if present at all, exists in a smaller quantity: the proportion of dextrine and water is, on the other hand, considerably increased. the bread of the paris city bakeries contains per cent. of water--the crumb, which forms / of the weight of the bread, containing per cent.; the crust, which constitutes the remaining / , containing per cent. in army bread per cent. of water are contained--the crumb, which constitutes / of the weight of the bread, holding per cent.; the crust which forms the remaining / , containing per cent. the addition of common salt naturally increases the proportion of ash left upon calcining bread. water is contained in stale bread in the same quantity as in fresh bread; but exists in a modified molecular condition: upon heating stale bread, it acquires the properties of fresh bread. the following substances are used in the adulteration of wheaten flour:[p] potato-starch. meals of various grains (rice, barley, corn, oats and rye). vegetable meals, (beans, horse-beans, kidney-beans, peas, vetch, lentils, etc.). darnel meal. buckwheat flour. linseed-meal. mineral substances (plaster, chalk, lime, alum, and sulphate of copper). [p] most of the substances here enumerated are rarely, if ever, used for the adulteration of flour in this country. the analyst should, however, give attention to the examination for such salts as alum, sulphate of copper, plaster, kaolin, etc.--_trans._ in order to detect these substances, the gluten, the starch, and the ash are separately examined. _a._ examination of the gluten. in order to separate the gluten, two parts of the flour to be examined and one part of water are mixed into a paste, and this is placed in a fine linen sack, in which it is kneaded under a stream of water so long as the washings have a turbid appearance: these are preserved. the gluten obtained from good wheaten flour possesses a light-yellow color; emits a stale odor; and spreads out, when placed in a saucer. in case the flour has been too strongly heated in the grinding, or otherwise badly prepared, the gluten is granulous, difficult to collect in the hand, and somewhat resembles flint-stone in appearance. gluten prepared from a mixture of equal parts of wheat and _rye_ is adhesive, blackish, without homogeneousness, spreads out more readily than pure wheaten gluten, separates easily and adheres somewhat to the fingers. gluten obtained from a mixture of wheat and _barley_ is non-adhesive, of a dirty reddish-brown color, and appears to be formed of intertwined vermicular filaments. gluten formed from a mixture of equal parts of wheat and _oats_ has a blackish-yellow color and exhibits, at the surface, numerous small white specks. the gluten from a mixture of wheat and _corn_ has a yellowish color, is non-adhesive, but firm, and does not readily spread. gluten prepared from a mixture of wheat and _leguminous flour_ is neither cohesive nor elastic, and, if the proportion of the latter present be considerable, can be separated and passed through a sieve, like starch. the gluten obtained from a mixture of equal parts of wheat and _buckwheat_ flour is very homogeneous, and is as easily prepared as the gluten from pure wheaten flour. it possesses when moist a dark-grey color; which changes to a deep black upon drying. the proportion of gluten in flour is exceedingly variable: good flour contains from to per cent. of dry gluten; poor flour from to per cent. of moist gluten, equal to about one-third of its weight of the dry compound. _b._ examination of the starch. the washings of the flour are allowed to stand for some time in a conical-shaped vessel. as soon as the amylaceous matter has entirely settled to the bottom of the vessel, the greater portion of the water is decanted, and the residual mass brought upon a small filter and allowed to dry. the residue is then examined for potato and rice starch. _potato starch._ the grains of potato starch are much larger than those of wheaten starch. if a portion of the residue mentioned above is crushed in an agate mortar, the granules of potato starch present are ruptured, and their contents liberated; the wheaten starch remaining unaltered. the mass is then taken up with water, and the fluid filtered. if potato starch be present, the filtrate will acquire a blue color upon addition of an aqueous solution of iodine; otherwise, a yellow or violet-rose coloration is produced. it is necessary to avoid crushing the residue for too long a time, as the granules of wheaten starch would also become ruptured by prolonged comminution. besides the difference presented by potato starch in the size of the granules in comparison to those of wheaten starch, the former swell to ten or fifteen times the volume of the latter, when treated with a solution of potassa: wheaten starch granules are not affected by the treatment, if the solution used does not contain more than per cent. of the salt. the results obtained by the above operation should be confirmed by a microscopic examination. a portion of the residue is moistened with solution of iodine, then carefully dried, and placed on the slide of a microscope. the mass is next moistened with a solution containing per cent. of potassa, and examined. the addition of iodine causes the potato starch granules to acquire a blue color, and renders their shape and volume more easily perceptible; thus allowing the two varieties of starch to be readily distinguished. fig. represents the relative size of the granules as observed under the microscope.[q] [q] it may be added, as a distinguishing property, that granules of potato starch, when viewed in polarized light by aid of a nicol's prism, present a well-defined black cross, corresponding to the hilum; wheaten-starch fails to exhibit this phenomenon.--_trans._ [illustration: fig. .] the presence of potato starch in bread is also detected by crushing a small portion of the sample under examination on the glass, and then adding a few drops of the alkaline solution. _rice and corn._--if rice or corn meal have been mixed with the flour, angular and translucent fragments (fig. ) are observed in the microscopic examination. corn meal acquires a yellow color, if treated with dilute potassa solution. [illustration: fig. .] miscellaneous tests. _linseed and rye meals._--if linseed meal is moistened with an aqueous solution containing per cent. of potassa and examined under the microscope, numerous minute characteristic granules, smaller than the grains of potato-starch, are observed. these possess a vitreous appearance, sometimes a reddish color, and usually form in squares or very regular rectangles. the test is equally applicable to bread. the detection of linseed and rye meals is simultaneously effected by exhausting the suspected flour with ether, then filtering the solution and allowing it to evaporate. if the flour contains rye, the oil left by the evaporation, when heated with a solution of mercury in concentrated nitric acid, is converted into a solid substance having a fine red color; but it remains unaltered, if entirely due to linseed. in case the oil becomes solidified, the mercury salt present should be removed by washing with water, the residue taken up with boiling alcohol of ° b. and the solution filtered: upon evaporating the alcoholic filtrate, a residue is obtained consisting of the linseed oil present. _buckwheat._--flour adulterated with buckwheat is less soft to the touch, does not pack as easily, and passes more readily through a sieve than pure wheaten flour. it presents, here and there, blackish particles, due to the perisperm of the grain, and has a dirty-white color. as previously remarked, the gluten obtained from a mixture of buckwheat and wheaten flour possesses a grey or even a black color. the starch furnished by buckwheat flour exhibits polyhedral agglomerations, analogous to those presented by corn. _darnel._--the use of darnel in the adulteration of wheaten flour may give rise to serious sanitary results. to effect its detection, the flour to be examined is digested with alcohol of ° b.: if the flour be pure, the alcohol remains limpid: it acquires a straw-yellow tint, due to traces of bran present, but--although a peculiar resin may be dissolved--the solution does not possess a disagreeable taste. when, on the contrary, darnel is present, the alcohol assumes a green tint, which gradually deepens, and possesses a bitter and nauseous taste; the residue, left by the evaporation of the tincture to dryness, has a greenish-yellow color, and a still more disagreeable flavor than the alcoholic solution. _legumens._--leguminous meals cannot be added otherwise than in small proportions to wheaten flour, owing to the rapidity with which they change the properties of the latter, and communicate to it their characteristic odor--noticeable upon treating the flour with a little boiling water. their presence is also easily detected by the distinctive properties of the vegetable itself, and by the appearance of the amylaceous residue in the microscopic examination. in order to decide as to the presence of legumens, the washings containing the starchy matter of the flour, after the particles of gluten present have been separated by passing the fluid through a silk sieve, are divided into two portions. one portion is allowed to undergo fermentation, at a temperature of ° to °: in case leguminous substances are not present, lactic fermentation occurs and the odor of sour milk is alone perceptible; if, on the other hand, legumens are contained in the fluid, rancid fermentation takes place, and an odor is emitted resembling that of decayed cheese. the remaining portion of the washings, after being decanted from the residue of amylaceous matter, is filtered and evaporated until a yellowish translucent pellicle appears upon its surface. the fluid is then again filtered from the coagulated albumen common to all flours, and the leguminous substances present coagulated by the addition, drop by drop, of acetic acid. the leguminous deposit produced appears white and flaky; when examined under the microscope, it presents lamilla emarginated at the border; it is odorless and tasteless; when dried, it assumes a horny appearance; it is insoluble, both in water and alcohol, and does not become gelatinous when treated with boiling water; it is readily soluble in potassa and other alkaline solutions, from which it is precipitated upon addition of nitric, hydrochloric, acetic, oxalic, and citric acids; upon protracted boiling in water, it loses its property of being soluble in ammonia. the above tests having been applied, the residue containing the starch is next examined. for this purpose, a small portion is moistened with a little water, a few drops of iodine solution added, and the mixture placed on the side of the microscope: the bluish grains contained in the polyhedral and cellular envelope (fig. ) are easily recognized. the mixture on the glass may also be treated with an aqueous solution of potassa (containing per cent. of the salt), or with dilute hydrochloric acid: these reagents dissolve the starch present, leaving the reticulated tissue intact. should this examination fail to give a definite result, the remaining portion of the amylaceous residue is subjected to a sort of levigation, and the part most slowly deposited separated. in this portion the reticulated tissues of the leguminous substances present are contained, and, as they are comparatively free from foreign matters, their identification is a matter of comparative ease. in case the presence of reticulated tissue is indicated, it is still necessary to apply confirmatory chemical tests. [illustration: fig. .] meals prepared from beans, horse-beans, and lentils, contain a tannin which imparts a green or black color to salts of iron. the coloration is rendered very sensitive if a rather considerable quantity of the flour to be examined is passed through a silk sieve, and the remaining bran treated with a solution of sulphate of iron (_ferrico-ferrous_ sulphate): the reaction immediately occurs, even if the sample contains but per cent. of bean meal. the meals of horse-beans and of vetches acquire a red color, when exposed to the successive action of nitric acid and of ammonia vapors. in order to apply this test, the suspected flour is placed upon the edge of a capsule containing nitric acid, the latter heated, and, as a yellow coloration appears, the acid removed and replaced by ammonia. the capsule is then set aside: if the flour is adulterated with either of the above vegetables, reddish spots, which are easily perceptible by aid of a magnifying glass, are soon produced. in case bread is to be examined, it is exhausted with water, the fluid passed through a sieve, the upper layer decanted, then evaporated, and the residue taken up with alcohol. the tincture so obtained is evaporated, and the second residuum treated with nitric acid and ammonia, as directed above. when meals prepared from beans, vetches, or lentils are heated on a water-bath with hydrochloric acid, diluted with three to four times its volume of water, a cellular tissue, possessing the color of wine-dregs, remains behind; flours of wheat, peas, and kidney-beans leave a colorless residue, when subjected to the same treatment. finally; the grains of the starch (_fecula_) of legumens possess a volume about equal to that of potato granules, and exhibit either a longitudinal furrow in the direction of their longer axis, or a double furrow arranged in a star-like form. _c._ examination of the ash. leguminous substances, and more particularly mineral salts, are detected by the examination of the ash left upon the incineration of the flour. _detection of legumens._--pure wheaten flour furnishes an ash consisting of about per cent. of its weight; whereas meals of legumens leave from to per cent. of their weight in ash. this difference is, however, too slight to furnish conclusive results; the analysis of the ash is also necessary. the ash of wheaten flour is non-deliquescent, dry, semi-fused, and chiefly consists of phosphates of potassa, soda, magnesia and lime, of sulphates, and of silica. the solution obtained by treating the ash with water has an alkaline reaction. the phosphates of the alkalies, present in the ash of wheat, exist in the state of pyrophosphates, and, as chlorides are absent, the addition of nitrate of silver to the aqueous solution of the ash produces a white precipitate, consisting entirely of pyrophosphate of silver, which is not affected by exposure to the light. the ash of leguminous meals is deliquescent and soluble in water, forming a _strongly_ alkaline solution, which contains both chlorides and _neutral_ phosphates. the latter give a clear yellow precipitate with nitrate of silver. upon adding a solution of this salt to the aqueous solution of the ash, a _pale_ yellow precipitate, which turns violet if exposed to the light, is therefore produced. _detection of mineral substances._--the principal mineral substances, that are fraudulently added to flour, are ground calcined bones, sand, lime, plaster, alum, and sulphate of copper. the two last named salts are almost invariably added in small quantities; alum renders the flour white, even when used in the proportion of one per cent.; sulphate of copper is added to impart a good appearance to bread made from a damaged flour. _a. ground bones_ (carbonate and phosphate of lime).--the washings of the gluten are placed in a conical vessel, and, after some time has elapsed, the clear supernatant fluid is removed by means of a syphon, a conical shaped deposit remaining on the bottom of the vessel: two hours later, the fresh layer of fluid that has formed is removed with a pipette. as soon as the residue becomes nearly solid, it is detached from the vessel, placed upon a fragment of plaster, and allowed to dry. the bones, being heavier than the amylaceous substances, are to be found in the apex of the cone formed by the residue. this is detached, and incinerated: in case the ash obtained contains phosphate and carbonate of lime, the addition of hydrochloric acid will cause effervescence, and, upon adding ammonia to the acid solution, a white precipitate will be formed. if the solution is then filtered and oxalate of ammonia added to the filtrate, a precipitate will be produced which, when heated to redness, leaves a residue of caustic lime possessing an alkaline reaction. _b. sand._--as this substance possesses a much greater specific gravity than the usual constituents of flour, it is only necessary, in order to accomplish its separation, to repeatedly stir the flour with water, and remove the deposit at first formed, which, if consisting of sand, will be insoluble in acids, and will grate, when placed between the teeth. _c. carbonates of lime and magnesia; vegetable ashes._--carbonic acid is always evolved, upon treating flour with hydrochloric acid. if the base present be calcium, upon adding oxalate of ammonia to the filtered solution--which has previously been neutralized with ammonia--a white precipitate, possessing the properties mentioned above, will be formed; in case the base is magnesia, the addition of oxalate of ammonia will fail to cause a precipitate, but upon adding solution of phosphate of ammonia to the fluid a granular precipitate of phosphate of ammonia and magnesia is produced; if, finally, the flour contains vegetable ashes--_i. e._ carbonates of the alkalies--bichloride of platinum will produce in the acid solution a yellow precipitate: the addition of vegetable ashes, moreover, would render the ash of the flour deliquescent and very strongly alkaline. _d. lime._--in presence of lime, carbonic acid produces a white precipitate, when conducted into the filtered aqueous extract of the flour. _e. plaster._--the flour is boiled with water acidulated with hydrochloric acid, the fluid filtered, and lime detected in the filtrate by means of ammonia and oxalate of ammonia. the presence of sulphuric acid is indicated by the formation of a precipitate insoluble in acids, upon addition of solution of chloride of barium. upon calcining the flour without access of air, sulphate of lime is converted into the corresponding sulphide: the residue of the calcination, when treated with hydrochloric acid, evolves sulphuretted hydrogen, and the lime present in the filtered acid solution is likewise precipitated by the addition of ammonia and oxalate of ammonia. _f. alum._--a portion of the flour to be examined is treated with water, the fluid filtered, and the filtrate divided in two portions: in one, sulphuric acid is detected by means of chloride of barium; in the other, alumina by adding a solution of potassa, which gives with its salts a white gelatinous precipitate, soluble in an excess of the reagent.[r] [r] if the detection of alum in bread is desired, a portion of the crumb is incinerated in a platinum dish, the ash is treated with concentrated hydrochloric acid, the filtered solution evaporated to dryness, and the residue treated with hydrochloric acid, which now leaves the silica present undissolved. the acid solution is then filtered, nearly neutralized with carbonate of soda, and an alcoholic solution of potassa added in excess. the earthy phosphates present are now precipitated, alumina remaining in solution. the use of aqueous potassa in this case--as well as in the case mentioned in the text--is not advisable, as it is seldom entirely free from alumina. upon slightly acidulating the alkaline filtrate with hydrochloric acid, and adding carbonate of ammonia, the alumina present is precipitated, and may be dried and tested by means of the reaction with nitrate of cobalt before the blow-pipe. in the quantitative estimation of alumina, the phosphoric acid usually present in the precipitate should be removed. this is done by dissolving the precipitate in nitric acid and immersing a piece of metallic tin in the boiling solution: phosphoric acid is thrown down as a mixture of stannic oxide and phosphate, and the alumina is then precipitated as usual by carbonate of ammonia.--_trans._ _g. sulphate of copper._--about grammes of the bread under examination are incinerated; the ash treated with nitric acid; the mixture evaporated until it acquires a sticky consistence, and the mass then taken up with water. the aqueous solution is next filtered; an excess of ammonia and several drops of solution of carbonate of ammonia added; the fluid again filtered, the filtrate slightly acidulated with nitric acid, and divided into two parts. it is then ascertained if sulphuretted hydrogen produces in one portion of the solution a brown precipitate of sulphide of copper, and if solution of ferrocyanide of potassium produces in the other a reddish-brown precipitate of ferrocyanide of copper.[s] [s] according to wagner, if the ash, obtained by incinerating the adulterated bread, is washed with water, shining spangles of metallic copper are separated.--_trans._ fixed oils. olive oil designed for table use is frequently adulterated with the oils of poppy, sesamé, cotton-seed, pea-nuts, and other nuts; olive oil, intended for manufacturing purposes, is often mixed with colza and nut oils. the tests used are of a rather unsatisfactory character. in all instances, when the chemist is called upon to pronounce as to the adulteration of an oil, it is necessary to execute comparative experiments with the pure oil, and with admixtures arbitrarily prepared: it is only when this is done that the indications obtained are of value. examination of olive oil intended for table use. _a._ the density of the oil is determined by means of a hydrometer (_oleometer_) provided with a scale giving the densities from . to . , for the temperature of .° pure olive oil possesses a specific gravity of . ; poppy oil one of . ; a mixture of the two, an intermediate density. since the fixed oils are not definite chemical compounds, this test is seldom conclusive. _b._ two or three cubic centimetres of concentrated nitric acid, containing nitric peroxide in solution (or a solution of mercury in strong nitric acid), are added to the oil to be examined, as well as to a sample of pure olive oil. the two samples are then allowed to stand in a room where the temperature does not exceed .° the _oleine_ of the olive oil is converted into solid _elaidine_, and the mixture after some time becomes sufficiently thick to remain in the vessel upon inversion. if the sample under examination is free from adulteration, it will solidify at the same time as the pure oil; whereas, the presence of one per cent. of poppy oil, or of other drying oils, suffices to retard the solidification for forty minutes. _c._ fifteen grammes of the oil are mixed in a glass vessel with the same amount of strong sulphuric acid, the temperature of the two liquids being previously observed. the mixture is stirred with a thermometer, and the maximum temperature noted: pure olive oil produces an elevation of temperature of .° ; pure poppy oil, an elevation of .° ; and a mixture of the two an elevation of temperature intermediate between .° and .° . _d._ one volume of nitric acid of sp. gr. . is agitated with grammes of the oil, and notice taken of the coloration produced after the lapse of five minutes. if the olive oil is pure, it acquires a pale green color; in case it is mixed with sesamé or nut oil, a deep-red color appears: poppy oil also communicates a reddish coloration, but one less deep than the preceding. if an acid of sp. gr. . is taken, it is still less difficult to distinguish between sesamé, nut and poppy oils; the latter assumes, in this case, a pale yellowish-red color. pea-nut oil fails to exhibit a coloration; but can be recognized by its conversion into a white solid, when mixed with / of its volume of a solution of caustic soda of sp. gr. . . examination of olive oil intended for manufacturing purposes. the chief adulterations are colza and nut oils. the latter is detected by means of the reaction with nitric acid, as described above. colza oil is recognized by mixing volumes of the sample to be examined, with volume of sulphuric acid of sp. gr. . : if colza or nut oils are present, a brown coloration ensues; under the same circumstances, pure olive oil assumes a pale greenish hue. in case the sample acquires a brown color when treated with sulphuric acid, and a red coloration is produced by the addition of nitric acid, it contains nut oil; if sulphuric acid produces a brown coloration, and nitric acid fails to change it, the presence of oil of colza is indicated. examination of hempseed oil. this oil is frequently adulterated with linseed oil. the reactions exhibited by these oils are nearly identical, and the detection of the admixture is extremely difficult. it is advisable to mix the suspected oil with sulphuric acid, notice being taken of the elevation of temperature produced, and to treat it with nitric acid and with dilute potassa solution, subjecting, at the same time, an artificial mixture of the two pure oils to the same treatment, and comparing the results obtained. tea and its adulteration. among alimentary substances probably no article is subjected to more adulteration than tea. the sophistications practised may be conveniently divided into three classes: . additions made for the purpose of giving increased bulk and weight, which include foreign leaves and exhausted tea-leaves, and also certain mineral substances, such as metallic iron, sand, brick-dust, etc. . substances added in order to produce an artificial appearance of strength in the tea decoction, catechu, or other bodies rich in tannin, and iron salts being chiefly resorted to for this purpose. . the imparting of a bright and shining appearance to the tea by means of various coloring mixtures or "facings," which adulteration, while sometimes practised upon black tea, is much more common with the green variety. this sophistication involves the use of steatite (soap-stone), sulphate of lime, china clay, prussian blue, indigo, turmeric, and graphite; chromate of lead and copper salts being but very rarely employed. the compound most frequently used consists of a mixture of soap-stone (or gypsum) with prussian blue, to which a little turmeric is sometimes added. genuine tea is the prepared leaf of _thea sinensis_. it contains: moisture, % to %; theine, . % to . %; tannin, (green) %, (black) %; ash, % to %; soluble extractive matters, % to %; and insoluble leaf, % to %. [illustration: fig. .] [illustration: fig. .] [illustration: fig. .] [illustration: fig. .] the presence of foreign leaves, and, in some instances, of mineral adulterants, in tea is best detected by means of a microscopic examination of the suspected sample. the genuine tea-leaf is characterized by its peculiar serrations and venations. its border exhibits serrations which stop a little short of the stalk, while the venations extend from the central rib, nearly parallel to one another, but turn just before reaching the border of the leaf (see fig. ). the chinese are said to employ ash, plum, camellia, velonia, and dog-rose leaves for admixture with tea, and the product is stated to be often subjected in england to the addition of the leaves of willow, sloe, beech, hawthorn, elm, box-poplar, horse-chestnut, and fancy oak (see figs. , , and ). for scenting purposes chulan flowers, rose, jasmine, and orange leaves are frequently employed. in the microscopic examination the sample should be moistened with hot water, spread out upon a glass plate, and then submitted to a careful inspection, especial attention being given to the general outline of the leaf and its serrations and venations. most foreign leaves will, in this way, be identified by their botanical character. the presence of exhausted tea-leaves may also often be detected by their soft and disintegrated appearance. if a considerable quantity of the tea be placed in a long glass cylinder and agitated with water, the coloring and other abnormal bodies present frequently become detached, and either rise to the surface of the liquid as a sort of scum or fall to the bottom as a deposit. in this way prussian blue, indigo, soap-stone, gypsum, sand, and turmeric can sometimes be separated and subsequently recognized by their characteristic microscopic appearance. the separated substances should also be chemically tested. prussian blue is detected by heating with a solution of caustic soda, filtering, and acidulating the filtrate with acid, and then adding chloride of iron, when, in its presence, a blue color will be produced. indigo is best discovered by its appearance under the microscope; it is not decolorized by caustic alkali, but it dissolves in sulphuric acid to a blue liquid. soap-stone, gypsum, sand, metallic iron, etc., are identified by means of the usual chemical tests. a compound, very aptly termed "lie-tea," is often met with. it forms little pellets consisting of tea-dust mixed with foreign leaves, sand, etc., and held together by means of gum or starch. this, when treated with boiling water, falls to powder. in the presence of catechu the tea infusion usually becomes muddy upon cooling; in case iron salts have been employed to deepen the color of the liquor, they can be detected by treating the ground tea-leaves with acetic acid and testing the solution with ferrocyanide of potassium. tea should not turn black upon immersion in hydrosulphuric acid water, nor should it impart a blue color to ammonia solution. the infusion should be amber-colored, and not become reddened by the addition of an acid. tea assay. in the following tea assay proper the estimation of theine is not included. the processes suggested for this determination are rather unsatisfactory; and there appears, moreover, to exist no direct relation between the quality of tea and the proportion of theine contained. the tests here mentioned, in connection with those already given, will, it is believed, usually suffice to indicate to the analyst the presence of spent leaves, inorganic coloring matters, and other mineral adulterations. tannin.--a good process for the estimation of tannin in tea has been published by allen (_chem. news_, vol. xxix. p. et seq.) a standard solution of lead acetate is prepared by dissolving grammes of the salt in distilled water and diluting the liquid to , c.c. as an indicator, milligrammes of potassic ferricyanide are dissolved in c.c. of water, and an equal volume of strong ammonia-water added. the exact strength of the lead solution is to be determined by means of a solution of pure tannin of known strength. two grammes of the tea to be tested are powdered, boiled with water, and, after filtering and thorough washing, the decoction is made up to a volume of c.c.; c.c. of the lead solution are now diluted with c.c. of boiling water, and the tea infusion is gradually added from a burette until a few drops of the liquid, when filtered and added to a little of the indicator placed upon a porcelain slab, causes a pink coloration to appear; , divided by the number of c.c. of tea infusion found to be necessary to produce the pink color, will give directly the percentage of tannin in the sample examined. as previously stated, green tea contains % of tannin, and black tea %. in spent tea, however, only about % of tannin is present; and, although any tea deficient in this constituent could be fortified by the addition of catechu, its determination often affords indications of value. the ash--_a. total ash._-- grammes of the sample are placed in a platinum vessel and heated over a bunsen burner until complete incineration has been accomplished. the vessel is allowed to cool in a desiccator, and is then weighed as quickly as possible. in genuine tea the total ash should not be much below % or much above %, and it should not be magnetic; in "faced" teas the proportion of total ash is often % or %; in "lie-tea" it may reach %, and in spent leaves it may fall as low as %, the ash in this case being abnormally rich in lime salts and poor in potash salts. tea-dust sometimes contains % of total ash without necessarily being considered bad in quality. in the proposed united states tea-adulteration law ( ) a maximum of % of total ash is allowed for tea-leaf. _b. ash insoluble in water._--the total ash obtained in _a_ is washed into a beaker and boiled with water for a considerable time. it is then brought upon a filter and the insoluble residue washed, dried, ignited, and weighed. in unadulterated tea it will not exceed % of the sample taken. _c. ash soluble in water._--this proportion is obtained by deducting ash insoluble in water from the total ash. genuine tea contains from % to . % of soluble ash, or at least % of the total ash, whereas in spent or exhausted tea the amount is often but . %. _d. ash insoluble in acid._--the ash insoluble in water is boiled with dilute hydrochloric acid and the residue separated by filtration, washed, ignited, and weighed. in pure tea the remaining ash ranges between . % and . %; in "faced" teas, or in teas adulterated by the addition of sand, etc., it may reach the proportion of % to %. fragments of silica and brick-dust are occasionally to be found in the ash insoluble in acid. the extract.--two grammes of the carefully-sampled tea are boiled with water until all soluble matter is dissolved, water being added from time to time to prevent the solution becoming too concentrated. the solution is poured upon a tared filter, and the remaining insoluble leaf repeatedly washed with hot water until the filtered liquid becomes colorless. the filtrate is now diluted to a volume of c.c., and of this c.c. are taken and evaporated in a weighed dish over the steam-bath until the weight of the extract remains constant; its weight is then determined. genuine tea affords from % to % of extract, according to its age and quality; in spent tea the proportion of extract will be greatly reduced. insoluble leaf.--the insoluble leaf obtained in the preceding operation, together with the weighed filter, is placed in an air-bath and dried for at least eight hours at a temperature of ° c.; its weight is then determined. in unadulterated tea the amount of insoluble leaf ranges between % and %; in exhausted tea it may reach a proportion of %. it should be noted that in the foregoing estimations the tea is taken in its ordinary air-dried condition. if it be desired to reduce the results obtained to a dry basis, an allowance for the moisture present in the sample (an average of %), or a direct determination of the same, must be made. the following tabulation gives the constituents of genuine tea so far as the ash, extract, and insoluble leaf are involved: _total ash_--ranges between . % and . %. _ash soluble in water_--ranges between % and . %; should equal % of total ash. _ash insoluble in water_--not over . %. _ash insoluble in acid_--ranges between . % and . %. _extract_--ranges between % and %. _insoluble leaf_--ranges between % and %. the table below may prove useful as indicating the requirements to be exacted when the chemist is asked to give an opinion concerning the presence of facing admixtures or of exhausted or foreign leaves in a sample of tea: _total ash_--should not be under . % or over %. _ash soluble in water_--should not be under % of total ash. _ash insoluble in water_--should not be over %. _ash insoluble in acid_--should not be over %. _extract_--should not be under %. _insoluble leaf_--should not be over %. note.--the british society of public analysts adopt: _total ash_ (dry basis)--not over % (at least % should be soluble in water). _extract_ (tea as sold)--not under %. milk. the chief constituents of milk are water, butter, caseine, lactose (milk-sugar), traces of albumen and mineral salts. butter is present in the form of minute globules, held in suspension; the caseine, for the greater part, is in solution, only a small portion being present in an insoluble suspended condition. in milk only a few days old, the _colostrum_ (the milk secreted during the first few days after parturition) consists largely of rather voluminous cellular conglomerations, containing a sufficient quantity of albumen to coagulate upon heating. the normal density of milk is . , water being . ; the density rising to . , if the fluid has been skimmed. good milk contains, on an average, . per cent. of butter; . per cent. of lactose, and leaves upon evaporation to per cent. of solid matters.[t] the most common adulteration of milk consists in the addition of water. this fraud is detected by means of an areometer (_lactodensimeter_) which gives directly the specific gravity of the fluid under examination. should the density be much below . , it is certain that water has been added. it does not, however, necessarily follow if it is about . that the milk is pure, since the gravity of the fluid, which would be increased upon skimming, could be subsequently reduced to . by the addition of water. the lactodensimeter, therefore, although useful in the detection of a simple admixture, fails to give reliable results if the fraud perpetrated is a double one; and a determination of the proportion of butter present is also usually necessary. numerous methods have been proposed to accomplish this estimation. the most preferable of these, owing to the rapidity with which the operation is executed, is the use of the lactoscope (_galactoscope_). this instrument consists of a tube provided with a glass plate fitted at one end, and with a movable glass plate at the other extremity. a few drops of the milk to be tested are placed between the two plates, and the tube lengthened, by screwing out the movable plate, until the fluid no longer transmits the light of a candle placed at a distance of one metre. as the opacity of milk is due to the butter present, it is evident that the proportion of this substance contained in the sample can be estimated by the relative distance which the plates have been separated. [t] the british society of public analysts regard the following as the _minimum_ proportions of constituents in unadulterated milk: fat . per cent. solids, not fat . " " ---- total . " " water . " " --_trans._ the lactoscope possesses, however, but a limited degree of precision. _m. marchand_ substitutes to its use the following tests: a test-tube is graduated in three equal divisions, the upper one being subdivided into hundredths extending above, in order to determine accurately the correct volume of the fluid, expanded, as it is, by the temperature of °, at which the examination is executed. the first division of the tube is filled with milk, a drop, or two of strong potassa lye added, and the mixture well shaken: the second portion is then filled with ether, and the third with alcohol. the mixture is next again thoroughly agitated, and then exposed to a temperature of ° in a water-bath. after standing for several hours, a layer of fatty matter becomes sufficiently separated to allow of measurement: but, as it contains some ether and as a small amount of butter may still be retained in the lower aqueous fluid, a correction of the results obtained is necessary. m. marchand has compiled a table, which facilitates this correction (_vide_: _journ. de pharm., novembre _, and _bulletin de l'académie de médecine, paris, _, xix., p. ). previously to the introduction of marchand's apparatus, use was made of the _lactometer_, which consists simply of a graduated glass tube, in which the suspected milk is allowed to remain for hours, at a temperature of °. after the lapse of this time, the cream present completely separates as a supernatant layer, the thickness of which indicates the quality of the sample taken. _m. lacomte_ recommends the addition of glacial acetic acid, in order to cause the more rapid separation of the cream. the estimation of the butter being accomplished, it is frequently needful to determine the amount of lactose present. for this purpose, recourse is had to barreswil's method, based upon the reduction of cupro-potassic tartrate by milk-sugar in the presence of alkalies. a solution is prepared containing grammes of pure crystallized sulphate of copper, or grammes of caustic soda lye of sp. gr. . , and grammes of neutral tartrate of potassa. the sulphate of copper and tartrate of potassa are previously dissolved separately in a little water, the three solutions united, and water added until the fluid acquires a volume of . cubic centimetres. in order to standardize this test solution, a known weight of pure lactose is dissolved in water and the fluid added, drop by drop, from a graduated burette, to a small flask containing cubic centimetres of the copper solution, diluted with cubic centimetres of distilled water, and heated to boiling. at first a yellow precipitate forms, which gradually turns red, and is deposited on the bottom of the flask, leaving the solution colorless. as soon as the test solution is completely decolorized, the addition of the lactose solution is discontinued, and the weight of lactose corresponding to cubic centimetres of the test fluid calculated from the quantity used. the standard of the test solution having been determined, the above operation is repeated, the milk under examination being substituted for the solution of pure lactose. the quantity of milk necessary to decolorize cubic centimetres of the copper solution will evidently contain the same amount of lactose as the quantity of solution used in the preliminary test, and the actual amount of lactose present is very easily calculated. when an estimation of the solid matter contained in the milk is required, a known weight is evaporated to dryness over a water-bath, and the residue weighed. in performing this evaporation, the addition of a known amount of sand, or ground glass, is advisable. the amount of ash present is determined by incinerating the residue left by the evaporation. foreign substances are sometimes added to milk, for the purpose of disguising the presence of an abnormal quantity of water, the principal of which are: chalk, bicarbonate of soda, emulsion of almonds, gum tragacanth, gum arabic, starch, flour, decoction of barley or rice, sugar, and cerebral substances. these bodies are detected as follows: _chalk._--if chalk is contained in the milk, it readily subsides upon allowing the sample to remain at rest for some time in a flask, forming a deposit which effervesces when heated with hydrochloric acid, and dissolves to a solution, in which the characteristic properties of a lime salt can be recognized. _bicarbonate of soda._--in presence of this compound the milk possesses a strongly alkaline reaction, furnishes a serum having a sharp and bitter taste, and leaves a residue of the salt upon evaporation. _emulsion of almonds._--the milk has a specific gravity of at least, . . if it is passed through a gauze, small opaque lumps are separated. when examined under the microscope, numerous minute globules, having a diameter of / of a millimetre, are observed, and, upon adding a few centigrammes of amygdaline to one or two grammes of the milk, the characteristic odor of bitter almonds is produced. _gum tragacanth._--when shaken in a glass flask and allowed to rest, the milk deposits on the sides small transparent lumps, which usually present a slightly elongated or angular form. _gum arabic._--the addition of alcohol produces an abundant white opaque precipitate. _starch, flour, decoction of barley, rice, etc._--upon boiling the suspected milk, and adding tincture of iodine, the amylaceous substances present produce a blue coloration in the fluid. _sugar._--if yeast is added, and the mixture allowed to stand for some time at a temperature of °, alcoholic fermentation ensues; under these circumstances, lactose does not undergo fermentation. _cerebral substances._--adulteration by these substances is probably of much less frequent occurrence than was formerly supposed. the admixture is detected by evaporating the milk to dryness, dissolving the residue in ether, evaporating the etherial solution, and fusing the second residue, which consists of fatty matters, with nitrate of potassa in a platinum crucible. the mass is then taken up with water, and chloride of barium added to the solution. if cerebral substances were contained in the milk, ether will dissolve the fatty matters present, the phosphorus of which is converted into a soluble phosphate by the calcination with nitrate of potassa and is thrown down as a white precipitate, upon the addition of a solution of chloride of barium. this test may be confirmed by a microscopic examination of the milk, when the peculiar appearance of cerebral matter will be detected.[u] [u] fragments of nerves, and other organic structures, are frequently observed in this examination.--_trans._ wine. the most common adulteration to which wines are subjected is the addition of water: wines having a rich color are frequently mixed by the dealer with lighter wines, and the fraud consummated by adding water. the detection of this adulteration is somewhat difficult, as water is a normal constituent of wine. in paris the following method is usually employed: as soon as the wine is confiscated, it is ascertained what kinds of wine are manufactured by the inculpated dealer, and a statement obtained from him, giving the proportions of alcohol, etc., contained in the various brands. a wine is then prepared, according to the information received, an estimation of the alcohol contained in the prepared sample made, and the results compared with those furnished by a similar examination of the suspected wine. in case the proportion of alcohol is less in the suspected wine than in the prepared sample, it is evident that a fraudulent adulteration has been committed. if, however, the quantity of alcohol is the same in both wines, it does not necessarily follow that the wine has escaped admixture, since this body may have been added after the adulteration with water. in addition to the estimation of alcohol, it is also necessary to determine the amount of cream of tartar (bitartrate of potassa) present, as the proportion of this salt would be sensibly decreased by the addition of alcohol and water to the wine. this fraud could, however, be disguised by subsequently adding the proper amount of cream of tartar. it is also well to ascertain if two equal quantities of the prepared sample and the wine under examination require the same amount of solution of hypochlorite of lime for decolorization. in case the suspected wine has been adulterated, the quantity of hypochlorite solution used will be less than the amount necessary to decolorize the prepared wine. foreign coloring matter may be added by the adulterator, but this fraud is easily detected by adding potassa to the sample: if its coloration is natural, a green tint is produced; whereas, if foreign matter has been introduced, the wine assumes various other colors upon the addition of the alkali.[v] [v] _cotlini_ (_ann. du genie civil_, no. , ) states that the following reactions occur when artificially colored wines are heated with potassa: pure wine no precipitate greenish hue elderberry violet " beet-sugar red " logwood red violet-red " privet violet-blue " turmeric light-blue " according to _m. de cherville_ (_quar. jour. sc._), a bright violet coloration is produced in the above test, if litmus be present. fuchsin is separated by treatment with subacetate of lead and addition of amylic alcohol (_jour. de ph. et de ch. mar. _).--_trans._ the indications furnished by the above test are rendered valueless, if the wine has been artificially colored by the addition of the coloring matter of grape-skins; but the execution of this fraud would require some knowledge of chemistry, and fortunately adulterators, as a class, are deficient in this branch of science. another method for detecting the addition of water is based upon the fact that fermented liquors do not contain air in solution, but only carbonic acid; whereas, water dissolves oxygen and nitrogen. it is executed as follows: the wine to be tested is placed in a flask, the delivery-tube of which is also filled, and heated; the evolved gas being collected in a tube filled with mercury. in case the wine is pure, the disengaged gas will be completely absorbed by potassa; if, on the other hand, water has been added, an unabsorbed residue, consisting of oxygen and nitrogen, will remain. this test is useless in case water, through which a current of carbonic acid gas has been passed for a considerable time, has been employed. under these circumstances, however, the presence of the gas would probably be detected by the taste of the wine, as well as by the estimation just mentioned, since the sample would invariably contain a larger proportion of the gas than the standard with which it is compared; indeed, it would be almost impossible to prepare a solution which contained exactly the proportion of carbonic acid ordinarily present in wine. it remains to mention the methods employed in determining the amount of alcohol and cream of tartar contained in wine. the alcometrical method usually employed is based upon the difference in density possessed by pure alcohol and by mixtures of alcohol and water. _gay-lussac_ has proposed an areometer (_alcoholmeter_), provided with a scale which directly indicates the proportion of alcohol contained in a mixture. as the indications furnished by this instrument vary with the temperature, and the scale is constructed on the basis of a temperature of °, a correction of the results obtained is necessary if the determination is made at other temperatures. gay-lussac has compiled a table which indicates at once the required correction; the following formula can also be used: _x = c ± . t_, where _x_ is the quantity of alcohol present in the sample; _c_ the degree indicated by the alcoholmeter, and _t_ the number of degrees differing from the temperature of °: the second member of the formula is subtracted from, or added to the first, as the temperature at which the estimation is made is greater or less than °.[w] [w] tralles alcoholmeter is almost exclusively employed in this country.--_trans._ in case the wine to be examined contains substances other than water and alcohol, which would affect its density, it is necessary, before making use of the alcoholmeter, to distil the sample and subsequently examine the distillate, which will consist of a simple mixture of water and alcohol. usually the distillation is discontinued as soon as one-third of the sample has passed over, and a quantity of distilled water, sufficient to render the volume of the mixture equal to the original volume of the wine, added to the distillate: the fluid remaining in the flask will be entirely free from alcohol. the addition of water to the distillate is not indispensable, but otherwise it is necessary to divide the degrees indicated by the alcoholmeter by , in order to reduce the result to the original volume of the wine taken. _m. salleron_ offers for sale a small apparatus (fig. ) used in examinations of this character, consisting of a flask, closed with a gutta-percha cork, containing a tube which connects with a worm passing through a cooler. the flask is supported by an iron stand, and heated with a gas or spirit lamp. [illustration: fig. .] in order to estimate the cream of tartar, the wine is evaporated to the consistency of an extract, alcohol of ° b. added, and the residue obtained calcined in a crucible. the amount of salt present in the fused mass is then determined by the alkalimetric method, as directed in all works on quantitative analysis. the carbonate obtained from gr. of cream of tartar exactly saturates . cubic centimetres of a solution containing grammes of sulphuric acid of ° b., and grammes of distilled water. the detection of toxical substances, often contained in wine, is accomplished by the methods described under the head of detection of poisons. vinegar. vinegar is frequently adulterated with water, and occasionally sulphuric acid is added to artificially increase its acidity. the ordinary reagents--such as chloride of barium, or nitrate of silver--are not adapted to the direct detection of sulphuric acid, or of other mineral acids, as sulphates and chlorides, which are as readily precipitated as the free acids, may also be present. the following method, proposed by _m. payen_, is usually employed: five centigrammes of starch (fecula) are added to a decilitre of table vinegar, the mixture boiled for or minutes, and, after the fluid has become _completely cooled_, a few drops of iodine solution added: dilute acetic acid does not affect starch, and, in case the vinegar is pure, a blue coloration is produced; if, on the other hand, even a minute quantity of a mineral acid be present, the starch is converted into dextrine, and the addition of iodine fails to cause a blue coloration. the water present is indirectly estimated by determining the amount of acetic acid contained in the vinegar. this can be accomplished in different ways: either the quantity of a standard solution of an alkali, necessary to exactly neutralize a measured quantity of the vinegar, is ascertained, or the vinegar is supersaturated with solution of baryta, the excess of the salt eliminated by conducting carbonic acid through the fluid, the precipitate removed by filtration, and the baryta salt in the filtrate precipitated by the addition of sulphuric acid. the second precipitate is then collected on a filter, washed, weighed, and the amount of acetic acid present calculated: this is done by multiplying its weight by . . sulphate of quinine. owing to the high price of this salt, it is frequently adulterated. the substances used for this purpose are: crystalline sulphate of lime, boric acid, mannite, sugar, starch, salicine, stearic acid, and the sulphates of cinchonine and quinidine. these bodies are detected as follows: _a._ upon slightly warming grammes of sulphate of quinine with grammes of alcohol of ° b., the pure salt completely dissolves; if, however, starch, magnesia, mineral salts, or various other foreign substances are present, they are left as insoluble residues. _b._ those mineral substances that are soluble in alcohol are detected by calcining the suspected sample: pure sulphate of quinine is completely consumed; whereas, the mineral substances present remain behind as a residue. _c._ in presence of salicine, the salt acquires a deep red color, when treated with concentrated sulphuric acid. _d._ stearic acid remains undissolved upon treating sulphate of quinine with acidulated water. _e._ to detect sugar and mannite, the sample is dissolved in acidulated water, and an excess of hydrate of baryta added: a precipitate, consisting of quinine and sulphate of baryta, is produced. carbonic acid is then passed through the fluid, in order to precipitate the excess of baryta as insoluble carbonate, the fluid saturated with ammonia, to throw down the quinine which may have been re-dissolved by the carbonic acid, and the mixture filtered. if the salt be pure, no residue will be obtained upon evaporating the filtrate; a residue of sugar or mannite is formed, if these substances are present. _f._ sulphate of quinine invariably contains or per cent. of cinchonine, originating, not from a fraudulent admixture, but from an incomplete purification of the salt. one of the best methods for detecting the respective quantities of quinine and cinchonine, present in a sample of the sulphate, is the following: several grammes of ammonia and ether (which has previously been washed with water) are added to one or two grammes of the salt under examination, the mixture thoroughly agitated, and then allowed to remain at rest. the supernatant etherial solution contains all of the quinine; the cinchonine, which is almost completely insoluble, both in water and ether, remaining suspended between the layers of the two fluids. the ether is next removed by means of a stop-cock funnel, evaporated to dryness, and the weight of the residue obtained determined. the operation is then repeated, the ether being replaced by chloroform in which both quinine and cinchonine are soluble. the residue, formed by the evaporation of the second solution, will be heavier than the first residue: the difference between the two weighings gives the weight of the cinchonine present. _g._ the detection of the presence of sulphate of quinidine is based upon the difference in the solubilities of the oxalates of quinine and quinidine. oxalate of quinidine is sufficiently soluble in cold water not to be precipitated by double decomposition when solutions of oxalate of ammonia and sulphate of quinidine are mixed. under the same circumstances, quinine is almost completely thrown down. the test is applied as follows: the suspected salt is dissolved in water, a slight excess of oxalate of ammonia added, and the precipitate formed separated by filtration. if the salt be pure, the filtrate is scarcely rendered turbid by the addition of ammonia; when, however, sulphate of quinidine is present, it will be entirely contained in the filtrate, in which ammonia will produce an abundant precipitate. examination of blood stains. this branch of legal chemistry formerly gave but very unreliable results. it is scarcely ten years since the reactions that are now regarded as only secondary and confirmative in their character, and far from conclusive, were the only ones in use: these are the tests based upon the presence of iron and albumen in the blood. since then, great progress has been made in the methods employed. it must not be understood, however, that the question under consideration always admits of an easy and decisive solution: the stains are sometimes too greatly altered to be identified; but in cases where the distinctive reactions of blood can be produced, the real nature of the stains under examination can, at present, be determined with certainty. the tests more recently introduced consist in the production of small characteristic crystals, termed _haemin_ crystals, and in the use of the spectroscope. crystals of haemin (first discovered by _teichman_) are formed when dry blood is dissolved in concentrated acetic acid, and the solution evaporated to dryness: they are of a brownish-red color. _brücke_ first suggested an analytical method, based upon this property of blood, which is equally characteristic and sensitive: it is only necessary to dissolve a minute portion of the matter to be examined (dried blood, or the residue left by the evaporation of the fluid obtained by treating the stain, or the dried blood, with cold water) in glacial acetic acid and evaporate the solution to dryness in order to obtain crystals of haemin, which can be readily recognized by means of a microscope having a magnifying power of diameters. if the crystals originate from fresh blood, they appear as represented in fig. ; crystals from old blood are represented in fig. . [illustration: fig. .] [illustration: fig. .] the former possess a reddish-brown, the latter a lighter color. the various methods now employed to produce haemin crystals were proposed by _hoppe-seyler_, by _brücke_ and by _erdman_. whichever process is used, the suspected stains are at first carefully separated from the material upon which they are deposited. if they are present on linen, or other fabrics, the stained portions, which always remain somewhat stiff, are cut off: they will present a reddish-brown color, in case the cloth is not dyed: if the stains are on wood, they are removed by means of a sharp knife; if on stone or iron, they are detached by scraping. in case hoppe-seyler's method is used, the stains, separated as directed above, are macerated with a little _cold_ water (warm water would coagulate the albumen present, and consequently prevent solution taking place): the stains become soft, striae and brown or reddish clouds are observed, especially when the dried blood is fresh, and, at the same time, the objects upon which the stains were deposited are decolorized. upon allowing the fluid obtained in this way to spontaneously evaporate on a watch-glass, a reddish brown or brownish residue is left, from which the crystals of haemin are prepared in the following manner: an almost imperceptible amount of common salt is added to the residue, then, six to eight drops of concentrated acetic acid, and the mass thoroughly mixed by stirring with a small glass rod. the mixture is at first heated over a small gas flame, then evaporated to dryness by the heat of a water-bath. if the stains were produced by blood, a microscopic examination of the residue will reveal the presence of haemin crystals. this method presents an objection: if the stained objects have been washed with warm water previously to the examination, the albumen will be coagulated, and the blood rendered insoluble; in this case, cold water will fail to dissolve anything, and the residue will not produce crystals when treated with acetic acid. in order to remedy this difficulty brücke operates directly upon the stained woven or ligneous fibre, or the matter removed from the stone or iron: the materials are boiled in a test-tube with glacial acetic acid, the fluid decanted or filtered, a trace of common salt added, and the liquid then evaporated on a watch-glass at a temperature between and °. if the stains really originated from blood, haemin crystals will now be easily perceptible upon examining the residue obtained under the microscope. the stained fabric, the matter removed from the stone or iron, or the residue left by the solution with which the stains have been treated, is placed on the glass, a trace of chloride of sodium added, and the whole covered with a thin glass plate. a drop of acetic acid is then placed at the edge of the plates--between which it is soon introduced by capillary attraction--and the mixture allowed to rest in the cold for a few moments. the mass is next brought into solution by slightly heating, and is then evaporated by holding the plate at a considerable distance above a gas burner. the fluid is examined from time to time under the microscope: when it is sufficiently concentrated, crystals, presenting the appearance represented in figs. or , will be observed. these are especially well-defined, if an insoluble substance is also present between the plates--which prevents their adhering. the fluid collects by capillary attraction at the points of contact of the plates as a more or less colored layer, in which the crystals are deposited. should the above test fail to present distinctive indications at first, one or two fresh drops of acetic acid are introduced between the plates, and the examination is repeated. the result is not to be regarded as negative, until several trials have proved fruitless, as the stained portions are but slowly soluble, and crystallization may have been prevented by the too rapid evaporation of the acetic solution. haemin crystals, once seen, can hardly be confounded with other substances; still, it is well to identify them by confirming their insolubility in water, alcohol, and cold acetic acid, as well as their instantaneous solubility in soda lye. the addition of common salt is ordinarily superfluous, as it is normally contained in the blood; but it is possible, if the stains were washed with warm water, that, in addition to the coagulation of the albumen, the solution of the salt may have taken place, in which case crystals will fail to form. the addition of salt is to remedy this possible contingency; albeit, the delicacy of the test is not affected, even if crystals of chloride of sodium are produced, as these are easily soluble in water, and are readily distinguished from those of haemin by aid of the microscope. the indications furnished by means of the spectroscope are less reliable than those given by the production of haemin crystals; moreover, the spectroscopic examination requires favorable weather for its execution. still, the test should be employed in all possible instances. the course pursued is the following: the aqueous fluid, with which the stains have been treated, is placed in a watch glass, and evaporated _in vacuo_ over sulphuric acid; the last remaining portion of the fluid being united in the bottom of the glass by causing it to collect in a single drop. when the evaporation of fluid is completed, the watch-glass is placed before the narrowed slit of a spectroscope, and a ray of diffused light (or better, light reflected from a heliostat) made to pass through the part of the glass containing the residue. if the stains originate from blood, the absorption lines of _haemoglobin_, consisting of two large dark bands, to the right of the sodium line (_frauenhofer's_ line d), will be observed in the spectrum. in case both of the above tests fail to give positive results, it is almost certain that the stains examined were not caused by blood. if, on the contrary, the reactions were produced, scarcely any doubt exists as to the presence of blood. under these circumstances it is advisable to confirm the results by means of the tests that have been previously spoken of as being formerly exclusively employed; these are the following: _a._ / to c. c. of ozonized oil of turpentine, _i. e._ turpentine which has been exposed to the air sufficiently long to acquire the property of decolorizing water that is slightly tinted with indigo--is introduced in a test-tube, and an equal volume of tincture of guaiacum added (the latter tincture is prepared by treating an inner portion of the resin with alcohol, until its brownish color is changed to a brownish-yellow). if upon adding some of the substance under examination to the above mixture a clear blue coloration ensues, and the insoluble matter thrown down possesses a deep blue color, the presence of coloring matter of the blood is indicated. the mixture also imparts a blue color to moistened spots from which the blood stains have been as completely extracted as possible. unfortunately sulphate of iron gives the same reaction.[x] [x] fresh gluten, gum arabic, and caseine also cause the blue coloration.--_trans._ _b._ upon heating the fluid obtained by treating the stains with cold water in a test-tube, its brown or reddish color disappears, and greyish-white flakes of coagulated albumen are thrown down. the precipitate acquires a brick-red color, when treated with an acid solution of nitrate of mercury containing nitrous acid. the albumen is also coagulated by the addition of nitric acid: it assumes a more or less yellow color, if heated with a slight excess of the acid. chlorine-water, especially upon heating, likewise precipitates albumen in the form of white flakes. _c._ if the fluid is acidulated with a few drops of acetic acid, and a drop of ferrocyanide of potassium added, a white precipitate, or, at least, turbidity is produced. _d._ the flakes of albumen, separated by heating, dissolve in caustic alkalies to a solution, from which they are re-precipitated by nitric acid, or chlorine water. _e._ upon treating blood stains with chlorine-water, a solution which contains chloride of iron, and acquires a red coloration by the addition of sulphocyanide of potassium, is formed. _f._ should the stains have failed to be affected by cold water (which, as has already been remarked, is the case when they have been previously washed with hot water), they are treated with weak soda lye. nitric acid, hydrochloric acid, and chlorine water will produce in the solution so obtained a white precipitate, which exhibits the general properties of albumen previously described. in case the stains are deposited upon linen, it is necessary to replace the soda by ammonia, in order to avoid dissolving the fabric. _g._ solutions of the alkalies, which dissolve the albumen, leave the coloring matters intact, and consequently do not decolorize the fabric. if the latter is afterwards subjected to the action of hydrochloric acid, the coloring matter is dissolved, forming a solution that leaves upon evaporation to dryness a residue containing iron, which gives a blue coloration with ferrocyanide of potassium, and a red coloration with sulphocyanide of potassium. _h._ the coloring matter of blood dissolves in boiling alcohol, to which sulphuric acid has been added, to a brown dichroic fluid (appearing green by transmitted light, and red by reflected light). a mixture of rust and blood exhibits the same phenomenon. _i._ if substances containing blood are heated in a dry tube, an odor resembling that of burnt horn is emitted. in case the stained fabric is a substance that would produce this odor, (such as wool, silk, or hair), the test naturally loses all value. _j._ if the fluid obtained by treating the stains either with water or alkali is evaporated with a little carbonate of potassa, and the residue heated, at first at °, then to redness, in a glass tube to which a fresh quantity of carbonate of potassa has been added, cyanide of potassium is formed. when cold, the tube is cut above the part containing the fused mixture, the mass heated with iron-filings and water, the fluid filtered, and the filtrate then acidulated with hydrochloric acid: ferrocyanide of potassium will be present in the fluid, and upon adding a drop of solution of perchloride of iron a green, or blue, color will be produced, and a precipitate of prussian blue gradually thrown down. if the stained cloth is non-nitrogenous (_per ex._: hemp, linen, or cotton), instead of treating it with water, it may be heated until pulverulent, mixed with carbonate of potassa, the mixture calcined, and the operation then completed as just described. this test having given affirmative results, the operations should be repeated with an unstained portion of the cloth, to remove all doubt that the indications obtained do not really originate from the fabric. in the present state of science, it is impossible to discriminate chemically between human and animal blood. _m. barruel_, it is true, is able, not only to accomplish this, but also to distinguish the blood of the various species of animals by its odor! but this test has a somewhat hypothetical value for scientific purposes. in regard to the crystals of haemin, they do not present sufficient difference to allow the blood of different animals to be distinguished. we have not yet treated of the globules. it often occurs that these minute organs are so altered as to be no longer recognized in the microscopic examination; when, however, the stains are tolerably recent, they may be detected by examining the moistened stained cloth, directly under the microscope: a discrimination between animal and human blood is then possible: corpuscules of human blood possess the greater size: those of the sheep, for instance, have only one-half the diameter of the former. it is, however, but seldom that this distinction can be made use of.[y] [y] _menstrual blood_ is recognized by the presence of epithelial cells.--_trans._ examination of spermatic stains. in cases where attempt at violence, rape or pederasty is suspected, the expert may be required to determine the nature of stains found on clothing, sheets, etc. the fact that the stains were produced by semen, may often be regarded, _per se_, as criminating evidence. this class of investigation possesses, therefore, considerable importance. _external appearance of the stains._--dry spermatic stains are thin, and exhibit a greyish or, occasionally, a citron-yellow color, if present on white cloth. in case the fabric is colored, they appear whitish and, if on linen, present a glossy aspect. they are translucid, when observed by transmitted light. if the fabric, upon which the stains are deposited, is of a heavy texture, they are visible only on one side: under all circumstances, their circumference is irregular and undulated. these indications, however, are not conclusive, but vary according to whether the stains were produced by the thick semen of a vigorous man, or the aqueous seminal fluid of an aged and diseased person, or by semen more or less mixed with the prostatic fluid. upon moistening spermatic stains, the distinctive stale odor of fresh semen is sometimes emitted, but this characteristic is usually obscured by the presence of foreign substances. semen stains are soluble in water, forming a gummy fluid, in which chlorine, alcohol, bichloride of mercury, acetate and subacetate of lead produce a white precipitate, but which fails to be coagulated by heating. plumbate of potassa does not impart a fawn-color to these stains, at a temperature above °, as is the case with those produced by albuminous substances. persulphate of iron imparts to spermatic stains a pale yellow color, sulphate of copper, a bluish grey color, cupro-potassic tartrate, a bluish grey color, nitrate of silver, a pale grey color, nitric acid, a pale yellow color. the above reactions, separate or united, are insufficient; they are not very delicate, and are likewise produced by stains originating from the other varieties of mucus: the indications furnished by a microscopic examination of the stains are alone conclusive. _microscopic examination._--semen contains as its principal and fecundating constituent, peculiar vibratory filaments, (_spermatozoa_), held suspended in a viscous fluid. these filaments, when preserved in a warm and moist place, retain their activity for a considerable time: it is even possible that they may exhibit vitality in the organs, into which they have been voluntarily or forcibly ejaculated, for ten, or even twenty-four hours. when exposed to cold air, the spermatozoa quickly expire; still, they preserve their form for some time, and, as this is very characteristic, it is then easy to identify them; moreover, since they originate exclusively in the testicles, their detection may be considered as certain evidence of the presence of semen. in stains produced by aged persons, and by persons enfeebled by excesses, the spermatozoa fail to be presented; in case they are discovered, this fact evidently does not affect the certainty of the spermatic origin of the stains. the contrary conclusion is never absolutely certain: still, if the use of the microscope fails to establish the presence of spermatozoa, it is almost certain that the stains were not produced by semen. of the various methods for obtaining from the stains a preparation adapted to the microscopic examination, the one proposed by m. charles robin is the most simple and reliable. a strip, c. c. in size (comprising the entire stain, if this be small, containing its inner portion, if it be large), is cut from the fabric under examination, care being taken that the two extremities of the sample extend beyond the stained portion. one end of the cloth is then immersed in a capsule, or watch-glass, containing pure water: the stains become moistened by capillary attraction, and, in a space of time varying from twenty minutes to two hours, acquire the appearance of fresh semen. as soon as the stained portion becomes swollen and softened, the surface of the cloth is gently scraped with a spatula, and the substance removed placed on the slide of the microscope. the particles are next slightly detached, a drop of water added, if necessary, and the whole covered with a small plate of very thin glass. the preparation is then examined by a microscope, having a magnifying power of from to diameters. in this way, the presence of either entire or broken spermatozoa is readily detected. their existence is rendered still more apparent, if the mucus present is dissolved by adding a drop of acetic acid to the preparation. entire spermatozoa consist of long slender filaments, having a length of . to . millimetre; the anterior extremity presents an oval enlargement, either round or pyriform, exhibiting a double outline, when magnified to diameters. this enlarged end is termed the "head;" the entire remaining portion being regarded as the "tail." in case the spermatozoa are broken, they are severed either near the head or in the middle of the tail, and a mass of detached fragments will be observed in the microscopic examination. the spermatozoa are not the only corpuscules revealed by the microscope; other substances, entirely different in character, are often observed. although the detection of these bodies is, in itself, of no value, it will be well to enumerate and characterize them; they are: _a._ oily globules. _b._ leucocytes, or spherical and finely granulous globules of mucus. _c._ corpuscules, originating from the seminal vesicles, termed sympexions. these are rounded or ovoid, possess an irregular outline, and are usually mixed with the spermatozoa and globules of mucus. _d._ crystals of phosphate of magnesia, varying greatly in size; the largest are from .mm. to .mm. in length. the crystals formed upon cooling the semen, present the form of an oblique prism, with a rhomboidal base. occasionally they are elongated and flattened; they then assume the form of a rhomboid. _e._ epithelial cells; originating from the mucous follicles of the urethra. _f._ irregular grains of dust; soluble in acetic and hydrochloric acids, with gaseous evolution. _g._ brownish-red grains of rust; only slightly soluble in acetic acid, but easily soluble in hydrochloric acid. _h._ filaments of the strained fabric; detected by their texture, and general appearance. _i._ grains of starch, in case the cloth has been stiffened. these are almost invariably swollen, and are frequently broken and deformed. if the examination is to be secretly executed, and the cloth cannot well be cut, it is rolled in a cone, in such a way that the external side contains the stained portion. the lower extremity of the cone (which should be free from stains) is dipped in a watch-glass containing water, so as to avoid directly wetting the stains. the cone soon becomes moistened by absorption, and the operation is then completed in the same manner as when the fabric has been cut; which is always preferable, when possible. the examination of spermatic stains consists, then, in moistening the stains with water, separating them as completely as possible from the stained cloth, and determining the presence of the spermatozoa by means of the microscope. all other tests are valueless; even their execution for confirmatory purposes is not advisable; inasmuch as they fail to possess a distinctive character, and the reagents employed in their production may destroy the fabric, and thus prevent the formation of the only conclusive reaction--the detection of the spermatozoa. in case the stains are deposited upon a woman's chemise, they are usually present on both the front and back portions, and are sometimes to be found on the sleeves. when a man's shirt is under examination, especial attention should be given to the anterior portions. the pantaloons are also often stained; usually in the interior, but sometimes also on the exterior, just above the thighs. in reporting the decision to the court, as to the nature of the stains, their precise position should invariably be stated, as, by this means, the circumstances attending the commission of the crime may be, at least partially, elucidated. the end. appendix. the following list of the literature of toxicology, and its allied branches, will, it is hoped, be of service to those readers who are desirous of obtaining further information on the subjects treated in this work.--_trans._ books. *accum*; a treatise on adulteration of food, and culinary poisons. london, . *adrien*; recherches sur le lait au point de vue de sa composition, de son analyse, de ses falsifications et surtout de l'approvisionnement de paris. paris, . *angell and hehner*; butter; its analysis and adulterations. london, . *anglada*; traité de toxicologie. paris, . *atcherly*; adulteration of food. london, . *bandein*; die gifte und ihre gegengifte. basel, . *beck*; elements of medical jurisprudence. albany, . *bellini*; lezionis perementali di tossicologia. firenze, . *bergman*; zur kentniss der putriden gifte. dorpat, . *bernard*; leçons sur les substances toxiques. paris, . *billard*; considerations medico-légale sur les empoisonnements par les irritants. paris, . *blondlot*; sur la recherche de l'arsenic par la methode de marsh. nancy, . _ibid_; sur la recherche toxicologique du phosphore par la coloration de la flamme. nancy, . _ibid_; sur le dosage de l'antimoine dans les recherches toxicologiques. nancy, . *boettcher*; ueber blutkrystalle. dorpat, . *bonsels*; ein beitrag zur analyse des arsens, vorzugsweise in gerichtlichen fällen. kiel, . *borie*; catechisme toxicologique. tuelle, . *bouchardt et quevenne*; du lait. paris, . *bowman and bloxam*; medical chemistry. london, . *briand et chaudé*; manuel complet de médicine légale; contenant un manuel de chimie légale. paris, . *buchner*; toxikologie. nüremburg, . *bureaux*; histoire des falsifications des substances alimentaires. paris, . *chapman*; manual of toxicology. london, . *chatin*; recherches experimentals et considerations sur quelques princips de la toxicologie. paris, . *chiaje*; tossicologia. napoli, . *chaussier*; médicine légale. paris, . *chevalier*; dictionaire des alterations et falsifications des substances alimentaires, médicamenteuses et commerciales, avec l'indication des moyens de les reconnaitre. paris, . _ibid_; essais practiques sur l'examen chimique des vins, considéré sous la rapport judiciaire. paris, . *christison*; a treatise on poisons. edinburg, . *collier*; paradoxology of poisoning. london, . *cooper*; tracts on medical jurisprudence. phila., . *cormenin*; memoire sur l'empoisonnement par l'arsenic. paris, . *cotter*; adulteration of liquors. n. y., . *cottereau*; des alterations et des falsifications du vin, et des moyens physiques et chimiques employés pour les reconnaitre. paris, . *cox*; poisons; their effects, tests and antidotes. london, . *culbrush*; lectures on the adulteration of food, and culinary poisons. newburg, . *dalton*; adulteration of food. london, . *divergie*; médicine légale. paris, . *dragendorff*; beiträge zur gerichtlichen chemie einzelner organischen gifte. st. petersburg, . _ibid_; untersuchungen aus dem pharmaceutischen institut in dorpat. st. petersburg, . _ibid_; manuel de toxicologie; traduit par e. ritter. paris, . *druitt*; on wines. london, . *duflos*; die wichtigsten lebenbedürfnisse, ihre aechtheit und güte; verunreinigungen, verfälschungen, etc. breslau, . _ibid_; die prüfung chemischer gifte. breslau, . _ibid_; handbuch der angewandten gerichtlich-chemischen analyse der chemischen gifte; ihre erkennung in reinem zustand und in gemischen betreffend. leipzig, . *duflos u. hirsch*; das arsen; seine erscheinung, u. s. w. breslau, . *dupasquier*; consultation medico-légale relative à 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recherche des alterations et falsifications des produits chimiques et pharmaceutiques. paris, . *garland*; précis d'analyse chemique qualitative. paris, . *gmelin*; allgemeine geschichte der thierischen und mineralischen gifte. erfurt, . *gorup-besanez*; anleitung zur qualitativen und quantitativen zoochemischen analyse. braunschweig, . *gosse*; des taches, au point de vue medico-légale. paris, . *griffin*; the chemical testing of wines and spirits. london, . *griffith and taylor*; a practical manual of the general, chemical, and microscopical character of the blood, etc. london, . *guerin*; nouvelle toxicologie. paris, . *guy*; principles of forensic medicine. london, . *gwosden*; ueber die darstellung des hämin aus dem blut und den qualitativen nachweis minimaler blutmengen. wien, . *hager*; untersuchungen. leipzig, . *hartung-schwarzkoff*; chemie der organischen alkalien. münchen, . *hassall*; adulteration of food. london, . *van hassett*; handbuch der giftlehre. braunschweig, . 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food. n. y., . *lerwin*; toxikologischen tabellen. berlin, . *liebreich*; outlines of toxicology. london, . *lindes*; beiträge zur gerichtlichen chemie. berlin, . *lunel*; guide pratique pour reconnaïtre les falsifications et alterations des substances alimentaires. paris, . *malle*; essai d'analyse toxique génerale. strasbourg, . *marset*; composition, adulteration, and analysis of food. london, . *marshall*; remarks on arsenic. london, . *marx*; geschichtlich darstellung der giftlehre. göttingen, . *mata*; tratado de medicina y cirugia legal. paris, . *mayercon and bergeret*; recherches sur la passage de l'arsenic et de l'antimoine dans les tissus et les humeurs. paris, . *meissner*; aräometrie in ihrer anwendung auf chemie und technik. wien, . *mitchell*; falsification of food. london, . *mohr*; chemische toxikologie. braunschweig, . *monier*; memoires sur l'analyse de la lait et des farines. paris, . *montgarney*; essai de toxicologie. paris, . *muller*; anleitung zur prüfung der kuhmilch. bern, . *münk und leyden*; phosphorvergiftung. berlin, . *neubauer*; chemie des weines. wiesbaden, . *neuman*; die erkennung des bluts bei gerichtlichen untersuchungen. leipzig, . *normandy*; the commercial hand-book of chemical analysis. london, . *odling*; a course of practical chemistry. london, . *oesterlen*; das menschliche haar und seine gerichtärtliche bedeutung. tübingen, . *orfila*; rapport sur les moyens de constater la presence de l'arsenic dans les empoisonnements par ce toxique. paris, . _ibid_; traité de médicine légale. paris, . _ibid_; elements de chimie médicale. paris, . _ibid_; traité de toxicologie. paris, . *otto*; anleitung zur ausmittelung der gifte, und zur erkennung der blutflecken bei gerichtlich-chemischen untersuchungen. braunschweig, . *payen*; substances alimentaires. paris, . *pelliken*; beiträge zur gerichtlichen medizin, toxikologie und pharmakodynamik. würztburg, . *petit lafitte*; instruction simplifiée pour la constatation des propriétées des altérations et des falsifications des principales, denrées alimentaires. bordeaux, . *plaff*; anleitung zur vornahme gericthlicher blutuntersuchungen. plauen, . *pierce*; examination of drugs, chemicals, etc. cambridge, . *planta*; verhaltung der wichtigsten alkaloiden gegen reagenten. heidelberg, . *pleck*; toxicologia. viennae, . *prescott*; chemical examination of alcoholic liquors. n. y., . *preyer*; die blutkrystalle. jena, . *reese*; a manuel of toxicology. phila., . *reveil*; introduction à un cours de toxicologie. paris, . *reyer*; die blausäure physiologisch untersucht. bonn., . *rich*; the analyst's annual note-book for . london, . *ritter*; ueber die ermittelung von blut, samen und excrementenflecken in kriminalfällen. würztburg, . _ibid_; beiträge zur gerichtlichen chemie. st. petersburg, . _ibid_; manuel de chimie practique, analytique, toxicologique et zoochimique. paris, . *robinet (fils)*; manuel practique d'analyse chimique des vins. paris, . *rebuteau*; elements de toxicologie et de médecine légale appliquée à l'empoisonnements. paris. . *roucher*; recherches toxicologiques. paris, . *roussin*; falsification des vins par l'alun. paris, . *ryan*; medical jurisprudence. london, . *schmidt*; ein beitrag zur kentniss der milch. dorpat . *schmidt*; diagnostik verdächtlicher flecken. leipzig, . *schneider*; die gerichtliche chemie. wien, . *schroff*; toxikologische versuche über arsen. wien, . _ibid_; beiträge zur kentniss des aconite. *simon*; die frauenmilch. berlin, . *sonnenkalb*; l'aniline et ses couleurs, au point de vue toxicologique. leipzig, . *sonnenschein*; ueber ein neues reagent auf alkaloiden. berlin, . _ibid_; handbuch der gerichtliche chemie. berlin, . *soubeiran*; nouveau dictionnaire des falsifications et des alterations des aliments, etc. paris, . *speyer*; recherche de la colchicine. dorpat, . *spratt*; toxicology. london, . *stowe*; a toxicological chart. london, . *tanner*; memoranda on poisons. london, . *tardieu*; etude 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[ ] v. . *helwig*; zeitsch. f. anal. chem., iii, . *luck*; zeitsch. f. chem. [ ] vi, . *mayer*; rep. chim. app., v, . *strecker*; ann. ch. pharem., xci, . *trapp*; jahresb. , . *wormley*; chem. news, vol. ii, july, . on morphine. *anderson*; ann. ch. pharm., lxxv, . *dupre*; chem. news, viii, ; jahresb., , . *erdman*; ann. ch. pharm. cxx, ; ibid, cxxii, . *flandin*; compt. rend., xxxvi, . *frohde*; zeitsch. f. anal. chem. v, ; arch. f. pharm., clxxvi. *huseman*; ann. ch. pharm., cxxviii, . *kalkbrunner*; zeitsch. d. all. oest. apot. ver., no. . *lassaigne*; ann. ch. pharm. [ ] xxv, . *lefert*; j. pharm. [ ] xl, . *mermer*; j. chim., xxiii, . *wormley*; chem. news, vol. ii, sept., . on strychnine. *bingley*; chem. gaz., , . *brieger*; jahresb. pr. pharm. xx, . *cloetta*; zeirsch. f. anal. chem., v, . *davy*; j. pharm. [ ] xxiv., . *djurberg*; chem centralb., , ; zeitsch. f. anal. chem., , . *eboli*; archiv der pharm., cxxxv, . *erdman and marchand*; jour. f. prakt. chem., xxxi, . *gorup-besenez*; handwörterb. [ ] i, . *graham and hofman*; pharm. trans., xi, ; chem. gaz., , ; ann. ch. pharm., lxxxiii, . *hagen*; ann. ch. pharm. ciii, . *hunefeld*; schw., lx. . *janssen*; zeitsch. f. anal. chem., jahrgang. *jordan*; n. repert., x, . *letheby*; pharm. j. trans. xvi, . *mack*; n. br. arch., xlvi, . *marchand*; chem. gaz., june , . *mayer*; j. pharm. [ ] xlvi. *reese*; chem. news. , . *rousseau*; j. chim. méd. xx, . *sonnenschein*; jahresb. , ; ber. d. deutsch. chem. gess. iii, . *schroder*; n. br. arch., xciii, . *thomas*; amer. jour. pharm. , . *thompson*; pharm. j. trans., ix., . *vogel*; n. repert. pharm., ii, . *de vrij and van der burg*; pharm. j. trans. xvi, . *wagner*; kopp's jahresb., , ; zeitsch. f. anal. chem., vi, . *wittstein*; pharm. viertelj., vi, . *wormley*; am. jour. sc. and arts., xxviii, sept., . on the detection of falsifications of writings. *lucas*; chem. centralb., , . *knecht-senefelder*; technol., xxvi, . *moride*; compt. rend., lviii, ; ding. poly. jour. clxxii, . *vorwerk*; ding. poly. jour., clxxii, . *----*; berl. ind. z., , . on the detection of adulterations in flour and bread. *barral*; compt. rend., lvi, . *bastelaer*; chem. centralb., , . *cailletet*; ibid, , . *corput*; ibid, , . *crooks*; chem. news., vol. xxxiii, . *danckwort*; archiv der pharm. [ ] xx, . *davis*; chem. news, xxv., . *eulenberg and vohl*; poly. centralb., cxcvii, . *gobley*; jour. de pharm., april, . *hadon*; chem. news, . *hager*; ding. poly. jour., clxxiii, . *harsley*; archiv der pharm., july and dec., ; chem. news, xxv, . *moitessier*; annal. d'hygiene, . *odling*; j. soc. arts, april , . *oser*; ding. poly. jour., clxxxiii, . *rivot*; ann. de phys. et de chim., e série t, xlvii. *rummel*; ding. poly. jour., cxxxix, . *tasbender*; ding. poly. jour., no. , ccvi. *wanklyn*; archiv der pharm., dec., ; chem. news, xxxiii, no. ; ber. med. jour., march , . on the examination of fatty oils. *behrens*; ding. poly. jour., cxxxi, . *calvert*; pharm. j. trans., xiii, . *clarke*; chem. news, xxiii, . *dingl*; poly. jour., clxxiv. *donny*; bull. soc. d'erc, , ; jahresb., , . *dragendorff*; pharm. zeitsch. f. russl., ii, . *fluckiger*; chem. centralb., , . *glassner*; (trans.) am. chem., dec., . *gobley*; j. pharm. [ ], iv, ; ibid. v. . *jacobson*; bull. soc. chim., [ ] vii, . *langlies*; zeitsch. f. anal. chem., , . *ludwig*; archiv der pharm., [ ] i, . *macnaught*; chem. centralb., , . *massie*; zeitsch. f. anal. chem., , . *maumene*; compt. rend., xxxv, . *nickles*; bull. soc. chim., [ ] vi, *penot*; bull. de mullh., xxvi, ; jahresb., , . *roth*; bull. de mullh., , . *ure's* dict. of arts, etc., iii, . *vogel*; chem. centralbl., , . *watt's* dict. of chem., iv., . on the examination of milk. *boussingault*; ann. chem. phys. [ ] xxv, . *baumhauer*; j. pr. chem., lxxxiv, . *casselman*; chem. centralb., , . *dancer*; chem. news, v, , p. . *daubrawa*; jour. f. prakt. chem., lxxviii, . *donne*; compt. rend., xvii, pp. , . *filhol and joly*; wurtz's dict. de chim., t. ii, p. . *gmelin*; handb. der chem., viii, [ ] - . *heeren*; chem. centralb., , . *hermstaedt*; pharm. centralb., , . *kletzinsky*; chem. centralb., , . *lade*; chem. centralb., , . *leconte*; ibid, , . *lehman*; lehrb. der phys. chem., , ii, pp. , ; (trans. by day) ii, pp. , . *macadams*; am. chem., may, , . *marchand*; jour. de pharm., nov., . *michaelson*; ding. poly. jour., cxlix, . *millon*; compt. rend., lix, . *muller*; zeitsch. f. anal. chem., no. , . *otto*; ann. chem. pharm., cii, . *pelouze and fremy*; traité de chim. gen., [ edit.] paris, , p. . *pribram*; dings. poly. jour., cxcvii, *reichelt*; bayr. k. u. gwbl., , . *reineck*; ding. poly. jour., cci, . *rosenthal*; chem. centralb., , . *seely*; sill. am. j., vii, . *vernois and becqueret*; ann. d'hygiéne, april, . *voelcker*; am. chem., may, , p. . *vogel*; poly. notizbl., no. , . *wanklyn*; pharm. viertelj., xx, : milk jour., , , ; chem. news, xxviii, no. ; ibid, no. ; pharm. journ. trans., [ ] i, . on the detection of adulteration in wine and beer. wine. *beck*; edinb. phil. jour., . *berthelot and fleurien*; compt. rend., lvii, . *blume*; dings. poly. jour., clxx, . *bolly and paul*; manual of tech. anal., p. . *boyer and coulet*; compt. rend., lxxvi, . *brande*; phil. trans., . *cotlini*; ann. du genie civil, no. , . *cotlini and fantazini*; ann. di chim. appl. alla medi., juli, . *christison*; edinb. phil. jour., . *diez*; ann. ch. pharm., xcvi, . *duclaux*; ann. de chim. et de phys., july and sept., ; compt. rend. lxxviii, . *duffield*; am. jour. pharm., mar. . *dupre*; chem. soc. jour. xx, . *fantenelle*; j. chim. méd., iii, . *faure*; j. pharm., vii, . *fischern*; ann. chem. pharm., lviii, . *fresenius*; ibid, lxiii, . *geiger*; mag. f. pharm., xix, . *geromont*; ann. ch. pharm., xvii, . *hager*; zeitsch. f. anal. chem., , . *hitchcock*; edinb. phil. jour., xxxvii, . *jacquemin*; ann. de chim. et de phys. v, série, nov., ; compt. rend., lxxix, . *kersting*; ann. ch. pharm., lxx, . *khol*; j. chim. méd., [ ] ii, . *liebig, poggendorff and wohler*; handwörterb. ix, . *ludersdorf*; j. f. prak. chem., xxiv, . *maisch*; proc. am. pharm. assn., , ; , ; , . *mallard*; j. chim. méd., iii, . *maumene*; bull. soc. chim., xxii, no. . *miller*; jour. de pharm. et de chim., mar., . *mitis*; baierisch. k. u. gewerbeblatt, . *phipson*; zeitsch. f. anal. chem., ix, . *reiman's* farb. zeit., nos. - , . *romei*; mon. scien., iii, t. iii, no. . *salleron*; compt. rend., lxxviii, no. . *scheitz*; arch. pharm., [ ] v, . *schubert*; pogg. annal., lxx, . *sestini*; landwirthsch. ver. stat., xv, . *tuchschmeidt*; jahresb., , . *zierl*; baierisch. kunst. gewerbebl, . beer. *blas*; viertelj. f. prakt. pharm., xxi, . *brunner*; archiv der pharm., april, ; dings. poly. jour., ccix, no. ; jour. de pharm. et de chim., sept., ; poly. nolizblatt, no. , . *dietz*; neues jahresb. f. pharm., xxxix, no. . *dragendorff*; archiv. der pharm., april and may, ; dings. poly. jour., ccxiv, pp. , . *dullo*; wieck's gaz., , . *gunckel*; arch. f. pharm., clxiv. *kubinki*; le technol, no. ; (trans.) amer. chem., nov., ; dings. poly. jour. ccxi, . *langley*; chem. centralb., , . *meme*; compt. rend., me sem., no. . *michælis*; ill. gewerbz., , . *muspratt's* chem. i, . *pohl*; wiener akad. ber., xii, . *ritter*; pharm. zeitsch. f. russl., i, pp. , . *shafhauel*; ding. poly. jour., cxxxii, . *schmidt*; jour. f. prakt. chem., lxxxvii, . *stolber*; ibid, xciv, iii. *ure's* dict. chem., th edit., , p. . *vogel and hammon's* mitth., , . *wittstein*; archiv der pharm., jan. . on the testing of vinegar. *bussy and buignet*; jahresb., , . *greville*; ding. poly. jour., cxxxi, . *liebig, poggendorff and wohler*; handwörterb, ii, . *mohr*; ann. ch. pharm., xxxi, . *mollerat*; ann. chim., lxviii, . *nicholson*; ding. pol. jour., cxxxix, . *otto*; ann. chem. pharm., cii, . *roscoe*; chem. soc. jour., xv, . *runge*; gewz. bayer. , . *strohl*; jour. de pharm. et de chim., sept., . *toorn*; jour. f. chem., vi, . *wagner*; chem. tech., (english trans.) p. . *williams*; pharm. j. trans., xiii, . on the detection of adulterations in sulphate of quinine. *delondre and henry*; j. pharm., [ ] xxi, . *gmelin's* handbuch, xvii, . *guibourt*; j. pharm., [ ] xxi, . *henry*; ibid, xiii, . *hesse*; ann. ch. pharm., cxxxv, ; jahresb., , . *korner*; zeitsch. f. chem., j. i, ; jahresb. , . *phillips*; lond. lanc., i, . *riegel*; jahresb. f. pharm., xxv, . on the detection of blood stains. *barruel*; ann. d'hygiéne pub., i. ; ibid, no. , . *bertolet*; am. jour. med., sc., jan., . *brucke*; jahresb., , . *van deen*; zeitsch. f. anal. chem., ii, . *erdman*; jour. pr. chem., lxxxv, ; jahresb., , . *falck*; ber. klinisch. wochb., . *van geuns and gunning*; zeitsch. f. anal. chem., , . *gwosden*; wiener akad. ber., liii, [ ] ; jahresb., , . *helwig*; zeitsch. f. anal. chem., , . *hirsch*; n. j. pharm., xxxii, . *hoppe-seyler*; med. chem. unters., i, ; jahresb., , . *krauss*; jahresb., , . *liebig, poggendorff and wohler*; handwörterb., iv, . *liman*; jahresb., , . *lowe*; pharm. centralb., , . *mandl*; lond. lanc., dec. , , . *muller*; zeitsch. f. anal. chem., , iii. *orfila*; jour. des progés des sc., iv, ; archiv. gen. de méd., fev., . *papillon*; mon. scien. ques., jan., , . *reynolds*; br. med. jour., jan. , . *rose*; jahresb. der pharm., ii, ; jahresb., , . *roussin*; ann. d'hyg. et de méd. lég., . *scriba, simon and buchner*; jahresb., , . *sonnenschein*; jour. de pharm. et de chim., july, ; mon. scien., ii, . *sorby*; chem. news, , xi, pp. , , , . *struve*; zeitsch. f. anal. chem., , . *taylor*; guy's hosp. rep., . *wicke*; pharm. centralb., , . *wittstein*; arch. der pharm., ii, . *zollikopfer*; ann. d. chem. u. pharm., xciii, ; pharm. centralb., , . on the detection of spermatic stains. *bayard*; ann. d'hygiéne. pub., , no. . *renak*; diagnostisch. u. pathologisch. unters. berlin, , pp. , . *schmidt*; diagnostik verdäch. flecken, leipzig, , pp. - . * * * * * the following are the most important works relating to poisons and food-adulteration that have been issued since the publication of the first edition of this book: *adam*; Ã�tude sur les principales methodes d'essai et d'analyse du lait. paris, . *averbeck*; die verfälschung der nahrungsmittel. bremen, . *bastide*; vins sophistiqués. beriès, . *bauer*; die verfälschung der nahrungsmittel. berlin, . *bell*; analysis and adulteration of food. . *binz*; intoxicationen. tübingen, . *birnbaum*; einfache methoden zur prüfung lebensmittel. . *blane*; de la contrefaçon. *blas*; de la présence de l'acide salicylique dans les bierres. paris, . *blochman*; ueber verfälschung der nahrungsmittel. königsberg, . *blyth*; dictionary of hygiene. london, . _ibid_; manual of chemistry. london, . _ibid_; foods, composition and analysis. london, . _ibid_; poisons, effects and detection of. london, . *boehn*; herzgifte. *bolley*; manuel pratique d'essai et de recherches chimiques. paris, . *bronner*; chemistry of food and drink. london. *caldwell*; agricultural chemical analysis. n. y., . *casper*; handbuch der gerichtlichen medizin. berlin, . *church*; food. n. y., . *cooley's* practical receipts. *dannehl*; die verfälschung des bieres. berlin, . *dietzsch*; die wichtigsten nahrungsmittel, etc. zurich, . *dragendorff*; recherches des substances amères dans la bière. paris, . _ibid_; gerichtlich chemische ermittellung von giften. st. petersburg, . *elsner*; die praxis nahrungsmittel chemikers. leipzig, . *eulenberg*; handbuch der gewerbe-hygiene. berlin, . *falk*; lehrbuch der praktischen toxicologie. stuttgart, . *flick*; die chemie im dienst der öffentlichen gesundheitspflege. dresden, . *fluegge*; lehrbuch der hygienischen untersuchungsmethoden. leipzig, . *focke*; massregeln gegen verfälschung der nahrungsmittel. chemnitz, . *fox*; sanitary examination of water, air, and food. . *franchini*; palmelle prodigieuse. bologne, . *gamgee*; text-book of physiological chemistry. london, . *gaultier*; la sophistication des vins. paris, . *gimlini*; experimentelle untersuchung über die wirkung des aconitins. erlangen, . *goppelsroeder*; sur l'analyse des vins. mulhouse, . *grandeau*; handbuch für agricultur-chemische analysen. berlin, . *griessmayer*; die verfälschung der wichtigsten nahrungs-und genussmittel. . *hahn*; die wichtigsten d. his jetzt bekannten geheimmittel u. specialitäten. . *hausner*; fabrikation der conserven und conditen. leipzig, . *hemming*; aids to forensic medicine and toxicology. london, . *hilger*; die wichtigsten nahrungsmittel. erlangen, . *hoffman*; lehrbuch der gerichtlichen medizin. wien, . *hoppe-seyler*; physiologische chemie. berlin, . *husson*; du vin. paris, . _ibid_; le lait, la créme, et le beurre. . *johnson's* encyclopædia, vol. iv. p. . *johnson*; chemistry of common life. n. y., . *judell*; die vergiftung mit blausäure. erlangen, . *kensington*; analysis of foods. london, . *klencke*; illustrirtes lexicon der verfälschung der nahrungsmittel und getränke. leipzig, . *koenig*; chemische zusammensetzung der menschlichen nahrungsmittel. *lang*; die fabrikation der kunstbutter, sparbutter, und butterin. . *lessner*; atlas der gerichtlichen medizin. berlin, . *lieberman*; anleitung zur chemischen untersuchung auf der gebiete der medicinal-polizei. stuttgart, . *lintner*; lehrbuch der bierbrauerei. . *loebner*; massregeln gegen verfälschung der nahrungsmittel. chemnitz, . *luerssen*; medicinisch botanik. leipzig, . *maschka*; handbuch der gerichtlichen medizin. tübingen, . *medicus*; gerichtlich-chemische prüfung von nahrungs-und genussmitteln. . *montgomery*; essai de toxicologie. paris, . *muter*; a key to organic materia medica. . *ogston*; lectures on medical jurisprudence. london, . *palm*; die wichtigsten und gebrauchlichsten nahrungsmittel. st. petersburg, . *parkes*; hygiene. phila., . *pasteur*; Ã�tudes sur la bière. paris, . *pavy*; a treatise on food and dietetics. london, . *pennetier*; leçons sur les matières premières organiques. paris, . *praag*; leerbock voor practische giftleer. utrecht. *pratt*; food adulteration. chicago, . *prescott*; proximate organic analysis. n. y., . *ritter*; des vins colorés par la fuchsine. paris, . *reitleitner*; die analyse des weines. wien, . *schnacke*; wörterbuch der verfälschung. jena, . *schmidt*; anleitung sanitarisch-und polizeilich-chemischen untersuchungen. zurich, . *schroff*; beitrag zur kenntniss des aconits. wien, . *selmi*; chimica applicata all' igiene alla economia domestica. milan. *sharples*; food and its adulteration. preston, . *smith*; on foods. n. y., . *smith, ed.*; manual for medical officers of health. london, . _ibid_; handbook for inspectors of nuisances. london. *spon's* encyclopædia. london, . *squibb*; proper legislation on adulteration of food. n. y., . *steirlin*; ueber weinverfälschung und weinfarbung. bern, . _ibid_; das bier und seine verfälschung. bern, . *thudicum and dupre*; wine. *vogel*; praktische spectral-analyse. nordlingen, . *wanklyn*; tea, coffee, and cocoa. london, . *wanklyn and cooper*; bread analysis. london, . *wenyl*; analytisches hülfsbuch. berlin, . *wittstein*; taschenbuch des nahrungs-und genussmittel lehre. nordlingen, . *woodman*; handbook of forensic medicine. london, . *wurtz*; traité élémentaire de chimie médicale. paris. memoirs. alkaloids. journal chem. soc. i, , p. ; ibid, i, , p. ; ibid, may, ; ibid, ccxliv, , p. . trans. internat'l med. cong., , vol. i, p. . virch., arch. bd. , , s. ; ibid, bd. , , s. . archiv. d. pharm., jan. , ; ibid, [ ] vii, pp. - ; ibid, [ ] vi, p. . liebig, anal. bd. , . berl. klin. wochenschr. , . pflüger's, , . lancet, sept. , ; ibid, nov. , ; ibid, nov. , . bull. farm. milano, , p. . zeitsch. f. anal. chem. i, . gazett. chim. ital. vi, - . pharm. zeitschr. f. russland, i, p. . vierteljahrsschr. f. gericht. med. xxiii, p. . arsenic and antimony. archiv, f. exper. path. u. pharm., leipzig, . pharm. journ. trans. [ ] pp. - . med. jahrbuch, . journ. d'hygiène, juil., . medical times and gaz. , p. . chem. news, jan., , p. ; ibid, xxxiii., pp. and . am. chem. journ. ii, no. . bull. soc. chim. [ ] xxvi, p. ; ibid, jan. , . zeitsch. f. anal. chem. xiv, pp. , , ; ibid, i, p. . liebig, anal. ccvii, p. . lancet, , p. ; ibid, may , . journ. chem. soc. no. , . mercury, copper and lead. zeit. f. phys. chem. , i, p. . analyst, , p. . chem. news, xxxi, p. ; ibid, xxxi, p. ; ibid, xxxiv, pp. , , and . analyst, , pp. and . journ. chem. soc. , ii, p. . dingl. pol. journ. ccxx, . med. gazette, xlviii, . prussic acid. analyst, apr., , p. . bull. gen. de thér. no. . am. journ. phys. sci., arnold, . virch., arch. f. path. anat. bd. , p. . news repert. f. pharm., , . journ. chem. soc. , i, p. . bericht. d. deutsch. chem. gess. ix, p. . viertelj. f. ger. med. , p. . zeit. f. anal. chem. von fresenius, xii, p. . flour and bread. analyst, june, ; ibid, jan., ; ibid, , no. ; ibid, vi, , p. ; ibid, iii, pp. , . chem. news, , , xxxix, p. . dingl. pol. journ. bd. . journ. pharm. [ ] iv, . chem. centr'b't, , . pharm. journ. xiii, . journ. chem. med. , p. . an. d. chem. u. pharm, bd. , u. . journ. f. pract. chem. xcix, ; ciii, , , , . zeit. anal. chem. , p. ; ibid, , vol. xviii, p. . chem. soc. jour. xxxv, p. . jour. d'hygiène, may, . pharm. jour. trans. , cccxii, . pharmacographia, , p. . sanitary engineer, vol. v, p. . tea. pharm. journ. ; d series, . chem. news, xxx, (allen); xxx, ; xxviii, . journ. pharm. [ ] xxvi, ; xii, , . analyst, june, ; (wigner). journ. chem. soc. , , ; ix, , ; . journ. f. pract. chem. x, ; xciv, ; li, . bull. soc. chim. [ ] xxvii, . journ. de pharm. d'anvers, , . journ. pharm. et chim. série, , xxiv, . repert. de pharm. , vii, p. . journ. chim. méd. série, , x, ; , . ann. chem. pharm. xxvi, ; xxix, ; xxxvi, . ann. chem. pharm. lxxxii, ; cxii, ; i, ; , ; lxiii, ; lxix, ; lxxi; cxviii, . ann. chem. xxv, . med. press and circular, , p. . kastu. arch. vii, . deut. chem. ges. ber. ix, . parliamentary papers, . mag. pharm. xix, . ann. chim. phys. [ ] xi, . schweigg, journ. chem. phys. lxi, ; lxiv, . phil. mag. j. xxiii, ; xiii, . milk. analyst, , jan. and may; , p. ; no. ; sept., dec.; , jan.; p. ; , mar. chem. news, . journ. chem. soc. clxxxix, sept., . comptes rendus, t. , . ann. chem. pharm. lxi, . milch zeit. , . wine and beer. analyst, , pp. , , , . ann. chim. phys. [ ] ii, pp. - . bull. soc. chim. [ ] xxv. deut. chem. ges. ber. ix, . comptes rendus, lxxxiv, . journ. chim. méd. t. ix, p. . arch. pharm. [ ] v. , , bd. , p. . chem. soc. journ. ii, , p. . ann. d'hyg. et méd. lég. , xvii, pp. , . vinegar. analyst, iii, , p. ; i, , p. . ann. d'hyg. et méd. lég. sér. t. xii. pharm. journ., jul. , . * * * * * within the last few years the subject of food-adulteration has been so prominently brought before the public that, in many instances, the various state boards of health have commissioned their chemists to furnish reports on this subject. these may be found in the annual publications of the same, notably in the volumes issued by the massachusetts, michigan, new jersey, and new york state boards of health. it may also be mentioned in this connection that the _sanitary engineer_ of new york, the _analyst_ of london, the _zeitschrift für untersuchung von lebensmitteln_, eichstatt, and the _zeitschrift gegen verfälschung der lebensmittel_, leipzig, are journals devoted to the consideration of adulterations and the more recent methods employed for their detection. j. p. b. index. a. acetic acid, , acids, , acetic, , boric, formic, hydriodic, hydrobromic, hydrochloric, hydrocyanic, hydrofluoric, hydrosulphuric, nitric, , oxalic, , , , phosphoric, , , phosphorous, sulphuric, , , aconitine, alcoholmeter (gay-lussac's), alkalies, , ammonia, baryta, lime, potassa, soda, strontia, alkaloids, aconitine, aniline, aricine, atropine, beberine, brucine, cinchonine, codeine, colchicine, conine, delphine, digitaline, emetine, morphine, narcotine, nicotine, papaverine, picrotoxine, quinine, solanine, strychnine, veratrine, alkaloids, separation of, by stas's method, separation of, by otto's method, separation of, by v. uslar and erdman's method, separation of, by rodgers & girdwood's method, separation of, by prollius's method, separation of, by graham & hofman's method, separation of, by dialysis, alkaloids, identification of, alloys, examination of, alum in flour and bread, aniline, antimony, , , detection of, by flandin and danger's method, detection of, by naquet's method, aricine, arsenic, , , detection of, by the method used prior to marsh's test, detection of, by marsh's test, detection of, by raspail's test, detection of, by reinsch's test, arsenic, estimation of, ashes, examination of, atropine, b. barley meal in flour, baryta, barreswil's test for milk, berberine, bicarbonate of soda in milk, bismuth, blood stains, detection of, bleaching of hair, boric acid, boutigny's examination of fire-arms, bromine, , , , brücke's test for blood stains, brucine, buckwheat in flour, , c. cadmium, carbonate of lime and magnesia in flour, cerebral substances in milk, chalk in milk, chlorine, chromium, cinchonine in sulphate of quinine, codeine, conine, coins, examination of, colchicine, copper, , corn meal in flour, , d. darnel in flour, delphine, determinative tests for poisons, digitaline, dusart's test for phosphorus, dialysis, , dyeing of hair, e. emetine, emulsion of almonds in milk, f. fire-arms, examination of, weapons provided with a flint, weapons not provided with a flint, fixed oils, examination of, hempseed, olive, flandin and danger's test for antimony, flandin and danger's test for mercury, food (flour and bread), examination of the gluten, examination of the starch, examination of the ash, formic acid, fresenius & neubauer's test for phosphorus, g. galactoscope, graham and hofman's method for alkaloids, ground bones in bread and flour, gum arabic in milk, gum tragacanth in milk, h. hæmin crystals, hair, examination of, hempseed oil, hoppe-seyler's test for blood, hydriodic acid, hydrobromic acid, hydrochloric acid, , hydrocyanic acid, hydrofluoric acid, hydrosulphuric acid, i. iodides, , iodine, , indicative tests for poisons, l. lactodensimeter, lactometer, lactoscope, lassaigne's test for writings, lead, legumens in flour, , , lentils in flour, lime, lime in flour, linseed meal in flour, m. macadam's method for alkaloids, magnesia in sulphate of quinine, mannite in sulphate of quinine, marchand's test for milk, marsh's test for arsenic, mercury, , , detection of, by smithson's pile, detection of, by flandin and danger's method, metals, antimony, , , arsenic, , , bismuth, cadmium, chromium, copper, , lead, mercury, , , silver, tin, , zinc, milk, examination of, mineral substances, in flour and bread, in milk, in sulphate of quinine, mistcherlich's test for phosphorus, morphine, n. naquet's test for antimony, narcotine, nicotine, nitric acid, , o. oatmeal in flour, oleometer, olive oil, orfila's test for phosphorus, organic matter destruction of, by _aqua regia_, destruction of, by chlorate of potassa, destruction of, by chlorine, destruction of, by nitrate of potassa, destruction of, by nitric acid, destruction of, by potassa and nitrate of lime, destruction of, by potassa and nitric acid, destruction of, by sulphuric acid, otto's method for alkaloids, oxalic acid, , , , p. papaverine, payen's test for vinegar, phosphoric acid, , , phosphorous acid, phosphorus, , detection of, by orfila's method, detection of, by mistcherlich's method, detection of, by dusart's method, detection of, by fresenius and neubauer's method, estimation of, picrotoxine, plaster in flour, poisons, detection of in cases where no clew exists, in cases where a clew exists, destruction of the organic matter, indicative tests, determinative tests, potato meal in flour, potassa, , prollius' method for alkaloids, prussic acid, q. quinine, r. raspail's test for arsenic, reinsch's test for arsenic, reveil's test for vinegar, rice meal in flour, robin's method for spermatic stains, rodgers and girdwood's method for alkaloids, rye meal in flour, , s. salicine in sulphate of quinine, sand in flour, silver, smithson's pile, soda, , , solanine, spermatic stains, detection of, spermatozoa, starch in sulphate of quinine, stearic acid in sulphate of quinine, stas's method for alkaloids, strychnine, sugar in milk, sugar in sulphate of quinine, sulphate of copper in bread, sulphate of quinidine in sulphate of quinine, sulphate of quinine, examination of, sulphuretted hydrogen, sulphuric acid, , , sympathetic inks, tests for, t. tea, tin, , u. v. uslar and erdman's method for alkaloids, v. veratrine, vinegar, examination of, w. wines, examination of, writings, examination of, z. zinc, becker & sons, manufacturers of balances and weights of precision, for [illustration] chemists, assayers, jewelers, druggists, _and in general for every use where accuracy is required_, no. murray st., new york. every balance and set of weights leaving this establishment is guaranteed to be accurately adjusted, as represented in our price list. --> our illustrated price list mailed on application. catalogue of the scientific, military, and naval publications of d. van nostrand, murray street and warren street, new york. *abbot, maj. henry l.--siege artillery against richmond.* illustrated. vo, cloth $ *adams, j. w.--sewers and drains for populous districts.* embracing rules and formulas for the dimensions and construction of works of sanitary engineers. second edition. vo, cloth *aldrich, m. almy.--history of the united states marine corps.* from official reports and other documents. compiled by capt. richard s. collum. vo, cloth *alexander, j. h.--universal dictionary of weights and measures*, ancient and modern, reduced to the standards of the united states of america. new edition, enlarged. vo, cloth *anderson, gen. robert.--evolutions of field batteries of artillery.* translated from the french, and arranged for the army and militia of the united states. published by order of the war department. plates. mo, cloth *andrews, maj.-gen. c. c.--campaign of mobile.* including the co-operation of general wilson's cavalry in alabama. with five maps and views. vo, cloth ---- *hints to company officers on their military duties.* mo, cloth *arnold, maj. a. k.--cavalry service.* notes on horses for cavalry service, embodying the quality, purchase, care, and diseases most frequently encountered, with lessons for bitting the horse and bending the neck. illustrated. mo, cloth *arnold, maj. frank s.--the discipline and drill of militia.* crown vo, limp cloth *atwood, geo.--practical blow-pipe assaying.* mo, cloth, illustrated *auchincloss, w. s.--link and valve motions simplified.* illustrated with wood-cuts and lithographic plates, together with a travel scale and numerous useful tables. vo, cloth *axon, w. e. a.--the mechanic's friend.* a collection of receipts and practical suggestions relating to aquaria--bronzing--cements--drawing--dyes--electricity--gilding-- glass-working--glues--horology--lacquers--locomotives--magnetism-- metal-working--modelling--photography--pyrotechny--railways--solders-- steam-engine--telegraphy--taxidermy--varnishes--waterproofing, and miscellaneous tools, instruments, machines, and processes connected with the chemical and mechanic arts. with numerous diagrams and wood-cuts. fancy cloth *bacon, f. w.--a treatise on the richards steam-engine indicator, with directions for its use.* by charles t. porter. revised, with notes and large additions as developed by american practice; with an appendix containing useful formulæ and rules for engineers. illustrated. fourth edition. mo, cloth *barba, j.--the use of steel for constructive purposes;* method of working, applying, and testing plates and brass. with a preface by a. l. holley, c.e. mo, cloth *barnard, maj.-gen. j. g.--the "c. s. a." and the battle of bull run.* vo, cloth ---- *the peninsular campaign and its antecedents,* as developed by the report of maj.-gen. geo. b. mcclellan and other published documents. vo, cloth mo, paper ---- *notes on sea-coast defence.* consisting of sea-coast fortification; the fifteen-inch gun; and casemate embrasure. with an engraved plate of the fifteen-inch gun. vo, cloth *barnard, maj.-gen. j. g., and barry, maj.-gen. w. f.--report of the engineer and artillery operations of the army of the potomac,* from its organization to the close of the peninsular campaign. illustrated by maps, plans, etc. vo, cloth *barnes, lieut.-com. john s.--submarine warfare, defensive and offensive.* comprising a full and complete history of the invention of the torpedo, its employment in war, and results of its use. descriptions of the various forms of torpedoes, submarine batteries, and torpedo boats actually used in war. with lithographic plates and many wood-cuts, vo, cloth *barre duparcq, edward de la.--elements of military art and history.* translated by col. geo. w. cullum, u.s.e. vo, cloth *barrett, capt. edward.--dead reckoning; or, day's work.* vo, flexible cloth ---- *gunnery instructions.* mo, cloth *beilstein, f.-an introduction to qualitative chemical analysis.* translated by i. j. osbun. mo, cloth *benet, gen. s. v.--electro-ballistic machines,* and the schultz chronoscope. second edition. illustrated. to, cloth ---- *military law and courts-martial.* a treatise on military law and the practice of courts-martial. sixth edition, revised and enlarged. vo, law sheep *benton, col. j. g.--ordnance and gunnery.* a course of instruction in ordnance and gunnery. compiled for the use of the cadets of the u. s. military academy. illustrated. fourth edition, revised and enlarged. vo, cloth *berriman, maj. m. w--the militiaman's manual and sword-play without a master.* rapier and broad-sword exercises, copiously explained and illustrated; small-arm light infantry drill of the united states army; infantry manual of percussion musket; company drill of the united states cavalry. fourth edition. mo, cloth *blake, w. p.--report upon the precious metals;* being statistical notices of the principal gold and silver producing regions of the world, represented at the paris universal exposition. vo, cloth ---- *ceramic art.* a report on pottery, porcelain, tiles, terra-cotta, and brick. vo, cloth *bow, r. h.--a treatise on bracing,* with its application to bridges and other structures of wood or iron. illustrations. vo, cloth *bowser, prof. e. a.--an elementary treatise on analytic geometry.* embracing plain geometry, and an introduction to geometry of three dimensions. mo, cloth ---- *an elementary treatise on the differential and integral calculus.* with numerous examples. mo, cloth *boynton, maj. edward c.--history of west point,* and its military importance during the american revolution; and the origin and progress of the u. s. military academy. with maps and engravings. second edition. vo, fancy cloth *brandt, j. d.--gunnery catechism.* as applied to the service of the naval ordnance. adapted to the latest official regulations, and approved by the bureau of ordnance, navy department. revised edition. illustrated. mo, cloth *brewerton, g. d.--the automaton battery; or, artillerist's practical instructor.* for all mounted artillery manoeuvres in the field. in box when sent by mail ---- *the automaton regiment; or, infantry soldier's practical instructor.* for all regimental movements in the field. in box when sent by mail ---- *the automaton company; or, infantry soldier's practical instructor.* for all company movements in the field. in box when sent by mail *brinkerhoff, capt. r.--the volunteer quartermaster.* mo, cloth *buckner, lieut. w. p.--calculated tables of ranges for navy and army guns.* vo, cloth *burgh, n. p.--modern marine engineering,* applied to paddle and screw propulsion. consisting of colored plates, practical wood-cut illustrations, and pages of descriptive matter, the whole being an exposition of the present practice of james watt & co., j. & g. rennie, r. napier & sons, and other celebrated firms. thick to vol., cloth half morocco *burt, w. a.--key to the solar compass, and surveyor's companion.* comprising all the rules necessary for use in the field; also description of the linear surveys and public land system of the united states, notes on the barometer, suggestions for an outfit for a survey of four months, etc. fifth edition. pocket-book form, tuck *butler, capt. john s.--projectiles and rifled cannon.* a critical discussion of the principal systems of rifling and projectiles, with practical suggestions for their improvement, as embraced in a report to the chief of ordnance, u. s. army. to, plates, cloth *cain, prof. wm.--a practical treatise on voussoir and solid and braced arches.* mo, cloth extra *caldwell, prof. geo. c., and breneman, prof. a. a.--manual of introductory chemical practice.* for the use of students in colleges and normal and high schools. third edition revised and corrected. vo, cloth, illustrated. new and enlarged edition *campin, francis.--on the construction of iron roofs.* vo, with plates, cloth *casey, brig.-gen. silas--u. s. infantry tactics.* vol. i.--school of the soldier; school of the company; instruction for skirmishers. vol. ii.--school of the battalion, vol. iii.--evolutions of a brigade; evolutions of a corps d'armée. lithographed plates. vols. mo, cloth *chauvenet, prof. w.--new method of correcting lunar distances, and improved method of finding the error and rate of a chronometer, by equal altitudes.* vo, cloth *church, john a.--notes of a metallurgical journey in europe.* vo, cloth *clark, d. kinnear, c.e.--fuel,* its combustion and economy; consisting of abridgments of treatise on the combustion of coal and the prevention of smoke, by c. w. williams; and the economy of fuel, by t. s. prideaux. with extensive additions on recent practice in the combustion and economy of fuel: coal, coke, wood, peat, petroleum, etc. mo, cloth ---- *a manual of rules, tables, and data for mechanical engineers.* based on the most recent investigations. illustrated with numerous diagrams. , pages. vo, cloth half morocco *clark, lt. lewis, u. s. n.--theoretical navigation and nautical astronomy.* illustrated with wood-cuts. vo, cloth *clarke, t. c.--description of the iron railway bridge over the mississippi river at quincy, illinois.* illustrated with lithographed plans. to, cloth *clevenger, s. r.--a treatise on the method of government surveying,* as prescribed by the u. s. congress and commissioner of the general land office, with complete mathematical, astronomical, and practical instructions for the use of the united states surveyors in the field. mo, morocco *coffin, prof. j. h. c.--navigation and nautical astronomy.* prepared for the use of the u. s. naval academy. sixth edition. wood-cut illustrations. mo, cloth *colburn, zerah.--the gas-works of london.* mo, boards *collins, jas. e.--the private book of useful alloys and memoranda for goldsmiths, jewellers, etc.* mo, cloth *cooke, brig.-gen. philip. st. george.--new cavalry tactics.* mo, morocco ---- *cavalry practice.* regulations for the movements of the cavalry of the army. mo. *cornwall, prof. h. b.--manual of blow-pipe analysis, qualitative and quantitative.* with a complete system of descriptive mineralogy. vo, cloth, with many illustrations *craig, b. f.--weights and measures.* an account of the decimal system, with tables of conversion for commercial and scientific uses. square mo, limp cloth *craig, prof. thos.--elements of the mathematical theory of fluid motion.* mo, cloth *craighill, wm. p.--the army officer's companion.* principally designed for staff officers in the field. partly translated from the french of m. de rouvre, lieut.-col. of the french staff corps, with additions from standard american, french, and english authorities. mo, full roan *cullum, col. george w.--military bridges.* systems of military bridges in use by the u. s. army; those adopted by the great european powers; and such as are employed in british india. with directions for the preservation, destruction, and re-establishment of bridges. with folding plates. vo, cloth *davis, c. b., and rae, f. b.--hand-book of electrical diagrams and connections.* illustrated with full-page illustrations. second edition. oblong vo, cloth extra *diedrich, john.--the theory of strains.* a compendium for the calculation and construction of bridges, roofs, and cranes. illustrated by numerous plates and diagrams. vo, cloth *dixon, d. b.--the machinist's and steam-engineer's practical calculator.* a compilation of useful rules, and problems arithmetically solved, together with general information applicable to shop-tools, mill-gearing, pulleys and shafts, steam-boilers and engines. embracing valuable tables, and instruction in screw-cutting, valve and link motion, etc. mo, full morocco, pocket form *dodd, geo.--dictionary of manufactures, mining, machinery, and the industrial arts.* mo, cloth *douglass, prof. s. h., and prescott, prof. a. b.--qualitative chemical analysis.* a guide in the practical study of chemistry, and in the work of analysis. fourth edition. vo, cloth *duane, gen. j. c.--manual for engineering troops.* consisting of--part i. ponton drill; ii. practical operations of a siege; iii. school of the sap; iv. military mining; v. construction of batteries. with plates and numerous wood-cut illustrations. mo, half morocco *dubois, a. j.--the new method of graphical statics.* with illustrations. vo, cloth *dufour, gen. g. h.--the principles of strategy and grand tactics.* translated from the french, by william p. craighill, u. s. engineers, from the last french edition. illustrated. mo, cloth *duryea, col. a.--standing orders of the seventh regiment national guards.* new edition. mo, cloth *eassie, p. b.--wood and its uses.* a hand-book for the use of contractors, builders, architects, engineers, and timber merchants. upwards of illustrations. vo, cloth *eddy, prof. h. t.--researches in graphical statics.* embracing new constructions in graphical statics, a new general method in graphical statics, and the theory of internal stress in graphical statics. vo, cloth *eliot, prof. c. w., and storer, prof. f. h.--a compendious manual of qualitative chemical analysis.* revised with the co-operation of the authors. by prof. william r. nichols. illustrated. mo, cloth *elliot, maj. geo. h., u. s. e--european light-house systems.* being a report of a tour of inspection made in . engravings and wood-cuts. vo, cloth *engineering facts and figures.* an annual register of progress in mechanical engineering and construction for the years - - - - - . fully illustrated vols. mo, cloth (each volume sold separately), per vol: *fanning, j. t.--a practical treatise on water-supply engineering.* relating to the hydrology, hydrodynamics, and practical construction of water-works in north america. third edition. with numerous tables and illustrations. pages. vo, cloth *fiske, lieut. bradley a., u. s. n.--electricity in theory and practice; or, the elements of electrical engineering.* vo, cloth *foster, gen. j. g., u. s. a.--submarine blasting in boston harbor, massachusetts.* removal of tower and corwin rocks. illustrated with seven plates. to, cloth *foye, prof. j. c.--chemical problems.* with brief statements of the principles involved. second edition, revised and enlarged. mo, boards *francis, jas. b., c. e.--lowell hydraulic experiments:* being a selection from experiments on hydraulic motors, on the flow of water over weirs, in open canals of uniform rectangular section, and through submerged orifices and diverging tubes. made at lowell, massachusetts. fourth edition, revised and enlarged, with many new experiments, and illustrated with twenty-three copperplate engravings. to, cloth *free-hand drawing.* a guide to ornamental figure and landscape drawing. by an art student. mo, boards *fry, brig.-gen. james b.--army sacrifices; or, briefs from official pigeon-holes.* sketches based on official reports, grouped together for the purpose of illustrating the services of the regular army of the united states on the indian frontier. mo. ---- *history of brevet rank.* the history and legal effects of brevets in the armies of great britain and the united states, from the origin in until the present time. crown vo, extra cloth *gillmore, gen. q. a.--treatise on limes, hydraulic cements, and mortars.* papers on practical engineering, u. s. engineer department, no. , containing reports of numerous experiments conducted in new york city during the years to , inclusive. with numerous illustrations. vo, cloth ---- *practical treatise on the construction of roads, streets, and pavements.* with illustrations. mo, cloth ---- *report on strength of the building-stones in the united states, etc.* vo, illustrated, cloth ---- *coignet beton and other artificial stone.* plates, views, etc. vo, cloth ---- *fort sumter.* official report of operations against the defences of charleston harbor, . comprising the descent upon morris island, the demolition of fort sumter, and the siege and reduction of forts wagner and gregg. with lithographic plates, views, maps, etc. vo, cloth half russia ---- *supplementary report on fort sumter.* supplementary report to the engineer and artillery operations against the defences of charleston harbor in . with lithographed maps and views. vo, cloth ---- *siege and reduction of fort pulaski, georgia.* illustrated by maps and views. vo, cloth *goodeve, t. m.--a text-book on the steam-engine.* illustrations. mo, cloth *gordon, j. e. h.--four lectures on static induction.* mo, cloth *grafton, capt. henry d.--a treatise on the camp and march.* with which is connected the construction of field-works and military bridges. mo, cloth *greener, wm., r. c. e.--a treatise on rifles, cannon, and sporting arms.* vo, cloth full calf *gruner, m. l.--the manufacture of steel.* translated from the french, by lenox smith, with an appendix on the bessemer process in the united states, by the translator. illustrated. vo, cloth *guide to west point and the u. s. military academy.* with maps and engravings. mo, flexible cloth *half-hours with modern scientists.--lectures and essays,* by professors huxley, barker, stirling, cope, tyndall, wallace, roscoe, huggins, lockyer, young, mayer, and reed. being the university series bound up. with a general introduction by noah porter, president of yale college. vols. mo, cloth, illustrated *hamersly, lewis b.--the records of living officers of the u. s. navy and marine corps.* compiled from official sources. third edition. cloth, vo. *hamilton, w. g.--useful information for railway men.* sixth edition, revised and enlarged. pages, pocket form. morocco, gilt *harrison, col. walter.--pickett's men.* a fragment of war history. with portrait of gen. pickett. mo, cloth *harrison, w. b.--the mechanic's tool book,* with practical rules and suggestions for use of machinists, iron-workers, and others. illustrated with engravings. mo, cloth *harwood, a. a.--naval courts-martial.* law and practice of united states naval courts-martial. adopted as a text-book at the u. s. naval academy. vo, law-sheep *haskins, c. h.--the galvanometer and its uses.* a manual for electricians and students. second edition. mo, morocco *haupt, brig.-gen. herman.--military bridges.* for the passage of infantry, artillery, and baggage-trains; with suggestions of many new expedients and constructions for crossing streams and chasms. including also designs for trestle and truss bridges for military railroads, adapted specially to the wants of the service of the united states. illustrated by lithographic engravings. vo, cloth *head, capt. george e.--a new system of fortifications.* illustrated. to, paper *heavy artillery tactics: .* instructions for heavy artillery; prepared by a board of officers, for the use of the army of the united states. with service of a gun mounted on an iron carriage, and plates. mo, cloth *henrici, olaus.--skeleton structures, especially in their application to the building of steel and iron bridges.* with folding plates and diagrams. vo, cloth *henry, guy v.--military record of civilian appointments in the united states army.* vols. vo, cloth *heth, capt. henry.--system of target practice.* for the use of troops when armed with the musket, rifle-musket, rifle, or carbine. prepared principally from the french. mo, cloth *hewson, wm.--principles and practice of embanking lands from river floods, as applied to the levees of the mississippi.* vo, cloth *holley, alexander l.--a treatise on ordnance and armor.* embracing descriptions, discussions, and professional opinions concerning the materials, fabrication, requirements, capabilities, and endurance of european and american guns, for naval, sea-coast, and iron-clad warfare, and their rifling, projectiles, and breech-loading; also, results of experiments against armor, from official records, with an appendix referring to gun-cotton, hooped guns, etc., etc. pages, engravings, and tables of results, etc. vo, half roan half russia ---- *railway practice.* american and european railway practice in the economical generation of steam, including the materials and construction of coal-burning boilers, combustion, the variable blast, vaporization, circulation, superheating, supplying and heating feed-water, etc., and the adaptation of wood and coke-burning engines to coal-burning; and in permanent way, including road-bed, sleepers, rails, joint-fastenings, street railways, etc., etc. with lithographed plates. folio, cloth *hotchkiss, jed., and allan, william.--the battle-fields of virginia.* chancellorsville, embracing the operations of the army of northern virginia, from the first battle of fredericksburg to the death of lt.-gen. t. j. jackson. illustrated with five maps and portrait of stonewall jackson. vo, cloth *howard, c. r.--earthwork mensuration on the basis of the prismoidal formulæ.* containing simple and labor-saving method of obtaining prismoidal contents directly from end areas. illustrated by examples, and accompanied by plain rules for practical uses. illustrated. vo, cloth *hunter, capt. r. f.--manual for quartermasters and commissaries.* containing instructions in the preparation of vouchers, abstracts, returns, etc. mo, cloth flexible morocco *induction-coils.--how made and how used.* illustrations. mo, boards *instructions for field artillery.* prepared by a board of artillery officers. to which is added the "evolutions of batteries." translated from the french by brig.-gen. r. anderson, u. s. a. plates. mo, cloth *isherwood, b. f.--engineering precedents for steam machinery.* arranged in the most practical and useful manner for engineers. with illustrations. two volumes in one. vo, cloth *ives, lieut. r. a.--military law.* a treatise on military law, and the jurisdiction, constitution, and procedure of military courts. with a summary of the rules of evidence as applicable to such courts. pages. vo, law-sheep *jannettaz, edward--a guide to the determination of rocks:* being an introduction to lithology. translated from the french by g. w. plympton, professor of physical science at brooklyn polytechnic institute. mo, cloth *jeffers, capt. w. n., u. s. n.--nautical surveying.* illustrated with copperplates and wood-cut illustrations. vo, cloth *jomini, gen. baron de.--campaign of waterloo.* the political and military history of the campaign of waterloo. translated from the french by gen. s. v. benét. third edition. mo, cloth ---- *treatise on grand military operations.* illustrated by a critical and military history of the wars of frederick the great. with a summary of the most important principles of the art of war. illustrated by maps and plans. translated from the french by col. s. b. holabird, u. s. a. vols. vo and atlas. cloth half calf or morocco half russia *jones, h. chapman.--text-book of experimental organic chemistry for students.* mo, cloth *joynson, f. h.--the metals used in construction: iron, steel, bessemer metal, etc., etc.* illustrated. mo, cloth ---- *designing and construction of machine gearing.* illustrated. vo, cloth *kansas city bridge, the.* with an account of the regimen of the missouri river, and a description of the methods used for founding in that river. by o. chanute, chief-engineer, and george morrison, assistant-engineer. illustrated with five lithographic views and twelve plates of plans. to, cloth *kelton, gen. j. c.--new bayonet exercise.* a new manual of the bayonet, for the army and militia of the united states. with beautifully engraved plates. fifth edition. revised. mo, cloth *king, w. h.--lessons and practical notes on steam,* the steam-engine, propellers, etc., etc., for young marine engineers, students, and others. revised by chief-engineer j. w. king, u. s. navy. nineteenth edition, enlarged. vo, cloth *kirkwood, jas. p.--report on the filtration of river waters for the supply of cities,* as practised in europe, made to the board of water commissioners of the city of st. louis. illustrated by double-plate engravings. to, cloth *larrabee, c. s.--cipher and secret letter and telegraphic code, with hogg's improvements.* the most perfect secret code ever invented or discovered. impossible to read without the key. mo, cloth *lazelle, capt. h. m., u. s. a.--one law in nature.* a new corpuscular theory, comprehending unity of force, identity of matter and its multiple atom constitution; applied to the physical affections, or modes of energy. mo. *lecomte, ferdinand.--the war in the united states.* a report to the swiss military department. translated from the french by a staff officer. mo, cloth *le gal, col. eugene.--school of the guides.* designed for the use of the militia of the united states. mo, cloth *lendy, capt.--maxims and instructions on the art of war.* a practical military guide for the use of soldiers of all arms and of all countries. translated from the french. mo, cloth *levy, com. u. p.--manual of internal rules and regulations for men-of-war.* third edition, revised and enlarged. mo, flexible cloth *lieber, francis, ll.d.--instructions for armies.* instructions for the government of armies of the united states in the field. mo, paper *lippitt.--special operations of war.* mo, cloth ---- *field service in war.* mo, cloth ---- *tactical use of the three arms.* mo, cloth ---- *intrenchments.* mo, cloth *lock, c. g., wigner, g. w., and harland, r. h.--sugar growing and refining.* treatise on the culture of sugar-yielding plants, and the manufacture and refining of cane, beet, and other sugars. vo, cloth, illustrated *lockwood, thos. d.--electricity, magnetism, and electro-telegraphy.* a practical guide for students, operators, and inspectors. vo, cloth *loring, a. e.--a hand-book on the electro-magnetic telegraph.* paper boards cloth morocco *luce, capt. s. b.--seamanship.* for the use of the united states naval academy. fourth edition. crown vo, revised and improved, illustrated by full-page copperplate engravings, half roan --> text-book at the u. s. naval academy, annapolis. ---- *naval light artillery.* by lieut. w. h. parker, u. s. n. third edition, revised by capt. s. b. luce, assistant instructor of gunnery and tactics at the u. s. naval academy. plates. vo, cloth *maccord, prof. c. 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all the battles and skirmishes that occurred. complete in twelve volumes royal vo. illustrated with steel engraved portraits of distinguished generals and prominent men, together with numerous maps and plans of battles. price in cloth library sheep half calf, antique half morocco half russia ---- *portrait gallery of the war, civil, military, and naval.* a biographical record. illustrated with fine portraits on steel. vol. vo, cloth half calf *morris, e.--easy rules for the measurement of earthworks, by means of the prismoidal formula.* illustrations. vo, cloth *morris, gen. wm. h.--field tactics for infantry.* illustrated. mo, cloth ---- *infantry tactics.* vols. mo. vols. in one, cloth transcriber's notes: the following corrections which did not concern obvious printer's errors have been made to the text. -in the table of content, the formatting of the entry for "dialysis" was changed in order to indicate that this part is a section of the chapter "methods of destruction of the organic substances" -"treated with "_mélaïnocome_"" was: "treated with "melaniocome"" -the sentence "m. salleron offers for sale a small apparatus (fig. )" wrongly referred to fig. . -"if the crystals originate from fresh blood, they appear as represented in fig. ; crystals from old blood are represented in fig. ." wrongly referred to fig. and ; the same was the case in "the fluid is examined from time to time under the microscope: when it is sufficiently concentrated, crystals, presenting the appearance represented in figs. or , will be observed." -"an oxidizing body" was: "an oxydizing body" -"condenser" was: "condensor" -"areometer (alcoholmeter)" was: "areometer (alcoolmeter)" transcriber's note italic text is denoted by _underscores_. bold text is denoted by =equal signs=. obvious typographical errors and punctuation errors have been corrected after careful comparison with other occurrences within the text and consultation of external sources. misspellings in the text, and inconsistent or archaic usage, have been retained. principles of public health a simple text book on hygiene presenting the principles fundamental to the conservation of individual and community health by thos. d. tuttle, b.s., m.d. secretary and executive officer of the state board of health of montana [illustration: (publisher's colophon)] yonkers-on-hudson, new york world book company conservation of health "our national health is physically our greatest asset. to prevent any possible deterioration of the american stock should be a national ambition."--theodore roosevelt. _the conservation of individual and national health is the keynote of these books_ principles of public health by thos. d. tuttle, m.d., secretary and executive officer of the state board of health of montana. illustrated. cloth. vii + pages. list price cents, mailing price cents. primer of hygiene by john w. ritchie, of the college of william and mary in virginia, and joseph s. caldwell, of the george peabody college for teachers, nashville, tennessee. illustrated. cloth. vi + pages. list price cents, mailing price cents. primer of sanitation by john w. ritchie. illustrated. cloth. vi + pages. list price cents, mailing price cents. human physiology by john w. ritchie. illustrated in black and colors. cloth. vi + pages. list price cents, mailing price cents. world book company caspar w. hodgson, _manager_ yonkers-on-hudson, new york _copyright, , by world book company. all rights reserved_ introduction the earliest history of remote ages describes methods employed in combating disease, and down through all the centuries the struggle against infection has been going on. the science of health as applied in recent years reveals wonderful progress in the avoidance of disease, and in the control of the violent epidemics by which in the past nations were almost exterminated. modern methods of hygiene and sanitation as applied to public health have robbed smallpox and diphtheria of their death-dealing power; cholera and yellow fever have been forced to retreat before the victorious hosts of applied medical science; tuberculosis, the greatest foe of human life, is slowly but surely receding before the determined efforts of modern preventive medicine. by nature man is endowed with resistive power sufficient to ward off most forms of disease, provided he keeps his health at a normal standard by right living. if, however, he allows his health to become impaired by reason of overwork, bad habits, wilful exposure to contagion or unhealthful surroundings, he readily falls a prey to disease. the author of _principles of public health_ has here set forth the general rules of life by the observance of which every adult and every child not only can do much to preserve his own health but also can prove himself a prominent factor in raising the standard of public health. a campaign of education is demanded to arrest the enormous loss of life which is carrying so many to untimely graves, and the instruction given in this volume will be of inestimable value in teaching people how to avoid avoidable disease. the author has not attempted to deal with all the diseases that may be classed as preventable; as the work is intended for use in the public schools, only such diseases are mentioned as it seems fitting to present to school children. to teach our children a proper respect for their own health and for the community welfare is to fit them for the best citizenship. e. a. pierce, m. d. portland, oregon acknowledgments the author wishes to express his sincere appreciation of the valuable assistance rendered in the preparation of this work by dr. s. t. armstrong, of new york city; dr. h. wheeler bond, commissioner of health, st. louis, missouri; dr. h. m. bracken, secretary and executive officer of the state board of health of minnesota; j. s. caldwell, professor of biology, george peabody college for teachers, nashville, tennessee; r. j. condon, superintendent of schools, providence, rhode island; mrs. nona b. eddy, of the public schools of helena, montana; dr. f. m. mcmurray, of teachers college, columbia university, new york city; miss jessie b. montgomery, supervising critic in training school, state normal school, terre haute, indiana; dr. e. a. pierce, secretary and executive officer of the state board of health of oregon. contents part i--the fight for health chapter page i. constant danger of illness ii. the necessity of caring for the body iii. how clothing affects health iv. the uses of food v. care of food--meats vi. care of food--milk vii. decomposition of food viii. harm done by improper cooking ix. how neatness, cheerfulness, and good manners promote health x. dangers from poor teeth xi. necessity for pure air and how to secure it xii. rest essential to health xiii. care of the eye and ear xiv. care of the skin xv. common poisons to be avoided part ii--the enemies of health xvi. disease germs xvii. encouragement of disease by uncleanly habits xviii. flies as carriers of disease xix. how disease germs get into water xx. transmission of disease through the air xxi. insects as carriers of disease xxii. how to keep germs out of wounds xxiii. transmission of diphtheria xxiv. the cure of diphtheria xxv. how typhoid fever germs are carried xxvi. hookworm disease and amoebic dysentery xxvii. how scarlet fever is carried xxviii. measles and whooping cough dangerous diseases xxix. how smallpox is prevented xxx. why vaccination sometimes seems a failure xxxi. consumption, the great white plague xxxii. how consumption is spread and how prevented xxxiii. how consumption is cured appendix--summary of anatomy suggestions to the teacher index part i the fight for health chapter i constant danger of illness every boy and girl confidently expects to grow into a strong and healthy man or woman. how often we hear a child say, "when i am a man," or "when i am a woman;" but i have never heard a boy or a girl say, "if i live to be a man or woman." when you think of what you will do when you are grown into men or women, it never occurs to you that you may be weak and sickly and therefore not able to do the very things that you would most like to do. this suggests that sickness is not natural, else the thought that you may perhaps become sick would enter your mind. as a matter of fact, most sickness is not natural. [sidenote: the fight for life] there is a constant struggle going on in the world. you see a fight about you every day among the animals. you see the spider catch the fly, the snake catch the frog, the bird catch the insect, and the big fish catch the minnow; and you have heard of wars where men kill one another. the greatest enemies that men have to fight, however, are not other men, or wild animals, but foes that kill more men, women and children every year than were ever killed in the same length of time by war. these foes are small, very small, but you must not think that because things are small they are not dangerous. we call these foes _disease germs_. [illustration: fig. . looking at cells through a microscope.] [illustration: fig. . some skin cells as seen through a microscope.] [sidenote: the nature of a germ] the germ is a very, very small body; it is the smallest living body that we know. later we shall learn that our bodies are made up of cells, and that these cells are extremely small--so small that it takes a very powerful microscope to see one of them. the germ is still smaller than the cells in our bodies, and it is made of a single cell. there are a great many kinds of germs in the world. fortunately, most of them are not harmful. some germs cause disease, but there are other germs that not only are not harmful, but are actually helpful to men. among the helpful germs are those that enrich the ground, and these should be protected; but all germs that cause disease should be destroyed as rapidly as possible. these germs are fighting all the time against our health. they are not armed with guns and cannon, neither do they build forts from which to fight; but they get inside our bodies and attack us there. [sidenote: how to fight germs] there are three principal ways by which we fight disease germs: _first_, by keeping our bodies so well and strong that germs cannot live in them; _second_, by keeping germs out of our bodies; _third_, by preventing germs from accumulating in the world--that is, by killing as many of them as possible. if it is possible to keep so well and strong that disease germs cannot live in our bodies, you will naturally infer that there are other causes of sickness besides disease germs. that is true, for there are a great many things beside germs that cause our bodies to get into such a condition that disease germs can enter and grow and make us ill. we sometimes call this a "run-down" condition. before we begin, then, to study the germs that cause disease, we must learn how to keep our bodies strong and ready to fight these germs. =questions.= . what evidence have we that sickness is not natural? . name some of the fights going on in the animal world. . what can you say of the amount of illness caused by germs? . tell what you have learned about germs. . name three ways of fighting germs. =remember.= . most sickness comes from failure to observe nature's laws. . we must keep up a constant fight against germs that cause sickness. . we fight germs by killing as many of them as we can, and by keeping our bodies so strong that if a disease germ enters it cannot grow. chapter ii the necessity of caring for the body [illustration: fig. . the organs of the body.] [sidenote: how the body is like an automobile] these bodies of ours are built somewhat like automobiles. an automobile is made up of a framework, wheels, body, gasoline tank, engine, and steering-gear. the human body has much the same form of construction. we have a frame, which is made of the bones of the body. we have arms and legs, which correspond to the wheels of the automobile. we have many little pockets in our bodies in which fat is stored, and these little pockets answer to the gasoline tank of the automobile. we have an engine which, like the automobile engine, is made up of many parts; and we have a head or brain, that plays the same part as the steering-gear of the automobile. the automobile has a tank in which is carried the gasoline necessary to develop power for the machine. if the gasoline gives out, the engine will not run, and before the owner starts on a trip, he is always careful to see that the tank is well filled. in the same way, if we do not provide new fat for the pockets in our bodies in which the fat is stored, our supply will soon give out and our bodies will refuse to work, just as the engine of the automobile will refuse to work when the gasoline is used up. [sidenote: what cells are like] the automobile is made of iron and wood and rubber, and each bit of iron and wood and rubber is made up of tiny particles. the body is made of bones and muscles, covered with skin, and all these are made up of very fine particles that we call cells. every part of the body is made of these fine cells. the cells are so small that they can be seen only with a powerful microscope. if you look at your hand you cannot see a cell, because it takes a great many cells to make a spot large enough for you to see. in figure you see a boy looking through a microscope, and beside him you see a picture of what he sees. this picture does not look like the skin on your hand, neither does it look like the skin on the boy's hand; but it is nothing more nor less than a piece of skin taken from that boy's hand, and it looks just as a piece of skin from your own hand would look if you were to see it through a very strong microscope. [sidenote: why cells must not be killed] the whole body is made up of just such little cells as you see in figure , and each cell is alive and has a certain work to perform. it is very important that we keep these cells from dying and that they perform the work for which they are intended, for if these cells die or fail to act, the body becomes sick or dies. [illustration: fig. . a cell. (a) cell body; (b) nucleus; (c) nucleolus.] you can scratch some of the paint from your automobile and the machine will work just as well as ever. apparently no harm has been done, but an opening has been made through which moisture and germs can enter and cause the wood to rot and the iron to rust. you can remove certain parts of the automobile and still the machine will do its work; but you cannot take away too much of any one part without weakening the automobile, and if certain parts are missing (such as the sparker, the battery, or the steering-gear), the usefulness of the machine is destroyed. so it is with the body. you can scratch off some of the skin and not do any apparent harm, but you have made an opening through which germs may get into the body. you can remove certain parts of the body, such as the arm or leg, and still the body will do efficient service. but there are certain parts of the body that are necessary to life, just as certain parts of the automobile are necessary to the usefulness of the machine. you cannot remove the heart and live; you cannot remove the brain and live. [sidenote: how cells are killed] you are probably thinking that it must be easy to kill such a little thing as a cell; and so it is. cells can be killed by too much heat or too much cold. when you skin your hand, you kill many cells, and at the same time make an opening for germs to get in and cause sickness. you can kill cells also by starving them, for they must have not only enough food, but the right kind of food. if you feed your bodies on nothing but candy, pie, and cake, most of the cells will refuse to perform their work and many of them will die. these cells must have also an abundance of air, and the air must be pure and fresh. if you breathe the air that others have breathed or that contains poison of any kind, you will soon find that you are not feeling well. this simply means that so many of the cells are being starved for fresh air, that not enough strong ones are left to do the necessary work. you can kill these cells by overwork, for they must have a proper amount of rest. if you go to school all day long and then sit up until midnight every night, you must not expect the cells of your body to keep strong and well. you can kill these cells by the use of certain things that act as poisons to them, such as tobacco, beer, wine, or whisky. =questions.= . in what way is the body like an automobile? . what are cells like? . why must cells not be killed? . name five ways by which we kill cells. =remember.= . each part of the body is important to the welfare of the whole body. . each part of the body is made up of very small particles that we call cells; each cell in the body is alive and has a certain work to perform. . cells are very easily weakened and killed. . there are five principal ways by which we kill the cells in our bodies: by too much heat or cold; by not giving them the proper kinds of foods; by not giving them enough fresh air; by giving them too much work to do; and by poisoning them. chapter iii how clothing affects health [illustration: fig. . warm, dry clothing necessary for health.] [sidenote: why the body should be equally covered] the body should always be kept at as nearly uniform a temperature as possible. in order to do this we wear clothing. clothing keeps out the heat on a hot day, just as it keeps the heat in and the cold out on a cold day. the clothing should be equally heavy on all parts of the body. it is not right to wear a thick dress over your chest and leave your shoulders and arms bare, or nearly so. people who do this are killing a great many cells by letting part of their bodies become chilled while the rest is warm, probably too warm. [sidenote: why clothing should not be too heavy] the clothing should be just heavy enough to keep the body warm. if you wear such heavy clothing indoors that you are constantly perspiring, your underclothes become damp, and when you go out, even though you put on your overcoat, your body becomes chilled. if you begin to sneeze, that is nature's way of telling you that you are killing many of your cells by too much cold. people sometimes get warm from exercising, and then take off their coats. they should have removed their coats before they began to exercise. if you take off your coat after you are too warm, your body becomes chilled. baseball pitchers know this, and if you watch a good pitcher, you will see that he always puts on his sweater as soon as he stops pitching, even though he is very warm. he knows that if he cools off too quickly, he will become stiff and sore and cannot pitch good ball. [sidenote: when a draft is dangerous] sometimes a person sits in a warm room until he begins to perspire freely. then he opens a window and sits in the draft. under ordinary conditions, the cool wind alone would chill the body, but now the rapid drying of the perspiration makes the body cool still more quickly. the sudden chill causes the person to take cold, which is simply another way of saying that he has killed many cells and caused others to fall sick, so that they cannot perform their work. we cannot get too much fresh air. drafts do not hurt us if we are thoroughly wrapped up; but it is very dangerous to allow the wind to strike the body when it is not well protected, and especially when it is damp with perspiration. [illustration: fig. . properly prepared for wet weather.] [sidenote: why damp clothing is dangerous] damp clothing chills the body very rapidly and kills many cells. indeed, if a single one of the germs that cause pneumonia were to enter your lungs while you were wearing damp clothing, it would grow so rapidly that you might have pneumonia in a very little while. that is why it is important to change your shoes and stockings as soon as you get them wet, and to take off immediately any clothing that becomes damp. it is hard for boys and girls to keep their feet dry in the winter and spring months, and rubbers are a nuisance; but if you expect to grow into the strong man or woman you picture yourself becoming, you must take care to wear your rubbers. otherwise you may become weak and sickly, and never be able to do the things you hope to do. the feet are not the only part of the body that needs to be kept dry. a wet coat is just as harmful as wet shoes and stockings; hence, you should always carry an umbrella or wear a raincoat when you go out into the rain. umbrellas are unhandy for boys and girls to carry, but if you will remember that thousands of little cells in your body are being injured when you get wet and chilled, you will be willing to take your umbrella. [sidenote: when to wear an overcoat] in cold weather the same amount of clothing should not be worn in the house and outdoors; for this reason, we have overcoats. if you wear your overcoat in the house, you will become overwarm and your underclothing will then become damp with perspiration; when you go outdoors into the cold air, this dampness will have just the same effect as would dampness that comes from outside. [illustration: figs. and . if you keep your overcoat on in the house, your underclothes become damp from perspiration, and when you go outdoors your body becomes chilled.] as soon as the weather gets cold, put on your overcoat every time you go outdoors, and take it off as soon as you come into the house. this is troublesome for boys and girls to do, because they want to run in and out of the house so often; but on the other hand, think of all the cells you will kill if you do not do this, and you will certainly consider it worth while to take off your coat and put it on again. =questions.= . how does keeping the body equally covered protect the cells? . give reasons for not wearing too heavy clothing. . when is it safe to sit in a draft, and when dangerous? . what is the danger of keeping on wet shoes or other damp clothing? . when and why should overcoats be worn? =remember.= . clothing should be just heavy enough to keep the body warm all the time. . never take off your coat or sit in a draft when you are too warm. . since wearing damp clothing causes a great deal of sickness, change your clothes as soon as they become wet or damp. . do not forget to take your umbrella when it is raining and to wear your rubbers when the ground is wet. . in cold weather wear your overcoat when you are outdoors, but take it off when you come into the house. chapter iv the uses of food we kill a great many of the cells in our bodies by starving them; either we do not give them enough food or we do not supply the right kind of food. [sidenote: why the body needs new cells] not only must we feed the cells in our bodies, but we must be constantly making new ones, for in all our work or play, awake or asleep, we are constantly using up certain cells. these cells are used to make the body go, just as the engine uses coal to form the steam that gives it power to run. boys and girls grow fast and, of course, if they expect to become well men and women, they must make a great many new cells all the time, in addition to those used in doing the work of the body. if we are to make new cells we must have the right kind of food with which to make them. [sidenote: how the body keeps itself warm] we want to do something besides make new cells; we want to keep warm and well the cells we already have. no amount of clothing would keep you warm if you were not making heat inside your body all the time, any more than you could make a telephone post warm by putting your coat on it. therefore it is necessary to have food that makes heat in the body, in addition to food that builds cells. we eat a great many kinds of foods, and all that we eat is used either for building new cells or for producing heat in the body. thus we can divide all our foods into two classes--building material and heat-producing material. the type of building material is lean meat, and the type of heat-producing material is fat meat and starches, such as potatoes and bread. milk contains much building material as well as heat-producing material. that is why a baby grows and keeps warm while he takes nothing but milk. [sidenote: the building foods] lean meat is the best of all building foods. eggs are largely a form of lean meat, and hence constitute a good article of food for building purposes. certain vegetables contain a large per cent of building material; this is especially true of dried beans and peas. wheat flour and corn meal (particularly when made of whole wheat and unbolted meal) contain much building material. it is possible for one to live and grow when eating only vegetable matter. but the boy or girl who tries to become a strong man or woman by eating only vegetables will be disappointed; these are mostly heat-producing foods and will not make strong bodies. experience has proved that the best results are obtained by eating what is called "a mixed diet," that is, a diet composed partly of lean meats and partly of fats and vegetables. [sidenote: the heat-producing foods] of the heat-producing foods, fat is the most powerful. most of the fat that we eat is used immediately for producing in the body heat, and therefore power, but a part of it is stored up for future use. we see it in all healthy young persons. it is this stored-up fat that gives the body its rounded form. when any one has been sick he is thin, because, to produce heat and power while he was sick, he has had to use the fat stored up in his body. to have such a supply of fat is like having a bank account to draw on when out of work. we might call the deposits of fat in our bodies our health banks. fat meat is not the only form in which we eat fats; we eat them in a great many other ways. certain vegetables, such as beans, contain an oil that forms fat. ripe olives contain a great deal of fatty oil. butter is a very important form of fat, and cream contains a large amount of it. [sidenote: cost of suitable foods] in selecting our foods we should think of two things: _first_, the value of the food as a heat-producer or as a building material; and _second_, the cost of the food. we may like butter much better than bacon, but we should remember that, pound for pound, bacon has a greater nourishing power than butter, and a pound of bacon will cost far less than a pound of butter.[ ] vegetable foods produce heat by means of the starch which they contain. all vegetables contain starch. this starch is changed into a kind of sugar in the body, and when thus changed it is used to produce heat and power. all vegetable foods do not have the same heat-producing power. there is more heat-producing power in a pound of oatmeal than there is in ten pounds of cabbage. ten cents' worth of dried beans will produce more heat in the body than will a dollar's worth of lettuce. thirty cents' worth of corn meal will do more building in the body than will a piece of mutton worth a dollar and a half; but you would have to eat a large amount of corn meal in order to secure the building effect that would result from eating a small quantity of mutton. in most fruits the only nourishing quality is in the sugar they contain. this sugar produces heat in the body just as starch does. [sidenote: the real value of advertised foods] you will see some foods advertised as possessing a wonderful nourishing power. do not let such statements deceive you, for no food can have a greater nourishing power than the things from which it is made. if the particular food advertised is made from wheat flour, its nourishing power is just the same as that of an equal quantity of wheat flour. if it is made from corn meal, it can have no greater nourishing power than has the meal itself. we have learned something about the materials necessary in food and why they are needed. we must now learn why foods that contain these materials sometimes do not give us as good results as we might hope for. =questions.= . what use does the body make of new cells? . how does the body keep itself warm? . name two uses that the body makes of food. . what foods are especially useful for making cells? . what foods are chiefly used for making heat? . select articles of food for two meals of equal nourishing value, one meal to be expensive and the other inexpensive. . how would you determine the real value of any food? =remember.= . foods are used to make heat and power in the body and to make the body grow. . the foods that make the body grow are called building materials, and lean meat is the best kind of building material. . the foods that produce heat and power in the body are called heat-producing materials, and fats and starches are the best heat-producers. . all vegetables contain starch, some of them contain a fatty oil, and most of them contain some building material. . you can get as much building and heat-producing material from cheap foods as you can from expensive foods. chapter v care of food--meats [sidenote: value of meat as a food] meat is one of the most important articles of our diet. it furnishes essential materials for building cells, and it furnishes fat for making heat and power in the body. [illustration: fig. . a double menace to health; the slaughterhouse is dirty, and the filth is drained into a stream.] [sidenote: characteristics of good meat] since meat is so important an article of food, we should be very careful to see that it is handled in a way to keep it always perfectly clean. we should make sure that it comes from animals absolutely free from any kind of disease, and that no germs have been allowed to develop poisons in it. [sidenote: how meat may be kept clean] while people know that they ought to pay attention to these things, as a matter of fact they do not do it. they take very little interest in the way the meat that they are to eat is handled, and very few ever go to the slaughterhouse or into the back room of the butcher shop to see whether things are kept clean or not. some people say, "oh, we do not like to go there because it is such a horrid place." if these places were kept clean, as they should be, they would not be "horrid." and if the people who buy the meat would occasionally visit them, these places would be kept clean. [illustration: fig. . properly displayed foods, protected from handling and from dirt and flies.] if the slaughterhouse and the butcher shop where your meats are handled are not kept clean, the meat is sure to have germs growing in it, and these germs will cause poisons called _ptomaines_ to form in the meat. there may not be enough of them to make you sick, but there will be enough to injure some of the cells of your body, and to deprive you of much of the nourishment that you would otherwise get from the meat. all boys and girls should belong to a "clean meat league" and should try to persuade their parents not to buy meat from any butcher who does not keep his slaughterhouse and butcher shop clean. [sidenote: dangers from diseased meat] sometimes butchers are anxious to make money fast and take little thought for the number of people they may make ill. they can buy sick cows very much cheaper than well ones. the meat from a sick cow looks just like the meat from a healthy cow, and the dishonest butcher sells both at the same price. the meat from the diseased cow is not suitable for food. it may cause you to have the same disease that the cow had, or it may only be changed to such an extent that it will not give you the nourishment that you should get from good meat. the butcher who sells you meat from a sick cow is of course dishonest. [illustration: fig. . improperly displayed foods, exposed to handling and to dirt and flies.] [sidenote: how to prevent the sale of diseased meats] ask your father to visit the slaughterhouse where your meat is killed. the only thing you need to do is to persuade him to go and see whether the cattle are sick or not. if the cattle look sick, you will not have to ask him not to buy the meat. no person should ever eat meat that comes from a diseased animal, no matter what the nature of the sickness may be. people who will take the trouble to visit the slaughterhouses occasionally, to investigate these things for themselves, will not have such meat offered them. [sidenote: importance of giving animals clean food] animals that are fed on filthy food are not fit for human consumption. butchers often feed the offal (the insides) of animals to the hogs. this makes the hogs fatten quickly, but it also makes them diseased. when you go to the slaughterhouse with your father, ask him to go around to the back door, and if you see hogs eating this filth, do not buy any more meat from that butcher. =questions.= . what use does the body make of meat? . what conditions are essential for good meat? . how can meat be kept clean? . why is meat from a diseased animal unfit for food? . how can you help in preventing the sale of meat from diseased animals? . why should animals not be fed with offal? =remember.= . meat that is not handled in a clean manner is sure to contain germs that cause a poison to form in the meat. . never buy meat from a butcher who does not keep his slaughterhouse and butcher shop clean. . meat from a diseased animal is not fit for food. . meat from animals fed on filthy food should not be eaten. . form a "clean meat league" and visit the slaughterhouse where your meat is killed. chapter vi care of food--milk [sidenote: value of milk as a food] milk is another important article of food. the department of agriculture at washington says that milk furnishes sixteen per cent of the nourishment of the people of the country. milk is an excellent food when it is pure, but when it is not pure it is very dangerous. [illustration: fig. . a clean dairy.] [sidenote: milk as a carrier of germs] milk has carried the germs of every disease of which the germ is known; it has also carried many diseases of which we do not know the germ. disease germs grow rapidly in milk, and they do not make the milk look different or taste different from milk that is perfectly pure. if you could take two bottles of milk entirely free from disease germs and put typhoid fever germs in one, and should set both bottles in an ice box for twenty-four hours, you would not then be able to tell into which one you had put the germs. the milk in both bottles would look and taste just the same. the only difference between the milk in the two bottles would be that if you drank from one it would make you stronger and would furnish you with both building material and power-producing material, while if you drank from the other you would become very ill and would probably die. [sidenote: how disease germs get into milk:] since we cannot tell from the taste or the appearance of milk whether or not there are disease germs in it, we must take every precaution possible to keep them out. the first step is to learn where the disease germs come from and how they get into the milk. [illustration: fig. . polluted milk is sure to come from a dairy where cleanliness is not observed.] [sidenote: (_ _) by dirt on the cow] every cow has more or less dirt on her sides and udder; some have a great deal. when the cow is milked, much of the dirt falls into the milk bucket. this dirt always contains a great many germs of different kinds, and many of them are germs that cause disease. straining the milk will take out much of the dirt, but disease germs will go through the finest strainer that was ever made. in figure we see a man milking a dirty cow. the owner has allowed his lot to become so dirty that the cow cannot find a clean place in which to lie down. if the man kept his lot clean, and if before milking the light dirt on the cow's sides and udder were wiped off with a damp cloth, no germs would fall into the milk. [sidenote: (_ _) by dirt in the cow barn] another source of dirt and disease germs in milk is the barn. the walls of a barn where cows are milked should always be kept clean and should be whitewashed frequently. if this is done, there will be comparatively little dirt on the walls to fall into the milk. [illustration: fig. . only clean milk will come from a dairy where proper precautions are taken.] of course the walls and floors of a barn cannot be kept absolutely clean. there will always be some dirt, and the movements of the cows shifting their position and switching their tails, will stir up the dust; so it is important to remove the milk from the barn as soon as possible. milk cans should never be kept in the barn. the milk should be taken directly from the barn to a cooling house and there strained. all barns where cows are kept should have plenty of windows, that there may be an abundance of light and fresh air. cows need fresh air just as much as people do, while a barn that is not supplied with plenty of light is very likely to be a dirty barn. keep dirt and disease germs out of the milk by keeping the barn clean and by taking the milk away from the barn as soon as possible. [illustration: fig. . a dirty, insanitary milk-house.] [illustration: fig. . a clean, inexpensive milk-house.] [sidenote: ( ) by dirt on the milkman] another source of dirt and disease germs in milk is the milkman or milkmaid. no matter how careful we may be, our clothes hold more or less dust, and all dust contains germs, very often disease germs. when a person is milking a cow, the dust from his clothes is shaken off into the milk. the only way to avoid this is to wear, while milking, a special suit of clothes made of white cloth, which may be washed as soon as it shows the least particle of dirt. the milker's hands, too, are often dirty. perhaps he carefully washes his hands after milking, but not before. it is a common custom for milkers to moisten their hands with milk while milking, and to do this frequently. the result is that dirty milk from their hands is constantly dropping into the milk pail. this is a very bad habit, and doubly bad if the milkman has not washed his hands before milking. sometimes there are sick people at the dairy farm. often some one nurses a sick person until milking time and then goes out and milks the cows. when this is done, the milker is almost sure to plant the germs of the disease in the milk. no milk should ever be used from any dairy where there is an infectious disease; and no one who has charge of a sick person, no matter what the nature of the sickness, should ever handle milk that is to be used by others. [illustration: fig. . a model bottling establishment.] [sidenote: ( ) by dirt in cans and bottles] the cans and bottles in which the milk is placed are frequently sources of dirt and germs. milk cans and bottles are supposed to be thoroughly washed before milk is put into them, and they should be thoroughly scalded after they are washed. this is not always done, and sometimes the bottles are not washed at all. some dairymen will tell you that the bottles and cans are always washed and scalded just before the milk is put into them, and that this is never neglected by any dairyman. that is what a dairyman once told me. then i asked him how he accounted for the fact that i had found a milk ticket in the bottle with the fresh milk. of course he could not explain this, though i thought i could explain it for him. the old milk bottle was returned to the milkman with the ticket for the new milk inside it. the deliveryman left the fresh milk, but forgot to take the ticket out of the bottle; and the man who "washed" the bottles must have forgotten to take out the ticket too. of course, the bottle was not washed at all, and if one bottle goes unwashed, it is reasonable to assume that others are neglected in the same way. milk bottles and cans should always be thoroughly washed before fresh milk is put into them. this washing cannot be done by little children; it is work for a man or woman, and careful work at that. [sidenote: ( ) by polluted water] i have just told you that milk vessels should be thoroughly washed. it is true, however, that disease germs may get into the milk through this very process of washing the vessels. water sometimes contains disease germs, especially the germs that cause typhoid fever, cholera, and other diseases of the intestines. such water is said to be polluted. when milk vessels are washed with polluted water, the germs are left in them and thus get into the milk. if the water used to wash the cans is thoroughly boiled, the germs will be killed; hence it is important to scald all milk vessels. all water used about a dairy should be perfectly pure. if there is the least suspicion about the quality of the water, it should be examined by a chemist; and if it is not pure, the milk from such a dairy should not be used. in order to prevent the possibility of any infection, all water used to wash milk vessels should be thoroughly boiled even when the water is known to be pure, and the vessels should afterward be scalded, to kill any germs that may be left after washing. [sidenote: ( ) by flies falling into the milk] flies very frequently get into the milk. later we shall learn more about how flies carry germs, but at present it is enough to know that on every fly there are a great many germs, and whenever a fly gets into milk it plants those germs and they grow very rapidly. as soon as a cow is milked, the milk should be taken to a clean cooling house, with screens at all the windows and doors, and there strained into a vessel and cooled. [sidenote: ( ) by disease in the cow] the last way that we will mention by which germs get into milk is by disease in the cow herself. cows suffer from many diseases, just as men do; and when a cow is sick, her milk is very likely to contain the germs of the disease that is making her sick. especially is this true of tuberculosis, or consumption, as it is called. a great many children get consumption by drinking milk from consumptive cows. no milk should ever be used from a cow that is not healthy. all dairy cows should be examined at frequent intervals by a competent veterinarian to make sure that they are free from any disease. =questions.= . milk forms what per cent of the food of the people of the united states? . why is it important that milk should be kept clean? . name some ways by which germs get into milk. . what is the danger from a dirty cow and barn? . how can this danger be prevented? . how does the milkman allow germs to get into the milk, and how can he avoid doing so? . how should milk cans and bottles be washed? . why is it important that only pure water be used about the dairy? . how can flies be kept out of milk? . how should milch cows be tested to make sure that they are free from tuberculosis? =remember.= . milk is a very important article of food; it is both a building and a heat-producing material. . when milk is not properly handled, it contains many disease germs. . disease germs often get into milk from unwashed bottles and cans; from dirty barns; from dirty milkmen; from dirty water used to wash the cans and bottles; from flies falling into the milk; from diseased cows. chapter vii decomposition of food [illustration: fig. . partially decayed fruit is not fit for food.] [sidenote: why partially decomposed foods should not be eaten] vegetables and fruits that are partially decayed should not be eaten. even if an orange is decayed only on one side, the products of decomposition--that is, the poisons produced by decay--have extended all through the orange. you cannot see them, but they are there. it is the same with a decaying apple, potato, or melon. it never pays to buy partially decayed or stale fruits or vegetables, for not only are they dangerous to health, but they are so reduced in nourishing qualities by decomposition that you get little value for the money you spend. it is always better economy to buy fresh fruits and vegetables, or even canned vegetables, when the latter are properly put up. [sidenote: what causes decomposition] all decomposition (rotting) in fruits and vegetables is due to the action of germs. if you will look at a bunch of old grapes, you will notice that some of the grapes are rotten, while others have dried up. now, if you examine them very carefully, you will find that all the decomposed grapes have breaks in the skin. the break may be very small, but it is there, and through this break the germs that cause decomposition have entered. you will find also that there is not the slightest break in the skin of any grape that has dried up. the germs could not enter, hence there has been no decomposition. it is the same with other fruits and vegetables: if the germs that cause decomposition cannot get inside, the fruit or vegetable will dry up, but will not rot. [illustration: fig. . fruits displayed for sale, but properly protected from flies, dust, and dirty hands.] germs can go through a very small opening--so small that you may not be able to find it; but if there is decomposition, the hole is there. the skin of the body acts in the same way as the skin of the grape and keeps out a great many germs that would make us sick were they able to get through the skin. they often get through the skin when we cut ourselves. meats decompose as well as fruits and vegetables, and the decomposition is due to the presence of germs in the meat. we cannot keep all germs out of meat, but we can keep out a great many of them by having everything clean about the meat, by keeping it covered as much of the time as possible, and by handling it only with clean hands. [illustration: fig. . fruits for sale, not properly protected from flies, dirt, and other sources of filth.] [sidenote: why foods do not decompose in very cold places] when meat is kept so cold that it is almost frozen, the germs cannot grow, and decomposition is prevented. in this way meat can be kept perfectly free from decomposition for several weeks. after the meat is taken from the cold storage room, it should be cut as soon as possible into steaks, roasts, and other pieces for cooking; and when taken to your home, it should be kept in an ice box until the time to cook it. you cannot keep meat very long at home without decomposition starting, because small ice boxes are not cold enough to check entirely the growth of germs. unless the meat is to be eaten hot, it should be cooled after cooking and placed again in the ice box as soon as possible. cooking kills the germs that are in the meat before it is cooked; but unless it is kept in a very cold place and protected from flies after it is cooked, germs will get into it again as soon as it is cold. cooked meat will decompose just the same as uncooked meat. [sidenote: what is formed in food by decomposition] when germs are allowed to grow in meat, as always happens when it is not kept in a very cold place, these germs cause the poisons that we call ptomaines. the people who eat such meat become sick, and in many cases do not recover. cooking meat that contains ptomaines will kill the germs that caused the poison, but it will not destroy the poison that has already been formed. [sidenote: why some canned meats are poisonous] people not infrequently are poisoned by eating canned meat. sometimes you will hear it said that the poison formed because the meat was in cans. this is not true; the cans had nothing to do with the forming of the poison. this was caused by germs that were allowed to grow in the meat before it was cooked. when the meat was cooked the germs were killed, but the poison was not destroyed. in other words, the poison developed before the meat was canned, and not after it was put into the cans. =questions.= . what is the objection to eating fruits when they are partially decayed? . why do some foods shrivel while others decay? . why does decomposition not go on in cold places? . what are ptomaines? . when are ptomaines formed in canned meats? =remember.= . partially decomposed fruits or vegetables are not suitable for foods. . meats in which germs have been allowed to grow should not be eaten. . cooking meat kills the germs in it, but does not destroy the poisons that the germs have formed. . when canned meats are poisonous, it is because the poison was formed before the meat was canned; the poison is not caused by the can. chapter viii harm done by improper cooking [sidenote: effects of improper cooking] nearly all food should be cooked before it is eaten; but if the cooking is not properly done, much of the nourishing power of the food is destroyed, and in some instances the food is rendered actually injurious. [sidenote: why starchy foods should be thoroughly cooked] starchy foods should be thoroughly cooked in order that the coverings which surround the little granules may be broken or made soft. if starchy foods are not thoroughly cooked, the little grains go into the stomach as hard as grains of sand; then most of them are not digested at all, but pass out of the system without furnishing any nourishment to the body. if starchy foods are fried in fats, as is the case with doughnuts, the granules of starch become coated with fat. as the fat is not digested until it comes to the intestines, the saliva never reaches the coverings of the starch, and more work is thrown on the other juices of the body. the result is that the little glands which make these other juices are overworked, or else the starch is not digested at all and therefore furnishes no nourishment to the body. when bread is sticky (we sometimes call it soggy) in the middle of the loaf, it is because the flour has not been thoroughly cooked and the little grains or granules of starch are still hard. you cannot feel these granules between your fingers, but they are hard just the same, and very little of such food is made use of in the body. remember that all starchy foods should be thoroughly cooked, and remember, too, that all vegetables are chiefly starchy in character. [sidenote: how fats should be cooked] when fats are cooked over a very hot fire, an acid is developed that is injurious to the body. this does not mean that when the fire is hot enough to broil a steak well, it causes this acid to form; neither does it mean that heat sufficient to boil the grease for cooking doughnuts will cause it to form. every cook knows that when she fries fat meat over a fire that is too hot, it has a bitter taste. this bitter taste is caused by an acid which will destroy a part of the usefulness of the food in the body and will cause many of the cells to stop doing their work properly. [sidenote: how meats should be cooked] there is a great difference of opinion in regard to cooking foods, especially meats. some people will tell you that meats should not be cooked at all; that man originally ate his meat raw and that this is the proper way. others will tell you that all meat should be cooked until it does not show a particle of red, even until it is dry throughout. these are the two extremes; and it is never well to go to extremes in anything, especially in matters that concern the health. meat should always be cooked, because by being cooked it is made more easily digestible; but it should not be cooked, until all the juices, which contain much of the nourishing matter, are dried up and the meat made hard. meat that is cooked until it is dry and hard is more difficult to digest than meat that is not cooked at all. =questions.= . what effect has improper cooking on foods? . why should starches be thoroughly cooked? . what is the objection to starchy foods fried in grease? . what changes take place in fatty food when it is fried over a very hot fire? . why should all meats be cooked? . what is the objection to cooking meat until the juices are dried out? =remember.= . starchy foods should be thoroughly cooked so that the fine grains may be softened and the food thus made more easy to digest. . fats should not be fried over a very hot fire because too much heat causes a poison to form in the fat. . meats should be cooked, but never until they become dry, as the juices in the meat contain most of the nourishing material. chapter ix how neatness, cheerfulness, and good manners promote health [sidenote: why mealtime should be pleasant] the dining table should be the pleasantest and most inviting place in the house. if you are complaining and quarreling during the meal, you cannot enjoy the food; you cannot eat it properly; and your ill temper will so affect your body that you cannot properly digest what you eat. a dirty table, with flies swarming over the food, is not very tempting, and when seated at such a table, one does not eat the things that are best for him and sometimes does not eat anything at all. [illustration: fig. . a clean, inviting dining-room.] [sidenote: how uninviting luncheons affect the appetite] the luncheons that boys and girls take to school with them are often prepared in so careless a way that they are extremely uninviting. the substantial school lunch can be made just as appetizing as the dainty refreshments at an afternoon tea or at a party. if the same care is devoted to the preparation of the one as of the other, boys and girls will eat their lunches with enjoyment and good appetites. [sidenote: why an attractive table calls for pleasing guests] if the table is made to look clean and inviting, do you not think that you, in your turn, should make yourself as neat and clean as possible before you come to it? dirt on your hands and face not only does not look well, but contains a great many germs that may get into your food and thus find their way into your body and try to make you ill. [illustration: fig. . two lunches. which is the more tempting?] [sidenote: how foods should be eaten] besides being eaten in pleasant surroundings, all food should be eaten slowly. let us suppose that we are all seated at a clean, inviting table and everyone is clean and happy. before the children is the very kind of food that is best for them. it looks good and they know it is good, and they want to eat all they can of it. but they think of a game of jacks or of ball that they want to play as soon as dinner is over, so they simply "bolt" their food. what are teeth made for? why, to chew with, of course. but why are we given some teeth that are sharp like knives, and some that are flat like millstones? it seems probable that these different kinds of teeth are intended for special purposes, and so they are. if our teeth were intended only for cutting our food into bits small enough to swallow without causing pain, there would be no need for any except the sharp, knife-like teeth. but we have the big grinders, which were made to use, and it is very important that they be used in the right way. [sidenote: why food should be thoroughly chewed] we do not chew our food simply to make it fine enough to swallow, but for quite another reason as well. in our mouths there is a fluid called _saliva_. think of something that you are very fond of eating, and the mere thought of it makes the saliva come into your mouth. this saliva has a very important duty to perform in connection with preparing the food for the little cells of the body. each little grain of starch--and you will remember that all vegetable foods are composed largely of starch--has a capsule about it. this simply means that it is done up in a little package. the saliva helps to open this capsule by making it soft (just as water will soften the paper on a package of candy), so that the other digestive juices can reach the starch and turn it into the kind of sugar that is used in the body. if you do not chew your food very fine, the saliva will not reach the starch granules, the little packages of starch will be hard to open when they go into the stomach, and much of the starch will never be made use of in the body. the saliva has much the same action on the coverings of the little packages of meat, for all the meat that we eat is done up in similar packages. a great englishman, mr. gladstone, who lived to be eighty-three, made a practice of chewing every bite of food twenty times, and he thought this had a great deal to do with his being such a strong and well man and living to such an old age. [sidenote: when desserts are not harmful] after you have eaten meats, bread, and vegetables, it will do no harm to eat a piece of pie or cake, or a dish of ice-cream or some other dessert. it is not easy, as a rule, to digest these things (that is, to get them into such shape that they can be used as food by the little cells in the body), but a moderate amount of them is very good for boys and girls, as well as for grown people. if you refuse to eat the meat and bread, but wait until the dessert is served and then fill your stomach with sweet things, you will be starving some of the little cells, and you will be reminded of this very soon. sometimes you may be reminded of it by having a pain in your stomach, but more often by getting low grades in your lessons at school. your teacher will know it, too, because you will be so restless and inattentive in your classes that she will have to give you a low grade in deportment as well. =questions.= . what kind of topics should be discussed at mealtime? . what is the objection to an untidy table? . what kind of luncheon do you like best? . what does a clean table call for? . what is the importance of eating slowly? . why should we chew our food thoroughly? . when are desserts not harmful? =remember.= . the dining table should be the most inviting place in the house. . unpleasant subjects should be avoided at mealtime. . a clean table calls for clean people. . eat slowly and chew your food thoroughly, that the saliva may reach each grain of starch. . desserts are not harmful if eaten at the end of a meal composed of good building and heat-producing materials. chapter x dangers from poor teeth we have learned that chewing is not merely a process of cutting our food into such lumps as we can swallow without hurting ourselves; but that the food must be ground up fine and thoroughly mixed with the saliva, that the saliva may reach every particle of starch. if we do not have good teeth, we cannot grind our food as fine as it ought to be ground, and, as a result, a great deal of the starch will not be reached by the saliva. nature starts every child with a full set of good, strong, clean teeth. these teeth, which we call first, or milk, teeth, are not very large, but they are perfect in every respect and last until the second, or permanent, teeth come in. that is, they will last so long _if they are taken care of_. if they are not taken care of, they will decay just as the later teeth will decay, and they must be cared for in the same way. [sidenote: why we have baby or milk teeth] boys and girls sometimes wonder why they have a set of teeth that come out before they can have the teeth that must last them the rest of their lives. this is simply because there is not room enough in a child's mouth for the big, permanent teeth. we must have teeth while our jaws are growing, so we have first a set of little teeth. then just as soon as our jaws get large enough for the big teeth, the little teeth come out and the big ones come in. teeth are about the hardest substance in the body. if we take care of our second teeth, they should last as long as we live. the only reason they do not last is because we do not take care of them. if a person would keep his teeth clean all the time, he would rarely be obliged to have a single permanent tooth pulled. [sidenote: why teeth break easily] teeth are so hard that they are brittle, that is, they break easily. glass is brittle, and you can chip off a piece of glass with a pin by sticking the pin into a crack in the glass. in just the same way you can chip off a piece of a tooth by sticking a pin between two teeth. that is what often happens when people pick their teeth with pins, or with any other hard substance. a metal toothpick is just as bad as a pin. [illustration: fig. . teeth were not intended for nutcrackers.] another way by which little pieces are chipped off the teeth is by biting hard things. sometimes we see boys and girls cracking nuts with their teeth; again we see them trying to bite wires in two. they put their teeth to many uses for which teeth were never made. they do not realize, while they are abusing their teeth in this way, that they are probably chipping the enamel, which is the hard, shiny covering of the tooth, and are destroying the one protection that their teeth have against decay. [sidenote: why teeth decay] when a little piece is chipped off a tooth, an opening is made through the enamel. through this opening germs may lodge in the inner part of the tooth, which is soft. when this happens, a little black speck appears on the tooth, and after a while the tooth begins to ache. if you have a toothache, you go to a dentist, and he probably finds that germs have caused the tooth to decay until there is a hole extending into the very center of it. teeth grow very close together, but there is always a little space between them. whenever you eat anything, particles of the food get into these spaces and if allowed to remain there, soon decompose. these decomposing particles of food between the teeth will gradually soften even the enamel, and in this way little openings are made for germs to get into the teeth. [sidenote: how to care for the teeth] never pick the teeth. you cannot make them clean by picking them. every morning and night brush your teeth with a stiff toothbrush and a little tooth powder. brush them both crosswise and up and down, to get out everything from between them. do not think you have done your duty if you brush only your front teeth, the ones that show. brush the back teeth just as thoroughly as you do the front teeth. very few people will see your back teeth, but these decay just as fast as your front teeth, if they are not kept clean. [illustration: fig. . a sanitary wash-basin with a separate bowl for washing the teeth.] [sidenote: how often one should go to the dentist] twice each year you should have a dentist examine your teeth, to see if there are any little spots where decay has started. if you have kept your teeth perfectly clean all the time, and have not chipped off little pieces, there will be none of these decayed spots. but it is a safe plan to have the teeth looked over at least twice a year, for you may have broken a tooth without knowing it, and by the time a decayed spot is large enough to cause pain, or has made a hole that you can feel with your tongue, it has advanced much farther than it should have been permitted to do. =questions.= . why should you chew your food thoroughly? . why is it necessary to have baby teeth? . how are teeth easily broken? . why do teeth decay? . what must you avoid in order to protect your teeth? . how should your teeth be brushed? . why should you have your teeth examined twice each year by a dentist? =remember.= . take care of your teeth and they will last you as long as you live. . do not pick them with pins, or toothpicks of any kind. . do not use them for nutcrackers or wire-cutters. . do not use them for tack pullers. . keep them clean at all times. . brush them up and down as well as crosswise. chapter xi necessity for pure air and how to secure it we have learned how the cells of the body are killed by starvation. now let us learn how they are choked to death, or killed by lack of air. [sidenote: how air is changed in the body] the cells of the body need _oxygen_, and the only way we can give it to them is by means of air. every time we take air into our lungs we are giving oxygen to the red corpuscles or cells in the blood, which distribute it to the other cells in the body. the air that goes into our lungs, if it is fresh and pure, contains a great deal of oxygen and a very little of another gas called _carbon dioxid_. the air that comes out of the lungs contains a very little oxygen and a great deal of carbon dioxid. the blood not only takes the oxygen out of the air, but gives carbon dioxid to the air. this carbon dioxid is very poisonous, and would kill the cells if it remained in the blood; hence we should never breathe the same air twice. there is no lack of fresh air in the world, and no excuse for anyone's ever breathing air that is not pure. [sidenote: effects of impure air] if you close all the windows and doors in the schoolroom and shut up the ventilators, you will soon find that you are not able to pay close attention to your studies, and in a little while you will begin to feel drowsy. this is because you have used up so much of the oxygen in the air that there is no longer enough to supply the demands of the little cells, and because, in addition, you are taking into your bodies the poisonous carbon dioxid that has been breathed out into the room. it takes a great deal of fresh air to supply the body with oxygen--about , cubic feet of air each hour. with thirty or forty children in a room, it does not take long to use up all the oxygen. so there should be a constant supply of fresh air coming into the room. [illustration: fig. . results of breathing good and bad air.] [sidenote: methods of ventilation] it is not only in the schoolroom that you need oxygen. when you are out-of-doors you get an abundance of fresh air, but from a great many houses every bit of fresh air is shut out. it is always possible to let an abundance of fresh air into any house without causing a draft. a piece of board can be made to fit into a window frame so that when the window is raised, the air will be directed upward and will not cause a draft. hot-air furnaces are made with cold-air pipes. the fresh air from outdoors comes through these cold-air pipes and, after being heated, is driven into the rooms of the house. some people think they will save coal by closing these drafts. not only do they not save coal (for the furnace does not give as much heat when this draft is closed), but they kill their body cells by refusing to give them oxygen. the cold-air pipe in a hot-air furnace should always be kept wide open. in houses heated with steam or hot water, either the windows must be kept open, or some other way must be provided for admitting fresh air and taking out foul air. these arrangements constitute a system of ventilation. houses heated with stoves must also be provided with some means of ventilation. the stove, by its draft, takes out a little of the foul air, but it will not take out more air than one person poisons. [illustration: fig. . restfulness: effect of good ventilation in a sleeping-room, with the right position for sleeping.] [illustration: fig. . restlessness: effect of poor ventilation in a sleeping-room, with the wrong position for sleeping.] [sidenote: why windows should be kept open at night] many people seem to think that they do not need fresh air at night, and they close their bedroom windows as tight as they can. those people do not sleep well and often have bad colds. you should always sleep with your windows open. if it is impossible for you to have your windows open without having a draft, choose the draft; it will do you no harm if you are well covered, and under no circumstances will it do you as much harm as the foul air that you breathe if your window is closed. some persons (fortunately they are few nowadays) will tell you that night air is dangerous. i wonder what kind of air these people expect to breathe at night. do they expect to fill the room in the daytime with enough air for use at night? such air would certainly not be very fresh. night air is the only kind of air that it is possible to breathe at night. [sidenote: the ventilation of public assembly rooms] churches, theaters, and ten-cent shows are often very poorly ventilated. you can always tell a poorly ventilated room by the foul odor when you go into it from the fresh air, and it is not wise to stay in such a room. you are killing the cells in your body when you do so, and you will very probably come out of it with a bad cold. when the fresh air strikes you, you feel chilly and you may think you are taking cold then, but in reality you took cold in that room full of foul air. [sidenote: ventilation of workshops] workshops are often poorly ventilated. no person should ever work in a badly ventilated place. the labor unions frequently strike for higher wages, but until recently a strike for better ventilation was rarely heard of. better ventilation would be practically equal to an increase in wages, because there would be fewer doctors' bills to pay, and less likelihood of losing work through illness. always have plenty of pure, fresh air wherever you are--in school, in bed, at work, or at play. [sidenote: why we should breathe through the nose] the cells in the skin of the nose secrete a watery fluid, and this fluid serves to moisten the air as it passes through the nose. dry air irritates the mucous membrane which lines the nose, throat, and lungs, and it is very important that the air be moistened before it reaches the throat. air is also warmed as it passes through the nose. cold air is irritating to the throat and lungs. the small hairs in the nose catch the dust and dirt in the air and prevent it from going into the lungs. the nose was made to breathe through, and all the air that goes into your lungs should pass through your nose, in order that it may be moistened, warmed, and cleansed. [illustration: fig. . showing position of adenoids and tonsils in the throat.] [sidenote: why some children breathe through the mouth] frequently we see boys and girls breathing through the mouth. they do this because there is something in the nose that prevents the air from passing freely through it. if there were nothing in the way, the child would breathe through the nose instead of the mouth, because the natural way of breathing is through the nose. the most common reason for mouth-breathing is the growth of small lumps in the throat just behind the nose. these little lumps are called adenoids. they are not natural, and should be taken out. we do not know why they grow in some children and not in others, but we do know that they should be taken out so that the child can breathe easily through the nose. large tonsils also cause boys and girls to breathe through the mouth. tonsils that are large enough to cause the child to breathe through the mouth ought always to be taken out. large tonsils and adenoids are often found in the same child. [sidenote: effects of mouth-breathing] when a child breathes through his mouth all the time, his face takes on a peculiar shape. his upper lip grows long, his lower jaw drops back, and his whole face looks flat. his voice has a peculiar sound, and he finds it very hard to keep up in his classes at school. children with adenoids and large tonsils are always backward in their school work, and may become deaf if the adenoids and tonsils are not removed. if you breathe through your mouth instead of through the nose, go to the doctor and let him see if you have adenoids or large tonsils; if you have, let him take them out. you cannot possibly grow into a strong, healthy man or woman if you have adenoids and do not have them removed. =questions.= . what does the body take out of the air? . what does the body put into the air? . what effect does impure air have on the body? . why should one sleep with windows open? . what causes the unpleasant odor in a crowded room? . how would workmen benefit by properly ventilated workshops? . name the helpful ways in which the air is changed while passing through the nose. . why do some children breathe through the mouth? . what effect comes from mouth-breathing? =remember.= . impure air destroys health. . never sleep in a room where the window is closed. . avoid going into public places or workshops that are not well ventilated. . air must pass through the nose before it is fit for the lungs. . mouth-breathing is not natural and is usually due to some defect that can easily be cured. chapter xii rest essential to health [sidenote: why exercise is necessary] exercise is necessary to make our bodies grow and become strong. if we stayed in bed all the time, our muscles would not grow and we could not even walk. if we did not exercise them, the cells in our brains would not grow and we should not know anything. every part of our body must have exercise, that is, each part must do some work every day. if we used only one part of the body and did not give the other parts any work to do, only the part that we used would grow, while all the rest of the body would be small and weak. [sidenote: proportion of rest required] while every part should do some work each day, the whole body needs also to have a proper amount of rest. even the heart, which seems to be working all the time, must rest. it rests between each beat. the muscles with which we breathe rest between each breath. every person must have a certain amount of rest each day. a man should have at least eight hours' sleep in every twenty-four hours; boys and girls should have from nine to ten hours' sleep in every twenty-four. it is only while we are sleeping that we have complete rest. [sidenote: effect of overwork] everybody should have some work to do. boys and girls should learn that work is a part of life, though they should not be expected to do too much. they should not be required to get up at four o'clock in the morning and work until eight, then go to school until four in the afternoon, and then work again until dark. they cannot do this and keep well. such children will surely neglect their lessons and will fail to keep up in their classes. it is not the children's fault, but the fault of the people who give them so much to do outside of school. sometimes bright children fall behind in their classes and seem to be sleepy during school hours. very often these children do not have to do any work at home, but play all the time they are out of school. we usually find that these children not only play all the afternoon, but also go to parties at night and often stay up until midnight. [illustration: fig. . children work when they play. the little girl skipping rope is killing the body cells by overwork; she has skipped more than one hundred times and is exhausted.] [sidenote: ways in which children overwork their bodies] you may think it is not work to go to a party, but it really is. you are working the muscles and the cells of your brain when you are playing games, and these get tired from play work just as they do from working. it is more fun to do play work than to do real work, but the cells are tired and need rest after either kind of exercise. when you go to a party and stay up until midnight, you do not get nine hours of sleep. how do you expect the cells of your bodies to get enough rest when you treat them in this way? another thing you do at parties is to eat food that tastes good, but which is not good building material or nourishing for the cells of the body. these things eaten late at night stay in your stomach long after you have gone to bed, and the cells of your stomach do not have a chance to rest at all. children should have their parties in the afternoon. you can have just as much fun at a party in the afternoon as you can at night, and then your stomach will have time to dispose of the cake and candies you have eaten, and will be ready to rest when you go to bed. small children should be in bed by eight o'clock at night, and even big girls and boys should be asleep by ten o'clock every night. if you do not give your bodies rest, you can never grow into strong men and women. [sidenote: the importance of regular meals] we have learned that every part of the body needs regular rest. your stomach is a part of your body. in the stomach and intestines all the food is changed so that the little cells can make use of it. do you think the cook would serve good meals if she were kept cooking all the time, both night and day? you know she would soon stop cooking for you if you did not give her time to rest. your stomach does work that is even more important to you than cooking. [sidenote: why meals should be at least four hours apart] it takes about four hours for your stomach to dispose of what you give it at a single meal. if you eat your breakfast at eight o'clock, your stomach is going to be kept busy to get rid of it by noon. of course you expect to give it more work to do at noon; that is, you expect to eat a good luncheon. it will be after four o'clock by the time your stomach has finished the task you put on it at noon, and there will be only about an hour and a half for the stomach to rest before you will be ready to give it another four hours' task, digesting your supper. this means that your stomach cannot go to sleep until ten o'clock. if you eat three meals a day, you will give your stomach just about two hours' rest between eight in the morning and ten at night. if you let it rest from ten at night until eight in the morning, it is not likely to give you any trouble. [sidenote: when and why candy eating is harmful] some people will not let their stomachs rest at all. often boys and girls give their stomachs extra work to do by eating sweetmeats in the middle of the morning while their stomachs are still busy with breakfast. then, as soon as school is out in the afternoon, they want to eat more cake and candy, and thus take away from the stomach the little rest it has a right to expect before it goes to work on supper. then suppose they go to a party and eat again about midnight. how much time will the stomach have to rest before breakfast? [sidenote: when candy eating is not harmful] now, i have not said that boys and girls must not eat candy; and what is more, i am not going to say any such thing. you may go home and tell your mother that candy is good for girls and boys and that they like it so well they ought to have it--no, not all the time. here is the part that some of you will not like. girls and boys ought to have all they want just after eating luncheon or dinner. if you have eaten a hearty meal, it is entirely safe for you to eat candy then; you will not be giving extra work to your stomach, for the candy will be taken care of along with the rest of the meal. =questions.= . why should we all take exercise? . how much rest is needed each day? . name some of the effects of overwork. . how do children overwork their bodies? . why should children have their parties in the afternoon? . why should meal hours be regular? . when and why is candy eating harmful? . when is candy eating not harmful? =remember.= . proper rest is necessary to health. . rest from play is as necessary as rest from work. . you must give the stomach rest by having regular meal hours and by eating nothing between meals. chapter xiii care of the eye and ear [sidenote: the loss of sight] sight is one of the greatest blessings we have. think how dreadful it is to be blind. if you take care of your eyes, there is no reason why you should be blind; but if you do not take care of your eyes, there is a possibility that you may lose your sight. most of the blind people in the world became blind because their eyes were not given proper care, and most of this lack of care happened when these people were babies. [illustration: figs. and . the roller towel is a common source of infection of eyes in schools; every school should have properly constructed wash-rooms, with individual towels.] [sidenote: how germs get into the eyes] many of the diseases that affect the eyes are catching. they are not carried through the air, but are transmitted by the use of a towel or handkerchief used by someone who had the disease. never use the towel or handkerchief that another has used. germs may be rubbed into the eyes. keep your hands away from your eyes. your hands may have disease germs on them, and when you rub your eyes you may put the disease germs into them. [sidenote: how eyes are overworked] many boys and girls ruin their eyes by making them do too much work. they do this by reading in a poor light, by reading where the light strikes into the eyes, or by reading in a bad position, as when in bed or lying down. when you are reading, drawing, or doing any work with the eyes, always have the best light possible, which means that the light should fall on your book or work over your left shoulder. if you are only reading, it does not make much difference which shoulder the light comes over, provided it comes from behind. if you are writing or drawing, and the light comes over your right shoulder, it makes the shadow of your hand fall just where you want to see. [illustration: figs. and . correct positions for reading and writing.] another way of working your eyes too much is by trying to see when the eyes are not focused right. sometimes people are said to be near-sighted, because they cannot see very well at a distance. this is due to the fact that the eyeball is too long, so that the lens does not cause the rays of light to focus on the retina. some people are called far-sighted. this means that they can see well at a distance, but that it is hard for them to see things close to them. far-sighted children can usually see things near by, but they do this by making the muscle that rules the lens of the eye work too hard. [sidenote: method of testing the eyes] probably your teacher has a test chart and can tell you whether your eyes are properly focused. if your eyes are not focused right, that is, if you cannot see the line of letters marked = = when you are twenty feet from this chart, there is something wrong with your eyes. in that case, you are not only injuring them by trying to study, but you are hurting the whole body by overworking a part of it. if you cannot see the letters on the test card clearly at a distance of twenty feet, ask your father to send you to a specialist who will fit you with the proper glasses or will treat your eyes so that you can see well. [sidenote: how to test the hearing] sometimes children are backward in their school work because they cannot hear well. your teacher can test your hearing by holding a watch near your ear. if you cannot hear a watch tick when it is held six feet from your ear, ask your father to take you to your doctor, that he may treat your ears. [sidenote: how to care for the ears] if your hearing is perfect, the best way to take care of the ears is to let them alone. never try to dig into the canal that leads to the middle ear. the ears must of course be washed to keep them clean, but in washing the ear you should not touch the delicate canal leading to the drum. a great specialist once said, "never put anything smaller than your elbow into your ear," to which another great specialist added, "and wrap a towel around your elbow." never try to dig the wax out of your ears; it belongs in your ears; it is there for a purpose, so let it alone. if it becomes hardened, you cannot get it out and will only injure your ears in trying to do so. an ear spoon is a dangerous thing. =questions.= . state the chief cause of loss of sight. . how can you keep germs out of your eyes? . name three ways by which you may overwork the eyes. . tell how to take care of the ears. =remember.= . overworking the eyes is as injurious as overworking the stomach. . keep your hands away from your eyes; germs on your hands may get into your eyes and cause them to become sore. . you overwork your eyes when you try to read or write in a poor light or in a bad position, as when lying down. . you overwork your eyes when you try to study with eyes that are not properly focused. . keep your fingers out of your ears. . take care of your ears by letting them alone. chapter xiv care of the skin if you break or cut the skin on your body, you make an opening through which germs can get in. you cannot always help breaking your skin, but you can always wash the break with soap and water, and put a clean cloth over it to keep out germs. [sidenote: the work of the sweat glands] the work of the little sweat glands is very important to your health. these glands are just as important as the kidneys, and if they did not do their work, you would die very quickly. if your body is covered with dirt, the work of these glands is seriously interfered with; and when the sweat glands are not doing their full amount of work, the kidneys must do more than their share. it is never right to make one part of your body do the work intended for another part. [illustration: fig. . a model bathroom.] when the body is dirty, not only are the sweat glands interfered with, but the little sebaceous (oil) glands become plugged up, and blackheads appear on the face and body. [sidenote: importance of bathing] in order that the various glands of the skin may be kept in good health, it is necessary for us to keep clean. to do this we wash our faces and hands and bathe our bodies. someone may ask, "how often ought a person to take a bath?" the question cannot be answered, except to say, "just as often as may be necessary for you to keep absolutely clean." some people do not have to bathe as often as others, but no one can keep clean unless he takes a bath at least twice a week. [sidenote: hot or cold baths] another question that is frequently asked is, "is it better to take a bath in cold or hot water?" this is another question that cannot be answered in the same way for every person. a cold bath is more stimulating than a warm bath. if, after you have taken a cold bath and rubbed yourself briskly with a rough towel, the skin becomes red and warm, a cold bath is best for you. but if, after you have taken a cold bath and rubbed yourself for not more than ten minutes, the skin appears bluish and cold, a cold bath is not good for you, and you should not take it. a cold bath should always be taken in the morning, just after getting out of bed, and a warm bath should always be taken in the evening, just before going to bed. [illustration: fig. . a nail properly cared for, and a nail not properly cared for. which should you prefer to have?] [sidenote: how to care for the nails] the finger nails and toe nails are a part of the skin and they also need to be taken care of. you will see at the root of your finger nails a thin layer of skin that is inclined to grow out with the nail. if this skin is not kept pushed back it becomes rough, breaks into little shreds, and forms "hang nails." this little band of skin should always be kept carefully pushed back. the finger nails should be kept evenly and neatly trimmed, but they should not be cut so close to the skin that the ends of the fingers project beyond the nails. the nails are for the protection of the ends of the fingers and toes. nails that are trimmed unevenly and nails that are bitten off are ugly and indicate untidy habits. the shape of the nails should follow the outline of the ends of the finger. neither is it a sensible fashion to trim the nails to points or to let them grow very long. the toe nails need attention just as much as do the finger nails. they should be trimmed to follow the shape of the toe. failure to trim the toe nails properly will result in ingrowing nails. dirt is very likely to collect under the nails. this should always be carefully cleaned out. you cannot wash this dirt out unless you use a stiff nail brush. if you clean your nails just after you wash your hands, you will find that it will be much easier to get the dirt out while the dirt and the nail are both softened by the soap and water. in cleaning your nails, use a dull nail cleaner or a smooth wooden stick. do not scrape the inside of the nail with a sharp knife. this scraping of the inside of the nails will cause them to catch the dirt more easily, as well as to grow thicker and thicker until they become very ugly. neat, clean finger nails help to make pretty hands; dirty, untidy nails spoil the prettiest hands. =questions.= . what are the uses of the sweat glands? . how often should people take baths? . how can you tell whether a hot or a cold bath is better for you? . tell how finger nails should be cared for. . how should toe nails be treated? =remember.= . if you do not keep your body clean, the glands of the skin cannot do their work properly. . every person should take a bath at least twice a week; some persons need a bath every day in order to keep clean. . if you take a bath in cold water, and the skin does not become warm and pink when you rub it with a rough towel, a cold bath is not good for you. . cold baths should be taken in the morning on getting up. . warm baths should be taken in the evening before going to bed. . finger nails should always be kept clean and neat; dirty, untidy nails make ugly hands. chapter xv common poisons to be avoided many people are killing the cells of their bodies by taking certain poisons into them. there are many kinds of poisons that can be taken into the body, but we are going to learn now about only two. these are tobacco and alcohol. [illustration: fig. . effect of cigarette smoking.] [sidenote: proof that tobacco is a poison] tobacco is a poison. those of you who have tried to smoke know this, because it made you sick the first time you tried it. there are many other indications that tobacco is a poison. we know that it affects the red blood cells in such a way that they do not carry the oxygen as well as do those of people who do not smoke. we know that it has a very bad effect on the heart and that it interferes with the action of the nervous system. [sidenote: the extra work caused by tobacco] when certain poisons get into the body, the blood makes something that will counteract the effects of those poisons. after one has used tobacco for some time, the cells of the body will take care of the tobacco poison by making an antidote for it. more than this, they begin to want it all the time. the tobacco user forces the cells of his body to make an antidote for this poison every time he uses tobacco. thus he makes the cells do work that is unnecessary, and keeps them from doing work that is necessary. [sidenote: other bad effects of tobacco: (_ _) on the nose and throat] tobacco smoke irritates the cells that line the throat and nose and causes inflammation. this is why so many smokers have catarrh. smoking is not the only cause of catarrh, for people who do not smoke often have this trouble, but it is one of the most frequent causes. smoking also irritates the throat so badly that many of those who smoke have "smoker's throat." this is a bad form of sore throat that can be cured only by stopping the use of tobacco. [illustration: fig. . the athlete knows that alcohol and tobacco are foes to speed, strength, and nervous control. (_from photograph of "the sprinter," modelled by dr. r. tait mckenzie._)] [sidenote: (_ _) on the blood] people who smoke a great deal have fewer red corpuscles (the little red cells of the blood) than those who do not smoke. especially is this true of cigarette smokers. it is the lack of red blood cells that causes the cigarette smoker to look pale and sallow. it is probably not the direct effect of tobacco that causes the loss of red blood cells, but something that is connected with the act of smoking. when you take smoke into your mouth, you take in at the same time a gas known as _carbon monoxid_. this gas is very poisonous to the body, and combines with the red blood cells in such a way that they cannot take up the oxygen in the lungs and carry it to the rest of the cells in the body. the cigarette smoker almost always inhales the smoke, and thus he absorbs a great deal more of the carbon monoxid than the man who does not inhale the smoke. of course, the more of this gas he takes into his body, the more red blood cells will be affected and the less oxygen will be taken to the other cells. [sidenote: (_ _) on the nervous system] we do not know just how tobacco affects the cells of the nervous system. it may be that they are affected mostly by being deprived of oxygen, or it may be that the tobacco affects them directly. however the harm is done, we know that the cells of the nervous system are affected by tobacco. one of the nerves that is most commonly affected by the use of tobacco is the nerve of the eye, the nerve that enables us to see. we know that when people use tobacco a great deal they sometimes lose their sight. this does not happen to everyone who uses tobacco, but you can never tell whom it will affect in this way. the only safe thing to do is not to use tobacco, and then you will know that you will not lose your sight from this cause. [sidenote: (_ _) on the stomach] the use of tobacco affects the stomach. people who use tobacco a great deal are likely to have indigestion. the tobacco causes this probably by depriving the stomach cells of oxygen through its effect on the blood cells. [sidenote: (_ _) on the heart] tobacco has a very bad effect on the heart. people who use much tobacco have what they call "palpitation of the heart," but doctors call it "tobacco heart," because it is caused by the use of tobacco. no insurance company will insure a person who has "tobacco heart." most boys grow up to be men before they manage to use enough tobacco to cause tobacco heart. however, long before they are grown, they show that the tobacco has affected their hearts, because they are short of breath and stand about as much chance of winning a race as does a mouth-breather. [sidenote: effects of alcohol:] the effect of alcohol is a subject on which i want to speak very plainly and frankly, because i do not want the boys and girls who read this to get the same idea that i got when i was in school, or to be affected by it as i was. when i was a little boy i was taught that if a person drank alcohol in any form the lining of his stomach would be eaten up. in proof of this statement i was shown a picture of an ulcerated stomach that was said to have resulted from drinking whisky. naturally i expected to find that people who drank whisky would not be able to eat anything at all, or would be troubled a great deal with pain in their stomachs. to my surprise, i found that many people had ulcers of the stomach who never took an alcoholic drink, while many of those who drank a great deal seemed to have the best of appetites and were never troubled with their stomachs. as a result, i came to the conclusion that all this talk about the evil effects of alcohol was foolishness. later i studied medicine, and learned that the effect of alcohol on the stomach is, in reality, the least of its evils. but i want to impress upon you that, as a result of forty years' study, i consider alcohol the most dangerous thing in the world to-day. by "alcohol" we mean any drink that contains alcohol, such as whisky, wine, brandy, beer, etc. [sidenote: (_ _) on the stomach] when alcohol is taken into the stomach, it first causes a congestion; that is, it causes an increase in the quantity of blood in the blood vessels of the stomach. it might seem that this would aid digestion in the stomach, but it does not, because alcohol affects the food in the stomach in such a way that it prevents the gastric juice from acting on the food. if the use of alcohol is persisted in, it causes the little cells in the stomach that make the gastric juice to become filled with fat, and then those cells cannot make the gastric juice. thus, continued use of alcohol causes a smaller supply of gastric juice, and the food passes from the stomach into the intestines without having been acted upon by the gastric juice, as it should have been. the result is that the food decomposes in the intestines and a poison is formed. this poison is taken up by the vessels that carry the food from the intestines and kills a great many of the cells of the body. alcohol does not burn holes in the stomach, but it destroys the usefulness of the stomach by its action on the cells that secrete the gastric juice. [sidenote: (_ _) on the liver] when alcohol is taken into the stomach, very little of it reaches the intestines. it is rapidly absorbed by the lining of the stomach and passes into the blood. the blood from the stomach goes directly to the liver. the alcohol makes the cells of the liver hard and causes them to become filled with fat, as it does the cells of the stomach. in this way it destroys the action of these cells and prevents their doing the work for which they are intended. from the liver the alcohol goes with the blood to all parts of the body, and it has its influence on all the cells in the body. this influence is always harmful. [sidenote: (_ _) on the body's powers of resistance] we know that when a man who is in the habit of drinking gets pneumonia, he is far more likely to die than is one who is not in the habit of using alcoholic drinks. the man who drinks cannot resist the effects of disease as can one who does not drink. this shows that the use of alcohol reduces our resisting powers, and puts our cells in such condition that we cannot overcome the effects of disease. people who are sick with a slow disease like consumption are often advised by their friends to take whisky to brace them up. it is true that the immediate effect of the whisky is to make the patient feel a little better, but the final effect is to leave him in a much weaker condition than before. more than this, the cells are much less able to resist the disease germs than they were before the alcohol was taken. when people are exposed to such diseases as scarlet fever and smallpox, they may think that if they take a drink of whisky they will not be so liable to contract the disease. it is just the other way. the alcohol reduces the resisting powers of the cells of the body, and anything that does this renders a person more liable to contract any disease to which he is exposed. [sidenote: (_ _) on the nervous system] the effect of alcohol on the cells of the nervous system is very marked. continued use will injure the nervous system and result in a kind of insanity called delirium tremens. it will also cause other forms of insanity. the effect of alcohol on the parent is passed on to the children of the next generation, and even beyond this. a large percentage of idiotic children are the offspring of alcoholic parents. [sidenote: (_ _) on the morals] the use of alcohol numbs the sense of right and wrong. more young men have become criminals from the use of alcohol than from any other one cause. anyone who reads the daily papers can see that many criminals give the use of alcohol as an excuse for having committed a crime. [sidenote: (_ _) on brain work] some people will tell you that alcohol stimulates the brain, so that one can work faster and better. this is not true. tests have been made in this matter, and it has been found that men doing mental work will work about one tenth slower and make one fourth more mistakes when given one drink of whisky a day, than they will when not given any whisky. if _one_ drink of whisky a day thus reduces a man's power and accuracy in doing mental work, what do you think three drinks, or ten drinks will do? [illustration: fig. . the mind not clouded by alcohol works quickly and makes few mistakes.] [illustration: fig. . the mind clouded by alcohol works slowly and makes many mistakes.] [sidenote: what business men think of men who drink] many business men drink, and they know the results of alcohol not only from the effects they have observed in others, but also from the effect they know it to have on themselves. when a man applies to them for a position, these business men almost invariably ask him if he drinks. the man who does not drink stands nine chances in ten of securing the position, while the man who drinks stands only one chance in ten. this shows what business men think of the effect of alcohol, even when taken in moderate quantities. they know that it reduces a man's power to do mental as well as physical work, that it causes him to make mistakes, and that it may finally destroy his morals and result in his becoming a thief or a criminal. =questions.= . how do we know that tobacco is a poison? . how does tobacco make extra work for the body? . what effect does tobacco have on the nose and throat? . what is the effect of tobacco on the blood? . on the nervous system? . on the heart? . mention some of the false ideas about the effect of alcohol. . how does alcohol affect the stomach? . the liver? . in what ways does alcohol reduce the resisting powers of the body? . how does alcohol affect the nervous system? . how does it influence mental work? . what do business men think of drinkers? . what influence has alcohol on the next generation? =remember.= . tobacco is a poison that has a very bad effect on the nervous system, the blood, the heart, the stomach, the nose, and the throat. . alcohol is a poison and not a food. . alcohol injures the stomach, the liver, and the nervous system. . alcohol reduces the power to do accurate mental work. . alcohol numbs the sense of right and wrong, and encourages crime. part ii the enemies of health chapter xvi disease germs we have learned that the body is made up of cells, and that each cell is alive. the cells in our bodies cannot live separately. there are, however, certain animals and plants that are each made up of a single cell. these animals and plants are called germs, and some of them cause disease. [sidenote: different germs cause different diseases] these germs are so exceedingly small that we can see them only with the aid of a microscope. they differ in appearance one from another, as a pine tree differs from an ash, or an american child from a chinese child. when you plant your garden, you put sweet peas in one place and asters in another, and you know that you will have sweet peas growing where you planted the pea seeds, and asters growing where the aster seeds were put. so it is with these little germs; you will no more get tuberculosis from typhoid fever germs than you would get asters from pea seeds. now, while there are many, many kinds of germs in the world, there are only certain ones that cause certain diseases, and we have learned where these germs like to live and how to kill them. we also know that they come only from some person or animal sick with the particular disease which they cause. typhoid fever germs are not given off by a person suffering with tuberculosis, nor are diphtheria germs given off by a typhoid fever patient, but the germ of each disease is given off by some person or animal suffering from that particular disease. [sidenote: how sickness due to germs can be prevented] if we kill all the germs that come from people sick with a certain disease, no one else can catch that disease. knowing this, it seems unnecessary for anyone ever to be sick with disease that is caused by a germ. this is literally true, and the only reason that we have germ diseases is because we do not kill the germs that come from the sick people. professor irving fisher of yale university has said, "it is entirely possible to wipe out consumption within a single generation." it may not actually be done so quickly, but it is certain that the disease can finally be wiped out, though it may require many generations to accomplish it. why, then, are germ diseases allowed to exist? simply because so many people do not know the facts; and because many who do know will not take the trouble to kill the germs, even when they realize that some one else may get the disease as a result of their carelessness. what do you think of a woman who said, "i do not care if my neighbor's children do get scarlet fever from us; she is not a friend of mine, any way"? a woman has been heard to make such a statement to a health officer. it is just such people as this who spread disease. =questions.= . how may germs be compared to seeds? . what do we know about disease germs that will help us to get rid of them? . how is it possible for us to get rid of consumption and other germ diseases? =remember.= . while there are many kinds of germs in the world, only a few cause disease. . the germ that causes a certain disease will cause that disease and no other. . it is entirely possible to kill all the germs that cause disease. chapter xvii encouragement of disease by uncleanly habits we shall not try to learn here all the ways by which it is possible to destroy the germs of disease as they come from sick people. but there are certain rules (we sometimes call them fundamental principles) that you must know, if you hope to keep well and to prevent others from getting sick. [illustration: fig. . how diseases are frequently transmitted to children.] [sidenote: why we should stay away from the sickroom] the first of these rules is: _do not go into the room where any one is sick unless it is absolutely necessary_. no one but the nurse should sleep in the room with a sick person. we know that certain diseases are communicable (catching), but it has not yet been determined whether some others are communicable or not. it has not been proved, for instance, that we cannot catch rheumatism from another person. only a few years ago it was believed that one could not take consumption from another person, but now we know that this is the very way to get it. therefore, stay away from sick people as much as possible. it is not good for the patient to have people around him, and it is dangerous for the well to come in contact with the sick. [sidenote: not using things used by the sick] the second rule is: _do not use anything used by a sick person until it has been washed_. this is a good rule to apply to things used by a well person also. it is neither safe nor pleasant to eat from the spoon or fork, or to use the napkin or towel which has been used by someone else. sometimes children think the food prepared for a sick person is ever so much nicer than that set before themselves, and wish they could have a little of it. how often have we seen a sick mother give her little ones "a taste" from the spoon with which she is eating. this is very dangerous, and if she knew it, the mother would cut her hand off before exposing her children to this danger. [sidenote: reason for scalding things used by the sick] third: _everything taken from a sickroom should be boiled before it is used again_. the knives, forks, and plates should not be put with other dishes until after they have been separately washed and boiled. towels, napkins, bedding, and clothing from a sickroom should not be washed with other bedding and clothing, but should be washed and boiled separately. some people send out the clothes from the sickroom with the rest of their washing, and in this way give disease to others. [sidenote: how excreta from the sick should be treated] fourth: _all discharges (sputum, urine, bowel discharges, and matter from sores) from any sick person should be thoroughly disinfected before being finally disposed of_. the sputum should be received on little rags or paper napkins, and burned; and the other discharges should be disinfected with some poison that will kill the germs. we shall say more about disinfection when we come to study the prevention of special diseases. [sidenote: necessity of washing the hands after touching the sick] fifth: _every person who touches a sick person, or handles anything that comes from a sickroom, should immediately wash his hands_. unless he washes his hands at once, the germs which may be on them may get into his mouth. [sidenote: how dirt causes disease] sixth: _dirt, which is an indirect cause of disease, must not be allowed to accumulate_. if your yard were full of dirt, garbage, and manure, it would not cause disease unless the germs of some disease became planted there. but such a place is an indirect cause of disease, in that it furnishes a fine place for germs to grow in. if a fly with typhoid germs on its feet were to alight in such a yard, the germs would be planted in a most favorable spot and would grow very fast. [illustration: fig. . a place that is an indirect cause of disease, since it furnishes a fine place for germs to grow in.] none of the disease germs like sunshine; neither do they like dry places. they die very quickly in the sunlight, and grow very slowly, if at all, in dry places; but in damp, dark places they grow very fast. dirty back yards make ideal gardens for germs. let a fly with germs on its feet alight in a clean yard where sunshine can reach every corner, and what chance will the germs have to grow? they will not even get a start. hence, while disease cannot be caused by dirt, disease germs stand a very good chance of living where there is plenty of dirt and no sunshine. filthy habits are on an equality with filthy conditions, and go hand in hand with them. one of the worst of habits, and a cause of much sickness, is that of answering nature's calls in places other than the closet. =questions.= . why should you never make unnecessary visits to a sick person? . why should you avoid anything used by a sick person? . why should everything taken from a sickroom be scalded? . what should be done with all discharges from a sick person? . how is dirt a source of disease? =remember.= . unless it is necessary, do not go into a room where anyone is sick. . never sleep in a room with a sick person. . never eat from a spoon or plate that has been used by another. . boil all the articles taken from the room of a sick person. . always wash your hands after touching a sick person or anything that comes from his room. . sunshine kills germs; let the sunshine into every corner of your house. chapter xviii flies as carriers of disease [sidenote: how germs get into our bodies] disease germs get into our bodies in three principal ways: they are eaten with our food; they are taken in with the air we breathe; and they get in through breaks in our skin, even though these breaks be very small, as when made by the bite of a mosquito or other insect. [sidenote: how germs get into our food:] [sidenote: (_ _) from the air] how do germs get into our food or drink? you must remember that these germs are extremely small, so small that many of them can be carried by a particle of dust that you can see only in a ray of sunshine. when the germs become dried, they float about on these particles of dust, the dust alights on our food, which is moist and warm, and the germs immediately begin to grow. [sidenote: (_ _) from the hands] another way by which germs get on food is from the hands through which it passes. did you ever think how many people handle an apple? first, the man who picks it from the tree; then the examiner in the packing house where apples are taken to see that they are the right kind to be packed in a certain box. then it is wiped off by a boy or girl--handling number three; then it is wrapped in paper--number four. next it is packed in a box, but in this case the paper protects the apple from dirty hands. when the merchant buys the apples he feels several of them, and puts them out on the display shelf; this makes handling number five. everyone who thinks of buying apples will touch one or more of them, and when they are sold the clerk handles them again. in other words, every apple goes through the hands of at least seven people before you get it. do you not think it needs washing? go into a butcher shop and see how many people will put their dirty fingers on the meat. some of them even keep their gloves on when they do this. imagine how many germs may be planted on the finger of a glove. our whole method of displaying foods for sale is wrong. the customer can see the fruits, vegetables, and meats just as well in a glass case as when they are on an open counter or shelf, and nothing is gained by poking a dirty finger into a piece of beef, or by rubbing your hands over the apples. a glass case not only will protect the fruits and meats from such practices, but will keep out germ-laden dust and flies whose feet are covered with germs. [illustration: fig. . the foot of a fly, highly magnified.] [sidenote: (_ _) from flies] _probably the most common source of germs on food is the fly._ did you ever watch a fly very closely for a long time? did you ever happen to see a manure pile early in the morning and notice how many tiny flies are on it? these flies have just been hatched. [sidenote: breeding places of flies] flies like manure because it is the best place they can find in which to lay their eggs. each female fly lays about three hundred eggs. they do not hatch directly into flies, as hen's eggs hatch into chickens, but when the fly's eggs hatch you find maggots, and these maggots later hatch into flies. [sidenote: the journey of the fly] turn over the manure some spring morning, and you will see it full of white specks. these specks are maggots that will hatch into flies. watch the flies as they leave the manure pile and see where they go. if there is a dead dog or cat or a filthy garbage can near, they will fly to it. then they will go into the water-closet and crawl over the filth there. their next trip will probably bring them to the kitchen, where they will crawl over the food. from here they will go to the cuspidor and take a drink of water, and will get their feet covered with the dirt that is in the cuspidor. next they will try a walk over the nipple of the baby's bottle, or they will light on your face, or get into the butter or milk. after the fly has been in dirty places, he "washes" his face and hands, that is, he rubs his feet together and then rubs them over his head. did you ever see a fly wash himself with water? no, you never did. [illustration: fig. . where a fly has walked; each little spot represents a growth of germs left by the fly.] after a fly has made his journey, you would suppose that his feet would be covered with dirt and germs, and so they are. not only does he carry germs on his feet and body but he also eats dirty and diseased things. moreover, fly specks contain the germs of disease, and the fly is not at all particular about where he puts his specks. [sidenote: proof that the fly is a germ carrier] if you let a fly walk over a culture plate, there will be a growth of germs wherever his feet touch. a culture plate is simply a glass plate covered with gelatine or something else in which these germs like to grow, and where they can easily be seen. each germ will multiply so fast that there will soon be a spot of them large enough to be seen readily with the naked eye. in the picture showing a culture plate over which a fly has walked (fig. ), the little specks are not single germs, but each speck represents a growth containing many thousands of germs. [illustration: fig. . flies go from filth to food.] [sidenote: how to get rid of the fly:] how are we going to get rid of flies? we cannot get rid of them entirely, but there are a great many ways by which we can prevent there being so many of them, and whereby we may keep them out of our houses and away from our food. [sidenote: (_ _) by removal of manure] we have learned that flies are always found about horse manure, because it makes a good place in which to hatch their eggs. if we could dispose of the manure, there would be one place less for the fly to lay her eggs. behind barns we usually find piles of manure. it is in these heaps that the fly lays her eggs, not in the little lumps found in the streets. now, there is no sense in keeping this great pile of manure about any barn. in towns the manure can be put into a box with a cover, so that the flies cannot get at it. in the country every well-managed farm has the barns cleaned out every day, and it would not be much more trouble for the farmer to throw the manure into a wagon and take it to the fields with him, than it is to pile it up beside his barn. if he did this, he would find that there would be few flies about his house. [sidenote: (_ _) by covering garbage cans] even if we were to take every particle of manure away as fast as possible, we should still have some flies, for when flies do not find manure for their hatching places, they will take the next best thing. it must be something dirty; clean things will not answer at all for a fly's home. next to the manure pile, the fly likes a dirty garbage can, a dead animal, or anything that is decomposing. if she cannot find anything better, she will take a rotting apple; but she does not really like this, and if she cannot find anything better than an old apple in your yard, she will probably go elsewhere to lay her eggs. [sidenote: (_ _) by keeping clean yards] we cannot entirely stop the hatching of flies, but if we do away with the old manure piles, keep fresh manure and garbage cans covered, and keep our yards free from everything that can decompose, we shall have very few flies about our houses. [sidenote: how to keep flies out of the house] since we cannot get rid of all the flies, the next best thing is to keep the few that may be left out of our houses and away from our food. this we can do by means of wire screens and netting. wire screens are very cheap, and if there are no wire screens on your house, you should persuade your father to buy some. but a screen will not keep flies out unless it is kept closed, so do your part by never leaving the screen door open for a second longer than is necessary for you to go in or out. our houses are not the only places that need screens. slaughterhouses, butcher shops, candy stores, grocery stores--every place where any kind of food is handled or sold--should be screened. flies should never be allowed to alight on anything which is to be eaten. =questions.= . name three ways by which germs get into our bodies. . how do germs get into our food? . why should foods be screened? . trace the fly from his birth-place to our food. . how do we know that flies have germs on their feet? . tell how we can get rid of most of the flies. . how can we keep flies out of the house? . what can boys and girls do to help keep them out? =remember.= . always wash an apple, pear, or any other fruit before you eat it. . all foods are handled by many people, and are not clean until they have been washed. . flies like to live in dirty places, and their feet and legs are covered with germs; get rid of the flies. . flies hatch in manure piles and other dirty places; keep your yard and lot clean so that flies will have no place to lay their eggs. . put screens on the house to keep flies out, and keep the screens closed. chapter xix how disease germs get into water the water that we drink frequently contains disease germs. it is not always the clearest water that is freest from disease germs, for the germs do not make the water cloudy. [illustration: fig. . an improperly located well; notice lines of seepage.] [sidenote: why sewage should not be put into streams] water does not get disease germs from the ground, but from man. almost every town has a sewer system that empties into some stream. this practice was started a long time ago when men thought that running water would purify itself in the course of a few miles. we have learned, however, that this is not true. germs will continue to live in running water just as they do in any other water, and disease germs will live in a stream from twenty-five to thirty-five days. estimate how far a stream will flow in that length of time, and you will know how far disease germs will travel in that way. no sewage should ever be allowed to get into a stream until the germs in the sewage have been killed. [sidenote: other sources of germs in streams] sewage is not the only means by which disease germs are carried into streams. often we find people building barns, slaughterhouses, and mills on the banks of a stream. the filth from barns and slaughterhouses always contains disease germs, and often the filth of mills contains poisons that are just as harmful as germs when taken into our bodies. none of these things should ever be allowed to get into a stream. water is a very important article of food, and we should take every care to keep it pure. [illustration: fig. . a properly located well.] [sidenote: how germs get into wells] the water from most wells is clear and cool, but nevertheless may contain many disease germs. "how does this happen?" you ask. because the well is too close to an out-house or some other source of filth. when a man in the country or in a small town builds a house, he immediately thinks of digging a well just as close to the house as he can, so that he need not carry the water far. next he thinks of locating the closet, and this, too, he wants near the house. the well and the closet are often near each other, and often the closet is on higher ground than the well. the vault under the closet is seldom water-tight. in fact, the intention of the owner is that a great part of the vault contents shall soak away. in many localities the ground is an open gravel, and the vault contents run through this gravel into the well, carrying disease germs with them. in one little town, with wells as a source of drinking water, the health officers found that the closet of every house was draining directly into its well. in some countries vaults can be used; but in any region where there is a gravel subsoil, the contents of the closet will find their way into the well, unless the closet is lower than the bottom of the well. in such places the vault must be made water-tight, in order to keep the vault contents out of the well.[ ] [sidenote: why springs are not always pure] springs are usually sources of pure water, but do not think that every particle of water that oozes from the ground is a spring. near a certain town is a so-called "very fine spring." this "spring" appeared after a man had made a cesspool on the hill above, and is simply the drainage from the cesspool. springs that come from deep sources, however, nearly always contain pure water. [sidenote: the safest sources of water] the safest source of water for domestic use is a stream that is known to be free from contamination, or a well so deep in the ground that it is hard for any polluting matter to reach it. but remember that sewage may follow a well pipe along the outside and thus reach even a deep well, if the well is not properly protected at the top. keep disease germs out of your drinking water. you cannot drown them out and you cannot strain them out, so do not let them get in, for you cannot drink water containing disease germs without running the risk of becoming sick. =questions.= . mention more than one way in which germs get into streams. . how long may disease germs live in running water? . mention some instances showing that running water does not purify itself. . how do disease germs get into milk? . describe the proper location of a well in regard to refuse. . how may springs become polluted? . what are the best sources of water for domestic use? =remember.= . disease germs get into water from dirty places along the banks of the streams; they do not come from the ground. . clear water is not always pure; germs do not make the water cloudy or muddy. . wells often become infected by matter from closets seeping into them; make your closet water-tight. . spring water is usually pure, but not all water that oozes out of the ground is spring water. chapter xx transmission of disease through the air [sidenote: disease germs in the air] we take germs into our bodies with the air that we breathe. since we cannot stop breathing and live, we must see to it that the air we breathe is kept pure. [illustration: fig. . (a) prevalence of germs in air of thickly populated districts. (b) prevalence of germs in air of sparsely populated districts.] there are always more germs in the air of places in which people live closely crowded together than where there are only a few people. this is proved by figure , which shows that many more germs were found on a culture plate exposed in the downtown part of new york city than on another plate exposed far uptown, where there are not so many people. remember, however, that all germs are not disease germs. [sidenote: how we may keep disease germs out of the air:] how do the disease germs get into the air? when one sneezes, a spray of droplets is thrown into the air. if the person sneezing has the grip, these droplets contain the germs that cause grip. whenever a person with consumption coughs, he sprays droplets which contain the germs that cause consumption. [sidenote: (_ _) when coughing or sneezing] if a person would hold a handkerchief before his mouth when he coughs or sneezes, these droplets of moisture would not be sprayed into the air, and the disease germs in them would not be scattered about. you ask, "shall everyone who is sick hold a handkerchief before the mouth when sneezing or coughing?" everyone, whether sick or well, ought to hold a handkerchief before the mouth when sneezing or coughing. learn to do this at once, and never forget it. [sidenote: (_ _) when spitting] another way by which disease germs get into the air is from the sputum. people spit on the floor or the sidewalk, and the sputum becomes dried; it is then blown about as dust. the germs of disease are not killed by drying, and when they get into our bodies with the dust which we breathe in, they immediately begin to grow. disease germs get into the air chiefly through careless habits of coughing, sneezing, and spitting, and these careless habits can easily be prevented. [sidenote: why well people should not spit on floor or sidewalk] a boy once said that if he saw a consumptive spit on the sidewalk, he would want to hit him, and to emphasize his remarks he spat on the floor of the room, just as you have seen boys spit on the ground when they were thinking of fighting. there might have been some germs of consumption in the sputum this boy left on the floor. of course he was very positive that he did not have consumption, but this was no proof that his sputum was free from the germs of this disease. remember that it is not only the sick who should never spit on the floor or sidewalk, but that no person should ever spit on any floor or sidewalk, or into any place except into a cuspidor, handkerchief, or spit-cup of some kind. if you spit into a handkerchief, a paper napkin, or a bit of cloth, be sure to burn it as soon as you can, before it becomes dry. =questions.= . in what places do we find germs most abundant in the air? . how do well-bred people avoid putting disease germs into the air? . why is it important for well people to take the same precautions as sick people? =remember.= . every person should hold a handkerchief before the face when coughing or sneezing. . never spit except into a cuspidor, handkerchief, spit-cup, or other special receptacle. . if well people will practice clean habits, the sick will be helped and encouraged to follow their example. . remember: no spit, no consumption. chapter xxi insects as carriers of disease [sidenote: some insects that carry disease] certain diseases are given to human beings by the bites of insects. we know that certain ticks and mosquitoes carry certain germs. it is also probable that disease germs are transferred from diseased to well persons by bedbugs and other insects that bite. [sidenote: how yellow fever is transmitted] for a long time it was thought that yellow fever was carried through the air, but now it has been proved that yellow fever is not carried in this way. a well person can sleep with one who has yellow fever and not catch the disease. yellow fever infection is carried from a yellow fever patient to a healthy person only by a certain mosquito. keep this mosquito away from the yellow fever patients and there can be no spread of the disease. [illustration: fig. . the mosquito that carries yellow fever.] it is not many years since yellow fever was one of the most dreaded diseases in warm countries. to-day there is not the same fear of it, for the source of the disease has been discovered and practical methods have been devised to get rid of the mosquito which carries it. [sidenote: how malaria is transmitted] malarial fever is another disease transmitted by the bite of a mosquito, but the mosquito that carries malarial fever is not the same as the one that carries yellow fever. for a long time it was supposed that malaria came from the gases which rise from marshes. to-day it is known that it is not the gases that cause the sickness, but a mosquito which lives and grows in the marshes. many countries that have heretofore been practically worthless on account of malarial fever, are being made valuable by draining the marshes and doing away with places where mosquitoes can hatch. [illustration: fig. . one of the places where mosquitoes hatch.] [sidenote: how to get rid of the mosquito] it might seem a very hard task to get rid of mosquitoes in countries where there are so many of them; but it can be done. the mosquito must have still water in which to lay her eggs. in countries where there is danger of yellow fever or malaria, the rain barrel and the cistern should be screened, and the swamps and water holes filled up. puddles of water should not be allowed to form anywhere, and low places where water might stand should be drained. by giving her no place in which to lay her eggs, we can get rid of the mosquito; and when the mosquito disappears, yellow fever and malaria disappear also. [sidenote: how wood-ticks transmit disease] in certain portions of montana, washington, idaho, utah, and wyoming, there is a peculiar disease known as rocky mountain spotted (tick) fever. it is now known that this disease is transmitted to people by the bite of a wood-tick. not all wood-ticks carry this fever, and for people living in districts where this disease does not exist there is no danger in the bite of a wood-tick; but in a part of the country where the disease prevails, the wood-tick should be avoided. [sidenote: how disease-bearing insects can be destroyed] all insects that are known to transmit diseases can be destroyed. if we will do away with stagnant water, the mosquito cannot hatch; if we will cut out underbrush and oil the domestic animals, the wood-tick will not find a place to grow. if we wish to get rid of disease, we must spend money and labor; but it is worth while, for human life is at stake. =questions.= . what insects are known to transmit diseases to man? . how is yellow fever transmitted? . malarial fever? . what disease is transmitted by the wood-tick? . how can we get rid of the mosquito? . how can we get rid of ticks? =remember.= . it is a proved fact that diseases are transmitted to man by the bites of mosquitoes and wood-ticks. . it is possible to do away with both the mosquito and the wood-tick almost completely, although it requires a great deal of work and the expenditure of a large amount of money. . health is the most valuable thing we have, and it is foolish to hesitate in giving the work and money necessary to exterminate disease-bearing insects, as well as the many other causes of sickness. chapter xxii how to keep germs out of wounds [sidenote: how germs get through the skin] germs get into our bodies through breaks in the skin. these breaks may be made by a cut or a scratch, by the bite of an insect, or even by the pulling out of a hair. there are some special germs, such as those which cause yellow fever, which are introduced by the bite of an insect; but at present we will consider only those germs that would naturally enter through any break in the skin. [illustration: fig. . small, deep wounds are very liable to become infected.] [sidenote: effect of germs in wounds] the skin of the human body acts as an armor against certain germs that are constantly trying to get through it. there are several germs of this class. some of them cause white pus, or matter, but this is the least dangerous kind of all. another kind causes boils or even blood poisoning, and another kind causes erysipelas. we cannot get rid of these germs, for they are everywhere, to a greater or less degree; but they are more abundant in dirty than in clean places. they cause every degree of inflammation, from a slight redness of the skin to the blood poisoning that brings death. [sidenote: real cause of suppuration] sometimes you will hear people say that a wound suppurated (that is, became inflamed and full of matter) because the blood was in bad condition. as a matter of fact, there would have been no suppuration if germs had not got into the wound. it was not the condition of the blood that caused the suppuration, but the germs. sometimes, when only a few germs get into a wound, and when the cells of the body are all in good condition and doing their work properly, the suppuration will be very slight, because the healthy cells of the body will kill the germs. but if very many germs get in, even healthy body cells cannot kill them all. we have said that the germs which cause suppuration are everywhere, so it would seem almost impossible to keep them out of a wound. this is true in a sense; but even after they have got into a wound, you can wash them out if you use plenty of soap and water to cleanse the wound thoroughly. when i said that it is impossible to keep them out of a wound, i meant an accidental wound, for it is quite possible to keep them out of a wound that is made intentionally, as is done by the surgeon. [sidenote: how the surgeon prevents suppuration] do you know how a surgeon gets ready to do an operation? the first thing he does is to see that the room is perfectly clean. he has the carpet taken up, the curtains taken down, and the floor and walls washed. this is to get rid of all the dirt and germs in the room. if you should look at the surgeon's instruments, so clean and bright, you would think it impossible for a germ to find a place to live on; but the surgeon knows how closely the germs cling, and therefore he boils all the instruments he is going to use. then he puts the towels into a place where they are made so hot by steam that all the germs on them are killed. after everything in the room is perfectly clean, the surgeon cleans his patient with a very stiff brush, using plenty of soap and water which has been boiled to kill all the germs in it. he scrubs the part where the wound is to be made and the skin around it until it is red. even then he is not satisfied, for he washes it off with alcohol and ether, to be sure that any germs that might be sticking in the fat are removed. he scrubs his hands in the same way. after all this is done, he can perform the operation without fear that any of the germs which cause suppuration will get in, for he knows that he has killed all of them that would touch the wound. [illustration: figs. and . always wash the simplest cut with soap and water; failure to do this may result in infection and much suffering.] [sidenote: how to prevent suppuration] boys and girls cannot do all this before they cut their hands or skin their shins, but they can do the next best thing--they can keep their hands and the rest of their bodies clean at all times, and thus have as few germs on them as possible. then, when they have cut themselves, they can go straight to some place where there is soap and water, and can wash the wound thoroughly. after this is done, a clean bandage should be placed on the cut part to prevent any other germs from getting in. if this is done every time you cut yourself, you will probably never have an infection--that is, a wound that suppurates. two boys were playing together one day. they ran into each other and each got a little cut on his hand. one boy went home at once, washed the wound, and put on a clean bandage. he lost a little time from his play, but was soon back and never had any trouble on account of the cut. the other boy thought it was foolish to quit his play to take care of such a little thing, so he tied his hand up in a dirty handkerchief. two weeks later he was very ill. his arm was badly swollen and had to be cut open in several places; indeed, he came near losing his arm. it always pays to take care of a wound, be it never so slight. deep wounds made with small instruments, such as small knives, nails or toy pistols, are especially dangerous, because they are hard to clean and because they quickly heal up on the surface and leave the germs to grow at the bottom of the wound. such wounds as these are dangerous for another reason. [sidenote: where germs of lockjaw grow] there is a germ that gets into wounds but does not cause suppuration. it is the germ of tetanus, or lockjaw. it lives in the ground, especially in the ground about barns, and its peculiar feature is that it will not grow in the air. if it gets into a large, open wound, it is easily killed, because it cannot grow where there is air. but when it gets into a small, deep wound where it cannot be reached, it stays there until the wound heals over on the surface, and then it begins to grow. it does not make the parts swell, as the germs of suppuration do, but quietly continues to grow, without the wound showing any sign of infection. finally it develops a very severe poison that is taken up by the blood; then the victim suddenly begins to have spasms about the face, and finally these spasms extend to the entire body and kill him. whenever you get a wound so deep that you cannot wash it thoroughly, go to a doctor and let him clean it out with some medicine that will kill the germs that cannot be reached by washing. [sidenote: how boils are caused] sometimes the germs that cause suppuration get under the skin at a point where a hair has been pulled out, or even work down beside the hair itself. when this happens, they cause suppuration under the skin, and the result is a boil. a boil is merely an infection with the germs that cause suppuration. =questions.= . how do germs get through the skin? . can we get rid of all the germs that cause suppuration? . why is it impossible for "bad blood" alone to cause suppuration? . how does the surgeon prevent suppuration? . how may you prevent suppuration? . what is the danger of cutting corns with an ordinary knife or razor? . where do germs of lockjaw grow? . what causes boils? =remember.= . germs and not "bad blood" are the cause of suppuration. . always keep as clean as possible, and immediately wash any cut, no matter how small. . if you have a deep wound, go at once to a doctor, and let him clean it out and kill the germs that may be at the bottom of the wound. chapter xxiii transmission of diphtheria [sidenote: how germs may cause sickness without entering the body] some germs that cause disease do not get into the body, but grow upon its surface, that is, they grow on the mucous membranes--the skin of the mouth, the throat, and the nose. as they grow, they develop poisons that are absorbed by the body, and that make us very sick. the germs that cause diphtheria belong to this class. [sidenote: prevalence of diphtheria] diphtheria is one of the most common of all the preventable diseases. it causes more deaths than any of the other diseases that can be prevented, except tuberculosis. the great prevalence of diphtheria is due to lack of care on the part of those who have this disease and of those who come in contact with them. [sidenote: where the diphtheria germ comes from] the germ that causes diphtheria always comes from some person or animal that has diphtheria. it never "just happens." if you went into your yard in the morning and found some beets growing in your flower bed, you would know positively that beet seeds had got into your flower bed in some way. you would not say that the beets just happened to grow there. so diphtheria will not "just happen." diphtheria is always caused by germs that come from some one who has diphtheria. they may have come in a letter that was written in the room with the sick person. they may have come from the library in a book that had been used by some one ill with diphtheria. they may have come on some toy that had been played with by a child that had the disease. there are a thousand ways by which the germs may be brought to you without your knowing where they come from. [sidenote: how to confine diphtheria germs] the public health officers try hard to keep these germs from being brought to you. in order to do this, they have to shut away from other people those who have diphtheria germs; that is, they make the sick ones stay at home until they are free from the germs of the disease. we call this _quarantine_. quarantine means that you must stay away from other people when you are sick with a communicable disease, and that other people must stay away from you. people are not put in quarantine because they are sick, but because they are dangerous, and because we are trying to prevent other people from getting the same disease. do not think the health officers unreasonable when they tell you that you must stay at home and that no one can come in to see you. this is done to protect other people and to keep them from getting the same disease that you have. if you ever have diphtheria, or any other communicable disease, you must remember that if any of your playmates come in to see you, they may get the same disease. [illustration: fig. . disease germs are as deadly as guns.] [sidenote: seriousness of breaking quarantine] diphtheria kills a great many children, and to play with your friends after you have had diphtheria, and before the health officer tells you that you may, is almost like trying to kill them. they might be very sick and die, or they might be very sick and get well, or they might not be sick at all; but you never can tell what will happen if they are exposed to the disease. if you were to take a gun and shoot at a friend, you might kill him, or you might shoot his leg off, or you might not hit him at all; but you would be trying to hit him, and it would not be your fault if you did not. it is just the same if you play with a friend when you have a communicable disease; you shoot the disease germ at him, and if you do not hit him, it is not your fault. [sidenote: why quarantine is not raised sooner] sometimes people who have been sick with a communicable disease feel perfectly well, but the health officer tells them he cannot let them out of quarantine. this is because he knows that such people still have in their bodies the germs that cause the disease, and that as long as these germs are there they can give the disease to other people. it is not pleasant to have to stay in quarantine when you feel that you are well, and children, as well as older people, are very likely to become restless under the circumstances. you see an illustration of such a patient in figure , where the little girl, who is under quarantine for scarlet fever, but who is feeling quite well, is giving a book to two of her friends. the book contains the germs that cause scarlet fever, and the boys are very likely to contract the disease by handling the book. [sidenote: why some cases of diphtheria escape quarantine:] [sidenote: (_ _) from failure to detect mild cases] if every case of diphtheria were quarantined, and the people obeyed the health officer, there would soon be no more diphtheria. but how does it happen that every case of diphtheria is not quarantined? diphtheria is a very peculiar disease. sometimes it makes people so sick that they die in spite of everything that can be done for them; sometimes it makes the throat only a little sore, and the child seems so slightly ill that his mother says to herself, "he is fretful," and does not call the doctor. in the latter case the child often keeps on going to school, and exposes other children to the disease; some of them catch it, and become very sick or even die. in still other cases, the mother thinks that a child has only a case of tonsillitis and does not call a doctor; the child's brothers and sisters go to school and may carry the germs to other children. i have known a great many cases of diphtheria to be spread in this way. [illustration: fig. . the old, insanitary slates and sponges have gone out of use, but many people of to-day still follow the dangerous habit of putting pencils into their mouths.] sometimes a dairyman thinks that his child has nothing more serious than tonsillitis, and goes on selling milk. a great many epidemics have resulted from such cases. sore throats should not be treated lightly, for the most severe forms of diphtheria may develop from germs that come from a throat that is only slightly sore. if there is a case of diphtheria in the town where you live, and if your throat feels the least bit sore, have your doctor examine it at once. if you do not wish to have your family doctor look at your throat, go to the health officer. had you not rather stay at home for a week or two than see your best friends ill or dead because of your carelessness? [sidenote: (_ _) from diphtheria germs in throats that are not sore] there is another peculiar thing about the germ of diphtheria. it will often get into a throat and grow a little, just enough to keep alive, but without making the throat sore at all. the person in whose throat the germs are will have no idea that they are there, but when he comes in contact with some one who has a delicate throat, he may give diphtheria to that person. the disease does not develop in some throats because the body cells are all healthy and doing their work so well that, when the diphtheria germs try to take hold, they are driven off and not allowed to grow. this is the reason that, before he raises the quarantine, the careful health officer takes a "culture" from the throat of everyone in a house where there has been diphtheria. [sidenote: how mild cases may be detected] the health officer takes a culture by wiping the throat with a little cotton on a long stick, which he then puts down into a long glass tube containing some substance that diphtheria germs like to grow on. if there are any diphtheria germs in the throat, they will soon show on this culture material. then the health officer will say, "no, we cannot let you out yet, for the germs are still in your throat." no person who has been staying in a house where there is diphtheria should be allowed to go out until a culture proves that his throat is free from the germs of diphtheria. you see how hard it is to quarantine all cases of diphtheria, when children are sometimes allowed even to go to school with sore throats that are really diphtheritic. only two things are necessary for getting rid of diphtheria: one is to quarantine every case, and the other, to have the people do just what they are told when under quarantine. this latter is just as important as the quarantine itself, for people often do not obey the health officer's directions. now let us see what are some of these directions. [illustration: fig. . how pets may become carriers of disease.] [sidenote: rules of quarantine] if you are the patient, the health officer will say that you must be put in a room where there is just enough furniture to make you comfortable, and that no one except the nurse and the doctor is to go into that room. he will say that the nurse must stay in your room all the time, or that she must at least not go into any other room in the house; that your meals must be left outside your door, and that the person who brings them must go away before the door is opened by the nurse. furthermore, as everything in the room that cannot be boiled, or otherwise disinfected, will have to be burned when you are well, your pet books and toys had better not be taken in. finally, nothing is to be carried from the room until it has been put into a solution that will kill the germs, and this means not only dishes, bedding, and clothing, but even books and letters. the nurse must see that all discharges from the throat and nose are received on little cloths, which are to be burned immediately. [sidenote: how quarantine rules are broken] these are the things that the health officer will tell your parents must be done. now let us see what sometimes happens. your mother will want to see her little child so much that she cannot wait until you are well, so she will slip into your room, kiss your forehead, and hold you tight against her. when a little later she kisses your baby brother, and is so thankful that he is not sick too, she does not realize that she is kissing the very same disease into his little throat. or, perhaps your mother is the nurse, and in the night she hears your little brother crying; she thinks, "surely i can slip out and just cover him up; it will not hurt him just for once," and she does so. what happens? in a few days your doctor tells you that your little brother will have to come in and stay with you. perhaps your father grows anxious to see you, and one morning he says he cannot stand it another minute, so he slips in for a few moments before going to business. in a few days one of his clerks fails to come to work. your father sends a messenger to see what the trouble is, and the word comes back, "he has diphtheria." then your father says, "what are these health officers doing that they do not stop this thing?" he is very indignant, but it never occurs to him that he himself has spread the disease by doing just what he promised the health officer he would not do. [sidenote: how dogs and cats carry disease germs] the doctor told your mother not to take anything from the room until it had been disinfected. but you do not consider towser, your dog, and tabby, your cat, "anything," so you persuade your mother to let them come in, and you have a good play with them. you let them rub against your face and romp on your bed, and do everything that pet dogs and cats like to do, and in the meantime their fur is getting full of diphtheria germs. then towser and tabby run out-of-doors and play with the boys and girls of the neighborhood. soon the parents are wondering why the health officers do not stop the spread of the disease. no dog or cat should ever be permitted to come into a house where there is a contagious disease. these are not all the ways in which people disobey the orders of the health officer and of the doctor, but these are enough to show you that it is a very important thing to do just what they tell you. it is not always easy to follow all these rules, but it is far better to follow these, and many more, than to have to think that you have caused the death of either a friend or a stranger. =questions.= . how does the poison of diphtheria get into the system? . where does the diphtheria germ come from? . what is quarantine? . what is the danger in breaking quarantine? . why is quarantine continued after you feel well? . how does it happen that some cases of diphtheria are not quarantined? . what is a diphtheria culture? . what rules should you observe while in quarantine? . tell some of the ways by which quarantine is broken. . how do pet dogs and cats sometimes get disease germs? =remember.= . the germs that cause diphtheria always come from some person or animal that carries diphtheria germs. . diphtheria is always caused by the diphtheria germ, and the diphtheria germ cannot cause any other disease. . people are quarantined to prevent other people from getting the disease. . if there is diphtheria in your neighborhood, and your throat becomes sore, have the doctor examine it. . every person who has been staying in a house where there is a case of diphtheria should have his throat examined to make sure he is not carrying germs. . never play with dogs or cats when you have a contagious disease. . people who do not obey quarantine regulations cause a great deal of suffering and many deaths. chapter xxiv the cure of diphtheria [sidenote: nature of diphtheria poison] the germs of diphtheria do not get into the blood through the skin, but grow on the surface of the mucous membrane (skin of the throat), and there produce a poison that gets into the blood through this membrane. it is this poison that makes you sick, and it is called a _toxin_. you already know that when people have diphtheria, they are sometimes very sick and sometimes only slightly sick, and that the germ can live in some throats without causing any ill effects whatever. [sidenote: how diphtheria toxin is fought] as soon as the diphtheria germ begins to grow in a throat, the little cells of the body begin to make a certain substance and to pour it into the blood. this substance we call _antitoxin_, which means opposed to the toxin in the blood. if the little cells make the substance fast enough, the germs will stop growing, or in some cases they never really get started growing, because they cannot exist where there is much antitoxin. antitoxin looks like clear water. the following experiment will show you something that acts in very much the same way that antitoxin does. if you take a solution of litmus that is made alkaline, it will be very blue, like indigo; but if you drop a few drops of lemon juice into this solution it will turn red.[ ] lemon juice is acid, and is just the opposite of alkali. now, if you put a few drops of ammonia, which is alkali, into the red solution, it will turn blue again. if you put a little more lemon juice, very carefully, drop by drop, into the blue solution, it will gradually turn lighter, until it is entirely clear. [sidenote: how antitoxin acts] we will suppose that the blue is due to the toxin produced by the diphtheria germ, and that the lemon juice is the antitoxin produced by the cells in the body. if the antitoxin is made fast enough, the blue disappears; but if the toxin is made faster than the antitoxin, the blue remains. it is the same way in the body, only it is not litmus and acids and alkalies that we have to deal with. if the toxin is made faster than the antitoxin, the germs grow, and we get sicker and sicker; but if the antitoxin is made faster than the toxin, then the germs cannot grow, and we soon get well, or perhaps do not get sick at all. [sidenote: how antitoxin was discovered] doctors knew that this was what happened, but for a great many years they could not discover the composition of the antitoxin that is made in the body. one day a doctor suggested, "if we cannot find out the chemical nature of this thing that is made in the body, why can we not make it in the body of some animal and then use the blood of the animal?" and that is just what they did. they put diphtheria germs into beef tea, and let them grow very fast and make all the toxin they could. then the doctors strained the germs out by passing the beef tea through a fine filter, in this way getting the poison, and not the germs. then they gave a strong, healthy horse a small quantity of this poison; they did not feed it to him, but injected it into his blood. of course the horse was sick for a while, but soon he began to get well again, for the cells in his body immediately went to work making antitoxin. when the horse was well, the doctors gave him more of the poison; this time he was not so sick and got well even more quickly. this treatment with toxin was repeated in gradually increasing doses until the poison did not affect the horse at all. then the doctors said, "his blood is full of antitoxin, and we will see what it will do when injected into some other animal." so they drew off some of the horse's blood and took out all the little red cells, leaving nothing but the clear fluid of the blood. they planted diphtheria germs in a rabbit's throat, and when the rabbit became very sick, they gave him some of the antitoxin from the horse. the rabbit immediately got well. afterward they gave some of this antitoxin to a little boy who was very sick with diphtheria, and he, too, got well. ever since then the doctors have been saving many lives by the use of antitoxin. [illustration: fig. . showing the number of deaths in cases of diphtheria when antitoxin is used on the first, second, third, fourth, and fifth days.] [sidenote: evidences that antitoxin saves lives] someone may ask, "how do we know that it is the antitoxin that saves lives?" in just this way: before we knew anything about antitoxin, about half of all the people with diphtheria died; but since we have had antitoxin, only about twelve die out of every hundred who have this disease. more than this, we know that when the antitoxin is given within the first twenty-four hours after the patient is taken sick, there is only about one death for every one thousand cases of diphtheria. do you not think that this is strong proof that antitoxin saves lives? [sidenote: how antitoxin saves lives] antitoxin saves lives not only by curing those who have diphtheria, but by preventing others from having it. if a person who has been where there is a case of diphtheria is given a dose of antitoxin, he will not have the disease, because his blood will contain enough antitoxin to destroy the diphtheria toxin present. if you will watch a careful doctor when he makes his first visit to a case of diphtheria, you will notice that, as soon as he gets through treating the patient, he gives all members of the family who have been near the patient a dose of antitoxin to keep them from getting sick. [sidenote: antitoxin not a poison] some people may tell you that antitoxin is a poison and should not be used. the statement that it is in itself a poison is true. but it is also true that in your body there are many things that would poison you if you got too much of them. for instance, there is a gland in your throat (the thyroid) which secretes a substance that is necessary for your health, but if you were to take the secretion of ten such glands it would kill you at once. now, if the cells in your body make antitoxin when you have diphtheria, it is probable that antitoxin is the very thing needed. and if you can help these cells by giving them antitoxin, ready-made, does it not seem a reasonable thing to do? people who give the name of poison to a substance which is known to have saved many lives are not worthy of attention. anything may prove a poison if taken in excess; too much play will prove a poison, and too much work also. =questions.= . what is the poison of diphtheria called? . what is antitoxin? . compare the action of antitoxin on the blood with the action of an acid on the litmus solution. . tell about the discovery of antitoxin. . how do we know that antitoxin saves lives? . how does antitoxin prevent diphtheria? . why should antitoxin not be regarded as a poison? =remember.= . antitoxin is what the cells in your body make when you have diphtheria. . by using the antitoxin taken from a horse, you save your own cells the struggle necessary to make it fast enough to kill the diphtheria germs. . if you have diphtheria, and antitoxin is given promptly, you will get well. . if you have been exposed to diphtheria, antitoxin will prevent your having the disease. . antitoxin is no more a poison than are many other medicines. chapter xxv how typhoid fever germs are carried [sidenote: how typhoid fever germs get into the system] there are certain diseases, the germs of which get into bodies through our mouths. that is, we eat or drink them. some of these diseases are typhoid fever, cholera, the summer complaints of children, tuberculosis, and diphtheria. at present we shall learn about the germ that causes typhoid fever, how it gets into our food and drink, and how we may prevent the disease by getting rid of this germ. typhoid fever, like all other diseases caused by germs, is caused by one kind of germ, and one kind only. you cannot get typhoid fever by eating cholera germs any more than you can get diphtheria from typhoid germs. [sidenote: animals free from typhoid] so far as we know, there is no animal except man that has typhoid fever. since the germs of any disease must come from an animal suffering from that disease, and as man is the only animal that has typhoid fever, it naturally follows that the only way to get typhoid fever is from some person who has the fever or has had it. [sidenote: how typhoid germs leave the body] we know that typhoid fever germs get into the body with food, but how do they get out? once in a great while germs are found in the matter that the patient vomits, or spits up, but this is a rare occurrence, so rare that we need hardly consider it. the germs are present in the blood of the sufferer, but other people do not get his blood on their hands or in their food. there are two things that come from the patient that are loaded with these germs, and these are the urine and bowel discharges. in these two excretions of the body are found practically all the typhoid germs that come from the patient, and these are the causes of other infections. in other words, it is from these two excretions that the germs get into food and drink. [sidenote: how typhoid germs get into water] how do the typhoid germs get into our food? what is done with the excretions after they come from the body? you will probably say that the nurse throws them into the sewer. very true; but where do they go when they are thrown into the sewer? the sewer must empty somewhere, and in most instances it empties into a stream, the water of which is used for drinking purposes. [illustration: fig. . pollution of a stream with sewage.] [sidenote: the widespread evil due to the sickness of one person] you may think that the germs from one person would not make much difference, but that is where you are mistaken. there is a town in pennsylvania of about eight thousand inhabitants, which gets its water from a stream that flows down from the mountains. one cold winter, while the stream was frozen, a man living on the bank of the stream was taken sick with typhoid fever. his nurse threw the urine and the discharges from his bowels on the ice on the bank of the creek. when the ice melted, the typhoid germs in the discharges found their way to the stream that furnished drinking water to people farther down, and in a very short time there were over one thousand cases of typhoid fever in that town. before the ice melted there had not been a single case of typhoid, and every one of the thousand cases came from the water into which had been allowed to flow the discharges from one man with typhoid fever. you see what germs from one person may do. [sidenote: how long typhoid fever germs live in a stream] sometimes people say that a stream purifies itself every few miles. it does purify itself of some things, but disease germs live from twenty-five to thirty-five days in water, and a stream flows a long way in thirty days. [sidenote: the pollution of streams with sewage] sometimes we hear people say that it is safe to put sewage into a certain stream, because no town uses that stream for drinking water. but of this they can never be sure. not long ago certain people said that the water from the river which flowed through their town was used only by two dairymen and a vegetable gardener, and therefore there was no danger in running sewage into the stream. yet the dairymen and the gardener sold all their produce in that very town. the townspeople never considered that the water into which they ran their sewage was used by the dairymen for washing their milk vessels (and perhaps for diluting the milk), and by the gardener for washing his lettuce and other vegetables. thus the germs of disease were brought directly back to the town. do not think that you are safe in polluting a stream with sewage because no town uses the water from that stream. the individual on the farm is entitled to protection just as much as the individual in the town. always remember that when you pollute with disease the water used by the farmer, he may bring that disease back into the town with the produce of his farm. no sewage, no matter how small the amount, should ever be permitted to go into a stream until all the disease germs it contains have been killed. this can be done, though it will cost something; but we cannot get rid of disease germs without work, and work cannot be done without being paid for. there are other ways of scattering typhoid germs besides running sewage into streams. sometimes the nurse does not throw the discharges from a typhoid fever patient into a sewer at all, but into a closet vault. remember how the material from a closet vault goes through open ground into a well, and you will understand what happens. the germs get into the well, and the whole family may then have typhoid fever. let us suppose that the nurse did not throw the discharges either into the closet or into the sewer, but carelessly threw them out on the ground behind the house, where, as it was winter time, they froze as hard as rocks. it does not seem to hurt typhoid germs in the least to be frozen; when they get warm again they are as lively as ever. let us suppose these particular germs lay there all winter, but in the spring when everything melted the germs were still alive and ready to spread disease. it happened that they did not get into the well or into the milk, but they did get on your food, and made you ill with typhoid fever. [sidenote: how flies carry typhoid germs] how did the germs get to your food? about the time that the germs were thawed out, and were beginning to double in number every hour or two, along came a fly and thought that spot an attractive one for a lunch. accordingly he walked over this mass of filth, collecting a supply of germs on his feet, and then came in and tracked them over your bread and butter or other food. [illustration: fig. . flies crawling on the edge of the glass or falling into the milk leave germs that cause disease.] [sidenote: how typhoid germs get into milk] that is how you got the fever; but the trouble did not stop with you. when you fell sick, your father thought it was time to clean the yard, but he was not very careful what he did with the dirt, including the typhoid fever discharges which the nurse threw out on the snow during the winter. there was a low place in the barnyard and there he dumped the dirt. one of the cows thought this fresh pile of dirt would make a comfortable place to lie down in. the next morning the milkman milked her without first washing her sides and udder, and hundreds of little particles of dirt, each one loaded with germs, fell into the milk. the milk from all the cows was mixed together, and by the time it got to town these germs had grown into many thousands. some of the people who drank the milk became ill with typhoid fever and wondered afterward where they had taken this disease. [sidenote: why the recovered patient is dangerous] the discharges from a typhoid fever patient contain typhoid germs not only while the disease lasts, but for many months after the patient is well. in some cases they are present for years after the illness is over. [sidenote: the story of the careless nurses] here is a story about typhoid fever that illustrates the importance of washing and boiling everything that comes from a sickroom. a few years ago there was an epidemic of typhoid fever in a certain town. one of the hospitals was very much crowded, and it became necessary to employ several extra nurses. all the nurses knew the importance of washing their hands after handling the patients, and the old nurses had seen so many bad results from failure to observe this rule that they were very careful. three of the new nurses, however, thought it a great deal of trouble to be washing their hands all the time, so more and more they neglected this important duty. the result was that all three of these girls got typhoid fever and died. they paid the penalty for neglecting the duty that they well knew they should have performed. typhoid fever can be wiped out by attention to neglected details--that is, by disinfecting discharges before throwing them away; by disposing of excretions only in places that are made for them; by adding lime to the closet vault every day to kill any germs present; by making the closet in such a way that flies cannot get into it; and by not permitting sewage to enter any stream until all the disease germs have been killed. all these things can be done. it will require a little work; but had you not rather take a little extra care than run the risk of catching or spreading typhoid fever? =questions.= . how do typhoid fever germs get into the body? . what is one source of these germs? . how do these germs leave the body? . name several ways by which typhoid germs in a stream may get into foods. . how do flies carry typhoid fever germs? . how do these germs get into milk? =remember.= . typhoid germs come from people who have typhoid fever; they are found in the urine and bowel discharges. . no one should ever answer nature's calls except in a place provided for that purpose. . no sewage should be allowed to go into any stream until all the germs in it have been killed. . disease germs will live in running water fully as long as they will in still water. . the discharges from a single person may infect a whole city. . when typhoid fever germs get into milk, they grow very rapidly; hundreds of people have been given typhoid fever by drinking the milk from a dairy where there was a single person sick with this disease. . people who have had typhoid often carry the germs for several months after they are well. chapter xxvi hookworm disease and amoebic dysentery hookworm disease and amoebic dysentery resemble typhoid fever in one respect, in that they, too are spread by the improper disposal of human excreta. [sidenote: where hookworm disease prevails] hookworm disease is found almost exclusively in tropical or subtropical climates. in the united states it is rarely seen north of the potomac and ohio rivers. [illustration: fig. . a full-grown hookworm, magnified; the short line shows the average length of the hookworm.] [sidenote: what the hookworm is] this disease is not caused by a germ, as is typhoid fever, but by a worm from a quarter to half an inch long, and about as thick as a small hairpin. these worms get into a person's intestinal canal, and there lay their eggs, which are later given off in the bowel discharges. when these discharges are thrown on the ground, or are put into an open water-closet, they may be carried about by chickens, flies, and pigs. then the eggs hatch in the soil and tiny hookworms result. when human excreta are not properly disposed of, in climates where hookworm disease prevails, the soil becomes practically full of these little worms, and from the soil they find their way into the bodies of the people. [sidenote: how it enters the body] there are two principal ways by which the hookworm may enter the body. one is through the mouth, which these worms reach in practically the same way as do typhoid fever germs. the hookworm may enter the body through the skin also. some authorities state that the worm bores its way in; but it is probable that it does not actually bore through sound skin, but enters at some point where there is a small break. [sidenote: where it lives in the body] after the worm gets through the skin, it is taken into the blood and carried to the lungs, and from there it finds its way to the throat and is swallowed. it makes no difference whether the hookworm is swallowed or enters the body through the skin; it finally reaches the intestinal canal, where it then makes its home. sometimes thousands of these worms are found in a single person, and each one of them entered the body through the mouth or through the skin. the worms do not multiply in the body, and the eggs they lay never hatch until after they have left the body. [sidenote: how it affects the patient] when the hookworm gets into the intestinal canal, it fastens itself to the wall and sucks the blood from it, at the same time giving off a poison that enters the blood of the victim. the loss of blood and the effects of the poison soon cause the person in whose body these worms are living to become weak, pale, and thin. he is not able to do much work, if any, and the result is that people suffering from this disease are often called lazy. they are not lazy; they are sick, and many of them die. [sidenote: how hookworm disease can be prevented] all this sickness and all these deaths might be prevented simply by the proper disposal of human excreta. no human excreta should ever be put anywhere except into a properly constructed sewer or properly constructed privy. if this rule were always observed, both hookworm disease and typhoid fever would be abolished. [sidenote: where amoebic dysentery prevails] amoebic dysentery is another disease that is confined almost entirely to tropical and subtropical climates, though cases sometimes occur in colder regions. [sidenote: how it is spread and how it may be prevented] this disease, like typhoid fever, is caused by a germ that leaves the body with the bowel discharges. the germ makes its way into the body in the same way that the typhoid germ enters; that is, it is taken in with food or drink. the various means by which this germ gets into our food are the same as those by which the typhoid germ gets in; and the precautions that will prevent the spread of typhoid fever will also prevent dysentery. amoebic dysentery kills a great many people in warm climates, though it does not kill as many as does typhoid fever. if it does not cause immediate death, it often leaves the patient very weak and sickly for months or years. =questions.= . in what climates are hookworm disease and amoebic dysentery commonly found? . in what respects do they resemble typhoid fever? . how does the hookworm enter the body? . where do the hookworm eggs hatch? . how can hookworm disease be prevented? . what other diseases can be prevented by the same precautions? =remember.= . typhoid fever, hookworm disease, and amoebic dysentery are all caused by the improper disposal of human excreta. . most of the sickness that can be prevented is the result of dirty habits; if all people would keep clean and see that everything about them was kept clean, a great deal of sickness would be prevented and a great many lives would be saved. chapter xxvii how scarlet fever is carried there are certain diseases that we know to be communicable (that is, "catching"), but as yet we do not know the germ that causes them, and therefore we cannot tell just how they are carried about. we do know that they are transferred from one person to another; but not being able to locate the cause, as we can in the diseases of which we do know the germ, we cannot explain how it is done. [sidenote: how scarlet fever is like diphtheria] among the diseases of this class we find scarlet fever. in one respect scarlet fever acts much the same as diphtheria. a person may have it and not be very sick, sometimes hardly sick at all. at night a child may have a high fever, with a slightly sore throat, and the next morning he may feel perfectly well. the mother supposes that the fever was due to an "upset stomach," thinks no more about it, and sends the child to school. the next time the child takes a bath, he perhaps notices that the skin peels off over some parts of the body. this means that the high fever was due to scarlet fever, but the breaking-out (rash) was so fine that it was not noticed. it also means that all the children in the school have been exposed to the disease. these very mild cases are the most dangerous because so often they are not recognized. [sidenote: why mild cases are dangerous:] [sidenote: (_ _) for the severe cases they cause] there are two things to be remembered in connection with these mild forms of scarlet fever, as well as of every other communicable disease. the first is that the same cause which produces a mild form of the disease in one child may produce its most severe form in another child. you can contract a mild form of the disease from exposure to a severe case; and you can contract a severe form from exposure to a mild case. the character of the case to which you are exposed will give no indication of the form the disease will assume in your body. [sidenote: (_ _) for the bad after effects] the next thing to be remembered about the mild form of scarlet fever is that, though the child may not be made very sick at the time, there may later be very bad results. a child who has had scarlet fever in such a mild form that he hardly knew he was sick, may, for a while, appear to be quite well; then suddenly he has an earache, and an abscess forms. this abscess is due to the scarlet fever germs which have gone from the throat to the ear, and as a result the child may lose his hearing entirely. the child may not, perhaps, have an abscess, but after a time he may begin to lose flesh, and to grow pale. he does not care for his meals, does not care to play, says he is tired, and wants to lie still all the time. finally his mother thinks it might be a good idea to have a doctor see him. the doctor examines his body carefully, and then asks for a sample of his urine. when he has examined this, he looks very serious and asks the mother when the child was sick last, and what the disease was. perhaps she has forgotten all about the slight attack of fever, and the doctor must question her very carefully before she recalls it. at length it occurs to her, and then the doctor asks, "after this attack of fever, did you notice that the skin came off his hands and body?" she replies that she did, and then the doctor tells her that the child really had scarlet fever, and, owing to lack of care, he now has kidney disease. this is a very serious trouble, from which he may never recover, or, in case of recovery, he may always be weak and sickly. even a mild attack of scarlet fever is not to be neglected; it is a severe and dangerous disease in its very mildest form. it not only kills a great many boys and girls, but it makes delicate in health for all their lives many of those who apparently recover. [illustration: fig. . one of the ways by which quarantine is broken.] [sidenote: how confusion of names causes mild cases to go undetected] we often hear people speak of two diseases which they think are not scarlet fever. these two diseases are scarlatina and scarlet rash. now scarlatina is simply the scientific name for scarlet fever. some doctors will tell you that you have scarlatina and that it is not exactly scarlet fever. a doctor who says this either is deceiving you or does not know any better. in either case, he ought not to be a doctor, for he lets children be exposed to a disease that is likely to kill many of them. it is the same with scarlet rash. this, too, is simply another name for scarlet fever. changing the name does not change the disease, and you may call it scarlet fever, scarlatina, or scarlet rash--it makes no difference which; the disease is one and the same. [sidenote: why quarantine is necessary for scarlet fever] quarantine is the only way known for preventing the spread of scarlet fever, as well as of diphtheria. if every case of scarlet fever were quarantined, we could soon stop this disease; but every case is not quarantined, because some of them are so mild that they are not recognized. [sidenote: how breaking quarantine shows selfishness] even when a case is quarantined, the people sometimes neglect the instructions given, just as they do when there is a case of diphtheria. then there are cases that are known to be scarlet fever but are not reported to the health officers, because the people do not want to be quarantined. they simply do not want to be put to any inconvenience themselves, and although this seems a very strange way for people to act, it happens very often. there are many selfish people in the world; there are even people who will not report a case of scarlet fever because to do so might prevent their going to a party. selfishness is at the bottom of it. it is extremely important that a child should be absolutely free from all the little scales of skin which are thrown off after scarlet fever, before he returns to school or mingles again with others. if there is a discharge from the nose or ears after the scales have disappeared from the skin, there is still danger of spreading the disease, for these discharges often retain the infection for many months. =questions.= . give two reasons why mild cases of scarlet fever should be carefully treated. . why is quarantine necessary? . how does selfishness lead people to spread scarlet fever? . when is it safe to let a scarlet fever patient mingle with well people? =remember.= . if you have scarlet fever and are not very sick, do not think that you will not be dangerous to others; severe cases sometimes come from exposure to the mildest cases. . mild cases of scarlet fever often leave very bad results, if the patient is not cared for. . be very careful until you are entirely well. . scarlatina and scarlet rash are nothing but scarlet fever; keep away from people who have them. . quarantine is the only way by which we can prevent the spread of scarlet fever; there is no medicine that will prevent it. . people who violate quarantine regulations are both selfish and stupid. chapter xxviii measles and whooping cough dangerous diseases measles is a disease in the same class as scarlet fever. we do not know the cause, but we do know that it is communicable. [sidenote: why measles should be avoided] measles is usually not a severe disease; that is, it does not kill as many persons in proportion to the number of cases as does scarlet fever. it does, however, kill more people than most of us think; a great many little babies die of it. how often we hear mothers say, "i wish my children would have measles and be done with it." it would be very convenient if they could have measles in a mild way and "be done with it." the trouble is, that we cannot tell whether it will take a mild form, and, worse than this, we do not know when they will be done with it. if you should go into the children's wards of a large hospital, you would know why measles should be avoided. there you would hear the doctors questioning the mothers about the previous diseases of the little ones. you would be surprised at the number who replied, "he has not had anything but measles." then you would hear the question, "how long since he had the measles?" "he was just over it when he was taken sick with this trouble." what is "this trouble"? follow the doctor along from bed to bed and see the cases of pneumonia that started when the child "was just over measles"; see how many cases of empyema (abscess in the chest) began just after the measles ended; how many cases of abscess in the bone, how many cases of disease of the kidneys appeared after the child recovered from the measles. then go down into the eye and ear wards and see how many diseased eyes and ears have followed an attack of the measles. the children would not have had these troubles had they not first had measles. [sidenote: necessity of care in measles] if you have measles, do not let others come near you, and do not think that, because you do not feel very sick, you can run about as usual. if you do not take good care of yourself, you may have some of the diseases that so often begin when children are getting over measles. measles causes more deaths than is commonly supposed, especially among young children and very old people; and a great many children die of diseases which they never would have had if they had not first had the measles. avoid people who have measles, and if you should get the disease, do not treat it as a slight thing, but consult your doctor at once. [illustration: _whooping cough_ _scarlet fever_ _measles_ _smallpox_ _ , _ _ , _ _ , _ _ _ fig. . deaths in from four common communicable diseases reported to the united states census bureau.] [sidenote: evil effects of whooping cough] whooping cough is much the same as measles in this respect. it kills many children, and, in cases where it does not kill them, their bodies become so weakened that they are liable to contract some other disease that may prove fatal. avoid people who have whooping cough. =questions.= . why should people avoid measles? . why should one take care of himself when he has measles? . why is whooping cough to be avoided? =remember.= . measles is more fatal, especially among babies, than people realize. . measles causes more diseases of the bones, ears, and eyes than any other communicable disease. . measles is not dangerous if properly cared for, but when neglected, it causes much suffering and many deaths. . whooping cough causes almost as many deaths as does measles. chapter xxix how smallpox is prevented we now come to the study of a disease, the cause of which has not been positively recognized. we know that it is very communicable; but we know also that there is absolutely no reason for anyone's ever contracting it, since there is a way by which it may easily be prevented. [sidenote: fatality of smallpox before the discovery of vaccination] something over a hundred years ago, smallpox was one of the most fatal diseases known. it is estimated that during the eighteenth century it killed over , , people. up to the time when the spaniards invaded mexico, there had been no smallpox there. the spaniards brought the disease with them, and historians tell us that out of the , , people living in mexico at that time, at least , , died from smallpox. at that time the disease was considered fatal throughout the world; when it broke out in a community, people fled without stopping to bury their dead. it was a rare thing to see a person not more or less disfigured by the marks the disease leaves on the face and body. to-day we find a very different condition. there are now fewer fatalities from smallpox than from almost any other communicable disease. during and only deaths from smallpox were reported from all over the united states to the census bureau at washington. what has caused this marked falling off in the fatality of the disease? [sidenote: discovery of vaccination] during the time that smallpox was killing so many people, all the doctors were trying to find something that would cure the disease or that would prevent it. in the latter part of the eighteenth century dr. edward jenner, an english physician, noticed that milkmaids did not have smallpox as much as did people of other occupations. he also noticed cows with little sores on their udders that looked very much like the sores that come with smallpox. he therefore tried making on the arms of people sores just like those on the udders of the cows. he did this by taking a little of the matter from the sores on the cows and putting it into the scratches on the people's arms. after these sores had healed, the people who had been thus treated did not have smallpox. this simple practice has caused one of the most deadly diseases known to man to become one of the most easily controlled. [sidenote: prevention of smallpox by vaccination:] though it is well known that before the discovery of vaccination smallpox was a fatal disease, there are still some persons who say that vaccination has done nothing to reduce the mortality. when you learn some of the facts, you can judge for yourself whether or not vaccination does prevent smallpox. [sidenote: (_ _) in the franco-prussian war] during the franco-prussian war in - , the german soldiers were all vaccinated, and only a part of the french army was vaccinated. smallpox broke out in the two armies. as a result, , of the french died from smallpox and only of the germans. in many instances, the german and the french soldiers were confined in the same hospitals, with exactly the same opportunities to contract the disease. but, you might ask, if vaccination prevents smallpox, how did it happen that there were _any_ cases among the german soldiers? in order to prevent smallpox, vaccination must be successful; that is, it must "take." we will tell you about different kinds of vaccination a little later. [illustration: fig. . in sweden, before vaccination, smallpox caused , deaths per million population (represented by the large square). since the introduction of vaccination the death rate has dropped to per million population (represented by the two small squares).] [sidenote: (_ _) in sweden] in sweden we find strong evidence that vaccination prevents smallpox. up to , before vaccination was introduced into that country, the yearly death rate from smallpox was , out of each million of the population. in vaccination was introduced into sweden, but the people were allowed to be vaccinated or not, just as they pleased. during the ten years ending with , the annual death rate from smallpox had dropped from , per million of the population to per million. later, vaccination was made compulsory (that is, everybody in sweden was obliged to be vaccinated), and in the death rate had dropped to only two deaths a year per million population. is it merely a coincidence that this great falling off in deaths from smallpox came after vaccination was discovered, or was it due to vaccination? [sidenote: (_ _) in the philippine islands] before the philippine islands were occupied by the americans, vaccination was very little practiced, and a large percentage of the deaths in those islands was caused by smallpox. in smallpox caused about , deaths. a few years later the americans enforced vaccination among the inhabitants of the philippines, and the result was that in there were only deaths from smallpox. there has been practically no quarantine for smallpox and no disinfection; the only cause of the suppression of the disease in the philippine islands is vaccination--nothing else. [sidenote: (_ _) in gloucester, england] in gloucester, england, there used to be a great many people who did not believe in vaccination, though it is doubtful if they themselves could have explained why they did not. they seem to have been much like the man who, when asked, "what do you think of this?" replied, "i don't know anything about it, but i am against it." in gloucester had a population of , people, most of whom had never been vaccinated. in the latter part of , smallpox broke out. quarantine was strictly carried out, but the disease continued to spread. as the people saw the number of victims rapidly increasing, many of them concluded that they had rather be vaccinated than have smallpox, even though they did not really believe in vaccination. by the first of april, , over , people had been vaccinated in gloucester, and by the first of august there was not a case of smallpox in the city. but what had happened in the meantime? there had been , cases of smallpox; a very large amount of money had been expended in quarantining; hundreds of persons had been disfigured for life; and lives had been lost. and all this simply because the people did not believe in vaccination. quarantining smallpox is a most expensive luxury, which may possibly retard the progress of this disease, but was never known to check an epidemic of it. every epidemic of smallpox during the last one hundred years has been checked by vaccination. [sidenote: why some diseases do not return] there are certain diseases which you are not likely to have more than once; one attack protects against another. why and how does one attack of a certain disease protect against another? when a person is taken sick with one of these diseases, the cells of his body immediately begin to make a substance called antitoxin. we learned something about antitoxin when we were studying diphtheria. in diseases like scarlet fever, measles, and smallpox, in which one attack protects against another, the antitoxin that is formed in the body when you are sick stays there for a long time, in some cases as long as you live. while this antitoxin is present in the blood, the cause of the disease cannot live in the body; hence you cannot have the disease again. after some diseases this antitoxin seems to disappear from the blood in a short time; after others, it seems to remain for several years; and after still others it remains as long as you live. after diphtheria it stays in the blood only a short time, so that one may have diphtheria a second time within a few years. some people have smallpox, measles, or scarlet fever a second time, but with most people these diseases never return. if we knew how to make the cells of our bodies produce this antitoxin and keep it stored up in the blood all the time, we should never have any of these diseases. but in many cases we do not know how to cause the cells to manufacture this antitoxin. however, in one or two diseases we do know how to persuade them to make the antitoxin, and the one in which we know how to accomplish this best is smallpox. this is just what is done by vaccination. [sidenote: how vaccination prevents smallpox] the object of vaccination is to put the cells of the body to work making antitoxin. to do this, it is necessary to get some of the toxin into the body. we want to get in just enough to make the cells work, and no more. therefore we make a very small scratch, and put into it some of the vaccine which contains the toxin of smallpox. it is impossible to have these germs in your body and not be affected by them to some degree. if you did not feel a little sick, the cells would not be making antitoxin, for the thing that makes you sick is what makes the cells go to work. but this sickness is only a matter of a day or two, and after the cells have made the antitoxin, it will stay in your body a long time, longer in some cases than in others. some people, after they have once been vaccinated, can never be successfully vaccinated again; neither can such people ever have smallpox. most people, however, can be successfully vaccinated every five to seven years, and there are a few people who will "take" if vaccinated every year or two. these conditions indicate the length of time that the antitoxin of smallpox will live in the bodies of these different persons. if vaccination, properly performed, does not take, the person is not in a condition at that time to catch smallpox; and if vaccination, properly performed, does take, it is positive evidence that if this person had been exposed to smallpox, he would have taken the disease. [sidenote: necessity of repeated vaccination] it is frequently asked, "how long will vaccination protect against smallpox?" you can no more answer this question than you can tell how long the antitoxin will live in the blood of any particular person. the only safe thing to do is to be vaccinated every few years, and if smallpox is present in your community, get vaccinated every year until the vaccination takes. if it takes, it shows that you were in a condition to catch the disease; and if it does not take, you may feel safe from smallpox for a while, at least. =questions.= . why was smallpox formerly more widespread and more often fatal than it is now? . tell of the discovery of vaccination. . give instances to show the influence of vaccination on smallpox epidemics. . why must there be repeated vaccinations? . show how vaccinating for smallpox is like taking antitoxin to prevent diphtheria. =remember.= . before the introduction of vaccination, smallpox was one of the most dangerous diseases known. . all evidence of history tends to show that vaccination has caused smallpox to become a very mild disease and a comparatively rare one. . successful vaccination repeated at proper intervals will prevent smallpox. . vaccination must be repeated because we do not know just how long the material developed in the body from a single vaccination will last. chapter xxx why vaccination sometimes seems a failure [sidenote: what constitutes a successful vaccination] how does it happen that those who have been recently vaccinated sometimes have smallpox? it is _successful_ vaccination that prevents smallpox, not recent vaccination; there is a vast difference between the two. a _successful_ vaccination is one that results in a sore identical with the sores of smallpox. such a sore is secured only as a result of the action of the germs that cause smallpox. if the arm is red from the shoulder to the wrist and so swollen that you cannot use it for weeks, it does not necessarily mean that you have had a successful vaccination. such arms are not the result of vaccination itself, any more than a railroad wreck is the result of the fact that there is steam in the engine. the railroad wreck is caused by carelessness on the part of some operator, and the badly inflamed and swollen arm is due to lack of care or knowledge on the part of the vaccinator or the person vaccinated. [sidenote: some pretended vaccinations] a fly blister is not a successful vaccination. such a statement may not seem necessary, until you hear this story. a man showed a sore on his arm, asserting that it was a successful vaccination. he was told that it was nothing but the result of a blister, and not vaccination, and that the work had been done by putting a small bit of blistering plaster on his arm. he admitted this to be the fact, and said that the "doctor" who did it told him that it was a new way of vaccinating. the doctors who say that vaccination will not prevent smallpox belong to the class who use fly blisters and call them vaccinations. when the patient gets smallpox, those who are opposed to vaccinations say that here is an illustration of their claim that vaccination will not prevent smallpox. [illustration: fig. . how vaccinated arms are sometimes infected.] some people who honestly think they were vaccinated have smallpox. there are sometimes instances in which a person recently vaccinated with apparent success nevertheless contracts smallpox; there are still other cases in which the disease develops after a vaccination that would not take. here is an example: a doctor vaccinates a child in the usual manner. at the end of four or five days, the dressing is taken from the arm, and the only thing to be seen is a little black scab. the child scratches this off. in a few days the spot becomes red and a small abscess forms, resembling a smallpox sore. naturally, this is taken for a completely successful vaccination, but it is not really so. when the child scratched off the scab, the vaccination wound was nearly healed, and the little abscess was caused by some very mild pus germs, which were under the finger nails with which he scratched the wound. the abscess was in no wise connected with the vaccination, but was simply such an infection as a child might get at any time that he scratched his arm. no one has ever claimed that such an abscess will prevent smallpox any more than that a boil will prevent it. _a successful vaccination will prevent smallpox._ the length of time for which it will prevent the disease varies in different individuals. some it will protect only for a year or two, while in others it will last through life. dr. h. w. bond, health commissioner of st. louis, missouri, states: "the experience of this department, based on the observation of thousands of cases, is that a well-pitted mark gives at least ten years' immunity. we have never seen a case of smallpox in a person with a well-pitted scar less than ten years old--that is, the scar less than ten years old." [sidenote: a sore arm not always due to successful vaccination] one of the strongest objections made against vaccination is that the arm sometimes becomes very sore from it. this is true, but the sore arm is not a common occurrence and is never caused by vaccination properly performed. there is always some cause for the bad arm besides the vaccination. [sidenote: cause of sore arms] the usual cause of a bad arm is improper vaccination; this means the lack of proper precautions on the part of the person who does the vaccinating. years ago, before vaccination was performed with the great care which is given it to-day, bad arms could not be prevented; but to-day the cause of the trouble is not the vaccine, but the vaccinator. sometimes a father thinks he will save a dollar by vaccinating his child himself, and he is likely to injure the child by attempting to vaccinate him without taking antiseptic precautions. the same surgical preparations must be made for a vaccination as for an operation. if this is not done, a bad arm will result, not because of the vaccination, but because of the negligence of the vaccinator. never allow any person, doctor or otherwise, to vaccinate you until the skin surface has been well washed with soap and water, rinsed clean, and wiped off with alcohol. see that the vaccine is fresh and has been properly kept. when it begins to "take," keep the spot absolutely clean and covered with a clean cloth, renewed daily. _never scratch or rub it._ these precautions will prevent the dreaded soreness of the arm. [sidenote: how people themselves infect their arms with pus germs] the person operated on is himself often responsible for the bad arm. a careful doctor will put a dressing on the arm, after he has supplied the vaccine, and will tell you to let that dressing alone, for he wishes to take it off himself. about the third or fourth day after the vaccination, your arm begins to itch. possibly you have forgotten what the doctor told you; at any rate, you pay no attention to directions and take the dressing off to scratch the arm. when you scratch the wound, you introduce pus germs into it, and you have no reason to expect anything but a sore arm. in this case, it is not the fault of the vaccinator or of the vaccination; it is your own fault. never touch a vaccination sore; in fact, it is dangerous to touch any sore. =questions.= . how is a successful vaccination determined? . what are some pretended vaccinations? . mention some of the things that cause bad arms after vaccination. =remember.= . a successful vaccination causes a sore identical with the sores that result from smallpox. . a fly blister is not a vaccination in any sense of the word. . a very sore arm does not result from a properly performed vaccination, but from carelessness on the part of the vaccinator or the person vaccinated. chapter xxxi consumption, the great white plague tuberculosis, or consumption, has been known for many centuries. it was known long before rome was ever heard of. hippocrates, a greek physician, studied it, and said that if it were treated in its early stages, it could be cured. [sidenote: why consumption is called the great white plague] tuberculosis is called the great white plague. it is called the great plague, because it kills more people than does any other one disease; the white plague, because people who suffer from it become so pale and white. [sidenote: consumption more destructive than war] it is estimated that nearly , people die from tuberculosis every year in the united states. this means that in this country there is one death from consumption every two minutes and thirty-six seconds. is it not fearful to think of nearly , people dying every year, in the united states alone, from a disease that we know can be prevented? do you not think that we ought to do everything we can to prevent this disease from spreading? during the civil war , soldiers were killed in both armies. this war lasted four years. during the same length of time there were , deaths from tuberculosis in the united states. this means that consumption killed over three times as many people as were killed during the same length of time in the civil war. in some parts of the country one out of every seven deaths is caused by this disease, but the average throughout the country is one death out of every ten. [illustration: fig. . comparing , deaths from tuberculosis the united states during four years with the , deaths in the civil war.] [sidenote: prevalence of tuberculosis] there are more than , people sick from tuberculosis every year in the united states alone. of this number nearly , die every year. tuberculosis is a disease that can be prevented. it may take a long time to get rid of it, but it can be abolished. when you think of all the people that are sick from tuberculosis, and of all those who die from it every year, you will surely want to do all you can to help prevent this suffering and death. [sidenote: tuberculosis a disease of various parts of the body:] when people speak of consumption they usually mean tuberculosis of the lungs; but tuberculosis is not confined to the lungs. the germs that cause tuberculosis may attack any part of the body, and from one part may go to other parts, setting up a growth wherever they go. [sidenote: (_ _) of the throat] tuberculosis of the throat is a common form of the disease. when the germs of tuberculosis settle in the throat, they destroy the tissues very rapidly and, as a rule, kill the patient much more quickly than they do when they start in the lungs. [sidenote: (_ _) of the joints] another frequent form of tuberculosis in occurs in the knee; this is popularly called "white swelling." it quickly destroys the knee joint and results in a stiff leg. the growth may stop there, but more often it extends from the knee to other parts of the body. often we see a little boy or girl wearing one shoe with a sole much thicker than the other. this is because one leg is shorter than the other, and we notice that the shortened leg is deformed as well. this condition sometimes results from an injury, but it is far more likely to be caused by tuberculosis of the hip joint. [sidenote: (_ _) of the spine] again we see boys and girls with diseases of the spine, so that they have "hunch backs" or are twisted to one side. these conditions result from tuberculosis of the bones of the spine. [illustration: fig. . one of the effects of tuberculosis.] [sidenote: (_ _) of the glands] sometimes we see children and grown people with swellings on their necks. these swellings may look smooth, but they feel as if they were made up of little bunches of grapes or plums under the skin. they are almost always due to the growth of the germs that cause tuberculosis of the little glands of the neck. [sidenote: (_ _) of the stomach] any one of the other glands of the body is just as liable to become affected by tuberculosis as are the glands of the neck. tuberculosis of the stomach or bowels is not at all uncommon. the germs of tuberculosis are likely to attack any of the tissues of the body, especially if the cells composing these tissues are for any reason weakened so that they cannot do the work required of them. when the tuberculosis germs grow in tissues, the tissues finally break down and an abscess forms. a tubercular abscess is sometimes called a "cold abscess." all such abscesses finally break and an open sore results. the matter that comes from the open sore and from the abscess when it is first opened is full of the germs that cause tuberculosis. if this matter is allowed to become dry, the germs are blown about in the dust. then other people may inhale them or take them into their bodies through the mouth or skin and thus contract consumption. [sidenote: the old belief that consumption is inherited] until a few years ago it was generally believed that consumption was inherited. that is, it was thought that children whose father or mother had consumption were born with the disease. even to-day many people hold to this idea, because they have not studied or learned of the discoveries made in recent years. these people still believe that if a child's father or mother dies of tuberculosis, the child will die of tuberculosis, too, no matter how careful he may be or how much of a fight he may make against it. it is true that many people whose parents have died of consumption also die from this disease; but this does not prove that they were born with consumption. it merely shows that they had a good chance to catch the disease by being continually with some one who had it. it is also true that a great many people die from consumption whose parents did not have it. if consumption is an inherited disease, where did these people get it? [sidenote: how the germ of tuberculosis was discovered] about thirty years ago, dr. robert koch discovered that all consumptives have in their sputum a long, slender germ which he called the tubercle bacillus. some of these germs he injected into guinea pigs, and he found that they caused the pigs to have consumption. then he made many other experiments, and proved beyond question that it is this very germ that causes tuberculosis, and that no one has consumption unless he has this germ in his body. [sidenote: evidence that consumption is not inherited] then the question arose, "is the baby whose parents have consumption born with this germ in its body?" this question could not at first be answered; but tests were made by taking the children of consumptive parents away from their parents, and keeping them in homes where there were no consumptives. it was found that these babies did not develop the disease. from these and many other tests, it has been proved that consumption is not inherited, and that the reason the child of the consumptive so often has consumption is because he lives with people having the disease. [sidenote: evidence that consumption is a house disease] consumption seems to be confined to certain families, and this has led many people to think that the disease is inherited, regardless of the proof that it is not. when we carefully study the facts in various cases, we find that the disease is not confined to a certain family, so much as it is to the _house_ in which the family lives. the record of a single house will illustrate how tuberculosis sticks to the house rather than to the family. from to , a particular house was occupied by a father, mother, and six children, of whom four died of consumption. from to the house was occupied by another father and mother with eight children. they moved away because of the great amount of sickness in the family. at present this father and one of his children have tuberculosis. in the house was occupied by still another family, consisting likewise of a father, mother, and eight children. now it is known that four of the children have tuberculosis, and it is feared that three others have also contracted the disease. in a son of the first occupant, with his wife and two children, returned to live in the house. the father of this family died of tuberculosis. up to the total results from this house, scattered through four families, were as follows: five deaths, six cases in people still living, and three suspected cases. [illustration: fig. . the constant danger of infection in railway cars, where germs can live as well as in a house.] [sidenote: why consumption is a house disease] when the consumptive coughs, he sends fine droplets of moisture into the air. these droplets contain the germs that cause tuberculosis. the moisture evaporates and the germs are left sticking to the floors, the walls, the curtains, and the furniture of the room. when the room is swept or dusted, the germs are stirred up with the dust and people inhale them. the germ that causes consumption will live for a long time in a house; you cannot see it, but it is there. wherever a consumptive has lived, he has left the germs of this disease behind him. [sidenote: how to disinfect houses] if a house in which a consumptive has lived is thoroughly disinfected, all the germs he left there will be killed. scattering disinfectants about a room does no good. the only proper way to disinfect is to close the house, for if the disinfectant is strong enough to kill the disease germs, no human being can stay in the house while it is being used. disinfecting should be done by the health officer, because he knows how much disinfectant is needed to kill every germ in the house and how it should be used. [sidenote: fraudulent disinfectants] sometimes you will see an advertisement saying that certain disinfectants will kill the germs of disease but will not affect the people. always remember that any disinfectant that is strong enough to kill the disease germs will also kill human beings, and do not be fooled by such advertisements. _never move into a house that has been previously occupied, until the house has been disinfected._ do not take it for granted that the people who lived there before had no communicable disease. do not take the word of the agent or of any one else that there has never been sickness in the house. people sometimes have tuberculosis without knowing it; people sometimes have tuberculosis or other communicable diseases without telling of it. it does not cost much to disinfect a house, and if the disinfection is properly done the disease germs will be killed. "an ounce of prevention is worth a pound of cure." try to convince your father that by having the new home disinfected he may save not only doctor's fees, but perhaps the lives of himself and his family. there are a great many things that boys and girls can do to help fight this disease. this "scourge" can be wiped out; but if the boys and girls do not help in this great work, it will never be done. =questions.= . why do people call consumption the great white plague? . what is the annual death rate from consumption in the united states? . compare the fatality from consumption with the number of soldiers killed during the civil war. . what amount of illness in the united states is due to consumption? . describe at least four forms of tuberculosis. . what determines the part of the body in which the germ of tuberculosis grows? =remember.= . tuberculosis and consumption are the same disease. . this disease kills more people than war, although it might be prevented. . tuberculosis is not confined to the lungs but may attack the tissues of any part of the body. . consumption is not inherited; it is a house disease rather than a family disease. . a house should be disinfected by the health officer before it is occupied by a new tenant. chapter xxxii how consumption is spread and how prevented [sidenote: how tuberculosis germs leave the body:] the sputum (spit) of the consumptive and the discharges from tubercular sores contain the germs that cause tuberculosis. sometimes these germs are so numerous that thousands of them would be found clinging to the point of a needle dipped into the sputum or discharges from a patient. when the consumptive coughs, he sends into the air many of the germs that cause tuberculosis. we cannot kill the germs while they are in the body of the consumptive; but we can kill them after they have left the body, by seeing that none of the sputum or discharge from tubercular wounds or sores is allowed to become dried and blown about as dust. [sidenote: (_ _) in discharges from sores] when the discharge from a tubercular sore becomes dried and blows about with the dust, the germs are inhaled into the lungs of other people, or fall into other sores and cause them to become tubercular. since this is one of the most frequent ways by which this dread disease is spread, you will say at once, "why, every particle of matter from a tubercular sore ought to be burned, so that there would be no possibility of the germs being scattered." this of course ought to be done, but this is not enough. people sometimes have consumption and are not aware that they have it. others may have tubercular sores and not know them to be such. any sore, whether it is tubercular or not, contains disease germs. they may not be the germs of tuberculosis, but even the least dangerous of them is the germ that causes pus (matter). since we are trying to get rid not only of the germs that cause tuberculosis, but also of the germs that cause all communicable diseases, it would be better to say, "all discharges from _any_ sore should be burned immediately." [sidenote: (_ _) in the sputum] when people spit on the sidewalk or on the floor, the sputum will of course become dry. sometimes a lady drags her dress through the sputum on the sidewalk or on the floor; it sticks to her dress and she takes the germs home with her. the sputum of the consumptive is loaded with the germs that cause tuberculosis, and if this sputum is allowed to be blown about with the dust, people will inhale it and thus get the germs into their lungs. certainly the consumptive should never spit on the sidewalk or on the floor, or in the mine, workshop, or in any place where the sputum may become dry and form dust. of course he should not fill the air about him with germs by coughing into it; everybody knows that. [illustration: fig. . a sputum cup of waterproof pasteboard.] [sidenote: why everybody should be careful about spitting and coughing] but _no_ man or woman, boy or girl, should ever spit on the floor or sidewalk. in the first place it is bad manners. no person does this who is well brought up. in the second place, we must remember that the consumptive does not like to have others know that he has consumption; this feeling is a part of the disease. if you expect the consumptive to refrain from spitting on the floor or sidewalk, you must help him by your example. you cannot expect him to be the only one to hunt up a cuspidor, when you yourself are spitting on floor or sidewalk. if you expect the consumptive to take the precaution necessary to protect you from this disease, you must take the same precaution yourself. in the matter of coughing, the same rules hold true. if you expect the consumptive to hold a handkerchief before his mouth when he coughs, you must do the same. [sidenote: how to avoid spitting on the floor or sidewalk:] since it is not right that the consumptive should spit on the floor or sidewalk, it will naturally be asked, "what is the consumptive to do with what he coughs up?" [sidenote: (_ _) by using paper napkins] at a very small cost he can buy paper napkins and envelopes which have been treated with paraffin to prevent moisture going through them. if every one with a cough or with any such trouble as catarrh, which makes him want to spit frequently, would carry a supply of these paper napkins and paraffin envelopes, he would always have a suitable place in which to spit. when you cough up anything, spit into one of these little napkins, put the napkin into the envelope, and when you get home burn the whole thing. [illustration: fig. . a pocket cuspidor.] [sidenote: (_ _) by using pocket cuspidors] there are other conveniences which can easily be carried in the pocket, called pocket cuspidors. some are made of thin cardboard, treated with paraffin, and filled with cotton to hold all the moisture of the sputum; others are made of glass, shaped like a bottle, with a wide mouth. those made of cardboard should be burned as soon as possible and the glass ones should be thoroughly washed with boiling water. [sidenote: (_ _) by having public cuspidors] in some cities cuspidors have been placed at the edge of the sidewalk in an effort to lessen the spread of disease caused by spitting. these cuspidors have a stream of water running through them constantly and are connected with the sewer. they are so made that they cannot easily be kicked over or upset, and they are placed on stands just high enough to make it easy to spit into them. if properly made, they are not unsightly. would it not be a good thing if your town would put such cuspidors on your streets, and if the merchants would put them into their stores? every office, every workshop, every store, every railway and street car should be provided with cuspidors. [illustration: fig. . the common drinking cup--a fruitful source of infection.] [illustration: fig. . the individual drinking cup--each cup clean and free from disease germs.] [sidenote: how consumption is spread from the lips:] we know that the substance which people cough up when they have consumption contains the germs that cause this disease. when they spit this matter out, many of the germs stick to the lips. this is true not only of consumption, but of the germs of other diseases, such as diphtheria, measles, and scarlet fever. [sidenote: (_ _) by drinking cups] when there are disease germs on the lips, it is impossible for a person to drink and not leave some of the germs sticking to the edge of the cup or glass. if the germs of disease are in the mouth, every time that the person suffering from this disease drinks from a cup, he leaves some of the germs on the edge of it. the next person to drink from that cup may get the germs into his mouth. [illustration: fig. . a sanitary drinking fountain for public places.] always avoid drinking from a cup or glass from which another person has been drinking. you can never tell who may have disease germs in his mouth, or when you may get them on your lips by drinking from the same cup. each individual should have his own cup and should never let any one else drink from it. [sidenote: (_ _) by putting pencils into the mouth] when you put the point of your pencil into your mouth, you will leave germs on it just as you do on the edge of a cup when you drink. never put your pencil into your mouth; never use any other person's pencil; never trade pencils. [sidenote: (_ _) by the common bite] sometimes we see a child giving his friends a bite of his apple or candy or cake. of course when disease germs are in the mouth of the one who takes a bite, the germs will be left on the apple, candy, or cake. by no means should a boy or girl be selfish, but if you have something to share with your friends, break it or cut it into pieces. never take into your mouth anything from which another person has taken a bite. [sidenote: how tubercular cows cause consumption] milk that comes from consumptive cows may contain the germs that cause tuberculosis. when you drink the milk from such cows, you take these germs into your body. they find their way from the stomach and intestine into the blood, and there they travel about until they find a spot where the cells are dead or are not doing their work properly. when they find such a place, they settle down and begin to grow; and the first thing you know, you will have tuberculosis in that part of your body. sometimes the germs do not have to go out of the stomach or intestines to find a favorable opportunity to take hold and grow. when this happens, we have consumption of the bowels. one cannot tell by looking at milk or by tasting it whether or not the germs of tuberculosis are present. they do not make the milk sour; neither do they make it look different from pure milk. one cannot tell by looking at a cow whether or not she has tuberculosis. sometimes a cow will have tuberculosis and yet look very healthy. there is, however, a way by which we can tell when a cow has this disease, no matter how healthy she may look. this is what is known as the tuberculin test. [sidenote: how to detect tuberculosis in a cow] if a little tuberculin is injected under the skin of a cow that has tuberculosis, it will make her have a fever and appear sick for a day or two. if she is free from tuberculosis, it will not make her sick at all. it would seem as if all people who sell milk would want to know whether their cows have consumption so as not to run any risk of conveying the disease to their customers. some of them do take this precaution, but a great many of them do not want to go to this trouble. sometimes you will hear them say, "oh, i do not believe in this tuberculin test." they do not want to believe in it because they know that the cows, if tested and found to have tuberculosis, will have to be killed. the reason that dairymen sell us milk from tubercular cows is the same that makes the man with scarlet fever in his house fail to tell the health officer about it; the same that makes the butcher buy and sell meat from diseased cattle; the same that makes some people absolutely regardless of the welfare of others--it is selfishness. =questions.= . how does a patient give off tuberculosis germs? . why should even well people refrain from spitting in public? . why should the sputum be taken care of? . why should we avoid the common drinking cup? . what is the danger from putting pencils into the mouth? . is it safe to use another person's pencil? . what is the best way of sharing food? . how can one be protected from tubercular milk? =remember.= . the sputum and discharges from all sores should be immediately burned or disposed of in such a way that they cannot become dry and be blown about as dust. . consumption may be contracted by the use of the common drinking cup, or by putting into your mouth such things as pencils and coins. . the milk from a cow suffering from consumption contains the germ of tuberculosis. . a cow may have tuberculosis and not appear to be sick. . the only way to determine whether a cow has tuberculosis is by using the tuberculin test. . every milch cow should be tuberculin tested. chapter xxxiii how consumption is cured [sidenote: consumption should be recognized early] when people first get consumption, they seldom realize that they are seriously sick. most of them think they have a bad cold, or are overworked, or that they have been staying too closely in the house. often they will not even see a doctor until they are so sick that the doctor cannot do much for them. when you have a slight cough that "hangs on"; when you feel feverish every afternoon; when you are short of breath; when you get tired very easily; when you do not feel like eating anything except candies and cakes--then you should think of consumption. these are not all the signs, but they are enough to make you go at once to a doctor. a long time ago the doctor would have felt badly if he had been obliged to tell you that you had consumption; but now he knows that if you go to him early in the disease and follow his directions, you will get well. [sidenote: how consumption is cured: (_ _) by rest] when the doctor finds that a person has consumption, the first thing he orders is rest. by this he means absolute _rest_. he does not mean that the patient can go to school or to the office part of the day and rest the remainder of the day. the doctor will want to watch him constantly. then there comes a time when he must begin to take a little exercise; the doctor tells him just how much exercise to take, and just what form of exercise is best for him. [sidenote: (_ _) by fresh air] the consumptive must have plenty of fresh air all the time; he must be out-of-doors as much as possible. you will wonder how the doctor expects him to be out-of-doors when he has been told that he must have absolute rest. later we will show you how one can practically be out-of-doors and yet at the same time be in bed. [sidenote: (_ _) by sunshine] sunshine will kill the germs of any disease more quickly than almost anything we know of, and a consumptive must have all the sunshine that he can get. of course it cannot get into the body to kill the germs, but it strengthens the cells of the body so much that they can fight with just that much more energy. [illustration: figs. and . living outdoors in cold weather.] [sidenote: (_ _) by nourishing food] nothing is more important than pure food in building up the body and in making heat and power. in consumption the food that is stored up in the body burns itself up very fast. the consumptive must therefore take not only the food needed to supply the usual demands of the body, but enough to make something extra for the disease to burn up without drawing on the reserve fund stored in the body. in order to do this, he will have to eat a great deal, and what he eats must be of the kind that makes the best building material and the most nourishing material. he cannot tax his stomach by eating things that are not nourishing; all the work his stomach can do must be devoted to the foods he really needs. the weapons with which we fight consumption are rest, good food, fresh air, and sunshine. these will do more good than all the medicine in the world. fresh air is not only one of the best things for the cure of consumption, but it is one of the best things for the prevention of consumption. you should always breathe plenty of fresh air night and day, and there is plenty of fresh air to be had if you will take it. [illustration: fig. . a window tent. (invented by dr. w. e. walsh.)] [sidenote: how to have fresh air at home:] if you have only a single window in your room, try to sleep with your head in the fresh air. it is not always easy to arrange a room in such a way that you can have fresh air without placing your bed in a draft, but even this difficulty can be overcome. [sidenote: (_ _) by window tents] there are several devices, called window tents, which you can buy. by the use of such a tent, your head will be out-of-doors all the time; yet the draft cannot strike your body, because a part of the tent fits around your neck and cuts off the air from the rest of your body. one of these tents is shown in figure . you do not put your head out of the window; your head is on your pillow just as if the tent were not there. your bed is placed directly in front of the window and the tent comes down over your pillow, allowing your head practically to be out-of-doors, but keeping the cold air out of the room. sleeping under a window tent is the next best thing to sleeping out-of-doors. [illustration: fig. . a sleeping porch built in a house.] [sidenote: (_ _) by sleeping porches] many of our modern houses are built with sleeping porches on which one can sleep outdoors summer and winter. where there is not a special sleeping porch on the house, an ordinary porch may often be made to serve the purpose, or a very inexpensive sleeping porch can be added to the house. [sidenote: (_ _) by tent cots] sometimes people cannot get the use of a porch of any kind. in such cases it may be possible to put up a tent in the yard. if the yard is very small, a tent cot may be used. this is simply a cot with a tent on it, which can be closed up and put away in the daytime and set up again at night. in a large city where the houses have no yards at all, this arrangement can be used by setting it up on the roof of the house. there is almost always some way of securing fresh air at night if we will only give a little thought to the matter. [sidenote: fresh air in schoolrooms] unfortunately, many of our school buildings are not provided with good ventilating plants. a proper system of ventilation furnishes at least cubic feet of fresh air per hour for each child in each room. [illustration: fig. . an open-air schoolroom for consumptive children.] [sidenote: the necessity for playgrounds] in large cities it is often impossible to find outdoor space in which boys and girls may play during recess. even this difficulty can be overcome by turning the roof of the school building into a playground, with a high wire netting around it. every school yard should be provided with swings, bars, and gymnasium apparatus to encourage the children to take plenty of exercise. children who live in crowded towns need exercise during vacation as well as during school days, and the school yards should be open to them at all times. a summer teacher who shows the children the best way to exercise, has work fully as important as that of any other teacher during the school term. a sound body is more valuable than education itself, but a good education and a sound body together are the best assets any man or woman can have. =questions.= . state the four things necessary to cure consumption; show the value of each. . what is the value of fresh air to every one? . how may an abundance of fresh air be secured in the home? . in the school? =remember.= . rest, fresh air, sunshine, and nourishing food are the cures for consumption. . all these things can be secured in any climate and by every person. . =tuberculosis is a communicable disease.= . =tuberculosis can be prevented.= . =tuberculosis can be cured.= appendix[ ] a summary of anatomy bones and joints [sidenote: the framework of the body] the framework of the body is composed of bones. there are bones (not including the teeth) in the body. the bones of the body are divided into four classes--long bones, short bones, flat bones, and irregular bones. [sidenote: construction of bones] regardless of their shape, all bones are composed in the same way. every bone has an outer and an inner portion. the outer portion is a dense layer called _compact bone_. the inner portion is more open, and is much weaker; this is called _cancellated bone_ (from _cancella_, a sponge). in the smaller bones, the marrow, which is quite soft, runs through the spongy bone; in the larger long bones, the marrow is distinct and is enclosed by the spongy bone. [sidenote: the periosteum] every bone is covered by a thick, tough layer, the _periosteum_, which has three uses. when the bone is injured by disease or accident, the periosteum makes new bone to fill in and repair the break. it also builds new bone on the surface of the old as long as the body is growing. finally, the periosteum gives strong and firm attachment to the muscles, which send tendons into it. [sidenote: joints] every bone in the body (except the hyoid bone, to which the tongue is attached) is joined with some other bone. most of them join with two or more bones. in most instances the end of a bone which joins with another is rounded off and made very smooth, so that it can slide easily over the other bone. there are three principal kinds of joints in the body. they are called the _ball and socket_ joint, the _hinge_ joint, and the _serrated_ or _saw-tooth_ joint. [illustration: fig. . the skeleton.] [sidenote: the ball and socket joint] the ball and socket joint is one that can move freely in all directions. we see it illustrated in the joints of the shoulder and hip. in these joints one of the bones has a deep depression in it, and this depression forms the _socket_. the other bone has a rounded head that fits into the depression. we call this rounded head the _ball_. [illustration: fig. . the structure of a bone.] [sidenote: the hinge joint] the hinge joint is illustrated in the knee and elbow joints. these joints can move backward and forward in one plane like a hinge, but they cannot move in a circle like the ball and socket joints. you cannot swing your forearm about on a pivot at the elbow as you can your whole arm, nor will the knee joint bend in every direction as does the joint at the hip. [sidenote: serrated joints] serrated joints do not move. the bones having serrated joints are fitted tightly together so that they form practically one bone. we find this kind of joint illustrated in the way the bones of the skull are put together. [sidenote: ligaments] the joints of the body are not held together by rivets, pins or bolts as are the joints of a machine, but by bands of very tough tissue placed about a joint in such a way as to allow it to move freely, although the bones are all the time held firmly together. these bands are called _ligaments_. ligaments are much better than bolts or pegs would be, because they stretch a little, and thus prevent the breaking of the bones when the joint is put under a severe strain. [illustration: fig. . the muscles.] muscles and tendons [sidenote: what muscle is] the lean meat of any animal is composed entirely of muscle tissue. it is the function of the muscles to move the body. [illustration: fig. . the biceps muscle contracted.] [sidenote: how the muscles work] the muscles are nearly all attached to the bones. they are just long enough to let the joint straighten out when the muscles are at rest, but when the joint bends the muscle contracts. when a muscle contracts it becomes shorter and thicker. sometimes it becomes very much thicker in one place. every boy knows how much thicker the arm muscle (_biceps_) becomes when he bends his elbow hard. he calls this "showing his muscle." [sidenote: tendons] there is not room enough on most of the bones for all the muscles to be attached directly to them. instead of being thus attached directly to the bone, they end in what we call _tendons_. these tendons are hard and strong, and a very small tendon will lift as much without breaking as quite a large muscle. the muscles are soft and would have to be attached over a large area in order to secure the required strength. the tendons, being so much stronger than the muscles, can be attached to a very small area and yet secure the same amount of power as would result from attaching the muscle itself. the tendons pass directly into the periosteum, the thick, strong covering of the bones. so strong is this attachment that the bone will often break before the tendon will pull loose. the skin [sidenote: the skin as an armor] the entire body is covered with skin, which regulates the heat of the body and acts as an armor against blows and cuts which would otherwise injure the delicate nerves and blood vessels beneath. it also serves to some extent to keep out the germs of disease. the skin appears to be smooth, but if you examine it through a strong magnifying glass you will see that it is divided into little areas. the dividing lines do not run straight, however, and the areas are not square like those you find on a checkerboard. [illustration: fig. . a section of the skin, highly magnified.] [sidenote: sweat glands] after looking at the skin with a strong magnifying glass you will think that you must have seen all its irregularities, but if you will look at it with a powerful microscope you will find out many other things. in the first place you will see many little openings in the skin. these little openings make the ridges which divide the skin into little areas. some of the openings are _sweat glands_, and there is always some perspiration coming out of them. when you are very warm you can see, without the aid of the glass, the drops of perspiration as they come out on the surface of the skin. when you are not very warm you cannot see these drops of perspiration, but they are nevertheless coming out all the time. when the perspiration comes so slowly that you cannot see it, it is called _insensible perspiration_. [sidenote: hair] the whole body is covered with hair. you can see the hair on your head and some of the hair on your arms and the backs of your hands, but most of the hair on the body is so fine that you cannot see it without a microscope. each of the fine hairs on the body has a root that goes through the skin just as the root from each hair on your head goes through it. [sidenote: sebaceous glands] opening into the little pockets in which the hairs stand, are glands that secrete a kind of oily material. they are called _sebaceous glands_ or _follicles_. sometimes these follicles become stopped up; then the material they secrete becomes thick and cheesy, and the little black points appear on the skin which we call _blackheads_. the white matter which comes out of these blackheads is merely the secretion of the glands from which the water has been absorbed, leaving the solid or cheesy portion. [sidenote: nails] there is a part of the skin that we do not usually think of as skin. we mean the _nails_. the finger nails and the toe nails do not look like the rest of the skin of the body, but they are made of just the same kind of cells. the cells of the nails are flat, dead, and closely packed together. there are no sweat glands, or sebaceous glands, or any hairs in the nails. the digestive system [sidenote: the alimentary canal] the digestive system is the part of our bodies in which the food we eat is so changed that it can be made use of by the little cells in the body. it is composed of a long canal with many parts and enlargements, each part necessary for a certain required work. this canal as a whole is called the _alimentary canal_. [sidenote: teeth] the mouth does the first part of the work for the digestive system. here we find the teeth, which are used for grinding the food. the teeth are composed of three parts, the _head_ (or _crown_), the _neck_ and the _root_. the head, or crown, is very hard. each tooth is hollow, and in the hollow portion there are nerves and blood vessels. [sidenote: the salivary glands] opening into the mouth are three pairs of glands known as _salivary glands_. one pair of glands is located just above the angle of the jaw. it is these glands that become swollen when we have mumps. another pair of glands is placed just inside the jaw bone, near the root of the tongue, and the third pair is located under the tongue. these three pairs of glands secrete the saliva which moistens the food and aids in digesting the starch. [illustration: fig. . the alimentary canal.] [sidenote: the esophagus] the food passes from the mouth; through a passage called the _esophagus_, or gullet, to the _stomach_. [sidenote: the stomach] the stomach is one of the enlarged parts of the alimentary canal. its walls are quite thick, and in these walls are thousands of little glands. these glands secrete a fluid called _gastric juice_. when the food enters the stomach it is held there for a long time, and the walls of the stomach squeeze upon it so that the food is mixed with the gastric juice until every bit of it that will be of any use to the body has become fluid in character. not only does the gastric juice make the food liquid, but it acts on it and changes some of it so that it will be suitable for use by the little cells of the body. as fast as the food is made liquid by the juices of the stomach it is allowed to pass into the intestine through an opening called the _pyloric opening_. [sidenote: the intestine] the intestine is a long, narrow, twisting and turning tube that is divided into two principal parts, the large and small intestine. in the walls of the intestine are many little glands that secrete a fluid that helps in digesting the food. two fluids, one made by the liver, the other by the pancreas, are brought into the intestine by two small tubes, which come together in the wall of the intestine six or seven inches below the pyloric opening. these fluids perform a very important part in the digestion of all the different foodstuffs. [sidenote: villi and lymphatics] besides the little glands in the walls of the intestine there are many thousands of little finger-like projections standing up from the walls. these are called _villi_. each villus has in it very small vessels, into which the food passes after it has been digested. these vessels are of two sorts: blood vessels, which take up the digested starch and proteid foods, and another sort known as _lymphatics_, which take up the fats. all the lymphatics combine into a single vessel which empties into the great vein at the base of the neck. thus the fatty foods pass into the blood and are mingled with the food materials taken up directly by the blood vessels. circulation of the blood [sidenote: two kinds of blood vessels] there are two kinds of blood vessels in the body. we call them _arteries_ and _veins_. the arteries serve to carry the blood from the heart to all parts of the body, and the veins serve to carry the blood back to the heart. the heart is really a part of the blood vessels, half of each side being like the veins and half like the arteries. [sidenote: arteries and veins] the walls of the arteries are thicker than those of the veins. two sets of arteries leave the heart, one from each side. the artery that starts from the right side of the heart goes to the lungs and carries _venous blood_, which has a very poor supply of oxygen and is full of impurities. we call this the _pulmonary artery_. the artery that leaves the left side of the heart goes to all parts of the body but the lungs and carries _arterial blood_, which has much more oxygen and is much more free from impurities. [sidenote: capillaries] if we follow the blood as it circulates we will see how it reaches all parts of the body. the big artery that leaves the left side of the heart divides into smaller and smaller arteries until there are branches going to every part of the body. these branches keep dividing until they are so small that we call them _arterioles_, and these little arterioles again divide and become so small that we call them _capillaries_. [sidenote: changes in the blood] while the blood is passing through the arterioles and the capillaries, something is happening to it. the little cells with which these small vessels come in contact have been taking the oxygen and the nourishing material out of the blood. at the same time they have been putting something into the blood. in place of the oxygen they have been putting in carbon dioxid and in place of the nourishing material they have been putting in the worn-out materials from the cells. as the blood passes through certain parts of the body, such as the kidneys, the worn-out materials from the cells are taken out of the blood and sent out of the body. the carbon dioxid is left in the blood until it goes to the lungs. [illustration: fig. . the white vessels represent the circulation of the arterial blood; the gray, the circulation of the venous blood.] [sidenote: venous blood] the blood has now been followed to the capillaries, where oxygen and nourishing material have been taken out of it, and where something else has been added to it. as we follow a little capillary, we find that instead of dividing again, it joins others and gradually grows larger. as these blood vessels grow larger the walls do not become so thick as the walls of the arteries of the same size. these larger vessels formed by the union of capillaries are called _veins_. in other words, the veins are simply continuations of the arteries that have divided into extremely small branches and have now come together again. the blood which has been changed is now called _venous blood_. it has much less oxygen in it, but has received a great deal of carbon dioxid. the veins continue to come together, until finally they form a single large vein which empties into the upper half of the right side of the heart. from there the blood is driven into the lower half of the right side of the heart and thence to the pulmonary artery, which goes to the lungs. the blood is not changed in the heart, so what goes into the pulmonary artery is still venous blood. [sidenote: arterial blood] the blood goes straight from the heart to the lungs and there it is changed into arterial blood. the change consists in taking oxygen from the air and giving off carbon dioxid to the air. from the lungs the blood goes through the capillaries again into the veins, the small capillaries in the lungs uniting to form the pulmonary veins. these veins finally unite into one vein that empties into the upper half of the left side of the heart, and from there the blood goes to the lower half of the same side. the blood has now reached its starting point and is ready to begin its journey again. the journey of the blood is as follows: [sidenote: entire circulation] from the right side of the heart to the arteries; from arteries into arterioles; from arterioles to capillaries; from capillaries into veins; from veins into the heart; from the heart to the lungs; and from the lungs back to the heart again. the respiratory system [sidenote: use of the respiratory system] that portion of the body by which we breathe is called the respiratory system. this system is composed of the _nasal passage_, the _pharynx_, the _larynx_, the _trachea_, the _bronchi_, and the _lungs_. the mouth is not a part of the respiratory system; we should never breathe through our mouths. [sidenote: the use of the nose in breathing] as the air passes through the nasal passage it is warmed and moistened, and a great deal of dust and dirt is taken out of it. thus the nasal passage serves to warm, to moisten, and to clean the air we breathe, and is a very important part of the respiratory system, since either cold or dry air is very irritating to the lungs. [illustration: fig. . the air passages of the head and throat.] [sidenote: pharynx, larynx, and trachea] there is only one tube leading from the back of the nasal passage to the lungs. different parts of this tube are given different names. the pharynx is that part that extends from the back of the nose to the vocal chords. the larynx is the part of the throat where the vocal chords are located. we sometimes call it the "adam's apple." it is very prominent in some men, but seldom noticeable in women. the trachea is the part of the tube leading down from the larynx. at the lower end of the trachea the tube divides into two parts that we call the bronchi, one leading to each lung. [sidenote: the bronchi] the bronchi carry the air from the trachea to the lungs. they divide again and again until they become so small that there is a branch for each little air cell in the lungs. [illustration: fig. . the lungs.] [sidenote: the lungs] the lungs are the most important part of the respiratory system. they are made up of lobes. there are two lobes in the left lung and three in the right. each lobe is divided into _lobules_, which means small lobes. each lobule is divided into air spaces. in these air spaces, or cells, the work of the lungs is performed. [sidenote: air cells] the capillaries run in the thin walls of the air spaces. the walls of these fine blood vessels are so very thin that the air in the air cells comes in almost direct contact with the blood in the vessels. while the blood is passing through the vessels in the walls of the air spaces, something happens to both the blood and the air. the air we take into our lungs contains a great deal of oxygen and very little carbon dioxid. the air that comes out of our lungs contains a great deal of carbon dioxid and much less oxygen. in other words, the oxygen from the air goes into the blood, and the carbon dioxid from the blood goes out into the air. [sidenote: necessity of pure air] if the air we breathe is not pure and does not contain enough oxygen, the blood cannot get all the oxygen we need, and the cells of the body become sick and die. if, when we breathe, we do not fill each little air cell in our lungs with air, a great deal of the blood sent to the lungs for oxygen cannot get it. if we wear very tight clothing we cannot take a full breath and hence cannot fill all the air spaces with air. if the air spaces in the lungs are not filled, the blood does not get the oxygen it needs, as there is no other place in the body to get it. the eye and the ear [sidenote: the eye compared to a camera] the eye is one of the most important organs in the body and also one of the most delicate. it is very much like a camera. [sidenote: the cornea and the sclera] when you look at an eye you are likely to think that the front of it is blue or brown. the colored part is not the front of the eye. if you look at the eye from the side you will see that there is a curved part in front of the colored part and that the curved part is perfectly clear. this curved clear part of the eye we call the _cornea_. the cornea connects with the white part of the eye, and this white part extends all around the rest of the eye, except at a small point in the back where the _optic nerve_ comes through. this white part we call the _sclera_. [sidenote: aqueous humor] the space between the cornea and the colored part of the eye is filled with a clear fluid that is called the _aqueous humor_, which means watery fluid. the space occupied by this fluid is called the _anterior chamber_ of the eye. [sidenote: the iris] the iris, which is the colored portion of the eye, is a curtain that is hung between the anterior and posterior chambers of the eye. it prevents any light getting into the posterior chamber except that which passes through a round hole in the iris called the _pupil_. the pupil grows larger or smaller according to the amount of light needed by the eye. if you look away from a bright light at something in the dark, the pupil grows larger; if you look back at the light, it grows smaller. you can see this in a hand mirror. [sidenote: lens] behind the pupil is a clear mass shaped like a very strong magnifying glass. this is the _lens_. the lens causes to be formed on the back of the eye a clear picture of whatever you are looking at. when you focus a camera, you move the back towards or away from the lens. when you focus your eye you cannot move the back of the eye, but you can make the lens more or less convex as may be needed to make a clear picture. [illustration: fig. . a cross-section of the eye.] [sidenote: vitreous humor] behind the iris and the lens, we find the posterior chamber of the eye. this occupies by far the greater portion of the ball and corresponds to the dark chamber of a camera. this chamber is filled with a clear fluid called the _vitreous humor_, which means jelly-like fluid. it is a clear, gelatinous substance. [sidenote: the retina and the optic nerve] the optic nerve enters the eyeball from the back and spreads its fibers out in a thin membrane called the _retina_, which corresponds to the sensitive plate in a camera. the lens focuses on the retina the image of any object you look at. the impression made on the minute nerve endings in the retina is carried by the optic nerve fibers to the brain. when this impression reaches the brain we see the object. [sidenote: movements of the eye] each eye has six muscles that turn it in whatever direction you want to look. these muscles are very delicate, and for true sight they must be exactly adjusted. if the muscles on one side of the eye are stronger than those on the other side, you will be cross-eyed or wall-eyed. if one of the muscles in one eye is stronger than the corresponding muscle in the other eye, it pulls the eyeball out of place and you "see double." [sidenote: the use of the outer ear] the portion of the ear that you see on the side of your head has as much to do with hearing as the outer rim of the horn into which you speak has to do with making a record for the phonograph. you know that the record is really made at the little end of the horn, while the big end simply collects the sound. the outside portion of the ear simply collects sounds, and the real hearing is done with the portion of the ear that is not seen. [illustration: fig. . the ear, showing the outer, middle, and the inner part.] the outer ear connects with the short tube that leads to the _drum_, which is a thin membrane that separates the middle ear from the outer ear. this drum does not have so much to do with hearing as is supposed. to have a hole in the drum does not mean that you cannot hear. [sidenote: the middle ear] the middle ear is that portion which is just inside the drum. in this we find a chain of little bones. the one attached to the drum is shaped much like a hammer, and is called the _malleus_, which means mallet or hammer. the next one is shaped like an anvil and is called _incus_, which means anvil, and the third is called _stapes_, which means stirrup. the flat part of the stapes fits into a small opening that leads to the internal ear. [sidenote: the inner ear] the internal ear is shaped like a snail shell. it makes several turns, which are hollow like the ends of a conch shell. in these channels the nerve that receives the impressions made by the sounds is distributed. this nerve carries the impressions to the brain. [illustration: fig. . the nervous system.] the nervous system [sidenote: importance of the nervous system] this system is so important in its use and so difficult to understand in its details, that a description of it should have more space than can be given in this summary. can you imagine having no feeling and being unable to move? this would be your condition if you had no nerves. [sidenote: nerves compared to telegraph system] briefly, the nerves might be called the telegraph system of the body. there is a great central station called the brain where messages are received and sent out; there are many sub-stations that make up the spinal cord. twelve great nerves pass directly from the brain to the body; all others pass from the spinal cord. [sidenote: extent of nervous system] every nerve leaving these centres divides and sub-divides into little threads as the arteries divide and sub-divide into arterioles and capillaries, until every part of the body--every muscle and part of the skin--has its nerve. [sidenote: voluntary and reflex action] every time you _choose_ to move your hand, your brain sends to the necessary muscles an instantaneous order to act. this is called _voluntary action_. if you put your finger against a hot stove you jerk it away before you could have time to _choose_ to do it. this happens as an order from a sub-station and is called _reflex action_. messages travel both ways and it is necessary that the nervous connection with every part of the body remain unbroken, and important that the nervous condition be kept healthy. notes to the teacher a false delicacy has often prevented the teaching of vital lessons to growing children. the day is how at hand when foolish sentiment must no longer prevent the spread of any knowledge which is necessary to exterminate the plagues that have afflicted the race. in chapters , , and , unpleasant facts are given in plain language. they are facts that parents do not teach their children and that most teachers will not frankly treat with classes in a school. though they are disagreeable to discuss, they are essential for children of school age to know. now that the dependence of public health upon personal hygiene is recognized, personal habits and sanitary conditions are more frankly dealt with than formerly. it is an excellent thing occasionally, to have one or two points of an assigned lesson answered in writing. any topic that the teacher may think advisable to treat in this manner may be discussed on paper at the beginning of the recitation, five or six minutes being allowed for that purpose. even a whole chapter may be assigned to be studied with a view of answering in writing the questions at the end of the chapter. the written test can then take the place of the usual oral recitation. this method is suggested to the teacher who hesitates to discuss orally certain plain but essential facts. chapter on the spread and prevention of consumption can be treated with best results orally, if the pupils are first made to _feel_ the great danger of consumption and to realize the possibility of preventing the vast havoc wrought by that dread disease. the attitude of teacher and pupils should be that while the discussion may be disagreeable, the disgusting habits referred to in the text are so commonly practised that unless their dangers are taught this disease can never be wiped out. index adenoids, , air, amount necessary for health, ; effects of impure, - ; fresh air, when needed, - ; how secured, , ; how changed in body, ; necessity of pure air, - air cells, alcohol, effect of, on body, - ; on brain work, ; on consumptives, ; on descendants, ; on liver, ; on morals, ; on nervous system, ; on powers of resistance, ; on stomach, ; false ideas about effects of, ; what business men think of, alimentary canal, , amoebic dysentery, how prevented, ; how spread, ; where prevalent, animals free from typhoid fever, antitoxin, how it acts, - ; how discovered, ; sometimes considered a poison, ; prevents diphtheria, ; saves lives, aqueous humor, arterial blood, arteries, articles used by the sick, dangers from, ; how to treat, bathing, importance of, ; frequency of, baths, hot, ; cold, bedtime for children, blood, arterial, ; how changed in the body, ; venous, , boils, how caused, , bones, bronchi, building foods, , candy, when harmful, ; when not harmful, canned meats, why poisonous, capillaries, cells, are alive, ; body made of, ; body needs new, ; how killed, ; must not be killed, ; size of a, ; what they are like, circulation of the blood, - clothing, effect of damp, ; promotes health, ; proper weight of, common drinking cup, consumption. _see tuberculosis_ cooking, effects of improper, , ; fatty foods, ; meats, ; starchy foods, cornea, coughing, dangers from, , - ; how to prevent dangers from, , cuspidors, in public buildings, ; pocket, ; street, dairy, sickness about a, , , decomposed foods dangerous, , decomposition, cause of, ; effect of cold on, ; of foods, - desserts, when harmful, ; when not harmful, dining table, effect of dirty, ; cheerfulness at, diphtheria, cure of, - ; germs present after recovery, , ; germs present when throat is not sore, ; how to confine germs, ; how poison is fought, - ; mild cases, how detected, ; nature of the poison, ; prevalence of, ; where germs come from, ; why some cases are not quarantined, - dirt, a cause of sickness, , ; getting into milk from cows, , ; from cow barns, - ; from milk cans and bottles, , ; from milkmen, ; from flies, , , diseased animals, effect on meats, - ; effect on milk, ; tuberculosis from, , drafts, evil effects of, ; how to prevent harm from, ear, care of, ; drum, ; inner ear, ; middle ear, ; outer ear, esophagus, excreta from sick, how dispose of, , exercise, necessity of, , eye, how germs get into, ; how overworked, ; method of testing, far sight, flies, breeding places for, , ; as germ carriers, , , ; how to get rid of, , ; how to keep out, fly screens, where needed, foods, advertised, ; building, - ; decomposition of, - ; heat-producing, - ; improper cooking of, , ; cost of suitable, ; uses of foods, - ; uses of starches, ; uses of fats, ; value of meat as a, ; value of milk as a, garbage cans, should be covered, germs, cause of poison in meats, , ; carried by dogs and cats, ; effect of, in wounds, - ; how, get through the skin, ; how, get into the body, ; how, get into foods, , ; how put into the air, , ; how kept out of the air, , ; how to fight, ; of lockjaw, ; man's greatest foe, ; nature of a, ; not alike, ; not killed by running water, hair, hearing, how tested, heat, how kept up in the body, hookworm disease, character of the worm, ; how it enters the body, ; how prevented, ; nature of the disease, ; where worm lives in the body, ; where prevalent, insects that carry disease, - intestines, iris, joints, larynx, , lens, the, ligaments, lungs, lymphatics, malaria, how transmitted, ; how prevented, manure, a hatching place for flies, , ; how to dispose of, meal times, frequency of, ; regularity of, ; should be pleasant, , measles, after effects of, ; fatality of, ; necessity of care in, ; seriousness of, ; why to avoid, meats, characteristics of good, ; clean meat league, ; from diseased animals, - ; germs cause poison in, , ; how kept clean, ; should be cooked, ; value of, as a food, milk, as carrier of disease, , ; effect of germs on, ; effect of disease in cow on, ; flies in, ; how germs get into, - ; impure, dangerous, ; polluted water in, ; typhoid fever carried by, ; value of, as a food, , mosquitoes, as disease carriers, , ; how to get rid of, mouth, why some breathe through, mouth-breathing, effect of, muscles, attachment of, nails, how to care for, , near sight, nerves, compared to telegraph system, ; distribution of, nose, importance of breathing through, overcoats, necessity of, overwork, effect of, , paper napkins for consumptives, parties, time for, pencils in mouth, pharynx, play a form of work, playgrounds, pocket cuspidors, ptomaines, quarantine, breaking, shows selfishness, ; how broken by family, ; rules of, ; seriousness of breaking, ; when safe to raise, ; why necessary, ; why some cases escape, - reflex action, respiratory system, - rest, proper amount of, retina, rocky mountain spotted (tick) fever, how transmitted, rubbers, necessity of wearing, saliva, effect of, on starches, , salivary glands, scarlet fever, a dangerous disease, ; mild cases dangerous, , scarlatina, scarlet rash, why quarantine is necessary in, school lunches, sclera, sebaceous glands, sewage, effect of, on water, - , sickness about a dairy, , , ; due to germs, how prevented, sick room, stay away from, skin, care of, , smallpox, fatality of, ; how prevented, - ; during franco-prussian war, ; in sweden, ; in gloucester, ; in the philippine islands, spitting, dangers from, ; how avoided, ; where to spit, , ; where not to spit, springs, how polluted, street cuspidors, sunshine, effect of, on germs, , suppuration, how the surgeon prevents, ; how you may prevent, ; real cause of, sweat glands, the work of, teeth, brittle, ; dangers from poor, - ; how to care for, ; necessity of baby teeth, ; uses of teeth, ; why, decay, tendons, tobacco, a poison, ; effect of, on blood, ; on heart, ; on nervous system, ; on nose and throat, ; on stomach, ; extra work caused by, toilets, improper construction of, ; proper construction of, ; relation to wells, - tonsils, , trachea, tuberculin test, , tuberculosis, can be prevented, , , ; fatality of, ; fresh air in, , ; germ, discovery of the, ; how to get, out of a house, , ; how germs leave the body, , ; how spread from cows, , ; how spread from the lips, - ; how detected in cows, ; a house disease, , ; not inherited, ; of the glands, ; of the joints, ; of the spine, ; of the stomach, ; of the throat, ; prevalence of, ; pure food in, ; rest in, ; should be recognized early, ; sunshine in, ; why called the great white plague, typhoid fever, animals free from, ; carried by flies, , , ; carried by milk, , ; effect of a single case, ; how germs leave the body, ; how germs get into the body, ; how germs get into water, ; importance of cleanliness, , ; life of germs in a stream, ; recovered patient dangerous, umbrellas, necessity of, vaccination, cause of sore arms after, , ; discovery of, ; how, prevents smallpox, ; necessity of repeating, ; pretended vaccination, ; when successful, ventilation, in homes, , ; in public buildings, , ; in workshops, veins, venous blood, , villi, vitreous humor, voluntary action, water, avoid polluting, - , ; effect of sewage on, , ; how germs get into, - ; polluted, in milk, ; safe sources of, wells, how polluted, , ; relation of toilets to, , windows, should be kept open, - ; should be screened, wood-ticks, as disease carriers, ; how abolished, wounds, importance of keeping clean, yards should be clean, yellow fever, how transmitted, ; how prevented, footnotes: [ ] bujar and baier state that the nourishing power of bacon is represented by , , while the nourishing power of butter is represented by , . [ ] the cleaning out of these cemented vaults is an exceedingly unpleasant task. some prefer to have a strong, water-tight box placed under the closet seats. when this box is nearly full, it can be removed to some place where fertilizer is needed, and there emptied, the contents being plowed into the ground. in order to make this task as simple as possible, it is a good plan to put the box on skids, and have a heavy strip in one end with a bolt and ring through it, so that a horse can be hitched to the box to draw it away. if a little dry earth or lime is put into the box each day, there will be no unpleasant odor. [ ] the teacher should demonstrate the action of acids and alkalies on a solution of litmus. [ ] at the request of many practical teachers the author has appended this brief summary of anatomy. the material is intended to be used for reference or to be assigned as lessons in connection with the chapters of the book, at the discretion of the teacher. produced from scanned images of public domain material from the google print project.) sound mind; or, _contributions_ to the natural history and physiology of the human intellect. by john haslam, m.d. late of pembroke hall, cambridge: formerly president of the royal medical, natural history, and chemical societies of edinburgh. london: printed for longman, hurst, rees, orme, and brown, paternoster-row. . printed by strahan and spottiswoode, printers-street, london. to sir james mackintosh, m.p. dear sir, the privilege of long acquaintance, and a sufficient experience of the kindness of your disposition, might be an adequate inducement to dedicate the following pages to your notice. to this offering, i am however impelled by motives, which boast a higher descent, and more enlightened character:--an admiration of your superior talents, and the adaptation of those excellent endowments, to the advancement and happiness of the human race,--and by which you have been enabled "the applause of listening senates to command." the subjects to which i now solicit the permission of prefixing your name, were once your favourite study; and i am induced to consider your profound researches into the nature and constitution of the human intellect, as the basis of that high reputation, you now so deservedly maintain among the wise and dignified of your contemporaries. i am, dear sir, with respect, esteem, and the kindest feelings, your very obedient servant, john haslam. preface. the indulgence of the public has been already extended to several works which i have submitted to its decision on the subject of insanity; and the same favourable interpretation is now solicited for the present performance,--which attempts the more difficult investigation of sound mind. in treating of mental derangement, i became very early sensible, that a competent knowledge of the faculties and operations of the intellect in its healthy state, was indispensably necessary to him, who professed to describe its disorders:--that in order to define the aberrations, the standard should be fixed. there was indeed no lack of theories and systems of metaphysic; and although they essentially differed, many possessed the highest reputation. amidst this distraction of conflicting opinions, which no mediator could adequately reconcile,--without daring to contend with a host of discrepancies, or presuming to demolish the lofty edifices which scholastic pneumatology had reared,--i determined to throw off the shackles of authority, and think for myself. for it was evident, on the freehold ground of literature, that there is "ample room and verge enough" for every man to build his own tenement;--and the present construction is too lowly to intercept another's prospect, and without those ornaments that might provoke the jealousy, or challenge the rivalship of surrounding inhabitants. the mind of every rational person may be considered as an elaboratory, wherein he may conduct psychological experiments:--he is enabled to analyze his own acquirement,--and if he be sufficiently attentive, he may note its formation and progress in his children:--and thus trace the accumulation of knowledge, from the dawn of infancy to the meridian of manhood. the prosecution of these means, according to my own views, will qualify the diligent observer, to become the natural historian and physiologist of the human mind. in the comparative survey of the capacities of man, and the intelligence of animals, the contrast has appeared so striking, that it was impossible wholly to abstain from the inference of his future destination:--notwithstanding very different conclusions had been extorted by some modern physiologists. it has been often remarked, that the practitioners of the healing art, have been very moderately impressed with a solicitude for the future. this observation, in some late instances, has been unhappily confirmed:--but it would be unjust to visit the whole tribe with a sweeping and acrimonious censure, for the transgressions of a few. the reproach has, however, long existed. the venerable father of english poetry, in his description of the doctor, has passed a high and merited compliment to his learning; which at that period was a heterogeneous compound of greek, latin, and arabian lore, mysteriously engrafted on galenicals and astrology:--yet with this courteous concession to his professional science he could not refrain from a dry and sarcastic memorandum, that "his study was but little in the bible." throughout this inquiry, the province of the theologian has never been invaded:--it has been my humble toil to collect and concentrate the scattered rays which emanate from natural reason,--a pale phosphoric light, and "uneffectual" glow, compared with the splendid and animating beams, which issue from the source of divine communication. as the object of these contributions, has been principally to convey my opinions, concerning the formation of the human mind, from the superior capacities that man possesses, many subjects have been left untouched, which, in similar works, urge an important claim to the attention of the reader. among these neglected articles, the imagination is the chief omission:--of which many authors have treated so copiously, and so well. according to my own views, the consideration of this faculty was not essential to the outline that has been traced;--and it has been rather deemed a graceful embellishment, than a constituent pillar of the edifice of mind. this gay attirer of thought, that decks passion and sentiment, is also the prolific parent of fiction;--and justly banished from the retreats of sober demonstration.--to the science of numbers,--to mathematical precision, and to the whole range of experimental philosophy,--imagination does not lend her glowing and gaudy tints. no vestiges of her colouring can be discovered in divine ordinances, or in the systems of human jurisprudence:--neither in the ten commandments nor in the statutes at large. imagination may indeed enliven the cold pages of historical narrative, and blend the "utile dulci"--but even here she is a profane intruder: and a vigilant eye must be directed, lest, in some unguarded moment, her seductive blandishments should decoy the nakedness of truth. a sedate and unambitious recorder of facts, does not presume to describe her regions, or to enumerate her attributes. that delightful task must be performed by her votaries, "the poet, the lunatic, and the lover;" nor should the orator be excluded from his fair participation and kindred alliance with this airy and fascinating group. if the present essay should conform to nature, and be founded in truth,--should it assist the young inquirer, and more especially the medical student,--for whom no compendium of the science of mind has been hitherto prepared; my own expectations will be fully answered; and this scantling may probably lead some more capable person to an extensive investigation, enlarged comprehension, and luminous arrangement of the phenomena of the human intellect. john haslam. . frith-street, soho-square, st november, . contents. page perception memory on the intellectual superiority which man has acquired by speech, and the possession of the hand on the nature and composition of language, as applied to the investigation of the phenomena of mind on will or volition on thought or reflection on reason instinct conclusion _works by the same author._ i. observations on madness and melancholy. ii. illustrations of madness. iii. on the moral management of the insane. iv. medical jurisprudence, as it relates to insanity. v. a letter to the governors of bethlem hospital. sound mind. perception. the faculty of perceiving the objects which surround us, is an important feature in the history of mind; but by what means or contrivance this is effected, can only be known to the supreme being, who has thus been pleased to endow us; and our utmost endeavours to detect the _modus operandi_ will be puerile and unavailing. the first operations of the infant are to educate its senses, in order to become acquainted, through these organs, with surrounding objects. this, in the human species, is a process of very slow attainment; and our information concerning this subject, must be derived from attentively watching the progress of the infant itself; as of these early perceptions, for a reason which will be afterwards assigned, we retain no distinct recollection. for the manner in which we become acquainted with the objects in nature, we have appropriated a term, which was probably supposed to be explanatory of the process, by which we received our intelligence of these phenomena, and have accordingly termed it _perception_. the intrinsic meaning of this word is the taking, seizing, or grasping, of an object, from the latin _cum_ and _capio_, and the same figure pervades most of the european languages. this term may sufficiently apply to the information we derive from the organ of touch; but it affords no solution of that which we obtain through the medium of the other senses, as sight, smell, and hearing. it has been the bane of philosophy, and the great obstacle to its advancement, that we have endeavoured to penetrate that which is inscrutable; and in this vain pursuit, we have neglected to detect and cultivate that which is obvious, and the legitimate province of our research. these organs of sense are the instruments by which we obtain our different perceptions; they are the tests by which we become acquainted with the objects of nature. when we view the newly-born infant, and consider its state for many weeks after it has become a member of our community, we are then enabled to form some opinion of the almost insensible gradations, by which it acquires its perceptions. an enumeration of the progressive steps of this tardy process is within the power of any patient and accurate observer; but this detail does not constitute a part of the plan which has been adopted. it has been endeavoured by writers on this subject, to establish a distinction between perception and sensation, and the reader for his information may consult their works: they do not however appear to have founded this distinction on any obvious difference, nor to have adduced sufficient reasons for their separate establishment, as independent properties of the nerves. to feel, to experience a sensation, or to perceive, implies consciousness; it is that which is transmitted by the nerves to the sensorium, either by the organs of sense, or by the internal nerves; as pain, or feelings of which we are conscious. consciousness is the test, the evidence, the proof of sensation or perception. this point has been adverted to, in order that terms should not be multiplied without a distinct and essential difference of meaning. the five senses, together with some auxiliaries, which will be the subjects of future notice, may be considered as the instruments or agents, by which the edifice of mind is constructed. in the act of perceiving by the different senses, there are some circumstances, which are particularly deserving of attention. in order that perception may fully and certainly take place, it is necessary that the person should be undisturbed; he ought to be exempt from external intrusions, and internal perturbation. during this process the respiration is in general more slowly drawn, the body endeavours to maintain a perfect quietude, and its position becomes fixed. when we perceive objects by the eye, this organ becomes fixed and the lips are usually closed. during our examinations by the touch, the eye is also fixed, the breathing is suspended, and the lips brought into contact: the fingers are separated, and their more delicately tangent surfaces applied to the object with their utmost expansion. in the exercise of audible perception, the neck is stretched forth, and the ear applied to the quarter from whence the sound appears to issue; the mouth is partly open to conduct the vibrations to the eustachian tube. when we acquire intelligence by the smell, the lips are very firmly closed, the nostrils become dilated, and the inspiration of air through them is conducted by short and successive inhalations. from the connection between the smell and organs of taste, (and this association is more remarkable in some animals than in man,) it is difficult to describe the process, which, however, principally consists, when minutely tasting, in moving the tongue (the principal discriminator) on the palate:--but when urged by strong appetite as in the act of feeding, and when divested of the restraints which refined society imposes; the nostrils are widely expanded, the eye is keenly directed to the portion, and the hands are busily employed. experience has sufficiently informed us that the organs of sense must be in a healthy state, in order to the due conveyance of perception. when the function of any organ is altogether defective, as when a person is born blind, he is cut off from all perception of light and of visible objects. if by nature deaf, from the intonation of sounds; and many unhappy instances of such connate defects abound among our species. in one particular subject, both these defects existed from birth; so that the sum of his intelligence was conveyed by the touch, smell, and taste, or in other words, his mind was exclusively composed of the perceptions he derived from these senses. this case will be more particularly noticed in a subsequent chapter. the alterations which take place in the state of our perceptions from a morbid cause, are generally known. thus a person labouring under a catarrh, will be unable to detect the odours which certain substances communicate in a healthy condition of his olfactory organ. in fever excited by a disordered stomach, the taste will become vitiated, and the partial obstruction of the ear by accumulated wax, will impress him with the bubbling of a pot, the singing of birds, or the ringing of bells. the same law that produces fatigue in a muscle from exertion, appears to obtain in the organs of sense. if they be excited by their appropriate stimuli too violently, or for a too long continuance, fatigue or languor is produced, their percipience is diminished, or confusedly conveyed; and they require a period of rest for their refreshment. as we advance in our enquiries into the nature of perception, it will be evident that we cannot long continue to treat of it as a simple act, or as a distinct faculty. the organs by which we obtain our different perceptions are not insulated parts, but communicate with a substance, termed the brain, and which is continued through the vertebral column. the ultimate expansion of a nerve of sense, has been termed its sentient or percipient extremity; and where it is united to the brain, its sensorial insertion. if we were to divide the optic nerve where it passes into the foramen, taking care to leave the apparatus of the eye uninjured, the visual organ would be deprived of its function, and the person or animal would be completely blind of that eye; so that a communication with the brain is necessary for the purpose or act of perception. as therefore the union of the nerve with the brain is indispensably necessary for the purpose or act of perception, we are naturally led to inquire into the properties of this substance, termed the brain. before we proceed to this part of the subject, it will be proper to notice a fact which is of frequent occurrence. in amputations of the thigh, at the moment the femoral nerve is divided, it often occurs that a pain is distinctly felt in the toes; and after the limb has been removed, even for many months, the same painful feeling of these lost extremities is occasionally experienced. this circumstance would render it probable that the larger branch of the nerve becomes itself impregnated with the sensation it transmits: indeed it is a continuation of the same substance, from its sentient extremity to its sensorial insertion. this intimate union of nerve and brain may be further illustrated: it has been already noticed, that a morbid state of the organs of sense will convey inaccurate perceptions; and it is equally certain, that disease of the brain, will excite phantasms, which appear as realities to the sensitive organs. as consciousness is implied, in order to constitute the act of perception, it is of some importance to investigate the nature and meaning of this term. the consciousness of _having experienced_ a perception by any of the senses would be an act of memory: consciousness, therefore, applies to the past; and it also accompanies our prediction of the future. when a person is writing a letter, he is at the time, conscious that his own hand is forming the characters; if this letter be afterwards submitted to his inspection, he is conscious that he wrote it; and if he be desired to write it over again, he is conscious that it will bear, both to himself and others, the character of his hand-writing. consciousness, therefore, accompanies human action through all its tenses: it is equivalent to the knowledge we possess of our own personal identity, the evidence of mind, and therefore must accompany every act of intelligence. thus we are equally conscious that we perceive, remember, think or reflect, and reason. as consciousness must accompany every act of perception, it follows that we cannot be impressed with more than one at the same instant; for it can never be contended that we are able to experience two acts of consciousness at the same moment. the very term two, implies repetition or succession, and we could as well conceive the possibility of being, at the same time, in two different places. as far as we are warranted to infer from the evidences it affords, an infant appears to possess no consciousness; but it may be considered of early acquirement, and coeval with distinctness of perception. these few preliminary remarks concerning perception have been submitted to the notice of the reader, in order to advance to another subject. the faculties which constitute mind are so blended, and dependant on each other, that it would only hazard confusion to proceed. but this subject will be resumed.[ ] footnote: [ ] there exists already furnished, a considerable mass of facts, dispersed in various works, which might be advantageously collected into a volume in order to illustrate the phenomena and laws of perception, and more especially to display the mutual assistance they afford to each other, and the superior knowledge which we have derived from their united co-operation. memory. allow a human being to be gifted with his five senses, exquisitely attuned for the conveyance of those perceptions, which the separate organs and common sensory are destined to receive: let him during fifty, or as many thousand years, scent the most delicious perfumes,--convey to his palate the flavour of the choicest viands,--to his eyes, present the fairest prospects in nature,--impart to his ear the sweetest music, and regale his touch with smoothness and warmth; moreover let him be conscious of each individual perception he receives:--what would he be at the expiration of this period, without recollection? he would be no more than a sheet of white paper, that had been carried round the world to receive, through the camera obscura, its most delightful views; or the bare walls of westminster abbey, after the commemoration of handel. perception and consciousness, therefore, although indispensable to the building up of mind, are by themselves inefficient and useless without the adjunct of memory. the writers who have treated of the human faculties, have usually and properly bestowed an elaborate investigation to the developement of this interesting subject: indeed, when men first began to describe the operations of their own minds, it might be expected that they would treat copiously of its most important function; but the nature of this endowment has received no elucidation from the aggregate of their labours. the term memory has been anglicised from the latin memoria; yet we possess two other words of similar meaning, and from their derivation, in a certain degree, explanatory of this process; namely, to remember and recollect. thus if an individual have seen any particular animal, and given sufficient attention to perceive accurately its construction, so as to possess a complete perception of the different parts or _members_ of which it is composed; he would, in the absence of the animal, be enabled to remember it. if his hand had been duly educated he might form its model, or chisel it from a block of marble; or on a plain surface, according to the rules of art, might make a drawing of the animal, and with such exactitude of its different _members_, that it would appear to those who compared it with the original, that he perfectly _re-membered_ it. to recollect is only a different figure for the same process, and implies to re-gather or collect, those parts which have been scattered in different directions. the perceptions we obtain by our different senses are all capable of being remembered, but in different ways. those which we derive from sight, may be communicated by the pictures of the objects, which become the means of assisting our recollection, and thus form a durable record of our visible perceptions; of course excepting motion, which pictures cannot represent; but motion, or change of place, implies a succession of perceptions. yet this manner of record does not directly apply to the other senses: we can exhibit no pictures of odours, tastes, the lowing of a cow, the roaring of a lion, or the warbling of birds; much less do hardness and softness admit of any picturesque representations as their record. the memory of animals seems to be in the simple state: they have, through their organs, different perceptions; and in many instances these organs are more susceptible than those of the human subject. the ear of some timid species is enabled to collect the feeblest vibrations of sound, and which are inaudible to us. the eye of some birds can tolerate an effulgence of light, that would dazzle and confuse our vision; and others "do their errands," in a gloom where we could not distinguish. in certain animals the smell is so acute, that it becomes a sense of the highest importance for the purposes of their destination. but animals are incapable of recording their perceptions by any signs or tokens: they therefore possess no means of recalling them, and their recollection can only be awaked from the recurrence of the object, by which the perception was originally excited: whereas man, by the possession of speech, and of the characters in which it is recorded, can at all times revive his recollection of the past. it is generally acknowledged that our memory is in proportion to the distinctness of the perception, and also to the frequency of its repetition. the simple acts of perception and memory appear to be the same in man and animals; and there are many facts which would induce us to suppose, if these faculties be identical in their nature, that the endowment of the latter is more excellent. this conjecture is hazarded from the greater susceptibility of the organs of some animals, and from their wonderful recollection of tracks which they have traversed. among the phenomena of memory there are two very curious occurrences, and for which no adequate explanation has been hitherto afforded. many of the transactions of our early years appear to be wholly obliterated from our recollection; they have never been presented as the subject of our thoughts, but after the lapse of many years, have been accidentally revived, by our being placed in the situation which originally gave them birth. although there are numerous instances on record, and some perhaps familiar to every reader, i shall prefer the relation of one which came under my immediate observation. about sixteen years ago, i attended a lady at some distance from town, who was in the last stage of an incurable disorder. a short time before her death, she requested that her youngest child, a girl about four years of age, might be brought to visit her, and which was accordingly complied with. the child remained with her about three days. during the last summer some circumstances led me to accompany this young lady to the same house. of her visit when a child she retained no trace of recollection, nor was the name of the village even known to her. when arrived at the house, she had no memory of its exterior; but on entering the room where her mother had been confined, her eye anxiously traversed the apartment, and she said, "i have been here before, the prospect from the window is quite familiar to me, and i remember that in this part of the room there was a bed and a sick lady, who kissed me and wept." on minute inquiry none of these circumstances had ever occurred to her recollection during this long interval, and in all probability they would never have recurred but for the locality which revived them. in a work professedly the fabric of fancy, but which is evidently a portrait from nature, and most highly finished,--in the third volume of guy mannering, the reader may peruse a similar but more interesting relation, where the return of bertram to the scenes of his childhood, awakens a train of reminiscences which conduce to the developement of his history and legitimate claims. according to my own interpretation, however wonderful these phenomena of memory may appear, they merely afford examples of the simplest acts of recollection, excited by the recurrence of the original objects, at a period when language was little familiar: in the same manner as an animal, at a distant time brought into its former haunts, would remember the paths it had heretofore trodden. but there are some facts in the history of recollection which do not admit of any satisfactory solution. from these it appears, that persons in their childhood have learned a language which, from the acquirement and usage of another during many years, they have entirely forgotten; so that when spoken by others, they have been wholly unable to understand it: yet during the delirium of fever, or from inflammation of the brain and its membranes, in consequence of external injury, the former and forgotten language has been revived, and spoken with fluency: but after a restoration to health no traces of its recollection have remained. a remarkable case of this kind has been published by mr. abernethy; and a similar instance is recorded of the lady of an ambassador. these few preliminary observations have been submitted to the reader, in order to introduce a principal part of the subject to his notice, to prevent repetitions, and from the impossibility of considering the more curious and important phenomena of perception and memory as simple and unconnected endowments. on the intellectual superiority which man has acquired by speech, and the possession of the hand. in our investigations of the nature and offices of the human mind, we are immediately and forcibly struck with two important circumstances, which appear to have contributed in an especial manner to the superiority of man over all other animals. let it be admitted, without at present discussing the question, or adducing any arguments; that the constitution of the human intellect is of a higher quality, or of a finer staple, than the intelligent principle of other creatures.[ ] these two endowments with which man may be considered as exclusively gifted, and which, on a deliberate survey, appear principally to have conduced to his pre-eminence in the range of intellectual creation, are speech and the possession of his hands. one of the chief characteristics by which man is distinguished from the other animals, is the capability he possesses of transmitting his acquirements to posterity. the acquirements of other animals perish with them: they are incapable of recording their achievements, and, as a community, they are stationary. if the reason be sought, it will be immediately found, that they do not enjoy the appropriate organs; and this defect will be detected to arise from their want of speech and hands. there may perhaps arise some of the difficulties already experienced, in the separate consideration of these human attributes,--speech and the hand; as much of the superiority which man possesses has resulted from their combined assistance. it is, however, important to treat of each individually, as far as their separate influence and effects can be distinctly traced. the consideration of speech or significant sound, would naturally introduce an enquiry into its structure and philosophy: but as this knowledge can be collected from the works of many enlightened writers on these subjects, it is unnecessary to obtrude on the reader that which he may find already prepared. speech is _ordinarily_ acquired by the ear[ ], and the sound conveyed through that organ is imitated by the voice. when any object in nature is named by its appropriate articulate sound, as a tree, a fish, a horse, if the object be duly noted and the term remembered, it will mutually, on the presentation of the object, recall the term; or if the term be mentioned, the recollection of the object will arise. without reverting to the formation of words by letters, or proceeding to the structure of sentences by words, which is the province of the grammarian, it will be seen that these significant sounds, enable human beings to convey to each other the perceptions they have experienced, or are impressed with, at the moment of communication. this endowment of speech to man would, alone, have constituted him vastly superior to the other animals. but whatever might have been his attainments, either from his own discoveries or from the experience of his contemporaries, his departure from life would have consigned the products of his genius and wisdom to the treachery and mutilation of another's recollection. even in the enlightened and polished period of our present existence, we are fully acquainted with the loss or addition which a fact experiences, from being transmitted through a succession of narrators. had man been merely furnished with speech, without the means of recording his acts and reflections, we might indeed have preserved by tradition, the names of homer, virgil, cicero, shakspeare, and milton; but their works,--those majestic columns which now support the temple of fame, would have perished, had there not been a contrivance to record the productions of their genius. this art, of conferring permanence on the significant sounds of the human voice, has taught us to appreciate and revere the taste and wisdom of our predecessors; and to feel, that although their bodies are buried in peace, yet their names live for evermore:--but more especially this contrivance has preserved the laws of nations, and above all other blessings, has transmitted, in the sacred volume, the commandments of the living god. from the brief notice which has been bestowed on this subject, it will be seen, that man could have made but inconsiderable advances in the scale of intellectual progression, by speech alone;--that how much soever this faculty might have elevated him above animals, by endowing his perceptions with intelligence, and rendering his thoughts the circulating medium of his community; yet had he remained without the power of registering the edicts of his mind, language would have expired in its cradle; and as the body mingles with its mother-earth, intelligent sound would have been blended and lost in the medium that produced it. the next subject to be considered, (and its importance will justify an ample review, and minute consideration,) is the hand; a member which may be considered, with some trifling exceptions, as exclusively bestowed on man. the wonderful construction of this part of the human body might be sufficiently exemplified by its achievements. its anatomy has not, hitherto, been so minutely investigated, as to demonstrate the almost infinite variety of motions to which it is adapted; nor has it been sufficiently compared with the somewhat analogous structure and function in certain of the simiæ, in the claw of the parrot, or with the proboscis of the elephant. at the extremity of the fingers, in the human hand, and on their inner surface, resides the organ of touch; a sense, of which animals are comparatively deficient. touch, is distinguished from feeling, which it is the general property of all the nerves to convey, and this feeling is likewise accompanied with consciousness. thus pain may be felt in the different organs of sense, without any corresponding perception, which it is their separate office to import. although the acute organ of touch has its seat at the extremity of the fingers, yet the whole surface of the skin (of the human subject) is susceptible, but in an inferior degree, of tangible perceptions. it is sensible of heat and cold, of hard and soft, rough and smooth. the tongue enjoys also a considerable capability of tangible discrimination; but let any person attempt to ascertain the state of his pulse, by applying the tongue to the wrist, he will find it a very unsatisfactory test.[ ] it has been already observed, that the perception of objects conveyed through the organ of vision, may be represented by drawings, so as sufficiently and accurately to convey the same perception to the eye of another: thus we recognise the likeness of a person by his portrait; the view of a known country from the landscape; the quadruped, bird, or insect, by its picture: but the perceptions of the organ of touch, can only be communicated through the medium of language; and the same may be observed concerning those derived from the smell and taste. we may indeed submit the same objects of touch, smell, and taste, to a number of persons, who, in all probability, (their organs being similar,) would be impressed with the same perceptions: but these perceptions, recollected, and the objects which excited them absent, can only be communicated through the medium of significant sound. it may be a subject of curious investigation, although foreign to our present enquiry, whether man, in possession of articulate organs, discovered speech, and imposed names on his perceptions; or whether he was originally gifted with this endowment. without attempting to discuss this question, it is sufficient to remark, that the structure and composition of our own language, and of its northern kindred, afford sufficient evidence of a very rude and necessitous origin. after man had acquired the means of communicating his perceptions by significant sounds, the next important discovery was the art of recording them, so that they might serve as the vehicle of intelligence to his distant contemporaries, or be transmitted to posterity as the sources of improvement. the human hand is the immediate agent by which this contrivance is displayed. it is not intended to trace the history of this wonderful and precious discovery, but to remark, that human ingenuity, has likewise established the record of sounds which are not significant, and which are termed the notations of music. the science of accurate admeasurements has been exclusively discovered by man; and for the attainment of this important acquisition, it will be seen that the hand has been chiefly and progressively instrumental. when we contemplate the present state of man, in our own nation, surrounded by the conveniences which gratify his wants, and behold him practised in their enjoyment, we are little disposed to revert to that period of his history, when he struggled to continue his existence, and trace his tardy progression from rudeness to refinement. pleas'd with himself, the coxcomb rears his head, and scorns the dunghill where he first was bred. although we now measure space and time, bodies solid and fluid, heat and its absence with the facility of a single glance; yet if we consider the slow, and painful steps, by which such acquirements have been attained, we shall be forcibly impressed, how much we are the creatures of patient experiment, and also how mainly the hand has contributed to our advancement. if we investigate the standards of admeasurement, we find that many have been derived from the human body, and more especially from its operative instrument, the hand. that the members and dimensions of our own body should have been the original standards of measurement is most natural, and the terms in which they are conveyed afford a sufficient illustration of the fact. thus, we have a nail; _pollex_, _pouce_, _pulgada_, swedish _tum_, for an inch; which word has been misapplied by our saxon predecessors, and corrupted from the latin _uncia_, which related only to weight. we still measure by digits, by fingers' breadth, by hands high. cubit from _cubitus_, was formerly employed. we now retain ell, _aune_, _ulna_. foot, pace, _pas_, _pes_. yard, not as mr. tooke supposed from the saxon gyrwan, to prepare, but from gyrdan, _cingere_, and is employed to represent the girth of the body. fathom, the distance of the arms when extended to embrace, from which the meaning is implied in most languages.[ ] but it will be immediately perceived, that measurement could not proceed to any considerable extent, could neither be compounded by addition, nor subdivided, without the employment and comprehension of numbers. in our childhood we are taught the knowledge of numbers; and those who have superintended the work of education, must have witnessed the difficulty of impressing on the mind of the child, this kind of information. alphabetic characters, compared with numbers, are readily acquired: whether it be from the imperfect manner, in which the science of numbers is usually taught, or from the actual difficulty in comprehending the subject, it is not pretended to determine; although, from some considerations, the latter is most probable. the names of different objects are easily acquired, and children examine such objects by their different senses, more especially by the eye and touch; they become desirous of learning their properties, or of becoming acquainted with their construction: and this investigation affords them delight, and excites or gratifies their curiosity. but numbers possess no such attraction; numbers, do not involve any of the obvious properties of these objects, neither their colour, shape, sound, smell, or taste; it therefore becomes perplexing for them to comprehend, if five similar substances, as so many apples, or nuts, be arranged before them, why each, should bear a name, different from the thing itself, and different from each other: why this nut should be termed one, another two, and the next three. in acquiring a knowledge of numbers, as far as the senses are concerned, the eye and the touch are especially exercised; but it appears that the touch is the corrector of the sight: if fifty pieces of money be laid on a table, they will sooner and more accurately be numbered by the touch, than the eye; and we know in other instances, that the motion of the hand is quicker than the discernment of the sight. there are many circumstances, although they do not amount to a proof, which might induce us to consider, that the human hand has much contributed to our knowledge of numbers.[ ] as far as we possess any direct evidence, none of the animals are capable of numerating; and this constitutes an essential difference between them and man in their intellectual capacities. in states of weakness of mind, this defect in the power of numerating, is very observable, and forms a just and admitted criterion of idiotcy; and it is well known that such persons exercise the organ of touch in a very limited degree, compared with those of vigorous capacity: their fingers are likewise more taper, and their sentient extremities less pulpy and expanded. the same state of the organ of touch may be remarked in some lunatics who have become idiotic, or where the hands have been confined for a considerable time. although in our own language, we have not been able to discover any rational etymology of the units, that is, what was originally the meaning of one, two, three, &c., or of what these units were the representatives, we have, however, by the ingenuity of mr. tooke, a very probable account of the origin of ten, which means, that which includes, or comprehends all numeration; and that it does so include it, may be learned from the composition of eleven[ ]; and if it should amount to no more than a curious coincidence, ten is the number of the manual extremities. notwithstanding neither our own, nor any of the european tongues, afford us any probable solution of the actual meaning or import of the units, yet this contrivance is satisfactorily developed in the language of some of the african tribes, (vide park's travels, p. .) where it will be found, that when they had arrived at six, they proceeded by composition; not by the composition of six and one, to form seven, but by five and two. one--_kidding_. two--_fidding_. three--_sarra_. four--_nani_. five--_soolo_. six--_seni_. seven--_soolo ma fidding_--five and two. eight--_soolo ma sarra_--five and three. nine--_soolo ma nani_--five and four. ten--_nuff_. as numbers must have been acquired in progression,--first one, then two, &c. there appears to be considerable difficulty in conceiving, of what the increase or addition would be the representative, except by adding the already designated numbers together: but our own units do not bear any ostensible marks of such composition, nor do the northern numerals, from whence our own have been imported. if we were now called on to construct a new language, and invent terms for the units, there are no objects familiar to me, which would suggest appropriate terms, as the types of the different units; and it is presumed, as far as we have extended our researches, that the names of things are not arbitrary, but have been imposed for some real or supposed reason. when we consider the importance of numbers to man, as an intellectual being, and compare the advancement he has made by this knowledge, beyond the animals who have wanted the means of acquiring such information, the importance of investigating this curious subject will be fully acknowledged. without numbers, by which the divisions of time, space, and value are characterised, man could have possessed no knowledge of the order and succession of events; he would, by wanting precise standards, have remained ignorant of admeasurements; and without the definite proportions which numbers confer, property would be a vague and uncertain name. from these remarks an opportunity is now presented, to enumerate the important achievements of the human hand; but as a powerful objection may be urged, against the views which have been sketched out concerning this subject, it will be proper to notice them, in order to refer their discussion to another and more appropriate chapter. it will naturally be stated that the hand is the mere auxiliary, in fact, the servant, of the mind; and in a healthy state of intellect is regulated by its directions, in the performances it executes. the truth of this, it is not intended to deny; but the examination of the objection must be referred to that part of the work, which treats of the influence, which does so regulate and direct, namely, the will, or, as it has been more scholastically termed, volition. we readily acknowledge that he who is born blind can have no perception of visible objects, and that the same negation may be extended to the other senses when defective: thus, if man had been created without hands, and, consequently, without the acute organ of touch, which resides in the extremities of these members, we must at least have been strangers to the "cloud-capt towers, the gorgeous palaces, and the solemn temples" which he has reared. had the upper extremities of the human body terminated at the wrist, such a man as phidias might have existed, but his occupation would have been unknown. thus truncated, how would the fleet have been constructed which reaped the laurel at the nile, at copenhagen, and trafalgar? the eternal city could not have existed, nor would our own metropolis have had a being. if we reflect for an instant, we shall perceive that all the conveniences we enjoy, all the arts we practise, and the sciences which elevate and dignify our nature, could never have been realised in a handless community. speech might indeed have prevailed, but its record could not have been established, and intelligent sounds would only have served to breathe forth the lamentations of misery and despair, or the accents of discontent. we must have remained naked, and perished from the inclemency of weather: man would have owed "the worm no silk, the beast no hide, the sheep no wool." it would be superfluous to pursue this subject further, as the reader has only to consider the superior enjoyments, and accumulated monuments, of art and of wisdom, which the mind of man has produced by the agency of his hand. "molto opró egli col senno ed con la mano." however it may gratify the pride of man, to find himself gifted with intellectual endowments of a higher order, and distinguished as the lord of creation; yet he must, on reflection, regard this superiority as a "painful pre-eminence." the possession of speech, and hands, the prompt executors of his will, have enabled him to become the perpetrator of crimes to which the tribes of animals are strangers. language has exclusively furnished man with the means of promulgating the result of his perceptions and thoughts: he thereby becomes capable of communicating to others, that which he has observed, or the opinions he has formed; and so highly has this accuracy of relation been estimated, in all periods of civilised society, that it has been proudly denominated the truth. but the possession of the same faculty of speech, has often induced him to relate that which never occurred, or to disown that which actually took place; and this assertion or denial has been severely reprobated and stigmatised by the appellation of a lie. it is unnecessary to enumerate the catalogue of the articulate vices which the tongue can commit, or sully the dignity of human nature, by the recollection that its lord has been convicted of perjury, slander, blasphemy, and libel. thus, the hand, this admirable instrument, the elaborations of which excite our wonder and delight, whether we contemplate the chiselled monuments of grecian art, or the curious manufactures of modern days,--all that is tasteful in art, or auxiliary to science,--even this plastic and creative member, the faithful notary of thought,--becomes the prostituted engine of the vilest fraud, or foulest atrocity. the same hand that fashioned the minerva of the parthenon might have picked a lock, or directed a dagger. it will be found, on an accurate investigation, that all laws, which are the voice of those whom we have delegated, or who may have assumed such power, and which are recorded by the hand, are principally directed to the lesions against individuals or society, which proceed from speech, or are perpetrated by the hand. footnotes: [ ] it must be felt by the reader that all the epithets, which can be applied to designate this superiority, must be of material character and signification:--whether we say superior structure, texture, purity, &c. in fact, we possess no appropriate expressions, to characterise that which is not material: but this poverty of language, affords no ground for the materiality of mind; on the contrary, it is a strong argument against such doctrine, that we are obliged to clothe the phenomena of mind in the garb of metaphor; for material objects can be well defined according to their obvious properties. [ ] those who are born deaf are taught to imitate articulate sounds independently of the ear. [ ] the reader may refer to works on comparative anatomy, for information concerning this sense in animals. they all agree that no animal possesses a complete hand, and that the thumb is especially defective in size, and in the strength which enables it to act in opposition to the combined force of the fingers. the sense of touch in many animals appears to reside in the large and fleshy nostrils, which appear highly sensible; and it is also evident, that in these the touch has an intimate alliance with their sense of smell. [ ] it is equally curious to observe that geographical positions, and the principal features of sea and land, have derived their origin from the rude anatomy of the human body. thus, in a short enumeration we have cape or _head_-land, ness, noss, or _nose_; the _brow_ of a mountain; _tongue_ of land; _mouth_ of a river; _chaps_ of the channel; _neck_ of land; _arm_ of the sea; coast, _costæ_, the ribs. we are said to penetrate into the _heart_ of the country, or to remove to the _back_ settlements. we descend into the _bowels_ of the earth, in order to discover a _vein_ of ore. we ascend from the _foot_ of the mountain; and from its _ridge_ (back) survey the prospect surrounding. numerous additions might be contributed by further recollection. [ ] on many occasions we observe the hands to be the natural refuge for the destitute in arithmetic, and therefore are not surprised at finding many persons counting by their fingers. some rude nations are said not to have advanced in their numeration beyond five: this may perhaps be uncertain and difficult to prove; but it will be shewn that when others have advanced to ten, that seven has been the compound of five and two, eight of five and three, &c. [ ] it is not uninteresting to examine the contrivances that have been resorted to, in order to express the number eleven. the greeks had [greek: _endeka_], one (and subaudit) ten; the romans _undecem_; and a similar adoption has been employed by the southern nations of europe. the northern people expressed eleven, by _one left_ (after ten, subaudit.) thus caxton states his recuyels of troy to have been "ended and fynished in the holy cyte of colen, the th day of septembre, in the yere of our sayd lord god, a thousand four hundred sixty and _enleven_." _en_, in old english, means one, and _leven_ is the past participle of, to leave, formerly written leve. on the nature and composition of language, as applied to the investigation of the phenomena of mind. mind, is an abstract term for all the phenomena of intelligence; and in order to describe them, they have usually been denominated powers, or faculties of the mind: we therefore commonly speak concerning the mind, as of an existence endowed with these properties.[ ] it has been already confessed, that we are at present uninformed, and in all probability shall remain ignorant of the nature and operation of our intellectual powers: at least, we shall never be able to comprehend the manner in which we perceive the objects that surround us, nor to explain how we recollect them when they are absent; yet under this acknowledged inability we have framed a language expressive of these powers and operations. this language therefore cannot be the type of such processes, as their nature and operation are unknown. the different terms that have been employed, have originated from the numerous hypotheses, which have prevailed on this subject: but so long as a perfect agreement subsists, concerning the meaning of these terms, it is of little importance; for as we have no knowledge of the actual processes, whereby we perceive, remember, or exert our will, the expressions we employ cannot be explanatory. the language of mind, therefore, is not peculiar, not derived as the nomenclature of modern chemistry, in which names are impregnated with the elements of their composition; but figurative or metaphorical, the vehicle of conjecture, and the ornament of hypothesis. the truth of these remarks, would be best illustrated by an enumeration and analysis of the terms, which have been applied, to designate the powers and operations of the human intellect. were we now to occupy ourselves, in the construction of a more appropriate language, to designate and explain the phenomena of mind; we should, from our ignorance, be equally incompetent with those who have preceded us. let the terms therefore remain, but endeavour to afford them a fixed and definite meaning, and suffer them to be so far analysed, as to detect their composition, and discover the reasons which imposed them. in this endeavour there will, however, be found considerable difficulty; especially as the minds of men are not yet agreed respecting the process, by which it is to be performed. there are, however, only two modes, to which we can resort, for the definite meaning of words; namely, etymology and authority. considering the history of our own language, and the nature of its composition, we are enabled satisfactorily to investigate, not only the primitive sense of our terms, but likewise their exact signification, in the languages from whence we imported them: for there still remain, sufficient authentic materials, in our saxon and norman records, to verify their original meaning. if we enquire into the causes, which have operated to deflect these terms from their primitive sense, we shall find authority to be the principal source of such corruption; and this infirmity appears to have pervaded most of the languages of those nations which have produced poets, orators, and metaphysicians.[ ] when we examine the nature of authority in language, as it now exists, we find it to be the arbitrary employment of words, by particular writers of acknowledged celebrity. many have become authorities in our language, from having improved its construction; others, by the perspicuous arrangement of subject, by the force of their reasoning, or the light of their philosophy. although we may allow the highest merit to these eminent writers, a praise, far beyond the dulness and drudgery of verbal criticism; yet it is by no means to be inferred, that they consequently become authorities, for the real and intrinsic meaning of words. it can never be expected, that the great mass of mankind should be etymologists: the generality must be regulated by the "jus et norma loquendi;" but if this jus, be the jus vagum, and the norma capricious, confusion must ensue, and they will scarcely be speaking the same language. those who are dignified with the title of authorities, ought to agree; for the sound interpreters of the law should never differ. language is the circulating medium of our thoughts; and the meaning of words much resembles the value of money. but great diversity of opinion prevails. in the minds of some philosophers, money means only metallic currency, which may be assayed, and its real value ascertained; and this seems to relate to etymology. others less solid in their views, and gifted with a finer fabric of fancy, are disposed to consider the abstractions of paper to be equivalent to the concrete of bullion, and have accordingly constituted it the jus and norma by authority. to insist on the meaning of a word, because its interpretation has been previously assumed, carries no conviction of its truth. the "jus et norma loquendi," must ever prevail as the currency between human beings; but this acknowledgment should not, in the course of circulation, diminish, the undoubted right we possess, to detect and refuse such as are base or counterfeit. it will not be disputed, that some words bear a much higher importance than others. the names of familiar objects are of little consequence, because we can examine them by our senses, and thereby obtain just perceptions of their character and properties: but general or abstract terms, which are not the objects of sense, but the abbreviations of subjects of reflection, are of the highest interest to our advancement in knowledge and moral conduct. to exemplify the views that have been taken on this subject, three words have been selected:--_to feel_, _to ransack_, and the adjective, _naked_. of the first, dr. johnson, the best authority we now possess, has given six different senses or acceptations as a verb active, and four, as a verb neuter, and has cited the different authorities. he says it is derived from the anglo-saxon, _felan_, without explaining what _felan_ means; it however means to feel: but the adduction of a word in another language, of similar sound and identical signification, does not impart meaning. yet when we find that in the anglo-saxon _fell_ means _skin_, which is the seat of feeling, we directly understand the word and all its dependencies; as _fell_ of hair, _felt_ hat, _fell_-monger, _film_, which is a thin fine skin or pellicle. thus we become enabled to understand and reconcile variety and extension of meaning, from the preservation of integrity of figure. the verb _to ransack_, is another example. of this word dr. johnson has given three senses. according to him, it is derived from _ran_, anglo-saxon, and _saka_, swedish, to search or seize; but we are not informed what _ran_ in anglo-saxon signifies, and it so happens that there is no such swedish word as _saka_, to search. the word _ransack_, for which the anglo-saxons had _ransaka_, is derived to us from the gothic, in which _razn_ (pronounced _ran_) signifies a house, and _sokjan_ to search; so that, _to ransack_, implies to search the house. to the adjective _naked_ dr. johnson has given four different meanings. its etymology, he says, is from the anglo-saxon, _nacod_, which in that language was of similar signification: but this imparts no meaning. it is a compound word: _na_, in anglo-saxon, signifies _new_, and _cenned_, _born_, so that the condition of the _new-born_ child affords an appropriate interpretation of the term _naked_. to ordinary minds, that which is said to be authority is decisive[ ]; a particular author of celebrity is cited, and thus the business concludes. the reasons, which induced him to employ the word in such particular sense, it is in most cases fruitless to enquire; as during their lives, authors have seldom been appreciated: so that the silence of death seems indispensable to procure the consent of authority. as language is the instrument of thought, the vehicle of intelligible communication among human beings, it is impossible to attach too high importance to its precise signification: the difficulties of effecting this concordance have been pointed out, but the remedy has not yet been applied. after all the investigation that has been given to this interesting subject, one leading fact seems indisputable, that all the terms which designate the faculties and operations of our minds, are of physical origin, as well as those which characterise the thinking or immaterial principle itself: and for this, there is sufficient reason; as all language, in order to be adapted for our use, in this state of existence, can only be the representative of the objects of our perceptions and reflections,--an instrument calculated for the meridian of this transitory life: for, when the holy light of happiness to come was revealed to the human race, it was found expedient, for their comprehension, to transmit its rays through a material prism.[ ] footnotes: [ ] mr. locke, as he advances in his essay, expresses considerable distrust of the existence of these powers and faculties of the mind. "yet i suspect, i say, that this way of speaking of faculties has misled many into a confused notion of so many distinct agents in us, which had their several provinces and authorities, and did command, obey, and perform several actions, as so many distinct beings; which has been no small occasion of wrangling, obscurity, and uncertainty in questions relating to them."--vol. i. p. . th edition. [ ] to afford a single illustration of this fact, let the verb to _bewray_ be selected, which, although a word of very different meaning, has been confounded with to _betray_. the meaning of the former is to discover, expose, and is derived from a saxon verb bearing that sense; the latter, dr. johnson has derived from the french _trahir_, and has cited some instances, as authorities for its perverted sense. it is but justice to observe, that these words preserve their distinct and separate sense in all the instances where they have been employed, both in shakspeare and the bible. it may therefore be inferred, to have been a recent corruption. [ ] of this, mr. locke appears to have been fully sensible:--"when men are established in any kind of dignity, 'tis thought a breach of modesty for others to derogate any way from it, and question the authority of men who are in possession of it. this is apt to be censured, as carrying with it too much of pride, when a man does not readily yield to the determination of approved authors, which is wont to be received with respect and submission by others; and 'tis looked upon as insolence for a man to set up, and adhere to his own opinion, against the current stream of antiquity, or to put in the balance against that of some learned doctor, or otherwise approved writer. whoever backs his tenets with such authorities, thinks he ought thereby to carry the cause; and is ready to stile it impudence in any one who shall stand out against them."--locke's works, vol. ii. p. . [ ] this material prism is to be understood to apply to language; and in this view newton himself surveyed the question. "for all language as applied to god, is taken from the affairs of men, by some resemblance, not indeed a perfect one, but yet existing to a certain degree."--newton's works, edit. horsley, vol. iv. p. . on will or volition. in the consideration of the nature and offices of the human mind, there is no subject of higher importance than the will, or volition. every person must have observed, that he is capable of performing certain motions, which he is able to commence, to continue, and to arrest; and the same faculty is possessed by many animals. a slight degree of information will also instruct him, that there are certain motions of his animal frame, over which he has no immediate control. the motions which he is able to direct and regulate, have been termed voluntary; and those over which he possesses no influence or command, have been denominated involuntary motions. the most perfect instances of the latter are the pulsations of the heart, and the movements of the intestines, usually called peristaltic. the curiosity which is natural to man as an intelligent being, would of course prompt him to enquire into the cause of these phenomena, although the result of his investigations might be inadequate to the toil of his research: for, he would be as much puzzled to account for the influence by which certain muscles are moved at will, as he would at others which possess a determinate motion, and are not subject to this direction. while man continues in a healthy state, he is enabled to move at pleasure those muscles or instruments of motion which are subject to his will; and the involuntary muscles continue duly to perform their appropriate office; but in certain morbid states it sometimes occurs, that the exertion of the will to move a leg or arm is ineffectually directed, and however much we desire, wish, or will such motion, these limbs are disobedient.[ ] this condition of the members has been termed paralytic: the will to move remains perfect; but the organs to be acted on are insensible to that influence which, in a sound state, excited them to motion. as in the healthy state the will has the power to produce motion, so it is also competent to prevent it; therefore to move or to abstain from motion, are equally the dictates of the will. but it not unfrequently happens, when we intend to thread a needle, to write our name, or to perform some surgical operation, that the will exerts all its influence to keep the hand steady for the due performance of these necessary acts; yet, notwithstanding these implicit commands, the hand continues to move in all directions, but those which could accomplish the object. so, that these muscles, ordinarily voluntary, become, in a certain degree, converted into involuntary muscles. a higher degree of this state prevails in the affection called st. vitus' dance, and likewise in some convulsive symptoms attendant on locked jaw, where the body is drawn with incredible violence. it may be noticed, that these states are attended with consciousness. concerning the nature of this influence, termed the _will_, a great variety of discordant opinions prevail. to enumerate or refute these would be unprofitable labour, more especially as the majority are the mere assumptions of their particular authors. they all, however, seem to be agreed that the will is an inherent faculty, or component part of the mind; and some are induced to consider it as holding the highest office in the department of intellect. the only mode of investigating this subject satisfactorily, according to my own views, is to trace the progress of volition from its feeble commencement, to the full exercise of its important function,--from the dawn to the meridian. as a general observation, it may be remarked that the same influence of the will, which directs the movements of the body, is likewise exerted over the faculties of the mind; although generally in an inferior degree, both from the greater difficulty and less importance of the latter, for the ordinary purposes of life. when we observe the newly-born infant,--that helpless mass of animation,--we perceive no indications to induce us to conclude, that it possesses a voluntary power of directing its movements.[ ] it is furnished with the organs of motion, but is unable to exert that influence which manifests direction; yet its involuntary motions continue perfect, and these, as will be subsequently explained, may be considered in their nature and effects as very similar to that, which, in animals, is termed instinct. in the progress of this enquiry, it will be seen that some degree of mental advancement must have been made, before the infant can _direct_ any of the motions of its body; because direction implies knowledge to an extent sufficient for the purposes of command, and also a consciousness of the effort. in the infant, all the organs of sense by degrees become awaked by their appropriate stimuli or objects, and perception is the result. although we have no memory of our earliest perceptions, which are solely produced by the excitation of external objects, without any direction of the will; yet from the mental indications of the infant, these perceptions would seem to be confused and indistinct. it is some time before the eye appears to notice, and longer before the hand can grasp and manipulate the substances within its reach: in this state, volition would be superfluous if it were possessed. by slow gradations, we find the child capable of directing its eye, of listening to sounds, and of examining by the touch; and these imply the efforts of the will, which appear to be subsequent to perception. as we advance in knowledge, our perceptions, which are the sources of intelligence, are principally acquired by the agency of volition, which directs the organ to the object, but we still continue to be acted on involuntarily by forcible impressions, or striking phenomena. previously to the acquirement of language, perception, memory, and volition are in their simplest state, such as we observe in animals, and as in them, we are only able to estimate the amount of their mental possessions, from the intellectual phenomena they display. in the infant, the separate and combined examination of objects by the eye and touch are the circumstances most deserving of notice. it may here be proper to explain why these earliest of our perceptions are never remembered in after-life. the long period of human infancy, is a powerful argument for the superiority of our species: the mind of man is built up by his own exertions, and his progress is in the ratio of his experience to his capacity: his mission is more important, and consequently requires a longer period to fulfil: he has few instincts; and the sum of his knowledge is the elaboration of his extended endowments. to have remembered the confused dawnings of his perceptions, the imperfect and obscure transmissions of his unpractised organs would have been superfluous, and the sources of error. in this early state, there is no medium by which his perceptions can be artificially connected; nor do they admit of communication or record. when language is acquired, our perceptions become "doubly armed," and impress the memory with additional effect: the employment of the term as the representative of the object, recalls the original perception, and thus invests the mental phantasm with "a local habitation and a name." thus our earliest recollections are never anterior to a certain progress in the art of speech. as we possess the instruments of motion in our muscles, they would have been useless without the performance of their function, and our bodies would have been stationary. it is also equally evident that this office must be performed by ourselves, or fulfilled by others. it has been already pointed out that there are certain motions, essential to the preservation of our animal system, termed _involuntary_, which do not originate from ourselves, but are the directions of a superior power, and are effected independently of our experience and control: the other motions, that have been termed voluntary, are the result of acquirement or practice, and have been gradually formed by our exertions. the reader will now be prepared to understand the wisdom of this arrangement, which, in a future chapter, will be more copiously treated; and to feel that the superiority of man, as an intellectual being, and a responsible agent, consists in the formation of his own mind, and in the direction of his thoughts and actions. that we should exert our utmost endeavours to become acquainted with the nature of this influence, which we term the will, is most natural; but hitherto our researches have been wholly unavailing; and it should be recollected that the appearances of life cannot be accounted for by that which is inanimate, nor can the phenomena of intelligence be solved by material analogies. as we are possessed of the implements of motion, it is evident that they were constructed to accomplish their destined purpose; but of the intimate nature of the stimulus which goads them to action, we have no conception: it seems, however, certain that there exists a mutual consent,--a reciprocal subaudition,--a compact, the result of exercise and experience,--between the implements of motion and the will or influence which excites them. as far as we are able to discover, by the most attentive and deliberate examination of our own minds, we do not appear conscious of any intermediate perception, between the motive and the performance of the action, or the execution of the will. if it were allowable to indulge in analogical reasoning, which usually diverts us from the consideration of the subject, we might endeavour to illustrate this process by the firing of a pistol. when we have taken due aim, we have only to draw the trigger, which produces the explosion: in doing this, however, we perceive the emission of light from the combustion of the powder; but to this there is nothing analogous in the operation of the will:--the dictate of the will, and the motion excited, when watched with the utmost attention, appear instantaneous, and become synchronous by habit. considering the celerity of our voluntary movements, there appears a good reason why no perceptible intervention should exist, to divert the mind from the immediate performance of the will. the correspondence of the motion to the intimation of the will, is the business of education and the performance of habit. the exertion of the will on the bodily organs having been generally described, it now remains to demonstrate its influence on the mind; and so far as we are enabled to discover, it appears to be performed by the same process. the direction of the several organs of sense to the examination of objects, is an act of the will, and has been named attention; which, by some writers, has been deemed a peculiar and constituent faculty of the mind; but in the present view it is considered only as the practical result of the operation of volition on the organs of sense, on memory, and on reflection. the soundest mind (as far as it has been hitherto considered) may be attributed to him who possesses the most enduring control over the organs of sense, in order to examine objects accurately, and thereby to acquire a full and complete perception. that memory is the best, which can voluntarily and immediately produce that which has been committed to its custody; and that reflection is the most perfect, which is exclusively occupied with the subject of consideration. there seems also to be a considerable similarity between the morbid states of the instruments of voluntary motion, and certain affections of the mental powers: thus, paralysis has its counterpart in the defects of recollection, where the utmost endeavour to remember is ineffectually exerted; tremor may be compared with incapability of fixing the attention, and this involuntary state of muscles ordinarily subjected to the will, also finds a parallel, where the mind loses its influence on the train of thought, and becomes subject to spontaneous intrusions; as may be exemplified in reverie, dreaming, and some species of madness. as attention is considered an exertion of the will on the organs of sense and faculties of the mind, it may be allowable to remark on the nature and meaning of the term. it was evidently imposed under a prevailing hypothesis, that the mind possessed a power of stretching or extending itself to the objects of its perception, or to the subjects of reflection; it is therefore a figurative term. indeed something of this nature actually takes place in the organ:--in minute examinations by the eye, we actually strain and stretch its muscles, and feel the fatigue which results from over-exertion:--when we listen, the neck is stretched forward, and such position enables us to collect those vibrations of sound, that would be otherwise inaudible. we are not unaccustomed to describe the higher and more felicitous productions of intellect, as a vigorous grasp of the mental powers, or as a noble stretch of thought: but to infer that the mind itself was capable of being extended, would be to invest it directly with the properties of substance, and at once plunge us into the grossest materialism. the perfection of this voluntary direction, or, as it has been termed, faculty of attention, consists in intensity and duration. of the former there can be no admeasurement, excepting by its effect, which is recollection: its duration can be well ascertained. the faculty of attention in the human mind may be exerted in two ways; first, by the organs of sense to the objects of perception; and, secondly, by the mind to the subjects of its recollection; and this latter exercise of attention, as will be hereafter explained, seems to be in a very great degree peculiar to man, and to be nearly wanting in animals. according to the nature and constitution of the human mind, the effective duration of the attention seems to be very limited: if the eye be steadily directed to any particular object, after a few seconds, it will be found to wander; and if the mind be exerted on the subjects of its recollection, there is very soon perceived an interruption, from the intrusion of irrelevant thoughts. the effective duration of the attention will much depend on the superior capacity, nature, or constitution of the intellect itself; but still more on the manner in which these habits of attention are exercised; for, by proper cultivation, its duration may be considerably protracted. as a proof of the limited endurance of the faculty of attention in ordinary minds, allow the following experiment to be made. let two ordinary persons, a. and b., take a map of a district with which they are unacquainted, and let each be allowed half an hour to study the map. desire a. to fix his attention undeviatingly to the map for this time; and at its expiration, the map being withdrawn, request him to put on paper the relative situations and names of the different places; and for the performance of his task, allow him another half hour. as the experiment has been repeatedly made, it may be confidently predicted, that a. would exhibit a very incorrect copy of the original map. let b. take the same map to study for the same time; but instead of keeping his eyes undeviatingly fixed to the object, desire him to view it only for a few seconds; and then, shutting his eyes, let him endeavour to bring the picture of the map before his mind: his first efforts will convey a very confused notion of the actual and relative positions; but he will become sensible of his defects, and reinspect the map for their correction. if this successive ocular examination and review by the mind, be continued during the half hour, or even for a less time, b. will be competent to make a drawing of the map with superior accuracy to a., who endeavoured to fix his attention for the whole of the time allotted. in conducting this experiment some very curious phenomena may be observed. if a. had directed his eyes to the object intensely and undeviatingly, especially in a strong light, and had then covered or shut his eyes, in order to recollect the relative situations in the map, the straining of the organ to the object would defeat his endeavours; and instead of being able to bring the picture before his mind, he would be annoyed and interrupted by the intrusion of ocular spectra, undergoing the succession of changes described by dr. darwin.[ ] thus there are limits to the duration of our effective attention: if the organ of vision be too long directed to the object of perception, ocular spectra arise, fatigue and confusion ensue in the other senses; and if the subjects of recollection be too long and intensely contemplated, delirium will supervene. in page , after enumerating the wonderful productions of the hand, an objection was foreseen, which may be conveniently examined in the present chapter. that all the performances of the human hand, and of the other members of the body, which are not the result of involuntary movements, must have been the consequence of the direction of the will, is indisputable: it is, in fact, the common relation of cause and effect: but the creation of this distinction, would assign separate offices to the mind and to the organ;--or to the power directing, and to the instrument by which the command is executed. sufficient has been already adduced, to render it obvious, that mind or organ _alone_ would be inadequate for the purposes of intelligence. perception, without its record or memory, would be a useless endowment; muscles or organs of motion, without a power to direct their actions, could have answered no purpose: to be effective, volition must have an object on which its influence can be exerted. in the case of a paralytic arm or leg, the exercise of the will is a fruitless endeavour; and the command to render fixed a tremulous hand is equally unavailing. the power or capacity of moving the muscles,--of directing the organs of sense to the examination of objects,--of recollecting,--and of regulating our thoughts or reflections, constitutes the will; but this acquirement is of very gradual formation, and the result of mutual and progressive exercise, both of mind and organ. ordinary persons have no information of the structure by which they perform their motions; and it may be also doubted if an able anatomist would be competent to describe the action of the different muscles, in complicated movements. the most dexterous artificer, is wholly ignorant of the intimate construction of the organs by which he performs his wonderful elaborations,--he has acquired the happy facility by repeated exercise. there is a tacit and practical convention between his mind and the powers which produce the performance; tacit, as he is unable to describe them, and practical, as, if naturally left-handed, he is unable by any mental directions or influence of volition, to exhibit the same performance with the right. the apparent facility and astonishing rapidity with which, by practice, we perform many of our voluntary motions, has induced an opinion, that such motions might be considered as automatical, which implies that they were performed by the organ independently of the will; but this would be to maintain, that the most difficult and felicitous of our voluntary motions were themselves involuntary. this supposition is so absurd that it refutes itself; its admission would be a libel on the perfection of human attainment, and tend to subvert the best portion of our existing morality. that voluntary muscles may be converted into involuntary, has been already observed; but this conversion is to be considered a morbid state, and must be regarded as a degradation of our nature, instead of its perfection. excess in the use of fermented liquors, will generally produce it; and the habitual practice of intemperance will destroy the influence of volition over the intellectual powers; so that the control over the succession of our thoughts can be no longer exerted, and when we give them utterance they are without connection, and we talk at random. it is not to be expected, in a work which professes to be merely contributions to the natural history and physiology of intelligent beings, that a particular discussion of moral subjects should be instituted; and such is the question concerning the freedom of the human will: the reader is therefore referred to those writers who have fully, and with considerable acuteness, discussed this intricate and important topic. the nature of this attribute is however so interwoven with the philosophy of mind, so connected with the view which has been taken of its history and constitution, that it is impossible wholly to abstain from the consideration of its influence on the excellence and demerit of human actions. it has been endeavoured, throughout this chapter, to establish, that the power which goads or stimulates the muscles to action, and the mind to exertion, is not inherent, but acquired by practice; and this is exemplified by the state of the new-born infant, which, at that period, manifests no more of volition, than of perception, reflection, or reason. it has also been conjectured, that the possession of this influence must be subsequent to perception, for reasons which have been assigned. with its intimate nature we are unacquainted; but we see, as far as muscular motion is concerned, that the same effect is produced by the stimulus of galvanism after the head is removed, and when, according to our existing philosophy, consciousness is destroyed, and the power of willing is abolished. it is by no means intended to suppose that the stimulus of the will has any affinity with the galvanic fluid, because we are unable to prove it; although such opinion has been entertained. according to my own interpretation, will is to be considered as the mere spur, the simple stimulus to action: it possesses no intelligence to direct; but in the healthy state, excites motion in consequence of being itself directed to such excitement. to invest will with intelligence sufficient for its purposes, would render reason, the highest of our attainments, superfluous. those who have most strenuously contended for the freedom of the will, have insisted that it possesses the liberty of choosing or preferring: allow this, and then enquire what must be the nature of that choice or preference, which is selected by an arbitrary decision, without the previous estimate or calculation of reason. man, beyond all other beings, is endowed with superior means of accumulating knowledge, and of preserving experience; by these, therefore, his actions should be directed. if, independently of these, his will possessed a power of directing his actions, it would be equivalent to the instinct of animals: he would, like them, be stationary, and his conduct liable to no responsibility. the long period of infancy in man has been frequently adverted to; and it is a considerable time before he acquires sufficient experience to direct his conduct; and during which, many of the species of animals have completed several generations. for this reason, the wisest legislators, of all ages, have exempted children under a certain age, from the punishment of death for their actions; and although many of them have entertained erroneous notions concerning the nature of the will, yet they tacitly admit, in the instances of infants, idiots, and madmen,--that is, where the understanding is not sufficiently formed by experience, or where it is perverted by disease, that the acts of the will ought not to be visited by the severity of the law. this is perhaps the best practical illustration, that the will to act, is governed and directed by reason. had the mind of man, like animals, been furnished with instinct, which, in them, implies a wise, preconcerted, and unvarying performance of important functions, for their individual preservation, and for the continuance of their race,--as may be exemplified in the construction of the habitations of the bee and beaver, together with their wonderful economy,--the fabrication of the spider's web, and many others,--he would, like them, have been stationary, having received from infinite bounty and wisdom sufficient for his destination: his will would have been directed by unerring motives; and thus his conduct would have been absolved from all responsibility. but man is gifted with few instincts, which appear to decline as his reason advances: his intellect is more capacious, and of a finer staple; he possesses additional organs for the accumulation of knowledge; and, by the peculiarity of his construction, is enabled to preserve his acquirements, to avail himself of the treasures of those who have preceded him, and to transmit his collections to posterity. man, in possession of ampler materials and superior capacity, becomes the architect of his own mind; and to him it is alone permitted, by the aid of experience, and the estimate of reason, to direct his actions: but this generous and exalted faculty involves him in awful responsibility. the same light which discovers to him that which is good and lawful, also exposes its opposite, which is evil and forbidden; and the nature of good and evil, as it forms the foundation of human institutions, has been derived from our experience of their effects, or a calculation of their tendencies. the will of man, therefore, is as free as his experience dictates, and his reason urges to action: yet, that he should often act in opposition to both, is as lamentable as certain: in the transport of immediate gratification, or in the hopes of enjoyment, precept ceases to influence, and example loses its warning. video meliora proboque, deteriora sequor. footnotes: [ ] in some of these instances, where the will has ceased to influence the muscles, the due sensibility of the nerves has remained.--medico-chirurgical transactions, vol. ix. p. . [ ] so little does the infant appear to possess any control over those organs which afterwards become subject to voluntary influence, that it may be sufficient to remark the flow of saliva, of urine, and the more solid evacuations, are subject to no restraint, and for some time are passed with little or no consciousness: even the motions which are excited in the limbs, appear to be spasmodic, rather than the effect of direction. [ ] vide darwin's thesis de spectris ocularibus. on thought or reflection. those recollected objects, which have been transmitted by the senses, or which we have perceived by their means, are the subjects of our thoughts or reflections; for these terms will be indifferently employed, as designating the same faculty or process. the obvious meaning of the word _reflection_, is the representation of any object in a mirror. this term, so well understood in that department of natural philosophy named optics, has been transferred to mind, in order to explain a process, supposed to be similar. if, however, we examine the analogy, it will not accord:--to produce reflection in the mirror, the object must be present; in the mind, the reflection takes place when the object is absent. although the simile, strictly speaking, is imperfect, yet the figure is beautiful, and, considering the metaphorical nature of language, as applied to mental operations, the most natural and appropriate that could have been selected; for, speaking in a general way, our thoughts, in themselves appear very much as the shadows or reflection of our perceptions. as we are but little capable of communicating the nature of our perceptions, independently of language, we must have recourse to inference and conjecture. it is fully understood that our visual perceptions, through the medium of recollection, may be represented by the skilful execution of the hand; and that those of smell, taste, and touch do not directly admit of such delineation. we might next inquire, if the odours we perceive are as strongly impressed on the olfactory organ, as the subjects of visual perception on the eye? are they as fully and distinctly recollected? and are they capable by themselves of affording the materials for thought or reflection? animals possess certain senses in common with ourselves; and, in many, the organs are more susceptible than our own; but there are no circumstances which have yet transpired, to induce us to suppose that the perceptions they have acquired are reviewed by their minds, when the objects which excited them are absent. the memory they possess of the perceptions they have experienced, is perhaps superior to that of human beings; still it does not appear, from any manifestations they afford, that it is actively exercised, as with ourselves, but occasionally excited by the recurrence of the object which originally produced it. language is the pencil which marks the bold outline, and lends a colouring to our different perceptions; and with this boon man is exclusively gifted. a rational curiosity will prompt the reader to inquire, in what our perceptions consist independently of the language in which we ordinarily clothe them. in the instance of optical perception, we know that it is _something_ which is retained by the memory, and may be traced by the hand, so as to convince others that it is truly remembered or recollected[ ]; but let the same enquiry be made concerning the perceptions we receive by the touch, the smell, and the taste: in this investigation we shall experience much greater difficulty, as it is an endeavour to conceive the nakedness of a figure which is always clothed. that these perceptions must also be _something_ abstracted from the terms which represent them, is proved, by the circumstance, that they are recollected when they occur again. as we are educated by language, and acquire a facility of employing it as the vehicle of our thoughts, we are little accustomed to contemplate the subject in this manner, and this also enhances the difficulty. when, however, the importance of speech is adequately considered, it will, i think, be detected, that the terms which we employ as the representatives of the perceptions of touch, smell, and taste, are the only media by which they can be voluntarily recollected or communicated to others; and, as signs of such perceptions, are equivalent to the representations by the hand of those which have been perceived by the organ of vision. to attempt the analysis of these silent deposits, to endeavour to describe these bare perceptions, would be altogether unavailing, because description implies language. in fact, it would be an effort to detect the symmetry of the human frame, by loading it with modern finery. the wonderful capacity which man exclusively enjoys, both for the communication of his thoughts, and for the improvement of his memory, in being enabled to acquire and transmit knowledge by impregnating sound with intelligence, and more especially in exhibiting its character embodied to the eye, leaves the rest of animated creation at a prodigious distance. this endowment of language to man, whereby he can, by an articulate sound, recall the perception of objects, (not indeed equal to the sensorial impression, but sufficient for their recollection, and also for the proof of their identity)--whereby he can with equal intelligence exhibit their character to the eye, is sufficient to explain of what the materials of his thoughts consist:--and to prove that animals being unable to substitute a term for their perceptions, are incapable of the process which we denominate thought or reflection. to fathom this mystery, is perhaps impossible; but, from attentively watching that which passeth within us,--from considering the state of animals which want this endowment altogether, it seems to be a law of our intellectual constitution, that our thoughts or reflections can only consist of the terms which represent our perceptions; and this is more evidently true, when we reflect on those subjects which are of a general or abstract nature. whoever will attentively watch the operation of his own mind,--for this subject admits of direct experiment,--will find that he employs terms when he conducts the process of reflection. in order to afford a fair trial, it is necessary that he should be alone, and subject to no interruptions. it will also add to the facility of the experiment, that he select a subject with which he is but little acquainted, as the process will be more deliberate. on topics with which we are familiar, we have acquired a rapidity of exercise which renders the detection of the process more difficult and perplexing. in this trial, he will be aware that he is repeating words as the materials of his thoughts. if the subject on which he should think involves persons with whom he is acquainted, or scenes he has viewed, he will, in addition to the terms he employs, have the pictures, or visible phantasmata, of these presented to his mind, conjunctively with such words. that we actually employ terms in this process is evident in many, who, when exercising their thoughts on any subject, are found, as we term it, talking to themselves; so that we are enabled to observe the motion of their lips: and this circumstance is to be noticed in most persons when they are counting. the contrivances of language enable us to connect our thoughts; for our perceptions are distinct and individual, and of themselves can possess no elective attraction to _associate_ and combine: they may however, by repetition or habit, become so allied, that the occurrence of one will excite the sequence of the other. we ordinarily recollect them very much in the order and succession of their occurrence; but we are also able to arrange and class them, and by such means, of recollecting them according to the artificial order of their distribution. this may be exemplified in the various expedients that have been devised for the acquirement and retention of knowledge: thus, chronology records events according to the order of their occurrence; an encyclopædia arranges according to alphabet or subject; and the most perfect of this kind, like the index to a book, consists in their mutual reference. this wonderful faculty of thought or reflection, so far as we possess the means of detecting, appears to be peculiar to man; and if it be admitted to consist of our recollected perceptions, by the contrivances of language, we shall find that animals are not in possession of the necessary materials. the ear transmits sounds to animals possessing this sense; and in some species it is so exquisitely susceptible, as to surpass, by many degrees, the acuteness of the same organ in the human subject. it is also recorded, that in some of the wilder tribes of man, the hearing possesses a delicacy of percipience unknown to the inhabitants of a polished community. superadded to the conveyance of ordinary sound, the ear of man is the great inlet of communication, and the vehicle of articulate intelligence. through the medium of this sense his knowledge becomes extended, and his memory improved; for every conversation is either a review of his stores, or an addition to his stock. as our thoughts or reflections are conducted by language, great caution is required that the terms we employ should possess a fixed and determinate meaning; and this is more especially important, when we employ words which are not the representatives of the objects of our perceptions, but of a complex nature, or, as they have been denominated, general terms; such as those which are used to designate the faculties and operations of the mind, and such as convey our moral attributes. the perfection of the process of thought, consists in the attention which the will can exert on the subjects of[ ] consideration. the nature and endurance of the attention, which the organs of sense can bestow on the objects of perception, have been already discussed; and it will be found, that the same influence is directed when we exercise reflection: so that that mind is to be considered as most efficient, (in proportion to its natural capacity,) which can dwell on the subjects of its thoughts without interruption from irrelevant intrusions. the exertion of voluntary control over our thoughts has been denied; but if we were to subscribe to such doctrine, it would follow that this noble faculty of reflection would be merely a spontaneous concurrence of images and terms accidentally revived,--on rare occasions fortuitously blundering on wit, and ordinarily revelling in the absurdities of distraction. in proportion as we have been duly educated, we become enabled to direct and fix the organs of sense to the objects of perception, to be able at will to revive our memoranda, or to call on the memory to exhibit the deposits which have been confided to its custody, and to dwell pertinaciously on the materials of reflection. it is, however, certain, that in ordinary minds, the attention is little capable of being fixed to objects, and still less to the subjects of reflection; but this incapacity, in both instances, is principally to be attributed to the defects of education, and to a want of proper discipline of the intellectual powers. the endurance of attention in minds of the highest order, by a wise law of our constitution, is limited; and if it be attempted to continue the exertion beyond the natural power, the effort is infructuous. as straining the muscles produces fatigue, stiffness, and tremor;--as ocula spectra intrude on the forced and protracted attention of the visual organs,--so confusion ensues, when thought is racked and goaded to exhaustion. as the staple of the human intellect is vastly superior to that of animals, so we find among our own species a considerable range of capacity; but however we may estimate mental excellence, it should be recollected, that its possession has seldom contributed to the happiness of the individual; so that experience would lead us to prefer the sober medium, which is included by a parenthesis, between the extremes of genius and dulness, and which appears to be the unenvied lot of the mass of society. the two great distinctions which mark the intellects of our species, seem to consist in the difference of character, which is established by those who excel in the exercise of their perceptions and consequent recollection, and those who cultivate and discipline the energies of thought. the former are distinguished by a vigorous activity, a penetrating and unwearied observation; their curiosity seems rather to be attracted by the object itself than directed by the mind. this incessant occupation and restless inquiry furnishes the memory with an abundant vocabulary: they recollect each object they have seen, and can retrace every path they have trodden; the ear greedily imbibes the conversations to which they are anxiously disposed to listen; that which they read, they verbally retain; they excel in quickness of perception and promptitude of memory, and appear to have every thing by heart; they are "the gay motes that people the sun-beams" of the intellectual world:--thus we find them, as inclination may sway, accurate chronologists, biographers pregnant with anecdote, expert nomenclators, botanists, topographers, practical linguists, and bibliographers; in short, the opulent possessors of whatever perception can detect, and memory preserve. the other order of men, (and they are comparatively few,) are the creatures of reflection:--with them the senses are little on the alert; they do not fatigue the wing by excursions through the field of nature; but that which the recollection retains becomes the subject of mental examination. an event is not registered from having merely occurred; but the causes which produced it are investigated, and a calculation is instituted concerning its probable tendency. words are not simply regarded as the floating currency or medium of exchange, but they are severely subjected to analysis to establish their standard, or to detect the excess of their alloy; their senses are little awake to external impressions; the objects which a change of scene presents are slightly noticed, and feebly remembered; their curiosity is not attracted from without, but excited from within; they are strangers to the haunts of gay and mirthful intercourse, and are rather consulted as oracles, than selected as companions. this constant occupation of thought produces the philosophical historian, profound critic, physiologist, mathematician, general grammarian, etymologist, and metaphysician. after long exertion they become disposed to melancholic disquietude, and often turn in disgust from a world, the beauties of which they want an incentive to examine, and taste to admire. both of these intellectual orders of our species contribute, but in different manners, to the stores of knowledge. the sound, efficient, and useful mind consists in a due balance and regular exercise of its different faculties. how great soever the pains which an individual may bestow, to fix his thoughts to the examination of a particular subject, he will find that the effective duration of his attention is very limited, and that other thoughts, often wholly unconnected with the subject, will intrude and occupy his mind; on some occasions they are so prevailing and importunate, that he loses the original subject altogether. it is acknowledged, that the soundest and most efficient mind, is distinguished by the control it is capable of exerting on its immediate thoughts; which consist, as has before been observed, of terms, and the phantasmata of visible recollection:--this wandering of the thoughts to other subjects, or this intrusion of irrelevant words and pictures, whichever may be the case, appears to bear a very strong resemblance to a morbid state. it is usually the attendant on indolence, and has probably its source in a want of the proper occupation of mind, and, by indulgence, may become an incurable habit. yet this rumination of mind has its votaries: by some it is courted as a delightful amusement, and eulogies are bestowed on the incoherent tissue of these reveries and day-dreams. although these illegitimate offsprings of "retired leisure" may be considered as a perversion of the noblest attribute of man; yet they serve, in some degree, to recruit our recollection of past transactions, which might otherwise have faded in obscurity, or perished from natural decay. in the soundest and most refreshing sleep we seldom dream; so, in those wholesome exercises of the intellect where the mind is fully occupied, and, more especially, when such pursuit is combined with bodily exertion, these masterless associates do not intrude. by continuance, this habit may be so formidably increased, more especially under the guidance of malignant or depressing passions, that these shadows become embodied, and assume a form so potent and terrible, that the will is unable to bind them down, and the understanding attempts to exorcise them in vain. the act of thought or reflection, therefore, appears to consist, not in the operation of an exclusive and particular faculty, but in the voluntary recollection of pictures, as far as visible perception is involved, and of terms or words which are the types or representatives of our perceptions, together with those general terms, which are to be considered as abbreviations of meaning or intelligence. all this would, however, only amount to an act of memory, of such pictures and terms, particular and general; and would not comprehend or include their analysis, estimate, admeasurement, or _ratio_, with inquiries into their source and tendency, which is denominated _reason_, and which will compose the materials of the following chapter. suffice it to observe that our thoughts on any subject can only be according to the extent of our knowledge of things and opinions; and, therefore, that our thoughts or reflections necessarily involve our reasonings, as they are only recollections without them. footnotes: [ ] in this capability animals will never rival us, as they are deficient of the _hand_, the operative instrument by which it is effected. [ ] it may be proper to explain the origin and meaning of this word, and of another usually employed in a similar sense, namely, contemplation. the former is compounded of _cum_ and _sidus_, and presumes a fixity of mind adequate to the survey of the heavenly bodies; the latter is derived from _cum_ and _templum_, and imports the same gravity and concentration of thought which we carry to the fane of devotion. on reason. the opinions of the thinking part of mankind have been much divided concerning the signification of the term reason. every person, conceives himself privileged to reason upon all the subjects of human intelligence; and whatever he may chuse to offer on any side of a question, he denominates his reasons for or against it. by some, this power is held to be the exclusive possession of man; and such persons naturally conclude that an offence is offered to his intellectual dignity, if the smallest portion be conceded to the most docile animals. this is, however, a question for future examination, and will be discussed when their faculties are more particularly investigated. those who have affirmed that our own species is exclusively gifted with reason, have not in any manner defined the nature of this faculty, or enumerated the steps of the process by which reasoning is performed: indeed, so ambiguous has been the signification annexed to this term, that it is not uncommon to meet, in the best authors, with the expressions of right reason, false or inconclusive reasonings, absurd reasons, &c. these epithets are, however, perfectly correct, as will be demonstrated in the course of this enquiry. if this capacity of reasoning be peculiar to man, it would not appear difficult to trace the gradations of the process when he employs it: every act of intellectual exertion, deliberately performed, is attended with consciousness; he must therefore be aware of the successive steps of his march: but as this effort might be perplexing to minds unaccustomed to such deliberate and minute investigation, a readier method presents itself in order to attain the object. there are writers in all the departments of human knowledge, who are deservedly held in the highest estimation, and who have reasoned on the subjects they have treated, with the utmost correctness and ability:--let the best specimens of that, which, in these authors, is allowed to be reasoning, be selected and analysed, which will readily demonstrate the means they have pursued to arrive at their conclusion. the whole of this process being conducted by significant sounds conveyed to the ear, or in the signs of these sounds presented to the eye, the inquirer would be immediately impressed, that intelligent sound, or its character, that is, language, must be the vehicle by which this process is performed. in the next place, he would be sensible that these sounds, or their signs, were the substitutes or intended representatives of the objects in nature, either individually or collectively; for he would find that men, by the instrument of speech, had contrived, by a term, equally to express collections as well as individuals; as a man, or an army, which latter might consist of many thousands of the same beings. when he had arrived at this knowledge, he would be persuaded of the importance of these terms, and feel the necessity of their precise and uniform signification, as the representatives of the particular objects or collections they professed to describe:--because, if different significations were affixed to the same term, those who employed it could not mean the same thing. these prefatory observations appear to be proper, and it is important that the reader should bear them in mind; but it will be evident that the most correct description of objects does not constitute the process of reasoning, however indispensable it may be as its foundation. reason, as the term itself shows, implies _ratio_, estimate, proportion, or admeasurement; and in all the instances of reasoning that can be adduced, this interpretation will apply in the strictest sense. but _ratio_, estimate, &c. involve numbers, by which they can alone be characterised or defined. thus, by way of illustration, the estimate for a building implies the number of the different materials, with their _cost_, which is the number of pounds, shillings, and pence; also the number of requisite workmen to be employed for such time, or number of weeks, days, &c. at a certain stipend: admeasurement also consists of numbers, whether it be employed on solids, fluids, or designate the succession of our perceptions, called time[ ]: and ratio or proportion is equally the creature of numbers. in a preceding part of these contributions, the importance of numbers has been considered, and a confident belief expressed that no animal is capable of numeration; and that the comprehension of addition and subtraction, the basis of all calculation is exclusively the province of the human intellect. this subject, however, requires a more extended investigation; and the research would doubtless reward the toil of the inquirer. it is generally acknowledged, that arithmetic, or the combination and separation of numbers, is the purest and most certain system of reasoning, and liable, when properly conducted, to no difference of opinion; because the meaning of number is definite and universally agreed on, there being no nation that affixes a different value to the units, which are the elements of all ulterior numerative progression; and although, in different languages, they are called by different names, as [greek: deka], _decem_, _dieci_, _dix_,--_taihun_, _tÿn_, _zehn_, _tien_, _ten_, yet they have an identical meaning, and denominate the same thing; and notwithstanding the roman and arabic symbols are of different character, they represent the same number, whether we employ x or . it is owing to this identity of meaning, that the reasoning in numbers is subject to no diversity of opinion. the names of those things which have an actual existence, and can be submitted to the inquisition of our senses, or are capable of being analysed, are subject to comparatively little error, when we reason concerning them, because their character is defined by observation and experiment: but we have terms to designate that which cannot immediately be submitted to the analytic operations of our senses, and which has no palpable existence; and from the undefined nature of these, the greatest discord and confusion have prevailed when we reason concerning them; as the terms, humanity, charity, benevolence, living principle, organisation, materialism, political expediency, taste, liberty, legitimacy, and a thousand besides. in order to proceed regularly with this subject, it appears that our reasonings may be employed concerning things, or the objects in nature, and on terms which are not the immediate representatives of natural phenomena, but as they have been denominated general or abstract; and which are intended to be the verbal representatives of multitudes of objects arbitrarily classed, or of opinions comprised under such term. that reason is not an inherent, peculiar, and independent faculty of the human mind, receives a strong confirmation from considering, that it cannot be voluntarily exerted on subjects of discussion, but requires, as the indispensable condition of its operation, the basis of knowledge, which is to be understood to mean, the result of observation and experiment: for the mere employment of language, on a subject with which we are unacquainted, is but idle prating and a lavishment of words. to reason, is to adapt our means, that is, our knowledge, for the attainment of the end or object proposed: it is the estimate or admeasurement of these means. if, for example, a military commander intended effectually to bombard a city;--such being the object proposed, he would immediately proceed to estimate, admeasure, or calculate his means to produce the effect, and his success would depend on the knowledge he possessed of the nature and properties of the materials employed: he must calculate the distance, elevation, proportionate quantity of powder, and the time the fuzee should burn previously to the explosion of the shell; with various other necessary circumstances. this is an example of a very pure process of reasoning as applied to things, and accords with the definition that has been attempted. if it were necessary to multiply instances of the reasoning on things, perhaps the construction of a thermometer would be a well-adapted illustration; and it would likewise exhibit that which i am very anxious to impress, namely, the very gradual manner in which knowledge, by the operation of reasoning has been applied to the purposes of utility. that many substances, and particularly metallic bodies, augmented in magnitude by being heated, or, as we now term it, expanded by heat, was known many centuries ago, and was a fact of hourly occurrence to the artificers in metals. a similar increment of bulk was also observed in fluids; and it was likewise known, that their dimensions contracted as they cooled. this fact appeared to obtain so generally, that it became an aphorism, that bodies expanded by heat and contracted by cold. of the precise gradations of heat they were, however, ignorant. most of the senses became tests, although they were inaccurate criteria. the sight conveyed some distinctive marks; so that when some metallic bodies were heated to a high degree, they were observed to become red, and as the heat was increased, they were rendered white. by the touch, a variety of discriminations of temperature was obtained, to which appropriate terms were annexed, explanatory of its effects, or according with the feelings; as burning, scorching, scalding, blistering hot;--descending to blood, loo, gently, or agreeably warm. the ear was not exempted from its share of information, by detecting the boiling of water, or by discovering when a heated metal was immersed in that fluid, that it was hissing-hot: even the smell detected some obscure traces, sufficient to discourage or invite an approach. these tests, although they might serve for ordinary purposes, were still wholly inadequate for philosophical accuracy. to ascertain quantity, it was necessary to associate number as the index of precision. notwithstanding the construction of this instrument now appears so simple and easy of contrivance, it is only within a few years that it occurred to fill a tube, having a bulb, with a fluid; and to note the points at which snow dissolved, and water boiled: when these were fixed, the intermediate space might form a scale according to any subdivisions, so as to endow it with precision by the adjunct of numbers. on many occasions, our sensations deceive us, especially in a morbid state of the body: a person in the cold stage of an ague shivers at the temperature that oppresses his attendant with heat; but the instrument described is subject to no variations, by marking the gradations of warmth with the definite character of number. it will now be seen, that man possesses materials for conducting his reasonings, which animals do not enjoy;--by language, and from his capacity of numerating. speech, of course, involves its record, whereby he can recall the transactions of former ages, and preserve the fruit of experience for his intellectual nurture, when the tree that produced it has perished. this record is the elaboration of the hand,--that wonderful instrument, the register of thought,--that active and and skilful agent that "turns to shape" the contrivances of the mind. it is perhaps impossible, in a few words, to describe precisely the nature of the operation termed reasoning. in general terms it may be defined, _the means we employ for the attainment of the end proposed; the employment of knowledge for the discovery of truth_; or _the process of demonstration_; whether the object be an arithmetical sum, a geometrical problem, or a discourse on taste. a part of the process of reasoning, according to received opinion, consists in comparison, either of things, or of general terms; and this comparison implies not merely their exterior similitude, but likewise their internal structure and composition: because two mineral substances may resemble each other in external appearance, and may wholly differ in their intrinsic properties. the process of ascertaining wherein they agree, and the circumstances which discriminate them, is an instance of reasoning, or the means we employ for the proposed end, and which means necessarily imply the previous possession of knowledge. it will also be seen that in the instance adduced, and indeed in most others, where we reason on things, that precision can only be attained through the medium of number; for these mineral substances, although similar in external character, may contain very different proportions of the precious metals, and their actual value can only be estimated by comparison; that is, by an analysis, founded in knowledge, to ascertain the per centage of gold or silver, which must be expressed in numbers: and the comparison that is instituted concerning general or abstract terms, must have for its basis the establishment of their legitimate force and meaning. when we consult authorities on this subject, and particularly dr. johnson's dictionary, we find that he has given eleven different significations of the term _reason_, which he defines to be "the power by which man _deduces_ one proposition from another, or proceeds from premises to consequences." there is, however, much ambiguity in this statement; and it would perhaps be impossible, in reasoning concerning things, (which is to be considered as the most perfect example of this process,) to adduce an instance, in which one proposition is strictly _deduced_ from another. every proposition is distinct, and independent: numbers, which are definite, may be added together, and the sum-total exhibited, or a lesser number subtracted from a greater, and the remainder shown. it is difficult to say what is really meant by the words "deduces one proposition from another." on examination, it will be found that every simple proposition contains some fact or dictum, something set up or laid down, _aliquid propositum_; and that nothing can be _deduced_ from it, more than the meaning which the words constituting such proposition legitimately convey: indeed, it must be evident, that any deduction from a simple proposition would destroy its force. the sum of our knowledge consists of individual facts, which are in themselves distinct, as much as a flock of sheep is the aggregate of the different animals that compose it; and it is only a misapplication of language, to affirm that we are able to deduce one proposition from another. one proposition may tend to explain or illustrate another; but every proposition, correctly so termed, relates only to itself. the other mode by which we reason, is on abstract or general terms, which are not the representatives of individual substances, or the objects of our perceptions; but the names of classes or collections, or of various hypotheses included or designated by a single name. the difficulties which environ this latter mode of reasoning become immediately evident, and satisfactorily account for the hostility and confusion it has engendered, and for the tardy advancement of real knowledge by this medium. the individual objects in nature can be investigated by observation and experiment, and may be sufficiently estimated; but multitudes of objects arbitrarily classed, or imaginary qualities comprehended by a single name, do not admit of the same analysis by the senses, and we are only enabled to ascertain their real meaning in the two ways that have been pointed out,--by authority, which, to be strictly such, ought to be invariable,--or by etymology, which will demonstrate their original signification, and the reasons which imposed them. thus when we reason concerning charity, benevolence, humanity, and liberty, terms certainly of the highest importance, but each of which involves a variety of circumstances, and the real signification of which, is to this moment differently interpreted, we are impeded in the process, and fail in our estimate, because the dimensions are uncertain. that which one man considers a charitable donation, another views as the means which encourage idleness, and vice, and a third person is perhaps induced to question the motive, by attributing the gift to pride and ostentation. these general terms seldom admit the precision of numbers, but are characterised as to their proportions by expressions equally general and indefinite: as, much, more, and most, to denote their augmentation; and, little, less, least, to define their diminution. these general but indefinite degrees of comparison, as they are termed, once defined the temperature of our atmosphere, until a scale was discovered to mark its increment and diminution by the accuracy of numbers. great as may be the convenience of general terms, both for abbreviation and dispatch, they are notwithstanding liable to considerable suspicion, and are the frequent sources of error and misapprehension. it has been principally for this reason, that in proportion to the advancement of the physical sciences, the study of scholastic metaphysic has been deservedly neglected. footnote: [ ] time, or the admeasurement of the successive order of our perceptions, embraces a wide area of definition; and it is perhaps impossible, in a few words, to circumscribe the range of its meaning. the sagacity of the human intellect, although by very slow gradations, has accumulated the wonderful mass of knowledge we now possess on this subject: and the investigations which have been made into the faculties of animals, justify the conclusion that its comprehension is limited to man. it would be highly interesting to trace the origin and progress of our information, concerning the nature of time; but a short note to a compressed essay, does not admit of such examination. however, it appears evident, that the striking and regular phenomena of nature have constituted some of our most important distinctions. thus, the ebbing and flowing of the tide have formed a very early notation; and we still retain in our language the traces of its application in whitsun_tide_, shrove_tide_, allhallow_tide_, &c. the great divisions of time are well understood; as day, from dawn; month, from moon; year, anglo-saxon gear, from gyrdan, the girth (of the zodiac). a moderate knowledge of the cognate languages of the north, would readily unravel the origin of all the terms that have been employed by us and kindred nations, for the purpose of characterising the succession of our perceptions. all these subdivisions necessarily imply a comprehension of numbers. from the experience of the past, man has inferred the _probability_ of the future; for by natural knowledge, the probability, great as it is, can only be deduced. the certainty has descended from a higher authority. although the grammar of our language has endeavoured to mark our predictions of the future by certain signs; yet these do not convey any definite intelligence of that which _is_ to come. in this state of being, man may receive assurances of ulterior existence, but he cannot invest his predictions with the certainty of numbers. the signs of will and shall, the utmost boundaries of his future glance, are both verbs in the present tense, and only signify his immediate intention of performance, at a time which may _probably_ arrive. instinct. it has been endeavoured, in the foregoing pages, to describe the intellectual capacities of the human being, and to account for his superiority, from the peculiarity of his structure, and the extended faculties it has conferred. it has also been attempted to maintain, that man, thus gifted, is the architect of his own mind; with the hopeful expectation, that it may tend to the improvement of his culture, but more especially, to exhibit him as the creature of responsibility, in consequence of his ampler endowments: "for unto whomsoever much is given, of him shall be much required." the mental phenomena which animals display is a subject of equal curiosity and interest; but it is to be lamented that they have not yet been sufficiently observed, or faithfully collected. their anatomy has been minutely and diligently investigated, and the functions which have resulted from the peculiarity of their structure, in many instances, have been industriously developed; but an enumeration of their intellectual bounties, and faculties of improvement, are still wanting to complete their history. as we are able to trace the progress of mind, in the infant, from its feeble glimmerings to its bright effulgence in the maturity of man; so we can contemplate the inherent wisdom that directs the animal tribe:--a liberal portion, sufficient for their individual protection, and for the continuance of their race. this definite allotment of mental craft to animals has rendered them stationary, while man has no barriers opposed to his improvement; but, under the fostering auxiliaries of a free soil, wholesome instruction, and intellectual labour, continually advances. however vast his present treasure may appear, its accumulation may be safely predicted; and it is to be expected, or at least, it may be hoped, that his career in moral practice will be commensurate with his progress in science. the human intellect, or the capacity of man for the accumulation of knowledge, has enabled him, in a great degree, to render himself the master of the animal creation; and more especially over those which dwell on the soil he inhabits or range in the atmosphere he respires: his authority or conciliation has little extended to the tenants of the deep. many of the larger quadrupeds he has subdued, and thereby has become enabled to substitute the exertion of their muscles to relieve the toil and fatigue of his own: of the swifter, he has coerced the speed, for the anticipation of his wishes: the breed of many he has extensively multiplied, to prey on their flesh, or to become nourished by their secretions: his knowledge has been directed to the physical improvements of their race, and he has also relieved them from many infirmities and diseases, consequent on their domestication and labour. the wonderful construction of animals is a fit subject for the serious contemplation of man: but the most striking and important lesson which it impresses, is the adaptation of their organs to the purposes of their destination, or the means they possess for the discharge of the offices they perform. this construction is throughout an exemplification of that which has been defined reason; and that it is perfect, may be concluded from its being the work of the creator. it has been already observed, that the perceptive organs of many animals, especially the eye, the ear, and the smell, are more acute and vigorous, than those in the human subject: with us, the olfactory organ is considered as the lowest sense, but in some animals it appears to be the most important; and even in man, under certain privations[ ], the smell has become a test of the nicest discriminations: indeed, so far as the senses are concerned as the importers of knowledge, animals appear to be gifted beyond our own species. their memory is also more perfect, as might be expected, from the exquisite sensibility of their perceptive organs. the accuracy with which they recognise persons and places is in many instances really astonishing; and the certainty with which they retrace the most intricate paths, is a proof of the excellence of their local recollection, and of the attention they are capable of bestowing on the objects of their perceptions. this enduring attention is perhaps to be accounted for from their want of reflection, which so frequently diverts man from dwelling on the objects of his senses. thus, a cat will undeviatingly watch the hole through which a mouse is known to pass, far beyond the time which man can exclusively devote to a subject of expectation. but here their superiority terminates. their recollection is not refreshed, as in man, by the substitution of a name for the object of perception; much less have they any contrivance to record such intelligent sound, whereby man can preserve and transmit his perceptions. thus whatever individual excellence animals may attain, they want the means of communicating, and of transmitting to their successors, and this sufficiently accounts for their stationary condition, and for the progression of man. that animals are _incapable of the power_ which has been termed thought or reflection is most probable. according to the interpretation that has been given of this faculty, they are deficient of the materials, or of terms, the representatives of perceptions; consequently of their abbreviations, and of the contrivances by which a proposition or sentence is constructed. that they understand some words, is evident; they know their own names, and, by certain sounds, can be made to stop or advance, to seize or let go, to rise up or lie down; but the extent of this intelligence is very limited, and altogether different from the comprehension of a sentence. it is not improbable that they dream; and, at such times, the recollection of objects and scenes may be presented to them in visible phantasmata; and in the delirium of canine madness, they are observed to snap at imaginary existences; but this is far below the process that constitutes reflection, which consists in the capacity of reviewing the whole of our perceptions; and it has been endeavoured to point out that this can only be effected through the medium of intelligent sound, or its visible representative. if we were to contend for their capacity of reflection, we must, at the same time, acknowledge, that they do not appear to derive any improvement from the process; and to suppose them endowed with that which was nugatory, and contributed in no degree to their advancement, would be an idle and useless hypothesis. when not employed and directed by man, their lives are principally occupied in procuring food, and in the propagation of their species; and when their appetites are satisfied, they repose or sleep: when not guided by instinct, they seem to act from established habits, or the dictates of immediate impression. they are capable of considerable acquirements under the coercive tuition of man, and may be taught a variety of tricks for his amusement or profit; but they do not appear to comprehend their utility, or to hold these instructions in any estimation, as they never practise them when alone. the most accomplished bear would not dance for his own entertainment; and the learned pig never attempted to become a school-master to the hogs of his acquaintance. it has been previously noticed, that in man, and most animals, there were movements of the highest importance to life, which were directed by the author of the universe, and over which they had no immediate control, termed involuntary motions; so we find, in the tribe of animals, various mental endowments, especially tending to the preservation of the individual, and to the succession of the race, which are not the results of their experience. these have been comprehended under a general term, and denominated instinct. by instinct, is meant the display of contrivance and wisdom by animals, which tends to preserve them as individuals, and to maintain their succession; an intellectual exercise so perfect, that human philosophy has not pretended to improve; so unvaried, that the excellence of its performance cannot be exceeded, and is never diminished; a clearness of execution, that "leaves no rubs and botches in the work," but which, it may be presumed, is not even comprehended by the animal itself, as it does not possess the organs or capacity to acquire the rudiments of the science on which its operations proceed. as man, in his healthy state, is little conscious of his involuntary motions, so i should presume that animals possess but a feeble consciousness of their instinctive achievements. this may be a subject for subtle disputants to decide; but it appears certain, during the exercise of instinct, that their volition must be suspended. when sufficient observation has collected the intuitive wisdom displayed by animals, we shall then be able to _define_ what is precisely meant by instinct; and, which is of much greater importance, to furnish their intellectual history, of which the definition is an abbreviation. one of the most useful contrivances of language, is its abbreviation for the purposes of dispatch; and a definition implies the fewest words into which its history can be compressed, for perfect discrimination and identity of character. without disputing about a term, it may be noticed, that young ducks hatched by a hen, immediately on their developement, and often with a part of the shell still attached to them, make directly for the water; while the hen, who has performed the office of a mother, screams with alarm for the consequences. a she-cat, the first time she brings forth her young, proceeds to secure the umbilical cord of each kitten, with the caution of an experienced midwife. in both these instances, experience cannot be adduced to account for the performance. when the admirable texture of a spider's web is contemplated; will it be contended that this elaboration is the result of mathematical knowledge _acquired_ by the spider? have the dwellings of the beaver, and the construction of the honey-comb, their solution in the geometrical attainments of the fabricators? the examples which have been enumerated, (and they are only a few, among multitudes,) can only be accounted for, by maintaining, that these wonderful phenomena proceed from a degree of knowledge acquired by these animals, and are the result of such attainment; or that they are independently furnished with such propensities by the creator. if it can be demonstrated that the animals displaying the greatest acts of intelligence, are unable to acquire the rudiments of the arts they practise, and cannot comprehend the wisdom they execute, there will remain but one conclusion--that they are the immediate endowments of god. man has his instincts, although they are few, and these appear to fade as his reason advances; woman enjoys a more bountiful supply. the intellectual difference of the sexes is strongly pronounced: the female is more the creature of perception: man, of reflection:--the duties imposed on her, require less of thought and volition; and when she resembles man by their possession and exercise, she becomes less amiable and attractive. but this is abundantly compensated by the intenseness and constancy of her affections. the gift of instinct to animals, does not exclude them from acquiring knowledge by experience; for their minds are capable of improvement, according to the extent of their capacities, and the intellectual organs with which they are furnished. the instinct which is allotted to them is mental possession which they could not have acquired, from the limited nature of their faculties. all their instincts are processes of the purest reasoning, but they do not originate from themselves; they are not, as in man, the elaboration of thought, the contrivance founded on the estimate of knowledge; but a boon,--an endowment, by which experience is anticipated, and wisdom matured without its progress and accumulation. animals form an estimate of that which they can accomplish: a horse will not voluntarily attempt a leap he cannot clear; but his admeasurement is instituted solely by his eye: he is deficient of the organ which man possesses;--nor can he measure by steps or paces, as he is unable to numerate. an old hound will spare himself much fatigue in the chace, by knowing, from experience, the doubles of the hare. as man cannot reason independently of knowledge, nor beyond the extent of his acquirements, neither can animals display this faculty further than they possess the means. the instinctive bounty of intellect to animals, of course, renders them stationary as a community; as instinct implies a definite portion of intuitive sagacity, wisdom, or reason, commensurate to their wants and destination. the early manifestation of instinctive wisdom, is the best reply to those philosophers who have argued against its existence; for in a multitude of instances it is exhibited, anterior to the possibility of experience. man, although gifted with superior capacities, and susceptible of higher attainments, does not, from the paucity of his instincts, arrive during many years at the same maturity both of mind and body, which most animals display within the space of a few weeks; so necessary and important is the protracted period of infancy to the edifice and destination of the human mind. footnote: [ ] notwithstanding we cannot sufficiently estimate the perfection of the senses in animals, yet in some instances we are enabled to observe, in our own species, the importance which a lower sense acquires, in consequence of the privation of those which are deservedly considered the more noble. a singular case of this nature occurred in scotland, the particulars of which have been published by mr. james wardrop an eminent surgeon and oculist, to. london, . this person, james mitchel, was born, very nearly blind and deaf. although he was not deprived of every glimmering and vibration, yet he was incapable of discerning an object, or hearing an articulate sound; consequently to him the visible world was annihilated. a ray of light might serve to delight him as a toy, but it did not enable him to have the visible perception of any substance:--his nerves, indeed, appeared to be agitated by the concussion of sound, yet it was wholly impossible to lodge in his ear the missile of a word. being thus deprived of the two nobler senses, his _mind_ was constituted of the perceptions he acquired by the organs of touch, smell, and taste. his attention was enduring, and his curiosity eager, far beyond those of any animal. mr. wardrop observes that "his organs of touch, of smell, and of taste, had all acquired a preternatural degree of acuteness, and appeared to have supplied, in an astonishing manner, the deficiencies in the senses of seeing and hearing. by those of touch and smell, in particular, he was in the habit of examining every thing within his reach. large objects, such as the furniture of the room, he felt over with his fingers, whilst those which were more minute, and which excited more of his interest, he applied to his teeth, or touched with the point of his tongue. in exercising the sense of touch, it was interesting to notice the delicate and precise manner by which he applied the extremities of his fingers, and with what ease and flexibility he would insinuate the point of his tongue into all the inequalities of the body under his examination. "but there were many substances which he not only touched, but smelled during his examination. "to the sense of smell he seemed chiefly indebted for his knowledge of different persons. he appeared to know his relations and intimate friends, by smelling them very slightly, and he at once detected strangers." from the whole of this interesting relation, it seems fair to conclude that this youth, even under the privation of sight and hearing, possessed, in the staple of his intellect, capacities beyond the most docile animals; and these consisted in the ardent curiosity which he displayed, and in his desire for the improvement of his limited faculties. had this boy been confided to my management, i should have endeavoured to educate him through the medium of his touch, so as to communicate his wants, and afford an occupation to his mind. thus, if milk had uniformly been served to him in a bowl, beer in a mug, water in a decanter with a glass stopper, and wine in a decanter with a cork: if these had been arranged in his apartment, he might have indicated his wish for any of these liquids, by producing the vessel that contained them: the two latter might have been subsequently abbreviated, by producing the glass stopper for water and the cork for wine. as he examined every object by the touch, it would have contributed both to his improvement and occupation, if he had been furnished with a quantity of ductile clay, which he might have modelled to represent the objects he examined, and which he might have preserved as a species of tangible vocabulary. according to my own suppositions, he might have been taught to numerate. it may be a subject of considerable curiosity to enquire, of what the reflections of james mitchel could have consisted. he had no visible impressions which his hand could record. being deaf, he could not have acquired the instrument of thought--language; therefore, for the objects of the senses he possessed,--smell, taste, and touch,--he could have no terms, as their substitutes, for the purpose of recollection. the next important question is, in what manner (wanting names whereby they might be represented) would the perceptions of smell, taste, and touch be represented to his mind in order to constitute reflection or thought on these experienced perceptions? if musk, rose, or garlic had been smelled, these perceptions, in a being constructed like mitchel, would remain dormant, until the same odour were again presented to his olfactory organ; when it would be recollected, or he would be conscious, that it had been previously presented. in such a being, there would be a necessity for a fresh excitation of the organ of sense by the object, to produce recollection; whereas, in those who possess language, the name produces the recollection of the thing perceived. conclusion. the subjects that have been discussed in these contributions, fully establish the pre-eminence of man, over all other created beings; and it has also been endeavoured to demonstrate the circumstances which have principally contributed to this superiority. the conclusions that may be drawn are equally important and consoling. when the capacities of the intellect are fully ascertained, we shall be enabled to supply it with the proper materials of instruction; so that the protracted period of infancy may conduce to the formation of virtuous and enlightened members of civil society. the healing art will be abundantly promoted by a knowledge of mind;--for the remedy of its infirmities and perversions ought to be founded on a thorough knowledge of its faculties and operations;--nor should it be forgotten that the prevention of crimes, and the reformation of delinquents, equally involve an intimate acquaintance with the temperaments of human character. in the contemplation of mind, from the highest order to the lowest rank,--from man, to the maggot that consumes him; we are imprest with the evidence of appropriate contrivance and infinite wisdom. although we are unable to penetrate the dense veil, that conceals the arcana of vitality and intellect; yet sufficient is exhibited to us, in the ample volume of nature, to satisfy our curiosity, and stimulate the exercise of reason. observation and experience have disclosed to us, in a great degree, the structure and functions of our own bodily frame; and the same persevering industry has unfolded the variations which obtain in animals. the conclusions that have been formed from the study of anatomy and physiology, amount to a conviction, that the contrivance is admirably adapted to produce the effects we behold;--that the means are competent to the end. the same reasoning applies to the phenomena of intellect, and may be illustrated by the comparative difference which appears in animals and man. the mental endowments and capacities which animals possess, have rendered them stationary; whatever the more docile and intelligent may have been compelled to learn, they do not appear to comprehend, and want the means to communicate: so that their contemporaries and descendants are unbenefited by the acquirement, and the attainment perishes with the individual. when brought into existence, the world is to them a recent creation, and bears no evidence of a former race, from archives or monuments which they can understand. the record of their ancestors has been discovered by man, in fossile preservation; but its characters are unintelligible to them. as they have not been endowed with the capacity to numerate, they can experience no solicitude for the past, nor apprehension for the future. their recollection is not an act of the will, but an excitation by the object that originally produced it. in the grammar of animals, the present is the only tense, and to punish them for the faults they had formerly committed, would be equally absurd and tyrannical. they are not the creatures of compact, and being unable to comprehend the nature of institutions, and the obligation of laws, they cannot be responsible agents. it has also been remarked, that they are destitute of sympathy for the sufferings of their fellows; but sympathy would be superfluous, where they cannot understand the nature of the affliction, and do not possess the power of administering relief. the features of the human mind are very differently shaped, and strongly indicate an ulterior destination. man possesses language, the instrument of thought, the vehicle of intelligible communication;--and he is gifted with the hand, to record the subjects of his experience, to fabricate his contrivances, and to rear the durable monuments of his piety and splendour. thus, he is rapidly progressive, his mind becomes opulent from the intellectual treasures of his ancestors, and, in his turn, he bequeaths to posterity the legacy of wisdom. his comprehension of numbers, on which the nature of time is founded, enable him to revert to the transactions of distant ages, and to invest faded events with the freshness of immediate perception. he alone can embalm the past, and welcome the tidings of the future. man alone is fitted to covenant, although he may occasionally waver in the performance. his exalted capacities, his comprehension of the law, constitute his responsibility: for where the conditions of the compact are not understood, there can be no disobedience or delinquency. the helpless condition of the human infant, and the paucity of its instincts, apparently render it less favoured than animals;--but it was necessary, in order to constitute man a moral agent and a responsible being, that he should be the architect of his own mind. when born, he has every thing to learn; and a large portion of his existence is consumed to qualify him for his station in society. had he, like animals, been gifted with intuitive wisdom, the donation would have been so perfect, as to render instruction superfluous;--and such endowment would have diminished the measure of his responsibility. the freedom of his will, by which is to be understood the impulse of reason, not the blind dictates of appetite, nor the sallies of tumultuous passions, renders him amenable. such is the force of the human mind, that it can surmount the difficulties which situation and circumstances oppose to its improvement: so powerful is reason, that it can correct the prejudices of early tuition, and atone for crime, by the pursuit of honourable practice. man alone can repent; he only can retrace the acts of former commission, and resolve on amelioration for the future. thus we find that moral responsibility has its basis in the comprehension of time. in proportion to our love and estimation of justice, we must be satisfied that, under the purest forms of human government, it is but imperfectly administered: the rewards and punishments in this life will ever be blended with the hopes and fears, the interests and passions, of our species; and there is much of evil, which human sagacity cannot detect. when we consider the attributes of the deity and the nature of man, we can never be induced to conclude that the tribunals of this world are the courts of final retribution. man bears in his intellectual construction the badge of moral responsibility, and, consequently, the germ of future existence: and the only incentive that can urge him to the advancement of science, and the practice of virtue, is the reward that revelation has unfolded. the end. printed by strahan and spottiswoode, printers-street, london. books by richard c. cabot published by houghton mifflin company a layman's handbook of medicine. with special reference to social workers. what men live by. social work. essays on the meeting-ground of doctor and social worker. social work essays on the meeting-ground of doctor and social worker by richard c. cabot, m.d. [illustration: logo] boston and new york houghton mifflin company the riverside press cambridge copyright, , by richard c. cabot _all rights reserved_ to mary e. richmond whose illuminating book on "social diagnosis" marks an epoch in the development of social work preface most writers who disclaim thoroughness are prone to describe their work as an outline, a sketch, or an introduction. but the chapters of this book are more like spot-lights intended to make a few points clear and leaving many associated topics wholly in the dark. possibly such isolated glimpses may serve better than a clear outline to suggest the interest of the whole topic. at any rate, that is my hope. part of the same material has been used in lectures given at the sorbonne in the early months of and published by crès & cie. under the title of _essais de médecine sociale_. contents introduction: historical development of social assistance in medical work vii part i: _medical-social diagnosis_ i. the medical standing, duties, and equipment of the social assistant ii. history-taking by the social assistant iii. economic investigation by the social assistant iv. mental investigation by the social assistant v. mental investigation by the social assistant, continued vi. the social worker's investigation of fatigue, rest, and industrial disease vii. the social worker's best ally--nature's cure of disease part ii: _social treatment_ viii. samples of social therapeutics ix. the motive of social work introduction historical development of social assistance in medical work i the profession of the social worker, which is the subject of this book, has developed in the united states mostly within the past twenty-five years. probably ten thousand persons are now so employed. it is known by various titles--social worker, school nurse, home and school visitor, welfare worker, hospital social worker, probation officer--varying according to the particular institution--the hospital, the court, the factory, the school--from which it has developed. but although the use of these visitors has been developed independently by each institution, and largely without consciousness of what was going on in the others, yet the same fundamental motive power has been at work in each case. because this is so, we shall do well, at the outset of our study of home visiting, to get a clear conception of the common trunk out of which various types of home visitor have come like branches. why has such an army of new assistants been called into existence? for this reason: in the school, in the court, in the hospital, in the factory, it has become more and more clear, in the last quarter of a century, that we are dealing with people in masses so great that the individual is lost sight of. the individual becomes reduced to a type, a case, a specimen of a class. these group features, this type of character, of course the individual possesses. he must be paid as "a hand," he must be enrolled in a school as "a pupil," admitted to the dispensary as "a patient," summoned before the court as "a prisoner." but in this necessary process of grouping there is always danger of dehumanization. there is always danger that the individual traits, which admittedly must be appreciated if we are to treat the individual according to his deserts, or to get the most out of him, will be lost sight of. we shall fail to make the necessary distinction between a and b. it is the recognition of this danger which has led, in the institutions which i have mentioned, to the institution of the social worker. above all of her duties it is the function of the social worker to discover and to provide for those individual needs which are otherwise in danger of being lost sight of. how are these needs found? in schools, hospitals, factories, courts, and in the home visiting carried out in connection with them, one can discern the two great branches of work which in the medical sphere we call _diagnosis and treatment_. thus, in the school, it is for the individualization of educational diagnosis and of educational treatment that the home visitor exists. the educational authorities become aware that they need to understand certain children or all the children of a group more in detail--each child's needs, difficulties, sources of retardation. this _educational diagnosis_ is made possible through the home visitor's study of the child in the home and out of school hours. there follows a greater individualization of _educational treatment_. the teacher is enabled, through the reports of the home visitor, to fit his educational resources more accurately to the particular needs of the scholar, so that they will do the most good. in the juvenile courts the judge needs to understand more in detail the child's individual characteristics, the circumstances, the temptations, which preceded and accompanied the commission of the offence which now brings the culprit before him. this is _penological diagnosis_, and the court visitor or probation officer, sometimes simply called the social worker, makes a study of the law-breaker in his home and in relation to all the influences, physical or moral, which may help to explain the commission of the particular offence which has brought him into trouble. all this leads to the greater precision of _penological treatment_. understanding more in detail why this particular boy has committed this particular theft, how he differs from other boys who have stolen, the judge is much more likely to choose wisely those measures of treatment which in the long run will do most to reëstablish the individual as a healthy member of society. in the factory the object of the employer in setting a home visitor or welfare worker at work is to create the maximum of satisfaction and good spirit among his employees, whereby each will do his best work and be as little likely as possible to change his employment. in the old days, when shops were small and the employer could know his employees personally, no intermediary such as a home visitor was necessary. the employer could keep human touch with his men. he could know not merely the amount of work done by each man, but something of the circumstances of his life, something of his personality, his adventures and misfortunes, so that help could be extended to him from time to time when special need occurred. it is only when the workshop has grown to the enormous size familiar in modern industrial plants that this relation of employer and employee has to be supplemented through the mediating offices of the home visitor. it is this same process of evolution, the same heaping-up of groups till finally they become unmanageable, which has led to the employment of the social worker in other institutions. it is because the schoolmaster must teach so many that he can no longer know his pupils and their families individually that he has to employ the home visitor to keep him better in touch with them. it is because the judge tries so many prisoners that he cannot grasp and pursue all the detailed characteristics of those who come before him for judgment that he is compelled to get them at second-hand from a home visitor. so finally when we approach the reasons for which the medical home visitor has come in the better dispensaries of the united states to be an essential part of the institution, we find that the unmanageable increase in the number of patients to be treated by the doctor is one of the chief reasons why the home visitor has become necessary. in the old days and in country practice especially, it was doubtless possible for the doctor to follow the lives of his patients individually as acquaintances, and through many years, to watch the growth and development of families, to know their members as a friend and not merely in a professional capacity. he would meet them as a neighbor, in church, in town meetings, in agricultural fairs, in village sports and holidays. thus he would touch the lives of his fellow citizens on many sides, and when he came to their aid in his narrower professional capacity he could supplement his diagnostic findings and his therapeutic resources out of the wealth of knowledge which years of association with them outside the sick-room had furnished him. ii but in the evolution of the particular type of social worker who is the subject of this book, the home visitor connected with a dispensary, there are other forces besides those described above, other motives besides that common to the rise of all the types of home visitors in all the other institutions named. for in the dispensary, not only has the number of applicants greatly increased, but it has increased because people realized that there was much more to be obtained by going to a dispensary than was formerly the case. the development of medical science and of the resources of diagnosis and treatment which can now be put at the service of the dispensary patient, has served to attract more patients there. but these new resources have also complicated the work of the physician in a dispensary, and made it more difficult for him to remember each patient and all the details about each patient as the physical, chemical, psychological, biological facts emerge in the complex ramifications of modern diagnosis and treatment. in the old days the dispensary, as its name suggests, was a place to dispense, to give out medicine in bottles or boxes. the patient mentioned the name of his ailment, the corresponding remedy was given. it was a quick and simple business--no individual study, no prolonged labor was necessary. moreover, one dealt only with a clearly defined class, the poor. there was no danger that the numbers applying for relief would swamp the institution or make it impossible for the dispenser to do his work properly. but within the past quarter of a century the dispensary, especially in the united states, has received a new idea, an access of fresh life. largely because it has become associated with universities and been used as an instrument of medical teaching, the influence of scientific medicine has begun to be felt there. this influence has enlarged and remodelled the dispensary in two respects. first it has compelled the introduction of modern accurate methods of diagnosis, instruments of precision, _time-consuming processes of examination_, specialization of labor, and subdivision of function, for the skilful application of these methods. the dispensary physician is no longer content to treat a headache or a cough as an entity, to dispense this or that drug as the remedy for such a symptom. he must discover if possible the underlying disease, and, moreover, the individual constitution and life-history in the course of which the patient's complaint now rises for the moment to the surface like a fleck of white foam on an ocean wave. but how is the physician to gain this radical and detailed knowledge of his patient's life outside the dispensary and enveloping the particular complaints for which he now demands relief? his difficulties are only increased when diagnosis is complete and he turns to the labors of treatment. for with the advance of modern medical science there are left now but few physicians who believe that disease can often be cured by a drug. it is recognized by the better element of the medical profession all over the world that only in seven or eight out of about one hundred and fifty diseases clearly distinguished in our textbooks of medicine, have we a drug with any genuine pretensions to cure. what is to take the place of drugs in dispensary treatment? in hospital patients we have the hospital régime, the unrivalled therapeutic values of rest in bed, the services of the nurses; but in dispensary practice all this is impossible. what is to take its place? for a good many years this question remained unanswered in american dispensaries, and as a result thereof there developed the pernicious habit of giving drugs no longer believed in by the physician, the custom of giving what we call _placebos_, remedies known to be without any genuine effect upon the disease, but believed to be justified because the patient must be given something and because we know not what else to do or how else to satisfy him. iii it was at this very unfortunate and undignified stage in the development of our dispensary work in america that we received priceless help from france, help which i am all the more anxious to acknowledge to-day because it has not, i think, been fully appreciated in the past. we in america have not given to france the full expression of the gratitude which, for her services in the field of medicine, as in even more important phases of our national life, it is to-day particularly fitting that we should utter. the timely contribution made by france at this halting and unsatisfactory stage in the evolution of our dispensaries came through the work of the great dr. calmette, of lille. calmette's introduction of the anti-tuberculosis dispensary as a focal centre of the fight against tuberculosis contained among other important provisions the institution of the _visite domiciliaire_. the functions of the person making this visit were not precisely the same as those of the social worker whom i am describing in this book, but the latter may truly be said to have grown out of the former, nourished by some contributing elements from other sources. so far as i know, calmette was the first to see that in the struggle of the dispensary against this particular disease, tuberculosis, it is essential to make contact with the home, and to treat the disease there as well as at the dispensary itself. in calmette's view the function of the _visite domiciliaire_ was an outgrowth of his bacteriological training and his bactericidal plan for treating tuberculosis. the home visitor was a part of the plan of antisepsis, a method of destroying the bacteria through disinfection and sterilization of the premises and of the patient's linen. in america the work of the home visitor in cases of tuberculosis has been concerned less with the disinfection and bactericidal procedures than with the positive measures of hygiene, such as the better housing of the patient, better nutrition, better provision for sunlight and fresh air, and above all instruction of the patient as to the nature of his disease and the methods to be pursued in combating it. but the great debt which we owe to calmette was the linkage of the dispensary and the home by means of the home visitor. in america we have applied this principle, outside the field of tuberculosis, to all other diseases, and we have broadened the field of work assigned to the social worker. nevertheless, the idea was primarily calmette's. there was another leading idea of calmette's which we have followed first in relation to tuberculosis, later in dealing with other diseases. like calmette we have stopped wholesale drugging, and put our trust in those scientific hygienic procedures which carry out our knowledge of the nature of the disease which we are combating. calmette's measures have the tone and the point of view of preventive medicine, and of that sound science which we have learned to associate with the pasteur institute and all that development of medicine which took its rise from pasteur. the focussing of interest upon a single disease which began, so far as i know, with calmette's anti-tuberculosis dispensaries, has been fruitful in many ways. in the first place, it has enabled science once more to _conquer by dividing the field_, to help humanity by devoting itself to a single manageable task. like others of calmette's ideas, this isolation of a single disease for group treatment in dispensaries has been followed in fields with which he never concerned himself. thus we have had special classes for cases of heart disease, for diabetes, for syphilis, for the digestive disturbances of infancy, and for poliomyelitis. a valuable measure of success has come in each of these diseases through the concentration of attention, at a special day and special hour by a special group of physicians and assistants, upon one disease at a time. we have even used class methods and taught the patients in groups as scholars are grouped and taught at school. but there has come another signal advantage in the point of view adopted by calmette in his dispensary campaign--the point of view, namely, of public health and public good. it has freed us from the limitations contained in the old idea that a dispensary is an institution concerned solely with the poor. tuberculosis, of course, like every other infectious disease pays but little respect to distinctions of property. from the point of view of the state a tuberculous individual is as dangerous to others and a cured tuberculous patient is as valuable as a possible asset to the state, whether his income is above or below a certain figure, whether, in other words, he is inside or outside the imaginary group sometimes called the poor. from the institution of tuberculosis dispensaries with their home visitors in america, the poverty of the individual ceased to be a necessary badge for admission. especially since many of our dispensaries have been instituted and maintained by the state, and therefore are paid for by all its citizens in their taxes, any one so unfortunate as to acquire tuberculosis, or be suspected of it, feels himself wholly justified in seeking help at a state-maintained tuberculosis dispensary. in this respect, as in many others, the campaign against tuberculosis has had a value far greater than its measure of success in checking that disease. it has introduced methods which were applicable outside the field of tuberculosis. one of these, as i have already said, was the utilization of the home visitor. a second was the disregarding of property lines. a third was the frank and confident reliance upon scientific measures and the relegation of eclecticism and quackery to the hands of those who make no pretence at scientific education or honest dealings with the public. iv i must speak at this point of another great french contribution towards the occupation which in its fully developed state we now call social work. i mean that which at present receives ordinarily the name of the "oeuvre grancher." grancher proceeded upon the same sound bacteriological foundations which guided calmette. since children are especially susceptible to tuberculous infection (though they rarely show alarming signs of it till later years), he planned the _separation of children from the neighborhood of tuberculous parents_ or other tuberculous persons as an essential measure for preventing contagion. i am not concerned now with the enormous benefit derived by the forces struggling against tuberculosis from this insight of grancher's, nor with the part which it has played in such success as that fight has already attained in the united states and elsewhere. what interests me particularly in connection with the topic of this book, is that the procedures suggested by grancher led the physicians who came in contact with the tuberculous individual in a dispensary to extend their interest to other persons who did not present themselves at the dispensary as patients. it is not obvious at first sight how great a transforming principle is thereby introduced. hitherto the doctor had been passive in his activities at the dispensary. he had concerned himself with such patients as chanced to appear there. he had never taken _the active or aggressive attitude_, searching for possible patients among those who had made no attempt to avail themselves of his services. now he goes to find patients. this is an epoch-making change. the physician becomes henceforth not merely a person who stands ready to treat disease when the accidental and incalculable forces of custom, hearsay, and natural propinquity bring the patient to him. he becomes now a person who actively wars against disease, who searches it out wherever it may be found. thus he approaches for the first time the possibility of truly preventive action, the possibility of killing disease in its infancy or preventing its birth. for it is well known that preventive action in relation to disease is well-nigh impossible if we are forced or accustomed to wait until the disease has made such progress that the patient himself is aware of it and forced by its ravages to ask medical aid. ordinarily the patient seeks the physician only when he has broken down. from the point of view of public health and public good, this is grievously late, far too late. it is as if one inspected an elevator only after it had fallen and killed or maimed its passengers, instead of inspecting it at regular intervals so as to prevent its breaking down. in this series of aggressive steps in the campaign against tuberculosis whereby one seeks out possibly infected children, brings them to a dispensary for examination, and separates them from their infected parents or house-mates, the social worker is the all-important executive. she finds the children, brings them or has them brought to the dispensary, and sees that financial aid or other assistance is given so as to carry out the isolation demanded by our bacteriological knowledge of the disease. v as far back as the reforms introduced by calmette and grancher in the field of tuberculosis had begun to modify and improve the treatment given in our dispensaries, not only to tuberculosis but to all other diseases. especially it had favored the growth of home visiting, at first for the specific ends for which it was designed by calmette and grancher, but later for the prosecution of various related purposes which the very process of visiting brought to light. not only in tuberculosis, but in other diseases, it was soon found that a knowledge of home conditions and of the family was essential for the treatment of the single patient who chanced to appear at the dispensary. it was my good fortune during the ten years preceding to work as a member of the board of directors of a private charitable society caring for children deserted by their parents, orphaned, cruelly treated; also for children whose parents found them unmanageable or for children who had special difficulties in getting on at school. the work of this society brought to me detailed knowledge of the life-histories of a good many children. i watched the careful studies made by the paid agents of the society into the character, disposition, antecedents, and record of the child, his physical condition, his inheritance, his school standing. i noticed during these years how the agents of this society, to whom the child was first brought by its parents or by others interested in it, utilized to the full the knowledge and resources of others outside its own field; how, for example, they enlisted the full coöperation of the child's school-teacher, secured facts and advice from the teacher, and agreed with her upon a plan of action to be carried out both by her and by the home visitor in concert. moreover, i saw how physicians were consulted about the child, and how their advice and expert skill contributed something quite different from that obtained from the teacher or that gained by the home visitor herself. the priest or clergyman connected with the family was also asked for aid, and sometimes could give very great help, differing essentially in kind from that given by the teacher or by the doctor. if there were problems involving poverty on the part of the parents, other societies concerning themselves particularly with the problems of financial relief were asked to aid, in order that indirectly the help given to the parents might make itself felt in the better condition of the child. sometimes free legal advice was obtained from the legal aid society formed for the purpose of giving such advice to those who were unable to pay for it. as i watched the application of this method over a period of a good many years and in the case of a great many children, i saw a good many failures in addition to some most encouraging successes. but what most of all impressed itself upon me was _the method_, the focussing of effort on the part of many experts upon the needs of a single child, the coöperation of many whose gifts and talents varied as widely as their interests, to the end that a single unfortunate child might receive benefit far beyond what the resources of any single individual, no matter how well intentioned, could secure. i have said that the doctor was a member of the group whose efforts were focussed upon the needs of a single child, but he was never a very closely connected member of this group. a few charitably inclined physicians, personal friends of those directing the charities, were called upon again and again to help out in individual cases by examining a child, by giving advice over the telephone or otherwise. through the free hospitals and dispensaries help was also obtained for the physical needs of persons who had come to the notice of the different charitable associations by reason of economic need or other misfortune. but the medical charities, the hospitals, dispensaries, convalescent homes, and the benevolence of individual physicians were not well connected with the group of charitable associations which i have been referring to above. at this period, in and , i had been working for some years as a dispensary physician, concerning myself chiefly with perfecting the methods of diagnosis in a dispensary, so that the patient could obtain there a diagnosis as correct and scientifically founded as he could obtain from a private physician. but in the course of these efforts for a complete and exact diagnosis which should do justice to the actual needs of the patient, i found myself blocked. i needed information about the patient which i could not secure from him as i saw him in the dispensary--information about his home, about his lodgings, his work, his family, his worries, his nutrition. i had no time--no dispensary physician had time--for searching out this information through visiting the patient's home. yet there was no one else to do it. my diagnoses, therefore, remained slipshod and superficial--unsatisfactory in many cases. both in these cases and in the others where no diagnosis was possible from the physical examination alone, i found myself constantly baffled and discouraged when it came to treatment. treatment in more than half of the cases that i studied during these years of dispensary work involved an understanding of the patient's economic situation and economic means, but still more of his mentality, his character, his previous mental and industrial history, all that had brought him to his present condition, in which sickness, fear, worry, and poverty were found inextricably mingled. much of the treatment which i prescribed was obviously out of the patient's reach. i would tell a man that he needed a vacation, or a woman that she should send her children to the country, but it was quite obvious, if i stopped to reflect a moment, that they could not possibly carry out my prescription, yet no other filled the need. to give medicine was often as irrational as it would be to give medicine to a tired horse dragging uphill a weight too great for him. what was needed was to unload the wagon or rest the horse; or, in human terms, to contrive methods for helping the individual to bear his own burdens in case they could not be lightened. detailed individual study of the person, his history, circumstances, and character were frequently essential if one was to cure him of a headache, a stomach-ache, a back-ache, a cough, or any other apparently trivial ailment. facing my own failures day after day, seeing my diagnoses useless, not worth the time that i had spent in making them because i could not get the necessary treatment carried out, my work came to seem almost intolerable. i could not any longer face the patients when i had so little to give them. i felt like an impostor. then i saw that the need was for a home visitor or a social worker to complete my diagnosis through more careful study of the patient's malady and economic situation, to carry out my treatment through organizing the resources of the community, the charity of the benevolent, the forces of different agencies which i had previously seen working so harmoniously together outside the hospital. thus i established in a full-time, paid social worker at the massachusetts general hospital, to coöperate with me and the other physicians in the dispensary, first in deepening and broadening our comprehensions of the patients and so improving our diagnoses, and second in helping to meet their needs, economic, mental, or moral, either by her own efforts, or through calling to her aid the group of allies already organized in the city for the relief of the unfortunate wherever found. to bring the succor of these allies into the hospital and apply it to the needs of my patients as they were studied jointly by doctor and home visitor, was the hope of the new work which i established at that time. in the thirteen years which have elapsed since this period, about two hundred other hospitals in the united states have started social work, some of them employing forty or fifty paid social workers for the needs of a single hospital. unpaid volunteer work has always been associated with that of the paid workers in the better hospitals. i should mention, in closing this chapter, three forms of medical-social work which had been undertaken previous to , and which were more or less like the work which i have just described, though not identical with it: ( ) the after-care of the patients discharged as cured or convalescent from english hospitals for the insane ( ). the visitors employed in this work followed the patients in their homes and reported back to the institution which they had left. their labors were directed chiefly to the prevention of relapses through the continuation in the home of the advice and régime advised by the hospital physician and previously carried out in the institution. ( ) the work of the lady almoners long existing in the english hospitals had begun about the time that i started medical-social-service work in america, to change its character so as to be more like the latter. originally the purpose of the lady almoners was to investigate the finances of hospital patients in order to prevent the hospital from being imposed upon by persons who were able to pay something, but who represented themselves as destitute and therefore fit subjects for the aid of a charitable hospital. gradually, however, the lady almoners had begun to be interested in the patients as well as in the hospital funds, and had begun to labor for the patients' benefit as well as for the hospital's. this brought them near to the idea of hospital social service as practised in this country since . ( ) the visiting nurses or public health nurses, employed by a board of health or by private agencies for the care of contagious diseases in the home and also for the nursing of the sick poor whatever their malady, have found it more and more difficult in late years to confine their work wholly to physical aid. they have been forced to take account of the patients' economic, mental, and moral difficulties, to extend their work beyond the field of nursing proper, and thus to approach very closely to the field of the social worker. it is my own belief that the frontier separating visiting nurse and medical social worker should be rubbed out as rapidly as possible, until the two groups are fused into one. the visiting nurse must study the economic and mental sides of the patients' needs, and the social worker must learn something of medicine and nursing. then the two groups will be fused into one, as indeed they are fast fusing at the present time. social work _part_ i medical-social diagnosis social work chapter i the medical standing, duties, and equipment of the social assistant i have said in the introduction that _home visiting_ may easily and properly spring up in connection with various institutions; for example, in connection with the schools, courts, or factories of the city as well as with the dispensaries. but it is essential in home visiting, no matter what institution it is connected with, that the social assistant should be distinctly recognized as _part of the machinery_ of that institution, or, in other words, as one of the means by which that institution does its work. if she is connected with the schools, she should be a part of the school system alone, not responsible to a board of health or to any other outside agency. so in the type of home visiting which now particularly concerns us, it is essential to make it clear from the outset that the social worker is a part of the medical organization. she is one of the means for diagnosis and treatment. all that she does from the moment when she first scrapes acquaintance with the patient is to be connected with the condition of the patient's health. she is not to pursue independent sociological or statistical inquiries. she is not to be the agent of any other non-medical society. it is unfortunate even if her salary should be paid from any source other than the medical institution itself. there are great advantages in this apparently formal and obvious point of connection. in the first place the _medical method of approach_ to close relations, to friendly relations, with a group of people, is decidedly the easiest. persons who may be suspicious or resentful of our approach if we appear primarily as investigators, or primarily as persons concerned with economic or moral control, will welcome the visitor if she appears as the arm, the cordially extended hand, of the medical institution where they have already found welcome and relief. i know well that charity organization workers, court workers and others may establish just as close a relation with their clients _in the end_ as is possible for the medical social worker. but the start is harder and needs more experience. because disease is the common enemy of mankind, all sorts and conditions of men are instinctively drawn together when it becomes necessary to resist the attacks of disease as the enemy of the human family. members of a family may disagree about many matters, and may be far from congenial with one another in ordinary times and upon ordinary subjects, but will draw together into the closest kind of unity if any one attacks the family, accuses or criticises the family. so human beings of widely different environment, taste, economic status, heredity, may find it quite easy to begin and to maintain friendly relations when that which brings them together is their common interest in the struggle against disease. it is, indeed, almost too easy to get friendly with people when they are suffering physically and we are endeavoring, however lamely, to bring them relief. the medical avenue of approach, then, the plan and hope of establishing intimate relations with a person or a family while we are trying to give them medical assistance, offers incomparable advantages. these advantages become clearer still if we compare them with the special difficulties which arise if one tries to begin an acquaintanceship with financial inquiries or with moral investigations. people who will agree on everything else will quarrel on money matters. there is nothing that so easily leads to friction, suspicion, and unfriendliness, as the interview in which one is trying to make out whether people are speaking the truth, the whole truth, and nothing but the truth, in relation to their income and expenditure. this matter very naturally seems to people their own business. they quite naturally resent inquiries on such matters by strangers. they feel attacked and in defence they are apt to conceal or color the truth. and yet, if a friendly relation has first been established through the patient's recognition of our genuine desire to help his physical difficulties, the financial inquiries which make a necessary part of the home visitor's work can much more easily follow. one has to understand what money is available in order to make the best plans for nutrition, for home hygiene, for rest and vacation--all of which naturally form part of our medical interest. i wish to make quite clear here my appreciation that good social workers never begin their relationships with a client by assuming a moral fault on his part and never push the economic questionnaire into the first interview. all i wish to point out is that it is perhaps easier for the medical social worker than for others to avoid these blunders. at the outset of a relationship which aims to be friendly, investigations which start with the assumption that there has been some _moral fault_ or weakness in those whom we wish to help are even worse than financial inquiries. the instant that the social worker finds herself in the position of a moral critic, it becomes next to impossible that a friendly relation not hitherto established, shall be built up from the beginning. late in the course of a friendship established long before, moral help, even moral criticism, may be welcome. but it cannot often or easily be one of the topics of conversation, one of the points of investigation, in the early stages of what we hope to make a friendly relation. everything stands or falls with this. we cannot even teach hygiene, we cannot even make medical principles clear unless we have succeeded to some extent, perhaps without any merit on our part, perhaps through extraordinary good fortune, in acquiring a genuine liking for the person whom we want to help. once that is attained, we can work miracles. but if it is wholly lacking, we cannot count upon accomplishing the simplest interchange of accurate information; we cannot achieve the most elemental hygienic instruction. but there is another signal advantage in the medical point of approach to a relationship which, as i have said, must be friendly in fact, not merely in name, if it is to succeed in any of its ulterior objects. when the social worker begins the difficult task of acquiring her influence in a family, she starts with a great deal in her favor if she appears in the home as _the agent of the physician_. he has prestige. by reason of his profession, by reason of the institution which he represents, by reason of confidence already established by him in the patients' friends and neighbors, the new family is ready to have confidence in him. he is not thought to have any axe to grind. he is assumed to be genuine in his desire of helpfulness. therefore any one who appears in his name, as his assistant, has a great deal in her favor, especially when compared with the visitors of societies which might be supposed to begin with economic or moral suspicions about the family. if the visitor appears in the home with the prestige of a medical institution enhancing the value of her own personality, she has a very definite advantage. _light on the severity of illness_ i have said that it is essential to the success of a medical visitor's work that she should be part of the medical machine, acknowledged as the doctor's agent, concerned wholly with helping to carry out his plans. but we must ask now, _what part_? and the answer is that the social worker is an assistant to the physician both _in diagnosis and in treatment_. i will begin with an account of what she is to do as his assistant in diagnosis. she is to discover, so far as she can, _what_ the disease is, _how much_ the disease is, and _why_ it is. i do not mean, of course, that she is to ape the doctor's scientific investigations, that she is to use instruments of precision, or to try to prescribe medicines. but she is to help the physician in some of the following ways: he is often very much at a loss to be sure how bad the patient's symptoms really are, how much the patient suffers, how serious the case is. the social worker is often able to help in discovering why the patient really came to the dispensary, discovering, perhaps, that the reason is such as to show that the malady is really a trifling one. she may find, for instance, that the patient has come merely because her husband had to come, anyway, and she thought she would get the benefit of whatever there was to be had in the way of medical assistance at the dispensary, even though, unless her husband had been going, anyway, it would not have occurred to her to make the independent visit upon her own account. or, again, the visit may be due chiefly to curiosity, especially if the dispensary has been newly established or has added some new features to its methods of diagnosis and treatment. these facts are passed along from person to person; the person hearing of them may appear as a patient chiefly to see just what it is that her neighbors are getting when they go to the dispensary. i have known a patient to come merely because he was alarmed as a result of a recent conversation with a friend. his friend had been hearing about heart trouble and had mentioned some symptoms such as pain about the heart or cold extremities or dizziness. any one sick or well on hearing such symptoms may easily remember that he has had them himself not long ago, or may even begin to feel them as a result of suggestion. straightway, perhaps, he will betake himself to the dispensary, complaining of symptoms which never would have been noticed but for his talk with the friend. or, again, the patient may have some definite organic disease or some obstinate train of discomforts and physical inconveniences. but he has adapted himself to them tolerably; he has settled down to bear or forget them as best he may. he may know that his troubles are really incurable and yet not serious. he may have become as accustomed to them as he is to an uncomfortable lodging or to a modest income. yet, as a result of some temporary fatigue, some newspaper paragraph, some fragment of gossip overheard, there may arise in him a crisis of alarm and worry about his familiar discomforts or inconveniences. thereupon he may betake himself to a dispensary, and give the physician an account which may be very difficult to interpret, because the physician does not understand the train of events which appear acute and new in that they have led the patient just now, rather than at any earlier time, to seek advice. after nearly twenty years' experience of dispensary work i should say that in no respect can a social worker give the doctor more welcome help than by discovering now and then reasons such as i have just suggested whereby the patient comes to the dispensary now rather than at any other time, and at a season not really connected in any special way with the nature of his disease. perhaps i can make this clearer by contrast with its opposite. a person who has just developed a scarlatinal rash, who has just coughed and raised a considerable quantity of blood, who has just lost the power to move half of his body, who has just begun to have swelling of the face, naturally consults a doctor at once. if he then comes to a dispensary for treatment, he has come at a time which is the right time, the reasonable time, considering the nature of his malady. something new has happened. an attack has been made which should be foiled if possible at once. the clue for usefulness on the part of the doctor is thus fairly clear. if, on the other hand, a person has had more or less back-ache all his life, and has grown used to getting along and doing his work, even enjoying life in spite of it, he may suddenly come to a dispensary for that back-ache because he has seen in the newspaper the wholly false statement that pain in the back means kidney trouble. yet when he comes to the dispensary _he may say nothing whatever about his having seen this newspaper advertisement_. indeed, it is very unlikely that he will mention this at all. he will describe his back-ache as something which demands immediate treatment, and the doctor may set in motion extensive and probably useless activities of investigation or treatment which never would have been undertaken had he known just what it was that brought the patient to the dispensary that day rather than months earlier or later. so far i have spoken only of cases in which the visitor's studies in the home make it clear that the case is not as bad or not as manageable as it might have seemed if one had known only what the patient himself could reveal in the dispensary. but occasionally on reaching the patient's home the visitor may find reason to believe that the symptoms are much more serious, the disease much more urgent, than could have been realized from the story told and the facts obtained at the dispensary. the visitor may find in the home conditions of disorganization, dirt, disorder, serious malnutrition, discouragement on the part of other members of the family, arguing a much more serious condition of the patient than one would have realized from talking with him at the dispensary. as a result of such findings the doctor, who must spend his energies for the patients who need him most, will see that he had better give more time and more effort to the patient than he would otherwise have thought right. still, again, the visitor may find that the symptoms are neither more serious nor less serious than he would have supposed from the dispensary interview; yet the clinical picture is different from the doctor's because the patient has thrust into the foreground of the clinical picture something which further knowledge shows to be really unimportant, while he has said almost nothing of some other feature of the trouble which is really much more serious. for example how much does the patient really eat, how does he do his work, are there complaints about him from his "boss," has he _always_ had the cough which he has only just now begun to complain of? such questions can be better answered after visits at the home and talks with the whole family. clearly the supplementary information thus secured by the social worker will count for nothing unless clearly explained to the doctor, and is taken up by him as part of the evidence on which he bases his diagnosis and his treatment. it is absolutely essential that the social worker should not merely make her visits and record them in her notebook, but should incorporate her findings in the medical record and deliver them not formally but effectively to the doctor's mind. such help is needed because she can often learn far more in the quiet of an interview at home than would be possible for the doctor despite all his medical skill. for at the dispensary he questions the patient when he is confused and forgetful, alarmed, perhaps, by the sights and sounds of the clinic, and so very unlikely to give a correct and well-balanced account. _nests of contagious disease_ so far i have been describing the work of the social worker as a process of finding out how much ails the patient and what his symptoms signify. but it is also a part of the social worker's duty to find how much disease is present not only in the individual who appears in the clinic, but in his immediate environment, to discover _nests, foci or hotbeds of disease_. in the case of a disease like smallpox, this is obvious. if a patient presented himself at a dispensary with the pustules of smallpox upon his body, it would be criminal negligence on the part of the physician not to set on foot a search of that patient's home, his industrial environment, or, in the case of a child, his school environment, for evidence that others have been exposed to the same contagion and possibly already infected. this sort of duty cannot be abandoned merely because there is no health officer at hand. it is a crying need and must be attended to at once. now in a minor degree this is true of many other diseases as well as smallpox. we are beginning to realize that it is true of tuberculosis, so that when one case of advanced and therefore contagious tuberculosis is seen at the dispensary, machinery should automatically and invariably be set in motion to search out possible paths of contagion from that patient to others, just as if he had smallpox. this principle which is well established in the case of dangerous contagious diseases like smallpox and diphtheria, and is beginning to be established in relation to tuberculosis, is even more important in dealing with syphilis. every case of syphilis means more cases of syphilis, and the danger of still more each day that the contagious patient is at large. no physician has done his duty unless, after seeing a case of syphilis, he attempts, through a social worker or otherwise, to get knowledge of others from whom this disease has been acquired, or to whom it may be freshly spread. at the massachusetts general hospital each patient with syphilis is asked to bring to the clinic for treatment the person who infected him. the method sounds impossible _but in fact it works_, and many cases are thus brought under treatment and prevented from infecting others. with contagious skin diseases such as scabies or impetigo, the principle is obviously the same, though the dangers of disregarding it are not so great. with typhoid fever, which not very infrequently shows itself even at a dispensary, the duty of the social worker is not so much to search for other persons through whom it may have been contracted or to whom it may be spread, as to investigate the water-supply and the milk-supply of the patient and of others in his environment. one case of typhoid always means more cases, usually more cases acquired, not by contact with one another, but through their share in a contaminated water-supply or milk-supply. the social worker, therefore, should know how to search out contaminated water-supplies, or at least to put in motion such machinery of public health investigation in the city or town where the case arises as may lead to good detective work in the attempt to track down the source of the trouble. it has been well said that every case of typhoid is some one's fault. it has even been asserted that for every case of typhoid some one should be punished. certainly there are some grounds for such an assertion. _hotbeds of industrial disease_ commoner and not less important than the contagious diseases that i have just mentioned are industrial diseases, or diseases aggravated by the conditions of industry. a physician may serve for many months in a dispensary without seeing a case of smallpox, of trichiniasis, or of typhoid fever, or feeling it his duty to set in motion the forces that i have just mentioned for rooting out the sources of contagion and preventing their further spread. but he cannot serve a month in any well-attended dispensary without seeing cases of industrial disease in the narrow sense, such as lead poisoning, or of independent disease aggravated by the conditions of industry, such as the functional neuroses of cigar-makers or of telephone operators. with such diseases, as with the infectious and contagious diseases, the presence of one case in the clinic should lead straight to the inference that there are others elsewhere, out of sight but no less important from the point of view of public good. this conclusion should lead in turn to the search through a social worker for the cases of disease which do not present themselves to any physician, which may be totally unknown even to the patient himself, yet which are important to the health of the nation. difficult though this field of industrial disease has shown itself to be, difficult though it is to separate out that portion of the patients' complaints which can justly be referred to the conditions of his work, and to distinguish it from the portions which are due to the way he lives, to his inheritance, to his habits or to diseases like tuberculosis and syphilis which may have been acquired without any connection with his work,--nevertheless we must try to disentangle and to recognize the elements in this knotty problem. and we can hardly fail to see that the social worker is an essential and logical assistant in the processes of investigation which we must carry out. if we can ever unravel the tangled skein of causes and effects whereby the hours of work, the strain of work, the patients' heredity and his home conditions, all combine to produce the symptoms of disease, it will be through such intimate, prolonged, detailed studies as the social worker can carry out, especially if she becomes a friend of the family. the doctor in his hours of consultation at the dispensary certainly can never do it. the official agent of the board of health, perhaps feared, certainly not a natural confidant for the family, may easily miss the truth which the social worker unearths, provided always she succeeds in differentiating herself altogether from the impersonal and professional investigator, and gradually becomes in the mind of the family and in truth their friend. i said above that the social worker should try to find out what disease, how much disease, and why this disease is present. the answers to these three questions cannot be kept separate. if one knows how much importance to attribute to a given symptom and whether it is as bad as it seems or worse than it seems in the dispensary interview, one may be steered straight to a correct diagnosis. to know _how much_ disease may thus mean knowing _what_ disease is present. furthermore, the understanding of these questions, even though it be only partial and unsatisfactory, leads us a considerable distance towards understanding why the disease has arisen. the search for sources for contagion is an example of a search for a _why_ in disease. the search for psychical factors--groundless fears, misleading newspaper advertisements, distracting rumors--all this is also a search for the cause as well as for the nature of disease. the social worker's investigations into the cause of disease may perhaps be still further exemplified. i once sent a social worker to my patient's home with the request that she try to find out what i had failed to find out, namely, why a young girl could not sleep. physical examination of the girl had revealed no cause; the exploration of such parts of her mind as she would reveal to me had thrown no light upon the trouble. i was at a loss and asked for help through the more intimate knowledge of the patient sometimes to be gained through a social worker's studies. such a search might easily have been fruitless--it often has been fruitless in my own experience. but in this case it was almost comically swift in reaching its goal. the visitor found that this girl was sleeping with two other girls of about her own age, in a bed hardly more than a metre wide. it needed only that she should acquire a separate bed for herself, which she was able to do without any financial assistance. she then regained her power to sleep. how often have such cases been treated with drugs or perhaps with more complicated physio-therapeutic or psycho-therapeutic procedures, when some simple fact like the size of the bed, the temperature of the sleeping-room, or the mental activities of the evening immediately preceding bedtime, are really responsible for the whole trouble. _medical outfit of the social worker_ in order to carry out the particular procedures of diagnosis and treatment which belong within the province of the social worker, a certain amount of medical knowledge is needed. because this is true, it has often been assumed that the social worker must be a trained nurse, prepared by months or years of experience in a hospital. but experience has shown that much of the knowledge possessed by nurses who have had this training cannot be used by the home visitor. on the other hand, the information which the social worker needs is often quite lacking even in well-trained nurses. furthermore, it may be said with truth that the training of a nurse, as we know it in america at any rate, really unfits a woman in some respects for the work of a social worker, since it accustoms her to habitual obedience and subordination. these habits are very useful in their proper place, but they are antagonistic upon the whole to the temper and mental activity which is important in the social worker. i mean the temper of aggression in relation to disease, and the mental attitude of the teacher and leader in relation to the patient. but of this point it will be more in place to speak when i come to consider the functions of the social worker as a teacher. let us return, then, to the question, what knowledge should the social worker possess in order to do her part in the "team-work" of the medical-social dispensary? her knowledge should approximate that of the public health officer. like him she should be, above all, familiar with what is known to medical science about _the causes of disease_. this is of great importance because it is especially in this field of medical science and medical ignorance that the public, the patients among whom the social worker will work, is most in need both of new knowledge and of the uprooting of old error and superstition. medical science knows very little of the causes of many diseases. but our patients, especially the more ignorant of them, are very glib and confident in their assertions as to what has caused the particular disease from which they just now suffer. they tell us about their "torpid livers," their "congestive chills," their "ptomaine poisonings" and the like. their supposed but unreal knowledge is extensive and detailed. indeed, so stubborn are their beliefs upon such matters that they often present a firm wall of resistance which must be broken down by the social worker before any truth upon these matters can be introduced into their minds. the social worker, then, should share such knowledge as the medical profession possesses about the causation of infectious disease, about direct personal contagion, and also about the indirect _methods by which disease is conveyed_ from person to person through insects or through instruments and utensils, such as the barber's razor, the family towel, or the public drinking-cup. she should be familiar with the small body of knowledge which we possess upon the transmission of disease by drinking-water, by milk, and other kinds of food. she should appreciate our still smaller body of knowledge about the relation of disease to climate, to weather, and to other physical agents such as the extreme heat and cold produced by some industrial processes, and the action of x-rays. in addition to this definite and specific knowledge of causes, she should know the generally accepted views of the medical profession on the subject of _bodily resistance_, _immunity_, inheritance, the diseases and perversions of metabolism, and the other non-bacterial factors in the production of disease. above all, she should realize the _multiplicity of causes_ which science more and more clearly recognizes in their single result. she should learn both by precept and by experience that for a single fact such as disease or health there are always many causes, so that any one who points confidently to a single cause, such as cold, fatigue, bacteria, or worry as a sufficient explanation of a person's disease, is almost certain to be wrong. obviously, this truth bears a close relation to what is to be said on the "historic and catastrophic points of view." chapter iii. the importance of teaching the social worker all that is known about the transmission and causation of disease is due to the following fact: whatever we succeed in accomplishing in our efforts at _preventive medicine_, whatever we do to nip disease in the bud or to check the spread of epidemics, is due to our knowledge of the causes of disease. the instructions of the doctor at the dispensary can accomplish but little in this field when compared with the detailed teaching of the social worker in the patient's house, in his workshop, in the schools and factories where disease is spread so much more frequently than in the dispensaries. if we hope to show people how they can avoid the disasters of illness, our teaching should be given in the very place where these disasters most often occur. there we can illustrate and demonstrate with the objects in sight what is to be done and to be avoided. it is for this reason that the social worker is above all others the person who can convey life-saving information to the public in an effective way. a considerable amount of this precious knowledge is now possessed by the medical profession; but it is shut away useless, unavailable, in medical libraries and in doctors' minds. the social worker can fight disease by spreading the contagion of medical truth. she can multiply the foci from which truth can spread still more after she is gone, just as disease is redistributed again and again from new nests of infection. the _prognosis of disease_, like its causation, is a subject on which the social worker should know almost as much as the doctor. this is possible because medical knowledge on this subject is still so very limited. for the purposes of one who has to combat the poverty, sorrow, idleness, and corroding fears which disease produces, knowledge of prognosis is a most useful tool. for example: if one is to make plans for the care of a group of children during their mother's illness, one must have some idea how long that illness is going to last. if it affects the bread-winner of the family, how long will he or she be disabled, and how completely; what are the hopes of ultimate and complete recovery; will chronic invalidism follow; is it worth while in this particular disease to spend a great deal of money and time in trying to achieve a complete cure, or is cure so improbable and at best so incomplete that our resources can be expended more wisely in other directions? a knowledge of prognosis will help the home visitor greatly in the solution of such problems. but it must be added that such knowledge as she already possesses about the prognosis of a disease, such as tuberculosis or heart trouble or kidney trouble, must always be supplemented by all the information that she can gain from the doctor as to the present prognosis in the case of the particular patient with whom the social worker has to deal. for the general prognosis of a disease is greatly modified by the particular circumstances in each individual case. physicians are not at all eager to impart their knowledge about prognosis, because this knowledge is so limited and so faulty. no scientific man likes to make definite statements upon so indefinite and hazy a matter as prognosis. nevertheless, it is essential for the patient's good that the doctor should be asked to give her as clear and definite a statement as is possible for him to make with the facts that he possesses. for it is only upon the basis of such a statement that an intelligent plan of social treatment can be constructed. besides acquiring all that she can learn of the causes and prognosis of disease, the social worker should be familiar with the symptoms of the more important and _common types of disease_. there are now several books written particularly with the object of conveying to social workers and others such knowledge as i have referred to, yet without any pretence of equipping the person either for nursing or for the practice of medicine. i will mention here a book by dr. roger i. lee, professor of hygiene in harvard university, "health and disease: their determining factors" (little, brown & co., boston, ), and my own book, "the layman's handbook of medicine" (houghton mifflin co., boston, ). in order to understand such books, and to arrange her knowledge of disease in such form that it may be easily handled, the social worker must have a slight knowledge of anatomy and physiology, so that she can arrange the symptoms of disease in connection with the different systems of organs: circulatory, digestive, respiratory, urinary, nervous, and locomotive. finally, the social worker must know the _principles of hygiene_, in order that she may effectively combat medical quackery and the prevalent medical superstitions of the people. that portion of hygiene which is both securely founded upon scientific evidence and useful in the preservation of health, makes up only a very small body of knowledge, so that it can be easily mastered by any intelligent person. our knowledge upon such matters as diet, exercise, bathing, sleep, ventilation, when such knowledge is both scientific and practically useful, could be written upon a very few pages. it consists largely of negatives which contradict the current superstitions. in my own work in this field i have found it essential that there should be no mystery and concealment, no obscurantism and mediæval latin in the methods of treatment which the social worker explains or carries out under the doctor's directions. she must be able to deal with the patients frankly, openly, without concealment or prevarication. otherwise she will not have moral force enough behind her statements to bring them home to the patient so as to secure any reform in his hygienic habits. such reforms are difficult enough in any case. they are usually impossible unless they can be initiated by one rendered eloquent and convincing by the consciousness that she leans upon the truth and has nothing to conceal. if she has mental reservations, if she is trying to protect the authority of the physician in a statement which she does not believe to be wholly true, the force of her appeal will be so weakened that it will probably be ineffective. _technical methods_ there are some technical processes of diagnosis and treatment which are usually carried out by the visiting nurse, but which may well be performed after a brief training by the social worker who is not a nurse. among these are: ( ) the accurate reading of the patient's temperature, pulse, and respiration, which she must often teach the patient to do for himself and to record accurately and clearly. this is of especial importance in tuberculosis, for in suspected cases of this disease one often needs daily measurements of the temperature as an aid in determining the diagnosis or in estimating the severity of the case and the fitness of the patient for work. ( ) the arrangement of a window tent or some other device for insuring the maximum of fresh air for the tuberculous patient both day and night. this device is also useful in pneumonia, typhoid fever, and other diseases, in case they are to be cared for at home and not in a hospital. ( ) the application of simple dressings to wounds, abscesses, and common skin diseases such as eczema, and impetigo. ( ) the care of the skin in bedridden patients. our primary object here is the prevention of bedsores, those ulcerations which occur in very emaciated patients at the points where their weight presses a bone against the bedclothes. ( ) the simpler procedures for the preparation of milk for sick children and of other foods commonly advised for patients who are confined to bed. ( ) the methods of emptying the lower bowel by means of an enema. into the details of these procedures this is not the place to enter, but i wish specially to assert that all of them may be learned within a few weeks by persons who have not studied medicine or had the full course for the training of a nurse. any one who possesses these simple bits of skill can do all that is necessary for the physical care of the sick poor in their homes, unless continuous attendance upon the patient is necessary. such attendance is not within the province of the social worker. but in the technical procedures just described it is all the more important that she be expert, because such skill makes her a welcome visitor and a trusted adviser outside the field of medicine. because she has given relief by dressing a wound, curing a skin disease, or applying a poultice, she will be listened to with liking and with confidence when, later, she comes to give advice in economic, educational, or moral difficulties. chapter ii history-taking by the social assistant history-taking concerns the social assistant especially because history-taking is one of the things one does, if one is wise, in any matter in which one is trying to help a human being. even if you were concerned to help not a stranger, but a member of your own family, still you would need a story or history of the person's life whether you wrote it down or not. _history and catastrophe_ in our attempts to be of use to people in their misfortunes, there are two very common and quite opposite points of view (roughly the right and the wrong), which i call (_a_) the "historic" and (_b_) the "catastrophic," the accidental, or the emergency point of view. confronted with people's troubles, whether physical or mental or spiritual, we are tempted, and above all _they_ are tempted to regard the sickness, the poverty, or the sorrow in the light of an emergency, an accident, and therefore as something to be treated at once and by means which have little to do with the past and the future. on the other hand, the standpoint of science and philosophy, and of any one who has labored long in the field of social work with or without science or philosophy, is the point of view of history. this is the habit of mind which makes us believe that a supposed "accident" belongs in a long sequence, a long chain of events, so that it is impossible to understand or to help it without knowledge, as extensive as our time and our wisdom will allow, of that whole chain. consider a few examples which contrast these two points of view. when a boy is brought into court for stealing, it is almost always his attempt, and the attempt of those who defend him, to show that such a thing has never happened in his life before; he "just _happened_ to steal." but as we inquire more closely into the facts, we almost always find that this is a fundamentally untrue statement of the case. for the offence which brought him into court is almost never the first offence. he has always stolen before. on the present occasion he was a member of a boy's gang; it was not in the least accidental that he got into that group of boys. as we search back in his history, and perhaps into his father's history, we find reasons why he is what he is now. again, we are trying to help some wayward girl who has taken an immoral step. we are told what a wholly unforeseeable _accident_ it was that got her into her trouble. but if we can get a good picture of her past, we find that we could have traced the tendency to weakness of this kind from the time she was born. so it is in medical matters. _emergencies are rare._ i remember being called out of a sound sleep one night to go "as quickly as possible" to see a man who had discovered a lump upon his breast bone. he was quite sure that the swelling had appeared since the time when he went to bed. it was then one o'clock in the morning, and he had gone to bed at eleven. well, i found a slight bony irregularity in his breast bone which doubtless had been there about forty-five years, as he was forty-six years old. he did not pretend that it hurt him, and did not undertake to show that he was ill in any other way. but this lump had come and naturally he wanted help at once. the great importance of the contrast between the historic and the catastrophic points of view is, in the first place, that one way is on the whole right and the other on the whole wrong; but still more, that the patients whom we are going to deal with, and all the unfortunate or needy people whom the social assistant tries to help, are very fond of the wrong point of view and hang to it extraordinarily. it is _the_ natural first impression of any untrained person that his troubles "simply happen" without any explanation that he knows. so that we have to start at once to tear down a structure of innocent and lifelong belief on the part of the patient, that troubles come suddenly and by accident. we have to disillusion him, a process which naturally he does not take to particularly pleasantly. our task in a dispensary is the same. the patient almost always starts with _the catastrophic point of view_, and can only be very gradually engineered into the other. and yet our work in relation to public health is largely to be summed up as finding out how,--that is by what history, through what chain of events, people come to be sick. repetition and extension of disease can be checked only in case we succeed in finding such clues. hence our labors to change people's point of view in this particular respect are as worth while as anything we can do, and we must not be discouraged by the fact that, week after week and year after year, we come up against the same difficulties, the same conviction, that troubles "just come" and have no cause. i have said that the historic prejudice is essentially right and the catastrophic prejudice essentially wrong. of course, there are exceptions. a man may be run over in the street for reasons that we cannot discover to be connected in any possible way with his previous history; a man gets a burn, gets a broken leg, is hit by a missile in an air raid over london or paris, in ways that are essentially catastrophic. and yet even in the field of accidents, industrial accidents for instance, the more we study, the more we find that injuries are not wholly accidental. the whole of science is the attempt to prove that nothing is an accident, that everything comes out of previous causes. the percentage of accident in the so-called "accidental" injuries decreases as we study industrial accidents. (_a_) they happen at certain hours of the day more than at other hours of the day: if they were really accidental this would not be so. (_b_) they happen on certain days of the week, especially mondays, for obvious reasons. (_c_) they happen especially to greenhorns, to the newcomers, who have not learned how to avoid them. one of the expenses incidental to hiring new help is the expense of accidents. thus these events turn out to have a good deal of law and reason, a good deal in the history of the individual (alcoholism?), and the nature of the industrial process (speeding up?) which helps to explain them. by eliminating such causative factors, we may prevent some accidents. the remedies that we apply fit the type of trouble; _in so far as the trouble is accidental or catastrophic, the remedy is mechanical_; in so far as the thing is historical and continuous, the remedy cannot be mechanical. when a man breaks his leg we put on a splint; that is mechanical. but if he is in a low state of health and the fracture won't unite, we have to do something non-mechanical, physiological, psychological. we may have to get him into a different state of nutrition or even into a better state of mind before his tissues will heal. our job, then, in taking histories--that is, in finding out how things happen that lead up to disease or misfortune--should begin by writing down _the thing for which the patient comes_--headache, cough, emaciation, poverty, desertion, unemployment. this is the "presenting symptom"; it should always be the first thing written down in our history, not in terms of medical diagnosis such as asthma or anemia, but in the form of a complaint. our attempt is first to put that down, to get a starting-point, and then to weave that into a chain of evidence which we call a history. that history makes it possible to make a diagnosis and to plan treatment. _the network of events_ but the particular event, the particular complaint for which the patient comes to us, is woven not merely into one chain of evidence, but into several. let us carry out the metaphor of the chain. we must imagine many chains woven into one another like the chain-armor of the mediæval knight. each link is a fact. but many chains of facts are interwoven in the history of one single patient. first there is the chain of medical evidence, the links (or symptoms) leading up to a diagnosis; second, the chain of social evidence, which we try to classify on our social history card. third, we must trace the links in the chain of relationship with other people, other members of the family, with friends and fellow workers or schoolmates. finally, the chain of heredity, of which we cannot make much at present except in relation to tuberculosis and mental disease or mental deficiency. but these studies of heredity in its bearing on character are going to be more important as the science of social work develops. our first attempt, then, after determining the "presenting symptom," is to find out by a series of questions _how this symptom is linked up into a tissue composed of many chains of facts_. our next task which is usually difficult, and frequently impossible, is to find out why this great tissue of evidence issues just now in one particular "presenting symptom." why did the patient come to us to-day? this question is often impossible to answer because the patient does not know, though he may think he knows. nevertheless, the social worker must try to find out. often it is not until we have known and liked a person for days or weeks that we find out why he came to us at this particular time. yet the answer to this question may be the most important thing that we can find out. for two reasons it is important; first, because it furnishes the clue to all our later investigation and assistance in this case; secondly, because it may show that the individual's complaints are not of any significance at all. i can illustrate this by a case studied at the massachusetts general hospital in boston. we looked up a series of patients at their homes in order to find out if we had really been of any service. the cases were not selected, but were taken from our files in numerical order. among others we visited a lady whose malady had been diagnosed as "sacro-iliac strain." she had been given a prescription for a belt. we wanted to find out whether she had ever bought the belt and whether it had helped her. after some difficulty the visitor finally got the following details: the lady had come from a city twenty miles distant from boston. she had taken an early morning train, and could not get back to her home the same night. hence she could not soon make another trip like that. she came to have her eyes examined. now it happened that we had no eye clinic at the hospital at that time. but the lady had heard a great deal about the hospital and its efficiency. she was determined not to go home without having got something out of the hospital. so when she was told at the admission desk that she could get no treatment for diseases of the eye, she wandered into the medical clinic, trying to remember or imagine some symptoms for the relief of which she could be admitted to the clinic. finally she managed to get out some sort of a story about a pain in her back; she was referred to the orthopedic division; there a diagnosis of sacro-iliac disease was made and a belt was advised. when she got home, of course, she laughed at the idea of buying a costly belt. now, if we could have found out in the beginning why she came to the hospital, we might have saved a good deal of bother for a good many people. it is astonishing how many patients turn out to have as little reason for coming now as this lady did. one of the things that shows the arbitrariness of choice in selecting a time for visiting the hospital, is the striking diminution in the number of patients in the week before christmas. that suggests that there are many postponable visits. or again, patients may come merely because somebody else from the same neighborhood is coming. _listening and questioning_ as the history-taker traces out the symptoms of the patient's illness after finding an answer to this first question, _why to-day?_ two opposite habits of mind must be employed, one passive, the other active. we must be sure that the patient shall feel that he has had a good listener, that his troubles have really been appreciated. but if we are constantly putting in questions, as we certainly must later, the patient does not feel that he has been listened to. we desire first of all to get his own story in his own words, passively. we may not necessarily write down a single word of it. but i have found that the patient's own way of expressing the nature of his troubles is often important and characteristic. it helps to prevent our histories from looking too much alike, which is their commonest fault. hence we should get into them somewhere a phrase or several phrases reported passively in the patient's own words; if possible a phrase in which he describes his "presenting symptom," the thing of which he chiefly complains. but the second stage in the process of taking a patient's history is the most important. in this part we should be active, not passive. we must attack our task with a tool in our hand, _a mental tool fitted to rake out of the mass of confused ideas in his mind certain significant facts_. that rake is a logical schedule of questions which you use upon him actively, not passively, and by using which you get answers either negative or positive. whenever you think well, you _think with a schedule_ of that kind in your mind. if you pack a trunk well, you pack it using a list, a schedule of the things that ought to go into that trunk. our printed social face-card helps us to think and question with a schedule before us, to think in an orderly way, without forgetting our items, and thus to select what we need out of the mass of disorderly facts in the patient's memory. in the second phase of history-taking, then, which begins after we have listened appreciatively but quietly to the patient's own version--usually catastrophic and full of fanciful theories--we lead him by questions (but not by "leading questions") along the paths which will open up a full view of the trouble, medical or social, which has been suggested to us by the patient's first statements. suppose, for instance, one happened to know of an extraordinarily rare but curable disease, one symptom of which the patient had mentioned, "my hair comes out by handfuls." one would go on to ask, "do you feel warmer or colder than usual this winter?" then, "the expression of your face is not notably changed, is it, so that your friends comment on it?" "is your skin drier or moister than usual?" "does your tongue bother you in any way?" "is your mind more or less active than usual?" thus one would confirm or refute the suggestion of the disease called myxoedema, a suggestion which was given to us by the patient's first complaint--rapid loss of hair. given one symptom in a known group, one can trace out the others as the anatomist who finds a single fishbone may be able to reconstruct imaginatively the whole fish. i said just now that we must not ask "leading questions." if we do, we can make a patient of a very suggestible type of mind say anything. if you ask him whether he has any symptom whatsoever he may obligingly say "yes." the way to avoid this is to put our questions in the negative: "you have no headache at all, have you?" "you do not cough?" "you never spit blood?" by these negatives we can get at the positive symptoms if they are present. schedules of questions to be used in history-taking may be medical or social. some of the social question-lists are suggested in later chapters of this book. a masterly account of social questioning is contained in miss mary e. richmond's "social diagnosis" (published by the survey associates, new york, ). i wish now to illustrate the methods to be used by social workers in questioning patients about their symptoms so as to assist the doctor in his diagnosis. _pain: how long?_ for a day, a month, a year, six years? very chronic pains are seldom serious but seldom curable. headache that has lasted years either has no cause known to medical science, or else it means neurasthenia. in either event it is apt to be stubborn. a headache that has lasted only a day, and did not occur before, cannot possibly be due to migraine. this suggests how the length of time that a pain has lasted is very important in diagnosis. the patient will often say, "i have always had it"; but to this we should oppose a pretty strong cross-examination. the patient usually means that he has had it off and on throughout an indefinite period. we ask him then, "when did you first have it?" and then, "how much of the time--half the time, a quarter of the time, for one day a week or one day a month?" _pain: where?_ patients rarely come to a doctor for a single _point_. but pain in several points is never as significant as pain in one point. one cannot learn much from scattered pains in relation to what ails the patient and what to do for him. _pain: how bad?_ that is a very difficult question to get the answer to. there is no thermometer or measure for pain. i suppose every doctor has wished many times that he had one. but there are certain rough measures which are of some use in judging how bad a pain is. ( .) we ask, "does it compel you to lose sleep?" some headaches may be pretty severe and yet a person sleep despite the pain. it may link itself up with a dulling of consciousness leading to sleep. but most pains and even most headaches that do not keep a person awake are not as bad as those that do. ( .) we ask, "does it prevent work?" any one can see all sorts of limitations to the use of that criterion. a man with a rugged type of mind will work with a pain that another weaker man will give up to. yet the question does bring out evidence of some value. ( .) another criterion, more subtle and not quite so useful, is this, "do you feel the pain more when you are quiet or when you are moving about?" the pains due to organic diseases are generally worse when one moves; while the functional type of pains are apt to be better when one moves about. one forgets it. quite often patients are very lucid and candid about this. _pain: how aggravated? how relieved?_ (_a_) a pain may be aggravated by position--for example, when the patient is on his feet--or worse when he is lying down--a headache, for instance. most abdominal pains are worse when the patient is on his feet. (_b_) a pain may be aggravated by motion. most of the surgical injuries, sprains, strains, tears of muscle or ligament, and fractures of bones are naturally made worse by motion. pain may be aggravated by certain particular motions, as is the case with some of the innumerable pains in the back. lumbago is a pain characteristically described as one that comes when the patient tries to lace his boots. especially when he tries to get up from that position, the pain is intolerable. pains in the chest are often worse on deep breathing--pleuritic pains, for example. but other thoracic pains may also be made worse by deep breathing. (_c_) pain may be aggravated by the taking of food, or by movements of the bowels. pain may also be relieved in any of these ways. the most important thing that one can know about a stomach pain is that it is relieved by food. the majority of all stomach pains are aggravated by food. pains are also relieved by heat or cold or by drugs or by rest. but those are not very important points. they may be important in relation to what we do to help the patient, but not in relation to diagnosis. some pains, whatever their cause, are relieved by cold, more by heat, and most are also relieved by rest. next to pain, _cough_ is the symptom, especially in the colder months of the year, that we have most to deal with. the question _how long?_ is vastly the most important one about cough. one can also measure its _severity_ by the question, "does it keep you awake?" and to some extent by the question, "does it prevent work?" more important is the question, "is it dry or productive of sputum?" the patient's description of his sputa in gross, without any microscopic examination, is also of a good deal of use. there are usually three things a patient can tell us about it: either it is yellow, or it is white, or it is bloody. there are two other important questions about bloody sputa. unless one gets these answered, the mere fact of spitting blood is not important. we must know whether there are merely streaks of blood which one often sees in the sputa of anybody who coughs hard, are of no importance, and have nothing to do with tuberculosis. but if, in contrast with this, we can really establish evidence of the spitting of blood in quantity, we have almost proved a diagnosis of tuberculosis. in ninety-nine cases out of one hundred the spitting of blood in quantity means tuberculosis. "in quantity" means a cupful or thereabouts of pure blood. if the doctor does not find tuberculosis after that he should nevertheless assume it, for it is almost always there. i should pay no attention to negative physical finding in such a case. the next point to ask about is whether the patient's _breathing_ is _wheezy_. when a horse has become broken-winded we can hear his breathing in the street as he comes along. he has become emphysematous. we find this wheezing respiration in emphysema, asthma, and bronchitis, which are diseases important for us to distinguish from tuberculosis; we almost never get it in tuberculosis. if the patient complains of _dyspnea_--difficult, rapid breathing, "short breath" as we say--we shall ask about _oedema_ or swelling of any part, especially of the legs. in every patient who has a cough we are concerned primarily with the diagnosis of one disease, that is, tuberculosis, its presence or absence. hence every patient who coughs should be questioned about the other symptoms of tuberculosis and especially about _emaciation_. a man with a chronic bronchitis or emphysema does not lose much flesh; he does not become emaciated. a person does not become thin from throat trouble. hence emaciation, especially recent, is a helpful guide to the doctor in making up his mind. _fever_ we investigate for the same reason. the only disease that often causes cough and fever during a long period is tuberculosis. unfortunately the patient's statement about fever is usually unreliable. we can believe most of what he says on the rest of these points. but he does not know whether he has fever or not. in women we must ask also about the _monthly sickness_, because it is suppressed in cases of moderately advanced tuberculosis. nephritis, anemia, heart trouble and emotional disturbances may have that same effect. it is a measure of the degree of disease, not its type. for the purpose of dispensary consultations i do not think we should take any family histories except when we suspect tuberculosis. but when the history leads us to think that the person may have tuberculosis, the social worker can help the doctor by asking the patient questions about the possibility of the same disease in mother, father, or others who are in contact with the patient--grandfather, grandmother, or other relatives or friends living in the same house. we believe less and less in the heredity of tuberculosis, more and more in infection by contact. if separated from a tuberculous father or mother in early infancy we believe that the child does not acquire tuberculosis. but the main mode of infection is by association in the same house, over a prolonged period, with people who have tuberculosis. often the patients do not know or will not confess that anybody in the family now has tuberculosis or has died of it. but if we can establish the fact that one of the patient's family has died after having a cough for many years, that he grew very weak, and spit blood, we have established the diagnosis without the name. not the degree of relationship to a tuberculous patient, but _the amount of time spent in the same house with a tuberculous individual_--what we call the degree of "exposure" to tuberculosis--_is the important thing_. _past history_ after getting the patient's present symptoms, one should ask, "were you ever sick _previous to this illness_? if so, what troubles have you had?" that is of use in clearing up the limits or boundaries of the present illness. the sicknesses which the patient says he has had are not of very much use to us in diagnosis because we cannot get true answers. the patient's diagnoses or his doctor's are apt to be vague or meaningless. but the questions about the patient's past history tend to make him more clear as to the date when his present illness began. hence his answers on these points should be written down very briefly, a word or two only about each, and usually in the words used by the patient. in our written histories in hospitals we usually take a considerable body of notes about the patient's habits. i do not advise this for social workers. but there are certain routine questions which should be asked of all patients concerning their _appetite_, _bowels_, _sleep_, _weight_, and _work_. the answers should be recorded in a separate paragraph, at the end of the history. what is printed here is meant to give a sample, not a full account, of medical-history-taking. competence in this field takes long practice. nevertheless the intelligent social worker can learn in a few weeks to be of great assistance to the doctor by taking either in the dispensary or in the home such histories as i have sketched. in social-history-taking there is no single order or schedule of questions agreed upon by all social workers. but there should be _some_ order and system determined partly by the personality of the worker and partly by the nature of the trouble. if poverty or destitution is the presenting symptom, one must find out the items in the family budget, the figures of income and outgo, paying especial attention as in medical histories to the question, "_how long?_" how long have you paid that rent, earned that wage, been without a job, taken boarders, been in debt? is sickness, childbirth, alcoholism, injury a factor? is there any family history of tuberculosis, pleurisy, insanity, epilepsy, feeble-mindedness? of miscarriages or of "scrofulous" children and "blood diseases"? what previous hard times? what economic and moral high-water marks and low-water marks can we trace in the past history? what relatives, friends, employers, doctors, teachers, neighbors, landlords, social agencies, public officials or records can be consulted for additional light on the person and his troubles? from all these sources one arrives finally at an opinion on "_what sort of person_ are we trying to help--what sort physically, mentally, and morally?" that is the central fact. chapter iii economic investigation by the social assistant it should be clear from what i have said already that the work of the social assistant _may_ have nothing to do with poverty. her only business in visiting a family may be to assist the doctor in his diagnosis and treatment by bringing him additional facts about the nature, seriousness, or cause of the disease and about the means by which it may be combated. but in many, perhaps most, of the families whom the social assistant attempts to befriend, there is a call for relief, for financial assistance, for money, food, coal, and clothes. this appeal like most medical appeals is apt to take the _form of an emergency_. help (we are told over the telephone) is needed at once, or disaster will follow. the family is eager for immediate relief, not for a slow and painstaking investigation of the causes which have led up to the present state of things, or of the exact nature of their present troubles. they are like the sick in this respect. prompt relief from pain is what the sick demand, not the tedious processes of questioning and examination. they want a remedy, a pain-killer, morphine or its equivalent. but we all know the dangers of giving morphine for the relief of pain. it never cures a disease; it only stifles a symptom. it gives delicious ease; but the need for its use soon recurs. hence there is always danger that before long the patient will have to fight, not only the disease which originally caused him pain and made him call for morphine, but the morphine habit in addition. this is all familiar. but not every one realizes that the giving of money in case of poverty is as dangerous as the giving of morphine in sickness. money like morphine satisfies an immediate need and hence is eagerly welcomed by the sufferer. but of money as of morphine it is true that a single dose soon makes the patient call for another, and often a larger dose; that it soon makes the patient dependent on this sort of relief, and so forms a dangerous habit. with the rarest exceptions, to give money or to give morphine does not cure. the state of things which produced the pain or the poverty is sure to recur. for (as i have said above) the patient's belief that his present troubles are an unforeseeable accident, a sudden catastrophe, is almost never true. the truth is that his pain or his poverty are but the last chapters in a long story produced by causes which can usually be traced out, and whose future action can often be foreseen. by giving money we are covering up a smouldering fire, not quenching it. for economic bankruptcy or breakdown, like physical bankruptcy or breakdown, is generally the result of _faulty organization_ in the system of income and expenditure. physically a person breaks down because he has been spending more energy than he can recoup by rest, food, and recreation. economically he breaks down because his scale of expenses exceeds his regular income. hence it gives but temporary relief to pay the bankrupt's debts, to cancel the sufferer's pain. the operation will soon have to be done over again unless some constructive plan for increasing his income or decreasing his expenditure can be worked out. _giving creates dependence_ because it atrophies industrial and moral initiative, just as a crutch or a splint causes muscles to waste. powers unused atrophy. if we support a person, except temporarily, he will soon lose the power of self-support. but the point of view impressed upon us by the sufferer himself is apt to be quite the opposite. what he wants is something immediate and temporary for the relief of something accidental. the beggar who meets us in the street has "accidentally" lost his purse and asks of us a small sum of money to reach his home. often i have said to such an applicant, "meet me at the railroad station half an hour before the train leaves for your home. i will buy you a ticket and see you on board." _he never comes._ this is an extreme instance and involves almost always a deliberate attempt to deceive us. in home visiting it is not like this. the sufferer does not usually intend to deceive. nevertheless his misfortunes are pictured by him as accidental and temporary catastrophes, maiming a life which needs no general reconstruction. he is so sure of this that he is apt to force the idea upon us unless we are alert, bracing ourselves to question it and to make sure that it is true. but actual experience has shown me and hundreds of others that this point of view is almost never true. it is not chance that the family is just now poor. it is no emergency which we are summoned to meet. it could have been foreseen long before and it will certainly recur unless we can trace out its causes and prevent their acting as they have hitherto. hence the detailed, prolonged, individual study of the family's economic state is necessary. one must find out, first of all, all the details of income and outgo. the family is likely to forget some of these, so that one must be ready to assist their memory. further, one must inquire carefully into possible sources of help from relations, friends, fellow members in some club or association, and so forth. for next to self-help the help from those naturally bound up with one is best. compared with impersonal charity, it is less artificial. it is less destructive to the natural family relationships which it is always our ultimate ideal and our immediate job to maintain or to restore so far as possible. whatever disturbs or threatens them is hostile to the social interests for which we labor. naturally one does not invoke the help even of family, friends, or fellow club members, unless it seems impossible for the individual, under the best plan that he and you can think out together, to get along without outside help. but if we are convinced that, for the present at any rate, this financial self-maintenance is impossible, it is to securing help from those nearest to the sufferer that one should look with least regret. gifts or loans from members of his family or from friends are more likely to be taken seriously by the recipient. he is less likely to feel (as he does with an impersonal agency or charity fund) that he can draw from a bottomless pit of money without making any one else the poorer. moreover, when he takes money from his brother or the fellow member of some club, the pressure for regaining his economic balance is likely to be exerted from without him as well as from within. he feels the pressure of his debt and thereby is stimulated towards regaining his independence. the sufferer's "catastrophic" point of view, which tends to isolate the present trouble from all its causes, to represent it as temporary and accidental, is related to his tendency to state that he has no friends, relations, or social connections through whom help could come to him. without any deliberate attempt to deceive us, he quite naturally forgets some of his relations. he does not want to appeal to them. hence they fall into the background of his mind, and are not easily recovered. when one finds them for him he is apt to say, "i did not think of him because i am not on speaking terms with him"; or, "i would not on any account take money from her, or allow you to ask her to help me." but such a sufferer may very properly be asked, "why is it that you are willing to take money from me, a stranger, or from this impersonal charitable agency, when you are not willing to call upon your own relations nor even to let them know that you are in trouble? you are concealing it from them, are you not? is there really any good reason for this? will it not be easier for you, as well as for them, that they should know at once? are you not really storing up trouble for yourself, postponing the evil day which, when it comes, will be worse than anything which you would have to bear at present?" of course, in all such advice we intend to say nothing that we should not wish to have said to ourselves. the social worker tries to treat people always as she would wish to be treated. but one cannot always avoid giving pain or even estrangement. because such interviews are necessarily difficult and may result in disaster to the relationship that we are trying to establish, they should be postponed if possible until we have already established in other ways a friendly understanding, a structure of friendship which will bear the strain of penetrating inquiries such as these economic matters necessarily entail. i have said that the first guide to helpful economic relief is a realization of its danger. the next is awareness of the advantages of self-help and the truth that next to self-help, assistance from those naturally and nearly related to one is best. the third principle, by following which we may hope to do the greatest good and run the least risk of harm in our giving, is this: never give hastily except in extraordinarily rare emergencies such as acute hunger or exposure to the elements. in all other cases give in accordance with a plan worked out as carefully as may be, whereby we are confident that our giving can be temporary. sometimes we can arrange that it shall come to an end automatically. that usually means that we arrange for a loan rather than a gift, with repayment either by instalments or in lump sum upon a definite date. (_a_) _loans._ it is in the hope of rendering service by these means that there have been organized philanthropic loan associations which lend money at low rates of interest and sometimes without interest or upon security which the commercial loan companies would not accept. the sufferer with whom we are dealing may know nothing of the existence of such agencies. if so, to connect him with one of them, to help in furnishing the security necessary to negotiate a loan, may perhaps be the best way in which we can help. or one may buy some rather expensive article such as a piece of medical apparatus, with the clear understanding that we are to be repaid in instalments or at weekly intervals. (_b_) _tools of a trade._ another example of the kind of giving which comes to an end and does not tend to form a habit like the morphine habit, is exemplified when we buy a man the necessary tools of his trade, or the stock and furniture necessary to start a store. the belief on which we rest in such cases is that after the initial act of acceptance, after an initial period of dependence, the individual will become self-supporting and independent. (_c_) _furniture._ or, again, one may give or loan a cooking-stove, so that the sufferer may no longer have to eat at restaurants, or some furniture in order that he may get the benefit of the lower rent to be had when one hires an unfurnished room. in all these cases the ideal thing is to arrange for repayment in small instalments. failing this we try to think out a plan such that after the original expenditure the sufferer will be able to go on independently. (_d_) _aid in illness._ a fourth example of temporary interference in the form of financial aid, is a gift or loan of money to tide a person over an illness, to make his convalescence complete or to rest him when he is dangerously tired. usually such aid can be rendered through services or institutions (nurses, hospitals, convalescent homes) which do not involve giving money outright. (_e_) _aid during unemployment._ a fifth good reason for giving money or other forms of relief temporarily is to tide the sufferer over a period of unemployment, during which he is actively looking for work or for better work than he now has. sometimes we can assist him in this search. but there is danger in this. a man is less likely to keep a job that some one else finds for him than one which he finds for himself. still, we may help him without harming him in case we can give him facts, names, positions, employment agencies by means of which he may secure employment, he himself taking the active part in securing the job. _information, which is what we here furnish, is one of the least dangerous of gifts._ in all these cases the principle is like that whereby we do surgery. surgery is a temporary injury to the body done with the expectation of ultimate good, a temporary interference of outside powers with the natural self-maintenance of the organism, in order that those functions may ultimately go on not only independently, but more satisfactorily than before. the surgery may kill the patient, or leave him worse than he was before. but our reasonable expectation is (in case our surgery is good) that his health--that is, the capacity of his body to maintain itself, or develop itself--will be improved. so in economic surgery we foresee a speedy end to the need for aid. the person is to be put upon his feet by our aid; our services can soon be dispensed with. the need will not recur. it is not chronic. it was not his fault and therefore is not likely to return upon him soon because of continuance of the same defect. obviously one must try to make clear--or, still better, try to have it clear without explanation, understood because of our previously established relation of trust, confidence, and affection--that it is not because of parsimony or close-fistedness that we are refusing to give quickly, constantly, and without inquiry. medical analogies must constantly guide us and be in the minds of those whom we try to help. we refuse money, as we refuse morphine, for the patient's good. we try to make our giving of money temporary and self-checking, for the same reason that we try never to begin giving morphine unless we can foresee a speedy termination of it, a speedy cessation of the need for it, as we do when we give it in gall-stone colic or acute diarrhea, or just before a surgical operation. if morphine were a possession of the doctor's, as money is a possession of the visitor or those whom she represents, then the doctor might often seem stingy, cruel, selfish in his refusal to give it. we must make it clear if we can that our hesitations, limitations, or refusals in relation to money have no more connection with our own control over that money, our own enjoyment of it, our own sense that we have any right to it, than the doctor's refusal to give morphine rests upon his desiring to take the morphine himself instead of giving it. all this is difficult to make clear, and it is chiefly for this reason that i have repeatedly insisted that the financial approach, the financial ground for an _entente cordiale_, should not be used early in our dealings with the sufferer, but should if possible be postponed until, through medical service and personal intimacy, something approaching true friendship has been established. it should be clear from what i have said that our judgments about giving financial aid can be sound, can result in doing good without harm or (as in surgery) good with a small element of harm, only in case they are the fruit of detailed, prolonged, individual study. it cannot be a wholesale matter. it cannot be done in exactly the same way in the case of any two individuals. let us stop to realize for a moment how arduous, how bold a task we have undertaken. we hope to construct a person's economic future better than he can construct it himself. we hope to see what the individual himself, despite the vividness and pressure of his immediate need, has not been able to see for himself--namely, how he can get himself out of his financial difficulties. we who do not wear the shoe are venturing to say where it pinches and how the pressure may be relieved, and to know about this better than the sufferer who feels the pressure in his own person and longs for its relief as it is hardly possible for any one else to desire it. it is almost as if we were trying to use his mind for him. it must not be that. but if it is not to be that, we must be sure that our aid is given through stimulating the individual to think for himself. "what do you think," we must constantly be asking him, "is the best way out of this our difficulty?" he must feel that we know it to be _our_ difficulty as well as his, that we are not looking on with the cold gaze of an outsider, that we suffer in his suffering, and still that it is at last his, and that with all our best efforts we can only contribute a little to what must be for the most part his own reconstruction, a reconstruction like that which the body performs when it heals a wound which the surgeon or the physician can only encourage a little towards its natural healing. without being impudent enough to attempt to use the sufferer's mind for him, to force our wills upon him, to take his burdens off his shoulders, to fill his place or to assume his responsibilities, we must try to help him in all these respects, largely by the kind of sympathy which stimulates, the kind of affection which encourages, the affection which changes useless brooding, ineffectual worrying, destructive grieving, into their opposites. we can help him to think by suggesting resources, possibilities that he does not know or that he has forgotten, by furnishing new material on which his mind may work, by helping to generate the power, the hope, the concentration, the prolongation of thought out of which new solutions may be born. he must really think of something new. he must really invent something, if he is to get upon his feet and become independent once more. ordinarily necessity is the mother of invention. we pull ourselves out of our difficulties when we finally realize that we must because disaster is otherwise imminent. but such pressure of necessity as would generate inventiveness in one person, may generate only despair in another. it is to avoid this tragedy, it is to make fruitful what were otherwise fruitless, that we hope to warm the sufferer into better life. we hope to rouse in him, by affection or by the stimulus of new facts (perhaps), the courage necessary to see his situation afresh and to reshape it. because we are comfortable where he is suffering, because we have free power of thought whereas his mind is numb and cramped, we may be able to think of some possibilities, some changes, some sources of hopefulness which he could not even imagine. he cannot take them from us ready-made. if he does they will be useless to him. but if we have reached the central fire of his life, if we have stimulated not this faculty or that, but the centre of his personality, then by the grace of god we may be able to do with him what he alone could not do. _housing_ a part of the economic life of our patients, aside from the food and clothes for which they may most urgently ask our aid, is their housing. (_a_) is it hygienic? (_b_) is it as inexpensive as can be obtained with due consideration of health, decency, distance from work, from friends, from amusements? (_c_) is it large enough to safeguard the decencies of family life? the last of these questions is the most important of all. it should be among the medical duties of the visitor to investigate the hygienic aspects of the home in order to explain them to the doctor, who can then include them among the facts on which his diagnosis, prognosis, and treatment are based. the social worker may then try to carry out such improvements in housing as the combined judgment of the doctor and the social worker suggests. more important than medicines, often, is the provision for proper warmth and proper ventilation of the patient's rooms during the day and especially at night. darkness, dirt, poor ventilation, favor the growth of germs, vermin, parasites of all sorts. they also depress the vigor and power of the human organism to resist disease. doctors and social workers cannot hold utopian views in matters of housing, but must content themselves with trying to secure something a little better than they find in the worst of the patient's lodgings, especially when these lodgings represent conditions below the family's own standard of living at some previous time. people adapt themselves wonderfully to bad hygienic conditions, and once so adapted, they may be able to preserve their health for a long period. but if then a family is suddenly forced to crowd itself into smaller, darker, dirtier, noisier quarters than it has been used to, or if a family group increases its numbers within the same quarters, the adaptive powers of the human organism may be overstrained and break down. it is against these conditions especially that the social worker and the doctor should labor. housing problems are among the most difficult of all that confront society. yet we should pledge ourselves to attempt some improvement, not disdaining slight gains because we are enamored of distant utopias. sometimes people are living beyond their means, are accepting bad quarters at high prices when they could get as good or better quarters for less money in some less crowded and popular district. human beings have a strong tendency to stay wherever they find themselves, to settle down by chance and resent any suggestion of change even for their own greater comfort. after a few months any place soon comes to have the attractions of home merely because we have been there. hence we stick in the same place, though we may know that it is chance and not choice or necessity that has put us there. under these conditions a social worker may do real service by her greater knowledge of other lodgings at lower prices, or (what is essentially the same thing) better lodgings for the same price now paid. if the social worker is familiar, as she should be, with the lodging conditions in the neighborhood in which she works, she may be able to give a patient facts about lodgings which were either unknown to him, or more probably unrealized, because he has never seen them. our mental horizon becomes restricted. any one who enlarges it by presenting new and helpful possibilities serves us well. so far i have spoken of the housing question mostly from the standpoint of health or cheapness, but, as i have already suggested, the moral aspects of the problem are still more important. it is difficult, for many impossible, to preserve personal decency and to keep family morality at a proper level, when adults and grown-up children are forced to sleep in the same room. lifelong injuries to body and soul may be forced upon innocent children in this way. nothing can be more important than this. we must remember, however, that custom and previous habits play a vast part here. one race or one set of people may have so adjusted themselves as to preserve decency under conditions impossible for another. we cannot generalize. we must know the particular people with whom we are dealing, and we must know their previous habits and standards in case they have shifted their lodging or increased the number of persons in a room within a short time, as is so frequently the case. _working conditions_ work and the conditions of work are among the most important and the most difficult of the economic problems in which a social assistant may find herself inevitably involved. these concern the patient's trade, the physical and moral conditions under which he practises it, his fitness or unfitness for it, the wages he receives, the future possibilities of advancement in pay and type of work which it offers. in all of these problems the social worker can sometimes help a little because of her greater freedom of mobility, mental and physical. she is not tied to her task as blindingly, as deafeningly, as the manual worker is. she may know more or be able to find out more as to labor markets, as to other, possibly better, positions, shops, employers. she may be able to see, better than the worker himself, his fitness or unfitness for the work he is doing. she may be able to realize better than he that his trade presents an _impasse_, has in it no possibilities of development, personal or financial. she may realize better than he the bad effects of his work upon health or morality. in all these respects she may be able to give the safest, and in some ways the most satisfactory, of all help,--namely information. i do not underestimate the difficulties of such help. it is not easy to know more about a man's business than he does. yet if the social worker's education, her health, her circle of acquaintances, is greater than that of the wage-worker, she may really be of some assistance to him even in the field that is more specially his own and that she can understand but superficially. it is for this reason among others that the social worker cannot be too broadly educated, too fresh physically, too vigorous in her powers of thought and observation, too widely acquainted in her community. among the problems growing out of the basal economic needs of which i have just spoken, are others with which i cannot here deal adequately. such are: (_a_) the problem of industrial hygiene and industrial disease. (_b_) the problems of school hygiene and school medicine, since school life is the industrial life of the child, who even receives wages for going to school in some communities. (_c_) the industrial and psychological problems of those who are maimed by accident, war, or disease. (_d_) the problem of industrial insurance and health insurance. all of these questions involve matters of state action, legislative control, and economic reform with which i do not wish to deal. but i wish to make it clear, in closing this chapter, that the social worker as a citizen is as much interested in these hopes for radical economic reforms as any one else can be, though she does not regard them as her special business. preventive medicine and the daily fight against individual cases of disease which we hope some day to prevent--these two activities go on side by side, each helping the other. the social worker corresponds to the private practitioner of medicine; the economic reformer and discoverer corresponds to the laboratory student of preventive medicine or to the public health official. in social work as in medicine the case worker should bring to the inventor and reformer new facts and illustrations suggestive of the evils to be reformed or possibly of the ways of combating them. and in the difficult, often disappointing, task of trying to help individuals, the case worker will also take part of his inspiration from the hopes and ideals of a better economic order sketched for him by the legislative reformer. the method and technique of economic investigation is complex and difficult. for a masterly treatment of this and all other aspects of social diagnosis miss mary e. richmond's epoch-making book on "social diagnosis" should be consulted. (published by the survey associates in new york city.) chapter iv mental investigation by the social assistant ever since the days of charcot, france has been the land of medical psychology. france has never failed, as other countries have failed, to take full account of the mental factors, the mental causes and results in disease. in america, on the other hand, the conspicuous disregard of medical psychology by physicians has led to widespread and serious revolt on the part of the public. our physicians have too often treated the patient as if he were a walking disease, a body without a mind. medical psychology has been neglected in our medical schools and in the practice of our most successful clinicians. the result has been a revolt upon the part of the laity, expressed in the popularity of the heretical healing cults such as christian science and new thought. these unscientific and unchristian organizations illustrate an error opposite to that of the physicians, but no greater in degree. indeed, i think that our physicians are more to be blamed than the leaders of these irrational cults, because our physicians having received a scientific training ought to be more thorough, more unprejudiced, more devoted to the truth, and therefore less inclined to shut their eyes to a huge body of facts. the physician often shuts his eyes to the existence of the mind as a cause of disease. the christian scientist shuts his eyes to the existence of the body as a cause of disease. both are equally and disastrously wrong. but the medical profession is on the whole more to blame, because they ought to know better, whereas the heretical healing cults have grown up among uneducated men who could not be expected to avoid the sort of narrowness and prejudice from which liberal education ought to free us. the situation in america, then, is very different and on the whole worse than in france. there, scientific men, educated physicians have taken the leadership in the field of medical psychology. in america it has been left for ignorant enthusiasts, devoid of any scientific training or breadth of culture, to press upon our attention the neglected elements of medical practice, and to lead a revolt against the medical profession, an anti-scientific revolution which numbers its adherents by millions. but in neither country has our established knowledge of the mental elements of disease been properly incorporated into medical practice, especially into the practice of dispensary physicians, and it is here that the social worker forms an essential link in the chain of effective action. let me describe more completely what i mean by the mental element in disease. i refer not merely to the so-called nervous diseases, the neuroses and psychoses, the myriad forms of nervousness without recognizable basis in organic disease, but also to the mental complications and results of serious organic diseases such as tuberculosis, arteriosclerosis, and surgical injuries. the classical studies of charcot, pierre janet, and others have made clear to the whole world the existence of a body of diseases in which the mental functions are obviously deranged while still the patient is not insane in any legal sense, and does not show on physical examination any evidence of gross organic disease. neurasthenia, psychasthenia, hysteria, are among the more common types marked out by the studies of great psychologists and clinicians. little or nothing has been added by the studies of german, american, and english physicians to our knowledge of these diseases. but throughout the history and development of france's leadership in the study of these diseases, one cannot help noticing that interest is concentrated largely upon diagnosis; comparatively little attention is paid to treatment. the great leaders have not been extensively followed. their suggestions have not been carried out on a large scale nor followed sufficiently into the field of practical therapeutics. especially is this true in the field of _visceral neuroses_ or nervous symptoms referred by the patient to one or another organ--the stomach, the pelvic organs, the bowels--in which nevertheless no evidence of disease can be found. in these diseases english, french, and american physicians alike persist for the most part in humoring and soothing the patient by the administration of remedies known to have no real influence upon disease and designed chiefly to make the patient feel that something is being done for him. this is superficial treatment. it makes no attempt to attack the determining causes of the disease. whether or not there are any psychogenic diseases, whether or not purely psychical events can be proved to produce the group of symptoms known as neurasthenia, psychasthenia, or hysteria, or whether there are physical causes contributing to produce the symptoms, this at any rate may be said with confidence: that if we are to root out the patient's trouble, if we are to bring about anything approaching a radical cure, we must attack the mental symptoms directly and upon their own grounds, that is, by mental means, chiefly by reëducation. _the mental element in these diseases is at any rate the most vulnerable point of attack._ it is here that we can most profitably exert therapeutic pressure. even in organic disease, such as tuberculosis or arteriosclerosis, it may still be true that we can help the patient chiefly through psychotherapy. there may be little that we can do for his arteries or his lungs, and indeed the incurable destruction which has gone on in these organs may not at the time that we are treating the patient be producing any symptoms. all his symptoms just now may depend upon mental states which we can quite easily influence and thereby cure him of all that at present torments him, though we recognize that the organic malady remains untouched, unimproved. many a case of tuberculosis suffers chiefly from his fears of the disease or from his discouragement. if we can rid him of his constant dread that the disease will advance or will injure others, if we can give him courage, the natural healing power of his tissues may be all that is needed to bring about the arrest of the disease. on the other hand, even an incipient case of pulmonary tuberculosis may go steadily on from bad to worse, because the patient is constantly fretting and worrying about his own condition, or about the present sufferings of his family. i remember a case of very early tuberculosis, but recently established at the summit of one lung, but unfortunately occurring in a patient of very active temperament, prone to fume and worry the instant that he was taken away from his work. he was devoted to his family, but as soon as he was aware of his trouble, he could think of them only as doomed to be dragged down by the contagion of his own disease or by the poverty resulting from his own inactivity. unfortunately, no proper study was made of this patient's malady. no account was taken of his character and temperament. the condition of his lung occupied the whole field of the physician's vision. the condition of that lung demanded for the patient isolation and complete rest in a sanatorium. this was prescribed and carried out. the patient remained in the sanatorium about two months, fuming and worrying constantly. he then refused to stay any longer, left the institution against the advice of his physician, returned to his family, and died about two months later. now i think it is at least probable that had we studied the patient's mind as carefully as we studied his lung in this case, his life might have been saved. but the physician who made the diagnosis and prescribed the treatment could spend but a few minutes upon the case, which formed but one of many trooping past him in his consultation hour at the dispensary. he had no time for the prolonged, detailed, wearisome studies necessary to win this patient's confidence, to make him feel that he was wholly understood, and bring him to the point when he would let himself be reëducated upon the mental side and receive docilely the advice given him. this work should have been carried out by the right type of social worker. such a visitor would no doubt have realized that one must compromise to a certain extent with the difficulties of the patient's temperament. one must adapt and modify the treatment suitable for the average case because this particular patient differs from many others in important respects. in the first place, he must be made to understand the importance of a correct mental attitude for the cure of his disease, must be taught that his recovery depends to a considerable extent upon his own efforts at self-control and self-education. next he must be convinced that his family will be adequately cared for during his absence from work. furthermore, the complete rest in bed which would probably be advisable for him if one had only the condition of his lung to consider, should probably in his case be modified owing to the fact that his mental state makes it impossible for him to rest when he is confined to bed. in such cases one has the outward appearances of repose but not the reality, one clings to the form but misses the substance. what one has prescribed is in reality _enforced impatience_, _enforced restlessness_, because one has put the patient under a régime where no result can be expected except impatient struggling against restraint. such a patient should be allowed a certain amount of work, carefully chosen and supervised, so as not to exercise the larger muscles of the body and thus produce fever, but sufficient to occupy an active mind and to make the patient forget himself. to find such occupation is difficult, no doubt, but it is not impossible. i have seen it done. in the case which i am now considering, no such effort was made. the patient was excessively lonely and isolated in the sanatorium to which he was sent. the doctor's visits were occupied with physical examination and the reiteration of commands that he should stop worrying and remain completely at rest. such treatment violated grossly one of the basal laws of medical psychology, which recognizes that no one ever stops worrying because he is told to do so. to give such a command is as irrational as to tell an epileptic not to have convulsions or a choreic patient not to wriggle his hands. yet this sort of error is constantly committed by physicians who have been well trained to understand the physical changes of disease, but have never concerned themselves to recognize the simplest and most obvious facts about the mental condition of the sick. as i have already said, it is impossible for the dispensary doctor to become acquainted with the details of the patient's malady, or to find out by investigation and experiment how the patient's mind may be made to aid his recovery rather than to impede it. this is the proper task for a social worker, partly because she has more time, partly because she is a woman, and is for that reason more fitted to get into close touch with the patient's mind and to use skill and tact in managing him. such studies of the social worker are equally important in the case of the functional neuroses; for example, in the cases where the patient's troubles can be most effectively attacked by ridding him of his fears. fear plays a dominant role in the sufferings of many cases both of organic and of functional disease. in a recent examination of six hundred and sixty-two young men about to enter harvard university, it was found that "there were more boys who thought they had a serious organic defect, usually of the heart, and were found entirely sound than boys who thought they were well and had disease." they had been threatened with heart disease by gymnasium instructors or ill-trained physicians. they had in consequence restricted their physical activities and been haunted by the fear that they might by some unusual exercise of mind or body make themselves seriously ill or perhaps suddenly die. such fears were all the more disastrous in these young men for being only half realized by themselves. it is exactly these shadowy apprehensions, these dreads which dwell in the half light, never quite faced in full consciousness, which torment and incapacitate us the most. careful physical examination showed that the young men just referred to were free from all disease, and the clear and emphatic statement of this fact rendered a prompt and important service. but if such fears haunt the students about to enter harvard college, who are young men drawn from the better educated and more well-to-do classes, we may be sure that fear plays even a larger part in producing the sufferings of patients such as we examine and treat in a public dispensary. for such patients are very apt to be influenced by groundless rumors, panics, neighborhood gossip. they are prone to believe medical lies which they read in newspapers and in the leaflets and circulars sent to them by charlatans. almost all their medical education comes to them from such sources, and is made up of a mass of systematic falsehoods designed to excite fear and to produce symptoms by suggestion. now if it is true that even among educated and relatively self-conscious classes the most troublesome and incapacitating fears are those which are but dimly known to the patient himself, this is sure to be still more frequently the case among dispensary patients. it is especially difficult and especially important, therefore, that their fears should be understood and brought to light through the investigations of some one who has time, patience, and tact to devote to the task. this cannot be the task of the physician who sees neurological cases in the dispensary, any more than the psychological twists and tangles of the tuberculous patient can be followed out by the specialist in tuberculosis who examines the patient's lungs. it is the proper task of the social worker. when she has brought the patient's fears to light, when she understands the details of his malady, she can communicate these facts to the physician. he then can exorcise the unclean spirits with the full authority of his medical position. just here one sees a good example of the proper coöperation between the physician and the social worker in the dispensary. each brings to light certain elements in the diagnosis. but in the end the physician must unite all the knowledge accumulated either by himself or by his social assistants, and thus must be enabled to act for the patient's benefit on the basis of a body of information much larger than he could have secured alone. the social worker is also an essential aid to the physician in bringing to light the mental torments and errors which result from difficult personal relations within the family. these difficulties can only be understood by one who visits the patient in his home, becomes intimate and friendly with other members of his family, and understands, therefore, the difficulties that may arise from friction, rivalry, jealousy, and temperamental incompatibility within the home. in some cases the patient's friends and companions in work or school must also be understood. in other words, one must take account of the totality of influences in the patient's environment, the physical influences of nutrition, ventilation, clothing, but also the psychical influences exerted upon him by his family and friends, by his own half-conscious thoughts, by his worries, his remorse, his fears. many a case of stomach trouble cannot be cured by diet or remedies until one can find out what it is that the patient is worrying about and can enable him to combat and subdue his mental enemies. innumerable vague pains which the doctor cannot attribute to any organic disease, and for which the use of drugs is only too likely to do harm, yield only when one can study and influence the whole extent of the patient's mental, moral, and spiritual life. nothing can be excluded here. it is utterly unscientific to close our eyes to any human interest no matter how little we may sympathize with it personally. it is one of the facts of the case, and must be understood and allowed for in our treatment. more and more frequently in america the dispensary physician is consulted about the physical and mental condition of children and adolescents who are sent to him from courts. the judges, especially in our juvenile courts, are coming to realize that their legal training, their knowledge of the nature, the evidence, and the prescribed punishments for proved offences, is only a small part of their equipment if they are to deal with juvenile offenders in such a way as to promote the public good. the legal profession is beginning to realize that the physical, mental, and moral study of juvenile offenders is essential if one is to do anything to prevent their offending again. if penology is to be constructive and reformatory, if it is not merely to represent revenge, repression, and intimidation, our judges must know something of medicine and especially of medical psychology. in this field, as in the field of the functional and visceral neuroses, france has furnished the leaders, but apparently these leaders have been insufficiently followed. the work of binet in the psychological measurements of school-children's intelligence seems to us in america to have been epoch-making. we recognize its limitations, we recognize that in its details it cannot be universally followed. but we have taken up the suggestions and the method of binet, and gratefully acknowledging our indebtedness to him we have tried to carry these suggestions and methods much further, to apply them to the needs of older children and to the examination of those who cannot read and write. binet's tests depended altogether too much upon the use of books and upon linguistic facility. yet with some modifications they seem to us in america to be of the greatest value, and in the remarkable book _the individual delinquent_ (macmillan co.) by dr. william healy, of boston, and in the books of his associates and followers, the science of medicine and medical psychology are intimately interwoven with the investigations and reports of the social worker. in the first of the books to which i have just referred, dr. healy presents in detail the cases of over three hundred children who were sent to him as a physician and medical psychologist by the judge of the juvenile court in chicago, who requested dr. healy to aid him in his legal treatment through a medical and psychological study of each case. dr. healy with his corps of assistants and social workers studied in each child the physical condition, especially the presence or absence of defects of sight and hearing, and the mental condition carefully measured by tests based upon those of binet, but extended considerably by dr. healy himself and by others. but he adds to the facts thus ascertained a careful investigation of the child's social environment, both physical and psychological; that is, of all the influences--hereditary, domestic, economic, industrial, and personal--which have contributed to lead the child into crime. the influence of other boys and girls of the same age, of associates in work or school, is investigated; also the good or bad example of parents, the amount and quality of schooling, and the presence or absence of religious instruction. all these latter investigations are carried out for dr. healy by social workers. their results are then pooled with those obtained by him after the physical and psychical examination of the child at the dispensary. one sees, then, that dr. healy and the other americans who have followed him in this field, insist upon covering in every case four classes of facts: ( ) the child's physical condition. ( ) the child's mental condition. ( ) his physical environment. ( ) his mental, moral, and spiritual environment. all this investigation is necessary because it is now recognized that crime may be committed because the child is an epileptic; because he is feeble-minded; because he is strained and tortured by defects of sight and hearing; by inability to keep up in school on account of these defects; because he is abnormally susceptible, under the influence of comrades, cinema shows, and sensational literature; because his inheritance, his education, or his home training has been defective or bad. since there is no reasonable doubt that physicians and judges will more and more coöperate in the study of offences against the law, and will more and more need the assistance of social workers to complete their studies and to carry out the reforms which those studies suggest, it can easily be appreciated that the social workers need to be familiar with the methods and results of psychological examination in this field of work. _mental diagnoses in social work_ the idea that social work necessarily concerns the poor is wholly wrong. it concerns the sick; it concerns the tuberculous; some of the sick and some of the tuberculous are poor. others are not. the state provides dispensaries for tuberculosis, and the people pay for them out of the taxes. hence all the people feel that they have the right to go there and that they are not in any sense accepting charity in going there. but social work is done in all these dispensaries. thus the connection between medical and social studies is tending to upset the old idea that social work is necessarily concerned with poverty, and that economic studies are the main part of it. in america our leading ideas about social work (formerly called charity), came originally from england and from the studies of english economists. hence to a considerable extent economic considerations have governed the history and evolution of social work even up to the present day. economists and people interested especially in political economy have studied, practised, and spoken and written upon these subjects, and all who are governed by the traditions inherited from england are still obsessed by the idea that money and money troubles are the gist of social work. nobody should turn up his nose at economics. anybody who is careless in money matters is sure to come to grief. but in my medical-social work, which has included a large number of cases where poverty existed, i have almost never found the economic trouble to be the essential one. economics is everywhere present, everywhere subordinate. that is an adaptation of a saying of the german philosopher lotze: "mechanism everywhere present, everywhere subordinate." the idea applies also to economics which has many qualities in common with mechanics. i shall therefore lay especial stress in this book, not upon economic but mental deficiencies, which in most cases seem to me more fundamental than economic need or physical weakness. a considerable portion of all social diagnoses should contain the word _ignorance_. i wish to distinguish ignorance from moral fault. it is true that somebody's sin, somebody's evil-doing is the fundamental thing in the social diagnosis of many cases. i have never yet studied carefully a case involving social work without finding some moral weakness as an important element in the trouble. moral elements always enter into the study of a case of social work, but they are often not the main element, often subordinate. _ignorance_, of course, is permanent. if we were not ignorant we should never progress. ignorance therefore does not necessarily mean culpable ignorance, but still it may be the keynote to the trouble in which any of us finds himself. consider industrial ignorance, ignorance of where best to turn one's forces. it would be impossible to say that any of us is free from that. are we perfectly sure that we have found the place where the lord intended us to work? this lack may not be such as to bring us into trouble. it may not force us to seek social aid. yet the lack of a clear idea about where we ought to be working, how we can earn the most money, do the most good, and be happiest--that is a deficiency that none of us is free from. _industrial ignorance_ has been the ultimate diagnosis in some of the cases that i have studied. the patient is an industrial misfit. he has not found his niche. perhaps there is no niche existing for him. some people seem to be made for another planet or another century. evidently, then, conception of an industrial misfit is wide, perhaps vague. yet it often dominates the economic situation. your patient perhaps cannot earn his living because he is working with only about one quarter of his powers, and that the least useful quarter. that with which he is trying to earn his living may be a mere superficiality. half the women that i know in industry are working with a wholly superficial part of themselves, unconnected with any of their deepest interests. that is less true of social workers than of any other body of women. they often can put the best of themselves into their work. but many women in industry, in business, hate it. they may be earning enough, but are unhappy and unsatisfied, because the powers with which they were meant to labor for the service of their kind are not being used at all. _medical ignorance_: a quarter, perhaps, of our task as social workers, is medical instruction, the breaking-up of medical ignorance. most well-trained physicians of the present day do not believe that many diseases can be cured by medicine or by surgery. we do not have great confidence in chemical, physical, or electrical therapeutics. we believe that when sick people are helped by a medical man or a social worker it is because they have learned something of what we call _how to live_, a large term which we usually limit to mean how to look after their physical machine. as i talk with supposedly educated people, i am amazed to see how little people who have lived forty or fifty years in the same tenement of clay have learned about that structure. i do not mean that everybody ought to study physiology. i mean, for example, such a simple thing as _how to rest_. one cannot rest just as somebody else rests. we have individual finger-prints, no two alike, and individual hand-writing. so we have--and should have found--our own way of working and of resting, which is probably as individual as our finger-prints. but we follow each other like sheep. the instructions we give to a tuberculous patient are needed because of his medical ignorance or that of others. i once received a wonderfully touching letter from a middle-aged tuberculous lawyer who finally learned the medical facts necessary to save his life through reading a popular magazine. he was being treated for tuberculosis, about as badly as a human being could be treated, but he did not know this. he had gone to the best doctor in his vicinity. through reading in a popular magazine an account of a medical conference on the treatment of tuberculosis he finally learned the truth and cured himself. medical ignorance in relation to diabetes, to stomach trouble, to venereal disease, to heart disease, it may be one of our tasks to remove before inculcating the régime needed in these troubles. _educational ignorance_, ignorance of proper institutions and methods to give a man the power which he needs, is often exemplified in relation to industrial training. one sees people in industry who could do a great deal better work if they had better training. but they do not know where to get it. in many cities there are scholarships and funds for people who show ambition to be better trained. educational ignorance, then, as well as industrial and medical ignorance, may bring people into economic trouble, even into physical trouble. such people often turn up at a dispensary asking the doctor merely to cure a headache or a stomach-ache. yet if the doctor is wise he will find this other trouble hidden in the background. obviously ignorance as a cause of trouble is a historic, not a catastrophic, cause. ignorance does not happen suddenly. its bad results accumulate gradually. _shiftlessness_ another mental element in social diagnosis i call _shiftlessness_, in a particular sense that i want to define. not shiftlessness in the sense of a general moral accusation, but as a failure of adjustment--maladjustment, due to shiftlessness in the sense of an inability to shift when there is a need for it. professor edouard fuster[ ] has spoken of social treatment as consisting almost entirely of helping people towards a better self-adjustment to their actual or attainable environment. people often make a failure of their lives because they do not shift when the proper time arrives. there are also people who shift too often, on the other hand. i shall speak of that later. the physical analogies of these mental faults are interesting, i think. a person who has too great physical shiftlessness gets a bed-sore. healthy people when they have lain in a certain position in bed for a time feel a discomfort and therefore instinctively turn over. we shift ourselves now and then in our chairs as we sit, and thus we relieve pressure which in turn would produce injury. but in chronic illness the patient sometimes lies in one position so long that he wears out his tissues till the raw flesh or even the bone is exposed. that is just as true on the mental side of life, true of us all. there is nothing i hate more than seeming to take a pharisaical attitude in our social diagnoses. all of us probably have failed to shift when we should. we might be more useful to-day if we had shifted more wisely. still, we are getting along somehow, and some other people come to us for advice because they are even more shiftless than we. i never yet made a social diagnosis in anybody that i could not make also in myself. it is only a question of degree. _industrial shiftlessness_ is an obvious example. a person gets into the wrong job and then does not get out of it. most people choose their professions by the most irrational process or lack of process that can be conceived of. when a boy is ready to choose a profession, does he look around him, study the alternatives, and select one? not at all. he does what the next man does, what his father did, what he happens to have heard most about. this is true whether people are pressed for money or not. they choose their job for no good reason; they are thrown into work by something pretty near to "chance." but they are often saved from the full consequence of their mindlessness because they shift. they shift either within the job or into another job. i got into medicine first on the laboratory side, began by writing a book on the blood and doing an unconscionable amount of work in the laboratory. it was wrong. i was not fitted for it, and luckily i knew enough to shift. social medicine was what i wanted. so many a man shifts within his profession. that is why the wrong choice made at the start does not always get people into serious trouble. but the chronically shiftless man remains immobile. he does not know where else he might be besides the place where he is. so he stays where he happens first to fall, gets bitter, hard, poor, drunken, all because he is in the wrong niche. one sees _racial shiftlessness_ when people cross the ocean and try to take root in a new country. this racial non-adjustment has very tragic results. we see it, for example, in the armenians in america who have come from a civilization two centuries back, and cannot jump these two centuries. hence comes the breaking-up of moral and industrial standards because they have come suddenly into a civilization to which they cannot adapt themselves. a third kind of shiftlessness one might call _domestic shiftlessness_. an english servant girl married an italian fruit-dealer. she was taken home into his italian family in boston and had to try to fit herself to italian customs. she and her husband got along excellently. but it was very hard for her to understand the shifts which she must make in order to adapt herself to his family. she was an old patient of mine, and after her marriage she brought her physical troubles to me, quite ignorant of the fact that she was worn out by family friction. my efforts were devoted chiefly to teaching her italian customs and defending her husband's family to her. i did not know any too much about it. i had myself to learn the subject which i was set to teach, as one does so often in social work. i had to find out the meaning of many queer italian customs in order to interpret them to her. at first she had no idea that when one crosses a racial line one must shift considerably. but she has finally learned it, and she is happy now. i have spoken of two social deficiencies--ignorance and shiftlessness. i believe there are very few cases in the social worker's domain which fail to show some sort of ignorance, some sort of shiftlessness, as an element in the social diagnosis. such diagnoses must usually be long. they are complicated and cannot often be expressed in one word. the word "feeble-minded" and the word "tramp" ("wanderlust") are among the rare examples of a brief social diagnosis which explains all the physical, economical, moral misfortunes which one finds in a person. but generally one cannot find such a phrase. so one makes a number of statements as one makes a list of many diseased states in the different organs of the human body. i do not regret this. the best medical diagnoses, those made after death, contain from thirteen to seventeen items on the average. one of my chief tasks during the last fifteen years has been to study diagnoses made after death and compare them with those made in life. the real diagnosis as it is revealed at autopsy contains on the average thirteen to seventeen items. the diagnosis made during life contains often but two or three items. this brevity is characteristic of the very partial truth contained in our clinical diagnoses. therefore i do not altogether regret it when i see in a social diagnosis a long series of items referring one after another to the main departments of human life. when we are making our medical diagnoses we try to say what is wrong with the heart, the arteries, the kidneys, the stomach, etc., in each patient. so in making our social diagnoses we ought to go through some such list as i have begun to give here. is _ignorance_ a factor? if so, where? is _shiftlessness_ in this particular case a factor, and how? there are certain organs of the human soul which one can go through and check up. (anything the matter here? anything the matter there?) as one goes through the bodily organs to make a medical diagnosis. _instability_ the shiftless person, in the sense in which i define the words, is the person who does not move often enough, who rests too long on one particular set of habits so that he allows the world to move away from him while he is left high and dry. or he allows himself to get fixed in one little set of habits and becomes a person with one idea. that is shiftlessness, the person who cannot accommodate or adapt himself. the opposite of this is _instability_--the defect of the person who shifts too often, who cannot stay in one field long enough. in the physical field this applies to people with motor nervousness, people who never can keep still. but we are more interested, of course, in the psychical side of it. any piece of work can be said to have three phases, something like the phases that sir almoth wright has emphasized in his writings on immunity. we have first a stage of interest and elation, then a slump, a depressed or negative phase, as wright said, a stage when things are not going smoothly or when organization seems endlessly complicated. then is the time when, if we are of an unstable type, we throw up our work. the unstable person cannot believe that the undertaking is going on and up to a third or positive phase, which in the end will be on a higher level than the phase in which we started. normal people habitually expect these three phases in every human undertaking. they foresee the negative phase before they get out of the first one. hence they are not astounded or bitter when the inevitable slump comes in the second phase. but the unstable person breaks off at that point and tries something else. it constitutes one of the most serious blots in any one's record if we find that he has changed his work four or five times already. "why did you leave your first job?" we ask, and, "why did you leave the second one?" there is never a satisfactory reason for so many changes. these people are rolling stones; they gather no moss. they never accumulate skill, power, and money as the result of having stuck long enough in one place. we see mental instability also in temperament, in spirits. many people get into trouble because they do not realize their own "negative" and "positive" phases. most people, we say, have their ups and downs. but if we take our ups and downs too seriously, then we may talk about suicide as so many people do. it is in these emotionally unstable phases that people give offence to others, quarrel with their families, lose their jobs. instability is much less important in the adolescent stage. many a parent has been in despair over his adolescent children. "nothing good ever can come out of that boy. he is too unstable," the parent is apt to say. yet great good often does come out of such a boy, simply because he grows older. such a boy is generally between thirteen and nineteen. tremendous physical changes are going on, which are rather more than he can manage. hence he becomes for a time unreliable, capricious, moody. there is almost no degree of mental instability and unsatisfactory conduct which may not wholly disappear as we get past the adolescent stage. on the other hand, the older a person is the more serious the outlook in a case of instability. a woman in the vicinity of sixty drifted into my hands some years ago, after having been the round of doctors whose diagnosis was essentially instability. although i labored very long and prayerfully with that individual, i cannot say that i produced any considerable effect. remember always the possibility that such instability is due to drugs. among the most unstable people are the morphine-takers, and because that has among other symptoms concealment and lying, it does not easily come to light. in the evening the morphine-taker is full of prowess, is full of hope, ready to make engagements for nine o'clock the next morning. but he almost never turns up for that engagement the next morning. this morning depression is common also in many other diseases, such as neurasthenia and that rare disease, anemia. the anemic patient has a hard time getting up in the morning, but it is the fault of his red corpuscles and not of his character. another phase of instability is _abnormal suggestibility_, abnormal openness to influence or "suggestion" in the psychological sense. i cannot count the number of fond but foolish mothers who have said to me about a child, "john is a good boy, only he is weak. he gets led astray by his companions." everybody is and ought to be somewhat suggestible, normally suggestible. the man who is not suggestible is the person with a monomania, who can see nothing but his own view, is stupidly attached to one set of ideas and so cannot learn. but one can easily be too suggestible. over-suggestible people run after every craze, are impressed with each new religion, or are tremendously excited with each new friend and think of each new experience: "ah! this is what i have been looking for all my life. nothing else matters." this is especially common at the adolescent age, but it is a danger for all of us, men and women of every age. we get carried away by popular crazes, by influences, by suggestions, so that we cannot remember the good that there was in our previous beliefs and interests. if so we are mentally unstable in this respect. we see in every dispensary many cases of abnormal physical suggestibility, people who think that they have caught every disease that they hear about. among medical students and nurses in training there are always some who become convinced that they have the disease which they have just been studying in the hospital. in the social assistant's work as a taker of histories she must remember that. highly suggestible people give curiously misleading histories because they become obsessed with the idea that they have some terrible disease. there are three examples of abnormal suggestibility which in my experience recur with especial frequency: _heart disease_, _cancer_, _insanity_. people are amazingly prone to fancy that they have heart disease. if they have any symptoms in that part of the body where they are taught to believe that the heart resides, or if they have heard anybody talk of heart disease, or especially if anybody whom they know has recently died of heart disease, there are many people likely first to believe that they have heart trouble, and then to have actual symptoms which they attribute to heart disease. they often say nothing about this fear. that is just why it is so essential for social workers to dig it out in the course of their history-taking. when people are afraid of a thing they are especially apt to conceal that fear. insanity is feared, i think, even more often than heart disease. every doctor is consulted by people who are sure on most trifling evidence that they are going insane. we hear people say, "why my mind must be failing, for i read down a page and when i get to the bottom i cannot remember what i have read." or, "i am losing all memory. i met a man recently suddenly and i could not remember his name." these two normal fatigue-products--failure of attention or failure of memory--often make people think that they are going insane. a third result of fatigue which often frightens people is the sense of unreality. such people say, "i seem to be numb. things do not seem real to me. i talk to people and i wonder if it is not all a dream. am i not going crazy?" there have been interesting essays written by french psychologists on the "sense of the _déjà vu_." for a few hours whatever we say or do seems a repetition; we have said, done, heard all that before we fancy. it is a very disquieting sense. but it is usually nothing but fatigue. cancer i suppose is the most dreaded of all diseases, but one of the most unnecessarily feared. patients may appear at the dispensary for most trifling pains or stomach troubles, troubles that all of us would disregard, and when we inquire why it is that they have come, sometimes a long distance and at considerable expense, we find out that it is because they have recently heard or read something about cancer, or remembered that there is cancer in the family. we cannot be too careful to tell people that cancer is not hereditary. people are apt to think it hereditary, but this is one of the medical fallacies that we should all of us do our part to eradicate from the public mind. i will mention one or two other common groundless physical fears. we should teach people that if they have a pain in the left side of the chest the chances are about nine out of ten that the heart is perfectly sound. if they have a pain, as they say, "across the kidneys," the chances are ninety-nine out of one hundred that the kidneys are perfectly healthy. the newspaper advertisements of charlatans do all they can to make people think that a pain in the back must be kidney trouble. we must fight such poisonous influences. footnote: [ ] conférence interalliée des mutilés. paris, may, . chapter v mental investigation by the social assistant (_continued_) _fears and forgetfulness_ it is not merely because of a doctor's mental habit that i speak of life in terms of diagnosis and treatment. for though those particular words are medical, any part of life can be thus conveniently summed up. one tries to find out the facts about some region of life in which one works or plays, fights, loves, or worships (diagnosis), and then one tries to do something about it (treatment). if one makes a friend one tries to find out something about him and then to treat him accordingly. if one comes to a new city one tries to diagnose its geography and to direct one's self accordingly. if there is anything not included in that set of phrases about the behavior of the human being towards the world, i do not know it. therefore it seems natural to sum up social work also in terms of diagnosis and treatment. i referred in the last chapter to social ignorance as a possible item in a social diagnosis. i meant to recall those parts of a person's outfit for dealing with life in which he is deficient because of _ignorance_, industrial ignorance, or educational ignorance, or physical ignorance. i went on to recall two other mental deficiencies or sources of incapacity, _shiftlessness_ and _instability_. in this chapter i want to exemplify _fears_ as sources of inefficiency or deficiency, as causes of sickness, economic dependence, and unhappiness. christian scientists define almost all human ills in terms of fear. that is extreme. i know many people who do not seem to suffer from any fears whatever. i sometimes wish they suffered from a few more. i should not say at all that fears were the cause of all evil, or that the fearless person was perfect. still, fear is a very great factor in social ills. i mentioned in the last chapter the three commonest physical fears as met with in medical practice: fears about the heart, about cancer, and about insanity. i sometimes feel that i will never let a patient go from me without saying, "you have not got heart disease, you have not got cancer, you are not going insane," even if he came to me for a cut forger or an ingrowing toe-nail. no one but a physician can appreciate how many people dread one of these three diseases. but about physical fears as about other fears, the most important thing to know is that they are disabling, crippling, in proportion as they are not recognized, or only semi-conscious. i am one of those who believe that one should not talk about unconscious consciousness, although synonymous phrases are very popular among modern psychologists. but we all of us know that a large part of our mental life is in a half light, neither in full consciousness nor in oblivion. these half lights may be quite harmless, but often they are especially mischievous. our vague, undefined experiences produce the fears which trouble us most. fear of the dark and fear of ghosts exemplify this rule, but it holds just as well for fears about disease. partly because of this vagueness, people often do not tell the doctor about their most serious fears. one has to go out of one's way to reassure people about their fears, because they so often conceal them. of course there are exceptions to that. people come to a doctor often for nothing else except fears. but that is not true of the majority of patients nor of those suffering the most harmful and haunting fears. it is for that reason that i am trying to give some idea of where to look for facts that do not come spontaneously to you as patients tell their stories. if the social assistant has not the medical knowledge or the authority necessary to reassure the patient, she can bring him to somebody who has. at the present time there is no piece of medical service more clean-cut and satisfactory than the power to reassure a person about an illness that he thinks he has, half-consciously fears he has, and therefore tries to banish from his mind. to discover groundless fears, then, fears of poverty, of ridicule, of marital unhappiness, and to cure them by bringing them to light, is the task that i think every social worker should consider as part of her job, in so far as she is connected with medical work, as she must be always so far as i see. it is astonishing how often people are relieved by knowing a truth which we shrink from imparting. i recently examined at a red cross dispensary in paris an old lady in face of whose troubles i was a little daunted when i came to carrying out the principle of telling the truth as i have long preached and tried to practise it. she had a chronic asthma. she suffered a good deal from it both night and day, and i could not see the slightest prospect that she would ever be any better, because in people past middle life asthma is for all intents and purposes an incurable disease. when i had finished examining this old lady and faced my task of telling her the truth, i did not feel comfortable about it at all. but i gave her the facts. the outcome was striking. "oh, yes," she said, "i rather thought that my asthma is incurable. i did not expect that you could do anything to cure it. all i wanted was to make sure that i had not got tuberculosis on top of it." about this fear of tuberculosis she had said not a word to the history-taker. it came to light quite unexpectedly. but when i assured her that she had not got tuberculosis on top of her asthma, she seemed quite contented and hobbled away very happily, puffing and blowing as she went. that illustrates the relief that comes to people from finding that a deeper-concealed fear is groundless. again and again i have pushed myself up to the task of telling people what i knew they had to know, and then found that instead of prostrating them i had relieved them of torturing uncertainty. i will relate an experience which shows how far this truth extends. an elderly lady, whom i had known for nearly twenty-five years at the time this incident happened, was in the habit each spring of coming from new york, where she lived, to boston, where she used to live, to make a round of visits among her friends. while still on one of these visits she telephoned me one day to come and see her. as i entered the house where she was staying, i was met, as i have been met so many times, by a member of the household, who, with finger on lip and every precaution for silence, beckoned me into a side room and proceeded to tell me "what nobody else must know." it was something like this: that my friend the old lady had begun the first of her round of visits about a month before this. on that first visit it had become pretty obvious to her friends that she was mentally queer. she was not a millionaire, yet she was spending and giving away an extraordinary amount of money. she was ordinarily a person of quiet habits and not prone to hurry about, but now she was making the dust fly all the time. she was ordinarily modest. she had now become boastful. the first friend with whom she stayed believed, as people usually do, that it would be dangerous to tell her anything about her mental condition, yet found it impossible to keep her in the house. therefore the hostess made the excuse that she had a maid leaving and could not really keep a visitor just now. would my friend mind moving on to the next visit? she moved on to number two; naturally the same thing happened there. so the second hostess passed her along to number three. she was with number four at the time when she called me. all this was given me in the strictest secrecy in the little anteroom close to the front door. my informant then tried to pledge me not to tell the old lady the truth, fearing an outbreak of violence. but as i had a good while ago sworn off all forms of lying, i refused to make any such promise. i went upstairs to see the patient. she poured out to me one of the most pitiful stories i ever heard--the same story just given, but from her own point of view. so far as she could see, her friends were all playing her false in some way, or losing their affection for her. she knew that it was not by accident that one friend after another had politely shown her the door. something was being concealed from her. what could it be? she was really worn out, she said with worry and sorrow about it. i told her at once the whole truth. i told her that she was insane. i could also tell her truthfully that she would come out of it (as she did), but that i must now take her away from this house, shut her up, and take care of her. "oh," she said, with immense relief in her voice, "is that all? is it nothing worse than that? insanity is nothing compared to losing all your friends." insanity is one of the greatest of human fears, but for this old lady, as for most of us, there is something still worse--the fear that one has not a friend in the world. even to know that she was doomed to what most people would consider one of the worst of fates was to her a relief; for there was a worse fear in reserve, and that she now knew was groundless. the _treatment of fears_, the only treatment that i know of, is that we face them, look straight at them, as we turn a skittish horse's head right towards the thing that he is going to shy at, so he can look at it squarely. so we try to turn the person's mental gaze straight upon the thing that he fears. people frequently consult a doctor because they are afraid of fainting, fainting in church or in the street, for example. in such cases i have found it most effective to say, "well, suppose you do--what harm will it do?" from the answers to this question i find generally that the patients have in the back of their minds, unconfessed, unrealized, the _fear that if they faint_ and nothing adequate is done to cure them _they will die_. they do not know that people who faint come to just as well if they are let alone, and that all the fussing about that is usual when people faint is useful merely to keep the bystanders busy and not to revive the patient. make a person face "the worst" and you disarm its terrors. "but suppose i get faint on the street?" "well, you probably will just sit down on the curbstone until you come to." that remark does not sound as if it would reassure a person even if made with a laugh. but it does, because he is thereby freed of a fear of something much worse, a fear that lurks in the background of his mind. there is one other thing to be said about the treatment of fears. if a person fears to do any particular act, such as going to church or into the subway, if he fears to be alone in crossing a big square, if he fears to get into a crowd (all these are common fears), the most important thing is to _force him to do what he most fears_. "do the thing you are afraid of, or soon you will be afraid of something else as well. and the more you do what you fear to do, the less you will be afraid of it, because your act will bring you evidence of the truth. your act will prove to you that you can do the thing that you fear you cannot. that fact will convince you a great deal more than all the talking that your doctor or anybody else can do. you will get conviction by reality, the best of all witnesses." among the poor, with whom we deal part of the time in social work--though i insist that social work is concerned with the rich as well--we have to face _economic fears_. in america and england economic fears are a very real evil--fears of the work-house, fears of coming to be dependent, of having no place of their own, are what poor people often dread. again, the clue for our usefulness is to find out what people do not tell us of these economic fears, and then to see if we can make them groundless. in a certain number of people (i do not feel competent to say how large a portion), life is rendered miserable by _the fear of being found out_. i happened, as i have already said, to get driven some years ago into a position where i thought it best to swear off medical lying. one of the surprising parts of this experience was the sense of relief which i felt when i knew that there was no longer anything in my medical work that i was afraid of having any one find out. it was in benevolent, unselfish medical lies that i had been dealing, according to the ordinary practice of the medical profession. but as soon as i decided that i could abandon these and need no longer fear that any patient might find out what was being done to him, i had the sense of a weight taken off my shoulders. _forgetfulness_ there is a very eloquent passage in one of mrs. bernard bosanquet's books[ ] about social work, in which she describes the psychology of the poorer classes among whom she worked in london, and dwells especially on their characteristic forgetfulness. they cannot learn because they cannot remember. they cannot learn how to avoid mistakes in future because they cannot remember past mistakes. one well-known difference between a feeble-minded person and a person competent to manage the affairs of life, is that the former forgets so extraordinarily, and therefore cannot build up through remembrance of his past how to steer better through the future. of course we all of us have this disease in varying degrees. we all forget, in the moral field as well as the physical, things that we ought to remember. there are things that we ought to forget. after we have started to jump a fence, we must not remember the possibility of our failing. the time to remember that is before we have begun to jump. moreover, there is no particular benefit in remembering our own past mistakes if they are such that we cannot do anything about them, morally or any other way. there are things, then, that we ought to forget, but allowing for these, forgetfulness means forgetting the things which we ought to remember. in alcoholism it is extraordinary how much the person forgets. one cannot fail to be struck by the fact that the alcoholic gets into trouble again and again because he cannot fully remember what happened before. in the field of sex faults this truth is equally obvious. a man is unfaithful to his wife because he allows himself to forget his wife--his memory of her is for the moment blotted out. nobody could violate his own standards in this field if he could vividly remember them. hence if we are to help any one else to govern himself in matters of affection we must help him to remember, help him _by planning devices that make it nearly impossible to forget_. bad temper can ordinarily be explained by forgetfulness. we can hardly lose our temper with a person if we remember the other sides of his nature opposed to that with which we are just now about to quarrel. nobody consists wholly of irritating characteristics. we all possess them; but we all possess something else besides. hence if we can realize some of our own moments of wrath, i think we must confess that for the moment the person with whom we were enraged possessed for us but a single characteristic. the rest were forgotten. my account of these five common types of mental deficiency: ignorance, shiftlessness, instability, fears, forgetfulness, is general and vague. i mean to make it so. if my suggestions are of any use to the reader it will be because he is able to make his own specific applications. i want, however, to mention one example of a much more specific fault, namely, _nagging_. in social work we often see families broken up or seriously cracked by some one's nagging. it consists in reminding people of their defects and shortcomings in season and out of season, until the reminder finally gets upon their nerves. you are aware that your husband, your wife, your child, has some very deleterious fault. admittedly he has it and it is constantly getting him into trouble. so you want to be quite sure that it never gets him into trouble again; and hence you keep reminding him of it again and again until you produce an irritation that only aggravates the original fault. why do i take so trivial and specific a case as this? because i can remember several cases where i could not possibly leave out nagging when i came to make my social diagnosis. it was one of the chief factors. one cures this disease, in case one does help it at all, by making the nagging person conscious of what it is that he is doing. the nagging impulse is like an itch. _it recurs and scratching does not stop it._ the nagger does not know quite why he does it; he finds himself doing it almost in his sleep. hence we try to wake him up, to make him conscious, if we can, of his foolishness, of the kind of harm he is doing, and of the degree of incurability he is inducing in the person whom he is trying to cure. i will now sum up the last four chapters in a diagram which we have used in boston at the massachusetts general hospital to assist us in making our social diagnoses. a social diagnosis can very seldom be made in one word, such as _idiocy_ or _tramp_. it must include the patient's physical state. it must summarize a person's physical, moral, and economic needs. our best social diagnoses, such as _idiocy_ or _feeble-mindedness_, do not refer to the mind only. they refer to the body just as much. feeble-mindedness is a statement about the child's body, his brain, his voracious appetite, the diseases to which he is likely to succumb, his extraordinary susceptibility to cold, and his poor chances of growing up. one says a great deal about the physical side of a child as soon as one pronounces the word "feeble-minded." also one says a great deal about his financial future. one knows that the feeble-minded child will never rise beyond a very low point in the economic scale. one says also a great deal about his moral future. we all know to what sexual dangers and temptations he is especially exposed. and on the purely psychological side one can predict his entire unteachability beyond a perfectly definite limit. all this is given in the medical-social diagnosis, "feeble-mindedness." this is an example, then, of an ideally complete and compact, though a very sad, social diagnosis. it is almost the only good one we have worked out as yet. the only other is "tramp." the tramp in a technical sense is a person who has what the germans call "wanderlust." he is unable to stay in one place. perpetually or periodically he desires to move and to keep moving. the tramp is a medical-social entity. he has certain physical limitations, certain economic limitations, certain moral deficiencies. but in america he is rather a rare being. one does not see many typical tramps here. since few social (or medical-social) diagnoses can be stated in a single word, one is usually forced to write down one's diagnosis in a great many different items. as a guide i made four years ago a schedule for our use at the massachusetts general hospital. use--the only test for that sort of thing--has shown this schedule to be of some value. + . physical--+ a. heredity. | + b. health. + i. the individual --| + a. mental deficiency. | + . mental --| b. mental disease. | | c. temperament. | + character. diagnosis | shall -| + a. food. clothes. characterize| | housing. | | b. industrial | | conditions. | + . physical--| c. school conditions. | | | d. climate. natural | | | beauty or + ii. his environment-| + ugliness. | + a. family and | | friends. + . mental --| b. education. | play. + c. religion. to make a social diagnosis we should make a summary statement about the individual in his environment. that summary is to include his mental and physical state, and the physical and mental characteristics of his environment. (i here use the word "mental" to include everything that is not physical; that is, to include the moral, the spiritual, every influence that does not come under physics or chemistry.) when the investigation of a patient is divided between doctor and social worker, the doctor studies his physique; the social worker studies the rest. i believe that there is nothing that we can want to know about any human being, rich or poor, that is not suggested in that schedule. suppose, reader, that a friend of yours was engaged to be married. suppose you wanted to know something about the fiancé. you would certainly want to know about his health and his heredity; then what sort of a person he was, his mentality, whether he had any money--what are the obvious physical facts about his environment. to what influences has he been subjected, and what mental supports, such as education and recreation, family, friends, and religion, can he count upon? you would not want to know any more and you ought not to want to know any less. so in summing up a social diagnosis i think it is convenient to use the four main heads that i have put down here. i think these headings will remind us of everything that we want to put down, and of everything that we may have forgotten to look up. that is one function of such a schedule--to remind us of the things which we have forgotten. made up in such a way as this, of course the social diagnosis will have many items, and like medical diagnosis it will be subject to frequent revisions. the doctor who never changes his diagnosis is the doctor who never makes one, or who makes it so elastic that it means nothing. so social workers should never fear to add to, to subtract from or to modify their social diagnoses. the best medical diagnoses--those made after death--often contain fifteen or twenty items. before death in a recent case we found pneumonia. after death we found in addition: meningitis, heart-valve disease, kidney trouble, gall-stones, healed tuberculosis, and ten minor troubles in various parts of the body. so a good social diagnosis will name many misfortunes of mind, body, and estate, healed wounds of the spirit that have left their scar, ossifications, degenerations, contagious crazes which the person has caught, deformities which he has acquired. footnote: [ ] bosanquet, helen. _the standard of life and other studies._ (london, macmillan & co., .) _the family._ (london, macmillan & co., .) chapter vi the social workers' investigation of fatigue, rest, and industrial disease _fatigue and rest_ fatigue is more important for medical-social workers to understand than any single matter in physiology or any aspect of the interworkings of the human body and soul, because it comes into almost every case from two sides: (_a_) from the workers' side because the quality of work that she puts into trying to help somebody else depends on how thoroughly she is rested, and how much she has to give; and (_b_) from the side of the patient, his physical, economic, and moral troubles, because fatigue is often at or near the root, of all these troubles. it is unfortunate that in spite of its importance, we do not know much about fatigue from the physiological point of view. since the war of - we have prospects of knowing more about it than ever before; for one of the grains of good saved out of the war's enormous evils has been the fruitful studies of fatigue made in england, studies more valuable than any that i know of. let us take fatigue in some of its very simple phases, as it applies to your life and mine. the first thing to recognize is that it can affect any organ; our stomachs can get tired just as well as our legs. when a patient complains of pain, vertigo, nausea, we first ask ourselves, "what disease has he got?" that is correct. disease must be found if it is there. but the chances are he has no disease, but only a tired stomach, since fatigue easily and frequently affects that organ. when the whole person has been strained by physical, moral, and especially by emotional work, he may give out anywhere. he may give out in his weakest spot, as we say. that weak spot is different in different people. therefore the study must be individual. we cannot do anything important with our own lives until we learn how and when we get tired. it is the same with people whom we try to help in social work. fatigue, then, may be _referred_ to any particular spot in the body. people often go to an oculist to see what is the matter with their eyes, when there is nothing in the world the matter with their eyes: the honest oculist tells them that they are tired, and that for some reason unknown to him their fatigue expresses itself in the eyes. this is a very common and very misleading fact. the patient finds it hard to believe that medicine ought seldom to be put on the spot where he feels his pain. if the pain is in his stomach he wants some medicine to put in his stomach and not a harangue on his habits, which is usually the only thing we can really do to help him. if he has a pain in his back he wants a plaster or a liniment for his back. it is very hard to get people out of that habit of mind, and we shall surely fail unless we are clear about it ourselves. it must be perfectly clear in our minds, or better, in our own experience, that fatigue may be referred to one spot or to another, in such a way as seriously to mislead us. i suppose that half of all the pains that we try to deal with in a dispensary--and pain, of course, is the commonest of complaints--are not due to any local or organic disease in the part. doubtless there are some wholly unexplored diseases or disturbances of nutrition in that part, as there may be in the eyes when they ache because you have been walking up a mountain. but medical science knows nothing about that. what we do know is that the pain, if it is to be helped, will be helped not by thinking about that spot or doctoring it, but by trying to get that person rested. fatigue, then, ought to be one of our commonest medical-social diagnoses, and to help people out of it, one of the attempts that we most often make. in dec., , a dozen or more y.m.c.a. boys consulted me in france, all with coughs, all wanting medicine to stop the cough, and most of them a good deal disappointed because they were told to go home and go to bed, told that they were tired, and that this fact depressed their resistance against bacteria, so that bronchitis or broncho-pneumonia resulted. the second point, then, that one wants to make about _fatigue is_, that it is _the commonest cause of infectious disease_. pasteur's great discovery, which set modern medicine upon the right bases, sometimes gets twisted out of perspective. sometimes we fail to realize that the seed may fall upon stony ground. the seed, of course, is bacteria, and its discovery was pasteur's immense service to humanity. but pasteur was so busy that he did not emphasize the truth that a seed can fall upon good ground or upon bad ground. when bacteria fall upon bad ground, that is, upon healthy tissue, they do not grow, they do not spring up and multiply. tired tissues, as has been abundantly proved by animal experimentation, are prone to infection. they are good soil for the growth of bacteria. it is true generally; it is true locally. a part that has been injured, for instance, a part that has been bruised without any break in the skin, without the entrance of any infection from the outside, is damaged by something that hurts its resisting power as fatigue does. such a part will often become inflamed, will often become subject to the action of bacteria which must have been in the body already, but which had been kept on the frontier by our powers of resistance. our "powers of resistance," then, which we cannot more definitely name, which we do not as yet know to be identified with leucocytes or with anything else, can get tired. when they get tired we "catch" a cold or a diarrhea, or a hundred things which seem to have nothing to do with fatigue, but _have_ nevertheless. _accumulated fatigue or physical debt._ if you go up a long flight of steps at a moderate rate, you can get to the top without being tired; if you go up at a rapid rate, as most of us do, you are tired at the top. physically you put out the same amount of energy, i suppose. i do not see that there can be any considerable difference in the energy consumed by the performance of that act whether we do it slowly or quickly. the difference is that in the first case we _rest between each two steps_ as we rest between each two days at night. when our activities are so balanced as not to run in debt, we rest between each two steps. you and i can walk at our individual peculiar gait on the level for a long time without any accumulation of fatigue, often with refreshment. but push us and we are soon exhausted. suppose that our normal walking rate is three and a half miles an hour; push us to four, and it may not be a quarter of a mile before we are done up, because we have not been able to avoid accumulated fatigue by resting between each two steps. it has been said that in rowing the crew that wins is the crew that rests between each two strokes. the person who does not get tired is the person who rests between each two days. he does not accumulate fatigue. it is the accumulation that finally breaks you, makes you bankrupt. it is the little unnoticed bit added day by day, week by week, month by month, that makes the break. fatigue we should think of as running in debt. one of the figures of speech that has served me best in teaching patients how to live is that figure of income and outgo. i have often said to people, "physically you are spending more than you earn, not to-day merely, but right along. you must earn more than you spend. you must get a plus balance in the bank. then you can run along with fatigue or illness." that figure of speech helps us also to express another fact about fatigue, which is important to recognize in ourselves and in our patients, because otherwise we get thrown off the track: _delayed fatigue_. the first day that your income begins to be less than your expenditures, nothing necessarily happens. the bank does not proclaim that there is no deposit there. it is some days later, usually, that you begin to reap your troubles. it is the same in physical fatigue. patients say to us, "i slept ten hours last night. i spent a virtuous sunday. why should i be tired to-day?" we should answer, "because of something you did last tuesday or thereabouts." we all are familiar with this in relation to sleep. it is not the day after a bad night, but several days later that its effects depress us. delayed fatigue, then, is an important thing to notice in ourselves and to bring home to the people that we are trying to help. i suppose one could say that _a great part of our business in social work is to call people's attention to things_; if they have recognized them before, they will perhaps get a lesson out of what we say. such matters are _referred fatigue_, _delayed fatigue_, _accumulated fatigue_,--familiar enough, only the person does not act on them because he does not notice them. the fatigue-rest rhythm, the alternation of fatigue and rest, i have already phrased by the metaphor of earning and spending. you can phrase it also by a metaphor very close to the physical facts as we know them, the metaphor of building up and tearing down. during the daytime, from the point of view of physiology and the workings of the body, we burn up tissue. in us oxidation processes are going on which are really burning, as really as if we saw the flame. tissue is being destroyed, broken down, going off in the form of heat, energy, and life. that is good in case it is followed, as it should be, by a period of rest in which we build up. presumably, if we could see with adequate powers of the microscope or powers of observation of some sort, what goes on during rest, we should see a perfect fever of rebuilding all that we have torn down during the day. people often say, "shall i take exercise?" yes, but remember that half of the process of taking exercise is getting rested afterwards. it will do you good provided you rest after it, provided what has been torn down in exercise is replaced by sufficient tissue or fresh power in rest. the english studies of fatigue to which i have referred have been of great importance because, so far as i know, they are the first attempt we have had in the way of testing when men or women in industry are too tired and how much too tired they are. i do not suppose that any employer of labor would want for his own profit or for more than a short time to overwork people in this sense, if he had the facts called to his attention. if he realized what he was doing, he would not want to break down his working force any more than he would to spoil his machinery. but some employers are careful of their steel machinery and careless of their human machinery. they will continue to be so, i fear, until we know more about fatigue. it is one of the most difficult things to measure that i know. take it in your own case: what tires you one day does not tire you another day. the individuality of it, the disturbing factors when we try to measure it, are perfectly extraordinary. such a disturbing factor in our calculations is "second wind"--mental or physical. a number of men marching along will grow less tired as time goes on by the acquisition of what we call "second wind." we do not know what it is. we have tried to connect it with the condition of the heart, to say that the heart finally gets to deal with the volume of blood that is running through it so that there is no overplus of blood stored in any one chamber at any moment. but we do not really know anything about that. we do not know what second wind is; but it is important to know that it exists. moreover, as professor william james pointed out in that essay called "the energies of men," there are "mental second winds." just when a man is worn out he often finds new strength. he often cannot get his best strength until he pushes himself even to despair. in the spiritual experiences of the world's saints and heroes we find that it was just when it seemed as if they were about to go under that this second wind, or third wind, for it sometimes comes again and again, this mitigation of fatigue without rest, comes to them. this is a most disturbing fact. if we were like a pitcher which is emptied out and filled up, we should know all about fatigue very soon. we are like a pitcher to a certain extent, but the similarity is disturbed by such factors as second wind, and disturbed, moreover, by mental and emotional intruders like music. a military band coming upon a body of marching men will give them strength when they had no strength. that is not a sentimental but a practical fact which army men have to take advantage of. then the fact that many people can rest by change of work without stopping, is also disconcerting. we say to a person, "you have been working hard all day; you must stop, lie down, go to bed." that person disobeys, keeps going on something different, is altogether fresh next morning, and we have to confess that we were wrong. it is a very familiar experience that one may be almost dead from one point of view, but quite fresh from another, as one wants no more meat, but has plenty of room for dessert. some people can rest by change of work and some cannot. it is very important for us to keep finding out in a great number of ways which of the classes into which people's bodies are divided we each belong to. do we belong in the class of the people who must get their rest by giving up, by the abolition of all function, or in the class who rest by the change of function, by doing something different from the day's work? it is a question of fact and must be found out by each individual for himself. just here the _individuality of fatigue_, which i have been trying to make clear all along, becomes obvious. we are rested by making a success of something. if we have been making what seems to us a failure of something, it is amazing how it rests us to make a success of something. the boat crew that wins is almost never tired at the finish; the crew that loses is almost always dead tired. that is why it is so refreshing to go home, to have a home to go to, and somebody to go to in that home, because there you have a tiny success. you have built up that home; it represents your savings, perhaps, if you are a working-man, or your success in winning somebody's affections. that success is linked up with joy. recreation re-creates us because it enables us to succeed when we have felt ourselves failures, or at any rate postponers. we are working for some "far-off divine event to which" (we hope) "creation moves," but moves very slowly. in recreation, in art, in beauty, in going to the theatre, dancing, music, we get at something where we can succeed, success by performance or by enjoyment and so be refreshed. one of the things that is always exasperating to students of industrial fatigue is that a girl who is nearly dead from working in a factory is sometimes made totally fresh by dancing. after being tired out by standing, she gets rested by dancing. it is certainly puzzling but not inconceivable if we take into account the psychical factors, which we are so apt to ignore because they are invisible. one of the things we want in rest is success where we have felt ourselves failures, achievement where we have felt we were postponing, trying to make goods which we never see finished, of which we do only a little piece. to balance all that, we want achievement, success, finish, the present delivery of something that is enjoyed now, of home, affection, or beauty. from another point of view, _a test of rest is forgetfulness_. forgetfulness ought to be achieved in our recreation and our time off. when people ask, "what form of exercise shall i take?" we have to bear in mind that the form of exercise which is most valuable is that which makes us forget. the easiest form of exercise, and the least valuable, usually, is walking. many people carry on while walking just the same train of thought that has tired them. if so the walk is nearly useless. for other people the act of walking is different enough from what they do, so that it will break the continuity of thought and achieve forgetfulness and rest. well-to-do people who can run an automobile usually can forget. that has been a little good that has come out of the many evils of the automobile. one of the good signs in modern education is that our old-fashioned gymnasiums are being stripped bare, the apparatus "scrapped," in order to give place to play a game. playing a game gives us present joy, the first thing we want in recreation; and in the second place, it makes us forget. i have spoken of rest through change of work. but the change ought to be such as sets free imprisoned, unused faculties that find no outlet in our daily work. it may be that marriages are made in heaven, but the marriage of a man to his job is very seldom made in heaven, and so mismating is common. the whole human race is too big for its jobs. the industrial system is altogether too small to fit us;--a large part of our powers remain unused. therefore, the purpose of our time for rest and recreation, our evenings and our sundays, should be to even up that balance, to use the part of us that is not used at other times. sunday ought to be a family day, just because in the working world people do not see much of their families during the week; it ought to be a day in the country because we have organized these things called cities and live in them during the week. it ought to be a day of worship because we forget our religion so much in the week's work. everything that we do on sundays ought to be an evening-up of what gets crowded out of our week-day lives. _tests of fatigue_ the english tests of fatigue are nowhere near being applied yet in america or anywhere else as we hope some day they will be, to solve this tremendous problem of industrial fatigue and industrial disease. in some of the ammunition works in england[ ] they took a body of people of approximately the same age and sex, living under the same conditions approximately, doing the same work. they changed the working hours of one set and left the other set unchanged as a "control." in any scientific test we have to have what we call a "control," something that enables us to compare the changes that we bring about experimentally with the unchanged state of things. (_a_) in one room the hours of labor were left unmodified, in the other modified, first increased, then decreased. they made interesting experiments to see whether a man produced as much output, in eight hours as he could in ten; they showed that he could produce as much in the shorter time as he could in the longer time, presumably because he was less tired, less bored, less strained. they made a further cut and found that then he did not produce as much. there is a limit, therefore. he could not probably produce as much in four as in eight hours. then they experimented on continuity and discontinuity of work--whether a person could produce as much or more in five continuous hours as in two batches of two and a half hours with rest in between. they found that the shorter periods did distinctly better. output, then, was the first rough, but still serviceable, test that they used in relation to fatigue. (_b_) next they recorded the general look and feeling of the men as the foreman and other interested people could size it up--the look of listlessness, of boredness, of fatigue in the working-man when they varied the hours and continuity of work in the ways that i have spoken of. (_c_) next they took the amount of illness, of time off, away from work, as a measure of fatigue, and it was very definitely shown that with a diminished number of hours the number of sicknesses of all kinds, such as colds, were diminished, illustrating the point that i made a moment ago,--that accumulated fatigue diminishes our resistance to infection. (_d_) finally, they made some physiological tests of powers of sight, quickness of answer, etc., after fatigue, and showed that a man was less keen in his senses, less capable of accurate response, after a certain number of hours' work than before, and that fatigue could to a certain extent be measured in that way. all these tests of fatigue can be applied in our lives and in the lives of people we are trying to help in social work. we have to take account of the number of hours, the possible breaks, intervals, that can be made in otherwise continuous labor. many people can get on very well if they break the day into manageable fragments. we must also take account of the effect of fatigue in producing infectious disease, of the general look of the person, and of such little physiological lapses as i have spoken of, weakened attention, the capacity for forgetting names, and mental numbness or the sense that things are unreal. in dispensary work, when we try to give up the use of particular medicines which are useless (as contrasted with the medicines that are useful), one of the chief things to put in their place is the study of fatigue and of the methods for resting our patients. we cannot make the social work of a medical-social clinic successful unless, whenever we take away something which we know to be a fraud and an untruth, we put something else in its place. it is for that reason that i have devoted so much space to the subject of fatigue and rest. footnote: [ ] see health of munition workers committee. final report, _industrial health and efficiency_. (london, .) chapter vii the social worker's best ally--nature's cure of disease fatigue is a matter that seems to me of particular importance in social work for two reasons: first, because it concerns the visitor's own work and the way she does it; and second, because it concerns the troubles of a large proportion of all patients. the ultimate diagnosis, if we could make it, in probably half of all the people who come to a general clinic, is fatigue of some form, falling upon the weakest organ or function. i want to connect this subject of fatigue with one of the policies which should govern medical-social work, namely, that we should be honest both in diagnosis and in treatment. that is a policy for which i have struggled and fought for a long time, but which we are still far from attaining. we have not yet an honest practice of medicine on any large scale, a frank declaration to patients of what ails them, how they may avoid its recurrence and so avoid coming to the doctor again. in the american red cross dispensaries in france we tried to pursue the policy of honesty in diagnosis and treatment. we were told by wise people at the beginning that it would not work there, that with french patients it would not do to explain carefully and honestly what was the matter or to refuse to give them drugs when we knew that drugs were no use. but one of the pleasantest experiences of our war work was to find that this warning was not true. we used the truth exclusively and successfully. our success seemed to me natural because on the whole the french are the most intelligent race that i have ever come in contact with. hence they took to this particular part of our policy even better than people take to it in america. that policy links itself up with the management of diseased states due to fatigue and with the explanation of how to prevent getting into poor condition again. in newspaper advertisements and advertisements in the street-cars, it is the fashion to state that a given remedy, a given panacea, "_will cure you in spite of yourself_." that is exactly what the patient wants. he wants to be put in perfect condition by the first of march, we will say. inquiring into his present distress we almost always find that he has been violating in some obvious way some hygienic law. but he _wants to be cured without reform_, in spite of persisting in his bad habits of eating, drinking, sleeping, working, worrying--to be cured by means of miraculous interference which he thinks a drug will produce. he wants a tonic, and he often does not take it well when you tell him that there is no such thing as a tonic. there never was and presumably there never will be such a thing. a tonic is a thing which does nature's work, which gives us in a moment artificially what food and sleep and air and rest and recreation slowly and naturally give us. there is no such thing. the nearest thing we have to a tonic--a thing which we sometimes give when people ask for a tonic--is an appetizer. there are drugs which will help a little in giving an appetite. but only to that extent can we give a tonic. but this is not what people want to be told. they want something to take away "that tired feeling." there is one thing (as unfortunately people discover only too soon) which _will_ take away the feeling of fatigue--alcohol. that is why people take it, because alcohol, a narcotic as it always is, dulls the sense of fatigue, and allows people to go ahead straining themselves, when they ought to have been compelled by nature's warnings to stop. perhaps it is because so many "tonics" contain alcohol that people have not got over the idea that there is any such thing as a real tonic, which abolishes, not the awareness of fatigue, but the fatigue itself. the promise to "_cure you in spite of yourself_," then, is the bait by which the quack attempts to tempt us, and his lie shows exactly the line in which we, as social workers or as physicians in a dispensary, ought to labor. we must try to show people that fatigue, strain, worry, and other natural causes have brought them where they are, and that there is no possible getting out of their troubles without following the line of common sense. no drug, no tonic, can take the place of obedience to common sense. we see people who have varicose veins, for instance, and whose work forces them to stand a great deal on their feet. they often come to us hoping to get cured _in spite of the fact that they are standing all the time_, and inviting the force of gravity to produce stagnation of blood in their legs. in advising such people we have two courses open to us, quite characteristic of the courses which may be followed in all such matters: . we can say, "well, i understand that you really cannot arrange to get off your feet. all right. the varicose veins will not get cured. but, on the other hand, they are not very dangerous; the consequences of neglecting them are not very serious. the number of cases when an over-distended vein breaks and causes a serious hemorrhage is not great. the chances of ulcer are not _very_ great." force the patient to face the danger and realize what will happen, in case he does not make any change in his habits; it is then perfectly proper in certain cases for a person to go on violating hygienic common sense provided he has counted the cost and faced it. each of us comes to some point in his life when he makes up his mind that for a good cause he will smash his health. i do not believe in the worship of health. there are many better things in the world than health. many a man makes up his mind to do what he knows will probably cost him a number of weeks or a year of his life. that is all right; only we must face it, in peace as well as in war. or ( ), when people come to us for the relief of skin abscesses, boils, and demand some drug which will cure these abscesses, we must ask the important questions, whence did you get them? why did they come? presumably not because the patient has failed to take a drug. we must find the fault in hygiene, generally constipation or overwork, or lack of sleep, causing a lowering of the body's vital resistance, whereby the germs, the staphylococci, which are deep in our skin and never to be rubbed off by any washing or sterilization, begin to multiply. the soil has become such that they can multiply. i have tried to suggest the importance that we ought to attribute to soil as well as to seed. modern doctrine about the cause of disease has called our attention to the tremendous importance of seed, that is, germs, bacteria. but on the whole, if one had to say which is the most important single factor in disease, he would have to say, not the seed, but the soil. take the tuberculosis bacillus, for instance. i do not think it is an exaggeration to say that nine tenths of all persons have had tuberculosis, usually in a harmless form, because the soil has been stony and so has killed off the bacteria. you know that the figures obtained by means of tests with the von pirquet reaction in almost any city or town, show that ninety per cent of the children of twelve years of age and on, have a positive reaction to this test for infection by tuberculosis. they have the tuberculosis bacillus somewhere in their bodies. that does not mean that they have the disease, but they have the bacteria in their bodies, and mostly in the process of being killed off by the tissues of the body which resist this infection. one of the reasons why i go into detail here about the changes that take place in the body through disease, is to make social workers feel as strongly as i feel, and convey to patients as strongly as i try to convey it, _what nature does in curing disease_. we have read of people who were walled up in masonry by way of vengeance, and left to die in a casket of stone. that is what nature does to a bacillus, literally walls it off in stone. after death when the pathologist's knife cuts down into a lung, the knife is sometimes broken by coming upon what feels like a stone. a stone it really is, a deposit of lime salts in the tissue, around a nest of tubercle bacilli. if one cuts such a stone in two, one finds in the centre bacilli often still alive and perfectly capable of increase, but harmless to the body because nature has built this wall around them. i do not think one can get the full force of this fact until one has seen it. that is one of the long list of things that the body is constantly doing in this process of resisting disease, and doing more intelligently than we can. since, then, it is chiefly the soil, the vital condition of our tissues, which resists disease, we must do our part in making that soil good or bad for disease. that is why our hygiene, our obedience to the individual laws of our own experience, which show us how we can keep well and how we get sick, must be learned and taught by every one of us so far as we can in such a place as a dispensary or a patient's home. for example: disease is often produced by lack of sleep; hence it is of central importance to teach people how to sleep. excluding organic disease in the causation of most cases of sleeplessness--for most people suffering from insomnia do not have organic disease--one can say this: _insomnia usually depends on something wrong in the patient's day_. the state of the night depends on the state of the day. if the day has been free not merely from gross sin, but free from hygienic blunder, then the night will go somewhere nearly right. if the day has been filled with concentrated work in which the mind has been wholly upon the thing it has in hand, if there have been no elements of strain through distraction or worry, causing double currents in the mind, then when night comes one can turn the mind off and go to sleep. on the other hand, the mind which has been intent half on its own job and half on its own worries, never wholly "turned on" during the day, cannot be "turned off" at night. any physician or any patient succeeds in curing insomnia who succeeds in finding out what is wrong in the way the sleepless person lives, and how it can be corrected. but most people want to go on living in just the same stupid way and yet to get rid of the sleeplessness "in spite of themselves." the obvious way is to take a drug that for a while will stop insomnia even when life goes on as before. there are many drugs that will give sleep, but there are no harmless drugs that give sleep--none. physicians receive about once a year advertisements of a drug for sleep which is "wholly without ill effects," but i do not think it shows undue skepticism or dogmatism to say that those drugs never do what they say, and never will. sleep being a natural process, anything that forces it upon us hardly can be free from ill effects. hence the first thing in attacking a case of insomnia is to say, "never take a drug again." natural processes whereby fatigue accumulates and puts us to sleep do not go on rightly if we are being artificially driven into sleep by a drug. one gives drugs for sleeplessness rightly when there is some rare and special reason for being awake, some catastrophic reason which will never occur again. this exemplifies the principle which i have tried to emphasize throughout this book. we may give money for some catastrophic cause which puts the person down and out, and will not occur again. so we give a drug for sleeplessness if there has been some special thing to interfere with sleep--if, for instance, you have been talking very hard with a friend and you know by your own feelings that your mind will not stop that night. then you may perfectly properly take a drug to put you to sleep, knowing that there is no reason to suppose that such a talk will occur again in the near future. knowing this, you do not need to waste that night. you take the drug. but it is only in rare catastrophic moments that one can be cured in spite of one's self, any more than one can give or take money safely. it is the same in the matter of constipation. the first thing to make clear to a patient is that drugs must be abandoned before he can ever teach his bowels to behave as they should. but it is a great deal of trouble to do that, and because people shirk that trouble, and want to be "cured in spite of themselves," they come to a doctor to be cured by drugs. alas, he is often weak enough to give them what they seek! i have tried to make this drug-fearing practice one of the policies that honest medicine must always stand for, because it seems to me that when the doctor allows himself to be tempted into behaving as a considerable number of his profession do--that is, into giving people what they ask for--he very soon loses his ideals, gives things that he knows more and more clearly that he has no right to give, and goes downhill. social assistants must help the doctor to avoid this disaster. they can do so by helping him to teach the truth. i want to deal a little further with some examples of what nature does in the way of warding off disease. for a large part of what we call disease, and what we feel in ourselves as disease, is not the attack of the enemy, but is our defence against the enemy. take, for instance, inflammation. when germs are beneath the skin, one finds redness, swelling, heat, pain, as the symptoms of inflammation. what does that mean? it is all like the defences which were set up round paris when the germans were coming there, or that are set up anywhere when one is getting ready to repel attack. the inflamed finger gets red because a great deal of blood is going there. the blood cells, especially the white cells of the blood, are coming there to defend. the finger gets red for the same reason that the railroads get congested in time of battle, namely, because so many soldiers are being carried there for defence. the finger gets swollen because so many cells and fluids are coming to attack the enemy; it is their crowding outside the blood vessels that makes the swelling. there is heat in the finger because there is more blood in the part and therefore the part is hotter. there is pain because with the extra accumulation of defenders there is a squeezing of the little nerve terminations there. when a lot of soldiers are suddenly quartered, billeted in a town, it is a painful process. there is pain in having defence come to your city. there is pain in having defence come to your finger. all of these symptoms, which we are apt to hate and to think of as misfortunes, we should realize are the thing which saves us from very serious illness. suppose these things did not happen. following out the metaphor, if it were not for these defences the enemy would penetrate into the whole body and we should have blood poisoning. it is because this local heat, redness, swelling, pain, appears at the point where bacteria are attacking us, that they do not penetrate the whole body with a _septicemia_, which is one of the most dangerous of all diseases. so while suffering what we must suffer, we ought to be glad of all that nature is doing, because if she neglected it the consequences would be very serious to us. but we may ask, "if this is true, where do medicine and surgery come in? why do they ever interfere if nature is so very wise?" because nature overdoes the thing every now and then. nature is first enormously wise and then a little blind. in another example i can bring this out a little better. you have sprained your knee and the knee gets very stiff. that in itself is good; it is a defencive reaction. the stiffness is like a splint. the knee ought to be kept quiet. so far so good. but nature overdoes the thing. the knee ought to be kept quiet, but for how long? we will say three days more or less, according to the severity of the injury. then you have to fight nature which stiffens the knee too much. you have to fight it by the use of the knee, by walking or by massage, which is not, however, so good as walking. if we respect blindly what nature does in stiffening the knee even to the exclusion of nature's other functions, such as walking, then the knee will get worse. one of the greatest improvements in the modern treatment of sprains, is that we no longer keep the patient in bed and put plaster of paris on, which makes the sprain last for months sometimes; but we let him walk at once on the sprained ankle, whereby the attempts of nature to cure by stiffening are not carried too far. another example of how nature overdoes things is in the formation of scar tissue. if a scar did not form to close the wound, the wound would remain open. hence the scar is vastly better than nothing. but scar tissue is never as good as the original tissue. one of its known ill results is contraction, so that a scar on the hand or on the neck often draws the part out of place. then we have to fight nature. we have to go against the workings of nature by surgery, in order to get the person right. in suppurative disease, such as appendicitis, it is often difficult to decide when nature is doing better than we can do, and when we can do better than nature. the appendix is a hollow tube the size of one's little finger, and hangs off from one part of the large bowel. when it gets inflamed nature at once begins the defences which i have described in the lung, namely, the walling-off process, which tends to make the bacteria harmless. there is danger that they will spread from the neighborhood of the appendix and produce a very dangerous disease, general peritonitis. hence nature begins to glue around the appendix the adjacent parts of the bowel and anything else at hand. this generally makes it harmless. most of us physicians now believe that the great majority of cases of appendicitis cure themselves, and that still more would cure themselves if given a chance. on the other hand, there are cases in which nature does not do her work rightly. then if the surgeon did not interfere the person would die. that is why medical and surgical judgment, the particular, minute, individual study of the person from hour to hour, makes the difference between right and wrong treatment. the surgeon who operates every time he makes a diagnosis of appendicitis, or who says he will never operate, is just as wrong as the person who gives money the first time he sees a case, or who never gives money. but most surgeons are wiser than that. i hope through these illustrations to make it clear that nature generally cures disease. when she does not, it is generally incurable. there is a small residuum left for the doctor. we have a function as physicians or nurses. we have a function, and that function is intermediate between two extremes. in disease or in other misfortune, there are three types of fortune, two extremes and a mean: ( ) the people who will get out of their troubles whatever you do, get out of their misfortunes, rally to meet their griefs, pull themselves out of financial difficulties, get over their disease. then ( ) there are people on the other side, who will die whatever you do. some cases of pneumonia, for instance, seem to be doomed from the start. it is the same with many other cases of disease and with some people's misfortunes. we have to face the fact in social work that there are many people whose mental twists and agonies we cannot help in the least, and many people who will be in money difficulties as long as they live. but ( ), intermediate between these two extremes--and our happiness and our success depend on our finding that group--are those cases where what we do makes the difference between success and failure. this triple division indicates a point of view which makes, not only for individual understanding of the situation, but for practical success. take the case of those maimed by war or accident. there are three classes of them: first, the people who will get back their jobs and get back into industry unaided; they are probably the majority. then the people who cannot be put back by any process. finally, there is the rather small intermediate class who, with our help, with a little extra education, with a hand in the back, will get back into work, but who never would succeed, humanly speaking, without our help. so it is in disease. _the vast majority of diseases get well without any help from anybody_, and that is the thing we must teach most often and to most people, in season and out of season. in our day and generation few people get a chance of observing that fact, because somebody comes along and gives them a drug. and unless one has seen people get well without any drugs, one continues to believe that it was the last drug given that cured every case of illness one has known to get well. on the other hand, the majority of illnesses that do not get well without drugs will not get well at all. i have mentioned before the figures which seem approximately true in relation to the cure of disease by drugs. drugs will cure about six or eight diseases out of about one hundred and fifty diseases known to science. anybody who fails to give a drug for one of those six or eight diseases is criminally negligent. we should press that drug upon the patient. i do not want anybody to think that i do not believe in drugs. i believe in them tremendously, in the particular cases where they are of use. but i do not stand for the habit of bolstering up people's beliefs that we have drugs all ready to cure most diseases. i think the future of cure by drugs is very hopeful. i do not feel hopeless of our discovering drugs for the one hundred and forty-two out of one hundred and fifty diseases which we still cannot cure. but if we falsely suppose that we have a cure already, we do not hustle around to get it. it is not until we realize that we have not a cure already, that we do hustle around to get it. _it is not until we realize that we are now very helpless in medicine that we shall labor in a way to become less so._ at present the best that we can do for most patients is to explain what the trouble is, let them know what is going to happen, to preach some hygiene, and above all to make them realize that we care and suffer with them. that is the essence of medical work and of the social assistant's work in the dispensary and in the home. _industrial disease_ industrial disease is a phrase we have heard much in the last ten or fifteen years, meaning that diseases are caused--some of them--by the conditions to which people are exposed in industry. a great deal of indignation, some of it fruitful, much of it harmful, has been aroused against employers and against the whole system of industry--because we have now recognized the fact of industrial disease. employers in the past have been more interested in their machinery than in their human help. that is not only bad, but very stupid. most of us believe that because it is stupid it is not likely to continue indefinitely. but aside from all these matters of controversy, there is one important distinction to make at the start. (_a_) industrial disease in the narrow, strict sense, i.e., something produced by the industry, something which would never have occurred in any form if the person had not been in that industry. (_b_) disease affected, modified, in some way by industry, but due in part to other causes. there are very few clear-cut and common industrial diseases. lead poisoning is almost the only one. disease due to the inhalation or swallowing of other poisons and the penetration through the skin or irritation of the skin by definite poisons are real dangers, but not common. more common, more difficult to deal with, and therefore more within the province of the social worker, are the diseases in which industry is only one factor in the complicated skein of causes. take such matters as exposure to unusual heat or cold, unusual humidity or dryness in industry--very common conditions; or still more, exposure to unusual strain and hurry from what we call "speeding-up" or from the piece-work system. i do not think there is any good evidence that those things produce any single disease. i think there is excellent evidence that they often dip the scale whereby a person who has been in equilibrium, able to get along with his outside troubles, and to keep his balance, is finally knocked down into disease. a person has tuberculosis. one of the favorite tricks of unscrupulous political orators is to say, "look at all that tuberculosis due to the greed and the cruelty of employers!" bad conditions of industry are doubtless a factor in the production of tuberculosis, but we must realize how many and important the other factors are. the eight or ten hours a person spends in industry is often a small factor in producing his ill health, compared to the fourteen or sixteen hours he spends outside the industry. hence if we are to understand the diseases of workmen we must investigate _these_ hours just as carefully as those in the factory. that is what we ordinarily omit. we find so many cases of tuberculosis in a given industry, and we say, "ah, then, these cases are _due_ to the hardships of that industry." in refutation of this idea there is one more dogma packed for transportation, which i should like to offer in the form of a logical fallacy which the mediæval logicians put down in latin terms: "_post hoc, ergo propter hoc_": "after this, therefore because of this." one of our duties as doctors and social workers is to combat fallacies, to teach people to think straight instead of crooked about their ill health and their other troubles. when thus occupied, a large part of our labors will consist in trying to overcome the popular fallacy quoted above. "you went into a particular industry and you had tuberculosis: therefore you had tuberculosis _because_ you went into that industry." "you had a given disease and you took a certain remedy: you got better, _therefore_ the remedy cured the disease." so the superstitions flourish. i do not believe it is easy for any of us to extricate ourselves from that particular fallacy, but we must try. in industrial disease we have the causative factor of industrial hardship intimately mixed up with other factors. one of my colleagues, dr. roger i. lee, of whose book i have already spoken, investigated, in our clinic at the massachusetts general hospital, the cases of one hundred young working-girls, factory employees, who either had tuberculosis or were suspected of tuberculosis--were in what is wrongly called the "pre-tubercular stage," when the doctor has not made up his mind whether the patient has tuberculosis or not. he studied these cases, as people ought to study them, always in proper coöperation with a social worker. he made his own careful observations in the dispensary. then he employed a social worker to study the girls in the home and outside the home, following up in their lives and personalities the tangles of disease. his total result was that he could not say in any given case that industry had produced a single one of the diseases which he found, though he was not willing to swear that it had not done so. he found that a certain number of these girls, in their perfectly natural search for recreation, were running around the streets or elsewhere until the small hours of the morning. that is an obvious factor in producing a diseased state. it is not that we want to blame people for seeking recreation; but the results cannot also serve as evidence of the harm done by industry, except in a very wide sense in which we might say that industry does harm because it does not provide for recreation, which is, i think, an extreme view. dr. lee's social assistants found that a good many of these girls had no habits of eating. it was not that their habits were so bad, but that they had none of any kind. sometimes they ate very well and sometimes they did not. then he found, as of course one would know that he would, the psychical factors in many of these cases--their love affairs and other worries which were often much more deleterious to their health than their habits of sleep or food or even their industrial conditions. when, therefore, one tries to consider industrial disease, one must realize how complex a thing it is, how essential it is to go beyond the inspection of the factory and to study all the conditions of the lives of the people that one is concerned with. in a big western american town that i visited recently, where the automobile tire industry was employing some fifty thousand hands in factories, the most obvious cause for ill health was the tremendous congestion in that town, and as a result the fearful state of the available lodgings. again most of the factory hands were foreigners; very few of them spoke english; they were wholly dislocated from normal family life, from any connection with their own countries and from their own previous interests. that is in itself a dangerous condition for hygiene as well as for morals. factors like that must be taken account of when we want to help anybody to get free of the troubles, the fatigue or strain or debility, which we are apt to attribute to industry. we are keen, and rightly keen, to find and to abolish poisons, such as lead, such as phosphorus, such as carbon monoxide. we ought to be keen to study poisons of that kind, and more interest has lately been concentrated upon them through war work and war industries than ever before. but there are moral poisons which we do not notice or mention. _monotony, for instance._ monotony is not altogether a horrible or hateful fact. most of us want _some_ monotony in our day. we want a rhythm and a certain recurrence in it, whereby our work comes to seem familiar to us and we do somewhere near the same thing each day. there is rest in that. but _how much_ we need is individual; the dose of monotony, the amount that is good for you and for me is limited. people often get too much, and when they get too much, then it is a moral poison. one of the most appalling things, i think, is its effect upon the mind. i have often wondered whether i ever had or ever would have any mind again, when i have come to the end of such a day. any one of us, of course, can duplicate that experience, and it certainly ought to make us think hard about the lives of manual workers whose days are quite likely to be like that right along. at the end of such a monotonous day a person may be pretty reckless, may feel that he does not care what happens to him. i have met that in a great many histories. it is not so much that monotony makes machines of them as that it makes wild animals of them. another moral poisoning is _the sense of injustice_, a sense that it is not right that somebody else, whom the lord did not make very different, has so much more of money and opportunity and happiness than the person himself has. it is altogether a secondary question to discuss whether that is true or not. i do not myself believe that the rich are any happier than the poor. on the whole, i think the evils of money are just as great as the evils of poverty. but the sense of injustice is often just as real even though the reasoning on which it is based is wrong; and the sense of injustice is a moral poison which breaks down health and spoils happiness. can we do anything about it? sometimes. by going over the details of people's lives, by telling them stories of other people's lives, by confessing a great deal about our own life, we can help people to see things differently. when i was speaking of pains in the region of the heart i said that one of the most important things that one could learn is _to distinguish between the pain and what we think of it_. the pain often cannot be changed, but our interpretation of it often can. the patient often suffers chiefly from what he thinks of the pain, and when he knows that the pain is not due to heart disease and that he probably will live to be a hundred, that particular form of suffering leaves him. so in this matter of the sense of injustice, the causes for suffering may be unchangeable, but if we can change the patient's point of view we may help him a great deal. a greater evil, i think, than any i have mentioned, and one that we are almost powerless to attack, is lowered sex standards, which come from the crowding of people of all ages and both sexes into industry. as in the housing problem, it is the moral rather than the physical side of crowding that is most serious. that is why the visiting part of social work seems to me so much the most important. the important part is what we hope goes on in home visits, when the social assistant meets people where they will talk as of course they cannot talk in the dispensary. _part_ ii social treatment chapter viii samples of social therapeutics . _order in social treatment_ the principles of linkage embodied in the work of the home visitor, in her cooperation with doctors and other social workers, and in good history-taking which avoids the fallacies of the catastrophic point of view, take on a little more impressiveness when we consider what a widely general law that "linking-up" law is. it is the essence of science; indeed, it is the essence of things still wider, for it is the essence of order. there is an old phrase that "order is heaven's first law." it certainly is an impressively universal principle. how universal this linking-up process is, and how it applies to all possible situations medical and social, can be made to stick in our memories by the phrase, "_in view of this, what next?_" this is a prosaic and unimpressive-sounding dictum; but with some trivial and some important illustrations i can show that it is really useful. . a terrier dog is watching a rat-hole: in view of this, what next?--a question full of importance for the dog and for the rat. . a cobbler is working on his shoe: in view of what he has already done upon that shoe, what shall he do next? the value of the shoe, the value of the cobbler's working time, depend upon his seeing truly, and then, in view of that vision, doing whatever is next called for by the conditions of the shoe which he is dealing with. . as we go down the bill of fare of a restaurant, we say, "in view of what i have eaten, what next?" presumably there is a method, an order in our madness. . we may have known, in the course of our lives, a few people who, when we ask them a question, think before they answer. these are the people who habitually say to themselves, "in view of this question and of the truth which i should speak, what words should issue from my lips?" . the whole science of logic is the science of seeing truly: in view of certain premises, what is next? what follows and must follow, if we are to be logical. . anybody who has got to a certain point in his profession says, "in view of my successes and my failures thus far, what is the next thing for me to do?" one can say the same, and i imagine that most people have often said it to themselves, in relation to friendships: in view of my present affection or dislike for that person, what next? we have come through the world's most gigantic war: in view of this, what next? . i tried to exemplify this principle also in our medical and social history-taking. our histories should be orderly. there is a thing that rightly comes first and a thing that, in view of this, should come next. . when the musician composes or plays, he is guided in the writing-out or in the instrumental expression of his musical idea by his consciousness of the whole piece--what is done and still to be done. "in view of this whole," he asks himself, "what notes come next?" . when a man prays he says to himself, "in view of my sins and of god, what next?" it appears, then, that the most trivial and the highest things that go through the human mind, if they go right, follow that formula, because it is simply a way of putting truth in order, and because order is as fundamental to a human mind that is working right and not wrong, as anything can be. the catastrophic point of view, on the other hand, is the point of view of disorder, the belief that things happen "as the result of accident," come upon us without order, were never in view beforehand, occurred for no known reason. the _principle of order_ is also closely knit to the principle of independence or integrity, which we want to achieve in social work when we give. physically we want the person to be independent, not depending upon a drug, not needing to be jacked up by a stimulant, not dependent as a sick man is dependent, on nursing, special diets, and long rests. in the economic field we try to avoid making a person depend on a crutch, a support, a pension, which atrophies his economic powers instead of developing them. at least we desire not to weaken them. we want to give and build, to give something that will go on by itself to make him independent of us. but independence is not altogether a good phrase. no human being, linked up in a world-order as we all are, is ever independent. what we mean by that not altogether satisfactory phrase is that we want to be dependent only upon something that we can rely upon, only upon permanent, central, orderly powers of the universe. physical independence does not mean independence of food or of rest; one soon comes to the end of his tether if one attempts such independence. dependence means hanging. we must all hang. but we want to hang upon something that will not let us down, upon food, air, warmth, exercise, rest, such as are always available in an orderly life, or should be. so in the economic field, no man is economically independent or ever will be. but we want his powers knit into an orderly system that is not dependent upon a protective tariff, on somebody's whim who pays his salary, or on political "pull." we want people to be independent in the sense that they get their living by connection with a well-ordered economic system. even then, of course, we are not independent. a planet may run into us and we shall then be wrecked in spite of the fact that we are not dependent upon charity or a protective tariff. obviously literal independence is also impossible in moral and personal relations. we are never independent of society, never capable of going it alone. the only question is, on what do we depend? do we depend on one person, or one particular kind of entertainment or stimulation? or can we find our food in any of a vast number of places and persons which in the natural order are fairly sure to be available? or in the absence of all finite persons can we find our food in god? that is the fundamental question in relation to personal independence. its answer states the degree in which our personal history is orderly and not catastrophic. if one is habitually trying to order his own life in this way, the principles by which he lives will guide his attempts at social treatment and give him continuity and steadiness. . _presence of mind in social treatment_ all our diagnostic duties, whether as doctor or social worker, are part of our search for truth, physical, economic, mental, and moral, as the basis for medical-social treatment. i have used again and again the figure of chains, each of them starting with the individual's present misfortune, need, or sorrow, as a central link, and radiating in different directions as we trace out the relevant physical and economic facts, the chain of the patient's relationships to family and friends, some of whom he is apt to forget, and finally the chain of mental and moral causes which lead up to the present moment. i believe in that method with all my heart. i also believe it can be employed so one-sidedly, so exclusively, as to spoil social work. the criticism of social work which recurs most often and most justly, i think, is that we are not human enough, not big enough people to do social work, that we have not vision, that we get into mechanical and routine methods which spoil the whole adventure. i know that this is true. we fail because it is difficult for us to drive in span two strongly contrasted ideals only one of which i have yet laid great stress on. truth and the following out of the links of truth, physical, economic, etc., is a process which we might call looking for the _background_ of the fact that presents itself close to you. we need to see that background. we must not get our perspective distorted. it is the doctor's commonest fault, that he sees only the disease that is just now before him, and nothing of its "background," economic, mental, or moral. hence he does not make a fundamental diagnosis or prescribe fundamental treatment. we need in our dispensary work to _find truth_. yes; but we need to _find joy_ also in our work; we need to see the _foreground_. we do not want to have attached to us the stigma and the weakness which we think of in professional work. we are accustomed to believe that professional philanthropists find no joy in their work, which they do as a matter of routine, for pay, without vision and without a sense of the unexpected and momentary values which are precious. the process of tracing chains, of looking off and away from the patient's present pain, sorrow or poverty for its causes and relations, tends to make us look over the head of the present fact. we all know people who always look over our heads when they talk, and we know how little they get into touch with us. we must not stare into the physical, economic, or mental background so constantly or so fixedly that we cannot see the present fact before us. that is preoccupation. i have often accused myself and my assistants of going about their work with a care-worn air, because we are thinking so much of the fine, helpful plans which we are making and the truths which we are going to discover, or of bothersome details which we have not got round to finishing up. but we shall do no good in the long run unless we enjoy our work. there may be some professions where a man or a woman can be of use who does not draw joy from work, but certainly social work is not such a profession. we have with stevenson the duty of happiness: "if i have faltered more or less in my great task of happiness," --what are we to do? we must wake up-- "lord, thy most pointed pleasure take and stab my spirit broad awake." we are not awake. we are half asleep, dreaming over our plans, our worries, our visions. that is why we are preoccupied; looking over the head of the immediate fact, we miss the amazing beauty of face, word, and character tempered and enhanced by suffering. much as i hate the fault of never going beyond the fact that we see before us, i hate just as much the opposite error of not getting the full vision of the foreground. we ought always to be able to feel, at the end of any single home visit, that we have done something, accomplished something. well: one of the things that we must make every effort to accomplish, and to feel ourselves a failure if we have not accomplished, is to find and to give pleasure, to enjoy ourselves, and if possible to give a little courage. the little embellishments of our work, the smile, the tone of voice, the jokes and courtesies of our fleeting contacts with individual patients, should be just as precious to us as any of our far-reaching plans and deep-plunging attempts to study into cases. how poignantly, how intensely christ put this to us in saying that inasmuch as we did any good thing unto the least of his brethren we did it unto him! i believe that he meant this not only of human beings, but of days, of moments. the least of these opportunities is infinitely precious and we are making a grievous mistake if we do not take it so. i have known a few social assistants who make each little deed and each little moment a perfect work of art in itself. art at its best this work is. it was my greatest single experience in - to admire the french art for finding joy in little things, and of making beauty in little things. i asked recently a group of americans what they had found the most admirable in their contact with the french people. everybody present had had the experience of finding in his own hotel or _pension_, a _femme de chambre_ or some other domestic who, though starting to work at five o'clock in the morning and working until late at night, nevertheless always kept joy or the appearance of joy in her work. on the first night that i was in paris i went with a friend to dine at a restaurant very late. there was but one waitress, who had nearly finished serving an enormous number of people. she ought to have been near the end of her day's work, which our arrival prolonged still more. but i never can forget the welcoming look and tone with which she said to us, "now i shall have the pleasure of serving _you_." we need the artistic spirit, the spirit of beauty in social work. it is not opposed to, but surely very different from, the spirit of science which i have been emphasizing in the earlier chapters of this book. i must confess my impression that, on the whole, thus far, social work has been ugly. social workers have not kept beauty and the sense of beauty in the foreground of their work. beauty and joy always tend to drop out in social work, but this must not be. there is an old story of an inspired social assistant in boston who had been working for a long time with a needy family who were at that time much discouraged. one day she had an idea: "what that woman needs is a blue dress. she is extraordinarily fond of that color. she has not had a new dress for a long time." and it was true. she was given a blue dress, and the history of that family afterwards began to show signs of the sort of change and upward constructive effort which had long been lacking. we cannot neglect that sort of thing, slight or sentimental though it may seem. i remember another family in which flowers, and money spent on giving the children a chance to grow flowers, played a beneficent rôle; and still another discouraged family in which a canary bird seemed an essential element in the social work done. there is something certainly very divine about the present moment. we shall never have it again. we are apt to think that next year we shall do something great. then, we think, at last we shall gather up all the forces of our soul and do something worthy. but i do not believe we can tell ourselves too often in social work that _now is the time_, and that the opportunity of the present moment is priceless. hence, after trying to exemplify the backgrounds which we ought to seek out when a fellow being comes to us in trouble, i must now correct that overemphasis by paying homage to that state of mind which sees foregrounds. what we want is _presence of mind_--a very familiar and hackneyed phrase, but one which may grow precious to us after analysis. my complaint against the preoccupied, solemn look in the social worker's face is that the person's mind is not there with his fellow beings; it is aloof with his own troubles. he is not "in it," not all there on the spot. the necessity of joy in one's work, and the necessity of seeing the momentary and infinitely precious opportunities, come to the same thing. if you are "in it," you get _your chance_. to have sufficient presence of mind to seize one's chance is surely the crucial act in social work or anywhere else, for that chance does not recur. but presence of mind connects itself with an interesting fact in our grammar about the _present tense_. the present tense, in contrast with past and future tenses, expresses presence of mind, attention to the wonder of the moment, the opportunity of the moment. but it also expresses a wholly different thing, namely, the _eternal_. some languages have an eternal tense and use it about facts that are not present or past or future. we use the present tense for the eternal. two and two make four. when? well, not of course at ten minutes before twelve on the th of november, , more than at any other time. we might just as well use the future tense. two and two always will make four. but by a peculiar accident we have hitched on to one tense the whole body of eternal truth. _why did we hitch the eternal to the present rather than to the past or to the future?_ because anything that we really grasp now, as truth or as joy or as beauty, anything that we really comprehend, can be eternally ours. in the physical sense it is so. the electric light that i am now looking at and which might be turned off at any moment, is eternal, for its vibrations are travelling off through space and always will be. the fact that those vibrations are going off through the ether is ever the same. any present fact, then, so far as we realize its truth or its wonder, is eternally ours. hence presence of mind is the quality needed in social work to balance the scientific habit which looks for past and future, for what is not present. investigation and history-taking must always be completed by _appreciation_, the other half of our mental life, which is acutely conscious of the present and therefore can be conscious of eternity. i hope i have not put the contrast of science and art in social work so sharply that it seems as if one must take one extreme or the other. i do not feel any such contradiction. i believe that we can get courage for the long, discouraging search for causes out of the present joy which we find in speaking and listening to a person now. on the other hand, these momentary contacts are thin, capricious, and insufficient if we are not also planning some solid progress which will give us something to show for it at the end of a day or a year. one of the dreary things in human beings' work is that sometimes, after a month or a year, they cannot see that they have accomplished anything. it is all a mass of details. i remember a very marvellous social worker saying to me, "i do not want to die thinking that i have never done anything but case work." case work seems to me as great a thing as any one can do. one might as well say, "i have never done anything but miracles." but i know what she meant. she meant that through case work she wanted to feel that there was a thread of continuity which ought to be science or character or friendship, a thread whereon something accumulates. we ought each year to be able to say and to _write_ what we have learned, or given. . _how to give in social treatment_ _social treatment is giving and constructing._ we want to give pleasure beauty money information education courage and to help build the power to get more of each. . _pleasure._ as we want to _find_ pleasure in our work, we surely want to try, so far as our human capacities allow us, to _give_ pleasure, to make people feel comfortable, to be always so polite to them and finally so fond of them, that they will enjoy the momentary contact no matter what it is about. as i look back over medical work of twenty-five years, i should say that in most of my cases i have failed from the medical point of view. yet in a great many of those failures i can see some redeeming feature because of the friendships that the patient and i built while i was failing in my medical job. such a blending of success and failure is the rule, not the exception. we make elaborate social plans, but we know that many of them are going to fail. it is humanly impossible that they should not fail. but they will not be _flat_ failures if along the way we have tried to treat people, not as they deserve, but a great deal better.[ ] but when we give pleasure we must try to provide that the stock shall go on. we want to try to build in and with the person some capacity to get that pleasure for himself after we have gone out of his life. this is just as true of course of _beauty_ which we surely want to try to bring into our patients' lives, and which is one of the things that redeems our failures on the other side of social work. even people who are dying sometimes can get great enjoyment of beauty. . _money_ is, i suppose, on the whole, the thing we are asked for directly or indirectly most often in social work. if we are not doing direct medical work, if we are not giving a direct medical relief or trying to, we are more than likely to be asked for help in the way of money, clothes, food, or rent. surely no one works long in social work who does not find the right place to give money. but i have to go back to the figure already used, the parallelism of money and morphine. a person comes to us with pain and begs for money or its equivalent--direct, immediate relief. what makes us hesitate in the one case is the same that makes us hesitate in the other. we may relieve, yes; but have we constructed? in the long run we must both construct and give, else our giving may be useless or harmful. when can we give money without doing harm? in a general way, when it is not going to lead to the repetition of the same demand. when are we perfectly sure that we may safely give morphine? in gall-stone colic. for it may be weeks, months, years, perhaps, before there will be another such attack of colic. we give morphine once only. the person gets over the attack, and does not want morphine again for months or years. but if the patient's pain is chronic or likely to recur soon and frequently, it is cruel to give morphine, because soon the patient will have all that pain again, and more--_the pain which is produced by morphine_ after it has been taken a little while. we never can tell that the pain suffered is not wholly due to morphine. so the person's trouble after we have given money may be due to the money itself, ill used. we should be able to say, after a careful, though not care-worn study of the case, that we know the patient's pecuniary need is not going to recur, because we are not dealing with a chronic difficulty like extravagance or alcoholism, which will recur and cannot be checked by money. . on the whole, the safest form of giving that i know, that which is surest to perpetuate itself, to be planted like a seed and go on without our having to stand by it, is giving _information_--a cold-sounding thing, but sometimes very useful. one difference between the social worker and the person for whom she works ought to be that the social worker has had more education, more freedom, more friends, more opportunity to look around the world and see resources. hence, when, for instance, she comes to find a job for a man, the social worker, because of the perfectly undeserved blessings that she happens to have, ought to be in a position to give information that is of value. one of the most precious kinds of information is information how to secure more information. the difference between uneducated people and those whom we call educated, is not that the latter know very much, but that if they do not know something they know how to go to one who does. the uneducated person is helpless to improve his education. he does not know and cannot find out how to look up a subject. i have distinguished information from education. information as such never changes character in my opinion. this subject has been discussed in recent years in connection with what some call quite falsely _sex hygiene_. information biological, pathological, physiological, talks about health and disease, never kept any man or woman straight morally. it never changes character. so our public school education sometimes represents only information, only the facts, not the meaning, the interpretation, the use of those facts. hence the public school is justly open to the criticism brought upon it by those who say that it does a child no lasting good to know facts. it may make him clever and so able (like german science in war) to do more harm than if he knew less. but when we give education--for example, hygienic or economic education--we give something else than information. education is that which, by reason of practice, by doing something again and again, and doing it if possible in the presence of a good model (living or dead, book or person), changes our character and our habits, as the use of a muscle changes the muscle. a person learns to write. that is not merely information--he has learned to do something. learning to swim is not information. we learn it by practice, by doing it, and by the imitation of good models. how does one learn to think? by doing the thing, and if there is any model in sight, by trying to imitate that model. . _education_ is what social workers try to give most often, most consciously, over the longest time, and sometimes with the greatest results. we try to give people hygienic education. we try to give, not merely hygienic information, but motives fit to bring about a change in habits, a wholly different thing, and one which may be of signal value. we try to teach self-control, the control of sleep, the control of emotion, the control of appetite. it is hard, but it can be done by prolonged effort, under such influences as give us courage to work at it. we try to give economic education, the power of foreseeing what is going to happen by reason of what has happened before. people are extraordinarily prone to forget things which they do not want to remember. we may help people by economic education, to economic foresight, to economic organization of their resources by practice, and by going over with them the cases of other people who have won out in similar difficulties. . anybody who does much talking is asked a good many times, "won't you please come round this evening and just give us a little inspiration?" there is no request that i look on more sadly, more wistfully, than i do on that. i know how little good such "inspiration" usually is because it can be given the same way as money or morphine can be given. inspiration or courage means emotion of some kind. nobody believes in emotion more than i do. i believe the greatest life is the life that feels the most, enjoys the most, suffers the most. but emotion is one of the most transient and unreliable of states. one may be in a most exalted and courageous state of mind at the end of a lecture, and a few hours later be as weak as an invalid, because, though courage has come, it is courage which does not provide for its reënforcement, for a new supply. we never give people help that has any permanence except when we give them reality. we try at first to help people in their woes through our own personalities. but we are not strong enough to keep anybody else afloat. we have to transmit something greater than ourselves, if possible to bring people in touch with a life-preserver that will be there after we are gone. i suppose that when we can teach people to work and give them something they can practise all their lives and get joy out of, when we teach people to play, to deal rightly with their affections, and to worship, we have given realities permanently buoyant. our social history cards at the red cross refugees' dispensary in paris had a great many blanks on them, which represented the blanks in our knowledge of the patients and the defects of our social work. we rarely entered deeply into our patients' lives in relation to their education, family life, recreation, religion. in our work at that dispensary we dealt chiefly with medical facts and economic facts. to go thus far and no farther cannot satisfy many nor remake lives. that dispensary was open but a few months and within that time, of course, nobody could expect us to enter into intimate relations with a human being's life. but if we were to work in any dispensary for years and still not one of those cards had any note about the patient's education, recreation, family relationships, and religion, i should feel that we had failed. i should feel not only that we had done superficial work (that is often inevitable), but that we had done nothing but superficial work, which is not satisfactory. it is because we want to give people the best, not that we have but that the world contains, that we should have spaces on our social history card for notes about those things which we believe are fundamental in our own lives and which we want therefore to see constructed or increased in somebody else. social treatment, then, is chiefly, the giving and building of health, pleasure, money, beauty, information, education, courage. it is not because we have such a tremendous stock of those goods to give away, but because we know that we must somehow help a person to self-help in those directions or else be superficial, that i have phrased social treatment in those terms. . _creative listening in social treatment_ one of the simple and yet honestly useful things that we can do in social work is to give a man a hearing. often he will solve his own problems with the aid of a little information from one whom he trusts and has talked things out with. but this implies unusual powers of listening on the social worker's part. it implies what mr. r. h. schauffler calls _creative listening_. some of the most delightful friendships are those one makes through a magazine. in the "atlantic monthly" some years ago i saw an article on playing string quartets by a man whom i had never heard of, mr. robert h. schauffler. mr. schauffler's writings, which i came to know through this article, contain many interesting points, but nothing so valuable to me as the essay on "the creative listener."[ ] it was founded upon an autobiographical incident. as a musical amateur he used to attend orchestral concerts in what was then his home city, chicago. he used to go with a certain group of friends, his brother and others, who liked to sit together because they found that in this way they enjoyed the music more. ordinarily they were very regular in their attendance. but one evening for some reason they had to miss the concert, and then it came to their knowledge that the orchestra had felt their absence very much, and really could not play their best without them. this is true. there are people whose attention makes us play or speak or act better than we could otherwise. we have known it in friendship we all know that some people when we talk with them, make us feel as if we really were worth something, had some ideas. others are destructive listeners who make us feel as if we had no ideas; our personality seems destroyed. i think it is perfectly within the province of any of us to make himself more of a creative listener than he has been before. for creative listening is due in part to the intensity of our sympathy, the whole-heartedness with which for the time being we give ourselves to the person we are with. under favorable conditions the power of the creative listener to enlarge and to remake a personality is not capable of limit. the people whom i most often help are the people for whom i do nothing. they tell their tale, spread it all out before me; then they see the solution themselves. just to state our difficulties clearly to another person who will listen not merely sympathetically but creatively, and with resistance as well as furtherance, is of value. with certain people we run against a stone wall every now and then, even though they are only listening silently. this is right and helpful. the right kind of listening is sympathetic when it ought to be and dissenting when it ought to be. we help people out of trouble in other ways also; often by bringing new facts. a person tells us about his difficulties at work. he sees it perhaps more clearly after he has talked about it. but he may not know some facts that we know, and therefore we may be able to help in some ways that go beyond creative listening. but in the end a person has to make his own decision, to find his own solution; and in many cases he will find it without any more active or physical help than this. . _the case-worker's pyramid in social treatment_ it might well be objected by any thoughtful reader that if a person carried out the physical, economic, mental, moral, spiritual investigations that i have suggested in this book, he could take care of no more than one patient at a time, and would need years to finish up the tasks suggested by the history of that one person. that is an objection that certainly deserves an answer. i will begin my answer by a comparison with medical work. a trained physician is supposed to know something of all the organs in the body. even a dentist or an oculist has had some training on all the bodily organs and not merely on the special ones he treats. among the organs of the body, the medical profession is supposed to include the brain and all the functions of the brain. this implies that he is supposed to have at his finger-ends the ability to make an examination so complete that a whole day would be needed to finish it. obviously if he attempted anything like that he would soon be overwhelmed. but on the other hand if he limits himself to the professional examination of a single organ, the one perhaps which the patient complains of, he does so at his peril. he is in danger of making a wholly wrong diagnosis. but that can be diminished only in proportion to his knowledge of all the other organs that he does not examine. a well-trained physician must and can safely do some superficial work. so a very well-trained social worker can and must do some superficial social work. in the practice of any doctor who counts up a month's patients we will say to one hundred, there will be about fifty that he has examined and treated very slightly. then there may be twenty-five whom he knows a little more about, fifteen perhaps that he could give a full account of, and possibly ten whom he has had to study from all the points of view that his medical education has made possible for him. his professional life then is not wholly superficial yet does not attempt to deal exhaustively with every case. as i see it, therefore, our work in the social or medical field ought to be something like a pyramid. . thoroughly studied cases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . superficially studied cases. we should study and treat many cases superficially, a smaller number more intensively, and at the top of the pyramid which represents our case-work will come a few to which days or weeks of time are devoted. such a distribution of time is not unsatisfactory or slipshod because not all the needs that come to our attention call for thorough study. such a pyramidal distribution of our energies is familiar and satisfactory in other fields of life, for instance in the field of friendship. nobody wants only intimate personal relations. everybody needs as a basis a host of acquaintances. out of them all he makes a few friends whom he hopes to know as well as he can know any human being. almost no one is satisfied to possess only acquaintances or only intimate friends. the properly balanced life has both. both among those for whom we attempt only slight study or slight service, and among those to whom we devote ourselves intensively, doctor and social assistant alike must count failures as well as successes. we do not try to balance failures and successes if we are wise. the lord only knows which of our seeming failures are really successes and which of our successes are failures. some of the people with whom we seem to have made total failures, a more complete knowledge might show to have been actually helped. all this we must face from the start. then we shall not be disappointed because we have to touch a great many people superficially and to fail a great many times. that is all right so long as we are not always superficial and do not always fail. such a philosophy is my defence for so elaborate and extensive a scheme of social investigation and social treatment as i have tried to explain in this book. the experienced physician and the well-trained social assistant can judge with some accuracy which cases to select for thorough study and continued devotion. but such a judgment is impossible unless one keeps always ready in the background of one's mind the whole apparatus of social diagnosis and treatment as it might be applied _in toto_, if time and strength were unlimited. footnotes: [ ] _polonius_ (_showing out the wandering actors_):--my lord, i will use them according to their desert. _hamlet_: odd's bodikin, man, much better! use every man after his desert and who shall 'scape whipping. [ ] in the volume called _the musical amateur_. (houghton mifflin co., boston.) chapter ix the motive of social work what is the _motive_ of social work? why do we do it? why is it worth while? what will keep it going? to me it seems like a head of energy behind a faucet or behind a dam, a pressure that has to be explained; and as we use the word _motive_, we may well think of it in a literal sense as something that pushes, something that moves. then what moves? energy, which is the source of our work, is perhaps the most general term that there is in the world. behind everything, we say, there is energy. behind the activities of our physical bodies there is energy to an extent that those who have not studied medicine or other physical sciences do not always recall. eighty per cent of any human being's body is made up of water. where did it come from? it came from what he has taken in in the form of drink. where did that come from? from the earth and the streams. where did they get it? from the clouds. where did the clouds get it? from the seas. where did the seas get it? from the interplanetary spaces and god knows where. eighty per cent of our bodies, of our available energy, comes out of something _as far off as that_, out of sources that have ultimately as little to do with us as that. the other twenty per cent, the solids of every organ in our body, the brain included, are alike widely distributed in source. we do not always stop to think how widely distributed are the foods out of which the body's solids are built. grains, fruits, vegetables, meats, we get them out of every part of the globe. the minerals that are deposited in us as what we call _bone_, the lime and other salts, are something which a plant once sucked up out of the earth, or another animal took out of his food to pass on to us. the bones of a human being come out of the bones of the earth through his food, animal and vegetable. the breath of the trees, the oxygen which the trees give out every day and every night, we breathe in. they take up in turn the carbon that we give out, so that there is constantly an exchange between the animal and vegetable kingdom and ours. we are warmed by inheritance from thousands of years in the coal that plants have laid down their lives in layers and strata to form; we are warmed also by the constant literal burning up of food energy in ourselves. we are clothed with borrowings from sheep and cows and other animals; birds' feathers go to make our pillows, beds, and hats. sometimes i wonder whether we are worth all this destruction and all the other forms of destruction whose living incarnation we are. i described, in speaking of fatigue and rest, how our physical life is a constant process of burning up and breaking down tissue, hence of destruction. and of course the money and labor of our parents that kept us alive up to the time that we call ourselves self-supporting, represents other stores of energy passed on through various way-stations, by the same sort of borrowing, from every part of the universe. all that death, that suffering, that destruction, are we worth all that? one certainly could see a tragic aspect to this question if one were so minded. many philosophers have so seen it. but the answer depends, i think, on what we do with that energy. it may easily be wasted. it may just run through us, as much of our information runs through us, uncaught, unused, sacrificed for us, and nothing come of it. but it may be used right. when we come to think of our mental energies, are we any less incurably borrowers, incurably indebted to the universe, incurably wasters except in so far as we make use of what we borrow? anybody who has not studied how the child learns to talk, does not realize what a borrowing the simplest acts of language are, what imitators we are from the earliest moments of our lives. and if we try to think back to the pieces out of which we have been actually made, our intellectual, moral, spiritual life, we could take ourselves apart like a piece of machinery and say where each piece came from. if we look into the generation of our own minds i think we shall be overcome with wonder as i often have been, by the consideration of how little there is left that is us if we take out what has been given us. i can say from whom every idea i have had came, from whom i had it as a free gift. i believe the greatest of all our borrowings are from people we never saw, from books, from music, from art, from personalities to whom we feel inexpressibly near although we never saw them in the flesh. our spiritual borrowings are not only from sources such as i have mentioned, but from impersonal sources also, from beauty, from nature, that does not speak to us through any man. i have seen a hepatica on a rocky hillside under brown oak leaves, the sight of which made me conscious that i could never pay off my debts for life. i have heard a thrush singing in the early morning in wet dark woods, and known then and there that after the gift of that song i could never get even with the universe. most of us have had that sort of experience many times; it goes on and on piling up our debt. but our obligation grows and grows when we think of our country, of the traditions of our race, and of what has been given us by the church or university or family in which we have found ourselves without our doing anything about it. what should we be without those? what shred of personality would remain? i do not think the figure of the body, as i have tried to describe its borrowings, is any more striking than that of the mind, the spirit, and the inexhaustible debts that it has laid up. all this energy poured into us from the material and from the spiritual universe around us accumulates in us. it accumulates bodily in vital force, zest, animal spirits, or "pep"; the desire to shout and sing or jump or slap somebody on the back. that is the vital side of our unexpended borrowings, the bodily expression of the fact that we have received more than we can easily take care of. but mental energy accumulates too; and the sense of its pressure is expressed in what seems to me the greatest word in our language--_gratitude_. gratitude is "happiness doubled by wonder," happiness such as anybody may contain almost unconsciously or may let out of him, if he is thoughtful, in action sprung from conscious gratitude. gratitude seems to me ultimately the motive of social work. we find in ourselves this painful head of energy--to me often painful. the sense of an animal caged, of a dog in leash, is the figure that most often comes to me as i am aware of what has been given to me and of how little i have paid it back. the extra flood of physical energy which any healthy human being or animal has, is paralleled in this tension of gratitude for all the gifts which we have not properly handed back, have not passed on, and never shall. the attempt to pay out, to pass on, this energy naturally divides itself up according to the ways in which we have received it. we have received the physical bounty of life. we know how good it is to get water when we are thirsty and food when we are hungry, and along with the full-flavored awareness of this good we feel the pain of not being able to share it as swiftly as we would like to share it, as fully as we would like to share it, with people who have not got what we have. we call that pity, the sense of kind. i think of it as the sense of a common need. other people are such as we. we are painfully aware of what has been given to us, and how much we and everybody else need it, and how little we deserve it. we are eager therefore to pass that on in any such form as it can be received. we are grateful for any good chance to pass it on. a homely but true image is that of the nursing mother. the baby needs milk and the mother needs to get rid of that milk. it is a painful pressure in her breast and a pressing need in her child. the two needs meet and satisfy each other. we are just as eager, i think, to give back in kind all the different sorts of delight and of beauty for which we are grateful. but we have not well expressed this eagerness. i have dwelt already on the great lack of beauty and of art in social work, on its ugliness and drabness, and on the care-worn look in the social worker's face. but no one who is vividly conscious of the gifts of beauty which have come into his own life can continue to make his attempts at social work as unbeautiful as they have been hitherto. if we have any sense of gratitude to the people that have cared for us, we want to pass on affection. we know the affection that was our physical creation in the beginning and our upbringing through childhood and youth, yet most of us have never tried through most of our lives to pay back these debts to our parents. indeed we usually do not become aware of those debts until it is too late. to know that would bring us to almost insupportable remorse after our parents have left us, if we were not aware that we could pay over to somebody else the affection and care which they once lavished on us. as we know that the physical energies of water and oxygen and carbon, of the food, the lime salts, and whatever else goes to make up our physical being, all come out of one source, so we are aware that all spiritual gifts come out of one and the same source. to be vividly aware of that, to stop and face the facts, to stop and take a view of where we are, tells us what next to do. it makes us eager to pay back some of that gratitude directly in prayer, and also indirectly through all the way stations by which this help has come to us. if you want to please a mother you do something for her children. a human being lives in his children, in the people or the undertakings that are his children literally or figuratively. if you love him, you feed his lambs. so we get the impulse to pass on the best fruits of life, first to the one source of all that makes us grateful, and then to the children of this central energy, the different way stations from which it has come to us. we eat our heads off like stabled horses with too much oats, if we do not get a chance to give away some of what has come to us. a man who tells funny stories is always grateful to the man who will listen to him. the same principle holds true all the way from story-telling to social work. it can be taken as humiliating, but properly viewed it is a sanifying and humbling fact. i wrote a moment ago of the sense of what we owe to our parents, a debt that seems almost insupportable sometimes. it would be insupportable if we could not pay it on to somebody else. were it not for this central fact our gratitude would be a curse not a blessing. but in fact those who gave to us, our parents and all the rest, are best pleased if we pay over their gifts to somebody else. that is how we can best repay them. if this is a right conception of the source out of which comes the energy that has set us going and will keep us going, i think we can trace out a justification for the principles of social work which i have tried to present in this book and will now summarize: . we want to do social work because we have got something that we must share, something that is too hot to hold. there is a false emphasis, approaching sentimentality, in saying that our social work is done because of our love for the individual people to whom we give. we have a hope that some day we may know a few of these people well enough to say that we love them. but that is hope, not fact or present impulse. hence it is not right (although it is not a fearful error) to say that we do social work for love of the particular individuals whom we try to help. we are looking for an opportunity and are grateful for the opportunity that social work gives us, to pass on the gifts which we are grateful for, not as has sometimes been said, to people whom we love but to every one who needs them. that may seem a very slight difference of emphasis. i think it is a very important difference of emphasis. we are in a much more self-respecting position if we do not have to think of ourselves as having already conquered at the beginning that which we aspire to win in the end, a personal affection for all our patients. if we remember that our patients are (unconsciously) doing us a favor in allowing us to pass on something to them, and that although we may have found a genuine need, still we are grateful to them because they want what we have to give, then our work is humble and free from taint of pharisaism. . the second principle is: _give as one passing on that which is not our own_. that is familiar enough in relation to money. any one who has any money and any capacity for thoughtfulness, knows that his money is not his own. whether it happens to be literally in trust or not, the only right he has is the right of rightly choosing what he will do with it. he holds it rightfully just so long as he needs to find the chance, the best opportunity for passing it on. such a sense of trusteeship we ought to feel about everything that we have and want to give: beauty, information, education, affection, and courage. one should give them (if he can!) not as one who has any special merits, not as one having property which is one's own, but as one who has received without any possible deserts an incredible wealth and would like above all things to share it because it is not his own. . we ought to _give and build_, because the effects of any giving that is not also building will not last. our bodies and our souls are what they are because of what has been given and built into them by nature and by man. the same energy which burns in our bodies and knows in our consciousness should make us desire always to give and build by giving, because we have ourselves been built up of such gifts. . we ought to _give and take_. that is another aspect of giving as one who passes on. we can give only what we have taken. hence if we allow our lives to get cooped up, narrow and stifled, so that we are not taking in steadily, or not getting fresh energy out of what we have already taken in during the years that are past, we soon have nothing to give. i have written of the ugliness and the depression that i have seen too much in social workers' lives. that is partly because they are often led into giving without providing for any adequate source of renewal. they are not taking in enough to have anything to give out. they give until they are drained dry, squeezed out. . we give not as people who find the world so pitiable, so miserable that we want to diminish its misery. we give as people who find the world so glorious, so overflowing, in what it has done for us, that we want to even up, to pay out. we want to _share our enthusiasms_. pity led schopenhauer to pessimism. he pitied the world so much that he thought everybody ought to get out of it by suicide. pity therefore does not necessarily lead us to social work. but if we admire anybody, that fact gives us a duty to get our admiration over to somebody, to share our enthusiasm. the whole of a christian's duty might be phrased as the duty to share his sense of the beauty and the wonder that is in jesus christ. almost the only act that we can be sure will be of use in the world is the act of sharing what enthusiasm we have. . but this cannot be done without some care to shape it, without some labor to put it in a form in which somebody else will understand this sense of our admiration or gratitude. without form and study to give it form, our enthusiasm is mere noise and good spirits. as i have described the fund of energy which comes into us, is felt as gratitude and then pours out of us in social work, one may have wondered, where does man's individual will and choice come in? where does he begin and these tumultuous energies stop? what is he? he is that which focusses, that which forms, which makes comprehensible, which expresses the energies that have been given him as a free gift. and because miraculously he is made new--for everything that is new is a miracle--because miraculously he is different from every human being that ever was, so different from all others is the gift that he has to give. i think it is sometimes comforting to look at a finger-print. one gets doubtful whether there is any special reason that the individual called by one's name should persist on top of the earth. then it is well to go back to simple, elemental facts like finger-prints, with the pretty nearly irresistible conclusion that the rest of our body and soul must be as unique as that, and so possesses something as original to contribute to the world. i have no doubt that there is waiting for each of us to-day a job much more individual than we have ever yet done. although, then, we can rightly give in social work merely as people who pass on to others in gratitude and wonder the energies which create our bodies and our souls, yet we can be perfectly sure that if we do what it is up to us to do, we shall in time be giving as people never gave before and never will again. we have missed rare chances in social work unless _through presence of mind we find our chance to express differently from what we have ever heard it expressed before that which we feel pushing in us to get out_. . since it is our business to give as people who pass on, we want if we can to make it clear sooner or later to the people to whom we pass it on, that we know this. then they will feel no shame in taking since they know that they do not take from us. there will be no sense that a higher being is distributing what a lower being has to take, if we make it clear that we are sharing that which it is uncomfortable not to share. we are sharing that which we share because in view of all the bounty which we have received, in view of the beauty which has struck us dumb, in view of the flood of affection that we never have answered, we know what to do next. we know that we are branches of a vine, and that the sap of that vine can flow out in us and through us to other tendrils. the end the riverside press cambridge. massachusetts u. s. a